CN210019586U - Intramedullary three-dimensional fixing system for calcaneus fracture - Google Patents

Intramedullary three-dimensional fixing system for calcaneus fracture Download PDF

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Publication number
CN210019586U
CN210019586U CN201920363799.9U CN201920363799U CN210019586U CN 210019586 U CN210019586 U CN 210019586U CN 201920363799 U CN201920363799 U CN 201920363799U CN 210019586 U CN210019586 U CN 210019586U
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China
Prior art keywords
guide
hole
nail
guide sleeve
screw group
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Expired - Fee Related
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CN201920363799.9U
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Chinese (zh)
Inventor
马利杰
刘中举
王鑫贵
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Third Hospital of Hebei Medical University
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Third Hospital of Hebei Medical University
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Priority to CN201920363799.9U priority Critical patent/CN210019586U/en
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Publication of CN210019586U publication Critical patent/CN210019586U/en
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Abstract

The utility model discloses an intramedullary three-dimensional fixation system for calcaneal fracture, which relates to the field of medical instruments for orthopedic surgery, and comprises a full-thread hollow screw group, a locking screw group, a first guiding device and a second guiding device; full-thread hollow screw group is including main nail, first supplementary nail and second supplementary nail, and rectangle draw-in groove and locating hole have all been seted up to its afterbody, and the locking perforation has all been seted up to its excircle, and the full-thread hollow screw group of telling is three horn shapes through first guider and squeezes in from the calcaneum rear end, locking screw group includes three locking screw, through the second guider, squeezes in and passes the locking hole from the sole, carries out three-dimensional locking to full-thread hollow screw group. The utility model discloses a three-dimensional fixed in calcaneum inside does not need the large tracts of land to peel off calcaneum surface soft tissue, has reduced the tissue damage of operation, has alleviateed patient's pain greatly, has reduced the risk of skin necrosis to have higher fixed strength, can make the patient carry a burden the training in advance, accelerated the function recovery who suffers from foot.

