CN103445833A - Shoulder joint dynamic and static combined regulation external fixator - Google Patents
Shoulder joint dynamic and static combined regulation external fixator Download PDFInfo
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- CN103445833A CN103445833A CN2013104008347A CN201310400834A CN103445833A CN 103445833 A CN103445833 A CN 103445833A CN 2013104008347 A CN2013104008347 A CN 2013104008347A CN 201310400834 A CN201310400834 A CN 201310400834A CN 103445833 A CN103445833 A CN 103445833A
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Abstract
The invention relates to a shoulder joint dynamic and static combined regulation external fixator, comprising a bone external fixation support, a steel needle fixation clamp connected to the bone external fixation support, and a steel needle clamped in the steel needle fixation clamp, wherein the bone external fixation support comprises a near end hole C-shaped ring and a far end hole C-shaped ring, and the opening directions of the near end hole C-shaped ring and the far end hole C-shaped ring are the same, the near end hole C-shaped ring and the far end hole C-shaped ring are uniformly provided with a plurality of holes, the middle parts of the near end hole C-shaped ring and the far end hole C-shaped ring are connected by an arc-shaped connecting rod, the two ends of the near end hole C-shaped ring and the far end hole C-shaped ring are connected by dynamic traction joint devices, each dynamic traction joint device comprises a first joint connecting piece connected with the hole at the end part of the near end hole C-shaped ring and a second joint connecting piece connected with the corresponding hole in the far end hole C-shaped ring, and the first joint connecting piece and the second joint connecting piece are connected by a central spindle and can swing relative to the central spindle. The fixator is flexible in operation, the curative effect is improved, and the complications of proximal humeral fracture of shoulder joints are reduced.
Description
Technical field
The invention belongs to medical instruments field, particularly a kind of bone external fixator that is used for the treatment of the shoulder joint fracture.
Background technology
In existing medical skill, when the shoulder joint proximal humeral fracture occurs in the patient, usually select plaster splint to fix, but the long-time so fixing triangular muscle that can cause crossing over joint, biceps brachii m., anconeus longus, coracobrachialis etc. cause shortened deformity, the strength that the upper and lower flesh of teres minor and ridge of rotation sleeve is greater than subscapularis causes the slight outward turning of near-end, and the head of humerus inboard adheres to without muscle, the upper and lower flesh in ridge causes the near-end abduction.Blood due to head of humerus ships from the tuberosity place in addition, and fracture of the humeral head easily causes the head of humerus ischemic necrosis.
So a kind of shoulder joint regulation and control external fixator of being association of activity and inertia need to be provided, flexible operation, improve curative effect, reduces corresponding complication.
Summary of the invention
The purpose of this invention is to provide a kind of shoulder joint regulation and control external fixator of being association of activity and inertia, flexible operation, improve curative effect, reduces the complication of shoulder joint proximal humeral fracture.
For achieving the above object, the invention provides a kind of shoulder joint regulation and control external fixator of being association of activity and inertia, comprise external fixed support for bone, be arranged on the steel needle fixing clamp on external fixed support for bone and pass through the fixing draw point of described steel needle fixing clamp, described external fixed support for bone comprises near-end C shape hole ring and far-end C shape hole ring, described near-end C shape hole ring is identical with the opening direction of described far-end C shape hole ring, and evenly is provided with a plurality of holes on it; Described near-end C shape hole ring and described far-end C shape hole ring middle part connect by arc-shaped connecting rod; Described near-end C shape hole ring and described far-end C shape hole ring two ends connect by dynamic traction joint device;
Described dynamic traction joint device comprise the first joint connector of being connected with the end hole of described near-end C shape hole ring and with the second joint connector that on described far-end C shape hole ring, corresponding hole is connected, between described the first joint connector and described second joint connector by mandrel be connected also can mandrel centered by the mutually countershaft swing of do.
As technique scheme preferably, between described the first joint connector and described hole, by the first threaded rod, be connected, described the first threaded rod is fixed by the upper lower locking nut that is positioned at near-end C shape hole ring and the above hole both sides of far-end C shape hole ring.
As technique scheme preferably, described arc-shaped connecting rod is curved, its two ends are thread segment, described thread segment and described hole are complementary and fix by upper lower locking nut.
