CN114259288A - Internal stay formula fixing device of femoral neck fracture - Google Patents
Internal stay formula fixing device of femoral neck fracture Download PDFInfo
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- CN114259288A CN114259288A CN202111647468.6A CN202111647468A CN114259288A CN 114259288 A CN114259288 A CN 114259288A CN 202111647468 A CN202111647468 A CN 202111647468A CN 114259288 A CN114259288 A CN 114259288A
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- 208000020089 femoral neck fracture Diseases 0.000 title claims abstract description 34
- 210000000689 upper leg Anatomy 0.000 claims abstract description 13
- 210000000078 claw Anatomy 0.000 claims description 65
- 230000007246 mechanism Effects 0.000 claims description 18
- 210000002303 tibia Anatomy 0.000 claims description 3
- 208000010392 Bone Fractures Diseases 0.000 abstract description 33
- 206010017076 Fracture Diseases 0.000 abstract description 32
- 210000002436 femur neck Anatomy 0.000 abstract description 22
- 230000000149 penetrating effect Effects 0.000 abstract description 14
- 210000000988 bone and bone Anatomy 0.000 description 13
- 230000000694 effects Effects 0.000 description 5
- 238000000034 method Methods 0.000 description 4
- 210000001694 thigh bone Anatomy 0.000 description 4
- 238000006073 displacement reaction Methods 0.000 description 3
- 238000001125 extrusion Methods 0.000 description 3
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 230000035515 penetration Effects 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 238000010586 diagram Methods 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 241000282414 Homo sapiens Species 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
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Abstract
The invention discloses an internal supporting type fixing device for femoral neck fracture, which comprises a supporting plate matched with a femur in a contact manner, wherein a medullary nail body is inserted on the supporting plate, a control channel penetrating through the medullary nail body is axially arranged in the medullary nail body, the top end of the medullary nail body is obliquely placed into a femoral head along the femur through the femoral neck and is connected with a traction end, a control cavity communicated with the inside of the medullary nail body is arranged in the traction end, a plurality of hooks are arranged at intervals along the circumference outside the traction end, the top ends of the hooks are hinged with the traction end, and the tail ends of the hooks are abutted against the outer wall of the medullary nail body; the invention has unique structure and convenient use, can effectively solve the problems of large operation difficulty coefficient and higher risk when the existing expansion type intramedullary nail is used, and also effectively solves the problems that the existing expansion type intramedullary nail is not firm in fixation and the fracture part is easy to loosen and shift.
Description
Technical Field
The invention belongs to the technical field of orthopedic instruments, and particularly relates to an internal supporting type fixing device for femoral neck fracture.
Background
The femoral neck fracture is a more common fracture in clinic, is mostly generated in the old, and the femoral neck fracture is generated in higher and higher proportion among young people along with the development of social economic society, the femoral neck fracture of the old aged over 65 years is mostly treated by artificial femoral head replacement, the femoral head retaining treatment is adopted for young patients, and along with the prolonging of the service life of human beings, the physical quality of many old people is better, the activity is large, and the desire of head retaining treatment is strong. The treatment methods for treating femoral neck fracture by retaining femoral head are more, such as intramedullary fixation technology and extramedullary fixation technology.
The examined Chinese patent document with the publication number of 'CN 2732197Y' discloses a self-locking intramedullary nail for femoral neck, which comprises a nail body, a self-locking nail core, a tail end anti-rotation clamp and an anti-rotation clamp fixing screw, wherein the nail body (1) of the self-locking intramedullary nail for femoral neck is a compression nail with a large-pitch thread at the front part and a standard-pitch thread at the rear part, the nail body of the self-locking intramedullary nail for femoral neck is hollow and is used for penetrating the self-locking nail core, and the middle part of the nail body is slightly close to the front point and is provided with a penetrating hole of the self-locking nail core.
The intramedullary nail disclosed by the patent adopts an expansion wire mode to expand in the femoral head, has the characteristic of reasonable structural design, but in practical use, the femoral neck is supported by outward extrusion force of expansion, and is fixed only by means of expansion pressure, so that an operator needs to accurately control the expansion degree of the expansion structure by means of experience and hand feeling, when the expansion pressure is too large, the inner cavity of the femoral head is easily damaged, even fractured, and when the expansion pressure is smaller, the intramedullary nail can gradually loosen, the connection at the femoral neck cannot be ensured, the risk is higher, the operation difficulty coefficient is large, and the use is inconvenient; and thus, as can be seen from the drawings in the specification of the patent, when the intramedullary nail provided by the patent is used, the distal end of the intramedullary nail forms a horn-shaped expansion structure, when the intramedullary nail is used, the contact between the outer inclined surface of the expansion structure and the inner inclined surface of the inner wall of a bone cavity is easy to slide and rotate, so that the fracture part is loosened and displaced, and the fracture effect is influenced.
