Arc-shaped retractor for maxillofacial bone defect repair

Abstract

The invention relates to the technical field of oral and maxillofacial surgery, in particular to an arc-shaped retractor for maxillofacial bone defect repair. The arc-shaped retractor for maxillofacial bone defect repair has a multi-point distributed three-dimensional traction guide function. Comprising an arc-shaped guide plate, two oppositely-distributed arc-shaped grooves are formed in the arc-shaped guide plate, and first fixing nails used for being fixedly connected to a jaw bone body and a defective bone respectively are movably arranged in the arc-shaped grooves in a sleeved mode. And a traction piece for directionally guiding and preliminarily positioning the two sides of the defective bone is arranged between the first fixing nail and the arc-shaped guide plate. Two groups of traction pieces which are mutually pulled are symmetrically arranged along the arc-shaped guide plate respectively, so that a stepless fixing structure for primary traction of a maxillofacial bone defect part can be formed; and through cooperation with a multi-point distributed three-dimensional traction tightening piece, suturing type multi-point and multi-direction traction tightening can be formed on the maxillofacial bone defect part, and the defect bone and the jaw bone body can be closely attached into a whole.

Description

Technical Field

[0001] This invention relates to the field of oral and maxillofacial surgery, specifically to an arc-shaped traction device for repairing maxillofacial bone defects. Background Technology

[0002] Mandibular contour defects are often caused by trauma, tumors, infections, or congenital developmental abnormalities, manifesting as facial asymmetry. For most patients with maxillofacial asymmetry and malocclusion, orthognathic surgery can resolve both functional and aesthetic issues. However, patients with good occlusion but significant facial asymmetry are often more concerned with improving facial aesthetics, making complex orthognathic surgery unnecessary for them.

[0003] For example, an arc-shaped traction device for repairing maxillofacial bone defects is disclosed on the Chinese patent website. The application date is December 30, 2022, and the authorized announcement is CN115869051B. The solution includes a main rod with a curved shape similar to the jawbone body. The main rod has an overall Y-shaped structure and includes a main pull rod and two branch rods. The end of the main pull rod of the main rod has a sliding insertion hole, and a protruding rod is slidably inserted into the sliding insertion hole. A fixed bent rod is reserved at the end of the protruding rod away from the main rod. The ends of the two branch rods are respectively reserved with a protruding rod one and a protruding rod two with a diameter smaller than the branch rod.

[0004] For example, an arc-shaped traction device for repairing maxillofacial bone defects, with an application date of May 7, 2025 and publication number CN120168073A, includes a defect bone fixation component comprising two No. 1 titanium plates. The outer surface of the No. 1 titanium plate is integrally connected to a protruding post with an internal screw hole. One end of the protruding post is connected to a support plate via a No. 1 medical screw. The outer surface of the support plate is provided with multiple rotating holes at equal intervals, three of which are rotatably connected to a pivot pin. The internal thread of the pivot pin is connected to a No. 2 medical screw.

[0005] Both of the above technical documents use a Y-shaped traction fixation structure, which uses spring tensioning or multi-hole positioning adjustment to pull and guide the defective bone. This method has the disadvantage of a single traction fixation structure, which fails to achieve the purpose of multi-point and multi-directional synchronous traction and tightening, and is difficult to flexibly adapt to maxillofacial bone defect repair surgery of different degrees. Summary of the Invention

[0006] In order to overcome the shortcomings of existing traction devices, such as simple structure and difficulty in forming a multi-point distributed three-dimensional traction structure, this invention provides an arc-shaped traction device for maxillofacial bone defect repair with multi-point distributed three-dimensional traction guidance.

[0007] The technical solution of the present invention is as follows: an arc-shaped traction device for repairing maxillofacial bone defects, comprising an arc-shaped guide plate, wherein two oppositely distributed arc-shaped grooves are formed in the arc-shaped guide plate, and a first fixing nail is movably sleeved in the arc-shaped groove for fixing and connecting to the jawbone body and the surface of the defect bone respectively. A traction member is provided between the first fixing nail and the arc-shaped guide plate for directional guidance and preliminary positioning of both sides of the defect bone. The traction member includes a connecting seat, and a connecting seat is provided on one side of the head of the first fixing nail. A threaded sleeve is movably sleeved on the connecting seat, and an adjusting rod is threadedly connected in the threaded sleeve. A traction tightening member is provided between the jawbone body and the defect bone, and the traction tightening member is used to form a multi-point distributed three-dimensional traction structure between the defect bone and the jawbone body.

