CN109350211A - Built-in Medullary fixation device - Google Patents

Built-in Medullary fixation device Download PDF

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Publication number
CN109350211A
CN109350211A CN201811499168.6A CN201811499168A CN109350211A CN 109350211 A CN109350211 A CN 109350211A CN 201811499168 A CN201811499168 A CN 201811499168A CN 109350211 A CN109350211 A CN 109350211A
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CN
China
Prior art keywords
bracing piece
inner bracing
screw hole
marrow
radial
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Pending
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CN201811499168.6A
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Chinese (zh)
Inventor
陈聚伍
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Individual
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Individual
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Publication of CN109350211A publication Critical patent/CN109350211A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7283Intramedullary pins, nails or other devices with special cross-section of the nail
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7291Intramedullary pins, nails or other devices for small bones, e.g. in the foot, ankle, hand or wrist
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564Methods for bone or joint treatment

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a kind of built-in Medullary fixation devices, including the marrow inner bracing piece that can be mounted in pulp cavity, at least provided with one and axial parallel rack gear in marrow inner bracing piece main body, radial screw hole has been disposed radially in rack gear region, Matching installation has locking radial nail in each radial direction screw hole, and dials shifting cutter equipped with what can be clamped with rack gear.The present invention has the advantages that the shortcomings that also having evaded intramedullary nail and steel plate outside intramedullary nail and steel plate.The reseting fracture under direct-view can reach anatomical reduction, and can retain the attachment of sclerite soft tissue, retain blood fortune, marrow inner bracing piece is implanted into from fracture end, easy to operate easy to learn.Implantation orientation can be adjusted flexibly in marrow inner bracing piece according to classification of fracture, to facilitate plus be screwed fracture.

