CN112754395B - Intramedullary nail and intramedullary nail internal bone grafting device - Google Patents

Intramedullary nail and intramedullary nail internal bone grafting device Download PDF

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Publication number
CN112754395B
CN112754395B CN202011631632.XA CN202011631632A CN112754395B CN 112754395 B CN112754395 B CN 112754395B CN 202011631632 A CN202011631632 A CN 202011631632A CN 112754395 B CN112754395 B CN 112754395B
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China
Prior art keywords
rod
intramedullary nail
bone grafting
tube
bone
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Active
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CN202011631632.XA
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Chinese (zh)
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CN112754395A (en
Inventor
杨承刚
齐艳芳
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Gu'an Bojian Biotechnology Co ltd
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Gu'an Bojian Biotechnology Co ltd
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Priority to CN202011631632.XA priority Critical patent/CN112754395B/en
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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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/317—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for bones or joints, e.g. osteoscopes, arthroscopes
    • 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
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M3/00—Medical syringes, e.g. enemata; Irrigators
    • A61M3/02—Enemata; Irrigators
    • A61M3/0279—Cannula; Nozzles; Tips; their connection means
    • 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
    • A61B2017/564—Methods for bone or joint treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/007—Auxiliary appliance with irrigation system

Abstract

The invention discloses an intramedullary nail and an intramedullary nail internal bone grafting device, which comprise an intramedullary nail rod and a sight, and are characterized in that the interior of the intramedullary nail rod is a cavity, and the interior of the intramedullary nail rod comprises a bone grafting structure for bone grafting, and the bone grafting structure is connected with the intramedullary nail rod in a combined way; the intramedullary nail rod comprises a bone grafting window allowing the bone grafting structure to extend; both ends of the intramedullary nail rod comprise locking holes which are matched with the locking screws; the sighting device is connected with the intramedullary nail rod in a combined way. The intramedullary nail and the bone grafting device in the intramedullary nail can implant bone at the bone defect part through the bone grafting structure, and have convenient operation and good treatment effect.

Description

Intramedullary nail and intramedullary nail internal bone grafting device
Technical Field
The invention belongs to the technical field of medical appliances, and particularly relates to an intramedullary nail and an intramedullary nail internal bone grafting device.
Background
The intramedullary nail is an ideal endophyte for treating diaphyseal fracture, and is the first choice for treating long tubular bones of limbs at present. Through the minimally invasive technique, the intramedullary nail can provide good stability, and simultaneously reduce soft tissue injury of fracture areas. Avoiding further damage to soft tissue surrounding the fracture region may promote vascularization and aid in the formation of bridged bone-setting gamma. The bone-intramedullary nail ply allows for early weight bearing and promotes healing.
As an internal fixator commonly used in bone surgery, the application of intramedullary nails to treat limb fractures has been quite long in history, and as early as 100 years ago, animal experiments and clinical observations have been made with rods of different materials. The Chinese is used from the 90 s of the last century, and then is applied to clinic and widely popularized, and the Chinese is continuously used until now after one-time improvement.
The intramedullary nail is a common orthopedic internal fixation instrument which is composed of a hollow intramedullary nail rod, a proximal locking screw hole and the like, wherein the fixed fracture part adopts a closed and minimally invasive technology, and the operation wound is small; in addition, the intramedullary nail does not damage the bone marrow of the patient, because the bone marrow of the human is red bone marrow with hematopoietic function in the period of infants, the bone marrow in the long tubular bone becomes yellow bone marrow without hematopoietic function until the period of adults, and the yellow bone marrow is regenerated after damage, so the intramedullary nail treats the fracture, the patient does not worry about damage to the bone marrow, and the intramedullary nail is popular with orthopedics doctors and patients, and is commonly used for treating various types of fracture.
While the prior intramedullary nail has the advantages, the prior intramedullary nail has simple structure and no function of bone particles or can not provide good conditions for bone particles implantation.
The present invention is directed to the above-mentioned problems, and provides an intramedullary nail and an intramedullary nail internal bone grafting device.
Disclosure of Invention
In order to overcome the problems in the prior art, the invention provides an intramedullary nail and an intramedullary nail internal bone grafting device.
An intramedullary nail and an intramedullary nail internal bone grafting device, which comprises an intramedullary nail rod and a sight, and is characterized in that the interior of the intramedullary nail rod is a cavity, and the interior of the intramedullary nail rod comprises a bone grafting structure for bone grafting, and the bone grafting structure is connected with the intramedullary nail rod in a combined way; the intramedullary nail rod comprises a bone grafting window allowing the bone grafting structure to extend; both ends of the intramedullary nail rod comprise locking holes which are matched with the locking screws; the sighting device is connected with the intramedullary nail rod in a combined way. The intramedullary nail and the bone grafting device in the intramedullary nail can implant bone at the bone defect part through the bone grafting structure, and have convenient operation and good treatment effect.
Further, the main body of the intramedullary nail rod is a cylinder, and the inside of the intramedullary nail rod is a cylindrical cavity. The intramedullary nail with the shape has no edges and corners on the outer surface, and is suitable for clinical use.
Further, the sight is located the rear end of intramedullary nail pole, and the rear end of intramedullary nail pole includes the external screw thread, and the sight includes corresponding internal screw thread, and intramedullary nail pole passes through screw thread combination with the sight and connects. When in use, the sighting device and the intramedullary nail are connected through the thread combination.
