TW201703731A - Fastening apparatus and method for intramedullary nail - Google Patents

Abstract

A fastening apparatus for intramedullary nail includes a positioning base metal component, a plurality of female joint tubes, a support rod and a handles. The positioning base is having a plurality of holes. The female joint tubes through in the holes. The female joint tubes are a pipe and providing a drill, a positioning needle and a fitting element passed through. The support rod is a bending pipe and connected to the positioning base. The handle is connected to an end of the support rod.

Description

Bone nail positioning device for bone marrow nail and positioning method thereof

The invention relates to a device for intramedullary nailing, in particular to a nail positioning device for a bone marrow nail and a positioning method thereof.

The intramedullary nail is the internal fixation used in fracture surgery. As the name suggests, the intramedullary nail is a long steel nail placed in the bone marrow cavity to help restore the shape of the bone after fracture to the natural state before the damage. When using the intramedullary nail, the hole is drilled at one end of the long bone, and the intramedullary nail is implanted into the bone marrow cavity of the long bone, and then the ends of the intramedullary nail are fixed through a plurality of bone screws to make the intramedullary nail The nail is firmly combined with the long bone.

Intramedullary nail surgery is usually performed under X-rays, so that the appropriate position perforation can be found directly on the femur, and the bone screw can be inserted from the side of the femur and aligned with the perforation of the intramedullary nail, and finally from the femur. The other side is worn out. However, when there is an error in the perforation of the position of the femur and the perforation of the intramedullary nail, the bone screw must be pulled out again and then in, which not only causes unnecessary physical damage, but also prolongs the recovery time and lengthens the operation time of the intramedullary nail. In addition, the current intramedullary nail surgery also through the X-ray machine from the outer end perspective to find the hole in the bone marrow, and then correct the drilling hole for construction, but because of the high cost of X-ray machine installation, and operation Personnel are often exposed to radiation from the source of light, causing health damage. To this end, how to provide a nail positioning device for bone marrow nails and a positioning method thereof to improve the accurate positioning of the intramedullary nails and to avoid radiation hazards is the motivation of the inventors.

In view of the above, the present inventors have made great efforts to study and cooperate with the application of the theory, and finally propose a novel design that is reasonable in design and effective in improving the above-mentioned defects.

An object of the present invention is to provide a nail positioning device for a bone marrow nail and a positioning method thereof, thereby improving the accuracy of nailing of the intramedullary nail.

In order to achieve the above object, the present invention is a nail positioning device for intramedullary nails for binding an intramedullary nail to a tibia. The nail positioning device comprises a nail positioning seat, a plurality of sleeves, a support rod and a handle. . The nail positioning seat has a plurality of through holes corresponding to the perforations of the intramedullary nails; the sleeves are correspondingly connected in the through holes, and each of the sleeves is a hollow tube for inserting the drill bit of the intramedullary nail, the positioning rod needle and the fixing member; The support rod is a bent pipe body, and the support rod is connected to one side of the nail positioning seat; the handle is disposed at the end of the support rod.

In order to achieve the above object, the present invention is a nail positioning method for a bone marrow nail, comprising: a) providing an intramedullary nail, at least one positioning rod needle, at least one drill bit and a plurality of fixing members, and the intramedullary nail has a spacing a perforation and a second perforation; b) providing a nail positioning device; c) identifying a first indication and a second indication corresponding to the first perforation and the second perforation on the tibia; d) a sleeve positioning device The tube is aligned with the first marking portion and the second marking portion, and the drill bit is inserted into the sleeve of the nail positioning device, and drilling is performed at the first marking portion and the second marking portion to correspondingly drill the first proximal end hole and a first distal hole; e) withdrawing the drill bit in step d), and then inserting the intramedullary nail into the tibia; f) rotating the intramedullary nail such that the first perforation of the intramedullary nail is aligned with the humerus a proximal end hole, the second perforation of the intramedullary nail is aligned with the first distal end of the tibia, and the positioning rod is inserted into the first proximal end of the tibia and the first perforation of the corresponding intramedullary nail; g) Passing the drill bit into the first distal hole of the tibia and the second perforation of the corresponding intramedullary nail, and in the tibia Drilling the opposite side of the first distal hole to drill a second distal hole; h) penetrating the fixation member into the first distal hole of the tibia, the second perforation of the corresponding intramedullary nail, and the second distal end of the tibia End holes and lock them.

