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CN112353442B - An anchor system for rotator cuff injury repair - Google Patents

An anchor system for rotator cuff injury repair Download PDF

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CN112353442B
CN112353442B CN202011252172.XA CN202011252172A CN112353442B CN 112353442 B CN112353442 B CN 112353442B CN 202011252172 A CN202011252172 A CN 202011252172A CN 112353442 B CN112353442 B CN 112353442B
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anchor
humeral head
push rod
tendon
rotator cuff
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CN112353442A (en
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贺业腾
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First Affiliated Hospital of Shandong First Medical University
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Abstract

本发明公开了一种肩袖损伤修复用锚钉系统,锚钉系统包括包括锚钉、缝合线、直筒、推杆,用于插入肱骨头的锚钉设有穿线孔和方孔,穿线孔用于穿缝合线,方孔用于与推杆的一端配合,推杆和缝合线都设于用于插入肱骨头和肩峰之间间隙的直筒内,直筒的一端设有换向部,当用于推送锚钉的推杆将锚钉从换向部推出时,锚钉插入肱骨头的方向偏离直筒插入肱骨头和肩峰之间间隙的方向。使用方法为先使弯筒在远离直筒的一端朝向肱骨头的骨面;然后使锚钉的尖端抵在肌腱上,用锚钉的尖端刺穿肌腱;再使锚钉拧入肱骨头;最后使锚钉和所述缝合线留在肱骨头上。本发明能够提高锚钉的抗拔出性能。

Figure 202011252172

The invention discloses an anchor system for repairing rotator cuff injury. The anchor system includes an anchor, a suture, a straight cylinder and a push rod. The anchor used for inserting the humeral head is provided with a threading hole and a square hole. For threading the suture, the square hole is used to cooperate with one end of the push rod. The push rod and the suture are all arranged in a straight cylinder for inserting into the gap between the humeral head and the acromion. When the push rod that pushes the anchor pushes the anchor out of the reversing portion, the direction in which the anchor is inserted into the humeral head deviates from the direction in which the straight barrel is inserted into the gap between the humeral head and the acromion. The method of use is to first make the end of the curved cylinder away from the straight cylinder facing the bone surface of the humeral head; then make the tip of the anchor against the tendon, and pierce the tendon with the tip of the anchor; then screw the anchor into the humeral head; The anchor and the suture remain on the humeral head. The invention can improve the pull-out resistance of the anchor.

Figure 202011252172

Description

一种肩袖损伤修复用锚钉系统An anchor system for rotator cuff injury repair

技术领域technical field

本发明涉及肩袖损伤修复技术领域,具体为一种肩袖损伤修复用锚钉系统。The invention relates to the technical field of rotator cuff injury repair, in particular to an anchor system for rotator cuff injury repair.

背景技术Background technique

肩袖是包绕在肱骨头周围的一组肌腱复合体,包括肩胛下肌腱、冈上肌腱、冈下肌腱、小圆肌腱,肩袖对维持肩关节稳定和肩关节活动起着重要作用。The rotator cuff is a group of tendon complexes surrounding the humeral head, including the subscapularis tendon, the supraspinatus tendon, the infraspinatus tendon, and the teres minor tendon. The rotator cuff plays an important role in maintaining the stability of the shoulder joint and the movement of the shoulder joint.

肩袖损伤大多指PASTA (部分关节表面肌腱撕脱) 损伤,PASTA损伤常见于冈上肌腱上。例如图1所示,肌腱附连在肱骨头上,在 PASTA 损伤中,如图2所示,是指肌腱在附连部分出现与肱骨头分离的现象。Rotator cuff injuries mostly refer to PASTA (partial articular surface tendon avulsion) injuries, which are commonly found on the supraspinatus tendon. For example, as shown in Figure 1, the tendon is attached to the humeral head. In a PASTA injury, as shown in Figure 2, the tendon is separated from the humeral head at the attachment portion.

对此,需要将肌腱的附连部分重新贴靠在肱骨头上来实现修复,修复时需要在肱骨头上原本附连有肌腱的位置设置带线锚钉(带线锚钉是指穿有缝合线的锚钉),来为施展缝线桥技术打下基础,缝线桥技术能够使用缝合线将肌腱按压到肱骨头上,使肌腱的附连部分重新贴靠在肱骨头上,以便于肌腱的附连部分重新和肱骨头长合在一起。In this regard, the attachment part of the tendon needs to be re-attached to the humeral head to achieve repair, and the repair needs to be placed on the humeral head where the tendon was originally attached. anchor), to lay the groundwork for the suture bridge technique, which uses sutures to press the tendon against the humeral head, allowing the tendon's attachment portion to rest against the humeral head for easy attachment of the tendon. The connecting part is reunited with the humeral head.

在设置带线锚钉时,需要使用到锚钉系统这一工具。如图3所示,现有的锚钉系统包括锚钉1、直筒2、推杆3、缝合线4,锚钉1的尾部设有穿线孔101和方孔102,缝合线4从穿线孔101穿过,推杆3的一端插入方孔102,推杆3和缝合线4都收容在直筒2的内腔中。When setting up anchors with wire, you need to use the anchor system tool. As shown in FIG. 3 , the existing anchor system includes an anchor 1, a straight cylinder 2, a push rod 3, and a suture 4. The tail of the anchor 1 is provided with a threading hole 101 and a square hole 102. The suture 4 passes through the threading hole 101. Passing through, one end of the push rod 3 is inserted into the square hole 102 , and both the push rod 3 and the suture 4 are accommodated in the inner cavity of the straight cylinder 2 .