Further, the sight comprises a through hole communicated with the intramedullary nail rod, the through hole and the intramedullary nail rod are on the same horizontal line, and the inner diameter of the through hole is equal to the inner diameter of the intramedullary nail rod. This arrangement facilitates the internal manipulation of the intramedullary nail shaft through the through hole.
Further, the sight isShape. The sight arranged in the way is convenient for a surgeon to hold.
Further, the bone grafting structure comprises a bone grafting tube and a bone grafting push rod, and the bone grafting push rod is positioned in the bone grafting tube. When in use, the bone particles are put into the bone grafting tube, and the bone particles can be implanted into the affected part by pushing the bone grafting push rod.
Further, the bone grafting tube is a soft cylindrical tube.
Further, the front end of the bone grafting tube is arranged into a pencil shape. The arrangement can enhance the accuracy of implanting bone particles to the affected part.
Further, the rear end of the bone grafting tube extends out of the guide tube, and the rear end of the bone grafting tube comprises a horn-shaped opening. The horn-shaped opening is arranged to facilitate the bone particles to be implanted into the bone grafting tube.
Further, the bone grafting push rod is a soft cylindrical rod. The bone grafting push rod can adapt to the trend of bone grafting pipes.
Further, the rear end of the bone grafting push rod extends out of the bone grafting tube, the rear end of the bone grafting push rod comprises a T-shaped handle, and the T-shaped handle is integrally connected with the bone grafting push rod. When in use, the bone grafting push rod is pushed and pulled by holding the T-shaped handle.
Further, a control structure for controlling the direction of the bone graft tube is provided.
Further, the control structure comprises a fixer and an operating rod, the fixer comprises a guide pipe and a fixed handrail, the fixed handrail is arranged at the rear end of the guide pipe and is integrally connected with the guide pipe, the fixed handrail is positioned outside the through hole, and the fixed handrail is connected with the sighting device in a combined way; the operating lever is arranged at the front end of the guide tube and is used for controlling the direction of the front end of the guide tube. In this kind of setting, through the direction of control guide tube front end of action lever control to realize adjusting the effect of bone grafting pipe direction, fixed handrail and sight composite connection, thereby with the holistic position fixation of fixer, guarantee the stability of bone grafting operation in the operation process. When in use, the bone grafting tube is arranged in the guide tube, and the direction of the front end of the bone grafting tube can be controlled through the operating rod.
Further, the guide tube is a cylindrical tube, the rear end of the guide tube is integrally connected with the fixed handrail, the front end of the guide tube is a front opening, and the front opening is positioned in the area where the bone grafting window is positioned; the rear end of the guide tube is provided with a rear opening which is positioned on the outer side wall of the fixed handrail; the bone graft tube is inserted from the rear opening and extends from the front opening. When in use, the front end of the bone grafting tube enters the guide tube from the rear opening and then extends out of the front opening of the guide tube, so that the front end of the bone grafting tube extends out of the bone grafting window of the intramedullary nail rod, and bone particles are implanted into the bone defect part.
Further, the fixed handrail is a transverse U-shaped rod, the bottom of the fixed handrail comprises an opening clamp, the opening clamp is integrally connected with the fixed handrail, and the fixed handrail is connected with the sighting device through the opening clamp. The fixing handrail is combined and connected with the sighting device through the opening clamp.
Further, an anti-slip washer is arranged on the inner wall of the opening clamp, and the anti-slip washer is fixedly connected with the opening clamp. This arrangement can increase the friction between the clip and the sight, enhancing the stability of the holder.
Further, the front end of the guide tube comprises a movable tube and a movable connecting structure, and the movable tube is movably connected with the guide tube through the movable connecting structure. This arrangement allows for directional adjustment of the endoscope through the movable tube.
Further, the movable connecting structure is a soft elastic connecting pipe, one end of the soft elastic connecting pipe is integrally connected with the guide end, and the other end of the soft elastic connecting pipe is integrally connected with the movable pipe.
Further, the front end of the operating rod comprises a connecting ring A, the outer side wall of the movable pipe comprises a connecting ring B, the connecting ring A is sleeved with the connecting ring B, the connecting ring A is integrally connected with the operating rod, and the connecting ring B is integrally connected with the movable pipe; the operating rod extends out of the through hole. When in use, the surgeon controls the direction of the movable tube by pulling the operating rod.
Further, the rear end of the operating rod comprises a traction handle which is convenient for an operator to operate, and the traction handle is integrally connected with the operating rod.
Further, the pulling handle is a semicircular rod. When in use, the operator can hook the semicircular rod with fingers to pull.
Further, an image acquisition structure for acquiring an image of the interior of the fracture wound is provided.
Further, the image acquisition structure comprises a soft endoscope and a control structure for controlling the direction of the endoscope, and the endoscope and the control structure enter the interior of the intramedullary nail rod from the through hole of the sighting device; the front end of the endoscope extends out of the bone grafting window. The wound condition of the broken end of the bone can be checked through the endoscope, and the direction of the endoscope can be controlled through the control structure, so that the wound condition can be checked in all directions.
Further, the endoscope is a fiber soft mirror and comprises a lens, an optical fiber and a control knob.
