CN107174324B - Minimally invasive repairing device for dislocation of acromioclavicular joint - Google Patents
Minimally invasive repairing device for dislocation of acromioclavicular joint Download PDFInfo
- Publication number
- CN107174324B CN107174324B CN201710494014.7A CN201710494014A CN107174324B CN 107174324 B CN107174324 B CN 107174324B CN 201710494014 A CN201710494014 A CN 201710494014A CN 107174324 B CN107174324 B CN 107174324B
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- China
- Prior art keywords
- guide
- coracoid
- rod
- positioning
- hole
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- 210000000142 acromioclavicular joint Anatomy 0.000 title description 27
- 238000000034 method Methods 0.000 claims abstract description 41
- 210000001991 scapula Anatomy 0.000 claims abstract description 18
- 210000002659 acromion Anatomy 0.000 claims description 16
- 210000003109 clavicle Anatomy 0.000 claims description 11
- 208000014674 injury Diseases 0.000 abstract description 2
- 230000008733 trauma Effects 0.000 abstract 1
- 210000003041 ligament Anatomy 0.000 description 11
- 238000005553 drilling Methods 0.000 description 6
- 206010023204 Joint dislocation Diseases 0.000 description 5
- 229910000831 Steel Inorganic materials 0.000 description 5
- 210000000988 bone and bone Anatomy 0.000 description 5
- 239000010959 steel Substances 0.000 description 5
- 230000033001 locomotion Effects 0.000 description 4
- 230000006378 damage Effects 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 230000000149 penetrating effect Effects 0.000 description 2
- 206010060820 Joint injury Diseases 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 210000000845 cartilage Anatomy 0.000 description 1
- 210000000852 deltoid muscle Anatomy 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
Classifications
-
- 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
-
- 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
-
- 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
-
- 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
Abstract
The utility model provides a dislocation minimally invasive prosthetic devices, two needle guide pipes that lead to the kirschner wire pass through the connecting rod and connect, are equipped with the stand pipe of taking the guiding hole on the connecting rod, have the coracoid process locating lever of following the guiding hole removal in addition, and the tip of this coracoid process locating lever is equipped with the location hook plate that sets up in the scapula coracoid process below, and it has two locating holes that overlap each other with the axis of two needle guide pipe through-holes respectively to open on the location hook plate, still is equipped with the hasp of fixing in a certain position with coracoid process locating lever on the stand pipe. The device has the advantages of simple structure, convenient operation, small trauma and high safety, can effectively reduce the learning curve of the operation, improve the accuracy and safety of the operation, and can be used for converting the traditional operation into quantized and standardized accurate operation.
Description
Technical Field
The invention relates to medical equipment, in particular to a minimally invasive repair device for treating acromioclavicular joint dislocation.
Background
The acromioclavicular joint is a plane joint of the shoulder of the human body and can do micro motion in all directions. As shown in fig. 1, the acromioclavicular joint is composed of the acromion 102 end joint surface of the clavicle 101 and the scapula coracoid 104 of the scapula 103. The acromioclavicular joint is damaged due to violence in movement, and is particularly characterized by subversion of scapula, downward movement of acromion and upturned distal end of collarbone, resulting in damage of ligaments and muscles around the acromioclavicular joint and dislocation of the acromioclavicular joint. Different treatment schemes can be adopted for the acromioclavicular joint injuries with different degrees, such as triangular towel fixation, drug treatment or repair by operation, and common operation methods include acromioclavicular joint incision reduction internal fixation, coracoid ligament reconstruction or fixation, collarbone external end excision, muscle dynamic reconstruction and the like.
