CN107669328B - Two-point multidimensional positioning device for femoral intramedullary nail - Google Patents
Two-point multidimensional positioning device for femoral intramedullary nail Download PDFInfo
- Publication number
- CN107669328B CN107669328B CN201711158718.3A CN201711158718A CN107669328B CN 107669328 B CN107669328 B CN 107669328B CN 201711158718 A CN201711158718 A CN 201711158718A CN 107669328 B CN107669328 B CN 107669328B
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- China
- Prior art keywords
- adjusting
- universal joint
- sleeve
- intramedullary nail
- dimensional
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Links
- 230000007246 mechanism Effects 0.000 claims abstract description 57
- 210000000689 upper leg Anatomy 0.000 claims abstract description 9
- 238000000034 method Methods 0.000 claims description 7
- 238000009434 installation Methods 0.000 claims description 3
- 206010061258 Joint lock Diseases 0.000 claims description 2
- 210000001694 thigh bone Anatomy 0.000 claims 1
- 210000000988 bone and bone Anatomy 0.000 abstract description 3
- 208000010392 Bone Fractures Diseases 0.000 description 3
- 206010016454 Femur fracture Diseases 0.000 description 3
- 206010017076 Fracture Diseases 0.000 description 3
- 238000010586 diagram Methods 0.000 description 2
- 229910000831 Steel Inorganic materials 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000003275 diaphysis Anatomy 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000005484 gravity Effects 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 238000001356 surgical procedure 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7241—Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
-
- 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
Abstract
The invention discloses a two-point multidimensional positioning device for a femur intramedullary nail, wherein the adjusting tail ends of a front group of two-dimensional adjusting mechanism and a rear group of two-dimensional adjusting mechanism are respectively provided with a front universal joint and a rear universal joint, each universal joint comprises a universal joint ball shell connected to a connecting rod, the inner surface of each universal joint ball shell is a spherical surface, the inner side of each universal joint ball shell is sleeved with a universal joint inner sphere, the center of each universal joint inner sphere is provided with an adjusting shaft hole, and an adjusting shaft sleeve is fixedly arranged in each front adjusting shaft hole and each rear adjusting shaft hole; the intramedullary nail is sleeved in the adjusting shaft sleeve; the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism are respectively vertically or longitudinally adjusted. The invention can adjust any angle of the intramedullary nail, can accurately nail the intramedullary nail at most twice, improves the nailing accuracy, reduces the nailing times, and has the advantages of rapidness and accuracy. Thereby reducing the operation difficulty of doctors and reducing the bone damage degree of patients.
Description
The invention belongs to the technical field of intramedullary nail medical appliances in orthopaedics, and particularly relates to a two-point multidimensional positioning device for a femoral intramedullary nail.
The intramedullary nail is a minimally invasive treatment method for treating femur fracture, at present, the surgical treatment for bone diaphysis fracture of long tube generally adopts fixation techniques such as intramedullary nail, steel plate, external fixation frame, etc., in the intramedullary nail fixation technique, the common intramedullary nail is provided with distal and proximal locking nail holes, so that the locking nail can pass through the long tube cortex and the distal and proximal locking nail holes on the intramedullary nail, achieve the locking effect, and have the functions of aligning and fixing the fracture block and supporting certain gravity, thereby facilitating the growth and fracture healing of porosis. When the intramedullary nail is used, the locking nails at the far end and the near end are required to be connected and fixed, and the intramedullary nail is drilled after being placed into a intramedullary cavity during installation, so that the position of the locking nail hole on the corresponding intramedullary nail can not be well found at the far end of the cortex of long bone, and the burden of operation of doctors is increased.
The intramedullary nail has higher technical requirements, so that the intramedullary nail cannot be fully developed, one of the difficulties is that the distal end locking is difficult, the problem is solved firstly that the position and the direction of an opening of a rotor space are correct, the intramedullary nail is deformed due to non-ideal condition, the distal end locking is difficult, and the ideal position and the direction need to be corrected for multiple times, thus being labor-consuming and repeated in perspective.
The invention aims to rapidly and accurately operate the intramedullary nail to treat the femur fracture through the two-point multidimensional positioning device of the femoral intramedullary nail, and solves the problems that the technical operation requirement is high and the intramedullary nail is deformed when the intramedullary nail is in an unsatisfactory state due to the fact that the femur fracture is treated by the intramedullary nail at present.