[0008] As a further improvement to the above technical solution, the traction component also includes a fixing seat, which is disposed on the arc-shaped guide plate. A guide sleeve is rotatably connected to the fixing seat, and the outer end of the adjusting rod is movably sleeved in the guide sleeve. By rotating the adjusting rod, the defective bone connected to the first fixing nail can be driven to move directionally along the arc-shaped groove so that the defective bone and the jawbone body fit together.

[0009] As a further improvement to the above technical solution, the traction tightening component includes multiple second fixing nails, which are distributed at intervals on the jawbone body and the surface of the defective bone. Each second fixing nail has a pull ring rotatably mounted on its head. Pull wires are sequentially and movably connected between each pull ring, and each pull wire has a retaining bead sleeved at both ends for abutting against the pull ring.

[0010] As a further improvement to the above technical solution, the traction tightening component also includes a fixed shaft. The fixed shaft is provided in the middle of the arc-shaped guide plate. A wire reel is movably sleeved on the fixed shaft. The wire reel is used to wind up the pull wire. A wire sleeve is connected to the inner side of the wire reel, and the pull wire is movably passed through the wire sleeve. Two adjustment holes are symmetrically opened on the upper side of the wire reel. The adjustment holes are used for inserting tools to drive the wire reel to rotate. By rotating the wire reel, the pull wire can be tightened so as to drive the defective bone to fit tightly with the jawbone body.

[0011] As a further improvement to the above technical solution, a locking component is also included. The locking component includes a fixed tooth. The upper part of the fixed shaft is connected to the fixed tooth via a key. A cavity is opened in the lower part of the inner side of the coil. A movable tooth is fixedly connected to the inner wall of the cavity, and the movable tooth is movably sleeved on the fixed shaft. The movable tooth can move upward to mesh with the fixed tooth. A washer is sleeved on the lower part of the fixed shaft. An elastic element abuts between the washer and the lower side of the movable tooth, and the elastic element is sleeved on the fixed shaft. The elastic element is used to provide an elastic force to the movable tooth toward the fixed tooth.

[0012] As a further improvement to the above technical solution, it also includes a base, the lower end of the fixed shaft is connected to the base, and the base is located on the lower side of the arc-shaped guide plate. The base is used to abut against the surface of the defective bone so that the arc-shaped guide plate forms a suspended state.

[0013] As a further improvement to the above technical solution, a protective cover is also included. The protective cover is provided in the middle of the arc-shaped guide plate and is placed on the outside of the coil and wraps around it.

[0014] As a further improvement to the above technical solution, a guide groove is provided on one side of the protective cover for the pull wire to pass through in a directional manner.

[0015] The beneficial effects of this invention are as follows: By symmetrically arranging two sets of mutually pulling traction components along the arc-shaped guide plate, a stepless fixation structure for initial traction of the maxillofacial bone defect can be achieved; and by cooperating with multi-point distributed three-dimensional traction and tightening components, a suture-like multi-point, multi-directional traction and tightening of the maxillofacial bone defect can be achieved, which is conducive to the close fit between the defect bone and the jawbone body; in addition, by setting a locking adjustment component, the traction line can be conveniently tightened and self-locked, which is conducive to the flexible adjustment of the tightening force. Attached Figure Description

[0016] Figure 1 This is a diagram showing the traction suture state of the jawbone body and the defective bone in this invention.

[0017] Figure 2 This is a schematic diagram of the connection structure between the traction component and the tensioning component of the present invention.

[0018] Figure 3 This is a three-dimensional structural diagram of the traction component of the present invention.

[0019] Figure 4 This is a partial structural schematic diagram of the traction component of the present invention.

[0020] Figure 5 This is a partial cross-sectional view of the traction component of the present invention.