Description

Built-in Medullary fixation device
Technical field
The invention belongs to fracture fixation instrument technical fields, and in particular to a kind of built-in Medullary fixation device.
Background technique
Fracture internal fixaiion mode steel plate and intramedullary nail nothing more than, Plate internal fixiation have that easy to operate, learning cycle is short, but It is that wound is big, accidentally injures probability height, infection and disunion, delayed union, broken nail and disconnected plate happens occasionally, and scar after the operation is big, influence Beauty, does not meet minimally invasive principle, intramedullary nail using closure and minimal invasive techniques, intramedullary nail with lock can prevent fracture rotation deformity, Reduce the risk of inner matter fracture;Reduce surgical infection rate;Promote union rate high;Center fixation avoids stress shielding Effect, refracture incidence are low;Meet minimally invasive principle, is current developing direction, but operating difficulties, find it difficult to learn habit, and intramedullary nail is remote End locking is difficult, resets and is divided to closure and two kinds of Limited exposure, but equal Unanatomic reduction, there is the hair of disunion and delayed union Raw, patient's pressure is larger.
Summary of the invention
There are various drawbacks for current fracture fixation mode in the present invention, develop one kind and be suitable for the long and short pipe of four limbs Shape bone fracture built-in Medullary fixation device, have it is easy to operate, wound is small, the small feature of scar after the operation.
Technical solution: a kind of built-in Medullary fixation device, including the marrow inner bracing piece that can be mounted in pulp cavity, in marrow Adjusting is stirred for left and right with axial parallel rack gear at least provided with one in inner bracing piece main body, and being furnished with can be with rack gear card What is connect dials shifting cutter, has been disposed radially radial screw hole in rack gear region, Matching installation has locking radial nail in each radial direction screw hole.
A kind of built-in Medullary fixation device, including caning absorb material support rod in the marrow that can be mounted in pulp cavity, It is can absorb in marrow in material support rod main body and has been disposed radially a series of radial screw holes, Matching installation has diameter in each radial direction screw hole To locking nail.
For the ease of installing radial locking nail, it is additionally provided with positioning installation frame.One kind being used for the built-in Medullary fixation The positioning installation frame of device, positioning installation frame is parallel with the marrow inner bracing piece, and location hole is distributed in positioning installation frame, each fixed Position hole is corresponding with each radial screwhole position, and one of positioning hole is fixedly installed with initial alignment pin, the initial alignment The side of pin is provided with side switch, while at least one radial screw hole inner wall of marrow inner bracing piece being provided with keyway, described initial Positioning pin can match in the insertion radial screw hole, side switch and keyway energy Matching installation.
In above scheme, being related to marrow inner bracing piece could alternatively be changeable prismatic, or be round or semicircle.
Furthermore it is also possible to further have auxiliary screw hole respectively on marrow inner bracing piece, auxiliary screw hole and the radial screw hole Center no longer same bus on, be also equipped in positioning installation frame with auxiliary the matched auxiliary positioning hole of screwhole position.With It is used convenient for dealing with comminuted fracture.
The present invention has the advantages that outside intramedullary nail (minimally invasive and center is fixed) and steel plate (anatomical reduction and be fixedly secured) also The shortcomings that having evaded intramedullary nail (far-end locking is difficult) and steel plate (notch is big, and wound is big, and periosteum stripping is wide).Because having following several A feature.
1, prismatic design can especially use triangular design, and the contact of pulp cavity crest line is most stable, and the damage of pulp cavity wall is minimum, Microcirculation destroys minimum.Marrow inner bracing piece is fixed through screw and backbone, has the characteristics that fixation is stable.
2, the reseting fracture under direct-view can reach anatomical reduction, and can retain the attachment of sclerite soft tissue, retain blood fortune, Marrow inner bracing piece is implanted into from fracture end, easy to operate easy to learn.
3, implantation orientation can be adjusted flexibly in marrow inner bracing piece according to classification of fracture, such as comminuted fracture, rotation Marrow inner bracing piece keeps radial screw hole to correspond to bone cips compared with multizone, to facilitate plus be screwed fracture.
4, backbone length is involved according to fracture and selects suitable long marrow inner bracing piece, center is fixed, and can be pressurizeed with center makes Gap fracture to minimum, the folded blocks fixing-stable such as butterfly, such as comminuted fracture, makes knochenbruch using the traction of marrow inner bracing piece Broken bone can be clamped in sutura gap by two sides in inside pressurization, keep nature clamping.
5, wound need to only appear fracture end and reach reset, reach minimally invasive purpose.
6, it does not need to expand marrow or very short expansion marrow, reduces the generation of fat embolism, internal haemorrhage amount.
7, direct-view lock-in techniques are selected in the locking of marrow inner bracing piece, do not have to perspective or seldom perspective, the locking far from wound It can be locked with machinery guidance, since marrow inner bracing piece length is shorter, so the arm of force is very short to make marrow inner bracing piece deformation probability very It is low, it is easy to radial screw hole is locked (existing intramedullary nail needs to squeeze into from epiphysis portion, span it is big and, Leading Edge Deformation amount compared with Greatly, difficult positioned at the locking of the lock hole of end).
Detailed description of the invention
Fig. 1 is the positive structure schematic of marrow inner bracing piece of the present invention.
