CN106308915B - A kind of jack-up device for resetting collapsed fracture block - Google Patents

Abstract

The utility model relates to a jacking device for resetting collapsed fracture fragments, which belongs to the technical field of orthopedic medical devices and is used for jacking up and reducing collapsed fracture fragments in tibial plateau joints. The technical solution is: the sleeve is made of thin metal plates, the top block is a plurality of identical pentahedrons, the top surface of each top block is rectangular, the two sides are trapezoidal, the other two sides of the top block are triangular, and the top block is The midpoint of the two trapezoidal sides of the block is connected to the top edge of the sleeve, and a plurality of top blocks are sequentially connected around the top of the sleeve. match. The present invention solves the problem of insufficient jacking area caused by tibial collapsed area being significantly larger than the diameter of the bone tunnel, and can significantly increase the jacking area during jacking to ensure the jacking effect; at the same time, the front end of the jacking device can be changed according to the position and shape of the fracture block Angle, to avoid the structural damage of the collapsed part caused by the mutual displacement and detachment of the fracture fragments, so as to facilitate better postoperative recovery.

Description

A jack-up device for resetting collapsed fracture fragments

technical field

The invention relates to a surgical instrument used for jacking up and reducing the intra-articular collapsed fracture block of the tibial plateau in the bone tunnel during operation, and belongs to the technical field of orthopedic medical instruments.

Background technique

Tibial plateau fracture is a common intra-articular fracture in clinical practice, and it is mostly seen in middle-aged and young people who have suffered high-energy injuries. Due to the complex and changeable fracture morphology, clinical treatment is more difficult. The purpose of treatment for tibial plateau fractures is to restore the smoothness of the articular surface and the alignment of the lower limbs, firmly fix the fracture fragments, and avoid long-term complications such as postoperative traumatic arthritis and joint stiffness. The key step in the surgical treatment of tibial plateau fractures is the reduction of displaced fracture fragments. In order to obtain a good surgical field of view in the traditional open reduction technique, it is often necessary to expose the soft tissue around the knee joint in a large area. For Schatzker type II and III lateral fractures, some scholars proposed to incise the anterior half of the lateral meniscus to fully expose the articular surface; for tibial plateau fractures with lateral and posterior displacement, Pires proposed to resect the proximal fibula to restore the posterolateral aspect bone fragments. Although these operations can bring convenience to reduction, the risks of postoperative soft tissue adhesion, incision infection, and nerve injury are greatly increased. At present, the development trend of intra-articular fractures is minimally invasive reduction, which can effectively protect the soft tissues around the fracture.

The biggest problem existing in minimally invasive surgical methods at present is that minimally invasive reduction of intra-articular fractures can only be performed by drilling away from the fracture site, and the tunnel formed by the drilling can reach below the fracture block for jacking and reduction. The front end of the device is consistent with the size of the outer hole of the bone tunnel, and the fracture collapse area is often significantly larger than the cross-sectional area of the outer hole of the bone tunnel, so problems such as insufficient jacking area often occur, resulting in insufficient jacking and affecting the jacking effect. In addition, the front end of the jacking device often cannot change the angle according to the position and shape of the fracture fragments, which may cause mutual displacement and detachment of the fracture fragments, resulting in structural damage of the collapsed part, which is very unfavorable for postoperative recovery. Therefore the jacking device that uses at present can not satisfy the requirement of minimally invasive surgery, it is very necessary to improve.

Contents of the invention

The technical problem to be solved by the present invention is to provide a jacking device for resetting collapsed fracture fragments, which can fully lift up the collapsed fracture fragments, ensure that the collapsed parts can all be restored to their original positions, and make all Fracture fragments are able to reach a reduced position.

