CN218391247U - Femoral intertrochanteric fracture restorer - Google Patents

Abstract

The utility model belongs to the technical field of orthopedic surgery medical instrument, a fracture restorer between thighbone tuberosity is related to. The clamping device comprises a first clamping mechanism and a second clamping mechanism hinged with the first clamping mechanism, wherein the first clamping mechanism comprises a first holding handle and a positioning unit which are connected with each other, the positioning unit comprises a first clamping arm and a positioning cavity, and the positioning cavity is connected with one end of the first clamping arm, which is far away from the first holding handle; the second clamping mechanism comprises a second holding handle and a positioning auxiliary unit which are connected with each other, the positioning auxiliary unit comprises a second clamping arm and a positioning auxiliary structure, the positioning auxiliary structure comprises an accommodating part and a fixing part, one end of the accommodating part is connected with one end of the second clamping arm, which is far away from the second holding handle, the other end of the accommodating part is connected with the fixing part, and the fixing part faces the positioning cavity; the central axis of the positioning cavity is perpendicular to a plane formed by hinging the first clamping mechanism and the second clamping mechanism. The soft tissue injury is reduced, sufficient fixing strength is provided, and the phenomenon of restoration and loss is avoided.

Description

Femoral intertrochanteric fracture restorer

Technical Field

The utility model belongs to the technical field of orthopedic surgery medical instrument, more specifically relates to a fracture restorer between thighbone tuberosity.

Background

Intertrochanteric femoral fractures are extracapsular fractures that occur between the base of the femoral neck to the lesser tuberosity of the femur, and are a type of hip fracture that is common in the clinic. With the aging of the population, the fracture between the femoral tuberosity of the old is more and more. At present, the common treatment method is closed reduction PFNA internal fixation under the traction of an orthopedic traction bed. Because the tuberosity part has abundant blood circulation and rarely does not heal after fracture, but the hip varus and other undesirable treatment effects are caused by the displacement between the thighbone tuberosity in the operation process and other reasons, particularly the fracture with serious pulverization and instability, the inner cortex is lack of effective support, and the fracture reduction is difficult to maintain. Usually, the bone blocks before and after reduction fixation are firstly used, and then the internal fixation of the lateral opening DHS (Dynamic Hip Screw) is carried out. The external open DHS internal fixation has the disadvantage of open reduction: (1) The soft tissue injury is large, (2) the fixation belongs to extramedullary fixation, the fixation strength of the fracture between the femoral tuberosity at the complex coronal position is not enough, and the failure rate is high.

SUMMERY OF THE UTILITY MODEL

Therefore, it is desirable to provide a femoral intertrochanteric fracture reduction device to reduce or avoid the soft tissue injury caused by the incision reduction in the current femoral intertrochanteric fracture reduction operation, provide sufficient fixing strength for maintaining reduction between the femoral intertrochanteric fractures, and avoid the separation or fracture end re-displacement during the driving of the main nail for reaming.

To achieve the above objects, the present inventors provide an intertrochanteric fracture reduction device, comprising:

the first clamping mechanism comprises a first holding handle and a positioning unit which are connected with each other, the positioning unit comprises a first clamping arm and a positioning cavity, and the positioning cavity is connected with one end, far away from the first holding handle, of the first clamping arm;

the second clamping mechanism is hinged to the first clamping mechanism and comprises a second holding handle and a positioning auxiliary unit which are connected with each other, the positioning auxiliary unit comprises a second clamping arm and a positioning auxiliary structure, the positioning auxiliary structure comprises an accommodating part and a fixing part, one end of the accommodating part is connected with one end, far away from the second holding handle, of the second clamping arm, the other end of the accommodating part is connected with the fixing part, and the fixing part faces the positioning cavity;

the central axis of the positioning cavity is perpendicular to a plane formed by hinging the first clamping mechanism and the second clamping mechanism.

Further, the positioning cavity is a cylindrical through hole.

Furthermore, the accommodating part is an arc-shaped rod body bent towards the positioning cavity.

