Remolition-free tension band internal fixation method for phalangeal condylar fracture

Abstract

The invention relates to the field of fracture treatment, and discloses a phalangeal condylar fracture removal-free tension band internal fixation system, which comprises: an absorbable bone anchor, which is made of a polylactic acid compound, the material characteristic of the polylactic acid compound enables the polylactic acid compound to be gradually degraded and absorbed in vivo, and the rejection reaction and the need of a secondary operation are reduced; one or more kirschner wires: ensuring that it can provide sufficient securing force; the absorbable bone anchor line ensures the operation simplicity and convenience in the operation process and the post-operation fixing reliability; the implanter is mainly used for reducing the complexity and time of surgical operation. According to the absorbable bone anchor, the holding force during fixing is increased through the barb structure at the front end of the absorbable bone anchor, it is ensured that the fracture position can bear necessary tension and pressure through selection and the implantation position of the kirschner wire, the bone block is effectively prevented from rotating and shifting, the absorbable bone anchor wire bypasses the kirschner wire and is tightly attached to the bone block, and the fixing effect is further enhanced.

Description

Technical Field

[0001] The invention relates to the field of fracture treatment, and in particular to a tension band internal fixation method for phalanx condyle fractures without removal. Background Art

[0002] Common surgical treatments for phalangeal condyles include:

[0003] 1. Kirschner wire internal fixation. Kirschner wire fixation does not exert pressure on the bone fragments, and has poor holding force, which can easily cause the bone fragments to rotate and shift. Smaller avulsed bone fragments can often only withstand the fixation of one Kirschner wire, which cannot form a stable biomechanical structure, leading to postoperative bone fragment displacement, joint instability and other sequelae;

[0004] Second, screw internal fixation for the treatment of finger joint fractures. Screw internal fixation is more stable than Kirschner wires and provides a certain amount of pressure. However, fractures of the condyle of the phalanges are relatively fragile, and the process of screwing in the screws can easily cause bone fragmentation, leading to surgical failure. In addition, the volume of the screws is much larger than that of the Kirschner wires, which will affect the blood supply and healing of the bone, thereby causing bone absorption and hardening.

[0005] 3. Micro-plate internal fixation has a stable mechanical structure and is suitable for larger fractures, but is not suitable for smaller bone fragments and requires a second surgery to remove. 4. The newer Kirschner wire and tension band internal fixation has a physiological mechanical structure and better stability, but the surgical operation is more complicated and also faces the need for a second surgery to remove the internal fixation. Summary of the invention

[0006] In order to make up for the above deficiencies, the present invention provides a method for internal fixation of phalangeal condyle fractures without removal of a tension band, aiming to improve the problem of "traditional treatment methods are low in efficiency" mentioned in the prior art.

[0007] In order to achieve the above-mentioned object, the present invention adopts the following technical scheme: a tension band internal fixation system for phalangeal condyle fractures without removal, comprising:

[0008] Absorbable bone anchors: Made of polylactic acid composites, the material properties of polylactic acid composites allow them to gradually degrade and be absorbed in the body, reducing rejection reactions and the need for secondary surgery;

[0009] One or more K-wires: Ensure they provide adequate fixation;

[0010] Absorbable bone anchor wire: ensures the ease of operation during surgery and the reliability of postoperative fixation;

[0011] Implanter: Mainly used to reduce the complexity and time of surgical operation;

[0012] Suture needle: used to pass the bone anchor line through the insertion point of the collateral ligament;

[0013] The diameter of the absorbable bone anchor is 1.0 mm or less, and the length can be selected according to the specific situation of the fracture site. It is provided with a spiral coil inside and a thread outside. The diameter of the Kirschner wire is 0.8 mm or 1.0 mm, and the diameter of the absorbable bone anchor wire is 0.5 mm. The implanter is used to drill a hole in the intact bone cortex 3 mm away from the fracture line and implant the absorbable bone anchor.

[0014] As a further description of the above technical solution:

[0015] The front end of the absorbable bone anchor is provided with a barb structure to increase the holding force during fixation.

[0016] As a further description of the above technical solution:

[0017] The absorbable bone anchor wire is made of a bioabsorbable material with higher strength and longer degradation time to ensure stable tension during the fracture healing process.

[0018] As a further description of the above technical solution:

[0019] The implanter comprises a drilling part and an implanting part, and is provided with a positioning sensor and a display screen, which can display the drilling depth and angle in real time, thereby ensuring the accuracy of the drilling position and the stability of the bone anchor implantation.

[0020] As a further description of the above technical solution:

[0021] The suture needle has a certain degree of curvature and can be flexibly operated between bone blocks and ligaments. A tiny sensor is provided at the needle tip to monitor the accuracy of suture penetration and fixation in real time.

