CN110478025A - A kind of internal fixing device for patellar fracture - Google Patents

A kind of internal fixing device for patellar fracture Download PDF

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Publication number
CN110478025A
CN110478025A CN201910828155.7A CN201910828155A CN110478025A CN 110478025 A CN110478025 A CN 110478025A CN 201910828155 A CN201910828155 A CN 201910828155A CN 110478025 A CN110478025 A CN 110478025A
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China
Prior art keywords
kneecap
needle
pressure cuffs
fixing device
diameter
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Pending
Application number
CN201910828155.7A
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Chinese (zh)
Inventor
汪瑞东
段顺举
陈晓宇
卢小贵
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Suzhou Jimei Rui Medical Equipment Ltd By Share Ltd
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Suzhou Jimei Rui Medical Equipment Ltd By Share Ltd
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Priority to CN201910828155.7A priority Critical patent/CN110478025A/en
Publication of CN110478025A publication Critical patent/CN110478025A/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
    • A61B17/683Internal 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
    • 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
    • A61B17/82Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • 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
    • 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
    • A61B2017/681Alignment, compression, or distraction mechanisms

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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 present invention provides a kind of internal fixing device for patellar fracture, including kneecap needle, wire and pressure cuffs, the cunning chamber for accommodating kneecap needle is equipped in the pressure cuffs, when kneecap needle is located at sliding intracavitary, kneecap needle and pressure cuffs are distributed in kneecap two sides and connect at least two fracture portions;Threading hole is equipped on the kneecap needle and pressure cuffs, pressure cuffs can be slid by sliding chamber along kneecap needle to shorten the distance between two threading holes, and wire both ends sequentially pass through two threading holes and are locked.The advantages of present invention fixation is stronger, and fixed device can effectively be avoided to fall off, shift, stimulate soft tissue, can give full play to tension band fixation, can early ambulant joint, prevent knee joint tetanic.