[0021] Figure 6 This is a three-dimensional structural diagram of the tensioning and tightening component and the arc-shaped guide plate of the present invention.

[0022] Figure 7 This is a schematic diagram of the connection structure of the tensioning component and the protective cover of the present invention.

[0023] Figure 8 This is a three-dimensional structural diagram of the locking component of the present invention.

[0024] Figure 9 This is a cross-sectional view of the tensioning and locking components of the present invention.

[0025] Figure 10 This is a structural separation diagram of the fixed shaft, fixed teeth, and movable teeth of the present invention.

[0026] The markings in the diagram are as follows: 1_arc-shaped guide plate, 10_arc-shaped groove, 11_first fixing pin, 12_connecting seat, 13_threaded sleeve, 14_adjusting rod, 15_fixed seat, 16_guide sleeve, 2_second fixing pin, 20_pull ring, 21_pull wire, 22_clamping bead, 3_fixed shaft, 30_thread reel, 31_thread sleeve, 32_adjusting hole, 33_base, 300_cavity, 4_fixed tooth, 40_movable tooth, 41_washer, 42_elastic element, 5_protective cover, 50_guide groove, 100_jawbone body, 200_defective bone. Detailed Implementation

[0027] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0028] Example: The present invention provides an arc-shaped traction device for repairing maxillofacial bone defects, such as... Figures 1 to 10 As shown, the device includes an arc-shaped guide plate 1 adapted to the surface contours of the jawbone body 100 and the defective bone 200. Two opposing arc-shaped grooves 10 are formed within the arc-shaped guide plate 1. First fixation pins 11 are movably fitted within the arc-shaped grooves 10 for fixing to the surfaces of the jawbone body 100 and the defective bone 200, respectively. The head diameter of the first fixation pin 11 is larger than the inner diameter of the arc-shaped groove 10. Two sets of traction devices are provided between the first fixation pin 11 and the arc-shaped guide plate 1 for directional guidance and preliminary positioning of both sides of the defective bone 200. The traction component includes a connecting seat 12. The connecting seat 12 is provided on one side of the head of the first fixing nail 11. A threaded sleeve 13 is movably sleeved on the connecting seat 12. An adjusting rod 14 is internally threaded into the threaded sleeve 13. By rotating the adjusting rod 14, the distance between the jawbone body 100 and the defective bone 200, on which the first fixing nail 11 is installed, can be adjusted. A traction tightening component is provided between the jawbone body 100 and the defective bone 200. The traction tightening component is used to traction and tighten the defective bone 200 and the jawbone body 100.

[0029] Furthermore, the traction component also includes a fixing seat 15, which is disposed on the arc-shaped guide plate 1. A guide sleeve 16 is rotatably connected to the fixing seat 15, and the outer end of the adjusting rod 14 is movably sleeved inside the guide sleeve 16. The outer end of the adjusting rod 14 is also connected to a washer ring that abuts against the outside of the guide sleeve 16, which is used to cooperate with the threaded sleeve 13 to form a tension force. By rotating the adjusting rod 14, the defective bone 200 connected to the first fixing nail 11 can be driven to move directionally along the arc-shaped groove 10, so that the defective bone 200 and the jawbone body 100 fit together, which is beneficial for the initial traction and positioning of the defective bone 200.

[0030] Furthermore, the traction tightening component includes multiple second fixing pins 2, which are spaced apart on the surfaces of the jawbone body 100 and the defective bone 200, forming a multi-point distributed three-dimensional traction structure, thereby facilitating precise fitting of the defective bone 200 to the jawbone body 100. Each second fixing pin 2 has a rotatable pull ring 20 at its head, and pull wires 21 are sequentially and movably connected between each pull ring 20. The two ends of each pull wire 21 are respectively fitted with retaining beads 22 for abutting against the pull rings 20. The traction tightening component also includes a fixing shaft 3 and an arc-shaped guide plate. A fixed shaft 3 is provided in the middle, and a wire reel 30 is movably sleeved on the fixed shaft 3. The wire reel 30 is used to wind up the pull wire 21. A wire sleeve 31 is connected to the inner side of the wire reel 30, and the pull wire 21 is movably passed through the wire sleeve 31. Two adjustment holes 32 are symmetrically opened on the upper side of the wire reel 30. The adjustment holes 32 are used for inserting tools to drive the wire reel 30 to rotate. By pressing down and rotating the wire reel 30, the pull wire 21 can be tightened, so as to drive the defect bone 200 to fit tightly with the jawbone body 100, which is conducive to further improving the stability and accuracy of the traction connection of the defect bone 200.

