CN106264694B - 爪式环形加压髌骨复位固定装置 - Google Patents
爪式环形加压髌骨复位固定装置 Download PDFInfo
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- 210000000078 claw Anatomy 0.000 title claims abstract description 64
- 210000004417 patella Anatomy 0.000 title claims abstract description 58
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 5
- 239000002184 metal Substances 0.000 claims 1
- 229910052755 nonmetal Inorganic materials 0.000 claims 1
- 208000010392 Bone Fractures Diseases 0.000 abstract description 10
- 206010017076 Fracture Diseases 0.000 abstract description 10
- 206010034122 Patella fracture Diseases 0.000 abstract description 7
- 230000000694 effects Effects 0.000 abstract description 3
- 208000024779 Comminuted Fractures Diseases 0.000 abstract description 2
- 238000006073 displacement reaction Methods 0.000 abstract description 2
- 238000000926 separation method Methods 0.000 abstract 1
- 238000010586 diagram Methods 0.000 description 3
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 239000000835 fiber Substances 0.000 description 2
- 210000000629 knee joint Anatomy 0.000 description 2
- 210000003041 ligament Anatomy 0.000 description 2
- 230000000399 orthopedic effect Effects 0.000 description 2
- 210000002435 tendon Anatomy 0.000 description 2
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 210000000845 cartilage Anatomy 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 210000003127 knee Anatomy 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 210000004285 patellofemoral joint Anatomy 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 210000000689 upper leg Anatomy 0.000 description 1
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/683—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
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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
- A61B2017/564—Methods for bone or joint treatment
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B2017/681—Alignment, compression, or distraction mechanisms
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Abstract
本发明公开了一种爪式环形加压髌骨复位内固定装置,属于医疗器械技术领域,专用于治疗髌骨骨折。该装置实现的是直视下进行髌骨骨折复位,采用线缆经多个放射状爪钩进行环抱收紧,以实现髌骨外缘全方位的向心加压固定。其创新装置是由髌骨爪和缆线组成,其中髌骨爪由中心环及连通的多个放射状排列的爪臂爪钩构成的环抱式钩状平面体,缆线穿过挂钩前端的缆线孔。使用时,用专用工具收紧线缆,使每个爪钩向心汇聚,其爪钩的尖端分别嵌入髌骨外缘骨质,髌骨爪和缆线协同作用,使骨折髌骨获得环抱加压对抗骨折上下分离及防止侧方和前后移位。该装置具有结构简单、低切迹、操作简便、复位有效、固定可靠等优势,对粉碎性骨折能获得更满意的疗效。
Description
技术领域
