KR101857910B1 - ankle fixation device - Google Patents

Abstract

The present invention relates to an ankle joint fixing device which is installed on the tibia or calcaneus to fix the fractured or dislocated tibia or calcaneus. The ankle joint fixing device, which is installed on the tibia or calcaneus, includes: a first member which has a distance reference unit formed to come in contact with a first point on the front part of the ankle having the tibia arranged therein; a second member which is installed to cover a side of the first member to relatively move against the first member and has a guide formed to come in contact with a second point on the rear part of the ankle having the calcaneus arranged therein while enabling measurement of the distance with the distance reference unit; and a fixing means which is formed to be inserted into the tibia and calcaneus through the second point by the guide in order to fix the tibia and calcaneus. The distance reference unit and the guide have parallel facing individual ends.

Description

An ankle fixation device

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ankle joint fixation device that enables fixation between a tibia and a calcaneus.

High-energy injuries, such as traffic accidents or high falls, can cause ankle-open fractures-dislocations with extensive skin and soft tissue defects. These injuries are often accompanied by comorbid injuries, and vital signs of the whole body are often not stable. In order to stabilize the fracture and dislocation, it is necessary to fix with metal plate and screws. However, prolonged operation and anesthesia for this purpose may exacerbate the general condition of the patient. In addition, The incision further exacerbates edema and increases the risk of infection. In this case, a temporary fixation of the ankle joint with an external fixator or the like, 1-2 weeks after the edema is submerged and the soft tissue condition is improved, the secondary fixation of the plate to the metal plate is being done. In this case, Przkora et al. Reported a method of temporary fixation from the calcaneal bone of the foot to the tibia through a metal wire (Przkora R, Kayser R, Ertel W, and Heyde CE. Temporary vertical tranarticular pin fixation on unstable ankle fractures with critical soft tissue conditions. Injury 2006; 37: 905-908.) Figure 1a shows an example of ankle open fracture-dislocation with extensive soft tissue injury.

FIG. 1B shows a state in which a metal wire is inserted upwards from the sole portion.

However, as shown in FIG. 1B, when a metal wire is inserted in the sole region, there is a high possibility of damaging blood vessels and nerves. Since the nerve and blood vessels travel from the medial side of the ankle to the footbath area, there is a high possibility that the metal wire will be inserted from the soles of the foot and cause damage to nerves and blood vessels.

Referring to FIGS. 1C and 1D, a black solid line indicates a metal wire, and arrows are likely to damage nerves and blood vessels by inserting metal wires into the blood vessels and nerves. Also, because the metal wire penetrates the subtalar joint and the ankle joint, it damages the cartilage. Once cartilage is damaged, it is difficult to regenerate, so there is a high likelihood of arthritis in this area. To overcome this disadvantage, the external fixation devices of Figs. 1E and 1F are used.

On the other hand, such an external fixation apparatus is disadvantageous in that it is expensive to use temporarily. In addition, although the operation time is less than the metal plate and screw fixation, since it takes a considerable time to apply the external fixation device, it is necessary to apply the device more quickly to minimize the physiological change (damage control orthopedics) . If there is a vascular injury in the open fracture site, the external fixator may obscure the visual field and treat complex wounds. Complex external fixators may interfere with vision and manipulation.

In particular, referring to FIG. 1G, recently, open-ended wound healing has been widely applied to open fractures (Lee YS, Cho JH, Park J, Han SH, The external fixation pin fingers, which are fixed in several places, are a major obstacle to attaching the film to apply the negative pressure. If there is a gap between the film and the skin due to the interference of the pin of the external fixation device and the air is allowed to pass through this place, the sound pressure is not applied. In this case, the exudation can not be discharged.

Therefore, it would be very helpful if there are devices and methods that can be applied faster than the external fixator without any damage to the cartilage, and also easy to apply the film for wound healing.

