CN111317524B

CN111317524B - Tendon stitching instrument and using method thereof

Info

Publication number: CN111317524B
Application number: CN202010127942.1A
Authority: CN
Inventors: 张�杰; 刘洋; 朱东明; 张晓波; 谷风康; 王静成
Original assignee: Second Xiangya Hospital of Central South University
Current assignee: Second Xiangya Hospital of Central South University
Priority date: 2020-02-28
Filing date: 2020-02-28
Publication date: 2021-01-29
Anticipated expiration: 2040-02-28
Also published as: CN111317524A

Abstract

The invention discloses a tendon suturing device and a using method thereof, and the tendon suturing device comprises two jackets for clamping and fixing two ends of a broken tendon respectively, and a locking structure for locking the two jackets to keep the broken tendon in a butt joint state, wherein each jacket comprises a first clamping plate and a second clamping plate which are elastically clamped with each other, tooth-shaped clamping plates are arranged at the ends of the first clamping plate and the second clamping plate on the opposite sides between the two jackets, a circle of tooth grooves are formed at the opposite ends of the tooth-shaped clamping plates around the circumference, and tendon lumens for allowing the tendons to pass through are formed between the first clamping plate and the second clamping plates and between the tooth-shaped clamping plates in a clamping state; and a plurality of guide pin holes penetrating through the clamping plates are respectively arranged on the first clamping plate and the second clamping plate. The invention can play a role in accurate and firm suture repair of the tendon broken end, greatly saves the time for the intraoperative suture and the whole operation by the standardized suture operation, has simple structure and easy operation, is not influenced by the personal experience of doctors, and can be widely popularized and applied clinically.

Description

Tendon stitching instrument and using method thereof

Technical Field

The invention belongs to a suture surgical instrument, and particularly relates to a tendon suture instrument and a use method thereof.

Background

Tendon rupture is a common and frequently encountered disease in hand surgery, and the conservative treatment effect is not good due to the traction action of muscles after rupture, so the surgical suture method is mostly adopted for treatment. Ideal tendon repair includes: safe, simple and rapid sewing; allowing early functional exercise after surgery; a very small gap between the severed ends of the two tendons; the tendon suture ends are smooth and consistent; while minimally disrupting the blood supply. In addition, the excellent sliding effect (no adhesion) of the long-term tendon after operation is also an indispensable suture requirement.

With the progress of the suture technology, Cross-tack and hall peripheral suture methods adopted by a lock suture method, a multistrand suture method, a Silverski suture method, Wade and the like appear, although the suture methods have enough strength, the operation is complex and is not easy to master, the technical requirements on doctors are high, the suture effect of different people often depends on the experience and cognition of the doctors to a great extent, the wide popularization and use in clinic is not facilitated, and therefore the suture methods cannot be popularized in hospitals.

The tendon needs to be fixed in a stable joint state in the tendon suturing process, the currently common means include fixing and clamping or clamping and fixing the tendon through a handheld clamp, the fixing and clamping is as an adjustable auxiliary medical tendon suturing fixator disclosed in patent document with application number 201120008291.0, the handheld clamp is as an auxiliary tendon suturing jaw and an auxiliary tendon suturing forceps disclosed in patent document with application number 201510219076.8, although the instruments can reliably clamp and fix the tendon suturing process, the instruments cannot provide assistance for the needle walking and suturing process of a doctor, but are easy to cause certain influence on the needle threading and routing in the suturing process, and on the contrary, the tendon suturing effect is easy to be influenced.

Disclosure of Invention

The technical problem solved by the invention is as follows: aiming at the problem that the existing tendon suturing effect is greatly influenced by a mechanical clamping instrument and the personal technical level of doctors, the tendon suturing device capable of realizing the standardized operation and the using method thereof are provided.