本发明涉及一种骨科医疗器械技术领域,具体涉及一种适合于治疗髌骨骨折的内固定装置。
背景技术
髌骨是人体骨骼中最大的籽骨,位于前部股四头肌肌腱内部,其上宽下窄呈倒三角形,高度小于宽度。髌骨的底边与尖端相比,底边更厚,髌骨的髌尖后部相对粗糙,连接髌韧带。髌骨的前面向前凸出呈球形,与股骨内外两髁之间的软骨面形成髌股关节。髌骨骨折发生率约为1%,其中髌骨粉碎性骨折的治疗最为困难。由于髌骨是人体伸膝装置的中间结构,膝关节活动也相较复杂,因此髌骨骨折多要求解剖复位,但因膝关节解剖特殊性及生物力学中扮演的杠杆作用,导致临床上髌骨骨折多固定不牢靠,固定时间过长,或解剖关系紊乱而造成髌骨正常滑动难以恢复,引起诸多后续并发症。
横行髌骨骨折常见的治疗方法包括张力带钢丝、髌骨爪等,但粉碎性骨折存在固定失效的风险问题,如何采用提高髌骨骨折的复位和固定质量,尤其是解决粉碎髌骨骨折的复位,仍是目前骨科医生亟待解决的难题。
发明内容
本发明所要解决的技术问题是提供一种爪式环形加压髌骨复位固定装置,术中将髌骨爪置于髌骨表面,各爪钩(3)置于髌骨外缘,用专用器械将对应两钩向心加压,爪臂(2)变形,爪钩(3)内聚使骨折复位,将线缆分别穿过爪钩(3)上的线缆孔,利用专用工具收缩线缆达到爪钩(3)形变向中心聚拢环形向心性加压,使爪钩(3)嵌入髌骨外缘骨质,同时线缆与髌骨外缘加压收紧及阻挡效应,以确保髌骨全方位复位,并且有效固定,防止前后及侧方移位。由于髌骨爪置于髌骨前面加之环形线缆环扎,以获得更好的张力带效应。对于髌骨粉碎性骨折通过360°环抱加压固定减少术后并发症,提高临床疗效。
解决上述技术问题的技术方案是:
直视下显露髌骨,骨折尽力复位后放置加压髌骨爪装置,在上下爪钩(3)分别纵向切开髌腱膜及髌韧带纤维,直至髌骨上下缘。将爪钩(3)置入切开的腱性纤维间,用专用加压钳分别将对应两钩挤压内收,并用带针的线缆一一穿过爪钩(3)的缆线孔(4),再分别在髌骨内外收紧线缆,使各爪钩(3)向中心聚拢,其钩尖刺入骨质。骨折髌骨在爪钩(3)和线缆同时加压获得良好的复位和坚强的固定,其钩尖的倒刺可起到固定和防退钩的作用。对于横行骨折或纵行骨折可根据具体情况剪断爪臂(2)拆除爪钩(3),以简化手术。
附图说明
1-中心环,2-爪臂,3-爪钩,4-缆线孔,5-缆线,6-穿孔针
图一为爪式环形加压髌骨复位内固定装置之俯视图
图二为爪式环形加压髌骨复位内固定装置之俯视并穿有缆线示意图
图三为爪式环形加压髌骨复位内固定装置之仰视图
图四为爪式环形加压髌骨复位内固定装置之仰视并穿有缆线示意图
图五为爪式环形加压髌骨复位内固定装置之仰视图髌骨复位示意图
图六为爪式环形加压髌骨复位内固定装置之左右爪臂工作示意图
图七为爪式环形加压髌骨复位内固定装置之上下爪臂示意图
图八为爪式环形加压髌骨复位内固定装置之带穿针器的缆线示意图
图九为爪式环形加压髌骨复位内固定装置之缆线穿过缆线孔示意图
图十为爪式环形加压髌骨复位内固定装置之爪钩带倒刺示意图
图十一为爪式环形加压髌骨复位内固定装置之爪钩倒梯形示意图
图十二为爪式环形加压髌骨复位内固定装置之髌骨爪侧面工作示意图
Claims (1)
1.一种爪式环形加压髌骨复位内固定装置,包括髌骨爪和缆线(5),其特征是髌骨爪为一个中心环(1)放射状连接6-14个弧形的爪钩(3)构成的环抱式爪钩体;每个爪钩的尖端设有一个缆线孔(4),以供缆线(5)穿过;缆线(5)为金属或非金属缆线,一端固定连接穿孔针(6), 使用时借助穿孔针引导,将缆线(5)顺序穿过各爪钩的缆线孔(4),利用专用工具收紧缆线使爪钩(3)形变向中心聚拢实现环形向心性加压,并使爪钩(3)嵌入髌骨外缘骨质;
所述的髌骨爪为中心环(1)、爪臂(2)和爪钩(3)三部分构成的环抱式爪钩体,中心环(1)为圆形或椭圆形,中心环(1)外缘连接6-14个放射状排列的爪臂(2)和爪钩(3),中心环的底面呈与髌骨表面解剖弧面一致的球窝状,以保证与髌骨表面的贴符性;
所述的爪钩(3)为爪臂(2)的延伸,呈钩状,在爪臂(2)与爪钩(3)的起始部厚度逐渐增加,至钩顶最厚,以保证爪钩(3)的刚度,爪钩(3)的尖端尖锐,爪钩底面设有倒刺,爪钩(3)截面为倒梯形,并横向设置一个所述缆线孔(4),供所述缆线(5)穿过;
爪臂(2)为中心环(1)与爪钩(3)之间连接的部位,其中上爪臂长,下爪臂短,爪臂(2)底面呈与髌骨表面弧度相一致的弧度,爪臂(2)截面厚度小于或等于中心环(1)厚度,以保证加压时爪臂(2)弧度加大变形。
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CN108309419A (zh) * | 2018-02-05 | 2018-07-24 | 沈影超 | 一种捆扎式防滑的髌骨爪 |
CN111616786B (zh) * | 2020-04-19 | 2022-10-18 | 河南科技大学第一附属医院 | 用于髌骨骨折的接骨装置 |
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US20160022337A1 (en) * | 2014-07-26 | 2016-01-28 | Empire Technology Development Llc | Compression clip for fractured bone |
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CN2551205Y (zh) * | 2001-09-03 | 2003-05-21 | 张春才 | 骶髂关节记忆固定器 |
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