Fig. 1h is a view of the ankle from the rear, showing the nerves and veins running inward. Referring to FIG. 1H, important blood vessels and nerves in the ankle joint run to the posterior medial side, and there are no important nerves and blood vessels in the middle of the ankle posterior. Because the nerve and blood vessels do not travel in the middle of the ankle posterior, the posterior foot endoscopy can be performed without damage to the nerve or blood vessels when there is lesion in the posterior part. The posterior aspect of the ankle joint is known to be safe for performing posterior foot endoscopic surgery. Therefore, the ankle joint can be fixed by passing through a metal wire.

FIG. 1I is a cross-sectional view of the ankle from top to bottom, showing nerves and blood vessels in the medial circle. The right side of the figure shows that the femoral endoscope can be safely performed because the nerve and blood vessels are running inside the ankle joint and there is no dangerous structure in the center.

Therefore, if a metal wire is inserted and fixed from the calcaneal bone to the tibia posterior to the ankle joint, the ankle joint can be securely fixed temporarily. Because it does not pass through the joints, it can be used with a thicker wire, no damage to the cartilage, and because the pin is not bonded to the body like an external fixator, it can easily cover the film for sound pressure wound treatment and make it easier to apply sound pressure.

As shown in Figs. 1J and 1K, if a thick metal wire is inserted in the tibial direction from the rigid rear surface of the calcaneus (heel bone), and inserted into the center of the tibia, temporary ankle joint fixation can be performed without damaging the medial nerve and blood vessels.

It is an object of the present invention to provide an apparatus for temporarily fixing an ankle joint from a calcaneus to a tibia without damaging blood vessels and nerves.

It is another object of the present invention to provide an apparatus for temporarily fixing ankle joints from the calcaneus to the tibia without disturbing visual field and operation and being applicable simply and quickly.

In order to solve the above problems, an ankle joint fixing device of the present invention is an ankle joint fixing device provided with a tibia and a calf bone to fix a fractured or dislocated tibia and a calamus, A first member having a distance reference portion formed to be contactable with a first point; A first member which is provided to surround one side of the first member so as to be movable relative to the first member and is capable of contacting a second point on the rear side of the ankle where the calf is located, A second member having a guide for allowing the first member to be in contact with the first member; And fixing means for allowing the calcaneus and tibia to be inserted into the calf and tibia through the second point by the guide, wherein the distance reference portion and the guide have respective ends facing each other Are arranged so as to be parallel to each other.

A scale may be displayed on the body of the first member so that the insertion length in which the fixing means is inserted into the tibia and the calf bone between the distance reference portion and the guide can be measured.

Wherein the second member is provided with a locking screw so that the locking screw tightens the second member so as to press the first member such that the distance between the guide of the distance reference portion and the guide of the second member is determined, Can be fixed to the first member.

The fixing means includes a penetrating portion passing through a center portion of the ankle back so as to prevent the soft tissues from being caught up and to fix the tibia and calf bone; A calf bone connecting portion connected to the penetrating portion and configured to be coupled to the calf bone; And a fastening portion provided on one side of the fastening means connected to the calf joint portion and having a hexagonal cross section so as to be rotatable together with the removal tool so that the fastening means can be separated from the calf bone .

Wherein the first point is a side view of the ankle taken by the side of the ankle by a C-type x-ray fluoroscope, wherein a steel wire is inclined to pass through the tibia and the calyx, A first display line horizontally displayed at a point where it meets the first display line; And an ankle taken in front of the ankle by the C-type x-ray fluoroscope, the first point being defined on the basis of a steel wire arranged in a vertical direction so as to pass through the center of the tibia, And a point between the steel wires arranged in the vertical direction so as to pass through the center.

The second point being a second indication line horizontally displayed at a point where the steel wire is arranged to pass through the tibia and the calyx and the skin adjacent to the calyx; And an ankle taken from the back by the C-type X-ray radiographing device, the second point being determined based on a steel wire arranged in a vertical direction so as to pass through the center of the calf, And a point between the steel wires arranged in the vertical direction so as to pass through the center.

The distance reference portion may be disposed at the first point through the guide member in a state where the end portion of the guide member is disposed at the first point.

