CN106473782B - Fibula stem high-position osteotomy retractor assembly - Google Patents
Fibula stem high-position osteotomy retractor assembly Download PDFInfo
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- CN106473782B CN106473782B CN201610875976.2A CN201610875976A CN106473782B CN 106473782 B CN106473782 B CN 106473782B CN 201610875976 A CN201610875976 A CN 201610875976A CN 106473782 B CN106473782 B CN 106473782B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
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- 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
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- 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
- A61B17/90—Guides therefor
-
- 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
- A61B2017/564—Methods for bone or joint treatment
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- Health & Medical Sciences (AREA)
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- Orthopedic Medicine & Surgery (AREA)
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Abstract
The invention discloses a fibula stem high-position osteotomy retractor assembly, which comprises a retractor device and a fixing device, wherein the retractor device comprises a first connecting arm and a second connecting arm in the middle, two ends of the first connecting arm and the second connecting arm are formed into a working end and a handle end, the working ends of the first connecting arm and the second connecting arm are formed with a substrate, the bottoms of the substrate are bent towards opposite directions, two opposite side surfaces of the substrate are respectively provided with a plug seat and a fixing boss, and the retractor device further comprises an additional piece matched with the plug seat for working. According to the invention, the working ends of the two connecting arms are connected through the inserting sheets to open the soft tissues at two sides of the operation part in the fibula stem high-position osteotomy process, so that soft tissue injury near the operation part is avoided, then the operation part is matched with the osteotomy component which can be fixed on the opening sheet, and the retractor and the osteotomy component are respectively arranged at the upper end and the lower end of the operation part, so that the stability of the retractor in the operation process is ensured, the operation steps are simplified, and the operation efficiency is improved.
Description
Technical Field
The invention relates to the field of medicine, in particular to a surgical instrument and a surgical method, and particularly relates to a fibula stem high-position osteotomy retractor assembly and a surgical method thereof.
Background
The fibula is one of two long bones on the lower leg of human and vertebrates (quadruped), is positioned at the outer side of the lower leg, is slender and is divided into a whole and two ends. Clinical observation shows that the medial platform of the tibia is unevenly settled due to the support of the fibula on the lateral platform under the action of gravity, so that the varus of the knee and the narrowing of the medial gap are caused, the lateral platform of the tibia loses the support of the fibula after the high-level osteotomy of the fibula, the load moves outwards when the load is loaded, the stress on the medial side of the knee is relieved, and the pain symptom of the osteoarthritis of the knee joint is relieved. At present, the high-position osteotomy position of the fibula is mostly selected to be about 6 cm to 8cm below the small head of the fibula, and the osteotomy is usually performed by adopting an osteotome, a swing saw or a wire saw. However, the fibula bone at the osteotomy position is very hard, so that the osteotomy operation is very difficult. At present, no better soft tissue retractor exists, a thyroid retractor is often used for retracting soft tissues, and a plurality of surgical assistants are often required to operate in a combined mode. Meanwhile, the bone cutting part is just a fibular deep nerve shape-moving part, and the thyroid retractor can not be fixed, so that irreversible damage is easily caused to soft tissues near the operation part, especially fibular deep nerves, in the actual operation process. The spirit of medical staff is high and tight in the operation process, so that the operation efficiency is low, the operation effect is poor easily, and the dual states of the spirit and the body of the medical staff are not small. Therefore, the better osteotomy mode is to protect soft tissues by using a retractor, then use a 2.0mm Kirschner wire to carry out multidirectional drilling on the osteotomy position to form a weak area, and finally use an osteotome or rongeur to carry out osteotomy on the weak area, thereby greatly improving the operation efficiency and the operation safety.
