CN111150437B - Auxiliary device for treating calcaneal fracture under arthroscope and operation method thereof - Google Patents
Auxiliary device for treating calcaneal fracture under arthroscope and operation method thereof Download PDFInfo
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- CN111150437B CN111150437B CN202010054331.9A CN202010054331A CN111150437B CN 111150437 B CN111150437 B CN 111150437B CN 202010054331 A CN202010054331 A CN 202010054331A CN 111150437 B CN111150437 B CN 111150437B
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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
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
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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
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
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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
- A61B17/8897—Guide wires or guide pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Abstract
The invention provides an auxiliary device for treating calcaneal fracture under an arthroscope, which comprises a simple retractor, a first auxiliary mechanism and a second auxiliary mechanism, wherein the first auxiliary mechanism comprises a first guide pin, a first inner core and a Y-shaped sleeve; the invention also provides a positioning operation method of the first auxiliary mechanism and the second auxiliary mechanism. By the aid of the operation method, smooth fixation of the Y-shaped sleeve and the positioning sleeve can be achieved, operation of the subtalar arthroscope and the manipulator can be conveniently achieved by the aid of the Y-shaped sleeve and the positioning sleeve, operation is facilitated smoothly, meanwhile, damage to soft tissues caused by repeated descending of the subtalar arthroscope and the manipulator can be prevented by the aid of the Y-shaped sleeve and the positioning sleeve, and operation effects can be guaranteed.
Description
Technical Field
The present invention relates to an auxiliary device for arthroscopic treatment of calcaneus fractures and a method of operating the same.
Background
Calcaneus fracture is the most common tarsal fracture, which can cause calcaneus height reduction and arch collapse, affecting the appearance and mechanical stability of the calcaneus; causing intra-articular fracture may cause traumatic arthritis of the subtalar joint; the heel bone is widened to cause complications such as tendon clamping, difficulty in wearing shoes and the like, and foot dysfunction is caused. At present, an incision reduction internal fixation method is the most common and effective method for treating the displaced calcaneus fracture, but the postoperative incision soft tissue is not healed, the built-in object is exposed, and complications such as postoperative infection, osteomyelitis and the like influence the treatment effect of the operation. When the fracture of calcaneus is treated under the subtalar arthroscope, because the subtalar clearance is narrow, the operation is difficult, the clinical application cannot be promoted, and the repeated implantation of the subtalar arthroscope is easy to cause soft tissue injury, so that the probability of postoperative infection is increased.
Disclosure of Invention
The invention aims to provide an auxiliary device for treating calcaneal fracture under an arthroscope and an operation method thereof, wherein in an operation, after the Y-shaped sleeve and the positioning sleeve are positioned in soft tissues, the arthroscope and a manipulator enter a damaged part through the Y-shaped sleeve or the positioning sleeve, and in a subsequent operation, the smooth operation of the arthroscope and the manipulator is facilitated, meanwhile, the damage degree of the soft tissues is reduced, the improvement of the operation efficiency is facilitated, and meanwhile, the operation effect is ensured.
The technical scheme adopted for solving the technical problems is as follows: the auxiliary device for treating calcaneal fracture under the arthroscope comprises a simple retractor, a first auxiliary mechanism and a second auxiliary mechanism, wherein the simple retractor comprises a threaded pipe and an adjusting threaded rod, one end of the adjusting threaded rod is sleeved in the threaded pipe, the other end of the adjusting threaded rod is fixedly provided with an adjusting seat, a first supporting rod distributed along the radial direction of the adjusting threaded rod is arranged on the adjusting seat, the first supporting rod can freely rotate by taking the axis of the adjusting threaded rod as a central shaft, the outer end of the threaded pipe is fixedly provided with a fixing seat, the fixing seat is fixedly provided with a second supporting rod distributed along the radial direction of the threaded pipe, the upper ends of the first supporting rod and the second supporting rod are hinged with a retracting rod, and the retracting rod freely swings in the radial plane of the adjusting threaded rod;
the first auxiliary mechanism comprises a first guide pin, a first inner core and a Y-shaped sleeve, the first guide pin is fixedly penetrated in the middle of the first inner core, the Y-shaped sleeve can be sleeved on the first inner core, and the Y-shaped sleeve can freely slide relative to the first inner core; the Y-shaped sleeve comprises a first inlet end, a second inlet end and an outlet end, wherein a plurality of first positioning holes are formed in the outer edges of the first inlet end and the second inlet end, and a second positioning hole corresponding to the first positioning hole is formed in the outer edge of the outlet end;
the second auxiliary mechanism comprises a second guide pin, a second inner core and a positioning sleeve, the second guide pin is fixedly penetrated in the middle of the second inner core, the positioning sleeve can be sleeved on the second inner core, and the positioning sleeve can freely slide relative to the second inner core.
