One kind is for approach tibial intramedullary nailing sleeve arrangement on kneecap
Technical field
The present invention relates to medical equipment fields, in particular to a kind of for approach tibial intramedullary nailing sleeve arrangement on kneecap.
Background technique
In recent years, since tibial intramedullary nailing has many advantages, such as that minimally invasive, fixing intensity is high, immediate postoperative activity, using in marrow
Nail treatment fracture of shaft of tibia becomes the preferred option of orthopedist.The operative approach master of the fracture of tibia of Intramedullary nailing treatment at present
Have under kneecap two kinds of approach on approach and kneecap.Approach has many advantages, such as that wound is small, easy to operate, patient is acceptant under kneecap, faces
Bed application is relatively broad, but is difficult to maintain more satisfactory position in art, and there are certain deformities, and fluoroscopy during operation is difficult, postoperative
Pain is more common before knee.Approach has as a kind of novel operative approach and is conducive to the reduction of the fracture and maintenance, fluoroscopy during operation side on kneecap
Just, the advantages such as pain disease incidence is low before postoperative knee.Patient lies supine position when approach is performed the operation on kneecap, suffering limb are in and partly stretch position, and operation is cut
Mouth is usually to be in kneecap median line from pat on the pole 2cm to limbs proximal end to do the stringer notch for being about 3-4cm, hereafter
Sharp property separates stock market trend prediction, and joint capsule is further opened from above kneecap, is inserted into the dedicated cannulated sleeve of approach on kneecap,
By protection sleeve along femoral bone pulley ditch until shin bone proximal segment is to reach best entry point.
In actual clinical operation, there are some problems for approach tool on kneecap.(1) approach tool on existing kneecap in the market
It is to be designed with the anatomical data of westerner.Since Chinese's physique is smaller, kneecap space is smaller, and protectiveness housing is inserted into art
When can encounter larger resistance, exist to intra-articular structure generate iatrogenic injury risk, and influence position guide pin merging, increase
Operating time is added.(2) in the market existing protectiveness housing be circle, and patellofemoral joint be V-arrangement, the two vpg connection not
It is to match very much.When patellofemoral joint pressure is larger, kneecap is to a Slideslip, and sleeve is to Slideslip.(3) it is open and can be produced when expanding marrow
Raw a large amount of clast, these iatrogenic clasts remain in articular cavity, can bring gonalgia, interlocking, even destroy joint
The serious consequences such as interior structure, therefore postoperative thorough cleaning is very important.But the operation path of approach is opposite closes on kneecap
The environment of conjunction, the available thorough flushing unlike the open operations such as knee replacements.How clast to be rinsed dry
In only reduces articular cavity foreign matter residual become on kneecap approach one it is more intractable but the problem of cannot ignore.
Summary of the invention
For the above defect of the existing technology, it is a primary object of the present invention to overcome the deficiencies in the prior art it
Place discloses one kind and protects sleeve for approach tibial intramedullary nailing sleeve arrangement on kneecap, including guide pin, positioning and guiding housing, connects
Connector and flushing pipe, wherein
The guide pin protection sleeve is the smooth cylindrical barrel structure in surface;
The positioning and guiding housing includes sleeve body, and the tail portion setting connection retaining mechanism of the sleeve body is used for
It is fixed with the connector;
The connector is arranged radially through-hole, and in front end setting and the matched engaging slot of the connection retaining mechanism;
The flushing pipe is connect with the through-hole of the connector.
Further, guide cone is arranged in the front end of the positioning and guiding housing.
Further, the angle α between the dorsal surface of the sleeve body is 120-160 °;The veutro of the sleeve body
120-150 ° of angle between face.
Further, the angle α between the dorsal surface of the sleeve body is 135-150 °;The veutro of the sleeve body
130-140 ° of angle between face.
Further, flank is arranged in the sleeve body two sides, and the flank is extended by facies ventralis and side to be crossed to form.
Further, the connection retaining mechanism includes block tongue, and the axial direction of the block tongue is oblique cone structure.
Further, limited block is arranged in one end of the block tongue.
Further, the flushing pipe and the through-hole interference are arranged.
Further, the outer diameter of the guide pin protection sleeve is identical as the outer diameter of the flushing pipe.
Further, the positioning and guiding housing is made of soft medical grade plastic material, the connector and described leads
Needle protection sleeve is made of rigid medical grade plastic material.
It is that the present invention obtains the utility model has the advantages that
(1) setting of device through the invention can easily and fast, accurately carry out the merging of intramedullary nail, reduce operation
Time, and can accurately find entry point.
