Traction device for mandible condylar fracture surgery

Abstract

The invention relates to a traction device for mandible condylar fracture surgery, which comprises a fixing device, a traction line, a holding device and a transdermal device, one end of the fixing device is fixed on a surgical site, the other end of the fixing device is connected with the traction line, one end of the traction line opposite to the fixing device is connected with the holding device, and the other end of the traction line is connected with the transdermal device. The end, opposite to the pull wire, of the holding device is connected with a skin penetrating device, and the pull wire can rotate universally relative to the fixing device.

Description

Technical Field

[0001] This invention relates to a surgical instrument, and more specifically to a traction device for surgery on mandibular condylar fractures. Background Technology

[0002] Mandibular condyle fracture is one of the common fracture types of the oral and maxillofacial region, frequently occurring in traffic accidents, falls, and violent injuries. Treatment methods mainly include conservative treatment and surgical treatment, depending on the degree of fracture displacement and clinical symptoms. For cases with significant displacement, functional impairment, or combined occlusal disorders, open reduction and internal fixation are usually required. In current surgical techniques, to achieve accurate reduction of the fracture fragments, traction and positioning of the proximal segment of the mandible (including the condyle) are often necessary. Because the condyle is located in the temporomandibular joint region, its anatomical position is deep, the operating space is limited, and important anatomical structures (such as facial nerve branches, blood vessels, and the joint capsule) are distributed around it, making intraoperative traction and control of the fracture fragments quite challenging. Currently, commonly used traction and reduction methods mainly include the following: Manual traction involves using bone clamps, such as Kocher clamps or bone grasping clamps, to directly grasp the mandibular ramus or fractured segment during surgery, applying traction and reduction. Its basic structure consists of a pair of clamps with toothed clamping ends, with torque applied via a handle to achieve clamping and traction. The structural relationship is as follows: the front of the clamps grips the bone surface; the middle of the clamps transmits the traction force; and the handle is manually controlled by the surgeon. The procedure involves: exposing the fracture area; using bone clamps to grasp the mandibular ramus or fractured segment; manually adjusting the position of the fractured segment through traction; and performing internal fixation while maintaining traction. The disadvantage is that secondary fractures can occur during clamping due to small / fragile fracture ends or excessive clamping force, affecting the precision of surgical reduction.

[0003] An intraoral retractor or occlusal pad assists in repositioning the mandible by altering the opening and closing of the mandible, thereby indirectly affecting the condyle position and aiding in repositioning. Its structure includes: an intraoral support device, intermaxillary support points, and a force transmission path (dentition-mandible-condyle). Its disadvantage is the need for repeated adjustments to the position of the retractor or occlusal pad to achieve the desired surgical outcome.

[0004] The percutaneous traction-assisted method uses a percutaneous traction pin to assist in reduction. The skin in the submandibular region is incised, and blunt dissection is performed to the surface of the mandible. A temporary titanium screw is implanted in the mandible as a traction point, and a traction suture is connected. The traction suture is clamped to further adjust the distal position of the mandibular fracture ends, achieving surgical reduction of the condylar fracture. Its disadvantages include the additional surgical incision, increasing surgical trauma and operation time. Furthermore, there are currently no ready-made traction devices available, requiring on-site fabrication during surgery, significantly prolonging the operation time, and it also involves a certain degree of technical sensitivity.

[0005] Although current surgical techniques for mandibular condylar fractures include manual traction, mouth retractors or occlusal pads for assisted reduction, and percutaneous traction-assisted reduction, these existing techniques still have the following shortcomings in clinical application: The traction point is unstable and the reset accuracy is insufficient. In existing techniques, whether using bone clamps to directly grasp the mandibular ramus or fractured segments, or employing temporary titanium screws or traction wires for assisted traction, the traction point relies heavily on intraoperative selection, lacking a stable and standardized traction fulcrum. This is particularly true in condylar fractures, where the fracture fragments are often small and located deep within the local anatomy, leading to an unstable traction force transmission path. This makes it difficult to continuously and precisely control the direction of fracture segment movement and reduction position, thus affecting surgical reduction accuracy. This is because the condylar region has a deep anatomical location and limited exposure, and the fracture fragments are small. Existing traction methods are mostly temporary procedures, lacking fixed or guiding traction structures specifically designed for condylar fractures.

