CN210095896U

CN210095896U - Metacarpal-phalangeal avulsion fracture reduction threading guide device

Info

Publication number: CN210095896U
Application number: CN201920186238.6U
Authority: CN
Inventors: 赵欣; 桑仲娜; 李津
Original assignee: TIANJIN HOSPITAL TIANJIN CITY
Current assignee: TIANJIN HOSPITAL TIANJIN CITY
Priority date: 2019-02-02
Filing date: 2019-02-02
Publication date: 2020-02-21
Anticipated expiration: 2029-02-02

Abstract

The utility model provides a palm tears to take off fracture and resets needle guide, including right side pincers handle and left side pincers handle, right side pincers handle and left side pincers handle pass through the hinge and articulate, right side pincers handle front end is equipped with right binding clip, left side pincers handle front end is equipped with left binding clip, and left binding clip and right binding clip correspond the setting, and right binding clip outer end is equipped with fixed needle guide head, fixed needle guide head is equipped with the guiding hole for the needle of wearing, left side binding clip outer end is equipped with skin and supports the support, and this skin supports the outer terminal surface of support and is planar structure, the fixed needle guide head for the needle of wearing with skin supports and holds in the palm outer terminal surface just to setting. The metacarpophalangeal avulsion fracture reduction threading guide device is simple in structure, convenient to manufacture and low in cost, can provide ideal needle feeding points and threading angles for kirschner wires (or hollow nail guide needles), further improves the one-time threading success rate, namely improves the threading accuracy, reduces the number of perspective times in an operation and shortens the operation time.

Description

Metacarpal-phalangeal avulsion fracture reduction threading guide device

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to a metacarpophalangeal avulsion fracture reduction puncture needle guider.

Background

The palm and finger bone avulsion fracture is a common case of hand surgery, and the (incision) reduction kirschner wire puncture needle or hollow nail is internally fixed in a commonly adopted treatment mode. However, the conventional resetting and fixing method has certain difficulties: 1. The torn bone pieces are usually attached to the insertion points of ligaments or tendons, and the ligaments or tendons have large pulling resistance during reposition, so that the reposition is difficult, and the alignment relationship is difficult to maintain stably after the reposition is successful. 2. The torn bone pieces are generally attached to ligament or tendon insertion points, the bone pieces are small, if the common vascular forceps are used for resetting and clamping the bone pieces, the exposed area of the surface of the bone pieces for needle threading is small, and a satisfactory needle insertion point is difficult to find; if the bone is fixed by a tissue clamp, the stability of single-point contact with the bone is not good. 3. When the reduction and the maintenance of the alignment are carried out, the iatrogenic damage to the soft skin tissue can be caused if the common vascular forceps or the tissue forceps are used for clamping the contralateral skin. 4. When the needle is penetrated and fixed by the kirschner wire (or the hollow nail guide needle) after satisfactory reset, the requirements on the needle inserting point and the needle penetrating angle are higher: the ideal needle insertion point is the center of the bone block, the ideal needle threading angle is perpendicular to the fracture line, the requirements on experience and technical level of an operator are high, the success rate of needle threading is low, the operator is easy to fatigue, the operation time is easy to prolong, the results of loosening of a kirschner wire, local osteonecrosis, bone absorption, unstable fracture fixation and even bone block crushing can be caused by needle threading for many times, and the damage of X-rays to the bodies of both the doctors and the patients can be increased by repeated fluoroscopy in the operation. Therefore, the method has higher requirements on experience, technology and physical strength of operators.

Disclosure of Invention

In view of the above, the present invention provides a metacarpophalangeal avulsion fracture reduction threading guide device to improve the success rate of reduction and threading during the reduction of bone blocks.

In order to achieve the purpose, the technical scheme of the invention is realized as follows:

the utility model provides a palm finger bone tears to take off fracture reduction threading needle director, includes right side pincers handle and left side pincers handle, and right side pincers handle and left side pincers handle pass through the hinge and articulate, right side pincers handle front end is equipped with right binding clip, left side pincers handle front end is equipped with left binding clip, and left binding clip and right binding clip correspond the setting, and right binding clip outer end is equipped with fixed threading needle direction head, fixed threading needle direction head is equipped with the guiding hole for the threading needle, left side binding clip outer end is equipped with the skin and supports the support, and this skin supports and holds in the palm outer terminal surface and be planar structure, the guiding hole for the threading needle of fixed threading needle direction head with skin supports and holds in the palm outer terminal surface and just to setting up.

Furthermore, the rear parts of the right forceps handle and the left forceps handle are correspondingly provided with forceps handle tooth buckles.

