CN204410917U - Clamp acromioclavicular joint reposition guidance system - Google Patents
Clamp acromioclavicular joint reposition guidance system Download PDFInfo
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- CN204410917U CN204410917U CN201420838240.4U CN201420838240U CN204410917U CN 204410917 U CN204410917 U CN 204410917U CN 201420838240 U CN201420838240 U CN 201420838240U CN 204410917 U CN204410917 U CN 204410917U
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- processus coracoideus
- clavicle
- pincers
- clamp
- acromioclavicular joint
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Abstract
The open clamp acromioclavicular joint reposition guidance system of this utility model, comprise processus coracoideus side pincers, clavicle side pincers and handle, processus coracoideus side pincers pincers point arranges a spherical base, form the sharp sample projection of a cone in described spherical base surface contact processus coracoideus side, clavicle side pincers pincers point arranges a rotatable hollow guiding device.The utility model has the advantage of: (1) disposable completes the reset of acromioclavicular joint and processus coracoideus, interclavicular " centralization linear bore "; (2) drilling guide is to accurately, avoids the fracture of processus coracoideus, clavicle; (3) drilling guide is to spherical designs that is accurate and processus coracoideus clamp end, avoids the damage of important blood vessels nerve inside processus coracoideus in art; (4) by the rule of clamp far-end, accurately measure the spacing of clavicle and processus coracoideus in the mode of " external pelivimetry ", thus select the appropriate length of the button loop ring needed for replacement and fixation; (5) instrumentation is simple and direct, safety, is reduced to by operation wound minimum, achieves real " Wicresoft ".
Description
Technical field
This utility model belongs to medical apparatus and instruments, more particularly, relates to the clamp acromioclavicular joint reposition guidance system being applied to Orthopeadic Surgery field.
Background technology
Acromioclavicular joint dislocation is a kind of common shoulder damage clinically, accounts for 12% of shoulder damage, accounts for the 4.4-5.98% of Whole Body Bone Scanning joint dislocation, wherein 43.5% sees the youngster of more than 20 years old.Acromioclavicular joint dislocation often because of contact to earth outside shoulder or suffering limb arm support ground indirect violence caused by.Mainly cause shoulder pain, on ipsilateral upper limb, when act or abduction, pain increases the weight of, and acromioclavicular joint local can be touched tenderness or occur deformity, and acromion outboard end swells, the organ point sign that depress extrusion is existing least, and X-ray film main manifestations is that beak lock gap increases.Acromioclavicular joint dislocation is divided into 6 types (Rockwood CA by ligament injury situation by Rockwood etc., Williams G, Young C. Injuries to the acromioclavicutar joint. [M] // Rockwood CA, Green D, Bucholz R, eds. Philadelphia:Lippicott-Raven, 1996:1341-1414.).Generally believe at present, that damages according to acromioclavicular joint dislocation hinders degree difference, and I, II type immediate dislocation should row expectant treatment; IV, V, VI type immediate dislocation should row operative treatment; III type acromioclavicular joint dislocation, although residual problem aesthetically, but for shoulder joint function and have no significant effect, therefore tend to first expectant treatment, if expectant treatment failure joint constant pain or young to minority and that mobility demand is larger patient, recommend operative treatment.Acromioclavicular joint dislocation therapeutic method of surgery is various, but neither one the recognized standard operation so far.Traditional therapy as fixed through acromioclavicular joint Kirschner wire, screw needle, strong fixing means restriction acromioclavicular joint fine motions such as beak lock screw is fixing, and inside-fixture displacement, fracture, the complication such as are unsuccessfully much, substantially do not use clinically.Now comparatively conventional method is Weaver-Dunn art formula and clavicular hook plate, though have certain acceptance rate postoperative, the complication such as acromioclavicular joint shakiness, shoulder pain, acromion shock, acromion sending down the fishbone dissolving, concurrent traumatic arthritis and upper limbs force weakens, Recurrent dislocation affect clinical effectiveness.
