A fixation device for posterior cruciate ligament tibial attachment avulsion fracture and use method thereof

Abstract

The present invention relates to a fixation device for avulsion fracture of posterior cruciate ligament tibial attachment point and a method of use. When in use, a guide rod is passed through the tibia and the fracture fragment from the front side of the tibia at the same time, and then a clamping ring is set on the guide rod between the clamping part and the fracture fragment from the rear side of the knee joint, and then the tightening part and the clamping ring are used to clamp the tibia and the fracture fragment to achieve the fixation of the tibia and the fracture fragment. Compared with the prior art, the present invention eliminates structures such as sutures and steel plates with loops, and cleverly achieves more stable rigid fixation through the tightening part and the clamping ring. Most importantly, the entire arthroscopic surgery does not require the complicated establishment of double tibial channels, and the surgical channel does not pass through the popliteal fossa blood vessels and nerve tissues, and has the characteristics of minimally invasive surgery under the whole microscope. In addition, the present invention eliminates the traditional repeated threading and winding, bundling and tying operations in the surgical process, making it more convenient and simpler to operate under arthroscopy.

Description

Technical Field

[0001] The invention relates to the technical field of medical instruments, and in particular to a fixation device for tibial avulsion fracture of the posterior cruciate ligament and a use method thereof. Background Art

[0002] The avulsion fracture of the tibia insertion of the posterior cruciate ligament is a special intra-articular fracture that often occurs in trauma and sports injuries. The characteristic of this type of fracture is that the fracture fragment floats upward due to the traction of the posterior cruciate ligament, resulting in failure of the posterior cruciate ligament, joint relaxation, and non-union of the fracture. The surgical treatment methods for this type of fracture include open surgery and arthroscopic treatment.

[0003] Due to the large number of blood vessels and nerve bundles in the popliteal fossa, open surgery is difficult to expose, has a high risk of injury, and scars affect the appearance. Therefore, minimally invasive arthroscopic surgical treatment methods are generally used. Arthroscopic surgical treatment requires the use of structures such as fixing screws, Kirschner wires, cerclage wires, and steel plates with loops. For example, Chinese invention patent application CN113208722A discloses a fixed suspension device and operation method for posterior cruciate ligament spondylosis fracture reduction surgery. The operation method can reduce the number of surgical steps and is simple and easy to perform. It only requires drilling a bone tunnel in the middle of the avulsed bone block, and the reduction, drilling of the bone tunnel, and wire passing can all be completed on the ACL locator. There is no need to perform suturing, wire passing, and knotting in the posterior knee joint cavity, which greatly simplifies the surgical steps and reduces the surgical risks. When the knee is flexed to about 90 degrees, the wire loop on the suspension loop is tightened, and the screw is screwed into the tunnel for fixation, so that the knee joint can maintain a constant pressure of the titanium plate with loops on the avulsed bone block within the flexion and extension range, which is conducive to fracture healing and early functional exercise.

[0004] However, the above method still requires the use of objects that are difficult to manipulate, such as titanium plates with loops and sutures, and the surgery requires operations such as threading, grasping, and bolting titanium plates with loops. These operations are not easy to perform in the narrow space of the knee joint under arthroscopy, which increases the complexity of the operation and the difficulty of the surgery.

[0005] Invention content

[0006] In view of this, it is necessary to provide a fixation device for tibial avulsion fracture of the posterior cruciate ligament to solve the problem that the existing arthroscopic posterior cruciate ligament fracture repair surgery requires the use of sutures during fixation, which makes it difficult to operate.