Disclosure of Invention
Aiming at the defects and problems in the existing femoral neck fracture treatment, the invention provides the femoral neck fracture internal-support type fixing device which is unique in structure and convenient to use, and not only can effectively solve the problems of large operation difficulty coefficient and high risk when the existing expansion type intramedullary nail is used, but also effectively solves the problems that the existing expansion type intramedullary nail is not firm in fixation and the fracture part is easy to loosen and shift.
The technical scheme adopted by the invention for solving the technical problems is as follows: an internal supporting type fixing device for femoral neck fracture comprises a supporting plate matched with a femur in a matched and contacted manner, wherein an intramedullary nail body is inserted into the supporting plate, a control channel penetrating through the intramedullary nail body is axially arranged in the intramedullary nail body, the top end of the intramedullary nail body is obliquely arranged in a femoral head along the femur through a femoral neck and is connected with a traction end, a control cavity communicated with the inside of the intramedullary nail body is arranged in the traction end, a plurality of hooks are arranged at intervals along the circumference outside the traction end, the top ends of the hooks are hinged with the traction end, and the tail ends of the hooks are abutted against the outer wall of the intramedullary nail body; a push-pull driving mechanism is arranged in the intramedullary nail body, a traction end of the push-pull driving mechanism extends upwards into the hole cavity and is connected with a hinge end of the hook claw, a control end of the push-pull driving mechanism penetrates through the intramedullary nail body to extend out of the tibia, and the traction end can be controlled by the control end to drive the hook claw to rotate around the hinge end (to be separated from the outer wall of the intramedullary nail body); the outer side of the bottom plate is provided with a locking base connected with the intramedullary nail body, the locking base and the intramedullary nail body are coaxially arranged, and the locking base can axially move along the intramedullary nail body and can be locked.
The outer terminal surface of drawing the end is gone up and is equipped with a plurality of articulated seats along the circumference even interval, and it has and draws the inside bar hole that communicates of end to open on the end surface of drawing in the articulated seat, collude the claw top and rotate through the round pin axle and install in corresponding articulated seat, and collude the claw top and be connected with the actuating arm, the actuating arm other end passes and corresponds the bar hole and extend into the control chamber to be connected with push-and-pull actuating mechanism.
The push-pull driving mechanism comprises a driving block, a connecting piece, a screw rod and an end cap, wherein the driving block is arranged in the control channel of the intramedullary nail body in a matching manner and can axially slide along the inner wall of the control channel; connecting pieces with the same number as the hook claws are arranged in the control channel between the driving block and the traction end along the circumference, one end of each connecting piece is connected with the driving slide block, and the other end of each connecting piece extends into the control cavity and is connected with the driving arm corresponding to the hook claw; the bottom surface of the driving block is axially provided with a threaded hole, the screw rod is installed in the control channel at the rear side of the driving block in a rotating mode at intervals, the top end of the screw rod is installed in the threaded hole of the driving block in a matched mode, and the other end of the screw rod extends outwards to form the intramedullary nail body and is connected with the end cap.
The inner wall of one side of the driving channel is provided with a guide groove along the axial direction, the driving block is radially fixed with a limiting boss at the position corresponding to the guide groove, and the other end of the limiting boss is inserted into the guide groove in a matching manner and can slide along the guide groove along with the driving block.
The connecting piece is a rod piece, and two ends of the rod piece are respectively hinged to the driving block and the driving arm.
The connecting piece is the haulage rope, the haulage rope both ends are connected in drive block and actuating arm respectively, and are used for colluding the epaxial torsional spring that matches of round pin of installing in articulated seat with the claw, and the torsional spring can order about colluding the claw and rotate around the round pin axle and contradict with the intramedullary nail body lateral wall under natural state.
The top of the traction end is conical in shape.
The intramedullary nail is characterized in that internal threads are arranged on the circumferential side wall of the tail end of the intramedullary nail body, and an external thread hole matched with the internal threads at the tail end of the intramedullary nail body is axially formed in the middle of the locking base and is sleeved on the internal threads at the tail end of the intramedullary nail body in a matching mode.
The diameter of the outer ring of the locking base is larger than that of the needle hole on the bottom plate.
The shape of the inner end face of the abutting plate is matched with the shape of the outer end face of the femoral head, the abutting plate is provided with a nail penetrating hole, and the intramedullary nail body is inserted into the femoral head through the nail penetrating hole.
