CN112043370B - Minimally invasive steel wire guider capable of being inserted into bendable surrounding skeleton - Google Patents
Minimally invasive steel wire guider capable of being inserted into bendable surrounding skeleton Download PDFInfo
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- CN112043370B CN112043370B CN202010952483.0A CN202010952483A CN112043370B CN 112043370 B CN112043370 B CN 112043370B CN 202010952483 A CN202010952483 A CN 202010952483A CN 112043370 B CN112043370 B CN 112043370B
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- guider
- handle
- steel wire
- sleeve
- bone
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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
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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
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
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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
Abstract
The invention belongs to the technical field of medical instruments, and particularly relates to a minimally invasive steel wire guider inserted into a bendable surrounding skeleton, which comprises a guider and a puncture steel wire; the guide comprises a body part, a handle part and a tightening part, wherein the body part comprises a head part, a movable part and a sleeve which are sequentially connected in series by the tightening part, the side wall of the head part is provided with an opening, and the movable part comprises a plurality of spherical joints of which the front ends are provided with notches; the handle part comprises a first handle and a second handle which are hinged by a rotating shaft, the end part of the first handle is connected with the sleeve, and the end part of the second handle extends into the sleeve to be connected with the fastening piece; the puncture steel wire passes through the sleeve and the movable part and can extend out of the opening. The invention has safe and reasonable structure, and can not penetrate soft tissues to damage nerves and blood vessels; the front part of the guider and the puncture steel wire can be bent and deformed, can turn and move forwards, can move forwards in a straight or reverse direction, can be matched with the size and the shape of a radian of a bone, and realizes minimally invasive penetration without penetrating into soft tissues to damage nerves and blood vessels.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a minimally invasive steel wire guider inserted into a bendable surrounding skeleton.
Background
The large limbs of the long oblique bone fracture (including periprosthetic fracture) or the displacement and separation of the third bone block can be reduced and fixed by adopting a steel wire cerclage method. The traditional direct exposure method by incision is used for threading steel wires, has large damage and more bleeding, can also damage vascular nerves, and has higher risks of postoperative infection and nonunion. The existing wire pliers can also guide the penetrating steel wire, but the shape and structure of the size, the bending radian and the like of each existing wire pliers are fixed, and the front part of the wire pliers cannot be randomly changed in shape to adapt to bones with different sizes and radians. Therefore, the defects that the sizes, the bending radians and other shapes of the wire pliers are not matched with the sizes and radians of bones and can penetrate into partial soft tissues exist in use; secondly, the metal structure of the micro-wound puncture needle cannot be bent, and the micro-wound puncture cannot be really realized. In addition, when a fretsaw is used for cutting the bone, the fretsaw needs to go around the bone for a circle, and the fretsaw cannot achieve minimally invasive penetration.
Disclosure of Invention
The invention aims to solve the problems, provides a minimally invasive steel wire guider inserted into a bendable surrounding skeleton for the large four-limb large long bone fracture, and the front part of the guider can be bent and deformed to match the shapes, sizes and radians of the skeletons with different specifications.
According to the technical scheme of the invention, the minimally invasive steel wire guider capable of being inserted into the bendable surrounding bone comprises a guider and a puncture steel wire; the guiding device comprises a body part, a handle part and a tightening part, wherein the body part comprises a head part, a movable part and a sleeve which are sequentially connected in series by the tightening part, an opening is formed in the side wall of the head part, and the movable part comprises a plurality of spherical joints of which the front ends are provided with notches; the handle part comprises a first handle and a second handle which are hinged by a rotating shaft, the end part of the first handle is connected with the sleeve, and the end part of the second handle extends into the sleeve to be connected with the fastening piece; the puncture steel wire passes through the sleeve and the movable part and can extend out of the opening.
Further, the opening is located on the same side of the body as the handle.
Further, the head part is conical.
Furthermore, the notch on the spherical joint is in the shape of a cambered groove.
Further, the take-up member is a wire rope.
Furthermore, the diameter of the puncture steel wire is 0.2-1.0 mm.
