WO2022095836A1

WO2022095836A1 - Internal fixation device for patella fracture

Info

Publication number: WO2022095836A1
Application number: PCT/CN2021/128022
Authority: WO
Inventors: 陈聚伍; 陈泓丹; 徐涤
Original assignee: 陈聚伍
Priority date: 2020-11-04
Filing date: 2021-11-02
Publication date: 2022-05-12
Also published as: CN112244982A

Abstract

An internal fixation device for patella fracture, comprising a knee holding ring (1), patella nails (4), adjusting rope belts (3a-3e), and an adjusting mechanism. The adjusting rope belts (3a-3e) and/or fixing rope belts (2) are connected to the edge of the knee holding ring (1), and the tail ends of the adjusting rope belts (3a-3e) and/or fixing rope belts (2) are sleeved and fixed on the both ends of the corresponding patella nails (4), wherein the lengths of the both ends or middles of the adjusting rope belts (3a-3e) can be adjusted, such that each fixing rope belt (2) and each adjusting rope belt (3a-3e) are tensioned. The rope belts can be adjusted in the radial direction and can also rotate moderately along the knee holding ring (1), and can thus adapt to nailing selections at different positions, there is no need to consider the constraint problems of the lengths and end hole positions of the rope belts during nailing, an optimal nailing position can be found, a positioning instrument is not required, and there is only a need to operate the rope belts for tensioning adjustment after nailing; therefore, the operation process is simple to operate and high in efficiency.

Description

Internal fixation device for patella fractures

technical field

The invention belongs to the technical field of internal fixation instruments for patella fractures.

Background technique

The patella is the largest sesamoid bone in the human body. It is located in front of the lower end of the femur, in the quadriceps tendon. Patellar fractures account for 1% to 2% of all fractures and are often caused by a primary rupture of the quadriceps muscle bond or by direct impingement on the femur. The patella has the function of protecting the knee joint and preventing the quadriceps tendon from rubbing against the cartilage surface of the femoral condyle. Patellar fracture is a relatively common injury. Improper treatment of patellar fracture may lead to complications such as fracture nonunion, joint adhesion, traumatic arthritis, and bone infection. There are usually many methods for internal fixation of patellar fractures. The clinical methods of treating patellar fractures can be divided into two categories: conservative and surgical. Part of the prior art adopts the outer fixing rope of the knee tuck ring, which is actually an external fixation component that ties the rope to the knee backing plate, such as the "centripetal inflatable patella reset balloon" with the publication number of CN23075272Y, published No.: CN2840957Y "patella fracture fixation frame", CN 201968880 U utility model "patella fracture fixation device", public number: CN 104644305 A "patella fracture fixation device" etc. These external fixation components are not directly Fixed on the patella, the fractured patella cannot be substantially fixed, and the fixation tension is concentrated on the front of the patella, while the back of the patella has no traction, which is easy to cause the back crease to open, resulting in the patella being out of shape during recovery, and the recovery is slow.

In the fixation after the incision of the patella fracture, such as Kirschner wire tension fixation, memory alloy patellar fixation with patella claw and tension band, the common problem is that a large incision is required during the operation to place the fixation. , but also requires a second surgery to remove the fixation. The disadvantages of patella claw fixation include: high cost, which increases the burden on patients; it is necessary to accurately grasp the size of the patella claw, otherwise it is easy to be too large or too small, causing the patella claw and the patella to not fit; the patella claw occupies a large area, causing the patella skin It is isolated from the patella, the volume increases, and the tension of the patella skin is too large, which is not conducive to suture, and is prone to cause necrosis of the patellar skin and exposed patellar claw. It is unreliable, often with Kirschner wire fixation, and the scope of use becomes smaller. Instead of using Kirschner wire and patella claw, it is better to simply use Kirschner wire tension band fixation, which makes the operation superfluous; because of concerns about the firmness of the fixation, so Early functional exercise is limited; it is not a fixed approach that can be used universally.

The high pressure per unit area between the wire linear fixation belt and the patella leads to necrosis, liquefaction, absorption, and fibrosis of the soft tissue, loosening the tension belt wire, and the irritation of the knotted part causing discomfort to the patient. For example, publication number: CN 110960306 A "a kind of patella fracture packing and fixing device" includes a fixing belt, a locking buckle, and a guiding device, the fixing belt is a flexible structure, and the fixing belt needs to be driven by the guiding device. The belt crosses the fracture crease, and the two ends of the fixing belt are connected by locking buckles and fixed by tension. This technique requires the use of a fixation belt to wrap around the patella for wrapping and fixing. There are large knots in the knotted part, which affects blood circulation, delays the recovery time, and even causes local tissue necrosis, which often causes discomfort to the patient. Another example is CN 209186903 U "a kind of internal fixation device for patella fracture operation" including a top post and a fixing block, a patella pin is installed inside the through hole of the bone, the top post is installed on the top of the patella pin, and the top post is located at the end of the installation groove. Inside, the installation groove is opened on the upper surface of the bone, the top end of the outer surface of the top column is provided with a steel wire, and the fixing block is installed on the bottom end of the patella pin. In the internal fixation device for patella fracture surgery, the top of the fixation device is a top column and is wound with steel wires. Affect blood circulation, delay recovery time, and even lead to local tissue necrosis, often causing discomfort to patients. The internal fixation is easy to protrude the skin, pierce the skin, cause pain and infection; postoperative knee joint pain is more; it is not conducive to early exercise; the Kirschner wire is easy to loosen and shift, and the steel wire is easy to fall off, which shortens the effective fixation time.