Preferably, a first annular band is provided outside the upper end of the first core.
Preferably, a second annular band is provided outside the upper end of the second core.
Further, a supporting lug is arranged on one side of the upper part of the positioning sleeve.
Further, the lower end of the positioning sleeve is semi-tubular.
The invention also provides a using and operating method of the first auxiliary mechanism, which comprises the following steps:
s1, fixing a first guide pin and a first inner core at corresponding positions;
s2, clamping the Y-shaped sleeve, enabling the outlet end of the Y-shaped sleeve to be sleeved on the first inner core slowly, and pushing the Y-shaped sleeve slowly to move down on the first inner core slowly until the Y-shaped sleeve reaches a proper position;
s3, fixing the Y-shaped sleeve by penetrating the first positioning hole and the second positioning hole through a traction Kirschner wire;
s4, taking the first guide pin and the first inner core out of the first inlet end or the second inlet end of the upper part of the Y-shaped sleeve, and then completing the positioning of the Y-shaped sleeve;
the invention also provides a using and operating method of the second auxiliary mechanism, which comprises the following steps:
s1, fixing a second guide pin and a second inner core at corresponding positions;
s2, clamping the positioning sleeve, enabling the lower end of the positioning sleeve to be sleeved on the second inner core slowly, and then pushing the positioning sleeve slowly to move down on the second inner core slowly until the positioning sleeve reaches a proper position;
s3, taking the second guide pin and the second inner core out of the positioning sleeve, and then completing positioning of the positioning sleeve.
The beneficial effects of the invention are as follows: the invention has simple structure and convenient use and operation; in an actual operation, the Y-shaped sleeve and the positioning sleeve are fixed and positioned according to the fracture injury position, the broken ends of bones are exposed after the Y-shaped sleeve and the positioning sleeve are positioned, meanwhile, the subtalar arthroscope is descended by the Y-shaped sleeve and the positioning sleeve, the operation of the subtalar arthroscope is facilitated, meanwhile, the wound condition is observed through the subtalar arthroscope, and the manipulator descends through the Y-shaped sleeve, so that the treatment of broken end hematoma and soft tissues is facilitated; the subtalar arthroscope and the manipulator repeatedly descend in the Y-shaped sleeve and the positioning sleeve, so that the damage to soft tissues is reduced, and the operation effect is guaranteed.
