WO2022073387A1

WO2022073387A1 - Single-rod dual-nail external fixing frame

Info

Publication number: WO2022073387A1
Application number: PCT/CN2021/112724
Authority: WO
Inventors: 陈聚伍
Original assignee: 陈聚伍
Priority date: 2020-10-10
Filing date: 2021-08-16
Publication date: 2022-04-14
Also published as: CN112022316A

Abstract

A single-rod dual-nail external fixing frame, comprising a head-end clamping plate (3a), a tail-end clamping plate (3b), a connecting rod (1), a head-end combining lock nail and a tail-end combining lock nail. Groove bottoms of the head-end clamping plate (3a) and the tail-end clamping plate (3b) are both provided with a nail penetrating round hole (33), and two respective side walls of the head-end clamping plate and the tail-end clamping plate are both provided with a nail rod penetrating hole (31) in a penetrating manner, wherein the fit clearance between the two respective side walls is a locking gap (32), and the diameter of the nail penetrating round hole (33) is greater than the width of the locking gap (32). The head end of the rod body of the connecting rod (1) is provided with a shaft seat (8), a shaft hole (9) is provided in the center of the shaft seat (8), and the tail end of the rod body thereof is provided with a screw rod section (14). The head-end combining lock nail and the tail-end combining lock nail each comprise a fixing nail (2) and a notch pin (10), wherein the lower end of a rod body of the fixing nail (2) is a self-tapping section (21) for being screwed into bone, a notch (23) is at least provided at the lower section of the fixing nail (2), and the notch (23) is combined with the notch pin (10).

Description

Single pole double nail external fixator

technical field

The invention belongs to the technical field of fracture locating frames, and in particular relates to an external fixation frame which can locate and fix fractures only through a single connecting rod and four nails.

Background technique

The fixation methods for fractures include steel plate fixation, external frame fixation and intramedullary nail fixation. The steel plate internal fixation has the advantages of simple operation and short learning cycle, but the current nail-plate combination structure has the following problems: large trauma, high probability of accidental injury, infection And non-union, delayed healing, broken nails and broken plates occur frequently, and the postoperative scar is large, which affects the appearance and does not conform to the principle of minimally invasive. There are many kinds of fixation frames used in the treatment of fractures, but all of them have the disadvantages of complex structure and many components. The existing external frame fixation mostly adopts fixing nails to be vertically driven into both sides of the fracture, and then passes through multiple universal joints and connecting rods. The rods are connected to each other to form a fixed frame. Since the universal joint needs to have the adjustment relationship of lateral rotation and locking and vertical rotation and locking, the volume of the universal wheel is relatively large, and the volume of the entire outer frame is relatively large, which is inconvenient for fracture patients to carry after installation and use. , the fracture site cannot be changed, which affects foreign activities. It is urgent to develop a fracture fixation frame that is easy to operate, easy to carry and easily accepted by patients. External frame fixation is a commonly used fracture fixation method. The existing external frame fixation mostly uses fixing nails to be vertically driven into both sides of the fracture, and then connected to each other by multiple universal joints and connecting rods to form a fixed frame. The adjustment relationship between lateral rotation and locking and vertical rotation and locking, the volume of the universal wheel is relatively large, and the volume of the entire outer frame is relatively large. It is inconvenient for patients with fractures to carry after installation and use. A fracture fixation external frame that is easy to operate, easy to carry and easily accepted by patients is developed.

Femoral shaft fractures and distal femoral fractures are common clinical fractures. Surgical treatment is the preferred treatment method. Before intramedullary nailing and bone plate fixation, both ends of the fracture site need to be reduced, docked and fixed. Traction is an important means to reduce femoral fractures and restore the length of lower limbs. At present, the retractors used in the reduction of patients with lower extremity fractures in various hospitals mainly include a traction rope and a pulley. One end of the traction rope is connected to the bracket at the fracture site, and the other end bypasses the pulley and then hangs the weights, and manually increase the number of weights or replace them. The weight of the weights controls the traction. Since the patient will move while lying in the hospital bed, the traction force will change. Once the traction force changes, the weight of the weight should be adjusted. For the existing manual control methods, frequent replacement of weights is extremely inconvenient, which not only increases the workload of hospital nurses, but also brings trouble to the reduction of fracture patients. On the other hand, because one end of the traction rope is connected to the distal end of the fracture site and requires a large amount of traction, the direction of traction on the distal end of the fracture can only be along the direction of the traction rope. In the case of torsion, in the prior art, the method of pulling the distal end of the fracture belongs to rigid traction, and it is not easy to rotate and swing the fracture, so that the optimal reduction effect cannot be achieved.

