CN112773487B - Intramedullary reduction device for long bone fractures of limbs - Google Patents
Intramedullary reduction device for long bone fractures of limbs Download PDFInfo
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- CN112773487B CN112773487B CN202110089427.3A CN202110089427A CN112773487B CN 112773487 B CN112773487 B CN 112773487B CN 202110089427 A CN202110089427 A CN 202110089427A CN 112773487 B CN112773487 B CN 112773487B
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- driving mechanism
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- 208000010392 Bone Fractures Diseases 0.000 title claims abstract description 37
- 230000009467 reduction Effects 0.000 title claims description 10
- 230000007246 mechanism Effects 0.000 claims abstract description 58
- 239000002775 capsule Substances 0.000 claims abstract description 17
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 14
- 239000003638 chemical reducing agent Substances 0.000 claims abstract 2
- 238000001125 extrusion Methods 0.000 claims description 8
- 230000009471 action Effects 0.000 claims description 5
- 230000005540 biological transmission Effects 0.000 claims description 4
- 206010017076 Fracture Diseases 0.000 description 13
- 208000006670 Multiple fractures Diseases 0.000 description 7
- 210000001185 bone marrow Anatomy 0.000 description 6
- 210000003275 diaphysis Anatomy 0.000 description 4
- 239000000306 component Substances 0.000 description 3
- 208000014674 injury Diseases 0.000 description 3
- 208000019155 Radiation injury Diseases 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000000642 iatrogenic effect Effects 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 238000012545 processing Methods 0.000 description 2
- 206010017088 Fracture nonunion Diseases 0.000 description 1
- 206010018852 Haematoma Diseases 0.000 description 1
- 206010067268 Post procedural infection Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 239000008358 core component Substances 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000001737 promoting effect Effects 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 238000003756 stirring Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary devices, e.g. pins or nails
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
- A61B17/921—Impactors or extractors, e.g. for removing intramedullary devices for intramedullary devices
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Neurology (AREA)
- Surgical Instruments (AREA)
Abstract
本发明公开了四肢长骨骨折髓内复位器，包括导向软管、导丝、驱动机构和送丝机构。导向软管能够伸入长骨干的髓腔内，于导向软管的前端固定有能够引导导向软管前进方向的胶囊本体。导丝穿入导向软管内，所述导丝的前端伸出导向软管并固定有与导向软管抵接的钝头。驱动机构用于驱动导向软管向前移动，所述驱动机构距导向软管前端的距离至少为10mm。送丝机构置于长骨干外，用于驱动导丝向前移动。
The present invention discloses an intramedullary reducer for long bone fractures of limbs, comprising a guide hose, a guide wire, a driving mechanism and a wire feeding mechanism. The guide hose can be extended into the medullary cavity of the long bone shaft, and a capsule body capable of guiding the forward direction of the guide hose is fixed at the front end of the guide hose. The guide wire is inserted into the guide hose, and the front end of the guide wire extends out of the guide hose and is fixed with a blunt head abutting against the guide hose. The driving mechanism is used to drive the guide hose to move forward, and the distance between the driving mechanism and the front end of the guide hose is at least 10 mm. The wire feeding mechanism is placed outside the long bone shaft and is used to drive the guide wire to move forward.
Description
Technical Field
The invention relates to the field of orthopedic medical instruments, in particular to an intramedullary restorer for long bone fracture of limbs.
Background
In orthopaedics treatment, long bone fracture of limbs is a common clinical injury, and two types of incision reduction internal fixation and closed reduction internal fixation are mainly used in an operation scheme for treating the long bone fracture of limbs.
The closed reduction internal fixation operation has become the mainstream technology for treating diaphyseal fracture because of small trauma, small blood loss of patients, reserved hematoma around fracture containing factors for promoting fracture healing, and relatively low incidence of postoperative infection, fracture nonunion and other complications.
However, in the current operation process of closed reduction, the reduction of the fracture with lateral displacement is difficult, no special appliance is provided, the accuracy and the operation quality of reduction are affected, and the problems in the treatment of the fracture of the long bones of the limbs are solved.