Furthermore, a needle threading guide hole for fixing the needle threading guide head is arranged opposite to the center of the outer end face of the skin support bracket.

Further, a rubber pad is arranged on the outer end face of the skin support bracket.

Furthermore, the skin support is a cone structure with a horizontal central axis, and the center of the bottom surface of the cone is arranged opposite to the fixed needle threading guide head.

Furthermore, a plurality of saw teeth are uniformly distributed on the end face of the fixed needle threading guide head facing the skin support bracket around the needle threading guide hole.

Furthermore, an included angle smaller than 90 degrees is formed between the right forceps handle and the right forceps head.

Furthermore, an angle which is larger than or equal to 90 degrees is formed between the left forceps head and the left forceps handle.

Furthermore, the right forceps handle is positioned between the hinge shaft and the right forceps head, and the left forceps handle is positioned between the hinge shaft and the right forceps head and is respectively of a curved handle structure protruding towards the center line direction of the guider.

Furthermore, the rear ends of the right forceps handle and the left forceps handle are respectively provided with a finger ring.

Compared with the prior art, the metacarpal-phalangeal avulsion fracture reduction threading guide device has the following advantages:

(1) the invention has simple structure, convenient manufacture and low cost. The torn bone pieces can be stably maintained in alignment after being reset, and meanwhile, iatrogenic injury to skin soft tissues is avoided; can provide ideal needle inserting points and needle threading angles for the Kirschner wire (or the hollow nail guide needle), further improve the one-time needle threading success rate, namely improve the needle threading accuracy, reduce the number of perspective times in the operation and shorten the operation time.

(2) The invention creates the disclosed palm and finger bone avulsion fracture reduction threading guide device, which can improve the one-time threading success rate, reduce the dependence on the skill and experience of an operator and reduce the damage of X-ray to the bodies of doctors and patients in the operation.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description, serve to explain the invention without limitation. In the drawings:

fig. 1 is a schematic structural view of a metacarpophalangeal avulsion fracture reduction threading needle guide according to the embodiment;

fig. 2 is a schematic structural view of a fixing threading needle guide head in the metacarpophalangeal avulsion fracture reduction threading needle guide device according to the embodiment;

FIG. 3 is a view illustrating an application state of a metacarpophalangeal avulsion fracture reduction threading needle guider according to the embodiment;

FIG. 4 is a schematic view of the stress on a bone block during an operation using the metacarpophalangeal avulsion fracture reduction threading needle guider according to the embodiment;

FIG. 5 is a schematic view of the bone block being stressed during a surgical operation using a conventional tissue clamp;

fig. 6 is a schematic diagram of the stress on a bone block during a conventional vascular clamp operation.

Description of reference numerals:

1-right forceps handle; 101-right forceps head; 2-left forceps handle; 201-left binding clip; 3, fixing a needle threading guide head; 31-a saw tooth structure; 4-skin support tray; 5-rubber pad; 6-buckling the clamp handle; 7-a finger ring; 8-a hinge shaft; 9-backbone; 10-avulsion of fracture pieces; 11-k-wire; 12-bone block needle insertion point; 14-a first force point; 15-a second force point; 16-third force point.

Detailed Description

It should be noted that the embodiments and features of the embodiments of the present invention may be combined with each other without conflict.

In the description of the present invention, it is to be understood that the terms "central," "longitudinal," "lateral," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are used in the orientation or positional relationship indicated in the drawings, which are merely for convenience in describing the invention and to simplify the description, and are not intended to indicate or imply that the referenced device or element must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be construed as limiting the invention. Furthermore, the terms "first", "second", etc. are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first," "second," etc. may explicitly or implicitly include one or more of that feature. In the description of the invention, the meaning of "a plurality" is two or more unless otherwise specified.

In the description of the invention, it is to be noted that, unless otherwise explicitly specified or limited, the terms "mounted", "connected" and "connected" are to be construed broadly, e.g. as being fixed or detachable or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the creation of the present invention can be understood by those of ordinary skill in the art through specific situations.

The invention will be described in detail with reference to the following embodiments with reference to the attached drawings.