The invention is realized by adopting the following technical scheme:

the tendon suturing device comprises two jackets for clamping and fixing two ends of a broken tendon respectively, and a locking structure for locking the two jackets to keep the broken tendon in a butt joint state,

the clamping sleeves comprise a first clamping plate and a second clamping plate which are elastically clamped with each other, toothed clamping plates are arranged at the end parts of the first clamping plate and the second clamping plate on the opposite sides between the two clamping sleeves, a circle of tooth grooves are formed around the circumference of the opposite end parts of the toothed clamping plates, and tendon tube cavities for allowing tendons to pass through are formed between the first clamping plate and the second clamping plate and between the toothed clamping plates in a clamping state;

be equipped with a plurality of guide pin holes that pierce through splint on first splint and the second splint respectively, guide pin hole one-to-one coaxial correspondence on first splint and the second splint is on same splint two liang of wire guide slot intercommunication through piercing through splint between the guide pin hole, guide pin hole and wire guide slot all lie in the projection region of tendon lumen on splint within, the guide pin hole that is close to the cusp clamping piece on first splint and the second splint is through the wire groove intercommunication that pierces through splint and cusp clamping piece.

Among the technical scheme of above-mentioned tendon stitching instrument, the guide pin hole on first splint and the second splint includes pinhole opening, receipts needle hole and a plurality of centre holes, pinhole opening and receipts needle hole all are located the center of tendon lumen, centre holes distribute gradually in the upper and lower both sides of pinhole opening and receipts needle hole line, and the metallic channel on same splint all inclines parallel arrangement according to same direction, the crisscross setting of metallic channel direction between first splint and the second splint.

In the technical scheme of the tendon suturing device, the thread outlet groove extends to the end part of the tooth groove of the tooth-shaped clamping piece from the narrowing hole along the axial direction of the tendon lumen.

In the technical scheme of above-mentioned tendon stitching instrument, all be equipped with the centre gripping handle on first splint and the second splint to it is articulated with torsional spring elasticity through the centre gripping handle, realize that first splint and second splint elasticity press from both sides tightly.

In the technical scheme of the tendon suturing device, the inner wall of the tendon tube cavity is provided with a positioning bulge for increasing tendon clamping and positioning.

In a preferable embodiment of the tendon suture instrument, the locking structure includes a positioning clip and a rack, the positioning clip is elastically hinged to one of the clamping sleeves through a torsion spring, the rack is fixedly assembled to the other clamping sleeve, and the positioning clip is embedded into the positioning teeth of the rack along with the relative movement between the two clamping sleeves, so as to achieve the position locking between the two clamping sleeves.

In the technical scheme of the tendon suturing device, locking structures are symmetrically arranged on two sides of the two clamping sleeves.

In another preferred embodiment of the tendon suturing device, the locking structure comprises a stud and a locking nut, the stud penetrates through the guide sleeves coaxially arranged on the two clamping sleeves, the locking nut is screwed at the end of the stud to lock the stud, and the position between the two clamping sleeves after the two ends of the broken tendon are clamped and butted is limited.

In the technical scheme of the tendon suturing device, the stud is a U-shaped stud, two guide sleeves are symmetrically arranged on two sides of the clamping sleeve respectively, rods on two sides of the U-shaped stud penetrate through all the guide sleeves respectively, and the locking nut is in threaded connection with the end portion of the U-shaped stud.

The invention also discloses a using method of the tendon suturing device, which comprises the following steps:

firstly, fixing the tendon,

clamping two clamping sleeves at two ends of a broken tendon respectively, butting the broken ends of the tendon, and fixing the position between the two clamping sleeves through a locking structure;

secondly, the axial suture and fixation of the broken tendon,

adopting double-needle suture, respectively penetrating one suture needle through a needle lifting hole on a first clamp plate and a second clamp plate of one clamp sleeve, penetrating the suture needle penetrating out of a guide pin hole of the first clamp plate or the second clamp plate from another guide pin hole communicated with the guide pin hole through a guide wire groove to a guide pin hole on the other side until the two suture needles respectively penetrate out of needle withdrawing holes of the first clamp plate and the second clamp plate, then leading out two ends of the suture from a thread outlet groove communicated with the needle withdrawing hole, adopting the other double-needle suture to walk on a tendon clamped by the other clamp sleeve according to the same step, and then carrying out homonymy tensioning and knotting on the two ends led out by the two suture threads;

