CN114699159A - Temporary fixing system for anterior and posterior cruciate ligament avulsion fracture through arthroscope auxiliary treatment - Google Patents

Temporary fixing system for anterior and posterior cruciate ligament avulsion fracture through arthroscope auxiliary treatment Download PDF

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Publication number
CN114699159A
CN114699159A CN202210246231.5A CN202210246231A CN114699159A CN 114699159 A CN114699159 A CN 114699159A CN 202210246231 A CN202210246231 A CN 202210246231A CN 114699159 A CN114699159 A CN 114699159A
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China
Prior art keywords
holder
nail
anterior
cruciate ligament
posterior cruciate
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Pending
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CN202210246231.5A
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Chinese (zh)
Inventor
段王平
宋文杰
卫小春
刘洋
任智远
王薛丁
马永胜
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Second Hospital of Shanxi Medical University
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Second Hospital of Shanxi Medical University
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Priority to CN202210246231.5A priority Critical patent/CN114699159A/en
Publication of CN114699159A publication Critical patent/CN114699159A/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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
    • 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
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0801—Prevention of accidental cutting or pricking
    • A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Neurology (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention belongs to the field of medical orthopedic surgery operation instruments, and particularly relates to a temporary fixing system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures; comprises a screwing device, a holder, a fixing nail and a puncture core; the holder is cylindrical, the upper port is circular, and the lower port is oblique elliptical; the screw driver comprises an insert rod which can extend into the holder, the head of the insert rod is connected with the top cap, and the tail end of the insert rod is provided with a threaded blind hole; the fixing nail can penetrate through the holder and comprises a nail cap and a nail rod, and the end of the nail cap is provided with a thread; the puncture core comprises a tamper, one end of the tamper is a tip, and the tamper can pass through the holder. This interim fixing system of cruciate ligament tears to take off fracture around arthroscope adjunctie therapy has concurrently and maintains the bone piece and resets, accurate location, does not disturb bone tunnel preparation simultaneously, is applicable to anterior and posterior cruciate ligament shin bone dead point and tears off fracture wicresoft's treatment, can shorten operation time, improves the operation success rate, adapts to present accurate medical treatment operation, quick recovered theory and direction.