According to the present invention, since the fixing means is made to be able to engage the calcaneus and the tibia through the guide of the second member, the ankle joint can be temporarily fixed from the calcaneus to the tibia without damaging the blood vessels and nerves.

The present invention is simple and fast to apply, since the first and second members are in contact with the first and second points and the fastening means is coupled to the calf and tibia through the first and second members, Enables temporary fixation of the ankle joint from the possible calcaneus to the tibia.

FIG. 1A is a conceptual diagram illustrating an example of ankle open fracture-dislocation with extensive soft tissue injury. FIG.
FIG. 1B shows a state in which a metal wire is inserted upwards from the sole portion.
1C is a conceptual diagram showing an example in which a metal wire is inserted into a blood vessel nerve.
1D is a conceptual diagram showing an example in which a metal wire is inserted into a blood vessel nerve.
FIG. 1E is a perspective view showing an example of an external fixation device. FIG.
1F is a perspective view showing another example of an exodeviation fixing device.
FIG. 1G is a conceptual diagram showing an example of sound-pressure wound treatment. FIG.
Fig. 1H is a conceptual diagram showing a posterior medial side and a posterior side of the ankle joint.
Figure 1i is a cross-sectional view of the ankle from top to bottom.
Fig. 1J is a conceptual view showing a metal wire in the direction of the tibia from the rear surface of the calcaneus.
FIG. 1K is a conceptual view showing a metal wire in the direction of the tibia from the rear surface of the calcaneus. FIG.
2 is a perspective view showing first and second members of the present invention;
3 is a perspective view showing the fixing means and the removal tool of the present invention;
4 is a conceptual view showing an example of disposing a metal wire next to an ankle joint using a C-type x-ray fluoroscopic apparatus.
5 is a conceptual view showing an example of disposing a metal wire in the vertical direction at the center of the tibia;
6 is a conceptual diagram showing an example in which a guide member and a position indicator are located at a first point;
7 is a conceptual diagram showing an example in which a first member is installed at a first point;
8 is a conceptual view showing an example in which first and second members are located at first and second points, and fixing means is installed;
FIG. 9 is a conceptual view showing an example in which fixing means is attached to the chest and tibia such that the posterior of the middle and the tibia are temporarily fixed.
10 is a conceptual view showing an example of covering an engaging portion by a shielding member and a film;

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings, wherein like or similar elements are denoted by the same or similar reference numerals, and redundant description thereof will be omitted. The suffix "part" for the constituent elements used in the following description is to be given or mixed with consideration only for ease of specification, and does not have a meaning or role that distinguishes itself. In the following description of the embodiments of the present invention, a detailed description of related arts will be omitted when it is determined that the gist of the embodiments disclosed herein may be blurred. It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are intended to provide further explanation of the invention as claimed. , ≪ / RTI > equivalents, and alternatives.

Referring to FIGS. 2 and 3, an ankle anchoring apparatus 100 of the present invention includes a first member 10, a second member 20, and a fixing means 30. The second member 20 is inserted into the first member 10 so that the second member 20 moves in the direction of the body of the first member 10. [ The distance between the distance reference portion 12 provided at the end portion of the first member 10 and the guide 22 of the second member 20 connected to the second member 20 corresponds to the distance Length. The distance reference portion 12 can be made to be contactable with the first point 1a.

The distance between the distance reference portion 12 and the guide 22 of the second member 20 can be measured through a scale indicated on the body of the first member 10. [ After the length is measured, the second member 20 is fixed to the first member 10 by tightening the lock screw 23 to the second member 20.

On the other hand, the guide 22 of the second member 20 can be brought into contact with the second point 3a.

The distance reference portion 12 and the position indication portion 16 can be fastened to the guide member 14 and the position fixing portion 26 can be fastened to the guide 22 of the second member 20.

The fastening means 30 of Figure 3 is configured to be insertable into the calf 3 and the tibia 1 via the second point 3a by the guide 22 of the second member 20 so that the calf 3 and the tibia & (1) can be fixed.

