CN106725713A - Front and rear Cruciate ligament reconstruction bone tunnel spinal cord road core drill and ligament fixing means - Google Patents
Front and rear Cruciate ligament reconstruction bone tunnel spinal cord road core drill and ligament fixing means Download PDFInfo
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 60
- 210000000278 spinal cord Anatomy 0.000 title claims abstract description 21
- 210000003041 ligament Anatomy 0.000 title abstract description 21
- 210000001264 anterior cruciate ligament Anatomy 0.000 claims abstract description 27
- 210000002967 posterior cruciate ligament Anatomy 0.000 claims abstract description 26
- 229910001220 stainless steel Inorganic materials 0.000 claims description 6
- 239000010935 stainless steel Substances 0.000 claims description 6
- 239000008280 blood Substances 0.000 claims description 3
- 210000004369 blood Anatomy 0.000 claims description 3
- 239000012634 fragment Substances 0.000 claims description 2
- 239000000203 mixture Substances 0.000 claims 1
- 238000000034 method Methods 0.000 abstract description 12
- 230000007774 longterm Effects 0.000 abstract description 8
- 208000006386 Bone Resorption Diseases 0.000 abstract description 3
- 230000024279 bone resorption Effects 0.000 abstract description 3
- 206010066902 Surgical failure Diseases 0.000 abstract 1
- 239000002184 metal Substances 0.000 abstract 1
- 238000010586 diagram Methods 0.000 description 4
- 210000002435 tendon Anatomy 0.000 description 3
- 238000005553 drilling Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 210000002303 tibia Anatomy 0.000 description 2
- 229910000831 Steel Inorganic materials 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000001125 extrusion Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000004353 tibial menisci Anatomy 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1675—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the knee
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
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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
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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
- A61B2017/564—Methods for bone or joint treatment
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Abstract
一种前后交叉韧带重建骨隧脊髓道空芯钻。如金属螺钉等异物与周围骨组织发生作用，短期尚无明显影响，但是异物的长期存在将导致骨隧道周围骨质吸收，继而骨隧道扩大，固定不再牢固，从而导致手术长远阶段的手术失败。一种前后交叉韧带重建骨隧道空芯钻，其组成包括：钻体，所述的钻体（1）为空心筒形，所述的钻体前部具有切削刃部（1‑1），所述的钻体中部具有腰孔部（1‑2），所述的钻体后部具有连接部（1‑3），所述的连接部中心具有引导孔A（1‑4）。本发明申请涉及医疗器械领域，特别应用于前后交叉韧带重建骨隧脊髓道空芯钻及韧带固定方法。
The utility model relates to a hollow core drill for reconstructing bone tunnel and spinal cord of anterior and posterior cruciate ligaments. For example, foreign bodies such as metal screws interact with the surrounding bone tissue, and there is no obvious impact in the short term, but the long-term presence of foreign bodies will lead to bone resorption around the bone tunnel, and then the bone tunnel will expand, and the fixation will no longer be firm, resulting in long-term surgical failure. . A bone tunnel hollow drill for anterior and posterior cruciate ligament reconstruction, which comprises: a drill body, the drill body (1) is hollow cylindrical, and the front part of the drill body has a cutting edge (1-1), the The middle part of the drill body has a waist hole (1-2), the rear part of the drill body has a connecting part (1-3), and the center of the connecting part has a guide hole A (1-4). The application of the present invention relates to the field of medical equipment, and is particularly applied to the hollow core drill of the anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord and the ligament fixation method.
Description
技术领域：Technical field:
本发明涉及一种医疗器械领域，尤其涉及一种前后交叉韧带重建骨隧脊髓道空芯钻及韧带固定方法。The invention relates to the field of medical devices, in particular to an anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill and a ligament fixation method.
