Patellar reduction and Kirschner wire guide fixation device

Abstract

The present invention belongs to a patella fixing device, and specifically relates to a patella reduction and Kirschner wire guiding and fixing device, comprising an L-shaped main bracket and a sub-bracket slidably connected to one end of the main bracket and parallel to the other end of the main bracket, L-shaped claws I are relatively arranged on the main bracket and the sub-bracket, and two relatively arranged L-shaped claws II are also slidably connected to the main bracket and the sub-bracket, respectively. The design of the main bracket, the sub-bracket, and the L-shaped claws I and L-shaped claws II of the present invention can achieve good reduction of the patella with irregular anatomical structure and uneven joint bottom surface, and the operation is simple, which greatly saves the fracture reduction time during surgery, and at the same time avoids the adverse treatment effects such as the damage of blood supply to the fracture fragments and surrounding soft tissues caused by repeated reduction, which affects the later fracture healing, thereby improving the satisfaction of the surgeon and the patient.

Description

Technical Field

[0001] The invention belongs to a patella fixing device, in particular to a patella repositioning and Kirschner wire guiding fixing device. Background Art

[0002] The patella is the largest sesamoid bone in the human body, embedded in the quadriceps tendon, and is an important anatomical structure for straightening the knee joint. Patellar fractures account for 1% to 2% of all fractures, often caused by primary rupture of the quadriceps tendon or direct impact on the femur. The former are mostly transverse or longitudinal fractures, and the latter often cause comminuted fractures of the patella. As for the fracture surgery, accurate and rapid reduction and accurate and rapid insertion of the Kirschner wire after reduction are the difficulties and keys of the entire operation. The treatment principles of patellar fractures are reliable reduction, restoration of the smooth characteristics of the articular surface, strong fixation, and early rehabilitation functional exercise. If the patellar fracture is not handled properly, it may cause complications such as nonunion of the fracture, joint adhesion, traumatic arthritis, and bone infection.

[0003] When the patella is fractured, the fracture end is easily displaced due to the traction of the quadriceps femoris. At present, the devices for reducing patellar fractures during clinical surgery are mainly various fracture reduction forceps, including pointed, curved, flat heads and reduction forceps developed spontaneously by other scholars. However, most of them contact the patella with a pointed tip, clamp a small part of the patella and rely on the surgeon's experience and intraoperative X-rays to complete the reduction of the patellar fracture. Moreover, since the patella is surrounded by soft tissue connecting tendons, the bottom surface is uneven, and the top is a hemispherical raised structure, it is difficult to achieve an ideal reduction with a flat joint surface. In addition, the operation is time-consuming and labor-intensive, and the surgeon is frequently exposed to radiation during the operation.

[0004] After fracture reduction is completed, during the surgical operation of Kirschner wire fixation or screw implantation after Kirschner wire fixation, the surgeon usually relies on personal experience and intraoperative X-rays to drive the two Kirschner wires into the ideal position of the patella. In addition, a few scholars have spontaneously developed Kirschner wire guides, which play a certain auxiliary role in the Kirschner wire insertion operation, but they do not have the function of fracture reduction, and the position and direction of the positioning holes are too fixed, with too little selectivity. Summary of the invention

[0005] The technical problem to be solved by the present invention is to provide a patella resetting and Kirschner wire guiding and fixing device which is convenient for patella resetting and positioning and Kirschner wire insertion.

[0006] The content of the present invention includes an L-shaped main bracket and a sub-bracket slidably connected to one end of the main bracket and parallel to the other end of the main bracket. L-shaped claws I are relatively arranged on the main bracket and the sub-bracket, and two relatively arranged L-shaped claws II are also slidably connected on the main bracket and the sub-bracket respectively.

[0007] Furthermore, the main bracket and the auxiliary bracket are both cylindrical, and the two L-shaped claws II are slidably connected to the auxiliary bracket and the main bracket through sliding sleeves I and II.

[0008] Furthermore, the two L-shaped claws II are connected by a connecting push rod.

[0009] Furthermore, the connecting push rod includes a connecting rod I and a connecting rod II fixedly connected to two L-shaped claws II, and a push rod slidably connected to the connecting rod I and the connecting rod II.

[0010] Furthermore, the connecting rod I, connecting rod II and push rod are arranged coplanarly with the main bracket, the auxiliary bracket is provided with a sliding groove, one end of the push rod is a screw rod, the push rod has a threaded side protruding through the sliding groove, and a nut is provided on the side of the push rod protruding from the sliding groove.

[0011] Furthermore, a slide groove is provided on the main bracket, and the push rod is slidably connected to the main bracket through the slide groove.

[0012] Furthermore, the connecting rod II is fixedly connected with a push-pull rod, and the push-pull rod runs through the main bracket.