[0006] The traction direction and traction force are not easy to control precisely. Manual traction primarily relies on the surgeon applying force manually with bone forceps to achieve reduction. The direction, angle, and force of traction are greatly influenced by the surgeon's experience, hand stability, and intraoperative space limitations. Opening retractors or occlusal pads mainly affect the fracture fragment position indirectly by altering the mandibular opening and closing state. Their traction direction is relatively indirect, making it difficult to achieve targeted three-dimensional adjustment of the fracture ends. While percutaneous traction can generate some external force, it usually still relies on the surgeon's immediate adjustments, lacking a precise, continuous, and quantifiable mechanical control mechanism. This is because current techniques lack dedicated devices for precisely adjusting the direction, force, and displacement of traction, especially multi-directional adjustment structures suitable for condylar fracture reduction.

[0007] It is difficult to maintain a continuous and stable traction state. After satisfactory fracture reduction, the surgeon must continue with the localization and internal fixation of the fracture fragments. Current techniques often require continuous manual traction, which is prone to repositioning due to fatigue, vibration, or differences in coordination. Opening retractors or occlusal pads also frequently require repeated adjustments during surgery. While percutaneous traction can extend the traction duration to some extent, it currently relies heavily on temporarily fabricated traction sutures and clamps, resulting in poor stability and repeatability. This is because most existing traction methods lack self-stabilizing, self-locking, or continuous traction capabilities, failing to maintain the fracture fragment position stably after reduction.

[0008] It can easily cause additional damage or increase surgical trauma. When using manual bone clamps, improper selection of the clamping site or excessive clamping force can cause further fragmentation of the fractured bone, cortical bone compression injury, and even secondary fractures. Percutaneous traction requires additional skin incisions and exposure of the mandibular surface, increasing the scope of soft tissue dissection and additional trauma, while also increasing the risk of postoperative scarring, infection, and damage to surrounding tissues. This is because current techniques mostly achieve traction by directly clamping the bone surface or creating a separate traction channel, lacking a traction structure that is less invasive, gentler, and better suited to the characteristics of condylar fractures.

[0009] (5) The surgical procedure is complicated and prolongs the operation time. Current reduction and traction techniques often require repeated intraoperative probing of the traction direction and reduction angle. For example, occlusal pads or retractors need to be adjusted in height and position multiple times, and percutaneous traction methods also require additional steps such as temporary titanium screw implantation, traction suture connection, and on-site assembly. Currently, there is a lack of readily available dedicated traction devices for this type of surgery in clinical practice, often requiring the use of temporary combined instruments during surgery to achieve traction, which significantly increases the number of surgical procedures and prolongs the operation time. This is because current techniques lack dedicated traction devices with integrated structures and standardized operations, leading to complex intraoperative preparation, installation, and adjustment processes, and a high degree of technical sensitivity.

[0010] (6) Highly dependent on the surgeon's experience and teamwork Current techniques largely rely on the surgeon's experience in judging the direction of condylar fracture displacement, traction angle, timing of traction, and reduction feel, as well as the close cooperation between the assistant and the surgeon. Insufficient experience or poor coordination can easily lead to improper traction, reduction deviation, or difficulty in fixation. This is because there is currently a lack of specialized devices that can provide a stable fulcrum, a clear traction path, and continuous reduction retention, meaning the reduction process still primarily depends on manual experience.

[0011] (7) Lack of ready-made traction devices specifically designed for condylar fracture surgery The bone-holding forceps, retractors, occlusal pads, and traction sutures used in existing technologies are mostly general-purpose instruments, not specifically designed for the reduction of mandibular condylar fractures. Therefore, they cannot simultaneously meet the comprehensive requirements of "stable traction fulcrum, adjustable direction, continuous maintenance, minimal trauma, and quick installation" in condylar fracture surgery. This is because existing technologies primarily address traction issues from the perspective of general surgical instruments, and have not yet developed a specialized device system suitable for the reduction of mandibular condylar fractures.