As technique scheme preferably, described steel needle fixing clamp comprises the far-end steel needle fixing clamp, described far-end steel needle fixing clamp comprises draw point pressure pad and draw point pad, be provided with the draw point hole slot that at least one and described draw point are complementary on described draw point pressure pad, described draw point pressure pad and described draw point pad are complementary, for described draw point is fixed.
As technique scheme preferably, the middle part of described draw point pressure pad and described draw point pad is provided with through hole, described through hole is for being socketed the second threaded rod, and the other end of described the second threaded rod stretches into described hole, and described the second threaded rod and described hole are fixed by upper lower locking nut.
As technique scheme preferably, described far-end steel needle fixing clamp also comprises for by described draw point pressure pad and described draw point pad and the fixing stop nut of described the second threaded rod, described stop nut is two, is spirally connected with described the second threaded rod and is positioned at the outside of described draw point pressure pad and described draw point pad.
As technique scheme preferably, the quantity of described far-end steel needle fixing clamp is two: one of them is arranged at the middle part of described far-end C shape hole ring, and the direction of stretching out of its second threaded rod is that described near-end C shape hole ring deviates from a side of described far-end C shape hole ring; Another is arranged at the end of described near-end C shape hole ring, its second threaded rod stretch out the upside that direction is described near-end C shape hole ring.
As technique scheme preferably, described steel needle fixing clamp also comprises the fine steel needle fixation clamp, described fine steel needle fixation clamp comprises the draw point locking cap, the bottom of described draw point locking cap is provided with the draw point hole slot that at least one and described draw point are complementary, the bottom of described draw point locking cap also is connected with the draw point locking cap threaded rod be complementary with described hole, and draw point locking cap threaded rod and the described hole of described fine steel needle fixation clamp are fixed by nut.
As technique scheme preferably, described fine steel needle fixation clamp comprises 2: one of them described fine steel needle fixation clamp is positioned at the middle part of described near-end C shape hole ring, another described fine steel needle fixation clamp is positioned at the end of described near-end C shape hole ring, with the two ends of far-end C shape hole ring, is oppositely arranged.
Beneficial effect of the present invention is:
1,, for shoulder joint topography and injury characteristic, the treatment theory of being association of activity and inertia with trans-articular, designed the external fixator fixing across shoulder joint.
2, early stage for guaranteeing the biological processes of union of fracture, increase arc-shaped connecting rod between humerus and clavicle device, by arc-shaped connecting rod, at near-end C shape hole ring and described far-end C shape hole ring middle part, be connected and fixed, form strong support configuration, and by the second threaded rod above near-end C shape hole ring and steel needle fixing clamp and screw thread half pin 32, after the second threaded rod below far-end C shape hole ring and steel needle fixing clamp and screw thread half pin combination are fixing, form three bar half-ring overall configurations: the strong static state of early implementation is fixed, can guarantee the stability of fracture, promote union of fracture and new bone growth.
3, for avoiding shoulder joint because of long-term fixing, the shoulder dysfunction caused, increased dynamic joint device in the trans-articular position, described dynamic traction joint device is by connecting to form by mandrel between the first joint connector and described second joint connector, and can do relative swing centered by mandrel, make far-end and near-end C shape hole ring there is dynamic adjustment function, and by adjusting the length of the threaded rod be connected with traction joint device, can implement moderately drawing-off in order to implement dynamically fixing at middle and late stage, can carry out the functional training of shoulder joint, can avoid shoulder joint stiff.
4, on proximal humerus hole semi-ring, can thread a needle to the syntripsis Rapid Implementation fixing, can be according to the concrete degree of impairment of comminuted fracture, after the reduction of the fracture, according to the direction of travel of fracture line, by the outside, the front outside or the rear outside, penetrate the screw thread half pin stable fracture broken ends of fractured bone.Adjust flexibly configuration draw point is installed, improve the acceptance rate that resets.
5, to have medical wound little in the present invention, be beneficial to protection blood for and promote the advantage such as union of fracture
6, reasonable in design of the present invention, simple in structure, easy to assembly, convenient operation
The invention provides a kind of shoulder joint regulation and control external fixator of being association of activity and inertia, for serious shoulder joint fracture open Shoulder Joint Injury particularly, provide effective Therapeutic Method new in.
The accompanying drawing explanation
By the description of its exemplary embodiment being carried out below in conjunction with accompanying drawing, the above-mentioned feature and advantage of the present invention will become apparent and easily understand.