锚钉系统的使用方法如下所述:(1)由于附连有肌腱的肱骨头的上方有肩峰遮挡,所以需要医生将直筒2倾斜插入肩峰和肱骨头之间的间隙,如图4所示;(2)在直筒2倾斜插入肩峰和肱骨头之后,利用锚钉1尖端锐利的性能,刺穿肌腱,继续将直筒2和推杆3向肱骨头进给,如图5所示;(3)医生旋拧推杆3,将锚钉1拧入肱骨头,如图6所示;(4)撤出手柄,此时只有穿好缝合线4的锚钉1留在了肱骨头上,如图7所示。The method of using the anchor system is as follows: (1) Since the acromion is blocked above the humeral head to which the tendon is attached, the doctor needs to insert the straight tube 2 obliquely into the gap between the acromion and the humeral head, as shown in Figure 4. (2) After the straight barrel 2 is obliquely inserted into the acromion and the humeral head, use the sharp tip of the anchor 1 to pierce the tendon, and continue to feed the straight barrel 2 and the push rod 3 to the humeral head, as shown in Figure 5; (3) The doctor twists the push rod 3 and screw the anchor 1 into the humeral head, as shown in Figure 6; (4) Withdraw the handle, at this time only the anchor 1 with the suture 4 is left on the humeral head , as shown in Figure 7.

如图7所示,由于肱骨头和肩峰之间的间隙狭窄,且锚钉插入肱骨头的方向与直筒插入肱骨头和肩峰之间间隙的方向相同,所以拉拔锚钉的方向L1(拉拔锚钉的方向是指用缝合线拉拽锚钉的方向,也是直筒插入肱骨头和肩峰之间间隙的方向)和锚钉插入肱骨头的方向L2几乎是平行的,从而降低了锚钉的抗拔出性能。As shown in Figure 7, since the gap between the humeral head and the acromion is narrow, and the direction of the anchor insertion into the humeral head is the same as the direction in which the straight barrel is inserted into the space between the humeral head and the acromion, the direction L1 of pulling the anchor (pulling The direction of the anchor refers to the direction in which the suture is used to pull the anchor, which is also the direction in which the straight tube is inserted into the space between the humeral head and the acromion) and the direction L2 in which the anchor is inserted into the humeral head is almost parallel, thus reducing the resistance of the anchor. Pull out performance.

锚钉的抗拔出性能越弱,锚钉越容易从肱骨头拔出,缝合线将肌腱按压到肱骨头上的力量越弱,肌腱的附连部分越不易贴靠在肱骨头上,从而耽误了肌腱的附连部分重新和肱骨头长合在一起。一旦锚钉从肱骨头上拔出,就需要重新进行手术,从而会耽误患者的康复,增大医疗成本。The weaker the pull-out resistance of the anchor, the easier it is to pull the anchor out of the humeral head, the weaker the force of the suture to press the tendon to the humeral head, and the less likely the attachment part of the tendon is against the humeral head. The attachment portion of the tendon is reunited with the humeral head. Once the anchor is removed from the humeral head, reoperation is required, delaying patient recovery and increasing medical costs.

从而,如何能够提高锚钉的抗拔出性能,是本领域的技术人员亟待解决的技术问题。Therefore, how to improve the pull-out resistance of the anchor is a technical problem to be solved urgently by those skilled in the art.

发明内容SUMMARY OF THE INVENTION

本发明就是针对现有技术存在的上述不足,提供一种肩袖损伤修复用锚钉系统,本发明能够提高锚钉的抗拔出性能。The present invention provides an anchor system for repairing rotator cuff damage in view of the above shortcomings of the prior art, and the invention can improve the pull-out resistance of the anchor.

为实现上述目的,本发明提供如下技术方案一:For achieving the above object, the present invention provides following technical scheme one:

一种肩袖损伤修复用锚钉系统,包括锚钉、缝合线、直筒、推杆,用于插入肱骨头的锚钉设有穿线孔和方孔,穿线孔用于穿缝合线,方孔用于与推杆的一端配合,推杆和缝合线都设于用于插入肱骨头和肩峰之间间隙的直筒内,直筒的一端设有换向部,当用于推送锚钉的推杆将锚钉从换向部推出时,锚钉插入肱骨头的方向偏离直筒插入肱骨头和肩峰之间间隙的方向。An anchor system for repairing rotator cuff injury, comprising an anchor, a suture, a straight cylinder and a push rod. The anchor used for inserting the humeral head is provided with a threading hole and a square hole, the threading hole is used for threading the suture, and the square hole is used for In order to cooperate with one end of the push rod, the push rod and the suture are all arranged in a straight cylinder for inserting into the gap between the humeral head and the acromion, and one end of the straight cylinder is provided with a reversing part. When the nail is pushed out of the commutator, the direction in which the anchor is inserted into the humeral head deviates from the direction in which the straight barrel is inserted into the space between the humeral head and the acromion.

进一步的,所述换向部采用弯筒,弯筒与直筒连通,所述锚钉设有外螺纹,所述推杆采用弹性杆。Further, the reversing portion adopts a curved cylinder, and the curved cylinder is communicated with the straight cylinder, the anchor is provided with an external thread, and the push rod is an elastic rod.

一种肩袖损伤修复用锚钉系统的使用方法,包括如下步骤:A method for using an anchor system for rotator cuff injury repair, comprising the following steps:

(1)将所述直筒插入肱骨头和肩峰之间的间隙,转动直筒,使所述弯筒在远离直筒的一端朝向肱骨头的骨面;(1) Insert the straight cylinder into the gap between the humeral head and the acromion, and rotate the straight cylinder so that the curved cylinder faces the bone surface of the humeral head at one end away from the straight cylinder;

(2)用所述推杆将所述锚钉从弯筒推出,使锚钉的尖端抵在肌腱上,用锚钉的尖端刺穿肌腱;(2) Push the anchor out of the curved cylinder with the push rod, so that the tip of the anchor is against the tendon, and the tip of the anchor is used to pierce the tendon;

(3)旋拧推杆,使锚钉拧入肱骨头;(3) Rotate the push rod to screw the anchor into the humeral head;

(4)撤出直筒和推杆,使锚钉和所述缝合线留在肱骨头上。(4) Withdraw the barrel and push rod, leaving the anchor and the suture on the humeral head.

