CN103445833B - 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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- CN103445833B CN103445833B CN201310400834.7A CN201310400834A CN103445833B CN 103445833 B CN103445833 B CN 103445833B CN 201310400834 A CN201310400834 A CN 201310400834A CN 103445833 B CN103445833 B CN 103445833B
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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 exter-nal fixer being used for the treatment of shoulder joint fracture.
Background technology
In existing medical skill, when there is shoulder joint proximal humeral fracture in patient, usually plaster splint is selected to fix, but the long-time so fixing triangular muscle, biceps brachii m., anconeus longus, coracobrachialis etc. crossing over joint that can cause causes shortened deformity, the strength that the upper and lower flesh of teres minor and ridge rotating sleeve is greater than subscapularis causes the slight outward turning of near-end, and without muscle attachment inside head of humerus, the upper and lower flesh in ridge causes near-end abduction.In addition because the blood of head of humerus ships from tuberosity place, fracture of the humeral head easily causes head of humerus ischemic necrosis.
So need to provide a kind of shoulder joint to be association of activity and inertia regulation and control external fixator, flexible operation, improves curative effect, reduces corresponding complication.
Summary of the invention
The object of this invention is to provide a kind of shoulder joint to be association of activity and inertia regulation and control external fixator, flexible operation, improve curative effect, reduce the complication of shoulder joint proximal humeral fracture.
For achieving the above object, the invention provides a kind of shoulder joint to be association of activity and inertia regulation and control external fixator, the draw point comprising external fixed support for bone, be arranged on the steel needle fixing clamp on external fixed support for bone and fixed by 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 it is evenly provided with multiple hole; Connected by arc-shaped connecting rod in the middle part of described near-end C shape hole ring and described far-end C shape hole ring; Described near-end C shape hole ring and described far-end C shape hole ring two ends are connected by dynamic traction joint device;
Described dynamic traction joint device comprises the second joint connector be connected to the first joint connector that the end hole of described near-end C shape hole ring connects and the hole corresponding with on described far-end C shape hole ring, is connected and can does mutually countershaft swing centered by mandrel between described first joint connector with described second joint connector by mandrel.
Preferred as technique scheme, described first joint connector is connected by the first threaded rod with between described hole, and described first threaded rod is fixed by the upper lower locking nut being positioned at described hole both sides on near-end C shape hole ring and far-end C shape hole ring.
Preferred as technique scheme, described arc-shaped connecting rod is curved, and its two ends are thread segment, and described thread segment and described hole are matched and fixed by upper lower locking nut.
Preferred as technique scheme, described steel needle fixing clamp comprises far-end steel needle fixing clamp, described far-end steel needle fixing clamp comprises draw point pressure pad and draw point pad, described draw point pressure pad is provided with the draw point hole slot that at least one and described draw point match, described draw point pressure pad and described draw point pad match, for fixing described draw point.
Preferred as technique scheme, 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 second threaded rod stretches into described hole, and described second threaded rod and described hole are fixed by upper lower locking nut.
Preferred as technique scheme, 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 second threaded rod, described stop nut is two, is spirally connected and is positioned at the outside of described draw point pressure pad and described draw point pad with described second threaded rod.
Preferred as technique scheme, 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 the side that described near-end C shape hole ring deviates from 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.
Preferred as technique scheme, described steel needle fixing clamp also comprises fine steel needle fixation clamp, described fine steel needle fixation clamp comprises 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 match, the bottom of described draw point locking cap is also connected with the draw point locking cap threaded rod matched 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.
Preferred as technique scheme, described fine steel needle fixation clamp comprises 2: fine steel needle fixation clamp described in one of them is positioned at the middle part of described near-end C shape hole ring, fine steel needle fixation clamp described in another is positioned at the end of described near-end C shape hole ring, is oppositely arranged with the two ends of far-end C shape hole ring.
Beneficial effect of the present invention is:
1, for shoulder joint topography and injury characteristic, the treatment concept of being association of activity and inertia with trans-articular, devises across the fixing external fixator of shoulder joint.
2, early stage for guaranteeing the biological processes of union of fracture, arc-shaped connecting rod is increased between humerus and clavicle device, be connected and fixed in the middle part of near-end C shape hole ring and described far-end C shape hole ring by arc-shaped connecting rod, 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, the second threaded rod below far-end C shape hole ring and steel needle fixing clamp and the combination of screw thread half pin fixing after, form three bar half-ring overall configurations: the strong static state of early implementation is fixed, the stability of fracturing can be ensured, promote union of fracture and new bone growth.