External frame fixation is a commonly used fracture fixation method. The existing external frame fixation mostly uses fixing nails to be vertically driven into both sides of the fracture, and then connected to each other by multiple universal joints and connecting rods to form a fixed frame. The adjustment relationship between lateral rotation and locking and vertical rotation and locking, the volume of the universal wheel is relatively large, and the volume of the entire outer frame is relatively large. It is inconvenient for patients with fractures to carry after installation and use. A fracture fixation external frame that is easy to operate, easy to carry and easily accepted by patients is developed.

The external fixator installation assembly for fractures with publication number CN 109009372A has a simple structure and can allow patients to carry less external fixator, but its operation process is complicated, and the number of structural components that need to be matched is large, which is difficult to implement.

SUMMARY OF THE INVENTION

Aiming at various drawbacks of the current fracture fixation methods, the present invention provides a single-rod double-pin external fixator with a simplified structure but better practicability, so as to achieve the purpose of minimally invasive and greatly simplified structure, and is beneficial to the flexibility of the patient's recovery period action, and reducing healthcare costs.

The technical solution to solve the above technical problems is to use a single-bar double-nail external fixing frame, which includes a head-end clamp plate a, an end clamp plate b, a connecting rod, and a combination lock nail at the head and tail. The clamp plate is U-shaped, and its groove bottom is set. There is a round hole for piercing nails, the two side walls of which are provided with perforations of the nail rod, the matching gap between the two side walls is a locking seam, and the diameter of the round hole for piercing nails is larger than the width of the locking seam; The head end of the rod body is provided with a shaft seat, the center of the shaft seat is provided with a shaft hole, and the end of the rod body is provided with a screw rod segment; the combined locking nail includes a fixed nail and a notched pin, and the lower end of the rod body of the fixed nail is used for self-tapping into the bone. For the wire segment, the fixing nail is provided with a notch at least in its lower section, and the notch is combined with the notch pin; the first-end combination locking nail is vertically sleeved in the nail-through hole of the head-end splint a, and the end combination locking nail is vertically sleeved on the end splint In the nail-piercing hole of b, the head end of the connecting rod and the head end of the connecting rod are combined with locking nails through the shaft hole through the shaft hole, and the screw rod segment is penetrated through the nail rod of the end splint b and then fixed.

One side of the fixing nail is provided with a notch from top to bottom, the notch is combined with the notch pin, and the combined combined locking nail is approximately cylindrical.

The lower end of the rod body of the fixing nail is a self-tapping section for screwing into the bone, the upper section has a threaded section, a pin nut is installed on the upper threaded section of the fixing pin, and the upper end of the notched pin is supported on the lower edge of the pin nut.

The notched pin and the fixing pin are fixed in a fixed manner by setting a diameter perforation between the fixing pin and the locking pin, and the locking pin is fixed therethrough.

A convex and concave pattern along the axial direction is arranged in the nail-piercing circular hole of each splint, or a convex and concave pattern is arranged on the outer side of the combination lock nail, so as to improve the locking degree between the clamp plate and the combination lock nail.

Concave and convex anti-skid lines are arranged around the perforations of the nail rods on the two outer side walls of each splint.

The present invention has the following beneficial effects: 1. The present invention has a simple structure, can reduce trauma to the patient as much as possible due to surgery, can reduce the volume and weight of the external support during the patient's recovery period, improve the mobility of the patient during the recovery period, and reduce external The compression of the stent on the fracture site is conducive to recovery.

2. The positioning operation of the present invention is simple, the operation can be completed only through simple training and learning, the operation workload is simplified, and the operation cost is reduced.

3. The present invention has simple and practical structure, low manufacturing cost, and reduced medical cost. Fewer structural components facilitate sterilization and maintenance handling. Not only is it easy to install, but it is also easy to remove.

Description of drawings

FIG. 1 is a schematic diagram of the application of the external fixator of the present invention.

Fig. 2 is a perspective view of a standard state of the external fixator of the present invention.

FIG. 3 is a schematic view of the assembled state of FIG. 2 .

FIG. 4 is a front view of FIG. 2 .

FIG. 5 is a side view of FIG. 2 .

FIG. 6 is a plan view of FIG. 2 .