本发明提供如下技术方案二:The present invention provides the following technical scheme two:

一种肩袖损伤修复用锚钉系统,包括锚钉、缝合线、直筒、推杆,用于插入肱骨头的锚钉设有穿线孔和方孔,穿线孔用于穿缝合线,方孔用于与推杆的一端配合,推杆和缝合线都设于用于插入肱骨头和肩峰之间间隙的直筒内,直筒的一端设有换向部,当用于推送锚钉的推杆将锚钉从换向部推出时,锚钉插入肱骨头的方向偏离直筒插入肱骨头和肩峰之间间隙的方向。An anchor system for repairing rotator cuff injury, comprising an anchor, a suture, a straight cylinder and a push rod. The anchor used for inserting the humeral head is provided with a threading hole and a square hole, the threading hole is used for threading the suture, and the square hole is used for In order to cooperate with one end of the push rod, the push rod and the suture are all arranged in a straight cylinder for inserting into the gap between the humeral head and the acromion, and one end of the straight cylinder is provided with a reversing part. When the nail is pushed out of the commutator, the direction in which the anchor is inserted into the humeral head deviates from the direction in which the straight barrel is inserted into the space between the humeral head and the acromion.

进一步的,所述换向部采用限位凸起,限位凸起设于所述直筒的内腔中,所述锚钉设有限位槽,限位槽与限位凸起配合。Further, the reversing portion adopts a limiting protrusion, the limiting protrusion is arranged in the inner cavity of the straight cylinder, the anchor is provided with a limiting groove, and the limiting groove cooperates with the limiting protrusion.

更进一步的,所述穿线孔设于所述锚钉的尖端。Further, the threading hole is provided at the tip of the anchor.

一种肩袖损伤修复用锚钉系统的使用方法,包括如下步骤:A method for using an anchor system for rotator cuff injury repair, comprising the following steps:

(1)将所述直筒插入肱骨头和肩峰之间的间隙,用所述推杆推动所述锚钉,直至所述限位凸起滑进锚钉的所述限位槽中,继续推动推杆,使锚钉绕限位凸起转动,直至锚钉的尖端抵在肌腱上;(1) Insert the straight cylinder into the gap between the humeral head and the acromion, push the anchor with the push rod until the limit protrusion slides into the limit groove of the anchor, and continue to push the anchor. rod to rotate the anchor around the limit protrusion until the tip of the anchor touches the tendon;

(2)用锤子敲打推杆,使推杆推着锚钉,让锚钉刺穿肌腱并钉入肱骨头中;(2) Hit the push rod with a hammer so that the push rod pushes the anchor, allowing the anchor to pierce the tendon and drive into the humeral head;

(3)撤出直筒和推杆,使锚钉和缝合线留在肱骨头上。(3) Withdraw the straight cylinder and push rod, leaving the anchor and suture on the humeral head.

进一步的,当所述穿线孔设于所述锚钉的尖端时,在步骤(2)和步骤(3)之间,需要进行如下操作:在保持所述推杆推动所述锚钉的同时,向外拉拽缝合线,使锚钉的尖端朝所述直筒抽出肱骨头和肩峰之间间隙的方向偏转。Further, when the threading hole is provided at the tip of the anchor, between step (2) and step (3), the following operations need to be performed: while keeping the push rod to push the anchor, Pulling the suture outward deflects the tip of the anchor in the direction that the straight barrel withdraws from the space between the humeral head and the acromion.

与现有技术相比,发明的有益效果是:Compared with the prior art, the beneficial effects of the invention are:

1、在肱骨头和肩峰之间的间隙狭窄的情况下,锚钉能够以偏离直筒插入肱骨头和肩峰之间的间隙的方向插入肱骨头,使得锚钉插入肱骨头的骨面的方向L2’和拉拔锚钉的方向L1并非是平行的,而是有一定夹角a的。所以与背景技术中拉拔锚钉的方向L1和锚钉插入肱骨头的方向L2几乎是平行的相比,本发明提高了锚钉的抗拔出性能。1. In the case of a narrow gap between the humeral head and the acromion, the anchor can be inserted into the humeral head in a direction deviating from the straight barrel inserted into the gap between the humeral head and the acromion, so that the anchor is inserted in the direction L2' of the bony surface of the humeral head. It is not parallel to the direction L1 of pulling the anchor, but has a certain angle a. Therefore, compared with the direction L1 in which the anchor is pulled out and the direction L2 in which the anchor is inserted into the humeral head in the background art, which are almost parallel, the present invention improves the pullout resistance of the anchor.

提高了锚钉的抗拔出性能之后,能够增大锚钉从肱骨头上拔出的难度,增大缝合线将肌腱按压到肱骨头上的力量,让肌腱的附连部分能够紧密地贴靠在肱骨头上,促进肌腱的附连部分重新与肱骨头长合在一起。降低了锚钉从肱骨头上拔出的风险,提高了手术成功率,从而降低了重新进行手术的几率,避免耽误患者的康复,节省医疗成本。After improving the pullout resistance of the anchor, it can increase the difficulty of pulling the anchor out of the humeral head, increase the force of the suture to press the tendon to the humeral head, and make the attachment part of the tendon can be closely attached On the humeral head, the attachment portion that promotes the tendon rejoins the humeral head. The risk of the anchor being pulled out from the humeral head is reduced, and the success rate of the operation is improved, thereby reducing the chance of re-operation, avoiding delaying the recovery of patients, and saving medical costs.

此外,因为本发明能够削弱肩峰对锚钉插入肱骨头方向的影响,即,在肱骨头和肩峰之间的间隙狭窄的情况下,仍然能够让锚钉以偏离直筒插入肱骨头和肩峰之间的间隙的方向拧入肱骨头,所以本发明尤其适用于冈上肌腱出现PASTA 损伤的情况。In addition, because the present invention can weaken the influence of the acromion on the direction of the insertion of the anchor into the humeral head, that is, in the case of a narrow gap between the humeral head and the acromion, the anchor can still be inserted between the humeral head and the acromion with a deviated straight tube. The direction of the gap is screwed into the humeral head, so the present invention is especially suitable for the PASTA injury of the supraspinatus tendon.

2、本发明无论是采用弯筒作为换向部,还是采用限位凸起作为换向部,本发明的一种肩袖损伤修复用锚钉系统结构简单,便于加工,降低加工成本,且便于操作,提高了手术成功率,降低了对医生技能的要求水平。2. No matter whether the present invention adopts the curved cylinder as the reversing part or the limiting protrusion as the reversing part, the anchor system for rotator cuff injury repair of the present invention has a simple structure, is easy to process, reduces the processing cost, and is convenient to use. operation, improve the success rate of surgery, reduce the level of requirements for the doctor's skills.