The invention has the beneficial effects that: the invention provides an internal supporting type fixing device for femoral neck fracture, which has a unique structure and comprises a supporting plate matched and contacted with a femur, wherein a medullary nail body is inserted on the supporting plate, a push-pull driving mechanism is arranged in the medullary nail body, the top end of the medullary nail body is obliquely arranged in a femoral head along the femur through the femoral neck and is connected with a traction end, a plurality of claws are arranged at intervals along the circumference outside the traction end, the top ends of the claws are hinged with the traction end and are connected with the push-pull driving mechanism in the medullary nail body, and a locking base connected with the medullary nail body is arranged outside a bottom plate. The operation is simple, the expanded hook claw can not contact with the inner wall of the femoral head around the traction end to apply pressure, the inner cavity of the femoral head can not be damaged, and the problems of large operation difficulty coefficient and higher risk in the use of the existing expansion type intramedullary nail are effectively solved; and when the locking base is screwed down and the distance between the locking base and the traction end is reduced, the thighbone and the femoral head on the front side and the rear side of the fracture part can be extruded, so that fracture lines are tightly aligned together, the tail end of the hook claw can be clamped with the hard part of the femoral cavity shoulder on the front side of the fracture, sliding or rotation cannot occur, effective fixation of the fracture part of the neck of the thighbone is achieved, and therefore loosening and displacement of the fracture part can be caused, and the problems that an existing expansion type intramedullary nail is not firm in fixation and the fracture part is prone to loosening and displacement are solved effectively.
The internal supporting type fixing device for femoral neck fracture, provided by the invention, has a unique structure, is convenient to use, can effectively solve the problems of high operation difficulty coefficient and high risk when the existing expansion type intramedullary nail is used, and also effectively solves the problems that the existing expansion type intramedullary nail is not firm in fixation and the fracture part is easy to loosen and shift.
Drawings
FIG. 1 is a schematic diagram of the present invention.
FIG. 2 is a schematic view of the nail body of the present invention.
Figure 3 is a schematic view of the internal structure of the intramedullary nail body according to the present invention.
Fig. 4 is one of the inner structures of the traction end of the present invention.
Fig. 5 is a schematic view of the hinge base structure of the present invention.
Fig. 6 is a schematic structural view of the push-pull driving mechanism of the present invention.
FIG. 7 is a schematic view of the retractable hook of the present invention.
Fig. 8 is a schematic view of the structure of the traction rope type connecting piece of the invention.
Fig. 9 is a second schematic diagram of the internal structure of the traction end of the present invention.
FIG. 10 is a schematic view of the structure of the universal ball according to the present invention in use.
Fig. 11 is a schematic view showing the installation position of the rubber pad of the present invention.
Fig. 12 is a schematic view of the lock base structure of the present invention.
FIG. 13 is a schematic view of the structure of a guide slot according to the present invention.
Reference numbers in the figures: 11 is a femur, 12 is a femoral neck, 13 is a femoral head, 2 is a resisting plate, 21 is a nail penetration hole, 3 is a intramedullary nail body, 31 is a control channel, 32 is a guide groove, 4 is a traction end, 41 is a control cavity, 42 is a strip-shaped hole, 43 is a connecting section, 44 is a conical guide section, 45 is a ring ball seat, 46 is a universal ball, 47 is a connecting shaft, 471 is a connecting channel, 48 is a rubber gasket, 5 is a hook claw, 61 is a hinge seat, 62 is a pin shaft, 63 is a driving arm, 71 is a driving block, 711 is a limiting boss, 712 is a threaded hole, 72 is a connecting piece, 73 is a screw rod, 74 is an end cap, 75 is a thrust seal bearing, 8 is a locking base, 81 is an annular base, 82 is a sliding screw rod, 821 is a abdicating hole, 83 is an anti-off top spring, 84 is a locking seat, 85 is a limiting ring platform, 86 is a guide slotted hole, 861 is a shaft section, 862 is a horizontal section, and 87 is a limiting blocking rod.
Detailed Description
The invention is further illustrated with reference to the following figures and examples.