[0007] The present invention provides a novel fixation device for posterior cruciate ligament tibial attachment point avulsion fracture, comprising:

[0008] A guide rod for passing through the tibia and fracture fragments;

[0009] A clamping ring is detachably mounted on one end of the guide rod and is used to abut against the end of the fracture fragment away from the tibia;

[0010] The clamping part is slidably connected to one end of the guide rod along the radial direction of the guide rod. When the clamping part slides to be embedded in the guide rod, the clamping part allows the clamping ring to slide through; when the clamping part slides to protrude from the guide rod, the clamping part is used to limit the clamping ring from sliding in a direction away from the tibia;

[0011] The tightening part is detachably connected to the other end of the guide rod along the extension direction of the guide rod, and is used for clamping the tibia and the fracture fragment together with the clamping ring.

[0012] Preferably, the clamping portion is slidably inserted into the outer peripheral surface of the guide rod along the radial direction of the guide rod, and the end of the clamping portion away from the guide rod forms a beveled surface, and the direction of the beveled surface is away from the guide rod and the fracture block at the same time.

[0013] Preferably, the clamping portion is cylindrical, the axis of the clamping portion extends radially along the guide rod, one end of the clamping portion is inserted into the guide rod, and a chamfered surface is formed at the other end of the clamping portion.

[0014] Preferably, a spring is further included, a peripheral surface of one end of the guide rod is formed with a slot for the clamping portion to be inserted, the spring is built into the slot, and two ends of the spring are respectively connected to the guide rod and the clamping portion.

[0015] Preferably, the number of the clamping parts is at least two, and the at least two clamping parts are arranged around the circumference of the guide rod at equal angles.

[0016] Preferably, a thread is formed on the circumferential surface of the other end of the guide rod, and the tightening portion is a nut, which is sleeved on the guide rod and threadably connected thereto.

[0017] Preferably, a Kirschner wire is further included, and a through hole for the Kirschner wire to pass through is formed along the axis of the guide rod.

[0018] Preferably, the outer peripheral surface of the clamping ring is formed by two arc-shaped surfaces and two planes, and the two planes are parallel.

[0019] Preferably, it also includes a mounting clamp, which includes two foldable clamp arms, and the two clamp arms have grooves on the sides facing each other, which are respectively used to clamp the two planes on the clamp ring to clamp the clamp ring.

[0020] The present invention also provides a method for using the above-mentioned posterior cruciate ligament tibial attachment point avulsion fracture fixation device, comprising:

[0021] Step 1, implanting the guide rod from the front of the tibia and passing through the fracture fragment;

[0022] Step 2, sleeve the clamping ring onto the guide rod from the posterior approach of the knee joint, and clamp it between the clamping part and the fracture block;

[0023] Step 3: Install the tightening part on the other end of the guide rod so that the tightening part and the clamping ring clamp and fix the tibia and the fracture fragment.

[0024] The posterior cruciate ligament tibial attachment point avulsion fracture fixation device and use method provided by the present invention, when in use, a guide rod is passed through the tibia and the fracture fragment from the front side of the tibia at the same time, and then a clamping ring is sleeved on the guide rod between the clamping part and the fracture fragment from the rear side of the knee joint, and then the tightening part and the clamping ring are used to clamp the tibia and the fracture fragment, thereby achieving fixation of the tibia and the fracture fragment.

[0025] Compared with the prior art, the present invention eliminates the need for sutures, steel plates with loops and other structures, and ingeniously achieves more stable rigid fixation through the tightening part and the clasp. Most importantly, during surgery, the clasp only needs to be inserted from the posterior tibia approach, and the tightening part can be fixed from the front side of the tibia where there is less tissue around the tibia, so that the entire arthroscopic surgery does not require the complicated establishment of double tibial channels, and the surgical channel does not pass through the popliteal fossa vascular and nerve tissue, and has the characteristics of minimally invasive surgery under the microscope. In addition, the present invention eliminates the traditional repeated threading and winding, bundling and tying operations during the surgical process, making it more convenient and easier to operate under arthroscopy. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] Figure 1 A schematic structural diagram of an embodiment of a fixation device for tibial avulsion fracture of the posterior cruciate ligament provided by the present invention;

[0027] Figure 2 An exploded view of an embodiment of a fixation device for posterior cruciate ligament tibial attachment avulsion fracture provided by the present invention;

