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CN111134817B - A bone transport device based on intramedullary nail system - Google Patents

A bone transport device based on intramedullary nail system Download PDF

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Publication number
CN111134817B
CN111134817B CN202010114264.5A CN202010114264A CN111134817B CN 111134817 B CN111134817 B CN 111134817B CN 202010114264 A CN202010114264 A CN 202010114264A CN 111134817 B CN111134817 B CN 111134817B
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nail
bone
rope lock
intramedullary nail
retractor
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CN111134817A (en
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任广凯
吴丹凯
彭传刚
袁宝明
刘贺
吴阳
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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
    • A61B17/60Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66Alignment, compression or distraction mechanisms
    • 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
    • A61B17/72Intramedullary devices, e.g. pins or nails
    • A61B17/7216Intramedullary devices, e.g. pins or nails for bone lengthening or compression
    • 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
    • A61B2017/564Methods for bone or joint treatment

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Neurology (AREA)
  • Surgical Instruments (AREA)

Abstract

The bone moving device based on the intramedullary nail system comprises an intramedullary nail, a main traction rope lock and a traction rope lock, wherein the intramedullary nail provides stable support for the limb of the bone defect, the main traction rope lock passes through the nail hole of the intramedullary nail or is fixed in the far end or near end normal bone of the bone defect through the side of the intramedullary nail, a slideway for the traction rope lock to move is arranged in the axial direction of the main traction rope lock, the head end of the traction rope lock is fixed on the traction rope of the main traction rope nail, the tail end of the traction rope lock is fixedly connected to the active bone block of the osteotomy through a drill after extending through a slideway, and the traction rope lock is driven by a mobile traction device to drive the active bone block of the osteotomy to move.

