CN209107727U - Radius far-end fracture reset is fixed to integration brace - Google Patents

Abstract

The utility model discloses an integrated support for reduction and fixation of distal radius fractures. After the manual reduction of the distal radius fracture is completed, the dorsal palm splint can be quickly installed, and the pressure pad can be used to maintain the reduction and continue to correct the displacement. More importantly, the ligament restoration formed by finger traction, wrist fractures can be It can achieve automatic reduction, and can well maintain the height of the distal radius articular surface. On the basis of maintaining the reduction, it allows the joints of the hand and wrist to perform functional exercises, promotes swelling, and preserves the patient's hand and wrist functions as much as possible. The rehabilitation effect is ensured, and at the same time, the utility model is also suitable for the treatment of multiple metacarpal fractures, special types of metacarpal fractures, ulna impingement syndrome and radiocarpal arthritis.

Description

Integrated Brace for Reduction and Fixation of Distal Radius Fractures

technical field

The utility model relates to the field of medical equipment, in particular to an integrated support for reduction and fixation of distal radius fractures.

Background technique

Fractures of the distal radius are common clinically and account for the highest proportion of emergency fracture patients in orthopaedics. 17% of women over the age of 50 will have distal radius fractures, which are mainly related to the susceptibility of postmenopausal women to osteoporosis. With the continuous extension of human life expectancy and the continuous improvement of the quality of life requirements, the treatment of distal radius fractures has received more and more attention. The radiocarpal joint has a high frequency of activities, and improper treatment after injury is prone to complicated chronic pain and joint stiffness, which greatly affects the function of hand movement. However, how to choose the correct treatment method is still controversial. At present, the main treatment methods are as follows: closed reduction plaster or small splint fixation, closed reduction Kirschner wire or stent external fixation, and open reduction plate and screw internal fixation. Cast immobilization is usually used to fix the wrist joint in palmar flexion and ulnar deviation after manual reduction, and then change to neutral position fixation after 2-3 weeks, while small splint fixation usually does not exceed 4-6 weeks of wrist joint fixation. The above-mentioned fixation methods are often the first choice for elderly patients due to their advantages of simplicity, non-invasiveness, and low cost. However, fracture reduction is lost, the height of the articular surface cannot be maintained, long-term swelling of the wrist (small splint fixation even causes severe swelling), and fracture deformity. Healing is common, and it is difficult to perform effective functional exercises early, and eventually lead to wrist joint weakness, pain, stiffness, and limited movement. Although surgical treatment generally has certain advantages in terms of stability and functional recovery after fracture reduction, However, this difference is not obvious in elderly patients, and there are risks or disadvantages of blood vessel, nerve, tendon injury, infection, prolonged hospital stay and high cost.

At present, there are some patent designs that try to improve the traditional gypsum or small splint technology, which we like to see, but these designs still have some defects. "Adjustable External Fixator for Distal Radius Fractures", this design realizes the adjustment and fixation of the wrist joint at different flexion and extension angles through the hinge structure of the splint at the wrist joint, but cannot adjust the deflection angle of the radial ulna; The Chinese utility model patent with the authorization bulletin number CN205515104U discloses "a regulated distal radius fixed splint", which is also designed to simultaneously realize palmar flexion, dorsal extension, ulnar deviation and radial deviation of the wrist joint through the hinge structure at the wrist joint. However, the above design also has a common defect, that is, the height of the articular surface of the distal radius cannot be maintained well (especially comminuted fractures), and most of the distal radius fractures are brittle fractures, which are caused by osteoporosis. Due to the traditional fixation method, the loss of fracture reduction and the reduction of the articular surface height of the distal radius are very common in the later stage. This situation has a great impact on the recovery of wrist joint function, and even in internal fixation surgery, it also results in poor postoperative results. main reason.

In addition, the Chinese invention patent with the authorized publication number CN 103989546B discloses a "non-invasive adjustable splint bracket for distal radius fractures", which is designed to connect a low-temperature thermoplastic plate splint of the forearm and the palm through an external fixation frame, which can realize the protection of the wrist. Adjusting in all directions seems to be able to maintain the articular surface height of the distal radius, but there are still the following defects: 1. The installation process is too cumbersome and time-consuming; There is no guarantee that the reset will not be lost; 3. If the re-examination of the X-ray film after the installation is completed and the reset is found to be poor, it will take too much time to reset and install again after disassembly. At this time, does the shape of the palm splint need to be reshaped? 4. The maintenance of the articular surface height of the distal radius requires a certain traction force. The hand splint in this patent is a "C"-shaped structure. The patent document does not mention whether the hand splint is installed from the ulnar side or the radial side. If the opening is on the radial side, can the hand splint maintain the force of distal traction due to the physiological structure of the palm gradually becoming thinner from proximal to distal? If the opening is on the ulnar side, the splint has a certain support at the first carpal metacarpal joint, and a certain traction force can be maintained when the connecting strap is fastened, but the movement of the thumb will be significantly restricted at this time, which should never be allowed. 5. The price of low-temperature thermoplastic sheet and external fixator is not cheap in China, how many patients are willing to use it; 6. How to keep warm when used in winter? Therefore, the invention is not practical.