In the Chinese patent No. 201310605218.5, an intramedullary restorer for fracture of long bones of limbs is disclosed, which is characterized in that a bent restoring head is inserted into a marrow cavity at the opposite side of a fracture end of a bone, a push-pull handle at the rear end of a restoring rod is pulled, so that the restoring head stirs the opposite side marrow cavity to restore the fracture of the opposite side bone, a guide wire (3) can be inserted into the marrow cavity at the fracture end at the opposite side, and the fracture part is restored and fixed by using an intramedullary nail matched tool after the outer sleeve is withdrawn. In the scheme, when in operation, two sections of fractured bones possibly have side-to-side or/and front-to-back angulation deformity, the reset rod is required to be continuously rotated, the angle of the reset head is adjusted, so that the fractured bones can enter the contralateral fractured bones, and an auxiliary device C-arm machine is required to be used for repeated perspective monitoring and guiding, so that the problems are that (1) the device is too complicated to operate and excessively depends on experience of an operator, and great uncertainty exists, and (2) the device adopts a mode of firstly resetting and then threading, but the reset head enters the intramedullary cavity of the contralateral fractured bones to be shallower, force acts on the break points of the fracture during resetting, and the broken bones are low in strength and large in brittleness after being subjected to violence, so that secondary injury is easy to cause during resetting.
Disclosure of Invention
The invention aims to solve the technical problem of providing an intramedullary repositor for long bone fracture of limbs, which can guide a guide wire to enter a bone marrow cavity of contralateral fracture.
In order to solve the technical problems, the invention adopts the following technical scheme:
an intramedullary reduction device for long bone fractures of limbs, comprising:
The guiding hose can extend into the marrow cavity of the long diaphysis, and a capsule body capable of guiding the advancing direction of the guiding hose is fixed at the front end of the guiding hose;
The guide wire penetrates into the guide hose, and the front end of the guide wire extends out of the guide hose and is fixed with a blunt end which is abutted with the guide hose;
a driving mechanism for driving the guide hose to move forward, the driving mechanism being at least 10mm from the front end of the guide hose, and
And the wire feeding mechanism is arranged outside the long diaphysis and is used for driving the guide wire to move forwards.
The driving mechanism is fixed on the guide hose, can walk in the intramedullary cavity, and the length of the guide hose in front of the driving mechanism is 10-50 mm.
A further technical solution is that the driving mechanism includes:
At least one inner tube which is arranged through the guide hose, the two ends of the inner tube are fixed with the guide hose, and the inner walls of the two ends of the inner tube are fixed with positioning baffle pieces;
Each inner tube is provided with:
The two mounting parts are arranged in the inner tube between the two positioning baffle parts, can axially move along the inner tube and are limited to rotate;
a spring disposed between the two mounting members and in a compressed state;
two driving motors I, respectively fixed on the outer sides of the two mounting pieces, the motor shaft of the driving motor I is arranged perpendicular to the axis of the inner tube, and
The two running wheels are respectively fixed on motor shafts of the two driving motors, and can extend out of the inner tube to run along the inner wall of the medullary cavity.
The further technical scheme is that the annular surface of the running wheel is provided with a tooth structure.
The further technical scheme is that the driving mechanism further comprises:
The extrusion sleeve is movably sleeved outside the guide hose and can be propped against the outside of the inlet of the marrow cavity, the inner hole of the extrusion sleeve is conical, and the large end opening is backwards, so that the driving mechanism can enter;
when the driving mechanism moves forwards, the two running wheels are extruded by the inner wall of the extrusion sleeve and can be retracted into the inner pipe.
Further technical solution is characterized in that the driving mechanism comprises:
The tooth row is distributed on the outer wall of the guide hose and is provided with a plurality of annular teeth which are arranged at equal intervals along the axial direction of the guide hose;
the outer hard guide sleeve is movably sleeved outside the guide hose and is arranged outside the marrow cavity;
A second driving motor fixed on the outer hard guide sleeve, and
The driving gear is assembled on a motor shaft of the driving motor II and is rotatably positioned in the outer hard guide sleeve to be meshed with the gear row for transmission.
The further technical scheme is that the driving mechanism further comprises:
the inner hard guide sleeve is arranged in the outer hard guide sleeve, and a circle of permanent magnet I is embedded on the outer wall of the inner hard guide sleeve;
The inner wall of the outer hard guide sleeve is embedded with a circle of permanent magnet II which is the same as the magnetic pole of the permanent magnet I, and the permanent magnet I and the permanent magnet II keep a set distance under the action of magnetic field repulsive force, so that an annular gap matched with the wall thickness of the guide hose is formed between the outer hard guide sleeve and the inner hard guide sleeve.
