CN108742821B - Nail guiding device is put in wicresoft's steel sheet coaptation art - Google Patents
Nail guiding device is put in wicresoft's steel sheet coaptation art Download PDFInfo
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- CN108742821B CN108742821B CN201810263444.2A CN201810263444A CN108742821B CN 108742821 B CN108742821 B CN 108742821B CN 201810263444 A CN201810263444 A CN 201810263444A CN 108742821 B CN108742821 B CN 108742821B
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- Prior art keywords
- sleeve
- locking
- hole
- fixing
- minimally invasive
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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
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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
Abstract
The invention discloses a nail-placing guide device for minimally invasive steel plate osteosynthesis, which comprises a bone fracture plate, an outer sleeve, a hollow locking sleeve and a fixing sleeve, wherein a plurality of combined holes are formed in the bone fracture plate, and the shape of the cross section of the inner surface of the outer sleeve corresponds to that of the combined holes. When the fixing sleeve and the locking sleeve are combined and collectively accommodated in the outer sleeve, the fixing sleeve and the locking sleeve correspond to the fixing hole and the locking hole in any combination hole, respectively. The invention can increase the accuracy of percutaneous nail placement, improve the working efficiency, avoid the error insertion of the locking screw into the sliding pressurizing hole, establish the nail placement working channel and optimize the nail placement process. Through the thread matching of the locking hole, the situation that the locking screw is mistakenly placed in the fixing hole is avoided. The outer sleeve of the guider can also be used as a working channel when the screw is screwed in, so that the screw is prevented from sliding out.
Description
Technical Field
The invention relates to the field of medical surgical instruments, in particular to a nail-placing guide device for minimally invasive steel plate bone-knitting operation.
Background
In minimally invasive steel plate osteosynthesis, a locking screw for locking a compression steel plate needs to be placed into the bone through the skin, so that surgical incisions are reduced to the greatest extent, and the damage of surgical operations to soft tissues is reduced. Currently, only a few steel plates (such as femur distal lateral LISS/LCP or tibia proximal lateral LISS/LCP) are equipped with standard sights through which screws can be accurately placed. LCP steel plates at other parts lack standard sighting devices, and percutaneous nail placement in minimally invasive steel plate internal fixation has certain difficulty.
In the actual operation process, due to the influence of factors such as tendon tissue tension, muscle fascia tissue resistance and the like, the locking screw is sometimes placed in the sliding pressurizing hole in the LCP steel plate combining hole by mistake, the stability of the skeleton-internal fixing structure is influenced, even the internal fixing is failed, and the treatment result of the fracture is influenced. In the traditional percutaneous lock nail placing operation process, a locking sleeve is firstly used for finding a steel plate combination locking hole, then an electric drill is used for drilling a hole in a cortical bone through the locking sleeve, then the locking sleeve is withdrawn, the locking hole needs to be found through fascia muscle tissues again, and the relation between a locking screw and the locking hole is adjusted again; the method is lack of a channel, so that the screw can easily slide out of the screwdriver in the screw placing process, the screw placing time is prolonged, and the pain of a patient is increased.
Disclosure of Invention
The purpose of the invention is as follows: the invention aims to provide a minimally invasive steel plate bone setting operation nail placing guide device which optimizes sleeve placing and improves nail placing accuracy.
The technical scheme is as follows: in order to achieve the purpose, the invention provides a minimally invasive steel plate osteosynthesis nail-placing guide device, which is characterized in that: the device comprises a bone fracture plate, an outer sleeve, a locking sleeve and a fixing sleeve; the bone fracture plate is provided with a plurality of combined holes, and the combined holes are special-shaped holes formed by overlapping a fixing hole and a locking hole; the cross section of the inner surface of the outer sleeve corresponds to the combination hole; the locking sleeve is cylindrical, the fixed sleeve is cylindrical like the side surface of which is provided with an inwards concave curved surface, the curved surface of the fixed sleeve is mutually attached to the side surface of the locking sleeve, and when the fixed sleeve and the locking sleeve are combined and jointly accommodated in the outer sleeve, the fixed sleeve and the locking sleeve respectively correspond to a fixed hole and a locking hole in any combined hole.
