WO2018228432A1

WO2018228432A1 - Multifunctional fracture resetting and guiding forceps

Info

Publication number: WO2018228432A1
Application number: PCT/CN2018/091062
Authority: WO
Inventors: 翟延荣
Original assignee: 翟延荣
Priority date: 2017-06-16
Filing date: 2018-06-13
Publication date: 2018-12-20
Also published as: CN107496008B; CN107496008A

Abstract

Disclosed are multifunctional fracture resetting and guiding forceps, comprising: a central guiding sleeve (1) having a sliding sleeve (2) movably provided on a surface thereof; the sliding sleeve (2) is provided with a pair of forceps-body hinged ends (3) thereon; the central guiding sleeve (1) has provided thereon a pair of forceps-opening hinged ends (4) corresponding to the forceps-body hinged ends (3); each of the two forceps-body hinged ends (3) has a forceps body (5) hinged thereto to form an extendable forceps body; each of the two forceps-arm hinged ends (4) has a forceps arm (6) hinged thereto to form an arc-shaped encircling forceps mouth; the forceps body (5) and the forceps arm (6) on the same side are hinged together by means of a common hinged end (7); when the forceps body (5) is rotated and extended with the forceps-body hinged ends (3) as a center, the forceps body (5) drives, via the common hinged end (7), the forceps arm (6) to rotate or to extend with the forceps-arm hinged ends (4) as a center, such that the central guiding sleeve (1) is always located on a line bisecting the two forceps arms (6), thereby determining the center of the cross section of a diaphysis; the central guiding sleeve (1) has a pressing sleeve (8) movably provided therein; and the central guiding sleeve (1) is further provided with engagement structures for limiting the motion positions of the pressing sleeve (8). The guiding forceps are simple to operate when used to assist with the resetting of fractures.

Description

Multifunctional fracture reduction guide pliers

Technical field

The invention relates to the field of medical instruments, in particular to a medical device for guiding drilling and assisting fracture reduction.

Background technique

Minimally invasive percutaneous plate osteosynthesis (MIPPO) is characterized by incision of the fracture end, indirect fracture closure, percutaneous insertion of anatomical locking bone plate fixation, maximally protecting the periosteal soft tissue blood supply at the fracture end It is beneficial to fracture healing. Its advantages are small surgical trauma, less bleeding, quick fracture healing, less infection complications, and shorter hospitalization time. However, due to indirect closed reduction, fracture reduction is difficult, and it cannot be temporarily fixed after fracture reduction. Complications such as fracture malunion and delayed healing often occur. These issues limit the widespread use of MIPPO technology.

In recent years, remote closed fracture reduction, robotic reduction of long bone fracture and other techniques to achieve minimally invasive surgery, especially the emergence of the current popular three-dimensional (3D) imaging navigation robot assisted fracture reduction and other techniques for the minimally invasive surgery, but because of expensive equipment The operation is complicated, the fracture closure position is not good, the reliability is poor, and it cannot be clinically popularized.

Patent (Publication No.: 203138653U) discloses a reset guide pliers for pairing, the embracing clamp is composed of two mutually intersecting calipers through a rotating shaft, and the jaws and the caliper body are in a "Z" shape, so that the jaws are The inner sleeve is on the same plane. However, the disadvantages of this type of resetting pliers are as follows: 1. The caliper structure of the resetting pliers is not in the same plane as the control center structure, and the stability is not good; 2. Due to the structural reasons, the front and back of the resetting pliers are relatively large. The resetting pliers cannot be placed on the adjacent screw holes of the bone plate; 3. The jaws and the caliper body are in a "Z" shape so that the jaws and the inner sleeve are on the same plane, which is prone to deformation when the force is restored, affecting the fracture reduction. ; 4. The two inverted "L"-shaped fasteners of the quick-pressure cylinder are easily slipped when they are pressed into the square thread.

Summary of the invention

It is an object of the present invention to overcome the problems of the prior art and to provide a multifunctional fracture reduction guide pliers.

