Posterior cruciate ligament tibial insertion avulsion fracture reduction and positioning nail guide and its usage method

Abstract

The present invention provides a reduction and positioning nail guide for posterior cruciate ligament tibial insertion avulsion fractures in the field of medical devices and a usage method. First, establish anterolateral and anteromedial approaches. The arthroscope enters the posteromedial compartment through the space between the posterior cruciate ligament and the medial femoral condyle via the anterolateral approach. After exposing the medial gastrocnemius tendon through the high-level posteromedial approach, insert the lens into the high-level posteromedial approach as the observation approach to expose the posterior cruciate ligament tibial insertion avulsion fracture fragment. Then, perform reduction and temporary fixation of the fracture fragment through the extremely high-level posteromedial approach using this device. Drill a Kirschner wire into the fracture fragment with the first sleeve and the second sleeve in this device, and screw in a hollow nail under the guidance of the Kirschner wire for fixation. It is convenient to reduce and fix the PCL tibial insertion avulsion fracture fragment, facilitate the fixation of the Kirschner wire and the hollow screw, can effectively avoid the risk of popliteal neurovascular injury, and the operation is simple and easy to establish, having extensive popularization and application value in the field of medical device technology.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and particularly relates to a reduction and positioning nail guide for avulsion fracture of the tibial insertion of the posterior cruciate ligament and a using method thereof. Background Art

[0002] The posterior cruciate ligament (PCL) is an extra-synovial intra-articular capsule ligament, originating from the anterolateral aspect of the medial femoral condyle and inserting into the posterior aspect of the proximal tibia, playing a role in restricting posterior displacement of the tibia and being an important structure for maintaining knee joint stability. In young patients, the incidence of avulsion fracture of the tibial insertion of the posterior cruciate ligament is higher than that of rupture of the substance of the posterior cruciate ligament. Most scholars believe that the treatment principle of PCL tibial insertion avulsion fracture should be determined according to the avulsion fracture classification. Currently, the most commonly used is the Meyers-Mckeever classification. Type I is an avulsion fracture with no obvious displacement; Type II is a suspended fracture with one end connected and the other end displaced; Type III is a completely separated and displaced avulsion fracture. For Type II or III fractures, since the displaced fractures cannot heal normally, conservative treatments such as using a brace or plaster fixation often leave complications such as knee joint pain, repeated effusion, and posterior knee joint instability, further leading to traumatic arthritis. Therefore, for Type II or III avulsion fractures, surgical treatment is required to better restore the function of the PCL.

[0003] With the development of arthroscopic minimally invasive technology, the technique of reducing the avulsion fracture of the tibial insertion of the posterior cruciate ligament by arthroscope and then fixing it with a hollow screw can overcome the disadvantages of traditional open reduction and internal fixation, such as large trauma, difficult intraoperative exposure, and slow postoperative recovery. However, the operation under arthroscope is relatively difficult and requires very skilled arthroscopic techniques. For fractures with obvious displacement or comminution, sometimes it is difficult to perform reduction under arthroscope. Currently, there is a lack of an effective reduction and positioning nail guide device for avulsion fracture of the tibial insertion of the posterior cruciate ligament. During the operation, it is difficult to implant Kirschner wires and hollow screws, which are prone to damage the nerves and blood vessels behind the knee joint, and the fixation is not strong enough, resulting in a complex surgical process and a high surgical operation difficulty. Summary of the Invention