Description

Intramedullary three-dimensional fixing system for calcaneus fracture
Technical Field
The utility model relates to an orthopedic surgery medical instrument field especially relates to a calcaneus fracture intramedullary three-dimensional fixing system.
Background
An important step in the treatment of calcaneal fractures is the fixation of the fractured portion after restoration. The currently commonly used fixation method is to make an incision in the soft tissue of the foot outside the calcaneus, peel the soft tissue from the bone, place the fixation steel plate at a predetermined position, and then fix and position the fractured calcaneus by using the fixation screw through the fixation hole on the fixation steel plate. The steel sheet is fixed, need wait that patient's fracture position detumescence a week back can be implemented, and the incision is big during the operation, still need to cover the soft tissue on the calcaneus simultaneously and peel off, great to soft tissue and nerve damage, the postoperative is painful serious, and most patients are difficult to bear, still has the difficult healing of wound, risks such as skin necrosis in the postoperative.
SUMMERY OF THE UTILITY MODEL
The technical problem to be solved by the utility model is to provide a calcaneus fracture intramedullary three-dimensional fixing system which can be used for early operation and minimally invasive operation.
In order to solve the technical problem, the utility model discloses the technical scheme who takes is:
an intramedullary three-dimensional fixing system for calcaneal fracture comprises a full-thread hollow screw group, a locking screw group, a first guiding device and a second guiding device.
The full-thread hollow screw group comprises a main screw, a first auxiliary screw and a second auxiliary screw, wherein the tail part of the main screw is provided with a rectangular clamping groove and a positioning hole; two ends of the main nail and the first auxiliary nail are provided with corresponding first through holes; corresponding second through holes are formed in the partial middle positions of the main nail and the second auxiliary nail; the first through hole and the second through hole are at a certain angle, the rectangular clamping groove on the main nail and the first auxiliary nail is parallel to the axis of the first through hole, and the rectangular clamping groove on the second auxiliary nail is parallel to the axis of the second through hole.
The locking screw group comprises three locking screws for three-dimensional locking of the full-thread hollow screw group.
The first guide device comprises a first fixing rod, a first guide sleeve and a second guide sleeve which are arranged in a triangular shape; the first guide sleeve and the second guide sleeve are fixed with the first fixing rod through the first connecting arm.
The front end of the first fixing rod is cylindrical, is matched with the inner hole of the main nail, and is provided with a positioning block matched with the rectangular clamping groove of the main nail. The first guide sleeve and the second guide sleeve are the same in structure, tend to intersect from the guide-in end to the guide-out end, are of columnar structures, and are provided with inner holes for guiding, and the diameters of the inner holes are respectively matched with the outer diameters of the first auxiliary nail and the second auxiliary nail; the leading-out ends of the first guide sleeve and the second guide sleeve are respectively provided with a sensor for sensing the position of a positioning hole on the auxiliary nail; the sensor is also connected with an alarm;
the first connecting arm comprises an upper arm and a lower arm which are hinged and locked through a connecting piece, the upper arm is fixed with the first fixing rod, the lower arm is fixed with the corresponding first guide sleeve or second guide sleeve, and the first guide sleeve and the second guide sleeve can swing and lock around the hinged part along with the lower arm; the upper arm is provided with angle marks which are radially arranged by taking the hinged axis as the center, and the lower arm is provided with a pointer line which can indicate scales;
the second guide device comprises a second fixing rod, a left guide rod and a right guide rod which are arranged in a triangular shape; and the left guide rod and the right guide rod are fixed with a second fixing rod through a second connecting arm.
The second fixing rod has the same structure as the first fixing rod.
And guide holes for guiding the locking screws are formed in the left guide rod and the right guide rod.
The structure of the second connecting arm is the same as that of the first connecting arm, the open angle of the second connecting arm is the same as that of the first connecting arm, the upper arm in the second connecting arm is fixed with the second fixing rod, and the lower arm in the second connecting arm is fixed with the corresponding left guide rod or right guide rod.
When the swing angles of the left guide rod and the first guide sleeve are the same, the guide hole on the left guide rod is matched with the first through hole.
When the swing angles of the right guide rod and the second guide sleeve are the same, the guide hole on the right guide rod is matched with the second through hole.