背景技术：Background technique:
膝关节内有两条交叉韧带，前交叉韧带附着于胫骨髁间前窝，斜向后外上方，止于股骨外侧髁内面的后份，有制止胫骨前移的作用；后交叉韧带位于前交叉韧带的后内侧，较前交叉韧带短，起自胫骨髁间后窝及外侧半月板的后端，斜向前上内方，附于股骨内侧髁外面的前份，具有限制胫骨后移的作用；交叉韧带重建的远期效果为如何，重点在于交叉韧带的固定及重建韧带的长久强度，传统方法是应用无头挤压螺钉或“门”型钉等机械固定的方式，而螺钉的螺纹对于韧带有一定的切割作用，将影响重建韧带的长远强度；另外，由于采用的是机械固定的方式，螺钉做为异物将长期存留于体内，目前术后随访10年已经发现部分患者存在明显问题，如异物与周围骨组织发生作用，导致骨隧道周围骨质吸收，继而骨隧道扩大，固定不再牢固，从而导致手术后远期效果不理想。There are two cruciate ligaments in the knee joint. The anterior cruciate ligament is attached to the anterior fossa between the tibial condyles, obliquely to the posterolateral superiority, and ends at the posterior part of the medial surface of the lateral femoral condyle, which has the function of preventing the tibia from moving forward; the posterior cruciate ligament is located in the anterior cruciate The posteromedial part of the ligament, shorter than the anterior cruciate ligament, originates from the posterior intercondylar fossa of the tibia and the posterior end of the lateral meniscus, obliquely anteriorly, superiorly and medially, and attaches to the anterior part of the medial femoral condyle, which has the function of restricting tibial posterior displacement What is the long-term effect of cruciate ligament reconstruction? The focus is on the fixation of the cruciate ligament and the long-term strength of the reconstructed ligament. The traditional method is to use mechanical fixation methods such as headless extrusion screws or "door" nails, and the thread of the screw is very important for the reconstruction of the cruciate ligament. The ligament has a certain cutting effect, which will affect the long-term strength of the reconstructed ligament. In addition, because of the mechanical fixation method, the screw will remain in the body for a long time as a foreign body. At present, some patients have been followed up for 10 years and have obvious problems. If the foreign body interacts with the surrounding bone tissue, it will lead to bone resorption around the bone tunnel, and then the bone tunnel will expand, and the fixation will no longer be firm, resulting in unsatisfactory long-term results after surgery.
发明内容：Invention content:
本发明的目的是提供一种前后交叉韧带重建骨隧脊髓道空芯钻及韧带固定方法。The purpose of the present invention is to provide a kind of anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill and ligament fixation method.
上述的目的通过以下的技术方案实现：Above-mentioned purpose realizes by following technical scheme:
一种前后交叉韧带重建骨隧脊髓道空芯钻，其组成包括：钻体，所述的钻体为空心筒形，所述的钻体前部具有切削刃部，所述的钻体中部具有腰孔部，所述的钻体后部具有连接部，所述的连接部中心具有引导孔A。A hollow core drill for anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord, which consists of: a drill body, the drill body is hollow cylindrical, the front part of the drill body has a cutting edge, and the middle part of the drill body has a The waist hole part, the drill body rear part has a connection part, and the center of the connection part has a guide hole A.
所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的钻体包括安装在前端的引导芯，所述的引导芯前部为圆柱形，后部具有梯形圆柱引导端，其内部具有引导孔B，所述的引导孔B内连接有引导针，所述的引导孔B前端中心具有一斜坡引导端，所述的引导芯的圆柱表面和梯形圆柱表面上沿周分布有导血槽。The anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow core drill, the drill body includes a guide core installed at the front end, the front part of the guide core is cylindrical, the rear part has a trapezoidal cylindrical guide end, and its interior has a Guide hole B, a guide needle is connected in the guide hole B, the center of the front end of the guide hole B has a slope guide end, and blood guide grooves are distributed along the circumference of the cylindrical surface of the guide core and the trapezoidal cylindrical surface .
所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的引导针为长度超过钻体长度的的不锈钢针，直径为φ2~2.5mm，所述的钻体和引导芯的材质同样为不锈钢。In the anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill, the guide needle is a stainless steel needle with a length exceeding the length of the drill body, with a diameter of φ2~2.5mm, and the materials of the drill body and the guide core are also Stainless steel.
所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的钻体的直径为φ8~8.5mm，所述的钻体的壁厚为0.4~0.5mm，所述的钻体后部的引导孔A的直径为φ4~4.5mm，所述的引导芯的外径为7~7.6mm，内部引导孔B的直径为φ2.1~2.6mm。The anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill, the diameter of the drill body is φ8~8.5mm, the wall thickness of the drill body is 0.4~0.5mm, the rear part of the drill body The diameter of the guide hole A is φ4~4.5mm, the outer diameter of the guide core is 7~7.6mm, and the diameter of the inner guide hole B is φ2.1~2.6mm.
所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的钻体钻取骨隧道后，钻体内的骨块会在腰孔部处显露出尾端，利用器械经此腰孔部将骨块自空芯钻内顶出。The anterior and posterior cruciate ligament reconstruction bone tunnel spinal canal hollow drill, after the drill body drills the bone tunnel, the bone block in the drill body will reveal the tail end at the lumbar hole, and the instrument will pass through the lumbar hole Bone fragments are ejected from the core drill.