A kind of shoulder joint that Fig. 1 provides for one embodiment of the invention be association of activity and inertia regulation and control external fixator structural representation;
Fig. 2 be in Fig. 1 shoulder joint be association of activity and inertia regulation and control external fixator decomposing schematic representation;
Fig. 3 be in Fig. 1 shoulder joint be association of activity and inertia regulation and control external fixator the using state schematic diagram;
Wherein, 1-external fixed support for bone; 11-near-end C shape hole ring; 12-far-end C shape hole ring; The 13-hole; The 14-arc-shaped connecting rod; 15-dynamic traction joint device; 151-the first joint connector; 152-second joint connector; The 153-mandrel; 154-the first threaded rod; 16-the second threaded rod; The 2-steel needle fixing clamp; 21-far-end steel needle fixing clamp; 211-draw point pressure pad; 212-draw point pad; 22-fine steel needle fixation clamp; 221-draw point locking cap; 222-draw point locking cap threaded rod; The 3-draw point; The 31-Kirschner wire; 32-screw thread half pin.
The specific embodiment
Below in conjunction with accompanying drawing, the present invention is described in further detail.
Proximal humeral fracture refers to the fracture that greater tubercle basilar part (surgical neck) is above.In, old common avulsion fracture and fracture of the humeral head, relevant with osteoporosis; Prime of life person comminuted fracture of the humeral head is many; The child mostly is fracture of surgical neck, and taking second place is epiphyseolisthesis.Proximal humeral fracture accounts for 4%～5% of whole body fracture, accounts for 45% of humeral fracture, and wherein 80%～85% be fracture without displacement or slight shift, and 15%～20% fractures for displacement.Women's sickness rate is higher, is 2 times of male.Overwhelming majority proximal humeral fractures can be taked expectant treatment, only have the serious or comminuted fracture of 15% left and right sidesing shifting just to need surgical intervention.For topography and injury characteristic, the treatment theory of being association of activity and inertia with trans-articular, the fixing external fixator across shoulder joint that design the present embodiment provides.A kind of shoulder joint that Fig. 1 provides for one embodiment of the invention be association of activity and inertia regulation and control external fixator structural representation, Fig. 2 be in Fig. 1 shoulder joint be association of activity and inertia regulation and control external fixator decomposing schematic representation, Fig. 3 be in Fig. 1 shoulder joint be association of activity and inertia regulation and control external fixator the using state schematic diagram, shown in Fig. 1, Fig. 2 and Fig. 3, the present embodiment provides a kind of shoulder joint regulation and control external fixator of being association of activity and inertia, and comprises external fixed support for bone 1, is arranged on steel needle fixing clamp 2 on external fixed support for bone and by the fixing draw point 3 of described steel needle fixing clamp.Draw point 3 can comprise 32 two kinds, Kirschner wire 31 and screw thread half pin usually.
External fixed support for bone 1 comprises near-end C shape hole ring 11 and far-end C shape hole ring 12, near-end C shape hole ring 11 is identical with the opening direction of far-end C shape hole ring 12, and evenly be provided with a plurality of holes 13 on it, positive outer edge and the reverse side outer edge of near-end C shape hole ring 11 and far-end C shape hole ring 12 all are carved with angle scale; Near-end C shape hole ring 11 and far-end C shape hole ring 12 middle parts connect by arc-shaped connecting rod 14; Near-end C shape hole ring 11 and far-end C shape hole ring 12 two ends connect by dynamic traction joint device 15.Concrete, near-end C shape hole ring 11 is fixing mainly for the humerus position, and fixing, early stage for guaranteeing the biological processes of union of fracture mainly for the clavicle position of far-end C shape hole ring 12, increase arc-shaped connecting rod 14 between humerus and clavicle device, implement static fixing; On the near-end C at humerus position shape hole ring 11, can thread a needle to the syntripsis Rapid Implementation fixing.But, for avoiding shoulder joint because of long-term fixing, the shoulder dysfunction caused, increased dynamic traction joint device 15 in the trans-articular position, in order to implement dynamically to fix at middle and late stage, carry out the functional training of shoulder joint.