Disclosure of Invention
In order to solve the problems that the existing fibula stem high-level osteotomy is easy to damage soft tissues nearby an operation part, has low operation efficiency, and has great pressure born by doctors and patients, the invention provides a fibula stem high-level osteotomy retractor assembly and an operation method thereof, and the specific scheme is as follows:
the high-position fibula osteotomy retractor assembly comprises a retractor device and a fixing device, wherein the retractor device comprises a first connecting arm and a second connecting arm which are hinged together in the middle, two ends of the first connecting arm and the second connecting arm are respectively formed into a working end and a handle end, the working ends of the first connecting arm and the second connecting arm are formed with substrates, the bottoms of the substrates are bent towards opposite directions, two opposite side surfaces of the substrates are respectively provided with a plugging seat and a fixing boss, and the retractor device further comprises an additional piece which is matched with the plugging seats to work; the number of the fixing devices is at least two, the fixing devices comprise arc-shaped bodies, and one ends of the bodies are provided with connecting bosses corresponding to the fixing bosses.
Further, a plurality of first limit protrusions are formed on the inner wall of the plug-in socket, and second limit protrusions corresponding to the first limit protrusions are formed at the position where the additional piece and the plug-in socket work in a matched mode.
Further, a horizontal bulge along the horizontal plane direction is formed in the middle of the fixing device body, a fibula positioning hole is formed in the bulge, and a plurality of Kirschner wire guide holes are formed in the body.
Further, the kirschner wire guide hole is a conical hole structure with the bottom surface aperture larger than the top surface aperture.
Further, the top surface shaping of fixed boss has a plurality of third spacing protruding, the bottom surface shaping of connection boss have a plurality of with the spacing protruding complex fourth spacing protruding of third.
Further, a bolt hole is formed in the connecting boss, a blind hole is formed in the fixing boss at a position corresponding to the bolt hole, and a positioning bolt is arranged in the bolt hole.
Further, the fixing boss is arranged on the opposite side surfaces of the substrate through a boss seat, and the thickness of the boss seat is larger than that of the plug seat.
Further, a limiting device is arranged at the handle end of the connecting arm.
A method of fibula stem high osteotomy, the method comprising the steps of:
step1, taking a longitudinal incision at an operation position of 6-8cm from the small head of the fibula, cutting skin, subcutaneous tissue and deep fascia, performing hemostatic treatment on the operation incision, separating and exposing fibular diaphysis from the gap between long fibula muscle and soleus muscle, and paying attention to exposing and protecting fibular deep nerves;
step2, under the help of a thyroid retractor, placing a parallel fibula of a spreading sheet in an incision, placing the bottom of the spreading sheet below the fibula and involuting to enable a deep fibular nerve to be out of the range of the spreader, inserting an additional sheet on the spreading sheet to spread soft tissues so that an operation field is fully exposed, and limiting by a limiting device on a handle end;
step3, respectively placing the 2 fixing devices on the corresponding fixing bosses, screwing the fixing bolts, and screwing the positioning bolts until the bolts are propped against the fibula, so that the spreader and the fibula are kept relatively stable;
step4, drilling a fibula osteotomy position through a guide hole on the fixing device by using the Kirschner wire, screwing out a positioning bolt, taking out the fixing device, osteotomy is carried out on a fibula appointed position by using rongeur and bone chisel, and a gelatin sponge is placed into an osteotomy stump to stop bleeding;
step5, releasing the limit of the retractor and taking out the retractor;
step6, washing the incision with normal saline, stitching the incisions layer by layer, placing 1 drainage strip, and treating the postoperative inflammation and pain.
The invention has the beneficial effects that: according to the fibula stem high-position osteotomy retractor assembly and the operation method thereof, the base sheet with the bottoms bent inwards is utilized to separate the fibula to be operated from the blood vessel and the nervous system below the fibula to avoid damaging various soft tissues below the fibula in the operation process, the additional sheet is positioned above the base sheet through the inserting seat and is used for pushing away the soft tissues at two sides of an operation position to expose the operation position, and the limit protrusions at the bottoms of the additional sheet are firmly clamped in the limit protrusions in the inserting seat due to the reasoning of the soft tissues at two sides of the operation opening, so that the stability of the fibula to be operated in the operation process is ensured; in the operation process, two groups of fixing devices are respectively arranged above and below the position to be operated, the stability of the retractor assembly in the operation process is guaranteed by utilizing the functions of all the components of the fixing devices, and the guide hole of the Kirschner wire is of a conical structure, so that the Kirschner wire can be inserted into the needle head from the guide hole to have a certain adjustment angle range, the operation efficiency is improved, and the operation steps are simplified.
