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CN103800067A - Steel wire guiding device for intertrochanteric fracture - Google Patents

Steel wire guiding device for intertrochanteric fracture Download PDF

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Publication number
CN103800067A
CN103800067A CN201410020890.2A CN201410020890A CN103800067A CN 103800067 A CN103800067 A CN 103800067A CN 201410020890 A CN201410020890 A CN 201410020890A CN 103800067 A CN103800067 A CN 103800067A
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handle
guiding tube
guide tube
tube
main
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CN103800067B (en
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储小兵
刘福存
童培建
陈巧玲
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Zhejiang Hospital
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Zhejiang Hospital
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90Guides therefor

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  • 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)
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Abstract

股骨转子间骨折用钢丝引导器,手柄上设有供主引导管插入的第一插孔和供副引导管插入的第二插孔,主引导管和副引导管的近端各自与手柄插接,主引导管的远端呈弯钩状套钩小转子骨折块,主引导管的远端和副引导管的远端连接,形成引导钢丝绕过股骨转子间骨折部位内侧的折弯通道;主引导管的一侧设有供钢丝顶出部件穿过的孔,另一侧开有容许钢丝脱出的缝隙;手柄还连接一个顶推机构,顶推机构包括一个插入手柄的推杆,推杆尾端设有与手柄螺接的螺杆;主引导管与顶推机构一起固定骨折部位。本发明采用组合式导引钢丝或钛缆和临时固定骨折的装置,组织伤害小,利于骨折愈合,实现微创操作,使用方便,操作简便可靠。

A wire guide for intertrochanteric fractures, the handle is provided with a first hole for the insertion of the main guide tube and a second hole for the insertion of the auxiliary guide tube, the proximal ends of the main guide tube and the auxiliary guide tube are respectively inserted into the handle , the distal end of the main guide tube is hook-shaped to hook the lesser trochanter fracture fragment, and the distal end of the main guide tube is connected to the distal end of the auxiliary guide tube to form a bending channel for the guide wire to bypass the inner side of the intertrochanteric fracture site; One side of the guide tube is provided with a hole for the steel wire ejection part to pass through, and the other side is provided with a gap to allow the steel wire to escape; the handle is also connected to a push mechanism, which includes a push rod inserted into the handle, and the end of the push rod The end is provided with a screw rod screwed with the handle; the main guiding tube and the pushing mechanism fix the fracture site together. The invention adopts a combined guide steel wire or titanium cable and a device for temporarily fixing fractures, which has little tissue damage, facilitates fracture healing, realizes minimally invasive operation, is convenient to use, and is easy and reliable to operate.