[0013] Furthermore, the L-shaped jaw I and the L-shaped jaw II are vertically provided with guide holes for installing the Kirschner wire guide head, and the Kirschner wire guide head is provided with a guide hole.

[0014] Furthermore, the guide hole is a circular slot hole with a notch, and an opening penetrating the L-shaped claw is arranged under the guide hole.

[0015] Furthermore, the L-shaped clamping jaws I and II are provided with spike-shaped clamping heads, and the upper sides of the spike-shaped clamping heads are provided with an inclination angle of 20°-40°.

[0016] The beneficial effects of the present invention are that, by providing the main support, the auxiliary support, the L-shaped clamping claw I and the L-shaped clamping claw II, the present invention can achieve good reduction of the patella with irregular anatomical structure and uneven joint bottom surface, and the operation is simple, which greatly saves the fracture reduction time during the operation, and at the same time avoids the damage to the blood supply of the fracture fragments and the surrounding soft tissues caused by repeated reduction, which affects the adverse treatment effects such as the later fracture healing, and improves the satisfaction of the surgeon and the patient;

[0017] The main bracket and the auxiliary bracket are both cylindrical, and the L-shaped claw II is slidably connected with the main bracket and the auxiliary bracket through a sliding sleeve, so that the overall structure of the device is simple, the sliding is smooth, and the jamming rate is reduced;

[0018] The two L-shaped claws II are connected by a push rod and operated by setting nuts and push-pull rods, which greatly simplifies the operation difficulty and improves the stability after fixation:

[0019] The provision of guide holes and Kirschner wire guide heads allows the Kirschner wires to be accurately inserted into the two ends of the patellar fracture fragment, allowing the Kirschner wires on both sides to be inserted into the corresponding parts of the patella (the outer 1 / 3 of both sides of the patella) in absolute parallelism, facilitating subsequent fixation operations, greatly reducing the difficulty of the operation, shortening the operation and anesthesia time, reducing the frequency of intraoperative X-ray use, and reducing the damage of X-rays to the surgeon and the patient.

[0020] The guide hole is set as a circular slot hole with a notch, providing multiple insertion positions, and the upper and lower positions of the Kirschner wire fixation can be selected according to different scenarios; at the same time, an opening is set below the guide hole to facilitate the removal of the entire device after the Kirschner wire is fixed. BRIEF DESCRIPTION OF THE DRAWINGS

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

[0022] Figure 2 It is a second angle structural schematic diagram of the present invention;

[0023] Figure 3 A top view of the present invention;

[0024] Figure 4 It is the front view of the present invention.

[0025] In the figure, 1-main bracket; 2-auxiliary bracket; 3-sleeve I; 4-sleeve II; 5-push rod; 6-nut; 7-K-wire guide head; 8-L-type claw I; 9-guide hole; 10-push-pull rod; 11-connecting rod I; 12-slide groove; 13-connecting rod II; 14-L-type claw II, 15 slide groove, 16 opening. DETAILED DESCRIPTION

[0026] like Figure 1-4As shown in the figure, the present invention includes a main bracket 1 in an L shape and a secondary bracket 2 that is slidably connected to one end of the L shape on the main bracket 1 and is parallel to the other end of the L shape on the main bracket 1. The main bracket 1 and the secondary bracket 2 as a whole are roughly in a "U" shape structure. Oppositely arranged L-shaped claws I 8 are provided on the main bracket 1 and the secondary bracket 2. Two L-shaped claws I 8 are arranged at the ends of the two parallel rods of the main bracket 1 and the secondary bracket 2. Two relatively arranged L-shaped claws II 14 are also slidably connected to the main bracket 1 and the secondary bracket 2 respectively. The main bracket 1 is slidably connected to the secondary bracket 2, that is, the two parallel rods can move relatively away from or close to each other. The two L-shaped claws II 14 are respectively slidably arranged on the main bracket 1 and the secondary bracket 2. While moving together with the main bracket 1 and the secondary bracket 2, the distance between the L-shaped claws II 14 and the L-shaped claws I 8 can also be adjusted to adapt to patella fixation of different sizes. Among them, the L-shaped claws I 8 and the L-shaped claws II 14 have the same structure, and both include a vertical rod with a guide hole 9 and a spiked chuck. The vertical rod and the spiked chuck are integrally formed to form an L-shaped claw. When performing reduction and fixation, the four vertical rods play a main limiting and clamping role, and the four spiked chucks are used to lift the bottom surface of the patella. The inclined surface on the spiked chuck increases the contact area with the bottom surface of the patella and improves the fixation stability.