Dynamic traction joint device 15 comprise the first joint connector 151 of being connected with the end hole 13 of near-end C shape hole ring 11 and with second joint connector 152, the first joint connectors 151 that on far-end C shape hole ring 12, corresponding hole 13 is connected and second joint connector 152 between also can relative mandrel 153 swings by mandrel 153 connections.Concrete the first joint connector 151 and the annexation between second joint connector 152 can be referring to Fig. 2, the first joint connector 151 is provided with hole slot, and second joint connector 152 is provided with corresponding projection, and then fixing by mandrel 153, between such the first joint connector 151 and second joint connector 152, can relatively swing, realize the relative swing between near-end C shape hole ring 11 and far-end C shape hole ring 12, dynamic traction joint device can substitute with locking joint device, this locking joint device is to have hinged and joint device locking function, can be spherical universal joint (Chinese patent application that application publication number is CN103006302A), the combination of any one or more in damping joint (Chinese patent application that application publication number is CN103006303A) or self-locking joint (Chinese patent application that application publication number is CN103006301A), at this, seldom repeat.
The shoulder joint provided by the invention regulation and control external fixator of being association of activity and inertia, by external fixed support for bone 1 is set, it comprises near-end C shape hole ring 11 and far-end C shape hole ring 12, the opening direction of near-end C shape hole ring 11 and far-end C shape hole ring 12 is identical, and evenly be provided with a plurality of holes 13 on it, the middle part of semi-ring connects by arc-shaped connecting rod 14, the two ends of semi-ring connect by dynamic traction joint device 15, this shoulder joint regulation and control external fixator flexible operation of being association of activity and inertia, improve curative effect, reduce the complication of shoulder joint proximal humeral fracture, scale design on near-end C shape hole ring 11 and far-end C shape hole ring 12, guaranteed the precision of operation, make the installation of connecting rod and the rotation that places of draw point all accomplish to quantize and accurately locate, both can guarantee that the bone external fixator carried out Fast Installation, can guarantee that again the bone external fixator is when being rotated malformation correction, RA is controlled accurately, can be respectively during use by near-end C shape hole ring 11 by steel needle fixing clamp fixedly draw point and on far-end C shape hole ring 12 by steel needle fixing clamp fixedly draw point be separately implemented on humerus and clavicle thread a needle-reset-fixing, can implement like this fixing across shoulder joint, the new bone growth in order to fracture, can implement local fixing of fracture mid-term, in order to carry out the shoulder joint function training, be and the excellent process for the treatment of shoulder joint complicated fracture.
The shoulder joint provided by the invention regulation and control external fixator of being association of activity and inertia, for serious shoulder joint fracture provides method, particularly open Shoulder Joint Injury, have medical wound little, be beneficial to protection blood for and promote the advantage such as union of fracture.The static fixing stability that can guarantee fracture, promote union of fracture; Middle and late stage, implement dynamically to fix, and facilitates the motion of shoulder joint, can avoid shoulder joint stiff.Humerus on by near-end C shape hole ring 11 fixing draw point to syntripsis fast implement to thread a needle fixing, with the raising acceptance rate that resets.
Can be by riveted joint between the first joint connector 151 and hole 13, the forms such as buckle are connected, but due in concrete use procedure, spacing between near-end C shape hole ring 11 and far-end C shape hole ring 12 is when different patients uses, distance is difference to some extent, so as technique scheme preferably, between the first joint connector 151 and hole 13, by the first threaded rod 154, be connected, the first threaded rod 154 is fixed by the upper lower locking nut that is positioned at the hole both sides.Adopt the first threaded rod 154 can adjust the first threaded rod 154 by upper lower locking nut and hole 13 and stretch out the length of hole 13, and then screw lower locking nut and make it fixing.So just can adjust according to actual needs the spacing between near-end C shape hole ring 11 and far-end C shape hole ring 12.
As technique scheme preferably, arc-shaped connecting rod 14 is curved, its two ends are thread segment, thread segment and hole 13 are complementary and fix by upper lower locking nut.The shape of arc-shaped connecting rod 14 can be referring to shown in accompanying drawing, and its overbending direction is bionical setting, consistent with humerus clavicle span.Arc-shaped connecting rod 14 and near-end C shape hole ring 11 and 12, far-end C shape hole ring are all fixed by upper lower locking nut, because thread segment has certain length, the length of stretching out by the adjustment thread segment can be adjusted the distance between near-end C shape hole ring 11 and far-end C shape hole ring 12 middle parts, so just can be adjusted according to needs different in actual mechanical process, concrete can rotate lower locking nut simultaneously, regulate concrete length to regulate upper lower locking nut with respect to the position of thread segment, after being of convenient length, thereby two nuts are fixed the adjusting that realizes arc-shaped connecting rod 14 and fix.
