Femoral neck fracture internal fixture implantation guider

Abstract

The invention discloses a femoral neck fracture internal fixture implantation guider, and relates to the technical field of medical instruments, the femoral neck fracture internal fixture implantation guider comprises a positioning base plate, an extension sleeve inserted into an insertion hole is fixed at one axial end of a guide locking sleeve, and a settling tank is formed in one end, far away from the extension sleeve, of the guide locking sleeve; a plurality of circular-arc-shaped guide plates which are of an annular structure and are evenly distributed at intervals are arranged on the side wall, away from the notch, of the settling tank, a turnover block is rotationally arranged between the side walls of the two sides of the turnover gap, an abutting block is fixed to the side wall of the side, facing the guide space, of the turnover block, and the turnover block can be turned over and adjusted towards the side close to or away from the center of the penetrating space. And the size of the clamping space is adjustable. A clamping space with a proper size can be provided, a guide needle or a hollow screw can be driven into a bone for guiding, the hollow screw cannot deviate from a preset driving direction due to deviation of a force application direction of an electric screwdriver, a normal bone structure remaining at the femoral head and neck is prevented from being damaged by repeated penetration operation, a plurality of screw paths are generated, and the operation efficiency is improved. And the bone density is sparse.

Description

Technical Field

[0001] The invention relates to the technical field of medical devices, in particular to a guide device for implanting an internal fixation device for a femoral neck fracture. Background Art

[0002] Internal fixation is a key part in the treatment of femoral neck fractures. Common internal fixation devices include hollow screws, plate screws, dynamic hip screws (DHS) and proximal femoral intramedullary nails (PFN). In general, for non-displaced or slightly displaced femoral neck fractures, a guide pin (Kirschner wire) is inserted, and under the guidance of the guide pin (Kirschner wire), a hollow screw is placed inside the femoral neck to achieve stability.

[0003] Due to the anteversion angle of the femoral neck and the large differences among different populations, multiple fluoroscopy is often required clinically to assist in the implantation of the guide needle (Kirschner wire) during the process of inserting the guide needle. After the guide needle is inserted, a hollow screw needs to be implanted. Currently, in clinical practice, the blade of an electric screwdriver is connected to the groove of the hollow screw cap to achieve power transmission. However, due to the lack of an external positioning device for the patient, the hollow screw is nailed into the patient's bone by the doctor's bare hands. When the doctor holds the electric screwdriver with bare hands and applies force, the hand may deviate from the axial direction of the guide needle and the hollow screw, causing the guide to deviate from the preset insertion route, thereby affecting the subsequent accurate insertion of the hollow screw into the ideal position in the center of the femoral head, and it needs to be reinserted. However, repeated operations will further damage the remaining normal bone structure of the femoral head and neck, produce multiple nail channels, cause sparse bone density, and cause unnecessary damage. Summary of the invention

[0004] The object of the present invention is to provide a guide for implanting an internal fixation device for femoral neck fracture to solve the problems raised in the above-mentioned background technology.

[0005] To achieve the above object, the present invention provides the following technical solution: a guide for implanting an internal fixation device for a femoral neck fracture, comprising a positioning substrate, one side wall of the positioning substrate being a fitting surface, the other side wall opposite thereto being a back surface, and a handle being provided obliquely at one end of the positioning substrate;

[0006] A guide locking sleeve, wherein a socket is provided at one end of the positioning substrate away from the handle, an extension sleeve connected to the socket is fixed to one axial end of the guide locking sleeve, a sedimentation groove is provided at one end of the guide locking sleeve away from the extension sleeve, and a plurality of circular arc-shaped guide plates evenly distributed in an annular structure are provided on the side wall of the sedimentation groove away from the groove, and the space between the plurality of circular arc-shaped guide plates is an interlaced space and is connected to the extension sleeve.

[0007] A turning gap is arranged between two adjacent arc-shaped guide plates, a turning block is rotatably arranged between the side walls on both sides of the turning gap, and a stop block is fixed to a side wall of the turning block facing the guide space.