Description

Bone moving device based on intramedullary nail system
Technical Field
The invention relates to the technical field of medical appliances, in particular to a bone moving device based on an intramedullary nail system.
Background
The defects of long bones of limbs are commonly caused by severe open comminuted fracture, postoperative infection of fracture, massive bone removal of osteomyelitis and bone tumor operation, and are often accompanied by limb shortening, deformity, osteomyelitis, muscular atrophy and stiffness of adjacent joints, which are one of the most troublesome problems in the orthopedics field.
Bone transport technology (bone transport) is an original method of treating bone defects by illizaloff physicians in the 70 th century, and is gradually used in clinic after the 80 th year, and is called one of the "twenty-century orthopedics three milestone technologies".
The existing bone moving technology provides stable support for the limb of the bone defect through an external fixator or an extension system combined with the inside and outside of an intramedullary nail and the external fixator, then cuts off the normal bone at the upper end or the lower end of the diaphysis of the bone defect, and moves the bone block with bioactivity after cutting the bone at a speed of 1mm per day by means of the fixation of a movable steel needle of the external fixator, so that the bone block gradually leans against the broken end of the corresponding bone defect, and further the bone defect is repaired.
The existing external fixing support is heavy in design and inconvenient to care after operation, and especially a plurality of steel needles are used for fixing the far and near ends of bone defects through skin, so that serious complications such as nail infection, joint stiffness and the like are easy to occur. The early stage of bone movement causes local nerve stimulation due to the traction of the Kirschner wire or the half nail, and the edema is not resolved at the early stage of bone movement, the local tension is larger, and the bone segment is moved, so that the nerve is excessively pulled and the local compression is caused in a high tension environment, and in the case of larger bone defects, the Kirschner wire or the half nail cuts the skin during the movement, so that the patient can feel serious pain in the early stage or the long-term bone movement process, and even the patient actively requires to abandon the treatment due to intolerable pain.
Disclosure of Invention
The invention aims to provide a bone moving device based on an intramedullary nail system, which is used for solving the problems in the background technology.
The technical scheme includes that the bone osteotomy device comprises an intramedullary nail, a main traction rope lock and a traction rope lock, wherein the main traction rope lock penetrates through a nail hole of the intramedullary nail or is fixed in a distal end or a proximal end of a bone defect through the side of the intramedullary nail, a slideway for the traction rope lock to move is arranged in the axial direction of the main traction rope lock, the head end of the traction rope lock is fixed on the traction rope of the main traction rope lock, the tail end of the traction rope lock is fixedly connected to an osteotomy active bone block through a drill after extending through the slideway, and the traction rope lock is moved to drive the traction rope lock to pull the osteotomy active bone block to move.
The working principle of the invention is as follows:
The device uses the unidirectional winding principle of the traction device on the traction device main nail, and the traction rope lock is used for traction the truncated active bone blocks, so that bone effect is generated between the active bone blocks and the original normal bone tissues, and the clinical purpose of bone movement and bone defect treatment is achieved.
The distal end and the proximal end of the bone defect are fixed by adopting an intramedullary nail system, a main traction device nail passes through a nail hole of the intramedullary nail or is fixed in the distal end or the proximal end of the bone defect through the side of the intramedullary nail, a slideway for the traction rope lock to move is arranged in the axial direction of the main traction device nail, the head end of the traction rope lock is fixed on the traction device of the main traction device nail, the tail end of the traction rope lock is fixedly connected on an active bone block of the osteotomy through drilling binding, and the traction device is moved to drive the traction rope lock to pull the active bone block of the osteotomy to move. The soft tissue is prevented from being stimulated by the traction rope lock in the whole traction and osteogenesis process, and the simplification and painless of the bone moving technology can be effectively realized.
The invention has the beneficial effects that:
1. The device combines the intramedullary nail and the bone traction device, maintains the stability of osteotomy, does not need to wear a heavy external fixing bracket in the bone moving process, and can systematically perform rehabilitation training for patients in the bone moving process, thereby realizing a simple, effective and painless bone moving technology.
2. The invention further improves the overall stability of the device, and is provided with the anti-rotation nail and the anti-rotation nail fixing device, the anti-rotation nail and the anti-rotation nail fixing device can prevent the main nail of the traction device from rotating in the traction process, and the universal joint with the locking function can change the angle of the anti-rotation nail placed into the bone of a patient according to actual needs, so that the anti-rotation nail traction device has practicability.
3. After the adjusting screw rod rotates for a certain angle, the traction rope lock can drive the osteotomy active bone block to move, the traction rope lock can be wound in the spiral winding groove, and the moving distance and speed of the active bone block can be accurately adjusted and controlled through the scale adjusting disc arranged at the head end of the traction sleeve.
Drawings
Fig. 1 is a schematic connection of a retractor staple, a retractor cord lock, and an anti-rotation staple fastening device.
Fig. 2 is a cross-sectional view of the connection of the retractor staple, the retractor cord lock, and the anti-rotation staple fastening device.
Fig. 3 is an enlarged partial cross-sectional view of the connection of the retractor staple, the retractor cord lock, and the anti-rotation staple fastening device.
Fig. 4 is a cross-sectional view of the connection of the retractor staple and the anti-rotation staple fastening device.
Fig. 5 is a schematic structural view of the adjusting lever.
Fig. 6 is an enlarged partial schematic view at a in fig. 4.
Fig. 7 is a cross-sectional view of the connection of the pin body and the pulling sleeve.
Fig. 8 is a cross-sectional view of the anti-rotation nail fixing device.
Fig. 9 is a schematic illustration of the cooperation of the scale adjustment plate and the reference indicator.
Fig. 10 is a perspective view of the anti-rotation nail fixing device.
Fig. 11 is a schematic structural view of the anti-rotation nail fixing device.