The beneficial effects of adopting above-mentioned technical scheme to produce lie in:
the device is provided with the capsule body, when the stubble department of broken bone is moved to the guide hose front end, under the environment of perspective, utilize the function that the capsule body can turn to, through the angle of control system regulation capsule body, make the guide hose's front end take the seal wire to get into contralateral fracture bone marrow intracavity, then withdraw from the guide hose, continue forward advancing the seal wire through wire feeding mechanism, thereby make the seal wire can penetrate the marrow chamber of two sections broken bones, finally drive into the intramedullary nail along the seal wire, accomplish the closed internal fixation that resets.
The automatic control of the device through the program replaces the manual operation of doctors, reduces the complexity of the operation, simplifies the operation steps, saves the operation time, and avoids the iatrogenic radiation injury caused by X-ray generated by repeated perspective to users.
In addition, the distance between the driving mechanism and the front end of the guide hose in the device is at least 10mm, and the setting of the specific position of the driving mechanism ensures that the length of the guide hose at the front end of the driving mechanism is not smaller than the distance between two sections of broken bones, so that the driving mechanism cannot enter the muscle between the two sections of broken bones, and the driving mechanism has landing support both in a marrow cavity and outside a long bone, thereby ensuring effective driving power.
Drawings
The invention will be described in further detail with reference to the drawings and the detailed description.
FIG. 1 is a schematic diagram of an embodiment of the present reset device;
FIG. 2 is a schematic diagram of another embodiment of the present reset device;
fig. 3 is an enlarged schematic view of the portion a in fig. 1.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and fully with reference to the accompanying drawings, in which it is evident that the embodiments described are some, but not all embodiments of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present invention, but the present invention may be practiced in other ways other than those described herein, and persons skilled in the art will readily appreciate that the present invention is not limited to the specific embodiments disclosed below.
Example 1
As shown in fig. 1 and 2, one embodiment of the intramedullary repositor for long bone fractures of limbs of the present disclosure includes a guide hose 1, a guide wire 3, a drive mechanism 5, and a wire feeding mechanism 6.
The guide tube 1 can extend into the intramedullary canal of the diaphysis, and a capsule body 2 capable of guiding the advancing direction of the guide tube 1 is fixed to the front end of the guide tube 1. The capsule body 2 is in the prior art, the existing capsule body 2 comprises a driving component, the driving component is a core component of the capsule body 2 and is generally integrated in the capsule body 2, the existing driving mode mainly comprises a motor driving mode, an electromagnetic driving mode, a compression spring 514 driving mode and the like, the capsule body 2 is in signal connection with an external control unit, the driving component is controlled through the processing of the external processing unit, the rotation of the capsule is controlled, and the running direction of the capsule body 2 can be adjusted.
The guide wire 3 is a medical guide wire 3 and has certain strength and toughness. The guide wire 3 penetrates into the guide hose 1, and the front end of the guide wire 3 extends out of the guide hose 1 and is fixedly provided with a blunt tip 4 abutting against the guide hose 1, and the blunt tip 4 can prevent the guide wire 3 from being pulled back out of the guide hose 1, so that the guide hose 1 can push the blunt tip 4 forward to move the guide wire 3 forward.
The driving mechanism 5 is used for driving the guide hose 1 to move forwards, and the distance between the driving mechanism 5 and the front end of the guide hose 1 is at least 10mm.
The wire feeding mechanism 6 is disposed outside the diaphysis, and an existing wire feeding mechanism such as a manipulator, a wheel set or manual wire feeding is adopted, which is not described herein. After the guide hose 1 is removed, the wire feeding mechanism 6 starts to work for driving the guide wire 3 to move forward continuously and enter the contralateral bone marrow cavity to provide guidance for the insertion of the intramedullary nail.