[0031] Furthermore, it also includes a locking component, which includes a fixed tooth 4. The fixed tooth 4 is connected to the upper part of the fixed shaft 3 via a key. A cavity 300 is opened in the lower part of the inner side of the coil 30. A movable tooth 40 is fixedly connected to the inner wall of the cavity 300. The movable tooth 40 is movably sleeved on the fixed shaft 3 and can move up and down along the fixed shaft 3. When the movable tooth 40 moves upward, it can mesh with the fixed tooth 4 to form a self-locking structure to lock the coil 30. A washer 41 is sleeved on the lower part of the fixed shaft 3. An elastic element 42 abuts between the washer 41 and the lower side of the movable tooth 40. The elastic element 42 is sleeved on the fixed shaft 3. The elastic element 42 is a compression spring and is used to provide an elastic force to the movable tooth 40 toward the fixed tooth 4.

[0032] Furthermore, it also includes a base 33. The lower end of the fixed shaft 3 is connected to the base 33, and the base 33 is located on the lower side of the arc-shaped guide plate 1. The base 33 is used to abut against the surface of the defective bone 200 so that the arc-shaped guide plate 1 forms a suspended state, which can effectively prevent the lower side of the arc-shaped guide plate 1 from directly abutting against the jawbone body 100 and the surface of the defective bone 200, thus avoiding pressure on the surgical area and affecting local blood circulation.

[0033] In addition, it also includes a protective cover 5. The protective cover 5 is provided in the middle of the arc-shaped guide plate 1. The protective cover 5 covers the outside of the coil 30 and wraps it, which can form a wrap-around anti-squeezing structure for the coil 30, so as to avoid touching the coil 30 and affecting the stability of the meshing between the movable teeth 40 and the fixed teeth 4. Furthermore, two guide grooves 50 distributed circumferentially are provided on one side of the protective cover 5 for the pull wire 21 to pass through in a directional manner, so that the pull wire 21 can be smoothly and steadily wound inside the coil 30 during the winding process.

[0034] Before surgery, the patient's mandible on the defective side was scanned by spiral CT to accurately obtain three-dimensional morphological data of the mandibular body 100 and the defective bone 200. The arc-shaped guide plate 1 of appropriate length was customized according to the defect range. The curvature of the arc-shaped guide plate 1 is consistent with the natural curvature of the healthy mandible. The two arc-shaped grooves 10 are parallel to the long axis of the mandible, and the spacing is adapted to the implantation position of the first fixation nail 11. At the same time, according to the bone thickness at both ends of the defective bone 200, the first fixation nail 11 and the second fixation nail 2 of appropriate length were selected (cortical bone fixation nail length 8-10mm, cancellous bone fixation nail length 10-12mm). Before use, the entire arc-shaped traction device was subjected to strict medical sterilization.

[0035] During the surgery, the patient was placed in a supine position and anesthesia was administered via nasal endotracheal intubation. An arc-shaped incision was made along the lower edge of the mandible on the affected side. The skin, subcutaneous tissue, and platysma muscle were incised layer by layer. Subperiosteal dissection was performed to expose the mandibular body 100 (proximal end of the defect) and the defective bone 200 (distal end of the defect). Scar tissue and granulation tissue in the defect area were thoroughly removed, and the surgical area was irrigated with saline. Based on the preoperative CT positioning marks, positioning bone holes were drilled at the predetermined fixation points of the mandibular body 100 and the defective bone 200 using a bone drill. The depth of the bone holes was slightly shorter than the length of the fixation pins to avoid penetrating the medial mucosa of the mandible.

