CN220293617U - Well type double reverse traction spreader - Google Patents
Well type double reverse traction spreader Download PDFInfo
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- CN220293617U CN220293617U CN202321389696.2U CN202321389696U CN220293617U CN 220293617 U CN220293617 U CN 220293617U CN 202321389696 U CN202321389696 U CN 202321389696U CN 220293617 U CN220293617 U CN 220293617U
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- 239000011148 porous material Substances 0.000 claims description 21
- 230000009977 dual effect Effects 0.000 claims description 3
- 210000000988 bone and bone Anatomy 0.000 abstract description 4
- 206010017076 Fracture Diseases 0.000 description 22
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- 210000000544 articulatio talocruralis Anatomy 0.000 description 9
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Abstract
The utility model belongs to the technical field of bone surgical instruments, and particularly relates to a well-type double-reverse traction spreader. Comprising the following steps: the two long stud assemblies are arranged in parallel; the two groups of end sleeves are fixed at the end parts of the long stud assembly, and a first steel needle is arranged between the two groups of end sleeves in a penetrating way; the two groups of sliding sleeves are slidably mounted on the long stud assembly, and a second steel needle is arranged between the two groups of sliding sleeves in a penetrating mode. The well-type double-reverse traction spreader can save one or even a plurality of assistant labor forces when being used in operation, and liberates the labor force.
Description
Technical Field
The utility model belongs to the technical field of bone surgical instruments, and particularly relates to a well-type double-reverse traction spreader.
Background
The concept of Pilon fracture is proposed by the French Eienne Deston in 1911, and refers to a serious trauma involving the articular surface of the distal tibia fracture, most of which are caused by high-energy violence of axial load, and the minority of which are caused by low-energy rotational injuries, the incidence rate of which is about 1% of that of the lower limb fracture and 5% -10% of that of the tibia fracture. The ankle joint is a heavy-load joint, so that traumatic arthritis is extremely easy to cause due to improper treatment, further, the limb movement is severely limited, and the ankle joint is a local loss for patients, families and society.
Complex pilot fractures present a significant challenge to any trauma surgeon, and the axial and lateral stresses caused by high-energy violence, result in distal tibial articular surface cleavage, collapse or separation from metaphyseal, often accompanied by damage to soft skin tissue, vascular nerves, and ankle ligaments.
The prognosis of the fracture is poorer than other types of other similar fractures, the disability rate is high, and the complications in the perioperative period are more. In addition, the treatment target is not completely consistent with other intra-articular fractures. Treatment of complex bone pilot folds should first avoid the occurrence of osteofascial syndrome and catastrophic infections, and second restore normal lower limb force lines and ankle stability, dissect the reduction articular surfaces, restore joint matching. The prevailing view now emphasizes the protection of soft tissue and the restoration of lower limb force lines without placing the anatomic reduction joint surfaces in the first place. In clinical work, there are not few examples of imperfect reduction of the articular surface but satisfactory functioning of the ankle of the patient. The timing of the procedure and the choice of access will depend on the severity of the local soft tissue injury, and when the local skin conditions are poor, a potentially disastrous complication may result from the ambulatory internal fixation treatment. The current mainstream approach is to carry out staged treatment: temporary fixation, calcaneus traction or gypsum fixation of the external fixing support of the ankle joint is carried out in the first stage, local soft tissue recovery is waited, and internal fixation operation is carried out in the second stage after the limb swelling degree is reduced and dermatoglyph symptoms appear. Staged treatment can significantly reduce the rate of incision complications.
Traditional surgical methods require extensive soft tissue dissection, incision of the joint capsule to reveal the articular surface, and fixation by reduction under direct vision. The reduction and fixation of the fracture can be easily realized by the operation mode, but the fragile soft tissues can be damaged, the blood supply of the far-end periosteum of the tibia is destroyed, and a plurality of complications and risks can be caused: short term complications include post-operative infections, skin necrosis, etc.; long-term complications include joint stiffness, delayed union of fractures, nonunion of fractures, proprioceptive disorders, and the like.
