CN105286967A - Installation method of distal radius external fixation support - Google Patents
Installation method of distal radius external fixation support Download PDFInfo
- Publication number
- CN105286967A CN105286967A CN201510625388.9A CN201510625388A CN105286967A CN 105286967 A CN105286967 A CN 105286967A CN 201510625388 A CN201510625388 A CN 201510625388A CN 105286967 A CN105286967 A CN 105286967A
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- China
- Prior art keywords
- schanze
- metacarpal bone
- nail
- radius
- fixation bracket
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/645—Devices extending alongside the bones to be positioned comprising a framework
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention discloses an installation method of a distal radius external fixation support. On the precondition of keeping the structure of an original external fixation support unchanged, the unbalanced stress in the prior art is changed and the long-term stability of traction and reduction is kept by changing a screw implanting position, replacing a schanze screw of the external fixation support by virtue of a universal kirschner wire and penetrating through the 2nd, 3rd, 4th and 5th metacarpal bases from the 2nd metacarpal base; therefore the external fixation support has the advantages of being convenient to use, and being capable of reducing pin track infection and the difficulty of skin nursing, adjusting fracture displacement towards an ulnar side easily, avoiding iatrogenic injury, being easy to be accepted by patients and being conducive to function recovery.
Description
Technical field
The present invention relates to orthopaedics fractures method, be specifically related to a kind of distal exterior fixation bracket of radius installation method.
Background technology
Radius far-end fracture exterior fixation bracket has been widely used in clinical, original technology, because planting the defect of nail method and skill, makes that exterior fixation bracket far-end is stressed is only limitted to second metacarpal bone, causes the pull strength required for exterior fixation bracket and stability to reduce, do not reach clinical requirement, cause therapeutic effect to reduce.
Summary of the invention
In order to overcome above-mentioned the deficiencies in the prior art, the object of this invention is to provide a kind of distal exterior fixation bracket of radius installation method, under the prerequisite not changing former exterior fixation bracket structure, nail position is planted by changing, and replace the schanze of one piece of former exterior fixation bracket to follow closely with a general Kirschner wire, run through 2,3,4,5 metacarpal bone substrates from the 2nd metacarpal bone substrate, thus change original technology by force unbalance and the long-term stability maintaining reduction by traction.
To achieve these goals, the technical solution used in the present invention is:
A kind of distal exterior fixation bracket of radius installation method, comprises the following steps:
1) patient selects brachial plexus block anesthesia, anaesthetizes successfully and gets dorsal position, and suffering limb abduction position is on side stage, and manual traction resets, and recovers suffering limb roughly anatomic form;
2) be labelling with a Kirschner wire, the lower most sites of accurate marker 2,3,4,5 metacarpal bone substrate Peng of C arm perspective, skin carries out labelling, at the 2nd metacarpal bone backside of substrate, oar then, body at the bottom of metacarpal bone has a common boundary, extensor carpi radialis longus stop far-end is entry point, does a labelling with marking pen on skin, at the bottom of fifth metacarpal bone, body has a common boundary for going out pin mark, on skin, do a line by 2, and by Kirschner wire labelling, C arm perspective confirms that position meets the requirements;
3) by after requirements of operation routine disinfection paving aseptic towel, according to the entry point of preceding mark with go out pin mark, special guider is placed;
4) keep patient's carpal joint neutral position, four refer to stretch position, palmar opposition of thumb pose gesture, by guider, bore and allow Kirschner wire accurately pass 2,3,4,5 metacarpal bone substrates along entry point, complete inserting of Kirschner wire with low speed;
5) according to exterior fixation bracket draw-in groove position, be parallel to kirschner nail in oar side, the second metacarpal bone body back side, first place guider (paracentesis trocar), Direct perforantes arrives the 2nd metacarpal bone, drills the 2nd metacarpal bone with 2mm drill bit, installs 2.5mm metacarpal bone schanze nail;
