Multifunctional guider for olecranal fracture and osteotomy and implementation method

Abstract

The invention discloses a multifunctional guider for olecranal fracture and osteotomy and an implementation method, and belongs to the technical field of surgical auxiliary instruments. The guider comprises a guide fixing plate, a guide sleeve and an adjustable guide assembly, a plurality of sets of positioning holes are formed in the head portion of the guide fixing plate, each set of positioning holes comprises two collinear positioning holes located in the two sides of the head portion of the guide fixing plate respectively, the guide sleeve is installed in one positioning hole in the head portion of the guide fixing plate, and the adjustable guide assembly is installed in the other positioning hole in the head portion of the guide fixing plate. An adjustable guide assembly with an adjustable angle is arranged at the tail of the guide fixing plate, the adjustable guide assembly comprises two sighting device sleeves which are parallel to each other, olecranon hooks are arranged on the guide fixing plate on the two sides of the adjustable guide assembly respectively, and an osteotomy guide opening and a plurality of fixing holes are formed in the middle of the guide fixing plate; the olecranon fracture reduction and fixation device can assist in olecranon fracture reduction and fixation, accurate screw placement and needle insertion, accurate osteotomy can be achieved during olecranon osteotomy, follow-up reduction and fixation are completed, and good clinical prognosis is achieved.

Description

Technical Field

[0001] The invention relates to a multifunctional guide and an implementation method, in particular to a multifunctional guide for olecranon fracture and osteotomy and an implementation method, belonging to the technical field of surgical auxiliary equipment. Background Art

[0002] Olecranon fracture is one of the common fractures in adults, among which transverse olecranon fracture is more common, which is an intra-articular fracture involving the semilunar notch. Anatomical reduction is an effective measure to prevent joint instability and osteoarthritis and other complications, and surgical treatment is often required. The most common surgical internal fixation method is Kirschner wire tension band fixation, which can convert the tension of the triceps pulling on the posterior cortex of the fracture into pressure at the fracture end, thereby ensuring early elbow movement and avoiding joint stiffness. The bilateral cortical tension band internal fixation technique recommended by the A0 organization (Arbeitsgemeinschaftfǖr Osteosynthesefragen) is commonly used in clinical practice. The Kirschner wire has better tensile strength through the proximal cortex of the olecranon and the distal ulnar palmar cortex, which can reduce the risk of fracture displacement and pin withdrawal failure. The insertion of the Kirschner wire after the reduction of the olecranon is basically blindly inserted according to the surgeon's surgical experience, and there will be human error in the direction and angle of the Kirschner wire insertion. Unsatisfactory Kirschner wire position can easily lead to reduced Kirschner wire holding force or even failure of withdrawal, or cause damage to the ulnar artery and median nerve in front of the elbow, and risk of fusion of the superior radioulnar joint. When clinicians are not familiar with the anatomy of the olecranon, manual insertion may require multiple attempts, which will inevitably increase the operation time, increase the number of radiation exposures of patients, and even cause more fracture fragments to be comminuted, increase the difficulty of surgery and affect the prognosis.

[0003] In addition, the surgical treatment of AO-C distal humeral fractures has always been the focus and difficulty in the field of orthopedics. The common surgical approach through the olecranon osteotomy is usually feasible and necessary. The olecranon osteotomy approach can better expose the articular surface, provide a good surgical field for the fracture end and the articular surface, and can anatomically reduce the intra-articular fracture fragments under direct vision to achieve reliable internal fixation, creating good conditions for patients' early postoperative rehabilitation training. The subsequent reduction and fixation of the olecranon osteotomy still requires Kirschner wire tension band fixation. The operation is basically based on the surgeon's surgical experience. The olecranon is manually sawed or chiseled off. It is difficult to control the length and angle of the osteotomy, which can easily cause uneven cross-sections; at the same time, the truncated olecranon is prone to rotation and displacement, and the upper and lower parts of the cross-section are prone to sliding and dislocation. The above situations are not conducive to subsequent precise docking and fixation, and affect postoperative healing.