With the updating of treatment concepts and internal fixation materials, fracture internal fixation strategies gradually change from absolute strong rigid internal fixation to biological fixation, and soft tissue protection is emphasized more. The application of MIPPO (Minimal Invasive Percutaneous Plate Osteosynthesis) technology greatly reduces the stripping of soft tissues in front of fracture ends and ankle joints, reduces iatrogenic injury, reserves a soft tissue skin bridge with enough width between a front inner side incision and a front outer side incision, and greatly reduces the probability of skin necrosis. Meanwhile, a limited contact pressurization locking steel plate (Limited Contact Dynamic Compression Plate, LC-DCP) can be placed through the periosteum external channel, so that the distal tibia nourishing artery is protected, and the risks of fracture nonunion and delayed union are reduced. The treatment of complex pilot fractures using MIPPO technology has become a major clinical approach. Although the MIPPO technology can obviously reduce the complication rate of the incision when used for treating the complex Pilon fracture, the MIPPO technology has higher technical difficulty and self disadvantages: 1. the joint surface cannot be directly exposed, the collapsed and split joint surface needs to be restored and fixed through skin, and the difficulty is high; 2. repeated fluoroscopy is required to assess the reduction of the articular surfaces and the radiation exposure to the patient and medical personnel is relatively high.
Zhang Yingze the concept of combining 'tendons and bones and dynamic and static combination' in traditional Chinese medicine of China provides a 'minimally invasive homeopathic resetting theory' for the first time, and the core idea is as follows: when the fracture is reduced, the mechanical axis of the limb is complied, and the axial traction force is converted into the lateral extrusion force of the fracture end through the soft tissue sleeve, so that the fracture is naturally reduced.
Disclosure of Invention
The utility model aims to solve the problems and provides a well-type double-reverse traction spreader.
The utility model adopts the following technical scheme: a well dual reverse traction spreader comprising: the two long stud assemblies are arranged in parallel; the two groups of end sleeves are fixed at the end parts of the long stud assembly, and a first steel needle is arranged between the two groups of end sleeves in a penetrating way; the two groups of sliding sleeves are slidably mounted on the long stud assembly, and a second steel needle is arranged between the two groups of sliding sleeves in a penetrating mode.
In some embodiments, the long stud assembly is marked with graduations.
In some embodiments, the end sleeve is provided with a first threaded hole, and the end of the long stud assembly is fixed in the first threaded hole in a penetrating way; the middle part of the end sleeve is provided with a first pore canal, the first pore canal is penetrated with a first steel needle, and the first threaded hole and the first pore canal are arranged in a crisscross manner at different heights.
In some embodiments, the end sleeve bottom is provided with a first bolt hole through which the end sleeve bottom is fitted with the first mount.
In some embodiments, a round hole is arranged on the sliding sleeve, and the middle part of the long stud assembly is penetrated and fixed in the round hole; the middle part of the sliding sleeve is provided with a second pore canal, the second pore canal is penetrated with a second steel needle, and the round hole and the second pore canal are arranged in a crisscross manner at different heights.
In some embodiments, the sliding sleeve bottom is provided with a second bolt hole through which the sliding sleeve bottom mounts a second mount.
In some embodiments, the slip sleeve is provided with slip nuts on both sides of the slip sleeve that fit over the long stud assembly.
Compared with the prior art, the utility model has the following beneficial effects:
1. the traditional traction apparatus is used for complex pilon fracture and has the defects of poor applicability, complex structure composition and complex operation.
2. The traction screw rods on the two sides are marked with scales, so that the respective traction distance can be accurately recorded and calculated (errors that the Kirschner wire possibly cannot be parallel to the ankle joint due to human errors in the process of placing the Kirschner wire are corrected), and the traction force can be quantified, and the normal force lines can be always ensured. And secondly, a safe spreading length is obtained so as not to cause damage to ligaments, nerves and blood vessels.
3. The well-type double-reverse traction spreader can save one or even a plurality of assistant labor forces when being used in operation, and liberates the labor force.
4. The well-type double-reverse traction spreader is parallel to the lower limb force line, the lower limb force line can be kept good and stable all the time in the operation process, the force is adjustable and constant, the traction time is durable, and the defects that the force line cannot be always correct, the traction force cannot be adjusted and unbalanced and the time cannot be sustained in the manual traction process are overcome.
5. In the fracture of the ankle joint part of the lower limb, the first element of fracture treatment recovery is the force line, and the spreader can always keep central reverse spreading consistent with the force line of the lower limb.
6. The spreader is positioned on the far side and the near side with the ankle joint as the center, avoids an operation area (the front inner side incision and the front outer side incision are all unaffected), does not occupy an operation area, has no obstacle to operation in operation, and does not affect operation of an operator.