[0004] To solve the difficulties in reducing the avulsion fracture fragment of the posterior cruciate ligament tibial insertion under arthroscope and implanting a cannulated screw into the reduced fracture fragment, avoid the risk of damage to the neurovascular structures behind the knee joint, and overcome the problem of relatively high technical requirements for arthroscopic operation, the object of the present invention is to provide a reduction and screw insertion guide for avulsion fracture of the posterior cruciate ligament tibial insertion. First, the anterolateral and anteromedial approaches are routinely established. The arthroscope enters the posteromedial compartment through the space between the posterior cruciate ligament and the medial femoral condyle from the anterolateral approach. Part of the synovial tissue in the posteromedial compartment of the right knee joint is resected through the high posteromedial approach to expose the medial gastrocnemius tendon. Then, the arthroscopic lens is inserted into the high posteromedial approach as the observation approach, and a shaver is inserted into the low posteromedial approach to expose the avulsion fracture fragment of the posterior cruciate ligament tibial insertion. Then, through the extremely high posteromedial approach, the rotation block drives the threaded rod to rotate, separating the threaded rod from the rubber pad. After moving the second sleeve to the appropriate position according to actual needs, the rotation block is rotated again. The rotation of the rotation block drives the threaded rod to rotate, making the threaded rod contact the rubber pad to fix the second sleeve that has been moved to the appropriate position. Then, the handle is held tightly, and the second sleeve is placed against the avulsion fracture fragment of the posterior cruciate ligament tibial insertion. The avulsion fracture fragment of the posterior cruciate ligament tibial insertion is reduced and temporarily fixed through the fish-mouth notch at the end of the second sleeve. A 1.5-mm Kirschner wire is drilled into the fracture fragment through the first sleeve and the second sleeve. Under the guidance of the Kirschner wire, a cannulated screw is screwed in for fixation. It is convenient to fix the avulsion fracture fragment of the PCL tibial insertion, and the length of the guiding tube can be adjusted according to actual needs, which is convenient for guiding the fixation of the Kirschner wire and the cannulated screw. This method establishes the approach from inside the joint to outside the joint, which can effectively avoid the risk of damage to the popliteal neurovascular structures, and the operation is simple and easy to establish, having wide popularization and application value in the technical field of medical devices.

[0005] The present invention is realized through the following technical solutions:

[0006] A reduction and screw insertion guide for avulsion fracture of the posterior cruciate ligament tibial insertion provided by the present invention includes a handle, a first sleeve, a second sleeve, a fixing plate, a connecting block, a guiding mechanism, and a limiting mechanism. The surface of the handle is fixedly connected with the first sleeve. The second sleeve is slidably connected to the outside of the first sleeve. The outside of the first sleeve is fixedly connected with the fixing plate. The outside of the second sleeve is symmetrically and fixedly connected with the connecting blocks, and both connecting blocks are slidably connected to the fixing plate. The surface of the fixing plate is symmetrically fixedly connected with the guiding mechanism, and the surface of the fixing plate is threadedly connected with the limiting mechanism.

[0007] In the present invention, the two guiding mechanisms include fixing blocks and guiding rods. The surface of the fixing plate is symmetrically fixedly connected with the fixing blocks. The surface of the fixing blocks close to the second sleeve is fixedly connected with the guiding rods, and the guiding rods are slidably connected to the connecting blocks. Through the guiding rods, a limiting effect is achieved, making the movement of the second sleeve stable.

[0008] In the present invention, the limiting mechanism includes a threaded rod and a rotating block. The threaded rod is threadedly connected to the surface of the fixing plate, and one end of the threaded rod is fixedly connected to the rotating block. According to actual needs, after moving the second sleeve to a suitable position, rotate the rotating block so that the threaded rod contacts the rubber pad to fix the second sleeve moved to the appropriate position.

[0009] In the present invention, grooves are formed on the surface of the second sleeve to reduce the placement space of the rubber pad.

[0010] In the present invention, a fish-mouth-shaped notch is provided at one end of the second sleeve away from the connecting block.

[0011] In the present invention, a rubber pad is fixedly connected to the surface of the groove, and the rubber pad is cooperatively connected with the threaded rod. Through the rubber pad, the contact friction with the threaded rod is increased to prevent the second sleeve from sliding.

[0012] In the present invention, the fixing plate is made of plastic material, and the plastic has the characteristics of light weight and corrosion resistance.

[0013] In the present invention, sliding grooves are symmetrically formed on the surface of the fixing plate, and the sliding grooves are slidably connected to the connecting block. Through the sliding grooves, it is convenient for the connecting block to support the fixing plate.

[0014] In the present invention, a limiting block is fixedly connected to one end of the guide rod away from the fixed block, which plays a role in limiting and prevents the first sleeve from separating from the second sleeve.

[0015] In the present invention, anti-slip lines are formed on the surface of the rotating block, which play an anti-slip role and facilitate the rotation of the rotating block.

[0016] In the present invention, an anti-slip sleeve is fixedly connected to the surface of the handle, which plays an anti-slip role and facilitates holding the handle.