3, for avoiding shoulder joint because of long-term fixing, the shoulder dysfunction caused, dynamic joint device is added in trans-articular position, described dynamic traction joint device is connected to form by mandrel by between the first joint connector and described second joint connector, and can opposing oscillatory be made centered by mandrel, far-end and near-end C shape hole ring is made to have dynamic adjustment function, and by adjustment and the length of drawing the threaded rod that joint device is connected, moderately drawing-off can be implemented to implement dynamically fixing at middle and late stage, the functional training of shoulder joint can be carried out, shoulder joint can be avoided stiff.
4, can thread a needle to syntripsis Rapid Implementation on proximal humerus hole semi-ring fixing, can 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, penetrate the screw thread half pin stable fracture broken ends of fractured bone by outside, front outside or rear outside.Draw point is installed in flexible adjustment configuration, improves reset acceptance rate.
5, to have medical trauma little in the present invention, be beneficial to protection blood for and promote the advantages such as union of fracture
6, reasonable in design of the present invention, structure is simple, easy to assembly, convenient operation
The invention provides a kind of shoulder joint to be association of activity and inertia regulation and control external fixator, be serious shoulder joint fracture particularly open Shoulder Joint Injury, provide effective Therapeutic Method new in.
Accompanying drawing explanation
By the description carried out its exemplary embodiment below in conjunction with accompanying drawing, the above-mentioned feature and advantage of the present invention will become apparent and easy understand.
Fig. 1 to be association of activity and inertia the structural representation of regulation and control external fixator for a kind of shoulder joint that one embodiment of the invention provides;
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 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; 13-hole; 14-arc-shaped connecting rod; 15-dynamic traction joint device; 151-first joint connector; 152-second joint connector; 153-mandrel; 154-first threaded rod; 16-second threaded rod; 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; 3-draw point; 31-Kirschner wire; 32-screw thread half pin.
Detailed description of the invention
Below in conjunction with accompanying drawing, the present invention is described in further detail.
Proximal humeral fracture refers to the fracture of more than greater tubercle basilar part (surgical neck).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; Child mostly then 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% is the fracture without displacement or slight shift, and 15% ~ 20% is displacement fracture.Women's sickness rate is higher, is 2 times of male.Overwhelming majority proximal humeral fracture can take expectant treatment, only has the serious or comminuted fracture of 15% left and right sidesing shifting just to need surgical intervention.For topography and injury characteristic, the treatment concept of being association of activity and inertia with trans-articular, the external fixator fixing across shoulder joint that design the present embodiment provides.Fig. 1 to be association of activity and inertia the structural representation of regulation and control external fixator for a kind of shoulder joint that one embodiment of the invention provides, 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 using state schematic diagram, shown in composition graphs 1, Fig. 2 and Fig. 3, present embodiments provide a kind of shoulder joint to be association of activity and inertia regulation and control external fixator, comprise external fixed support for bone 1, be 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 Kirschner wire 31 and 32 two kinds, 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 it being evenly provided with multiple hole 13, front outer edge and the reverse side outer edge of near-end C shape hole ring 11 and far-end C shape hole ring 12 are all carved with angle scale; Connected by arc-shaped connecting rod 14 in the middle part of near-end C shape hole ring 11 and far-end C shape hole ring 12; Near-end C shape hole ring 11 and far-end C shape hole ring 12 two ends are connected by dynamic traction joint device 15.Concrete, near-end C shape hole ring 11 fixing mainly for humerus position, and far-end C shape hole ring 12 fixing mainly for clavicle position, in early days for guaranteeing the biological processes of union of fracture, between humerus and clavicle device, increase arc-shaped connecting rod 14, implement static fixing; The near-end C shape hole ring 11 at humerus position can be threaded a needle to syntripsis Rapid Implementation fixing.But for avoiding shoulder joint because of long-term fixing, the shoulder dysfunction caused, adds dynamic traction joint device 15 in trans-articular position, to implement dynamically fixing at middle and late stage, carry out the functional training of shoulder joint.