Compared with the prior art, the nail positioning device of the intramedullary nail of the present invention and the positioning method thereof are first marked on the perforation position of the corresponding intramedullary nail on the tibia, and then the nail positioning device is used at the identification position (the side of the tibia) Perforation, then penetrate the intramedullary nail, and then wear the set rod for alignment, to drill the other side of the humerus, and finally put the fixation member in the aligned tibia and bone marrow nail In the perforation, thereby ensuring that the drilling of the tibia can be properly positioned with the perforation of the intramedullary nail to improve the accurate positioning of the intramedullary nail; that is, the present invention first drills the first proximal hole in the tibia and a first distal hole, so that the first perforation and the second perforation of the intramedullary nail can be aligned through the first proximal end hole and the first distal end hole when inserting the intramedullary nail; further, in the bone marrow of the present invention The nail nail positioning device and the positioning method thereof do not need to use an X-ray machine, so that the radiation hazard can be avoided, and the utility of the invention is further increased.

The detailed description and technical content of the present invention are set forth in the accompanying drawings.

Please refer to FIG. 1 to FIG. 4 , which are respectively a perspective view of a nail positioning device combined with an auxiliary positioning device according to the present invention, a perspective exploded view, a stereoscopic appearance of one side of the nail positioning device, and another side of the nail positioning device. Schematic diagram of the three-dimensional appearance of the direction. The nail positioning device 1 of the intramedullary nail of the present invention is for bonding an intramedullary nail 100 having a perforation to the tibia 2 (please refer to Fig. 10). The nail positioning device 1 includes a nail positioning seat 10, a plurality of sleeves 20, a support rod 30 and a grip 40. The sleeves 20 are attached upright to the staple positioning seat 10. The support rod 30 is connected to the nail positioning seat 10 and is provided with the handle 40 for the user to hold and perform the nailing operation of the intramedullary nail 100.

The staple positioning seat 10, preferably a stainless steel block, has a plurality of through holes 11 corresponding to the perforations of the intramedullary nail 100 (the first perforation 100a and the second perforation 100b). The sleeves 20, preferably stainless steel tubes, are correspondingly connected in the through holes 11 of the nail positioning seat 10. Each of the sleeves 20 is a hollow tube that can be inserted into the drill bit 101, the positioning rod needle 102 and the fixing member 103; further, each of the sleeves 20 has an internal thread at one end connected to the nail positioning seat 10. 21, the internal thread 21 is arranged to thread the article that penetrates the sleeve 20.

The support rod 30 is a bent pipe body, and the support rod 30 is connected to one side of the nail positioning seat 10. Moreover, the handle 40 is disposed at the end of the support rod 30; preferably, the support rod 30 is a stainless steel tube; in addition, the handle 40 is a wooden handle having an embossed pattern to provide anti-slip when held effect.

In the present embodiment, the nail positioning device 1 of the intramedullary nail further includes an auxiliary positioning device 1'. The auxiliary positioning device 1' includes an auxiliary positioning seat 10', an extension rod 30' connecting the auxiliary positioning seat 10', and an auxiliary grip 40' disposed at the end of the extension rod 30'. Further, the auxiliary positioning seat 1' has a two-pass hole 11' corresponding to the sleeve 20 of the nail positioning device 1. In actual implementation, the auxiliary positioning seat 10 ′ is disposed outside the two sleeves 20 and is located below the nail positioning seat 10 to provide a supporting balance force, thereby preventing the nail positioning device 1 from shaking. The nail positioning device 1 has a better alignment effect.