[0008] A clamping space is formed between the plurality of abutment blocks, and the flipping block can be flipped and adjusted toward a side close to or away from the center of the interlaced space, and the size of the clamping space is adjustable.

[0009] In a further embodiment, a fastening sleeve is further included, the fastening sleeve is provided with an internal thread, and a side wall of one side of the interlaced space on the back of the multiple arc-shaped guide plates is provided with an external thread, the fastening sleeve is sleeved on the outer walls of the multiple arc-shaped guide plates, and the internal thread matches the external thread.

[0010] In a further embodiment, a side wall of the flip block facing away from the interlaced gap is provided with a pushing slope.

[0011] When the fastening sleeve rotates clockwise on the outer wall of the arc-shaped guide plate, the fastening sleeve is adjusted to the side close to the extension sleeve, and the inner side wall of the end of the fastening sleeve pushes against the pushing inclined surface, thereby pushing the stop block toward the center of the interlaced space.

[0012] When the fastening sleeve rotates counterclockwise on the outer wall of the arc-shaped guide plate, the fastening sleeve is adjusted to the side away from the extension sleeve, the inner side wall of the end of the fastening sleeve gradually separates from the inclined pushing inclined surface, and the stop block loses thrust.

[0013] In a further embodiment, a rectangular rod is provided on the back side of the positioning substrate near one end of the handle, a connecting rod is fixed to the radial side wall of the guide locking sleeve, and a socket is provided at one end of the connecting rod for sliding connection with the rectangular rod.

[0014] In a further embodiment, a positioning piece is also included, which includes a screw cap and a clip, the radial side wall of the screw cap is provided with an annular slot for the clip to rotatably engage, the radial side wall of the clip is fixed with a second connecting rod, the second connecting rod is provided with a second socket for slidingly inserting with the rectangular rod, and the screw cap is coaxially distributed with the guide locking sleeve.

[0015] A nail groove is formed at one end of the screw cap facing the guide locking sleeve, and a protruding plug is fixed on a side wall of the nail groove away from the notch, and the protruding plug is gradually reduced toward the notch of the nail groove.

[0016] A transmission slot is provided at one end of the screw cap facing away from the guide locking sleeve.

[0017] In a further embodiment, the protruding plug is any one of a cross structure, a straight structure or a plum blossom structure.

[0018] In a further embodiment, the stopper is a spherical structure.

[0019] Compared with the prior art, the present invention has the following beneficial effects:

[0020] The present invention is a guide for implanting an internal fixation device for a femoral neck fracture, which can provide a clamping space of appropriate size and can be used for driving a guide pin or a hollow screw into a bone guide. When driving the hollow screw, a screw cap is added to assist in fixing one end of the hollow screw cap. As long as the positioning base plate is held stationary, the hollow screw will not deviate from the preset driving direction due to the deviation of the force direction of the electric screwdriver during implantation, thereby avoiding repeated penetration operations that damage the remaining normal bone structure of the femoral head and neck, generate multiple screw channels, and cause sparse bone density. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 It is a schematic diagram of the main structure of the present invention;

[0022] Figure 2 It is a schematic diagram of the positioning substrate and handle structure of the present invention;

[0023] Figure 3 It is a schematic diagram of the disassembly of the screw cap and the clip of the present invention;

[0024] Figure 4 It is a schematic diagram of the assembly structure of the screw cap and the clip of the present invention;

[0025] Figure 5 It is a schematic diagram of the disassembly of the guide locking sleeve and the fastening sleeve of the present invention;

[0026] Figure 6 It is a structural schematic diagram of the guide locking sleeve of the present invention from another viewing angle;

[0027] Figure 7 It is a schematic diagram of the assembly structure of the flip block and the stop block of the present invention;

[0028] Figure 8 It is a schematic diagram of the independent assembly structure of the guide locking sleeve and the positioning base plate of the present invention.