Further, the fixing portion is a tapered tip.

Furthermore, the femoral intertrochanteric fracture restorer further comprises a limiting structure, the limiting structure comprises a limiting screw and a limiting nut, the first holding handle or the second holding handle is provided with a limiting screw fixing position and/or a limiting screw through hole, and the limiting screw is connected to the limiting screw fixing position of the first holding handle or the second holding handle, penetrates through the limiting screw through hole and is matched with the limiting nut, and is used for limiting the distance between the first holding handle and the second holding handle.

Furthermore, the first clamping arm and the positioning cavity are also provided with a connecting part.

Furthermore, the first clamping arm and the second clamping arm are both arc-shaped, the circle centers of the arc-shaped first clamping arm and the arc-shaped second clamping arm are located on the same plane, the arc-shaped first clamping arm and the arc-shaped second clamping arm are oppositely arranged, and an opening is formed in the direction opposite to the direction of the first holding handle and the direction of the second holding handle.

Further, the femoral intertrochanteric fracture restorer also comprises a Steiner.

Furthermore, one end of the connecting part is connected to the first clamping arm, and the positioning cavity is welded to the other end of the connecting part.

Further, the length of the cylindrical through hole is equal to the height of the arc-shaped rod body bent to the positioning cavity.

Different from the prior art, the technical scheme provides an orthopedic medical auxiliary instrument which can realize effective reduction of powerful fixation and effectively maintain fracture reduction in operation only by minimally invasive operation for PFNA internal fixation of femoral intertrochanteric fracture, and the femoral intertrochanteric fracture restorer of the invention can furthest reduce the damage to soft tissues.

Drawings

FIG. 1 is a schematic view of the overall structure of a femoral intertrochanteric fracture repositor according to an embodiment;

FIG. 2-1 is another embodiment of a femoral intertrochanteric fracture repositor;

fig. 2-2 is a top view of another femoral intertrochanteric fracture reducer according to an embodiment;

FIG. 3 is an enlarged schematic view of the receiving portion of the femoral intertrochanteric fracture reduction device according to an embodiment;

FIG. 4 is an enlarged schematic view of a fixing portion of the femoral intertrochanteric fracture reduction apparatus according to an embodiment;

FIG. 5 is a schematic diagram of another femoral intertrochanteric fracture reducer according to an embodiment;

FIG. 6 is a schematic diagram of a positioning unit of another femoral intertrochanteric fracture reduction device according to an embodiment;

FIG. 7 is a schematic view of another femoral intertrochanteric fracture reducer according to an embodiment;

fig. 8 is a schematic structural view of another femoral intertrochanteric fracture reduction device according to an embodiment.

Description of reference numerals:

1. the clamping device comprises a first clamping mechanism 11, a first holding handle 12, a positioning unit 121, a first clamping arm 122, a positioning cavity 123 and a connecting part;

2. the second clamping mechanism 21, the second handle 22, the positioning auxiliary unit 221, the second clamping arm 222, the positioning auxiliary structure 2221, the accommodating part 2222 and the fixing part;

3. the limiting structure 31, the limiting screw 32, the limiting nut 311, the limiting screw fixing position 312 and the limiting screw through hole;

4. a Stewart needle.

Detailed Description

In order to explain technical contents, structural features, objects and effects of the technical solutions in detail, the following detailed description is given with reference to the accompanying drawings in combination with the embodiments.

Embodiments of the present invention will be described in detail below with reference to the accompanying drawings. The following examples are only used to illustrate the technical solutions of the present application more clearly, and therefore are only used as examples, and the protection scope of the present application is not limited thereby.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs; the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application; the terms "including" and "having," and any variations thereof, in the description and claims of this application and the description of the above figures are intended to cover non-exclusive inclusions.

In the description of the embodiments of the present application, the technical terms "first", "second", and the like are used only for distinguishing different objects, and are not to be construed as indicating or implying relative importance or implicitly indicating the number, specific order, or primary-secondary relationship of the technical features indicated. In the description of the embodiments of the present application, "a plurality" means two or more unless specifically defined otherwise.