Description

A kind of internal fixing device for patellar fracture
Technical field
Present invention relates particularly to a kind of internal fixing device for patellar fracture.
Background technique
Kneecap is the maximum sub- bone of human body, is located in front of knee joint, has and protects kneed effect.The subsequent pass of kneecap Nodal section is opposite with femoral bone pulley face.Quadriceps muscle of thigh is attached to kneecap upper limb, and part fascia is through extending for ligamentum patellae in front of kneecap, only In tibial tubercle.Kneecap plays a crucial role in human knee moves, for example, the intermediate knot as Quadriceps mechanism Structure, the pulling force that quadriceps muscle of thigh generates is transmitted to kneecap tendon by it;Kneecap plays leverage when stretching knee, can effectively increase and stretch knee dress Set the lever arm of force that axis point is bent and stretched for knee joint;By sliding of the kneecap on femoral bone pulley face, a strand four-head can also be cut down Flesh is to the friction before distal part of femur.
The method of clinical treatment patellar fracture can be divided into conservative and operative treatment two major classes.To the kneecap bone of no displacement Folding, is usually fixed with gypsum or brace.Operation is the major way for treating patellar fracture, usually there is patella claw and tension band at present Two kinds of modus operandis, but there are still deficiencies for the two;The fixed disadvantage of patella claw has: higher cost, making patients' burden;It needs The size for accurately holding patella claw, is not so easy to excessive and too small, patella claw is caused not apply with kneecap;Because patella claw occupies face Product is big, causes to be isolated between kneecap skin and kneecap, and volume increases, and kneecap skin tension is excessive, is unfavorable for suturing, and is easy to cause Kneecap cutaneous necrosis, patella claw are exposed;It is preferable for transverse fracture effect, but for pole bone under complex comminuted fracture and kneecap Folding fixed effect is simultaneously unreliable, and often by means of Kirschner wire fixation, use scope becomes smaller, and adds patella claw with Kirschner wire with it, no If fixed using tension band wiring merely, Surgery Surgery is made to become to make an unnecessary move;Because of the firmness that worry is fixed, so early Phase functional training is restricted;It is not the fixing means that can generally use;
The shortcomings that tension band fixation has: inside-fixture is easy to protrusion skin, punctures skin, causes pain and infection;It is postoperative Gonalgia is more;It is unfavorable for early exercise;Kirschner wire is easy to loose shift, and steel wire is easy to fall off, and makes effective set time Shorten.
Summary of the invention
In order to solve the above technical problems, the present invention provides a kind of internal fixing device for patellar fracture, fixed stronger, energy It enough the advantages of effectively avoiding fixed device from falling off, shift, stimulate soft tissue, tension band fixation can be given full play to, can live in early days Movable joint prevents knee joint tetanic.
The present invention adopts the following technical scheme:
A kind of internal fixing device for patellar fracture, including kneecap needle and wire, further include pressure cuffs, are set in the pressure cuffs There is the cunning chamber for accommodating kneecap needle, when kneecap needle is located at sliding intracavitary, kneecap needle and pressure cuffs are distributed in kneecap two sides and connect at least Two fracture portions;Threading hole is equipped on the kneecap needle and pressure cuffs, pressure cuffs can be slid by sliding chamber along kneecap needle To shorten the distance between two threading holes, wire both ends sequentially pass through two threading holes and are locked.
Preferably, the pressure cuffs are in the form of a column, the sliding chamber run through pressure cuffs one end end face, the pressure cuffs it is another End is equipped with the stopper section greater than pressure cuffs diameter, and threading hole runs through stopper section.
Preferably, the stopper section is substantially in cylindrical type, and the diameter and height of the stopper section are all larger than the straight of pressure cuffs Diameter, threading hole is axially through stopper section.
Preferably, the stopper section is also connected with the foot piece coaxial with pressure cuffs, passes through between the foot piece and stopper section Broken part connection.
Preferably, the diameter of the broken part is less than the internal diameter of pressure cuffs.
Preferably, it is in the taper shunk to end that pressure cuffs, which are located at one end of sliding chamber opening,.
Preferably, the kneecap needle includes shank, and the shank is cylindrical metal stick, and one end of the shank is cone cell Guide end, the other end of shank are connecting pin, and threading hole runs through the connecting pin.
Preferably, the kneecap needle further includes the drive rod for connecting with drilling machine, and the drive rod is coaxially set with shank It sets, is connected between the drive rod and connecting pin by broken part, the diameter of the broken part is less than the diameter of shank.
Preferably, the diameter of the drive rod is greater than the diameter of shank, leads between the end and broken part of the drive rod Cross tapering transition.
Preferably, the threading hole is the hole of circle, diamond shape, rectangle or ellipse.
Beneficial effects of the present invention: the present invention is intracavitary along the sliding of kneecap needle in cunning by pressure cuffs, can promote fractures Point close to each other, realization gathers auxobaric effect, and on this basis, locking wire tightening is fixed, and fixation is stronger, can Fixed device is effectively avoided to fall off, shift, stimulate soft tissue;Simultaneously because pressure cuffs can be slided effectively, can give full play to The advantages of tension band fixation, can early ambulant joint, prevent knee joint tetanic.