[0029] In the figure: 1. positioning base plate; 11. handle; 12. rectangular rod; 13. socket; 2. guide locking sleeve; 21. connecting rod 1; 22. fastening sleeve; 23. extension sleeve; 24. sedimentation trough; 25. arc-shaped guide plate; 26. flip block; 27. stop block; 3. screw cap; 31. clip; 32. connecting rod 2; 33. nail groove; 34. protruding plug. DETAILED DESCRIPTION

[0030] The following will be described clearly and completely in conjunction with the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only 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 ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0031] Embodiment, this embodiment provides a femoral neck fracture internal fixation implantation guide, such as Figure 1 and Figure 2 As shown, it includes a positioning substrate 1, one side wall of the positioning substrate 1 is a fitting surface, which is the side facing the surgical incision of the patient. The other side wall opposite is the back side, which is the side facing the surgeon. A handle 11 is provided obliquely at one end of the positioning substrate 1, and the handle 11 extends obliquely to the side away from the fitting surface. On the one hand, it is convenient for the surgeon to hold and operate the positioning substrate 1 to place it in the fitting position on the patient's body surface during surgery, and on the other hand, the oblique extension setting does not block the surgeon's surgical field of view.

[0032] like Figure 1 , Figure 2 , Figure 5 , Figure 6 and Figure 8 As shown, a guide locking sleeve 2 is also disclosed, a socket 13 is provided at one end of the positioning substrate 1 away from the handle 11, an extension sleeve 23 plugged into the socket 13 is fixed to one axial end of the guide locking sleeve 2, a sedimentation groove 24 is provided at one end of the guide locking sleeve 2 away from the extension sleeve 23, and a plurality of arc-shaped guide plates 25 evenly spaced and in an annular structure are provided on the side wall of the sedimentation groove 24 away from the notch, the space between the plurality of arc-shaped guide plates 25 is an interlaced space, and is connected with the extension sleeve 23, the extension sleeve 23 of the guide locking sleeve 2 is inserted into the socket 13, the side wall of the end of the guide locking sleeve 2 abuts against the back side of the positioning substrate 1, and the end of the extension sleeve 23 does not extend out of the opening at one end of the socket 13 located at the fitting surface, and the interlaced space is connected with the internal space of the extension sleeve 23 to allow a guide pin or a hollow screw to pass through.

[0033] A turning gap is provided between two adjacent arc-shaped guide plates 25, and a turning block 26 is rotatably provided between the side walls on both sides of the turning gap, and a stopper 27 is fixed to the side wall of the turning block 26 facing the guide space. A clamping space is formed between multiple stops 27, and preferably three stops 27 are provided here, and three stops 27 form three evenly distributed points against the radial side wall of the guide needle or hollow screw passing through the clamping space. As long as the turning block 26 can be turned and adjusted to one side close to or away from the center of the interlaced space, the size of the clamping space can be adjusted to be suitable for guide needles or hollow screws with different diameters.

[0034] Of course, after the three stop blocks 27 follow the flip block 26 to flip and adjust their positions, their positions need to be restricted to ensure that the guide needle or hollow screw does not shake during the driving process, thereby causing deviation from the preset driving route. For this purpose, a fastening sleeve 22 is also included, such as Figure 5As shown, the fastening sleeve 22 is provided with an internal thread, and the side wall of the space at the back of the plurality of arc-shaped guide plates 25 is provided with an external thread. The fastening sleeve 22 is sleeved on the outer wall of the plurality of arc-shaped guide plates 25, and the internal thread matches the external thread. The fastening sleeve 22 can be rotatably sleeved on the outer wall of the plurality of arc-shaped guide plates 25, and can be rotated clockwise to feed and counterclockwise to disengage. Most importantly, as Figure 7 As shown, a push slope is provided on the side wall of the flip block 26 facing away from the interpenetrating gap. When the fastening sleeve 22 is rotated clockwise on the outer wall of the arc-shaped guide plate 25, the fastening sleeve 22 is adjusted to the side close to the extension sleeve 23, and the inner side wall of the end of the fastening sleeve 22 pushes against the push slope, thereby pushing the block 27 toward the center of the interpenetrating space, that is, Figure 5 The three stoppers 27 shown are pushed toward the center of the insertion space, thereby reducing the clamping space, which is suitable for guide needles or hollow screws with smaller diameters.