Drawings
In order to more clearly illustrate the embodiments of the invention or the technical solutions of the prior art, the drawings which are used in the description of the embodiments or the prior art will be briefly described, it being obvious that the drawings in the description below are some preferred embodiments of the invention and that other drawings can be obtained from these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic view of the overall construction of a simple retractor of the invention;
FIG. 2 is a schematic structural view of a first lead and a first core;
FIG. 3 is a schematic view of the structure of a Y-shaped sleeve;
FIG. 4 is a schematic view of a Y-shaped cannula guided sliding through a first guide pin and a first core;
FIG. 5 is a schematic structural view of a second lead and a second core;
FIG. 6 is a schematic view of the structure of the positioning sleeve;
FIG. 7 is a schematic view of the guiding sliding of the positioning sleeve through the second guide pin and the second inner core;
FIG. 8 is an enlarged view of FIG. 2 at A;
FIG. 9 is an enlarged view of FIG. 3B;
FIG. 10 is an enlarged view of FIG. 3 at C;
FIG. 11 is an enlarged view of FIG. 5 at D;
in the figure: the device comprises a threaded pipe 11, a fixed seat 111, a second supporting rod 112, an adjusting threaded rod 12, an adjusting seat 121, a first supporting rod 122, a retracting rod 13, a first guide pin 21, a first inner core 22, a first annular belt 221, a Y-shaped sleeve 23, a first inlet end 231, a second inlet end 232, an outlet end 233, a first positioning hole 234, a second positioning hole 235, a second guide pin 31, a second inner core 32, a second annular belt 321, a positioning sleeve 33 and a lug 331.
Detailed Description
The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to specific embodiments and fig. 1 to 11, and it is obvious that the described embodiments are only some of the preferred embodiments of the present invention, but not all embodiments. Similar modifications can be made by those skilled in the art without departing from the spirit of the invention, and therefore the invention is not to be limited by the specific embodiments disclosed below.
The invention provides an auxiliary device for treating calcaneal fracture under arthroscope, which comprises a simple retractor, a first auxiliary mechanism and a second auxiliary mechanism, wherein the simple retractor comprises a threaded pipe 11 and an adjusting threaded rod 12, one end of the adjusting threaded rod 12 is sleeved in the threaded pipe 11, an adjusting seat 121 is fixedly arranged at the other end of the adjusting threaded rod 12, a first supporting rod 122 distributed along the radial direction of the adjusting threaded rod 12 is arranged on the adjusting seat 121, the first supporting rod 122 can be used for adjusting the axis of the threaded rod 12 to freely rotate as a central shaft, a fixing seat 111 is fixedly arranged at the outer end of the threaded pipe 11, a second supporting rod 112 distributed along the radial direction of the threaded pipe 11 is fixedly arranged on the fixing seat 111, a retracting rod 13 is hinged to the upper ends of the first supporting rod 122 and the second supporting rod 112, the retracting rod 13 freely swings in the radial plane of the adjusting threaded rod 12, in practical application, the distance between the two retracting rods 13 can be adjusted by rotating the threaded rod 12, in turn, and in addition, the simple retractor is utilized for expanding the symmetric joint, and the extension of the height of a calcaneal joint can be continuously recovered, and the calcaneal joint can be easily and used for the extension and the extension of the side of a patient.
The first auxiliary mechanism comprises a first guide pin 21, a first inner core 22 and a Y-shaped sleeve 23, wherein the first guide pin 21 is fixedly penetrated through the middle part of the first inner core 22, the Y-shaped sleeve 23 can be sleeved on the first inner core 22, and the Y-shaped sleeve 23 can freely slide relative to the first inner core 22; the Y-shaped sleeve 23 includes a first inlet end 231, a second inlet end 232, and an outlet end 233, a plurality of first positioning holes 234 are provided on outer edges of the first inlet end 231 and the second inlet end 232, and a second positioning hole 235 corresponding to the first positioning holes 234 is provided on an outer edge of the outlet end 233, in order to facilitate clamping of the first guide pin 21 and the first inner core 22 and to facilitate taking out of the first guide pin 21 and the first inner core 22 from the Y-shaped sleeve 23 in practical application, and a first annular band 221 is provided outside an upper end of the first inner core 22.