As shown in fig. 1 and 2, a metacarpal-phalangeal avulsion fracture reduction threading guide device comprises a right forceps handle 1 and a left forceps handle 2, wherein the right forceps handle 1 and the left forceps handle 2 are hinged through a hinge shaft 8, a right forceps head 101 is arranged at the front end of the right forceps handle 1, a left forceps head 201 is arranged at the front end of the left forceps handle 2, the left forceps head 201 and the right forceps head 101 are correspondingly arranged, a fixed threading guide head 3 is arranged at the outer end of the right forceps head 101, a threading guide hole is arranged in the fixed threading guide head 3, a skin support tray 4 is arranged at the outer end of the left forceps head 201, the outer end surface of the skin support tray 4 is of a planar structure, and the threading guide hole in the fixed threading guide head 3 is opposite to the outer end surface of the skin support tray 4. Preferably, the skin support bracket 4 is a cone structure with a horizontal central axis, and the bottom surface of the cone is arranged opposite to the fixed needle threading guide head 3; the end surface of the fixed needle threading guide head 3 facing the skin support bracket 4 is uniformly distributed with a plurality of saw teeth 31 around the needle threading guide hole; preferably, one end of the fixed threading needle guide head 3, which is opposite to the skin support bracket 4, is protruded out of the outer end of the right forceps head 101. In this embodiment, the fixed needle threading guide head 3 is preferably a cylindrical structure, but of course, the fixed needle threading guide head 3 may also be a circular truncated cone or a cone structure with a horizontal center line and a concentric center line, where the center line is a central hole, and the central hole is a needle threading guide hole, and the diameter of the needle threading guide hole is set corresponding to the diameter of a kirschner wire or other medical needle threading. In this embodiment, the outer end surface of the skin support 4 is provided with a rubber pad 5, which is used for protecting the skin when the force is applied and pressurized in the opposite direction of the fixed guide head. In this embodiment, the rear portions of the right forceps handle 1 and the left forceps handle 2 are correspondingly provided with forceps handle tooth buckles 6 so as to enhance the stability of fixation of the guide device after the avulsion fracture block 10 is reset. In the embodiment, in order to further hold and control the guider, the rear ends of the right forceps handle 1 and the left forceps handle 2 are respectively provided with a finger ring 7; the operator can hold the two finger rings 7 and perform the operation. The operation process is that as shown in figure 3, when in use, the avulsion fracture block 10 is reset on the backbone 9, the fixing puncture needle guide head 3 is pressed on the avulsion fracture block 10, the skin support bracket 4 is arranged outside the contralateral cortex of the wound, at the moment, the fixing puncture needle guide head 3 and the skin support bracket 4 are enabled to exert pressure in opposite directions to clamp and fix the avulsion fracture block 10, and the forceps handle tooth buckle 6 is locked after the resetting is satisfied, because the fixing puncture needle guide head 3 is in a cylindrical structure, the end surface of the fixing puncture needle guide head 3 facing the skin support bracket 4 is uniformly distributed with a plurality of saw teeth 31 around the puncture needle guide hole thereof, as shown in figure 4, because the contact of the fixing puncture needle guide head 3 and the fixing avulsion fracture block 10 is in a multi-point uniform contact pressure distributed in a circumference, a plurality of first stress points 14 of the avulsion fracture block 10 are arranged, and the plurality of first stress points 14 are arranged around the center of the fixing puncture needle guide point 12 of the avulsion fracture block 10, the contact stress mode is stable and balanced, and the bone block is not easy to turn over, shift and crack. The rubber pad 5 contacted with the skin can not cause blunt or sharp injury to the skin soft tissue, an operator can apply enough force to pressurize, the forceps handle tooth buckle 6 is locked after the counterpoint is satisfactory and the pressurizing and fixing are firm, the kirschner wire is inserted into the central hole of the hollow guider 3, namely, the tip of the kirschner wire 11 (or the hollow nail guide wire) is inserted into the central hole of the fixed threading guide head 3 to carry out threading and fixing operation on the torn fracture block 10, and the satisfactory internal fixing effect can be obtained. The operation results are as follows: the puncture is successful once, only one fluoroscopy is needed during the operation, the operation time is only 25 minutes, and the operator has no obvious fatigue; the finger body swelling after operation is light, the pain of the patient is light, and no pain killer is applied.

In the conventional bone block reduction operation, tissue forceps or a conventional blood vessel are commonly used for reducing the bone block into a fixed bone block, the stress state of the bone block is shown in fig. 5 when the tissue forceps is used, the occupied area of the tip part of the head part of the tissue forceps is small, the influence on the selection of the needle feeding point is small, but the tissue forceps and the bone block are only in single-point contact, namely, the second stress point 15 is a point when the avulsion fracture block 10 is reduced, the second stress point 15 is positioned at the side of the needle feeding point 12 of the avulsion fracture block 10, the stability of the single-point reduction fixing mode of the avulsion fracture block 10 is poor, so the avulsion fracture block 10 is easy to displace again, the reduction operation needs to be repeatedly carried out, the satisfactory alignment and the stability are difficult to obtain, when the stable fracture alignment cannot be obtained by repeatedly trying the reduction, only pressure can be increased, and the skin of the soft tissues on the opposite; when conventional vascular forceps are used as shown in fig. 6, blunt jaw trauma to the contralateral cutaneous soft tissue is also present, whereas if the surgeon is not dared to apply sufficient force to reduce trauma to the cutaneous soft tissue, it may be difficult to obtain sufficient force to maintain alignment of the bone pieces. Meanwhile, even if the head of the vascular forceps for clamping the avulsion fracture block 10 is larger than the avulsion fracture block after the fracture block is satisfactorily reset, the area of the third stress point 16 occupies larger area of the surface of the fracture block when the avulsion fracture block 10 is reset and fixed (the characteristic is determined by the structure of the forceps head of the hemostatic forceps), so that an operator cannot obtain an ideal needle inserting point 12 positioned in the center of the avulsion fracture block 10 in the next needle inserting step, thereby increasing the difficulty for needle inserting.