The technical scheme is as follows: a two-point multidimensional positioning device of a femoral intramedullary nail comprises a fixed part fixedly connected with a carrier, wherein a front group of two-dimensional adjusting mechanisms and a rear group of two-dimensional adjusting mechanisms which can vertically and longitudinally move and are locked are arranged on the fixed part; the tail ends of the front two-dimensional adjusting mechanism and the tail end of the rear two-dimensional adjusting mechanism are respectively provided with a front universal joint and a rear universal joint, the universal joints comprise universal joint ball shells connected to one connecting rod, the inner surfaces of the universal joint ball shells are spherical surfaces, the inner sides of the universal joint ball shells are sleeved with universal joint inner spheres, the centers of the universal joint inner spheres are provided with adjusting shaft holes, and an adjusting shaft sleeve is fixedly arranged in the front adjusting shaft hole and the rear adjusting shaft hole; the intramedullary nail is sleeved in the adjusting shaft sleeve; the two-dimensional adjusting mechanism comprises a fixed upright post on the upper side of the installation fixing part, lifting sliding sleeves are respectively sleeved on the outer sides of the fixed upright posts, longitudinal holes are formed in the lifting sliding sleeves, longitudinal adjusting rods are installed on the lifting sliding sleeves, lifting locking pins and longitudinal adjusting locking pins are respectively arranged on the side surfaces of the lifting sliding sleeves, universal joints are installed at the tail ends of the corresponding longitudinal adjusting rods, and the lower ends of the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism are installed on the same fixing part; or the two-dimensional adjusting mechanism comprises a fixed vertical sleeve arranged on the fixed part, a movable upright post is sleeved in the fixed vertical sleeve and provided with a lifting locking pin, the upper end of the movable upright post is connected with a longitudinal adjusting sleeve, a longitudinal adjusting rod is sleeved in the longitudinal adjusting sleeve and provided with the longitudinal adjusting locking pin, the universal joint is arranged at the tail end of the corresponding longitudinal adjusting rod, and the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism are respectively arranged on the front fixed part and the rear fixed part.
And a rotation adjusting mechanism is further arranged between the fixing part and the two-dimensional adjusting mechanism, the rotation adjusting mechanism comprises a vertical rotating shaft and a vertical rotating sleeve, and a vertical rotating locking pin is vertically arranged on the side wall of the vertical rotating sleeve.
An initial position locating mechanism is arranged on a bracket connected with the fixed part or an independent fixed bracket and used for determining the initial position of an adjusting end point of the adjusting shaft sleeve. The initial position positioning mechanism comprises a sliding rod fixed on a bracket connected with a fixed part or an independent fixed bracket, a sliding sleeve is sleeved outside the sliding rod, a sliding sleeve lock pin is arranged, a swinging rod is arranged on the sliding sleeve, the swinging rod is connected with an indication rod through a joint locking pin, and the tail end of the indication rod is an indication endpoint.
The invention has the following beneficial effects: the invention respectively adjusts the front universal joint and the rear universal joint through the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism, thereby controlling the adjusting shaft sleeve positioned on the universal joint to control the angle of the intramedullary nail. The invention can realize the adjustment of any angle of the intramedullary nail in a proper range.
According to the method, the two-time nailing mode is utilized, and the angle of the adjusting sleeve which needs to be adjusted is modified on the basis of the first nailing point, so that the intramedullary nail can be correctly nailed at most two times, the nailing accuracy is improved, the nailing frequency is reduced, and the method has the advantages of being rapid and accurate. Thereby reducing the operation difficulty of doctors and reducing the bone damage degree of patients.
Drawings
Fig. 1 is a schematic diagram of the structure of the present invention.
FIG. 2 is a second schematic structural view of the present invention.
FIG. 3 is a third schematic diagram of the structure of the present invention.
Fig. 4 is a partially enlarged schematic view of the structure of fig. 1.
Fig. 5 is a connecting structure of the fixing jig.
Fig. 6 is a schematic view of the device of the present invention in a driven-in state.
Fig. 7 is a schematic view of the initial driving state.
Fig. 8 is a schematic view of the post-correction driving state.