The fastening means 30 may include a penetrating portion 33, a calamus coupling portion 35 and a fastening portion 37, wherein the penetrating portion 33 has a length varying the length of the fastening means 30 And the length of the calamus coupling portion 35 and the coupling portion 37 may be constant. On the other hand, the penetrating portion 33 is slippery without any thread, so that the soft tissue is prevented from being caught up when it passes the center portion of the ankle backward. The calcaneal joining portion 35 is a portion to be coupled to the calcar bone 3 and prevents the coupling portion 37 from sinking into the calcar bone 3. The fastening portion 37 is laterally fastened to the removal tool 40 in a hexagonal shape when the fastening means 30 is removed to facilitate removal thereof.

The first point 1a can be defined on the basis of the first indication line 1b and the steel wire 5 arranged in the vertical direction so as to pass through the center of the tibia 1. [

The first indication line 1b is configured such that the ankle is photographed from the side by a C-type X-ray inspecting device (not shown), and the steel wire 5 is inclined so as to pass through the tibia 1 and the calamus 3, Is a line horizontally displayed at the point where the steel wire 5 disposed so as to pass through the tibia 1 and the calcaneus 3 and the skin adjacent to the tibia 1 meet.

The steel wire 5 arranged in the vertical direction so as to pass through the center of the tibia 1 is taken from the front side of the ankle by the C-type X-ray inspecting apparatus and arranged in the vertical direction so as to pass through the center of the tibia 1 have.

The second point 3a can be determined based on the steel wire 5 arranged in the vertical direction so as to pass through the second indication line 3b and the center of the calamus 3.

The second indication line 3b is a line horizontally displayed at a point where the steel wire 5 is arranged to pass through the tibia 1 and the calamus 3 and the skin adjacent to the calamus 3.

A steel wire (5) arranged in the vertical direction so as to pass through the center of the calcaneus (3) is taken in the vertical direction by passing through the center of the calcaneus (3) while the ankle is photographed by the C- .

The first and second points 1a and 3a will be described in the following description.

Referring to FIG. 4, a position to fix the fixing means 30 is determined by using a metal wire 5 while observing the lateral view of the ankle using the C-type X-ray radiographing apparatus. The area that does not damage the articular cartilage through the calcaneus (3) is determined. The position on the anterior skin of the ankle is marked parallel to the ankle using a surgical pen.

5 shows an example in which the position is indicated at the anterior portion of the ankle joint and the central portion of the tibia 1 is also displayed while viewing the C-type x-ray fluoroscopic apparatus using the metal wire 5.

Referring to FIG. 6, after a small incision is made on the marked portion, the position indicator 16 is fastened to the guide member 14 and positioned thereon. After that, check the position again using the C-type X-ray device.

After removing the position indicator 16 from the guide member 14, the distance reference portion 12 of the first member 10 is inserted into the guide member 14 and fastened as shown in FIG.

8 shows an example of inserting the positioning member 26 after fastening the positioning member 26 to the guide 22 of the second member 20 after marking the back of the vertical bone 3 in a similar manner. Then, the distance between the distance reference portion 12 and the guide 22 of the second member 20 is measured with a scale indicated by the body of the first member 10. The length measured at this time is the length of the penetrating portion 33 and the calcaneous joining portion 35 of the fixing means 30. Then, after the position designating portion 26 is removed, the fixing means 30 having the measured length is inserted through the guide 22 of the second member 20. The fixing means 30 inserted through the guide 22 of the second member 20 is brought into contact with the distance reference portion 12. The fixing means 30 is fixed to the anterior cortical bone of the tibia 1. [

Fig. 9 shows a state in which the fixing means 30 is fixed to the cervical bone 3 and the tibia 1. Fig. Through this, the back of the rigid calcaneus 3 and the tibia 1 are fixed, thereby enabling temporary fixation.

If there is extensive soft tissue damage around the ankle joint, the film 55 should be covered on the skin for sound pressure wound healing and the sound pressure device should be connected. The joint portion 37 can be easily covered with the film 55, have.

