Intramedullary reduction device for long bone fractures of limbs

Abstract

The present invention discloses an intramedullary reducer for long bone fractures of limbs, comprising a guide hose, a guide wire, a driving mechanism and a wire feeding mechanism. The guide hose can be extended into the medullary cavity of the long bone shaft, and a capsule body capable of guiding the forward direction of the guide hose is fixed at the front end of the guide hose. The guide wire is inserted into the guide hose, and the front end of the guide wire extends out of the guide hose and is fixed with a blunt head abutting against the guide hose. The driving mechanism is used to drive the guide hose to move forward, and the distance between the driving mechanism and the front end of the guide hose is at least 10 mm. The wire feeding mechanism is placed outside the long bone shaft and is used to drive the guide wire to move forward.

Description

Technical Field

[0001] The invention relates to the field of orthopedic medical instruments, and in particular to an intramedullary reducer for long bone fractures of limbs. Background Art

[0002] In orthopedic treatment, fractures of long bones of the limbs are common clinical injuries. There are two main surgical options for treating fractures of long bones of the limbs: open reduction and internal fixation and closed reduction and internal fixation.

[0003] Closed reduction and internal fixation surgery has become the mainstream technology for treating diaphyseal fractures because of its small trauma, small blood loss for patients, and the retention of hematoma around the fracture containing factors that promote fracture healing. The incidence of complications such as postoperative infection and fracture nonunion is relatively low.

[0004] However, during the current closed reduction surgery, it is difficult to reduce fractures with lateral displacement, and there are no special instruments, which affects the accuracy of reduction and the quality of surgery. This has become a difficult problem in the treatment of long bone fractures of the limbs and has not been solved so far.

[0005] Chinese invention patent CN201310605218.5 discloses an intramedullary reducer for long bone fractures of limbs. The reducer extends a bent reduction head into the medullary cavity on the opposite side of the fracture end, pulls the push-pull handle at the rear end of the reduction rod, and causes the reduction head to move the medullary cavity on the opposite side to reduce the fractured bone on the opposite side, thereby allowing a guide wire (3) to be inserted into the medullary cavity on the opposite side of the fracture end, and after the outer sleeve is withdrawn, the fracture site is reduced and fixed using an intramedullary nail supporting tool. During the surgical operation, the two broken bones may have lateral and / or anterior-posterior angular deformities, and the reduction rod needs to be rotated continuously to adjust the angle of the reduction head so that it can enter the contralateral fracture. This requires the use of an auxiliary device, a C-arm machine, for repeated fluoroscopic monitoring and guidance. Therefore, the following problems exist: (1) The operation of the device is too complicated and overly dependent on the operator's experience, which results in great uncertainty. (2) The device adopts the method of reduction first and then threading the wire, but the reduction head enters the medullary cavity of the contralateral fracture shallowly, and the force is applied to the fracture point during reduction. The fracture at this point has low strength and high brittleness after being subjected to violence, which can easily cause secondary injury during reduction. Summary of the invention

[0006] The technical problem to be solved by the present invention is to provide an intramedullary reduction device for long bone fractures of limbs which can guide a guide wire into the bone marrow cavity of the opposite bone fracture.

[0007] In order to solve the above technical problems, the technical solution adopted by the present invention is:

[0008] An intramedullary reduction device for long bone fractures of limbs, characterized in that it comprises:

[0009] The guide hose can be inserted into the medullary cavity of the long bone shaft, and a capsule body capable of guiding the forward direction of the guide hose is fixed at the front end of the guide hose;

[0010] A guide wire is inserted into the guide hose, the front end of the guide wire extends out of the guide hose and is fixed with a blunt head that abuts against the guide hose;

[0011] A driving mechanism, used for driving the guide hose to move forward, wherein the driving mechanism is at least 10 mm away from the front end of the guide hose; and

[0012] The wire feeding mechanism is placed outside the long bone shaft and is used to drive the guide wire forward.

[0013] A further technical solution is that the driving mechanism is fixed on the guide hose and can move in the medullary cavity, and the length of the guide hose in front of the driving mechanism is 10 to 50 mm.

[0014] A further technical solution is that the driving mechanism comprises:

[0015] At least one inner tube is intersected with the guide hose, and both ends of the inner tube are fixed to the guide hose. Positioning stoppers are fixed on the inner walls of both ends of the inner tube.