7. The soft tissue hinge is utilized to indirectly conduct fracture reduction, so that further damage to soft tissues is avoided, the requirement of damage control is met, and the rapid rehabilitation medicine required by the current mainstream is combined.
8. The novel double-reverse traction spreader can be used for temporary fixation (preoperative use) of patients with extremely poor soft tissue conditions of complex Pilon fracture, and creates opportunities and conditions for further surgical treatment.
Drawings
FIG. 1 is a schematic diagram of a well-type double-reverse traction spreader;
FIG. 2 is a top view of FIG. 1;
FIG. 3 is a schematic view of an end sleeve configuration;
FIG. 4 is a schematic view of a first base/second base structure;
FIG. 5 is a schematic view of a long stud assembly;
FIG. 6 is a schematic view of a sliding sleeve structure;
FIG. 7 is a schematic view of the present utility model in use;
in the figure: the device comprises a 1-long stud assembly, a 2-end sleeve, a 2.1-first threaded hole, a 2.2-first pore canal, a 2.3-first bolt hole, a 3-sliding sleeve, a 3.1-round hole, a 3.2-second pore canal, a 3.3-second bolt hole, a 4-sliding nut, a 5.1-first steel needle and a 5.2-second steel needle.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present utility model more clear, the technical solutions in the embodiments of the present utility model will be clearly and completely described below, and it is apparent that the described embodiments are some embodiments of the present utility model, but not all embodiments; all other embodiments, which can be made by those skilled in the art based on the embodiments of the utility model without making any inventive effort, are intended to be within the scope of the utility model.
Referring to fig. 1 and 2, a well-type double-reverse traction spreader, comprising:
the two long stud assemblies 1 are arranged in parallel between the two long stud assemblies 1;
two groups of end sleeves 2, wherein the end sleeves 2 are fixed at the end parts of the long stud assembly 1, and a first steel needle 5.1 is arranged between the two groups of end sleeves 2 in a penetrating way;
and two groups of sliding sleeves 3, wherein the sliding sleeves 3 are slidably arranged on the long stud assembly 1, and a second steel needle 5.2 is arranged between the two groups of sliding sleeves 3 in a penetrating way.
Specifically, the first steel needle 5.1 and the second steel needle 5.2 are kirschner wires, the sliding sleeve 3 is arranged at the sliding adjustment position of the long stud assembly 1, and the sliding sleeve is adjusted to a proper position according to the length of different leg bones.
The long stud assembly 1 is marked with scales. The distance of each retraction can be accurately calculated (errors that the Kirschner wire may not be parallel to the ankle joint due to human errors in the process of inserting the Kirschner wire are corrected), and firstly, the quantification of the traction force can be ensured, and the normal force line is always ensured. And secondly, a safe spreading length is obtained so as not to cause damage to ligaments, nerves and blood vessels.
Referring to fig. 3 and 4, a first threaded hole 2.1 is formed in the end sleeve 2, and the end of the long stud assembly 1 is fixed in the first threaded hole 2.1 in a penetrating manner; the middle part of the end sleeve 2 is provided with a first pore canal 2.2, the first pore canal 2.2 is penetrated with a first steel needle 5.1, and the first threaded hole 2.1 and the first pore canal 2.2 are arranged in a crisscross manner at different heights.
The bottom of the end sleeve 2 is provided with a first bolt hole 2.3, and the bottom of the end sleeve 2 is provided with a first base 6.1 through the first bolt hole 2.3.
Specifically, the long stud assembly 1 is fixed in the first threaded hole 2.1 in a threaded manner, and the first steel needle 5.1 penetrates through the first pore canal 2.2. The upper end of the first base 6.1 is provided with a screw rod which is screwed in the first bolt hole 2.3.
The sliding sleeve 3 is provided with a round hole 3.1, and the middle part of the long stud assembly 1 is penetrated and fixed in the round hole 3.1; the middle part of the sliding sleeve 3 is provided with a second pore canal 3.2, the second pore canal 3.2 is penetrated with a second steel needle 5.2, and the round hole 3.1 and the second pore canal 3.2 are arranged in a crisscross manner at different heights.
The sliding sleeve 3 bottom is provided with second bolt hole 3.3, and second base 6.2 is installed through second bolt hole 3.3 to sliding sleeve 3 bottom.