Drawings
Figure 1 is a front view of the structure of embodiment 1 of the present invention,
figure 2. A left side view of the structure of embodiment 1 of the present invention,
figure 3. Structural plan view of embodiment 1 of the present invention,
figure 4 is a front view showing the structure of the fixing device of embodiment 1 of the present invention,
figure 5 is a left side view of the structure of the fixing device of embodiment 1 of the present invention,
FIG. 6 is a schematic view showing the structure of a pilot hole of a Kirschner wire in example 1 of the invention,
FIG. 7 is an enlarged schematic view of the connection structure of the fixing boss and the connection boss according to embodiment 1 of the present invention,
FIG. 8 is an enlarged schematic view of the connection structure between the attachment piece and the socket according to embodiment 1 of the present invention,
FIG. 9 is an enlarged schematic view of the structure of the handle end stop in embodiment 1 of the present invention,
figure 10 is a front view showing the structure of the fixing device according to embodiment 2 of the present invention,
figure 11 is a left side view of the structure of the fixing device of embodiment 2 of the present invention,
figure 12 is a front view of the structure of embodiment 2 of the present invention,
FIG. 13 is a schematic view showing the structure of the handle end stop device in the working state I of embodiment 3 of the present invention,
fig. 14 is a schematic structural view showing the working state I I of the handle end stop device according to embodiment 3 of the present invention,
fig. 15 is a schematic view showing the structure of the handle end limiting device according to embodiment 3 of the present invention in the working state ii.
Figure number and name: 1. the first connecting arm, 2, the substrate, 21, the first spacing protruding, 3, the additional piece, 4, the handle end, 41, the stop device, 42, the hasp, 43, the locking strip, 5, the second connecting arm, 6, the fixing device, 601, the body, 602, the Kirschner wire guiding hole, 603, the fibula locating hole, 604, the bolt hole, 605, the connection boss, 606, the horizontal protruding, 607, the positioning bolt, 608, the fixing boss, 609, the fourth spacing protruding, 610, the third spacing protruding, 7, the socket, 71, the second spacing protruding, 8, the boss seat, 9, the fibula, 10, the muscle soft tissue.
Detailed Description
In order to describe the technical content, constructional features, achieved objects and effects of the present invention in detail, the following examples are given by way of example and are described in detail with reference to the accompanying drawings.
In the description of the present invention, it should be understood that the terms "center," "longitudinal," "lateral," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, merely to facilitate describing the present invention and simplify the description, and do not indicate or imply that the devices or elements being referred to must have a specific orientation, be configured and operated in a specific orientation, and therefore should not be construed as limiting the scope of the present invention.
Example 1
Referring to fig. 1-3, a fibula stem high-level osteotomy retractor assembly comprises a retractor device and a fixing device 6, wherein the retractor device comprises a first connecting arm 1 and a second connecting arm 5 hinged together in the middle, two ends of the first connecting arm 1 and the second connecting arm 5 are respectively formed into a working end and a handle end 4, a substrate 2 is formed at the working ends of the first connecting arm 1 and the second connecting arm 5, the bottom of the substrate 2 is bent towards the opposite directions of the two substrates, a socket 7 and two fixing bosses 608 which are positioned on the same horizontal plane are arranged on two opposite side surfaces of the substrate 2, and the socket 7 is arranged in the middle of the two fixing bosses 608; as shown in fig. 8, the retractor device further comprises an additional piece 3 which can be in plug-in fit with the plug socket 7; as shown in fig. 9, the connecting arm handle end 4 is provided with a limiting device 41 for fixing the angle of the connecting arm.