Description

Temporary fixing system for anterior and posterior cruciate ligament avulsion fracture through arthroscope auxiliary treatment
Technical Field
The invention belongs to the field of medical orthopedic surgery operation instruments, and particularly relates to a temporary fixing system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures.
Background
The anterior cruciate ligament/posterior cruciate ligament is an important structure for maintaining the stability of the knee joint, wherein the anterior cruciate ligament can limit the forward excessive displacement of the tibia and prevent the tibia from hyperextension and excessive pronation, and the posterior cruciate ligament can limit the tibia to move backwards and supination so as to avoid the hyperextension of the knee.
The torn fracture of the anterior and posterior cruciate ligaments is a violent injury in the field of sports medicine, which is commonly seen in traffic accidents or high-level sports injuries of athletes. The traditional treatment method is incision reduction internal fixation, and the operation has many defects, such as limited exposure in the operation, difficult anatomical reduction of the fracture joint due to the touch of fingers, more damaged tissues, large damage range, more postoperative complications, slow recovery of flexion and extension functions and great influence on the knee joint functions. With the continuous development of surgical instruments and surgical techniques, orthopedic surgery is gradually developing towards simplicity and minimal invasion. The arthroscope technology is clinically accepted by more and more doctors and patients for treating patients with fracture of tibial insertion point of cruciate ligament around knee joint due to the advantages of small trauma, small injury, visual fracture reduction, quick recovery, less complications and the like.
At present, the surgical scheme of fixing through a tibial bone channel suture and the like is generally selected for treating ligament avulsion fracture under a knee arthroscope, but when the internal fixation operation is carried out through tibial tunnel steel wire binding at present, clinical conventional surgical instruments cannot assist the arthroscope to carry out good bone block resetting and maintain the position after resetting, the tibial bone channel is prepared and lead is led under the state that the bone block is not reset, so that the problems of poor fracture resetting, displacement and the like are caused, and the effect after healing is influenced.
Disclosure of Invention
The invention aims to provide a temporary fixing system for arthroscope assisted treatment of anterior and posterior cruciate ligament avulsion fracture, which is reasonable in structure, convenient to operate and good in working effect.
In order to achieve the aim, the invention provides a temporary fixing system for arthroscopic adjuvant therapy of anterior and posterior cruciate ligament avulsion fracture, which comprises a screwing device, a holder, a fixing nail and a puncture core; the holder is cylindrical, the upper port is circular, and the lower port is oblique elliptical; the screw driver comprises a cylindrical insertion rod which can extend into the holder, the head of the insertion rod is connected with the top cap, and the tail end of the insertion rod is provided with a threaded blind hole; the fixing nail can pass through the holder and comprises a nail cap and a nail rod, and the end of the nail cap is provided with a thread which can be combined with the threaded blind hole; the puncture core comprises a cylindrical tamper, one end of the tamper is a tip, the other end of the tamper is provided with a larger stick head, and the tamper can pass through the holder.
Furthermore, one end of the nail cap close to the nail rod is provided with a limiting ring which protrudes outwards, the circumferential surface of the limiting ring is connected with the inner wall of the holder, and the end surface of the limiting ring is blocked with the inserted rod.
Furthermore, the inner wall of the holder is provided with two axial sliding chutes which are positioned at two ends of the diameter; the limiting ring is provided with two sliding blocks which are matched with the sliding grooves one by one.
Further, the threaded blind hole comprises a conical hole with the depth gradually reduced from the hole opening to the hole and a threaded straight hole connected with a small opening of the conical hole, and the diameter of the plug rod is equal to that of the limiting ring.
Furthermore, scales are marked on the inserted link along the length direction.
Furthermore, the outer wall of the holder is provided with anti-skid grains at the palm grasping position.
Furthermore, the included angle between the elliptical surface of the lower port of the holder and the horizontal plane is 30 degrees, and the elliptical surface is a frosted surface.
Furthermore, the screwing device, the holder and the fixing nail are all stainless steel components.
Further, the length of the nail rod is 6mm, 4mm or 2mm, and the diameter of the nail rod is unified to be 1 mm.
Compared with the prior art, the invention has the advantages that:
the temporary fixing system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fracture is reasonable in structure, convenient to operate and good in working effect, and the fracture block is reset under arthroscopic monitoring, and the temporary fixing instrument is adopted to maintain the reset and fixation of the fracture block. And then, under the condition of fracture reduction, the operations of tibial bone tract preparation, lead wire and the like are carried out, so that the reduction of the bone block is always kept, the reduction state of the final bone block is ensured, and the displacement is prevented. The bone block reduction and accurate positioning are maintained, the preparation of a bone tunnel is not interfered, the minimally invasive treatment device is suitable for minimally invasive treatment of fracture due to avulsion of tibial insertion points of anterior and posterior cruciate ligaments, can shorten operation time, improve operation success rate, exercise functions at early postoperative period, adapt to the current concept and direction of accurate medical operation and rapid rehabilitation, and has great market value.
Drawings
FIG. 1 is a schematic structural diagram of the present invention.
FIG. 2 is a schematic structural diagram of the holder.
FIG. 3 is a cross-sectional view of the holder.
Fig. 4 is a schematic structural view of the fastener.