[0004] The Chinese utility model patent with application number 202122901746.8 discloses a needle placement guide device for olecranon fractures, and the Chinese invention patent application with application number 202110932187.9 discloses an olecranon osteotomy guide and its implementation method; although both can bring certain beneficial effects to the treatment of olecranon fractures and osteotomy respectively, they have single functions, insufficient positioning guidance, limited scope of application, and still rely heavily on the surgical experience of clinical physicians when used in practice, and have limited improvement in treatment efficiency. Summary of the invention

[0005] 1. Technical issues to be resolved

[0006] The technical problem to be solved by the present invention is to solve the problem that there is currently no reliable instrument product in clinical practice that can assist in the reduction and fixation of olecranon fractures, accurately position and guide the placement of nails and needles, and at the same time, can accurately perform osteotomy during olecranon osteotomy and complete subsequent reduction and fixation to achieve the best clinical prognosis.

[0007] (II) Technical solution

[0008] In order to solve the above technical problems, the present invention provides a multifunctional guide for olecranon fractures and osteotomies, which includes a guide fixing plate, a guide sleeve and an adjustable guide assembly. The guide fixing plate is provided with a plurality of groups of positioning holes at the head portion, each group of positioning holes includes two positioning holes respectively located on both sides of the guide fixing plate head portion and collinear, a guide sleeve is installed in one of the positioning holes at the head portion of the guide fixing plate, an adjustable guide assembly with adjustable angle is provided at the tail portion of the guide fixing plate, the adjustable guide assembly includes two aiming sleeves parallel to each other, olecranon hooks are respectively provided on the guide fixing plates on both sides of the adjustable guide assembly, and an osteotomy guide opening and a plurality of fixing holes are provided in the middle portion of the guide fixing plate.

[0009] Furthermore, a positioning suspension arm is provided at the rear of the guide fixing plate, an arc-shaped slideway is provided on the positioning suspension arm, and the adjustable guide assembly is provided on the arc-shaped slideway and can slide and lock along the arc-shaped slideway.

[0010] Furthermore, the adjustable guide assembly also includes a parallel guide and a fixing bolt, the parallel guide is provided with an arc-shaped slot, a locking screw hole and a plurality of sleeve holes parallel to each other, the arc-shaped slide is inserted into the arc-shaped slot, the fixing bolt passes through the locking screw hole and is tightened against the arc-shaped slide, and the sight sleeve is installed in the sleeve hole.

[0011] Furthermore, an arc-shaped observation port is provided on the parallel guide on one side of the arc-shaped slot, an angle scale of 10 to 30° is provided on the arc-shaped slideway corresponding to the side of the arc-shaped observation port, and a reading arrow is provided on the parallel guide at the arc-shaped observation port.

[0012] Furthermore, a circular arc retaining groove is provided on one side of the circular arc slideway, and the fixing bolt passes through the locking screw hole and is tightly pressed into the circular arc retaining groove.

[0013] Furthermore, the parallel guide is provided with two groups of sleeve holes, each group including three sleeve holes.

[0014] Furthermore, the osteotomy guide opening is a V-shaped opening, with its tip disposed toward the head of the guide fixing plate. The V-shaped angle of the osteotomy guide opening is 130 to 150°, and its inlet direction forms an angle of 10 to 25° with the guide fixing plate.

[0015] Furthermore, a circle of raised parts is arranged on the back side of the guide fixing plate along the osteotomy guide opening, and the inlet direction of the middle part of the raised parts is consistent with the inlet direction of the osteotomy guide opening.

[0016] Furthermore, the positioning hole is a threaded hole, the front end of the guide sleeve is provided with a matching thread, the positioning suspension arm provided at the tail of the guide fixing plate is tilted upward by 30 to 45 degrees, and two fixing holes are respectively provided on the head and tail sides of the osteotomy guide port.

[0017] Furthermore, the present invention also provides an implementation method of the multifunctional guide, which is as follows:

[0018] When used for wire tension band fixation of olecranon fractures, the following steps are involved:

[0019] S1. Make an incision behind the elbow to expose the fractured arm of the patient;

[0020] S2. Straighten the patient's elbow joint, correct the fracture ends, use a guide fixation plate to fit the back of the olecranon of the ulna, use the olecranon hook to pressurize the olecranon of the ulna, and then use a point reduction clamp, pass the clamp through the fixing hole on the back of the guide fixation plate to achieve pressurized fixation of the fracture ends;