FIG. 7 is a schematic diagram of the combined state of the combined fixing nail.

Fig. 8 is a schematic diagram of the disassembled state of the combined fixing nail.

Figure 9 is a schematic diagram of the structure of the connecting rod.

Figure 10 is a schematic diagram of the structure of the clamping block.

Fig. 11 is a perspective view of the general state of the external fixing frame of the present invention.

Figure 12 is one of the combined structures of the fixing pin and the notched pin.

Figure 13 is the second combination structure of the fixing nail and the notched pin.

Labels in the figure: connecting rod 1, combination locking nail 2, self-tapping section 21, thread section 22, notch 23, flat surface 24, splint 3, head end splint 3a, end splint 3b, nail rod perforation 31, locking seam 32 , piercing round hole 33, convex and concave anti-skid 34, lock nut 4, screw 5, shaft seat anti-skid 6, plane 7, shaft seat 8, shaft hole 9, notched pin 10, ejector pin nut 11, locking nail 12, diameter Perforation 13, screw segment 14.

Detailed ways

Example 1: For fractures of the femur, tibia, humerus, ulna, and radius, etc., an external fixator is used for fixation. At present, fixation nails are usually driven vertically to both sides of the fracture, and the exposed ends of each fixation nail are respectively installed with a universal The joints are fixed by connecting rods between adjacent universal joints. At least two fixation nails are inserted in each of the two fracture segments to ensure that each fracture segment does not rotate. Due to the possible deviation of the nailing position, it is difficult to connect four fixation nails through a connecting rod. There must be a connecting rod between the two fixing nails, which is fixed by a universal joint. In this external fixation method, there are many connecting rods with different directions, and each universal joint needs to have the adjustment relationship of lateral rotation and locking and vertical rotation and locking, which makes the entire outer frame relatively large and can be installed on fracture patients. It is inconvenient to carry after use, resulting in patients unable to wear and change clothes and affecting foreign activities. The present invention aims to provide a solution that simplifies the structure of the outer frame and simplifies the installation steps as much as possible. The following embodiments illustrate several main implementation forms of the outer frame. After the outer frame is applied, the simplified effect as shown in FIG. 1 can be achieved.

Embodiment 1: a single-bar double-nail external fixing frame as shown in Figure 2, Figure 3 is the assembled state of Figure 2, as can be seen from the figure: the outer frame is mainly composed of a head end clamp plate 3a, an end clamp plate 3b , Connecting rod 1, head end combination lock nail, tail end combination lock nail, screw 5 and lock nut 4. It can be seen that the number of components is small, and its assembly is simple in the form shown in Figure 2. Compared with the structure of the existing external fixing frame, the structure is obviously simplified, accounting for about 1/3 of the number and volume of the existing external fixing frame. .

Figures 4 to 6 show the outer frame from side orthographic views, respectively. From Figure 4, it can be seen that the head end clamp 3a allows the connecting rod 1 to rotate and lock in the lateral direction, and the end clamp 3b allows the connecting rod 1 to be axially locked. adjustment, as well as allowing longitudinal rotation of the tail combination pin.

The combined locking nail as shown in Figures 7 and 8 includes a fixing nail 2 and a notched pin 10. The lower end of the rod body of the fixing nail 2 is a self-tapping segment 21 for screwing into the bone, and the fixing nail 2 is at least in its lower segment. A notch is provided, and the notch is combined with the notch pin. Specifically, in this embodiment, a notch is provided on one side of the fixing nail 2 from top to bottom, the notch is combined with the notch pin, and the combined combined locking nail is approximately cylindrical.

The self-tapping segment 21 of the combined locking nail is provided with a helical blade on the circumferential surface, which can be screwed into the bone and form a helical hole. The fixing nail 1 occupies most of the combined cylindrical nail body, and the notched pin 10 occupies a small part of the combined cylindrical nail body. As can be seen from FIG. 8 , one side of the fixing nail 2 has a plane, that is, a notch. One side of the notch pin 10 also has a flat surface, and the two flat surfaces are matched to butt. The notch pin and the fixing pin are fixed, and the combination of the two does not need to be directly fixed. After fixing the corresponding splint, the fixing pin 2 and the notch pin 10 can be clamped together, that is, the two are fixed as one. Lateral convex and concave structures can also be provided on the adjacent planes of the fixing nail 2 and the notch pin 10, respectively, when the two are fastened together and fixed by the corresponding splint, the two can be prevented from sliding relative to each other in the axial direction.