Further, the interior of the intramedullary nail shaft includes a fixation assembly for preventing the intramedullary nail from jogging.
Further, the fixing assembly comprises a fixing screw and a linkage rod, the linkage rod comprises a first link rod and a second link rod, the first link rod is hinged with the front end of the fixing screw, the second link rod is movably connected with the fixing screw, and the free end of the first link rod is hinged with the free end of the second link rod; a through hole allowing the free ends of the first link rod and the second link rod to extend is arranged on the side wall of the intramedullary nail rod. In the arrangement, the second link rod can move on the fixed screw rod, so that the included angle between the first link rod and the second link rod is adjusted, the free ends of the first link rod and the second link rod extend out of the intramedullary nail rod from the through hole to be in contact with the bone cavity wall, and the stability of the intramedullary nail is enhanced.
Further, arc plates with smooth edges are arranged at the free ends of the first link rod and the second link rod. The arrangement contacts the bone cavity wall through the arc-shaped plate, so that the damage to tissues in the bone cavity can be avoided.
Further, the main bodies of the fixed screw and the linkage rod are cylinders.
Further, the fixing screw includes an external thread section and an unthreaded section, the length of the external thread section being greater than the length of the unthreaded section.
Further, the sleeve ring sleeved on the periphery of the fixed screw rod is arranged, the inner diameter of the sleeve ring is larger than the diameter of the fixed screw rod, and the link rod II is hinged with the sleeve ring through a screw. In this arrangement, the second link can be extended by sliding the collar, thereby changing the angle between the first link and the second link.
Further, a pushing structure for pushing the lantern ring to move is arranged, the pushing structure comprises a threaded sleeve and a rotating handle, the threaded sleeve is sleeved on the fixing screw rod, and the threaded sleeve is in threaded connection with an external thread section of the fixing screw rod; the threaded sleeve is rotationally connected with the lantern ring; the rotating handle is detachably connected with the threaded sleeve, and extends out of the sighting device. When the movable connecting rod is used, the threaded sleeve is rotated by rotating the handle, and the threaded sleeve is displaced on the fixed screw rod by rotation, so that the lantern ring is pushed to move, and the second connecting rod is moved; after the operation is completed, the rotary handle is detached from the threaded sleeve and withdrawn from the patient.
Further, a rotating shaft is arranged on the lantern ring, a matched rotating groove is arranged on the threaded sleeve, and the lantern ring is rotationally connected with the threaded sleeve through the rotating shaft.
Further, the threaded sleeve comprises a cross-shaped groove, the rotating handle comprises a cross-shaped connector, the cross-shaped connector is inserted into the cross-shaped groove, and the rotating handle is inserted into the threaded sleeve through the cross-shaped groove. When the screw rod is used, the cross-shaped connector of the rotary handle is inserted into the cross-shaped groove of the screw sleeve, then the rotary handle is rotated by hand, so that the screw sleeve is rotated, the screw sleeve is rotated on the fixed screw rod to displace, and the lantern ring is pushed to move, so that the second connecting rod is changed in position.
Further, a row column for stabilizing the position of the fixing assembly is arranged at the bottom of the fixing screw rod and consists of at least two cylinders, and the row column is integrally connected with the fixing screw rod; a round hole allowing the row column to extend out is arranged on the side wall of the intramedullary nail rod, and the row column extends out of the intramedullary nail rod through the round hole. In the arrangement, the row of columns extends out of the intramedullary nail rod to be contacted with the bone cavity wall, so as to play a role in strengthening the stability of the intramedullary nail.
Further, the bottom of the row of columns, i.e. the end contacted with the bone cavity wall, is a semicircle. The bottom of the row column is smooth, and the damage to the tissues in the bone cavity is avoided.
Further, the whole fixed component is made of titanium alloy or stainless steel materials. The fixing component has high strength and corrosion resistance, and accords with clinical use standards.
Further, at least two fixation assemblies are provided inside the intramedullary nail shaft. This arrangement enhances the stabilization of the intramedullary nail.
Further, an irrigation structure for irrigating and diminishing inflammation is arranged, and the irrigation structure is connected with the intramedullary nail rod in a combined way.
Further, the flushing structure comprises a flushing pipe and a liquid storage bag, the flushing pipe is integrally connected with the liquid storage bag, and the flushing pipe is communicated with the liquid storage bag; the liquid storage bag comprises a liquid inlet, the liquid inlet comprises a threaded cover which is connected in a combined mode, and the liquid storage bag comprises a soft bag body. When the anti-inflammatory liquid is used, anti-inflammatory liquid is injected into the liquid storage bag through the liquid inlet, then the flushing pipe is placed into the guide pipe from the rear opening of the guide pipe, the front end of the flushing pipe extends out of the front opening of the guide pipe, the liquid storage bag is extruded, and the anti-inflammatory liquid can be sprayed out, so that wounds are flushed and anti-inflammatory.
Further, the front end of the flushing pipe is provided with a spray head, the spray head comprises a spray opening, and the spray head is integrally connected with the flushing pipe. This arrangement results in a more uniform spray of liquid.
Further, the flushing pipe is made of soft silica gel materials or soft plastics. The flushing pipe with the arrangement is soft in texture, and the flushing direction of the front end of the flushing pipe can be controlled by controlling the operating rod.