Fig. 2 is the A-A the schematic diagram of the section structure of Fig. 1.
Fig. 3 is location and installation schematic diagram of the present invention.
Fig. 4 is the anti-feather key assembling structure of initial alignment pin in Fig. 3.
Fig. 5 is one of B-B the schematic diagram of the section structure in Fig. 1.
Fig. 6 is two of B-B the schematic diagram of the section structure in Fig. 1.
Fig. 7 is three of B-B the schematic diagram of the section structure in Fig. 1.
Fig. 8 is four of B-B the schematic diagram of the section structure in Fig. 1.
Fig. 9 is marrow inner bracing piece installation original state schematic diagram of the present invention.
Figure 10 is that marrow inner bracing piece of the present invention is installed on knochenbruch left part schematic diagram.
Figure 11 is to move cutter drives marrow inner bracing piece using group to translate schematic diagram.
Figure 12 is marrow inner bracing piece while the structural schematic diagram for being built in knochenbruch two sides.
Figure 13 is that schematic diagram is fixed to built-in marrow inner bracing piece by locking radial nail.
Figure 14 is the schematic diagram for taking out marrow inner bracing piece after rehabilitation from side.
Figure 15 is the schematic diagram to comminuted fracture installation marrow inner bracing piece.
Figure 16 is the schematic diagram that marrow inner bracing piece is removed from end axle center hole.
Figure 17 is the schematic diagram of the special locking nail containing interior chuck.
Figure 18 is the positive structure schematic of another marrow inner bracing piece of the invention.
Figure label: 1 is marrow inner bracing piece, and 2 be radial screw hole, and 3 be rack gear, and 4 be positioning installation frame, and 5 be initial alignment Pin, 6 be side switch, and 7 be keyway, and 8 be location hole, and 9 follow closely for locking radial, and 10 be drilling tool, and 11 be screw thread, and 12 move hole for initial dial, 13 is dial shifting cutter, and 14-1 is knochenbruch left part, and 14-2 is knochenbruch right part, and 15 be pulp cavity, and 16 be bone side opening relic, and 17 open for bone side Hole, 18 be end axle center hole.
Specific embodiment
Embodiment 1: built-in Medullary fixation device as shown in Figure 1, suitable for consolidating for the long and short tubular bone fracture of four limbs Fixed, wherein marrow inner bracing piece 1 can be mounted in pulp cavity 15, and can be free to slide.Institute's inner bracing piece is smooth isometrical bar, Both ends are round and smooth or containing tapered, in favor of assembly.As shown in fig. 6, this implementation preferably uses the marrow inner bracing piece of triangular-section 1。
Rack gear 3, rack gear 3 and axial direction are provided in the middle part of at least one side on three sides of 1 main body of marrow inner bracing piece In parallel.Meanwhile as shown in Fig. 2, be uniformly arranged radial screw hole 2 in the radially equidistant d in 3 region of rack gear, each radial direction screw hole 2 Center is located on same bus.
When in use, referring to Fig. 9, marrow inner bracing piece 1 is inserted into knochenbruch left part 14-1 from knochenbruch for this implementation.It inserts completely It is shown in Figure 10 to enter state.Meanwhile a side opening corresponding with rack gear 3 on knochenbruch left part 14-1 is needed, it is dialled as initial Move hole 12.Due to initially dialling 3 face of rack gear moved on hole 12 and marrow inner bracing piece 1, so being passed through initially by dialling shifting cutter 13 It dials after moving hole 12, the translation of marrow inner bracing piece 1 or so can be stirred.The tip location for dialling shifting cutter 13 can be clamped with rack gear 3.
As shown in figure 12, make the approximate inner cavity for being equably moved to knochenbruch two sides of marrow inner bracing piece 1 by dialling shifting cutter 13 In.It needs to follow closely all or part of marrow inner bolt hole on 9 pairs of marrow inner bracing pieces 1 at this time by locking radial to be fixed.Diameter is installed It can be the securely position between two knochenbruch of marrow inner bracing piece 1 after to locking nail 9, reach fixed purpose.
As shown in figure 13, it during installing each locking radial nail 9 into corresponding radial screw hole 2, needs to distinguish Knochenbruch left part 14-1 and knochenbruch right part 14-2 aperture just can be carried out.There are two types of modes at this time, and one is move hole 12 initially to dial Center is starting point, passes through scale or empirically determined punch position;Another way is to be beaten by positioning installation frame 4 come quickly determination Hole site.There are two types of the modes of punching, and one is the locking radial nails 9 using drilling tool installation with thread tapping, and diameter passes through disconnected Bone side wall enters in the radial screw hole 2 of marrow inner bracing piece 1;Another way is first to be drilled in corresponding position by drilling tool, drilling Afterwards in installation locking radial nail 9.
Implantation orientation can be adjusted flexibly in relationship through the above structure, marrow inner bracing piece 1 according to classification of fracture, added with facilitating It is screwed fracture.Involve backbone length according to fracture and selects suitable long marrow inner bracing piece 1, the present embodiment above structure Outstanding feature is that (1) has the function of drawing to center, after side is fixed, by stirring rack gear, Neng Goula again For tight knochenbruch left part 14-1 and knochenbruch right part 14-2 to central pressing, which can not only keep knochenbruch left part 14-1 and knochenbruch right Portion 14-2 is securely docked, and can be provided compression for comminuted fracture and be ensured (since tubular bone contains inner cavity, by propping up in marrow Strut can be avoided bone chip and enter in inner cavity from medial support, so that squeezing knochenbruch inwardly becomes feasible).(2) center is led Draw the relationship of this part traction docking, capable of guaranteeing knochenbruch periphery uniform stressed, (existing fixed solution is in reality to central reduction Occur edge stress during applying, when inevitably knochenbruch being caused to dock and block to lead to uneven situation).(3) center fixation can in Heart pressurization make to fracture gap to it is minimum while, be conducive to the folded blocks fixing-stable such as butterfly.To make operating time by counting originally Hour foreshortens to or so half an hour, reduces operation risk, and average of operation periods influences very little to patient's sclerite soft tissue, is conducive to rehabilitation.
