Novel matters of the invention
In view of the foregoing, it is desirable to provide a fixing device for a tibial dead center avulsion fracture of a posterior cruciate ligament, which is used for solving the problem that the existing arthroscopic dead center fracture repair operation requires the use of suture lines during fixation, resulting in difficult operation.
The invention provides a posterior cruciate ligament tibia dead center avulsion fracture fixing device, which comprises:
The guide rod is used for penetrating through the tibia and the fracture block;
The clamping ring is detachably sleeved at one end of the guide rod and used for propping against one end of the fracture setting folding block, which is away from the tibia;
The clamping part is connected to one end of the guide rod in a sliding way along the radial direction of the guide rod, and can be used for allowing the clamping ring to slide when the clamping part slides to be embedded into the guide rod;
and the tightening part is detachably connected to the other end of the guide rod along the extending direction of the guide rod and is used for clamping the tibia and the fracture block together with the clamping ring.
Preferably, the clamping part is slidably inserted into the outer circumferential surface of the guide rod along the radial direction of the guide rod, the end part of the clamping part, which is away from the guide rod, forms a chamfer, and the direction of the chamfer is away from the guide rod and the fracture block at the same time.
Preferably, the clamping portion is cylindrical, the axis of the clamping portion extends along the radial direction of the guide rod, one end of the clamping portion is inserted into the guide rod, and the chamfer is formed at the other end of the clamping portion.
Preferably, the guide rod further comprises a spring, a slot into which the clamping part is inserted is formed in the peripheral surface of one end of the guide rod, the spring is arranged in the slot, and two ends of the spring are respectively connected with the guide rod and the clamping part.
Preferably, the number of the clamping parts is at least two, and the at least two clamping parts are arranged around the peripheral surface of the guide rod in an equiangular manner.
Preferably, the periphery of the other end of the guide rod is provided with threads, the tightening part is a nut, and the tightening part is sleeved on the guide rod and is in threaded connection with the guide rod.
Preferably, the device further comprises a Kirschner wire, and the guide rod is provided with a through hole for the Kirschner wire to pass through along the axis of the guide rod.
Preferably, the outer peripheral surface of the snap ring is formed by encircling two arc-shaped surfaces and two planes, and the two planes are parallel.
Preferably, the clamp further comprises a mounting clamp, wherein the mounting clamp comprises two foldable clamp arms, clamping grooves are formed in opposite sides of the two clamp arms, and the clamping grooves are respectively used for clamping two planes on the clamping ring so as to clamp the clamping ring.
The invention also provides a using method of the posterior cruciate ligament tibia dead center avulsion fracture fixing device, which comprises the following steps:
step 1, implanting the guide rod from the front of the tibia and penetrating through a fracture block;
Step2, sleeving the clamping ring on the guide rod from a knee joint rear side access way, and clamping the clamping ring between the clamping part and the fracture block;
And 3, installing the tightening part at the other end of the guide rod, so that the tightening part and the clamping ring clamp and fix the tibia and the fracture block.
The invention provides a fixing device for avulsion fracture of a posterior cruciate ligament tibia dead center and a use method thereof, when in use, a guide rod simultaneously passes through tibia and a fracture block from the front side of tibia, and then the clamping ring is sleeved on the guide rod between the clamping part and the fracture block from the rear side access way of the knee joint, and the tightening part and the clamping ring clamp the tibia and the fracture block through the tightening part, so that the fixation of the tibia and the fracture block is realized.
Compared with the prior art, the invention omits structures such as suture lines, belt loop steel plates and the like, and skillfully realizes more stable and rigid fixation through the tightening part and the clamping ring. Most importantly, the clasp is only required to extend into the suture from the posterior approach of the tibia during operation, and the tightening part can be fixed from the anterior side with less tissue around the tibia, so that the whole arthroscopic operation does not need to build a double tibial channel, the operation channel does not pass through the popliteal vascular nerve tissue, the characteristics of full-scope minimally invasive are achieved, and the traditional operations of repeated threading, winding, binding and the like are omitted in the operation process, so that the operation under the arthroscope is more convenient, simpler and easier.