The existing internal fixation mainly adopts a common internal fixation material of orthopaedics, namely a Kirschner wire for fixation, in the operation process, an arc incision from the distal end of a collarbone to the coracoid process is firstly needed to be taken, a acromioclavicular joint is exposed, a cartilage disc in the joint is cleared, the first Kirschner wire is drilled from a lower position of the acromion, the Kirschner wire enters the distal end of the collarbone through the acromioclavicular joint, the needle insertion depth is 5cm, the 2 nd Kirschner wire is drilled in the same way and is crossed with the first Kirschner wire, and the needle tail is left outside the skin to form a 90-degree angle; exposing coracoid process via deltoid muscle, freeing coracoid ligament, and cutting coracoid ligament acromion end; then, the broken ends of the coracoid ligaments are sutured with a plurality of absorbable threads, and the coracoid ligaments are dissociated to coracoid processes for later use; two holes are drilled on the cortex of the 1.5cm distance from the acromioclavicular joint at the distal end of the collarbone, the coracoid ligament with absorbable suture is pulled out through the collarbone hole, and the coracoid ligament is pulled out and tied, so that the ligament is fixed on the collarbone. Another method is to cut the distal end of the collarbone and fix the distal end by using a collarbone hook steel plate, and the method has larger damage and has no reconstruction of structures such as coracoid ligaments and the like, so that the treatment effect is not ideal. In recent years, along with popularization of arthroscope technology, a good effect is achieved by reconstructing a minimally invasive coracoid ligament under a shoulder arthroscope, but the method is complex in operation process, extremely high in personal technical level requirements on operating doctors, long in growth period required by learning technology and difficult to master in a short period, meanwhile, a special acromioclavicular joint repair tool is still lacking at present, so that the operation difficulty is huge, the time consumption is long, the effective control and the grasping are difficult, and the operation and the rehabilitation of patients are not facilitated.
Disclosure of Invention
The invention aims to provide a minimally invasive repair device for treating acromioclavicular joint dislocation, so as to reduce the operation difficulty and improve the operation precision.
The minimally invasive repair device for dislocation of the acromioclavicular joint comprises two needle guide pipes for guiding a Kirschner wire, wherein axial through holes are formed in the needle guide pipes, and the axial directions of the two needle guide pipe through holes simultaneously point to the acromion end of a clavicle and the coracoid process of the scapula; the middle parts of the two needle guide pipes are connected through a connecting rod, a guide pipe is arranged on the connecting rod, a guide hole is formed in the guide pipe, and the direction of the guide hole is positioned at the acromion end of the clavicle and the outer side of the coracoid process of the scapula; the coracoid positioning rod moves along the guide hole, a positioning hook plate is arranged at the bottom end of the coracoid positioning rod, the positioning hook plate is positioned below the coracoid of the scapula, two positioning holes are formed in the coracoid positioning rod, and the axes of the two positioning holes are respectively overlapped with the axes of the two needle guide tube through holes; the guide tube is also provided with a lock catch for fixing the coracoid locating rod at a certain position.
According to the minimally invasive repair device for dislocation of the acromioclavicular joint, the two needle guide pipes, the connecting rod and the guide pipe are connected into a whole, wherein the two needle guide pipes can guide the Kirschner wire, the guide pipe and the coracoid positioning rod are mutually oriented and limited, and the two Kirschner wires sequentially penetrate through the clavicle acromion and the coracoid process of the scapula and then respectively penetrate into the two positioning holes on the positioning hook plate. When the device is used for repairing the acromioclavicular joint, a Kirschner wire is used for penetrating from the acromion end to temporarily fix the acromioclavicular joint, an approximate incision is made at the level of the coracoid process on the collarbone, the incision is clung between the front edge of the collarbone and the outer edge of the coracoid process, and then a coracoid process positioning