The guide device of the invention is used for placing the nail, and the operation steps are as follows:
(1) after the bone fracture plate is placed in the built-in bone fracture plate, the locking sleeve and the fixing sleeve are assembled and inserted into the outer sleeve. The fixing sleeve is placed through a small skin incision, and tissues such as subcutaneous tissues, fascia and muscles are separated bluntly and enter the fixing hole of the bone fracture plate; the direction is adjusted to make the guiding device vertical to the bone fracture plate, and then the locking sleeve is arranged.
(2) And a kirschner wire (generally two specifications of 1.5mm and 3.0 mm) with corresponding specification is drilled into the fixing sleeve to be used as a positioning guide wire for stabilizing the guiding device.
(3) And (3) maintaining the stability of the guider, drilling a hole on the backbone by using a drill bit (generally two specifications of 2.8mm and 4.3 mm) with a corresponding specification through the locking sleeve, withdrawing the drill bit and the locking sleeve after drilling through a single-layer or double-layer cortex, and screwing a locking screw with a required length into the outer sleeve of the guiding device after the depth gauge detects the depth.
(4) And withdrawing the positioning guide pin and the guider.
The bone fracture plate provided by the invention comprises a metal bone fracture plate which is made of any one material of steel, titanium and titanium alloy and meets the national medical industry standard.
Compared with the prior art, the invention firstly utilizes the positioning guide pin (Kirschner wire) to stabilize the position and the angle of the guide device and then screws in the locking screw through the combined hole and the fixed sleeve and the locking sleeve which are correspondingly combined, thereby solving the problem that the locking hole is difficult to find again after the locking sleeve is withdrawn.
In order to further enhance the locking effect, the locking hole is provided with an internal thread; the front end of the locking sleeve is provided with an external thread matched with the internal thread of the locking hole. In the step (1), the locking sleeve is placed in the bone fracture plate, and then the threads are screwed to vertically fix the locking sleeve on the bone fracture plate.
Furthermore, the inside of the fixing hole is a smooth curved surface. The fixing hole can be used for inserting and passing through the fixing sleeve and can adjust the angle within a certain range.
Further, the locking sleeve comprises a barrel body and a bolt head positioned at the tail end of the barrel body, and the length of the fixing sleeve does not exceed the length of the barrel body of the locking sleeve; and a bolt hole is formed in the side surface of the bolt head.
And chamfers or fillets are arranged at the adjacent positions of the fixing holes and the locking holes and the upper surface and the lower surface of the bone fracture plate. Furthermore, the front end of the fixing sleeve and/or the locking sleeve is provided with a conical surface or a blunt round curved surface, the conical surface or the blunt round curved surface is beneficial to floating of the fixing sleeve within a certain angle range, and is beneficial to accurate thread matching of the front end of the locking sleeve, so that the locking sleeve is perpendicular to the bone fracture plate after being screwed down.
Further, the hollow inner cavity of the fixed sleeve is eccentrically arranged. I.e. the axis of the hollow cavity is parallel to and does not overlap the axis of the cylindrical portion of the fixation sleeve.
As a preferable scheme of the invention, for the locking screw with the outer diameter of 3.5mm, the minimum inner diameter of the fixing hole is 6.2mm, and the inner diameter of the locking hole is 5.2 mm; the external diameter of the fixed sleeve is 6.0mm, an eccentric guide pin hole with the internal diameter of 1.5mm is arranged, the external diameter of the bolt head of the locking sleeve is 5.0mm, and the external diameter of the cylinder body is smaller than the external diameter of the bolt head.
As another preferable aspect of the present invention, for a locking screw with an outer diameter of 5.0mm, the inner diameter of the fixing hole is 8.2mm, and the minimum inner diameter of the locking hole is 6.8 mm; the external diameter of the fixed sleeve is 8.0mm, an eccentric guide pin hole with the internal diameter of 3.0mm is arranged, the external diameter of the bolt head of the locking sleeve is 6.6mm, and the external diameter of the cylinder body is smaller than the external diameter of the bolt head.