[0028] Figure 3 for Figure 1 A partial enlarged view of the middle A;

[0029] Figure 4 A schematic structural diagram of a clamping portion of an embodiment of a fixation device for tibial avulsion fracture of the posterior cruciate ligament provided by the present invention;

[0030] Figure 5 This is a schematic structural diagram of the mounting clamp in one embodiment of the posterior cruciate ligament tibial attachment point avulsion fracture fixation device provided by the present invention. DETAILED DESCRIPTION

[0031] The preferred embodiments of the present invention are described in detail below in conjunction with the accompanying drawings, wherein the accompanying drawings constitute a part of this application and are used together with the embodiments of the present invention to illustrate the principles of the present invention, but are not used to limit the scope of the present invention.

[0032] Combination Figures 1 to 5As shown, the present invention provides an embodiment of a fixation device for avulsion fracture of tibia with posterior cruciate ligament attachment point, which comprises a guide rod 1, a clamping ring 2, a clamping portion 3 and a tightening portion 4. The guide rod 1 is used to pass through the tibia and the fracture fragment, and the clamping ring 2 is movably sleeved on one end of the guide rod 1, that is, located on the side of the fracture fragment away from the tibia, and is used to abut the fracture fragment. The clamping portion 3 is connected to the peripheral surface of one end of the guide rod 1 and abuts the end surface of the clamping ring 2 away from the fracture fragment. The clamping portion 3 and the guide rod 1 are movably connected to enable the clamping ring 2 to pass over the clamping portion 3 from one end of the guide rod 1 and be sleeved on the guide rod 1. The tightening portion 4 is movably connected to the other end of the guide rod 1 along the extension direction of the guide rod 1, that is, located on the side of the tibia away from the fracture fragment, and is used to abut the tibia, and it drives the clamping portion 3 to press the clamping ring 2 on the fracture fragment to complete the fixation.

[0033] The posterior cruciate ligament tibial attachment point avulsion fracture fixation device and use method provided by the present invention are as follows: when in use, a guide rod 1 is passed through the tibia and the fracture fragment from the front side of the tibia at the same time, and then a clamping ring 2 is sleeved on the guide rod 1 between the clamping part 3 and the fracture fragment from the rear side of the knee joint, and then the tightening part 4 and the clamping ring 2 are used to clamp the tibia and the fracture fragment, thereby fixing the tibia and the fracture fragment.

[0034] It can be understood that the tibia in the present invention refers to the tibia body, and the fracture fragment refers to the part of the tibia attachment point of the posterior cruciate ligament, which is disconnected from the tibia body and connected to the posterior cruciate ligament. Like the posterior approach to the knee joint, they are all existing concepts and common sense in the relevant field, and will not be further explained in this article.

[0035] The following will describe each of the above components in more detail:

[0036] As a preferred embodiment, the guide rod 1 of this embodiment is made of an inert metal material and has a length of 60 mm. The two ends of the guide rod 1 are respectively a head end and a tail end. After the guide rod 1 passes through the tibia and the fracture fragment, the side of the fracture fragment away from the tibia is the head end, that is, the end of the guide rod 1 away from the fracture fragment in the above text, and the end of the tibia away from the fracture fragment is the tail end, that is, the end of the guide rod 1 away from the tibia in the above text.

[0037] The outer peripheral surface of the tail end of the guide rod 1 is threaded for connecting the tightening part 4. The guide rod 1 is a hollow structure, that is, a through hole with a diameter of 2.2 mm is opened inside along its axis for the Kirschner wire 6 mentioned later to pass through.

[0038] As a preferred embodiment, the outer circumference of the snap ring 2 in this embodiment is formed by two arcuate surfaces 21 and two planes 22, and the two planes 22 are parallel. The outer circle of the snap ring 2 forms a waist shape with two straight edges, and the two planes 22 on the circumference of the snap ring 2 and the end face of the snap ring 2 are set at an angle, preferably a right angle. The two planes 22 can facilitate the mounting clamp 7 mentioned later to clamp the snap ring 2, so that the snap ring 2 is more stable when it is extended into the rear access and sleeved on the guide rod 1.