[0012] In summary, existing technologies for mandibular condylar fracture surgery generally suffer from problems such as unstable traction fulcrum, difficulty in precisely controlling traction direction and force, difficulty in maintaining the reduction state, easy to cause additional damage, cumbersome and time-consuming surgical procedures, and strong dependence on the surgeon's experience. Therefore, it is necessary to provide a mandibular condylar fracture surgical traction device that is structurally specialized, easy to operate, provides stable traction, and can assist in precise reduction. Summary of the Invention

[0013] In view of the problems existing in the surgery of mandibular condyle fracture, such as unstable traction fulcrum, difficulty in accurately controlling traction direction and force, difficulty in maintaining the reduction state, easy to cause additional damage, complicated surgical procedures, and strong dependence on the surgeon's experience, the purpose of this invention is to provide a traction device for mandibular condyle fracture surgery.

[0014] This invention constructs a stable traction support structure and sets up an adjustable traction mechanism to make the traction point clear and fixed, thereby achieving stable traction on the fracture segment; at the same time, through a multi-directional adjustment structure, the traction direction and force can be precisely controlled to meet the needs of three-dimensional spatial adjustment during the reduction of condylar fractures.

[0015] Furthermore, by setting up a traction retention structure, the present invention enables the fractured segment to maintain a stable state after reaching the ideal reduction position, reducing the reliance on continuous manual traction; and by optimizing the traction method, it avoids directly clamping the fracture ends or adding additional surgical incisions, thereby reducing the risk of secondary fracture injury and soft tissue trauma.

[0016] Furthermore, through its integrated structural design, this invention enables the traction device to be quickly installed and adjusted, reducing repetitive steps during surgery, shortening surgical time, improving surgical efficiency, and reducing reliance on the surgeon's experience and teamwork.

[0017] Through the above-mentioned technical means, the present invention aims to achieve a stable, directionally controllable, simple, and safe auxiliary reduction process in mandibular condylar fracture surgery, thereby improving the surgical reduction accuracy and overall treatment effect.

[0018] Therefore, the present invention provides a traction device for mandibular condyle fracture surgery, comprising: a fixation device, a traction line, a holding device, and a skin-penetrating device. One end of the fixation device is fixed to the surgical site, and the other end is connected to the traction line. The end of the traction line opposite to the fixation device is connected to the holding device, and the end of the holding device opposite to the traction line is connected to the skin-penetrating device. The traction line is omnidirectionally rotatable relative to the fixation device.

[0019] According to one aspect of the invention, the fixation device includes a screw, the tip of which is fixed to the surgical site, the head of which is provided with a groove, and the traction wire is disposed in the groove in a manner that allows it to rotate circumferentially along the head of the screw.

[0020] According to one aspect of the invention, the skin-piercing device is provided with external threads, and the inner cavity of the holding device is provided with internal threads, thereby the skin-piercing device and the holding device are detachably connected by a threaded connection.

[0021] According to one aspect of the invention, the holding device is rigidly connected to the traction line.

[0022] According to one aspect of the invention, the skin-piercing device includes a bend structure, the bend being 15-20°.

[0023] According to one aspect of the invention, the traction line is a single or multiple strands of metal wire or a high-tensile wire.

[0024] According to one aspect of the invention, the metal wire comprises Ti6Al4V medical titanium alloy or 316L surgical grade stainless steel.

[0025] According to one aspect of the invention, the fixing device includes a plurality of fixing devices, and the traction line includes a plurality of traction lines.

[0026] According to one aspect of the invention, the screw comprises a medical cortical bone screw. Attached Figure Description

[0027] The accompanying drawings, which illustrate various embodiments of the present invention, are described below. In the drawings, the same reference numerals denote the same parts. The drawings are not necessarily drawn to scale, and some parts may be enlarged to show the details of the present invention.

[0028] Figure 1 A diagram showing the state of the traction device according to the invention for mandibular condyle fracture surgery when inserted into the surgical site of the mandibular condyle fracture; Figure 2 Detailed diagrams are shown of a traction device for mandibular condylar fracture surgery according to the present invention; Figure 3 A diagram showing the traction device according to the invention for mandibular condyle fracture surgery in a first state during mandibular condyle fracture surgery; Figure 4 yes Figure 3 The enlarged diagram shows in detail the surgical site of the mandibular condyle fracture and the traction device used in the surgery. Figure 5This is a diagram illustrating the second state of the traction device for mandibular condyle fracture surgery according to the present invention during mandibular condyle fracture surgery. Figure 6 yes Figure 5 The enlarged illustration shows in detail the surgical site of the mandibular condyle fracture and the traction device used in the surgery. Detailed Implementation

[0029] Specific embodiments of the present invention will now be described with reference to the accompanying drawings.