The material of built-in marrow inner bracing piece 1 in the present invention, it is optional that the later period is needed to take out metal material or absorbable material Material.When using metal material, the removal method of such as Figure 14 can be passed through after rehabilitation.By in built-in 1 region of marrow inner bracing piece Bone side-wall hole takes out built-in marrow inner bracing piece 1.The mode of aperture can take standard-sized sheet or half-open mode.It is half-open to be After 1 one side opening of marrow inner bracing piece, built-in intramedullary nail is along inclined direction pulled out.When using absorbing material, after being not necessarily to Phase takes out operation.
The present invention can choose the marrow inner bracing piece 1 of different model (length and diameter is different) for the position of fracture site It uses.Such as shown in Figure 15 when fracture is located at close to fixed end portion, or because being propped up in the longer marrow of comminuted fracture implantation When strut 1, removal method as shown in figure 16 can be used after rehabilitation, i.e., in fixed end portion open end axle center hole 18, taken from end Marrow inner bracing piece 1 out.
It preferably is designed as sharp point in 1 one end of marrow inner bracing piece, the later period is facilitated to take out from one end.Locking radial nail 9 is best It is designed as full wire self threading pin.In addition matched squeeze into can be designed by changing gets device, machinery guidance instrument.
For the present invention intramedullary nail fixed relative to existing minimally invasive and center, it can be reached in reseting fracture under direct-view To anatomical reduction, the problem of intra medullary nail far-end locking difficulty can be evaded, marrow inner bracing piece 1 is implanted into from fracture end, operation letter It is single easy to learn.Since direct-view lock-in techniques are selected in the locking of marrow inner bracing piece 1, perspective or seldom perspective, the lock far from wound are not had to Surely it can be locked with machinery guidance, since the arm of force is very short so the deformation probability of marrow inner bracing piece 1 is very low, the difficult probability of locking is very It is low.Also, it is not necessary to expand marrow or very short expansion marrow, the generation of fat embolism, internal haemorrhage amount are reduced.
For the present invention for Interal fixation (notch is big, and wound is big, and periosteum stripping is wide), wound need to only appear fracture end Reach reset, reached minimally invasive purpose, and the attachment of sclerite soft tissue can be retained, retains blood fortune.
Embodiment 2: on that basis of example 1, using positioning installation frame 4 as shown in Figure 3 and Figure 4, the positioning installation frame 4 Main body rod piece it is parallel with marrow inner bracing piece 1.Location hole 8 is distributed in equidistant d on the main body rod piece of positioning installation frame 4, benefit With each location hole 8 of external positioning installation frame 4, to determine the position of each radial screw hole 2 on built-in marrow inner bracing piece 1.
As shown in figure 3, it is fixedly installed with initial alignment pin 5 in one of location hole 8, the side of the initial alignment pin 5 It is provided with side switch 6.Meanwhile at least one radial 2 inner wall of screw hole of marrow inner bracing piece 1 being provided with keyway 7, the initial alignment Pin 5 can match in the insertion radial screw hole 2, and side switch 6 and keyway 7 can Matching installations.Utilize the cooperation of side switch 6 and keyway 7 Relationship can prevent positioning installation frame 4 from will not rotate, so can ensure that each trend of location hole 8 is walked with each radial screw hole 2 To consistent.When carrying out aperture to knochenbruch centered on each location hole 8, the radial screw hole 2 of inside can be corresponded directly to.
Embodiment 3: on the basis of embodiment 1 or 2, marrow inner bracing piece 1 is changeable prismatic, shown in Figure 5 respectively Regular hexagonal prism, quadratic prism shown in Fig. 7 and shown in Fig. 8 round or semicircle prism.Prismatic design can especially use three Angular design, the contact of 15 crest line of pulp cavity is most stable, and the damage of 15 wall of pulp cavity is minimum, and microcirculation destroys minimum.Marrow inner bracing piece 1 is through spiral shell Adjusting screw is fixed with backbone, has the characteristics that fixation is stable.
Embodiment 4: on the basis of embodiment 1 or 2, and having auxiliary screw hole respectively on marrow inner bracing piece 1, auxiliary screw hole with On the center no longer same bus of the radial direction screw hole 2, which can be directed to part comminuted fracture, can be by multidirectional Broken bone is fixed in fixed mode.
Embodiment 5: on the basis of embodiment 1 or 2, if finding knochenbruch left part 14-1 after installation locking radial nail and breaking Bone right part 14-2 docks not tight enough problem, or when needing to force to squeeze knochenbruch left part 14-1 and knochenbruch right part 14-2, can be with By installing the special locking nail containing interior chuck as shown in figure 17 in hole to the initial group of shifting outside reaming in hole, then initially dialling to move It is fixed.Alternatively, initial on knochenbruch is dialled move hole it is larger it is not easy to use make, directly abandon that initial dial is used to move hole.
Embodiment 6: another built-in Medullary fixation device, as shown in figure 18, which, which is one, to install In marrow in pulp cavity can absorb material support rod, in marrow can absorb material support rod main body on be disposed radially it is a series of Radial screw hole, it is each radial direction screw hole in Matching installation have locking radial nail.Its function and mounting means are as described in Example 1, unknown It states.It can absorb material support rod in marrow used by the present embodiment, treatment or necessary can be just completed after first operation Check, does not need to carry out dismounting operation.