(2) positioning and guiding housing is made of soft medical grade plastic material, and guide cone is arranged in front end, is inserting it
It play the guiding role when entering patellofemoral joint gap, reduces resistance, avoid generating tissue damage or damage, reduce iatrogenic damage
The risk of wound.
(3) angle α and β are set in sleeve body, and flank is set in ontology two sides, makes it between kneecap and femur
Positioning action is played, prevents to break away, is subjected to displacement offset.
(4) sleeve body tail portion setting connection retaining mechanism, and its block tongue is axial oblique cone structure, it can be with connector
Fast Installation while ensuring leakproofness and tight type, and flushing pipe and its through-hole interference is cooperated to be arranged, guarantee articular cavity
There is certain pressure, to achieve the effect that clean articular cavity.
Detailed description of the invention
Fig. 1 is a kind of structural schematic diagram of the approach tibial intramedullary nailing sleeve arrangement on kneecap of the present invention;
Fig. 2 is the perspective view of positioning and guiding housing;
Fig. 3 is the main view of positioning and guiding housing;
Fig. 4 is the usage state diagram of positioning and guiding housing;
Fig. 5 is the perspective view of connector;
Fig. 6 is the radial cross-section of connector;
Fig. 7 is that guide pin protects sleeve to be inserted into patellofemoral joint gap schematic diagram;
Fig. 8 is that guide pin is inserted into schematic diagram;
Fig. 9 is that positioning and guiding sleeve is inserted into patellofemoral joint gap schematic diagram;
Figure 10 is to rinse schematic diagram;
Appended drawing reference is as follows:
1, guide pin protection sleeve, 2, positioning and guiding housing, 3, connector, 4, flushing pipe, 6, guide pin, 21, sleeve body,
22, tail portion, 23, connection retaining mechanism, 24, limited block, 25, guide cone, 26, flank, 31, through-hole, 32, engaging slot, 51, stock
Bone, 52, kneecap, 53, shin bone, 211, dorsal surface, 212, facies ventralis, 213, side.
Specific embodiment
In order to make the objectives, technical solutions, and advantages of the present invention clearer, right with reference to the accompanying drawings and embodiments
The present invention is described in further detail.It should be appreciated that described herein, specific examples are only used to explain the present invention, and does not have to
It is of the invention in limiting.
One kind of the invention protects sleeve 1, positioning and guiding for approach tibial intramedullary nailing sleeve arrangement on kneecap, including guide pin
Housing 2, connector 3 and flushing pipe 4, wherein
As shown in Figure 1, guide pin protection sleeve 1 is the smooth cylindrical barrel structure in surface;By rigid medical grade plastics material
Material is made, and surface is smooth, and for the guiding and protection tissue of guide pin, perienchyma is damaged when preventing guide pin from importing.
As in Figure 2-4, positioning and guiding housing 2 includes sleeve body 21, the setting of the tail portion 22 connection lock of sleeve body 21
Tight mechanism 23, for fixed with connector 3, can be used for the handle for being put into positioning and guiding housing 2 in joint into
Row is fixed;Wherein, connection retaining mechanism 23 includes block tongue, and the axial direction of block tongue is oblique cone structure;In one embodiment,
Limited block 24 is arranged in one end of block tongue, prevents its rotation excessively, causes to loosen.Positioning and guiding set 2 is by soft medical grade plastics material
Material is made, and avoids generating tissue damage or damage.
As seen in figs. 5-6, connector 3 is arranged radially through-hole 31, and matches in front end setting with retaining mechanism 23 is connect
Engaging slot 32;Block tongue is placed between adjacent engaging slot 32, and by rotary connecting joint 3, block tongue is screwed in engaging slot 32, real
The connection of existing connector 3 and positioning and guiding set 2.Pass through the setting of block tongue oblique cone structure, it is ensured that connector 3 and positioning and guiding set 2
It fits closely, reaches locking and sealing function.Connector 3 is made of rigid medical grade plastic material.
As shown in Figure 10, flushing pipe 4 is connect with the through-hole of connector 3.Preferably, the through-hole 31 of flushing pipe 4 and connector 3
Interference setting, it is ensured that articular cavity has certain pressure, to achieve the effect that clean articular cavity.
In one embodiment, as shown in Fig. 2, guide cone 25 is arranged in the front end of positioning and guiding housing 2.The end of guide cone 25
Therefore the diameter that diameter is less than itself and 21 connecting pin of sleeve body play the guiding role when being inserted into patellofemoral joint gap, reduce
Resistance reduces the risk of iatrogenic injury.