thirdly, the broken tendon is fixed by circumferential stitching,

taking a third double-needle suture, penetrating one suture needle into the tendon from a tooth socket of the toothed clamping piece on the same jacket at an interval of 180 degrees, wherein one suture needle is used for alternately suturing two tendon broken ends along the same circumferential direction according to the tooth sockets opposite to the toothed clamping pieces on the two jackets, the other suture needle is used for alternately suturing the two tendon broken ends along the other circumferential direction according to the tooth sockets opposite to the toothed clamping pieces on the two jackets, and after suturing for at least one circle along the circumferential direction of the two tendon broken ends, tensioning and knotting the two ends of the suture;

and fourthly, loosening the tendon, loosening the locking structure between the two clamping sleeves, and then respectively removing the two clamping sleeves from the sutured tendon.

The tendon suturing device provided by the invention has the advantages that the two independent clamping sleeves are used for clamping tendons, the two clamping sleeves are relatively locked through the locking structure, continuous and stable pressing force can be applied to the tendon stumps in the suturing process, enough holding force is provided for tendon stump suturing, complications of suture fracture caused by tendon tensioning after surgery can be avoided, early functional exercise can be performed after tendon suturing, and short time or gypsum-assisted fixation after surgery is not needed, so that the occurrence probability of tendon adhesion after surgery is reduced.

The tendon suturing device provided by the invention has the advantages that the clamping sleeve is adopted to clamp the tendon, and meanwhile, the guide pin hole and the guide wire groove are arranged on the clamping sleeve, so that the suturing process is the same and standard, the tendon suturing difficulty is reduced, and the problem of poor postoperative incision suturing caused by the difference of the suturing quality caused by different doctors is solved.

The thread passing sewing scheme adopted by the tendon suturing device ensures that the tendon is horizontally stressed after being sutured, the tendon is flat after being sutured, the stress direction of the suture is consistent with the direction of a tendon contraction force line, complex weaving and suturing are changed into simple left-right insertion operation of a suture needle, and the design can enable a tendon clamp to be smoothly taken down after the tendon is sutured, and the subsequent suture knotting operation is not influenced.

In conclusion, the tendon suturing device can play a role in accurate and firm suturing and repairing of tendon broken ends, the normalized suturing operation greatly saves the suturing time in the operation and the whole operation time, the occurrence of adhesion and breakage after the tendon suturing operation is effectively prevented, satisfactory postoperative function recovery can be obtained, the structure is simple, the operation is easy, the tendon suturing device is not influenced by personal experience of doctors, and the tendon suturing device can be widely popularized and applied in clinic.

The invention is further described with reference to the following figures and detailed description.

Drawings

Fig. 1 is a schematic view of an overall structure of a tendon stapler according to an embodiment.

FIG. 2 is a front view of the tendon stapler according to the first embodiment.

FIG. 3 is a schematic view showing the structure of the second collet of the tendon suture instrument according to the first embodiment.

Fig. 4 is a schematic structural view of a first clamping plate of a second clamping sleeve in the first embodiment.

FIG. 5 is an enlarged view of a portion of one end of the first clamping plate according to the first embodiment.

FIG. 6 is an enlarged view of the other end of the first splint according to the first embodiment, showing the tooth-shaped splints.

FIG. 7 is a schematic view of a locking structure of the tendon stapler according to an embodiment.

FIG. 8 is a schematic view showing a needle passing sewing line on the first jaw of the first collet according to the first embodiment.

FIG. 9 is a schematic view of the needle-passing suture path on the second jaw of the first collet and the suture connection between the two collets according to the first embodiment.

FIG. 10 is a schematic view of a suture trace on a tendon at the severed end according to an embodiment.

