CN106618719B - Hollow lag screw guide pin aiming fixer for reduction through posterior femoral lesser tuberosity - Google Patents
Hollow lag screw guide pin aiming fixer for reduction through posterior femoral lesser tuberosity Download PDFInfo
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- CN106618719B CN106618719B CN201710019272.XA CN201710019272A CN106618719B CN 106618719 B CN106618719 B CN 106618719B CN 201710019272 A CN201710019272 A CN 201710019272A CN 106618719 B CN106618719 B CN 106618719B
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8897—Guide wires or guide pins
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/171—Guides or aligning means for drills, mills, pins or wires for external fixation
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
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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
- A61B17/74—Devices for the head or neck or trochanter of the femur
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
- A61B2017/922—Devices for impaction, impact element
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- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
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Abstract
The invention discloses a hollow lag screw guide pin aiming fixator capable of being reset through a small tuberosity of a posterior femur, which comprises an arc guide frame, wherein one end of the arc guide frame is provided with a reset frame, and the other end of the arc guide frame is provided with a combined sleeve moving along the arc guide frame; the tail end of the reset frame is connected with the arc guide frame, the front end of the reset frame is provided with a reset hook, and the reset frame is provided with a limit groove; the combined sleeve comprises an outer cylinder and an inner cylinder, the inner cylinder is coaxially movable in the outer cylinder, and the outlet ends of the inner cylinder and the outer cylinder are provided with sharp claws; the combined sleeve always points to the circle center of the arc guide frame in the moving process of the arc guide frame. This hollow lag screw guide pin that resets through little tuberosity of back femoral inserts from the rear when aiming the fixer operation, pushes away muscle with the arc form reset frame in the place ahead, resets the hook and hooks little tuberosity fracture piece and to the tractive of back below, can avoid the slip of this aiming the fixer in addition square spacing groove, and the effect that resets is directly reliable.
Description
Technical Field
The invention relates to the field of orthopedic surgery equipment, relates to a guide pin sighting device, and particularly relates to a hollow lag screw guide pin sighting fixer for reduction through a small tuberosity of a posterior femur.
Background
The intertrochanteric fracture of femur is a common fracture in orthopedics clinic, and the defect of a fracture stress side fulcrum caused by poor reduction and fixation of a small intertrochanteric fracture block is a key reason of internal fixation failure (causing screw loosening and withdrawing, steel plate fracture, re-fracture, hip varus deformity and the like) of intertrochanteric fracture of femur. Due to the special anatomical position of the small trochanter of the femur (which is positioned at the inner side of the rear part of the femur and is the insertion point of the iliocostalis muscle), the small trochanter fracture block can be pulled by the iliocostalis muscle to move forwards and upwards after fracture and the position is deep, so that the small trochanter fracture block can not be exposed and reset directly in the operation; and the minor trochanter is located medially and posteriorly of the proximal femur, the optimal direction for screw fixation should be from the anterior-lateral to the posterior-medial side of the proximal femur after fracture block reduction.
Most of the current clinical operations use a bone hook to reset from the front, but the resetting effect is poor and the small tuberosity cannot be effectively fixed; in addition, the existing minor tuberosity resetting device is also inserted from the front of the proximal end of the femur in the operation so as to hook and reset the minor tuberosity fracture block by using the tip of the device, but the device also has poor resetting effect, and a guide pin and a fixing screw cannot be placed in an ideal direction, so that the injury of anterior and medial tissues is caused due to the excessive traction on soft tissues, and the iatrogenic injury of posterior structures such as sciatic nerves is easily caused due to the lack of blockage of the guide pin during the drilling, so that the injury of peripheral tissues caused by the operation is extremely large.
There is currently no special device available for inserting and repositioning from the posterior side of the proximal femur and simultaneously compression-fixing small tuberosity fractures.
Disclosure of Invention
The invention aims to provide a hollow lag screw guide pin aiming fixator capable of being reset through the small tuberosity of the femoral bone on the back side, which has a simple structure, is convenient to use, is safe and reliable, is inserted from the back during an operation and effectively avoids the damage to the surrounding tissues.