Example 1
The intramedullary nail used for the existing femoral neck fracture adopts an expansion wire mode to expand in the femoral head, so that the fracture part of the femoral neck is pulled and fixed; however, the existing intramedullary nail supports the femoral neck through outward extrusion force of expansion, when the existing intramedullary nail is fixed by only depending on expansion pressure in actual use, the requirement on the size of the expansion pressure is high, when the expansion pressure is too large, the femoral head inner cavity is easy to damage, even bone fracture is caused, when the expansion pressure is small, the expansion pressure gradually loosens, the connection of the femoral neck cannot be ensured, but because the femoral head bone cavities are different in size, the size of the expansion pressure needs to be controlled by operators through experience and hand feeling, and the use is inconvenient; and thus, as can be seen from the drawings in the specification of the above patent, when the intramedullary nail provided by the above patent is used, the distal end of the intramedullary nail forms a horn-shaped expansion structure, when the intramedullary nail is used, the contact between the outer inclined plane of the collision structure and the inner inclined plane of the inner wall of the bone cavity is easy to slide and rotate, the fracture part is easy to loose and shift, and the effect of postoperative recovery is affected.
In view of the above problems, the present embodiment provides an internal supporting type fixing device for femoral neck fracture, which has a unique structure and can solve the above problems, as shown in fig. 1-7, the internal supporting type fixing device for femoral neck fracture provided by this embodiment includes a supporting plate 2 matching and contacting with a femur 11, a nail body 3 is inserted on the supporting plate 2, a control channel 31 penetrating through the nail body 3 is axially arranged in the nail body 3, the shape of the inner end surface of the supporting plate 12 matches with the shape of the outer end surface of the femoral head, a nail penetration hole 21 is arranged on the supporting plate 2, the nail body 3 is inserted into the femur through the nail penetration hole, and the top end of the nail-broken nail body is obliquely placed into the femoral head along the femur neck and is connected with a traction end 4; the intramedullary nail body 3 can be connected to the traction end 4 in various ways, for example: the intramedullary nail body 3 and the traction end 4 are of an integrated structure coaxially arranged, the abutting plate 12 is placed on the outer side of the femur in a matching mode before insertion, then a intramedullary nail hole penetrating through an inner cavity of the femur and an inner cavity of a femoral neck and extending into the inner cavity of the femoral head is drilled at the nail penetrating hole, and then the intramedullary nail body connected with the traction end is inserted into the intramedullary nail hole.
As shown in fig. 2, the top of the traction end 4 is tapered to facilitate the insertion of the intramedullary nail body into the intramedullary nail hole; be equipped with in the traction end 4 with the control chamber 41 of the inside intercommunication of intramedullary nail body, traction end 4 is equipped with many along the circumference interval outward and colludes claw 5, the top of colluding claw 5 is articulated with traction end 4, the tail end that colludes claw 5 sets up backward, and contradict with the outer wall of traction end rear side intramedullary nail body, be equipped with push-and-pull actuating mechanism in the intramedullary nail body 3, push-and-pull actuating mechanism's drive end upwards extends into in vestibule 41, and be connected with colluding the 5 hinged ends of claw, push-and-pull actuating mechanism's control end passes the intramedullary nail body and extends the shin bone, and can control the drive end through the control end and order about colluding the claw and rotate around the hinged end and prop the expansion, with intramedullary nail body outer wall separation, specifically:
as shown in fig. 5, a plurality of hinge seats 61 are uniformly arranged on the outer end surface of the connection part of the traction end and the intramedullary nail body at intervals along the circumference, the hinge seats 61 are radially arranged and fixedly connected with the circumferential side wall below the conical top end of the traction end, and the number of the hinge seats 61 is the same as that of the hook claws 5; open on the end face of drawing in the articulated seat 5 have with draw the bar hole 42 that holds 4 internal control chambeies in intercommunication, collude 5 tops of claw and rotate through round pin axle 62 and install in corresponding articulated seat 61, and collude 5 tops of claw and be connected with actuating arm 63 on the lateral wall in bar hole, the actuating arm 63 other end passes and corresponds bar hole 42 and extend into the control intracavity to be connected with push-and-pull actuating mechanism, and the actuating arm is greater than 90 with the contained angle of colluding between the claw.
The push-pull driving mechanism comprises a driving block 71, a connecting piece 72, a screw rod 73 and an end cap 74, wherein the driving block 71 is arranged in the control channel 31 of the intramedullary nail body 3 in a matching way and can axially slide along the inner wall of the control channel, and various modes are provided for enabling the driving block to axially slide along the control channel, such as: the inner wall of one side of the driving channel 31 is provided with a guide groove 32 along the axial direction, the driving block 71 is fixed with a limiting boss 711 along the radial direction at the position corresponding to the guide groove, and the other end of the limiting boss 711 is inserted into the guide groove in a matching manner and can slide along the guide groove along with the driving block, so that the driving block is restrained to slide only along the axial direction of the control channel.
