Knotting method for connecting wire ring in wire anchor and wire anchor
Technical Field
The application relates to the field of medical instruments, in particular to a knotting method of a connecting wire ring in a wire anchor and the wire anchor.
Background
As the number of sports population grows, sports injuries also become more common. The most common sports injuries today involve tendons or ligaments. Tendons generally refer to the connection of muscles to bones, and mainly play a role in controlling skeletal movements. The ligament often refers to the connection between bones and mainly plays a role in the connection and fixation between bones. Repair of tendon and ligament injuries involves the use of repair implants to re-fix the damaged tissue. When repairing sports injuries, the most commonly used prosthetic implant in clinic is a band wire anchor. The suture anchors are implanted into the positions of the tendon or ligament bone attachment points, and then the tendon or ligament is sutured by using the sutures on the suture anchors, and finally the injured tendon or ligament is re-fixed, so that the functional recovery is realized.
The anchor body with the wire consists of an anchor body, a connecting line ring woven by long wires and a suture, the anchor body is connected with the suture through the connecting line ring, and then the suture is sewn with the damaged tendon to realize repair. Therefore, the body of the anchor with the wire is required to meet the requirement of mechanical strength firstly and the specification of microorganism indexes secondly.
In the prior art, the requirement of biomechanical strength of the belt line anchor body requires that glue is smeared at the connection position of the head end of the anchor body and the connecting line ring to ensure the mechanical strength, but the glue smearing mode can cause rejection reaction of partial patients, so that the belt line anchor body has biocompatibility risk.
Disclosure of Invention
In order to improve the situation of rejection reaction of patients as much as possible under the condition of meeting the requirement of biomechanical strength of the band wire anchor, so as to reduce the risk of biocompatibility of the band wire anchor, the application provides a knotting method of a connecting wire ring in the band wire anchor.
The application provides a knotting method of a connecting wire loop in a belt line anchor, which adopts the following technical scheme:
the knotting method of the connecting wire loop in the belted line anchor comprises the following steps:
Step 1, selecting a long wire made of an ultra-high molecular polyethylene material, wherein two ends of the long wire are respectively provided with a braiding end A and a braiding end B, the braiding end A is wound on the braiding end A to form a first coil, and the braiding end B penetrates through the first coil to form a second coil;
step 2, tensioning the braiding end A to enable the first coil to be tightened to form a first knot, enabling the second coil to form a first loop, and enabling the braiding end B to slide in the first knot;
step 3, a node, opposite to the first thread, in the first thread ring is penetrated out from the tail of the anchor body after extending into the threading through hole from the head of the anchor body, and one end of the suture thread penetrates through the first thread ring positioned at the tail of the anchor body;
Step 4, winding a ring section of the first wire loop, which is close to the braiding end B, around the braiding end B and winding the ring section of the first wire loop, which is close to the braiding end B, and then winding the ring section of the first wire loop, which is close to the braiding end B, and forming a third coil;
step 5, tensioning the braiding end B to enable the third coil to be tightened to form a second knot, and forming an adjusting loop between the first knot and the second knot;
step 6, cutting off redundant long line segments at the tail ends of the first line knot and the second line knot;
And 7, pulling the suture line in a direction deviating from the first wire loop until the first wire knot and the second wire knot are positioned in the wire clamping hole and abut against the bottom of the wire clamping hole.
By adopting the technical scheme, when the tendon or the ligament is sutured, the suture lines tighten the first thread ring along the direction close to the bottom of the anchor body, so that the first thread knot and the second thread knot move along the direction close to each other, the adjusting thread ring is smaller, the first thread ring is larger, the first thread knot and the second thread knot are mutually abutted to enable the first thread knot and the second thread knot to be suspended in the thread clamping hole at the same time, the first thread knot and the second thread knot cannot be separated from the anchor body due to the action of external force, and the biomechanics requirement is met;
And compared with the fixing mode of glue application, the risk of biocompatibility is avoided by knotting the wire loop. Greatly reduces the possibility of rejection reaction of the patient body to the product, and is beneficial to postoperative rehabilitation of the patient. Secondly, only the knotted line ring is used for suspending the suture on the anchor body, additional raw materials such as glue are not needed, the manufacturing cost is reduced, and meanwhile, the steps of smearing glue on the head end of the anchor body and hot pressing are saved, so that the production difficulty is reduced.
Preferably, the knitting end a presses the long wire segment near the knitting end a to form a first knitting loop, and then the knitting end a bypasses the long wire segment near the knitting end a and passes through the first knitting loop to form a first loop.