Further, the soft capsule body of the liquid storage capsule is made of soft silica gel materials.
The invention has the beneficial effects that: (1) The bone grafting can be carried out on the bone defect part, the operation is simple, and the treatment effect is good; (2) The internal condition of the fracture wound can be checked, so that an operator can know the fracture condition more, and an optimal treatment scheme is adopted; (3) Can flush and diminish inflammation of fracture wounds, reduce inflammatory reaction and avoid infection; (4) Can prevent the intramedullary nail from inching and avoid the situation of bone nonunion at the broken end of the bone.
Drawings
FIG. 1 is a schematic view of the overall structure of the present invention with a bone grafting structure;
FIG. 2 is a schematic view showing the positional relationship among a bone grafting tube, a guide tube and a bone grafting window according to the present invention;
FIG. 3 is a schematic view of the relationship between the fixation arm, the bone graft tube and the sight according to the present invention;
FIG. 4 is a schematic view showing the bone grafting structure and the use state of the guide tube according to the present invention;
FIG. 5 is a partially enlarged view of the bone grafting structure and guide tube of the present invention;
FIG. 6 is an enlarged view of the front end of the bone grafting tube and guide tube according to the present invention;
FIG. 7 is a schematic view showing the structure of the bone grafting structure according to the present invention in use;
FIG. 8 is a schematic view of the overall structure of the intramedullary nail shaft of the present invention with a fixation assembly disposed therein;
FIG. 9 is a schematic view of the overall structure of the intramedullary nail shaft of the present invention from above with a fixation assembly disposed therein;
FIG. 10 is a schematic overall elevational view of the intramedullary nail shaft of the present invention with a fixation assembly disposed therein;
FIG. 11 is a schematic view of the overall structure of the fixing assembly of the present invention;
FIG. 12 is an enlarged schematic view of the structure of the fixing assembly extending through the through hole of the present invention;
FIG. 13 is an enlarged schematic view of the fastening assembly of the present invention;
FIG. 14 is a schematic elevational view of a fastening assembly of the present invention;
FIG. 15 is an enlarged schematic view of the connection of the collar and threaded sleeve of the present invention;
FIG. 16 is an enlarged schematic view of the threaded sleeve of the present invention;
FIG. 17 is a partially enlarged schematic view of the rotary handle of the present invention;
FIG. 18 is an enlarged cross-sectional view of the threaded sleeve of the present invention;
FIG. 19 is an enlarged schematic view of the hinge of the free end of the first link and the second link according to the present invention;
FIG. 20 is an enlarged schematic view of the hinge of the first link with the front end of the fixing screw according to the present invention;
FIG. 21 is an enlarged schematic view of the hinge of the second link with the collar of the present invention;
FIG. 22 is a schematic top plan view of a portion of the present invention with two sets of securing members;
FIG. 23 is a schematic view showing the overall structure of the present invention in which a guide tube and an endoscope are provided;
FIG. 24 is a schematic view showing the structure of the guide tube and endoscope of the present invention in use;
FIG. 25 is an enlarged view of the front end of the endoscope and guide tube of the present invention;
FIG. 26 is a schematic view of the positional relationship of a guide tube, endoscope and bone grafting window according to the present invention;
FIG. 27 is a schematic view showing the assembled connection of the fixed armrest and the sight according to the present invention;
FIG. 28 is a schematic view of the structure of the present invention for securing the armrest with the endoscope in use;
FIG. 29 is a schematic view of the overall structure of the control structure of the present invention;
FIG. 30 is an enlarged schematic view of the stationary handrail of the present invention;
FIG. 31 is a schematic view of the overall structure of the present invention with a flushing structure;
FIG. 32 is a schematic view of the positional relationship of the irrigation tube, guide tube and bone grafting window of the present invention;
FIG. 33 is a schematic view of the positional relationship of the stationary handrail, sight and reservoir of the present invention;
FIG. 34 is an enlarged schematic view of the stationary handrail and the flushing structure of the present invention;
FIG. 35 is a schematic view of the overall structure of the flushing structure in the use state of the present invention;
FIG. 36 is a front elevational view of the overall structure of the irrigation structure in its use configuration of the present invention;
in the figure, 1, intramedullary nail rod; 11. a through hole; 12. a bone grafting window; 13. a locking hole; 2. a sight; 21. a through hole; 3. a fixed screw; 31. a link rod I; 32. a link II; 33. a collar; 331. a rotating shaft; 34. a threaded sleeve; 341. a cross-shaped groove; 35. rotating the handle; 351. a cross-shaped connector; 36. arranging columns; 37. an arc-shaped plate; 4. a guide tube; 41. a movable tube; 42. a soft elastic connecting pipe; 43. an operation lever; 431. pulling the handle; 44. fixing the armrests; 441. an opening clamp; 45. an endoscope; 5. a flushing pipe; 51. a reservoir; 511. a screw cap; 52. a spray head; 6. a bone grafting tube; 61. a bone grafting push rod; 62. a horn-like opening; 63. t-shaped handle.
Detailed Description
The following detailed description of the embodiments of the present invention will be made more apparent to those skilled in the art from the following detailed description, in which the invention is embodied in several, but not all, embodiments of the invention. The invention may be embodied or applied in other specific forms and features of the following examples and examples may be combined with each other without conflict, all other examples being contemplated by those of ordinary skill in the art without undue burden from the present disclosure, based on the examples of the invention.