Description

Intertrochanteric fracture wire introducer
Technical field
The present invention relates to a kind of intertrochanteric fracture wire introducer.
Background technology
Intertrochanteric fracture, refers to that base of nebk ot femur is to the fracture between lesser trochanter of femur, is one of modal fracture of old people, especially sees 70 years old above man at an advanced age and serious sufferers of osteoporosis face, and Bone fracture characteristics is that syntripsis is many, osteoporosis.
Clinically, the operative treatment mode of intertrochanteric fracture is more, comprise various internal fixation operations or prosthetic replacement's operation, but the intertrochanteric fracture of pulverizing need to add and fix sclerite, to avoid after interior fixing or artificial joint operation because the support that loses rotor portions bone leads to the failure, technically can select the methods such as screw, steel wire, titanium cable, but the fixed effect of tying up with steel wire or titanium cable is the most reliable.
Steel wire or titanium cable need to be walked around all footpaths of intertrochanteric fracture and can implement to tie up, prior art is to send and draw or guide to reach this object with traveller depending on lower dependence operating forceps blind, owing to having a large amount of muscle and joint capsule tissue apposition at fracture end, need to be by peeling off muscle and joint capsule tissue, steel wire is walked around to fracture end to carry out cerclage and fixes, need large otch to appear, operating difficulties, and larger to tissue injury, cannot realize the function of Wicresoft's guide wire or titanium cable and interim auxiliary fixing fracture
The for example patent No. is the Orthopedic wire guiding device of announcing in 200620080153.2, can guiding steel wire cerclage fissure fracture piece, but in the time that reality is used, steel wire bracing wire is not very convenient, and does not arrange and grip structure and carry out assisted surgery and operate to guarantee good surgical effect.
Summary of the invention
Not good shortcoming in order to overcome the use inconvenience of existing fracture wire introducer and effect, the invention provides a kind of intertrochanteric fracture wire introducer.
The technical solution used in the present invention is:
Intertrochanteric fracture wire introducer, handle, main guiding tube and secondary guiding tube, described handle is provided with the first jack inserting for main guiding tube and the second jack inserting for secondary guiding tube, the near-end of described main guiding tube is connected with handle, the near-end of secondary guiding tube and handle are pegged graft, the far-end of described main guiding tube is hook solid cover hook lesser trochanter sclerite, the far-end of described main guiding tube is connected with the far-end of secondary guiding tube, and formation guiding steel wire is walked around the bending passage of inner side, intertrochanteric fracture position;
Described secondary guiding tube is connected with the second jack by the intubate connecting on it, and the length of intubate connecting handle and angle are adapted to the described far-end of main guiding tube and the connection of the far-end of secondary guiding tube;
One side of described main guiding tube is provided with the hole of passing for steel wire ejector member, and opposite side has the gap of allowing that steel wire is deviate from;
Described handle also connects a top-pushing mechanism, and top-pushing mechanism comprises that is inserted a push rod for handle, and push rod tail end is provided with the screw rod being spirally connected with handle, and described push rod head end is provided with the pad of pushing of outside surface of bone after pushing tow greater trochanter; The far-end of described main guiding tube and described pushing are padded and are fixed fracture site.
After steel wire is deviate from secondary guiding tube and shifted out secondary guiding tube, the push rod of described top-pushing mechanism inserts the second described jack.
The first jack of described handle and the second jack are all along the length direction of handle, and described main guiding tube and secondary guiding tube are parallel to each other.
Intubate on described secondary guiding tube is U font, and one end of described intubate is connected with the second through hole, and the other end and secondary guiding tube UNICOM are also provided with steel wire outlet in bending place.
On described screw rod, manual knob is housed, the screw front end of described knob is provided with projection, and described pushing ram end is provided with the slot that forms joinery and its construction with described projection; The front end of described projection is provided with the ring-type draw-in groove around described projection, and described pushing ram is provided with the backing pin that can insert described ring-type draw-in groove.
The both sides of described handle are provided with non slip surface.
For preserving femoral intertrochanteric bone amount, maintain the supporting function of rotor portions bone, need to add steel wire or titanium cable is tied up the comminuted fracture piece of intertrochanteric fracture, increase fracture fixation intensity.By mini-invasive incision technology outside hip joint, utilize the substep operation of guiding tube, pushing ram, can realize two of intertrochanteric fracture large main sclerites---after lesser trochanter sclerite and greater trochanter, interim reset, the fixing and guiding wire rope of outside sclerite tied up, and operation technique is easy to be reliable.