The existing external fixator nails used for fractures have self-tapping screws at the lower end but no self-locking structure, which is not suitable for independent application, that is, it is not suitable to use only a single nail to fix the two segments of the fracture, otherwise the two segments of the fracture are not fixed. There is the possibility of spin to loosen or disengage the docking position. However, when the combined locking nail is used in this embodiment, after the single combined locking nail is implanted into the fractured segment, the combined locking nail will not rotate relative to the fractured segment, that is, the single combined locking nail is locked with the fractured segment, so that only the single combined locking nail is locked with the fractured segment. The root combination locking nail can achieve the fixation of a fracture segment. In addition, many existing fixation nails are easily loosened due to reversal after implantation into bone, which affects the fixation effect, but the combined locking nail used in this embodiment will not reverse after implantation into bone, thus completely solving the problem of loosening.

It can be seen from Figure 1 that the application of this example can realize the self-locking function of the single nail, and the single nail can be directly applied to a segment of the fracture, and there is no possibility of any rotation between the fixed nail and the bone. In the application of the locking nail in this example, the fixing nail 2 is firstly screwed into the bone through a drill. Since the fixing nail 2 occupies most of the combined cylindrical nail body, a cylindrical cavity can be formed in the bone after being screwed in. , the helical edge of the fixing nail 2 and the bone are embedded in each other, there is a gap between the plane (notch) on one side of the fixing nail 2 and the cylindrical cavity of the bone, and then the notch pin 10 is axially pressed into the gap. The side of the cylindrical surface of the notched pin 10 is a smooth surface or has convex and concave grooves along the axial direction. When the notched pin 10 is pressed into the thread gap in the axial direction, the cylindrical surface of the notched pin 10 can form the inner wall of the gap due to the spiral edge. If the thread is damaged, the notched pin 10 is clamped in the gap to prevent the fixing nail 2 from rotating. On this basis, one side of the cylindrical surface of the notch pin 10 can also be set as a special-shaped surface, for example, including a triangular ridge along the axial direction, and the inner wall of the gap is pressed by the triangular ridge to form an anti-rotation effect.

It can be seen that the head-end combination locking nail is vertically sleeved in the nail-piercing round hole 33 of the head-end splint 3a, and the end combination locking nail is vertically sleeved in the nail-piercing circular hole 33 of the end splint 3b, and the fixing nail 2 plays the main role. For connection and fixation, the installation of the notched pin 10 can prevent the problem of loosening the fixed position of the fixing nail 2 due to the reverse rotation. The fixing nail 1 of the nail and the notched pin 10 are clamped and combined into one.

As shown in FIG. 9 , the head end of the rod body of the connecting rod 1 has a shaft seat, the center of the shaft seat has a shaft hole, and the end of the rod body has a screw rod segment. The shaft seat and the shaft hole can realize horizontal rotation adjustment, and the screw rod segment can realize axial adjustment and vertical rotation adjustment. Further, three-dimensional adjustment can be realized, so as to adapt to the possible appearance of any form of the combination lock nail at the head end and the combination lock nail at the tail end. It can be seen from Fig. 9 that the middle of the connecting rod 1 is plate-shaped, with a stop at the left end and a plate-shaped right end. There is a plane 7 that transitions to the shaft seat 8, so that the end face of the shaft seat 8 and the splint have a joint plane.

The splint shown in Figure 10: the overall structure is U-shaped, with groove bottom and two side walls. Among them, the bottom of the groove is provided with a round hole 33 for piercing nails, and the two side walls of the hole are provided with through holes 31 for nail rods. The matching gap between the two side walls is a locking seam 32. 32 width.

The head end of the connecting rod 1 and the head end of the connecting rod 1 are combined and fixed by the screw through the shaft hole, and the screw rod segment is passed through the nail rod hole 31 of the end clamp plate 3b and then fixed. As can be seen from the figure, convex and concave anti-skid lines are arranged around the nail rod perforations 31 of the two outer side walls of each splint to improve the stability of the components after connection. A convex and concave pattern along the axial direction can also be provided in the nail-piercing circular hole 33 of each clamping plate, or a convex and concave pattern can be provided on the outer side of the combination lock nail to improve the locking degree between the clamping plate and the combination lock nail.