The further technical scheme is as follows: the connecting piece comprises a pin shaft and a nut; the bottom of the pin shaft is provided with external straight teeth, the end part of the pin shaft is provided with external threads, the lower arm is hinged to the bottom of the pin shaft, and a hinge hole of the lower arm is provided with internal straight teeth matched with the pin shaft; the nut is screwed at the end part of the pin shaft and pressed on the lower arm.
The further technical scheme is as follows: the end face of the nut, which is attached to the lower arm, is provided with anti-skid grains.
The further technical scheme is as follows: the full-thread hollow screw group, the locking screw group, the first guiding device and the second guiding device are all made of titanium alloy.
The further technical scheme is as follows: the length of the guide holes in the left guide rod and the right guide rod is greater than 20 mm.
The further technical scheme is as follows: the alarm is a sound, light or audible and visual alarm.
Adopt the produced beneficial effect of above-mentioned technical scheme to lie in:
by adopting the small incision minimally invasive surgery, the soft tissue stripping of the calcaneus of the patient is avoided, the pain of the patient is relieved, and the risk of non-healing of the wound and skin necrosis is reduced.
Can be used for early operation without waiting for detumescence of the affected foot, and shortens the treatment period.
Adopts intramedullary three-dimensional fixation, has firm fixation, can carry weight training in advance, and accelerates the functional recovery of the affected foot.
Drawings
The present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.
FIG. 1 is a schematic view of a three-dimensional support structure for screws in the calcaneus of the present invention;
fig. 2 is a schematic structural view of the first guiding device of the present invention;
fig. 3 is a schematic structural view of a second guiding device according to the present invention;
fig. 4 is a schematic structural diagram of the connecting member of the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention are clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, not all, embodiments of the present invention. Based on the embodiments in the present invention, all other embodiments obtained by the skilled in the art without creative work belong to the protection scope of the present invention.
In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present invention, but the present invention may be implemented in other ways different from the specific details set forth herein, and one skilled in the art may similarly generalize the present invention without departing from the spirit of the present invention, and therefore the present invention is not limited to the specific embodiments disclosed below.
As shown in fig. 1 to 4, the intramedullary three-dimensional fixation system for the calcaneus fracture comprises a full-thread hollow screw group 1, a locking screw group 2, a first guiding device 3 and a second guiding device 4. The full-thread hollow screw group 1 comprises a main nail 11, a first auxiliary nail 12 and a second auxiliary nail 13, wherein the tail part of the main nail is provided with a rectangular clamping groove 16 and a positioning hole 17; both ends of the main nail 11 and the first auxiliary nail 12 are provided with corresponding first through holes 14; the main nail 11 and the second auxiliary nail 13 are provided with corresponding second through holes 15 at the middle part; the first through hole 14 and the second through hole 15 are at a certain angle, the axes of the rectangular clamping groove 16 on the main nail 11 and the first auxiliary nail 12 are parallel to the axis of the first through hole 14, and the axes of the rectangular clamping groove 16 on the second auxiliary nail 13 are parallel to the axis of the second through hole 15. The locking screw group 2 comprises three locking screws for three-dimensional locking of the full-thread hollow screw group 1.
The first guiding device 3 comprises a first fixing rod 31, a first guiding sleeve 32 and a second guiding sleeve 33 which are arranged in a triangular shape; the first guide sleeve 32 and the second guide sleeve 33 are fixed to the first fixing lever 31 by the first connection arm 34. The front end of the first fixing rod 31 is cylindrical and is matched with the inner hole of the main nail 11, and a positioning block 311 matched with the rectangular clamping groove 16 of the main nail 11 is arranged. The first guide sleeve 32 and the second guide sleeve 33 have the same structure, are in an intersecting trend from a guide-in end to a guide-out end, are in a columnar structure, and have inner holes for guiding, and the diameters of the inner holes are respectively matched with the outer diameters of the first auxiliary nail 12 and the second auxiliary nail 13; the leading-out ends of the first guide sleeve 32 and the second guide sleeve 33 are respectively provided with a sensor for sensing the position of the positioning hole 17 on the auxiliary nail; the sensor is also connected with an alarm. The first connecting arm 34 comprises an upper arm 341 and a lower arm 342 which are hinged and locked through a connecting piece 35, the upper arm 341 and the first fixing rod 31 are fixed, the lower arm 342 is fixed with the corresponding first guide sleeve 32 or the second guide sleeve 33, and the first guide sleeve 32 and the second guide sleeve 33 can swing and lock around the hinged part along with the lower arm 342; the upper arm 341 has angular graduations radially disposed about the axis of the hinge, and the lower arm 342 has a pointer line indicating the graduation.