In order to achieve the above technical effects and achieve the above technical effects, the present invention is achieved by the following technical solutions:

A multifunctional fracture reduction guide pliers includes a central guiding sleeve, a surface of the central guiding sleeve is movably provided with a sliding sleeve, and the sliding sleeve is provided with a pair of caliper hinged ends, the central guiding sleeve A pair of jaw hinge ends corresponding to the hinge end of the caliper body are arranged, and a caliper body is hinged on each of the hinged ends of the two caliper bodies to form a telescopic caliper body, and the jaw joints of the two jaws are respectively hinged with a jaw to form an arc embracing a jaw, the same side of the caliper body and the jaws are hinged together by a common hinge end, the tong body is rotated around the hinged end of the caliper body, and the jaw is hinged through the common hinge end driving jaw The central rotation is hovering or unfolding, and the jaws and the central guiding sleeve cooperate such that the central guiding sleeve is always on the bisector between the two jaws, thereby determining the center of the backbone cross-section, the central guiding sleeve is movable A pressing sleeve is arranged, and the central guiding sleeve is provided with a fastener structure to limit the movement position of the pressing sleeve.

Further, the two clamp body hinge ends are symmetric along the center of the sliding sleeve, the two jaw hinge ends are symmetric along the center of the center guide sleeve, and the clamp body hinge end is coplanar with the jaw hinge end .

Further, the tong body hinge end, the jaw hinge end and the common hinge end are a rotating auxiliary structure, the tong body is provided with a tong body bending section at one end, and the jaw end is provided with a jaw bending section at the end of the tong body. The intersection of the caliper body and the tong body bending section is rotatably disposed on the tong body hinge end, and the intersection of the jaw and the jaw bending section is rotatably disposed on the jaw hinge end, and the tong body is folded One end of the curved section and the jaw bending section are rotatably coupled together by a common hinge end.

Further, the jaw is an arc-shaped embracing structure, and a longitudinal triangular-shaped structure groove is disposed inside the arc of the jaw.

Further, the front end of the jaw is a conical converging structure, and a circular arc transition section is provided at a tip end of the conical converging structure.

Further, the caliper body and the tong body bending section are an integral structure, and the jaws and the jaw bending section are an integral structure.

Further, the two tongs are respectively provided with a long rack and a buckle ring that cooperate with each other.

Further, the fastener structure is composed of a mating block, a bolt and a spring piece, and the bottom of the mating block is fixed on the central guiding sleeve, and the upper part of the mating block is provided with a groove, and the bolt is disposed at the upper part of the mating block In the groove, and the pin is rotatably connected to the mating block through the rotating shaft, and the spring piece is fixed on the outer side of the mating block, and one end of the spring piece presses the back of the tooth of the pin and presses the tooth of the pin A pre-thrust is applied to the back, and the outer surface of the pressing sleeve is provided with a helical tooth thread, and the tooth tip portion of the bolt tooth cooperates with the helical tooth thread of the outer surface of the pressure sleeve.

Further, the upper end of the pressing sleeve is provided with a flat key surface, and the flat key surface is matched with a T-type wrench, and the inner side of the T-type wrench is provided with a convex block, and the T-shaped wrench passes through the convex block and The flat key surface cooperates to twist the pressure sleeve to rotate.

The beneficial effects of the invention are:

1. The fracture reduction guiding plier structure of the invention fits the theory of "reciprocal tangential axis reduction", and the fracture reduction is good and reliable, the operation is simple, the difficulty of closed reduction in clinical operation is solved, and the fixation can be temporarily fixed, the operation time is short, and the operation is short. Less, the incision is small.

2. The fracture reduction guide pliers of the present invention can be combined with the MIPPO (minimally invasive percutaneous plate fixation) technique, and the fracture end closure is not performed during the operation, the soft tissue and periosteal injury at the fracture end are small, and the fracture healing is fast, which is beneficial to reduce infection. occur.

3. Fracture reduction is reliable and reliable. There is no need for multiple fluoroscopy adjustments during surgery to reduce the radiation exposure of doctors and patients. In principle, as long as the traction is sufficient, the fracture can be reset well.

4. When the reduction of the fracture-reducing guide forceps is used, the single fixation function of the traditional anatomical locking bone plate is changed, and the anatomical locking bone plate is used as a reference for the reduction and fixation with the fracture reduction guide pliers.

5. Fracture reduction guide jaws are curved and embracing structures. The jaws only need to extend beyond the semi-circum of the femoral shaft to fix the backbone. It is not necessary to completely surround the femoral shaft. It is easy to place and has less trauma, so as to avoid damage to important vascular nerves deep in the bone. Safe and reliable.

6. Reset fixation is fixed by elastic bridge, allowing the fracture end to be slightly fretting, stimulating bone regeneration, which is conducive to the formation of callus.

7. If you need to adjust the position of the anatomical locking bone plate, you only need to loosen the reset forceps to avoid the conventional temporary drilling and fixing the bone plate and reduce the occurrence of iatrogenic fractures.