SUMMARY OF THE INVENTION

Aiming at the common defects and problems of various existing instruments for patella fractures, the present invention provides an internal fixation device for patella fractures that can adjust and tighten each rope without needing to pay attention to the nailing position, so as to simplify the operation. Difficulty, shorten the operation time, eliminate nodes, and significantly reduce the degree of bulge.

The solution adopted by the present invention to solve the technical problem is as follows: an internal fixation device for patella fracture, comprising a knee tuck ring, a patella nail, and an adjusting rope belt and an adjusting mechanism, and the knee tuck ring is a circular steel ring , its circumferential edge is connected with at least two adjusting rope belts and other fixed rope belts, or all of them are connected with adjusting rope belts. When one end of the rope is fixedly connected with the knee tuck ring, the other end is provided with an end adjustment mechanism or a length adjustment mechanism in the middle of the rope between the other end and the patella nail. One end is connected with a loop, at least two patella nails run through both sides of the patella fracture in approximately parallel, and the ends of each fixing rope and each adjusting rope are respectively sleeved on the end of the corresponding patella nail, and the radial direction is adjusted. When adjusting the mechanism or the end adjusting mechanism or the length adjusting mechanism, each fixed rope belt and each adjusting rope belt are tensioned.

An internal fixation device for patella fracture, comprising a knee tuck, a fixing rope, a patella nail, and an adjusting rope and an adjusting mechanism. The rope and the rest of the fixed rope, or all connected to the adjustment rope, one end of the fixed rope is fixed on the edge of the knee tuck, and the other end is connected with a loop. When the loop is fixedly connected, an end adjustment mechanism is set between the other end and the patella nail or a length adjustment mechanism is set in the middle of the rope. The patella nail runs through both sides of the patella fracture site in approximately parallel, and the ends of each fixing rope and each adjusting rope are respectively sleeved on the end of the corresponding patella nail, and the radial adjustment mechanism or the length adjustment mechanism is adjusted so that the Each fixing strap and each adjusting strap are tensioned.

An internal fixation device for patella fracture, comprising a knee tuck ring and a patella nail, the knee tuck ring is a circular steel ring or an elastic ring, and a plurality of socket holes and a plurality of rope belts are evenly distributed around its circumference. One end of the rope is fixed with a collar and the other end is fixed with an articulated collar, and the articulated collar is sleeved in each socket hole, or at least one end of the rope is fixed with a collar and the other end is fixed with an articulated collar. The collar is sleeved in each sleeve connection hole, and the rest are fixed ropes, one end of the fixed ropes is fixed on the edge of the knee tuck, and the other end is connected with a collar.

The first radial adjustment mechanism: a plurality of radial perforations are arranged on the circumferential edge of the rigid knee tuck a along the radial direction, and elastic clips are respectively arranged in each radial perforation, and a tie-type adjustment rope is used. c. One end is fixed with a collar, the other end is provided with anti-slip inverted teeth, each anti-slip inverted tooth is inserted into the corresponding radial hole, and each chuck can be automatically inserted into the groove of the anti-slip inverted tooth; or, in a rigid knee tuck The circumferential edge of the circle a connects part of the fixed rope, and connects part of the tie-type adjustment rope c through a plurality of radial perforations, so that the fixed rope is used in cooperation with the adjustment rope.

The second radial adjustment mechanism: a plurality of shallow grooves are radially arranged on the circumferential edge of the rigid knee tuck ring a, and a screw hole is arranged in the middle of the shallow groove, and the groove bottom of each shallow groove has internal teeth in the groove, and the flat ring type is adopted. Adjusting rope d, one end of which is fixed with a collar, the other end is connected to an adjusting plate, an adjusting hole is arranged in the middle of the adjusting plate, and one side of the adjusting plate is provided with anti-skid teeth. Inside, the lock wire is inserted into the adjustment hole and screwed into the corresponding screw hole, and the cap of the lock wire is used to press the surface of the adjustment plate to fix it in the shallow groove; , and connecting part of the flat ring type adjusting rope belt d through a plurality of radial shallow grooves, and using the fixed rope belt with the adjusting rope belt.

The third radial adjustment mechanism: a plurality of dovetail grooves are radially arranged on the circumferential edge of the rigid knee tuck ring a and a screw hole is arranged in the middle of the shallow groove, a dovetail-shaped adjustment rope e is used, and a collar is fixed at one end thereof. The other end is connected to a dovetail plug, there is an adjustment hole in the middle of the dovetail plug, and there are anti-skid teeth on the outer side of the adjustment plate. Insert each dovetail plug into the corresponding dovetail groove in the radial direction and can slide and adjust in the radial direction, and the outer side of each dovetail plug is also covered. There is a flat gasket a, the anti-skid teeth on one side of the flat gasket a are matched and buckled in the anti-skid teeth on the outside of the corresponding dovetail plug, and the lock wire passes through the perforation of the flat gasket a and is further inserted into the adjustment hole of the dovetail plug, The lock wire is threaded into the corresponding screw hole, and the cap of the lock wire is used to press the surface of the flat washer a and then press the dovetail plug to fix it in the shallow groove, or fix the rope on the peripheral edge of the rigid knee ring a. , and connecting part of the dovetail-shaped adjusting rope e through a plurality of radial shallow grooves, and using the fixed rope with the adjusting rope.