The technical scheme that solves the above-mentioned technical problem is:

A jacking device for resetting collapsed fractures, which includes a sleeve, a top block, and a push rod, the sleeve is made of a thin metal plate, the length of the sleeve is greater than the length of the bone tunnel, and the top block is a plurality of identical pentahedrons , the top surface of each top block is rectangular, the two sides of the top block are trapezoidal, the long sides of the two trapezoidal sides are arc-shaped, the arc of the arc matches the circumference of the sleeve, and the short side of the trapezoidal side The length is equal to the length of the short side of the top of the rectangle, and is respectively connected to the two short sides of the top of the rectangle, the arc-shaped long sides of the two trapezoidal sides are connected, and the other two sides of the top block are triangular , the triangular side is composed of the side of the rectangular top surface and the sides of the two trapezoidal sides, the midpoint of the arc-shaped long sides of the two trapezoidal sides of the top block is connected with the top edge of the sleeve, and multiple top blocks surround the sleeve The tops of the tops are sequentially connected, the rectangular top surfaces of multiple jacking blocks are opposite to the center of the sleeve, the ejector rod is located in the inner cavity of the sleeve, the outer diameter of the ejector rod matches the diameter of the inner cavity of the sleeve, and the length of the ejector rod is longer than that of the sleeve. barrel length.

In the aforementioned jacking device for resetting collapsed fractures, the top block is connected to the top edge of the sleeve through a connecting piece, the connecting piece is an elastic steel sheet, and the upper end of the steel sheet plane is connected to the two trapezoidal sides of the top block. The midpoint of the long side is welded and connected, and the lower end of the steel sheet plane is welded to the top edge of the sleeve.

In the above-mentioned jacking device for resetting collapsed fracture fragments, the sleeve is a two-body structure, the sleeve is composed of two metal sleeves with the same diameter, and the tube walls of the two sleeves are connected by multiple springs. Both ends of the plurality of springs are respectively welded and connected to the two sleeves, the plurality of springs are evenly distributed along the circumference of the two sleeves, and the compression direction of the springs is parallel to the length direction of the sleeve.

The above-mentioned jacking device for resetting collapsed fracture fragments, the spring is a cylindrical spring, or a zigzag planar spring, the upper end of the spring is welded to the lower edge of the upper sleeve, and the lower end of the spring is connected to the upper edge of the lower sleeve. Solder connection.

The beneficial effects of the present invention are:

The sleeve of the present invention is placed in the bone tunnel, and the upper end of the sleeve is opposite to the collapsed fracture fragment of the tibial plateau. For jacking up, multiple jacking blocks can be turned around along the upper edge of the sleeve. After the jacking blocks are turned over, the jacking area of the upper end of the sleeve is significantly enlarged, and the bone block in the collapsed part that is larger than the diameter of the bone tunnel can be jacked up; the sleeve The spring connection structure in the middle of the sleeve can make the jacking plane at the upper end of the sleeve tilt according to the pressure of the bone block when jacking up, which is suitable for the inclined collapsed bone block and helps to avoid damage to the connection structure of the collapsed bone block.

The present invention solves the problem of insufficient jacking area caused by tibial collapsed area being significantly larger than the diameter of the bone tunnel, and can significantly increase the jacking area during jacking to ensure the jacking effect; at the same time, the front end of the jacking device can be changed according to the position and shape of the fracture block Angle, to avoid the structural damage of the collapsed part caused by the mutual displacement and detachment of the fracture fragments, so as to facilitate better postoperative recovery.

The invention is the first creation of a tibial subsidence bone block jacking device in orthopedic surgery, which provides strong support for the development of orthopedic minimally invasive surgery, and can be used in various orthopedic surgery for bone block collapse jacking operations, and is extremely useful in the field of orthopedic surgery Good prospects for promotion and use.

Description of drawings

Fig. 1 is a structural representation of the present invention;

Fig. 2 is the top view of Fig. 1;

Fig. 3 is the structural representation of top block;

Fig. 4 is a schematic diagram of the use state of the present invention;

Fig. 5 is a cross-sectional view along line A-A of Fig. 4 .