Since the fastening portion 37 protrudes out of the heel skin, the film 55 needs to be replaced after each treatment after the wound healing. Therefore, when the fastening portion 37 is attached to the fastening portion 37, As shown in FIG. 10, when the shielding member 53 is used and the film 55 is put on the film 55, the air can be kept clean when the negative pressure is applied. The shielding member 53 may be a disposable sterile vinyl condom.

When the state of the soft tissue is improved and the final metal plate or screw is to be fixed, the fixing means 30 to be fastened to the fastening portion 37 can be removed by using the removal tool 40.

The ankle joint fixation apparatus 100 described above is not limited to the configuration and the method of the embodiments described above, but the embodiments may be configured by selectively combining all or a part of the embodiments so that various modifications can be made .

It will be apparent to those skilled in the art that the present invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. Accordingly, the above description should not be construed in a limiting sense in all respects and should be considered illustrative. The scope of the present invention should be determined by rational interpretation of the appended claims, and all changes within the scope of equivalents of the present invention are included in the scope of the present invention.

1: tibia 3: calyx
1a: first point 1b: first indication line
3a: second point 3b: second display line 5: steel wire
10: first member 12: distance reference portion
13: scale part 14: guide member
16: position indicator 20: second member
22: Guide of the second member 23: Locking screw
26: Position specification 30: Fixing means
33: penetrating part 35: calamus coupling part 37: fastening part
40: Removal tool
53: shielding member 55: film

Claims (7)

An ankle joint fixation apparatus comprising a tibia and a calf bone for fixing a fractured or dislocated tibia and a calcaneus,
A first member having a distance reference portion formed so as to be contactable with a first point in front of an ankle where the tibia is located;
A first member which is provided to surround one side of the first member so as to be movable relative to the first member and is capable of contacting a second point on the rear side of the ankle where the calf is located, A second member having a guide for allowing the first member to be in contact with the first member; And
And fixing means for being able to be inserted into the calf and tibia through the second point by the guide to fix the calf and tibia,
Wherein the distance reference portion and the guide are disposed such that their respective ends face each other and are parallel to each other.
The method according to claim 1,
Wherein a scale is displayed on the body of the first member such that an insertion length of the fixing means inserted into the tibia and the calf bone can be measured between the distance reference portion and the guide.
The method according to claim 1,
Wherein the second member is provided with a locking screw so that the locking screw tightens the second member so as to press the first member such that the distance between the guide of the distance reference portion and the guide of the second member is determined, So as to be fixed to the first member. The method according to claim 1,
Wherein,
A penetrating portion that passes through a center portion of the ankle back to fix the soft tissue and prevents the tibia and the calcaneus from being attached;
A calf bone connecting portion connected to the penetrating portion and configured to be coupled to the calf bone; And
And an engaging portion provided on one side of the fixing means connected to the calf joint portion and having a hexagonal cross section so as to be rotatable together with the removal tool so that the fixing means can be separated from the calf bone, .
The method according to claim 1,
Wherein the first point
The ankle is photographed from the side by the C-type X-ray inspecting apparatus, and a steel wire is inclined so as to pass through the tibia and the calybra so as to be horizontally positioned at a point where the steel wire is arranged to pass the tibia and the calyx and the skin adjacent to the tibia A first display line displayed; And
The ankle is photographed from the front by the C-type x-ray apparatus, and is determined on the basis of a steel wire arranged in the vertical direction so as to pass through the center of the tibia,
Wherein the first point is a point that meets between the first indication line and the steel wire arranged in the vertical direction so as to pass through the center of the tibia.
6. The method of claim 5,
The second point,
A second display line horizontally displayed at a point where a steel wire disposed across the tibia and the calamus and a skin adjacent to the calamus meet; And
The ankle is photographed from the back surface by the C-type x-ray fluoroscope and is determined based on a steel wire arranged in the vertical direction so as to pass through the center of the calcaneus,
And the second point is a point that meets between the second indication line and the steel wire arranged in the vertical direction so as to pass through the center of the calf bone.
The method according to claim 1,
The distance-
Wherein an end portion of the guide member is disposed at the first point through the guide member in a state where the end portion of the guide member is disposed at the first point.

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