CN111870335A - Kirschner wire positioning instrument for closed reduction of pelvic fracture - Google Patents
Kirschner wire positioning instrument for closed reduction of pelvic fracture Download PDFInfo
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- CN111870335A CN111870335A CN202010877192.XA CN202010877192A CN111870335A CN 111870335 A CN111870335 A CN 111870335A CN 202010877192 A CN202010877192 A CN 202010877192A CN 111870335 A CN111870335 A CN 111870335A
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- ring
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- adjusting ring
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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
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- General Health & Medical Sciences (AREA)
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Abstract
The invention belongs to the field of auxiliary tools for operations, and particularly relates to a Kirschner wire positioning instrument for closed reduction of pelvic fracture. The invention includes a reference ring; an adjusting ring is arranged beside the reference ring, a ball cavity section is arranged in a ring cavity of the adjusting ring, a ball head is matched with the ball in the ball cavity section in a spherical manner, a positioning hole for the Kirschner wire to pass through is coaxially arranged in the ball head in a penetrating manner in the relative adjusting ring, and the aperture of the positioning hole is matched with the outer diameter of the Kirschner wire to be passed through; the reference ring and the adjusting ring are fixedly connected with each other through an adjusting rod capable of axially adjusting the length, and the lower ring surface of the adjusting ring and the lower ring surface of the reference ring are positioned on the same reference plane. By the invention, proper distance and angle can be quantitatively achieved, the accuracy and safety of the operation are greatly improved, the radiation injury of doctors and patients caused by long-time repeated fluoroscopy is reduced, and the convenience and efficiency of the actual closed reduction operation of pelvic fracture are improved.
Description
Technical Field
The invention belongs to the field of auxiliary tools for operations, and particularly relates to a Kirschner wire positioning instrument for closed reduction of pelvic fracture.
Background
Pelvic fracture is a fracture with high fatality rate caused by high-energy external force, is mostly seen in young and strong years and is often seen in traffic accidents and high-altitude falling. The fracture type is complicated, if good reduction and fixation can not be obtained, patients often need to be bedridden for a long time or have walking and labor dysfunction. The former operation mode is mostly cutting and resetting internal fixation, the operation incision is large and exposed widely, and the operation risk of large amount of bleeding in the operation is high.
In recent years, with the deep research on the anatomical structure of the pelvis and the development of internal fixing materials, the closed reduction internal fixation becomes the main trend of the treatment of the pelvic fracture, a kirschner wire, namely a guide pin, is implanted after the traction reduction in the operation, and then a hollow screw is implanted according to the position of the guide pin; particularly for the fixation of the posterior pelvic ring, closed implantation of sacroiliac joint screws is the most commonly used method. However, a large number of vascular venous plexuses and peripheral nerve structures are arranged around the pelvis, and due to the special structure of the pelvis, the space of a bony tunnel through which a hollow screw can actually pass is extremely narrow, so that the requirements on the position and the direction of the screw placement are extremely high; once deviation occurs in the operation, the front end of the hollow screw is easy to damage internal organs and important blood vessels inside and outside the pelvis, so the operation risk is high, and the risk of developing pelvic fracture treatment by many doctors is also considered.
In the conventional closed reduction, a surgeon drives in a guide needle under the monitoring of an X-ray (C-arm machine), the depth and the direction of a nail feeding point and a kirschner wire are determined by repeated perspective in the operation, and the surgeon and a patient often receive a certain dose of radioactive injury. The operator usually finds that the position or the direction of the first guide pin is not satisfied, and the operator can drive the second guide pin again according to the reference of the first guide pin, and the process needs to be adjusted by the hand feeling of the operator and the clinical experience of the operator. Although the ideal direction and position of the second lead are determined during the operation, the precise adjustment is affected due to the interference of soft tissue, the elasticity of the lead or the skill of the operator, and the ideal position is often not satisfied.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide the kirschner wire positioning instrument for closed reduction of pelvic fracture, which has a reasonable structure and a lower operation threshold, and can correct the distance and the angle according to the required position and direction by taking the first driven kirschner wire as a reference wire and then drive the second driven kirschner wire in an ideal position. By the invention, proper distance and angle can be quantitatively achieved, the accuracy and safety of the operation are greatly improved, the radiation injury of doctors and patients caused by long-time repeated fluoroscopy is reduced, and the convenience and efficiency of the actual closed reduction operation of pelvic fracture are improved.