As shown in FIG. 3 and FIG. 4, in an embodiment of the present invention, the support rod 30 includes a connecting portion 31 connecting the nail positioning base 10 and a curved portion 32 extending from the connecting portion 31, wherein The curved section 32 is formed with a skew angle A in the axial direction of the connecting section 31, and an upper inclination angle B is formed in the horizontal direction of the connecting section 31. Preferably, the angle of the skew angle A is between 45 degrees and 60 degrees, and the angle of the uptilt angle B is between 30 degrees and 45 degrees. The setting of the skew angle A and the uptilt angle B can be provided. The user preferably applies force and operating angle. The positioning method of the nail positioning device 1 of the present invention will be described in detail later.

Please refer to FIG. 5 to FIG. 11 respectively, which are respectively a flow chart of a nail positioning method for a bone marrow nail according to the present invention, a schematic diagram of the use, a drilling schematic diagram of the distal hole, a drilling schematic diagram of the proximal hole, a positioning schematic diagram, and a distal end. Schematic diagram of hole drilling and locking of the distal hole. When the nail positioning device 1 of the intramedullary nail of the present invention is used, as shown in FIGS. 5 and 6, an intramedullary nail 100, at least one drill 101, at least one positioning rod 102, and a plurality of fixing members 103 are first provided. The intramedullary nail 100 has a first perforation 100a and a second perforation 100b spaced apart (step a); in addition, the aforementioned nail positioning device 1 is provided (step b).

It is to be noted that an auxiliary positioning device 1' may be additionally provided in step a. The auxiliary positioning device 1' is coupled to the nail positioning device 1 to provide a supporting balance force to the nail positioning device 1, thereby preventing the nail positioning device 1 from rattling.

Next, a first indication 2a and a second indication 2b corresponding to the first perforation 100a and the second perforation 100b are identified on a tibia 2 (step c). Subsequently, the sleeve 20 of the nail positioning device 1 is aligned with the first indication portion 2a and the second indication portion 2b, and the drill bit 101 is inserted into the sleeves 20.

Referring to FIG. 7 and FIG. 8 , drilling is performed on the first marking portion 2 a and the second marking portion 2 b to drill a first proximal hole 3 a and a first distal hole 3 b (step d). . The auxiliary positioning device 1' can then be removed.

It should be noted that, in the present invention, the upper part of the tibia 2 is connected to the human knee, and the lower part of the tibia 2 is connected to the human ankle. In addition, the proximal end in the present invention refers to the side close to the knee of the human body; on the other hand, the distal end refers to the side close to the ankle of the human body.

Referring to FIG. 9 to FIG. 11 , after the first proximal hole 3 a and the first distal hole 3 b are drilled on the tibia 2, the drill bit 101 in the step d is extracted, and the intramedullary nail 100 is worn. Into the tibia 2 (step e), the intramedullary nail 100 is rotated such that the first perforation 100a of the intramedullary nail 100 is aligned with the first proximal hole 3a of the tibia 2, and the second end of the intramedullary nail 100 The perforation 100b is aligned with the first distal end hole 3b of the tibia 2; that is, the present invention is inserted into the bone marrow by first drilling the first proximal end hole 3a and the first distal end hole 3b in the tibia 2 When the nail 100 is received, the first perforation 100a and the second perforation 100b of the intramedullary nail 100 can be aligned through the first proximal end hole 3a and the first distal end hole 3b, and then the positioning rod needle 102 is inserted into the nail The first proximal hole 3a of the tibia 2 and the corresponding first perforation 100a of the intramedullary nail 100 (step f).

It should be noted that the first proximal end hole 3a and the first distal end hole 3b may not be drilled at the same time. In actual implementation, the drill bit 101 may drill the first proximal end hole at the first indication portion 2a. After the 3a, the positioning rod needle 102 is first inserted into the first proximal end hole 3a and the first through hole 100a; subsequently, the drill bit 101 is drilled at the second indication portion 2b to drill the first distal end hole 3b. The other positioning rod needle 102 is inserted into the first proximal hole 3a of the tibia 2 and the corresponding first perforation 100a of the intramedullary nail 100 (step f).