Dynamic traction joint device 15 is comprised second joint connector 152, first joint connector 151 be connected to the first joint connector 151 that the end hole 13 of near-end C shape hole ring 11 connects and the hole 13 corresponding with on far-end C shape hole ring 12 and is connected by mandrel 153 with between second joint connector 152 and can swing by relative mandrel 153.Annexation between the first concrete joint connector 151 and second joint connector 152 can see Fig. 2, first joint connector 151 is provided with hole slot, and second joint connector 152 is provided with corresponding projection, and then fixed by mandrel 153, can opposing oscillatory between such first joint connector 151 and second joint connector 152, realize the opposing oscillatory 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 has hinged and joint device that is locking function, can be spherical universal joint (application publication number is the Chinese patent application of CN103006302A), the combination of any one or more in damping joint (application publication number is the Chinese patent application of CN103006303A) or self-locking joint (application publication number is the Chinese patent application of CN103006301A), seldom repeat at this.
Shoulder joint provided by the invention is association of activity and inertia regulation and control external fixator, by arranging external fixed support for bone 1, 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 it is evenly provided with multiple hole 13, the middle part of semi-ring is connected by arc-shaped connecting rod 14, the two ends of semi-ring are connected by dynamic traction joint device 15, this shoulder joint is association of activity and inertia regulation and control external fixator flexible operation, 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, ensure that the precision of operation, the rotation that places of the installation of connecting rod and draw point is made all to accomplish to quantize and accurately locate, both can ensure that exter-nal fixer carried out Fast Installation, can ensure that again exter-nal fixer is when carrying out rotation deformity and correcting, RA is controlled accurately, during use can respectively by near-end C shape hole ring 11 fixes draw point by steel needle fixing clamp and fixed by steel needle fixing clamp on far-end C shape hole ring 12 draw point be separately implemented on humerus and clavicle thread a needle-reset-fix, fixing across shoulder joint can be implemented like this, the new bone growth to fracture, can implement the fixing of local of fracturing mid-term, to carry out shoulder joint function training, be the excellent process with treatment shoulder joint complicated fracture.
Shoulder joint provided by the invention is association of activity and inertia regulation and control external fixator, and for serious shoulder joint fracture provides method, particularly open Shoulder Joint Injury, has medical trauma little, be beneficial to protection blood for and promote the advantages such as union of fracture.The static fixing stability that can ensure to fracture, promotes union of fracture; Middle and late stage, implements dynamically to fix, facilitates the motion of shoulder joint, shoulder joint can be avoided stiff.Implement to thread a needle fixing soon to syntripsis, to improve reset acceptance rate at humerus by draw point fixing on near-end C shape hole ring 11.
Can by riveting between first joint connector 151 and hole 13, the forms such as buckle connect, but due in concrete use procedure, spacing between near-end C shape hole ring 11 from far-end C shape hole ring 12 is when different patients uses, distance difference to some extent, so preferred as technique scheme, the first joint connector 151 is connected by the first threaded rod 154 with between hole 13, and the first threaded rod 154 is fixed by the upper lower locking nut being positioned at hole both sides.Adopt the first threaded rod 154 can adjust by upper lower locking nut and hole 13 length that first threaded rod 154 stretches out hole 13, and then screw lower locking nut and make it fixing.So just can adjust the spacing between near-end C shape hole ring 11 and far-end C shape hole ring 12 according to actual needs.
Preferred as technique scheme, arc-shaped connecting rod 14 is curved, and its two ends are thread segment, and thread segment and hole 13 are matched and fixed by upper lower locking nut.The shape of arc-shaped connecting rod 14 can see shown in accompanying drawing, and its overbending direction is bionical setting, consistent with humerus clavicle span.All fixed by upper lower locking nut between arc-shaped connecting rod 14 and near-end C shape hole ring 11 and far-end C shape hole ring 12, because thread segment has certain length, distance between the length of being stretched out by adjustment thread segment can be adjusted in the middle part of near-end C shape hole ring 11 and far-end C shape hole ring 12, so just can adjust according to needs different in actual mechanical process, concrete can rotate lower locking nut simultaneously, to regulate upper lower locking nut relative to the position of thread segment to regulate concrete length, after being of convenient length, two nuts are fixed thus realize the adjustment of arc-shaped connecting rod 14 and fix.