The front end of the intramedullary nail rod is the end which firstly enters the bone of the patient, and the rear end is the end which finally enters the bone.
Example 1
An intramedullary nail and an intramedullary nail internal bone grafting device, which comprises an intramedullary nail rod 1 and a sight 2, and is characterized in that the interior of the intramedullary nail rod 1 is a cavity, the interior of the intramedullary nail rod 1 comprises a bone grafting structure for bone grafting, and the bone grafting structure is combined and connected with the intramedullary nail rod 1; the intramedullary nail rod 1 comprises a bone grafting window 12 allowing the bone grafting structure to protrude; both ends of the intramedullary nail rod 1 comprise locking holes 13, and the locking holes 13 are matched with locking screws; the sight 2 is combined and connected with the intramedullary nail rod 1. The intramedullary nail and the bone grafting device in the intramedullary nail can implant bone at the bone defect part through the bone grafting structure, and have convenient operation and good treatment effect.
The main body of the intramedullary nail rod 1 is a cylinder, and the inside of the intramedullary nail rod 1 is a cylindrical cavity. The intramedullary nail with the shape has no edges and corners on the outer surface, and is suitable for clinical use.
The sighting device 2 is positioned at the rear end of the intramedullary nail rod 1, the rear end of the intramedullary nail rod 1 comprises external threads, the sighting device 2 comprises corresponding internal threads, and the intramedullary nail rod 1 is connected with the sighting device 2 through a thread combination. When in use, the sighting device 2 and the intramedullary nail are connected through the screw thread combination.
The sight 2 comprises a through hole 21 communicating with the intramedullary nail shaft 1, the through hole 21 and the intramedullary nail shaft 1 are on the same horizontal line, and the inner diameter of the through hole 21 is equal to the inner diameter of the intramedullary nail shaft 1. This arrangement facilitates the internal handling of the intramedullary rod 1 by means of the through holes 21.
The sighting device 2 isShape. The sight 2 thus arranged is convenient for the surgeon to hold.
The bone grafting structure comprises a bone grafting tube 6 and a bone grafting push rod 61, wherein the bone grafting push rod 61 is positioned inside the bone grafting tube 6. In use, bone particles are placed in the bone grafting tube 6, and the bone particles can be implanted into the affected part by pushing the bone grafting push rod 61.
The bone grafting tube 6 is a soft cylindrical tube.
The front end of the bone grafting tube 6 is provided with a pencil shape. The arrangement can enhance the accuracy of implanting bone particles to the affected part.
The rear end of the bone graft tube 6 protrudes outside the guide tube 4, and the rear end of the bone graft tube 6 includes a horn-shaped opening 62. Such a flared opening 62 is provided to facilitate the insertion of bone particles into the bone graft tube 6.
The bone grafting pusher 61 is a soft cylindrical rod. The bone grafting push rod 61 can adapt to the trend of the bone grafting tube 6.
The rear end of the bone grafting push rod 61 extends out of the bone grafting tube 6, and the rear end of the bone grafting push rod 61 comprises a T-shaped handle 63, and the T-shaped handle 63 is integrally connected with the bone grafting push rod 61. When in use, hold the 'T'
The font handle 63 pushes and pulls the bone grafting push rod 61.
The application method of the embodiment is as follows: the bone grafting tube 6 is placed in the intramedullary nail rod 1, the front end of the bone grafting tube 6 extends out of the bone grafting window 12, the front end of the bone grafting tube 6 is aligned with an affected part needing bone grafting, and the bone grafting push rod 61 is pushed to enable bone particles to reach the affected part; after the bone grafting is completed, if no other operation is performed, the fixing assembly is placed inside the intramedullary nail rod 1, so that the position of the intramedullary nail is fixed, and the intramedullary nail is prevented from inching.
Example 2
A control structure for controlling the direction of the bone graft tube 6 is provided on the basis of embodiment 1.
The control structure comprises a fixer and an operating rod 43, the fixer comprises a guide tube 4 and a fixed handrail 44, the fixed handrail 44 is arranged at the rear end of the guide tube 4, the fixed handrail 44 is integrally connected with the guide tube 4, the fixed handrail 44 is positioned outside the through hole 21, and the fixed handrail 44 is combined and connected with the sighting device 2; an operation lever 43 is provided at the front end of the guide tube 4, and the operation lever 43 is used to control the direction of the front end of the guide tube 4. In the arrangement, the direction of the front end of the guide tube 4 is controlled by the operating rod 43, so that the effect of adjusting the direction of the bone grafting tube 6 is realized, and the fixed handrail 44 is combined and connected with the sighting device 2, so that the whole position of the fixer is fixed, and the stability of bone grafting operation in the operation process is ensured. In use, the bone graft tube 6 is placed in the guide tube 4, and the direction of the front end of the bone graft tube 6 can be controlled by the operating rod 43.
The guide tube 4 is a cylindrical tube, the rear end of the guide tube 4 is integrally connected with the fixed handrail 44, the front end of the guide tube 4 is a front opening, and the front opening is positioned in the area where the bone grafting window 12 is positioned; the rear end of the guide tube 4 is provided with a rear opening which is positioned on the outer side wall of the fixed handrail 44; the bone graft tube 6 is introduced from the rear opening and protrudes from the front opening. In use, the front end of the bone grafting tube 6 enters the guide tube 4 from the rear opening and then extends out of the front opening of the guide tube 4, so that the front end of the bone grafting tube 6 extends out of the bone grafting window 12 of the intramedullary nail rod 1, and bone particles are implanted into the bone defect position.