The second auxiliary mechanism comprises a second guide pin 31, a second inner core 32 and a positioning sleeve 33, wherein the second guide pin 31 is fixedly penetrated through the middle part of the second inner core 32, the positioning sleeve 33 can be sleeved on the second inner core 32, and the positioning sleeve 33 can freely slide relative to the second inner core 32, in practical application, in order to facilitate the clamping of the second guide pin 31 and the second inner core 32 and the removal of the second guide pin 31 and the second inner core 32 from the positioning sleeve 33, a second annular belt 321 is arranged outside the upper end of the second inner core 32; in order to facilitate the clamping of the positioning sleeve 33, a supporting lug 331 is arranged on one side of the upper part of the positioning sleeve 33, further, in order to facilitate the observation and assessment of the fracture reduction condition of the rear outer side edge of the calcaneus by the subtalar arthroscope through the positioning sleeve 33, the lower end of the positioning sleeve 33 is arranged in a semi-tubular shape, when the lower part of the positioning sleeve 33 is in a semi-tubular shape, the side with a tube wall can be used for blocking soft tissues, and then, the side without the tube wall is used for observation.
The invention also provides a using and operating method of the first auxiliary mechanism, which comprises the following steps:
s1, fixing a first guide pin 21 and a first inner core 22 at corresponding positions;
s2, clamping the Y-shaped sleeve 23, and then enabling the outlet end 233 of the Y-shaped sleeve 23 to be slowly sleeved into the first inner core 22
Then, the Y-shaped sleeve 23 is slowly pushed to slowly move downwards on the first inner core 22 until the Y-shaped sleeve 23 reaches a proper position;
s3, fixing the Y-shaped sleeve 23 by penetrating the first positioning hole 234 and the second positioning hole 235 through a traction kirschner wire;
s4, the first guide pin 21 and the first inner core 22 are taken out from the first inlet end 231 or the second inlet end 232 at the upper part of the Y-shaped sleeve 23, and then the positioning of the Y-shaped sleeve 23 is completed.
The invention also provides a using and operating method of the second auxiliary mechanism, which comprises the following steps:
s1, fixing a second guide pin 31 and a second inner core 32 at corresponding positions;
s2, clamping the positioning sleeve 33, enabling the lower end of the positioning sleeve 33 to be sleeved on the second inner core 32 slowly, and then pushing the positioning sleeve 33 to move down slowly on the second inner core 32 slowly until the positioning sleeve reaches a proper position;
s3, taking the second guide pin 31 and the second inner core 32 out of the positioning sleeve 33, and then completing positioning of the positioning sleeve 33.
The operation method for carrying out the internal fixation of the reduction of the root bone fracture by using the device provided by the invention comprises the following steps:
firstly, implanting a traction Kirschner wire from the anterior lateral malleolus and the lateral dorsal lateral side of the lateral process by about 1cm, penetrating the traction Kirschner wire to the tibial side, and enabling the direction to be perpendicular to the sagittal plane; implanting a traction Kirschner wire from a calcaneus tuberosity position and penetrating the needle to the side of a shin (wherein the needle feeding position and direction of the calcaneus tuberosity Kirschner wire depend on the position of a calcaneus fracture line, the Bohler angle change and the presence or absence of varus deformity), then implanting a simple retractor at the fracture position, continuously symmetrically retracting bilaterally, recovering the length and the height of the calcaneus and correcting the varus of the calcaneus;
secondly, a diameter of 2.7mm caliber is adopted by the subtalar arthroscope, an angle is 15 degrees, a subtalar arthroscope entrance is determined from a front outer entrance and a rear outer entrance, a mark is made, a notch with a diameter of about 1cm can be cut from the front outer entrance, the notch is placed into the first guide needle 21 and the first inner core 22, after the position is proper, the Y-shaped sleeve 23 is implanted through the guiding action of the first guide needle 21 and the first inner core 22, an operation window is formed, then the fixing of the Y-shaped sleeve 23 is realized by penetrating the first positioning hole 234 and the second positioning hole 235 through a Kirschner wire, after the Y-shaped sleeve 23 is fixed, the first guide needle 21 and the first inner core 22 are taken out from the Y-shaped sleeve 23, the subtalar arthroscope is applied to enter the Y-shaped sleeve 23 from the first entrance end 231 or the second entrance end 232, the wound surface condition is observed, and the manipulator enters through the rest first entrance end 231 or the second entrance end 232, and hematoma and soft tissues at the broken end are processed; the second guide needle 31 and the second inner core 32 are implanted from the posterolateral approach, after the position is proper, the positioning sleeve 33 is implanted through the guiding action of the second guide needle 31 and the second inner core 32, after the positioning sleeve 33 is proper in position, the second guide needle 31 and the second inner core 32 are taken out from the positioning sleeve 33, then, the subtalar arthroscope is implanted, the fracture reduction condition of the heel bone posterolateral edge is evaluated, after the fracture reduction, the fracture reduction condition of the subtalar joint lateral edge is observed from the positioning sleeve 33, the internal fixation is carried out through the Y-shaped sleeve 23, and then the fracture reduction internal fixation operation of the heel bone is completed.