Through adopting above-mentioned technical scheme, weave like this and hold B and pass first coil after, can realize weaving the gliding effect of end B in first coil after the first coil tightens up to the size of first wire loop of adjustment, first line knot is difficult for pine simultaneously.
Preferably, the braiding end B passes through the first wire loop and presses the long wire segment near the braiding end B to form a second braiding loop, and then the braiding end B bypasses the long wire segment near the braiding end B and passes through the second braiding loop to form a third braiding loop.
Through adopting above-mentioned technical scheme, the third coil of weaving like this is difficult for the pine of second knot after tightening into the second knot, can adjust the size of the regulation wire loop that is located between first knot and the second knot simultaneously to adjust the distance between first knot and the second knot, make the knot receive external force to pull the back, can realize that the distance between first knot and the second knot is progressively smaller, the knot becomes tighter effect more.
Preferably, the loop segments of the first loop located at two sides of the first knot are a first loop segment and a second loop segment, the first loop segment is connected with the knitting end A, the second loop segment is connected with the knitting end B and slides into or out of the first knot along with the knitting end B, and the second knot is located on the first loop segment.
Through adopting above-mentioned technical scheme, only the second line knot is located on the first ring section, and the second line knot can slide on the first ring section to the realization is to the effect of adjusting the size of regulation wire loop.
Preferably, after one end of the suture passes through the first loop, the braided end B is pulled in a direction away from the anchor body, adjusting the first loop to a desired length.
Through adopting above-mentioned technical scheme, the length of first wire loop should not be overlength, and first wire loop is whole to be located the inside effect of anchor body best, and the suture can not contact with tendon or ligament when sewing up tendon or ligament like this to avoid leading to patient organism secondary damage's phenomenon to take place because first wire loop rocks during suture.
Preferably, the first thread loop passes through the threading through hole through the threading tool, one end of the threading tool penetrates into the anchor body from the tail part of the anchor body and penetrates out from the head part of the anchor body, and one end of the threading tool penetrating through the head part of the anchor body is connected with the first thread loop and pulls the first thread loop along the direction close to the tail part of the anchor body until the first thread loop penetrates through the threading through hole to be connected with the suture.
Through adopting above-mentioned technical scheme, first line annular form is out of shape along with the exogenic action easily, and threading through-hole length is longer, and first line ring penetrates the threading through-hole degree of difficulty higher, consequently, in order to make things convenient for first line ring to pass the threading through-hole, adopt the wire tool to stretch into the threading through-hole by anchor body afterbody and stretch out from anchor body head, so that wire tool and first line knot are connected, drag first line ring through wire tool along the direction that is close to anchor body afterbody, direction the direction of movement of first line ring, so that first line ring penetrates the threading through-hole, thereby reduce the connection degree of difficulty of line knot and suture.
Preferably, the threading tool comprises a threading long rope capable of bending deformation, two ends of the threading long rope are respectively provided with a rope end A and a rope end B, the rope end A penetrates from the tail part of the anchor body through a threading through hole and penetrates out of the head part of the anchor body, then the rope end A penetrates through a first wire ring, then the rope end A penetrates from the head part of the anchor body and penetrates out of the tail part of the anchor body, the rope end A and the rope end B are positioned on the same side of the anchor body, and then the rope end A and the rope end B are simultaneously pulled along the direction deviating from the anchor body until the first wire ring penetrates through the threading through hole.
Through adopting above-mentioned technical scheme, because the long rope of line is soft and easy to deform, be convenient for pass threading through-hole and first wire loop on the one hand and crooked back through the threading through-hole, reduce the degree of difficulty for follow-up traction first wire loop. On the other hand, when the threading long rope moves in the threading through hole, the threading long rope is soft, so that the risk of scratch on the wall of the threading through hole is reduced, and the integrity of the anchor body and the line knot is kept as much as possible.
Preferably, whether the knotting mode of the connecting wire loop is correct is checked, namely the first wire knot and the second wire knot are pulled along the direction deviating from each other, the first wire knot and the second wire knot can slide along the direction deviating from each other, the adjusting wire loop is enlarged, and the knotting mode of the connecting wire loop is correct.
By adopting the technical scheme, the situation that the knot is easy to have a braiding error when braiding is performed, if the knot is braided in error, the strength of the knot can be influenced, and the risk that the knot is separated from an anchor can be increased. In order to find out whether the knotting mode of the knot is correct in time, after the knot is finished, the first knot and the second knot are pulled along the direction away from each other, the distance between the first knot and the second knot is increased, and then the knotting mode of the connecting loop is correct.