[0027] Process of patella reduction and fixation: First, align and limit the chuck of the L-shaped claw I 8 located on the main bracket 1 with the patella surface on the fractured side. Subsequently, adjust the distance between the secondary bracket 2 and the main bracket 1 so that the chuck of the L-shaped claw I 8 located on the secondary bracket 2 is aligned and limited with the other side of the patella. Finally, adjust the two L-shaped claws II 14 slidably arranged on the main bracket 1 and the secondary bracket 2 so that the two L-shaped claws II 14 are respectively aligned and pressed and fixed on the other side of the patella to reduce the fracture of the patella. During specific operation, according to the different directions of patella fracture, the order of adjusting the positions of the four chucks and applying pressure can be adjusted. The operation is simple and flexible. After reduction, fixation can be performed, which simplifies the difficulty of subsequent insertion of Kirschner wires.

[0028] The sliding connection between the present invention can adopt a slot and block sliding connection or a cylindrical sleeve sliding connection.

[0029] Specifically, the main bracket 1 and the secondary bracket 2 are both cylindrical, which can reduce the edges and corners of the device and avoid damage to the operator during the operation. In addition, the two L-shaped claws II 14 are slidably connected to the secondary bracket 2 and the main bracket 1 through a sliding sleeve I 3 and a sliding sleeve II 4. Through the sliding sleeve connection, the structure of the device is extremely simplified, and the sliding effect is good with a low jamming rate.

[0030] In order to simplify the operation difficulty of the L-shaped claws II 14, the two L-shaped claws II 14 are connected by a connecting push rod. When pushing the two L-shaped claws II 14, only the connecting push rod is needed to operate the two L-shaped claws II 14, which simplifies the operation difficulty.

[0031] Specifically, the connecting push rod includes a connecting rod Ⅰ11 and a connecting rod Ⅱ13 fixedly connected to two L-shaped claws Ⅱ14 and a push rod 5 slidably connected to the connecting rod Ⅰ11 and the connecting rod Ⅱ13. In this embodiment, the connecting rod Ⅰ11 and the connecting rod Ⅱ13 are fixedly connected to the sliding sleeve Ⅰ3 and the sliding sleeve Ⅱ4 respectively. The connecting rod Ⅰ11 and the connecting rod Ⅱ13 are L-shaped structures. The push rod 5 is slidably connected to the connecting rod Ⅰ11 and the connecting rod Ⅱ13. The connecting rod Ⅰ11 and the connecting rod Ⅱ13 are provided with sliding sleeves, and are slidably connected to the push rod 5 through the sliding sleeves. At this time, the push rod 5 is perpendicular to the two parallel parts of the main bracket 1 and the auxiliary bracket 2. By operating the push rod 5, the two L-shaped claws Ⅱ14 can be controlled to move simultaneously, which greatly simplifies the operation difficulty.

[0032] Furthermore, the connecting rod I11, connecting rod II13 and push rod 5 are arranged coplanar with the main bracket 1, and a sliding groove 15 is arranged on the auxiliary bracket 2. The push rod 5 is a screw at one end, and the push rod 5 has a threaded side that protrudes through the sliding groove 15. A nut 6 is arranged on the side of the push rod 5 that protrudes from the sliding groove 15. When the patella is repositioned and fixed in this embodiment, the distance between the two L-shaped claws II14 and the two L-shaped claws I8 is first adjusted by the push rod 5, and then the L-shaped claws I8 and L-shaped claws II14 on the main bracket 1 are fixed to the two ends of one side of the patella for position limiting. Finally, by rotating the nut 6, the auxiliary bracket 2 and the L-shaped claws I8 and L-shaped claws II14 on the auxiliary bracket 2 are abutted against the two ends of the other side of the patella for position limiting and fixing. Finally, the nut 6 is further rotated to apply pressure to reposition the patella at the fracture. The self-locking function of the nut 6 can fix the position of the main bracket 1 and the auxiliary bracket 2 to ensure the fixing effect.

[0033] In order to improve the smoothness of movement of the push rod 5 and the stability after fixation, a slide groove 12 is provided on the main bracket 1, and the push rod 5 is slidably connected to the main bracket 1 through the slide groove 12, and a slider is provided on the side of the push rod 5 that cooperates with the slide groove 12.

[0034] In order to further improve the operational portability of the push rod 5, the connecting rod II 13 is fixedly connected with a push-pull rod 10, and the push-pull rod 10 is arranged through the main bracket 1. Specifically, the push-pull rod 10 is arranged on a sliding sleeve on the connecting rod II 13. By operating the push-pull rod 10, the two L-shaped claws II 14 are controlled to move relative to the L-shaped claw I8 at the same time.