Deepen continuously along with to the research of acromioclavicular joint anatomical features and biomechanical characterization, seek the Anatomical Reconstruction to acromioclavicular joint dislocation clinically gradually thus recovery acromioclavicular joint anatomical structure and mechanics stable type, in treatment, requirement resets completely, fixes reliably, and retain acromioclavicular joint fine motion function, early ambulant after permission operation in patients, to obtain better clinical efficacy.Therapeutic Method newer is at present band button loop button steel plate (Endobutton CL) Anatomical Reconstruction edge lock ligament treatment acromioclavicular joint dislocation.Though this method can meet above-mentioned treatment requirement and short-term curative effects is obvious, then higher to the requirement of operator.Need in art fully to appear visual area, how long skin incision is 8-10cm; Boring repeatedly or the location inaccuracy in processus coracoideus and clavicle duct often cause processus coracoideus and clavicular fracture; Repeatedly hole excessive to duct, easily make Endobutton steel plate skid off from tunnel; Because there is the important feature such as brachial plexus nerve and axillary artery inside processus coracoideus, in art, the operation of processus coracoideus side may injure these important feature of adjoining; Dimensional measurement difficulty when button loop ring is selected, or the non-anatomical reduction of acromioclavicular joint, all can cause button loop ring size select bigger than normal and occur postoperative subluxation, reduce postoperative effect.Though there is supervision in the capable art of report application arthroscope improve operation precision and reduce intraoperative compliaction, the method is then more strict to the requirement of patient, is difficult to universal.Therefore, we are by repeatedly practising and groping in clinical, think and be necessary very much independent research and design a set of Wicresoft acromioclavicular joint reposition and fixing stereotactic system, operative incision can be made to foreshorten to 2.5-3.5cm, the disposable boring completing acromioclavicular joint reposition and processus coracoideus, clavicle bone road, brachial plexus nerve and axillary artery is not touched in art, accurately can measure required button loop ring length, thus make operation process safer, more simplify, the obvious shortening operating time, to ensure while surgical effect and to be easier to grasp and extensively promote in grass-roots unit.
Utility model content
First object of the present utility model is to provide the clamp acromioclavicular joint reposition guidance system of the reset that disposablely can complete acromioclavicular joint and processus coracoideus, interclavicular " centralization linear bore ".
For realizing above object, this utility model discloses following technical scheme: clamp acromioclavicular joint reposition guidance system, comprise processus coracoideus side pincers, clavicle side pincers and handle, it is characterized in that, processus coracoideus side pincers pincers point arranges a spherical base, forms the sharp sample projection of a cone in described spherical base surface contact processus coracoideus side, and clavicle side pincers pincers point arranges a rotatable hollow guiding device.
As a preferred version, described rotatable hollow guiding device comprises rotatable fixing joint and pilot sleeve, described rotatable fixing joint is provided with screw thread, there are a nut and threaded engagement, rotatable fixing joint side and clavicle side are clamped tip clamp part position and are connected, and opposite side is connected with pilot sleeve.
As a preferred version, pilot sleeve can hold guide pin to be passed through, and it points to the sharp sample projection of cone.
As a preferred version, in the middle of two handles, rule is set.
The utility model has the advantage of: (1) disposable completes the reset of acromioclavicular joint and processus coracoideus, interclavicular " centralization linear bore "; (2) drilling guide is to accurately, avoids the fracture of processus coracoideus, clavicle; (3) drilling guide is to spherical designs that is accurate and processus coracoideus clamp end, avoids the damage of important blood vessels nerve inside processus coracoideus in art; (4) by the rule of clamp far-end, accurately measure the spacing of clavicle and processus coracoideus in the mode of " external pelivimetry ", thus select the appropriate length of the button loop ring needed for replacement and fixation; (5) instrumentation is simple and direct, safety, is reduced to by operation wound minimum, achieves real " Wicresoft "; (6) instrumentation is easy to grasp, and is conducive to extensively promoting at different medical unit.
Accompanying drawing explanation
Fig. 1 is the structural representation of this utility model clamp acromioclavicular joint reposition guidance system.
Label in diagram is:
1---processus coracoideus side is clamped; 11---processus coracoideus side pincers pincers point; 12---spherical base; 13---bore sharp sample projection; 2---clavicle side is clamped; 21---clavicle side pincers pincers point; 22---rotatable hollow guiding device; 221---rotatable fixing joint, 222---pilot sleeve; 3---hands handle; 31---rule.