Detailed description of the invention
Attached drawing is used to provide to preferred understanding of the invention, and constitutes part of specification, with reality of the invention It applies example to be used to explain the present invention together, not be construed as limiting the invention.In the accompanying drawings:
Fig. 1 is the structural schematic diagram of kneecap needle of the present invention;
Fig. 2 is the structural schematic diagram of pressure cuffs of the present invention;
Fig. 3 is the schematic diagram of the single kneecap needle of the present invention and pressure cuffs by wire when fixed;
Fig. 4 is the present invention two in the schematic diagram between criss-cross kneecap needle and pressure cuffs by wire when fixed;
Fig. 5 is the schematic diagram for carrying out dotted reset in the present embodiment to kneecap;
Fig. 6 is the schematic diagram that kneecap needle penetrates fracture portions in the present embodiment;
Fig. 7 is the schematic diagram that shank is truncated in the present embodiment;
Fig. 8 is the schematic diagram that pressure cuffs are squeezed into the present embodiment;
Fig. 9 is the schematic diagram that the second threading hole is exited in the present embodiment;
Figure 10 is that wire passes through the first threading hole, the second threading hole is in the schematic diagram of " 8 " font connection in the present embodiment;
Figure 11 is the schematic diagram that wire passes through the first threading hole, the second threading hole connects in a ring;
Figure 12 is the schematic diagram to pressurize to Figure 10;
Figure 13 is that wire both ends are locked schematic diagram in Figure 12;
Figure 14 is the schematic diagram that wire is in the locking of " 8 " font after foot piece and drive rod are truncated in Figure 13;
Figure 15 is the schematic diagram that wire is locked in a ring after foot piece and drive rod are truncated on the basis of Figure 11.
Specific embodiment
A specific embodiment of the invention is described with reference to the accompanying drawing.
It as shown in Figures 1 to 4, is a kind of internal fixing device for patellar fracture of the present embodiment, including kneecap needle 100 and metal Silk 200, kneecap needle 100 are used to connect the fracture portions of kneecap, and wire 200 is fixed on kneecap needle 100, are pressed in patellar fracture The fixed effect of tightening is played at place;The inner fixing device further includes pressure cuffs 300, is equipped in pressure cuffs 300 and accommodates kneecap needle 100 Cunning chamber 301, the internal diameter of sliding chamber 301 is slightly larger than the diameter of kneecap needle 100, when kneecap needle 100 is located in sliding chamber 301, kneecap needle 100 and pressure cuffs 300 be distributed in kneecap two sides and connect at least two fracture portions, i.e. kneecap needle 100 penetrates at patellar fracture, Pressure cuffs 300 pass through sliding chamber 301 and are placed on 100 outside of kneecap needle, so that fracture portions are connected, according to the specific fracture feelings of kneecap Condition is at least connected with two fracture portions in penetrating on path for kneecap needle 100, guarantees fracture fixation effect;
Wherein pressure cuffs 300 are equipped with the first threading hole 302, and kneecap needle 100 is equipped with the second threading hole 101, according to reality Border needs, and the first threading hole 302, the second threading hole 101 can be the hole of circle, diamond shape, rectangle or ellipse;Pressure cuffs 300 can be slid by sliding chamber 301 along kneecap needle 100 to shorten the distance of 302 to the second threading hole 101 of the first threading hole, energy Enough promote fracture portions close to each other, realization gathers auxobaric effect, and 200 both ends of wire sequentially pass through the second threading hole 101 With the first threading hole 302 and be locked, on the basis of gathering auxobaric, the locking tightening of wire 200 is fixed, and fixation is more firm Gu fixed device can effectively be avoided to fall off, shift, stimulate soft tissue;Moreover, because pressure cuffs 300 can be slided effectively, energy The advantages of enough giving full play to tension band fixation, can early ambulant joint, prevent knee joint tetanic;
The inner fixing device can use a variety of fixed modes, as shown in figure 3, being independent fixed form, using single kneecap The mating single pressure cuffs 300 of spicule 100, after 200 both ends of wire sequentially pass through the second threading hole 101 and the first threading hole 302 It tightens and fixes in " 8 " font;It or as shown in figure 4, is right-angled intersection fixed form, using two 100 mating two, kneecap needle Pressure cuffs 300 penetrate kneecap in cross, and wire 200 tightens fixation in a ring;It can also be according to specific there are many fixed mode Patellar fracture situation is selected, and is repeated no more;By above-mentioned a variety of fixed modes, which can be suitable for a variety of The operative treatment of patellar fracture.
Specifically, pressure cuffs 300 are in the form of a column, sliding chamber 301 runs through one end end face of pressure cuffs 300, and pressure cuffs 300, which are located at, to be slided One end of 301 opening of chamber is in the taper shunk to end, is entered in the drilling of kneecap convenient for pressure cuffs 300;Pressure cuffs 300 The other end is equipped with the stopper section 303 greater than 300 diameter of pressure cuffs, and stopper section 303 is substantially in cylindrical type, the diameter of stopper section 303 It is highly all larger than the diameter of pressure cuffs 300, when pressure cuffs 300 are located in the drilling of kneecap, stopper section 303 stays in outside, the For one threading hole 302 axially through stopper section 303, pressure cuffs 300 pass through sliding chamber 301 along 100 slipping of kneecap needle, can be with Push the fracture portions of kneecap close to each other by stopper section 303, realization gathers auxobaric effect.