FIG. 11 is a schematic view of a tendon being sutured circumferentially according to the first embodiment.

FIG. 12 is a schematic view of the overall structure of a tendon stapler according to the second embodiment.

Fig. 13 is an overall top view of the tendon suturing device in the second embodiment, showing a schematic locking structure of the tendon suturing device.

FIG. 14 is a schematic view of the assembly of the suture for axial suturing of two tendon stumps according to one embodiment and another embodiment.

FIG. 15 is a schematic view of the suture on one side of the tendon stumps in accordance with the first and second embodiments.

FIG. 16 is a schematic view of another suture side of axial suture of tendon stumps according to one and the same embodiments.

FIG. 17 is a schematic view of a suture obtained by circumferentially suturing two tendon stumps according to one or more embodiments.

Reference numbers in the figures: 100-tendon, 21-first jacket, 22-second jacket, 23-locking structure, 201-first splint, 202-second splint, 203-clamping handle, 204-dentate clamping piece, 205-positioning clamp, 206-rack, 207-guide sleeve, 208-U-shaped stud, 209-locking nut, 2011-tendon lumen, 2012-guide pin hole, 2013-guide wire groove, 2014-positioning bulge, 2015-outlet groove, 31-suture and 32-suture needle.

Detailed Description

Example one

Referring to fig. 1 and 2, a tendon suturing instrument shown in the drawings is a specific embodiment of the present invention, and includes a first collet 21, a second collet 22, a locking structure 23, and a suturing needle 32 and a suture 31 for suturing a severed end of a tendon 100, wherein the first and

second collets

21 and 22 clamp and fix two ends of the severed tendon 100 respectively, expose the severed tendon end at opposite ends of the two collets, then approach the first and

second collets

21 and 22 in a tendon direction to butt the severed tendon 100 at the severed tendon end, the locking structure 23 locks the positions of the first and

second collets

21 and 22 with respect to each other to keep the severed tendon end of the tendon 100 in a butt-fixed state, and the suturing needle 32 and the suture 31 perform a regular tendon suture through a guide needle and a guide wire structure set on the first and

second collets

21 and 22.

The first jacket 21 and the second jacket 22 are the same clamping structure, and the specific structure of the two jackets is described in detail below by taking the second jacket 22 as an example in conjunction with fig. 3 to 6.

As shown in fig. 3 and 4, the second clamping sleeve 22 includes a first clamping plate 201, a second clamping plate 202 and a clamping handle 203, the first clamping plate 201 and the second clamping plate 202 are respectively provided with the clamping handle 203, the clamping handles are symmetrical to each other, and are assembled into a clamping structure through the clamping handles 203, the initial state of the clamping structure is an elastic clamping state, the clamping handle 203 between the first clamping plate 201 and the second clamping plate 202 is elastically hinged through a torsion spring (not shown in the figure), the clamping state is maintained by the elastic force of the torsion spring, the first clamping plate 201 and the second clamping plate 202 can be opened by pressing the two clamping handles 203 towards each other to overcome the elastic force of the torsion spring, and after clamping the tendon, the first clamping plate 201 and the second clamping plate 202 can clamp the tendon 100 by releasing the elastic force of the torsion spring by releasing the clamping handles 203.

The first clamping plate 201 and the second clamping plate 202 are of symmetrical structures, the semi-cylindrical through grooves are respectively formed in the opposite clamping sides of the first clamping plate 201 and the second clamping plate 202, a through cylindrical space is formed after the first clamping plate 201 and the second clamping plate 202 are clamped, taking the first clamping plate 201 as an example, specifically as shown in fig. 4, a tooth-shaped clamping piece 204 is arranged at one end of the first clamping plate 201, the tooth-shaped clamping piece 204 is a semi-circular pipe piece, and a continuous tooth socket is formed at the outer side end far away from the first clamping plate 201. The semi-circular inner diameter of the tooth-shaped clamping piece 204 is the same as the diameter of the semi-cylindrical through groove on the first clamping plate 201, after the first clamping plate 201 and the second clamping plate 202 are clamped, a cylindrical channel communicated with the cylindrical space between the first clamping plate 201 and the second clamping plate 202 is formed between the tooth-shaped clamping piece 204 on the first clamping plate 201 and the tooth-shaped clamping piece on the second clamping plate 202, and the cylindrical channel is a tendon lumen 2011 for allowing a tendon to pass through when the second clamping sleeve 22 clamps the tendon. In practice, the internal diameter of the tendon lumen 2011 is slightly smaller than the external diameter of the tendon 100, because the tendon 100 has elasticity, so that it can be clamped between the first splint 201 and the second splint 202.