Detailed Description
The following detailed description of the novel preferred embodiments of the application is made in connection with the accompanying drawings, which form a part hereof, and together with the description of the novel principles of the application, are shown by way of illustration, and not limitation, of the novel scope of the application.
Referring to fig. 1 to 5, the present invention provides an embodiment of a device for fixing a avulsion fracture of a tibial dead center of a posterior cruciate ligament, which includes a guide rod 1, a clasp 2, a clamping portion 3, and a tightening portion 4. The guide rod 1 is used for penetrating through the tibia and the fracture block, and the clamping ring 2 is movably sleeved at one end of the guide rod 1, namely, at one side of the fracture block away from the tibia and used for propping against the fracture block. The clamping part 3 is connected to the peripheral surface of one end of the guide rod 1, and abuts against the end surface of the clamping ring 2, which is away from the fracture block, and the clamping part 3 and the guide rod 1 are movably connected so that the clamping ring 2 can be sleeved on the guide rod 1 from one end of the guide rod 1 beyond the clamping part 3. The tightening part 4 is movably connected to the other end of the guide rod 1 along the extending direction of the guide rod 1, namely, is positioned at one side of the tibia away from the fracture block and is used for abutting the tibia, and the clamping part 3 is driven to compress the clamping ring 2 on the fracture block to complete fixation.
The invention provides a device for fixing avulsion fracture of a posterior cruciate ligament tibia dead center and a use method, wherein a guide rod 1 simultaneously passes through tibia and a fracture block from the front side of the tibia when in use, a clamping ring 2 is sleeved on the guide rod 1 between a clamping part 3 and the fracture block from a rear side approach of a knee joint, and the tightening part 4 and the clamping ring 2 clamp the tibia and the fracture block through a tightening part 4, so that the fixation of the tibia and the fracture block is realized.
It is to be understood that the tibia of the present invention refers to the tibial body, and the fracture block refers to a portion of the posterior cruciate ligament that is disconnected from the tibial body and connected to the posterior cruciate ligament, as well as the posterior approach of the knee, are all prior concepts and are common knowledge in the relevant arts, and will not be described in detail herein.
The above components will be described in more detail below:
As a preferred embodiment, the guide bar 1 of this embodiment is made of an inert metal material and has a length of 60mm. The both ends of guide bar 1 are head end and tail end respectively, and after guide bar 1 passed shin bone and fracture piece, lie in the fracture piece and deviate from the one side of shin bone and be the head end, the one end that the preceding guide bar 1 deviates from the fracture piece is located the shin bone and deviate from the one end of fracture piece and be the tail end, the one end that the preceding guide bar 1 deviates from the shin bone is located.
The outer circumferential surface of the tail end of the guide rod 1 is threaded for connecting the tightening part 4. The guide bar 1 is of hollow construction, i.e. its interior is provided with a through hole of 2.2mm diameter along its axis for the passage of a k-wire 6, which will be mentioned later.
As a preferred embodiment, the outer circumferential surface of the snap ring 2 in this embodiment is formed by two arcuate surfaces 21 and two flat surfaces 22, and the two flat surfaces 22 are parallel. So that the outer circle of the clamping ring 2 forms a waist shape with two straight sides, and two planes 22 on the peripheral surface of the clamping ring 2 and the end surface of the clamping ring 2 are arranged at an angle, preferably at a right angle. The two planes 22 facilitate the clamping of the clamping ring 2 by the mounting pliers 7, which will be mentioned later, so that the clamping ring 2 is more stable when extending into the rear side passage and being sleeved on the guide rod 1.
As a preferred embodiment, the clamping part 3 in the present embodiment is slidably inserted into the outer circumferential surface of the guide rod 1 along the radial direction of the guide rod 1, and the end of the clamping part 3 facing away from the guide rod 1 forms a chamfer 31, and the direction of the chamfer 31 faces away from both the guide rod 1 and the fracture block.