6) exterior fixation bracket be installed and adjust, make exterior fixation bracket and forearm, the palm, wrist in line, according to the position of fracture line, at fracture line near-end astragalus broken line 6 ~ 8cm place, from the abductor pollicis longus of oar side and carpi radialis long, extensor hallucis brevis gap is inserting needle, exterior fixation bracket draw-in groove installs paracentesis trocar, Direct perforantes reaches radius, radius is drilled by sleeve pipe with 2.5mm drill bit, install the schanze nail of 4mm, same method installs one piece of schanze nail again at the parallel first piece of schanze nail of near-end, and two nails are at a distance of more than 4cm;
7) first lock radius near-end two pieces of schanze nails, the Distance geometry parallel relation distance again adjusting exterior fixation bracket and suffering limb is 1 ~ 2cm;
8) rack far end fastening bolt is unscrewed, clockwise direction die nut rotates extension rod, and the distance length of root distance fracture compression struts, and observes reduction of the fracture situation under dynamic C arm X-ray machine, until recover original anatomic form, and carpal joint gap is made to increase 3 ~ 5mm than original;
9) if any lateral displacement, between fracture of radius line far-end and support, then place the supporter that a size is applicable to, do not loosen near-end schanze nail clip nut, directly pull with T the schanze nail that turns clockwise, get final product the radius near-end of radiad lift ulnad displacement, reach replacement and fixation object;
10) C arm has an X-rayed confirmation again, and position, positive side of fracturing all returns to normal anatomic form, locks all fastening studs, completes operation.
The invention has the beneficial effects as follows:
The present invention compared with the prior art, solves exterior fixation bracket far-end discontinuity equalization, and can not effectively maintain the deficiency causing fracture redisplacement after reduction by traction, and has following characteristics:
1) change fracture distal stent stressed, make rack far end energy producing balanced forces.Suitable cantilever beam action, makes far-end become a stable triangle structure.
2) position passed through of entry point and Kirschner wire is without blood vessel, nerve and vital tissue, avoids iatrogenic injury.
3) utilize the lift of fracture proximal stent schanze nail, easily can adjust the displacement of fracture ulnad.
4) trocar puncturing, avoids skin incision, decreases pin track infection and skin nursing difficulty.
5) postoperative patients can active movement in early days, is conducive to functional rehabilitation.
6) both Burnf(1979 is met) concept of elasticity extenal fixation of fracture is proposed, also meet the biological theory of union of fracture needs stress stimulation
7) for comminuted fracture of distal radius provides a kind of new Therapeutic Method and technological means.And dynamic adjustment.
8) simple to operate, low to technical requirement, to operation unskilled person also can install by guider.
9) easy to use, patient is acceptant.
Accompanying drawing explanation
Fig. 1 is mounting structure schematic diagram of the present invention.
Fig. 2 is guider schematic diagram.
Fig. 3 resets for lift and struts schematic diagram.
Detailed description of the invention
Below in conjunction with accompanying drawing, the present invention is described further.
As shown in Figure 1, 2, 3, a kind of distal exterior fixation bracket of radius installation method, comprises the following steps:
(1) patient selects brachial plexus block anesthesia, anaesthetizes successfully and gets dorsal position, and suffering limb abduction position is on side stage;
(2) manual traction resets, and recovers suffering limb roughly anatomic form;
(3) be labelling with a Kirschner wire, the lower most sites of accurate marker 2,3,4,5 metacarpal bone substrate Peng of C arm perspective, skin carries out labelling, at the 2nd metacarpal bone backside of substrate, oar then, body at the bottom of metacarpal bone has a common boundary, extensor carpi radialis longus stop far-end is entry point, does a labelling with marking pen on skin, at the bottom of fifth metacarpal bone, body has a common boundary for going out pin mark, on skin, do a line by 2, and by Kirschner wire labelling, C arm perspective confirms that position meets the requirements;