[0035] On the contrary, when the fastening sleeve 22 is rotated counterclockwise on the outer wall of the arc-shaped guide plate 25, the fastening sleeve 22 is adjusted to the side away from the extension sleeve 23, and the inner side wall of the end of the fastening sleeve 22 gradually separates from the inclined push inclined surface, and the stopper 27 loses thrust. When a guide needle or hollow screw with a slightly larger diameter is inserted into the clamping space, the three stoppers 27 can be pushed outward to ensure that the guide needle or hollow screw can smoothly pass through the clamping space. According to the diameter of the guide needle or hollow screw, the medical staff can adjust the tightness of the outer wall of the three stoppers 27 and the radial side wall of the guide needle or hollow screw by rotating the fastening sleeve 22, that is, it does not affect the smooth passage of the guide needle or hollow screw, and it is necessary to ensure that there is no gap between the stopper 27 and the guide needle or hollow screw during the passage, so as to avoid shaking and deviation during the insertion process.

[0036] The abutment 27 is specially designed to be a spherical structure. When the three abutment 27 are evenly distributed and abut against the radial side wall of the guide needle or hollow screw, the abutment 27 with a spherical structure can make point contact with the radial outer wall of the guide needle or hollow screw, thereby reducing the resistance of the guide needle or hollow screw to be driven into the bone. At the same time, it can also play a clamping limit role to prevent shaking and instability during the driving process.

[0037] In order to increase the stability of the cannulated screw during the initial stage of driving, Figure 1 , Figure 2 and Figure 3As shown, a rectangular rod 12 is provided at one end of the back side of the positioning base plate 1 near the handle 11, a connecting rod 1 21 is fixed to the radial side wall of the guide locking sleeve 2, and a socket 13 1 is provided at the end of the connecting rod 1 21 for sliding insertion with the rectangular rod 12. A positioning member is also included, the positioning member includes a screw cap 3 and a clip 31, the radial side wall of the screw cap 3 is provided with an annular groove for rotating insertion of the clip 31, the clip 31 is made of stainless steel elastic material, and a snap-in opening is provided at the end of the clip 31. The snap-in opening of the clip 31 is opened by using the inner wall of the annular groove to facilitate snapping into the clip 31, and a connecting rod 2 32 is fixed to the radial side wall of the clip 31, and the connecting rod 2 32 is provided with a socket 13 2 for sliding insertion with the rectangular rod 12, and the screw cap 3 and the guide locking sleeve 2 are coaxially distributed.

[0038] Moreover, a nail groove 33 is formed at one end of the screw cap 3 facing the guide locking sleeve 2, and a protruding plug 34 is fixed on the side wall of the nail groove 33 away from the notch. Here, the protruding plug 34 is any one of a cross structure, a straight structure or a plum blossom structure. Figure 4 As shown, a cross structure is preferably adopted, and the protruding plug is gradually reduced toward the notch of the nail groove 33. The purpose of such a setting is that the depth and size of the cross groove on the surface of the top cap of different hollow screws vary. Therefore, in order to adapt to different hollow screws, the reduced setting can be inserted into the cross grooves of different depths and sizes. When the screw cap 3 rotates, the hollow screw can be rotated synchronously with the protruding plug 34. At the same time, a transmission slot is opened at the end of the screw cap 3 facing away from the guide locking sleeve 2. The transmission slot can be any one of a cross structure, a straight structure or a plum blossom structure, which can be selected according to the blade structure of the electric screwdriver, and a cross structure is preferred.

[0039] When rotating and driving the hollow screw, the hollow screw is placed in the nail groove 33 of the screw cap, and the protruding plug 34 can be inserted into the nail cap notch of the hollow screw. The tip of the hollow screw passes through the clamping space and the extension sleeve 23. According to the diameter of the hollow screw, the position of the three stop blocks 27 is limited after adjustment. The blade of the electric screwdriver is inserted into the transmission slot of the screw cap 3. The electric screwdriver rotates to drive the hollow screw to rotate and feed. At the same time, the second connecting rod 32 can be fed along the outer wall of the rectangular rod 12 to the side close to the guide locking sleeve 2. In this way, as long as the position of the positioning base plate 1 does not change or shake, the hollow screw will be accurately driven into the bone according to the axial direction of the screw cap 3 and the guide locking sleeve 2.