In order to achieve the purpose, the technical scheme of the invention is as follows: the hollow lag screw guide pin aiming fixator capable of being reset through the small tuberosity of the posterior femur is provided, wherein the hollow lag screw guide pin aiming fixator comprises an arc guide frame, one end of the arc guide frame is provided with a reset frame, and the other end of the arc guide frame is provided with a combined sleeve moving along the arc guide frame; the tail end of the reset frame is connected with the arc guide frame, the front end of the reset frame is provided with a reset hook, and the reset frame is provided with a limit groove; the combined sleeve comprises an outer cylinder and an inner cylinder, the inner cylinder is coaxially movable in the outer cylinder, and the outlet ends of the inner cylinder and the outer cylinder are both provided with sharp claws; the combined sleeve always points to the circle center of the arc guide frame in the moving process of the arc guide frame.
Furthermore, an axial hole for placing the Kirschner wire is formed in the inner cylinder.
Further, the front end part of the reset frame is bent to form an arc-shaped stripping piece.
Furthermore, the tail end of the reset frame is connected with the arc guide frame through a fixing block, a through groove for the reset frame to be fixedly placed is formed in the fixing block, the reset frame can move along the through groove, and therefore the position of the tip outlet of the Kirschner wire, located at the small tuberosity, can be adjusted in different directions such as up, down, inside and outside.
Furthermore, the combined sleeve is connected with the arc guide frame through a sliding block, a through groove for the arc guide frame to be placed and fixed is formed in the upper end of the sliding block, and the arc guide frame can move along the through groove; the lower end of the sliding block is provided with a sleeve groove for the combined sleeve to be placed into and fixed, and the combined sleeve can move along the sleeve groove.
Furthermore, scales are arranged on the arc guide frame.
Furthermore, the upper end of the sleeve sliding block is provided with an adjusting and locking device, so that the sleeve sliding block is fixed on the arc guide frame.
Furthermore, an adjusting and locking device is arranged below the sleeve sliding block, so that the combined sleeve is fixed on the sleeve sliding block.
Furthermore, an adjusting and locking device is arranged on the fixing block, so that the resetting frame is fixed on the fixing block.
Furthermore, the limit groove is positioned between the reset hook and the fixed block and is close to the reset hook; the reset hook is positioned on the inner side of the front end of the reset frame.
The hollow lag screw guide pin aiming fixator for reduction through the small tuberosity of the posterior femur has the following beneficial effects:
1. the hollow lag screw guide pin aiming fixator for reduction through the small tuberosity of the posterior femur has the advantages of simple structure, convenience in use, safety, reliability, accurate reduction and accurate pressurization fixation on the basis of maintaining reduction of a fracture block.
2. This hollow lag screw guide pin that resets through little tuberosity of back femoral inserts from the rear when aiming the fixer operation, pushes away muscle with most advanced arc stripper, resets the hook and hooks little tuberosity fracture piece and to the tractive of back below, can avoid the slip of this aiming the fixer in addition square spacing groove, and the effect that resets is direct reliable.
3. The approach between the outer sleeve sharp claw and the reset hook is utilized to reset the fracture block, so that the fracture block is convenient, quick and effective;
4. after the fracture is reset, the outer sleeve can be locked by adjusting the locking device, and the small tuberosity fracture block can be stabilized;
5. due to the blocking of the front reset hook, the Kirschner wire cannot be overlong to cause auxiliary damage, and the length of the required screw is extremely easy to measure;
6. in the process of moving the combined sleeve, the combined sleeve always points to the circle center (the small tuberosity fracture part) of the arc guide frame, and the combined sleeve is accurate and reliable;
7. after the outer barrel is fixed and the fracture block is reset, the operations of drilling the Kirschner wire, drilling the hollow drill, measuring the depth, screwing the screw and the like through the inner barrel are all implemented in the outer barrel, and the damage to surrounding tissues is effectively avoided.
Drawings
FIG. 1 is a schematic structural view of a hollow lag screw guide pin aiming fixture for reduction through a posterior femoral lesser tuberosity according to the present invention;
in the figure: 1. a circular arc guide frame; 2. adjusting the locking bolt; 3. a combination sleeve; 4. a sharp claw; 5. a reset hook; 6. a limiting groove; 7. a reset frame; 8. a fixed block; 9. adjusting the locking bolt; 10. a sleeve groove; 11. adjusting the locking bolt; 12. a sleeve slider; 13. an arcuate stripper member.
