CN202277410U - Protection device for preventing hand contracture - Google Patents

Protection device for preventing hand contracture Download PDF

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CN202277410U
CN202277410U CN 201120395212 CN201120395212U CN202277410U CN 202277410 U CN202277410 U CN 202277410U CN 201120395212 CN201120395212 CN 201120395212 CN 201120395212 U CN201120395212 U CN 201120395212U CN 202277410 U CN202277410 U CN 202277410U
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strap
finger
thumb
wrist
fixed
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应文娟
彭春华
郑宇琼
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First Affiliated Hospital of Shantou University Medical College
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First Affiliated Hospital of Shantou University Medical College
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Abstract

一种防止手部挛缩的保护器具,包括塑料护板,塑料护板包括一体连接的护腕部、护掌部、拇指固定部和四指固定部;塑料护板下侧设有衬垫;护腕部上设有腕部固定系带,拇指固定部上设有拇指固定系带,四指固定部上设有四指固定系带。本实用新型使用时安放在病人的手背上,衬垫与手背接触,然后利用腕部固定系带、拇指固定系带和四指固定系带分别包裹固定病人的腕部、拇指和其余四指,并调节至松紧合适,使病人的手保持在功能位,从而有效防止病人手部挛缩,促进病人康复,并且具有结构简单、使用方便的优点。而且,使用时手指端部外露,既便于观察保护器具的固定情况,又不致于阻碍病人末梢血液循环,同时可辅以手指被动活动,更好地促进病人康复。

Figure 201120395212

A protective device for preventing hand contracture, comprising a plastic guard, the plastic guard includes an integrally connected wrist guard, palm guard, thumb fixing part and four finger fixing parts; a liner is provided on the lower side of the plastic guard; The wrist is provided with a wrist fixed tie, the thumb fixed part is provided with a thumb fixed tie, and the four finger fixed part is provided with a four-finger fixed tie. When the utility model is in use, it is placed on the back of the patient's hand, the liner is in contact with the back of the hand, and then the patient's wrist, thumb and other four fingers are respectively wrapped and fixed by the wrist fixed lace, thumb fixed lace and four-finger fixed lace. And it is adjusted to a suitable tightness, so that the patient's hand is kept in the functional position, thereby effectively preventing the patient's hand contracture, promoting the patient's recovery, and has the advantages of simple structure and convenient use. Moreover, the finger ends are exposed during use, which is convenient for observing the fixation of the protective device and does not hinder the patient's peripheral blood circulation. At the same time, it can be supplemented by passive finger movements to better promote the patient's recovery.

Figure 201120395212

Description

一种防止手部挛缩的保护器具A protective device for preventing hand contracture

技术领域 technical field

本实用新型涉及理疗康复器具,具体地说,涉及一种防止手部挛缩的保护器具。The utility model relates to a physiotherapy rehabilitation appliance, in particular to a protective appliance for preventing hand contracture.

背景技术 Background technique

神经疾病患者由于手术或疾病而造成全身瘫痪或偏瘫,以致肢体不能自主活动,肢体容易发生关节畸形,难以保持其功能位。若不加以保护,使肢体保持在功能位,则极易造成肢体肌肉挛缩,并且患病时间越长,则造成肢体肌肉挛缩的机会就越大。Patients with neurological diseases are paralyzed or hemiplegic due to surgery or disease, so that the limbs cannot move independently, and the limbs are prone to joint deformities, making it difficult to maintain their functional positions. If it is not protected and the limbs are kept in a functional position, it is very easy to cause limb muscle contracture, and the longer the illness lasts, the greater the chance of limb muscle contracture.

发明内容 Contents of the invention

本实用新型所要解决的技术问题是提供一种防止手部挛缩的保护器具,这种保护器具结构简单,使用方便,能够使病人的手部保持在功能位,有效防止病人手部挛缩,促进病人康复。采用的技术方案如下:The technical problem to be solved by the utility model is to provide a protective device for preventing hand contracture. This protective device is simple in structure, easy to use, can keep the patient's hand in the functional position, effectively prevent the patient's hand contracture, and promote the patient's recovery. The technical scheme adopted is as follows:

一种防止手部挛缩的保护器具,其特征在于包括塑料护板,塑料护板包括一体连接的护腕部、护掌部、拇指固定部和四指固定部;塑料护板下侧设有衬垫;护腕部上设有腕部固定系带,拇指固定部上设有拇指固定系带,四指固定部上设有四指固定系带。A protective device for preventing hand contracture, which is characterized in that it includes a plastic guard, and the plastic guard includes an integrally connected wrist guard, palm guard, thumb fixing part and four finger fixing parts; the lower side of the plastic guard is provided with a lining pad; the wrist part is provided with a wrist fixed strap, the thumb fixed part is provided with a thumb fixed strap, and the four-finger fixed part is provided with a four-finger fixed strap.

