CN113100896A - Comminuted calcaneus fracture closed reduction device - Google Patents
Comminuted calcaneus fracture closed reduction device Download PDFInfo
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- CN113100896A CN113100896A CN202110404005.0A CN202110404005A CN113100896A CN 113100896 A CN113100896 A CN 113100896A CN 202110404005 A CN202110404005 A CN 202110404005A CN 113100896 A CN113100896 A CN 113100896A
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
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Abstract
The invention belongs to the technical field of medical instruments, and particularly relates to a comminuted calcaneus fracture closed reduction device which comprises a calcaneus fixing component, a calcaneus air bag extrusion component and a calcaneus traction component; the calcaneus fixing component is used for fixing the calcaneus front bone and the talus, and meanwhile, the calcaneus air bag extrusion component can be limited, the calcaneus air bag extrusion component extrudes and supports the fracture part of the calcaneus from the two sides and the bottom of the calcaneus, and the calcaneus traction component pulls one end of the calcaneus to move downwards to the original position. The calcaneus closed reduction device can reduce comminuted calcaneus fracture without an external surgical incision, and then is fixed percutaneously by adopting a Kirschner wire, bone cement or a locking steel plate. Thereby reducing intraoperative bleeding and complications associated with surgical incisions.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a closed reduction device for comminuted calcaneus fracture.
Background
Comminuted calcaneus fracture can cause traumatic arthritis due to joint surface collapse, change of calcaneus shape and the like, if the normal calcaneus shape is recovered without operation, heel pain of a patient when walking affects daily life of the patient, and finally, calcaneal distance joint fusion operation is needed.
In an X-ray examination: the lateral slice may explicitly show the Bohler angle and the Gissane angle, which reflect the degree of fracture compression; the normal Bohler angle ranges from 25 ° to 40 °, and once the Bohler angle is less than 15 °, it is considered a severe damage; the Gissane angle is a very important anatomical landmark, which is formed by the lateral extension of the anterior and posterior articular surfaces of the calcaneus and the lateral extension of the calcaneus body, and has a good indication of the reduction of the fracture to which the articular surface of the calcaneus must be reduced.
The existing operation adopts 'incision reduction internal fixation', and the operation steps are as follows:
(1) the lateral calcaneus L-shaped incision was made all the way to the periosteum and dissected subclavian. Typically the incision starts between the fibula and the achilles tendon and extends down to the side of the calcaneus end where the skin structure changes (the intersection of the hairy and unhatched regions). Then the part extends forwards to the fifth metatarsal bone base to ensure that the whole layer is completely cut;
(2) the fibular tendon was examined and protected, and the peroneal muscle support band was cut to turn the tendon to the side. Since the heel calf ligament forms the outer lateral wall of the subtalar joint capsule, it needs to be incised. In addition, care is taken to protect the sural nerve above the incision, and careful operation is performed when the plantar surface of the foot is dissected, so as to avoid damaging abductor muscles;
(3) a k-wire is drilled into the lateral process of the talus, distal fibula or calcaneus, cuboid to aid in visualization. Bending the k-wires to secure the flap;
(4) soft tissues in front of the posterior articular surface of the subtalar joint are removed, so that the operation of the anterior process of the calcaneus is facilitated;
(5) the outer side wall is protected after incision, and soft tissue and bone attachment are guaranteed. It may lose part of the periosteal attachment during the dissection process. The outer side wall is well protected and turned downwards or towards the rear side;
(6) a fracture block with a larger posterior articular surface, particularly a fracture block at the back, protects the soft tissue adhesion of the fracture block, and temporarily fixes the kirschner wire after reduction;
(7) during the operation, the lateral and axial calcaneus pieces are examined by X-ray, and after Bohler angle, Gissane angle, calcaneus joint surface and inward and outward turning are ideal, the calcaneus joint surface is fixed by bone cement, screws or steel plates.
However, a fall or impact can cause severe soft tissue damage in addition to comminuted fractures of the calcaneus bone. In fact, soft tissue damage due to violence is often more severe than the fracture of the calcaneus itself. Soft tissue blisters typically appear 24 hours after the first injury. Fractures themselves can exacerbate soft tissue injury. The surgical incision used for incision reduction is positioned in the blood supply marginal area around the calcaneus, the blood supply is poor, and the surgical incision is poor in healing and easy to necrotize and infect.