Based on the above solutions, when the outer frame of this embodiment is applied, it is possible to adapt to any form of the combination locking nail at the head end and the combination locking nail at the tail end. As shown in Fig. 11, after the combined nails are implanted in the two segments (distal and proximal) of the fracture, the two nails are implanted so that there is no need to rely on auxiliary positioning tools, and only two combined nails need to be blindly punched within one side of the bone. The nails can be used. The connecting rod 1 and the splints at both ends can be used to adapt to two combined nails. After adaptive adjustment, the screw and lock wire can be tightened. The operation is simple, easy to carry and store, the wound surface is small, and the external structure is simple and easy to be accepted by patients. .

Example 2: On the basis of Example 1, the lower end of the rod body of the fixation pin is designed to be a self-tapping segment 21 for screwing into the bone, and the upper segment has a threaded segment 22, as shown in Figure 12, which is also on the upper segment of the fixation pin. The ejector pin nut 11 is installed on the threaded section, and the upper end of the notched pin 10 is supported on the lower edge of the ejector pin nut 11. When the fixing nail 2 and the notched pin 10 are implanted into the bone respectively, the notched pin 10 is pressed by the ejector pin nut 11 to prevent the It pushes out.

Example 3: On the basis of Example 1, the fixing method between the notched pin and the fixing pin adopts the structure shown in Figure 13, that is, a diameter through hole 13 is arranged between the fixing pin and the locking pin, and is fixed therethrough. Locking pegs 12. The notch pin 10 is prevented from withdrawing in the axial direction, so that the fixing nail 2 can be firmly fixed without loosening.

On the basis of the above embodiments, the present invention may also have other modified forms of the above embodiments, which will not be described in detail. Compared with the structure of the existing external fixator for fractures in which several connecting rods and a plurality of universal joints are frequently used, the structure of the external fixator in this embodiment is extremely simplified, and the operation process is simple. For the installation assembly, the present invention further simplifies the operation difficulty and the number of applied parts on the basis of the simplified structure.

Claims

A single-rod double-pin external fixing frame, characterized in that it comprises a head end clamp plate (3a), an end clamp plate (3b), a connecting rod (1), and a head and tail combination locking nail, wherein the clamp plate is U-shaped, and its groove The bottom is provided with a nail-piercing round hole (33), the two side walls are provided with nail rod through-holes (31), and the matching gap between the two side walls is a locking seam (32). The diameter is greater than the width of the locking seam (32); the head end of the rod body of the connecting rod (1) has a shaft seat, the center of the shaft seat has a shaft hole, and the end of the rod body has a screw rod segment; the combined locking nail includes a fixing nail (2) and a notch pin (10), the lower end of the rod body of the fixation pin (2) is a self-tapping segment (21) used to be screwed into the bone, and the fixation pin (2) is provided with a notch at least in its lower segment, the notch Combined with the notched pin; the first-end combination locking nail is vertically sleeved in the nail-piercing round hole (33) of the head-end clamp plate (3a), and the end combination locking nail is vertically sleeved in the nail-piercing circular hole (33) of the end clamp plate (3b). ), the head end of the connecting rod (1) and the head end of the connecting rod (1) are combined with locking nails through the shaft hole through the screw rod, and the screw rod segment is passed through the nail rod perforation (31) of the end splint (3b) and then fixed.
The single-rod double-pin external fixator according to claim 1, wherein a notch is provided on one side of the fixing pin (2) from top to bottom, the notch is combined with the notch pin, and the combined locking pin is approximately cylindrical shape.
The single-rod double-nail external fixator according to claim 1, wherein the lower end of the rod body of the fixing nail is a self-tapping segment (21) for screwing into the bone, and the upper part has a threaded segment (22), An ejector nut (11) is installed on the upper threaded section of the fixing nail, and the upper end of the notched pin (10) is supported on the lower edge of the ejector nut (11).
The single-rod double-pin external fixator according to claim 1, characterized in that, the fixing method between the notched pin and the fixing pin is to set a diameter through hole (13) between the fixing pin and the locking pin, and through which a hole is fixed. Locking Spike (12).
The single-rod double-nail external fixator according to claim 1, characterized in that, convex and concave grooves along the axial direction are arranged in the nail-piercing holes (33) of each clamping plate, or convex and concave grooves are arranged on the outer side of the combined locking nail, for the purpose of Improve the locking degree between the splint and the combination lock nail.
The single-bar double-pin external fixator according to claim 1, characterized in that, convex and concave anti-skid grooves are arranged around the nail rod perforations (31) of the two outer side walls of each splint.