rod is stretched in from the incision under the monitoring of a shoulder arthroscope until a positioning hook plate at the end part of the coracoid process is placed below the coracoid process of the scapula, and a positioning hole on the positioning hook plate is positioned at a required proper position; then, a guide hole of the guide tube is sleeved on the coracoid positioning rod so that the guide tube slides in along the coracoid positioning rod until the end part of a needle catheter connected with the guide tube is tightly attached to the central position of the upper edge bone surface of the collarbone, and then the guide tube and the coracoid positioning rod are mutually locked and fixed by utilizing a lock catch; sequentially drilling a Kirschner wire along the through holes of the two needle guide pipes, drilling holes on the acromion of the clavicle and the coracoid process of the scapula by using the Kirschner wire, releasing the lock catch after drilling holes are finished, and removing the repairing device; finally, threading the belt loop steel plate from the bone canal drilled by the Kirschner wire in sequence according to the traditional method, knotting the fixed steel plate, and removing the Kirschner wire used for temporary fixation at the shoulder, thereby completing the operation of the whole operation. The minimally invasive repair device is simple in structure, and only comprises the sighting frame consisting of the needle guide tube, the connecting rod and the guide tube and the coracoid process positioning rod with the positioning hook plate, so that the minimally invasive repair device is extremely convenient to operate, small in wound and high in safety, and can be safely operated without special experience, the accuracy and safety in the operation process are effectively improved, and the operation time is shortened; meanwhile, the learning curve of the operation is shortened, and the difference of the operation effect caused by the personal technical difference of doctors is eliminated; the occurrence rate of postoperative complications can be greatly reduced, the traditional operation is evolved into quantitative and standardized accurate operation, a new method is provided for rapid and accurate positioning in operation of an operator, and the difference of the technical levels of the operations of different medical institutions is reduced, so that a new thought is provided for solving the medical problems of excessive concentration of medical resources and the like caused by the difference of the technical levels in China to a certain extent.
Drawings
Fig. 1 is a schematic diagram of the skeleton structure of a acromioclavicular joint.
Fig. 2 is a schematic structural view of the minimally invasive acromioclavicular joint dislocation repairing device.
Fig. 3 is a schematic view of the connection structure of the catheter, the link and the guide tube.
Fig. 4 and 5 are schematic views of the state change of the minimally invasive acromioclavicular joint dislocation repair device.
Fig. 6, 7 and 8 are schematic views of the use state of the minimally invasive acromioclavicular joint dislocation repair device.
Fig. 9 is a schematic view of an aperture of a acromioclavicular joint.
Fig. 10 is a schematic structural view of the guide tube.
Fig. 11 is a schematic structural view of the coracoid positioning rod.
Fig. 12 is a schematic structural view of the shackle.
Description of the embodiments
The minimally invasive repair device for dislocation of acromioclavicular joint comprises two needle guide tubes 1 for guiding a Kirschner wire 200, wherein axial through holes are formed in the needle guide tubes, and the axial directions of the two needle guide tube through holes simultaneously point to the acromion end of clavicle and coracoid process of scapula; the middle parts of the two needle catheters are connected through a connecting rod 2, a guide tube 3 is arranged on the connecting rod, a guide hole 4 is formed in the guide tube, and the direction of the guide hole is positioned at the outer sides of the acromion of the clavicle and the coracoid process of the scapula; the coracoid positioning rod 5 moves along the guide hole, the bottom end of the coracoid positioning rod is provided with a positioning hook plate 6, the positioning hook plate is positioned below the coracoid of the scapula, two positioning holes 7 are formed in the positioning hook plate, and the axes of the two positioning holes are respectively overlapped with the axes of the two needle guide tube through holes; the guide tube is also provided with a lock catch 8 for fixing the coracoid positioning rod at a certain position.