上述塑料护板的形状及尺寸按人体手部形状及大小进行设计,其中护腕部、护掌部、拇指固定部和四指固定部分别对应腕部、手掌、拇指、其余四个手指。塑料护板起支撑作用。The shape and size of the plastic shield are designed according to the shape and size of the human hand, wherein the wrist guard, palm guard, thumb fixing part and four finger fixing parts correspond to the wrist, palm, thumb and other four fingers respectively. The plastic guard serves as a support.

上述衬垫可采用较为柔软的布料制成,或采用具有海绵夹层的面料制成,使用时衬垫处于手背与塑料护板之间,能够使病人的手感觉较为舒适,减轻保护器具对手产生的压迫,并避免塑料护板对手产生伤损。衬垫与塑料护板形状相适应,并且衬垫的尺寸通常略大于塑料护板。The above-mentioned liner can be made of relatively soft cloth or fabric with a sponge interlayer. When in use, the liner is between the back of the hand and the plastic guard, which can make the patient's hand feel more comfortable and reduce the impact of the protective device on the hand. Compression and avoid damage to the opponent with the plastic guard. The liner conforms to the shape of the plastic fender and is usually slightly larger in size than the plastic fender.

上述腕部固定系带可包括左腕部系带和右腕部系带,左腕部系带和右腕部系带分别连接护腕部的两侧,左腕部系带与右腕部系带通过尼龙搭扣连接。尼龙搭扣由尼龙钩带和尼龙绒带两部分组成。上述腕部固定系带中,尼龙钩带设于左腕部系带(或右腕部系带)上,相应的,尼龙绒带设于右腕部系带(或左腕部系带)上。The above-mentioned fixed wrist strap may include a left wrist strap and a right wrist strap, the left wrist strap and the right wrist strap are respectively connected to both sides of the wrist guard, and the left wrist strap and the right wrist strap are connected by Velcro . Velcro is made up of two parts: nylon hook belt and nylon velvet belt. In the above-mentioned fixed wrist strap, the nylon hook strap is arranged on the left wrist strap (or the right wrist strap), and correspondingly, the nylon velvet strap is arranged on the right wrist strap (or the left wrist strap).

上述腕部固定系带也可包括腕部带环和腕部系带体,腕部带环连接护腕部的一侧,腕部系带体连接护腕部的另一侧,腕部系带体的一面上沿腕部系带体的长度方向依次设有尼龙钩带和尼龙绒带,使用时腕部系带体穿过腕部带环后弯折,调节至松紧合适后,使尼龙钩带与尼龙绒带贴合。The above-mentioned fixed wrist strap may also include a wrist strap ring and a wrist strap body. On one side of the body, there are nylon hook straps and nylon velvet straps in sequence along the length of the wrist strap body. When in use, the wrist strap body passes through the wrist strap loop and then bends. After adjusting to a suitable degree of tightness, the nylon hook The straps are fitted with nylon fleece straps.

上述拇指固定系带可包括左拇指系带和右拇指系带,左拇指系带和右拇指系带分别连接拇指固定部的两侧,左拇指系带与右拇指系带通过尼龙搭扣连接。上述拇指固定系带也可包括拇指带环和拇指系带体,拇指带环连接拇指固定部的一侧,拇指系带体连接拇指固定部的另一侧,拇指系带体的一面上沿拇指系带体的长度方向依次设有尼龙钩带和尼龙绒带,使用时拇指系带体穿过拇指带环后弯折,调节至松紧合适后,使尼龙钩带与尼龙绒带贴合。The thumb fixing strap may include a left thumb strap and a right thumb strap, the left thumb strap and the right thumb strap are respectively connected to both sides of the thumb fixing part, and the left thumb strap and the right thumb strap are connected by Velcro. The above-mentioned thumb fixing strap may also include a thumb strap ring and a thumb strap body, the thumb strap ring is connected to one side of the thumb fixing part, the thumb strap body is connected to the other side of the thumb fixing part, and one side of the thumb strap body is along the thumb The length direction of the lacing body is provided with a nylon hook belt and a nylon velvet belt in turn. When in use, the thumb lacing body passes through the thumb belt ring and is bent. After adjusting to a suitable degree of tightness, the nylon hook belt and the nylon velvet belt are fitted together.