Connecting pieces 72 with the same quantity as the hook claws are arranged in the control channel 31 between the driving block 71 and the traction end 4 along the circumference, the connecting pieces 72 are hard rod pieces, the top ends of the connecting pieces upwards penetrate through the control channel and extend into a control cavity of the traction end, the connecting pieces are hinged with the end parts of driving arms correspondingly extending into the control cavity on the hook claws, the other ends of the connecting pieces are hinged with the top ends of the driving blocks 71, when the driving blocks outwards slide along the control channel, the driving blocks can drive the driving arms to drive the hook claws to outwards rotate around pin shafts through the connecting pieces, and the hook claws distributed on the outer side of the traction end are synchronously outwards spread.
As shown in fig. 6, the bottom surface of the driving block 71 is axially provided with a threaded hole 712, the screw rod 73 is rotatably installed in the control channel below the driving block 71 at intervals through the thrust sealing bearing 75, the screw rod 71 and the threaded hole of the driving block are coaxially arranged, the top end line of the screw rod 71 extends and is inserted into the threaded hole 712 of the driving block in a matching manner, the other end of the screw rod extends outwards to form the control channel and is connected with the end cap, when the screw rod is rotated through the end cap, because the driving block can only axially slide along the control channel, and the axial position of the screw rod is constrained by the bearing, the driving block can be driven to axially slide along the inner wall of the control channel when the screw rod rotates.
The outer side of the abutting plate 2 is provided with a locking base 8 connected with the intramedullary nail body, the locking base 8 and the intramedullary nail body are coaxially arranged, the locking base can axially move along the intramedullary nail body and can be locked, and specifically:
as shown in fig. 6, the circumferential side wall of the tail end of the intramedullary nail body is provided with internal threads, the middle part of the locking base is provided with an external thread hole matched with the internal threads at the tail end of the intramedullary nail body along the axial direction, the locking base is sleeved on the internal threads at the tail end of the intramedullary nail body in a matching manner, and the diameter of the outer ring of the locking base is larger than that of the pin through hole on the bottom plate.
When in use, the support plate is placed on the outer side of a femoral stem in a matching way, then a nail breaking hole penetrating through an inner bone cavity of the femoral head and an inner bone cavity of a femoral neck and penetrating into the inner bone cavity of the femoral head is drilled at the nail penetrating hole, then the intramedullary nail body connected with the traction end is inserted into the intramedullary nail hole, the position of the traction end is deeply judged according to the insertion of the intramedullary nail body in the process, when the traction end penetrates through the femoral neck and enters the inner bone cavity of the femoral head, an operator originally twists the end cap to drive the driving block in the intramedullary nail body to slide outwards so that the claws distributed on the outer side of the traction end are outwards spread in the bone cavity of the femoral head, then the locking base on the outer side of the bottom plate is rotated to drive the locking base and the support plate to be abutted together, then the locking base is continuously rotated, the intramedullary nail body can move outwards along the axial direction under the rotation of the locking base, and when the intramedullary nail body moves outwards, the propped claw can be driven by the traction end to move outwards synchronously, the tail ends of the hook claws are respectively clamped and hung at the hard positions of the cavity shoulders of the femoral head at the front side of the fracture, and the pressure fixed by the hook claws acts on the pin shaft, so that the fracture positions of the femoral neck are continuously pressurized when the locking base is continuously screwed, the fracture lines are tightly matched together, and the fracture positions of the femoral neck are fixed; furthermore, the hook claw is of a strip-shaped plate structure, and the outer end face of the hook claw is provided with a sharp chamfer, so that the resistance borne by the hook claw when the hook claw is unfolded in a femoral head bone cavity can be reduced on the premise of improving the supporting strength of the hook claw.
After the fracture is healed, firstly, the locking base is unscrewed, a distance enough for the intramedullary nail body to deeply enter the bone cavity is reserved between the locking base and the floor, then the intramedullary nail body is pushed to push through the needle hole to reset, the hook claw which is opened in the femoral head can be separated from the femoral head bone cavity in the process, then the unfolded hook claw is driven to rotate around the hinged end to reset and recover by rotating the end cap, after the tail end of the hook claw is contacted with the intramedullary nail body, the intramedullary nail body and the traction end can be pulled out outwards, and then the abutting plate is taken out.