[0040] By adding the screw nut 3, the hollow screw can be kept in a stable clamping state without shaking in the initial stage of insertion. In addition, during the insertion process, even if the holding force of the handheld electric screwdriver deviates slightly from the screw nut 3, as long as the blade of the electric screwdriver does not separate from the transmission slot of the screw nut 3, the power is still transmitted. During implantation, the hollow screw will not deviate from the preset insertion direction due to the deviation of the force direction of the electric screwdriver, thereby not affecting the accurate insertion of the hollow screw into the bone.

[0041] It is worth noting that the applicant has also found in clinical practice that the existing guide sleeves used in clinical practice have a certain length and an open structure at both ends. After use, disinfection and cleaning are more troublesome, and a sleeve brush is required to clean the inner wall. In addition, the inner diameter does not have an adjustable function, and multiple sizes of guide sleeves are required. The guide locking sleeve 2 and the screw cap 3 in this design are actually equivalent to guiding and limiting at both ends of the hollow screw axis. The problem solved is the same as the guide sleeve shown in clinical practice, but in terms of disinfection, the guide locking sleeve 2 and the screw cap 3 have fewer hidden dead corners, which is convenient for disinfection and cleaning.

[0042] According to the clinical surgical procedure of implantation of internal fixation devices for femoral neck fracture, taking the implantation of hollow screws as an example, the specific implantation process is as follows:

[0043] First, under fluoroscopy, use X-rays to determine the layout of the middle and lower guide pins (Kirschner wires) in two planes. Separate the fascia layer along the incision of the patient's affected area, and use an appropriate separator to separate along the muscle fibers. The specific method of inserting the guide pin includes: inserting a guide pin along the distal cortex of the femoral neck through the femoral calcar above the lesser trochanter; inserting two proximal guide pins in parallel, as far up as possible and 5mm away from the anterior and posterior cortices; adjusting the depth of the guide pin to reach 5mm below the cartilage. When introducing the guide needle, the surgeon holds the handle 11 with one hand, brings the fitting surface of the positioning substrate 1 close to or attaches it to the incision, matches one end of the guide needle with the electric rotator, and lets the tip of the guide needle pass through the insertion space and the extension sleeve 23. According to the diameter of the selected guide needle, the position of the three abutments 27 is adjusted and fixed, and the size of the clamping space is adjusted to ensure that the three abutments 27 can stably abut against the radial side wall of the guide needle. The electric rotator is rotated to install the guide needle in the preset route and drive it into the bone to obtain the posterior and anterior cortical support of the femoral neck. During the insertion of the guide needle, the depth of the guide needle is adjusted so that it reaches the appropriate position under the cartilage. Then, the bone is pre-processed with a reamer, the depth is measured and a suitable hollow screw is selected, the clamping space size of the three abutments 27 is adjusted again to match the selected hollow screw, and the screw cap 3 is provided with a screw groove 33 which is sleeved on the screw cap of the hollow screw. The blade of the electric screwdriver is inserted into the transmission slot of the screw cap 3, and the electric screwdriver rotates to drive the hollow screw to rotate and feed, completing the implantation operation of the hollow screw. The number of hollow screws is usually 3, forming an "inverted triangle" configuration or other configurations as needed.

[0044] In summary, the above structure can provide a clamping space of appropriate size, which can be used for guiding the guide pin or hollow screw into the bone. When inserting the hollow screw, a screw cap 3 is added to assist in fixing one end of the hollow screw cap. As long as the positioning substrate 1 is held in place, the hollow screw will not deviate from the preset insertion direction due to the deviation of the force direction of the electric screwdriver during implantation, thereby avoiding repeated penetration operations that damage the remaining normal bone structure of the femoral head and neck, and generating multiple screw channels, resulting in sparse bone density.