4、本发明通过在锚钉的尖端设置穿线孔,能够在将锚钉插入肱骨头后,通过拉拽缝合线,让锚钉的尖端朝直筒抽出肱骨头和肩峰之间间隙的方向偏转,能够让锚钉插入肱骨头的方向与锚钉的拔出方向的夹角进一步增大,从而进一步提高了肱骨头固定锚钉的效果,更进一步提高了锚钉的抗拔出性能。继而进一步促进肌腱的附连部分重新与肱骨头长合在一起,且进一步提高了手术成功率,节省医疗成本。4. In the present invention, a threading hole is arranged at the tip of the anchor, so that after the anchor is inserted into the humeral head, the tip of the anchor can be deflected in the direction of the straight cylinder pulling out the gap between the humeral head and the acromion by pulling the suture, so that The included angle between the direction in which the anchor is inserted into the humeral head and the direction in which the anchor is pulled out is further increased, thereby further improving the effect of fixing the anchor in the humeral head and further improving the pull-out resistance of the anchor. Then, the attachment part of the tendon is further promoted to grow back together with the humeral head, which further improves the success rate of the operation and saves the medical cost.

5、本发明的一种肩袖损伤修复用锚钉系统的使用方法,能够利用本发明的一种肩袖损伤修复用锚钉系统,将锚钉以偏离直筒插入肱骨头和肩峰之间的间隙的方向插入肱骨头,使得拉拔锚钉的方向和锚钉插入肱骨头的骨面的方向并非是平行的,拉拔锚钉的方向是指用缝合线拉拽锚钉的方向。所以与背景技术中拉拔锚钉的方向和锚钉插入肱骨头的方向几乎是平行的相比,本发明提高了锚钉的抗拔出性能。5. The method of using an anchor system for repairing rotator cuff damage of the present invention can use the anchor system for repairing rotator cuff damage of the present invention to insert the anchor into the gap between the humeral head and the acromion with a deviated straight cylinder The direction of pulling out the anchor is not parallel to the direction in which the anchor is inserted into the bony surface of the humeral head, and the direction of pulling the anchor refers to the direction of pulling the anchor with the suture. Therefore, compared with the direction in which the anchor is pulled out and the direction in which the anchor is inserted into the humeral head in the background art is almost parallel, the present invention improves the pull-out resistance of the anchor.

提高了锚钉的抗拔出性能之后,能够增大锚钉从肱骨头上拔出的难度,增大缝合线将肌腱按压到肱骨头上的力量,让肌腱的附连部分能够紧密地贴靠在肱骨头上,促进肌腱的附连部分重新与肱骨头长合在一起。降低了锚钉从肱骨头上拔出的风险,提高了手术成功率,从而降低了重新进行手术的几率,减轻患者的手术痛苦,节省医疗成本。After improving the pullout resistance of the anchor, it can increase the difficulty of pulling the anchor out of the humeral head, increase the force of the suture to press the tendon to the humeral head, and make the attachment part of the tendon can be closely attached On the humeral head, the attachment portion that promotes the tendon rejoins the humeral head. The risk of the anchor being pulled out from the humeral head is reduced, the success rate of the operation is improved, the probability of re-operation is reduced, the operation pain of the patient is reduced, and the medical cost is saved.

附图说明Description of drawings

图1为背景技术PASTA损伤前的示意图;Fig. 1 is the schematic diagram before background art PASTA is damaged;

图2为背景技术PASTA损伤后的示意图;Fig. 2 is the schematic diagram after background art PASTA is damaged;

图3为背景技术中锚钉系统的结构示意图;3 is a schematic structural diagram of an anchor system in the background art;

图4为背景技术中锚钉系统的使用示意图一;4 is a schematic diagram 1 of the use of the anchor system in the background technology;

图5为背景技术中锚钉系统的使用示意图二;5 is a schematic diagram 2 of the use of the anchor system in the background technology;

图6为背景技术中锚钉系统的使用示意图三;6 is a schematic diagram three of the use of the anchor system in the background technology;

图7为背景技术中锚钉系统的使用示意图四;7 is a schematic diagram 4 of the use of the anchor system in the background technology;

图8为实施例1一种肩袖损伤修复用锚钉系统的结构示意图一;8 is a schematic structural diagram 1 of an anchor system for repairing a rotator cuff injury in Example 1;

图9为实施例1一种肩袖损伤修复用锚钉系统的结构示意图二;9 is a schematic structural diagram 2 of an anchor system for repairing a rotator cuff injury in Example 1;

图10为实施例1一种肩袖损伤修复用锚钉系统的结构示意图三;10 is a schematic structural diagram three of an anchor system for repairing a rotator cuff injury in Example 1;

图11为实施例1一种肩袖损伤修复用锚钉系统的使用示意图一;11 is a schematic diagram 1 of the use of an anchor system for repairing a rotator cuff injury in Example 1;

图12为实施例1一种肩袖损伤修复用锚钉系统的使用示意图二;12 is a schematic diagram 2 of the use of an anchor system for repairing a rotator cuff injury in Example 1;

图13为实施例1一种肩袖损伤修复用锚钉系统的使用示意图三;13 is a schematic diagram 3 of the use of an anchor system for rotator cuff injury repair in Example 1;

图14为实施例1一种肩袖损伤修复用锚钉系统的使用示意图四;14 is a schematic diagram 4 of the use of an anchor system for repairing a rotator cuff injury in Example 1;

图15为实施例2一种肩袖损伤修复用锚钉系统的结构示意图一;15 is a schematic structural diagram 1 of an anchor system for rotator cuff injury repair in Example 2;

图16为实施例2一种肩袖损伤修复用锚钉系统的结构示意图二;FIG. 16 is a schematic structural diagram 2 of an anchor system for repairing a rotator cuff injury in Example 2;

图17为实施例2一种肩袖损伤修复用锚钉系统的结构示意图三;17 is a schematic structural diagram 3 of an anchor system for repairing a rotator cuff injury in Example 2;

图18为实施例2一种肩袖损伤修复用锚钉系统的使用示意图一;18 is a schematic diagram 1 of the use of an anchor system for repairing a rotator cuff injury in Example 2;