In order to achieve the purpose, the invention adopts the following technical scheme:
the utility model provides a closed ke shi needle locater that resets of pelvis fracture which characterized in that: the positioning instrument comprises a reference ring, wherein a ring cavity of the reference ring forms a positioning cavity for coaxial sleeve connection of a reference needle, and the pipe diameter of the positioning cavity is matched with the outer diameter of the reference needle; an adjusting ring is arranged beside the reference ring, a ball cavity section is arranged in a ring cavity of the adjusting ring, a ball head is matched with the ball cavity section in a spherical manner, a positioning hole for the passing of the Kirschner wire is coaxially arranged in the ball head in a penetrating manner in an opposite adjusting ring, and the aperture of the positioning hole is matched with the outer diameter of the Kirschner wire to be passed; the reference ring and the adjusting ring are fixedly connected with each other through an adjusting rod capable of axially adjusting the length, and the lower ring surface of the adjusting ring and the lower ring surface of the reference ring are positioned on the same reference plane.
Preferably, the adjusting ring is of a hemispherical structure, and the bottom surface of the adjusting ring forms a lower ring surface; the spherical surface of the adjusting ring is provided with a cross-shaped guide hole, and the guide hole is communicated with the ring cavity of the adjusting ring so that the spherical surface of the adjusting ring forms an upper ring surface of the adjusting ring; a guide sleeve extends from the spherical head to the direction of the guide hole, the axis of the guide sleeve is coaxial with the axis of the positioning hole, and the diameter of the guide sleeve is matched with the aperture of the positioning hole; the guide sleeve and the guide hole form a slide rail matching relationship; scales or angle sensors for judging the inclination angle of the guide sleeve relative to the reference plane are uniformly arranged on four guide edges of the cross-shaped guide hole.
Preferably, an arrow mark used with a scale is arranged on the outer wall of the guide sleeve.
Preferably, the ball cavity section is located at the middle annular cavity of the adjusting ring, and the lower annular cavity of the adjusting ring forms a flared hole structure which is convenient for the Kirschner wire to perform the spherical hinging action and has a gradually expanded opening.
Preferably, the reference ring is circular, and balls with a rolling friction function are densely distributed on the wall of the positioning cavity.
Preferably, the adjusting rod comprises a first screw rod directly fixedly connected with the outer ring surface of the reference ring, a second screw rod directly fixedly connected with the outer ring surface of the adjusting ring, and a threaded sleeve for simultaneously and threadedly matching the adjacent ends of the first screw rod and the second screw rod, and the thread directions of the first screw rod and the second screw rod are opposite.
The invention has the beneficial effects that:
1) through the scheme, after the pelvis fracture position is irradiated by matching with an X-ray machine, the reference pin which is shot in advance is used as an anchor point, and the adjusting rod length and the hinging angle of the spherical head are operated, so that the adjusting effect of the position and the angle of the Kirschner wire which penetrates into the positioning hole at present can be realized, and the Kirschner wire can accurately reach the required position. Different from the traditional method of completely relying on hand feeling and experience to perform puncture positioning relative to a reference needle, the invention utilizes the accurate positioning characteristic of a mechanical structure to enable the puncture positioning process of the new Kirschner wire to be brainless and the operation threshold to be obviously reduced. By the invention, proper distance and angle can be quantitatively achieved, the accuracy and safety of the operation are greatly improved, the radiation injury of doctors and patients caused by long-time repeated fluoroscopy is reduced, and the convenience and efficiency of the actual closed reduction operation of pelvic fracture are improved.