Detailed description of the invention
Below in conjunction with specific embodiment, set forth this utility model further.The experimental technique used in following embodiment if no special instructions, is conventional method.Material used in following embodiment, reagent etc., if no special instructions, all can obtain from commercial channels.Should be understood that these embodiments are only not used in restriction scope of the present utility model for illustration of this utility model.
Embodiment 1.
Refer to Fig. 1, clamp acromioclavicular joint reposition guidance system comprises processus coracoideus side pincers 1, clavicle side pincers 2 and handle 3, processus coracoideus side pincers pincers point 11 arranges a spherical base 12, form the sharp sample projection 13 of a cone in described spherical base surface contact processus coracoideus side, clavicle side pincers pincers point 21 arranges a rotatable hollow guiding device 22.
Rotatable hollow guiding device 22 comprises rotatable fixing joint 221 and pilot sleeve 222, described rotatable fixing joint 221 is provided with screw thread, there are a nut and threaded engagement, rotatable fixing joint 221 side is clamped tip clamp part position with clavicle side and is connected, and opposite side is connected with pilot sleeve 222.The guide pin that pilot sleeve 222 can hold 2.0mm passes through, and it points to the sharp sample projection of cone.
In the middle of two handles, rule 31 is set.
The treatment of acromioclavicular joint dislocation, first be namely the normal relationship in a mutual action of the acromioclavicular joint recovering to have dislocated resets, the correspondingly clear-cutting forestland normal anatomical relationship of clavicle and processus coracoideus, and then hole on clavicle and processus coracoideus, put into implants, thus reach the effect maintaining and reset.Therefore, to reset clinically at present and boring is distinct two steps, first reset and hole again.And for completing boring, first must apply 2-3 piece of draw point and playing temporary fixed and effect that is reset joint through joint.This will inevitably cause damage to joint and corresponding skeleton, and along having grown operating time.
Processus coracoideus is positioned at inside acromioclavicular joint, distance about 3cm.Clamp acromioclavicular joint reposition guidance system of the present utility model, can the upper surface of direct clamp corresponding clavicle above processus coracoideus bottom and its, sclerotin is hard herein, directly can apply external force clamping, thus complete the reset of acromioclavicular joint when not needing interference joint and corresponding epiphysis; Then, then pass through corresponding hole-drilling system, complete boring simultaneously.So namely, disposable completing resets and the operation of boring, has both avoided acromioclavicular joint and the damage of skeleton around it, and in turn simplify step, obviously shorten operating time.
The position that " centralization linear bore " namely holes normally should be positioned at the center of processus coracoideus substrate and clavicle upper surface, and holes is on same straight line.If duct off-center is even positioned at edge, then very easily cause fracture.In current clinical treatment, because clavicle can directly expose, namely generally can ensure the centralization in clavicle duct, therefore clavicular fracture probability is very low; But, due to the dark and out-of-shape in processus coracoideus position, boring is made to be positioned at the method for processus coracoideus base center mainly by the technology feel of patient in clinical at present, need in art repeatedly to hole to reach desirable position more, and can be less for fixing bone volume, repeatedly boring to processus coracoideus damage greatly, will inevitably have a strong impact on the anti-tractive intensity of boring metacoracoid, therefore the probability of fracture of coracoid process of scapula on average up to 20%, can become postoperative failed one of the main reasons.In addition, if holes does not form straight line, fixing will inevitably to be formed " deflection angle " in one of passed through duct with button loop rope, postoperative in upper limb activity button loop rope repeatedly to rub the edge of cell walls or gateway, duct, cause button loop to restrict final fracture, operative failure.
This utility model clamp acromioclavicular joint reposition guidance system fully takes into account above-mentioned art risk main points:
(1) substrate design of processus coracoideus side pincers pincers point is spherical base, spherical surface contact processus coracoideus side forms a little cone point sample projection, being touched by spherical base in such art to confirm in processus coracoideus after lateral border, then be easy to the center of orienting processus coracoideus substrate, then rely on the cone on spherical base surface point sample to be projected on center and to form effective clamping.
(2) side of clavicle side pincers pincers point, the rotatable hollow guiding device of composite design one, the guide pin that pilot sleeve can hold 2.0mm passes through, and it points to the sharp sample projection of cone.