Intertrochanteric fracture wire introducer, comprise a main guiding tube, its handle total length has 2 through holes, wherein 1 the first jack for being connected with main guiding tube inner duct that diameter is less, the first jack cross section is rounded, for running through guiding steel wire or titanium cable.Larger the second jack of another 1 diameter is at its opposite side, and the second jack is rounded at handle rear cross section, at handle head section ovalize, for inserting secondary guiding tube and pushing ram.The far-end of main guiding tube is smaller part circle, diameter and femoral intertrochanteric skeleton width adapt, tip is 30 ° of acute angle designs, be convenient to pierce through by tissue, main guiding tube completes after cover hook lesser trochanter sclerite, secondary guiding tube inserts in second jack of handle afterbody at main guiding tube place, after being advanced to the end, be just in time connected with the tip of main guiding tube, the tip of secondary guiding tube far-end is the 30 ° acute angle designs contrary with main guiding tube tip direction, thread eye by main guiding tube handle tail side imports steel wire or titanium cable, main guiding tube veutro total length has gap, and have aperture in main guiding tube tail side one end, after steel wire or titanium cable are combined by main guiding tube and secondary guiding tube and are guided successfully, use draw point by aperture, steel wire or titanium cable to be pushed and depart from main guiding tube.Remove secondary guiding tube, in the second jack, insert pushing ram, the additional pad of pushing of pushing ram head end, adapts with outside surface of bone arc after greater trochanter, pushes pad and is asymmetrical design, relatively greater trochanter of femur rear direction.Pushing ram tail side is a circular knob, by turning knob, pushing ram is advanced (in the middle of pushing ram, having rotation-propelling transformational structure), and the interior lateral direction that matches with main guiding tube clamps reset, fixing fracture temporarily.Tighten up steel wire or titanium cable completes tying up of intertrochanteric fracture.
Beneficial effect of the present invention is embodied in: the present invention adopts the device of combination type guiding steel wire or titanium cable and temporary fixed fracture, only need to be in hip joint outside by mini-invasive incision technology, by the cooperation of guiding tube, pushing ram, can realize two of intertrochanteric fracture large main sclerites---after lesser trochanter sclerite and greater trochanter, outside sclerite resets, temporary fixed and guiding wire rope ties up, can protect to greatest extent the complete of periosteum and fracture surrounding soft tissue, tissue injury is little, be beneficial to union of fracture, realize Micro-operation; Simple in structure, easy to use, operation technique is easy to be reliable.
Accompanying drawing explanation
Fig. 1 is the main guiding tube guiding wire rope schematic diagram that is connected with secondary guiding tube.
Fig. 2 is the main guiding tube guiding wire rope cross-sectional view that is connected with secondary guiding tube.
Fig. 3 is the structural representation of secondary guiding tube while shifting out from handle.
Fig. 4 is main guiding tube and pushing ram connection diagram.
Fig. 5 is that main guiding tube is connected generalized section with pushing ram.
Fig. 6 is pushing ram rotation-push structure (Fig. 5 centre circle inner structure details) schematic diagram.
Fig. 7 is the main traveller assembling schematic diagram that is connected with pushing ram.
Fig. 8 is pushing ram tail side schematic diagram enlarged drawing.
Fig. 9 is that (wherein a is that main guiding tube head end makes it hook lesser trochanter sclerite to intertrochanteric fracture traveller work enforcement schematic diagram, imports steel wire or titanium cable by the first through hole port of handle afterbody, passes from secondary guiding tube steel wire outlet; B is that the second through hole handle afterbody end inserts pushing ram, the additional pad of pushing of pushing ram head end, and rotation advances pushing ram is advanced, and the interior lateral direction that matches with main guiding tube resets temporarily and grips bone; C tightens up steel wire or titanium cable completes tying up of intertrochanteric fracture; D is the structural solid figure that removes main guiding tube and pushing ram complete operation).
The specific embodiment
With reference to accompanying drawing, intertrochanteric fracture wire introducer, handle 1, main guiding tube 3 and secondary guiding tube 4, described handle 1 is provided with the first jack 11 inserting for main guiding tube 3 and the second jack 12 inserting for secondary guiding tube 4, the near-end of described main guiding tube 3 is connected with handle, near-end and the handle 1 of secondary guiding tube 4 are pegged graft, the far-end of described main guiding tube 3 is hook solid cover hook lesser trochanter sclerite, the far-end of described main guiding tube 3 is connected with the far-end of secondary guiding tube 4, and formation guiding steel wire 2 is walked around the bending passage of inner side, intertrochanteric fracture position;