The length adjustment mechanism: one end of the adjustment rope is fixedly connected to the rigid knee tuck ring a, the other end is fixedly connected to the collar, and a length adjustment mechanism is arranged in the middle.

The end adjustment mechanism: a strip-shaped adjustment plate is fixed at the end of the rope, and there is a flat and long adjustment hole in the middle of the adjustment plate. The end cap and the nut at the end press the corresponding adjustment plate, there is a perforation in the center of the gasket and is sleeved on the outside of the patella nail, there are anti-skid teeth on the surface of the adjustment plate, and anti-slip teeth on the surface of each gasket.

Said fixed rope belt or adjustment rope belt: one end of the fixed rope belt is provided with a movable hook connected with the knee tuck loop so as to facilitate the replacement of rope belts of different types for different patients.

The knee tuck ring is a composite ring of a rigid ring and a flexible ring.

The beneficial effects of the present invention: the rope belt can be adjusted steplessly along the radial direction and can be rotated moderately along the knee tuck ring, so that it can adapt to the selection of nails at different positions. When nailing, there is no need to consider the constraints of the length of the rope and the hole position of the belt end. It can find the best position to set the nail without the help of positioning equipment. After the nail is set, it is only necessary to adjust the tension of the rope. The surgical procedure is simple and efficient.

Compared with the prior art, which needs to be wrapped, wound and fixed around the patella with a fixing belt, the present invention does not cause the problem of overlapping and thickening of the ropes, does not cause the problem of knots at the ends of the ropes, and does not require the trouble of on-site winding. The treatment is in a flattened state that has been flattened during the manufacturing process, so there will be no major bulge problem after surgery. With the device of the present invention, the fractured patella fragments can be firmly closed together, and the stepless adjustment function adopted makes the force of each fracture surface balanced, avoiding fracture dislocation and crease opening, and each rope and lock The thickness of the buckle is small, which will not cause tissue protrusion and discomfort, which is beneficial to shorten the fracture healing time.

The rope of the present invention can also use absorbable material, which solves the problem that the implant needs to be removed by a second operation, significantly reduces the difficulty of the operation and saves at least half of the operation time compared with the traditional method.

Description of drawings

Fig. 1 is a schematic diagram of an inner fixing device of an adjusting cord with an end adjusting mechanism.

FIG. 2 is a schematic diagram of applying the internal fixation device of the present invention to the patella.

FIG. 3 is an enlarged structural schematic diagram of part A in FIG. 1 .

Fig. 4 is one of the structural schematic diagrams of the double-adjusting rope belt of the rigid knee tuck.

Figure 5 is the second schematic diagram of the structure of the rigid knee tuck with double adjustment ropes.

FIG. 6 is a schematic diagram of the structure of the elastic knee tuck ring with a single adjustment cord.

Fig. 7 is a schematic diagram of an inner fixing device with a middle adjustment mechanism for the adjustment cord.

Fig. 8 is a schematic diagram of the inner fixing device of the tie-type adjusting rope.

FIG. 9 is a schematic diagram of the matching relationship between the cable tie and the perforation in FIG. 8 .

Fig. 10 is one of the schematic diagrams of the inner fixing device with the radial adjustment mechanism of the adjusting rope.

FIG. 11 is a perspective structural view of the adjusting cord in FIG. 10 .

Fig. 12 is the second schematic diagram of the inner fixing device with the radial adjustment mechanism of the adjusting rope.

FIG. 13 is a partial enlarged view of the radial adjustment mechanism in FIG. 12 .

FIG. 14 is a perspective structural view of the adjusting cord in FIG. 12 .

Fig. 15 is the third schematic diagram of the inner fixing device with the radial adjustment mechanism of the adjusting rope.

Fig. 16 is the fourth schematic diagram of the inner fixing device with the radial adjustment mechanism of the adjusting rope.

Fig. 17 is the fifth schematic diagram of the inner fixing device with the radial adjustment mechanism of the adjusting rope.

Labels in the figure: Rigid knee tuck 1a, flexible knee tuck 1b, fixed rope 2, end adjustment rope 3a, middle adjustment rope 3b, cable tie type adjustment rope 3c, flat ring type adjustment rope 3d, dovetail Shaped adjusting rope 3e, adjusting plate 301, adjusting hole 302, anti-slip tooth 303, fixing belt 304, adjusting belt 305, one-way helical tooth 306, joint sleeve 307, fixed sleeve 308, fixed sleeve 309, anti-fall Teeth 310, Chuck 311, In-slot Teeth 312, Dovetail Plug 313, Patella Nail 4, Top Cap 41, Flat Washer 42a, Wedge Washer 42b, Elastic Wedge Washer 42c, Teeth 421, Bottom Sheet 422, V-shaped Spring Piece 423, give way slot 424, perforation 43, anti-skid tooth 44, nut 45, self-tapping section 46, screw sleeve 47, screw 48, collar 5, socket hole 6, radial perforation 7, shallow groove 8 , screw hole 9, lock wire 10, dovetail groove 11.