Stopper section 303 is also connected with the foot piece 304 coaxial with pressure cuffs 300, passes through between foot piece 304 and stopper section 303 The connection of first broken part 305;The diameter of first broken part 305 is less than the internal diameter of pressure cuffs 300;Foot piece 304 is primarily to facilitate behaviour Make pressure cuffs 300, after the pressurization of the poly- heart, foot piece 304 is fractureed by the first broken part 305, only only stopper section 303 Protrusion on the outside of kneecap, and stopper section 303 substantially be in cylindrical type, the smooth of the edge, avoid stimulation skin caused by pain and Infection, is conducive to early functional exercise.
Specifically, kneecap needle 100 includes shank 102, shank 102 is cylindrical metal stick, and one end of shank 102 is cone cell Guide end 103, the other end of shank 102 are connecting pin 104, and the second threading hole 101 runs through connecting pin 104, and connecting pin 104 is same It is the smooth of the edge, it is preferably identical as the structure of stopper section 303;It further include the drive rod 105 for being connect with drilling machine, transmission Bar 105 and shank 102 are coaxially disposed, and are connected between drive rod 105 and connecting pin 104 by the second broken part 106, second fractures The diameter in portion 106 is less than the diameter of shank 102;The diameter of drive rod 105 is greater than the diameter of shank 102, the end of drive rod 105 By tapering transition between the second broken part 106, drive rod 105 is mainly used for for kneecap needle 100 being clamped on drilling machine, In It squeezes at patellar fracture under the action of drilling machine, after the pressurization of the poly- heart, drive rod 105 is fractureed by the second broken part 106 , due to 104 the smooth of the edge of connecting pin, equally can be avoided stimulation skin.
As shown in Fig. 5 to Figure 15, by taking kneecap transverse breakage fracture as an example, illustrate fixation procedure in kneecap of the invention:
Fracture skin is cut, clamp is first passed through by upper and lower two fracture portions and carries out dotted reset, as shown in Figure 5;
The drive rod 105 of kneecap needle 100 is clamped on drilling machine, kneecap needle 100 is squeezed into from top by kneecap by drilling machine Fracture penetrates two fracture portions up and down, as shown in fig. 6, squeezing into two kneecap needles at this time since lateral fracture is big 100, and squeeze at maximum displacement, i.e., drive rod 105 contacts kneecap, and guide end 103 extend out to kneecap enough below length;
The shank 102 at guide end 103 is successively truncated by specific purpose tool, only retains the part stretched out part, such as Fig. 7 It is shown;
Pressure cuffs 300 are passed through sliding chamber 301 to be successively placed on the shank 102 of truncation, and are squeezed into kneecap, due to pressure cuffs 300 diameter is greater than 102 diameter of shank, can slightly expand the hole of kneecap bottom by reamer at this time, is convenient for pressure cuffs 300 Into, and the first threading hole 302 is kept to expose outside, as shown in Figure 8;
Kneecap needle 100 is pulled up, shank 102 slides in sliding chamber 301, and the connecting pin 104 on kneecap needle 100 is allowed to move Out, expose the second threading hole 101, as shown in figure 9, two kneecap needles 100 successively operate;
Wire is entered from subcutaneous, sequentially passes through the first threading hole 302, second threading of two kneecap needles 100 Wire both ends are threaded together by hole 101, and " 8 " font is integrally formed in wire, and as shown in Figure 10 or wire is integrally formed Annular, as shown in figure 11;
As shown in figure 12, it is pressurizeed by pressurizing tool to kneecap needle 100 and pressure cuffs 300, clamping kneecap needle 100 is protected It is constant to hold position, clamping pressure cuffs 300 slide to 100 direction of kneecap needle and pressurize, under pressure cuffs 300 are pushed by stopper section 303 Side fracture portions are close to upside, until it can not slide;
After pressurization, fixation is tightened at wire both ends, as shown in figure 13;
Finally fracture from the first broken part 305 foot piece 304, and fracture drive rod 105 from the second broken part 106, such as schemes Shown in 14, wire is locked in " 8 " font, final skin suture;It can also pressurize on the basis of Figure 11, finally Wire is locked in a ring, as shown in figure 15;
Operation minimally invasive can be completed, and notch is small, can open surgery, can also closed reduction, minimally invasive interior fixation, while can be minimally invasive It takes out, as long as finding steel wire, it is easy to take out fixed device, and at low cost, can reduce burden of patients.
The foregoing is only a preferred embodiment of the present invention, is not intended to restrict the invention, although referring to aforementioned reality Applying example, invention is explained in detail, for those skilled in the art, still can be to aforementioned each implementation Technical solution documented by example is modified or equivalent replacement of some of the technical features.It is all in essence of the invention Within mind and principle, any modification, equivalent replacement, improvement and so on be should all be included in the protection scope of the present invention.