[0022] A method for internal fixation of phalangeal condyle fractures without removing a tension band specifically comprises the following steps:

[0023] S1: Preoperative preparation: Perform preoperative imaging examination to determine the specific situation of the fracture site;

[0024] S2: Surgical incision: Select the appropriate incision position to expose the fracture ends;

[0025] S3: Layer-by-layer separation: separate the tissue layer by layer to avoid damaging the collateral ligament and surrounding periosteum tissue;

[0026] S4: Fracture reduction: Appropriate traction on the joint to reduce the fracture under direct vision, and fix the fracture fragments with towel clamps or by an assistant;

[0027] S5: Kirschner wire fixation: Choose a suitable Kirschner wire to fix the vertical fracture line, ensure that the bone cortex is 1-1.5mm high to prevent the suture from coming out, bury it under the skin, and the distal Kirschner wire should be 0.5-1cm out of the skin;

[0028] S6: Bone anchor implantation: Use an implanter to drill holes in the intact bone cortex 3 mm away from the fracture line and implant absorbable bone anchors. Pull back the anchor line to ensure the stability of the anchor implantation.

[0029] S7: Bone anchor wire fixation: The needle of the bone anchor wire is passed through the ligament from the end point of the bone block, and after being wrapped around the Kirschner wire, the sutures at both ends are tightened and knotted for pressure fixation;

[0030] S8: Intraoperative examination: Passive flexion and extension of the joint and C-arm fluoroscopy were used to confirm satisfactory fracture reduction;

[0031] S9: Postoperative treatment: X-ray examination is performed in the outpatient clinic 4-6 weeks after surgery. If the fracture line is blurred, the Kirschner wire can be removed in time. There is no need to remove the anchor again.

[0032] As a further description of the above technical solution:

[0033] In S5 and S6, a C-arm machine was used for multiple fluoroscopy to ensure the accuracy of fracture reduction and firm fixation.

[0034] As a further description of the above technical solution:

[0035] The S7 is reinforced with bioabsorbable high-strength threads to further reduce the risk of loosening and dislocation.

[0036] As a further description of the above technical solution:

[0037] In S9, patients need to undergo 6-8 weeks of rehabilitation training, including passive and active joint flexion and extension exercises.

[0038] As a further description of the above technical solution:

[0039] The surgical incision in S2 is selected at a position far away from the joint to avoid damaging the ligaments and periosteum tissue around the joint. In addition, the insertion and fixation of the bone anchor wire should ensure that it is close to the bone block and Kirschner wire to avoid loosening and dislocation.

[0040] The present invention has the following beneficial effects:

[0041] 1. In the present invention, the barb structure at the front end of the absorbable bone anchor increases the holding force during fixation. At the same time, the selection and implantation position of the Kirschner wire ensure that the fracture site can withstand the necessary tension and pressure, effectively preventing the rotation and displacement of the bone block. In addition, the absorbable bone anchor wire bypasses the Kirschner wire and adheres closely to the bone block, further enhancing the fixation effect and ensuring the stability of the biomechanical structure, thereby reducing the sequelae of postoperative bone block displacement and joint instability.

[0042] 2. In the present invention, bone anchors and bone anchor wires made of bioabsorbable materials are gradually degraded and absorbed by the body during the fracture healing process, and no secondary surgery is required for removal. This design avoids the surgical risks, pain and economic burden brought by secondary surgery, which is particularly beneficial for elderly patients because they usually have slower fracture healing and higher surgical risks. In addition, experimental results show that all patients do not need additional surgery to remove the fixation device, which is of great significance for improving the overall efficacy and quality of life of patients after surgery.

[0043] 3. In the present invention, by providing a positioning sensor and a display screen, the drilling depth and angle can be displayed in real time, which not only reduces the repeated confirmation of the fracture reduction and fixation position during the operation, but also improves the accuracy of the surgical operation. The tiny sensor at the tip of the suture needle can monitor the accuracy of suture penetration and fixation in real time. These functions greatly simplify the surgical operation process, shorten the operation time, and thus reduce the surgical risk, especially for patients with complex fractures. BRIEF DESCRIPTION OF THE DRAWINGS

[0044] Figure 1 The present invention is a schematic diagram of the complete process of a tension band internal fixation method for phalangeal condyle fractures without removal. DETAILED DESCRIPTION

[0045] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only 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] Embodiment 1

[0047] Reference Figure 1 The present invention provides a phalanx condyle fracture free-removal tension band internal fixation system, comprising:

[0048] Absorbable bone anchor: Made of polylactic acid composite, the material properties of polylactic acid composite make it gradually degrade and be absorbed in the body, reducing rejection and the need for secondary surgery. Specifically, the front end of the absorbable bone anchor is provided with a barb structure to increase the holding force during fixation. In addition, the absorbable bone anchor line is made of bioabsorbable material with higher strength and longer degradation time to ensure stable tension during fracture healing.