Specifically, the long stud assembly 1 passes through the round hole 3.1, no threads are arranged in the round hole 3.1, and the position of the sliding sleeve 3 on the long stud assembly 1 is convenient to adjust. The upper end of the second base 6.2 is provided with a screw rod which is screwed in the second bolt hole 3.3.
The sliding nuts 4 sleeved on the long stud assemblies 1 are arranged on two sides of the sliding sleeve 3. After the position of the sliding sleeve 3 on the long stud assembly 1 is adjusted, the sliding nuts 4 on both sides are tightened to the middle by a wrench, thereby fixing the position of the sliding sleeve 3.
When in use, one Kirschner wire (the first steel needle 5.1) is used for inserting the needle from outside to inside (taking care of preventing the total fibular nerve from damaging) on the proximal tibia of the fracture, and one Kirschner wire (the second steel needle 5.2) is used for inserting the needle from inside to outside on the calcaneus. The needle insertion direction is that two Kirschner wires are parallel to the ankle joint surface. Two k-wires were secured to a "well" type double reverse retractor. The sliding nut position of the double-sided long stud assembly 1 is rotated by a spanner to achieve the purpose of double reverse traction.
The application occasions are as follows:
1. the medicine is used before operation: maintaining limb length, controlling pain, reducing hemorrhage, and preventing further injury of soft tissue.
2. The method is used in the operation: when the fracture is reduced, the mechanical axis of the limb is complied, and the axial traction force is converted into the lateral extrusion force of the fracture end through the soft tissue sleeve, so that the fracture is naturally reduced.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present utility model, and not for limiting the same; although the utility model has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the utility model.
Claims (7)
1. A well dual reverse traction spreader comprising:
the two long stud assemblies (1) are arranged in parallel between the two long stud assemblies (1);
two groups of end sleeves (2), wherein the end sleeves (2) are fixed at the end parts of the long stud assembly (1), and a first steel needle (5.1) is arranged between the two groups of end sleeves (2) in a penetrating way;
the two groups of sliding sleeves (3), the sliding sleeves (3) are slidably mounted on the long stud assembly (1), and a second steel needle (5.2) is arranged between the two groups of sliding sleeves (3) in a penetrating mode.
2. A well dual reverse traction spreader according to claim 1, wherein the long stud assembly (1) is marked with graduations.
3. The well type double-reverse traction spreader according to claim 1, wherein a first threaded hole (2.1) is formed in the end sleeve (2), and the end of the long stud assembly (1) is fixed in the first threaded hole (2.1) in a penetrating manner; the middle part of the end sleeve (2) is provided with a first pore canal (2.2), the first pore canal (2.2) is penetrated with a first steel needle (5.1), and the first threaded hole (2.1) and the first pore canal (2.2) are arranged in a crisscross manner at different heights.
4. A well-type double counter traction spreader according to claim 1 or 3, characterized in that the bottom of the end sleeve (2) is provided with a first bolt hole (2.3), and the bottom of the end sleeve (2) is provided with a first base (6.1) through the first bolt hole (2.3).
5. The well type double-reverse traction spreader according to claim 1, wherein a round hole (3.1) is formed in the sliding sleeve (3), and the middle part of the fixed long stud assembly (1) is penetrated in the round hole (3.1); the middle part of the sliding sleeve (3) is provided with a second pore canal (3.2), the second pore canal (3.2) is penetrated with a second steel needle (5.2), and the round hole (3.1) and the second pore canal (3.2) are arranged in a crisscross manner at different heights.
6. The well-type double-reverse traction spreader according to claim 1 or 5, wherein the sliding sleeve (3) is provided with a second bolt hole (3.3) at the bottom, and a second base (6.2) is mounted at the bottom of the sliding sleeve (3) through the second bolt hole (3.3).
7. The well-type double-reverse traction spreader according to claim 1, wherein the sliding sleeve (3) is provided on both sides with a sliding nut (4) which is sleeved on the long stud assembly (1).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202321389696.2U CN220293617U (en) | 2023-06-02 | 2023-06-02 | Well type double reverse traction spreader |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202321389696.2U CN220293617U (en) | 2023-06-02 | 2023-06-02 | Well type double reverse traction spreader |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN220293617U true CN220293617U (en) | 2024-01-05 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202321389696.2U Active CN220293617U (en) | 2023-06-02 | 2023-06-02 | Well type double reverse traction spreader |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN220293617U (en) |
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2023
- 2023-06-02 CN CN202321389696.2U patent/CN220293617U/en active Active
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