DRAWINGS

Figure 1 is a front view of the present invention;

Figure 2 is a side elevational view of the present invention;

Figure 3 is a top plan view of the present invention (vertical);

Figure 4 is a perspective view of the off-axis stereotype of the present invention;

Figure 5 is a perspective view of the caliper body of the present invention;

Figure 6 is a perspective view of the jaw of the present invention;

Figure 7 is a structural view of the front end portion of the jaw of the present invention;

Figure 8 is a schematic structural view of a fastener of the present invention;

Figure 9 is a front view of the pressure sleeve of the present invention;

Figure 10 is a perspective view of the T-type wrench of the present invention;

Figure 11 is a bottom view of the T-wrench of the present invention;

Figure 12 is a perspective view showing the structure of the inner locking sleeve of the present invention.

The figures indicate: 1, center guiding sleeve, 2, sliding sleeve, 3, tong body hinged end, 4, jaw hinged end, 5, caliper body, 51, caliper bending section, 6, jaw, 61 , jaw bending section, 62, vertical triangular structure groove, 63, tapered converging structure, 64, arc transition section, 7, common hinged end, 8, pressurized sleeve, 81, flat key surface, 9, with the block, 10, bolt, 11, spring, 12, helical thread, 13, long rack, 14, buckle ring, 15, T-wrench, 151, raised block, 16, inner locking sleeve cylinder.

detailed description

The invention will be described in detail below with reference to the drawings in conjunction with the embodiments.

Referring to FIG. 1 to FIG. 4, a multifunctional fracture reduction guide pliers includes a central guiding sleeve 1 , and a surface of the central guiding sleeve 1 is movably provided with a sliding sleeve 2, and the sliding sleeve 2 is provided There is a pair of caliper hinged ends 3, and the central guiding sleeve 1 is provided with a pair of jaw hinge ends 4 corresponding to the caliper hinged ends 3, in the present embodiment, the two caliper hinged ends 3 are in the sliding sleeve 2 The upper side is symmetrically disposed with the center line of the sliding sleeve 2, and the two jaw hinged ends 4 are symmetrically disposed on the center guiding sleeve 1 with the center line of the center guiding sleeve 1, and the two jaw body hinge ends 3 and the jaw joint ends 4 coplanar setting, two tong body hinged ends 3 are respectively hinged with a caliper body 5 to form a folding caliper body, and two jaw hinged ends 4 are respectively hinged with a jaw 6 to form a curved embracing jaw, the same side of the tongs The body 5 and the jaws 6 are hinged together by a common hinged end 7 which is rotated around the tong body hinged end 3 and is driven by the common hinged end 7 to drive the jaws 6 to the jaw joint end 4 For the central rotation to hug or unfold, the jaw 6 and the central guiding sleeve 1 cooperate to determine the center of the backbone cross-sectional view, and the central guiding sleeve 1 can be Provided pressing the sleeve 8, the guide sleeve is provided with the central position of the fastener structure limiting movement of the pressing sleeve 8 1.

The two jaw body hinge ends 3 are symmetric along the center of the sliding sleeve 2, the two jaw hinge ends 4 are symmetrically centered along the center guiding sleeve 1, and the jaw body hinge end 3 and the jaw hinge end 4 are Coplanar settings.

Referring to FIG. 5 and FIG. 6, the caliper hinge end 3, the jaw hinge end 4 and the common hinge end 7 are rotating sub-structures, and the caliper body 5 is provided with a caliper bending section 51 at one end, the tongs One end of the mouth 6 is provided with a jaw bending section 61, and the intersection of the caliper body 5 and the tong body bending section 51 is rotatably disposed on the tong body hinge end 3, and the jaw 6 and the jaw bending section 61 The junction is rotatably disposed on the jaw hinge end 4, and one end of the caliper bend section 51 and the jaw bend section 61 are rotatably coupled together by a common hinge end 7.

Referring to Fig. 7, the jaws 6 are arcuately embracing, and the inner side of the arc of the jaws 6 is provided with a longitudinal triangular structure groove 62, which can prevent slip and reduce soft tissue damage.

The front end of the jaw 6 is a conical converging structure 63, and a circular transition portion 64 is provided at the tip of the conical converging structure. The conical converging structure facilitates the reduction of the jaw 6 to penetrate the soft tissue outside the bone, and the circle The arc transition section 64 easily slides over the rough surface of the bone, preventing the tip of the jaw 6 from snapping into the bone, maximally protecting the bone and surrounding soft tissue.