Utility model content

In view of the various defects of the prior art, the utility model provides an integrated support for the reduction and fixation of the distal radius fracture, which can be quickly installed after the manual reduction of the distal radius fracture is completed, and then the distal radius is pulled by fingers. The fracture can also achieve further reduction, which can not only maintain the height of the articular surface of the distal radius, but also adjust the direction of traction according to changes in the situation. On the basis of maintaining the reduction, the wrist joint and other joints beyond are allowed to move, preserving as much as possible. The patient's hand function, so as to ensure the recovery effect.

In order to solve the above-mentioned technical problems, the technical scheme adopted by the present utility model is: an integrated support for the reduction and fixation of distal radius fractures, including a dorsal splint, a volar splint and a traction device connected thereto. The lateral splint is docked with the volar splint to achieve rapid and effective fixation of the distal radius fracture, and then the initial reduction is maintained through the installation and adjustment of the traction device, and the fracture reduction is further promoted through the principle of ligament restoration. Promote and maintain reset.

The main body of the dorsal splint is a medical thermoplastic plate, and one side of the distal end has two 90s holes, and the other side has two lateral sliding 90s holes in symmetrical positions.

The volar splint is similar in structure to the dorsal splint, and two fixing bolts are arranged at the corresponding positions of the 90 holes, and the height of the fixing bolts is higher than the thickness of the wrist joint, and there are also two fixing bolts on the other side. Slide the sockets laterally.

The volar splint is provided with a slide rail in the middle of the proximal bottom surface, and the slide rail is fixed on the volar splint by fixing screws.

The traction device is composed of a finger traction sleeve, a traction bow and a "T"-shaped fastener. A traction ring is fixed on the horizontal bar at the distal end of the traction bow. The proximal end is secured with a "T" fastener.

Said "T"! The type fastener conforms to the slide rail, and can be inserted into the slide rail for sliding, and can also be locked with the slide rail by the fastener screw.

The finger traction sleeve has a mesh structure and is made of polyester fiber. The distal end of the finger traction sleeve is tightened with a closing buckle, and then connected with a metal buckle. The metal buckle is provided with a spring switch, and the spring switch can be locked on the traction ring. Inside.

In addition to the two fixed bolts, the other two groups of the two sets of bolts are two non-fixed bolts, and the nut is used for fixing one side of the lateral sliding hole, and the height of the non-fixed bolts is higher than the thickness of the wrist joint.

The pressure pad includes a dorsal palm pressure pad and a radial ulnar pressure pad. The dorsal palm pressure pad is made of soft and breathable material and can be pasted on the inner surface of the splint; the bottom of the radial ulnar pressure pad is made of plastic. It has a "C" shape and its top surface is made of soft breathable material.

The beneficial effect of the utility model is that after the manual reduction of the distal radius fracture is completed, the volar splint and the dorsal splint can be quickly installed and connected to complete the fixation; the pressure pad can be used to maintain the reduction and continue to correct the displacement; Ligament restoration, wrist fractures can achieve automatic reduction, and can well maintain the height of the distal radius joint surface; when the finger joints need to be moved, the buckle on the finger sleeve can be opened to release the traction of the finger, while other The finger cuff can continue to maintain the traction force, and the hand function exercise can also promote fracture reduction while maintaining the traction force; when the wrist joint needs to be moved, the bolts of the splint can be temporarily adjusted to a relatively tight level. The brace is equivalent to a traditional small splint, which can relieve all finger traction at this time; the utility model can also be applied to the treatment of multiple metacarpal fractures, special types of metacarpal fractures, ulna impingement syndrome and radiocarpal arthritis.

Description of drawings

The present utility model will be further described below in conjunction with the accompanying drawings and embodiments.

Fig. 1 is the top view of the back side splint of the utility model;

Fig. 2 is the side plan view of the volar splint of the utility model;

Fig. 3 is the bottom view of the volar splint of the present utility model;

Fig. 4 is the bottom view of the utility model traction bow and "T" type fastener;

Fig. 5 is the cross-sectional schematic diagram of the connection between the "T" type fastener and the slide rail of the present invention;

Fig. 6 is the structure diagram of the utility model finger traction sleeve;

7 is a schematic view of the radial ulna side pressure pad of the present invention;

FIG. 8 is a diagram showing the effect of installation and use of the utility model (radial ulnar pressure pad is not shown).

