A miniature external fixation combined frame for treating comminuted fractures of interphalangeal joints of the hand
By using a ring-shaped connection device and a 3D-printed individualized joint micro-shield combination frame in the comminuted fracture of the hand and the uncontrollable elasticity of the rubber band in the prior art, the problem of joint surface reduction not only and the elasticity of the rubber band in the prior art is solved, and the problem of joint surface reduction is not smooth and the elasticity of the rubber band is uncontrollable in the prior art. The reduction of surgical difficulty and the retention of postoperative function have reduced the occurrence of complications.
Patent Information
- Application Number
- CN201910602348.0
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- Filing Date
- 2019-07-01
- Publication Date
- 2025-01-03
- Estimated Expiration
- 2039-07-01
AI Technical Summary
In the treatment of comminuted fractures of the interphalangeal joints in the prior art, the reduction of the joint surface is not smooth, and the elasticity of the rubber band in the dynamic traction frame is uncontrollable, resulting in postoperative joint bloating deformity, loss of function, interphalangeal arthritis and other complications, lack of Effective reset fixture.
A miniature external fixing combination frame consisting of a ring-shaped connection device, a double-head threaded support frame and 3D-printed individual joint micro-shields are used to connect the double-head threaded fixing needle and fixing rod using ring-shaped screw holes and ring cups, combining with 3D printing The articular surface of the micro-shield is reset to avoid the uncontrollable elasticity of the rubber band, and the joint gap is maintained through 3D printing of the micro-shield, simplifying the difficulty of surgery and postoperative recovery.
It significantly reduces the difficulty and time of surgery, reduces postoperative complications, retains the joint function between fingers and fingers, reduces trauma and cost, and improves the simplicity and effectiveness of treatment.
Smart Images
Figure CN112237467B_ABST
Abstract
Description
Technical Field
[0001] The invention relates to the technical field of medical equipment, in particular to a micro external fixation combined frame for treating comminuted fractures of interphalangeal joints of hands. Background Art
[0002] Interphalangeal fractures of the hand are relatively common, among which Pilon fracture is quite special. It is a comminuted fracture of the interphalangeal joint caused by longitudinal violent conduction of the fingers. It is characterized by central compression of the basal articular surface of the phalanges and peripheral separation. It is an unstable fracture and is prone to joint pain, stiffness, degeneration, subluxation, flexion contracture and joint instability in the later stage.
[0003] Comminuted fractures of the interphalangeal joints of the hand are difficult to operate on because of the comminuted fractures and involvement of the articular surfaces. Currently, the most recognized surgical methods are dynamic traction stents and Kirschner wire cross internal fixation. However, due to the uneven reduction of the articular surfaces and the uncontrollable elasticity of the rubber bands of the dynamic traction stents, postoperative complications such as joint bulging deformity, loss of function, and interphalangeal arthritis are easily caused. So far, there is no good reduction and fixation device in the world.
[0004] Therefore, it is necessary to provide a new fixation device to solve the above problems, so that the treatment of comminuted fractures of the interphalangeal joints of the hand can be simpler, faster and more effective, and the postoperative complications can be reduced. Summary of the invention
[0005] In view of the deficiencies in the prior art, the purpose of the present invention is to provide an external fixator combination specifically for comminuted fractures of the interphalangeal joints of the hand, which can effectively solve the above-mentioned problems, greatly reduce the difficulty and time of surgery, preserve the function of the interphalangeal joints of the fingers after fracture surgery, and has the advantages of low cost, less trauma, and easy dismantling, thus filling an international gap.
[0006] The technical solution adopted to achieve the above purpose is that the combined frame is composed of a ring-shaped connecting device, a double-threaded support frame and a 3D printed individualized joint micro-gasket. The ring-shaped connecting device is composed of a ring-shaped screw hole, a solid fixing rod and a ring cup, which is used to connect the double-threaded fixing needle and the double-threaded fixing rod; the support frame is composed of two 3.5cm long double-threaded fixing needles, 4 1.5cm long double-threaded fixing rods and a hollow threaded sleeve. The ring-shaped screw hole connects the fixing needle, the ring cup connects the solid fixing rod, and the double-threaded fixing rods are connected in pairs through the hollow sleeve. After the three are connected, the length can be adjusted in the range of 3-5cm; the 3D printed micro-gasket is a special instrument for comminuted fractures of the interphalangeal joint articular surface, with a thickness of 0.2cm, which is squeezed in the joint during surgery. The materials used in the combined frame are all titanium alloys.
[0007] The key innovative designs of this patent include:
[0008] (1) Originally developed ring-shaped connection device: The ring screw hole has a threaded nut function (connecting the threaded fixing pin), and the ring cup has a threaded nut function (connecting the threaded fixing rod). The length of the rod can be extended or shortened by rotating the thread, thereby achieving extension and pressure on the fracture end while occupying a very small space.