As technique scheme preferably, steel needle fixing clamp 2 comprises far-end steel needle fixing clamp 21, far-end steel needle fixing clamp 21 comprises draw point pressure pad 211 and draw point pad 212, be provided with the draw point hole slot that at least one and draw point 3 are complementary on draw point pressure pad 211, draw point pressure pad 211 is complementary with draw point pad 212, for fixing to draw point 3.As technique scheme preferably, the middle part of draw point pressure pad 211 and draw point pad 212 is provided with through hole, through hole stretches into hole 13, the second threaded rods 16 for the other end that is socketed the second threaded rod 16, the second threaded rods 16 and fixes by upper lower locking nut with hole 13.Stretch out the position that the length of hole 13 can realize draw point fixing on steel needle fixing clamp 21 by adjusting the second threaded rod 16.Concrete can rotate lower locking nut simultaneously, regulate with respect to the position of the 3rd threaded rod the particular location that the second threaded rod 16 stretches out hole 13 to regulate upper lower locking nut, after extension elongation is suitable, thereby two upper lower locking nuts are fixed to the adjusting that realizes the second threaded rod 16 extension elongations.By unclamping locking nut adjustment draw point pressure pad 211 and draw point pad 212 angle with respect to the second threaded rod 16, realize the adjustment to the draw point angle in addition.
As technique scheme preferably, far-end steel needle fixing clamp 21 also comprises for by draw point pressure pad 211 and draw point pad 212 and the fixing stop nut of the second threaded rod 16, stop nut is two, is spirally connected with the second threaded rod 16 and is positioned at the outside of draw point pressure pad 211 and draw point pad 212.Concrete far-end steel needle fixing clamp 21 is with reference to shown in Fig. 2, the draw point hole slot with draw point 3 profile couplings arranged on draw point pressure pad 211 can make the stiff end for the treatment of of draw point stretch into, thereby after draw point pad 212 is coordinated with it by its chucking, by getting final product after the locking nut locking that is positioned at draw point pressure pad 211 and draw point pad 212 both sides, realize fixing draw point again.In like manner, can adjust the position of draw point by the position of adjusting two relative the second threaded rods 16 of stop nut.
As technique scheme preferably, the quantity of far-end steel needle fixing clamp 21 is two: one of them is arranged at the middle part of near-end C shape hole ring, the direction of stretching out of its second threaded rod is the side that near-end C shape hole ring 11 deviates from far-end C shape hole ring 12; Another is arranged at the end of near-end C shape hole ring 12, and the direction of stretching out of its second threaded rod is the side that far-end C shape hole ring 12 deviates from near-end C shape hole ring 11.The setting of concrete far-end steel needle fixing clamp is to set according to the humerus clavicle position, for fixing draw point, makes draw point thrust corresponding position, thereby realizes fixing.Concrete extension elongation, stretch out angle and should be adjusted according to actual needs.
Use for far-end steel needle fixing clamp 21 is: in the hole 13 that the second threaded rod 16 is inserted, and be screwed into lower locking nut in its both sides, thereby the second threaded rod 16 is fixed on hole.The second threaded rod 16 first be screwed into one piece of nut for stationary remote probe fixation clamp stiff end, then penetrate in order draw point pressure pad 211, draw point pad 212, then draw point 3 inserted in the first hole slot of draw point pressure pads, then be screwed into another piece of nut.After adjusting the angle of draw point 3, keep draw point 3 and the second threaded rod 16 to be vertical 90 degree, tighten afterwards two nuts that are positioned at draw point pressure pad 211 and draw point pad 212 outsides, thereby draw point 3 is locked.
As technique scheme preferably, steel needle fixing clamp 2 also comprises fine steel needle fixation clamp 22, fine steel needle fixation clamp 22 comprises draw point locking cap 221, the bottom of draw point locking cap 221 is provided with the second hole slot that at least one and draw point 3 are complementary, the bottom of draw point locking cap 221 also is connected with the draw point locking cap threaded rod 222 be complementary with hole 13, and draw point locking cap threaded rod 222 and the hole 13 of fine steel needle fixation clamp are fixed by nut.Concrete in conjunction with shown in Fig. 1 and Fig. 2, the draw point hole slot arranged on the draw point locking cap 221 of the fine needle fixation clamp 22 of attached type, the stiff end for the treatment of of this draw point hole slot and draw point is complementary, by draw point after stiff end snaps in this draw point hole slot, adjust again the angle of draw point, by nut and draw point locking cap threaded rod 222 are screwed, can realize fixing to draw point.