In this embodiment, the right forceps handle 1 and the left forceps handle 2 are respectively in a curved handle structure protruding towards the center line direction of the guider, wherein the curved handle structure is positioned between the hinge shaft 8 and the right forceps head 101, and the curved handle structure is positioned between the hinge shaft 8 and the right forceps head 101; an included angle smaller than 90 degrees is formed between the right forceps handle 1 and the right forceps head 101; an angle larger than or equal to 90 degrees is formed between the left forceps head 201 and the left forceps handle 2.

The above description is only for the purpose of illustrating the preferred embodiments of the present invention and should not be taken as limiting the invention, so that any modifications, equivalents, improvements and the like, which are within the spirit and principle of the present invention, should be included in the scope of the present invention.

Claims

1. The utility model provides a palm tears to take off fracture reduction and pierces needle director which characterized in that: including right side pincers handle (1) and left pincers handle (2), right side pincers handle (1) and left pincers handle (2) are articulated through hinge (8), right side pincers handle (1) front end is equipped with right binding clip (101), left side pincers handle (2) front end is equipped with left binding clip (201), and left binding clip (201) and right binding clip (101) correspond the setting, and right binding clip (101) outer end is equipped with fixed direction head (3) of wearing the needle, fixed direction head (3) of wearing the needle is equipped with the guiding hole for wearing the needle, left side binding clip (201) outer end is equipped with skin and supports support (4), and this skin supports and holds in the palm (4) outer terminal surface and be planar structure, the fixed guiding hole for wearing the needle of wearing needle direction head (3) with skin supports and holds in the palm (4) outer terminal surface and just to setting.

2. The metacarpophalangeal avulsion fracture reduction threading needle guide device as claimed in claim 1, characterized in that: and the rear parts of the right forceps handle (1) and the left forceps handle (2) are correspondingly provided with forceps handle tooth buckles (6).

3. The metacarpophalangeal avulsion fracture reduction threading needle guide device as claimed in claim 1, characterized in that: the needle threading guide hole of the fixed needle threading guide head (3) is arranged opposite to the central position of the outer end face of the skin support bracket (4).

4. The metacarpophalangeal avulsion fracture reduction threading needle guide device as claimed in claim 1, characterized in that: the outer end face of the skin support (4) is provided with a rubber pad (5).

5. The metacarpophalangeal avulsion fracture reduction threading needle guide device of claim 4, which is characterized in that: the skin support bracket (4) is a cone structure with a horizontal central axis, and the central position of the bottom surface of the cone is arranged right opposite to the fixed needle threading guide head (3).

6. The metacarpophalangeal avulsion fracture reduction threading needle guide device as claimed in claim 1, characterized in that: the end surface of the fixed needle threading guide head (3) facing the skin support bracket (4) is uniformly distributed with a plurality of saw teeth (31) around the needle threading guide hole.

7. The metacarpophalangeal avulsion fracture reduction threading needle guide device according to any one of claims 1 to 6, wherein: an included angle smaller than 90 degrees is formed between the right forceps handle (1) and the right forceps head (101).

8. The metacarpophalangeal avulsion fracture reduction threading needle guide device of claim 7, which is characterized in that: an angle larger than or equal to 90 degrees is formed between the left forceps head (201) and the left forceps handle (2).

9. The metacarpophalangeal avulsion fracture reduction threading needle guide device of claim 8, which is characterized in that: the right forceps handle (1) is located between the hinge shaft (8) and the right forceps head (101), and the left forceps handle (2) is located between the hinge shaft (8) and the right forceps head (101) and is of a curved handle structure protruding towards the direction of the center line of the guider.

10. The metacarpophalangeal avulsion fracture reduction threading needle guide device of claim 7, which is characterized in that: the rear ends of the right forceps handle (1) and the left forceps handle (2) are respectively provided with a finger ring (7).