Description of reference numerals

1. Dorsal splint; 2. Volar splint; 4. Traction arch; 5. Finger traction sleeve; 6. Radial ulnar pressure pad; 7. Dorsal palm pressure pad; Bandage; 11. Ventilation hole; 12. 卯 hole; 13. Lateral sliding 卯 hole; 21. Fixing bolt; 22. Slide rail; 23. Fixing screw; 41. Traction ring; 42. "T" type fastener; 43. Fastener screw; 44. Rod; 51. Closing buckle; 52. Metal buckle; 53. Spring switch; 61. Cushion; 81. Nut.

Detailed ways

The present utility model will be further described below in conjunction with specific embodiments.

As shown in Figure 1, the main body of the back side splint 1 is a thermoplastic plate, with ventilation holes 11 scattered on the plate, two 90 holes 12 on one side of the distal end of the splint, and two transverse sliding 90 holes 13 at the corresponding positions on the other side.

As shown in FIGS. 2 to 3 , the structure of the volar splint 2 is similar to that of the dorsal splint 1, and two fixing bolts 21 are provided at the corresponding positions of the 9-hole 12, while the other side also has two transverse bolts 21. The sliding 90 hole 13 is also provided with a sliding rail 22 in the middle of the bottom surface of the proximal end. The sliding rail 22 is fixed to the volar splint 2 by fixing screws 23 .

As shown in Figures 4 to 6 and 8, the traction device is composed of a finger traction sleeve 5, a traction bow 4 and a "T"-shaped fastener 42. A traction ring 41 is fixed on the horizontal bar at the distal end of the traction bow 4. The traction bow The two arms of 4 are closed at their proximal ends to form a rod 44, the proximal end of the rod 44 is fixed with a "T"-shaped fastener 42, and the "T"-shaped fastener 42 conforms to the slide rail 22 and can be inserted into the slide rail 22. Sliding inside, it can also be locked with the slide rail 22 by the fastener screw 43, the finger traction sleeve 5 is a mesh structure, made of polyester fiber, its distal end is tightened with a closing buckle 51, and then connected with a metal buckle 52 , there is a spring switch 53 on the metal retaining ring 52 , and the spring switch 53 can be locked in the traction ring 41 .

As shown in Figures 7 to 8, the pressure pad includes a dorsal palm pressure pad 7 and a radial ulnar pressure pad 6. The dorsal palm pressure pad 7 is made of soft and breathable material and can be pasted on the inner surface of the splint; The bottom of the pressure pad 6 is made of plastic, in a "C" shape, and its top surface is made of soft breathable material.

As shown in FIG. 8 , two sets of bolts are required to install the support. One side of the fixing bolt 21 is connected to the socket hole 12, each bolt is fixed with a nut 81, and two sets of bolts are used on the side of the lateral sliding socket hole 13. 8 non-fixed bolts 8 for connection, but each non-fixed bolt 8 needs to be fixed with 3 nuts 81, which can adapt to the width of different individual wrist joints, and also facilitate the adjustment of the radial ulnar pressure, self-adhesive elastic bandage 9 It is used to fix the proximal end of the splint, and the number of self-adhesive elastic bandages 9 can be increased according to the situation.

The specific use method of the utility model is as follows: in the first step, the dorsal palm pressure pads 7 are respectively pasted on the inner surfaces of the distal ends of the dorsal splint 1 and the volar splint 2 before fracture reduction; in the second step, the two non-fixed The bolts 8 pass through the two lateral sliding holes 13 of the volar splint 2 from bottom to top, respectively, and are respectively sleeved with two nuts 81 for later use; the third step is to connect the proximal end portion of the dorsal splint 1 and the volar splint 2 Immerse in hot water to soften, and complete the shaping on the unaffected forearm; the fourth step is to perform manual reduction of the distal radius fracture; the fifth step, the volar splint 2 is placed on the volar forearm, and then the dorsal splint is placed 1 is placed on the back side of the forearm, so that the two fixing bolts 21 pass through the 90-hole 12, and each is initially fixed with a nut 81; the sixth step, the two non-fixing bolts 8 continue to pass through the back side splint 1 from bottom to top The two lateral sliding sockets 13 are fixed from the top with a nut 81; the seventh step is to adjust the four nuts 81 on the top in turn to make the pressure of the fractured section suitable, and then pre-tighten the non-fixed bolts 8 respectively. The two inserted nuts 81 move up and down to be close to the two splints respectively, so that the non-fixed bolts 8 and the splints are stably fixed; the eighth step is to use self-adhesive elastic bandages 9 to perform annular compression and fixation at the proximal end of the splint; the ninth step, the The finger traction sleeves 5 are respectively sleeved into each finger, and then the "T"-shaped fasteners 42 at the proximal end of the traction bow 4 are inserted into the slide rails 22, and then the metal buckles 52 are respectively inserted into the corresponding traction rings 41 to form with the splint. After resisting, the distal end of the traction bow 4 is pulled, so that the finger traction sleeve 5 is tightened to form an appropriate traction force, and the operation of locking the fastener screw 43 is completed.