In order to ensure the axial positioning effect of the clamping sleeve on the tendon, in this embodiment, a positioning protrusion 2014 for increasing the clamping and positioning of the tendon is disposed on the inner wall of the tendon lumen 2011, as shown in fig. 5 and 6, that is, a plurality of positioning protrusions 2014 protruding from the inner wall of the first clamping plate 201, the second clamping plate 202 and the tooth-shaped clamping plate 204 are disposed on the inner wall in the circumferential direction, after the clamping sleeve clamps the tendon, the positioning protrusions 2014 sink into the surface of the tendon, and the fixing acting force of the inner wall of the clamping sleeve on the tendon is increased.

The second clamping plate 202 and the first clamping plate 201 are symmetrical structures, and the structure of the second clamping plate 202 is not described herein in detail.

Referring again to fig. 4, a plurality of guide pin holes 2012 penetrating through the first clamping plate 201 and a plurality of guide wire grooves 2013 are respectively formed on the first clamping plate 201, wherein the guide pin holes 2012 are used for the suture needles 32 to pass through, and the guide wire grooves 2013 are used for the suture threads 31 to pass through. The guide pin holes 2012 on the first clamping plate 201 and the second clamping plate 202 are coaxially corresponding one to one, and in the state that the tendon is clamped by the clamping sleeve, the suture needle 32 can penetrate through the tendon vertically from the guide pin hole 2012 of any clamping plate and can penetrate out from the corresponding guide pin hole 2012 on the clamping plate on the other side of the clamping sleeve, so that the threading of the tendon is completed. On the first clamping plate 201, the wire groove 2013 connects the guide pin holes 2012 two by two, that is, two ends of any wire groove 2013 are provided with only two unique guide pin holes 2012, the wire groove 2013 penetrates through the clamping plate, when the suture needle 32 penetrating out from the guide pin hole 2012 at one end of the wire groove 2013 penetrates through the guide pin hole 2012 at the other end, the suture line 31 connected with the suture needle 32 just sticks to the appearance of the tendon through the wire groove 2013, so that the jacket can be separated from the sutured tendon smoothly. The guide pin holes 2012 and the guide wire grooves 2013 of all the splints should be located within the projected area of the tendon lumen 2011 on the splint so that the suture needle 32 can be accurately threaded into the tendon. The guide pin hole on the first clamping plate 201 close to the tooth-shaped clamping piece is communicated with the wire outlet groove 2015 penetrating through the first clamping plate 201 and the tooth-shaped clamping piece 204, and is used for leading out the suture after the threading and routing on the tendon.