[0021] S3. According to the location of the fracture ends, 1 to 4 cm away from the fracture ends, preferably 4 cm, select the positioning hole to screw into the guide sleeve, and drill a 2.0 mm Kirschner wire through the guide sleeve;

[0022] S4. Install the adjustable guide assembly, adjust the angle of the sight sleeve according to the size of the patient's ulnar olecranon, and fix it;

[0023] S5, drill 2.0 mm Kirschner wires through two sighting sleeves respectively;

[0024] S6. Use C-arm X-ray to see the elbow joint in the anteroposterior and lateral positions to confirm that the fracture reduction is satisfactory and the position and depth of the Kirschner wire are satisfactory;

[0025] S7, remove the Kirschner wire of the guide fixation plate, dismantle the multifunctional guide, and complete the "8" wire tension band fixation through two Kirschner wires and the Kirschner wire reserved holes at the distal end of the fracture;

[0026] When used for transolecranon osteotomy for distal humeral fracture fixation or intra-articular surgery, it involves the following steps:

[0027] Step 1: Make a post-elbow incision on the patient's arm to expose the proximal olecranon of the ulna;

[0028] Step 2: Use the guide fixing plate to fit the back of the olecranon of the ulna, and use the olecranon hook to pressurize and hook the olecranon of the ulna;

[0029] Step 3, drill a 2.0 mm Kirschner wire through the fixing hole of the guide fixing plate for fixation;

[0030] Step 4: Use a bone knife or an oscillating saw to perform osteotomy on the ulna olecranon through the osteotomy guide port;

[0031] Step 5: Remove the Kirschner wire of the guide fixation plate, dismantle the multifunctional guide, and flip the olecranon proximally to expose the distal humeral articular surface, providing a good surgical field for the articular surface.

[0032] Step 6: After the distal humeral fracture fixation or intra-articular surgery is completed, the wire tension band fixation of the olecranon fracture is completed according to the steps for using the multifunctional guide for the wire tension band fixation of the olecranon fracture.

[0033] (III) Beneficial effects

[0034] The above technical solution of the present invention has the following advantages:

[0035] The present invention cooperates with a guide fixing plate, a guide sleeve and a sighting sleeve of an adjustable guide assembly. The guide fixing plate fits the shape of the olecranon of the ulna, and the angle of the sighting sleeve of the adjustable guide assembly is adjustable. The position of the sighting sleeve can be adjusted according to the differences in the olecranons of different patients. The invention has a wide range of applications and can simply and accurately assist the insertion of Kirschner wires in the wire tension band fixation of the olecranon fracture. The positioning assistance is convenient, the operation is simple, and the efficiency of surgical needle placement can be improved, thereby better fixing the olecranon fracture. In addition, an osteotomy guide port is set on the guide fixing plate to realize positioning and guiding in one; the osteotomy efficiency can be accelerated, the error rate of osteotomy and the damage rate of the wound surface can be reduced, and the osteotomy angle can be precisely determined.

[0036] The present invention can assist in the reduction and fixation of olecranon fractures, accurately locate and guide the placement of nails and needles, and can accurately cut the bones during olecranon osteotomy to complete subsequent reduction and fixation, so as to achieve a better clinical prognosis, thereby providing a simple-structured and easy-to-use surgical instrument for clinical use.

[0037] The present invention can assist in the reduction of olecranon fractures and can also accurately position and guide according to different individual patients and anatomical differences; it can not only increase surgical accuracy and safety, reduce the error rate and iatrogenic injury rate, but also has little surgical trauma and can be widely used.

[0038] In addition to the technical problems solved by the present invention, the technical features of the technical solutions constituted by the present invention, and the advantages brought about by the technical features of these technical solutions described above, other technical features of the present invention and the advantages brought about by these technical features will be further explained in conjunction with the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0039] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0040] Figure 1 Axonometric measurement of the present invention Figure 1 Schematic diagram.

[0041] Figure 2 Axonometric measurement of the present invention Figure 2 Schematic diagram.

[0042] Figure 3 It is a schematic diagram of an explosion diagram of the present invention.

[0043] Figure 4 This is a schematic diagram of the present invention being placed on the ulna.