Has the advantages that: the invention can increase the accuracy of percutaneous nail placement, improve the working efficiency, avoid the error insertion of the locking screw into the sliding pressurizing hole, establish the nail placement working channel and optimize the nail placement process. The specification design is matched with the universal 3.5mm and 5.0mm locking hole specifications. Compared with the traditional single-cylinder type guider, the single-cylinder type guider can better resist the resistance of tissues such as tendons, muscles and the like, the fixing sleeve has a good tissue blunt separation effect, and the situation that the locking screw is mistakenly placed in the fixing hole is avoided through the matching of the threads of the locking hole. The outer sleeve of the guider can also be used as a working channel when the screw is screwed in, so that the screw is prevented from sliding out.
Drawings
FIG. 1 is a schematic cross-sectional view of the locking sleeve and retaining sleeve assembled;
FIG. 2 is a schematic longitudinal cross-sectional view of the locking sleeve;
fig. 3 is a schematic view of the bone plate.
Detailed Description
The invention is further described below with reference to the accompanying drawings.
Example 1
As shown in fig. 1 to 3, the minimally invasive steel plate osteosynthesis screw-placing guide device is suitable for upper limb bone osteosynthesis fixation (3.5mm specification), and comprises a titanium alloy bone fracture plate 1, an outer sleeve 2, a locking sleeve 3 and a fixing sleeve 4; the bone plate 1 is provided with a plurality of combination holes which are special-shaped holes formed by partially overlapping a fixing hole 11 and a locking hole 12, and the locking hole 12 is provided with internal threads 13. The inner side of the fixing hole 11 is a smooth curved surface 14. The adjacent parts of the fixing holes 11 and the locking holes 12 and the upper and lower surfaces of the bone plate 1 are provided with round corners 15.
The cross-sectional shape of the inner surface of the outer sleeve 2 corresponds to the shape of the combination hole. The locking sleeve 3 is cylindrical and comprises a barrel 32 and a bolt head 33 at the rear end of the barrel 32. The front end of the cylinder 32 is provided with a conical surface which is provided with an external thread 31 matched with the internal thread 13 of the locking hole 12, and the side surface of the bolt head 33 is provided with a bolt hole.
The fixing sleeve 4 is of a cylinder-like shape with an inward concave curved surface 41 arranged on the side surface, and the length of the fixing sleeve 4 does not exceed that of the cylinder body 32 of the locking sleeve 3. The curved surface of the fixed sleeve 4 and the side surface of the locking sleeve 3 are mutually attached, and when the fixed sleeve 4 and the locking sleeve 3 are combined and jointly accommodated in the outer sleeve 2, the fixed sleeve 4 and the locking sleeve 3 respectively correspond to a fixed hole 11 and a locking hole 12 in any combination hole.
The minimum inner diameter of the fixing hole 11 is 6.2mm, and the inner diameter of the locking hole 12 is 5.2 mm; the outer diameter of the fixing sleeve 4 is 6.0mm, an eccentric guide pin hole 42 with the inner diameter of 1.5mm is arranged, the outer diameter of a bolt head 33 of the locking sleeve 3 is 5.0mm, the inner diameter of the cylinder body is 2.8mm, a drill bit with the diameter of 2.8mm can be used for preparing a bone channel, and a locking screw with the diameter of 3.5mm can be screwed in after the drill bit is withdrawn from the locking sleeve.
The guide device of the embodiment is used for setting the nail, and the operation steps are as follows:
(1) the internal bone plate 1 is placed, the locking sleeve 3 and the fixing sleeve 4 are assembled, and the external sleeve 2 is inserted. The fixing sleeve 4 is placed in a small incision (about 10mm) through skin, and tissues such as subcutaneous tissues, fascia and muscles are separated bluntly and enter the fixing hole 11 of the bone fracture plate 1; the direction is adjusted to ensure that the guiding device is vertical to the bone fracture plate 1, then the locking sleeve 3 is arranged, and the screw thread is screwed, so that the locking sleeve 3 is vertically fixed on the bone fracture plate 1.