Therefore, when processus coracoideus side, pincers pincers point is positioned at processus coracoideus base center, and clavicle side pilot sleeve is positioned at clavicle upper surface center, is naturally namely formed " centralization linear bore " through the boring of pilot sleeve to processus coracoideus side pincers pincers pointed cone point sample projection.
Processus coracoideus medial wall has the important feature such as brachial plexus nerve and axil arteriovenous, and the damage of brachial plexus nerve can cause sensation and the dyskinesia of homonymy upper limb; The arteriovenous damage of axil then can cause that accidental haemorrhage in homonymy upper limb circulatory disturbance, art is more even causes hemorrhagic shock and lethal.In current clinical treatment, can only by the accidental injury fully reporting the important feature exposed inside processus coracoideus to avoid in art, this will inevitably increase corresponding soft tissue injury, also may cause the accidental injury of neurovascular structure in the process simultaneously appeared.
The substrate of this utility model clamp acromioclavicular joint reposition guidance system processus coracoideus side pincers pincers point is spherical designs, bores the side that sharp sample projection is positioned at spherical surface contact processus coracoideus, and for the spherical structure of smooth bumps effectively can protect the vital tissue of inner side inside it.In addition, as mentioned above accurate drilling guide device, when also can avoid completely holing, guide pin slides to inner side and accidentally injures important neurovascular structure, guarantees to protect the important feature such as the brachial plexus nerve that adjoins processus coracoideus medial wall and axillary artery.
Namely distance between clavicle and processus coracoideus duct collar extension is the length of required button loop ring, clavicle and processus coracoideus is bundled, recover the anatomy relationship of clavicle and processus coracoideus, thus maintain the reset of acromioclavicular joint by this button loop ring.If selected button loop ring is partially long, the postoperative subluxation that namely there will be acromioclavicular joint; If selected button loop ring is partially short, postoperatively occur that because of the excessive reset of acromioclavicular joint shoulder is uncomfortable, even in art, namely the binding that cannot complete between clavicle and processus coracoideus is fixed.Therefore, accurately measure the distance between clavicle and processus coracoideus, select suitable button loop ring length, especially most important to postoperative effect.Clinically at present be measured as duct " interior measurement " technology, namely apply depth scale and pass clavicle to processus coracoideus, carry out the distance between measuring holes collar extension.The soft tissue of processus coracoideus substrate, processus coracoideus and interclavicular soft tissue, the direction in duct and duct inwall often can make dipstick cannot be anchored in the edge of duct outlet or make dipstick generation deformation, cause affecting the accuracy measured.
This utility model clamp acromioclavicular joint reposition guidance system adopts " external pelivimetry " technology, namely in the handle side of type acromioclavicular joint reposition guidance system, rule is installed, when after clamp reset clavicle and processus coracoideus, the rule got final product distally directly reads the distance between clavicle and processus coracoideus, the exact length of required button loop ring can be obtained so accurately, thus ensure that postoperative effect.
Routine operation operates, for reset acromioclavicular joint, accurate location clavicle, processus coracoideus and boring and avoid neurovascular damage important inside processus coracoideus, need fully to appear acromioclavicular joint, clavicle and processus coracoideus in art, therefore skin incision from acromioclavicular joint along clavicle inwardly to its processus coracoideus opposite position, nearlyer 90 degree of arcs distally inside processus coracoideus until processus coracoideus substrate distally is about about 2cm.This otch is inverted "L" shaped, is generally about 10-12cm, can cause obvious impact to outward appearance, especially to cicatrix body constitution person.
Application this utility model clamp acromioclavicular joint reposition guidance system, according to above-mentioned use principle, only need set up the transverse direction " window " of 3 1cm: acromioclavicular joint window, the situation that assessment resets also is observed in cleaning joint; Clavicle window, upper surface before clavicle, and positioning and guiding sleeve; Processus coracoideus window, in processus coracoideus substrate, places the beak protruding end of clamp.By this 3 window, fully can complete the reset of acromioclavicular joint at the auxiliary lower of apparatus and fix.Therefore, decrease incision length significantly, outward appearance of namely having improved looks.