Claims (10)

1. a kind of internal fixing device for patellar fracture, including kneecap needle and wire, which is characterized in that it further include pressure cuffs, it is described The cunning chamber for accommodating kneecap needle is equipped in pressure cuffs, when kneecap needle is located at sliding intracavitary, kneecap needle and pressure cuffs are distributed in kneecap two sides And connect at least two fracture portions;Threading hole is equipped on the kneecap needle and pressure cuffs, pressure cuffs can pass through sliding chamber edge Kneecap needle slides to shorten the distance between two threading holes, and wire both ends sequentially pass through two threading holes and are locked.
2. a kind of internal fixing device for patellar fracture according to claim 1, which is characterized in that the pressure cuffs are in the form of a column, The sliding chamber runs through one end end face of pressure cuffs, and the other end of the pressure cuffs is equipped with the stopper section greater than pressure cuffs diameter, wears String holes runs through stopper section.
3. a kind of internal fixing device for patellar fracture according to claim 2, which is characterized in that the stopper section is substantially in round Column type, the diameter and height of the stopper section are all larger than the diameter of pressure cuffs, and threading hole is axially through stopper section.
4. a kind of internal fixing device for patellar fracture according to claim 3, which is characterized in that the stopper section is also connected with The coaxial foot piece with pressure cuffs is connected between the foot piece and stopper section by broken part.
5. a kind of internal fixing device for patellar fracture according to claim 4, which is characterized in that the diameter of the broken part is small In the internal diameter of pressure cuffs.
6. a kind of internal fixing device for patellar fracture according to any one of claim 2 to 5, which is characterized in that pressure cuffs One end positioned at sliding chamber opening is in the taper shunk to end.
7. a kind of internal fixing device for patellar fracture according to claim 1, which is characterized in that the kneecap needle includes needle Bar, the shank are cylindrical metal stick, and one end of the shank is the guide end of cone cell, and the other end of shank is connecting pin, is worn String holes runs through the connecting pin.
8. a kind of internal fixing device for patellar fracture according to claim 7, which is characterized in that the kneecap needle further includes using In the drive rod connecting with drilling machine, the drive rod and shank are coaxially disposed, by fractureing between the drive rod and connecting pin Portion's connection, the diameter of the broken part are less than the diameter of shank.
9. a kind of internal fixing device for patellar fracture according to claim 8, which is characterized in that the diameter of the drive rod is big Pass through tapering transition between the diameter of shank, the end and broken part of the drive rod.
10. a kind of internal fixing device for patellar fracture according to claim 1, which is characterized in that the threading hole be it is round, The hole of diamond shape, rectangle or ellipse.
CN201910828155.7A 2019-09-03 2019-09-03 A kind of internal fixing device for patellar fracture Pending CN110478025A (en)

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Application Number Priority Date Filing Date Title
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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2840934Y (en) * 2005-08-30 2006-11-29 侯庆忠 Patella fixing carriage
CN201119909Y (en) * 2007-08-22 2008-09-24 李家立 Fracture of patella internal fixation needle with holes and capable of being broken
CN201831952U (en) * 2010-11-01 2011-05-18 厦门大博颖精医疗器械有限公司 Patella guiding needle device
US20110137356A1 (en) * 2008-08-12 2011-06-09 Uso-Ck, Llc Bone compression device and methods
CN102488546A (en) * 2011-11-15 2012-06-13 叶立民 Cylindrical tension band pressurizing fixing apparatus for patellar fracture and service method of cylindrical tension band pressurizing fixing apparatus
CN102579119A (en) * 2012-02-15 2012-07-18 上海市第十人民医院 Pressurization needle cable fixed system for patella fracture and application thereof
CN210843402U (en) * 2019-09-03 2020-06-26 苏州吉美瑞医疗器械股份有限公司 Internal fixing device for patellar fracture

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2840934Y (en) * 2005-08-30 2006-11-29 侯庆忠 Patella fixing carriage
CN201119909Y (en) * 2007-08-22 2008-09-24 李家立 Fracture of patella internal fixation needle with holes and capable of being broken
US20110137356A1 (en) * 2008-08-12 2011-06-09 Uso-Ck, Llc Bone compression device and methods
CN201831952U (en) * 2010-11-01 2011-05-18 厦门大博颖精医疗器械有限公司 Patella guiding needle device
CN102488546A (en) * 2011-11-15 2012-06-13 叶立民 Cylindrical tension band pressurizing fixing apparatus for patellar fracture and service method of cylindrical tension band pressurizing fixing apparatus
CN102579119A (en) * 2012-02-15 2012-07-18 上海市第十人民医院 Pressurization needle cable fixed system for patella fracture and application thereof
CN210843402U (en) * 2019-09-03 2020-06-26 苏州吉美瑞医疗器械股份有限公司 Internal fixing device for patellar fracture

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