Referring to fig. 4-6, the number of the fixing devices 6 is two, the fixing devices 6 include an arc-shaped body 601, and connection bosses 605 corresponding to the fixing bosses 608 are disposed at two ends of the body 601. A plurality of first limiting protrusions 21 are formed on the inner wall of the plug-in socket 7, and second limiting protrusions 71 corresponding to the first limiting protrusions 21 are formed at the positions where the additional piece 3 and the plug-in socket 7 work cooperatively. The middle of the fixing device body 601 is formed with a horizontal protrusion 606 along the horizontal plane direction, a fibula positioning hole 603 is formed in the fixing device body, a plurality of Kirschner wire guide holes 602 are formed in the fixing device body 601, and the Kirschner wire guide holes 602 are conical structures with the bottom surface aperture larger than the top surface aperture. The top surface of the fixing boss 608 is formed with a plurality of third limit protrusions 610, and the bottom surface of the connecting boss 605 is formed with a plurality of fourth limit protrusions 609 matched with the third limit protrusions 610. As shown in fig. 7, the connecting boss 605 is provided with a bolt hole 604, the fixing boss 608 is provided with a blind hole corresponding to the bolt hole 605, and the bolt hole 604 is provided with a positioning bolt 607. The fixing boss 608 is provided on the opposite side of the substrate 2 by a boss 8, and the thickness of the boss 8 is greater than that of the socket 7.
Example 2
Referring to fig. 10-12, the difference between embodiment 2 and embodiment 1 is that: the two fixing devices 6 are respectively provided with the connecting boss 605 at different ends of the body, the two side substrates 2 are respectively provided with the fixing boss 608 corresponding to the position of the connecting boss 605, so that the fixing devices 6 can be ensured to work normally and simultaneously more Kirschner wire guide holes 602 can be formed in the fixing device body 601, the number and the weight of the whole retractor assembly are reduced, the operation of medical staff is facilitated, and the operation effect is improved.
Example 3
Referring to fig. 13-15, embodiment 3 differs from embodiment 1 in that: the limiting device of the handle end 4 is characterized in that a lock catch 42 and a lock bar 43 are respectively arranged on two connecting arms 1 and 5 through a connecting assembly, the lock bar 43 penetrates through the lock catch 42, a plurality of teeth are formed on one side, in contact with the lock catch 42, of the lock catch 42, the lock bar 43 can slide in the lock catch 42 freely, at the moment, the angle between the two limiting arms is adjustable, when the angle needs to be fixed, the lock catch 42 is pulled downwards, and the lock catch 42 is meshed with the teeth on the lock bar 43, so that the limitation of the retractor is completed.
The method for performing fibular diaphysis high-level osteotomy by using the retractor assembly comprises the following steps:
step1, taking a longitudinal incision at an operation position of 6-8cm from the small head of the fibula, cutting skin, subcutaneous tissue and deep fascia, performing hemostatic treatment on the operation incision, separating and exposing fibular diaphysis from the gap between long fibula muscle and soleus muscle, and paying attention to exposing and protecting fibular deep nerves;
step2, under the help of a thyroid retractor, placing a parallel fibula of a spreading sheet in an incision, placing the bottom of the spreading sheet below the fibula and involuting to enable a deep fibular nerve to be out of the range of the spreader, inserting an additional sheet on the spreading sheet to spread soft tissues so that an operation field is fully exposed, and limiting by a limiting device on a handle end;
step3, respectively placing the 2 fixing devices on the corresponding fixing bosses, screwing the fixing bolts, and screwing the positioning bolts until the bolts are propped against the fibula, so that the spreader and the fibula are kept relatively stable;
step4, drilling a fibula osteotomy position through a guide hole on the fixing device by using the Kirschner wire, screwing out a positioning bolt, taking out the fixing device, osteotomy is carried out on a fibula appointed position by using rongeur and bone chisel, and a gelatin sponge is placed into an osteotomy stump to stop bleeding;
step5, releasing the limit of the retractor and taking out the retractor;
step6, washing the incision with normal saline, stitching the incisions layer by layer, placing 1 drainage strip, and treating the postoperative inflammation and pain.