The caliper body 5 and the caliper bending section 51 are of a unitary structure, and the jaws 6 and the jaw bending section 61 are of a unitary structure.

The two caliper bodies 5 are respectively provided with a long rack 13 and a sprocket ring 14 which are engaged with each other.

Referring to FIG. 8 , the fastener structure is composed of a mating block 9 , a bolt 10 and a spring piece 11 . The bottom of the mating block 9 is fixed on the central guiding sleeve 1 , and the upper part of the mating block 9 is provided with a groove. The pin 10 is disposed in a recess in the upper portion of the mating block 9, and the pin 10 is rotatably coupled to the mating block via a rotating shaft, and the spring piece 11 is fixed on the outer side of the mating block 9, one end of the spring piece 11 Pressing the back of the tooth of the pin 10 and applying a pre-thrust to the back of the tooth of the pin 10, the outer surface of the press sleeve 8 is provided with a helical thread 12, the tip of the pin 10 and the pressurization The helical thread 12 of the outer surface of the sleeve 8 cooperates.

Referring to FIG. 9 to FIG. 11 , the upper end of the pressing sleeve 8 is provided with a flat key surface 81 , and the flat key surface 81 is fitted with a T-shaped wrench 15 , and the T-shaped wrench 15 is provided with a convex block inside. 151, the T-type wrench 15 is rotated by the cooperation of the convex block 151 and the flat key surface 81 to rotate the pressure sleeve 8. In this embodiment, an inner locking sleeve 16 for engaging with the bone plate is further disposed. Referring to FIG. 12, the upper end of the inner locking sleeve 16 is also provided with a flat key surface, and the lower end of the inner locking sleeve 16 is tapered, and the tapered surface is provided with a surface thread to cooperate with the locking hole thread on the bone plate. In use, the inner locking sleeve 16 is screwed into the locking hole thread of the bone plate and fixed as a unitary structure. During the process of being twisted by the T-wrench 15, the lower end is positioned to abut the bone plate.

Process and principle of the invention

The specific use process is as follows: after the patient's anesthesia is effective, the supine position is taken, the surgical area is routinely disinfected and the towel is cut, the C-arm machine is used to determine the fracture end, and the proximal end and the distal end of the fracture are each made into a 4 cm incision, and the skin is cut and subcutaneously separated. In the muscular layer, a subcutaneous tunnel is established outside the periosteum, a locking anatomical locking bone plate is inserted from the subcutaneous tunnel, two inner locking sleeves 16 are mounted at each end, and then a resetting forceps is placed at each inner locking sleeve 16, first tightening Two reduction clamps at the distal end of the fracture, using a T-wrench 15 to tighten the rapid compression cylinder 8, tow the distal end of the fracture, and then install the two proximal reduction clamps, also tighten the two proximal reduction clamps at the proximal end of the fracture, using a T-type The wrench 15 tightens the rapid compression tube 8 at this time, and the proximal and distal bones of the fracture are parallel to the bone plate. Without the fracture end, the interaction between the reduction clamp, the anatomical locking bone plate and the backbone is performed without any screws. In the case of fixation, the fracture can be reset and temporarily fixed firmly. After the C-arm machine sees the fracture reduction condition and the position of the anatomical locking bone plate is good, the inner locking sleeve 16 is drilled, and then the inner locking sleeve 16 is screwed out from the pressure sleeve 8 in the pressure sleeve 8 Fix the screw to prevent the screw from slipping into the deep part of the muscle, which may cause difficulty in fixing. At this time, the screw passes through the center of the backbone, and finally the incision is flushed and the incision is closed.

The principle is: the resetting jaw structure of the present invention can be in any state, the central guiding sleeve 1, the pressing sleeve 8 and the inner locking sleeve 16 are on the bisector of the jaw 6, the bone plate locking hole is perpendicular to the axis of the bone plate When the bone plate locking hole thread is screwed into the inner locking sleeve 16, the center guiding sleeve 1, the pressing sleeve 8 and the inner locking sleeve 16 are perpendicular to the axis of the bone plate, and the resetting clamp embracing the backbone, the inner locking sleeve 16 The extension line passes through the center of the cross section of the backbone, and the compression sleeve 8 is screwed to pull the backbone toward the bone plate. When the backbone is in contact with the bone plate, the cross section of the backbone phase is tangent to the bone plate, and the two points determine the straight line. When the two proximal reduction clamps are fixed at the proximal end and the distal end of the fracture, the circular long trunk axis and the long axis of the anatomical locking bone plate are in a parallel relationship in space, and the fracture can be reset.