Detailed ways

In order to better understand the technical solutions of the present invention, the technical solutions and applications can be understood from different aspects through the following typical examples.

Example 1:

Figure 1 is a rigid tugging ring double-adjusting rope-type internal fixation device for patella fractures. It can be seen from the figure that four ropes are fixed and connected around the rigid tuck 1a, respectively two fixed ropes 2 and two adjustment cords 3. On this basis, the number of fixed ropes and adjustment ropes can also be increased, usually in pairs. It is advisable to keep the total number of ropes at an even number, but the possibility of adding an odd number of ropes is not excluded. Or prepare multiple spare cords, which can be trimmed as needed during surgery.

Figure 2 shows when the internal fixation device in Figure 1 is in the patella state, it can be seen that, under normal circumstances, two patella nails run through both sides of the patella fracture in approximately parallel, and the ends of each fixing rope and each adjusting rope are respectively covered. Connect to the end of the corresponding patella nail. When it is necessary to increase the number of patella nails or the number of straps in special circumstances, it is also required to add a fixed strap and an adjustment strap on the peripheral edge of the rigid tuck loop 1a. When an odd number of cords are added as described above, one patella nail is required for blind driving, and only the top cap is exposed, which is suitable for comminuted fractures. Therefore, when designing the rigid tuck ring and the number of each rope, different models can be set. In addition to the size model, it should also be considered to design and connect different numbers of ropes around the tuck. A better way is to fix a plurality of various cords at the same time around the rigid knee tuck, and use the corresponding number of cords as needed, and the excess cords can be cut off directly after the operation.

For this embodiment, it can be seen from FIG. 1 that the knee tuck is a circular steel ring, and the two fixed ropes 2 connected to the periphery of the rigid knee tuck 1a have one end fixed on the edge of the knee tuck, and the other end. A collar is connected. When nailing (the nails are inserted after drilling), pull the collar to the position where the nails need to be nailed, and align the nails with the nails in the collar. The two end adjustment straps 3a connected to the periphery of the rigid knee tuck loop 1a, as can be seen from Figure 1, in this embodiment, one end of the adjustment strap is fixedly connected to the knee tuck loop, and the other end is set between the patella nail. Ministry adjustment mechanism. The end adjustment mechanism is shown in FIG. 1 . A strip-shaped adjustment plate 301 is fixed at the end of the rope. The middle of the adjustment plate 301 has a flat and long adjustment hole 302. The adjustment plate 301 is sleeved on the corresponding patella nail. 4. After the outer side, press the corresponding adjusting plate 301 through the end caps 41 and the nut 45 at both ends of the patella nail. As can be seen from FIG. 1 , the flat washer 42a or the wedge-shaped washer 42b or the elastic wedge-shaped washer 42c has a hole 43 in the center and is sleeved on the outside of the patella nail 4, and there are anti-skid teeth 303 on the surface of the adjusting plate 301, The surface of the gasket has anti-skid teeth 44 . After adjusting the position of each adjusting plate, after screwing the nut 45, the upper and lower spacers shrink inward and squeeze each adjusting plate on the surface of the patella, so that each spacer and the corresponding adjusting plate mesh with anti-skid teeth to form a non-slip fixed relationship.

The wedge-shaped washer 42b and the elastic wedge-shaped washer 42c can be respectively provided with different models, and are mainly used to fit the patella nail and may have an inclination angle (non-perpendicular) when entering the patella. The wedge-shaped washer 42b can be provided with different models to match different inclination angles to achieve approximate matching, but the elastic wedge-shaped washer 42c is more adaptable and can adapt to almost any inclination angle. As can be seen from FIG. 3 , the elastic wedge-shaped washer 42c includes a toothed piece 421 and a bottom piece 422 , both of which have a hole 43 in the middle, a V-shaped spring 423 contains an escape groove 424 , and two pages of the V-shaped spring 423 The toothed piece 421 and the bottom piece 422 are respectively fixed, and the vacant slot corresponds to each through hole.

As can be seen from FIG. 1 , the upper end of the rod body of the patella nail 4 is provided with a top cap 41 , and the lower end is provided with a wire and sleeved with a wire nut 45 . The screw-type patella screw 4 can be inserted after drilling, or the patella screw 4 can be designed as a self-tapping screw with a self-tapping tip to facilitate direct screwing and penetrating bone. Another kind of patella nail is shown in the lower left part of Fig. 8, and has a self-tapping segment 46 at the upper end of the nail body, which is used for screwing into the bone hole. When the respective cords are secured and tensioned, the ends of the pins can be exposed beyond the skin or the overhangs can be cut off.