本发明的有益效果：Beneficial effects of the present invention:
1.本发明的前后交叉韧带重建骨隧脊髓道空芯钻，结构简单、操作方便、安全可靠，减少了现有机械固定方式对重建造成的影响，避免了造成关节内的意外损伤。1. The anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill of the present invention has simple structure, convenient operation, safety and reliability, reduces the influence of existing mechanical fixation methods on reconstruction, and avoids accidental damage in the joint.
本发明的前后交叉韧带重建骨隧脊髓道空芯钻，应用后，有力地推进了前、后交叉韧带重建手术，能够更加顺利地完成手术，且未出现负面效应及意外不良情况。The anteroposterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill of the present invention, after application, effectively promotes the anterior and posterior cruciate ligament reconstruction operations, and can complete the operation more smoothly without negative effects or accidental adverse events.
本发明的前后交叉韧带重建骨隧道空芯钻，用骨腱固定后愈合的方式取代了传统的螺钉等机械固定的方式，避免了螺钉做为异物长期存留于体内。传统的螺钉等机械固定方式，目前术后随访10年以上时已经发现部分患者存在明显问题，如异物与周围骨组织发生作用，导致骨隧道周围骨质吸收，继而骨隧道扩大，固定不再牢固，导致固定螺钉松动，甚至脱落，手术后远期效果不理想，甚至需要二次手术。The bone tunnel core drill for anterior and posterior cruciate ligament reconstruction of the present invention replaces traditional mechanical fixation methods such as screws with bone tendon fixation and healing, avoiding the long-term retention of screws in the body as foreign bodies. Traditional mechanical fixation methods such as screws have been followed up for more than 10 years and some patients have been found to have obvious problems, such as foreign bodies interacting with the surrounding bone tissue, resulting in bone resorption around the bone tunnel, and then the bone tunnel expands, and the fixation is no longer firm , causing the fixing screws to loosen or even fall off, the long-term effect after the operation is not ideal, and even a second operation is required.
本发明的前后交叉韧带重建骨隧脊髓道空芯钻，在钻取隧道过程中，将骨隧道的骨质基本完整的保留下来，重建韧带穿过后，再将所保留的圆柱形骨块安装回骨隧道中，同时起到挤压固定韧带的作用；同时，骨组织与腱组织长期是可以愈合在一起的，并且粘和牢固，强度不逊色于螺钉固定。The anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill of the present invention, in the process of drilling the tunnel, the bone of the bone tunnel is basically completely preserved, and after the reconstruction ligament passes through, the retained cylindrical bone block is installed back In the bone tunnel, it also plays the role of compressing and fixing the ligament; at the same time, the bone tissue and tendon tissue can be healed together for a long time, and they are sticky and firm, and the strength is not inferior to screw fixation.
附图说明：Description of drawings:
附图1是本发明的结构示意图。Accompanying drawing 1 is a structural representation of the present invention.
附图2是本发明的钻体尾端结构示意图。Accompanying drawing 2 is the schematic diagram of the structure of the tail end of the drill body of the present invention.
附图3是本发明的切削刃口端结构示意图。Accompanying drawing 3 is the schematic diagram of the structure of the cutting edge end of the present invention.
附图4是本发明的引导针的结构示意图。Accompanying drawing 4 is the structure schematic diagram of guide needle of the present invention.
附图5是本发明的引导芯的侧面结构示意图。Accompanying drawing 5 is the side structural schematic view of the guiding core of the present invention.
附图6是本发明的引导芯的端面结构示意图。Accompanying drawing 6 is the end face structure schematic diagram of the guiding core of the present invention.
图中：1 —钻体；1-1 —切削刃部；1-2 —腰孔部；1-3 —连接部；1-4 —引导孔；2—引导芯；3 — 引导针。In the figure: 1—drill body; 1-1—cutting edge; 1-2—waist hole; 1-3—connecting portion; 1-4—guiding hole; 2—guiding core; 3—guiding pin.
具体实施方式：detailed description:
实施例1：Example 1:
一种前后交叉韧带重建骨隧脊髓道空芯钻，其组成包括：钻体，所述的钻体1为空心筒形，所述的钻体前部具有切削刃部1-1，所述的钻体中部具有腰孔部1-2，所述的钻体后部具有连接部1-3，所述的连接部中心具有引导孔A1-4。A hollow core drill for anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord, which comprises: a drill body, the drill body 1 is a hollow cylinder, the front part of the drill body has a cutting edge 1-1, the drill body The middle part of the drill body has a waist hole 1-2, the rear part of the drill body has a connecting part 1-3, and the center of the connecting part has a guide hole A1-4.