Like this, when guide bar 1 inserts from the tibia anterior side, joint portion 3 can utilize chamfer 31 to retract, and then makes things convenient for whole guide bar 1 to pass, simultaneously, when installing snap ring 2, chamfer 31 also can be when it contacts snap ring 2 can be said, and then allows snap ring 2 to cross joint portion 3 and advance.
Specifically, the clamping portion 3 in this embodiment is cylindrical, the axis of the clamping portion 3 extends along the radial direction of the guide rod 1, one end of the clamping portion 3 is inserted into the guide rod 1, and the chamfer 31 is formed at the other end of the clamping portion 3. In addition, the number of the clamping parts 3 in the embodiment is four, and the four clamping parts 3 are equiangularly arranged around the circumferential surface of the guide rod 1 for improving the stability when the snap ring 2 is fixed.
It is easy to understand that in practice, the number of the clamping portions 3 can be changed according to specific situations, and two or more than two of the clamping portions can achieve a relatively stable effect. Further, the clamping portion 3 may have other shapes than a cylindrical shape, such as a prismatic shape or other special shapes.
As a preferred embodiment, the fixing device for avulsion fracture of the posterior cruciate ligament tibia dead center in this embodiment further includes a spring 5, a slot into which the clamping portion 3 is inserted is formed on the circumferential surface of the end of the guide rod 1 located at one side of the fracture block facing away from the tibia, the spring 5 is disposed in the slot, and two ends of the spring 5 are respectively connected with the guide rod 1 and the clamping portion 3. The spring 5 is used for driving the clamping part 3 to reset, and when the clamping ring 2 is installed, the retracted clamping part 3 stretches out again, so that the clamping ring 2 is prevented from exiting the guide rod 1.
It will be appreciated that the spring 5 is merely an example of a preferred embodiment for resetting the engaging portion 3, and that in practice, other segments may be used to achieve the resetting, for example, the spring 5 may be replaced by an elastic rubber pad or an elastic member made of other materials, which may achieve the same effect. Further, instead of providing the spring 5, the clamping portion 3 itself may be changed to an elastic structure, for example, a fastening structure in an existing eye-splice may be used as the clamping portion 3, and when the snap ring 2 is sleeved, the clamping portion 3 may be slightly deformed to allow the snap ring 2 to pass over.
As a preferred embodiment, the tightening part 4 in this embodiment is a nut, and the tightening part 4 is sleeved at one end of the guide rod 1 facing away from the tibia and is matched with threads on the peripheral surface thereof to realize threaded connection. And through the precession of the tightening part 4, the guide rod 1 can be driven to drive the clamping part 3 and the clamping ring 2 to move towards the direction close to the tightening part 4, so that the tightening part 4 and the clamping ring 2 are tightened, and the fixing operation is completed.
It should be noted that, in practice, according to different situations, the tightening part 4 may have other structures, for example, the tightening part 4 is a plug pin, the guide rod 1 is provided with a plurality of jacks perpendicular to the axis of the guide rod 1, the plug pin is inserted into the jacks to realize fixation, and the plurality of jacks are equidistantly arranged along the extending direction of the guide rod 1 to adapt to different sizes.
As a preferred embodiment, the posterior cruciate ligament tibia dead center avulsion fracture fixing device in the embodiment further comprises a Kirschner wire 6, wherein the Kirschner wire 6 is a commonly used internal fixing material for orthopaedics, the original specification is generally fixed at about twenty centimeters, and the diameters of the internal fixing material are different from each other between 0.5 and 2 millimeters. The fracture fixation device is used for fixing short and small fracture or avulsion fracture and other fracture fixation with low stress, and is also commonly used for fixing temporary fracture blocks in orthopedic operation.
In this embodiment, before the guide rod 1 is inserted, the k-wire 6 may be used to perform positioning and pre-drilling, and after the hole diameter is enlarged, the guide rod 1 may be sleeved on the k-wire 6 by using its through hole, and may be extended into the tibia and the fracture block along the guide of the k-wire 6. The kirschner wire 6 can be withdrawn after the guide rod 1 is fixed. Of course, in practice, other methods are possible, such as drilling before the guide rod 1 is implanted.