The second guide means 4 includes a second fixing bar 41, a left guide bar 42 and a right guide bar 43 arranged in a triangle; the left guide rod 42 and the right guide rod 43 are fixed to the second fixing rod 41 by a second connecting arm 44. The second fixing lever 41 has the same structure as the first fixing lever 31. The left guide rod 42 and the right guide rod 43 are both provided with guide holes for guiding the locking screws. The second connecting arm 44 has the same structure as the first connecting arm 34, and the opening angle of the second connecting arm 44 is the same as the opening angle of the first connecting arm 34, an upper arm of the second connecting arm 44 is fixed to the second fixing lever 41, and a lower arm of the second connecting arm 44 is fixed to the corresponding left guide lever 42 or right guide lever 43.
When the left guide rod 42 and the first guide sleeve 32 have the same swing angle, the guide hole is matched with the first through hole 14. When the right guide rod 43 and the second guide sleeve 33 have the same swing angle, the guide hole is matched with the second through hole 15.
When the main nail driving device is used, the main nail 11 is firstly driven into the heel from the rear part of the heel along the outer side of the calcaneus axis through skin, and the main nail 11 is manually rotated by using a tool after the main nail is driven into the heel, so that the lower end of the rectangular clamping groove 16 on the main nail inclines towards the outer side of the calcaneus axis.
The first guide 3 is then used to drive the first auxiliary nail 12 and the second auxiliary nail 13 into the calcaneus, the steps of use of the first guide 3 being as follows:
firstly, inserting a first fixing rod 31 of a first guiding device 3 into an inner hole of a main nail 11, and embedding a positioning block 311 into a rectangular clamping groove 16 of the main nail 11;
secondly, according to the size of the calcaneus of the patient and the position of the fracture, the vertical swing angles of the first guide sleeve 32 and the second guide sleeve 33 are adjusted through the connecting piece 35, so that the lower arm 342 in the first connecting arm 34 rotates along the connecting piece 35 to change the included angle between the upper arm 341 and the lower arm 342, the lower arm 342 drives the pointer line to rotate in the process, and after the swing angles are adjusted, the connecting piece 35 is used for locking the two first connecting arms 34, so that the guiding states of the first guide sleeve 32 and the second guide sleeve 33 are fixed;
thirdly, observing and recording scales indicated by the pointer lines on the two first connecting arms 34, namely the final swinging angles of the first guide sleeve 32 and the second guide sleeve 33;
fourthly, percutaneously driving the first auxiliary nail 12 and the second auxiliary nail 13 along the first guide sleeve 32 and the second guide sleeve 33 respectively, so that the first auxiliary nail 12 and the second auxiliary nail 13 penetrate most of the broken bone pieces and are converged toward the front end of the main nail 11 along the first guide sleeve 32 and the second guide sleeve 33;
fifthly, when the front ends of the first auxiliary nail 12 and the second auxiliary nail 13 are to be aligned with the front end of the main nail 11, the hand tool is replaced, the first auxiliary nail 12 and the second auxiliary nail 13 rotate slowly respectively, the corresponding sensor can monitor the position of the positioning hole 17 at the tail of the first auxiliary nail 12 or the second auxiliary nail 13 in real time, when the sensor monitors the positioning hole 17, the sensor can send a feedback signal to the alarm, the alarm can send an alarm to indicate that the first auxiliary nail 12 or the second auxiliary nail 13 of the doctor rotates to the position.
When the first auxiliary nail 12 and the second auxiliary nail 13 rotate to the right position, the main nail 11, the first auxiliary nail 12 and the second auxiliary nail 13 are parallel and level in the front and back direction in the length direction and are arranged in an unequal triangular manner, the first auxiliary nail 12 and the second auxiliary nail 13 are in a state of converging towards the main nail 11, the main nail 11 and the first auxiliary nail 12 are both positioned at the outer side of the axis of the calcaneus, the second auxiliary nail 13 is positioned at the inner side of the axis of the calcaneus, and the first through holes 14 arranged at two ends of the main nail 11 and the first auxiliary nail 12 are correspondingly aligned; the second perforations 15 provided in the offset of the main nail 11 and the second auxiliary nail 13 will be aligned accordingly.