Described secondary guiding tube 4 is connected with the second jack 12 by the intubate 41 connecting on it, and the length of intubate 41 connecting handles 1 and angle are adapted to the described far-end of main guiding tube 3 and the connection of the far-end of secondary guiding tube 4;
One side of described main guiding tube 3 is provided with the hole 32 of passing for steel wire ejector member, and opposite side has the gap 31 of allowing that steel wire 2 is deviate from;
Described handle 1 also connects a top-pushing mechanism, and top-pushing mechanism comprises a push rod 5 that inserts handle, and push rod 5 tail ends are provided with the screw rod 6 being spirally connected with handle 1, and after described push rod 5 head ends are provided with pushing tow greater trochanter, pushing of outside surface of bone pads 52; The far-end of described main guiding tube 3 and described pushing are padded 52 and are fixed fracture site.
After steel wire 2 is deviate from secondary guiding tube 4 and shifted out secondary guiding tube 4, the push rod 5 of described top-pushing mechanism inserts the second described jack 12.
The first jack 11 of described handle 1 and the second jack 12 are all along the length direction of handle 1, and described main guiding tube 3 and secondary guiding tube 4 are parallel to each other.
Intubate 41 on described secondary guiding tube 4 is U font, and one end of described intubate 41 is connected with the second through hole 12, and the other end and secondary guiding tube 4 UNICOMs are also provided with steel wire outlet 411 in bending place.
On described screw rod 6, manual knob 62 is housed, screw rod 6 front ends of described knob 62 are provided with projection 61, and described pushing ram 5 ends are provided with the slot 51 that forms joinery and its construction with described projection 61; The front end of described projection 61 is provided with the ring-type draw-in groove 611 around described projection 61, and described pushing ram 5 is provided with the backing pin 511 that can insert described ring-type draw-in groove 611, to limit the stroke of described knob 62.
The both sides of described handle 1 are provided with non slip surface 13.
Orientation of the present invention statement adopts the medically direction statement of human body.Take human body median line as mark, take close median line as " inner side ", be " outside " away from median line.Health veutro direction is " front side ", and health dorsal part direction is " rear side ".Guiding tube is " side " near human body median line, is " tail side " away from human body median line.Guiding tube is " veutro " near surface of bone side, is " dorsal part " away from surface of bone side.
For preserving femoral intertrochanteric bone amount, maintain the supporting function of rotor portions bone, need to add steel wire or titanium cable is tied up the comminuted fracture piece of intertrochanteric fracture, increase fracture fixation intensity.In operation technique by mini-invasive incision outside hip joint, press close to femoral intertrochanteric skeleton below carries out soft tissue and peels off and form one and allow the passage that main guiding tube 3 is worked with elevator in front side, insert main guiding tube 3 to head end and cross femur inner edge, 90 ° of main guiding tube 3 head ends of upset make it hook lesser trochanter sclerite 81, now can under perspective, confirm that whether cover hook lesser trochanter sclerite 81 is successful, after success, secondary guiding tube 4 is inserted in the second through hole 12 of handle, and be advanced to the end and be connected with main guiding tube 3.The first through hole 11 ports by handle 1 afterbody import steel wire 2 or titanium cable, after the steel wire outlet 411 of secondary guiding tube 4 passes, remove secondary guiding tube 4.One side of described main guiding tube 3 is provided with the hole 32 of passing for steel wire ejector member, opposite side has the gap 31 of allowing that steel wire 2 is deviate from, by aperture 32, steel wire 2 or titanium cable are ejected to main guiding tube 3 with draw point, steel wire 2 or titanium cable depart from for subsequent use from gap 31 with main guiding tube 3.Pushing ram 5 is run through in described the second through hole 12, described push rod 5 head ends are provided with pushing of the rear outside of pushing tow greater trochanter 82 surface of bone and pad 52, the described pad 52 of pushing is the cambered surface suitable with the rear outside of greater trochanter 82 surface of bone 82, the described pad 52 of pushing, for being partial to the dissymmetrical structure in outside, is partial to greater trochanter of femur 82 rear direction.Manual rotation knob 62, advances pushing ram 5, matches and resets temporarily and grip fracture together with main guiding tube 3 from interior lateral direction.Finally tighten up steel wire 2 or titanium cable completes tying up of intertrochanteric fracture, removing main guiding tube 3 and pushing ram 5 is complete operation.
Content described in this description embodiment is only enumerating of way of realization to inventive concept; protection scope of the present invention should not be regarded as only limiting to the concrete form that embodiment states, protection scope of the present invention also and conceive the equivalent technologies means that can expect according to the present invention in those skilled in the art.