图19为实施例2一种肩袖损伤修复用锚钉系统的使用示意图二;19 is a schematic diagram 2 of the use of an anchor system for rotator cuff injury repair in Example 2;

图20为实施例2一种肩袖损伤修复用锚钉系统的使用示意图三;20 is a schematic diagram 3 of the use of an anchor system for rotator cuff injury repair in Example 2;

图21为实施例2一种肩袖损伤修复用锚钉系统的使用示意图四;21 is a schematic diagram 4 of the use of an anchor system for repairing a rotator cuff injury in Example 2;

图22为实施例2一种肩袖损伤修复用锚钉系统的使用示意图五;22 is a schematic diagram 5 of the use of an anchor system for repairing a rotator cuff injury in Example 2;

图23为实施例2一种肩袖损伤修复用锚钉系统的使用示意图六;Figure 23 is a schematic diagram 6 of the use of an anchor system for repairing a rotator cuff injury in Example 2;

图24为实施例3一种肩袖损伤修复用锚钉系统的使用示意图。FIG. 24 is a schematic diagram of the use of an anchor system for rotator cuff injury repair in Example 3. FIG.

图中:In the picture:

1-锚钉,101-穿线孔,102-方孔,103-限位槽,2-直筒,3-推杆,4-缝合线,5-弯筒,6-限位凸起。1-Anchor, 101-Threading hole, 102-Square hole, 103-Limiting groove, 2-Straight cylinder, 3-Push rod, 4-Suture thread, 5-Bending cylinder, 6-Limiting protrusion.

具体实施方式Detailed ways

下面将结合本发明实施例中的附图,对本发明实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本发明一部分实施例,而不是全部的实施例。基于本发明中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本发明保护的范围。The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present invention.

实施例1:Example 1:

如图8-10所示,一种肩袖损伤修复用锚钉系统,包括锚钉1、直筒2、推杆3、缝合线4。As shown in Figures 8-10, an anchor system for rotator cuff injury repair includes an anchor 1, a straight cylinder 2, a push rod 3, and a suture 4.

锚钉1用于插入肱骨头。锚定1的外表面设有外螺纹,锚钉1的尾端设有穿线孔101,穿线孔101用于穿缝合线4。锚钉1的尾端还设有方孔102(方孔102为四棱柱形孔),在推杆3的一端插入方孔102后,旋转推杆3,锚钉1能够随着推杆3一起转动。除了采用方孔102,还可采用三棱柱形孔或五棱柱形孔或六棱柱形孔来替代,例如在采用三棱柱形孔时,推杆3则采用与三棱柱形孔匹配的三棱柱形。Anchor 1 is used to insert the humeral head. The outer surface of the anchor 1 is provided with external threads, and the tail end of the anchor 1 is provided with a threading hole 101 , and the threading hole 101 is used for threading the suture 4 . The rear end of the anchor 1 is also provided with a square hole 102 (the square hole 102 is a quadrangular prism hole). turn. In addition to the square hole 102, a triangular prism hole, a penta prism hole or a hexagonal prism hole can also be used instead. .

直筒2用于插入肱骨头和肩峰之间的间隙。直筒2的一端设有换向部,换向部采用弯筒5,弯筒5与直筒2为一体成型,弯筒5的内腔与直筒2的内腔连通,弯筒5的轴线与直筒2的轴线的夹角b为160-165°。The straight tube 2 is used to insert into the gap between the humeral head and the acromion. One end of the straight cylinder 2 is provided with a reversing portion, and the reversing portion adopts a curved cylinder 5. The curved cylinder 5 and the straight cylinder 2 are integrally formed. The included angle b of the axis is 160-165°.

推杆3和缝合线4都依次穿过直筒2的内腔、弯筒5的内腔。推杆3采用弹性杆。推杆3用于将锚钉1从直筒2的内腔推到弯筒5的内腔,继续用推杆3推动锚钉1,就能将锚钉1从弯筒5的内腔推出。具体的,推杆3采用具有高强度、高韧性、回弹明显的钛合金杆。此外,还可直接使用背景技术中的推杆3,这是因为推杆3本身就是细长杆形状,细长杆本身就具有良好的韧性和回弹性能。在使用推杆3将锚钉1沿着直筒2、弯筒5推动时,因为推杆3具有弹性,所以推杆3靠近锚钉1的一端插入弯筒5时,能够随着弯筒5的转弯而弯曲,在将推杆3从弯筒5抽出时,推杆3复原。同样因为推杆3具有弹性,所以在推杆3将锚钉1推出弯筒5且推杆3靠近锚钉1的一端还插在弯筒5的内腔中时,旋拧推杆3,推杆3插在弯筒5中的一部分也会旋转,从而能够带动锚钉1一起旋转。Both the push rod 3 and the suture 4 pass through the inner cavity of the straight cylinder 2 and the inner cavity of the curved cylinder 5 in sequence. The push rod 3 adopts an elastic rod. The push rod 3 is used to push the anchor 1 from the inner cavity of the straight cylinder 2 to the inner cavity of the curved cylinder 5 . Specifically, the push rod 3 adopts a titanium alloy rod with high strength, high toughness and obvious rebound. In addition, the push rod 3 in the background art can also be used directly, because the push rod 3 itself is in the shape of an elongated rod, and the elongated rod itself has good toughness and resilience. When the push rod 3 is used to push the anchor 1 along the straight cylinder 2 and the curved cylinder 5, because the push rod 3 has elasticity, when the end of the push rod 3 close to the anchor 1 is inserted into the curved cylinder 5, it can follow the curve of the curved cylinder 5. After turning and bending, when the push rod 3 is pulled out from the bending cylinder 5, the push rod 3 is restored. Also because the push rod 3 has elasticity, when the push rod 3 pushes the anchor 1 out of the curved cylinder 5 and the end of the push rod 3 close to the anchor 1 is still inserted into the inner cavity of the curved cylinder 5, the push rod 3 is rotated to push A part of the rod 3 inserted in the curved cylinder 5 also rotates, so as to drive the anchor 1 to rotate together.