Preferred as technique scheme, 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, draw point pressure pad 211 is provided with the draw point hole slot that at least one and draw point 3 match, draw point pressure pad 211 and draw point pad 212 match, for fixing draw point 3.Preferred as technique scheme, 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 for the other end being socketed the second threaded rod 16, second threaded rod 16, and the second threaded rod 16 is fixed by upper lower locking nut with hole 13.The length of stretching out hole 13 by adjusting the second threaded rod 16 can realize the position of draw point fixing on steel needle fixing clamp 21.Concrete can rotate lower locking nut simultaneously, the second threaded rod 16 is regulated to stretch out the particular location of hole 13 to regulate upper lower locking nut relative to the position of the 3rd threaded rod, after extension elongation is suitable, two upper lower locking nuts are fixed thus realize the adjustment of the second threaded rod 16 extension elongation.Additionally by unclamping locking nut adjustment draw point pressure pad 211 and draw point pad 212 relative to the angle of the second threaded rod 16, realize the adjustment to draw point angle.
Preferred as technique scheme, 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 and is positioned at the outside of draw point pressure pad 211 and draw point pad 212 with the second threaded rod 16.Concrete far-end steel needle fixing clamp 21 is with reference to shown in Fig. 2, what draw point pressure pad 211 was arranged can make the end to be fixed of draw point stretch into the draw point hole slot of draw point 3 form fit, thus clamped after draw point pad 212 is coordinated with it, locking nut again by being positioned at draw point pressure pad 211 and draw point pad 212 both sides realizes fixing draw point after locking.In like manner, the position of draw point can be adjusted by the position of relative second threaded rod 16 of adjustment two stop nuts.
Preferred as technique scheme, 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, and 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 according to the setting of humerus clavicle position, for fixing draw point, makes draw point thrust corresponding position, thus realizes fixing.Concrete extension elongation, stretching out angle should adjust according to actual needs.
Use for far-end steel needle fixing clamp 21 is: in the hole 13 insert the second threaded rod 16, and be screwed into lower locking nut in its both sides, thus be fixed on hole by the second threaded rod 16.First be screwed into one piece of nut at the second threaded rod 16 for stationary remote probe fixation clamp stiff end, then penetrate draw point pressure pad 211, draw point pad 212 in order, then draw point 3 is inserted in the first hole slot of draw point pressure pad, 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 in vertical 90 degree, tighten two nuts be positioned at outside draw point pressure pad 211 and draw point pad 212 afterwards, thus draw point 3 is locked.
Preferred as technique scheme, 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 match, the bottom of draw point locking cap 221 is also connected with the draw point locking cap threaded rod 222 matched 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.Shown in concrete composition graphs 1 and Fig. 2, the draw point hole slot that the draw point locking cap 221 of the fine needle fixation clamp 22 of attached type is arranged, the end to be fixed of this draw point hole slot and draw point matches, after the end to be fixed of draw point is snapped in this draw point hole slot, adjusting the angle of draw point again, fixing draw point can be realized by nut and draw point locking cap threaded rod 222 being screwed.
Preferred as technique scheme, 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.Shown in composition graphs 1 to 3, the setting of the particular location of fine steel needle fixation clamp 22 is also specifically with humerus clavicle need position location to determine.As shown in Figure 3, fix a draw point between two fine steel needle fixation clamps on near-end C shape hole ring 12, the middle part of draw point is through clavicle.The draw point locking cap threaded rod 222 of fine steel needle fixation clamp is inserted in hole, and is screwed into nut, draw point 3 is inserted in the draw point hole slot of draw point locking cap 221, determine fastening nut after draw point 3 angle, fine steel needle 3 is locked.Under normal circumstances when the number of draw point hole slot is 1 time, fine steel needle fixation clamp can fix one piece of draw point, is commonly called as " little partially ", when the number of the second hole slot is 2, fine steel needle fixation clamp can fix two pieces of draw points accordingly, is commonly called as " inclined greatly ".The number of the second concrete hole slot needs to select according to actual needs.