[0044] In the figure: 1. guide fixing plate; 2. guide sleeve; 3. adjustable guide assembly; 4. positioning hole; 5. sight sleeve; 6. eagle hook; 7. fixing hole; 8. positioning suspension arm; 9. arc-shaped slide; 10. parallel guide; 11. fixing bolt; 12. arc-shaped slot; 13. sleeve hole; 14. arc-shaped observation port; 15. reading arrow; 16. arc-shaped retaining groove; 17. protrusion; 18. osteotomy guide port. DETAILED DESCRIPTION

[0045] In order to make the purpose, technical solution and advantages of the embodiments of the present invention clearer, the technical solution in the embodiments of the present invention will be clearly and completely described below 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 ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0046] In the description of the present invention, it should be noted that, unless otherwise clearly specified and limited, the terms "installed", "connected" and "connected" 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;

[0047] It can be directly connected, or indirectly connected through an intermediate medium, or it can be internal communication between two elements. For ordinary technicians in this field, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0048] Example 1

[0049] like Figure 1-4 As shown, a multifunctional guide for olecranon fracture and osteotomy includes a guide fixing plate 1, a guide sleeve 2 and an adjustable guide assembly 3. The guide fixing plate 1 is an arc-shaped plate, and one or two groups of positioning holes 4 are arranged at its head, and each group of positioning holes 4 includes two positioning holes 4 located at both sides of the head of the guide fixing plate 1 and collinear. The guide sleeve 2 is movably installed in one of the positioning holes 4 at the head of the guide fixing plate 1, and the guide sleeve 2 can be installed on one of the positioning holes 4 in any group of positioning holes 4 at the head of the guide fixing plate 1 to meet the use needs of patients with different body shapes; the adjustable guide assembly 3 with adjustable angle is arranged at the tail of the guide fixing plate 1, which is also to meet the use needs of patients with different body shapes. The adjustable guide assembly 3 includes two sighting sleeves 5 which are parallel to each other. Since the angle of the adjustable guide assembly 3 is adjustable, the angle of the sighting sleeve 5 is also adjustable. The guide fixing plates 1 on both sides of the adjustable guide assembly 3 are respectively provided with olecranon hooks 6, and the angle of the olecranon hooks 6 is consistent with the angle of the olecranon tip of the ulna. The middle part of the guide fixing plate 1 is provided with an osteotomy guide opening 18 and a plurality of fixing holes 7.

[0050] The above-mentioned multifunctional guide structure setting can be used in olecranon fracture and osteotomy surgery. In order to more accurately realize the above-mentioned structure setting, the proximal ulna varus angle in the anteroposterior and lateral positions of the elbow joint, the length and width of the olecranon at the narrowest part, and the angle between the tangent line of the tip of the olecranon through the olecranon fossa and the axis of the ulna can be measured by imaging. Combined with cadaver specimens, the proximal width of the ulna 2 cm away from the tip of the olecranon, the length and width of the olecranon at the narrowest part are measured. The above measurement parameters provide a theoretical reference for the direction, angle and width of the Kirschner wire placement of the olecranon tension band, and also provide a theoretical basis for the design of this embodiment.

[0051] The guide fixing plate 1 described in this embodiment is a stainless steel metal plate printed by a 3D printer based on the olecranon fracture model and the model after reduction, and can fit well on the olecranon bone surface.

[0052] Example 2

[0053] This embodiment is based on the embodiment 1, and further optimizes and refines the structure of the guide fixing plate 1, specifically:

[0054] The tail of the guide fixing plate 1 is provided with a positioning suspension arm 8, which is similar to a crane lifting arm. The tail of the positioning suspension arm 8 is provided with an arc-shaped slideway 9, and the adjustable guide assembly 3 is arranged on the arc-shaped slideway 9 and can slide and lock along the arc-shaped slideway. The arc-shaped slideway at the tail of the suspension arm slides in combination with the adjustable guide assembly 3, and the up and down arc-shaped sliding can ensure that the needle insertion point of the sighting device sleeve 5 from the tip of the ulna olecranon (the upper part of the triceps brachii insertion point) remains unchanged, and multi-angle sliding adjustment can be performed.

[0055] In this embodiment, the positioning suspension arm 8 provided at the tail of the guide fixing plate 1 is tilted upward by 30 to 45 degrees, or in other words, the tangent of the positioning suspension arm 8 is inverted by 30 to 45 degrees with the central axis of the ulna, preferably 40 degrees.