When in use, as shown in Figure 2, first support the knee tuck of the device in the middle area of the anterior side of the patella, then pull the fixing rope 2 to a suitable position, and implant at least two patella nails 4 along the direction approximately perpendicular to the fracture seam. , each patella nail goes into the loop of the fixed rope or the adjustment hole of the adjustment rope. It can be seen from the figure that each rope forms an X shape, and the loop or adjustment hole at the end is located at the end of the two patella nails in turn. four ends. Referring to Figure 4 and Figure 5 respectively, Figure 4 shows the situation in which two adjustment cords are located at the two ends of the same patella nail, and Figure 5 shows the situation in which the two adjustment cords are located at the lower ends of the two patella nails, respectively. In both cases, the adjustable tensioning function can be achieved. In addition, on the basis of the above, it is also possible to design the case of using three adjusting ropes and one fixing rope, and further design the case of using four adjusting ropes.

After screwing the nut 45, the upper and lower spacers contract inwardly and squeeze the adjustment plates on the surface of the patella, but they are not pressed to death. When the self-tapping screw body as shown in FIG. 8 is used, the nut 45 is no longer needed, and the screw body only needs to be screwed to make the self-tapping segment 46 enter the bone for fixation. At this time, move each adjustment plate to a suitable position, maintain a moderate tension, and then further screw each nut, so that each nut presses each gasket, and then each gasket is meshed with the corresponding adjustment plate through the anti-skid teeth to form a non-slip fixed relationship . It can be seen that, through the above solution of this embodiment, the position of nailing is not limited by the length of the rope or the position of the collar, so that the best nailing position can be found. When nailing, there is no need to use positioning instruments, and after nailing, only the The tension of the operating rope can be adjusted, so that the operation of the surgical procedure is simple and efficient. Moreover, each rope belt can be adjusted in the radial direction and can be properly rotated along the knee tuck loop, so that it can adapt to the selection of lower nails at different positions. It can also be seen that, since the fixed relationship between the knee tuck and each rope is reinforced before leaving the factory, the connection between the two can be maintained to have a flat structure, and the collar or adjustment plate at each end of the patella nail can also be a side. The sheet-like structure can minimize the number of nodes, avoid overlapping and thickening of each rope, and prevent the occurrence of rope knots, which may cause the internal fixator to easily protrude the skin, pierce the skin, and cause pain and infection. Compared with the current method of winding the rope or wire rope by hand during the operation process, the use of the collar and the adjustment plate in this embodiment can realize the surgical operation conveniently and quickly, and the collar and the adjustment plate will not fall off as easily as the bundled rope or steel wire. , which guarantees a valid fixed time.

Example 2:

On the basis of Example 1, an elastic knee tuck loop double-adjustment cord-type internal fixation device for patella fractures is used, as shown in Figure 6, the device includes a knee loop, a fixed cord, a patella nail, an adjustment cord and mechanism.

The knee tuck ring is a circular elastic ring, and its peripheral edge is connected with an adjusting rope belt and the remaining three fixed rope belts. Wherein, one end of the fixing rope is fixed on the edge of the knee tuck, and the other end is connected with a loop. When one end of the adjusting rope is fixedly connected with the knee tuck ring, an end adjustment mechanism is set between the other end and the patella nail or a length adjustment mechanism is set in the middle of the rope. A loop is connected, at least two patella nails run through both sides of the patella fracture in approximately parallel, and the ends of each fixing rope and each adjusting rope are respectively sleeved on the end of the corresponding patella nail, and the radial adjustment is adjusted. During the mechanism or the length adjustment mechanism, each fixed rope belt and each adjustment rope belt are tensioned.

In this embodiment, since the elastic knee wrap 1b is used, the elastic knee wrap can be appropriately deformed. After the three fixing straps are respectively fixed by the corresponding patella nails, by adjusting the last strap, that is, the adjusting strap, The process of tensioning and adjusting the rope can pull the elastic knee tuck 1b to deform appropriately, so as to overcome the situation that the remaining three fixed ropes may have insufficient tension (the two diagonal fixed ropes can be tightened in advance during nailing. ).

Example 3:

On the basis of Example 1, the adjusting rope is replaced with another adjusting rope as shown in FIG. 7 to realize a new internal fixation device for patella fractures. Take the belt as an example. The fixing rope will not be described in detail. As shown in Figure 7, one end of the adjusting rope is fixedly connected to the rigid knee tuck loop 1a, and the other end is fixedly connected to the collar 5, and a length adjustment mechanism is arranged in the middle.

As shown in FIG. 7 , the middle-section adjusting rope 3b includes a fixing belt 304 and an adjusting belt 305. One end of the fixing belt 304 is fixedly connected to the collar 5, and the other end is connected to the fixed sleeve 309. The sleeve ring 308 is connected, and the other end side wall is provided with a one-way helical tooth 306 and passes through the fixing sleeve 309. The inner wall of the fixing sleeve 309 is provided with a convex block that can be clamped to the one-way helical tooth 306, so that the one-way helical tooth 306 can only move in one direction Entering the fixing sleeve 309, the fixing belt 304 and the adjusting belt 305 of the middle-section adjusting rope 3b are relatively tightened. The middle-section adjusting rope 3b can also realize the expansion and contraction adjustment function like the end adjusting rope 3a in the first embodiment. For the adjustment mode of the adjustment rope, the relative adjustment can also be achieved by fixing the collar 5 at one end and the articulating collar 307 at the other end, and changing different models. A plurality of socket holes 6 are evenly distributed on the periphery of the rigid knee hugging ring 1a in FIG.