Compared with the use of the existing expansion type intramedullary nail, the femur neck fracture internal support type fixing device provided by the embodiment can be used for accurately adjusting the expansion size of the hook claw after the intramedullary nail body is inserted, so that the expanded hook claw can be clamped on the hard shoulder of the femoral head cavity on the front side of fracture, the operation is simple, the expanded hook claw cannot be in contact with the femoral head inner wall around the traction end to apply pressure, the inner cavity of the femoral head cannot be damaged, and the problems of large operation difficulty coefficient and higher risk when the existing expansion type intramedullary nail is used are effectively solved; and when the locking base is screwed down and the distance between the locking base and the traction end is reduced, the thighbone and the femoral head on the front side and the rear side of the fracture part can be extruded, so that fracture lines are tightly aligned together, the tail end of the hook claw can be clamped with the hard part of the femoral cavity shoulder on the front side of the fracture, sliding or rotation cannot occur, effective fixation of the fracture part of the neck of the thighbone is achieved, and accordingly the fracture part can be loosened and displaced, and the problems that an existing expansion type intramedullary nail is not firm in fixation and the fracture part is prone to loosening and displacement are effectively solved.
Example 2
Example 2 differs from example 1 in the different connections used.
As shown in fig. 8, the connecting member used for connecting the driving arm and the driving block together in the femur neck fracture internal bracing fixing device provided in this embodiment is a traction rope, two ends of the traction rope are respectively connected with the driving block and the driving arm, and the torsion spring is arranged on the pin shaft for installing the hook claw in the hinge seat in a matching manner, the torsion spring can drive the hook claw to rotate around the pin shaft to be abutted against the outer side wall of the nail body in a natural state, when the driving block moves down, the driving arm can be pulled by the traction rope to drive the hook claw to overcome the torsion of the torsion spring and rotate outwards around the hinge, after the use is completed, when the driving block is controlled to reset, the hook claw can rotate around the hinge end thereof to reset and recover under the action of the torsion spring, so that the tail end of the hook claw is abutted against the nail body. Compared with the rod piece connected with the connecting piece in the embodiment 1, the traction rope is adopted, so that the manufacturing cost of the device can be reduced, the traction rope can be directly connected with the driving arm driving block, and the hinged connection part is not required to be additionally arranged, so that the assembling difficulty is reduced.
Example 3
The embodiment 2 provides a femoral neck fracture internal support formula fixing device when using, because the angle between colluding the claw after strutting and the intramedullary nail body is fixed to can cause the colluding claw of expansion can't block simultaneously on the femoral head bone cavity shoulder stereoplasm in femoral neck fracture front side because of femoral cavity inner wall shape difference in the in-service use, the pressure that each colludes the claw and receives is different, thereby gives the fixed effect of femoral neck fracture.
In order to solve the above problems, the traction end and the intramedullary nail body of the internal supporting type fixing device for femoral neck fracture provided by the embodiment are mounted together in a universal connection mode, specifically:
as shown in fig. 9-10, the traction end 4 includes a connection section 43 spaced from the same axis of the intramedullary nail body, a conical guide section 44 is fixed at the top end of the connection section 43, cavities communicated with each other are formed in the conical guide section and the connection section, the two cavities are combined to form a control cavity 41, a plurality of hinging seats 61 for mounting hooks are uniformly arranged on the outer annular surface of the connection section 43 along the circumference, strip-shaped holes 42 communicated with the interior of the traction end control cavity are formed in the outer annular surface of the connection section of the hinging seats, and the strip-shaped holes extend to the conical guide section along the axis; the tail end of the connecting section 43 is connected with the top end of the intramedullary nail body in a universal way through a universal ball structure; the universal ball structure comprises an annular ball seat 45 which is hermetically arranged in the top end of the intramedullary nail body, a universal ball 46 is arranged in the annular ball seat in a matching way, the upper end and the lower end of the universal ball protrude out of the annular ball seat, the top end of the universal ball is vertically connected with the bottom of the connecting section through a connecting shaft, and in a natural state, the traction end can be kept in a standing state through the friction force between the universal ball and the annular ball seat; a connecting channel 471 is arranged in the connecting shaft 47, the top end of the connecting channel is communicated with the internal control cavity of the traction end, the internal connecting channel of the connecting shaft penetrates through the universal ball downwards and is communicated with the control channel inside the intramedullary nail body, and the traction rope on the claw control arm penetrates through the universal ball structure through the connecting channel on the connecting shaft and is connected with a driving block in the intramedullary nail body.
Compared with embodiment 2, when the rotation locking base presses and fixes the femoral neck fracture part, the traction end drives the hook claw to incline towards the hook claw side which is not in hard contact with the femoral head cavity shoulder around the center of the universal ball by taking the bottom of the hook claw in hard contact with the femoral head cavity shoulder as the top end, so that the hook claw on the traction end can be clamped and hung with the femoral head cavity shoulder, and the problem that the unfolded hook claw cannot be clamped and hung on the femoral head cavity shoulder hard side of the femoral neck fracture front side in embodiment 2 is solved.