[0035] The L-shaped claws I8 and L-shaped claws II14 are provided with guide holes 9 for installing the Kirschner wire guide head 7 in the vertical direction. Specifically, the Kirschner wire guide head 7 is circular at one end and conical at the other end. When in use, the conical side of the Kirschner wire guide head 7 is inserted into the guide hole 9 to facilitate the subsequent insertion of the Kirschner wire. The axis of the Kirschner wire guide head 7 is provided with a guide hole whose diameter matches the diameter of the Kirschner wire. The guide hole prevents the Kirschner wire from going off when being inserted, and can be correspondingly passed out from the opposite side, and can ensure that the Kirschner wire can be horizontally inserted into the two end faces of the patella. By providing the Kirschner wire guide head 7 and the guide hole 9, the Kirschner wire is guided and fixed, which facilitates the accurate and parallel insertion of two Kirschner wires into the corresponding parts of the fracture block during the operation. At the same time, after the Kirschner wire is inserted, the Kirschner wire guide head can be removed so that the entire device is moved out of the Kirschner wire position without affecting the subsequent internal fixation operation.

[0036] The design of the L-shaped claw I8, L-shaped claw II14, main support 1 and auxiliary support 2 as well as their movement mode facilitates the adjustment of the insertion position of the K-wire and the corresponding patella.

[0037] The guide hole 9 is a circular slot hole with a notch. The circular slot hole structure with a notch enables a guide hole 9 to have multiple insertion positions along its height direction. When reducing patellar fractures of different sizes during surgery, the upper and lower positions of the Kirschner wire fixation can be selected according to design requirements, and the corresponding insertion positions on the guide hole 9 can be selected accordingly, providing more options suitable for clinical needs. An opening 16 that passes through the L-shaped claw is provided under the guide hole 9. The size of the opening 16 is slightly larger than the diameter of the Kirschner wire. After the Kirschner wire is fixed, the Kirschner wire guide head 7 is removed and the nut 6 is loosened, so that the entire device can be smoothly removed, and the device is separated from the Kirschner wire through the opening 16.

[0038] The L-shaped claw I8 and the L-shaped claw II 14 are provided with spike-shaped clamps, and the upper side of the spike-shaped clamps is provided with an inclination angle of 20°-40°, preferably 30°. The inclination angle corresponds to the slightly sloped structure on the side of the bottom surface of the patella, so that the spike-shaped clamps can fit tightly with the bottom surface of the patella to improve the fixing effect.

Claims

1. A patellar reduction and Kirschner wire guide fixation device, characterized in that: The invention comprises an L-shaped main bracket (1) and a sub-bracket (2) slidably connected to one end of the main bracket (1) and parallel to the other end of the main bracket (1), the main bracket (1) and the sub-bracket (2) are provided with L-shaped claws I (8) opposite to each other, and the main bracket (1) and the sub-bracket (2) are also slidably connected to two L-shaped claws II (14) opposite to each other; The two L-shaped claws II (14) are connected via a connecting push rod; The connecting push rod comprises a connecting rod I (11) and a connecting rod II (13) fixedly connected to two L-shaped claws II (14), and a push rod (5) slidably connected to the connecting rod I (11) and the connecting rod II (13); The connecting rod I (11), the connecting rod II (13) and the push rod (5) are arranged coplanarly with the main bracket (1); the auxiliary bracket (2) is provided with a sliding groove (15); one end of the push rod (5) is a screw rod; one side of the push rod (5) has a thread and penetrates through the sliding groove (15) and protrudes; a nut (6) is provided on one side of the push rod (5) protruding from the sliding groove (15); The connecting rod II (13) is fixedly connected to a push-pull rod (10), and the push-pull rod (10) is arranged to pass through the main bracket (1).

2. The patellar reduction and Kirschner wire guiding and fixing device according to claim 1, characterized in that: The main support (1) and the auxiliary support (2) are both cylindrical, and the two L-shaped claws II (14) are slidably connected to the auxiliary support (2) and the main support (1) via a sliding sleeve I (3) and a sliding sleeve II (4).

3. The patellar reduction and Kirschner wire guiding and fixing device according to claim 1, characterized in that: The main support (1) is provided with a slide groove (12), and the push rod (5) is slidably connected to the main support (1) via the slide groove (12).

4. The patellar reduction and Kirschner wire guiding and fixing device according to any one of claims 1, 2 and 3, characterized in that: The L-shaped clamping claw I (8) and the L-shaped clamping claw II (14) are provided with guide holes (9) in the vertical direction for installing the Kirschner wire guide head (7), and the Kirschner wire guide head (7) is provided with a guide hole.

5. The patellar reduction and Kirschner wire guiding and fixing device as claimed in claim 4, characterized in that: The guide hole (9) is a circular slotted hole with a notch, and an opening (16) penetrating the L-shaped claw is provided below the guide hole (9).

6. The patellar reduction and Kirschner wire guiding and fixing device according to any one of claims 1, 2 and 3, characterized in that: The L-shaped clamping claw I (8) and the L-shaped clamping claw II (14) are provided with spike-shaped clamping heads, and the upper sides of the spike-shaped clamping heads are provided with an inclination angle of 20°-40°.

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