[0036] After the bone hole positions are completed, the base 33 is placed against the outer surface of the defective bone 200, ensuring that the base 33 fits tightly against the bone surface. At this time, the arc-shaped guide plate 1 is suspended to prevent it from directly compressing the periosteum and affecting local blood flow. First, two sets of first fixation nails 11 are passed through the two arc-shaped grooves 10 of the arc-shaped guide plate 1, with two nails in each set. Then, they are screwed into the bone holes of the jawbone body 100 and the defective bone 200 in sequence. Since the diameter of the fixation nail head is larger than the width of the arc-shaped groove 10, it can... The adjusting rod 14 can fix and limit the arc-shaped guide plate 1; by rotating the adjusting rod 14, the threaded sleeve 13 can drive the connecting seat 12 and the first fixing nail 11 to slide along the path of the arc-shaped groove 10, thereby driving the defective bone 200 to move along the arc-shaped groove 10 towards the jawbone body 100 until the distance between the bone end face of the defective bone 200 and the jawbone body 100 is reduced to 1-2mm. At this time, excessive traction is avoided, and only the defective bone 200 is initially positioned and traction adjusted to prepare for the precise fitting of the subsequent traction tightening component.

[0037] Next, 3-4 second fixation nails 2 are implanted at intervals of 5-8 mm along the outer bone surfaces of the jawbone body 100 and the defective bone 200, with at least 3 nails on each side, forming a stable traction unit. Since the head of each second fixation nail 2 is rotatably mounted with the pull ring 20, the pull ring 20 can rotate 360 ​​degrees arbitrarily, so that the pull wire 21 can be smoothly pulled and tightened. After the pull wire 21 is pre-passed through the guide groove 50 and the wire sleeve 31, the two ends of the pull wire 21 are sequentially passed through the pull ring 20 on the jawbone body 100 side and the defective bone 200 side. Since the two ends of the pull wire 21 are respectively sleeved with the retaining bead 22, the diameter of the retaining bead 22 is larger than the hole diameter of the pull ring 20, to prevent the pull wire 21 from slipping off.

[0038] Then, after inserting the tool into the adjustment hole 32, press it down slightly and rotate it (to move the movable tooth 40 down and disengage from the fixed tooth 4, thus releasing the lock). This allows the suture reel 30 and the suture sleeve 31 to rotate synchronously, gradually tightening and adjusting the suture 21. This, in turn, allows the defective bone 200 to slowly move towards the jawbone body 100. The fit of the bone end faces is confirmed by intraoperative C-arm fluoroscopy. If the defective bone 200 has a slight misalignment, it can be finely adjusted by rotating the adjustment rod 14 until the jawbone body 100 and the bone end faces of the defective bone 200 are completely aligned, ensuring no steps or misalignments. Once the bone end faces are completely aligned, release the tool. The compression and storage of the elastic element 42 will push the movable tooth 40 and the suture reel 30 to automatically return to their original position, allowing the movable tooth 40 to engage with the fixed tooth 4, thus quickly locking and positioning the suture reel 30. The bone alignment accuracy and the stability of the traction device were confirmed again by C-arm fluoroscopy to ensure that there were no loose fixation screws or broken traction wires 21.

[0039] Finally, the surgical area was rinsed with saline solution to completely stop the bleeding. A soft tissue flap was then placed on the outside of the traction device, and the platysma muscle, subcutaneous tissue, and skin were sutured layer by layer. A drainage strip was placed in the surgical area (to be removed after 24-48 hours).

[0040] Postoperatively, antibiotics are routinely administered for 3-5 days to prevent infection, and dressings are changed regularly. The surgical area is observed for redness, swelling, effusion, and subcutaneous emphysema. CT scans are performed at 1 week, 1 month, and 3 months postoperatively to assess bone healing. During this period, chewing hard objects on the affected side should be avoided to prevent overloading of the traction device. After bone healing, a second surgery is usually performed 3-6 months later to remove the traction device. During removal, the suture coil 30 is first unlocked, and the movable teeth 40 are pressed downwards to separate them from the fixed teeth 4. Then, the pull wire 21, the second fixing nail 2, the first fixing nail 11, and the arc-shaped guide plate 1 are removed in sequence.

[0041] The embodiments of the present invention have been described in detail above with reference to the accompanying drawings. However, the present invention is not limited to the above embodiments. Within the scope of knowledge possessed by those skilled in the art, various changes can be made without departing from the spirit of the present invention.