[0056] Example 3

[0057] This embodiment is based on the embodiment 2, and further optimizes and refines the structure of the adjustable guide assembly 3, specifically:

[0058] The adjustable guide assembly 3 also includes a parallel guide 10 and a fixing bolt 11. The parallel guide 10 is provided with an arc-shaped slot 12 (for matching and nesting with the circular arc slide 9), a locking screw hole and a plurality of sleeve holes 13 parallel to each other. The adjustable guide assembly 3 and the positioning suspension arm 8 are slidably connected with the circular arc slide 9 through the arc-shaped slot 12. Specifically, the circular arc slide 9 is inserted into the arc-shaped slot 12 and slides. The fixing bolt 11 passes through the locking screw hole (the two are threadedly connected) and is pressed against the circular arc slide 9, thereby locking the adjustable guide assembly 3. The sight sleeve 5 is installed in the sleeve hole 13, which is convenient for quick installation and use.

[0059] Example 4

[0060] This embodiment is based on the embodiment 3, and further optimizes and refines the multifunctional guide structure, specifically:

[0061] The multifunctional guide described in this embodiment has an arc-shaped observation port 14 on the parallel guide 10 on one side of the arc-shaped slot 12, and an angle scale of 10 to 30° is provided on the arc-shaped slideway 9 corresponding to the side of the arc-shaped observation port 14 (that is, the parallel guide 10 can be adjusted to a sliding angle of 10-30°), and a reading arrow 15 is provided on the parallel guide 10 at the arc-shaped observation port 14, so as to facilitate the quick and accurate adjustment of the angle of the parallel guide 10 or the aiming sleeve 5 to suit different patients.

[0062] It should be noted that the width of the arc-shaped observation port 14 is smaller than that of the arc-shaped slide 9, that is, the arc-shaped slide 9 will not be laterally separated from the arc-shaped observation port 14. After the arc-shaped slot 12 opens the arc-shaped observation port 14, the arc-shaped slide 9 can still be limited so that it can only slide up and down in an arc shape.

[0063] One of the better options is to arrange the fixing bolt 11 and the arc-shaped observation port 14 on one opposite side of the arc-shaped slot 12, which has a more reliable structure and is more convenient for operation and observation.

[0064] Example 5

[0065] This embodiment is based on the fourth embodiment, and further optimizes and refines the locking structure of the fixing bolt 11, specifically:

[0066] A circular arc retaining groove 16 is provided on one side of the circular arc slide 9 (usually the side opposite to the arc observation port 14), and the circular arc retaining groove 16 is recessed on one side of the circular arc slide 9, and the fixing bolt 11 passes through the locking screw hole and is pressed against the circular arc retaining groove 16. Through this form of structural setting, the parallel guide 10 can be fixed in the circular arc retaining groove 16 of the positioning suspension arm 8. When the parallel guide 10 or the adjustable guide assembly 3 slides along the circular arc slide 9 to adjust the position, the end of the fixing bolt 11 is stuck in the circular arc retaining groove 16, so that the parallel guide 10 will not be separated from the circular arc slide 9, and the adjustable guide assembly 3 can be prevented from falling. At the same time, the sliding adjustment of the parallel guide 10 can be carried out by adjusting the tightness of the fixing bolt 11 (but it will never be separated from the circular arc retaining groove 16).

[0067] In this embodiment, the parallel guide 10 is provided with two groups of sleeve holes 13, each group including three sleeve holes 13. That is, the parallel guide 10 has 6 sleeve holes 13 arranged in parallel, 3 on each side, which can be fine-tuned according to the narrowest width of the olecranon of different individuals, and the sighting device sleeve 5 is inserted through the guide holes on the left and right sides respectively.

[0068] Example 6

[0069] This embodiment is based on the embodiment 5, and further optimizes and refines the structure of the osteotomy guide opening 18, specifically:

[0070] The osteotomy guide opening 18 is a V-shaped opening, and its tip (apex) is arranged toward the head of the guide fixing plate 1, and the apex of the V-shaped opening is 2 cm away from the tip of the olecranon. The V-shaped angle of the osteotomy guide opening 18 is 130-150°, such as 130°, 135°, 140°, 145°, 150°, etc., preferably 140°, and its inlet direction is 10-25° with the guide fixing plate 1 (or 10-25° with the vertical plane of the tangent of the bare area of ​​the olecranon), that is, the angle between the osteotomy plane and the vertical plane of the tangent of the bare area is 10-25°, which can be 10°, 15°, 20°, 25, etc., preferably 20°.