[0016] Each inner tube is provided with:

[0017] Two mounting parts are placed in the inner tube between the two positioning stoppers, and can move along the axial direction of the inner tube and be restricted from rotating;

[0018] a spring, placed between the two mounting members and in a compressed state;

[0019] Two drive motors are fixed to the outsides of the two mounting members respectively, and the motor shaft of the drive motor is perpendicular to the axis of the inner tube; and

[0020] The two running wheels are respectively fixed on the motor shafts of the two driving motors and can extend out of the inner tube and run along the inner wall of the medullary cavity.

[0021] A further technical solution is that the annular surface of the running wheel has a tooth structure.

[0022] A further technical solution is that the driving mechanism further comprises:

[0023] The extrusion sleeve is a movable sleeve arranged outside the guide hose and can be against the outside of the entrance of the medullary cavity. The inner hole of the extrusion sleeve is conical, and the large end opening faces backwards, so that the driving mechanism can enter;

[0024] When the driving mechanism moves forward, the two running wheels are squeezed by the inner wall of the squeezing sleeve and can be retracted into the inner tube.

[0025] A further technical solution is characterized in that the driving mechanism comprises:

[0026] The tooth row is arranged on the outer wall of the guide hose and has a plurality of annular teeth arranged at equal intervals along the axial direction of the guide hose;

[0027] The external hard guide sleeve and the movable sleeve are arranged outside the guide hose and outside the medullary cavity;

[0028] A second driving motor is fixed on the outer hard guide sleeve; and

[0029] The driving gear is assembled on the motor shaft of the second driving motor and is rotatably located in the outer hard guide sleeve to mesh with the gear row for transmission.

[0030] A further technical solution is that the driving mechanism further comprises:

[0031] The inner hard guide sleeve is placed inside the outer hard guide sleeve, and a circle of permanent magnets is embedded on the outer wall of the inner hard guide sleeve;

[0032] A circle of permanent magnets 2 having the same magnetic pole as permanent magnet 1 is embedded on the inner wall of the outer hard guide sleeve. Under the action of magnetic field repulsion, permanent magnets 1 and 2 maintain a set distance, so that an annular gap matching the wall thickness of the guide hose is formed between the outer hard guide sleeve and the inner hard guide sleeve.

[0033] The beneficial effects of adopting the above technical solution are:

[0034] The device is provided with a capsule body. When the front end of the guide hose runs to the joint of the broken bones, in a perspective environment, the capsule body is able to turn and the angle of the capsule body is adjusted through the control system, so that the front end of the guide hose carries the guide wire into the bone marrow cavity of the opposite bone fracture. The guide hose is then withdrawn and the guide wire is continuously pushed forward through the wire feeding mechanism, so that the guide wire can penetrate into the bone marrow cavity of the two broken bones. Finally, an intramedullary nail is driven in along the guide wire to complete closed reduction and internal fixation.

[0035] The device replaces the doctor's manual operation with automated program control, which reduces the complexity of surgical operations, simplifies the operating steps, saves surgical time, and avoids medical radiation damage to users caused by X-rays caused by repeated fluoroscopy.

[0036] In addition, the driving mechanism in the device is at least 10 mm away from the front end of the guide hose. The specific position of the driving mechanism is set so that the length of the guide hose at the front end of the driving mechanism is not less than the distance between the two broken bones, and the driving mechanism will not enter the muscle between the two broken bones. The driving mechanism has landing support both in the medullary cavity and outside the long bone, ensuring effective driving power. BRIEF DESCRIPTION OF THE DRAWINGS

[0037] The present invention will be further described in detail below in conjunction with the accompanying drawings and specific embodiments.

[0038] Figure 1 It is a structural schematic diagram of an implementation mode of the resetter;

[0039] Figure 2 It is a structural schematic diagram of another embodiment of the resetter;

[0040] Figure 3 yes Figure 1 Schematic diagram of the enlarged structure of part A in the middle. DETAILED DESCRIPTION

[0041] The following is a clear and complete description of the technical solutions in the embodiments of the present invention in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are 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 those skilled in the art without creative work are within the scope of protection of the present invention.

[0042] In the following description, many specific details are set forth to facilitate a full understanding of the present invention, but the present invention may also be implemented in other ways different from those described herein, and those skilled in the art may make similar generalizations without violating the connotation of the present invention. Therefore, the present invention is not limited to the specific embodiments disclosed below.