2) During actual adjustment, the middle section ring cavity of the adjusting ring can be inwards convex or concave in the radial direction, so that a spherical cavity for clamping the spherical head and generating spherical hinge motion is formed. In a further preferred embodiment of the present invention, a cross-shaped guide hole is disposed on the upper annular surface or spherical surface of the adjusting ring, so as to achieve a cross-shaped guide effect for the guide sleeve extending from the spherical head. When executing the art, adjust the pole and realized treating the interval regulation effect of puncture point to present by the benchmark needle, and the guiding hole has then realized the angle location function of current puncture point department ke shi needle, has finally realized the reliable accurate puncture location purpose to current ke shi needle in coordination.
3) When the relative guiding hole of uide bushing and the ke shi needle that is located the uide bushing produced the angle modulation, for the accuracy nature of guaranteeing the regulation number of degrees, accessible naked eye carries out the mode of observing to the scale, also can be through arranging angle sensor etc. to realize electronic scale and detect the purpose, its implementation mode can be for multiple, and this place is no longer repeated.
4) The horn hole structure is arranged, when the spherical head generates spherical hinging action, the Kirschner wire generates lateral deviation along with the spherical hinging action, and the original lower half part annular cavity of the adjusting ring and the action path of the Kirschner wire are avoided. The ball is then be convenient for realize the relative quick cup joint effect of benchmark needle of benchmark ring to promote the convenience in the operation.
Drawings
FIG. 1 is a schematic perspective view of the present invention;
FIG. 2 is a cross-sectional view of the present invention;
FIG. 3 is a plan view of the regulating portion in the state shown in FIG. 2;
FIG. 4 is a cross-sectional view of the present invention in use;
FIG. 5 is a plan view of the regulating portion in the state shown in FIG. 4;
fig. 6 is a graph showing the distribution of the puncture points of a newly inserted needle with respect to a reference needle.
The actual correspondence between each label and the part name of the invention is as follows:
a-datum needle b-new needle c-bone surface
10-reference ring 20-adjusting ring
21-spherical head 21 a-positioning hole 22-guide hole 23-guide sleeve
24-Scale 25-arrow identification
30-adjusting rod 31-first screw 32-second screw 33-threaded sleeve
Detailed Description
For the convenience of understanding, the original kirschner wire or hollow wire is collectively referred to as a reference wire a, and the punctured kirschner wire is positioned as a new insertion wire b after the position of the reference wire a is taken as a reference; the specific structure and operation of the present invention will be further described with reference to the accompanying drawings as follows:
the detailed structure of the present invention is shown with reference to fig. 1-6, and the main structure thereof comprises three major parts, namely a reference ring 10, an adjusting ring 20 and an adjusting rod 30 connected with each other, wherein:
the reference ring 10 is used to perform a telescoping function with respect to the reference pin a, thereby forming the anchor point configuration of the present invention, upon which the entire subsequent action of the adjusting ring 20 is mechanically operated. The shape of the reference ring 10 is shown in fig. 1, and the reference ring is circular ring-shaped, and the ring cavity is exactly threaded and sewed on the reference needle a. Certainly, in actual operation, the reference ring 10 may also be designed to be in a "U" shape or other shapes capable of matching and positioning the reference pin a, and only the precise matching effect of the two is required to be ensured. Even if necessary, the ring cavity of the reference ring 10 may be provided with balls as shown in fig. 2 and 4 to improve the easy insertion of the reference ring 10 with respect to the reference pin a.
For adjusting ring 20, as exemplified by the particular embodiment shown in fig. 2-4, adjusting ring 20 is substantially annular in shape throughout. The upper ring surface of the adjusting ring 20 extends radially and oppositely to form a spherical surface, and a cross-shaped guide hole 22 communicating with the annular cavity of the adjusting ring 20 is formed on the upper ring surface as the spherical surface. In fig. 2 and 4, it is clearly seen that the annular space of the adjusting ring 20 is divided into three sections, namely a section in which the upper guide bore 22 is located, a ball chamber section in the middle section for the engagement of the ball head 21, and a bell-mouth configuration in the lower section. When the concrete arrangement is as follows: the spherical head 21 is retained at the ball cavity segment as shown in fig. 2, which may be formed by extending radially toward each other or by extending radially in the opposite direction. The flared hole structure is that when the spherical head 21 performs spherical hinging action, the newly inserted needle b generates lateral deviation, and the original lower half annular cavity of the adjusting ring 20 and the action path of the newly inserted needle b should be avoided. In fig. 2 to 4, the angle of the new needle b inserted into the guide sleeve 23 at the ball joint 21 is determined by the visual alignment of the scale 24 and the arrow mark 25. In practice, rapid reading can also be performed by modern electronic devices such as angle sensors.