The first guide means 3 can then be removed and replaced by the second guide means 4 for guiding the locking screw set 2. The use steps of the second guiding device 4 are as follows:
firstly, inserting a second fixing rod 41 of a second guiding device 4 into an inner hole of a main nail 11, and embedding a positioning block on the second fixing rod into a rectangular clamping groove 16 of the main nail 11 in place;
secondly, adjusting the swinging angles of the left guide rod 42 and the first guide sleeve 32 to be the same and the swinging angles of the right guide rod 43 and the second guide sleeve 33 to be the same according to the recorded final swinging angles of the first guide sleeve 32 and the second guide sleeve 33, and locking two second connecting arms 44 by using a connecting piece 35 to ensure that a guide hole on the left guide rod 42 is matched with the first through hole 14 and a guide hole on the right guide rod 43 is matched with the second through hole 15;
thirdly, three locking screws are respectively driven into the first through hole 14 and the second through hole 15 from the sole along the guide holes of the left guide rod 42 and the right guide rod 43, and the main nail 11, the first auxiliary nail 12 and the second auxiliary nail 13 are three-dimensionally locked;
and fourthly, removing the second guiding device 4 to complete the operation of the intramedullary three-dimensional fixation of the calcaneus fracture.
At the moment, the full-thread hollow screw group 1 and the locking screw group 2 form a triangular three-dimensional structure with a small front end and a large rear end inside the fractured calcaneus, and the fractured calcaneus can be reliably fixed.
Because the calcaneus is a bone body mainly made of cancellous bone and has poor mechanical strength after being decomposed into fragments, the calcaneus is fixed by adopting the full-thread hollow screw, and the fixing effect of the screw and the calcaneus is enhanced.
The full-thread hollow screw group 1 is driven into the length capable of penetrating through the whole calcaneus from the rear end of the calcaneus, and the natural length of the calcaneus can be effectively recovered.
In addition, because the shapes, the number, the sizes and the spatial positions of fracture blocks of different patients are different, the independent full-thread hollow screws cannot achieve reliable fixing effect, and the screws can be conveniently interlocked with each other by utilizing the interlocking screw principle and the guide device to form a three-dimensional frame, so that the fractured calcaneus is reliably fixed inside.
The connecting member 35 includes a pin 351 and a nut 352; the bottom of the pin 351 is provided with external straight teeth, the end part of the pin is provided with external threads, the lower arm 342 is hinged at the bottom of the pin 351, and a hinge hole of the lower arm is provided with internal straight teeth matched with the pin 351; a nut 352 is threaded onto the end of the pin 351 and bears against the lower arm 342.
During the use, separate lower arm 342 and upper arm 341, make the pointer line of lower arm 342 and the corresponding angle scale line of upper arm 341 align according to required angle, overlap lower arm 342 to round pin 351 on, the internal tooth is interlock with the external tooth, can effectively prevent uide bushing and guide bar at the deflection of nailing in-process, then fixed through nut 352, can avoid lower arm 342 along round pin 351 axis drunkenness. This structure thus achieves reliable positioning and locking of the upper and lower arms 341 and 342.
The end surface of nut 352 that engages lower arm 342 is provided with anti-slip threads. The anti-slip thread effectively improves the locking reliability of the upper arm 341 and the lower arm 342.
The full-thread hollow screw group 1, the locking screw group 2, the first guiding device 3 and the second guiding device 4 are all made of titanium alloy. Because the titanium alloy has high strength, light weight, corrosion resistance and mechanical properties close to those of human bones.
In order to ensure reliable guiding, the length of the guide holes on the left guide rod 42 and the right guide rod 43 is more than 20 mm.
In order to ensure that the first auxiliary nail 12 and the second auxiliary nail 13 can reliably alarm when rotating in place, the alarm is an audible, optical or audible and visual alarm.
The utility model discloses an adopt the fix with screw, but the operation of wicresoft does not need the large tracts of land to peel off calcaneus surface soft tissue, has reduced the tissue damage of operation, has alleviateed patient's pain greatly, has reduced the risk of skin necrosis.
The utility model discloses an with adopting screw group three-dimensional fixed in calcaneum marrow, have higher fracture fixation intensity, can make the patient carry a burden the training in advance for suffer from sufficient function recovery.
The above is only the preferred embodiment of the present invention, and any person can make some simple modifications, deformations and equivalent replacements according to the present invention, all fall into the protection scope of the present invention.