[0043] Embodiment 1

[0044] like Figure 1 and Figure 2 As shown, a specific embodiment of the intramedullary reduction device for long bone fractures of limbs disclosed in the present invention includes a guide hose 1, a guide wire 3, a driving mechanism 5 and a wire feeding mechanism 6.

[0045] The guide hose 1 can be extended into the medullary cavity of the long bone, and a capsule body 2 capable of guiding the forward direction of the guide hose 1 is fixed at the front end of the guide hose 1. The capsule body 2 is a prior art, and the existing capsule body 2 includes a driving component, which is the core component of the capsule body 2 and is generally integrated in the capsule body 2. The existing driving modes mainly include: motor driving mode, electromagnetic driving mode, compression spring 514 driving mode, etc. The capsule body 2 signal is connected to an external control unit, and the driving component is controlled by the external processing unit to control the rotation of the capsule, and the running direction of the capsule body 2 can be adjusted.

[0046] The guide wire 3 is a medical guide wire 3 with certain strength and toughness. The guide wire 3 is inserted into the guide hose 1, and the front end of the guide wire 3 extends out of the guide hose 1 and is fixed with a blunt head 4 that abuts against the guide hose 1. The setting of the blunt head 4 can prevent the guide wire 3 from being withdrawn backward from the guide hose 1, so that the guide hose 1 can push the blunt head 4 forward to move the guide wire 3 forward.

[0047] The driving mechanism 5 is used to drive the guide hose 1 to move forward, and the distance between the driving mechanism 5 and the front end of the guide hose 1 is at least 10 mm.

[0048] The wire feeding mechanism 6 is placed outside the long bone shaft, and an existing wire feeding mechanism such as a manipulator, a wheel set or manual wire feeding can be used, which will not be described in detail. After the guide hose 1 is taken out, the wire feeding mechanism 6 starts to work, and is used to drive the guide wire 3 to continue to move forward, enter the contralateral fractured bone marrow cavity, and provide guidance for the placement of the intramedullary nail.

[0049] The device is provided with a capsule body 2. When the front end of the guide hose 1 runs to the joint of the broken bone (which can be determined by fluoroscopy or by setting a position tracking system), in a fluoroscopy environment, the capsule body 2 is able to turn by using the steering function, and the capsule body 2 is rotated by adjusting the control system outside the body to change the forward direction, so that the front end of the guide hose 1 carries the guide wire 3 into the bone marrow cavity of the opposite bone fracture. After the front end of the guide wire 3 enters the bone marrow cavity of the opposite bone, the medical staff withdraws the guide hose 1, and then continues to push the guide wire 3 forward through the wire feeding mechanism 6, and stops after the wire feeding reaches a certain position, so that the guide wire 3 can penetrate into the bone marrow cavities of the two fractures, and finally the intramedullary nail is driven along the guide wire 3 to complete the closed reduction and internal fixation.

[0050] The device replaces the doctor's manual operation with automated program control, which reduces the complexity of surgical operations, simplifies the operating steps, saves surgical time, and avoids medical radiation damage to users caused by X-rays caused by repeated fluoroscopy.

[0051] In addition, the driving mechanism 5 in the device is at least 10 mm away from the front end of the guide hose 1. The specific position of the driving mechanism 5 is set so that the length of the guide hose 1 at the front end of the driving mechanism 5 is not less than the distance between the two broken bones, and the driving mechanism 5 will not enter the muscle between the two broken bones. The driving mechanism 5 has landing support both in the medullary cavity and outside the long bone, ensuring effective driving power.

[0052] Embodiment 2

[0053] According to a specific embodiment of the disclosed intramedullary reduction device for long bone fractures of limbs, as Figure 1 and Figure 3 As shown, the driving mechanism 5 is fixed on the guide hose 1 and can move in the medullary cavity. The length of the guide hose 1 in front of the driving mechanism 5 is 10-50 mm. This length is sufficient for the doctor to directly put the driving mechanism 5 into the medullary cavity at the beginning; and at the position of the fractured bone joint, when the front guide hose 1 turns to enter the medullary cavity of the opposite fractured bone, the driving mechanism 5 can stay in the rear medullary cavity of the fractured bone, and the medullary cavity supports the driving mechanism 5.