As technique scheme preferably, the fine steel needle fixation clamp at least comprises 2: one of them fine steel needle fixation clamp is positioned at the middle part of far-end C shape hole ring 11, another fine steel needle fixation clamp is positioned at the end of far-end C shape hole ring 11, and the two ends that all the other two fine steel needle fixation clamps lay respectively at near-end C shape hole ring 12 are oppositely arranged.In conjunction with shown in Fig. 1 to 3, the setting of the particular location of fine steel needle fixation clamp 22 is also that the need position location concrete with the humerus clavicle determined.As shown in Figure 3, between two fine steel needle fixation clamps on near-end C shape hole ring 12, fix a draw point, the middle part of draw point is through clavicle.The draw point locking cap threaded rod of fine steel needle fixation clamp 222 is inserted in holes, and be screwed into nut, draw point 3 is inserted in the draw point hole slot of draw point locking caps 221, determine fastening nut after draw point 3 angles, fine steel needle 3 is locked.Generally when the number of draw point hole slot is 1, the fine steel needle fixation clamp can be fixed one piece of draw point, is commonly called as into " little partially ", when the number of the second hole slot is 2, the fine steel needle fixation clamp can be fixed two pieces of draw points accordingly, is commonly called as " partially large ".The number of the second concrete hole slot need to be selected according to actual needs.
Fig. 3 be in Fig. 1 shoulder joint be association of activity and inertia regulation and control external fixator the using state schematic diagram, as shown in Figure 3, the shoulder joint that the present embodiment provides be association of activity and inertia regulation and control external fixator the draw point fixing step be:
1, shoulder is threaded a needle: acromioclavicular joint penetrates one piece of full pin after by forward direction; Outside clavicle, one piece of screw thread, half pin 32(wears as shown in the figure in 1/3 place); With near-end C shape hole ring, draw point is connected and fixed, full pin is called again Kirschner wire 31(as shown in FIG.), the two ends that full pin penetrates bone, its pin need to be fixed by fixation clamp, and half pin is for penetrating bone but not penetrating, and the one end is fixed by fixation clamp;
2, in humerus, thread a needle in upper 1/3 place: by penetrating one piece of full pin after forward direction, be fixed in as shown in Figure 3 far-end C shape hole ring, should note in the time of fixedly maintaining shoulder joint in functional position;
3, the reduction of the fracture: with dynamic traction joint device, that near-end C shape hole ring and far-end C shape hole ring is tentatively fixing, application external fixator drawing-off function tentatively resets fracture;
4, the inspection that resets: under X-ray examination, to the place that resets, be confirmed, and be adjusted the reduction of the fracture, as reset dissatisfied can be in conjunction with manual reduction;
5, wear and put screw thread half pin: after the reduction of the fracture, according to the direction of travel of fracture line, by the outside, the front outside or the rear outside, penetrate the screw thread half pin stable fracture broken ends of fractured bone;
6, configuration is installed: after the X line is had an X-rayed the satisfaction of confirming to reset, with dynamic traction joint device or locking joint device, be connected and fixed the far and near hole ring of holding in the outside, form three bar half-ring overall configurations;
7, adjust the shoulder joint regulation and control external fixator of being association of activity and inertia: adjust the be association of activity and inertia position of regulation and control external fixator and limbs of shoulder joint, draw point is fixed on to near-end C shape hole ring, far-end C shape hole ring relevant position;
8, pin hole is processed: the errorless rear conventional wrapping pin hole of Integrated Checkout, triangular bandage suspension forearm.
Shoulder joint be association of activity and inertia regulation and control external fixator method of adjustment:
1, the reduction of the fracture adopts closed reduction, and fracture is pulverized and can't the fixing case of manual reduction be adopted open reduction.While resetting, upper arm is slight abduction, external rotatory position.At first row resets substantially, recovers length and obvious lateral displacement;
2, draw point layout and the plane of threading a needle
(1) the fracture near-end is threaded a needle: adopt screw thread half pin, diameter 3mm, can directly penetrate.The near-end entry point is position before the outer lateral deviation of greater tubercle and partially, as bad as the fracture end plane contact, and the cripetura tendency is arranged, and does not want parallel inserting needle.Thread a needle and 65 ° of left and right of humeral shaft angulation, and with become 20 °～40 ° after the elbow joint Xdirection, deeply reach 5～10mm under the head of humerus cartilage.Because of when operation positions that adopt upper limb to be put in front more, upper arm 90 ° of inward turnings now, so should be backward 110 ° while threading a needle～120 °;
(2) the fracture far-end is threaded a needle: 1. in the humerus outside, about triangular muscle stop below first penetrates one piece of screw thread, half pin 32, temporary fixed with steel needle fixing clamp and connecting rod connecting rod; 2. in humeral shaft astragalus broken line 2cm place, near connecting rod, penetrate second piece of screw thread of far-end, half pin 32, and temporary fixed with connecting rod;
(3) whole fixing: the X-ray examination confirmation is locked each position nut after resetting and being satisfied with.Be unsatisfied with and also can loosen the nut of region of interest if reset, retighten again after reduction is satisfied.