Fig. 12 is a cross-sectional view at B-B in fig. 11.
Fig. 13 is a cross-sectional view of the present invention.
Fig. 14 is a schematic view of the structure of the present invention.
Fig. 15 is a schematic view of the present invention installed in a bone defect of a long bone.
Detailed Description
Referring to fig. 1 to 14, a bone moving device based on an intramedullary nail system includes an intramedullary nail 1, a main traction device nail 2 and a traction rope lock 3, the main traction device nail 2 passes through a nail hole of the intramedullary nail or is fixed in a far end or near end normal bone of a bone defect through the side of the intramedullary nail, a slideway 25 for moving the traction rope lock 3 is arranged in the axial direction of the main traction device nail 2, the head end of the traction rope lock 3 is fixed on a traction device of the main traction device nail 2, the tail end of the traction rope lock 3 is fixedly connected to an active bone block of an osteotomy through a drill after being extended by the slideway 25, and the traction rope lock 3 is driven by the mobile traction device to move the active bone block of the osteotomy.
Furthermore, the main retractor nail 2 comprises a nail body 20, an adjusting rod 21 and a retractor sleeve 22, wherein a slideway 25 is arranged in the nail body 20, the head end of the retractor rope lock 3 is fixedly connected to the adjusting rod 21, the adjusting rod 21 and the retractor sleeve 22 are matched to do irreversible movement along the axial direction of the retractor sleeve 22, and the irreversible movement along the single direction means that the adjusting rod 21 always moves forwards along the axial direction of the retractor sleeve 22 and cannot retract, or always moves backwards along the axial direction of the retractor sleeve 22 and cannot advance.
Furthermore, the adjusting rod 21 is an adjusting screw, and the inner cavity of the pulling sleeve 22 is provided with an internal thread 220 matched with the adjusting screw.
Furthermore, the inner cavity of the tail end of the traction sleeve 22 is fixedly connected with a linear bearing 24, the inner cavity of the linear bearing 24 is axially and slidably connected with a one-way bearing 23, and the tail end of the adjusting screw is fixedly connected with an inner ring of the one-way bearing 23.
Still further, the bone traction device further comprises an anti-rotation nail 5 and an anti-rotation nail fixing device 4, the head end of the anti-rotation nail fixing device 4 is fixedly connected to the tail end of the traction sleeve 22, and the anti-rotation nail 5 is fixed into the nail hole of the intramedullary nail 1 or fixed into normal bone through the side of the intramedullary nail through the anti-rotation nail fixing device 4.
Further, the anti-rotation nail fixing device 4 includes a universal joint 40 with a locking function and an anti-rotation nail clamp 41, the tail end of the universal joint 40 with the locking function is fixedly connected with the tail end of the traction sleeve 22, and the adjusting end of the universal joint 40 with the locking function is fixedly connected with the head end of the anti-rotation nail clamp 41.
Furthermore, the universal joint 40 with locking function is a rod-shaped ball-end rod-end joint bearing with locking function, which consists of a rod-shaped ball 400 and a shell 401 for the ball to rotate, wherein 3 adjustable studs 402,3 adjustable studs 402 are uniformly arranged in the radial direction of the shell 401 to lock the rod-shaped ball 400 in a locking state.
Furthermore, the anti-rotation nail clamp 41 comprises a clamp base 410 and a clamp arm 411, the clamp arm 411 is hinged to the tail end of the clamp base 410 through a hinge, the clamp base 410 is connected with the clamp arm 411 through a detachable locking bolt, and a clamping groove for clamping the anti-rotation nail 5 is formed between the clamp base 410 and the clamp arm 411.
Further, the adjusting rod 21 includes a winding area 210 and a pulling area 211, and spiral winding grooves 212 extending along the axial direction of the adjusting rod 21 are uniformly formed on the outer surface of the winding area 210, and the width of the spiral winding grooves 212 is equal to the diameter of the pulling rope lock 3.
Furthermore, the pulling rope lock 3 is a titanium cable, the pulling rope lock 3 is provided with a clamping block 30, and the tail end of the pulling rope lock 3 is fixed on the pulling rope lock 3 through the clamping block 30 after being wound around the osteotomy.
Furthermore, the head end of the pulling sleeve 22 is provided with a scale adjusting disc 222, and the head end of the adjusting bolt is provided with a reference indicator 221.
The working principle and the using process of the embodiment are as follows:
When in use, the intramedullary nail 1 is fixed in the bone cavity of a patient, the far and near ends of the bone defect are fixed at the center, the main traction device nail 2 passes through the nail hole of the intramedullary nail or is fixed in the far end or near end normal bone of the bone defect through the side of the intramedullary nail, the far end or near end of the bone defect is drilled by a Kirschner wire, the tail end of the traction rope lock 3 is wound on a bone segment to be cut, the fixing mode can be locked by using the U-shaped clamp block 30 or can be locked by adopting other clamping mechanisms, then the bone segment fixed at the tail end of the traction rope lock 3 is cut at the metaphyseal end, and the bone segment to be moved is free into an active bone block. In order to further improve the overall stability of the device, the anti-rotation nail 5 and the anti-rotation nail fixing device 4 have the functions of assisting in fixing the main traction nail 2, preventing the main traction nail 2 from rotating in the traction process, and the universal joint 40 with the locking function can change the angle of the anti-rotation nail 5 placed into the bone of a patient according to actual needs, so that the anti-rotation nail fixing device has practicability.
After the adjusting screw rod rotates on the retractor by a certain angle, the adjusting screw rod moves along the axial direction of the traction sleeve 22, the unidirectional bearing 23 arranged at the rear end of the adjusting screw rod can ensure that the adjusting screw rod does unidirectional irreversible movement, the linear bearing 24 can ensure that the unidirectional bearing 23 and the adjusting screw rod only slide along the axial direction, the distance of the axial movement of the unidirectional bearing 23 relative to the linear bearing 24 is equal to the distance of the adjusting screw rod relative to the traction sleeve 22, it is required that the unidirectional bearing 23 can only do axial movement in the linear bearing 24 and cannot do radial rotation movement, which is defined by the self structure of the linear bearing 24, the linear bearing 24 is in the prior art, after the adjusting screw rod rotates by a certain angle, the traction rope lock 3 can drive the osteotomy active bone block to move, and the traction rope lock 3 can be wound in the spiral winding groove 212. The distance and speed of the moving of the active bone pieces are precisely regulated by a scale regulating disc 222 arranged at the head end of the traction sleeve 22.