Furthermore, through holes for the tightening piece and the puncture steel wire to pass through are arranged on the spherical joint of the movable part and in the sleeve.
The invention has the beneficial effects that: the bone fracture reduction device can not only reduce and fix the oblique fracture of the long bone with large limbs or the third bone block in a minimally invasive way, but also guide a wire saw to cut the bone in a minimally invasive way; the front part of the guider and the puncture steel wire can be bent and deformed, can move forwards in a turning way, can move forwards in a straight way or in a reverse way, can be matched with the sizes and the shapes of radians of bones, and overcomes the defects that the sizes and the shapes of the radians of the steel wire guide forceps are fixed and not changed, and are not matched with the sizes and the shapes of the radians of the bones with different specifications, so that minimally invasive penetration cannot be really realized and part of soft tissue penetration exists; the guider and the puncture steel wire can sense whether to advance on the bone surface or not, and the soft tissue cannot penetrate into the nerve and the blood vessel which are damaged by the soft tissue.
Drawings
FIG. 1 is a schematic structural diagram of the present invention.
Fig. 2 is a schematic view of the movable portion in a tightened state.
Fig. 3 is a schematic view showing a loose state of the movable portion.
Description of reference numerals: 1-guide, 1.1-body, 1.1.1-head, 1.1.2-active, 1.1.3-sleeve, 1.1.4-opening, 1.2-handle, 1.2.1-shaft, 1.2.2-first handle, 1.2.3-second handle, 1.3-tightening piece, 2-puncture steel wire.
Detailed Description
The invention is further illustrated by the following examples and figures.
As shown in fig. 1: the minimally invasive steel wire guider capable of being inserted into a bendable surrounding skeleton comprises a guider 1 and a puncture steel wire 2, wherein the guider 1 comprises a body part 1.1, a handle part 1.2 and a tightening part 1.3, the body part 1.1 comprises a head part 1.1.1, a movable part 1.1.2 and a sleeve 1.1.3 which are sequentially connected in series by utilizing the tightening part 1.3, an opening 1.1.4 is formed in the side wall of the head part 1.1.1, the movable part 1.1.2 comprises a plurality of spherical joints with notches at the front ends, and the sleeve 1.1.3 can be a common hollow metal sleeve. The handle part 1.2 is scissors-shaped and comprises a first handle 1.2.2 and a second handle 1.2.3 which are hinged with a rotating shaft 1.2.1, the end part of the first handle 1.2.2 is connected with a sleeve 1.2.3, the end part of the second handle 1.2.3 extends into the sleeve 1.2.3 to be connected with a fastening part 1.3, and the fastening part 1.3 can be tightened or loosened by adjusting the included angle between the first handle 1.2.2 and the second handle 1.2.3, so that the movable part 1.1.2 is tightened, fixed and hardened (as shown in figure 2) or loosed and flexibly deformed (as shown in figure 3). The puncture wire 2 passes through the sleeve 1.1.3 and the movable part 1.1.2 and can protrude out of the opening 1.1.4.
In particular, the opening 1.1.4 is located on the same side of the body 1.1 as the shank 1.2, so that the inserted piercing wire can be advanced along one side of the bone surface, rather than towards the soft tissue. The head 1.1.1 is conical to facilitate advancement along a side surface of the bone. The notch on the spherical joint is in the shape of a cambered groove, so that the bending angle of the movable part 1.1.2 is increased. The tightener 1.3 is a wire rope, flexible and bendable. The puncture steel wire 2 is a medical catheter puncture steel wire with certain hardness and good elasticity, and the diameter is 0.2-1.0 mm. Through holes for the tightening part 1.3 and the puncture steel wire 2 to pass through are arranged on the spherical joint of the movable part 1.1.2 and in the sleeve 1.1.3 respectively, so that the mutual interference of the tightening part 1.3 and the puncture steel wire 2 is avoided.