(2) A kirschner wire with the specification of 1.5mm is drilled into the fixing sleeve 4 to be used as a positioning guide pin for stabilizing the guiding device.
(3) And (3) maintaining the stability of the guider, drilling a hole on the backbone by using a drill bit with the specification of 2.8mm through the locking sleeve 3, withdrawing the drill bit and the locking sleeve 3 after drilling through a single-layer or double-layer cortex, and screwing a locking screw with a required length into the outer sleeve 2 of the guiding device after the depth gauge detects the depth.
(4) And withdrawing the positioning guide pin and the guider.
Example 2
As shown in fig. 1 to 3, the minimally invasive steel plate osteosynthesis screw-placing guide device is suitable for lower limb bone osteosynthesis fixation (5.0mm specification), and comprises a titanium alloy bone fracture plate 1, an outer sleeve 2, a locking sleeve 3 and a fixing sleeve 4; the bone plate 1 is provided with a plurality of combination holes which are special-shaped holes formed by partially overlapping a fixing hole 11 and a locking hole 12, and the locking hole 12 is provided with internal threads 13. The inner side of the fixing hole 11 is a smooth curved surface 14. The adjacent parts of the fixing holes 11 and the locking holes 12 and the upper and lower surfaces of the bone plate 1 are provided with round corners 15.
The cross-sectional shape of the inner surface of the outer sleeve 2 corresponds to the shape of the combination hole. The locking sleeve 3 is cylindrical and comprises a barrel 32 and a bolt head 33 at the rear end of the barrel 32. The front end of the cylinder 32 is provided with a conical surface which is provided with an external thread 31 matched with the internal thread 13 of the locking hole 12, and the side surface of the bolt head 33 is provided with a bolt hole.
The fixing sleeve 4 is of a cylinder-like shape with an inward concave curved surface 41 arranged on the side surface, and the length of the fixing sleeve 4 does not exceed that of the cylinder body 32 of the locking sleeve 3. The curved surface of the fixed sleeve 4 and the side surface of the locking sleeve 3 are mutually attached, and when the fixed sleeve 4 and the locking sleeve 3 are combined and jointly accommodated in the outer sleeve 2, the fixed sleeve 4 and the locking sleeve 3 respectively correspond to a fixed hole 11 and a locking hole 12 in any combination hole.
The inner diameter of the fixing hole 11 is 8.2mm, and the minimum inner diameter of the locking hole 12 is 6.8 mm; the outer diameter of the fixing sleeve 4 is 8.0mm, an eccentric guide pin hole 42 with the inner diameter of 3.0mm is arranged, the outer diameter of a bolt head 33 of the locking sleeve 3 is 6.6mm, the inner diameter of the cylinder body is 4.4mm, a 4.3mm drill bit can pass through a prepared bone channel, and a locking screw with the outer diameter of 5.0mm can pass through after exiting from the locking sleeve.
The guide device of the embodiment is used for setting the nail, and the operation steps are as follows:
(1) the internal bone plate 1 is placed, the locking sleeve 3 and the fixing sleeve 4 are assembled, and the external sleeve 2 is inserted. The fixing sleeve 4 is placed in a small incision (about 10mm) through skin, and tissues such as subcutaneous tissues, fascia and muscles are separated bluntly and enter the fixing hole 11 of the bone fracture plate 1; the direction is adjusted to ensure that the guiding device is vertical to the bone fracture plate 1, then the locking sleeve 3 is arranged, and the screw thread is screwed, so that the locking sleeve 3 is vertically fixed on the bone fracture plate 1.
(2) A kirschner wire with the specification of 3.0mm is drilled into the fixing sleeve 4 to serve as a positioning guide pin for stabilizing the guiding device.
(3) And (3) maintaining the stability of the guider, drilling a hole on the backbone by using a drill bit with the specification of 4.3mm through the locking sleeve 3, withdrawing the drill bit and the locking sleeve 3 after drilling through a single-layer or double-layer cortex, and screwing a locking screw with a required length into the outer sleeve 2 of the guiding device after the depth gauge detects the depth.
(4) And withdrawing the positioning guide pin and the guider.