上述四指固定系带可包括左四指系带和右四指系带,左四指系带和右四指系带分别连接四指固定部的两侧,左四指系带与右四指系带通过尼龙搭扣连接。上述四指固定系带也可包括四指带环和四指系带体,四指带环连接四指固定部的一侧,四指系带体连接四指固定部的另一侧,四指系带体的一面上沿四指系带体的长度方向依次设有尼龙钩带和尼龙绒带,使用时四指系带体穿过四指带环后弯折,调节至松紧合适后,使尼龙钩带与尼龙绒带贴合。The above-mentioned four-finger fixed strap may include a left four-finger strap and a right four-finger strap, the left four-finger strap and the right four-finger strap are respectively connected to both sides of the four-finger fixing part, and the left four-finger strap and the right four-finger strap The straps attach with Velcro. The four-finger fixed strap may also include a four-finger belt ring and a four-finger belt body, the four-finger belt ring is connected to one side of the four-finger fixing part, the four-finger belt body is connected to the other side of the four-finger fixing part, and the four-finger belt ring is connected to the other side of the four-finger fixing part. One side of the lacing body is provided with nylon hook straps and nylon velvet straps in sequence along the length direction of the four-finger lacing body. Nylon hook strap fits with nylon fleece strap.

本实用新型使用时安放在病人的手背上,衬垫与手背接触,然后利用腕部固定系带、拇指固定系带和四指固定系带分别包裹固定病人的腕部、拇指和其余四指,并调节至松紧合适,使病人的手部保持在功能位,从而有效防止病人手部挛缩,促进病人康复,并且具有结构简单、使用方便的优点。而且,使用时手指端部外露,既便于观察保护器具的固定情况,又不致于阻碍病人末梢血液循环,同时可辅以手指被动活动,更好地促进病人康复。When the utility model is in use, it is placed on the back of the patient's hand, the liner is in contact with the back of the hand, and then the patient's wrist, thumb and other four fingers are wrapped and fixed by the wrist fixed lace, thumb fixed lace and four-finger fixed lace respectively. And it is adjusted to a suitable tightness, so that the patient's hand is kept in the functional position, thereby effectively preventing the patient's hand contracture, promoting the patient's recovery, and has the advantages of simple structure and convenient use. Moreover, the finger ends are exposed during use, which is convenient for observing the fixation of the protective device, and does not hinder the patient's peripheral blood circulation. At the same time, it can be supplemented by passive finger movements to better promote the patient's recovery.

附图说明 Description of drawings

图1是本实用新型一实施例的结构示意图。Fig. 1 is a schematic structural view of an embodiment of the utility model.

具体实施方式Detailed ways

如图1所示,这种防止手部挛缩的保护器具包括塑料护板1,塑料护板1包括一体连接的护腕部11、护掌部12、拇指固定部13和四指固定部14;塑料护板1下侧设有衬垫2;护腕部11上设有腕部固定系带3,拇指固定部13上设有拇指固定系带4,四指固定部14上设有四指固定系带5。As shown in Figure 1, this protective device for preventing hand contracture includes a plastic shield 1, and the plastic shield 1 includes a wrist guard 11, a palm guard 12, a thumb fixing part 13 and a four-finger fixing part 14 integrally connected; The lower side of the plastic shield 1 is provided with a liner 2; the wrist part 11 is provided with a wrist fixing strap 3, the thumb fixing part 13 is provided with a thumb fixing strap 4, and the four-finger fixing part 14 is provided with a four-finger fixing lacing5.