Claims (6)

1.股骨转子间骨折用钢丝引导器,其特征在于:手柄、主引导管和副引导管,所述的手柄上设有供主引导管插入的第一插孔和供副引导管插入的第二插孔,所述的主引导管的近端与手柄连接,副引导管的近端与手柄插接,所述的主引导管的远端呈弯钩状套钩小转子骨折块,所述的主引导管的远端和副引导管的远端连接,形成引导钢丝绕过股骨转子间骨折部位内侧的折弯通道;1. The steel wire guide for femoral intertrochanteric fracture is characterized in that: a handle, a main guide tube and a secondary guide tube, and the handle is provided with a first jack for the main guide tube to insert and a second hole for the secondary guide tube to insert. Two jacks, the proximal end of the main guiding tube is connected to the handle, the proximal end of the secondary guiding tube is plugged into the handle, the distal end of the main guiding tube is hook-shaped to hook the lesser trochanteric fragment, the The distal end of the main guide tube is connected to the distal end of the auxiliary guide tube to form a bending channel for the guide wire to bypass the inner side of the intertrochanteric fracture site; 所述的副引导管通过连接其上的插管与第二插孔连接,插管连接手柄的长度和角度适应于所述的主引导管的远端和副引导管的远端的连接;The secondary guiding tube is connected to the second jack through the cannula connected thereto, and the length and angle of the connecting handle of the cannula are adapted to the connection between the distal end of the main guiding tube and the distal end of the secondary guiding tube; 所述的主引导管的一侧设有供钢丝顶出部件穿过的孔,另一侧开有容许钢丝脱出的缝隙;One side of the main guide tube is provided with a hole for the steel wire ejector to pass through, and the other side is provided with a gap allowing the steel wire to escape; 所述的手柄还连接一个顶推机构,顶推机构包括一个插入手柄的推杆,推杆尾端设有与手柄螺接的螺杆,所述的推杆头端设有顶推大转子后外侧骨面的推挤垫;所述的主引导管的远端与所述的推挤垫配合固定骨折部位。The handle is also connected to a push mechanism, the push mechanism includes a push rod inserted into the handle, the tail end of the push rod is provided with a screw threaded with the handle, and the head end of the push rod is provided with a push rod on the rear outer side of the large rotor. A pushing pad on the bone surface; the distal end of the main guiding tube cooperates with the pushing pad to fix the fracture site. 2.如权利要求1所述的钢丝引导器,其特征在于:在钢丝脱出副引导管并移出副引导管之后,所述的顶推机构的推杆插入所述的第二插孔。2. The wire guide as claimed in claim 1, characterized in that: after the wire escapes from the secondary guiding tube and moves out of the secondary guiding tube, the push rod of the pushing mechanism is inserted into the second insertion hole. 3.如权利要求1或2所述的钢丝引导器,其特征在于:所述的手柄的第一插孔和第二插孔均沿手柄的长度方向,所述的主引导管和副引导管相互平行。3. The wire guide according to claim 1 or 2, characterized in that: the first jack and the second jack of the handle are all along the length direction of the handle, and the main guide tube and the secondary guide tube are parallel to each other. 4.如权利要求3所述的钢丝引导器,其特征在于:所述的副引导管上的插管呈U字形,所述插管的一端与第二通孔连接,另一端与副引导管联通并在弯折处设有钢丝出口。4. The wire guide as claimed in claim 3, characterized in that: the insertion tube on the auxiliary guide tube is U-shaped, one end of the insertion tube is connected to the second through hole, and the other end is connected to the auxiliary guide tube Unicom and a steel wire outlet is provided at the bend. 5.如权利要求4所述的钢丝引导器,其特征在于:所述的螺杆上装有手动旋钮,所述旋钮的螺杆前端设有凸柱,所述推进杆末端设有与所述凸柱形成榫卯结构的插槽;所述凸柱的前端设有环绕所述凸柱的环状卡槽,所述推进杆上设有可插入所述环状卡槽的挡销。5. The wire guide as claimed in claim 4, characterized in that: said screw rod is provided with a manual knob, the front end of the screw rod of said knob is provided with a boss, and the end of said push rod is provided with a boss formed with said boss. A slot of mortise and tenon structure; the front end of the protruding post is provided with an annular slot surrounding the protruding post, and the push rod is provided with a stop pin that can be inserted into the annular slot. 6.如权利要求5所述的股骨转子间骨折用钢丝引导器,其特征在于:所述手柄的两侧设有防滑面。6 . The wire guide for intertrochanteric fractures according to claim 5 , wherein anti-slip surfaces are provided on both sides of the handle. 7 .
CN201410020890.2A 2014-01-17 2014-01-17 Intertrochanteric fracture wire introducer Expired - Fee Related CN103800067B (en)

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Cited By (4)

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CN107157618A (en) * 2017-05-26 2017-09-15 王俊 Coracoclavicular ligament titanium cable rebuilds the method for reconstructing of guider and coracoclavicular ligament
CN108852495A (en) * 2018-09-12 2018-11-23 苏州大学附属第二医院 A kind of bone holding clamp
CN114129251A (en) * 2021-12-06 2022-03-04 孟庆广 Universal fracture reduction fixing device
CN115486925A (en) * 2022-09-05 2022-12-20 无锡科恩智造科技有限公司 Hallux valgus correction guide device and correction method

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CN203208105U (en) * 2012-12-05 2013-09-25 唐佩福 Sliding guide-rotation steel wire guide
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CN107157618A (en) * 2017-05-26 2017-09-15 王俊 Coracoclavicular ligament titanium cable rebuilds the method for reconstructing of guider and coracoclavicular ligament
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CN108852495A (en) * 2018-09-12 2018-11-23 苏州大学附属第二医院 A kind of bone holding clamp
CN114129251A (en) * 2021-12-06 2022-03-04 孟庆广 Universal fracture reduction fixing device
CN114129251B (en) * 2021-12-06 2024-10-25 孟庆广 General fracture reduction fixing device
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