It should be noted that each of the positioning rod pins 102 has a tapered end, and the tapered end is arranged for the positioning rod needle 102 to make a notch on the inner wall surface of the tibia 2 to prevent the tibia 2 from being positioned by the positioning rod The impact of 102 caused a scum.

In addition, the step f further includes the positioning rod needle 102 penetrating the first proximal hole 3a and the first through hole 100a, and tapping the positioning rod needle 102 with a foreign object to make the positioning rod needle 102 (conical a first positioning hole 4a' is formed on the inner wall surface of the tibia 2 relative to the first proximal hole 3a; likewise at the first distal hole 3b, the step f includes the positioning rod pin 102 penetrating The first distal hole 3b and the second through hole 100b, and a second positioning hole 4b' is formed on the inner wall surface of the tibia 2 relative to the first distal hole 3b. The first positioning hole 4a' and the second positioning hole 4b' are advantageous for the drill bit 101 to drill the tibia 2 more accurately.

Referring to FIG. 12, after the positioning rod needle 102 penetrates the first proximal hole 3a and the first through hole 100a, the drill bit 101 is then inserted into the first distal hole 3b of the tibia 2 and Corresponding to the second perforation 100b of the intramedullary canal 100, and drilling a second distal end hole 4b on the opposite side of the first distal end hole 3b of the tibia 2 (the second positioning hole 4b') Step g).

Referring to FIG. 13, after the drill bit 101 drills the first distal hole 3b and the second distal hole 4b on opposite sides of the tibia 2, the positioning rod needle 102 is removed from the second through hole 100b. Moving out, the fixing member 103 is inserted into the first distal hole 3b of the tibia 2, the corresponding second perforation 100b of the intramedullary nail 100, and the second distal hole 4b of the tibia 2, and is locked. (Step h).

In this embodiment, the step (a) further includes providing a screwdriver 104. Further, the fixing member 103 is a screw. In the step h, the screwdriver 104 extends into the sleeve 20 and locks the fixing member 103 into the first distal hole 3b, the second through hole 100b and the second distal hole 4b.

Please refer to FIG. 14 to FIG. 16 , which are schematic diagrams of the proximal hole drilling of the nail positioning device of the intramedullary nail of the present invention, the locking diagram of the proximal hole and the planar view of the intramedullary nail. Referring to FIG. 14, after the fixing member 103 is locked into the first distal hole 3b, the second through hole 100b and the second distal hole 4b, the screwdriver 104 can be removed from the sleeve 20 first. At this time, another positioning rod needle 102 is removed from the first perforation 100a, and then the drill 101 is inserted into the first proximal hole 3a of the tibia 2 and the corresponding first perforation of the intramedullary nail 100. 100a, and drilling a second proximal hole 4a on the opposite side of the first proximal hole 3a of the tibia 2 (the first positioning hole 4a') (step i).

Referring to FIG. 15 , another fixing member 103 is further inserted into the first proximal hole 3 a of the tibia 2, the corresponding first perforation 100 a of the intramedullary nail 100 and the second proximal end of the tibia 2 . The hole 4a is locked and locked (step j). It is to be noted that in step j, another screwdriver 103 can be used to extend into the sleeve 20, and the fixing member 103 (screw) is locked into the first proximal hole 3a, the first through hole 100a and the second In the proximal hole 4a.

Subsequently, as shown in Fig. 14, the two screwdrivers 104 are removed from the sleeve 20, and finally the nail positioning device 1 is removed. Accordingly, the intramedullary nail 100 is locked in the tibia 2 through the two fixing members 103 to complete the positioning operation of the intramedullary nail 100.

The above is only the preferred embodiment of the present invention, and is not intended to limit the scope of the invention, and other equivalent variations of the patent spirit of the present invention are all within the scope of the invention.