Claims (7)

1.一种基于髓内钉系统的骨搬移装置,其特征在于:包括髓内钉(1)、牵拉器主钉(2)和牵拉绳锁(3),所述的牵拉器主钉(2)穿过髓内钉的钉孔或经髓内钉侧方固定于骨缺损的远端或近端正常骨质内,所述的牵拉器主钉(2)轴向方向设置有供牵拉绳锁(3)移动的滑道(25),牵拉绳锁(3)首端固定于牵拉器主钉(2)的牵拉器上,牵拉绳锁(3)尾端经滑道(25)延伸后通过钻孔固连在截骨活性骨块上,移动牵拉器带动牵拉绳锁(3)牵动截骨的活性骨块进行搬移;1. A bone transport device based on an intramedullary nail system, characterized in that it comprises an intramedullary nail (1), a retractor main nail (2) and a retractor rope lock (3), wherein the retractor main nail (2) passes through the nail hole of the intramedullary nail or is fixed to the normal bone at the distal or proximal end of the bone defect through the side of the intramedullary nail, and the retractor main nail (2) is provided with a slideway (25) in the axial direction for the retractor rope lock (3) to move, the head end of the retractor rope lock (3) is fixed to the retractor of the retractor main nail (2), and the tail end of the retractor rope lock (3) is extended through the slideway (25) and fixedly connected to the osteotomy active bone block through a drilling hole, and the retractor is moved to drive the retractor rope lock (3) to move the osteotomy active bone block; 所述的牵拉器主钉(2)包括钉体(20)、调节杆(21)和牵拉套筒(22),滑道(25)设置在钉体(20)内,牵拉绳锁(3)的首端固连在调节杆(21)上,调节杆(21)与牵拉套筒(22)配合沿着牵拉套筒(22)轴向方向做单一方向不可逆转运动;The retractor main nail (2) comprises a nail body (20), an adjusting rod (21) and a pulling sleeve (22); a slideway (25) is arranged in the nail body (20); the head end of the pulling rope lock (3) is fixedly connected to the adjusting rod (21); the adjusting rod (21) cooperates with the pulling sleeve (22) to perform a single direction irreversible movement along the axial direction of the pulling sleeve (22); 所述的调节杆(21)为调节螺杆,牵拉套筒(22)内腔设置有与调节螺杆相匹配的内螺纹(220),所述的牵拉套筒(22)首端设置有刻度调节盘(222),所述的调节螺杆首端上设置有基准指示(221);The adjusting rod (21) is an adjusting screw, the inner cavity of the pulling sleeve (22) is provided with an internal thread (220) matching the adjusting screw, the front end of the pulling sleeve (22) is provided with a graduated adjusting disk (222), and the front end of the adjusting screw is provided with a reference indicator (221); 所述的调节杆(21)包括缠绕区(210)和牵拉区(211),缠绕区(210)外表面上均匀的设置有沿着调节杆(21)轴向方向延伸的螺旋缠绕槽(212),所述的螺旋缠绕槽(212)的宽度等于牵拉绳锁(3)的直径。The adjusting rod (21) comprises a winding area (210) and a pulling area (211), and the outer surface of the winding area (210) is evenly provided with spiral winding grooves (212) extending along the axial direction of the adjusting rod (21), and the width of the spiral winding grooves (212) is equal to the diameter of the pulling rope lock (3). 2.根据权利要求1所述的一种基于髓内钉系统的骨搬移装置,其特征在于:所述的牵拉套筒(22)末端内腔固连有直线轴承(24),直线轴承(24)内腔轴向滑动连接有单向轴承(23),调节螺杆末端固连在单向轴承(23)内圈上。2. A bone transport device based on an intramedullary nail system according to claim 1, characterized in that: a linear bearing (24) is fixedly connected to the inner cavity of the end of the pulling sleeve (22), a one-way bearing (23) is axially slidably connected to the inner cavity of the linear bearing (24), and the end of the adjusting screw is fixedly connected to the inner ring of the one-way bearing (23). 3.根据权利要求1所述的一种基于髓内钉系统的骨搬移装置,其特征在于:还包括防旋钉(5)和防旋钉固定装置(4),所述的防旋钉固定装置(4)首端固连在牵拉套筒(22)的末端,所述的防旋钉(5)穿过防旋钉固定装置(4)固定至髓内钉(1)钉孔内或经髓内钉侧方固定于正常骨质内。