(4) by after requirements of operation routine disinfection paving aseptic towel, according to the entry point of preceding mark with go out pin mark, special guider is placed;
(5) assistant keeps patient's carpal joint neutral position, and four refer to stretch position, palmar opposition of thumb pose gesture;
6) patient is by guider, bores and allows Kirschner wire accurately pass 2,3,4,5 metacarpal bone substrates along entry point, complete inserting of Kirschner wire with low speed;
(7) according to exterior fixation bracket draw-in groove position, be parallel to kirschner nail in oar side, the second metacarpal bone body back side, first place guider (paracentesis trocar), Direct perforantes arrives the 2nd metacarpal bone, drills the 2nd metacarpal bone with 2mm drill bit, installs 2.5mm metacarpal bone schanze nail;
(8) exterior fixation bracket adjusting is installed, makes exterior fixation bracket and forearm, the palm, wrist in line;
(9) according to the position of fracture line, at fracture line near-end astragalus broken line 6-8cm place, from the abductor pollicis longus of oar side and carpi radialis long, extensor hallucis brevis gap is entry point; Exterior fixation bracket draw-in groove installs paracentesis trocar, and Direct perforantes reaches radius, drills radius with 2.5mm drill bit by sleeve pipe; Install the schanze nail (once mounting does not put in place, stays a part of screw thread, be convenient to dynamic conditioning outside skin) of 4mm, same method is at the parallel first piece of schanze nail of near-end; Install one piece of schanze nail again, two nails are at a distance of more than 4cm;
(10) first lock radius near-end two pieces of schanze nails, again adjust the Distance geometry parallel relation (require certain space and can play maximum stability again, general 1-2cm) of exterior fixation bracket and suffering limb;
(11) rack far end fastening bolt is unscrewed, clockwise direction die nut rotates extension rod, and the distance length of root distance fracture compression struts, and observes reduction of the fracture situation under dynamic C arm X-ray machine, until recover original anatomic form, and carpal joint gap is made to increase 3-5mm than original;
12) if any lateral displacement, between fracture of radius line far-end and support, then place the support powder that a size is applicable to, do not loosen near-end schanze nail clip nut, direct T pulls the schanze nail that turns clockwise, get final product the radius near-end of radiad lift ulnad displacement, reach replacement and fixation object;
(13) C arm has an X-rayed confirmation again, and position, positive side of fracturing all returns to normal anatomic form, locks all fastening studs, completes hands art;
(14) postoperative brachial plexus nerve anesthetic action disappears the finger that namely comes into play, and reaches the object of early functional exercise.
Claims (1)
1. a distal exterior fixation bracket of radius installation method, is characterized in that, comprises the following steps:
1) patient selects brachial plexus block anesthesia, anaesthetizes successfully and gets dorsal position, and suffering limb abduction position is on side stage, and manual traction resets, and recovers suffering limb roughly anatomic form;
2) be labelling with a Kirschner wire, the lower most sites of accurate marker 2,3,4,5 metacarpal bone substrate Peng of C arm perspective, skin carries out labelling, at the 2nd metacarpal bone backside of substrate, oar then, body at the bottom of metacarpal bone has a common boundary, extensor carpi radialis longus stop far-end is entry point, does a labelling with marking pen on skin, at the bottom of fifth metacarpal bone, body has a common boundary for going out pin mark, on skin, do a line by 2, and by Kirschner wire labelling, C arm perspective confirms that position meets the requirements;
3) by after requirements of operation routine disinfection paving aseptic towel, according to the entry point of preceding mark with go out pin mark, special guider is placed;
4) keep patient's carpal joint neutral position, four refer to stretch position, palmar opposition of thumb pose gesture, by guider, bore and allow Kirschner wire accurately pass 2,3,4,5 metacarpal bone substrates along entry point, complete inserting of Kirschner wire with low speed;