[0017] Compared with the prior art, using the posterior cruciate ligament tibial insertion avulsion fracture reduction positioning nail guide provided by the present invention can obtain the following beneficial effects:

[0018] Rotate the rotating block and the threaded rod to adjust the position of the second sleeve, which is convenient for finding, grasping and fixing the avulsion fracture fragment of the posterior cruciate ligament tibial insertion. Place the second sleeve on the avulsion fracture fragment of the posterior cruciate ligament tibial insertion, fix the fracture fragment through the fish-mouth-shaped notch on the second sleeve, and move the fracture fragment to its original position. Drill a 1.5 mm Kirschner wire into the fracture fragment through the first sleeve and the second sleeve, and then screw in a hollow screw under the guidance of the Kirschner wire for fixation. The length of the guide tube can be adjusted according to actual needs. Find, move and fix the avulsion fracture fragment of the posterior cruciate ligament tibial insertion through the fish-mouth-shaped notch. The fixation is convenient. By establishing an approach from the inside of the joint to the outside of the joint, the risk of popliteal neurovascular injury can be effectively avoided, and the operation is simple and easy to establish, which has wide popularization and application value in the technical field of medical devices. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] In order to more clearly illustrate the specific embodiments of the present invention or the technical solutions in the prior art, the following will briefly introduce the drawings required for the description of the specific embodiments or the prior art. Obviously, the drawings in the following description are some embodiments of the present invention. For those of ordinary skill in the art, without creative efforts, other drawings can also be obtained based on these drawings.

[0020] Figure 1 Shown is a schematic structural view of the present invention;

[0021] Figure 2 Shown is the present invention Figure 1 A partial enlarged view of part A in;

[0022] Figure 3 Shown is the present invention Figure 1 A partial enlarged view of part B in;

[0023] Figure 4 Shown is a schematic structural view of the second sleeve in the present invention;

[0024] Figure 5 Shown is the front view of the second sleeve in the present invention;

[0025] Figure 6 Shown is a schematic structural view of the limiting mechanism in the present invention.

[0026] Reference numerals: 1 - handle, 2 - first sleeve, 3 - second sleeve, 4 - fixing plate, 5 - connecting block, 6 - guiding mechanism, 7 - limiting mechanism, 8 - fixing block, 9 - guiding rod, 10 - threaded rod, 11 - rotating block, 12 - groove, 13 - rubber pad, 14 - sliding groove, 15 - limiting block, 16 - anti-slip sleeve, 17 - fish-mouth-shaped notch. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0027] The following will clearly and completely describe the technical solutions of the present invention in conjunction with the attached Figures 1-6 Obviously, the described embodiments are some embodiments of the present invention, rather than all embodiments.

[0028] In the description of the present invention, it should be noted that the orientation or positional relationship indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. is based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be construed as a limitation to the present invention. In addition, the terms "first", "second", "third" are only used for descriptive purposes and cannot be construed as indicating or implying relative importance.

[0029] In the description of the present invention, it should be noted that unless otherwise clearly specified and limited, the terms "installation", "connection", and "coupling" should be understood in a broad sense. For example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be directly connected or indirectly connected through an intermediate medium, and it can be the communication inside two components. For those of ordinary skill in the art, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0030] In the present invention, for the convenience of description, the description of the relative position relationship of each component in the reduction and positioning nail guide for avulsion fracture of the tibial attachment point of the posterior cruciate ligament is based on the Figure 1 layout mode of the attached Figure 1 drawing. For example, the positional relationships such as up, down, left, and right are determined according to the layout direction of the attached

[0031] Embodiment 1: Reduction and positioning nail guide for avulsion fracture of the tibial attachment point of the posterior cruciate ligament

[0032] A reduction and positioning nail guide for avulsion fracture of the tibial attachment point of the posterior cruciate ligament provided by the present invention includes a handle 1, a first sleeve 2, a second sleeve 3, a fixing plate 4, a connecting block 5, a guiding mechanism 6, and a limiting mechanism 7. The surface of the handle 1 is fixedly connected with the first sleeve 2. The outer side of the first sleeve 2 is slidably connected with the second sleeve 3. The outer side of the first sleeve 2 is fixedly connected with the fixing plate 4. The outer sides of the second sleeve 3 are symmetrically and fixedly connected with connecting blocks 5. Both connecting blocks 5 are slidably connected with the fixing plate 4. The surface of the fixing plate 4 is symmetrically and fixedly connected with the guiding mechanism 6. The surface of the fixing plate 4 is threadedly connected with the limiting mechanism 7.