一种肩袖损伤修复用锚钉系统的使用方法,包括如下步骤:A method for using an anchor system for rotator cuff injury repair, comprising the following steps:

(1)将直筒2插入肱骨头和肩峰之间的间隙,转动直筒2,使弯筒5在远离直筒2的一端朝向肱骨头的骨面。(1) Insert the straight cylinder 2 into the gap between the humeral head and the acromion, and turn the straight cylinder 2 so that the curved cylinder 5 faces the bony surface of the humeral head at the end away from the straight cylinder 2.

(2)用推杆3将锚钉1从弯筒5推出,使锚钉1的尖端抵在肌腱上,如图11所示,用锚钉1的尖端刺穿肌腱,如图12所示。因为在步骤(1)中,弯筒5在远离直筒2的一端是朝向肱骨头的骨面的,所以当锚钉1从弯筒5被推杆3推出时,锚钉1的尖端的方向能够与弯筒5的走向一致,都朝向肱骨头的骨面,从而能够让锚钉1的尖端抵在肌腱上,并且锚钉1的尖端的朝向是偏离直筒2插入肱骨头和肩峰之间的间隙的方向的。(2) Push the anchor 1 out of the curved cylinder 5 with the push rod 3, so that the tip of the anchor 1 is against the tendon, as shown in Figure 11, and pierce the tendon with the tip of the anchor 1, as shown in Figure 12. Because in step (1), the end of the curved barrel 5 away from the straight barrel 2 faces the bone surface of the humeral head, so when the anchor 1 is pushed out from the curved barrel 5 by the push rod 3, the direction of the tip of the anchor 1 can be Consistent with the direction of the curved barrel 5, both face the bony surface of the humeral head, so that the tip of the anchor 1 can rest on the tendon, and the tip of the anchor 1 is oriented away from the straight barrel 2. Insert the gap between the humeral head and the acromion direction.

(3)旋拧推杆3,使锚钉1拧入肱骨头,如图13所示。因为在步骤(2)中,锚钉1的尖端的朝向是偏离直筒2插入肱骨头和肩峰之间的间隙的方向的,所以旋拧推杆3时,锚钉1就能够拧入肱骨头,并且,锚钉1拧入肱骨头的方向也是偏离直筒2插入肱骨头和肩峰之间的间隙的方向的。(3) Screw the push rod 3 to screw the anchor 1 into the humeral head, as shown in Figure 13. Because in step (2), the direction of the tip of the anchor 1 is deviated from the direction in which the straight cylinder 2 is inserted into the gap between the humeral head and the acromion, so when the push rod 3 is screwed, the anchor 1 can be screwed into the humeral head, Moreover, the direction in which the anchor 1 is screwed into the humeral head is also deviated from the direction in which the straight cylinder 2 is inserted into the gap between the humeral head and the acromion.

(4)撤出直筒2和推杆3,使锚钉1和缝合线4留在肱骨头上,如图14所示。(4) Withdraw the straight cylinder 2 and the push rod 3, leaving the anchor 1 and the suture 4 on the humeral head, as shown in Figure 14.

通过上述过程可知:Through the above process, we can know that:

在肱骨头和肩峰之间的间隙狭窄的情况下,因为锚钉1能够被推杆3推着来顺着弯筒5的方向移动,从而在弯筒5远离直筒2的一端朝向肱骨头的骨面时,锚钉1能够以偏离直筒2插入肱骨头和肩峰之间的间隙的方向拧入肱骨头,使得锚钉1插入肱骨头的骨面的方向L2’和拉拔锚钉1的方向L1并非是平行的,而是有一定夹角a的。所以与背景技术中拉拔锚钉1的方向L1和锚钉1插入肱骨头的方向L2几乎是平行的相比,本实施例1的一种肩袖损伤修复用锚钉系统,提高了锚钉1的抗拔出性能。In the case of a narrow gap between the humeral head and the acromion, because the anchor 1 can be pushed by the push rod 3 to move in the direction of the curved barrel 5, the end of the curved barrel 5 away from the straight barrel 2 faces the bone of the humeral head. When facing the humeral head, the anchor 1 can be screwed into the humeral head in a direction deviating from the straight cylinder 2 into the gap between the humeral head and the acromion, so that the direction L2' of the anchor 1 being inserted into the bony surface of the humeral head and the direction L1 of pulling the anchor 1 Not parallel, but with a certain angle a. Therefore, compared with the direction L1 in which the anchor 1 is pulled out and the direction L2 in which the anchor 1 is inserted into the humeral head in the background art, which are almost parallel, the anchor system for repairing rotator cuff injury in this embodiment 1 improves the performance of the anchor. 1 anti-pull-out performance.

提高了锚钉1的抗拔出性能之后,能够增大锚钉1从肱骨头上拔出的难度,增大缝合线4将肌腱按压到肱骨头上的力量,让肌腱的附连部分能够紧密地贴靠在肱骨头上,促进肌腱的附连部分重新与肱骨头长合在一起。降低了锚钉1从肱骨头上拔出的风险,提高了手术成功率,从而降低了重新进行手术的几率,避免耽误患者的康复,节省医疗成本。After improving the pull-out resistance of the anchor 1, the difficulty of pulling the anchor 1 from the humeral head can be increased, and the force of the suture 4 to press the tendon to the humeral head can be increased, so that the attached part of the tendon can be tightly It rests on the humeral head, promoting the attachment of the tendon to re-grow with the humeral head. The risk of the anchor pin 1 being pulled out from the humeral head is reduced, and the success rate of the operation is improved, thereby reducing the probability of re-operation, avoiding delaying the recovery of the patient, and saving medical costs.

此外,因为本实施例1的一种肩袖损伤修复用锚钉系统,能够削弱肩峰对锚钉1插入肱骨头方向的影响,即,在肱骨头和肩峰之间的间隙狭窄的情况下,仍然能够让锚钉1以偏离直筒2插入肱骨头和肩峰之间的间隙的方向拧入肱骨头,所以本实施例1的一种肩袖损伤修复用锚钉系统,尤其适用于冈上肌腱出现PASTA 损伤的情况。In addition, because the anchor system for rotator cuff injury repair of the present embodiment 1 can weaken the influence of the acromion on the direction in which the anchor 1 is inserted into the humeral head, that is, when the gap between the humeral head and the acromion is narrow, The anchor 1 can still be screwed into the humeral head in a direction deviating from the straight cylinder 2 into the gap between the humeral head and the acromion, so the anchor system for repairing a rotator cuff injury of the present embodiment 1 is especially suitable for the appearance of the supraspinatus tendon. In the case of PASTA injury.