The research aims at designing a comminuted calcaneus fracture closed reduction device, avoiding complications such as infection, hemorrhage, soft tissue necrosis and the like after the previous incision reduction operation, and providing a more scientific basis for clinic.
Disclosure of Invention
The research aims at designing the comminuted calcaneus fracture closed reduction device, avoiding the complications such as infection, hemorrhage, soft tissue necrosis and the like after the previous incision reduction operation, providing a more scientific basis for clinic and providing the comminuted calcaneus fracture closed reduction device.
The technical scheme of the invention is as follows:
a closed reduction device for comminuted calcaneus fracture comprises a calcaneus fixing component, a calcaneus air bag extrusion component and a calcaneus traction component; the calcaneus fixing component is used for fixing the calcaneus front bone and the talus, and meanwhile, the calcaneus air bag extrusion component can be limited, the calcaneus air bag extrusion component extrudes and supports the fracture part of the calcaneus from the two sides and the bottom of the calcaneus, and the calcaneus traction component pulls one end of the calcaneus to move downwards to the original position.
Furthermore, the calcaneus fixing component comprises a plate I and a plate II, the plate I and the plate II are symmetrically arranged on two sides of the calcaneus, and a plurality of fixing holes are distributed at the front end and the upper end of the plate I and the plate II; the stud fixes the talus bone through the fixing holes at the upper ends of the first plate and the second plate, and fixes the calcaneus anterior bone through the hole at the front end.
Further, a first air bag is arranged between the first plate and the calcaneus, a second air bag is arranged between the second plate and the calcaneus, and a third air bag is arranged at the bottom of the fracture of the calcaneus; the first air bag, the second air bag and the third air bag are inflated to support the fracture.
Furthermore, guide rail screws are arranged at the upper part and the lower part of the rear ends of the first plate and the second plate, the calcaneus traction assembly comprises an upper transverse guide rail and a lower transverse guide rail which are fixed on the guide rail screws, a longitudinal guide rail is arranged between the upper transverse guide rail and the lower transverse guide rail, and the longitudinal guide rail transversely moves on the upper transverse guide rail and the lower transverse guide rail and is fastened at a certain position through the screws; the outer surface of the longitudinal guide rail is provided with a first occlusion tooth, and the middle of the longitudinal guide rail is provided with a long hole; the device also comprises a rotating rod, a side rod I, a side rod II, a transverse connecting rod, a longitudinal connecting rod, a traction rod and a fixing column; threaded holes are formed in the two ends of the rotating rod and penetrate through holes drilled in the calcaneus in advance, and the two ends of the first side lever and the second side lever are connected to the rotating rod in a threaded mode; threaded holes are formed in the middle and two ends of the transverse connecting rod and are connected to the first side rod, the second side rod and the longitudinal connecting rod; one end of the longitudinal connecting rod is arranged to be a polygonal structure, the other end of the longitudinal connecting rod is provided with a spherical structure, and the spherical structure is connected with the groove of the traction plate in a spherical mode; the fixing column is of a hollow structure, one end of the hollow structure is polygonal and is connected with one end of the longitudinal connecting rod to limit the rotation of the longitudinal connecting rod; the other end of the hollow structure of the fixing column is provided with an internal thread, and the internal thread is connected with the traction rod in a matching way; and the end surface of the fixing column facing the longitudinal guide rail is provided with a second occlusion tooth which is matched with the first occlusion tooth of the longitudinal guide rail.
The invention achieves the following beneficial effects:
the calcaneus closed reduction device can reduce comminuted calcaneus fracture without an external surgical incision, and then is fixed percutaneously by adopting a Kirschner wire, bone cement or a locking steel plate. Thereby reducing intraoperative bleeding and complications associated with surgical incisions.