Referring to fig. 8 and 9, in this embodiment, the guide pin holes 2012 on the first clamping plate 201 and the second clamping plate 202 each include a needle raising hole, a needle retracting hole and a plurality of intermediate holes, where the needle raising hole and the needle retracting hole are respectively located at two ends of all the guide pin holes and are located at the center of the tendon lumen, the remaining intermediate holes are sequentially distributed on the upper and lower sides of the connecting line of the needle raising hole and the needle retracting hole and are distributed along the upper and lower sides of the connecting line of the needle raising hole and the needle retracting hole, in this embodiment, the same number of intermediate holes are symmetrically distributed on the upper and lower sides of the connecting line of the needle raising hole and the needle retracting hole, respectively, as shown in fig. 8, the guide pin holes corresponding to the positions k0 and k12 on the first clamping plate 201 are needle raising holes and needle retracting holes, respectively, and the remaining guide pin holes corresponding to the positions k3, h4, k7, h8, k11, h1, k4, h5, k8 and h9 are intermediate holes, respectively, and the guide pin holes corresponding to the positions of k1 and, the rest of the guide pin holes corresponding to the positions of k2, h3, k6, h7, k10, h2, k5, h6, k9 and h10 are all middle holes, wherein the positions of the guide pin holes between k3 and k2, between h4 and h3, between k7 and k6, between h8 and h7, between k11 and k10, between h1 and h2, between k4 and k5, between h5 and h6, between k8 and k9 and between h9 and h10 correspond to one another. The wire guide slots 2013 on the same clamping plate are all inclined and parallel along the same direction according to the distribution of the wire guide holes 2012, although the positions of the wire guide holes 2012 on the first clamping plate 201 and the second clamping plate 202 in the embodiment are in one-to-one correspondence, the inclination directions of the wire guide slots between the first clamping plate 201 and the second clamping plate 202 are opposite and staggered, that is, the wire guide slots on one clamping plate are inclined upwards, and the wire guide slots on the other clamping plate are inclined downwards.

The guide pin holes 2012 and the guide wire grooves 2013 on the first splint 201 and the second splint 202 are used for the threading positioning of axial tendon suture, the sutured tendon is as shown in fig. 10, one suture 31 is crosswise divided around two sides of the tendon, the suture fixing effect on the tendon is better, the thread outlet groove 2015 extends to the tooth groove end of the tooth-shaped clamping piece 204 along the axial direction of the tendon lumen from the narrowing hole, and is used for respectively threading two broken tendons and then leading out the suture end for knotting connection, and suturing and fixing the tendon in the axial direction of the tendon. The continuous tooth socket formed at the end of the tooth-shaped clamping piece 204 combined with the first clamping plate 201 and the second clamping plate 202 is used for positioning the running needle of the circumferential suture of the tendon stump, the suture needle on the suture thread 31 is sequentially crossed and sutured at the two sides of the tendon stump along the circumferential direction of the tendon stump along the tooth socket on the tooth-shaped clamping piece 204, and the sutured tendon stump is shown in fig. 11. The walking suture route of the tendon is planned through the guide pin hole, the guide wire groove and the tooth groove which are set on the clamping sleeve, and the suture effect of the tendon is ensured.

Referring to fig. 7, in the present embodiment, the locking structure 23 for locking the position between the first jacket 21 and the second jacket 22 includes two sets of positioning clips 205 and racks 206, where the two sets of positioning clips 205 and racks 206 are both provided, the two positioning clips 205 are elastically hinged to two sides of the second jacket 22 through torsion springs, the two positioning clips 205 are symmetrically disposed, the two racks 206 are fixedly assembled on the first jacket 21 along the axial direction of the tendon lumen, a guide hole for the rack 206 to pass through is provided on a hinged seat between the second jacket 22 and the positioning clips 205, continuous positioning teeth are provided on the rack 206, the positioning clips 205 are embedded into the positioning teeth of the rack 206 under the action of the hinged torsion springs thereof, and after the two jackets butt-joint the broken tendon in place, the positioning clips 205 are controlled to be embedded into the corresponding positioning teeth of the rack 206, so as to realize the joint fixation of the first jacket 21 and the second jacket 22 on the broken tendon.

Example two

Referring to fig. 12 and 13, the tendon suture instrument in this embodiment is another specific embodiment of the present invention, and specifically includes a first collet 21, a second collet 22, a locking structure 23, and a suture needle 32 and a suture 31 for suturing a broken end of a tendon 100, and the specific structures of the first collet 21 and the second collet 22 are the same as the first embodiment, and the first embodiment is not repeated, and is different from the first embodiment in that: in this embodiment, the locking structure 23 for locking the first jacket 21 and the second jacket 22 is a stud-nut locking structure, and the stud is locked at the end of the stud by means of screw-thread fit after the stud passes through the coaxial guide sleeves 207 on the two jackets by arranging the coaxial guide sleeves 207 on the two sides of the first jacket 21 and the second jacket 22, so as to limit the position between the two jackets after the two ends of the broken tendon are clamped and butted.