塑料护板1的形状及尺寸按人体手部形状及大小进行设计,其中护腕部11、护掌部12、拇指固定部13和四指固定部14分别对应腕部、手掌、拇指、其余四个手指。The shape and size of the plastic shield 1 are designed according to the shape and size of the human hand, wherein the wrist guard 11, the palm guard 12, the thumb fixing part 13 and the four finger fixing parts 14 correspond to the wrist, the palm, the thumb, and the remaining four fingers respectively. fingers.

衬垫2可采用具有海绵夹层的面料制成,衬垫2与塑料护板1形状相适应,并且衬垫2的尺寸略大于塑料护板1。The liner 2 can be made of fabric with a sponge interlayer, the liner 2 is adapted to the shape of the plastic guard 1 , and the size of the liner 2 is slightly larger than the plastic guard 1 .

本实施例中,腕部固定系带3包括左腕部系带31和右腕部系带32,左腕部系带31和右腕部系带32分别连接护腕部11的两侧,左腕部系带31与右腕部系带32通过尼龙搭扣连接,该尼龙搭扣由尼龙钩带33和尼龙绒带34两部分组成。腕部固定系带3中,尼龙钩带33设于左腕部系带31上,尼龙绒带34设于右腕部系带32上,使用时调节至松紧合适后使尼龙钩带33与尼龙绒带34贴合,实现左腕部系带31与右腕部系带32之间的连接。In this embodiment, the wrist fixed tether 3 includes a left wrist tether 31 and a right wrist tether 32, the left wrist tether 31 and the right wrist tether 32 are respectively connected to both sides of the wrist guard 11, and the left wrist tether 31 It is connected with the right wrist strap 32 by a Velcro, and the Velcro is made up of two parts, a nylon hook belt 33 and a nylon velvet belt 34. In the fixed tether 3 of the wrist, the nylon hook belt 33 is located on the left wrist tether 31, and the nylon velvet belt 34 is located on the right wrist frenulum 32. When in use, the nylon hook belt 33 and the nylon velvet belt are adjusted to fit properly. 34 fit, realize the connection between the left wrist tether 31 and the right wrist tether 32.

本实施例中,拇指固定系带4包括拇指带环41和拇指系带体42,拇指带环41连接拇指固定部13的一侧,拇指系带体42连接拇指固定部13的另一侧,拇指系带体42的一面上沿拇指系带体42的长度方向依次设有尼龙钩带43和尼龙绒带44,使用时拇指系带体42穿过拇指带环41后弯折,调节至松紧合适后,使尼龙钩带43与尼龙绒带44贴合,实现拇指固定系带4的连接固定。In this embodiment, the thumb fixing strap 4 includes a thumb strap ring 41 and a thumb strap body 42, the thumb strap ring 41 is connected to one side of the thumb fixing part 13, and the thumb strap body 42 is connected to the other side of the thumb fixing part 13, One side of the thumb strap body 42 is sequentially provided with a nylon hook strap 43 and a nylon velvet strap 44 along the length direction of the thumb strap body 42. During use, the thumb strap body 42 passes through the thumb strap ring 41 and then bends to adjust to tightness. After fitting, make the nylon hook strip 43 and the nylon velvet strip 44 fit together, so as to realize the connection and fixation of the thumb fixing strap 4 .

本实施例中,四指固定系带5包括四指带环51和四指系带体52,四指带环51连接四指固定部14的一侧,四指系带体52连接四指固定部14的另一侧,四指系带体52的一面上沿四指系带体52的长度方向依次设有尼龙钩带53和尼龙绒带54,使用时四指系带体52穿过四指带环51后弯折,调节至松紧合适后,使尼龙钩带53与尼龙绒带54贴合,实现四指固定系带5的连接固定。In this embodiment, the four-finger fixing strap 5 includes a four-finger strap ring 51 and a four-finger strap body 52, the four-finger strap ring 51 is connected to one side of the four-finger fixing part 14, and the four-finger strap body 52 is connected to the four-finger strap body 52. On the other side of the portion 14, on one side of the four-finger strap body 52, nylon hook straps 53 and nylon velvet straps 54 are successively arranged along the length direction of the four-finger strap body 52. During use, the four-finger strap body 52 passes through four After the finger belt ring 51 is bent, after being adjusted to a suitable degree of tightness, the nylon hook belt 53 and the nylon velvet belt 54 are fitted together to realize the connection and fixation of the four-finger fixed frenulum 5 .