Preferably, the tie wire comprises a tie wire ring woven by a tie wire ring knotting method in a tie wire anchor, and further comprises an anchor body connected with the tie wire ring, wherein the anchor body is made of PEEK or HA-PEEK materials.
Through the technical scheme, the anchor body made of PEEK or HA-PEEK material can improve the biocompatibility of the anchor body while guaranteeing the structural strength of the anchor body.
In summary, the present application includes at least one of the following beneficial technical effects:
1. When the tendon or the ligament is sutured, the suture tightens the first thread ring along the direction close to the bottom of the anchor body, so that the first thread knot and the second thread knot move along the direction close to each other, the adjusting thread ring is smaller, the first thread ring is larger, the fixed knot is tighter and tighter under the action of external force, and the whole sizes of the first thread knot and the second thread knot can be suspended in the thread clamping hole, so that the first thread knot and the second thread knot cannot be separated from the anchor body under the action of external force, and the biomechanical requirement is met;
2. after the knot is tightened, the effect that the knitting end B slides in the first knot can be achieved, so that the size of the first loop can be adjusted conveniently, and meanwhile, the first knot is not easy to loosen;
3. after the third coil is tightened into the second knot, the second knot is not easy to loosen and can adjust the distance between the first knot and the second knot, so that the effect that the distance between the first knot and the second knot is smaller and the fixed knot is tighter can be achieved after the knot is pulled by external force.
Drawings
Fig. 1 is a schematic view of the external structure of a belted anchor according to the present application.
Fig. 2 is a schematic view of the internal structure of a belted anchor according to the present application.
FIG. 3 is a schematic representation of the knitting pattern of a first knot in an embodiment of the application.
Fig. 4 is a schematic diagram of a first wire knot and a position of a first wire loop in an embodiment of the application.
Fig. 5 is a schematic diagram showing the connection of the long rope and the first wire loop in the embodiment of the present application.
Fig. 6 is a schematic illustration of the attachment of a first wire loop to a suture in an embodiment of the present application.
FIG. 7 is a schematic diagram of a second knot knitting mode in an embodiment of the application.
FIG. 8 is a schematic diagram of the placement of a first knot and a second knot in an embodiment of the application.
In the figure, 1, an anchor body, 11, a threading through hole, 12, a wire clamping hole, 2, a connecting wire loop, 21, a fixed knot, 22, a wiring ring, 3, a suture, 4, a long wire, 41, a knitting end A, 42, a knitting end B, 43, a first coil, 44, a second coil, 45, a third coil, 5, a first wire knot, 6, a first wire loop, 61, a first ring section, 62, a second ring section, 7, a second wire knot, 8, an adjusting wire loop, 9, a wire passing long rope, 91, a rope end A, 92 and a rope end B.
Detailed Description
The application is described in further detail below with reference to fig. 1-8.
Referring to fig. 1 and 2, the band wire anchor comprises an anchor body 1, a connecting wire loop 2 and a suture 3.
Wherein, the inside threading through-hole 11 of laying along self axis direction of seting up of anchor body 1, threading through-hole 11 intercommunication anchor body 1 head and anchor body 1 afterbody, anchor body 1 head set up with the coaxial line hole 12 of intercommunication of threading through-hole 11, the diameter of line hole 12 is greater than threading through-hole 11.
In addition, the wire loop 2 includes a fixing knot 21 and a connection ring 22, and the fixing knot 21 and the connection ring 22 are formed by knitting one long wire 4. The fixing knot 21 is positioned in the thread clamping hole 12 and is abutted with the bottom of the thread clamping hole 12 so as to prevent the fixing knot 21 from entering the threading through hole 11 as much as possible. The wire loop 22 is located in the through hole 11. The suture 3 is threaded into the threading through hole 11 from the tail of the anchor body 1 and is connected with the wiring ring 22.
When the suture 3 is used for suturing tendons or ligaments, the suture 3 tightens the wire connecting ring 22 along the direction close to the tail of the anchor body 1, so that the fixing knot 21 is driven to abut against the hole bottom of the wire clamping hole 12, the position of the fixing knot 21 is limited through the wire clamping hole 12, the probability that the fixing knot 21 is separated from the anchor body 1 is further reduced, and the connection strength of the anchor body 1 and the wire connecting ring 2 is enhanced.