Detailed Description
In order to explain the technical content and the structural characteristics of the hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity of the invention in detail, the following combined embodiment is further explained with the accompanying drawings.
As shown in fig. 1, the hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity comprises an arc guide frame 1, wherein one end of the arc guide frame 1 is provided with a reduction frame 7, and the other end of the arc guide frame 1 is provided with a combined sleeve 3 moving along the arc guide frame, and the concrete structure is as follows:
the tail end of the reset frame 7 is connected with the arc guide frame 1 through the fixing block 8, the front end part of the reset frame 7 is bent to form an arc-shaped stripping part 13, the inner side of the front end is provided with the reset hook 5, the arc-shaped stripping part 13 is positioned in front of the reset hook 5 and is opposite in direction (the reset hook 5 is positioned on the inner side of the reset frame, and the arc-shaped stripping part 13 is positioned on the outer side of the reset frame); the reset frame 7 is provided with a square limit groove 6, and the limit groove 6 is positioned between the reset hook 5 and the fixed block 8 and is close to the reset hook 5. The fixing block 8 is provided with a through groove for the reset frame 7 to be placed into, the reset frame can move along the through groove, after the reset frame moves, the reset frame 7 is fixed on the fixing block by adjusting the locking device, and the adjusting locking device is an adjusting locking bolt 9.
The combined sleeve 3 comprises an outer cylinder and an inner cylinder, the inner cylinder coaxially moves in the outer cylinder, and the outlet ends of the inner cylinder and the outer cylinder are both provided with a sharp claw 4; the combined sleeve 3 always points to the circle center of the arc guide frame in the moving process of the arc guide frame. An axial hole for placing the Kirschner wire is arranged in the inner cylinder. The inner tube is two-layer (well section of thick bamboo and little section of thick bamboo) at least, and the fixed kirschner wire after the axial hole of the little section of thick bamboo of inlayer matches with the kirschner wire external diameter, and the internal diameter of well section of thick bamboo matches with the external diameter of core drill, plays the guide effect of core drill, ensures that the direction of core drill is not squinted all the time, reaches the purpose that high accuracy bored into.
The combined sleeve 3 is connected with the arc guide frame 1 through the sleeve sliding block 12, a through groove for the arc guide frame to be fixedly arranged is formed in the upper end of the sliding block 12, the arc guide frame can move along the through groove, after the arc guide frame moves, the sleeve sliding block is fixed on the arc guide frame through adjusting the locking device, and the adjusting and locking device is used for adjusting the locking bolt 2. The lower end of the sliding block 12 is provided with a sleeve groove 10 for placing the combined sleeve into the fixed sleeve, the combined sleeve can move along the sleeve groove 10, after moving, the combined sleeve is fixed on the sleeve sliding block by adjusting a locking device, and the adjusting locking device is an adjusting locking bolt 11.
The arc guide frame 1 is provided with scales.
The use process of the hollow lag screw guide pin aiming fixator for reduction through the small tuberosity of the posterior femur comprises the following steps:
1. when in operation, the bone is inserted from the back, the arc stripping piece at the tip is used for pushing away muscles, and the reduction hook hooks the small tuberositas fracture block to draw the reduction fracture block towards the back lower part;
2. the fracture block is restored by closing the outer sleeve between the sharp claw and the restoration hook;
3. after resetting, the outer sleeve can be locked by adjusting the locking bolt;
5. after the outer cylinder is fixed and the fracture block is reset, the inner cylinder is inserted into the outer cylinder and a Kirschner wire is drilled into the central axial hole of the inner cylinder, and the Kirschner wire penetrates through the inner cylinder and the femur and then penetrates through the small tuberosity; because the front reset hook and the limit groove block, the Kirschner wire cannot be overlong to cause auxiliary damage.
6. Keeping the outer cylinder fixed and maintaining the fracture block to reset, firstly taking out the innermost small cylinder and along the direction of the Kirschner wire, drilling a hollow drill along the inner diameter of the middle cylinder, and taking out the middle cylinder after the hollow drill is placed.
7. The operations of measuring the length of the required screw, screwing the screw and the like are carried out in the outer barrel.
The above disclosure is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the scope of the present invention, therefore, the present invention is not limited by the appended claims.