After the installation of the brace, a radiograph can be performed. The metal parts on the front and side will not interfere with the imaging of the fracture. If it is found that there is still displacement of the ulna and radial side at the fracture end, it needs to be actively corrected. Loosen the nut 81 to increase the gap between the bolt and the radial ulna, then insert two pieces of pressure pads 6 on the radial and ulnar side into the gap on the ulnar and radial side respectively, adjust the pressure on the dorsal palm and the radial ulnar side again, and then tighten the nuts 81. The raised portions at both ends of the radial pressure pad 6 can be prevented from sliding after being blocked by bolts.

When the finger joint needs to be moved, the spring switch 53 on the finger traction cover 5 can be turned on to release the traction of the finger, and other finger covers can also maintain the traction force; when the wrist joint needs to be moved, the nut 81 can be temporarily adjusted. To keep the splint at a relatively tight level, at this time, the integrated brace plays the same role as the traditional small splint, allowing moderate movement of the wrist joint in this state; some cases may no longer require traction after 2 to 3 weeks , the traction device can be removed separately at this time. one

The above embodiments are only used to further illustrate an integrated support for reduction and fixation of distal radius fractures of the present invention. However, the present invention is not limited to the embodiments. Any simple modification, equivalent change and modification all fall within the protection scope of the technical solution of the present invention.

Claims (9)

1. a kind of radius far-end fracture reset is fixed to integration brace, it is characterised in that: including dorsal fitting splint (1), palmar clamping plate (2) and its connection traction device, dorsal fitting splint (1) can be docked with palmar clamping plate (2) by two groups of bolts, to realize oar The fast and effective fixation of bone fracture of distal, then maintains initial stage to reset, and pass through ligament by the installation and adjustment of traction device Reduction principle further promotes the reduction of the fracture, can advantageously promote and maintain with the use of pressure pad to reset.

2. radius far-end fracture reset according to claim 1 is fixed to integration brace, it is characterised in that: the back side Clamping plate (1) main body is medical thermoplastic plate, and the side of distal end is there are two mortise (12), and there are two laterally sliding for other side corresponding position Dynamic mortise (13).

3. radius far-end fracture reset according to claim 1 is fixed to integration brace, it is characterised in that: the palmar Clamping plate (2) its structure is similar to dorsal fitting splint (1), and the corresponding position of itself and mortise (12) is provided with two pieces of fixing bolts (21), and the height of fixing bolt (21) is higher than wrist joint thickness, and then equally there are two slide laterally mortise (13) for the other side.

4. radius far-end fracture reset according to claim 1 is fixed to integration brace, it is characterised in that: the palmar It is provided with sliding rail (22) in the middle part of its proximal end bottom surface of clamping plate (2), sliding rail (22) is fixed screw (23) and is fixed on palmar clamping plate (2).

5. radius far-end fracture reset according to claim 1 is fixed to integration brace, it is characterised in that: the traction Device is made of finger traction casing (5), traction bow (4) and T-shape fastener (42), is fixed on the cross bar of traction bow (4) distal end Bail (41), the two-arm of traction bow (4) are closed up at its proximal end for a bar (44), the proximal end and T-shape fastener (42) of bar (44) It is fixed.

6. radius far-end fracture reset according to claim 5 is fixed to integration brace, it is characterised in that: " T " Type fastener (42) and sliding rail (22) are conformal, and can be inserted into sliding rail (22) and slided, can also be by fastener screw (43) and sliding Rail (22) locking.

7. radius far-end fracture reset according to claim 5 is fixed to integration brace, it is characterised in that: the finger Traction casing (5) be reticular structure, be made of polyester fiber, distal end with close up button (51) tightening, then with metal retaining ring (52) Be connected, have on metal retaining ring (52) snap switch (53), snap switch (53) can padlock in the bail (41).

8. radius far-end fracture reset according to claim 1 is fixed to integration brace, it is characterised in that: described two groups Bolt is two pieces of on-fixed bolts (8) for another group in addition to two pieces of fixing bolts (21), and attaching nut (81) is for sliding laterally the fourth of the twelve Earthly Branches The height of the fixation of hole (13) side, on-fixed bolt (8) is higher than wrist joint thickness.

9. radius far-end fracture reset according to claim 1 is fixed to integration brace, it is characterised in that: the pressure pad Including palm back side pressure pad (7) and ruler oar side pressure pad (6), palm back side pressure pad (7) is made of soft gas permeable material, and Pasting is in clamping plate Inner face；The bottom of ruler oar side pressure pad (6) is made of plastics, and is C-shaped, top surface is made of soft gas permeable material.