Claims

1. An arc-shaped traction device for repairing maxillofacial bone defects, comprising an arc-shaped guide plate (1), characterized in that: The arc-shaped guide plate (1) has two oppositely distributed arc-shaped grooves (10). The arc-shaped grooves (10) are movably fitted with first fixing nails (11) for fixing and connecting to the surfaces of the jawbone body (100) and the defect bone (200) respectively. A traction member is provided between the first fixing nail (11) and the arc-shaped guide plate (1) for directional guidance and preliminary positioning of both sides of the defect bone (200). The traction member includes a connecting seat (12). A connecting seat (12) is provided on one side of the head of the first fixing nail (11). A threaded sleeve (13) is movably fitted on the connecting seat (12). An adjusting rod (14) is threadedly connected inside the threaded sleeve (13). A traction tightening member is provided between the jawbone body (100) and the defect bone (200). The traction tightening member is used to form a multi-point distributed three-dimensional traction structure between the defect bone (200) and the jawbone body (100).

2. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 1, characterized in that: The traction device also includes a fixing seat (15), which is disposed on the arc-shaped guide plate (1). A guide sleeve (16) is rotatably connected to the fixing seat (15), and the outer end of the adjusting rod (14) is movably sleeved in the guide sleeve (16). By rotating the adjusting rod (14), the defective bone (200) connected to the first fixing nail (11) can be driven to move in a direction along the arc-shaped groove (10) so that the defective bone (200) and the jawbone body (100) fit together.

3. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 1, characterized in that: The traction tightening component includes multiple second fixing nails (2), which are distributed at intervals on the surface of the jawbone body (100) and the defective bone (200). Each second fixing nail (2) has a pull ring (20) rotatably mounted on its head. Pull wires (21) are sequentially and movably connected between each pull ring (20). Each pull wire (21) has a locking bead (22) at both ends for abutting against the pull ring (20).

4. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 3, characterized in that: The traction tightening component also includes a fixed shaft (3). The fixed shaft (3) is provided in the middle of the arc-shaped guide plate (1). A wire reel (30) is movably sleeved on the fixed shaft (3). The wire reel (30) is used to wind up the pull wire (21). A wire sleeve (31) is connected to the inner side of the wire reel (30), and the pull wire (21) is movably passed through the wire sleeve (31). Two adjustment holes (32) are symmetrically opened on the upper side of the wire reel (30). The adjustment holes (32) are used for inserting tools to drive the wire reel (30) to rotate. By rotating the wire reel (30), the pull wire (21) can be tightened so as to drive the defective bone (200) to fit tightly with the jawbone body (100).

5. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 4, characterized in that: It also includes a locking component, which includes a fixed tooth (4). The upper part of the fixed shaft (3) is connected to the fixed tooth (4) by a key. A cavity (300) is opened in the lower part of the inner side of the coil (30). A movable tooth (40) is fixedly connected to the inner wall of the cavity (300). The movable tooth (40) is movably sleeved on the fixed shaft (3). The movable tooth (40) can move upward and mesh with the fixed tooth (4). A washer (41) is sleeved on the lower part of the fixed shaft (3). An elastic element (42) abuts between the washer (41) and the lower side of the movable tooth (40). The elastic element (42) is sleeved on the fixed shaft (3). The elastic element (42) is used to provide an elastic force to the movable tooth (40) towards the fixed tooth (4).

6. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 4, characterized in that: It also includes a base (33), the lower end of the fixed shaft (3) is connected to the base (33), and the base (33) is located on the lower side of the arc-shaped guide plate (1). The base (33) is used to abut against the surface of the defective bone (200) so that the arc-shaped guide plate (1) forms a suspended state.

7. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 4, characterized in that: It also includes a protective cover (5), which is provided in the middle of the arc-shaped guide plate (1), and the protective cover (5) covers the outside of the coil (30) and wraps it.

8. The arc-shaped traction device for repairing maxillofacial bone defects as described in claim 7, characterized in that: The protective cover (5) has a guide groove (50) on one side for the pull wire (21) to pass through in a directional manner.

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