[0054] Specifically, the driving mechanism 5 is fixed on the guide hose 1 and enters the medullary cavity along with the guide hose 1. The driving mechanism 5 includes at least one inner tube 511, and each inner tube 511 is provided with two mounting members 513, a spring 514, two driving motors 515 and two running wheels 516.

[0055] The inner tube 511 is intersected with the guide hose 1, and its two ends are fixed to the guide hose 1. Positioning stoppers 512 are fixed on the inner walls of the two ends of the inner tube 511, and the positioning stoppers 512 protrude inwardly from the inner wall of the guide hose 1. When multiple inner tubes 511 are used, the multiple inner tubes 511 are arranged in parallel.

[0056] The two mounting members 513 are placed in the inner tube 511 between the two positioning members 512. The positioning members 512 can prevent the mounting members 513 from being separated from the inner tube 511. The two mounting members 513 can move axially along the inner tube 511 and be restricted from rotating. The structure for restricting rotation can be realized by a concave-convex matching structure. The spring 514 is placed between the two mounting members 513 and is in a compressed state. The two driving motors 515 are respectively fixed to the outer sides of the two mounting members 513, and the motor shafts of the driving motors 515 are arranged perpendicular to the axis of the inner tube 511. The two running wheels 516 are respectively fixed to the motor shafts of the two driving motors 515, and can extend out of the inner tube 511 and travel along the inner wall of the medullary cavity, wherein the annular surface of the running wheel 516 has a tooth structure to prevent the running wheel 516 from slipping. The compressed spring 514 always exerts an outward force on the mounting member 513, so that the running wheel 516 extends out of the inner tube 511 and contacts the inner wall of the medullary cavity, and a certain pressure is created between the running wheel 516 and the inner wall of the medullary cavity, so that the running wheel 516 can move normally.

[0057] During use, personnel can manually squeeze the two running wheels 516 inwards to further compress the spring 514, so that the running wheels 516 retract into the inner tube 511, so that the device can enter the medullary cavity at the beginning. After entering the medullary cavity, the spring 514 resets and stretches to drive the two running wheels 516 to extend out of the inner tube 511 and contact the inner wall of the medullary cavity. The driving motor 515 is started, and the driving mechanism 5 can drive the wire hose to move forward and deep into the medullary cavity.

[0058] Furthermore, the driving mechanism 5 also includes an extrusion sleeve to facilitate the driving mechanism 5 to enter the medullary cavity initially.

[0059] The extrusion sleeve is movably mounted outside the guide hose 1 and can be against the entrance of the medullary cavity without entering the medullary cavity. The inner hole of the extrusion sleeve is conical, with the large end opening facing backwards, so that the drive mechanism 5 can enter. As the guide hose 1 moves forward with the drive mechanism 5, the two running wheels 516 are squeezed by the inner wall of the extrusion sleeve and can be retracted into the inner tube 511.

[0060] Embodiment 3

[0061] According to a specific embodiment of the disclosed intramedullary reduction device for long bone fractures of limbs, as Figure 2 As shown, the driving mechanism 5 is arranged outside the body, including a gear row, an external hard guide sleeve 521, a second driving motor and a driving gear 522.

[0062] The teeth are arranged on the outer wall of the guide hose 1, and there are multiple annular teeth arranged at equal intervals along the axial direction of the guide hose 1. The outer hard guide sleeve 521 is a hard guide sleeve, which is slidably sleeved outside the guide hose 1 and placed outside the medullary cavity. The drive motor 2 is fixed to the outer hard guide sleeve 521 through the motor seat. The drive gear 522 is assembled on the motor shaft of the drive motor 2, and is rotatably located in the outer hard guide sleeve 521 to engage with the teeth on the gear row to realize transmission. The drive motor 2 is started, and the guide hose 1 can be driven forward or backward by the forward and reverse rotation of the drive motor 2 under the action of the drive gear 522.

[0063] Furthermore, in order to prevent the driving gear 522 and the guide hose 1 from deforming when the driving gear 522 and the guide hose 1 are meshed and driven, so that the driving gear 522 and the gear row cannot mesh, the driving mechanism 5 further includes an inner hard guide sleeve 523 .