It should be noted that fixedly the time carrying out the shoulder joint regulation and control external fixator of being association of activity and inertia:
When 1, proximal humerus places full pin, should avoid biceps tendon and cephalic vein;
When 2, proximal humerus places half pin, should avoid deeply damaging the armpit nervus vasculairs, far-end half pin should note damaging radial nerve;
3, should carry out the x-ray inspection in art, whether through joint, as penetrate deeply with the half pin front end of determining the head of humerus place, the draw point front end need be retreated to home.
Shoulder joint be association of activity and inertia regulation and control external fixator the management after operation method:
1, conventional bone External fixation and nursing;
2, postoperative triangular bandage suspension forearm;
3, functional exercise, hold the trouble elbow with healthy side hand during early functional exercise, prevents that the upper limb action of gravity from causing fracture end to separate.The shoulder joint activity is considered as effective activity with Glenohumeral joint motion, prevents from facing juxta-articular compensatory activity and Glenohumeral joint after causing more is stiff;
4, remove external fixator after fracture reaches the bony union standard, can first loosen the locking joint device of connecting rod and hole ring, the activity suffering limb, as without pain, abnormality activity, i.e. dismountable external fixator.
Use shoulder joint that the present embodiment the provides regulation and control external fixator complication of being association of activity and inertia: fixedly complication is comparatively rare outward for bone, carry out effective shoulder joint function training if fail, can cause the shoulder joint limitation of activity, need to carry out rehabilitation training and make its recovery after removing external fixator.But it is unavoidable that III type fracture or serious comminuted fracture of the humeral head are left over joint function disturbance.
Above-described embodiment is not the exhaustive of the specific embodiment; also other embodiment can be arranged; above-described embodiment purpose is to illustrate the present invention, but not limits the scope of the invention, and all application that come by simple change of the present invention all drop in protection scope of the present invention.
This patent specification use-case goes to show the present invention, comprising optimal mode, and those of ordinary skill in the art is manufactured and use the present invention.This invents delegatable scope and comprises the content of claims and the content of the specific embodiment in description and other embodiment.These other examples also should belong to the scope of patent right requirement of the present invention, as long as they contain the described technical characterictic of the identical written language of claim, or they include and the similar literal language described technical characterictic of claim without essence difference.
All patents, the full content of patent application and other list of references should be incorporated to present specification by reference.But if a term in the application conflicts mutually with the term of including list of references in, preferential with the application's term.
All scopes disclosed herein all comprise end points, and between end points, are to combine independently of one another.
It should be noted that " first ", " second " or similar vocabulary do not mean any order, and quality or importance just are used for distinguishing different technical characterictics.The implication that the qualifier " approximately " used in conjunction with quantity comprises described value and content context appointment (for example: it includes the error while measuring specific quantity).
Claims (9)
1. the shoulder joint regulation and control external fixator of being association of activity and inertia comprises external fixed support for bone, is arranged on steel needle fixing clamp on external fixed support for bone and, by the fixing draw point of described steel needle fixing clamp, it is characterized in that:
Described external fixed support for bone comprises near-end C shape hole ring and far-end C shape hole ring, and described near-end C shape hole ring is identical with the opening direction of described far-end C shape hole ring, and evenly is provided with a plurality of holes on it; Described near-end C shape hole ring and described far-end C shape hole ring middle part connect by arc-shaped connecting rod; Described near-end C shape hole ring and described far-end C shape hole ring two ends connect by dynamic traction joint device;
Described dynamic traction joint device comprise the first joint connector of being connected with the end hole of described near-end C shape hole ring and with the second joint connector that on described far-end C shape hole ring, corresponding hole is connected, between described the first joint connector and described second joint connector by mandrel be connected also can mandrel centered by the mutually countershaft swing of do.