The fixed handrail 44 is a transverse U-shaped rod, the bottom of the fixed handrail 44 comprises an opening clamp 441, the opening clamp 441 is integrally connected with the fixed handrail 44, and the fixed handrail 44 is combined and connected with the sighting device 2 through the opening clamp 441. This arrangement connects the fixed armrest 44 in combination with the sight 2 via the split clip 441.
An anti-slip washer is provided on the inner wall of the split collet 441, and is fixedly connected with the split collet 441. This arrangement increases the friction between the split clip 441 and the sight 2, enhancing the stability of the holder.
The front end of the guide tube 4 comprises a movable tube 41 and a movable connecting structure, and the movable tube 41 is movably connected with the guide tube 4 through the movable connecting structure. This arrangement allows for directional adjustment of the endoscope 45 by the movable tube 41.
The movable connecting structure is a soft elastic connecting pipe 42, one end of the soft elastic connecting pipe 42 is integrally connected with the guiding end, and the other end is integrally connected with the movable pipe 41.
The front end of the operating rod 43 comprises a connecting ring A, the outer side wall of the movable tube 41 comprises a connecting ring B, the connecting ring A is sleeved with the connecting ring B, the connecting ring A is integrally connected with the operating rod 43, and the connecting ring B is integrally connected with the movable tube 41; the operation lever 43 protrudes outside the through hole 21. In use, the surgeon controls the direction of the movable tube 41 by pulling the operating rod 43.
The rear end of the operating lever 43 includes a pulling grip 431 for convenient operation by the surgeon, and the pulling grip 431 is integrally connected with the operating lever 43.
The pulling handle 431 is a semicircular rod. When in use, the operator can hook the semicircular rod with fingers to pull.
The application method of the embodiment is as follows: the guide tube 4 is placed in the intramedullary nail rod 1, bone particles are filled into the bone grafting tube 6 from the horn-shaped opening 62, the bone grafting tube 6 is placed in the guide tube 4, the direction of the movable tube 41 is controlled through the operating rod 43, so that the direction of the front end of the bone grafting tube 6 is adjusted, the front end of the bone grafting tube 6 extends out of the bone grafting window 12, the front end of the bone grafting tube 6 is aligned with an affected part needing bone grafting, and the bone grafting push rod 61 is pushed to enable the bone particles to reach the affected part; after the bone grafting is completed, if no other operation is performed, the fixing assembly is placed inside the intramedullary nail rod 1, so that the position of the intramedullary nail is fixed, and the intramedullary nail is prevented from inching.
Example 3
An image acquisition structure for acquiring an image of the inside of a fracture wound is provided on the basis of example 2.
The image acquisition structure comprises a soft endoscope 45 and a control structure for controlling the direction of the endoscope 45, wherein the endoscope 45 and the control structure enter the interior of the intramedullary nail rod 1 from the through hole 21 of the sight 2; the front end of the endoscope 45 protrudes from the bone grafting window 12. The wound condition of the fractured bone end can be checked through the endoscope 45, and the direction of the endoscope 45 can be controlled through the control structure, so that the wound condition can be checked in all directions.
The endoscope 45 is a fiber optic soft scope including a lens, optical fibers, and a steering knob.
The application method of the embodiment is as follows: the guiding tube 4 is placed in the intramedullary nail rod 1, the endoscope 45 is placed in the guiding tube 4, and the movable tube 41 at the front end of the guiding tube 4 is controlled by the operating rod 43, so that the direction of the front end of the endoscope 45 is controlled, and a doctor can view the condition of the broken end of the fracture and wound in an omnibearing manner; after the inspection, if there is no other operation, the fixation assembly is placed inside the rod 1, thereby fixing the position of the intramedullary nail.
Example 4
An irrigation structure for irrigating and diminishing inflammation of the wound is provided on the basis of embodiment 2, and the irrigation structure is combined and connected with the intramedullary nail rod 1.
The flushing structure comprises a flushing pipe 5 and a liquid storage bag 51, the flushing pipe 5 is integrally connected with the liquid storage bag 51, and the flushing pipe 5 is communicated with the liquid storage bag 51; the liquid storage bag 51 comprises a liquid inlet, the liquid inlet comprises a threaded cover 511 which is connected in a combined mode, and the liquid storage bag 51 comprises a soft bag body. When in use, anti-inflammatory liquid is injected into the liquid storage bag 51 through the liquid inlet, then the flushing pipe 5 is placed into the guide pipe 4 from the rear opening of the guide pipe 4, the front end of the flushing pipe 5 extends out of the front opening of the guide pipe 4, the liquid storage bag 51 is extruded, and the anti-inflammatory liquid can be sprayed out, so that wounds are flushed and anti-inflammatory.
A spray head 52 is provided at the front end of the flushing pipe 5, the spray head 52 including a spray port, the spray head 52 being integrally connected with the flushing pipe 5. This arrangement results in a more uniform spray of liquid.