实施例2:Example 2:

如图15-17所示,一种肩袖损伤修复用锚钉系统,包括锚钉1、直筒2、推杆3、缝合线4。As shown in Figures 15-17, an anchor system for rotator cuff injury repair includes an anchor 1, a straight cylinder 2, a push rod 3, and a suture 4.

直筒2用于插入肱骨头和肩峰之间的间隙。直筒2的一端设有换向部,换向部采用限位凸起6,限位凸起6设于直筒2的内腔中,限位凸起6与直筒2为一体成型。The straight tube 2 is used to insert into the gap between the humeral head and the acromion. One end of the straight cylinder 2 is provided with a reversing portion, and the reversing portion adopts a limiting protrusion 6 , which is arranged in the inner cavity of the straight cylinder 2 , and the limiting protrusion 6 is integrally formed with the straight cylinder 2 .

锚钉1用于插入肱骨头。锚钉1的尾端设有穿线孔101,穿线孔101用于穿缝合线4。锚钉1的尾端还设有方孔102(方孔102为四棱柱形孔),在推杆3的一端插入方孔102后,旋转推杆3,锚钉1能够随着推杆3一起转动。除了采用方孔102,还可采用三棱柱形孔或五棱柱形孔或六棱柱形孔来替代,例如在采用三棱柱形孔时,推杆3则采用与三棱柱形孔匹配的三棱柱形。锚钉1还设有限位槽103,限位槽103与限位凸起6配合。Anchor 1 is used to insert the humeral head. The rear end of the anchor 1 is provided with a threading hole 101 , and the threading hole 101 is used for threading the suture 4 . The rear end of the anchor 1 is also provided with a square hole 102 (the square hole 102 is a quadrangular prism hole). turn. In addition to the square hole 102, a triangular prism hole, a pentagonal prism hole or a hexagonal prism hole can also be used instead. . The anchor 1 is further provided with a limit groove 103 , and the limit groove 103 is matched with the limit protrusion 6 .

推杆3和缝合线4都设于直筒2的内腔中。推杆3用于把锚钉1推送出直筒2的内腔,在推杆3将锚钉1推至直筒2设有限位凸起6的一端时,限位凸起6能够滑入锚钉1的限位槽103中,继续推动推杆3,因为限位凸起6已经插入了限位槽103中,所以锚钉1将会绕限位凸起6转动,使得锚钉1尖端的朝向发生改变。Both the push rod 3 and the suture 4 are arranged in the inner cavity of the straight cylinder 2 . The push rod 3 is used to push the anchor 1 out of the inner cavity of the straight cylinder 2. When the push rod 3 pushes the anchor 1 to the end of the straight cylinder 2 with the limiting protrusion 6, the limiting protrusion 6 can slide into the anchor 1. In the limit groove 103, continue to push the push rod 3, because the limit protrusion 6 has been inserted into the limit groove 103, the anchor 1 will rotate around the limit protrusion 6, so that the orientation of the tip of the anchor 1 occurs. Change.

一种肩袖损伤修复用锚钉系统的使用方法,包括如下步骤:A method for using an anchor system for rotator cuff injury repair, comprising the following steps:

(1)如图18所示,将直筒2插入肱骨头和肩峰之间的间隙;用推杆3推动锚钉1,直至限位凸起6滑进锚钉1的限位槽103中,如图19所示;继续推动推杆3,使锚钉1绕限位凸起6转动,直至锚钉1的尖端抵在肌腱上,如图20所示,此时,锚钉1的尖端的朝向是偏离直筒2插入肱骨头和肩峰之间的间隙的方向的。(1) As shown in Figure 18, insert the straight cylinder 2 into the gap between the humeral head and the acromion; push the anchor 1 with the push rod 3 until the limit protrusion 6 slides into the limit groove 103 of the anchor 1, as shown in As shown in Figure 19; continue to push the push rod 3 to make the anchor 1 rotate around the limiting protrusion 6 until the tip of the anchor 1 touches the tendon, as shown in Figure 20, at this time, the tip of the anchor 1 is facing It deviates from the direction in which the straight tube 2 is inserted into the gap between the humeral head and the acromion.

(2)用锤子敲打推杆3,使推杆3推着锚钉1,让锚钉1以偏离直筒2插入肱骨头和肩峰之间的间隙的方向刺穿肌腱并钉入肱骨头中,如图21-22所示。(2) Hit the push rod 3 with a hammer, so that the push rod 3 pushes the anchor 1, and let the anchor 1 pierce the tendon and drive it into the humeral head in a direction deviating from the straight tube 2 into the gap between the humeral head and the acromion, such as shown in Figures 21-22.

(3)撤出直筒2和推杆3,将锚钉1和缝合线4留在肱骨头上,如图23所示。(3) Withdraw the straight cylinder 2 and the push rod 3, and leave the anchor 1 and the suture 4 on the humeral head, as shown in Figure 23.

通过上述过程可知:Through the above process, we can know that:

在肱骨头和肩峰之间的间隙狭窄的情况下,因为限位凸起6的设置和锚钉1上限位槽103的设置,能够在使用推杆3推动锚钉1时,让锚钉1绕限位凸起6转动,使锚钉1能够以偏离直筒2插入肱骨头和肩峰之间的间隙的方向钉入肱骨头,使得锚钉1插入肱骨头的骨面的方向L2’和拉拔锚钉1的方向L1并非是平行的,而是有一定夹角a的。所以与背景技术中拉拔锚钉1的方向L1和锚钉1插入肱骨头的方向L2几乎是平行的相比,本实施例的一种肩袖损伤修复用锚钉系统,提高了锚钉1的抗拔出性能。In the case where the gap between the humeral head and the acromion is narrow, because of the setting of the limiting protrusion 6 and the setting of the upper limiting groove 103 of the anchor 1, when the push rod 3 is used to push the anchor 1, the anchor 1 can be wound around the anchor 1. The limiting protrusion 6 is rotated, so that the anchor 1 can be inserted into the humeral head in a direction deviating from the straight cylinder 2 into the gap between the humeral head and the acromion, so that the anchor 1 is inserted into the direction L2' of the bony surface of the humeral head and the anchor is pulled out. The direction L1 of the nail 1 is not parallel, but has a certain angle a. Therefore, compared with the direction L1 in which the anchor 1 is pulled out and the direction L2 in which the anchor 1 is inserted into the humeral head in the background art, which are almost parallel, the anchor system for repairing rotator cuff damage in this embodiment improves the performance of the anchor 1 pull-out resistance.