[0033] Please refer to Figure 1 , Figure 2 and Figure 3 . In the present invention, the two guiding mechanisms 6 include fixing blocks 8 and guiding rods 9. The surface of the fixing plate 4 is symmetrically and fixedly connected with fixing blocks 8. The surface of the fixing blocks 8 close to the second sleeve 3 is fixedly connected with guiding rods 9. The guiding rods 9 are slidably connected with the connecting blocks 5. Through the guiding rods 9, a limiting effect is achieved to make the movement of the second sleeve 3 stable.

[0034] Please refer to Figure 1 , Figure 3 and Figure 6 . In the present invention, the limiting mechanism 7 includes a threaded rod 10 and a rotating block 11. The surface of the fixing plate 4 is threadedly connected with the threaded rod 10. One end of the threaded rod 10 is fixedly connected with the rotating block 11. According to actual needs, after moving the second sleeve 3 to a suitable position, rotate the rotating block 11 to make the threaded rod 10 contact the rubber pad 13 to fix the second sleeve 3 at the suitable position.

[0035] Please refer to Figure 1 and Figure 4 、 Figure 5 In the present invention, a groove 12 is formed on the surface of the second sleeve 3. Through the groove 12, the placement space of the rubber pad 13 is reduced.

[0036] Please refer to Figure 1 and Figure 4 、 Figure 5 In the present invention, a fish-mouth-shaped notch 17 is provided at one end of the second sleeve 3 away from the connecting block 5. Through the fish-mouth-shaped notch 17, the fractured bone fragment to be searched for and avulsed can be located. The fish-mouth-shaped notch facilitates the movement and reduction of the avulsed fractured bone fragment, facilitating the surgical nail insertion operation.

[0037] Please refer to Figure 1 and Figures 3 to 6 In the present invention, a rubber pad 13 is fixedly connected to the surface of the groove 12. The rubber pad 13 is cooperatively connected with the threaded rod 10. Through the rubber pad 13, the contact friction with the threaded rod 10 is increased, preventing the second sleeve 3 from sliding.

[0038] Please refer to Figures 1 to 3 In the present invention, the fixing plate 4 is made of plastic material. Symmetrically arranged chutes 14 are formed on the surface of the fixing plate 4. The chutes 14 are slidably connected with the connecting block 5. Plastic has the characteristics of light weight and corrosion resistance. Through the chutes 14, it is convenient for the connecting block 5 to support the fixing plate 4.

[0039] Please refer to Figure 1 and Figure 3 In the present invention, a limit block 15 is fixedly connected to one end of the guide rod 9 away from the fixed block 8. Through the limit block 15, a limiting effect is achieved, preventing the first sleeve 2 from separating from the second sleeve 3.

[0040] Please refer to Figure 6 In the present invention, anti-slip lines are formed on the surface of the rotating block 11. Through the anti-slip lines, an anti-slip effect is achieved, facilitating the rotation of the rotating block 11.

[0041] Please refer to Figure 1 In the present invention, an anti-slip sleeve 16 is fixedly connected to the surface of the handle 1. Through the anti-slip sleeve 16, an anti-slip effect is achieved, facilitating the gripping of the handle 1.

[0042] Embodiment 2: Method for using a reduction and nail insertion guide for avulsion fracture of the tibial insertion point of the posterior cruciate ligament