The markings in the figure are as follows: sleeve 1, top block 2, ejector rod 3, spring 4, connecting piece 5, tibia 6, tibial plateau collapsed fracture fragment 7, bone tunnel 8, rectangular top surface 9, trapezoidal side 10, triangular side 11 .

Detailed ways

The present invention is made up of sleeve 1, ejector block 2, ejector rod 3.

As shown in the figure, the sleeve 1 is made of thin metal plate, the outer diameter of the sleeve 1 matches the diameter of the bone tunnel 8 , and the length of the sleeve 1 is greater than the length of the bone tunnel 8 . The sleeve 1 is placed in the bone tunnel 8 and is the main structure of the jack.

Shown in the figure, jacking block 2 is the action mechanism of jacking device. The top block 2 is a plurality of identical pentahedrons, the top surface of each top block 2 is rectangular, the two sides are trapezoidal, and the long sides of the two trapezoidal side surfaces 10 are arc-shaped, and the arc of the arc is the same as that of the sleeve 1. Circumferential radians match, the length of the short side of the trapezoidal side 10 is equal to the length of the short side of the rectangular top 9, and is respectively connected with two short sides of the rectangular top 9, and the arc length of the two trapezoidal sides 10 is The sides are connected, and the other two sides of the top block 2 are triangular respectively, and the triangular side 11 is composed of the side of the rectangular top surface 9 and the sides of the two trapezoidal sides 10, and the arc shape of the two trapezoidal sides 10 of the top block 2 The midpoint of the long side is connected with the top edge of the sleeve 1 .

As shown in the figure, the long sides of the two trapezoidal sides 10 of the top block 2 are overlapped and connected to the midpoint of the top edge of the sleeve 1 . The connection is realized through the connecting piece 5, which is an elastic steel sheet, the upper end of the steel sheet plane is welded to the midpoint of the long sides of the two trapezoidal sides 10 of the top block 2, and the lower end of the steel sheet plane is connected to the sleeve 1 Top edge solder connection. Under normal conditions, the connecting piece 5 is in a horizontal position, and when the top block 2 is jacked up, the connecting piece is upward, and the top piece 2 is located above the connecting piece 5 . Since the connecting sheet is an elastic steel sheet, it can be bent without breaking.

As shown in the figure, a plurality of top blocks 2 are sequentially connected around the top of the sleeve 1 , and the rectangular top surfaces 9 of the plurality of top blocks 2 face the center of the sleeve 1 and face each other. Under normal circumstances, a plurality of top blocks 2 are closed toward the center of the sleeve 1 , the top blocks 2 are located in the inner cavity of the sleeve 1 , and a trapezoidal side 10 of the top blocks 2 is located on the upper level of the sleeve 1 .

As shown in the figure, the ejector rod 3 is located in the inner cavity of the sleeve 1 , the outer diameter of the ejector rod 3 matches the diameter of the inner cavity of the sleeve 1 , and the length of the ejector rod 3 is greater than that of the sleeve 1 . The effect of push rod 3 is to jack up jack block 2 upwards, increases the jacking area of sleeve 1 upper end.

As shown in the figure, the sleeve 1 is a two-body structure. The sleeve 1 is composed of two metal sleeves of the same diameter. The tube walls of the two sleeves are connected by multiple springs 4 . They are respectively welded and connected to the two sleeves, a plurality of springs 4 are evenly distributed along the circumference of the two sleeves, and the compression direction of the springs 4 is parallel to the length direction of the sleeve 1 . The spring 4 connection structure in the middle of the sleeve 1 can make the jacking plane at the upper end of the sleeve 1 tilt according to the pressure of the bone block when jacking up, and fit the inclined collapsed bone block, which is beneficial to avoid damage to the connection structure of the collapsed bone block .

Shown in the figure, the spring 4 is a cylindrical spring, or a zigzag planar spring, the upper end of the spring 4 is welded to the lower edge of the upper sleeve, and the lower end of the spring 4 is welded to the upper edge of the lower sleeve.