Drawings
FIG. 1 is a perspective view of a comminuted calcaneus fracture reduction device;
FIG. 2 is a second perspective view of a comminuted calcaneus fracture closed reduction device;
FIG. 3 is a third perspective view of the calcaneus distraction assembly of the comminuted calcaneus fracture closed reduction device pulled downwardly along the longitudinal rails;
fig. 4 is a fourth perspective view of the comminuted calcaneus fracture closed reduction device after pulling a traction rod backward in the state of the third perspective view;
fig. 5 is a perspective view of the comminuted calcaneus fracture closed reduction device, wherein after the traction rod is rotated in the state of the fourth perspective view, the fixing column moves forwards, and the second occlusal tooth is in clenching fit with the first occlusal tooth;
FIG. 6 is a view of the heel bone in a tilted state after fracture;
FIG. 7 is a view of the condition of the heel bone after fracture;
fig. 8 is a front view a and a cross-sectional view b of a portion of a calcaneus distraction assembly of a comminuted calcaneus fracture closed reduction device.
In the drawings, 1, a calcaneus fixing component; 11. a first plate; 12. a second plate; 13. a fixing hole; 14. a stud bolt I; 15. a stud II; 2. a calcaneus air bag compression assembly; 21. a first air bag; 22. a second air bag; 23. a third air bag; 3. a calcaneus distraction assembly; 30. fixing a column; 301. a second occluding tooth; 31. an upper transverse guide rail; 32. a lower transverse guide rail; 33. a longitudinal guide rail; 331. a first occluding tooth; 332. a long hole; 34. rotating the rod; 35. a first side rod; 36. a second side lever; 37. a transverse connecting rod; 38. a longitudinal link; 39. a drawbar.
Detailed Description
To facilitate an understanding of the present invention by those skilled in the art, specific embodiments thereof are described below with reference to the accompanying drawings.
As shown in fig. 1-1, a comminuted calcaneus fracture closed reduction device comprises a calcaneus fixing component 1, a calcaneus air bag extrusion component 2 and a calcaneus traction component 3; subassembly 1 is fixed to calcaneus is used for fixing calcaneus anterior bone and talus, can spacing calcaneus gasbag extrusion assembly 2 simultaneously, and calcaneus gasbag extrusion assembly 2 extrudees and holds up calcaneus fracture position from calcaneus both sides and bottom, and calcaneus pulls subassembly 3 and pulls the one end downstream to the normal position that the calcaneus stooped.
The calcaneus fixing component 1 comprises a first plate 11 and a second plate 12, the first plate 11 and the second plate 12 are symmetrically arranged on two sides of the calcaneus, and a plurality of fixing holes 13 are distributed at the front ends and the upper ends of the first plate 11 and the second plate 12; the stud bolt I14 is used for fixing the talus bone through a fixing hole 13 at the upper end of the plate I11 and the plate II 12, and the stud bolt II 15 is used for fixing the calcaneus anterior bone through a hole at the front end.
A first air bag 21 is arranged between the first plate 11 and the calcaneus, a second air bag 22 is arranged between the second plate 12 and the calcaneus, and a third air bag 23 is arranged at the bottom of the fracture of the calcaneus; the first air bag 21, the second air bag 22 and the third air bag 23 are inflated to support the fracture part, and air pumps of the first air bag 21, the second air bag 22 and the third air bag 23 are not shown in the drawing.