[0045] Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that various changes, modifications, substitutions and variations may be made to the embodiments without departing from the principles and spirit of the present invention, and that the scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A guide for implanting an internal fixation device for femoral neck fracture, characterized in that: include: A positioning substrate (1), wherein one side wall of the positioning substrate (1) is a fitting surface, and the other side wall opposite thereto is a back surface; and a handle (11) is provided at one end of the positioning substrate (1) in an inclined manner; A guide locking sleeve (2), wherein an insertion hole (13) is provided at one end of the positioning base plate (1) away from the handle (11), an extension sleeve (23) plugged into the insertion hole (13) is fixed to one axial end of the guide locking sleeve (2), a sedimentation groove (24) is provided at one end of the guide locking sleeve (2) away from the extension sleeve (23), a side wall of the sedimentation groove (24) away from the notch is provided with a plurality of circular arc-shaped guide plates (25) evenly spaced and in an annular structure, the space between the plurality of circular arc-shaped guide plates (25) is an interlaced space, and is communicated with the extension sleeve (23), A turning gap is provided between two adjacent arc-shaped guide plates (25), a turning block (26) is rotatably provided between the side walls on both sides of the turning gap, and a stop block (27) is fixed to a side wall of the turning block (26) facing the guide space; A clamping space is formed between the plurality of abutment blocks (27), and the flipping block (26) can be flipped and adjusted toward a side close to or away from the center of the interlaced space, and the size of the clamping space is adjustable.

2. The femoral neck fracture internal fixation implant guide according to claim 1, characterized in that: It also includes a fastening sleeve (22), the fastening sleeve (22) is provided with an internal thread, and a side wall of a side of the back insertion space of the plurality of arc-shaped guide plates (25) is provided with an external thread, the fastening sleeve (22) is sleeved on the outer wall of the plurality of arc-shaped guide plates (25), and the internal thread matches the external thread.

3. The femoral neck fracture internal fixation implant guide according to claim 2, characterized in that: The side wall of the flip block (26) facing away from the interlaced gap is provided with a pushing inclined surface; When the fastening sleeve (22) rotates clockwise on the outer wall of the arc-shaped guide plate (25), the fastening sleeve (22) is adjusted to a side close to the extension sleeve (23), and the inner side wall of the end of the fastening sleeve (22) pushes against the pushing inclined surface, thereby pushing the stop block (27) toward the center of the interlaced space; When the fastening sleeve (22) rotates counterclockwise on the outer wall of the arc-shaped guide plate (25), the fastening sleeve (22) is adjusted to a side away from the extension sleeve (23), the inner side wall of the end of the fastening sleeve (22) gradually separates from the inclined pushing slope, and the stopper (27) loses its thrust.

4. The femoral neck fracture internal fixation implantation guide according to claim 1, characterized in that: A rectangular rod (12) is provided on the back side of the positioning base plate (1) near one end of the handle (11), a connecting rod (21) is fixed to the radial side wall of the guide locking sleeve (2), and a socket (13) is provided at the end of the connecting rod (21) for slidingly plugging with the rectangular rod (12).

5. The femoral neck fracture internal fixation implantation guide according to claim 4, characterized in that: It also includes a positioning member, the positioning member includes a screw cap (3) and a clip (31), the radial side wall of the screw cap (3) is provided with an annular clip groove for the clip (31) to be rotatably clipped, the radial side wall of the clip (31) is fixed with a second connecting rod (32), the second connecting rod (32) is provided with a second plug hole (13) for slidingly plugging with the rectangular rod (12), and the screw cap (3) is coaxially distributed with the guide locking sleeve (2); The end of the screw cap (3) facing the guide locking sleeve (2) is provided with a nail groove (33), and a protruding plug (34) is fixed on the side wall of the nail groove (33) away from the notch, and the protruding plug is gradually reduced toward the notch of the nail groove (33); A transmission slot is provided on one end of the screw cap (3) which is opposite to the guide locking sleeve (2).

6. The femoral neck fracture internal fixation implantation guide according to claim 5, characterized in that: The protruding plug (34) is any one of a cross structure, a straight structure or a plum blossom structure.

7. The femoral neck fracture internal fixation implantation guide according to claim 1, characterized in that: The stop block (27) is a spherical structure.

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