The using method of the present invention is as follows:

The patient underwent surgery under spinal anesthesia, and was placed in the supine position after the anesthesia effect was satisfactory. Under fluoroscopy, a Φ2.5mm guide wire was inserted in an appropriate direction from 3 cm below the tibial tuberosity, and the top of the guide wire stopped at about 1 cm below the collapsed fracture fragment of the tibial plateau.

Then drill the hole with a bone tunnel former (another patent) that can retain bone along the direction of the guide pin. The drill hole reaches below the tibial plateau collapsed fracture block 7, withdraws from the bone tunnel 8 from the bone tunnel former, and cuts the bone. The pieces are brought outside the bone tunnel 8 by the bone tunnel former.

The sleeve 1 of the present invention is put into the bone tunnel, tapped lightly with a small hammer until it reaches below the collapsed fracture fragment 7 of the tibial plateau, and the spring 4 fits the top end of the sleeve 1 to the fracture fragment. Knock the ejector rod 3 with a small hammer to open the ejector block 2 upwards, and the ejector block 2 will jack up the fracture fragment.

Take out the jack, measure the length of the bone tunnel 8, put the absorbable bone defect filler (another patent) into the bone tunnel 8 to fill, and finally fix the fracture with a bone plate.

Claims (4)

1. A jacking device for resetting collapsed fractures, characterized in that it includes a sleeve (1), a top block (2), and a push rod (3), and the sleeve (1) is an elastic metal sheet Composition, the length of the sleeve (1) is greater than the length of the bone tunnel (8), the top block (2) is a plurality of identical pentahedrons, the top surface of each top block (2) is rectangular, each top block (2 ) are trapezoidal, the long sides of the two trapezoidal sides (10) are arc-shaped, the arc of the arc matches the circumference of the sleeve (1), and the length of the short side of the trapezoidal side (10) is the same as The lengths of the short sides of the rectangular top surface (9) are equal, and are respectively connected with the two short sides of the rectangular top surface (9), and the arc-shaped long sides of the two trapezoidal sides (10) are connected, and each top block The other two sides of (2) are triangular respectively, and the triangular side (11) is composed of the sides of the rectangular top (9) and the sides of two trapezoidal sides (10), and each top block (2) has two trapezoidal The midpoint of the arc-shaped long side of the side (10) is connected to the top edge of the sleeve (1), and multiple top blocks (2) are sequentially connected around the top of the sleeve (1), and the multiple top blocks (2) The rectangular top surface (9) is opposite to the center of the sleeve (1), the ejector rod (3) is located in the inner cavity of the sleeve (1), and the outer diameter of the ejector rod (3) is the same as the diameter of the inner cavity of the sleeve (1). match, the length of the push rod (3) is greater than the length of the sleeve (1). 2. The jacking device for resetting collapsed fracture fragments according to claim 1, characterized in that: each jacking piece (2) is connected to the top edge of the sleeve (1) through a connecting piece (5), and connected The sheet is an elastic steel sheet, the midpoint of the long sides of the two trapezoidal sides (10) of each top block (2) is welded to the upper end of the corresponding steel sheet plane, and the lower end of each steel sheet plane is connected to the sleeve (1) Welded connection at the top edge. 3. The jacking device for resetting collapsed fracture fragments according to claim 2, characterized in that: the sleeve (1) is a two-body structure, and the sleeve (1) is composed of two metal sleeves of the same diameter The pipe walls of the two sleeves are connected by multiple springs (4), and the two ends of the multiple springs (4) are respectively welded to the two sleeves, and the multiple springs (4) are connected along the two sleeves. The circumference of the tube is evenly distributed, and the compression direction of each spring (4) is parallel to the length direction of the sleeve (1). 4. The jack-up device for resetting collapsed fracture fragments according to claim 3, characterized in that: the plurality of springs (4) are cylindrical springs, or zigzag planar springs, and the upper end of each spring (4) It is welded to the lower edge of the upper casing, and the lower end of each spring (4) is welded to the upper edge of the lower casing.