下面简述一下本保护器具的使用方法:使用时,将本保护器具安放在病人的手背上,衬垫2与手背接触(即衬垫2处于手背与塑料护板1之间);然后利用腕部固定系带3、拇指固定系带4和四指固定系带5分别包裹固定病人的腕部、拇指和其余四指,并调节至松紧合适后连接,从而将病人的腕部、拇指和其余四指分别固定在保护器具上,使病人的手保持在功能位,防止病人手部挛缩。The usage method of this protective device is briefly described below: when in use, the protective device is placed on the back of the patient's hand, and the liner 2 is in contact with the back of the hand (that is, the liner 2 is between the back of the hand and the plastic guard 1); Fix the patient's wrist, thumb and other four fingers with the fixed lace 3, the fixed lace for the thumb 4 and the fixed lace 5 for the four fingers, respectively, and connect them after adjusting to a suitable degree of tightness, so that the patient's wrist, thumb and other four fingers The four fingers are respectively fixed on the protective device to keep the patient's hand in a functional position and prevent the patient's hand from contracture.

在其它实施方案中,腕部固定系带也可包括腕部带环和腕部系带体,腕部带环连接护腕部的一侧,腕部系带体连接护腕部的另一侧,腕部系带体的一面上沿腕部系带体的长度方向依次设有尼龙钩带和尼龙绒带,使用时腕部系带体穿过腕部带环后弯折,调节至松紧合适后,使尼龙钩带与尼龙绒带贴合。In other embodiments, the wrist strap may also include a wrist loop and a wrist strap body, the wrist loop attaches to one side of the wristband, and the wrist strap body attaches to the other side of the wristband , One side of the wrist strap body is provided with a nylon hook strap and a nylon velvet strap along the length direction of the wrist strap body in sequence. When in use, the wrist strap body passes through the wrist strap loop and then bends to adjust to a suitable tightness. Finally, make the nylon hook strap and the nylon velvet strap fit together.

在其它实施方案中,拇指固定系带也可包括左拇指系带和右拇指系带,左拇指系带和右拇指系带分别连接拇指固定部的两侧,左拇指系带与右拇指系带通过尼龙搭扣连接。In other embodiments, the thumb fixing strap may also include a left thumb strap and a right thumb strap, the left thumb strap and the right thumb strap are respectively connected to both sides of the thumb fixing part, and the left thumb strap and the right thumb strap are respectively connected to each other. Attached by Velcro.

在其它实施方案中,四指固定系带也可包括左四指系带和右四指系带,左四指系带和右四指系带分别连接四指固定部的两侧,左四指系带与右四指系带通过尼龙搭扣连接。In other embodiments, the four-finger fixing strap may also include a left four-finger strap and a right four-finger strap, the left four-finger strap and the right four-finger strap are respectively connected to the two sides of the four-finger fixing part, and the left four-finger The strap is connected to the right four-finger strap by Velcro.

Claims (7)