The operation method comprises the following steps: a small incision of about 0.5-1.0cm is made where the wire needs to be inserted. The first step is to tighten the tightener in the center of the guide with the shank, stiffen the active part of the guide, which consists of a plurality of spherical joints, insert the guide with the guide wire from the incision and advance it along one of the bone side surfaces. When the bone needs to go forward continuously along the turning of the bone, the opening side faces the bone surface, and the puncture steel wire is inserted forward by about 1 cm; since the opening of the head of the guide faced the facet of the bone, the puncture wire pushed forward and inserted was bent to advance 1cm toward the facet of the bone, and the puncture wire made a bone-cracking feeling in contact with the periosteum surface, confirming that the puncture wire was on the facet of the bone. The second step is to maintain the position of the puncture steel wire, and to open the handle part to loosen the tightening part in the center of the guider, so that the movable part of the guider, which is composed of a plurality of spherical joints, becomes soft and can be bent freely. The third step is to push the sleeve at the rear of the introducer forward with force, pushing the softened active portion forward 1cm along the curved puncture wire. The fourth step is to tighten the tightening piece at the center of the guide again by using the handle part, so that the movable part consisting of a plurality of spherical joints at the front part of the guide is hardened again, and the whole guide becomes a hard structure. At this time, the front portion of the guide is strongly pulled in a direction opposite to the contact point with the bone in order to further bring the front portion of the guide into close contact with the bone surface while sensing whether it is on the bone surface. If the straight movement is needed, the guide puncture steel wire is returned to the opening of the guider, the hardened state of the guider is kept, and the guider is pushed forwards like a straight foreign body forceps, namely the straight movement is realized; if the bending is needed to be continued, the four steps are repeated. The insertion guide can be bent 1cm forward around the bone surface with each repetition. Repeating for a plurality of times until the head of the guider with the puncture steel wire is visible from a small incision after encircling the bone for one circle. Finally, the guide device is used for guiding the required steel wire to penetrate, and the fracture is bound and fixed or the wire saw is guided to cut the bone. Because the front part of the guider is tightened or loosened by a tightening part consisting of a plurality of spherical joints and the direction of the opening at the front part of the guider can be controlled, if the guider does not need to turn to move forwards, the puncture steel wire can be withdrawn to the opening of the guide needle, and the front part of the guider which is hardened is pushed to move forwards to be straight; when the guide is rotated by 180 degrees and the opening is in the opposite direction, the guide is advanced, and the guide is turned to advance in the opposite direction. In a word, according to the state of an illness needs, the needle inserting direction can be adjusted, if the third bone block is displaced and separated, the guider needs to move straight at the soft tissue gap in front of the third bone block, and then moves forwards along the surface of the third bone block in a turning way after reaching the third bone block, namely, the guider can move forwards in a straight line or in a bending way or in a reverse direction according to the situation. Therefore, the minimally invasive inserting and bending steel wire guiding device can adapt to bones with any radian and size and is an effective, safe and simple method for minimally invasive insertion of the steel wire guiding device capable of bending and surrounding the bones and annular bone bundling for the fracture of long bones with large limbs. To ensure safety, the procedure can be monitored by fluoroscopy to further confirm that the guide and the penetrating wire have not penetrated the soft tissue and are in the correct position.