[0064] The inner hard guide sleeve 523 is placed inside the outer hard guide sleeve 521, and a circle of permanent magnets 1 524 is embedded on the outer wall of the inner hard guide sleeve 523. A circle of permanent magnets 2 525 with the same magnetic pole as the permanent magnets 1 524 is embedded on the inner wall of the outer hard guide sleeve 521. Under the action of the magnetic field repulsion, the permanent magnets 1 524 and 2 525 maintain a set distance, so that an annular gap matching the wall thickness of the guide hose 1 is formed between the outer hard guide sleeve 521 and the inner hard guide sleeve 523. The guide hose 1 passes through the gap, and through the cooperation of the inner and outer hard guide sleeves 521, the guide hose 1 at this location can be supported, so that the driving gear 522 and the gear row can effectively mesh and transmit.

[0065] The above are only preferred embodiments of the present invention. Any simple modification, deformation and equivalent substitution made by anyone to the present invention based on the contents of the present invention shall fall within the protection scope of the present invention.

Claims

1. An intramedullary reducer for long bone fractures of limbs, characterized in that: include: A guide hose (1) is capable of extending into the medullary cavity of a long bone shaft, and a capsule body (2) is fixed at the front end of the guide hose (1) and is capable of guiding the forward direction of the guide hose (1); A guide wire (3) is inserted into the guide hose (1), the front end of the guide wire (3) protrudes from the guide hose (1) and is fixed with a blunt head (4) that abuts against the guide hose (1); a driving mechanism (5) is used to drive the guide hose (1) to move forward, and the distance between the driving mechanism (5) and the front end of the guide hose (1) is at least 10 mm; and A wire feeding mechanism (6) is disposed outside the long bone shaft and is used to drive the guide wire (3) to move forward; The driving mechanism (5) comprises: At least one inner tube (511) is intersected with the guide hose (1), and its two ends are fixed to the guide hose (1). Positioning stoppers (512) are fixed on the inner walls of the two ends of the inner tube (511); Each inner tube (511) is provided with: The two mounting members (513) are placed in the inner tube (511) between the two positioning stoppers (512), and can move axially along the inner tube (511) and be restricted from rotating; A spring (514) is placed between the two mounting members (513) and is in a compressed state; Two driving motors (515) are respectively fixed to the outsides of the two mounting members (513), and the motor shafts of the driving motors (515) are arranged perpendicular to the axis of the inner tube (511); Two running wheels (516) are respectively fixed on the motor shafts of the two driving motors (515), and can extend out of the inner tube (511) and run along the inner wall of the medullary cavity; An extrusion sleeve, which is movably arranged outside the guide hose (1) and can be pressed against the outside of the entrance of the medullary cavity, wherein the inner hole of the extrusion sleeve is conical, and the large end opening faces backwards, so that the driving mechanism (5) can enter; When the driving mechanism (5) moves forward, the two running wheels (516) are squeezed by the inner wall of the squeezing sleeve and can be retracted into the inner tube (511); A tooth row is arranged on the outer wall of the guide hose (1), and has a plurality of annular teeth arranged at equal intervals along the axial direction of the guide hose (1); An outer hard guide sleeve (521), the movable sleeve is arranged outside the guide hose (1) and is placed outside the medullary cavity; A second driving motor is fixed on the outer hard guide sleeve (521); A driving gear (522) is mounted on the motor shaft of the second driving motor and is rotatably located in the outer hard guide sleeve (521) to mesh with the gear row for transmission; and An inner hard guide sleeve (523) is placed inside the outer hard guide sleeve (521), and a circle of permanent magnets (524) is embedded on the outer wall of the inner hard guide sleeve (523); A circle of permanent magnets (525) having the same magnetic pole as the permanent magnet (524) is embedded on the inner wall of the outer hard guide sleeve (521). Under the action of the magnetic field repulsion, the permanent magnets (524) and the permanent magnets (525) maintain a set distance, so that an annular gap matching the wall thickness of the guide hose (1) is formed between the outer hard guide sleeve (521) and the inner hard guide sleeve (523).

2. The intramedullary reduction device for long bone fractures of limbs according to claim 1, characterized in that: The driving mechanism (5) is fixed on the guiding hose (1) and can move in the medullary cavity. The length of the guiding hose (1) in front of the driving mechanism (5) is 10 to 50 mm.

3. The intramedullary reduction device for long bone fractures of limbs according to claim 1, characterized in that: The annular surface of the running wheel (516) has a tooth structure.

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