Reference herein to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment can be included in at least one embodiment of the application. The appearances of the phrase in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. It is explicitly and implicitly understood by one skilled in the art that the embodiments described herein can be combined with other embodiments.

In the description of the embodiments of the present application, the term "and/or" is only one kind of association relationship describing the association object, and means that three relationships may exist, for example, a and/or B, and may mean: a exists alone, A and B exist simultaneously, and B exists alone. In addition, the character "/" herein generally indicates that the former and latter related objects are in an "or" relationship.

In the description of the embodiments of the present application, the term "plurality" refers to two or more (including two), and similarly, "plural sets" refers to two or more (including two), and "plural pieces" refers to two or more (including two).

In the description of the embodiments of the present application, the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", "axial", "radial", "circumferential", and the like, indicate the directions or positional relationships indicated in the drawings, and are only for convenience of description of the embodiments of the present application and for simplicity of description, but do not indicate or imply that the referred device or element must have a specific direction, be constructed and operated in a specific direction, and thus, should not be construed as limiting the embodiments of the present application.

In the description of the embodiments of the present application, unless otherwise explicitly specified or limited, the terms "mounted," "connected," "fixed," and the like are to be construed broadly, e.g., as meaning fixedly connected, detachably connected, or integrated; mechanical connection or electrical connection is also possible; either directly or indirectly through intervening media, either internally or in any other relationship. The specific meanings of the above terms in the embodiments of the present application can be understood by those of ordinary skill in the art according to specific situations.

Femoral intertrochanteric fractures are primarily fractures between the base of the femoral neck to the level of the lesser trochanter of the femur, a clinically common type of hip fracture. With the aging process, the incidence of femoral intertrochanteric fracture in the elderly is increasing. Local pain, swelling, tenderness and dysfunction are obvious after trauma, subcutaneous blood stasis spots can be seen on the outer side of the hip sometimes, and the injured limb is limited in movement and can not stand or walk. Swelling, tenderness and shortness of injured limbs in the greater tuberosity part, extreme supination at the distal fracture site, 90-degree supination in severe cases, and adduction deformity. The operation treatment can carry out stable and effective internal fixation on the fracture end through various internal fixation systems, or replace the whole joint to recover the function of the joint. The main types of surgical treatment of femoral intertrochanteric fractures are:

(1) Fixing with a hollow nail;

(2) Side nail plates;

(3) Intramedullary nail systems include Gamma nails, proximal femoral intramedullary nails (PFN), and proximal femoral anti-rotation intramedullary nails (PFNA).

(4) Prosthesis replacement in cases where the life span of an aged intertrochanteric fracture is expected to be within 10 years, a cement-type prosthesis replacement may be selected as a treatment modality as long as the physical condition is tolerable.