Claims (4)
1. A minimally invasive insertion bendable steel wire guider surrounding bones is characterized by comprising a guider (1) and a puncture steel wire (2); the guiding device (1) comprises a body part (1.1), a handle part (1.2) and a tightening piece (1.3), wherein the body part (1.1) comprises a head part (1.1.1), a movable part (1.1.2) and a sleeve (1.1.3) which are sequentially connected in series by the tightening piece (1.3), an opening (1.1.4) is formed in the side wall of the head part (1.1.1), and the movable part (1.1.2) comprises a plurality of spherical joints of which the front ends are provided with notches; the handle part (1.2) comprises a first handle (1.2.2) and a second handle (1.2.3) which are hinged by a rotating shaft (1.2.1), the end part of the first handle (1.2.2) is connected with a sleeve (1.1.3), and the end part of the second handle (1.2.3) extends into the sleeve (1.1.3) to be connected with a fastening part (1.3); the puncture steel wire (2) penetrates through the sleeve (1.1.3) and the movable part (1.1.2) and can extend out of the opening (1.1.4);
the opening (1.1.4) is located on the same side of the body (1.1) as the handle (1.2);
the notch on the spherical joint is in a cambered surface groove shape;
through holes for respectively allowing the tightening piece (1.3) and the puncture steel wire (2) to pass through are arranged on the spherical joint of the movable part (1.1.2) and in the sleeve (1.1.3);
when in use, the handle part is used for tightening the tightening piece in the center of the guider, so that the movable part consisting of a plurality of spherical joints is hardened, the guider with the guide steel wire is inserted, and the guide steel wire advances forwards along one side surface of the bone; when the bone needs to go forward continuously along the turning of the bone, the opening side faces the bone surface, and the puncture steel wire is inserted forward by 1 cm; the handle part is opened to loosen the tightening part in the center of the guider, and the movable part consisting of a plurality of spherical joints at the front part of the guider becomes soft and can be freely bent; the sleeve at the rear part of the guider is pushed forwards with force, and the softened movable part is pushed forwards by 1cm along the bent puncture steel wire; tightening the tightening piece in the center of the guider by using the handle part to tighten again, so that the movable part consisting of a plurality of spherical joints in the front part of the guider becomes hard again; if the straight movement is needed, the guide puncture steel wire is retracted to the opening of the guider, the hardened state of the guider is kept, and the guider is pushed forwards to move straight.
2. A minimally invasive insertion bendable wire guide to encircle a bone according to claim 1, characterized in that the head (1.1.1) is conical.
3. Minimally invasive insertion of a wire guide bendable around a bone according to claim 1, characterized in that the tightener (1.3) is a wire cable.
4. A minimally invasive insertion bendable wire guide to encircle bone according to claim 1, characterized in that the piercing wire (2) has a diameter of 0.2-1.0 mm.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010952483.0A CN112043370B (en) | 2020-09-11 | 2020-09-11 | Minimally invasive steel wire guider capable of being inserted into bendable surrounding skeleton |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010952483.0A CN112043370B (en) | 2020-09-11 | 2020-09-11 | Minimally invasive steel wire guider capable of being inserted into bendable surrounding skeleton |
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| CN112043370A CN112043370A (en) | 2020-12-08 |
| CN112043370B true CN112043370B (en) | 2022-05-27 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN113500479B (en) * | 2021-07-07 | 2022-06-03 | 彭忠捷 | Automatic processing robot for steel wire guide hook for orthopedic operation |
| CN114376741B (en) * | 2021-12-21 | 2022-09-27 | 无锡市第九人民医院 | Device for assisting closed reduction of femoral neck fracture and internal fixation of needle |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| DE19509115C2 (en) * | 1995-03-16 | 1997-11-27 | Deutsche Forsch Luft Raumfahrt | Surgical device for preparing an anastomosis using minimally invasive surgical techniques |
| US9610092B2 (en) * | 2011-08-29 | 2017-04-04 | Microsoft Orthopedics Holdings Inc. | Precision hip replacement method |
| CN201267462Y (en) * | 2008-10-10 | 2009-07-08 | 上海医疗器械（集团）有限公司手术器械厂 | Push-and-pull device of organ for minimally invasive celioscope operation |
| CN204092167U (en) * | 2014-09-12 | 2015-01-14 | 苏州大学附属第二医院 | A kind of be applicable to comminuted fracture tie up guiding device |
| CN204446034U (en) * | 2015-02-02 | 2015-07-08 | 中国人民解放军第四军医大学 | One is universal can illumination scalpel |
| CN106725733B (en) * | 2017-01-17 | 2023-07-07 | 上海市第五人民医院 | Novel purse-string forceps for laparoscope |
| CN208741073U (en) * | 2017-12-01 | 2019-04-16 | 青岛市市立医院 | A kind of nose tissue punch forceps |
| CN108309207B (en) * | 2018-03-12 | 2020-07-17 | 湖南瀚德微创医疗科技有限公司 | Bidirectional bending-adjusting endoscope |
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