Fig. 9 is a schematic structural view of the initial position positioning mechanism.
In the figure, reference numeral 1 denotes an intramedullary nail, 201 denotes a front fixed upright, 202 denotes a rear fixed upright, 203 denotes a front lifting sliding sleeve, 204 denotes a rear lifting sliding sleeve, 205 denotes a front lifting locking pin I, 206 denotes a rear lifting locking pin I, 207 denotes a longitudinal adjusting rod, 208 denotes a longitudinal adjusting locking pin, 209 denotes a locking block, 210 denotes a connecting rod, 211a denotes a rear universal joint ball shell, 211b denotes a front universal joint ball shell, 212 denotes an universal joint inner ball, 213 denotes a fixing pin, 214 denotes an adjusting shaft hole, 215 denotes an adjusting shaft sleeve, 216 denotes a transverse connecting rod I, 217 denotes a vertical shaft, 218 denotes a vertical rotating sleeve, 219 denotes a vertical rotating locking pin, 220 denotes a longitudinal adjusting sleeve, 221 denotes a front movable upright, 222 denotes a rear movable upright, 223 denotes a front fixed vertical sleeve, 224 denotes a rear fixed vertical sleeve, 225 denotes a front lifting locking pin II, 226 denotes a rear lifting locking pin II, 227 denotes a transverse connecting rod II, 3 denotes a fixing clamp, 4 denotes a nail-in point, 5 denotes an initial position positioning mechanism, 51 denotes a sliding rod, 52 denotes a sliding sleeve, 53 denotes a sliding sleeve, 54 denotes a joint indicating rod, 55 denotes a joint indicating pin, 57 denotes a swing rod.
Example 1: the two-point multidimensional positioning device of the femoral intramedullary nail 1 shown in fig. 1 comprises a fixing part fixedly connected with a carrier, wherein the carrier can be a bedstead or an instrument fixing clamp or other fixing frames. The fixing member may employ a fixing jig 3 as shown in fig. 1 or 5.
The fixed part is provided with a front group of two-dimensional adjusting mechanisms and a rear group of two-dimensional adjusting mechanisms which can vertically and longitudinally move and are locked. Front and rear universal joints are respectively arranged at the tail ends of the front and rear two-dimensional adjusting mechanisms, adjusting shaft holes are respectively arranged on the free swinging part of each universal joint, and an adjusting shaft sleeve 215 is fixedly arranged in the front and rear adjusting shaft holes. Intramedullary nail 1 is nested within adjustment sleeve 215.
Specifically, in fig. 1, the two-dimensional adjustment mechanism includes a front fixing upright 201 and a rear fixing upright 202 mounted on the upper side of the same fixing member, and the front fixing upright 201 and the rear fixing upright 202 are fixed together by a first cross link 216. A front lifting sliding sleeve 203 and a rear lifting sliding sleeve 204 are respectively sleeved outside the front fixing upright post 201 and the rear fixing upright post 202, and the front lifting sliding sleeve 203 and the rear lifting sliding sleeve 204 are respectively provided with longitudinal holes and are respectively provided with a longitudinal adjusting rod 207. The sides of the front lifting sliding sleeve 203 and the rear lifting sliding sleeve 204 are respectively provided with a front lifting locking pin 205 and a rear lifting locking pin 206, a front longitudinal adjustment locking pin and a rear longitudinal adjustment locking pin.
The universal joint comprises a universal joint ball shell connected to one connecting rod, the inner surface of the universal joint ball shell is a spherical surface, the inner side of the universal joint ball shell is sleeved with an inner ball body of the universal joint, and the center of the inner ball body of the universal joint is provided with an adjusting shaft hole.
In fig. 1, locking blocks 209 are respectively installed at the ends of the front and rear longitudinal adjustment rods 207, and a connecting rod fixed with a universal joint ball housing is inserted into a vertical hole of the locking block 209 and fixed by a fixing pin. Therefore, each universal joint can realize local lifting adjustment by utilizing the adjustment relation between the connecting rod and the locking piece 209, and the fine adjustment operation is convenient.