Example 4:

On the basis of Example 1, the adjusting rope is replaced with another adjusting rope as shown in FIG. 8 to realize a new internal fixation device for patella fracture. Take the belt type as an example (the possibility of using elastic knee wraps is not excluded). A radial adjusting mechanism is arranged between one end of the adjusting rope and the knee tuck, and the other end is connected with a collar 5. When adjusting the radial adjusting mechanism, each fixing rope and each adjusting rope are tensioned.

Specifically, as shown in FIG. 8 , a plurality of radial perforations 7 are radially provided on the circumferential edge of the rigid knee tuck 1a, and elastic clamping heads 311 are respectively provided in each radial perforation 7, as shown in FIG. 9 . Show.

This embodiment adopts a tie-type adjusting rope 3c. It can be seen from FIG. 8 that one end of the tie-type adjusting rope 3c is fixed with a collar 5, and the other end is provided with anti-slip inverse teeth 310, and each anti-slip inverse tooth 310 is inserted into the corresponding into the radial through hole 7, and ensure that each chuck 311 can be automatically inserted into the groove of the anti-slip inverted tooth 310.

This embodiment uses a tie-type adjusting rope 3c, which can be bent by itself. In the application of this embodiment, the corresponding loops are first fixed with each patella nail, and then the nut 5 is screwed to press the loops on the patella. Then insert the anti-slip inverse teeth 310 of each part or all of the tie-type adjustment cords 3c into the corresponding radial holes 7 and tighten them.

On the basis of the above-mentioned structure of this embodiment, it is also possible to design a fixed cord at the circumferential edge of the rigid tuck loop 1a, and a tie-type adjustment cord 3c connected to a part through a plurality of radial perforations 7. Realize the possibility of using a fixed cord with an adjustment cord.

Example 5:

As shown in FIG. 10 , a plurality of shallow grooves 8 are radially provided on the circumferential edge of the rigid tuck ring 1a, and a screw hole 9 is provided in the middle of the shallow grooves. At the same time, there are also in-slot teeth 312 at the bottom of each shallow slot 8 .

A flat ring type adjusting rope 3d as shown in FIG. 11 is used, one end of which is fixed with the collar 5 and the other end is connected to the adjusting plate 301 . As can be seen from FIG. 11 , there is an adjustment hole 302 in the middle of the adjustment plate 301 , and one side surface of the adjustment plate 301 has anti-skid teeth 303 .

As can be seen from FIG. 10 , after adjusting each anti-skid tooth 303 in the radial direction, it is clamped in the corresponding shallow groove 8, the lock wire 10 is inserted into the adjustment hole 302 and screwed into the corresponding screw hole 9, and the lock wire cap is used. Press the surface of the adjusting plate to fix it in the shallow groove.

This embodiment uses a flat ring type adjusting rope 3d, which can be bent by itself. When applying this embodiment, each patella nail is used to fix the corresponding loop first, and then screw the nut 5 to press each loop to the patella. Then, some or all of the adjustment plates 301 of the flat ring type adjustment rope 3d are stretched radially and then clamped to the anti-skid teeth 303 of the corresponding shallow grooves, and then the corresponding lock wires are screwed to fix the adjustment plates.

On the basis of the above-mentioned structure of this embodiment, it is also possible to design a fixed rope at the peripheral edge of the rigid tuck loop 1a, and a flat ring type adjustment rope 3d connected by a plurality of radial shallow grooves 8. Realize the possibility of using a fixed cord with an adjustment cord.

Example 6:

As shown in FIG. 12 , a plurality of dovetail grooves 11 are radially provided on the circumferential edge of the rigid tuck loop 1a, and a screw hole 9 is provided in the middle of the shallow groove. A dovetail-shaped adjusting rope 3e as shown in FIG. 14 is used, one end of the adjusting rope is fixed with the collar 5 , and the other end is connected with the dovetail plug 313 . Specifically, there is an adjustment hole 302 in the middle of the dovetail plug 313 , and an anti-skid tooth 303 is arranged on the outer side of the adjustment plate 301 .

As shown in FIG. 13 , each dovetail plug 313 is inserted into the corresponding dovetail groove 11 in the radial direction and can be slidably adjusted in the radial direction. The outer side of each dovetail plug 313 is also covered with a flat washer 42a. The anti-skid teeth 44 are matched and snapped into the anti-skid teeth 303 on the outer side of the corresponding dovetail plug 313, and the lock wire 10 passes through the through hole 43 of the flat gasket 42a and is further inserted into the adjustment hole 302 of the dovetail plug 313, and the lock wire 10 is threadedly connected to In the corresponding screw hole 9, the surface of the flat washer 42a is pressed against the surface of the flat washer 42a by the cap of the lock screw, and then the dovetail plug 313 is pressed to be fixed in the shallow groove.