[0071] In this embodiment, a circle of raised portions 17 is provided along the osteotomy guide opening 18 on the back side of the guide fixing plate 1. The inlet direction of the middle part of the raised portion 17 is consistent with the inlet direction of the osteotomy guide opening 18, which is equivalent to the outward extension of the osteotomy guide opening 18, thereby increasing the supporting area of ​​the osteotomy guide opening 18 for osteotomy tools, etc. during osteotomy, making it easier to perform osteotomy operations.

[0072] Example 7

[0073] This embodiment is based on the embodiment 6, and further optimizes and refines the multifunctional guide structure, specifically:

[0074] The multifunctional guide described in this embodiment has a positioning hole 4 on the guide fixing plate 1 which is a threaded hole (the thread is not shown in the accompanying drawings), and the front end of the guide sleeve 2 is provided with a thread matching the positioning hole 4. The two are threadedly connected for easy use. In addition, two fixing holes 7 are respectively provided on the guide fixing plates 1 at the head and tail sides of the osteotomy guide opening 18.

[0075] Example 8

[0076] This embodiment provides an implementation method of the multifunctional guider described above, which includes at least two situations:

[0077] Situation 1: When it is used for wire tension band fixation of olecranon fracture, the following steps are included:

[0078] S1. Make an incision behind the elbow on the patient's fractured arm, cut the skin longitudinally with the fracture end as the center, about 6 cm long. Cut the fascia and periosteum to expose the fracture end. Remove blood in the joint cavity, fracture fragments, and soft tissue embedded in the fracture end.

[0079] S2, straighten the patient's elbow joint, correct the fractured ends, use the device of the present invention to fit the back of the olecranon of the ulna, and the olecranon hook 6 pressurizes and hooks the olecranon of the ulna. Use point reduction forceps, and pass the clamp through the round hole on the back of the guide fixing plate 1 to achieve pressurized fixation of the fractured ends.

[0080] S3. According to the position of the fracture ends, 1 to 4 cm away from the fracture ends, preferably 4 cm, select appropriate threaded holes on both sides of the guide fixing plate 1, screw in the guide sleeve 2, and drill a 2.0 mm Kirschner wire through the guide sleeve 2 to achieve temporary fixation of the fracture ends.

[0081] S4. Install the adjustable guide assembly 3, screw the fixing bolt 11 into the locking screw hole of the slot part of the parallel guide 10, fix the parallel guide 10 in the recessed arc-shaped retaining groove 16 of the positioning suspension arm 8, slide the adjustable guide assembly 3 by adjusting the tightness of the fixing bolt 11, and perform a sliding adjustment of 10 to 30°. According to the size of the patient's ulnar olecranon, adjust the appropriate angle of the parallel guide 10, select the appropriate sleeve hole 13, and insert the two aiming sleeves 5.

[0082] S5. Drill 2.0 mm Kirschner wires through the two aiming sleeves 5 respectively. During the drilling process, when the Kirschner wire passes through the palmar cortex of the opposite ulna and a second breakthrough feeling is felt, slightly withdraw the Kirschner wire.

[0083] S6. Use C-arm X-ray to see the elbow joint in the anteroposterior and lateral positions to confirm that the fracture reduction is satisfactory and the position and depth of the Kirschner wire are satisfactory;

[0084] S7. Remove the Kirschner wires on the guide fixing plate 1, dismantle the adjustable guide assembly 3 and the guide fixing plate 1, etc. Use two 1.0 mm diameter steel wires, one to pass horizontally under the two Kirschner wires and deep to the triceps, and the other to pass horizontally through the Kirschner wire reserved hole at the distal end of the fracture. After crossing the two steel wires to form an "8" shape, tighten and tighten the steel wires evenly on both sides to complete the pressure. Cut the steel wire knot and stick it to the bone surface. Bend the tail end of the Kirschner wire and cut it short, bury it deep to the triceps and knock it into the bone surface. Rinse and suture the wound.