In the embodiment, in order to facilitate symmetrical locking of two sides of two jackets, a U-shaped stud 208 is adopted, guide sleeves 207 are respectively and fixedly arranged on two sides of the first jacket 21 and the second jacket 22, rods on two sides of the U-shaped stud 208 respectively penetrate through all the guide sleeves 207 on two sides of the first jacket 21 and the second jacket 22, and then a rod end portion on one side of the U-shaped stud 208 is locked through a locking nut 209.

The following will specifically describe the suturing operation steps of the tendon suture instrument in the first and second embodiments with reference to fig. 8, 9, and 14-17.

The method comprises the following steps:

firstly, fixing the tendon.

The first jacket 21 and the second jacket 22 are used for clamping two ends of the broken tendon respectively, the broken ends of the tendon 100 are required to extend out of the toothed clamping pieces on the first jacket 21 and the second jacket 22 respectively, the two jackets are moved to butt the broken ends of the broken tendon, and then the position between the two jackets is fixed through the locking structure 23, so that the broken ends between the tendons 100 are kept in a joint state. In the first embodiment, the positioning clamp and the rack are loosened by pressing the handle of the positioning clamp inwards, the position between the first clamping sleeve 21 and the second clamping sleeve 22 is adjusted to joint the tendons, and then the handle of the positioning clamp is loosened to enable the positioning clamp to be re-embedded into the tooth grooves on the rack to lock and fix the two clamping sleeves; second embodiment after the tendon is engaged by adjusting the position between the first and

second jackets

21 and 22, the two jackets can be locked and fixed by passing a U-bolt through guide sleeves on the first and second jackets and by locking nuts.

And secondly, axially suturing and fixing the broken tendon.

Referring to fig. 14 in combination, a double-needle suture is adopted, that is, two end portions of one suture 31 are respectively connected with a suture needle 32, needle threading and routing are firstly carried out on tendons clamped by one of the jackets, one suture needle of the double-needle suture is threaded through a needle lifting hole k0 and threaded out of a needle lifting hole k1 on the jacket, half of the suture and one suture needle connected with the end portions are led out from both sides of a first clamping plate and a second clamping plate of the jacket, both the suture needles can be used as needle threading from the needle lifting holes on both sides, according to the needle threading sequence that the suture needle threaded out from a guide pin hole of the first clamping plate or the second clamping plate is threaded from another guide pin hole communicated with the guide pin hole through a guide wire groove to the guide pin hole on the other side, the needle threading path of the suture needle threaded out from the needle lifting hole k0 on one side of the first clamping plate 201 is k0-h1-h2-h3-h 4-5-h 6-h-8-h 73, after passing through the contraction hole h11 on the second splint 202, the suture passes through the left side E1 of the center of the tendon stump, and the suture is sutured on the tendon side as shown in fig. 8 and 15; the suture needle on one side of the second splint 202 passes through the needle lifting hole k1 along a needle passing route k1-k2-k3-k4-k5-k6-k7-k8-k9-k10-k11-k12, passes through the needle withdrawing hole k12 of the first splint 201, and then passes through the right side E2 of the center of the tendon broken end, and the suture section is sutured on the tendon side as shown in fig. 9 and 16. Then the same double-needle suture is adopted to carry out the same order of threading and routing on the tendons clamped and butted by the other jacket, finally the suture which penetrates out of the broken ends of the two tendons is tensioned and knotted at the same side, and the suture and the tendons are fixed and then axially tensioned from the tendons to realize suture fixation.

And thirdly, circumferentially suturing and fixing the broken tendon.