As a preferred embodiment, the present embodiment further includes a mounting clamp 7, where the mounting clamp 7 includes two foldable clamp arms 71, and two opposite sides of the two clamp arms 71 are provided with clamping grooves 72 for respectively clamping the two planes 22 on the snap ring 2 so as to clamp the snap ring 2. The clamping groove 72 has sharp corners formed therein, which conform to the shape of the collar 2 near the flat surface 22 to more stably clamp the collar 2 and prevent the collar 2 from sliding during implantation. Other structures in the mounting clip 7, such as handles for driving the movement of the clip arms 71, may be any known technique and will not be described in detail herein.
The invention also provides a using method of the posterior cruciate ligament tibia dead center avulsion fracture fixing device, which comprises the following steps:
step 1, implanting a guide rod 1 from the front of tibia and penetrating through a fracture block;
step 2, sleeving the clamping ring 2 on the guide rod 1 from a knee joint rear side approach, and clamping the clamping ring between the clamping part 3 and the fracture block;
and 3, installing the tightening part 4 at one end of the guide rod 1, which is far away from the tibia, so that the tightening part 4 and the clamping ring 2 clamp and fix the tibia and the fracture block.
It can be seen that the posterior cruciate ligament tibia dead center avulsion fracture fixing device does not need complex threading and binding wire operation, and is simpler and more convenient to fix.
Specifically, in combination with all the foregoing embodiments, the specific usage method of this embodiment is as follows:
1. revealing the dead point of the posterior cruciate ligament and the boundary of the fracture block.
2. The center of the fractured mass was positioned using a conventional posterior cruciate ligament positioner.
3. A k-wire 6 is implanted from the front of the tibia.
4. The bone tunnel was enlarged using a 5.5mm drill bit.
5. The guide rod 1 is implanted until the clamping part 3 completely penetrates out of the fracture block.
6. The clamp ring 2 is inserted into the knee joint from the rear side of the knee joint by using the mounting clamp 7 and is sleeved on the guide rod 1 beyond the clamping part 3.
7. The guiding rod 1 is pulled reversely to the reduction and fixation of the fracture block.
8. The tightening part 4 is connected to the guide rod 1 at the anterior tibial opening, and the tightening part 4 is fixed to the cortex at the tibial opening.
The invention provides a device for fixing avulsion fracture of a posterior cruciate ligament tibia dead center and a use method, wherein a guide rod 1 simultaneously passes through tibia and a fracture block from the front side of the tibia when in use, a clamping ring 2 is sleeved on the guide rod 1 between a clamping part 3 and the fracture block from a rear side approach of a knee joint, and the tightening part 4 and the clamping ring 2 clamp the tibia and the fracture block through a tightening part 4, so that the fixation of the tibia and the fracture block is realized.
Compared with the prior art, the invention omits structures such as suture lines, belt loop steel plates and the like, and skillfully realizes more stable and rigid fixation through the tightening part 4 and the clamping ring 2. Most importantly, the clasp 2 only needs to be stretched into from the rear side of the tibia during operation, and the tightening part 4 can be fixed from the front side with less peripheral tissues of the tibia, so that the whole arthroscopic operation does not need to build a double tibial channel, the operation channel does not pass through the popliteal vascular nerve tissue, the characteristics of full-scope minimally invasive are achieved, the traditional repeated threading, winding, binding and other operations are omitted in the operation process, the arthroscopic operation is more convenient, simpler and easier, and the arthroscopic operation has good application prospect.
In this specification, each embodiment is described in a progressive manner, and each embodiment is mainly described in a different point from other embodiments, so that the same or similar parts between the embodiments are referred to each other.
The above-mentioned embodiments are only preferred embodiments of the present invention, but the scope of the present invention is not limited thereto, and any changes or substitutions easily contemplated by those skilled in the art within the scope of the present invention should be covered by the scope of the present invention.