As shown in fig. 3-5, the two needle guide tubes, the connecting rod and the guide tube are connected with each other to form an integral aiming bracket, wherein the two needle guide tubes can guide the kirschner wires, the guide tube and the coracoid positioning rod are mutually oriented and limited, and the two kirschner wires sequentially penetrate through the clavicle acromion and the coracoid of the scapula and then respectively penetrate into the two positioning holes on the positioning hook plate. When the device is used for repairing the acromioclavicular joint, a Kirschner wire is used for penetrating from the acromion end to temporarily fix the acromioclavicular joint, an approximate incision is made at the level of the coracoid process on the collarbone, the incision is clung between the front edge of the collarbone and the outer edge of the coracoid process, and then a coracoid process positioning rod is extended into the incision until a positioning hook plate at the end part of the coracoid process is placed below the coracoid process of the scapula, and a positioning hole on the positioning hook plate is positioned at a required proper position, as shown in fig. 6; then, the guide hole of the guide tube is sleeved on the coracoid positioning rod so that the guide tube slides in along the coracoid positioning rod until the end part of the needle guide tube connected with the guide tube is tightly attached to the central position of the upper edge bone surface of the collarbone, and then the guide tube and the coracoid positioning rod are mutually locked and fixed by utilizing a lock catch, as shown in fig. 7; then, sequentially drilling a Kirschner wire along the through holes of the two needle catheters, and drilling holes on the clavicle acromion and the coracoid process by using the Kirschner wire to form a hole site 105, as shown in figures 8 and 9; after the drilling is finished, the lock catch is released, the repairing device is removed, and finally, the belt loop steel plate can be brought in through threading from the bone canal drilled by the Kirschner wire in sequence according to the traditional method, then the fixed steel plate is knotted, and the Kirschner wire used for temporary fixation at the shoulder is removed, so that the operation of the whole operation is completed.
As shown in fig. 10 and 11, the guiding hole 4 of the guiding tube 3 comprises a guiding through hole 41 and a guiding chute 42 which are parallel to each other in the axial direction, and one side of the guiding chute is communicated with the side edge of the guiding through hole; the coracoid positioning rod 5 comprises a guide rod 51 matched with the guide through hole, and a limiting rod 52 matched with the guide chute is arranged on one side of the guide rod facing the positioning hook plate 6; the length of the limiting rod 52 is smaller than that of the guide rod 51, and two ends of the limiting rod are arranged at the top and middle positions of the guide rod. The guide hole and the coracoid positioning rod are simple in structure, high in matching strength and convenient to move relatively between the guide hole and the coracoid positioning rod, and the limiting rod is arranged at the upper part and the middle part of the guide rod, so that the cross section of the lower part of the coracoid positioning rod is smaller, the coracoid positioning rod is more convenient to place closely to a bone, and the operation convenience of the coracoid positioning rod can be improved.
As shown in fig. 10 and 12, the lock catch 8 comprises a buckle seat 81 fixedly mounted on the guide tube 3 and a buckle 82 hinged on the buckle seat, and a torsion spring is arranged between the buckle seat and the buckle and has a tendency of driving the end part of the buckle to press against the coracoid process positioning rod 5. The guide tube and the coracoid positioning rod can be mutually positioned by matching the buckle and the coracoid positioning rod, a plurality of inwards concave clamping grooves can be formed on one side of the coracoid positioning rod 5 at intervals along the axial direction, and one end of the lock catch 8, which faces the guide hole 4, can be clamped into or withdrawn from the clamping grooves to be mutually fixed with the coracoid positioning rod; and because the hasp is located in the human body, in order to improve its convenience of operation, can set up the one side of coracoid process locating lever 5 and the terminal surface of buckle 82 towards guiding hole 4 one end to have the one-way locking surface of certain tapering for the stand pipe can only slide in along coracoid process locating lever and can not reverse roll-off, lock both from this, until need release the locking between the two can, press the hasp, this kind of simple structure just easily operates, can reduce the possibility to human injury, avoid unnecessary wrong relative movement between stand pipe and the coracoid process locating lever through the setting of this kind of structure, guarantee the safe going on of operation.