Claims (8)
1. The hollow lag screw guide pin that resets through little tuberosity of rear side femoral aims the fixer, its characterized in that: the device comprises an arc guide frame, wherein one end of the arc guide frame is provided with a reset frame, and the other end of the arc guide frame is provided with a combined sleeve moving along the arc guide frame; the tail end of the reset frame is connected with the arc guide frame, the front end of the reset frame is provided with a reset hook, and the reset frame is provided with a limit groove; the combined sleeve comprises an outer cylinder and an inner cylinder, the inner cylinder is coaxially movable in the outer cylinder, and the outlet ends of the inner cylinder and the outer cylinder are provided with sharp claws; the combined sleeve moves along the arc guide frame, and the sharp claw always points to the circle center of the arc guide frame; an axial hole for placing a Kirschner wire is formed in the inner cylinder, and the front end part of the reset frame is bent to form an arc-shaped stripping piece.
2. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 1, wherein: the tail end of the reset frame is connected with the arc guide frame through the fixing block, the fixing block is provided with a through groove for the reset frame to be fixedly placed, and the reset frame can move along the through groove.
3. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 1, wherein: the combined sleeve is connected with the arc guide frame through a sleeve sliding block, a through groove for the arc guide frame to be placed and fixed is formed in the upper end of the sleeve sliding block, and the arc guide frame can move along the through groove; the lower end of the sleeve sliding block is provided with a sleeve groove for the combined sleeve to be placed into and fixed, and the combined sleeve can move along the sleeve groove.
4. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 1, wherein: and scales are arranged on the arc guide frame.
5. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 3, wherein: and an adjusting and locking device is arranged at the upper end of the sleeve sliding block, so that the sleeve sliding block is fixed on the arc guide frame.
6. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 3, wherein: and an adjusting and locking device is arranged below the sleeve sliding block, so that the combined sleeve is fixed on the sleeve sliding block.
7. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 2, wherein: and the fixed block is provided with an adjusting and locking device, so that the reset frame is fixed on the fixed block.
8. The hollow lag screw guide pin aiming fixture for reduction through the posterior femoral lesser tuberosity as claimed in claim 1, wherein: the limiting groove is positioned between the reset hook and the fixing block and is close to the reset hook; the reset hook is positioned on the inner side of the front end of the reset frame.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710019272.XA CN106618719B (en) | 2017-01-11 | 2017-01-11 | Hollow lag screw guide pin aiming fixer for reduction through posterior femoral lesser tuberosity |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710019272.XA CN106618719B (en) | 2017-01-11 | 2017-01-11 | Hollow lag screw guide pin aiming fixer for reduction through posterior femoral lesser tuberosity |
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| CN106618719A CN106618719A (en) | 2017-05-10 |
| CN106618719B true CN106618719B (en) | 2023-04-18 |
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Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109730756A (en) * | 2018-12-24 | 2019-05-10 | 宁波市第六医院 | Fracture removing aims at locator |
| CN112168279B (en) * | 2020-08-28 | 2021-07-13 | 中南大学湘雅医院 | Intramedullary fixed drilling support for femoral head |
| CN112089475B (en) * | 2020-08-28 | 2021-07-13 | 中南大学湘雅医院 | Femoral head marrow external fixation type drilling support |
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| EP0347874A2 (en) * | 1988-06-24 | 1989-12-27 | Dunsch-Herzberg, Renate | Device for the fixation of a broken bone, in particular in the region of the femoral neck |
| CN2367262Y (en) * | 1999-02-01 | 2000-03-08 | 广州市中医医院 | Thigh-bone small tuberosity resetting fixer |
| WO2011002903A2 (en) * | 2009-06-30 | 2011-01-06 | Kohsuke Watanabe | Orthopaedic implant and fastener assembly |
| CN203400194U (en) * | 2013-07-08 | 2014-01-22 | 周军 | Thighbone lesser trochanter reposition fixer with guide device |
| CN203524755U (en) * | 2013-10-28 | 2014-04-09 | 韩文冬 | Reduction fixator for small femoral trochanter fracture |
| WO2015122807A1 (en) * | 2014-02-12 | 2015-08-20 | Swemac Innovation Ab | Targeting device and method |
| CN205251675U (en) * | 2015-11-29 | 2016-05-25 | 戚珊红 | Empty core rod and cortex of bone fixing device that interlocking intramedullary nail distal end aimed |
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