[0085] Scenario 2: When it is used for transolecranon osteotomy to provide a good surgical field of the articular surface for distal humeral fracture fixation or intra-articular surgery, the following steps are included:

[0086] 2.1. Use an incision behind the elbow to cut the fascia to expose and free the protected ulnar nerve and expose the proximal olecranon of the ulna.

[0087] 2.2. The device of the present invention is attached to the back of the olecranon of the ulna, and the olecranon hook 6 is pressed to hook the olecranon of the ulna, so that the guide fixing plate 1 and the proximal end of the ulna can be fixed.

[0088] 2.3. Osteotomy is preferably performed at the bare area of ​​the olecranon without cartilage. The apex of the olecranon osteotomy guide groove (osteotomy guide opening 18) on the back of the osteotomy guide fixing plate 1 of the present invention is shaped like a "V" at the distal end, with an angle of 140°. The "V"-shaped osteotomy guide groove protrudes from the fixing plate, and is 20° to the vertical plane of the tangent of the bare area of ​​the ulna olecranon (the angle between the osteotomy plane and the vertical plane of the tangent of the bare area is 20°), and the apex of the "V" of the guide groove is 2 cm away from the tip of the ulna olecranon.

[0089] 2.4. Drill a 2.0 K-wire through the circular hole on the dorsal distal end of the "V"-shaped osteotomy guide opening 18 of the osteotomy guide fixation plate 1 to achieve distal fixation of the guide fixation plate 1 to the ulna (fixation of the osteotomy guide fixation plate 1 to the proximal and distal ends of the ulna can avoid loosening or errors during the osteotomy process).

[0090] 2.5. Use a bone knife or an oscillating saw to perform osteotomy on the olecranon through the raised “V”-shaped guide groove (osteotomy guide opening 18) on the back of the guide fixing plate 1.

[0091] 2.6. After the osteotomy is completed, the Kirschner wire of the guide fixation plate 1 is removed, the osteotomy guide fixation plate 1 is dismantled, and the olecranon of the ulna is turned proximally to better expose the distal articular surface of the humerus and provide a good surgical field of the articular surface.

[0092] 2.7. After the distal humeral fracture fixation or intra-articular surgery is completed, the tension band fixation of the olecranon can be completed according to the surgical steps S1 to S7 in the above-mentioned scenario 1.

[0093] In addition, in the description of the invention, unless otherwise specified, the terms "multiple", "multiple roots", "multiple groups" are used to mean two or more than two, and "several", "several roots", "several groups" are used to mean one or more than one. 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", "inside", "outside", etc. is based on the orientation or positional relationship shown in the accompanying drawings, which is only for the convenience of describing the present invention and simplifying the description, and does not indicate or imply that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on the present invention. In addition, the terms "first", "second", and "third" are used only for descriptive purposes and cannot be understood as indicating or implying relative importance.

[0094] The specific implementation modes of the present invention are described in detail above in conjunction with the accompanying drawings, but the present invention is not limited to the above implementation modes, and various changes can be made within the knowledge scope of ordinary technicians in this field without departing from the purpose of the present invention.

Claims

1. A multifunctional guide for olecranon fracture and osteotomy, characterized in that: It includes a guide fixing plate, a guide sleeve and an adjustable guide component. The front part of the guide fixing plate is provided with multiple groups of positioning holes, each group of positioning holes includes two positioning holes respectively located on both sides of the front part of the guide fixing plate and collinear, a guide sleeve is installed in one of the positioning holes at the front part of the guide fixing plate, an adjustable guide component with adjustable angle is provided at the rear part of the guide fixing plate, the adjustable guide component includes two aiming device sleeves parallel to each other, hawkbill hooks are respectively provided on the guide fixing plates on both sides of the adjustable guide component, and an osteotomy guide opening and multiple fixing holes are provided in the middle part of the guide fixing plate.

2. The multifunctional guide according to claim 1, characterized in that: The tail of the guide fixing plate is provided with a positioning suspension arm, the positioning suspension arm is provided with an arc-shaped slideway, and the adjustable guide component is provided on the arc-shaped slideway and can slide and lock along the arc-shaped slideway.