The device is provided with a capsule body 2, when the front end of a guide hose 1 runs to a stubble connecting position of broken bones (can be determined through perspective, can also be judged by a position tracking system), under the perspective environment, the capsule body 2 is regulated to rotate by utilizing the steering function of the capsule body 2 through an external control system, the advancing direction is changed, the front end of the guide hose 1 is enabled to carry a guide wire 3 to enter a bone marrow cavity of contralateral bone fracture, after the front end of the guide wire 3 enters the contralateral bone marrow cavity, medical staff withdraws the guide hose 1, then continues to advance the guide wire 3 through a wire feeding mechanism 6, and the wire feeding is stopped after reaching a certain position, so that the guide wire 3 can penetrate into two sections of broken bone marrow cavities, and finally, intramedullary nails are driven along the guide wire 3, thereby completing closed reset internal fixation.
The automatic control of the device through the program replaces the manual operation of doctors, reduces the complexity of the operation, simplifies the operation steps, saves the operation time, and avoids the iatrogenic radiation injury caused by X-ray generated by repeated perspective to users.
In addition, the distance between the driving mechanism 5 and the front end of the guide hose 1 in the device is at least 10mm, and the setting of the specific position of the driving mechanism 5 ensures that the length of the guide hose 1 at the front end of the driving mechanism 5 is not smaller than the distance between two sections of broken bones, so that the driving mechanism 5 can not enter the muscle between the two sections of broken bones, and the driving mechanism 5 has landing support both in the intramedullary cavity and outside the long bones, thereby ensuring effective driving power.
Example two
According to one embodiment of the disclosed intramedullary restorer for long bone fracture of limbs, as shown in fig. 1 and 3, the driving mechanism 5 is fixed on the guide hose 1, and can walk in the intramedullary canal, and the length of the guide hose 1 in front of the driving mechanism 5 is 10-50 mm. The length is enough that a doctor can directly put the driving mechanism 5 into the marrow cavity at the initial time, and when the guiding hose 1 at the front end turns to enter the opposite-side broken marrow cavity at the position of broken bone and stubble, the driving mechanism 5 can be left in the rear broken marrow cavity, and the driving mechanism 5 is supported by the marrow cavity.
Specifically, the driving mechanism 5 is fixed to the guide hose 1, and enters the intramedullary canal along with the guide hose 1. The driving mechanism 5 comprises at least one inner tube 511, and two mounting pieces 513, springs 514, two driving motors 515 and two running wheels 516 are arranged on each inner tube 511.
The inner tube 511 is disposed to intersect the guide hose 1, both ends of the inner tube are fixed to the guide hose 1, positioning stoppers 512 are fixed to inner walls of both ends of the inner tube 511, and the positioning stoppers 512 protrude inward from the inner walls of the guide hose 1. When a plurality of inner tubes 511 is employed, the plurality of inner tubes 511 are disposed in parallel.
The two mounting members 513 are disposed in the inner tube 511 between the two positioning stoppers 512, the positioning stoppers 512 can prevent the mounting members 513 from separating from the inner tube 511, the two mounting members 513 can move axially along the inner tube 511 and be limited to rotate, and the rotation limiting structure can be realized by a concave-convex matching structure. The spring 514 is disposed between the two mounts 513 and is in a compressed state. Two driving motors 515 are respectively fixed on the outer sides of the two mounting pieces 513, and the motor shafts of the driving motors 515 are perpendicular to the axis of the inner tube 511. The two running wheels 516 are respectively fixed on the motor shafts of the two driving motors 515 and can extend out of the inner tube 511 to run along the inner wall of the medullary cavity, wherein the annular surface of the running wheels 516 is provided with a tooth structure, and the running wheels 516 can be prevented from slipping. The compressed spring 514 always has an outward force on the mounting member 513, causing the running wheel 516 to extend out of the inner tube 511 into contact with the intramedullary canal wall and have a certain pressure against the intramedullary canal wall to cause the running wheel 516 to run normally.
In use, a person can manually press the two running wheels 516 inwards to further compress the spring 514, so that the running wheels 516 retract into the inner tube 511, the device can enter the medullary cavity initially, after entering the medullary cavity, the two running wheels 516 are driven to extend out of the inner tube 511 under the action of the reset extension of the spring 514, and the two running wheels 516 are started by a first driving motor 515 and the driving mechanism 5 can drive the guide wire hose to move forwards and deep into the medullary cavity together with the intramedullary cavity inner wall mechanism.
Further, the drive mechanism 5 also includes a compression sleeve to facilitate initial entry of the drive mechanism 5 into the intramedullary canal.