The Proximal femur anti-rotation intramedullary Nail, PFNA (Proximal Femoral Nail inflammation), belongs to a novel Proximal femur internal fixation system, is a new and improved PFN (Proximal Femoral Nail), on one hand inherits the advantages of the original PFN, namely the same biological and mechanical characteristics, on the other hand has some innovation in the concrete design, so that the fixation is more effective and the operation is simpler. PFNA is applicable to various types of intertrochanteric femoral fractures: fracture under femoral tuberosity, fracture at the base part of femoral neck, fracture of femoral neck with fracture of femoral shaft, and fracture between femoral tuberosity with fracture of femoral shaft. The main surgical procedures of PFNA internal fixation are: observing the fracture and the reduction condition of the front and side pieces of the affected limb under C-arm fluoroscopy, drawing the affected limb to close the reduction fracture end, after the bone fracture reduction is satisfactory displayed in the positive position and the axial position, taking the longitudinal incision on the outer side above the greater tuberosity of the femur to cut layer by layer, exposing the vertex of the greater tuberosity of the femur, determining the needle insertion point, namely, an opener opening at the front middle part of the vertex of the greater tuberosity, drilling the guide pin about 15cm through a hollow opening cone, inserting the protective sleeve along the guide pin to the vertex of the greater tuberosity, removing the guide pin drill sleeve, drilling the guide pin to the limit position along the guide pin by using the hollow drill, pulling out the hollow drill, the sleeve and the guide pin, selecting an intramedullary nail with proper specification, using a connecting bolt to connect and fix the main nail and the near-end aiming frame, inserting the main nail into the medullary cavity along the opened nail path, until the near end of the main nail is immersed into 0.5cm below the tuberosity cortex, the near end guide rod is connected to the insertion handle, the screw blade nail sleeve nut is screwed to the 1/3 position outside, the skin is cut, the soft tissue is stripped, the screw blade nail sleeve is screwed until the blade nail sleeve is jacked to the outer bone cortex, the trocar is taken out, the guide needle is drilled to be about 5-10cm away from the femoral head articular surface, the length of the guide needle is measured by a depth gauge, the screw blade with proper length is selected, the guide needle drill sleeve is taken out, the near end hollow cortical drill is used for drilling to the limiting position along the guide needle, the limiting position is drilled along the guide needle after the depth of the depth limiting hollow drill is adjusted, the guide needle is confirmed to be in the medullary cavity under the normal position and axial perspective, the near end is reamed, and the main nail of the intramedullary nail is inserted into the medullary cavity. Installing a sighting device, firstly driving 1 Kirschner wire through the femoral neck, drilling and tapping after confirming that the position is satisfied under the perspective of the positive position and the axial position, driving a screw blade compression screw after measuring the length, and determining that the position and the depth of the screw are proper through the perspective of the positive position and the axial position again. Installing a far-end sighting device, putting 2 far-end locking nails, performing perspective resetting on the right position and the side position again to satisfy, and sewing the incision after the positions and the depths of the spiral blade and the locking nails are proper.

In the operation process, when the intramedullary nail main nail is inserted into the medullary cavity to expand the medullary and is driven into the spiral blade compression screw, if the fracture reduction is not good enough, the serious and unstable fracture is crushed, especially for Evans lV fracture, the inner cortex is lack of effective support, and the fracture reduction is difficult to maintain; the opening position of the guide pin is wrong, and the guide pin is easy to reset and lose after the main nail is inserted no matter the guide pin is inclined to the front, the back, the outside and the inside; the diameter of the intramedullary nail is selected to be too large, so that the cortex of the femur is split when the main nail is driven in the operation, and the stability of the PFNA fixed fracture is reduced.

Therefore, fracture reduction and its maintenance during PFNA surgical procedures are critical factors for the success of the surgery. The current PFNA operation generally adopts incision reduction, and the defects of the incision reduction are as follows: the soft tissue injury of a patient is large, DHS internal fixation belongs to extramedullary fixation, the fixation strength of the fracture between the femoral tuberosity in a complex coronal position is not enough, and the failure rate is high.

Referring to fig. 1 to 8, the present application provides a femoral intertrochanteric fracture repositor, which includes a first clamping mechanism 1 and a second clamping mechanism 2 hinged to the first clamping mechanism 1, wherein the first clamping mechanism 1 includes a first holding handle 11 and a positioning unit 12 connected to each other, the positioning unit includes a first clamping arm 121 and a positioning cavity 122, and the positioning cavity 122 is connected to one end of the first clamping arm 121 away from the first holding handle 11;

the second clamping mechanism 2 comprises a second grip handle 21 and a positioning auxiliary unit 22 which are connected with each other, the positioning auxiliary unit 22 comprises a second clamping arm 221 and a positioning auxiliary structure 222, the positioning auxiliary structure 222 comprises a receiving portion 2221 and a fixing portion 2222, one end of the receiving portion 2221 is connected with one end of the second clamping arm 221 far away from the second grip handle 21, the other end of the receiving portion 2221 is connected with the fixing portion 2222, and the fixing portion 2222 faces the positioning cavity 122;

the central axis of the positioning cavity 122 is perpendicular to the plane formed by the first clamping mechanism 1 and the second clamping mechanism 2 in a hinged manner.