This embodiment adopts a dovetail-shaped adjusting rope 3e, which can be bent by itself. When applying this embodiment, first fix the corresponding loops with each patella nail, and then screw the nut 5 to press the loops on the surface of the patella. Then, stretch and slide the dovetail plugs 313 of each part or all of the dovetail-shaped adjusting ropes 3e along the radial direction and insert them into the corresponding dovetail plugs 313, and then screw the corresponding lock wires to fix the adjustment plate.

On the basis of the above structure of the present embodiment, it is also possible to design a fixed rope at the connecting portion of the circumferential edge of the rigid tuck loop 1a, and connect a portion of the dovetail-shaped adjusting rope 3e through a plurality of radial shallow grooves 8. Realize the possibility of using a fixed cord with an adjustment cord.

On the basis of the above embodiments, the knee hugging ring can also be designed as a composite ring of a rigid ring and a flexible ring, for example, a rigid or elastic ring is embedded on the upper surface or inside of the flexible ring. Based on the above concept, the present invention can also have other embodiments. For example, when radial perforations are arranged on the peripheral edge of the tuck ring in Embodiment 4, it can be changed to a dovetail radial groove, such as the shallow groove in Embodiment 5. , it is possible to directly change the teeth in the groove into the clamping teeth on the surface of the knee tuck without setting the shallow groove. All knee tuck rings can also be configured as a composite two-layer structure. When applied to Examples 4 to 6, the upper and lower layers of the rings are combined together to form radial perforations at the combined surface, or a closed shallow groove or closed The dovetail groove and other structures. As shown in Figure 16, when the upper and lower layers are used for composite fixation, anti-skid lines can be set on the inner surfaces of the upper and lower rings (the upper and lower lines are parallel or vertical, and can be embedded in each other when they are parallel. When they are vertical, it is best to use steel rings and flexible belts after pressing. can be embedded into each other), and the end of the adjusting rope is provided with corresponding patterns that can fit with the anti-skid pattern, which can be tightened radially respectively. When the upper and lower rings are pressed and fixed, each adjusting rope is fixed. .

For example, in a variation on the basis of implementation, when the knee tuck is designed as a single-layer structure, there may be multiple annular slots on its upper surface, as shown in FIG. The ring-shaped grooves are matched and fastened together, and each adjustment plate is adjusted radially in place. After being fixed by the lock wire, the adjustment plate at the end of the adjustment rope can be pressed and fixed on the knee tuck. Or as shown in Figure 17, when the knee tuck is designed as a single-layer structure, its circumference is evenly distributed with screw holes, its surface is smooth or textured, and the inner end of the adjusting rope is flat and has surplus, tighten the adjusting rope. After matching the flat position of the belt with the corresponding screw holes, drill holes and install screws in the screw holes.

At the same time, the patellar needle protruding from the upper surface of the top column can be cut off, thereby effectively reducing the irritation of the skin at the top during fixation. Alternatively, one end of the used patella nail has a screw sleeve 47 with a screw cap, and the other end is a screw rod 48 with a top cap. As shown in FIG. 17 , the length of the screw rod 48 screwed into the screw sleeve 47 is controllable. Also, the adjustment cords of the above embodiments can be mixed and used, and so on.