[0009] (2) Originally developed micro-traction frame: It avoids the disadvantages of bilateral asymmetry, uncertainty and non-adjustability of elastic force of rubber bands used in the past; it eliminates the need for multiple pinning operations to fix fractures; it does not damage the periosteum, causes little damage to tissues near the joints, is easy to operate, and shortens anesthesia and surgery time.
[0010] (3) The world's first original 3D printed individualized joint micro-shim: It has the function of maintaining and expanding the interphalangeal joint space. The proximal end of the gasket is concave to squeeze and grind the convex cartilage surface of the proximal end of the fracture, and the distal end of the gasket is convex to squeeze and grind the concave cartilage surface of the distal end of the fracture. During the operation, it is only necessary to hold the patient's interphalangeal joint for a few flexion and extension movements to achieve a smooth and flat interphalangeal joint surface. The tedious and time-consuming operation of reducing the comminuted joint surface and fixing it with Kirschner wires is eliminated during the operation (the bone fragments of interphalangeal joint comminuted fractures are extremely small, and some are in the form of slag, which are difficult to fix with Kirschner wires), greatly simplifying the difficulty of the operation. Since the gasket conforms to the proximal and distal anatomical structure of the normal interphalangeal joint, it can effectively reduce the incidence of traumatic arthritis and ensure the activity function of the interphalangeal joint.
[0011] The beneficial effects of the present invention are simple structure, easy manufacture, low price and strong operability. It is designed according to the characteristics of comminuted fractures of interphalangeal joints of the hand and the shortcomings of modern surgery, and overcomes the problems of poor postoperative recovery, poor functional activity and postoperative complications of comminuted fractures of interphalangeal joints of the hand at home and abroad. BRIEF DESCRIPTION OF THE DRAWINGS
[0012] The present invention is further described below with reference to the accompanying drawings and embodiments.
[0013] Figure 1 It is a structural schematic diagram of the present invention
[0014] Figure 2 This is a schematic diagram of the ring-shaped connection device structure.
[0015] Figure 3 Three views of 3D printed individualized joint micro-shims DETAILED DESCRIPTION
[0016] The present invention will be further described below in conjunction with the accompanying drawings.
[0017] like Figure 1As shown, ① 1.5 cm long double-threaded fixing rod ② ring-shaped connecting device (self-created) ③ thread ④ 3.5 cm long double-threaded fixing needle ⑤ hollow threaded sleeve ⑥ ring-shaped screw hole ⑦ solid fixing rod ⑧ ring cup ⑨ 3D printed individualized joint micro-gasket (first of its kind)
[0018] The combined frame of the present invention is composed of a ring-shaped connecting device, a double-threaded support frame and a 3D printed micro-shim for interphalangeal joints. The present invention is mainly suitable for comminuted fractures of interphalangeal joints of the hand, which can be closed or open fractures.
[0019] Before the operation, the selected combination frame and joint micro-gaskets should be disinfected.
[0020] The operation was performed under brachial plexus anesthesia and air bag tourniquet, and routine disinfection and draping were performed. 1. For patients without peripheral nerve, blood vessel and ligament injury, the lateral rotation center of the proximal phalanx condyle of the fracture end was used as the needle insertion point, and a 3.5 cm long double-headed threaded fixation needle was inserted percutaneously perpendicular to the bone shaft through the opposite cortex. The exposed lengths of the inner and outer fixation needles should be symmetrical. Another fixation needle was inserted in the same plane of the distal phalanx of the fracture, and the distal and proximal ends ④ should remain parallel. The ⑥ ring-shaped screw holes of the four ② ring-shaped connecting devices were fixed to the two threaded ends of the two ④ double-headed threaded fixation needles, and the distances on both sides were kept symmetrical. By rotating the ring-shaped screw holes, the four ⑧ ring cups were parallel to the phalanx force line. The ⑧ ring cup on the same side was between the ④ double-headed threaded fixation needles, and the ⑧ ring cups, ④ double-headed threaded fixation needles and phalanges were in the same horizontal plane. A small arc-shaped incision is made on the dorsal side of the interphalangeal joint of the affected finger, and a small longitudinal incision is made to cut the extensor tendon to expose the joint surface. The 3D-printed individualized joint micro-gasket is squeezed into the joint during the operation. The interphalangeal joint surface can be smoothed by holding the patient's interphalangeal joint for a few flexion and extension activities, which saves the tedious and time-consuming operation of crushing the joint surface and fixing it with Kirschner wires during the operation. Two ① double-headed threaded fixing rods with a length of 1.5 cm are connected through ⑤ hollow threaded sleeves. The threaded end of one fixing rod is screwed into one end of the hollow sleeve, and the threaded end of the other fixing rod is screwed into the other end of the hollow sleeve. The three are combined to form a long combined fixing rod, and the telescopic length can be controlled to 3-5 cm. The two ends of the long combined fixing rod are the threaded ends of the ① double-headed threaded fixing rod. The threaded ends at both ends are screwed into the two ⑧ ring cups on the same side of the phalanx. The length of the long combined fixing rod is adjusted by twisting the hollow sleeve or the double-headed threaded fixing rod to achieve the length required to stabilize the fracture structure. Two long combined fixation rods and double-ended threaded fixation pins at the far and near ends form a miniature external fixation combined frame, which is shaped like a rectangle or square. 2. For patients with peripheral nerve, blood vessel and ligament injuries due to fracture, the peripheral nerve, blood vessel and ligament can be repaired first before the above operation.