Claims (5)

1. a kind of built-in Medullary fixation device, it is characterized in that: including the marrow inner bracing piece that can be mounted in pulp cavity, in marrow Adjusting is stirred for left and right with axial parallel rack gear at least provided with one in support rod main body, is radially set in rack gear region It is equipped with radial screw hole, Matching installation has locking radial nail in each radial direction screw hole.
2. a kind of built-in Medullary fixation device, it is characterized in that: including caning absorb material branch in the marrow that can be mounted in pulp cavity Strut can absorb in material support rod main body in marrow and has been disposed radially a series of radial screw holes, matching in each radial direction screw hole Locking radial nail is installed.
3. a kind of positioning installation frame for built-in Medullary fixation device as claimed in claim 1 or 2, it is characterized in that: positioning peace It shelves parallel with the marrow inner bracing piece, is distributed with location hole in positioning installation frame, each location hole and each radial screw hole position Correspondence is set, one of positioning hole is fixedly installed with initial alignment pin, and the side of the initial alignment pin is provided with side switch, simultaneously At least one radial screw hole inner wall of marrow inner bracing piece is provided with keyway, the initial alignment pin can match the insertion diameter Into screw hole, side switch and keyway energy Matching installation.
4. built-in Medullary fixation device according to claim 1 or 2, it is characterized in that: the marrow inner bracing piece is changeable Prismatic, or be round or semicircle.
5. built-in Medullary fixation device according to claim 1 or 2 or 3, it is characterized in that: on the marrow inner bracing piece There is auxiliary screw hole respectively, auxiliary screw hole is also set in positioning installation frame on the center no longer same bus of the radial screw hole It is equipped with and the auxiliary matched auxiliary positioning hole of screwhole position.
CN201811499168.6A 2018-08-20 2018-12-08 Built-in Medullary fixation device Pending CN109350211A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN2018109502158 2018-08-20
CN201810950215.8A CN108992153A (en) 2018-08-20 2018-08-20 Built-in Medullary fixation device

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CN109350211A true CN109350211A (en) 2019-02-19

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CN201810950215.8A Pending CN108992153A (en) 2018-08-20 2018-08-20 Built-in Medullary fixation device
CN201811499168.6A Pending CN109350211A (en) 2018-08-20 2018-12-08 Built-in Medullary fixation device

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113509254B (en) * 2020-06-02 2022-06-21 林凤飞 Interlocking intramedullary nail suite capable of improving mechanical environment

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070173835A1 (en) * 2006-01-13 2007-07-26 Medoff Robert J Intramedullary implant for fracture fixation and method of using the same
CN202397580U (en) * 2012-01-04 2012-08-29 张建林 Intramedullary locked type intramedullary nail
CN104055567A (en) * 2014-07-10 2014-09-24 苏州吉美瑞医疗器械有限公司 Locking nail of PFNA
CN105213070A (en) * 2015-11-10 2016-01-06 张英泽 A kind ofly be fixed by socket device for fixing hip prosthesis surrounding fracture
CN205215339U (en) * 2015-07-28 2016-05-11 深圳市众恒德科技开发有限公司 Fixing system and supplementary apparatus of putting into in calcaneum marrow

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070173835A1 (en) * 2006-01-13 2007-07-26 Medoff Robert J Intramedullary implant for fracture fixation and method of using the same
CN202397580U (en) * 2012-01-04 2012-08-29 张建林 Intramedullary locked type intramedullary nail
CN104055567A (en) * 2014-07-10 2014-09-24 苏州吉美瑞医疗器械有限公司 Locking nail of PFNA
CN205215339U (en) * 2015-07-28 2016-05-11 深圳市众恒德科技开发有限公司 Fixing system and supplementary apparatus of putting into in calcaneum marrow
CN105213070A (en) * 2015-11-10 2016-01-06 张英泽 A kind ofly be fixed by socket device for fixing hip prosthesis surrounding fracture

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