Example 2: on the basis of embodiment 1, the two-dimensional adjusting mechanism comprises a front fixing upright 201 and a rear fixing upright 202 which are respectively arranged on the upper sides of a front fixing part and a rear fixing part, and as shown in fig. 2, a front lifting sliding sleeve 203 and a rear lifting sliding sleeve 204 are respectively sleeved outside the front fixing upright 201 and the rear fixing upright 202, longitudinal holes are respectively formed in the front lifting sliding sleeve 203 and the rear lifting sliding sleeve 204, a longitudinal adjusting rod 207 is respectively arranged on the side surfaces of the front lifting sliding sleeve 203 and the rear lifting sliding sleeve 204, and a front lifting locking pin 205 and a rear lifting locking pin 206, and a front longitudinal adjusting locking pin and a rear longitudinal adjusting locking pin are respectively arranged on the side surfaces of the front lifting sliding sleeve 203 and the rear lifting sliding sleeve 204; the front and rear gimbals are mounted at the ends of the front and rear longitudinal adjustment bars 207, respectively.
Example 3: referring to fig. 3, on the basis of embodiment 1, the two-dimensional adjusting mechanism includes a fixed vertical sleeve provided on a fixed member, the fixed vertical sleeve being internally fitted with a movable upright and provided with a lifting locking pin; the upper end of the movable upright post is connected with a longitudinal adjusting sleeve, a longitudinal adjusting rod is sleeved in the longitudinal adjusting sleeve, and a longitudinal adjusting locking pin is arranged in the longitudinal adjusting sleeve; the universal joints are arranged at the tail ends of the corresponding longitudinal adjusting rods.
Example 4: referring to fig. 5, on the basis of any one of embodiments 1 to 3, a rotation adjusting mechanism is further provided between the fixing member and the two-dimensional adjusting mechanism, the adjusting mechanism includes a vertical shaft and a vertical rotating sleeve, and a vertical rotating locking pin is vertically installed on a side wall of the vertical rotating sleeve.
Example 5: on the basis of any one of the embodiments 1 to 3, an initial position positioning mechanism 5 is provided on the bracket connected to the fixing member or on a separate fixing bracket for determining the initial position of the adjustment end point of the adjustment sleeve.
Referring to fig. 9, the initial position positioning mechanism 5 includes a slide bar 51 fixed on a bracket connected with a fixing member or an independent fixing bracket, a slide sleeve 52 is sleeved outside the slide bar 51, a slide sleeve lock pin 53 is provided, a swing rod 54 is mounted on the slide sleeve, the swing rod 54 is connected with an indication rod 55 through a joint lock pin 56, and the end of the indication rod is an indication end point 57.
Example 6: referring to fig. 1, the adjusting ends of the front and rear two-dimensional adjusting mechanisms are respectively provided with a front universal joint and a rear universal joint, the free swinging part of each universal joint is respectively provided with an adjusting shaft hole, and an adjusting shaft sleeve 215 is fixedly arranged in the front and rear adjusting shaft holes; intramedullary nail 1 is nested within adjustment sleeve 215. The lower parts of the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism are fixed on the carrier.
Referring to fig. 6, the intramedullary nail 1 is nailed into the femur for the first time by vertically or longitudinally adjusting the front and rear two-dimensional adjustment mechanisms, respectively, such that the adjustment sleeve 215 carries the intramedullary nail 1 to adjust and align with the end surface of the femur.
Referring to fig. 7 and 8, the deflection of the angle nail in the femur in the first-time nailing intramedullary nail is judged through X-ray perspective, and the data required to be adjusted for correcting the intramedullary nail 1 are calculated; and then the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism are respectively vertically or longitudinally adjusted by using the corrected data, so that the adjusting shaft sleeve 215 carries the intramedullary nail 1 to be opposite to the femur end surface nailing point 4 and keeps the corrected correct direction, and the intramedullary nail 1 is nailed into the femur again.