The first gripper mechanism 1 and the second gripper mechanism 2 are hinged to form a pincer-or scissors-shaped body, but the two gripper mechanisms have different structures at the ends opposite to the first grip 11 and the second grip 21. The first grip 11 and the second grip 21 are similarly designed to be gripped by the hands of the medical care provider for reduction maintenance during the femoral intertrochanteric fracture surgery, and any shape may be used as the grip as long as the medical care provider can smoothly grip the femoral intertrochanteric fracture and can apply opposing pressure, and examples thereof include, but are not limited to, a smooth arc shape, an elliptical ring shape, a rectangular shape, a diamond shape, and an irregular curved shape.

The positioning unit 12 connected with the first handle 11 through the hinge structure is used as a reduction maintaining process to replace a steel plate or an acetabulum retractor for providing reduction strength during incision reduction.

Different from the prior art, the central axis of the positioning cavity 122 is perpendicular to the plane formed by the first clamping mechanism 1 and the second clamping mechanism 2 in a hinged manner. Therefore, the plane of the positioning cavity is perpendicular to the plane formed by the first clamping arm 121 and the second clamping arm 221, namely the first holding handle 11 and the second holding handle 21, so that the strongest fixation can be provided and the reduction is not lost during reduction, and meanwhile, the positioning cavity only needs to provide a minimally invasive wound to reduce the soft tissue injury to the minimum degree.

Referring to the two different embodiments shown in fig. 2-1 and 2-2, the positioning cavity 122 may be a cylindrical through hole, which is directly connected to the first clamping arm 121 (fig. 2-2) or connected to the first clamping arm 121 (fig. 2-1) through a connecting portion 123, and the cylindrical through hole is used for passing through a cylindrical matching positioning pin or positioning rod.

Referring to fig. 3, in other embodiments, different from the embodiment of fig. 1, the accommodating portion 2221 is an arc-shaped rod bent toward the positioning cavity 122. The arrangement is adaptive to ergonomics, so that the restorer of the invention is most suitable for the shape and the structural characteristics from the base of the femoral neck to the small tuberosity of the femur in the process of maintaining the reduction of the fracture between the tuberosities of the femur, and plays the role of the restorer to the maximum extent.

Referring to fig. 4, according to some embodiments of the present application, the fixing portion 2222 is optionally a tapered tip. In other embodiments, the shape of the fixing portion may be a shape with a small top portion capable of providing a sufficient pressure, and the top portion may be a circular truncated cone, a half circular truncated cone, a trapezoidal truncated cone, or the like, which is expanded toward the accommodating portion and capable of providing a sufficient supporting force.

Referring to fig. 5, according to some embodiments of the present application, optionally, the reduction device for femoral intertrochanteric fracture further includes a limiting structure 3, the limiting structure 3 includes a limiting screw 31 and a limiting nut 32, the first grip handle 11 or the second grip handle 21 is provided with a limiting screw fixing position 311 and/or a limiting screw through hole 312, the limiting screw 31 is connected to the limiting screw fixing position 311 of the first grip handle 11 or the second grip handle 21, and passes through the limiting screw through hole 312 to be matched with the limiting nut 32, so as to limit the distance between the first grip handle 11 and the second grip handle 21. Of course, the limiting structure may also adopt other conventional implementation manners, including but not limited to a clip structure, a snap structure, a clamping structure, a sliding rail structure, and the like.

Referring to fig. 6, according to some embodiments of the present application, optionally, the first clamping arm 121 and the positioning cavity 122 are further provided with a connecting portion 123. The advantage of this arrangement is that the positioning cavity can be aligned to a better position of the macro-tuberosity. The specific shape of the connecting portion is not particularly limited.