2. the shoulder joint according to claim 1 regulation and control external fixator of being association of activity and inertia, it is characterized in that, between described the first joint connector and described hole, by the first threaded rod, be connected, described the first threaded rod is fixed by the upper lower locking nut that is positioned at near-end C shape hole ring and the above hole both sides of far-end C shape hole ring.
3. the shoulder joint according to claim 1 regulation and control external fixator of being association of activity and inertia, is characterized in that, described arc-shaped connecting rod is curved, and its two ends are thread segment, and described thread segment and described hole are complementary and fix by upper lower locking nut.
4. the shoulder joint according to claim 1 regulation and control external fixator of being association of activity and inertia, it is characterized in that, described steel needle fixing clamp comprises the far-end steel needle fixing clamp, described far-end steel needle fixing clamp comprises draw point pressure pad and draw point pad, be provided with the draw point hole slot that at least one and described draw point are complementary on described draw point pressure pad, described draw point pressure pad and described draw point pad are complementary, for described draw point is fixed.
5. the shoulder joint according to claim 4 regulation and control external fixator of being association of activity and inertia, it is characterized in that, the middle part of described draw point pressure pad and described draw point pad is provided with through hole, described through hole is for being socketed the second threaded rod, the other end of described the second threaded rod stretches into described hole, and described the second threaded rod and described hole are fixed by upper lower locking nut.
6. the shoulder joint according to claim 5 regulation and control external fixator of being association of activity and inertia, it is characterized in that, described far-end steel needle fixing clamp also comprises for by described draw point pressure pad and described draw point pad and the fixing stop nut of described the second threaded rod, described stop nut is two, is spirally connected with described the second threaded rod and is positioned at the outside of described draw point pressure pad and described draw point pad.
7. according to the described shoulder joint of the claim 5 or 6 regulation and control external fixator of being association of activity and inertia, it is characterized in that, the quantity of described far-end steel needle fixing clamp is two: one of them is arranged at the middle part of described far-end C shape hole ring, and the direction of stretching out of its second threaded rod is that described near-end C shape hole ring deviates from a side of described far-end C shape hole ring; Another is arranged at the end of described near-end C shape hole ring, its second threaded rod stretch out the upside that direction is described near-end C shape hole ring.
8. the shoulder joint according to claim 1 regulation and control external fixator of being association of activity and inertia, it is characterized in that, described steel needle fixing clamp also comprises the fine steel needle fixation clamp, described fine steel needle fixation clamp comprises the draw point locking cap, the bottom of described draw point locking cap is provided with the draw point hole slot that at least one and described draw point are complementary, the bottom of described draw point locking cap also is connected with the draw point locking cap threaded rod be complementary with described hole, and draw point locking cap threaded rod and the described hole of described fine steel needle fixation clamp are fixed by nut.
9. the shoulder joint according to claim 8 regulation and control external fixator of being association of activity and inertia, it is characterized in that, described fine steel needle fixation clamp comprises 2: one of them described fine steel needle fixation clamp is positioned at the middle part of described near-end C shape hole ring, another described fine steel needle fixation clamp is positioned at the end of described near-end C shape hole ring, with the two ends of far-end C shape hole ring, is oppositely arranged.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310400834.7A CN103445833B (en) | 2013-09-06 | 2013-09-06 | Shoulder joint dynamic and static combined regulation external fixator |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310400834.7A CN103445833B (en) | 2013-09-06 | 2013-09-06 | Shoulder joint dynamic and static combined regulation external fixator |
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| Publication Number | Publication Date |
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| CN103445833A true CN103445833A (en) | 2013-12-18 |
| CN103445833B CN103445833B (en) | 2015-05-13 |
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| CN201310400834.7A Active CN103445833B (en) | 2013-09-06 | 2013-09-06 | Shoulder joint dynamic and static combined regulation external fixator |
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| CN109528278A (en) * | 2018-12-21 | 2019-03-29 | 中国人民解放军陆军军医大学第附属医院 | A kind of Combined type three dimensional ankle traction fixing bracket |
| CN110495937A (en) * | 2018-05-18 | 2019-11-26 | 武汉德骼拜尔外科植入物有限公司 | Ring external fixation support and fixed device |
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| CN103445833B (en) | 2015-05-13 |
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