Certainly, the position of the spherical cavity section should be as close to the bone surface as possible in actual operation, and the corresponding spherical head 21 has the same principle, so that the kirschner wire can be ensured to do hinged swinging motion around the needle point of the kirschner wire in a mode that the needle point is as close to the bone surface as possible, and further, the operation error is eliminated to the maximum extent; the large size of the ball head 21 and the ball cavity segment in fig. 2 and 4 is illustrated for clarity, and the specific positions of the ball head and the ball cavity segment are only referred to for convenience of description.
For the adjustment lever 30, a conventional bar-type structure may be used, and a bidirectional screw-type bar-type structure shown in fig. 2 and 4 may also be used. In fig. 2 and 4, the adjusting rod 30 includes a first screw 31 directly fixed to the outer circumferential surface of the reference ring 10, a second screw 32 directly fixed to the outer circumferential surface of the adjusting ring 20, and a threaded sleeve 33 for simultaneously threadedly engaging the adjacent ends of the first screw 31 and the second screw 32, wherein the first screw 31 and the second screw 32 are oppositely threaded. When the threaded sleeve 33 is screwed, the first screw 31 and the second screw 32 can generate coaxial synchronous opposite and apart actions, so as to realize the function of adjusting the distance between the new needle b and the reference needle a.
In practical operation of the present invention, the length of the adjusting rod 30 is adjusted and measured according to the current position of the reference pin a, so as to ensure that the distance between the axis of the positioning hole 21a and the axis of the reference pin a is in an ideal condition. Thereafter, the reference ring 10 is nested along the reference pin a until the reference plane of the present invention is located at the facet c, as shown with reference to FIGS. 2-3. Thereafter, a new needle b is inserted into the positioning hole 21a, and the new needle b is slowly pulled, so that the guide sleeve 23 starts to perform a spherical motion along the guide hole 22 as shown in fig. 4 to 5. The puncture operation of the new inserting needle b relative to the bone surface c can be carried out by observing the spherical action angle of the new inserting needle b until the angle is equal to the preset design angle. Of course, the angle adjustment operation of the guide sleeve 23 may be completed before the present invention is sleeved on the reference pin a, and the present invention may be used as a mold. After the positioning operation of the new inserted needle b is finished, the reference needle a is pulled out, and then the novel inserted needle b is taken out along the axial direction of the new inserted needle b, so that the novel inserted needle b is extremely convenient and flexible to use.
Of course, the above is one specific embodiment of the present invention. In practice, the ball cavity segment may be designed separately in the annular cavity of the adjusting ring 20, or may be designed as a single piece as shown in fig. 2; the adjusting rod 30 can also be designed into a loop bar structure or a rack or even a slide rail telescopic structure and the like; even the balls can be synchronously applied to the hole wall of the positioning hole 21a, and such continuous structural changes based on the known structure of the present invention should be considered as equivalent or similar designs and fall within the protection scope of the present invention.
Claims (6)
1. The utility model provides a closed ke shi needle locater that resets of pelvis fracture which characterized in that: the positioning instrument comprises a reference ring (10), wherein a ring cavity of the reference ring (10) forms a positioning cavity for coaxial sleeve joint of a reference needle, and the pipe diameter of the positioning cavity is matched with the outer diameter of the reference needle; an adjusting ring (20) is arranged beside the reference ring (10), a ball cavity section is arranged in a ring cavity of the adjusting ring (20), a ball head (21) is matched in the ball cavity section in a spherical manner, a positioning hole (21a) for the Kirschner wire to pass through is coaxially arranged in the ball head (21) in a penetrating manner relative to the adjusting ring (20), and the aperture of the positioning hole (21a) is matched with the outer diameter of the Kirschner wire to be passed through; the reference ring (10) and the adjusting ring (20) are fixedly connected with each other through an adjusting rod (30) capable of axially adjusting the length, and the lower annular surface of the adjusting ring (20) and the lower annular surface of the reference ring (10) are on the same reference plane.