The upper and lower parts of the back ends of the first plate 11 and the second plate 12 are provided with guide rail screws, the calcaneal traction assembly 3 comprises an upper transverse guide rail 31 and a lower transverse guide rail 32 which are fixed on the guide rail screws, the upper transverse guide rail 31 and the lower transverse guide rail 32 can adjust the distance between the first plate 11 and the second plate 12 under the control of the guide rail screws, a longitudinal guide rail 33 is arranged between the upper transverse guide rail 31 and the lower transverse guide rail 32, and the longitudinal guide rail 33 transversely moves on the upper transverse guide rail 31 and the lower transverse guide rail 32 and is fastened at a certain position through the screws; the outer surface of the longitudinal guide rail 33 is provided with a first engaging tooth 331, the middle part of the longitudinal guide rail is provided with a long hole 332, the longitudinal link 38 can penetrate through the long hole 332, the width of the long hole 332 is matched with two surfaces of the multi-deformation of the longitudinal link 38, so that when the traction rod 39 is rotated, the traction rod 39 cannot rotate together, and the function of limiting the rotation of the longitudinal link 38 is achieved; the device also comprises a rotating rod 34, a first side rod 35, a second side rod 36, a transverse connecting rod 37, a longitudinal connecting rod 38, a traction rod 39 and a fixing column 30; threaded holes are formed in the two ends of the rotating rod 34 and penetrate through holes drilled in the calcaneus in advance, and the two ends of the first side rod 35 and the second side rod 36 are connected to the rotating rod 34 in a threaded mode; the transverse connecting rod 37 is provided with screw holes at the middle and both ends and is connected to the first side rod 35, the second side rod 36 and the longitudinal connecting rod 38; one end of the longitudinal connecting rod 38 is arranged to be a polygonal structure, and the other end of the longitudinal connecting rod is arranged to be a spherical structure which is in spherical connection with the groove of the traction plate; the fixing column 30 is a hollow structure, one end of the hollow structure is polygonal and is connected with one end of the longitudinal connecting rod 38 to limit the rotation of the longitudinal connecting rod 38; the other end of the hollow structure of the fixing column 30 is provided with an internal thread, and the internal thread is matched and connected with the traction rod 39; the end face of the fixing column 30 facing the longitudinal guide rail 33 is provided with a second occlusion tooth 301 which is matched with the first occlusion tooth 331 of the longitudinal guide rail 33, and the longitudinal guide rail 33 is also provided with a client for controlling the rotating angle.
Placing the first plate 11 and the second plate 12 on two sides of the foot, finding proper positions of fixing holes 13 at the front end and the upper end of the first plate 11 and the second plate 12, using a first stud bolt 14 and a second stud bolt to penetrate through the first plate 11 and the second plate 12 of the talus and the calcaneus anterior bone, placing a first air bag 21, a second air bag 21 and a third air bag in two sides of the first plate 11 and the second plate 12 and on the sole of the foot, adjusting and installing an upper transverse guide rail 31 and a lower transverse guide rail 32 on guide rail screws of the first plate 11 and the second plate 12 and fastening the guide rail screws, enabling a rotating rod 34 to penetrate through holes which are drilled in advance at the rear end of the calcaneus, installing a first side rod 35, a second side rod 36 and a transverse connecting rod 37, installing a longitudinal guide rail 33, enabling a longitudinal connecting rod 38 to penetrate through a; and after the installation is finished, inflating the air bag I21, the air bag II 22 and the air bag III 23, adjusting the installation lengths of the side rod I35 and the side rod II 36, controlling the downward rotating angle of the traction rod 39, pulling the traction rod 39 backwards to finely adjust the position of the calcaneus after the traction rod 39 rotates downwards to a proper position, finishing the fine adjustment, rotating the traction rod 39, enabling the fixing column 30 to move forwards, enabling the occlusion tooth I331 to be engaged with the occlusion tooth II 301, and finishing the resetting.
The above-described embodiments of the present invention do not limit the scope of the present invention. Any modification, equivalent replacement, and improvement made within the spirit and principle of the present invention should be included in the scope of the claims of the present invention.
Claims (4)
1. The utility model provides a closed resetting means of comminuted calcaneus fracture which characterized in that: comprises a calcaneus fixing component, a calcaneus air bag extrusion component and a calcaneus traction component; the calcaneus fixing component is used for fixing the calcaneus front bone and the talus, and meanwhile, the calcaneus air bag extrusion component can be limited, the calcaneus air bag extrusion component extrudes and supports the fracture part of the calcaneus from the two sides and the bottom of the calcaneus, and the calcaneus traction component pulls one end of the calcaneus to move downwards to the original position.
2. The closed reduction device for comminuted calcaneal fractures according to claim 1, wherein: the calcaneus fixing component comprises a first plate and a second plate, the first plate and the second plate are symmetrically arranged on two sides of the calcaneus, and a plurality of fixing holes are distributed at the front end and the upper end of the first plate and the second plate; the stud fixes the talus bone through the fixing holes at the upper ends of the first plate and the second plate, and fixes the calcaneus anterior bone through the hole at the front end.