[0049] One or more K-wires: Ensure they provide adequate fixation;

[0050] Absorbable bone anchor wire: ensures the ease of operation during surgery and the reliability of postoperative fixation. Specifically, the absorbable bone anchor wire is made of bioabsorbable materials with higher strength and longer degradation time to ensure stable tension during fracture healing;

[0051] Implanter: Mainly used to reduce the complexity and time of surgical operations. The implanter includes a drilling part and an implanting part, and is equipped with a positioning sensor and a display screen, which can display the drilling depth and angle in real time to ensure the accuracy of the drilling position and the stability of the bone anchor implantation;

[0052] Suture needle: used to pass the bone anchor line through the end point of the collateral ligament. The suture needle has a certain degree of curvature, which can be flexibly operated between the bone block and the ligament. A tiny sensor is installed at the tip of the needle to monitor the accuracy of suture penetration and fixation in real time.

[0053] The diameter of the absorbable bone anchor is 1.0mm or less, and the length can be selected according to the specific situation of the fracture site. It has a spiral coil inside and a thread outside. The diameter of the Kirschner wire is 0.8mm or 1.0mm, and the diameter of the absorbable bone anchor line is 0.5mm. The implanter is used to drill a hole in the intact bone cortex 3mm away from the fracture line and implant the absorbable bone anchor.

[0054] The present invention also provides a method for internal fixation of phalangeal condyle fractures without removing the tension band, which specifically comprises the following steps:

[0055] S1: Preoperative preparation: Perform preoperative imaging examination to determine the specific situation of the fracture site;

[0056] S2: Surgical incision: Choose a suitable incision location to expose the fracture end. In this step, the surgical incision is selected at a location far away from the joint to avoid damaging the ligaments and periosteum around the joint. In addition, the insertion and fixation of the bone anchor wire should ensure that it is close to the bone block and Kirschner wire to avoid loosening and dislocation.

[0057] S3: Layer-by-layer separation: separate the tissue layer by layer to avoid damaging the collateral ligament and surrounding periosteum tissue;

[0058] S4: Fracture reduction: Appropriate traction on the joint to reduce the fracture under direct vision, and fix the fracture fragments with towel clamps or by an assistant;

[0059] S5: Kirschner wire fixation: Choose a suitable Kirschner wire to fix the vertical fracture line, ensure that the bone cortex is 1-1.5mm high to prevent the suture from coming out, bury it under the skin, and the distal Kirschner wire should be 0.5-1cm out of the skin;

[0060] S6: Bone anchor implantation: Use an implanter to drill holes in the intact bone cortex 3 mm away from the fracture line and implant absorbable bone anchors. Pull back the anchor line to ensure the stability of the anchor implantation. Use C-arm machine for multiple fluoroscopy in S5 and S6 to ensure the accuracy of fracture reduction and firm fixation.

[0061] S7: Bone anchor wire fixation: The needle of the bone anchor wire is passed through the ligament from the end point of the bone block, and after being wrapped around the Kirschner wire, the sutures at both ends are tightened and knotted for pressure fixation. In this step, bioabsorbable high-strength wire is used for reinforcement to further reduce the risk of loosening and dislocation;

[0062] S8: Intraoperative examination: Passive flexion and extension of the joint and C-arm fluoroscopy were used to confirm satisfactory fracture reduction;

[0063] S9: Postoperative treatment: X-ray examination is performed in the outpatient clinic 4-6 weeks after surgery. If the fracture line is blurred, the Kirschner wire can be removed in time. There is no need to remove the anchor again. During this step, the patient needs 6-8 weeks of rehabilitation training, including passive and active joint flexion and extension exercises.

[0064] Find three experimental subjects for surgical experiments and present them in the following table:

[0065]

[0066]

[0067] Experimental results: In the three experiments, the tension band internal fixation method can be effectively used for the treatment of phalangeal condylar fractures, providing sufficient stability to support fracture healing. No obvious complications such as infection or large foreign body reactions were observed during and after the operation. The recovery of the young patients in Experiment 1 and the middle-aged patients in Experiment 2 was relatively ideal, showing the effectiveness of the system for patients of different ages. Although the recovery of the elderly patients in Experiment 3 was slightly lower than that of the young people, considering that the fracture healing process of the elderly is generally slower, the system still showed its advantages. Finally, all patients in the experiments did not need to undergo additional surgery to remove the fixation device, which reduced the surgical risk and economic burden, and improved the quality of life, especially for the elderly.

[0068] Finally, it should be noted that the above is only a preferred embodiment of the present invention and is not intended to limit the present invention. Although the present invention has been described in detail with reference to the aforementioned embodiments, it is still possible for those skilled in the art to modify the technical solutions described in the aforementioned embodiments or to make equivalent substitutions for some of the technical features therein. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and principles of the present invention should be included in the protection scope of the present invention.