实施例2：Example 2:
根据实施例1所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的钻体连接有引导芯2，所述的引导芯前部为圆柱形，后部具有梯形圆柱引导端，其内部具有引导孔B，所述的引导孔B内连接有引导针3，所述的引导孔B前端中心具有一斜坡引导端，所述的引导芯的圆柱表面和梯形圆柱表面上沿周分布有导血槽。According to the anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow core drill described in Example 1, the drill body is connected with a guide core 2, the front part of the guide core is cylindrical, and the rear part has a trapezoidal cylindrical guide end, which There is a guide hole B inside, and a guide needle 3 is connected inside the guide hole B. The center of the front end of the guide hole B has a slope guide end, and the cylindrical surface of the guide core and the trapezoidal cylindrical surface are distributed along the circumference. Blood channel.
实施例3：Example 3:
根据实施例2所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的引导针为长度超过钻体长度的的不锈钢针，直径为φ2~2.5mm，所述的钻体和引导芯的材质同样为不锈钢。According to the anterior and posterior cruciate ligament reconstruction bone tunnel spinal canal hollow core drill described in Example 2, the guide needle is a stainless steel needle whose length exceeds the length of the drill body, and the diameter is φ2~2.5mm, and the drill body and guide core The material is also stainless steel.
实施例4：Example 4:
根据实施例2所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的钻体的直径为φ8~8.5mm，所述的钻体的壁厚为0.4~0.5mm，所述的钻体后部的引导孔A的直径为φ4~4.5mm，所述的引导芯的外径为7~7.6mm，内部引导孔B的直径为φ2.1~2.6mm。According to the anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill described in Example 2, the diameter of the drill body is φ8~8.5mm, the wall thickness of the drill body is 0.4~0.5mm, and the drill body The diameter of the guide hole A at the rear of the body is φ4-4.5mm, the outer diameter of the guide core is 7-7.6mm, and the diameter of the inner guide hole B is φ2.1-2.6mm.
实施例5：Example 5:
根据实施例2所述的前后交叉韧带重建骨隧脊髓道空芯钻，所述的钻体钻取骨隧道后，钻体内的骨块会在腰孔部处显露出尾端，利用器械经此腰孔部将骨块自空芯钻内顶出。According to the anterior and posterior cruciate ligament reconstruction bone tunnel spinal cord hollow drill described in Example 2, after the drill body is drilled into the bone tunnel, the bone block in the drill body will reveal the tail end at the waist hole, and the instrument is used to pass through the bone tunnel. The waist hole pushes out the bone block from the hollow core drill.
利用所述的前后交叉韧带重建骨隧道钻的韧带固定方法，用定位器在骨组织上定位后用直径2.5mm钢针钻入骨组织，后将所述的引导芯经引导孔套入，引导芯外再套上所述的钻体，钻体尾端连接部连接电钻作为动力，将骨钻出需要的骨隧道，同时得到圆柱形骨块，将之前准备好的编制成的韧带穿过骨隧道，重建韧带穿过后，再将钻取隧道过程中得到的圆柱形骨块修整适合后安装回骨隧道中，同时起到挤压固定韧带的作用；因此，利用此方式固定后，重建的肌腱是可以和骨组织生长在一起的，从而避免了以往利用无头螺钉或门型钉挤压固定重建韧带所带来的一些列弊端。Utilize the ligament fixation method of the anterior and posterior cruciate ligament reconstruction bone tunnel drill, use a locator to position on the bone tissue, drill into the bone tissue with a steel needle with a diameter of 2.5mm, and then insert the guide core through the guide hole, and guide the core Put the above-mentioned drill body on the outside, connect the electric drill at the tail end of the drill body as power, drill the bone out of the required bone tunnel, and obtain a cylindrical bone block at the same time, pass the previously prepared ligament through the bone tunnel , after the reconstructed ligament passes through, the cylindrical bone block obtained during the drilling of the tunnel is trimmed and installed in the bone tunnel, and at the same time it plays the role of squeezing and fixing the ligament; therefore, after being fixed in this way, the reconstructed tendon is It can grow together with the bone tissue, thus avoiding a series of disadvantages caused by the compression and fixation of the reconstructed ligament by headless screws or portal nails in the past.
Claims (5)
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| CN201611251952.6A CN106725713A (en) | 2016-12-30 | 2016-12-30 | Front and rear Cruciate ligament reconstruction bone tunnel spinal cord road core drill and ligament fixing means |
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Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
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