[0021] Comminuted joint surface reduction
[0022] The first original 3D printed individualized joint micro-gasket. During the operation, the dorsal side of the finger joint is opened and inserted between the joints. The proximal end of the gasket is concave, which is used to extrude and grind the convex cartilage surface of the proximal end of the fracture to reduce the fracture. The distal end of the gasket is convex, which is used to extrude and grind the concave cartilage surface of the distal end of the fracture to reduce the fracture. During the operation, only the joints need to be moved to achieve a smooth and flat interphalangeal joint surface. There is no need for Kirschner wire fixation, which simplifies the difficulty of the operation and reduces the incidence of postoperative complications.
[0023] Bone lengthening and bone end compression
[0024] When there is a large bone defect and severe comminution during fracture, the purpose of bone lengthening can be achieved by twisting the hollow threaded sleeve or double-headed threaded fixing rod. When bone lengthening is not required, the threaded rod can be rotated in the opposite direction to pressurize the bone ends and promote fracture healing.
[0025] The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications, combinations and variations. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention shall be included in the protection scope of the present invention.
Claims
1. A miniature external fixation assembly for treating comminuted fractures of interphalangeal joints of the hand, comprising: The ring-shaped connection device, the double-threaded support frame and the interphalangeal joint 3D printed micro-gasket are composed of the ring-shaped connection device, the ring-shaped screw hole, the solid fixing rod and the ring cup; the support frame is composed of two 3.5cm long double-threaded fixing pins, four 1.5cm long double-threaded fixing rods and a hollow threaded sleeve, the ring-shaped screw hole is connected to the double-threaded fixing pins, the ring cup is connected to the double-threaded fixing rods, and the double-threaded fixing rods are connected in pairs through the hollow threaded sleeve. After the three are connected, the length telescopic adjustment range is 3-5cm; the 3D printed micro-gasket is a special instrument for comminuted fractures of the articular surface of the interphalangeal joint, with a thickness of 0.2cm, and is clamped in the joint during surgery; the material used in the combined frame is titanium alloy; Both ends of the double-threaded fixing needle and the double-threaded fixing rod in the double-threaded support frame are threaded, the threaded end of the double-threaded fixing needle is screwed into the ring-shaped screw hole, and the threaded end of the double-threaded fixing rod is screwed into the ring cup; the double-threaded fixing needle is 3.5 cm long and 0.3 cm in diameter; the double-threaded fixing rod is 15 cm long and 0.5 cm in diameter; There are threads inside the ring-shaped screw hole and the ring cup, which are used to connect the double-ended threaded fixing pin and the double-ended threaded fixing rod to form an external fixator; the ring-shaped screw hole is shaped like a nut, with a pentagonal outer edge, a tube diameter of 0.3cm, and an inner and outer edge thickness of 0.2cm; the ring cup is a hollow threaded cylinder with a tube diameter of 0.5cm; the solid fixing rod is 0.3cm long and 0.2cm in diameter.
2. The micro external fixation assembly according to claim 1, characterized in that: The hollow threaded sleeve is provided with threads, and the threaded end of a double-threaded fixing rod is screwed into one end of the hollow sleeve, and the threaded end of another double-threaded fixing rod is screwed into the other end of the hollow sleeve, and the three are combined to form a long combined fixing rod; the hollow threaded sleeve is 2 cm long and has a tube diameter of 0.5 cm; the length of the long combined fixing rod can be adjusted by twisting the hollow threaded sleeve, and the controllable length range is 3-5 cm.
3. The micro external fixation assembly according to claim 2, characterized in that: The two threaded ends of the long combined fixing rod are respectively screwed into the ring cups with a tube diameter of 0.5 cm, and the double-headed threaded fixing needle is screwed into the ring-shaped screw hole with a tube diameter of 0.3 cm.
4. The micro external fixation assembly according to claim 1, characterized in that: The 3D printed individualized joint micro-gasket is round and concave in the middle, similar to a contact lens. The proximal end is concave for extrusion and grinding to reduce the fracture, and the distal end of the gasket is convex for extrusion and grinding to reduce the fracture, and the distal end of the gasket is concave for extrusion and grinding to reduce the fracture. The diameter of the joint micro-gasket is 1.5 cm and the thickness is 0.2 cm.