In one embodiment, as shown in Figures 3 and 4, the angle α between the dorsal surface 211 of cylinder ontology 21 is 120-160 °;Set
Angle β is 120-150 ° between the facies ventralis 212 of cylinder ontology 21.Preferably, the angle between the dorsal surface 211 of sleeve body 21
α is 135-150 °;Angle β is 130-140 ° between the facies ventralis 212 of sleeve body 21.In one embodiment, sleeve
Angle α between the dorsal surface 211 of ontology 21 is 142 °;Angle β is 135 ° between the facies ventralis 212 of sleeve body 21.Pass through
Angle α is set in sleeve body 21, plays positioning and guiding in the 51 coaster ditch angle direction γ of femur, prevents from breakking away, it is fixed to play
Position effect;Angle β is set, plays positioning and guiding in 52 direction kneecap face angle θ of kneecap, prevents from breakking away, play positioning action.
In one embodiment, flank 26 is arranged in 21 two sides of sleeve body, and flank 26 is extended by facies ventralis 212 and side 213
It is crossed to form.Further prevent the generation positional shift of sleeve body 21 or rotation, flank 26 from playing to kneecap 52 and lifting work
With,
In one embodiment, the outer diameter of guide pin protection sleeve is identical as the outer diameter of flushing pipe.
In the following, being illustrated in conjunction with attached drawing 1-10 to application method of the invention, the specific steps are as follows:
Step 1, suitable preoperative position is selected, patient takes dorsal position, and placement knee pillow, which is in, at Huan Zhi popliteal nest partly stretches position
(10 ° -20 ° of buckling).Strong side lower limb are lowerd convenient for having an X-rayed below.If patient is dextro manuality, recommendation is stood on the left of patient always,
C arm X-ray machine is always positioned on the right side of patient, is convenient for latter acts.It is on the contrary if patient is left handedness.
Step 2, it is in kneecap median line from pat on the pole 2cm and does the stringer that one is about 3-4cm to limbs proximal end and cut
Mouthful, cut skin sub-dermal soft tissue.
Step 3, sharp property cuts stock market trend prediction, and joint capsule is further opened from above kneecap.A finger can be used
Put in the initial gross separation that joint capsule does soft tissue.
Step 4, protect sleeve 1 to shin as shown in fig. 7, being gently inserted into guide pin along 51 coaster ditch of femur after opening joint capsule
Near 53 entry point of bone;Then, as shown in figure 8, piercing Ф 3.2mm guide pin 6, progress fluoroscopy during operation is hereafter needed to determine that guide pin is located at
Best entry point.Entry point normotopia X-ray film is located at the interior lateral margin of the intercondylar spine of lateral of tibia, side position X-ray film be located at front side cortex and
Articular surface boundary edge, inserting needle direction keep consistent with tibial shaft direction.
Step 5, extraction guide pin protective case, 1, positioning and guiding housing 2 is inserted into along guide pin 6.As shown in Figure 9.
Step 6, it is open along 6 direction of guide pin;Expand marrow after merging guide pin 6;It is inserted into suitable intramedullary nail;Far and near end pinning
It is fixed;It is placed in tail cap.
Step 7, as shown in Figure 10, connector 3 is installed, pulse lavage jet pipe 4 is inserted into along the through-hole 31 of connector 3 and carries out arteries and veins
It washes in a state of excitement.
Step 8, notch is closed.
It is that the present invention obtains the utility model has the advantages that
(1) setting of device through the invention can easily and fast, accurately carry out the merging of intramedullary nail, reduce operation
Time, and can accurately find entry point.
(2) positioning and guiding housing is made of soft medical grade plastic material, and guide cone is arranged in front end, is inserting it
It play the guiding role when entering patellofemoral joint gap, reduces resistance, avoid generating tissue damage or damage, reduce iatrogenic damage
The risk of wound.
(3) angle α and β are set in sleeve body, and flank is set in ontology two sides, makes it between kneecap and femur
Positioning action is played, prevents to break away, is subjected to displacement offset.
(4) sleeve body tail portion setting connection retaining mechanism, and its block tongue is axial oblique cone structure, it can be with connector
Fast Installation while ensuring leakproofness and tight type, and flushing pipe and its through-hole interference is cooperated to be arranged, guarantee articular cavity
There is certain pressure, to achieve the effect that clean articular cavity.
The foregoing is merely a prefered embodiment of the invention, practical range not for the purpose of limiting the invention;If not departing from this
The spirit and scope of invention, modify or equivalently replace the present invention, and should all cover the protection in the claims in the present invention
In range.