[0039] As a preferred embodiment, the clamping portion 3 in this embodiment is slidably inserted into the outer peripheral surface of the guide rod 1 along the radial direction of the guide rod 1, and the end of the clamping portion 3 away from the guide rod 1 forms a bevel surface 31, and the direction of the bevel surface 31 is away from the guide rod 1 and the fracture fragment at the same time.

[0040] In this way, when the guide rod 1 is inserted from the front side of the tibia, the clamping part 3 can retract using the beveled surface 31, thereby facilitating the passage of the entire guide rod 1. At the same time, when installing the snap ring 2, the beveled surface 31 can also be displaced when it contacts the snap ring 2, thereby allowing the snap ring 2 to advance over the clamping part 3.

[0041] Specifically, the clamping portion 3 in this embodiment is cylindrical, the axis of the clamping portion 3 extends along the radial direction of the guide rod 1, one end of the clamping portion 3 is inserted into the guide rod 1, and the chamfered surface 31 is formed at the other end of the clamping portion 3. In addition, the number of the clamping portions 3 in this embodiment is four, and the four clamping portions 3 are arranged around the circumference of the guide rod 1 at equal angles to improve the stability when fixing the clamp ring 2.

[0042] It is easy to understand that the number of the clamping parts 3 can be changed according to the specific situation, and two or more can achieve a relatively stable effect. Further, the clamping part 3 can also be other shapes besides cylindrical, such as prism or other special shapes.

[0043] As a preferred embodiment, the posterior cruciate ligament tibial attachment point avulsion fracture fixation device in this embodiment further includes a spring 5. A slot for inserting the clamping portion 3 is formed on the peripheral surface of the guide rod 1 located at one end of the fracture block away from the tibia, and the spring 5 is built into the slot. The two ends of the spring 5 are respectively connected to the guide rod 1 and the clamping portion 3. The spring 5 is used to drive the clamping portion 3 to reset. When the clamp ring 2 is installed, the retracted clamping portion 3 is re-extended, thereby preventing the clamp ring 2 from withdrawing from the guide rod 1.

[0044] It is understandable that the above-mentioned spring 5 is only an example of a preferred embodiment for realizing the reset of the clamping part 3. In practice, other sections can also be used to realize the reset. For example, the spring 5 can be replaced by an elastic rubber pad or an elastic element of other materials to achieve the same effect. Furthermore, the spring 5 can also be omitted, and the clamping part 3 itself can be changed to an elastic structure. For example, the clamping structure in the existing buckle is used as the clamping part 3. When the clamping ring 2 is sleeved, the clamping part 3 can be slightly deformed to allow the clamping ring 2 to pass over.

[0045] As a preferred embodiment, the tightening part 4 in this embodiment is a nut, which is sleeved on the end of the guide rod 1 away from the tibia and cooperates with the thread on the peripheral surface thereof to achieve a threaded connection. And by screwing the tightening part 4, the guide rod 1 can be driven to drive the clamping part 3 and the clamping ring 2 to move in a direction close to the tightening part 4, thereby tightening the tightening part 4 and the clamping ring 2 to complete the fixing operation.

[0046] It should be noted that in practice, depending on the specific circumstances, the tightening part 4 can also be other structures. For example, the tightening part 4 is a pin, and the guide rod 1 is provided with a plurality of sockets perpendicular to the axis of the guide rod 1. The pins are inserted into the sockets for fixation, and the plurality of sockets are equidistantly arranged along the extension direction of the guide rod 1 to accommodate different sizes.