1‧‧‧nail positioning device

1'‧‧‧Assisted positioning device

2‧‧‧胫骨骨

2a‧‧‧First Marking

2b‧‧‧Second Markings

3a‧‧‧First proximal hole

3b‧‧‧first remote hole

4a’‧‧‧First positioning hole

4b’‧‧‧Second positioning hole

4a‧‧‧Second proximal hole

4b‧‧‧Second distal hole

100‧‧‧ intramedullary nail

100a‧‧‧first perforation

100b‧‧‧second perforation

101‧‧‧ drill bit

102‧‧‧ Positioning rod

103‧‧‧Fixed parts

104‧‧‧ Screwdriver

10‧‧‧nail positioning seat

10’‧‧‧Assisted Positioning Block

11‧‧‧Tongkong

11’‧‧‧through hole

20‧‧‧ casing

21‧‧‧ internal thread

30‧‧‧Support rod

30’‧‧‧Extension rod

31‧‧‧Connection section

310‧‧‧Axial

311‧‧‧ horizontal direction

32‧‧‧bend

40‧‧‧Handle

A‧‧‧歪 oblique angle

B‧‧‧Upper angle

1 is a schematic perspective view of a nail positioning device combined with an auxiliary positioning device according to the present invention;

2 is a perspective exploded view of the nail positioning device of the present invention combined with an auxiliary positioning device;

Figure 3 is a perspective view showing the stereoscopic appearance of the nail positioning device of the intramedullary nail of the present invention in one direction;

Figure 4 is a perspective view showing the perspective of the other side of the nail positioning device of the intramedullary nail of the present invention;

5 is a flow chart of a nail positioning positioning method of the intramedullary nail of the present invention;

Figure 6 is a schematic view showing the use of the nail positioning device of the intramedullary nail of the present invention;

Figure 7 is a schematic view showing the drilling of the distal hole of the nail positioning device of the intramedullary nail of the present invention;

Figure 8 is a schematic view showing the drilling of the proximal hole of the nail positioning device of the intramedullary nail of the present invention;

9 is a schematic view showing the distal hole and the proximal hole alignment of the nail positioning device of the intramedullary nail of the present invention; FIG. 10 is a far short hole and a proximal hole pair of the nail positioning device of the intramedullary nail of the present invention; Bit completion diagram;

Figure 11 is a schematic view showing the positioning of the nail positioning device of the intramedullary nail of the present invention;

Figure 12 is a schematic view showing the distal hole drilling of the nail positioning device of the intramedullary nail of the present invention;

Figure 13 is a schematic view showing the locking of the distal hole of the nail positioning device of the intramedullary nail of the present invention;

Figure 14 is a schematic view showing the proximal hole drilling of the nail positioning device of the intramedullary nail of the present invention;

Figure 15 is a schematic view showing the locking of the proximal hole of the nail positioning device of the intramedullary nail of the present invention;

Figure 16 is a plan view showing the interlocking of the intramedullary nail of the present invention.

1‧‧‧nail positioning device

10‧‧‧nail positioning seat

11‧‧‧Tongkong

20‧‧‧ casing

30‧‧‧Support rod

31‧‧‧Connection section

32‧‧‧bend

40‧‧‧Handle

A‧‧‧歪 oblique angle

Claims (14)