提高了锚钉1的抗拔出性能之后,能够增大锚钉1从肱骨头上拔出的难度,增大缝合线4将肌腱按压到肱骨头上的力量,让肌腱的附连部分能够紧密地贴靠在肱骨头上,促进肌腱的附连部分重新与肱骨头长合在一起。降低了锚钉1从肱骨头上拔出的风险,提高了手术成功率,从而降低了重新进行手术的几率,避免耽误患者的康复,节省医疗成本。After improving the pull-out resistance of the anchor 1, the difficulty of pulling the anchor 1 from the humeral head can be increased, and the force of the suture 4 to press the tendon to the humeral head can be increased, so that the attached part of the tendon can be tightly It rests on the humeral head, promoting the attachment of the tendon to re-grow with the humeral head. The risk of the anchor pin 1 being pulled out from the humeral head is reduced, and the success rate of the operation is improved, thereby reducing the probability of re-operation, avoiding delaying the recovery of the patient, and saving medical costs.

此外,因为本实施例2的一种肩袖损伤修复用锚钉系统,也能够削弱肩峰对锚钉1插入肱骨头方向的影响,即,在肱骨头和肩峰之间的间隙狭窄的情况下,仍然能够让锚钉1以偏离直筒2插入肱骨头和肩峰之间的间隙的方向拧入肱骨头,所以本实施例2的一种肩袖损伤修复用锚钉系统,也适用于冈上肌腱出现PASTA 损伤的情况。In addition, because of the anchor system for rotator cuff injury repair of the present embodiment 2, the influence of the acromion on the direction in which the anchor 1 is inserted into the humeral head can also be weakened, that is, in the case where the gap between the humeral head and the acromion is narrow , the anchor 1 can still be screwed into the humeral head in a direction that deviates from the straight cylinder 2 and is inserted into the gap between the humeral head and the acromion, so the anchor system for rotator cuff injury repair of the present embodiment 2 is also suitable for the supraspinatus tendon. A case of PASTA injury occurs.

实施例3:Example 3:

本实施例3与实施例2相同,不同之处在于,在本实施例3的一种肩袖损伤修复用锚钉系统中,穿线孔101设于锚钉1的尖端。The third embodiment is the same as the second embodiment, the difference is that in the anchor system for rotator cuff injury repair of the third embodiment, the threading hole 101 is provided at the tip of the anchor 1 .

当穿线孔101设于锚钉1的尖端时,在实施例2的步骤(2)和步骤(3)之间,还需要进行如下操作:在保持推杆3推动锚钉1的同时,向外拉拽缝合线4,使锚钉1以锚钉1和推杆3的接触位置为回转中心逆时针转动,从而使锚钉1的尖端朝直筒2抽出肱骨头和肩峰之间间隙的方向偏转,如图24所示。When the threading hole 101 is provided at the tip of the anchor 1, between steps (2) and (3) of Embodiment 2, the following operations are also required: while keeping the push rod 3 to push the anchor 1, outwards Pull the suture 4 to make the anchor 1 rotate counterclockwise with the contact position of the anchor 1 and the push rod 3 as the center of rotation, so that the tip of the anchor 1 is deflected toward the direction of the straight cylinder 2 to draw out the gap between the humeral head and the acromion, As shown in Figure 24.

通过上述过程可知:Through the above process, we can know that:

本实施例3能够在实施例2的基础上,通过让锚钉1的尖端朝直筒2抽出肱骨头和肩峰之间间隙的方向偏转,能够让锚钉1插入肱骨头的骨面的方向L2’与锚钉1的拉拔方向L1的夹角a进一步减小,从而进一步提高了肱骨头固定锚钉1的效果,更进一步提高了锚钉1的抗拔出性能。继而进一步促进肌腱的附连部分重新与肱骨头长合在一起,进一步提高了手术成功率,节省医疗成本。In the third embodiment, on the basis of the second embodiment, by deflecting the tip of the anchor 1 in the direction in which the straight cylinder 2 is drawn out of the gap between the humeral head and the acromion, the anchor 1 can be inserted into the bony surface of the humeral head in the direction L2' The included angle a with the pull-out direction L1 of the anchor 1 is further reduced, thereby further improving the effect of fixing the anchor 1 on the humeral head and further improving the pull-out resistance of the anchor 1 . Then, the attachment part of the tendon is further promoted to grow back together with the humeral head, which further improves the success rate of the operation and saves the medical cost.

显然,本领域的技术人员可以对本发明进行各种改动和变型而不脱离本发明的精神和范围。这样,倘若本发明的这些修改和变型属于本发明权利要求及其等同技术的范围之内,则本发明也意图包含这些改动和变型在内。It will be apparent to those skilled in the art that various modifications and variations can be made in the present invention without departing from the spirit and scope of the invention. Thus, provided that these modifications and variations of the present invention fall within the scope of the claims of the present invention and their equivalents, the present invention is also intended to include these modifications and variations.

Claims (2)

1. An anchoring nail system for repairing rotator cuff injury comprises an anchoring nail, a suture thread, a straight barrel and a push rod, wherein the anchoring nail used for being inserted into a humeral head is provided with a threading hole and a square hole, the threading hole is used for penetrating the suture thread, the square hole is used for being matched with one end of the push rod, and the push rod and the suture thread are both arranged in the straight barrel used for being inserted into a gap between the humeral head and a shoulder.
2. The anchor system for rotator cuff injury repair of claim 1, wherein said threadhole is provided at a tip end of said anchor.
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CA2587683A1 (en) * 2004-11-15 2006-05-26 Scandius Biomedical, Inc. Method and apparatus for the repair of a rotator cuff (rtc) tendon or ligament
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