Other than the technical features described in the specification, all are known to those skilled in the art.
While the preferred embodiments and examples of the present invention have been described in detail with reference to the accompanying drawings, the present invention is not limited to the embodiments and examples, and it will be apparent to those skilled in the art that various modifications and variations can be made without departing from the spirit of the present invention, and the scope of the invention is also defined by the appended claims.
Claims (4)
1. The auxiliary device for treating calcaneal fracture under the arthroscope is characterized by comprising a simple retractor, a first auxiliary mechanism and a second auxiliary mechanism, wherein the simple retractor comprises a threaded pipe and an adjusting threaded rod, one end of the adjusting threaded rod is sleeved in the threaded pipe, the other end of the adjusting threaded rod is fixedly provided with an adjusting seat, a first supporting rod distributed along the radial direction of the adjusting threaded rod is arranged on the adjusting seat, the first supporting rod can freely rotate by taking the axis of the adjusting threaded rod as a central shaft, a fixing seat is fixedly arranged at the outer end of the threaded pipe, a second supporting rod distributed along the radial direction of the threaded pipe is fixedly arranged on the fixing seat, a retracting rod is hinged to the upper ends of the first supporting rod and the second supporting rod, and the retracting rod freely swings in the radial plane of the adjusting threaded rod;
the first auxiliary mechanism comprises a first guide pin, a first inner core and a Y-shaped sleeve, the first guide pin is fixedly penetrated in the middle of the first inner core, the Y-shaped sleeve can be sleeved on the first inner core, and the Y-shaped sleeve can freely slide relative to the first inner core; the Y-shaped sleeve comprises a first inlet end, a second inlet end and an outlet end, wherein a plurality of first positioning holes are formed in the outer edges of the first inlet end and the second inlet end, and a second positioning hole corresponding to the first positioning hole is formed in the outer edge of the outlet end;
the second auxiliary mechanism comprises a second guide pin, a second inner core and a positioning sleeve, the second guide pin is fixedly penetrated through the middle part of the second inner core, the positioning sleeve can be sleeved on the second inner core, and the positioning sleeve can freely slide relative to the second inner core; one side of the upper part of the positioning sleeve is provided with a supporting lug.
2. An aid for arthroscopic treatment of calcaneal fractures according to claim 1 and wherein a first annular band is provided outside the upper end of said first core.
3. An aid for arthroscopic treatment of calcaneal fractures according to claim 2 and wherein a second annular band is provided outside the upper end of said second core.
4. An aid for arthroscopic treatment of calcaneus fractures according to claim 3 and wherein said positioning sleeve has a half-tube shape at its lower end.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010054331.9A CN111150437B (en) | 2020-01-17 | 2020-01-17 | Auxiliary device for treating calcaneal fracture under arthroscope and operation method thereof |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010054331.9A CN111150437B (en) | 2020-01-17 | 2020-01-17 | Auxiliary device for treating calcaneal fracture under arthroscope and operation method thereof |
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| CN111150437A CN111150437A (en) | 2020-05-15 |
| CN111150437B true CN111150437B (en) | 2023-06-20 |
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