Claims

1. A tension band internal fixation system for phalangeal condyle fractures without removal, comprising: Absorbable bone anchors: Made of polylactic acid composites, the material properties of polylactic acid composites allow them to gradually degrade and be absorbed in the body, reducing rejection reactions and the need for secondary surgery; One or more K-wires: Ensure they provide adequate fixation; Absorbable bone anchor wire: ensures the ease of operation during surgery and the reliability of postoperative fixation; Implanter: Mainly used to reduce the complexity and time of surgical operation; Suture needle: used to pass the bone anchor line through the insertion point of the collateral ligament; The invention is characterized in that: the diameter of the absorbable bone anchor is 1.0 mm or less, the length can be selected according to the specific situation of the fracture site, a spiral coil is provided inside, and a thread is provided outside. The diameter of the Kirschner wire is 0.8 mm or 1.0 mm, the diameter of the absorbable bone anchor wire is 0.5 mm, and the implanter is used to drill a hole in the intact bone cortex 3 mm away from the fracture line and implant the absorbable bone anchor.

2. A tension band internal fixation system for phalangeal condyle fractures without removal according to claim 1, characterized in that: The front end of the absorbable bone anchor is provided with a barb structure to increase the holding force during fixation.

3. The non-removal tension band internal fixation system for phalangeal condyle fracture according to claim 1, characterized in that: The absorbable bone anchor wire is made of a bioabsorbable material with higher strength and longer degradation time to ensure stable tension during the fracture healing process.

4. The non-removal tension band internal fixation system for phalangeal condyle fracture according to claim 1, characterized in that: The implanter comprises a drilling part and an implanting part, and is provided with a positioning sensor and a display screen, which can display the drilling depth and angle in real time, thereby ensuring the accuracy of the drilling position and the stability of the bone anchor implantation.

5. The non-removal tension band internal fixation system for phalangeal condyle fracture according to claim 1, characterized in that: The suture needle has a certain degree of curvature and can be flexibly operated between bone blocks and ligaments. A tiny sensor is provided at the needle tip to monitor the accuracy of suture penetration and fixation in real time.

6. A method for internal fixation of phalangeal condyle fractures without removing the tension band according to any one of claims 1 to 7, characterized in that: The specific steps include: S1: Preoperative preparation: Perform preoperative imaging examination to determine the specific situation of the fracture site; S2: Surgical incision: Select the appropriate incision position to expose the fracture ends; S3: Layer-by-layer separation: separate the tissue layer by layer to avoid damaging the collateral ligament and surrounding periosteum tissue; S4: Fracture reduction: Appropriate traction on the joint to reduce the fracture under direct vision, and fix the fracture fragments with towel clamps or by an assistant; S5: Kirschner wire fixation: Choose a suitable Kirschner wire to fix the vertical fracture line, ensure that the bone cortex is 1-1.5mm high to prevent the suture from coming out, bury it under the skin, and the distal Kirschner wire should be 0.5-1cm out of the skin; S6: Bone anchor implantation: Use an implanter to drill holes in the intact bone cortex 3 mm away from the fracture line and implant absorbable bone anchors. Pull back the anchor line to ensure the stability of the anchor implantation. S7: Bone anchor wire fixation: The needle of the bone anchor wire is passed through the ligament from the end point of the bone block, and after being wrapped around the Kirschner wire, the sutures at both ends are tightened and knotted for pressure fixation; S8: Intraoperative examination: Passive flexion and extension of the joint and C-arm fluoroscopy were used to confirm satisfactory fracture reduction; S9: Postoperative treatment: X-ray examination is performed in the outpatient clinic 4-6 weeks after surgery. If the fracture line is blurred, the Kirschner wire can be removed in time without removing the anchor again.

7. A method for internal fixation of phalangeal condyle fractures without removing the tension band according to claim 6, characterized in that: In S5 and S6, a C-arm machine was used for multiple fluoroscopy to ensure the accuracy of fracture reduction and firm fixation.

8. The method for internal fixation of phalangeal condyle fractures without removing the tension band according to claim 6, characterized in that: The S7 is reinforced with bioabsorbable high-strength threads to further reduce the risk of loosening and dislocation.

9. A method for internal fixation of phalangeal condyle fractures without removing the tension band according to claim 6, characterized in that: In S9, patients need to undergo 6-8 weeks of rehabilitation training, including passive and active joint flexion and extension exercises.

10. A method for internal fixation of phalangeal condyle fractures without removing the tension band according to claim 1, characterized in that: The surgical incision in S2 is selected at a position far away from the joint to avoid damaging the ligaments and periosteum tissue around the joint. In addition, the insertion and fixation of the bone anchor wire should ensure that it is close to the bone block and Kirschner wire to avoid loosening and dislocation.

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