3. A bone transport device based on an intramedullary nail system according to claim 1, characterized in that it also includes an anti-rotation nail (5) and an anti-rotation nail fixing device (4), the head end of the anti-rotation nail fixing device (4) is fixedly connected to the end of the pulling sleeve (22), and the anti-rotation nail (5) passes through the anti-rotation nail fixing device (4) and is fixed to the nail hole of the intramedullary nail (1) or is fixed to the normal bone through the side of the intramedullary nail. 4.根据权利要求3所述的一种基于髓内钉系统的骨搬移装置,其特征在于:防旋钉固定装置(4)包括带锁定功能的万向节(40)和防旋钉夹(41),带锁定功能的万向节(40)末端与牵拉套筒(22)末端固定连接,带锁定功能的万向节(40)的调节端与防旋钉夹(41)首端固连。4. A bone transport device based on an intramedullary nail system according to claim 3, characterized in that: the anti-rotation nail fixing device (4) includes a universal joint (40) with a locking function and an anti-rotation nail clamp (41), the end of the universal joint (40) with a locking function is fixedly connected to the end of the pulling sleeve (22), and the adjustment end of the universal joint (40) with a locking function is fixedly connected to the head end of the anti-rotation nail clamp (41). 5.根据权利要求4所述的一种基于髓内钉系统的骨搬移装置,其特征在于:所述的带锁定功能的万向节(40)为带锁定功能的直杆形球头杆端关节轴承,由直杆形球头(400)和供球头转动的壳体(401)组成,壳体(401)径向方向上均匀设置有3个可调节螺柱(402),3个可调节螺柱(402)在锁紧状态时将直杆形球头(400)锁死。5. A bone removal device based on an intramedullary nail system according to claim 4, characterized in that: the universal joint (40) with a locking function is a straight rod ball head rod end joint bearing with a locking function, which is composed of a straight rod ball head (400) and a shell (401) for the ball head to rotate, and three adjustable studs (402) are evenly arranged in the radial direction of the shell (401), and the three adjustable studs (402) lock the straight rod ball head (400) when in a locked state. 6.根据权利要求4所述的一种基于髓内钉系统的骨搬移装置,其特征在于:所述的防旋钉夹(41)包括夹具基体(410)和夹臂(411),夹臂(411)和夹具基体(410)尾端通过铰轴铰接,夹具基体(410)和夹臂(411)通过可拆卸的锁定螺栓连接,夹具基体(410)和夹臂(411)之间构成夹取防旋钉(5)的夹取槽。6. A bone transport device based on an intramedullary nail system according to claim 4, characterized in that: the anti-rotation nail clamp (41) includes a clamp base (410) and a clamp arm (411), the clamp arm (411) and the clamp base (410) are hinged at their rear ends through a hinge shaft, the clamp base (410) and the clamp arm (411) are connected by a detachable locking bolt, and a clamping groove for clamping the anti-rotation nail (5) is formed between the clamp base (410) and the clamp arm (411). 7.根据权利要求1-6任一所述的一种基于髓内钉系统的骨搬移装置,其特征在于:所述的牵拉绳锁(3)为钛缆,所述的牵拉绳锁(3)上设置有夹块(30),牵拉绳锁(3)尾端缠绕截骨后通过夹块(30)固定在牵拉绳锁(3)上。7. A bone transport device based on an intramedullary nail system according to any one of claims 1 to 6, characterized in that: the pulling rope lock (3) is a titanium cable, and a clamping block (30) is provided on the pulling rope lock (3), and the tail end of the pulling rope lock (3) is fixed to the pulling rope lock (3) through the clamping block (30) after being wrapped around the osteotomy.
CN202010114264.5A 2020-02-25 2020-02-25 A bone transport device based on intramedullary nail system Active CN111134817B (en)

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CN111839711B (en) * 2020-08-19 2025-03-11 吴丹凯 A gun-type lifting forceps capable of effectively pressurizing the fracture ends
CN220089617U (en) * 2023-03-29 2023-11-28 孙建民 Intramedullary guiding device
CN120114159B (en) * 2025-03-19 2025-11-04 中国人民解放军联勤保障部队第九二〇医院 Pull-type bone moving system of titanium cable pulley track in sleeve-mediated body without outer frame

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