Example 4
The difference between the embodiment 4 and the embodiment 3 is that, as shown in fig. 11, the connecting shaft between the traction end and the intramedullary nail body is sleeved with a rubber gasket 48 in a matching manner, and when the traction end rotates around the universal ball, the rubber gasket is deformed by the extrusion of the traction end and the connecting shaft, so as to provide a driving force for the rotation and resetting of the traction end around the universal ball after the use is completed.
Example 4
When the femur neck fracture internal-support type fixing device provided by embodiment 3 is used, because the locking base and the intramedullary nail body are locked through the screw thread, but when a bone absorption phenomenon is generated in the healing process of the femur neck, the locking base cannot automatically pressurize in the healing process, so that the device becomes loose, the fracture cannot be effectively dragged and fixed continuously, and the treatment effect of the fracture is influenced.
In order to solve the above problems, the locking base structure of the internal supporting type fixing device for femoral neck fracture provided in this embodiment is different from the locking base structure of the internal supporting type fixing device for femoral neck fracture provided in embodiment 3, specifically:
as shown in fig. 12-13, the locking base includes an annular base 81, a sliding screw 82 and an anti-drop top spring 83, the annular base is fixedly installed inside the tail end of the intramedullary nail body 3, an internal thread is provided outside the sliding screw 82, the sliding screw 82 is sleeved inside the annular base 81 in a matching manner and can slide and rotate along the axial direction of the annular base, an abdicating hole 821 penetrating through the sliding screw is provided in the middle of the sliding screw 82 along the axial direction, the tail end of the screw 73 axially passes through the abdicating hole 821 of the sliding screw, extends out of the intramedullary nail body and is connected with the end cap in a matching manner; the tail end of the sliding screw rod extends outwards to form a nail body, and is sleeved with a locking seat 84 in a matching mode, and the diameter size of the outer ring of the locking seat is larger than that of the nail through hole of the abutting plate.
The top end of the sliding screw 82 extends upwards into the nail body and is fixedly sleeved with a limit ring platform 85 which can rotate and slide along the control channel, the inner wall of the control channel outside the limit ring platform 85 is uniformly provided with a plurality of L-shaped guide slotted holes 86 along the circumference, each guide slotted hole 86 comprises a shaft section 861 arranged along the axial direction and a horizontal section 862 vertically communicated with the tail end of the shaft section, the orientation of the horizontal section is the same as the direction of the screw rotating and penetrating into the driving seat and the rotating and screwing direction of the locking seat, the horizontal sections of the guide slotted holes on the nail body are respectively provided with a limit stop rod 87 along the radial direction, the limit stop rods penetrate into the control channel and are connected with the limit ring platform, when the limit ring platform rotates along the opposite direction of the rotating and screwing of the locking seat, the limit stop rods can be driven to synchronously rotate along the horizontal sections corresponding to the guide slotted holes and enter the shaft sections of the corresponding guide slotted holes, so that when the locking seat 82 or the screw 73 rotates and screws to drive the hook claws to be unfolded, the limit ring table is limited by the limit stop lever and the horizontal section and cannot synchronously rotate; the anti-drop top spring 83 is compressed and sleeved on the sliding screw rod between the annular base and the limiting ring platform, the upper end and the lower end of the anti-drop top spring are respectively in top contact with the limiting ring platform and the annular base, and the length dimension of the anti-drop spring is larger than the distance dimension between the annular base and the top end of the shaft section under the unnatural state.
Further, the outer circumferential surface of the locking seat 84 is provided with a friction block or a handle plate for facilitating manual screwing of the locking seat.
Compared with the embodiment 3, after the device provided by the embodiment is fixed by screwing the locking seat, the sliding screw rod is driven to drive the limiting ring table 85 to rotate in the opposite direction of screwing the locking seat, so that the limiting stop lever on the limiting ring table synchronously rotates along the horizontal section corresponding to the guide slot hole to enter the shaft section corresponding to the guide slot hole, at the moment, the anti-falling top spring in a compressed state loses the axial restraint of the horizontal section of the guide slot hole, and applies a driving force sliding inwards along the shaft section of the guide slot hole to the limiting ring table, namely the locking seat, so that the device is constantly in a state of traction and fixation on a fracture part, the problems in the embodiment 3 are effectively solved, and the distance between the end cap and the abutting plate cannot change in the process.
It is to be understood that the above-described embodiments of the present invention are merely illustrative of or explaining the principles of the invention and are not to be construed as limiting the invention. Therefore, any modification, equivalent replacement, improvement and the like made without departing from the spirit and scope of the present invention should be included in the protection scope of the present invention. Further, it is intended that the appended claims cover all such variations and modifications as fall within the scope and boundaries of the appended claims or the equivalents of such scope and boundaries.