[0047] As a preferred embodiment, the posterior cruciate ligament tibial attachment avulsion fracture fixation device in this embodiment also includes a Kirschner wire 6, which is a commonly used internal fixation material in orthopedics, and its original specification is generally fixed at about 20 cm, and there are several different specifications with a diameter between 0.5-2 mm. It is used to fix fractures with low stress such as short fractures or avulsion fractures, and is also often used in the fixation of temporary fracture fragments in orthopedic surgery.

[0048] In this embodiment, before inserting the guide rod 1, the Kirschner wire 6 can be used for positioning and pre-drilling. After the aperture is enlarged, the guide rod 1 can be sleeved on the Kirschner wire 6 by using its through hole, and then extended into the tibia and the fracture block along the guide of the Kirschner wire 6. When the guide rod 1 is fixed, the Kirschner wire 6 can be pulled out. Of course, other feasible methods can also be used in practice, such as drilling before implanting the guide rod 1.

[0049] As a preferred embodiment, the present embodiment also includes a mounting clamp 7, which includes two foldable clamp arms 71, and a clamping groove 72 is provided on the opposite sides of the two clamp arms 71, which are respectively used to clamp the two planes 22 on the clamp ring 2 to clamp the clamp ring 2. A sharp angle is formed in the clamping groove 72, and its shape fits the shape near the plane 22 on the clamp ring 2, so as to clamp the clamp ring 2 more stably and prevent the clamp ring 2 from sliding during the implantation process. Other structures in the mounting clamp 7, such as the handle for driving the clamp arm 71 to move, can adopt any existing technology, and no further explanation is given herein.

[0050] The present invention also provides a method for using the above-mentioned posterior cruciate ligament tibial attachment point avulsion fracture fixation device, which comprises:

[0051] Step 1, implanting a guide rod 1 from the front of the tibia and passing through the fracture fragment;

[0052] Step 2: Sleeve the clamping ring 2 onto the guide rod 1 from the posterior approach of the knee joint, and clamp it between the clamping part 3 and the fracture fragment;

[0053] Step 3: Install the tightening part 4 on the end of the guide rod 1 away from the tibia, so that the tightening part 4 and the clamping ring 2 clamp and fix the tibia and the fracture fragment.

[0054] It can be seen that when using the present posterior cruciate ligament tibial attachment avulsion fracture fixation device, complicated threading and binding operations are not required, and fixation is more convenient.

[0055] Specifically, in combination with all the above embodiments, the specific method of use of this embodiment is as follows:

[0056] 1. Expose the insertion point of the posterior cruciate ligament and the boundary of the fracture fragment.

[0057] 2. Use a traditional posterior cruciate ligament locator to locate the center of the fracture fragment.

[0058] 3. Implant the Kirschner wire 6 from the front of the tibia.

[0059] 4. Use a 5.5mm drill bit to enlarge the bone tunnel.

[0060] 5. Implant the guide rod 1 until the clamping part 3 completely passes through the fracture fragment.

[0061] 6. Use the installation pliers 7 to insert the clamp 2 from the posterior approach of the knee joint, and make it pass over the clamping part 3 and be sleeved on the guide rod 1.

[0062] 7. Pull the guide rod 1 in the reverse direction until the fracture fragment is reduced and fixed.

[0063] 8. Connect the tightening part 4 to the guide rod 1 at the anterior opening of the tibia, and fix the tightening part 4 to the cortex of the tibia opening.

[0064] The posterior cruciate ligament tibial attachment point avulsion fracture fixation device and use method provided by the present invention are as follows: when in use, a guide rod 1 is passed through the tibia and the fracture fragment from the front side of the tibia at the same time, and then a clamping ring 2 is sleeved on the guide rod 1 between the clamping part 3 and the fracture fragment from the rear side of the knee joint, and then the tightening part 4 and the clamping ring 2 are used to clamp the tibia and the fracture fragment, thereby fixing the tibia and the fracture fragment.