3. The multifunctional guide according to claim 2, characterized in that: The adjustable guide assembly also includes a parallel guide and a fixing bolt. The parallel guide is provided with an arc-shaped slot, a locking screw hole and a plurality of sleeve holes parallel to each other. The arc-shaped slide is inserted into the arc-shaped slot. The fixing bolt passes through the locking screw hole and is tightened against the arc-shaped slide. The sight sleeve is installed in the sleeve hole.

4. The multifunctional guide according to claim 3, characterized in that: An arc-shaped observation port is arranged on the parallel guide on one side of the arc-shaped slot, an angle scale of 10 to 30 degrees is arranged on the arc-shaped slideway corresponding to the arc-shaped observation port, and a reading arrow is arranged on the parallel guide at the arc-shaped observation port.

5. The multifunctional guide according to claim 4, characterized in that: A circular arc retaining groove is arranged on one side of the circular arc slideway, and the fixing bolt passes through a locking screw hole and is tightly pressed in the circular arc retaining groove.

6. The multifunctional guide according to claim 5, characterized in that: The parallel guide is provided with two groups of sleeve holes, each group including three sleeve holes.

7. The multifunctional guide according to claim 6, characterized in that: The osteotomy guide opening is a V-shaped opening, with its tip facing the head of the guide fixing plate. The V-shaped angle of the osteotomy guide opening is 130-150°, and its inlet direction forms an angle of 10-25° with the guide fixing plate.

8. The multifunctional guide according to claim 7, characterized in that: A circle of raised parts is arranged along the osteotomy guide opening on the back side of the guide fixing plate, and the inlet direction of the middle part of the raised parts is consistent with the inlet direction of the osteotomy guide opening.

9. The multifunctional guider according to claim 8, characterized in that: The positioning hole is a threaded hole, the front end of the guide sleeve is provided with a matching thread, the positioning suspension arm provided at the tail of the guide fixing plate is tilted upward by 35 to 45 degrees, and two fixing holes are respectively provided at the head and tail sides of the osteotomy guide port.

10. The implementation method of the multifunctional guide according to any one of claims 1 to 9, characterized in that: When used for wire tension band fixation of olecranon fractures, the following steps are involved: S1. Make an incision behind the elbow to expose the fractured arm of the patient; S2. Straighten the patient's elbow joint, correct the fracture ends, use a guide fixation plate to fit the back of the olecranon of the ulna, use the olecranon hook to pressurize the olecranon of the ulna, and then use a point reduction clamp, pass the clamp through the fixing hole on the back of the guide fixation plate to achieve pressurized fixation of the fracture ends; S3. According to the location of the fracture ends, select the positioning hole 1 to 4 cm away from the fracture ends, screw in the guide sleeve, and drill a 2.0 mm Kirschner wire through the guide sleeve; S4. Install the adjustable guide assembly, adjust the angle of the sight sleeve according to the size of the patient's ulnar olecranon, and fix it; S5, drill 2.0 mm Kirschner wires through two sighting sleeves respectively; S6. Use C-arm X-ray to see the elbow joint in the anteroposterior and lateral positions to confirm that the fracture reduction is satisfactory and the position and depth of the Kirschner wire are satisfactory; S7, remove the Kirschner wire of the guide fixation plate, dismantle the multifunctional guide, and complete the "8" wire tension band fixation through two Kirschner wires and the Kirschner wire reserved holes at the distal end of the fracture; When used for transolecranon osteotomy for distal humeral fracture fixation or intra-articular surgery, it involves the following steps: Step 1: Make a post-elbow incision on the patient's arm to expose the proximal olecranon of the ulna; Step 2: Use the guide fixing plate to fit the back of the olecranon of the ulna, and use the olecranon hook to pressurize and hook the olecranon of the ulna; Step 3, drill a 2.0 mm Kirschner wire through the fixing hole of the guide fixing plate for fixation; Step 4: Use a bone knife or an oscillating saw to perform osteotomy on the ulna olecranon through the osteotomy guide port; Step 5: Remove the Kirschner wire of the guide fixation plate, dismantle the multifunctional guide, and flip the olecranon proximally to expose the distal humeral articular surface, providing a good surgical field for the articular surface. Step 6: After the distal humeral fracture fixation or intra-articular surgery is completed, the wire tension band fixation of the olecranon is completed according to the steps for using the multifunctional guide for the wire tension band fixation of the olecranon fracture.

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