Fig. 3 be in Fig. 1 shoulder joint be association of activity and inertia regulation and control external fixator 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 draw point fixing step be:
1, shoulder is threaded a needle: acromioclavicular joint is by penetrating one piece of full pin after forward direction; At clavicle, one piece of screw thread half pin 32(wears as shown in the figure in outer 1/3 place); Be connected and fixed by draw point with near-end C shape hole ring, full pin is also called Kirschner wire 31(as shown in FIG.), full pin penetrates bone, the two ends of its pin need to be fixed by fixation clamp, and half pin is for penetrating bone but not penetrating, and its 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, is fixed on far-end C shape hole ring as shown in Figure 3, should note maintaining shoulder joint in functional position time fixing;
3, the reduction of the fracture: with dynamic traction joint device by near-end C shape hole ring and far-end C shape hole ring tentatively fixing, application external fixator drawing-off function makes fracture tentatively reset;
4, reset inspection: will confirm reset place under X-ray examination, and adjust the reduction of the fracture, and being unsatisfied with as resetted can 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, penetrate the screw thread half pin stable fracture broken ends of fractured bone by outside, front outside or rear outside;
6, configuration is installed: the confirmation of X line perspective resets after satisfaction, is connected and fixed the far and near hole ring held with dynamic traction joint device or locking joint device in outside, forms three bar half-ring overall configurations;
7, adjust shoulder joint to be association of activity and inertia regulation and control external fixator: adjustment shoulder joint is association of activity and inertia the position of regulation and control external fixator and limbs, draw point is fixed on near-end C shape hole ring, far-end C shape hole ring relevant position;
8, pin hole process: the errorless rear routine 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 the fixing case of manual reduction cannot be adopted open reduction.During reset, upper arm is slight abduction, external rotatory position.First row resets substantially, recovers length and obvious lateral displacement;
2, draw point layout and plane of threading a needle
(1) near-end of fracturing is threaded a needle: adopt screw thread half pin, diameter 3mm, can directly penetrate.Near-end entry point is position to the front and to the rear in the outside of greater tubercle, as bad in fracture end plane contact, has cripetura to be inclined to, not parallel inserting needle.Thread a needle and humeral shaft angulation about 65 °, and with become 20 ° ~ 40 ° after elbow joint X direction, deeply reach 5 ~ 10mm under head of humerus cartilage.Because during operation, many employings upper limb is put in the position of front, now upper arm inward turning 90 °, so should backward 110 ° when threading a needle ~ 120 °;
(2) fracture far-end thread a needle: 1. outside humerus, about below triangular muscle stop, first penetrate one piece of screw thread half pin 32, with steel needle fixing clamp and connecting rod connecting rod temporary fixed; 2. in humeral shaft astragalus broken line 2cm place, far-end second piece of screw thread half pin 32 is penetrated near connecting rod, and temporary fixed with connecting rod;
(3) overall fixing: X-ray examination locks each position nut after confirming that reset is satisfied.The dissatisfied nut that also can loosen region of interest if reset, retightens after reduction is satisfied again.
Carry out shoulder joint be association of activity and inertia regulation and control external fixator fix time it is to be noted that
1, when proximal humerus places full pin, biceps tendon and cephalic vein should be avoided;
2, when proximal humerus places half pin, should avoid deeply damaging armpit nervus vasculairs, far-end half pin should be noted damaging radial nerve;
3, x-ray inspection should be carried out in art, to determine that whether the half pin front end at head of humerus place is through joint, as dark in penetrated, draw point front end need be retreated to home.
Shoulder joint be association of activity and inertia regulation and control external fixator management after operation method:
1, conventional bone External fixation and nursing;
2, postoperative triangular bandage suspension forearm;
3, functional exercise, holds trouble elbow with healthy side hand during early functional exercise, prevents upper limb action of gravity from causing fracture end to be separated.Shoulder mobility is considered as effective activity with Glenohumeral joint motion, prevents from facing juxta-articular compensatory activity and causing the Glenohumeral joint more stiff;
4, remove external fixator when fracture reaches bony union standard after, first can loosen the locking joint device of connecting rod and hole ring, activity suffering limb, as without pain, abnormality activity, i.e. dismountable external fixator.
The shoulder joint that theres is provided of the present embodiment is used to be association of activity and inertia regulation and control external fixator complication: bone extenal fixation complication is comparatively rare, effective shoulder joint function training is carried out if fail, shoulder mobility then can be caused limited, after dismounting external fixator, need to carry out rehabilitation training make it recover.But III type fracture or serious comminuted fracture of the humeral head are left over joint function disturbance and are can hardly be avoided.
Above-described embodiment is not the exhaustive of detailed description of the invention; also can there is other embodiment; above-described embodiment object is the present invention is described, but not limits the scope of the invention, and all application 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 uses the present invention.This invents the content that delegatable scope comprises detailed description of the invention in the content of claims and description and other embodiment.These other examples also should belong to the scope of claims of the present invention, as long as they contain the technical characteristic described by the identical written language of claim, or they include with claim without essence difference similar literal language described by technical characteristic.