[0065] Compared with the prior art, the present invention eliminates structures such as sutures and steel plates with loops, and ingeniously achieves more stable rigid fixation through the tightening part 4 and the clamping ring 2. Most importantly, during surgery, the clamping ring 2 only needs to be inserted from the posterior tibia approach, and the tightening part 4 can be fixed from the front side of the tibia where there is less tissue around the tibia, so that the entire arthroscopic surgery does not require the complicated establishment of double tibial channels, and the surgical channel does not pass through the popliteal fossa vascular and nerve tissue, and has the characteristics of minimally invasive surgery under the full scope. In addition, the present invention eliminates the traditional repeated threading and winding, bundling and tying operations during the surgical process, making the operation under arthroscopy more convenient, simpler and easier, and has good application prospects.

[0066] The various embodiments in this specification are described in a progressive manner, and each embodiment focuses on the differences from other embodiments. The same or similar parts between the various embodiments can be referenced to each other.

[0067] The above description is only a preferred specific implementation manner of the new invention, but the protection scope of the new invention is not limited thereto. Any changes or substitutions that can be easily thought of by any technician familiar with the technical field within the technical scope disclosed in the new invention should be covered within the protection scope of the new invention.

Claims

1. A fixation device for tibial avulsion fracture of the posterior cruciate ligament, characterized in that: include: A guide rod for passing through the tibia and fracture fragments; A clamping ring is detachably sleeved on one end of the guide rod and is used to abut against the end of the fracture fragment away from the tibia. The outer peripheral surface of the clamping ring is formed by two arc-shaped surfaces and two planes. The two planes are parallel, and the two planes and the end surface of the clamping ring are set at an angle. A clamping portion is slidably connected to one end of the guide rod along the radial direction of the guide rod, and when the clamping portion slides to be embedded in the guide rod, the clamping portion allows the clamping ring to slide through; when the clamping portion slides to protrude from the guide rod, the clamping portion is used to limit the clamping ring from sliding in a direction away from the tibia; A tightening portion, detachably connected to the other end of the guide rod along the extension direction of the guide rod, and used to clamp the tibia and the fracture fragment together with the clamping ring; It also includes a Kirschner wire, and the guide rod is provided with a through hole along its axis for the Kirschner wire to pass through; It also includes an installation pliers, which includes two foldable pliers arms, and a clamping groove is opened on the side facing each other of the two pliers arms, which is used to clamp the two planes on the clamping ring respectively, and a folding angle is formed in the clamping groove, and the shape of the folding angle is in line with the angle between the plane and the end face of the clamping ring, so that the clamping groove can stably clamp the clamping ring.

2. The fixation device for posterior cruciate ligament tibial attachment avulsion fracture according to claim 1, characterized in that: The number of the clamping parts is at least two, and at least two of the clamping parts are arranged around the circumference of the guide rod at equal angles.

3. The fixation device for tibial avulsion fracture of the posterior cruciate ligament according to claim 2, characterized in that: The clamping portion is slidably inserted into the circumferential surface of the guide rod along the radial direction of the guide rod, and the end of the clamping portion away from the guide rod forms an oblique surface, and the oblique surface is oriented away from the guide rod and the bone fragment at the same time.

4. The fixation device for posterior cruciate ligament tibial attachment avulsion fracture according to claim 3, characterized in that: The clamping portion is cylindrical, the axis of the clamping portion extends along the radial direction of the guide rod, one end of the clamping portion is inserted into the guide rod, and the chamfered surface is formed at the other end of the clamping portion.

5. The fixation device for tibial avulsion fracture of the posterior cruciate ligament according to claim 4, characterized in that: It also includes a spring, a peripheral surface of one end of the guide rod is formed with a slot for the clamping part to be inserted, the spring is built into the slot, and two ends of the spring are respectively connected to the guide rod and the clamping part.

6. The fixation device for posterior cruciate ligament tibial attachment avulsion fracture according to any one of claims 1 to 5, characterized in that: The circumferential surface of the other end of the guide rod is formed with a thread, and the tightening part is a nut, which is sleeved on the guide rod and threadedly connected with the guide rod.

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