Traditional operation, the reset of acromioclavicular joint and temporary fixed will be processed respectively, " centralization linear bore " between clavicle and processus coracoideus, measure the distance between clavicle and processus coracoideus and select suitable button loop ring length, will take into account simultaneously and avoid the important blood vessel of damage and neuromechanism, therefore operating process is complicated, and difficulty is larger, operating time is longer, is unsuitable for applying at basic hospital.Application this utility model clamp acromioclavicular joint reposition guidance system, can in less mini-incision, and disposable safe completes embolia effectively, centralization linear bore and range finding.Thus, make whole operation obviously simple and direct, be easy to grasp, favourablely extensively promote in grass-roots unit.
The above is only preferred implementation of the present utility model; it should be pointed out that for those skilled in the art, under the prerequisite not departing from this utility model principle; can also make some improvements and modifications, these improvements and modifications also should be considered as protection domain of the present utility model.
Claims (4)
1. clamp acromioclavicular joint reposition guidance system, comprises processus coracoideus side pincers, clavicle side pincers and handle, it is characterized in that, processus coracoideus side pincers pincers point arranges a spherical base, forms the sharp sample projection of a cone in described spherical base surface contact processus coracoideus side, and clavicle side pincers pincers point arranges a rotatable hollow guiding device.
2. clamp acromioclavicular joint reposition guidance system according to claim 1, it is characterized in that, described rotatable hollow guiding device comprises rotatable fixing joint and pilot sleeve, described rotatable fixing joint is provided with screw thread, there are a nut and threaded engagement, rotatable fixing joint side and clavicle side are clamped tip clamp part position and are connected, and opposite side is connected with pilot sleeve.
3. clamp acromioclavicular joint reposition guidance system according to claim 1, is characterized in that, pilot sleeve can hold guide pin to be passed through, and it points to the sharp sample projection of cone.
4. clamp acromioclavicular joint reposition guidance system according to claim 1, is characterized in that, arranges rule in the middle of two handles.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201420838240.4U CN204410917U (en) | 2014-12-26 | 2014-12-26 | Clamp acromioclavicular joint reposition guidance system |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201420838240.4U CN204410917U (en) | 2014-12-26 | 2014-12-26 | Clamp acromioclavicular joint reposition guidance system |
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| CN204410917U true CN204410917U (en) | 2015-06-24 |
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| CN201420838240.4U Expired - Fee Related CN204410917U (en) | 2014-12-26 | 2014-12-26 | Clamp acromioclavicular joint reposition guidance system |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104546064A (en) * | 2014-12-26 | 2015-04-29 | 上海交通大学医学院附属第九人民医院 | Clamp-type acromioclavicular joint embolia reduction guiding system |
| CN106955150A (en) * | 2017-03-30 | 2017-07-18 | 马良 | A kind of Orthopeadic Surgery magnetic force is oriented to reseting fixture |
| RU2690611C1 (en) * | 2018-02-01 | 2019-06-04 | Ахметкали Зайнолдаевич Дюсупов | Device for closed reduction of acromial extremity of clavicle dislocation |
| RU2722355C2 (en) * | 2018-02-01 | 2020-05-29 | Ахметкали Зайнолдаевич Дюсупов | Device for reduction and retention of bone fragments of spongy bones during their osteosynthesis |
-
2014
- 2014-12-26 CN CN201420838240.4U patent/CN204410917U/en not_active Expired - Fee Related
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104546064A (en) * | 2014-12-26 | 2015-04-29 | 上海交通大学医学院附属第九人民医院 | Clamp-type acromioclavicular joint embolia reduction guiding system |
| CN106955150A (en) * | 2017-03-30 | 2017-07-18 | 马良 | A kind of Orthopeadic Surgery magnetic force is oriented to reseting fixture |
| RU2690611C1 (en) * | 2018-02-01 | 2019-06-04 | Ахметкали Зайнолдаевич Дюсупов | Device for closed reduction of acromial extremity of clavicle dislocation |
| RU2722355C2 (en) * | 2018-02-01 | 2020-05-29 | Ахметкали Зайнолдаевич Дюсупов | Device for reduction and retention of bone fragments of spongy bones during their osteosynthesis |
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Granted publication date: 20150624 Termination date: 20201226 |
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| CF01 | Termination of patent right due to non-payment of annual fee |