An intramedullary nail nail positioning device for binding a perforated intramedullary nail to a tibia, the nail positioning device comprising: a nail positioning seat having a plurality of through holes corresponding to the perforation of the intramedullary nail a plurality of sleeves correspondingly connected to the through holes, each of the sleeves being a hollow tube for inserting the drill bit, the positioning rod needle and the fixing member of the intramedullary nail; a support rod for a bend a folded body attached to one side of the nail positioning seat; and a grip disposed at an end of the support rod. The staple positioning device of the intramedullary nail according to claim 1, wherein the nail positioning seat is a stainless steel block seat, and each of the sleeve and the support rod is a stainless steel tube, and the handle is a wooden handle. The nail positioning device of the intramedullary nail according to claim 1, wherein each of the sleeves has an internal thread at an end connected to the nail positioning seat. The nail positioning device of the intramedullary nail according to claim 1, wherein the support rod comprises a connecting portion connecting the nail positioning seat and a curved portion extending from the connecting portion, the curved portion is The connecting section has an oblique angle formed in the axial direction and an upward inclination angle with respect to the horizontal direction of the connecting section. The nail positioning device of the intramedullary nail according to claim 4, wherein the angle of the skew angle is between 45 degrees and 60 degrees, and the angle of the uptilt angle is between 30 degrees and 45 degrees. The nail positioning device of the intramedullary nail according to claim 4, further comprising an auxiliary positioning device, the auxiliary positioning device comprising an auxiliary positioning seat, an extension rod connecting the auxiliary positioning seat, and an end disposed at the end of the extension rod An auxiliary positioning seat has two through holes corresponding to the two sleeves. A method for positioning a nail in a bone marrow nail, comprising: a) providing an intramedullary nail, at least one positioning rod, at least one drill bit, and a plurality of fixing members, wherein the intramedullary nail has a first perforation and a second perforation b) providing a nail positioning device as claimed in claim 1; c) identifying a first indication and a second indication corresponding to the first perforation and the second perforation on a tibia; d) The sleeve of the nail positioning device is aligned with the first marking portion and the second marking portion, and the drill bit is inserted into the sleeve of the nail positioning device, and is performed at the first marking portion and the second marking portion Drilling a corresponding first proximal hole and a first distal hole; e) withdrawing the drill bit in the step d), and then inserting the intramedullary nail into the tibia; f) rotating the intramedullary nail Aligning the first perforation of the intramedullary nail with the first proximal end of the tibia, the second perforation of the intramedullary nail is aligned with the first distal end of the tibia, and the positioning rod is inserted into the tibia a first proximal hole and a corresponding first perforation of the intramedullary nail; g) penetrating the drill bit into the first distal hole of the tibia and the corresponding second perforation of the intramedullary nail, and drilling a hole in the opposite side of the first distal hole of the tibia to drill a second far An end hole; and h) penetrating the fastener into the first distal end of the tibia, the corresponding second perforation of the intramedullary nail, and the second distal end of the tibia, and locking. The nail positioning method of the intramedullary nail according to claim 7, wherein in the step a), an auxiliary positioning device as claimed in claim 6 is additionally provided, and the auxiliary positioning device is coupled to the nail positioning seat. The nail positioning method of the intramedullary nail according to claim 7, wherein the drill bit drills the first proximal hole at the first indication, and then the positioning rod needle penetrates the first proximal hole and After the first perforation, the drill bit subsequently drills the first distal hole at the second indication. The nail positioning method of the intramedullary nail according to claim 7, wherein each of the positioning rod needles has a tapered end, and the step f) further comprises the positioning rod needle penetrating the first proximal end hole and the first Piercing and punching a first positioning hole in the inner wall surface of the tibia relative to the first proximal hole. The nail positioning method of the intramedullary nail according to claim 10, wherein the step f) further comprises the positioning rod needle penetrating the first distal hole and the second perforation, and the first humerus is opposite to the first A second positioning hole is formed in the inner wall surface of the distal hole. The nail positioning method of the intramedullary nail according to claim 7, wherein the step a) further comprises: providing a screwdriver, the fixing member is a screw, and the screw driver extends into the sleeve in the step h) And locking the screw into the first distal hole, the second through hole and the second distal hole. The nail positioning method of the intramedullary nail according to claim 7, further comprising the step i), wherein the step i) is that the drill bit penetrates into the first proximal hole of the tibia and the corresponding intramedullary nail A perforation is made and a second proximal hole is drilled by drilling a hole in the opposite side of the first distal hole of the tibia. The nail positioning method of the intramedullary nail according to claim 13, further comprising the step j), wherein the step j) is to insert another fixing member into the first proximal hole of the tibia, corresponding to the bone marrow The first perforation of the inner nail and the second proximal end of the tibia are locked.