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 including list of references in, preferential with the term of the application.
All scopes disclosed herein all comprise end points, and are combine independently of one another between end points.
It should be noted that " first ", " second " or similar vocabulary do not represent any order, quality or importance, are only used to distinguish different technical characteristics.The qualifier " approximately " used in conjunction with quantity comprises implication that described value and content context specify (such as: error when it includes measurement specific quantity).
Claims (9)
1. shoulder joint is association of activity and inertia a regulation and control external fixator, 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 it is evenly provided with multiple hole; Connected by arc-shaped connecting rod in the middle part of described near-end C shape hole ring and described far-end C shape hole ring; Described near-end C shape hole ring and described far-end C shape hole ring two ends are connected by dynamic traction joint device;
Described dynamic traction joint device comprises the second joint connector be connected to the first joint connector that the end hole of described near-end C shape hole ring connects and the hole corresponding with on described far-end C shape hole ring, is connected and can does mutually countershaft swing centered by mandrel between described first joint connector with described second joint connector by mandrel.
2. shoulder joint according to claim 1 is association of activity and inertia regulation and control external fixator, it is characterized in that, described first joint connector is connected by the first threaded rod with between described hole, and described first threaded rod is fixed by the upper lower locking nut being positioned at described hole both sides on near-end C shape hole ring and far-end C shape hole ring.
3. shoulder joint according to claim 1 is association of activity and inertia regulation and control external fixator, and it 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 matched and fixed by upper lower locking nut.
4. shoulder joint according to claim 1 is association of activity and inertia regulation and control external fixator, it is characterized in that, described steel needle fixing clamp comprises far-end steel needle fixing clamp, described far-end steel needle fixing clamp comprises draw point pressure pad and draw point pad, described draw point pressure pad is provided with the draw point hole slot that at least one and described draw point match, described draw point pressure pad and described draw point pad match, for fixing described draw point.
5. shoulder joint according to claim 4 is association of activity and inertia regulation and control external fixator, 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 second threaded rod stretches into described hole, and described second threaded rod and described hole are fixed by upper lower locking nut.
6. shoulder joint according to claim 5 is association of activity and inertia regulation and control external fixator, 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 second threaded rod, described stop nut is two, is spirally connected and is positioned at the outside of described draw point pressure pad and described draw point pad with described second threaded rod.
7. the shoulder joint according to claim 5 or 6 is association of activity and inertia regulation and control external fixator, 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 the side that described near-end C shape hole ring deviates from 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. shoulder joint according to claim 1 is association of activity and inertia regulation and control external fixator, it is characterized in that, described steel needle fixing clamp also comprises fine steel needle fixation clamp, described fine steel needle fixation clamp comprises 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 match, the bottom of described draw point locking cap is also connected with the draw point locking cap threaded rod matched 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. shoulder joint according to claim 8 is association of activity and inertia regulation and control external fixator, it is characterized in that, described fine steel needle fixation clamp comprises 2: fine steel needle fixation clamp described in one of them is positioned at the middle part of described near-end C shape hole ring, fine steel needle fixation clamp described in another is positioned at the end of described near-end C shape hole ring, is oppositely arranged with the two ends of far-end C shape hole ring.
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| CN201310400834.7A CN103445833B (en) | 2013-09-06 | 2013-09-06 | Shoulder joint dynamic and static combined regulation external fixator |
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| CN201310400834.7A CN103445833B (en) | 2013-09-06 | 2013-09-06 | Shoulder joint dynamic and static combined regulation external fixator |
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| CN103445833A CN103445833A (en) | 2013-12-18 |
| CN103445833B true 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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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| 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 |
| CN109528278B (en) * | 2018-12-21 | 2024-01-30 | 中国人民解放军陆军军医大学第一附属医院 | Combined ankle joint three-dimensional traction fixing frame |
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| CN1060204A (en) * | 1990-09-28 | 1992-04-15 | 黄克勤 | External elastic fixator for fracture |
| RU2139689C1 (en) * | 1995-09-12 | 1999-10-20 | Российский научный центр "Восстановительная травматология и ортопедия" им.акад.Г.А.Илизарова | Method and device for treating femur dislocation cases |
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| CN103445833A (en) | 2013-12-18 |
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