Taking a third double-needle suture, penetrating one suture needle 32 from the tooth sockets of the toothed clamping pieces on the same jacket at an interval of 180 degrees into the tendon, wherein the suture needle at one end of the suture penetrates through the tendon from the tooth sockets on the toothed clamping pieces on the two jackets and suture the two tendon broken ends in a clockwise direction according to the opposite tooth sockets of the toothed clamping pieces on the two jackets, namely penetrating out from the other tooth socket adjacent to the toothed clamping piece on the other tendon in the clockwise direction, alternately suturing and running the suture needle back and forth between the circumferences of the end surfaces of the two tendons in the clockwise direction, and the suture needle at the other end of the suture penetrates through the two tendon broken ends in a counterclockwise direction according to the opposite tooth sockets of the toothed clamping pieces on the two jackets and suture the two suture needles together for at least one circle in the circumferential direction of the two tendon broken ends, and tensioning and knotting the A, B of the, the suture can suture and fix the tendon broken end from the circumferential direction of the tendon broken end, and the tooth socket on the dentate clamping piece is used for guiding the needle passing. If the tendon is thick, it is also contemplated to use a fourth suture to assist in the tightening of the knot.

And fourthly, loosening the tendon.

After the suture is finished, the locking structure between the two clamping sleeves is loosened, and then the two clamping sleeves are respectively taken down from the sutured tendon through the clamping handles.

The foregoing embodiments illustrate the principles and features of the present invention and their advantages, and it will be understood by those skilled in the art that the present invention is not limited by the embodiments described above, which are merely illustrative of the specific principles of operation of the present invention, and that various changes and modifications may be made therein without departing from the spirit and scope of the invention as defined by the appended claims and their equivalents.

Claims

1. Tendon stitching instrument, its characterized in that: comprises two jackets for clamping and fixing two ends of a broken tendon respectively, and a locking structure for locking the two jackets to keep the broken tendon in a butt joint state,

2. The tendon suture instrument according to claim 1, wherein the guide holes of the first and second splints include a needle hole, a needle hole and a plurality of middle holes, the needle hole and the needle hole are located at the center of the tendon lumen, the middle holes are sequentially distributed at the upper and lower sides of the connecting line of the needle hole and the needle hole, the guide slots of the same splint are all obliquely and parallelly arranged in the same direction, and the guide slots of the first and second splints are arranged in a staggered manner.

3. The tendon stapler of claim 2 wherein the exit slot extends axially from the narrowing hole along the tendon lumen to the end of the gullet of the toothed clip.

4. The tendon suture instrument according to claim 1, wherein the first clamping plate and the second clamping plate are each provided with a clamping handle, and the clamping handles are elastically hinged to the torsion spring, so that the first clamping plate and the second clamping plate are elastically clamped.

5. The tendon stapler of claim 1, wherein an inner wall of the tendon lumen is provided with a positioning protrusion for increasing tendon clamping positioning.

6. The tendon stapler of any one of claims 1-5 wherein the locking structure includes a positioning clip elastically hinged on one of the clamping sleeves by a torsion spring and a rack fixedly fitted on the other clamping sleeve, the positioning clip is embedded in the positioning teeth of the rack with the relative movement between the two clamping sleeves to achieve the position locking between the two clamping sleeves.

7. The tendon stapler of claim 6 wherein two sides of the two jackets are symmetrically installed with locking structures.

8. The tendon stapler of any one of claims 1-5 wherein the locking structure includes a stud passing through a coaxially disposed guide sleeve on the two collet sleeves and a locking nut threaded on the end of the stud to lock the stud and define the position of the two collet sleeves relative to each other after clamping the two ends of the tendon to be severed into abutment.

9. The tendon suture instrument according to claim 8, wherein the stud is a U-shaped stud, two sides of the two clamping sleeves are symmetrically provided with guide sleeves, two side rods of the U-shaped stud penetrate all the guide sleeves, and the locking nut is screwed with the end of the U-shaped stud.