The above description is only the preferred embodiment of the present invention, and is not intended to limit the present invention, and various modifications and changes can be made to the present invention. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and scope of the present invention are intended to be included within the scope of the present invention.

Claims

A multifunctional fracture reduction guide pliers comprising a central guiding sleeve (1), characterized in that a surface of the central guiding sleeve (1) is movably provided with a sliding sleeve (2), the sliding sleeve (2) There is a pair of caliper hinged ends (3), and the central guiding sleeve (1) is provided with a pair of jaw hinge ends (4) corresponding to the tong body hinge ends (3), and two tong body hinge ends (3) Each of the upper hinges has a caliper body (5) to form a telescopic jaw body, and the two jaw hinge ends (4) are respectively hinged with a jaw (6) to form an arc-shaped embracing jaw, and the same side of the caliper body (5) Between the jaws (6) and a common hinged end (7) hinged together, the caliper body (5) is driven by the common hinge end (7) when it is rotated around the tong body hinge end (3). The jaw (6) is circumscribed or unfolded around the jaw hinge end (4) such that the center guide sleeve (1) is always on the bisector between the two jaws (6), thereby determining the center of the backbone cross-section, A pressing sleeve (8) is movably disposed in the central guiding sleeve (1), and the central guiding sleeve (1) is provided with a fastener structure to limit the movement position of the pressing sleeve (8).
The multifunctional fracture reduction guide pliers according to claim 1, wherein said two jaw body hinge ends (3) are symmetrically centered along a sliding sleeve (2), and said two jaw hinge ends (4) ) symmetrical along the center of the central guiding sleeve (1), and the caliper articulated end (3) is coplanar with the jaw articulated end (4).
The multifunctional fracture reduction guide pliers according to claim 1 or 2, wherein the caliper hinge end (3), the jaw hinge end (4) and the common hinge end (7) are rotating sub-structures. One end of the caliper body (5) is provided with a caliper bending section (51), and one end of the jaw (6) is provided with a jaw bending section (61), and the caliper body (5) and the caliper body bending section The intersection of (51) is rotatably disposed on the caliper hinge end (3), and the intersection of the jaw (6) and the jaw bending section (61) is rotatably disposed on the jaw hinge end (4) One end of the caliper bend section (51) and the jaw bend section (61) are rotatably coupled together by a common hinge end (7).
The multifunctional fracture reduction guiding forceps according to claim 3, wherein the jaw (6) is an arc-shaped embracing structure, and the inner side of the arc of the jaw (6) is provided with a longitudinal triangular-shaped structure groove (62). ).
The multifunctional fracture reduction guide pliers according to claim 3, characterized in that the front end of the jaw (6) is a conical converging structure (63), and an arc is provided at the tip of the conical converging structure. Transition section (64).
The multifunctional fracture reduction guide pliers according to claim 3, wherein the caliper body (5) and the caliper body bending section (51) are integrated, and the jaws (6) and the jaws are bent. Segment (61) is an integral structure.
The multifunctional fracture reduction guide pliers according to claim 3, characterized in that the two caliper bodies (5) are respectively provided with a long rack (13) and a ring (14) which cooperate with each other. .
The multifunctional fracture reduction guide pliers according to claim 1, wherein the fastener structure is composed of a mating block (9), a bolt (10) and a spring piece (11), and the mating block (9) The bottom is fixed on the central guiding sleeve (1), the upper part of the mating block (9) is provided with a groove, the bolt (10) is disposed in the groove of the upper part of the mating block (9), and the bolt teeth ( 10) Rotatingly connecting the mating block through the rotating shaft, fixing the spring piece (11) outside the mating block (9), one end of the spring piece (11) pressing the back of the tooth of the pin (10) and pressing A pre-thrust is applied to the back of the tooth of the bolt (10), and the outer surface of the press sleeve (8) is provided with a helical thread (12), and the tip end of the bolt (10) and the pressing sleeve (8) The helical thread (12) of the outer surface cooperates.
The multifunctional fracture reduction guide pliers according to claim 1 or 8, wherein the upper end of the pressure sleeve (8) is provided with a flat key surface (81), and the flat key surface (81) is fitted with a T-type wrench (15), the inside of the T-type wrench (15) is provided with a convex block (151), and the T-type wrench (15) is screwed by the convex block (151) and the flat key surface (81) The dynamic pressure sleeve (8) rotates.