Claims (7)
1. The utility model provides a nail guider is put in wicresoft's steel sheet coaptation art which characterized in that: the device comprises a bone fracture plate, an outer sleeve, a hollow locking sleeve and a hollow fixing sleeve; the bone fracture plate is provided with a plurality of combined holes, and the combined holes are special-shaped holes formed by overlapping a fixing hole and a locking hole; the cross section of the inner surface of the outer sleeve corresponds to the combination hole;
the locking sleeve is cylindrical, the fixed sleeve is cylindrical, the side face of the fixed sleeve is provided with an inwards concave curved surface, the curved surface of the fixed sleeve is mutually attached to the side face of the locking sleeve, and when the fixed sleeve and the locking sleeve are combined and jointly accommodated in the outer sleeve, the fixed sleeve and the locking sleeve respectively correspond to a fixed hole and a locking hole in any combined hole;
the locking hole is provided with an internal thread; the front end of the locking sleeve is provided with an external thread matched with the internal thread;
the front end of the fixed sleeve is provided with a conical surface or a blunt round curved surface.
2. The minimally invasive steel plate osteosynthesis screw-placing guide device according to claim 1, characterized in that: the inside of the fixing hole is a smooth curved surface.
3. The minimally invasive steel plate osteosynthesis screw-placing guide device according to claim 1, characterized in that: the locking sleeve comprises a barrel body and a bolt head positioned at the tail end of the barrel body, and the length of the fixing sleeve does not exceed the length of the barrel body; and a bolt hole is formed in the side surface of the bolt head.
4. The minimally invasive steel plate osteosynthesis screw-placing guide device according to claim 1, characterized in that: and chamfers or fillets are arranged at the adjacent positions of the fixing holes and the locking holes and the upper surface and the lower surface of the bone fracture plate.
5. The minimally invasive steel plate osteosynthesis screw-placing guide device according to claim 1, characterized in that: the hollow inner cavity of the fixed sleeve is eccentrically arranged.
6. The guide device for placing the nail in minimally invasive steel plate osteosynthesis according to any one of claims 1 to 5, characterized in that: the inner diameter of the fixing hole is 6.2mm, and the inner diameter of the locking hole is 5.2 mm; the outer diameter of the fixed sleeve is 6.0 mm.
7. The guide device for placing the nail in minimally invasive steel plate osteosynthesis according to any one of claims 1 to 5, characterized in that: the inner diameter of the fixing hole is 8.2mm, and the inner diameter of the locking hole is 6.8 mm; the outer diameter of the fixed sleeve is 8.0 mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810263444.2A CN108742821B (en) | 2018-03-27 | 2018-03-27 | Nail guiding device is put in wicresoft's steel sheet coaptation art |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810263444.2A CN108742821B (en) | 2018-03-27 | 2018-03-27 | Nail guiding device is put in wicresoft's steel sheet coaptation art |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN108742821A CN108742821A (en) | 2018-11-06 |
| CN108742821B true CN108742821B (en) | 2021-02-05 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201810263444.2A Active CN108742821B (en) | 2018-03-27 | 2018-03-27 | Nail guiding device is put in wicresoft's steel sheet coaptation art |
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Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6743234B2 (en) * | 1999-02-04 | 2004-06-01 | Sdgi Holdings, Inc. | Methods and instrumentation for vertebral interbody fusion |
| US8043297B2 (en) * | 2004-11-03 | 2011-10-25 | Synthes Usa, Llc | Aiming arm for bone plates |
| US20160045238A1 (en) * | 2014-08-13 | 2016-02-18 | Biomet C.V. | Calcaneal bone plate targeting guide |
| CN204484288U (en) * | 2015-01-06 | 2015-07-22 | 上海微创骨科医疗科技有限公司 | A kind of medical guider and guidance system |
| CN206621411U (en) * | 2016-08-10 | 2017-11-10 | 唐佩福 | A kind of dissection locking for Complex Acetabular is oriented to steel plate |
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2018
- 2018-03-27 CN CN201810263444.2A patent/CN108742821B/en active Active
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| CN108742821A (en) | 2018-11-06 |
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