In summary, the present invention is not limited to the preferred embodiments, but is intended to cover modifications and equivalent arrangements included within the scope of the appended claims and their equivalents.
Claims (6)
1. A fibula stem high osteotomy retractor assembly, characterized in that: the retractor assembly comprises a retractor device and a fixing device, wherein the retractor device comprises a first connecting arm and a second connecting arm, the middle of the first connecting arm and the middle of the second connecting arm are hinged together, two ends of the first connecting arm and two ends of the second connecting arm are respectively formed into a working end and a handle end, the working ends of the first connecting arm and the second connecting arm are formed with substrates, the bottoms of the substrates are bent towards opposite directions, two opposite side surfaces of the substrates are respectively provided with a plug seat and a fixing boss, and the retractor device further comprises an additional piece matched with the plug seat for working; the number of the fixing devices is at least two, the fixing devices comprise arc-shaped bodies, and one ends of the bodies are provided with connecting bosses corresponding to the fixing bosses; a plurality of first limiting protrusions are formed on the inner wall of the plug seat, and second limiting protrusions corresponding to the first limiting protrusions are formed at the positions where the additional piece and the plug seat work in a matched mode; and a limiting device is arranged at the handle end.
2. A fibula shaft high osteotomy retractor assembly as in claim 1, wherein: the middle of the fixing device body is provided with a horizontal bulge along the horizontal plane direction, the horizontal bulge is provided with a fibula positioning hole, and the body is provided with a plurality of Kirschner wire guide holes.
3. A fibula shaft high osteotomy retractor assembly as in claim 2, wherein: the Kirschner wire guide hole is a conical hole structure with the bottom surface aperture larger than the top surface aperture.
4. A fibula shaft high osteotomy retractor assembly as in claim 1, wherein: the top surface shaping of fixed boss has a plurality of third spacing protruding, the bottom surface shaping of connection boss have a plurality of with the spacing protruding complex fourth spacing protruding of third.
5. A fibula shaft high osteotomy retractor assembly as in claim 1 or 4, wherein: the connecting boss is provided with a bolt hole, the fixing boss is provided with a blind hole corresponding to the position of the bolt hole, and a positioning bolt is arranged in the bolt hole.
6. A fibula shaft high osteotomy retractor assembly as in claim 1, wherein: the fixing boss is arranged on the opposite side surfaces of the substrate through a boss seat, and the thickness of the boss seat is larger than that of the plug seat.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
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| CN201610875976.2A CN106473782B (en) | 2016-09-30 | 2016-09-30 | Fibula stem high-position osteotomy retractor assembly |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201610875976.2A CN106473782B (en) | 2016-09-30 | 2016-09-30 | Fibula stem high-position osteotomy retractor assembly |
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| CN106473782A CN106473782A (en) | 2017-03-08 |
| CN106473782B true CN106473782B (en) | 2024-02-27 |
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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107028640B (en) * | 2017-05-27 | 2023-07-18 | 辽宁省肿瘤医院 | A limb bone osteotomy guide plate and using method thereof |
| CN108294805B (en) * | 2018-03-22 | 2020-06-12 | 中国人民解放军总医院 | Universal Congenital Acetabular Dysplasia Femoral Osteotomy Guide |
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| EP2976024B1 (en) * | 2013-03-18 | 2017-05-10 | Claes, Antoon | Surgical device for proper orientation during osteotomy |
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| US5558622A (en) * | 1994-09-02 | 1996-09-24 | Greenberg Surgical Technologies, Llc | Mandibular border retractor and method for fixating a fractured mandible |
| RU2128014C1 (en) * | 1996-08-01 | 1999-03-27 | Варшавский Исай Михайлович | Clamp-lock |
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