Claims

An internal fixation device for patella fracture, comprising a knee tuck ring and a patella nail, and is characterized in that it also includes an adjustment rope and an adjustment mechanism, the knee tuck ring is a circular steel ring, and its circumferential edge is connected with at least two The adjustment rope and the rest of the fixed rope, or all connected to the adjustment rope, one end of the fixed rope is fixed on the edge of the knee tuck, and the other end is connected with a loop, the adjustment rope, when one end is connected to the tuck. When the knee ring is fixedly connected, an end adjustment mechanism is arranged between the other end and the patella nail, or a length adjustment mechanism is arranged in the middle of the rope. Each patella nail runs through both sides of the patella fracture in approximately parallel, and the ends of each fixing rope and each adjusting rope are respectively sleeved on the end of the corresponding patella nail, and the radial adjustment mechanism or the end adjustment mechanism is adjusted. Or the length adjustment mechanism, so that each fixed rope belt and each adjustment rope belt are tensioned.
An internal fixation device for patella fracture, comprising a knee tuck ring, a fixing rope and a patella nail, and is characterized in that it also includes an adjusting rope and an adjusting mechanism, the knee tuck ring is a circular elastic ring, and its circumferential edge is at least One end of the fixed rope is connected to the edge of the knee tuck, and the other end is connected with a loop. The adjustment rope, when its When one end is fixedly connected with the knee tuck ring, the other end is provided with an end adjustment mechanism or a length adjustment mechanism in the middle of the rope between the other end and the patella nail. At least two patella nails run through both sides of the patella fracture in approximately parallel, and the ends of each fixing rope and each adjusting rope are respectively sleeved on the end of the corresponding patella nail, and the time or length of the radial adjustment mechanism is adjusted. The adjusting mechanism makes each fixing rope and each adjusting rope tensioned.
An internal fixation device for patella fracture, comprising a knee-tuck ring and a patella nail, wherein the knee-tuck ring is a circular steel ring or an elastic ring, and a plurality of socket holes ( 7), one end of the plurality of ropes is fixed with a collar and the other end is fixed with a joint sleeve (307), and the joint sleeve (307) is sleeved in each sleeve hole (7), or at least one rope One end is fixed with a ferrule and the other end is fixed with an articulating sleeve (307), the articulating sleeve (307) is sleeved in each sleeve connecting hole (7), the rest are fixed ropes, and one end of the fixed ropes is fixed on the clasp. The edge of the knee ring, and the other end is connected with a loop.
The internal fixation device for patella fracture according to any one of claims 1-3, characterized in that, in the radial adjustment mechanism 1: a plurality of radials are arranged along the radial direction on the circumferential edge of the rigid tuck ring (1)a Perforations (7), and elastic clamping heads (311) are respectively arranged in each radial perforation (7), and a tie-type adjusting rope (3) c is used, one end of which is fixed with a collar (5), and the other is One end is provided with anti-slip inverted teeth (310), each anti-slip inverted tooth (310) is inserted into the corresponding radial through hole (7), and it is ensured that each clamping head (311) can be automatically inserted into the groove of the anti-slip inverted tooth (310); or , connect part of the fixed rope at the circumferential edge of the rigid knee tuck (1)a, and connect part of the tie-type adjustment rope (3)c through a plurality of radial perforations (7), and match the fixed rope with the adjustment rope use.
The internal fixation device for patella fractures according to any one of claims 1-3, characterized in that, in the radial adjustment mechanism 2: a plurality of shallow grooves are radially arranged on the circumferential edge of the rigid tuck ring (1)a (8) A screw hole (9) is provided in the middle of the shallow groove, and the groove bottom of each shallow groove (8) is provided with groove inner teeth (312), and a flat ring type adjusting rope belt (3) d is used, one end of which is fixed with a sleeve The other end of the ring (5) is connected to the adjusting plate (301), the adjusting plate (301) has an adjusting hole (302) in the middle, and one side of the adjusting plate (301) is provided with anti-skid teeth (303). After radial adjustment, it is clamped into the corresponding shallow groove (8), the lock wire (10) is inserted into the adjustment hole (302) and screwed into the corresponding screw hole (9), and the adjustment plate is pressed by the cap of the lock wire The surface makes it fixed in the shallow groove; or the rigid tuck (1) a circumferential edge connecting part of the fixed rope, and connecting part of the flat ring type adjusting rope (3) through a plurality of radial shallow grooves (8) d. Use the fixing strap with the adjusting strap.
The internal fixation device for patella fracture according to any one of claims 1-3, characterized in that, in the radial adjustment mechanism 3: a plurality of dovetail grooves are radially arranged on the circumferential edge of the rigid tuck ring (1)a (11) and a screw hole (9) is provided in the middle of the shallow groove, and a dovetail-shaped adjusting rope (3)e is used, one end of which is fixed with a collar (5), and the other end is connected to a dovetail plug (313), the dovetail plug (313) ) There is an adjustment hole (302) in the middle, and the outer side of the adjustment plate (301) has anti-skid teeth (303), insert each dovetail plug (313) into the corresponding dovetail groove (11) in the radial direction and can slide and adjust in the radial direction , the outside of each dovetail plug (313) is also covered with a flat washer (42)a, and the anti-skid teeth (44) on one side of the flat washer (42)a are matched and fastened to the anti-skid teeth on the outside of the corresponding dovetail plug (313). In (303), through the through hole (43) of the flat washer (42) a through the lock wire (10), and further insert into the adjustment hole (302) of the dovetail plug (313), the lock wire (10) is threadedly connected to the corresponding In the screw hole (9) of the screw, use the lock screw cap to press the surface of the flat washer (42)a and then press the dovetail plug (313) to fix it in the shallow groove, or on the circumference of the rigid knee tuck (1)a The edge connecting part fixes the rope, and connects part of the dovetail-shaped adjusting rope (3)e through a plurality of radial shallow grooves (8), so that the fixed rope and the adjusting rope are used together.
The internal fixation device for patella fractures according to any one of claims 1-3, characterized in that, the length adjustment mechanism: one end of the adjusting rope is fixedly connected to a rigid knee tuck ring (1)a, and the other end is fixedly connected to a connecting sleeve The ring (5) is provided with a length adjusting mechanism in the middle.
The internal fixation device for patella fracture according to any one of claims 1-3, characterized in that, the end adjustment mechanism: a strip-shaped adjustment plate (301) is fixed at the end of the rope, and the adjustment plate ( 301) There is a flat and long adjusting hole (302) in the middle. After the adjusting plate (301) is fitted on the outside of the corresponding patella nail (4), the end caps (41) and the silk nut (45) at both ends of the patella nail are paired. The corresponding adjusting plate (301) is pressed, there is a hole (43) in the center of the washer and is set on the outside of the patella nail (4), and there are anti-skid teeth (303) on the surface of the adjusting plate (301). There are anti-skid teeth (44) on the surface.
The internal fixation device for patella fracture according to any one of claims 1-3, characterized in that, one end of the fixed rope or adjustment rope is provided with a movable hook connected with the knee tuck so that it is convenient for different The patient changes to a different type of cord.
The internal fixation device for patella fracture according to any one of claims 1 to 3, wherein the knee hugging ring is a composite ring of a steel ring and a flexible ring.