Claims (6)

1. The intramedullary three-dimensional fixing system for calcaneus fracture is characterized in that: comprises a full-thread hollow screw group (1), a locking screw group (2), a first guiding device (3) and a second guiding device (4);
the full-thread hollow screw group (1) comprises a main screw (11), a first auxiliary screw (12) and a second auxiliary screw (13), wherein the tail part of the main screw is provided with a rectangular clamping groove (16) and a positioning hole (17); two ends of the main nail (11) and the first auxiliary nail (12) are provided with corresponding first through holes (14); the main nail (11) and the second auxiliary nail (13) are provided with corresponding second through holes (15) at the middle part; the first through hole (14) and the second through hole (15) form a certain angle, the rectangular clamping grooves (16) on the main nail (11) and the first auxiliary nail (12) are parallel to the axis of the first through hole (14), and the rectangular clamping grooves (16) on the second auxiliary nail (13) are parallel to the axis of the second through hole (15);
the locking screw group (2) comprises three locking screws and is used for carrying out three-dimensional locking on the full-thread hollow screw group (1);
the first guide device (3) comprises a first fixing rod (31), a first guide sleeve (32) and a second guide sleeve (33) which are arranged in a triangular shape; the first guide sleeve (32) and the second guide sleeve (33) are fixed with the first fixing rod (31) through a first connecting arm (34);
the front end of the first fixing rod (31) is cylindrical, is matched with an inner hole of the main nail (11), and is provided with a positioning block (311) matched with a rectangular clamping groove (16) of the main nail (11);
the first guide sleeve (32) and the second guide sleeve (33) are identical in structure, tend to intersect from the guide-in end to the guide-out end, are of columnar structures and are provided with inner holes for guiding, and the diameters of the inner holes are respectively matched with the outer diameters of the first auxiliary nail (12) and the second auxiliary nail (13); the leading-out ends of the first guide sleeve (32) and the second guide sleeve (33) are respectively provided with a sensor for sensing the position of the positioning hole (17) on the auxiliary nail; the sensor is also connected with an alarm;
the first connecting arm (34) comprises an upper arm (341) and a lower arm (342) which are hinged and locked through a connecting piece (35), the upper arm (341) and the first fixing rod (31) are fixed, the lower arm (342) is fixed with a corresponding first guide sleeve (32) or second guide sleeve (33), and the first guide sleeve (32) and the second guide sleeve (33) can swing and lock around the hinged part along with the lower arm (342); the upper arm (341) is provided with angle marks which are radially arranged by taking the hinged axis as the center, and the lower arm (342) is provided with a pointer line which can indicate scales;
the second guide device (4) comprises a second fixing rod (41), a left guide rod (42) and a right guide rod (43) which are arranged in a triangular shape; the left guide rod (42) and the right guide rod (43) are fixed with a second fixing rod (41) through a second connecting arm (44);
the second fixing rod (41) has the same structure as the first fixing rod (31);
the left guide rod (42) and the right guide rod (43) are respectively provided with a guide hole for guiding a locking screw;
the structure of the second connecting arm (44) is the same as that of the first connecting arm (34), the opening angle of the second connecting arm (44) is the same as that of the first connecting arm (34), the upper arm of the second connecting arm (44) is fixed with a second fixing rod (41), and the lower arm of the second connecting arm (44) is fixed with a corresponding left guide rod (42) or right guide rod (43);
when the swing angles of the left guide rod (42) and the first guide sleeve (32) are the same, a guide hole on the left guide rod is matched with the first through hole (14);
when the swing angles of the right guide rod (43) and the second guide sleeve (33) are the same, the guide hole on the right guide rod is matched with the second through hole (15).
2. The intramedullary stereoscopic fixation system for a calcaneus fracture according to claim 1, wherein: the connecting piece (35) comprises a pin shaft (351) and a nut (352); the bottom of the pin shaft (351) is provided with external straight teeth, the end part of the pin shaft is provided with external threads, the lower arm (342) is hinged at the bottom of the pin shaft (351), and a hinge hole of the lower arm is provided with internal straight teeth matched with the pin shaft (351); the nut (352) is screwed at the end part of the pin shaft (351) and pressed on the lower arm (342).
3. The intramedullary stereoscopic fixation system for a calcaneus fracture according to claim 2, wherein: the end face of the nut (352) attached to the lower arm (342) is provided with anti-slip threads.
4. The intramedullary stereoscopic fixation system for a calcaneus fracture according to claim 1, wherein: the full-thread hollow screw group (1), the locking screw group (2), the first guide device (3) and the second guide device (4) are all made of titanium alloy.
5. The intramedullary stereoscopic fixation system for a calcaneus fracture according to claim 1, wherein: the length of the guide holes on the left guide rod (42) and the right guide rod (43) is more than 20 mm.
6. The intramedullary stereoscopic fixation system for a calcaneus fracture according to claim 1, wherein: the alarm is a sound, light or audible and visual alarm.
CN201920363799.9U 2019-03-21 2019-03-21 Intramedullary three-dimensional fixing system for calcaneus fracture Expired - Fee Related CN210019586U (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201920363799.9U CN210019586U (en) 2019-03-21 2019-03-21 Intramedullary three-dimensional fixing system for calcaneus fracture

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN201920363799.9U CN210019586U (en) 2019-03-21 2019-03-21 Intramedullary three-dimensional fixing system for calcaneus fracture

Publications (1)

Publication Number Publication Date
CN210019586U true CN210019586U (en) 2020-02-07

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CN201920363799.9U Expired - Fee Related CN210019586U (en) 2019-03-21 2019-03-21 Intramedullary three-dimensional fixing system for calcaneus fracture

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