Claims (4)
1. The utility model provides a dislocation minimally invasive prosthetic devices which characterized in that: comprises two needle guide pipes (1) for guiding the Kirschner wire, wherein the needle guide pipes are provided with axial through holes, and the axial directions of the two needle guide pipe through holes simultaneously point to the acromion end of the clavicle and the coracoid process of the scapula; the middle parts of the two needle catheters are connected through a connecting rod (2), a guide tube (3) is arranged on the connecting rod, a guide hole (4) is formed in the guide tube, and the direction of the guide hole is positioned at the outer sides of the acromion end of the clavicle and the coracoid process of the scapula; the coracoid positioning rod (5) moves along the guide hole, the bottom end of the coracoid positioning rod is provided with a positioning hook plate (6), the positioning hook plate is positioned below the coracoid of the scapula, two positioning holes (7) are formed in the positioning hook plate, and the axes of the two positioning holes are respectively overlapped with the axes of the two needle guide tube through holes; a lock catch (8) for fixing the coracoid positioning rod at a certain position is also arranged on the guide tube; the guide hole (4) of the guide pipe (3) comprises a guide through hole (41) and a guide chute (42) which are mutually parallel in the axial direction, and one side of the guide chute is mutually communicated with the side edge of the guide through hole; the coracoid positioning rod (5) comprises a guide rod (51) matched with the guide through hole, and a limiting rod (52) matched with the guide chute is arranged on one side of the guide rod facing the positioning hook plate (6); the lock catch (8) comprises a buckle seat (81) fixedly installed on the guide tube (3) and a buckle (82) hinged to the buckle seat, a torsion spring is arranged between the buckle seat and the buckle, and the torsion spring has a trend of driving the end part of the buckle to press the coracoid locating rod (5).
2. The acromioclavicular dislocation minimally invasive prosthetic device of claim 1, wherein: the length of the limiting rod (52) is smaller than that of the guide rod (51), and two ends of the limiting rod are arranged at the top and middle positions of the guide rod.
3. The acromioclavicular dislocation minimally invasive prosthetic device of claim 1 or 2, wherein: one side of the coracoid positioning rod (5) is provided with a plurality of inwards concave clamping grooves at intervals along the axial direction, and one end of the lock catch (8) facing the guide hole (4) can be clamped into or withdrawn from the clamping grooves to be mutually fixed with the coracoid positioning rod.
4. The acromioclavicular dislocation minimally invasive prosthetic device of claim 1 or 2, wherein: one side of the coracoid positioning rod (5) and the end face of the buckle (82) facing one end of the guide hole (4) are provided with one-way locking surfaces with a certain taper.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710494014.7A CN107174324B (en) | 2017-06-26 | 2017-06-26 | Minimally invasive repairing device for dislocation of acromioclavicular joint |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710494014.7A CN107174324B (en) | 2017-06-26 | 2017-06-26 | Minimally invasive repairing device for dislocation of acromioclavicular joint |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN107174324A CN107174324A (en) | 2017-09-19 |
| CN107174324B true CN107174324B (en) | 2023-10-31 |
Family
ID=59845304
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710494014.7A Active CN107174324B (en) | 2017-06-26 | 2017-06-26 | Minimally invasive repairing device for dislocation of acromioclavicular joint |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN107174324B (en) |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2419940Y (en) * | 2000-04-29 | 2001-02-21 | 佟杰 | Two Purpose external fixed for curing clavicular fracture and acromioclavicular joint dislocation |
| US20040193172A1 (en) * | 2003-03-24 | 2004-09-30 | Ross Herbert Earl | Device and method to assist in arthroscopic repair of detached connective tissue |
| CN105769326A (en) * | 2016-01-08 | 2016-07-20 | 深圳市第二人民医院 | Surgery binocular locator |
| CN207693664U (en) * | 2017-06-26 | 2018-08-07 | 吴宇峰 | A kind of minimally invasive prosthetic device of dislocation of acromioclavicular joint |
-
2017
- 2017-06-26 CN CN201710494014.7A patent/CN107174324B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2419940Y (en) * | 2000-04-29 | 2001-02-21 | 佟杰 | Two Purpose external fixed for curing clavicular fracture and acromioclavicular joint dislocation |
| US20040193172A1 (en) * | 2003-03-24 | 2004-09-30 | Ross Herbert Earl | Device and method to assist in arthroscopic repair of detached connective tissue |
| CN105769326A (en) * | 2016-01-08 | 2016-07-20 | 深圳市第二人民医院 | Surgery binocular locator |
| CN207693664U (en) * | 2017-06-26 | 2018-08-07 | 吴宇峰 | A kind of minimally invasive prosthetic device of dislocation of acromioclavicular joint |
Also Published As
| Publication number | Publication date |
|---|---|
| CN107174324A (en) | 2017-09-19 |
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