Claims (10)
1. An internal supporting type fixing device for femoral neck fracture comprises a supporting plate matched with a femur in a contact manner, wherein an intramedullary nail body is inserted in the supporting plate; a push-pull driving mechanism is arranged in the intramedullary nail body, a driving end of the push-pull driving mechanism extends upwards into the hole cavity and is connected with the hinging end of the hook claw, a control end of the push-pull driving mechanism penetrates through the intramedullary nail body to extend out of the tibia, and the driving end can be controlled by the control end to drive the hook claw to rotate around the hinging end (to be separated from the outer wall of the intramedullary nail body); the outer side of the bottom plate is provided with a locking base connected with the intramedullary nail body, the locking base and the intramedullary nail body are coaxially arranged, and the locking base can axially move along the intramedullary nail body and can be locked.
2. The internal supporting type fixing device for femoral neck fracture according to claim 1, wherein a plurality of hinge seats are uniformly arranged on the outer end surface of the traction end along the circumference at intervals, strip-shaped holes communicated with the interior of the traction end are formed on the end surface of the traction end in each hinge seat, the top ends of the hook claws are rotatably arranged in the corresponding hinge seats through pin shafts, the top ends of the hook claws are connected with driving arms, and the other ends of the driving arms extend into the control cavity through the corresponding strip-shaped holes and are connected with the push-pull driving mechanism.
3. The femoral neck fracture internal support type fixing device according to claim 2, wherein the push-pull driving mechanism comprises a driving block, a connecting piece, a screw rod and an end cap, the driving block is arranged in the control channel of the intramedullary nail body in a matching mode and can slide axially along the inner wall of the control channel; connecting pieces with the same number as the hook claws are arranged in the control channel between the driving block and the traction end along the circumference, one end of each connecting piece is connected with the driving slide block, and the other end of each connecting piece extends into the control cavity and is connected with the driving arm corresponding to the hook claw; the bottom surface of the driving block is axially provided with a threaded hole, the screw rod is installed in the control channel at the rear side of the driving block in a rotating mode at intervals, the top end of the screw rod is installed in the threaded hole of the driving block in a matched mode, and the other end of the screw rod extends outwards to form the intramedullary nail body and is connected with the end cap.
4. The internal stay type fixing device for femoral neck fracture according to claim 3, wherein the inner wall of one side of the driving channel is provided with a guide groove along the axial direction, a position limiting boss is radially fixed at the position of the driving block corresponding to the guide groove, and the other end of the position limiting boss is inserted into the guide groove in a matching way and can slide along the guide groove along with the driving block.
5. A femoral neck fracture internal stay type fixation device as claimed in claim 3, wherein the connecting member is a rod member, and both ends of the rod member are hinged with the driving block and the driving arm respectively.
6. The internal stay type fixing device for femoral neck fracture according to claim 3, wherein the connecting member is a traction rope, two ends of the traction rope are respectively connected with the driving block and the driving arm, and a torsion spring is arranged on a pin shaft for mounting the hook claw in the hinge seat in a matching manner, and the torsion spring drives the hook claw to rotate around the pin shaft to collide with the outer side wall of the intramedullary nail body in a natural state.
7. The femoral neck fracture internal stay fixation device of claim 1, wherein the top profile of the traction end is tapered.
8. The femoral neck fracture internal support type fixing device according to claim 1, wherein the circumferential side wall of the tail end of the intramedullary nail body is provided with internal threads, and the middle part of the locking base is provided with an external thread hole matched with the internal threads of the tail end of the intramedullary nail body along the axial direction and is sleeved on the internal threads of the tail end of the intramedullary nail body in a matching manner.
9. The femoral neck fracture internal bracing fixation device of claim 8, wherein the outer ring diameter dimension of the locking base is greater than the diameter dimension of the puncture hole in the base plate.
10. The internal supporting type fixing device for femoral neck fracture according to claim 1, wherein the shape of the inner end surface of the resisting plate is matched with the shape of the outer end surface of the femoral head, the resisting plate is provided with a nail through hole, and the intramedullary nail body is inserted into the femur through the nail through hole.
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| CN202111647468.6A CN114259288B (en) | 2021-12-30 | 2021-12-30 | Internal bracing type fixing device for fracture of femoral neck |
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| CN202111647468.6A CN114259288B (en) | 2021-12-30 | 2021-12-30 | Internal bracing type fixing device for fracture of femoral neck |
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| CN114259288B CN114259288B (en) | 2024-04-16 |
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| CN114259288B (en) | 2024-04-16 |
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