1.一种防止手部挛缩的保护器具,其特征在于包括塑料护板,塑料护板包括一体连接的护腕部、护掌部、拇指固定部和四指固定部;塑料护板下侧设有衬垫;护腕部上设有腕部固定系带,拇指固定部上设有拇指固定系带,四指固定部上设有四指固定系带。 1. A protective device for preventing hand contracture, which is characterized in that it comprises a plastic guard, and the plastic guard includes integrally connected wrist guards, palm guards, thumb fixing parts and four finger fixing parts; the lower side of the plastic guard is provided with There is padding; there is a wrist strap on the wrist guard, a thumb strap on the thumb strap, and a four-finger strap on the four-finger strap. 2.根据权利要求1所述的防止手部挛缩的保护器具,其特征是:所述腕部固定系带包括左腕部系带和右腕部系带,左腕部系带和右腕部系带分别连接护腕部的两侧,左腕部系带与右腕部系带通过尼龙搭扣连接。 2. The protective device for preventing hand contracture according to claim 1, characterized in that: the fixed wrist strap includes a left wrist strap and a right wrist strap, and the left wrist strap and the right wrist strap are respectively connected On both sides of the wrist guard, the left wrist strap and the right wrist strap are connected by Velcro. 3.根据权利要求1所述的防止手部挛缩的保护器具,其特征是:所述腕部固定系带包括腕部带环和腕部系带体,腕部带环连接护腕部的一侧,腕部系带体连接护腕部的另一侧,腕部系带体的一面上沿腕部系带体的长度方向依次设有尼龙钩带和尼龙绒带。 3. The protective device for preventing hand contracture according to claim 1, characterized in that: the fixed wrist strap comprises a wrist strap ring and a wrist strap body, and the wrist strap ring is connected to one of the wrist guards. On the other side, the wrist strap body is connected to the other side of the wrist guard, and one side of the wrist strap body is sequentially provided with nylon hook straps and nylon velvet straps along the length direction of the wrist strap body. 4.根据权利要求1所述的防止手部挛缩的保护器具,其特征是:所述拇指固定系带包括左拇指系带和右拇指系带,左拇指系带和右拇指系带分别连接拇指固定部的两侧,左拇指系带与右拇指系带通过尼龙搭扣连接。 4. The protective device for preventing hand contracture according to claim 1, characterized in that: the thumb fixing strap includes a left thumb strap and a right thumb strap, and the left thumb strap and the right thumb strap are connected to the thumb respectively. On both sides of the fixing part, the left thumb strap and the right thumb strap are connected by Velcro. 5.根据权利要求1所述的防止手部挛缩的保护器具,其特征是:所述拇指固定系带包括拇指带环和拇指系带体,拇指带环连接拇指固定部的一侧,拇指系带体连接拇指固定部的另一侧,拇指系带体的一面上沿拇指系带体的长度方向依次设有尼龙钩带和尼龙绒带。 5. The protective device for preventing hand contracture according to claim 1, characterized in that: the thumb fixing strap comprises a thumb strap ring and a thumb strap body, the thumb strap ring is connected to one side of the thumb fixing part, and the thumb strap is The strap body is connected to the other side of the thumb fixing part, and one side of the thumb strap body is sequentially provided with a nylon hook strap and a nylon velvet strap along the length direction of the thumb strap body. 6.根据权利要求1所述的防止手部挛缩的保护器具,其特征是:所述四指固定系带包括左四指系带和右四指系带,左四指系带和右四指系带分别连接四指固定部的两侧,左四指系带与右四指系带通过尼龙搭扣连接。 6. The protective device for preventing hand contracture according to claim 1, characterized in that: the four-finger fixed strap includes a left four-finger strap and a right four-finger strap, a left four-finger strap and a right four-finger strap The frenulum is respectively connected to both sides of the four-finger fixing part, and the left four-finger frenulum and the right four-finger frenulum are connected by Velcro. 7.根据权利要求1所述的防止手部挛缩的保护器具,其特征是:所述四指固定系带包括四指带环和四指系带体,四指带环连接四指固定部的一侧,四指系带体连接四指固定部的另一侧,四指系带体的一面上沿四指系带体的长度方向依次设有尼龙钩带和尼龙绒带。 7. The protective device for preventing hand contracture according to claim 1, characterized in that: the four-finger fixing strap comprises a four-finger belt ring and a four-finger belt body, and the four-finger belt ring is connected to the four-finger fixing part. On one side, the four-finger lacing body is connected to the other side of the four-finger fixing part, and one side of the four-finger lacing body is sequentially provided with a nylon hook belt and a nylon velvet belt along the length direction of the four-finger lacing body.
CN 201120395212 2011-10-17 2011-10-17 Protection device for preventing hand contracture Expired - Fee Related CN202277410U (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108325081A (en) * 2018-03-31 2018-07-27 河南中医药大学 Hand medicine leads heating intermediate frequency electrode plate
CN108926420A (en) * 2017-05-26 2018-12-04 北京德益达美医疗科技有限公司 Medical rehabilitation wrist guard
CN109498083A (en) * 2018-12-05 2019-03-22 江苏省肿瘤医院 A kind of knot pusher under hysteroscope

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108926420A (en) * 2017-05-26 2018-12-04 北京德益达美医疗科技有限公司 Medical rehabilitation wrist guard
CN108325081A (en) * 2018-03-31 2018-07-27 河南中医药大学 Hand medicine leads heating intermediate frequency electrode plate
CN109498083A (en) * 2018-12-05 2019-03-22 江苏省肿瘤医院 A kind of knot pusher under hysteroscope

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