5) according to exterior fixation bracket draw-in groove position, be parallel to kirschner nail in oar side, the second metacarpal bone body back side, first place guider (paracentesis trocar), Direct perforantes arrives the 2nd metacarpal bone, drills the 2nd metacarpal bone with 2mm drill bit, installs 2.5mm metacarpal bone schanze nail;
6) exterior fixation bracket be installed and adjust, make exterior fixation bracket and forearm, the palm, wrist in line, according to the position of fracture line, at fracture line near-end astragalus broken line 6 ~ 8cm place, from the abductor pollicis longus of oar side and carpi radialis long, extensor hallucis brevis gap is inserting needle, exterior fixation bracket draw-in groove installs paracentesis trocar, Direct perforantes reaches radius, radius is drilled by sleeve pipe with 2.5mm drill bit, install the schanze nail of 4mm, same method installs one piece of schanze nail again at the parallel first piece of schanze nail of near-end, and two nails are at a distance of more than 4cm;
7) first lock radius near-end two pieces of schanze nails, the Distance geometry parallel relation distance again adjusting exterior fixation bracket and suffering limb is 1 ~ 2cm;
8) rack far end fastening bolt is unscrewed, clockwise direction die nut rotates extension rod, and the distance length of root distance fracture compression struts, and observes reduction of the fracture situation under dynamic C arm X-ray machine, until recover original anatomic form, and carpal joint gap is made to increase 3 ~ 5mm than original;
9) if any lateral displacement, between fracture of radius line far-end and support, then place the supporter that a size is applicable to, do not loosen near-end schanze nail clip nut, directly pull with T the schanze nail that turns clockwise, get final product the radius near-end of radiad lift ulnad displacement, reach replacement and fixation object;
10) C arm has an X-rayed confirmation again, and position, positive side of fracturing all returns to normal anatomic form, locks all fastening studs, completes operation.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510625388.9A CN105286967A (en) | 2015-09-28 | 2015-09-28 | Installation method of distal radius external fixation support |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510625388.9A CN105286967A (en) | 2015-09-28 | 2015-09-28 | Installation method of distal radius external fixation support |
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| CN105286967A true CN105286967A (en) | 2016-02-03 |
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| CN201510625388.9A Pending CN105286967A (en) | 2015-09-28 | 2015-09-28 | Installation method of distal radius external fixation support |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108635030A (en) * | 2018-05-24 | 2018-10-12 | 陈金凤 | A kind of long bone fracture therapeutic device for orthopaedics |
| CN108969082A (en) * | 2018-06-27 | 2018-12-11 | 衡水增力医疗器械有限公司深州分公司 | A kind of auxiliary reset device of child femoral shaft fracture closed reduction |
| CN112220541A (en) * | 2020-11-11 | 2021-01-15 | 佳木斯大学附属第一医院 | Wrist fracture first aid external fixation support |
| CN113967062A (en) * | 2021-10-18 | 2022-01-25 | 燕山大学 | Traction fixing device for finger puncture positioning |
| CN117084732A (en) * | 2023-10-19 | 2023-11-21 | 广州医科大学附属第五医院(广州再生医学与健康广东省实验室附属医院) | Talus rear pulley focus shows serial instruments |
-
2015
- 2015-09-28 CN CN201510625388.9A patent/CN105286967A/en active Pending
Cited By (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108635030A (en) * | 2018-05-24 | 2018-10-12 | 陈金凤 | A kind of long bone fracture therapeutic device for orthopaedics |
| CN108635030B (en) * | 2018-05-24 | 2020-05-19 | 南京医科大学 | Long bone fracture treatment device for orthopedics department |
| CN108969082A (en) * | 2018-06-27 | 2018-12-11 | 衡水增力医疗器械有限公司深州分公司 | A kind of auxiliary reset device of child femoral shaft fracture closed reduction |
| CN112220541A (en) * | 2020-11-11 | 2021-01-15 | 佳木斯大学附属第一医院 | Wrist fracture first aid external fixation support |
| CN113967062A (en) * | 2021-10-18 | 2022-01-25 | 燕山大学 | Traction fixing device for finger puncture positioning |
| CN113967062B (en) * | 2021-10-18 | 2023-10-20 | 燕山大学 | Traction fixing device for finger puncture positioning |
| CN117084732A (en) * | 2023-10-19 | 2023-11-21 | 广州医科大学附属第五医院(广州再生医学与健康广东省实验室附属医院) | Talus rear pulley focus shows serial instruments |
| CN117084732B (en) * | 2023-10-19 | 2024-01-09 | 广州医科大学附属第五医院(广州再生医学与健康广东省实验室附属医院) | Talus rear pulley focus shows serial instruments |
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Application publication date: 20160203 |