Referring to fig. 7, according to some embodiments of the present disclosure, the first clamping arm 121 and the second clamping arm 221 are both arc-shaped, the circle centers of the arc-shaped first clamping arm 121 and the arc-shaped second clamping arm 221 are located on the same plane, and the arc-shaped first clamping arm 121 and the arc-shaped second clamping arm 221 are disposed opposite to each other, so that the opening faces the direction opposite to the direction of the first handle 11 and the direction opposite to the direction of the second handle 21.

Referring to fig. 8, according to some embodiments of the present application, the femoral intertrochanteric fracture repositor further comprises a schanz needle 4, and the schanz needle 4 is adapted to the positioning cavity 122, so as to avoid the loss of reposition during the driving of the helical blade and the guide pin, and keep strong fixation.

According to some embodiments of the present application, one end of the connecting portion 123 is connected to the first clamping arm 121, and the positioning cavity 122 is welded to the other end of the connecting portion 123.

According to some embodiments of the present application, the length of the cylindrical through hole is equal to the height of the arc-shaped rod bent towards the positioning cavity 122.

It should be noted that, although the above embodiments have been described herein, the scope of the present invention is not limited thereby. Therefore, based on the innovative concept of the present invention, the changes and modifications of the embodiments described herein, or the equivalent structure or equivalent process changes made by the contents of the specification and the drawings of the present invention, directly or indirectly apply the above technical solutions to other related technical fields, all included in the protection scope of the present invention.

Claims (10)

1. A femoral intertrochanteric fracture restorer, characterized in that the femoral intertrochanteric fracture restorer includes:

the first clamping mechanism comprises a first holding handle and a positioning unit which are connected with each other, the positioning unit comprises a first clamping arm and a positioning cavity, and the positioning cavity is connected with one end, far away from the first holding handle, of the first clamping arm;

the second clamping mechanism is hinged to the first clamping mechanism and comprises a second holding handle and a positioning auxiliary unit which are connected with each other, the positioning auxiliary unit comprises a second clamping arm and a positioning auxiliary structure, the positioning auxiliary structure comprises an accommodating part and a fixing part, one end of the accommodating part is connected with one end, far away from the second holding handle, of the second clamping arm, the other end of the accommodating part is connected with the fixing part, and the fixing part faces the positioning cavity;

the central axis of the positioning cavity is perpendicular to a plane formed by hinging the first clamping mechanism and the second clamping mechanism.

2. The femoral intertrochanteric fracture reducer of claim 1, wherein the positioning cavity is a cylindrical through-hole.

3. The femoral intertrochanteric fracture reducer of claim 2, wherein the receiving portion is an arcuate rod bent toward the positioning cavity.

4. The femoral intertrochanteric fracture reducer of claim 1, wherein the fixation portion is a tapered tip.

5. The femoral intertrochanteric fracture restorer of claim 1, further comprising a limiting structure, wherein the limiting structure comprises a limiting screw and a limiting nut, the first grip handle or the second grip handle is provided with a limiting screw fixing position and/or a limiting screw through hole, and the limiting screw is connected to the limiting screw fixing position of the first grip handle or the second grip handle, passes through the limiting screw through hole and is matched with the limiting nut, and is used for limiting the distance between the first grip handle and the second grip handle.

6. The femoral intertrochanteric fracture reducer of claim 1, wherein the first clamp arm and the positioning cavity are further provided with a connecting portion.

7. The femoral intertrochanteric fracture restorer of claim 1, characterized in that first arm lock and second arm lock are arc-shaped, and the centre of circle that the arc-shaped of first arm lock and the arc-shaped of second arm lock are located the coplanar, the arc-shaped of first arm lock and the arc-shaped of second arm lock set up relatively, form the opening and face opposite direction with first handle and the second handle direction.

8. The femoral intertrochanteric fracture reducer of claim 1, further comprising a Steiner.

9. The femoral intertrochanteric fracture restorer of claim 6, wherein one end of the connecting portion is connected to a first clamping arm, and the positioning cavity is welded to the other end of the connecting portion.

10. The femoral intertrochanteric fracture reducer of claims 2 or 3, wherein the cylindrical through-hole has a length equal to the height of an arc-shaped rod bent toward the positioning cavity.

Images