Fig. 5 is a schematic structural view of the fixing nail.
Fig. 6 is a top view of a staple.
Fig. 7 is a schematic view of the structure of the piercing core.
In the figure: 1-screwing device; 1.1-top cap; 1.2-inserting the rod; 1.3-threaded blind holes; 2-a holder; 2.1-a chute; 3-fixing the nail; 3.1-nail cap; 3.2-nail rod; 3.3-a limit ring; 3.4-sliding block; 4-puncture core; 4.1-a tamper; 4.2-club head.
Detailed Description
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.
As shown in FIG. 1; a temporary fixing system for arthroscopic adjuvant therapy of anterior and posterior cruciate ligament avulsion fracture comprises a screw driver 1, a holder 2, a fixing nail 3 and a puncture core 4.
As shown in fig. 2 and 3; the circular sleeve of holder 2 for stainless steel's cavity, the overall length is 15cm, the external diameter is 1cm, it is circular to go up the port, the port is oblique ellipse down, outer wall palm gripping department is equipped with anti-skidding texture, gripping and fixing in the convenient art, the elliptical surface of port is 30 with the contained angle of horizontal plane down, this elliptical surface is the frosting, can increase the friction, help fixed free bone block in the apparatus art, avoid the slippage possibility, 2 wall thickness of holder is 2mm, the inner wall is equipped with two axial spouts 2.1, two spouts 2.1 are located the both ends of diameter, spout 2.1 is the semicircle spout of radius 1mm, spout 2.1 combines together with the slider on the staple 3, restriction staple 3 rotary motion, only can slide from top to bottom in holder 2 along with screwer 1.
As shown in fig. 4; the screw driver 1 is made of stainless steel, the screw driver 1 comprises a cylindrical insertion rod 1.2 which can be inserted into the holder 2, the length of the insertion rod 1.2 is 20cm, and the diameter is 6 mm; the top cap 1.1 is connected to the head of inserted bar 1.2, the tail end is equipped with screw thread blind hole 1.3, and screw thread blind hole 1.3 includes from the drill way to the tapered circular cone hole of bore depth and the screw thread straight hole of linking with the osculum of circular cone hole, and the diameter of screw thread straight hole is 2mm, and length is 2mm, and the screw thread straight hole combines with 3 screws up of staple, drives staple 3 and reciprocates in holder 2. Top cap 1.1 thickening at inserted bar 1.2 top, the diameter is 1cm, highly is 1cm for hammering in the art, and inserted bar 1.2 is gone up and is marked scale along length direction, can be used to judge that staple 3 squeezes into the degree of depth, avoids squeezing into too deeply and send free bone piece breakage.
As shown in fig. 5 and 6; the staple 3 is stainless steel, and the staple 3 can pass holder 2, and the staple 3 includes head of a nail 3.1, nail pole 3.2, and the end of head of a nail 3.1 is equipped with the screw thread that can combine together with screw thread blind hole 1.3, and the length of screw thread section is 2mm, and the staple 3 combines together with the ware of screwing in 1 and impels in holder 2 to it fixes to squeeze into free bone piece. According to different sizes of free bone blocks, the fixing nails 3 are designed to have corresponding lengths, such as 6mm, 4mm and 2mm, and the diameters of the nail rods 3.2 are unified to be 1mm, so that the free bone blocks are prevented from being damaged; so as to be used according to the needs in the operation. One end of the nail cap 3.1 close to the nail rod 3.2 is provided with a limiting ring 3.3 which is annularly and outwards protruded, the diameter of the limiting ring 3.3 is 6mm, the height is about 1mm, the circumferential surface of the limiting ring 3.3 is connected with the inner wall of the holder 2, and the end surface is blocked and connected with the inserted rod 1.2, so that the tip of the screw driver 1 can be prevented from damaging free bone blocks. The limiting ring 3.3 is provided with two sliding blocks 3.4 which are matched with the sliding grooves 2.1 one by one, and the sliding blocks 3.4 are semicircular column bars with the radius of about 1 mm; the sliding block 3.4 is combined with the sliding groove 2.1 to limit the fixed nail 3 to rotate and move in the arthroscope sleeve, so that the fixed nail is ensured to be combined with the bottom thread of the screw driver to avoid falling.
As shown in fig. 7; the puncture core 4 is a stainless steel sample and comprises two coaxial stages of cylinders, the diameter of the thin cylinder is 6mm, the length of the thin cylinder is 15cm, and the thin cylinder is used as a tamper 4.1 and can extend into the holder; the diameter of the thick cylinder is 1cm, the height of the thick cylinder is 1cm, the thick cylinder is used as a rod head 4.2, the end face of the thick cylinder is in blocking connection with the holder, the bottom end of the tamper 4.1 is a conical tip, and the length of the conical section is 5 cm. The conical tip design can assist the holder to enter the tissue more easily, and reduce the damage of muscle nerve blood vessels.
In operation, the holder 2 and the puncture core 4 are inserted from a proper arthroscopic approach, muscle tissues are arranged through the puncture core 4 under the condition of direct view of the arthroscope, the holder 2 is assisted to safely enter a joint cavity under the condition of not damaging the tissues, and the oblique elliptical lower end head of the holder 2 is used for pressing a free bone block under the condition of direct view of the arthroscope, so that the smoothness of a joint surface is restored and maintained. Under the condition of ensuring the reduction of the fracture, the holder 2 is transversely moved, and the direction and the angle between the holder 2 and the free bone block are set, so that the maximum stability of the biomechanics is achieved after the bone block is fixed. Then the screw driver 1 is screwed and combined with the fixing nail 3 with proper length, and then the bone fragments are temporarily fixed by driving the free bone blocks through the operation hammer along the sliding groove of the holder. Can also fix nail top nail cap and be the lever, cooperate the probe to prize and dial bone fragment and make bone fragment reset, resume the planarization of articular surface, the fixed condition of staple 3 is observed to the 2 positions of the accessible regulation of art in the accessible. After the free bone block is properly fixed in the operation, the combining fixing nail 3 is screwed down by the screwing device 1 and is pulled out of the body.
The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