The extrusion sleeve is movably sleeved outside the guide hose 1 and can be propped against the outside of the inlet of the medullary cavity without entering the medullary cavity. The inner hole of the extrusion sleeve is conical, the large end opening is backwards, the driving mechanism 5 can enter, and as the guide hose 1 moves forwards with the driving mechanism 5, the two running wheels 516 are extruded by the inner wall of the extrusion sleeve and can be retracted into the inner pipe 511.
Example III
According to one embodiment of the disclosed intramedullary repositor for long bone fractures of extremities, as shown in fig. 2, the drive mechanism 5 is provided outside the body, and includes a row of teeth, an outer hard guide sleeve 521, a second drive motor, and a drive gear 522.
The teeth are arranged on the outer wall of the guide hose 1, and a plurality of annular teeth are arranged at equal intervals along the axial direction of the guide hose 1. The outer hard guide sleeve 521 is a hard guide sleeve, is sleeved outside the guide hose 1 in a sliding manner, and is arranged outside the medullary cavity. The second driving motor is fixed on the outer hard guide sleeve 521 through a motor seat. The driving gear 522 is assembled on the motor shaft of the driving motor II, and is rotatably positioned in the outer hard guide sleeve 521 to be meshed with teeth on the tooth row to realize transmission. The second driving motor is started, and forward or backward driving of the guide hose 1 can be realized by forward rotation and backward rotation of the second driving motor under the action of the driving gear 522.
Further, to prevent the hose from being deformed when the drive gear 522 and the guide hose 1 are engaged, the drive gear 522 and the row of teeth cannot be engaged, and thus the drive mechanism 5 further includes an inner hard guide sleeve 523.
The inner hard guide sleeve 523 is arranged in the outer hard guide sleeve 521, and a circle of permanent magnet 524 is embedded on the outer wall of the inner hard guide sleeve 523. The inner wall of the outer hard guide sleeve 521 is embedded with a circle of permanent magnet II 525 with the same magnetic pole as the permanent magnet I524, and the permanent magnet I524 and the permanent magnet II 525 keep a set distance under the action of magnetic field repulsive force, so that an annular gap matched with the wall thickness of the guide hose 1 is formed between the outer hard guide sleeve 521 and the inner hard guide sleeve 523. The guide hose 1 can be supported by the guide hose passing through the gap through the cooperation of the inner and outer hard guide sleeves 521, so that the drive gear 522 and the gear row can be effectively meshed for transmission.
The foregoing is only a preferred embodiment of the present invention, and any and all simple modifications, variations and equivalents of the present invention will fall within the scope of the present invention.
Claims (3)
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| Application Number | Priority Date | Filing Date | Title |
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| CN202110089427.3A CN112773487B (en) | 2021-01-22 | 2021-01-22 | Intramedullary reduction device for long bone fractures of limbs |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202110089427.3A CN112773487B (en) | 2021-01-22 | 2021-01-22 | Intramedullary reduction device for long bone fractures of limbs |
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| CN112773487A CN112773487A (en) | 2021-05-11 |
| CN112773487B true CN112773487B (en) | 2025-02-28 |
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Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN215306591U (en) * | 2021-01-22 | 2021-12-28 | 河北医科大学第三医院 | Intramedullary reducer for long bone fractures of extremities |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE69839051T2 (en) * | 1997-03-07 | 2009-01-15 | Disc-O-Tech Medical Technologies, Ltd. | PERCUT BONE SYSTEMS AND SPINAL STABILIZATION, MOUNTING AND REPAIR |
| US7914532B2 (en) * | 2005-10-21 | 2011-03-29 | Acumed Llc | Orthopedic rod with locking aperture |
| CN101431951B (en) * | 2006-04-26 | 2012-03-14 | 伊卢米诺斯医学有限公司 | Devices and methods for delivering reinforcing materials to bone |
| JP2012196463A (en) * | 2012-05-10 | 2012-10-18 | Saint Louis Univ | Intramedullary nail device and method for mending long bone |
| CN103610489B (en) * | 2013-11-26 | 2014-10-15 | 张英泽 | Intramedullary repositor for fracture of long bones of arms and legs |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN215306591U (en) * | 2021-01-22 | 2021-12-28 | 河北医科大学第三医院 | Intramedullary reducer for long bone fractures of extremities |
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