The embodiment of the application discloses a knotting method for a connecting wire loop in a belt wire anchor. The method specifically comprises the following steps:
step 1;
referring to fig. 3, the long wire 4 has a braiding end a41 and a braiding end B42 at both ends, the braiding end a41 being wound on itself to form a first coil 43, and the braiding end B42 passing through the first coil 43 to form a second coil 44.
Step 2;
referring to fig. 4, tightening the braided end a41 causes the first coil 43 to tighten to form the first knot 5, and the second coil 44 to form the first loop 6, the braided end B42 being slidable within the first knot 5;
As shown in fig. 3, the first coil 43 is knitted in such a manner that the knitting end a41 presses the long wire 4 segment near the knitting end a41 to form a first knitted coil, and then the knitting end a41 passes around the long wire 4 segment near the knitting end a41 and through the first knitted coil to form the first coil 43;
After the first stitch 5 is formed, the knitting end B42 slides in the first stitch 5 under the action of external force, so that the first stitch 5 is not easy to fall down, and the firmness of the first stitch 5 is improved.
Step 3;
referring to fig. 5 and 6, the node of the first thread loop 6 opposite to the first thread knot 5 is penetrated out from the tail of the anchor body 1 after extending into the threading through hole 11 from the head of the anchor body 1, so that the first thread loop 6 is a thread connection loop 22, and one end of the suture 3 penetrates through the first thread loop 6 positioned at the tail of the anchor body 1;
The shape of the first wire loop 6 is easy to deform along with the action of external force, the length of the threading through hole 11 is longer, the difficulty in penetrating the threading through hole 11 by the first wire loop 6 is higher, and in order to facilitate the connection between the first wire loop 6 and the suture 3, a threading tool is needed to facilitate the first wire loop 6 to penetrate the threading through hole 11. The wire passing tool can select a wire passing long rope 9 which can be bent and deformed;
The two ends of the threading long rope 9 are a rope end A91 and a rope end B92 respectively, the rope end A91 penetrates into the threading through hole 11 from the tail part of the anchor body 1 and penetrates out from the head part of the anchor body 1, then the rope end A91 penetrates through the first thread loop 6, then the rope end A91 penetrates into the head part of the anchor body 1 and penetrates out from the tail part of the anchor body 1, the rope end A91 and the rope end B92 are positioned at the tail part of the anchor body 1, and then the rope end A91 and the rope end B92 are simultaneously pulled along the direction deviating from the anchor body 1 until the first thread loop 6 penetrates through the threading through hole 11;
One end of the suture 3 passes through the first loop 6 at the tail of the anchor body 1, thereby achieving the connection of the first loop 6 and the suture 3. The threading long rope 9 is soft, and can reduce the risk of scratches on the wall of the threading through hole 11 while guiding the first thread loop 6 to pass through the threading through hole 11, so that the integrity of the anchor body 1 is maintained as much as possible.
Step 4;
Referring to fig. 2 and 6, after the suture 3 is connected to the first loop 6, the first loop 6 is still located at the tail of the anchor body 1, and when the suture 3 is used for suturing tendons or ligaments, the first loop 6 can shake to contact with the tendons or ligaments, so that the probability of secondary damage of the body of the patient is increased. Therefore, the length of the first wire loop 6 should not be too long, and the effect that the first wire loop 6 is located entirely inside the anchor body 1 is best;
Thus, after one end of the suture 3 passes through the first loop 6, the braided end B42 is pulled in a direction away from the head of the anchor body 1, and the first loop 6 is gradually retracted into the anchor body 1 until the desired length of the first loop 6.
After the first loop 6 is adjusted, the size of the first loop 6 needs to be limited, and the knitting end B42 is still in a condition that the first loop 5 can slide at will, so that the knitting end B42 is easy to separate from the first loop 5 under the action of external force, and the loop 2 and the suture 3 are separated. Therefore, the braid end B42 needs to be restrained.
Step 5;
Referring to fig. 7, the braiding end B42 passes through the first thread loop 6 and presses the long thread 4 segment adjacent to the braiding end B42 to form a second braiding loop, after which the braiding end B42 bypasses the long thread 4 segment adjacent to the braiding end B42 and passes through the second braiding loop to form a third loop 45, and the loop segment of the first thread loop 6 adjacent to the braiding end B42 is located in the third loop 45;
the loop segments of the first loop 6 on both sides of the first knot 5 are a first loop segment 61 and a second loop segment 62, the first loop segment 61 is connected with the braiding end a41, the second loop segment 62 is connected with the braiding end B42 to slide in or out of the first knot 5 along with the braiding end B42, and the second knot 7 is located on the first loop segment 61.