2. The kirschner wire positioning instrument for closed reduction of pelvic fracture according to claim 1, wherein: the adjusting ring (20) is of a hemispherical structure, and the bottom surface of the adjusting ring (20) forms a lower annular surface; a cross-shaped guide hole (22) is arranged at the spherical surface of the adjusting ring (20), and the guide hole (22) is communicated with the ring cavity of the adjusting ring (20) so that the spherical surface of the adjusting ring forms the upper annular surface of the adjusting ring (20); a guide sleeve (23) extends from the spherical head (21) to the direction of the guide hole (22), the axis of the guide sleeve (23) is coaxial with the axis of the positioning hole (21a), and the diameter of the guide sleeve (23) is matched with the aperture of the positioning hole (21 a); the guide sleeve (23) and the guide hole (22) form a slide rail matching relationship; scales (24) or angle sensors for judging the inclination angle of the guide sleeve (23) relative to the reference plane are arranged on four guide edges of the cross-shaped guide hole (22).
3. The kirschner wire positioning instrument for closed reduction of pelvic fracture according to claim 2, wherein: an arrow mark (25) used by a matched scale (24) is arranged on the outer wall of the guide sleeve (23).
4. The kirschner wire positioning instrument for closed reduction of pelvic fracture according to claim 1, 2 or 3, wherein: the ball cavity section is positioned at the middle annular cavity of the adjusting ring (20), and the lower annular cavity of the adjusting ring (20) forms a flared hole structure which is convenient for the Kirschner wire to perform spherical hinging action and the mouth part of which is gradually expanded outwards.
5. The kirschner wire positioning instrument for closed reduction of pelvic fracture according to claim 1, 2 or 3, wherein: the reference ring (10) is annular, and balls with a rolling friction function are densely distributed on the wall of the positioning cavity.
6. The kirschner wire positioning instrument for closed reduction of pelvic fracture according to claim 1, 2 or 3, wherein: the adjusting rod (30) comprises a first screw rod (31) directly fixedly connected with the outer ring surface of the reference ring (10), a second screw rod (32) directly fixedly connected with the outer ring surface of the adjusting ring (20) and a threaded sleeve (33) used for simultaneously and spirally matching the adjacent ends of the first screw rod (31) and the second screw rod (32), and the thread turning directions of the first screw rod (31) and the second screw rod (32) are opposite.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010877192.XA CN111870335A (en) | 2020-08-27 | 2020-08-27 | Kirschner wire positioning instrument for closed reduction of pelvic fracture |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010877192.XA CN111870335A (en) | 2020-08-27 | 2020-08-27 | Kirschner wire positioning instrument for closed reduction of pelvic fracture |
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| Publication Number | Publication Date |
|---|---|
| CN111870335A true CN111870335A (en) | 2020-11-03 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010877192.XA Pending CN111870335A (en) | 2020-08-27 | 2020-08-27 | Kirschner wire positioning instrument for closed reduction of pelvic fracture |
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| CN (1) | CN111870335A (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113796943A (en) * | 2021-05-12 | 2021-12-17 | 蚌埠医学院第一附属医院（蚌埠医学院附属肿瘤医院） | Femoral Kirschner wire positioning and adjusting device |
-
2020
- 2020-08-27 CN CN202010877192.XA patent/CN111870335A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113796943A (en) * | 2021-05-12 | 2021-12-17 | 蚌埠医学院第一附属医院（蚌埠医学院附属肿瘤医院） | Femoral Kirschner wire positioning and adjusting device |
| CN113796943B (en) * | 2021-05-12 | 2023-11-10 | 蚌埠医学院第一附属医院（蚌埠医学院附属肿瘤医院） | Femur Kirschner wire positioning and adjusting device |
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