[0043] First, the anterolateral and anteromedial approaches are routinely established. The arthroscope enters the posteromedial compartment through the space between the posterior cruciate ligament and the medial femoral condyle via the anterolateral approach. The synovial tissue in the posteromedial compartment of the right knee joint is partially resected through the high posterior medial approach to expose the medial gastrocnemius tendon. Then, the lens is inserted into the high posterior medial approach as the observation approach, and the shaver is inserted into the low posterior medial approach to expose the avulsion fracture fragment of the tibial attachment of the posterior cruciate ligament. Then, the reduction positioning nail guide for the avulsion fracture of the tibial attachment of the posterior cruciate ligament is inserted through the extremely high posterior medial approach. By rotating the rotating block 11 to drive the threaded rod 10 to rotate, the threaded rod 10 is separated from the rubber pad 13. After moving the second sleeve 3 to the appropriate position according to the actual position of the avulsion fracture fragment of the tibial attachment of the posterior cruciate ligament, the rotating block 11 is rotated again. The rotation of the rotating block 11 drives the threaded rod 10 to rotate, so that the threaded rod 10 contacts the rubber pad 13 to fix the second sleeve 3 that has been moved to the appropriate position. Then, the handle 1 is held tightly, and the second sleeve 3 is pressed against the avulsion fracture fragment of the tibial attachment of the posterior cruciate ligament. The fish-mouth notch 17 at the end of the second sleeve 3 is used to press against the avulsion fracture fragment of the tibial attachment of the posterior cruciate ligament for reduction and temporary fixation. A 1.5-mm Kirschner wire is drilled into the fracture fragment through the first sleeve 2 and the second sleeve 3, and a hollow screw is screwed in under the guidance of the Kirschner wire to fix the avulsion fracture fragment of the PCL tibial attachment. The length of the second sleeve can be adjusted according to actual needs to facilitate finding, grasping, and temporarily fixing the avulsion fracture fragment of the tibial attachment of the posterior cruciate ligament, and at the same time facilitate guiding the fixation of the Kirschner wire and the hollow screw. Since this method establishes the approach from the joint interior to the joint exterior, it can effectively avoid the risk of injury to the popliteal neurovascular bundle, and the operation is simple and easy to establish, reducing the operation difficulty of the surgery, and has wide popularization and application value in the field of medical device technology.

[0044] The standard parts used in this application document can all be purchased from the market, and can be customized according to the description in the specification and the drawings. The specific connection methods of each part all adopt conventional means such as bolts, rivets, and welding that are mature in the prior art. The machines, parts, and equipment all adopt conventional models in the prior art.

[0045] Finally, it should be noted that: the above embodiments are only used to illustrate the technical solutions of the present invention, and are not intended to limit them; although the present invention has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that: they can still modify the technical solutions described in the foregoing embodiments, or perform equivalent replacements on some or all of the technical features; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the scope of the technical solutions of the embodiments of the present invention.

Claims

1. Posterior cruciate ligament tibial insertion avulsion fracture reduction and positioning nail guide, comprising a handle (1), a first sleeve (2), a second sleeve (3), a fixing plate (4), a connecting block (5), a guiding mechanism (6) and a limiting mechanism (7). Characterized in that: The surface of the handle (1) is fixedly connected with a first sleeve (2), the outside of the first sleeve (2) is slidably connected with a second sleeve (3), the outside of the first sleeve (2) is fixedly connected with a fixing plate (4), the outside of the second sleeve (3) is symmetrically and fixedly connected with connecting blocks (5), both of the two connecting blocks (5) are slidably connected with the fixing plate (4), the surface of the fixing plate (4) is symmetrically and fixedly connected with a guiding mechanism (6), and the surface of the fixing plate (4) is threadedly connected with a limiting mechanism (7); The two guiding mechanisms (6) include fixing blocks (8) and guiding rods (9), the surface of the fixing plate (4) is symmetrically and fixedly connected with fixing blocks (8), the surface of the fixing blocks (8) close to the second sleeve (3) is fixedly connected with guiding rods (9), and the guiding rods (9) are slidably connected with the connecting blocks (5); The limiting mechanism (7) includes a threaded rod (10) and a rotating block (11), the surface of the fixing plate (4) is threadedly connected with the threaded rod (10), and one end of the threaded rod (10) is fixedly connected with the rotating block (11); A groove (12) is formed on the surface of the second sleeve (3), and a fish-mouth notch (17) is provided at one end of the second sleeve away from the connecting block; Symmetrical sliding grooves (14) are formed on the surface of the fixing plate (4), and the sliding grooves (14) are slidably connected with the connecting blocks (5); A limiting block (15) is fixedly connected to the end of the guiding rod (9) away from the fixing block (8).

2. The posterior cruciate ligament tibial insertion avulsion fracture reduction and positioning nail guide according to claim 1, Characterized in that, A rubber pad (13) is fixedly connected to the surface of the groove (12), and the rubber pad (13) is cooperatively connected with the threaded rod (10).

3. The posterior cruciate ligament tibial insertion avulsion fracture reduction and positioning nail guide according to claim 1, Characterized in that, The material of the fixing plate (4) is plastic material.

4. The posterior cruciate ligament tibial insertion avulsion fracture reduction and positioning nail guide according to claim 1, Characterized in that, Anti-slip lines are formed on the surface of the rotating block (11), and an anti-slip sleeve (16) is fixedly connected to the surface of the handle (1).

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