Step 6;
Referring to fig. 2 and 8, pulling on braided end B42 causes third stitch 45 to tighten to form second knot 7, forming adjustment loop 8 between first knot 5 and second knot 7;
The third stitch 45 thus knitted is not liable to fall off the second knot 7 after being gathered into the second knot 7, and at the same time, the size of the adjusting thread loop 8 located between the first knot 5 and the second knot 7 can be adjusted, thereby adjusting the distance between the first knot 5 and the second knot 7. The first knot 5 and the second knot 7 form a fixed knot 21 together, and after being pulled by external force, the distance between the first knot 5 and the second knot 7 can be reduced, so that the effect that the fixed knot 21 is tightened is achieved.
Step 7;
the redundant long wire 4 segments at the tail ends of the first knot 5 and the second knot 7 are cut off, so that the long wire 4 in the human body is reduced, the probability of contact between the long wire 4 and tendons or ligaments is reduced, and the patient can recover later conveniently.
Step 8;
pulling the suture 3 in a direction away from the first loop 6, the first knot 5 and the second knot 7 being located in the suture hole 12 and abutting against the bottom of the suture hole 12;
If the wire loop 2 is woven in error, the strength of the wire loop 2 is affected and the risk of the wire loop 2 being separated from the anchor body 1 is increased. Therefore, a method for judging whether the knot of the wire loop 2 is correct is required;
If the connecting wire loop 2 is tied in the correct way, the first and second wire loops 5, 7 are pulled in a direction away from each other, the adjusting wire loop 8 can be made larger and the first wire loop 6 can be made smaller.
When the tendon or ligament is stitched, the suture 3 tightens the first thread loop 6 along the direction close to the bottom of the anchor body 1, so that the first thread loop 5 and the second thread loop 7 move along the direction close to each other, the adjusting thread loop 8 becomes smaller, the first thread loop 6 becomes larger, the connecting thread loop 2 becomes tighter under the action of external force, and the size of the thread loop can be suspended in the thread clamping hole 12, so that the thread loop cannot be separated from the anchor body 1 under the action of external force.
In order to enable the long thread 4 used for braiding the suture 3 and the connecting wire loop 2 to meet the mechanical requirement, the long thread 4 and the suture 3 are both made of ultra-high molecular polyethylene materials. The anchor body 1 is made of PEEK or HA-PEEK material, so that the biocompatibility of the suture anchor is improved.
The braided wire loop 2 meets biomechanics requirements in the aspect of carrying the pulling strength of external force, and meanwhile, compared with the traditional wire loop connecting method of wire knot and glue, the application has the following advantages:
Firstly, the application adopts the method of knotting the wire loop to be connected with the anchor body 1, avoids the risk of biocompatibility, greatly reduces the possibility of rejection reaction of a patient body to products, and is beneficial to postoperative rehabilitation of the patient;
Secondly, the tensile strength of the line knot in the horizontal direction in the prior art is lower, deformation is easy to generate, and then the line knot is pulled into the threading through hole, so that the anchor with the line is invalid, and glue is required to be smeared to fix the line knot. The connecting wire ring 2 woven by the knotting method can suspend the suture 3 on the anchor body 1, the tensile strength of the integral wire knot formed by the first wire knot 5 and the second wire knot 7 in the horizontal direction is higher in the suture pulling process, the deformation in the horizontal direction is not easy to occur, and the raw materials such as extra glue are not needed, so that the manufacturing cost is reduced;
Thirdly, glue is coated at the head end of the anchor nail, and hot pressing is needed to be carried out on the glue so as to facilitate drying the glue.
The implementation principle of the knotting method for the connecting wire ring in the strip line anchor is that when tendon or ligament is stitched, the suture 3 tightens the first wire ring 6 along the direction close to the bottom of the anchor body 1, so that the first wire ring 5 and the second wire ring 7 move along the direction close to each other, the adjusting wire ring 8 becomes smaller, the first wire ring 6 becomes larger, the connecting wire ring 2 becomes tighter under the action of external force, the connecting wire ring 2 can be suspended in the wire clamping hole 12, the connecting wire ring 2 cannot be separated from the anchor body 1 due to the action of external force, the requirement of biomechanics is met, and the situation of rejection reaction of a patient is improved as much as possible under the requirement of biomechanics of the strip line anchor is finally met, so that the risk of biocompatibility of the strip line anchor is reduced.
The above embodiments are not intended to limit the scope of the application, so that the equivalent changes of the structure, shape and principle of the application are covered by the scope of the application.