Claims (9)

1. The utility model provides an arthroscope adjunctie therapy anterior and posterior cruciate ligament tears off interim fixing system of fracture which characterized in that: comprises a screwing device (1), a holder (2), a fixing nail (3) and a puncture core (4); the holder (2) is cylindrical, the upper port is circular, and the lower port is oblique elliptical; the screwing device (1) comprises a cylindrical inserted rod (1.2) which can extend into the holder (2), the head of the inserted rod (1.2) is connected with the top cap (1.1), and the tail end of the inserted rod is provided with a threaded blind hole (1.3); the fixing nail (3) can penetrate through the holder (2), the fixing nail (3) comprises a nail cap (3.1) and a nail rod (3.2), and the end of the nail cap (3.1) is provided with a thread which can be combined with the threaded blind hole (1.3); the puncture core (4) comprises a cylindrical tamper (4.1), one end of the tamper (4.1) is a tip, the other end of the tamper is provided with a larger rod head (4.2), and the tamper (4.1) can pass through the holder (2).
2. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to claim 1, wherein: one end of the nail cap (3.1) close to the nail rod (3.2) is provided with a limiting ring (3.3) which is annularly protruded outwards, the circumferential surface of the limiting ring (3.3) is connected with the inner wall of the holder (2), and the end surface is blocked with the inserted link (1.2).
3. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to claim 2, wherein: the inner wall of the holder (2) is provided with two axial sliding chutes (2.1), and the two sliding chutes (2.1) are positioned at two ends of the diameter; the limiting ring (3.3) is provided with two sliding blocks (3.4) which are matched with the sliding grooves (2.1) one by one.
4. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to claim 2, wherein: the threaded blind hole (1.3) comprises a conical hole with gradually reduced depth from the hole opening to the hole and a threaded straight hole connected with a small opening of the conical hole, and the diameter of the inserted rod (1.2) is equal to that of the limiting ring (3.3).
5. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to claim 1, wherein: the inserted bar (1.2) is marked with scales along the length direction.
6. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to claim 1, wherein: the outer wall of the holder (2) is provided with anti-skid grains at the palm grasping position.
7. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to claim 1, wherein: the included angle between the elliptical surface of the lower port of the holder (2) and the horizontal plane is 30 degrees, and the elliptical surface is a frosted surface.
8. The temporary fixation system for arthroscopic assisted treatment of anterior and posterior cruciate ligament avulsion fractures according to any one of claims 1-7, wherein: the screwing device (1), the holder (2) and the fixing nail (3) are all stainless steel components.
9. The temporary fixation system for anterior and posterior cruciate ligament avulsion fracture as claimed in claim 2, wherein: the length of the nail rods (3.2) is 6mm, 4mm or 2mm, and the diameters of the nail rods (3.2) are unified to be 1 mm.
CN202210246231.5A 2022-03-14 2022-03-14 Temporary fixing system for anterior and posterior cruciate ligament avulsion fracture through arthroscope auxiliary treatment Pending CN114699159A (en)

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CN202210246231.5A CN114699159A (en) 2022-03-14 2022-03-14 Temporary fixing system for anterior and posterior cruciate ligament avulsion fracture through arthroscope auxiliary treatment

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Application Number Priority Date Filing Date Title
CN202210246231.5A CN114699159A (en) 2022-03-14 2022-03-14 Temporary fixing system for anterior and posterior cruciate ligament avulsion fracture through arthroscope auxiliary treatment

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CN114699159A true CN114699159A (en) 2022-07-05

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