Claims (2)
1. The utility model provides a two-point multidimensional positioning device of thighbone intramedullary nail, includes the fixed part of being connected with carrier fixed, characterized by: the fixed part is provided with a front group of two-dimensional adjusting mechanisms and a rear group of two-dimensional adjusting mechanisms which can vertically and longitudinally move and are locked; the tail ends of the front two-dimensional adjusting mechanism and the tail end of the rear two-dimensional adjusting mechanism are respectively provided with a front universal joint and a rear universal joint, the universal joints comprise universal joint ball shells connected to one connecting rod, the inner surfaces of the universal joint ball shells are spherical surfaces, the inner sides of the universal joint ball shells are sleeved with universal joint inner spheres, the centers of the universal joint inner spheres are provided with adjusting shaft holes, and an adjusting shaft sleeve is fixedly arranged in the front adjusting shaft hole and the rear adjusting shaft hole; the intramedullary nail is sleeved in the adjusting shaft sleeve; the two-dimensional adjusting mechanism comprises a fixed upright post on the upper side of the installation fixing part, lifting sliding sleeves are respectively sleeved on the outer sides of the fixed upright posts, longitudinal holes are formed in the lifting sliding sleeves, longitudinal adjusting rods are installed on the lifting sliding sleeves, lifting locking pins and longitudinal adjusting locking pins are respectively arranged on the side surfaces of the lifting sliding sleeves, universal joints are installed at the tail ends of the corresponding longitudinal adjusting rods, and the lower ends of the front two-dimensional adjusting mechanism and the rear two-dimensional adjusting mechanism are installed on the same fixing part; or the two-dimensional adjusting mechanism comprises a fixed vertical sleeve arranged on the fixed part, a movable upright post is sleeved in the fixed vertical sleeve and provided with a lifting locking pin, the upper end of the movable upright post is connected with a longitudinal adjusting sleeve, a longitudinal adjusting rod is sleeved in the longitudinal adjusting sleeve and provided with a longitudinal adjusting locking pin, a universal joint is arranged at the tail end of the corresponding longitudinal adjusting rod, and a front two-dimensional adjusting mechanism and a rear two-dimensional adjusting mechanism are respectively arranged on the front fixed part and the rear fixed part; the automatic positioning device comprises a fixed part and a support, wherein the fixed part is connected with the support, the support is connected with the fixed part, the support is independent, the initial position positioning mechanism is arranged on the support connected with the fixed part or the independent fixed support, the initial position positioning mechanism comprises a sliding rod fixed on the support connected with the fixed part or the independent fixed support, a sliding sleeve is sleeved outside the sliding rod, a sliding sleeve lock pin is arranged on the sliding sleeve, a swinging rod is arranged on the sliding sleeve, the swinging rod is connected with an indication rod through a joint lock pin, and the tail end of the indication rod is an indication endpoint; the method comprises the steps that a twice nailing point mode is utilized, the angle of an adjusting sleeve which needs to be adjusted is modified on the basis of a first nailing point so as to improve nailing accuracy and reduce nailing times, an initial position positioning mechanism is used for determining an initial position of an adjusting end point of an adjusting shaft sleeve, the deflection condition of an angle nail in a femur in the intramedullary nailing process is judged through X-ray perspective, and data which need to be adjusted for correcting the intramedullary nail are calculated; and then vertically or longitudinally adjusting the front and rear two-dimensional adjusting mechanisms respectively by using the corrected data, so that the intramedullary nail is carried by the adjusting shaft sleeve to be opposite to the femur end surface nailing point, the corrected correct direction is maintained, and the intramedullary nail is nailed into the femur again.
2. The femoral intramedullary nail two-point multidimensional positioning device of claim 1, wherein: and a rotation adjusting mechanism is further arranged between the fixing part and the two-dimensional adjusting mechanism, the rotation adjusting mechanism comprises a vertical rotating shaft and a vertical rotating sleeve, and a vertical rotating locking pin is vertically arranged on the side wall of the vertical rotating sleeve.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711158718.3A CN107669328B (en) | 2017-11-20 | 2017-11-20 | Two-point multidimensional positioning device for femoral intramedullary nail |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711158718.3A CN107669328B (en) | 2017-11-20 | 2017-11-20 | Two-point multidimensional positioning device for femoral intramedullary nail |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN107669328A CN107669328A (en) | 2018-02-09 |
| CN107669328B true CN107669328B (en) | 2024-03-26 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201711158718.3A Active CN107669328B (en) | 2017-11-20 | 2017-11-20 | Two-point multidimensional positioning device for femoral intramedullary nail |
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| CN (1) | CN107669328B (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111658123B (en) * | 2020-07-10 | 2021-07-16 | 牛鸣 | External positioning device for replacement of femoral bone marrow by knee joint |
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|---|---|
| CN107669328A (en) | 2018-02-09 |
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