3. The comminuted calcaneus fracture closed reduction device according to claim 2, wherein: a first air bag is arranged between the first plate and the calcaneus, a second air bag is arranged between the second plate and the calcaneus, and a third air bag is arranged at the bottom of the fracture of the calcaneus; the first air bag, the second air bag and the third air bag are inflated to support the fracture.
4. The comminuted calcaneus fracture closed reduction device according to claim 2, wherein: guide rail screws are arranged at the upper part and the lower part of the rear ends of the first plate and the second plate, the calcaneus traction assembly comprises an upper transverse guide rail and a lower transverse guide rail which are fixed on the guide rail screws, a longitudinal guide rail is arranged between the upper transverse guide rail and the lower transverse guide rail, and the longitudinal guide rail transversely moves on the upper transverse guide rail and the lower transverse guide rail and is fastened at a certain position through screws; the outer surface of the longitudinal guide rail is provided with a first occlusion tooth, and the middle of the longitudinal guide rail is provided with a long hole; the device also comprises a rotating rod, a side rod I, a side rod II, a transverse connecting rod, a longitudinal connecting rod, a traction rod and a fixing column; threaded holes are formed in the two ends of the rotating rod and penetrate through holes drilled in the calcaneus in advance, and the two ends of the first side lever and the second side lever are connected to the rotating rod in a threaded mode; threaded holes are formed in the middle and two ends of the transverse connecting rod and are connected to the first side rod, the second side rod and the longitudinal connecting rod; one end of the longitudinal connecting rod is arranged to be a polygonal structure, the other end of the longitudinal connecting rod is provided with a spherical structure, and the spherical structure is connected with the groove of the traction plate in a spherical mode; the fixing column is of a hollow structure, one end of the hollow structure is polygonal and is connected with one end of the longitudinal connecting rod to limit the rotation of the longitudinal connecting rod; the other end of the hollow structure of the fixing column is provided with an internal thread, and the internal thread is connected with the traction rod in a matching way; and the end surface of the fixing column facing the longitudinal guide rail is provided with a second occlusion tooth which is matched with the first occlusion tooth of the longitudinal guide rail.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110404005.0A CN113100896B (en) | 2021-04-15 | 2021-04-15 | Comminuted calcaneus fracture closed reduction device |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202110404005.0A CN113100896B (en) | 2021-04-15 | 2021-04-15 | Comminuted calcaneus fracture closed reduction device |
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| CN113100896A true CN113100896A (en) | 2021-07-13 |
| CN113100896B CN113100896B (en) | 2022-05-24 |
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Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN200991297Y (en) * | 2006-12-06 | 2007-12-19 | 陈新华 | Calcaneus 3-D elastic prizing picking resetting fixer |
| CN107744402A (en) * | 2017-12-01 | 2018-03-02 | 杨英果 | A kind of restorer of fracture of calcaneus |
| CN111067607A (en) * | 2019-12-30 | 2020-04-28 | 朱怀宇 | Heel restorer |
| CN112022313A (en) * | 2020-09-17 | 2020-12-04 | 河北医科大学第三医院 | Calcaneus fracture three-dimensional traction reduction device |
| US20210059719A1 (en) * | 2019-09-04 | 2021-03-04 | The Third Hospital Of Hebei Medical University | Lower limb traction device for intramedullary nail implantation operation |
-
2021
- 2021-04-15 CN CN202110404005.0A patent/CN113100896B/en active Active
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN200991297Y (en) * | 2006-12-06 | 2007-12-19 | 陈新华 | Calcaneus 3-D elastic prizing picking resetting fixer |
| CN107744402A (en) * | 2017-12-01 | 2018-03-02 | 杨英果 | A kind of restorer of fracture of calcaneus |
| US20210059719A1 (en) * | 2019-09-04 | 2021-03-04 | The Third Hospital Of Hebei Medical University | Lower limb traction device for intramedullary nail implantation operation |
| CN111067607A (en) * | 2019-12-30 | 2020-04-28 | 朱怀宇 | Heel restorer |
| CN112022313A (en) * | 2020-09-17 | 2020-12-04 | 河北医科大学第三医院 | Calcaneus fracture three-dimensional traction reduction device |
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| CN113100896B (en) | 2022-05-24 |
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