The flushing pipe 5 is made of soft silica gel material or soft plastic. The rinse pipe 5 thus provided is soft in texture, and the rinse direction of the front end of the rinse pipe 5 can be controlled by manipulating the operation lever 43.
The soft capsule body of the liquid storage capsule 51 is made of soft silica gel material.
The application method of the embodiment is as follows: the guide tube 4 is placed in the intramedullary nail rod 1, the flushing tube 5 is placed in the guide tube 4, the direction of the movable tube 41 at the front end of the guide tube 4 is controlled by the operating rod 43, so that the flushing direction of the flushing tube 5 is controlled, the front end of the flushing tube 5 extends out of the bone grafting window 12, the liquid storage bag 51 is extruded, the liquid in the liquid storage bag 51 is sprayed out from the spray head 52, and the fracture wound is fully flushed and anti-inflammatory, so that infection is avoided; after the flushing is completed, if no other operation is performed, the fixing assembly is placed inside the intramedullary nail rod 1, so that the position of the intramedullary nail is fixed, and the intramedullary nail is prevented from inching.
Example 5
Based on example 1 or 2: the interior of the intramedullary nail shaft 1 comprises a fixation assembly for preventing the intramedullary nail from inching.
The fixed assembly comprises a fixed screw 3 and a linkage rod, the linkage rod comprises a first link rod 31 and a second link rod 32, the first link rod 31 is hinged with the front end of the fixed screw 3, the second link rod 32 is movably connected with the fixed screw 3, and the free end of the first link rod 31 is hinged with the free end of the second link rod 32; through holes 11 are provided in the side walls of the intramedullary nail shaft 1, which allow the free ends of the first and second links 31, 32 to protrude. In this arrangement, the second link rod 32 is movable on the fixing screw rod 3, so as to adjust the included angle between the first link rod 31 and the second link rod 32, and the free ends of the first link rod 31 and the second link rod 32 extend out of the intramedullary nail rod 1 from the through hole 11 to contact with the bone cavity wall, so that the stability of the intramedullary nail is enhanced.
An arc 37 with rounded edges is provided at the free ends of the first link 31 and the second link 32. This arrangement, by contacting the bone cavity wall through the arcuate plate 37, can avoid damaging tissue within the bone cavity.
The main bodies of the fixed screw 3 and the linkage rod are cylinders.
The fixing screw 3 includes an external thread section and an unthreaded section, the length of the external thread section being greater than the length of the unthreaded section.
The sleeve ring 33 sleeved on the periphery of the fixing screw 3 is arranged, the inner diameter of the sleeve ring 33 is larger than the diameter of the fixing screw 3, and the link rod II 32 is hinged with the sleeve ring 33 through a screw. In this arrangement, the second link 32 can be extended by sliding collar 33, thereby changing the angle between the first link 31 and the second link 32.
A pushing structure for pushing the lantern ring 33 to move is arranged, the pushing structure comprises a threaded sleeve 34 and a rotating handle 35, the threaded sleeve 34 is sleeved on the fixed screw 3, and the threaded sleeve 34 is in threaded connection with an external thread section of the fixed screw 3; the threaded sleeve 34 is in rotational connection with the collar 33; the turning knob 35 is detachably connected to the threaded sleeve 34, and the turning knob 35 protrudes outside the sight 2. When in use, the threaded sleeve 34 is rotated by rotating the handle 35, and the threaded sleeve 34 is displaced on the fixed screw 3 by rotation, so that the lantern ring 33 is pushed to move, and the movement of the link rod II 32 is realized; after the operation is completed, the turning handle 35 is detached from the threaded sleeve 34 and withdrawn from the patient.
The collar 33 is provided with a rotating shaft 331, the threaded sleeve 34 is provided with a matched rotating groove, and the collar 33 is rotatably connected with the threaded sleeve 34 through the rotating shaft 331.
The threaded sleeve 34 comprises a "cross" groove 341, the turning handle 35 comprises a "cross" shaped connector 351, the "cross" shaped connector 351 is plugged with the "cross" groove 341, and the turning handle 35 is plugged with the threaded sleeve 34 through the "cross" groove 341. In use, the "cross" shaped connector 351 of the turning handle 35 is inserted into the "cross" groove 341 of the threaded sleeve 34, and then the turning handle 35 is turned by hand to turn the threaded sleeve 34, and the threaded sleeve 34 is displaced when turned on the fixing screw 3, so that the collar 33 is pushed to move, and the second link rod 32 is changed in position.
A column row 36 for stabilizing the position of the fixed assembly is arranged at the bottom of the fixed screw 3, the column row 36 consists of at least two cylinders, and the column row 36 is integrally connected with the fixed screw 3; a circular hole is provided in the side wall of the intramedullary nail shaft 1 to allow the row of posts 36 to protrude, through which the row of posts 36 protrude outside the intramedullary nail shaft 1. In this arrangement, the row of posts 36 extends beyond the intramedullary rod 1 to contact the bone cavity wall and serves to enhance the stability of the intramedullary nail.
The bottom of row of posts 36, i.e., the end that contacts the bone cavity wall, is a hemisphere. The bottom of such row of posts 36 is smooth and avoids damaging the internal tissues of the bone cavity.
The whole fixed component is made of titanium alloy or stainless steel materials. The fixing component has high strength and corrosion resistance, and accords with clinical use standards.
At least two fixation assemblies are provided inside the intramedullary rod 1. This arrangement enhances the stabilization of the intramedullary nail.
The application method of the embodiment is as follows: inserting the cross-shaped connector 351 of the rotating handle 35 into the cross-shaped groove 341 of the threaded sleeve 34, placing the front end of the fixed screw rod 3 into the intramedullary nail rod 1, enabling the row column 36 to reach the round hole of the intramedullary nail rod 1 corresponding to the row column 36, inserting the row column 36 into the round hole, fixing the fixed screw rod 3, rotating the rotating handle 35 by hand to enable the threaded sleeve 34 to rotate on the fixed screw rod 3, enabling the threaded sleeve 34 to move towards the front end of the fixed screw rod 3, pushing the lantern ring 33 to move when the threaded sleeve 34 moves, enabling the position of the link rod two 32 to change when the lantern ring 33 moves, and enabling the included angle between the link rod one 31 and the link rod two 32 to change; because the length of the external thread section of the fixing screw 3 is longer than that of the unthreaded section, the threaded sleeve 34 can be fixed in position through threads, and because the threaded sleeve 34 is rotationally connected with the collar 33 through the rotating shaft 331, the position of the collar 33 is also fixed, and the position fixing of the link rod I31 and the link rod II 32 is ensured.
The above description of embodiments is only for the understanding of the present invention. It should be noted that it will be apparent to those skilled in the art that modifications can be made to the present invention without departing from the principles of the invention, and such modifications will fall within the scope of the claims.

Claims (2)

1. An intramedullary nail and an intramedullary nail internal bone grafting device, which comprises an intramedullary nail rod and a sight, and is characterized in that the interior of the intramedullary nail rod is a cavity, and the interior of the intramedullary nail rod comprises a bone grafting structure for bone grafting, and the bone grafting structure is connected with the intramedullary nail rod in a combined way; the intramedullary nail rod comprises a bone grafting window allowing the bone grafting structure to extend; both ends of the intramedullary nail rod comprise locking holes which are matched with the locking screws; the sighting device is connected with the intramedullary nail rod in a combined way; setting a control structure for controlling the direction of the bone grafting tube; the control structure comprises a fixer and an operating rod, the fixer comprises a guide pipe and a fixed handrail, the fixed handrail is arranged at the rear end of the guide pipe, the fixed handrail is integrally connected with the guide pipe, the fixed handrail is positioned outside the through hole, and the fixed handrail is connected with the sighting device in a combined way; the operating rod is arranged at the front end of the guide tube and is used for controlling the direction of the front end of the guide tube; the guide tube is a cylindrical tube, the rear end of the guide tube is integrally connected with the fixed handrail, the front end of the guide tube is a front opening, and the front opening is positioned in the area where the bone grafting window is positioned; the rear end of the guide tube is provided with a rear opening which is positioned on the outer side wall of the fixed handrail; the bone grafting tube enters from the rear opening and extends out from the front opening; the fixed handrail is a transverse U-shaped rod, the bottom of the fixed handrail comprises an opening clamp, the opening clamp is integrally connected with the fixed handrail, and the fixed handrail is connected with the sighting device through the opening clamp; the front end of the guide pipe comprises a movable pipe and a movable connecting structure, and the movable pipe is movably connected with the guide pipe through the movable connecting structure; the front end of the operating rod comprises a connecting ring A, the outer side wall of the movable pipe comprises a connecting ring B, the connecting ring A is sleeved with the connecting ring B, the connecting ring A is integrally connected with the operating rod, and the connecting ring B is integrally connected with the movable pipe; the operating rod extends out of the through hole; setting an image acquisition structure for acquiring a wound of a patient; the image acquisition structure comprises a soft endoscope and a control structure for controlling the direction of the endoscope, and the endoscope and the control structure enter the intramedullary nail rod from the through hole of the sighting device; the front end of the endoscope extends out of the bone grafting window; the intramedullary nail comprises a intramedullary nail rod, a connecting rod and a connecting rod, wherein the intramedullary nail rod is internally provided with a fixing component for preventing the intramedullary nail from micro-moving, the fixing component comprises a fixing screw rod and a linkage rod, the linkage rod comprises a first connecting rod and a second connecting rod, the first connecting rod is hinged with the front end of the fixing screw rod, the second connecting rod is movably connected with the fixing screw rod, and the free end of the first connecting rod is hinged with the free end of the second connecting rod; a through hole which allows the free ends of the first link rod and the second link rod to extend out is arranged on the side wall of the intramedullary nail rod; the bone grafting structure comprises a bone grafting tube and a bone grafting push rod, and the bone grafting push rod is positioned in the bone grafting tube; the bone grafting tube is a soft cylindrical tube; the rear end of the bone grafting tube extends out of the guide tube, and comprises a horn-shaped opening; the bone grafting push rod is a soft cylindrical rod; the rear end of the bone grafting push rod extends out of the bone grafting tube, and comprises a T-shaped handle which is integrally connected with the bone grafting push rod.
2. The intramedullary nail and intramedullary nail internal bone grafting apparatus of claim 1, wherein the leading end of the bone graft tube is configured as a "pencil-like" shape.
CN202011631632.XA 2020-12-31 2020-12-31 Intramedullary nail and intramedullary nail internal bone grafting device Active CN112754395B (en)

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