[0030] Figure 1 This diagram illustrates the state of the traction device for mandibular condyle fracture surgery according to the present invention when inserted into the surgical site. As shown, the traction device for mandibular condyle fracture surgery is fixed to the surgical site by a fixation device 4. The traction line 3 extends outward from the fixation device 4 in multiple directions. The skin-piercing device 1 pierces the skin to expose the traction line 3 and the holding device 2 outside the body. After the traction line 3 and the holding device 2 are exposed, the skin-piercing device 1 can be removed from the holding device 2. Then, the holding device 2 is clamped with medical instruments such as forceps or pliers, and an outward force is applied to provide traction in a suitable direction. Figure 1 As shown, two traction devices for mandibular condyle fracture surgery can be fixed at the surgical site. These two traction devices can provide double fixation and provide relatively large or different traction forces through two traction lines 3. Of course, if the fixation and traction force requirements are not so large, one traction device can be used, or if the fixation and traction force or traction angle requirements are high, two or more traction devices can be used.

[0031] Figure 2 Detailed illustrations are shown of a traction device for mandibular condylar fracture surgery according to the present invention. Figure 2As shown, the traction device for mandibular condyle fracture surgery according to the present invention includes: a fixation device 4, a traction wire 3, a holding device 2, and a skin-penetrating device 1. One end of the fixation device 4 is fixed to the surgical site, and the other end of the traction wire 3 is connected thereto. The end of the traction wire 3 opposite to the fixation device 4 is connected to the holding device 2, and the end of the holding device 2 opposite to the traction wire 3 is connected to the skin-penetrating device 1. The traction wire 3 is rotatable relative to the fixation device 4. The fixation device 4 can be a screw, such as a medical cortical bone screw, which can be a self-tapping screw. Of course, it is conceivable that the fixation device 4 can also be other fastening devices, such as bolts, rivets, snap-fit ​​components, etc., and its material can also be other medical environmentally friendly materials. The traction wire 3 can be a single strand or multiple strands of metal wire. It can be Ti6Al4V medical titanium alloy or 316L surgical grade stainless steel, or the traction wire 3 can also be a single strand or multiple strands of high-tensile wire, or a high-strength medical fiber filament. The holding device 2 can be textured on its surface to increase friction and facilitate force application. One end of the holding device 2 can be rigidly connected to the traction line 3, and the other end can be detachably connected to the skin-penetrating device 1. Specifically, an external thread can be provided on the outer surface of the rear end of the skin-penetrating device 1 that connects to the holding device, and a corresponding internal thread can be provided in the inner cavity of the holding device 2, thereby detachably connecting the holding device 2 and the skin-penetrating device 1 through a threaded connection. Of course, an external thread can also be provided on the holding device 2, and an internal thread can be provided in the inner cavity of the skin-penetrating device 1, or other detachable connection methods can be considered, such as key connection, snap connection, or groove-protrusion connection. The skin-penetrating device 1 can be a skin-penetrating needle or a skin-penetrating cannula, used to guide the traction line 3 from inside the mouth or surgical incision area to the body surface. The skin-penetrating device 1 can be segmented, for example... Figure 2 As shown, its first section is connected to the holding device 2, and the second section extends from the first section and forms an angle relative to the first section to facilitate puncture. This angle can be 15-20°, but other angles are also possible. On the fixing device 4, if the fixing device 4 is a screw, on the head of the screw, as shown... Figure 2 As shown in the enlarged view, the ring has a groove 5, which is partially formed around the circumference of the screw head. In the non-working state, the traction cable 3 can be looped and placed in the groove 5. In the working state, the ring is loosened to pull out the traction cable 3. Since the groove 5 has a certain circumferential extension range, the traction cable 3 can rotate omnidirectionally within the groove 5, thereby being pulled outward in multiple different directions. Of course, instead of the groove 5, the screw head may also have an elongated hole or other structure that allows the traction cable 3 to rotate omnidirectionally therein, and the traction cable 3 may also be detachably placed therein.

[0032] Figures 3-6 An operational example of the traction device for mandibular condyle fracture surgery according to the present invention is shown, wherein... Figure 3A diagram showing the traction device according to the invention for mandibular condyle fracture surgery in a first state during mandibular condyle fracture surgery; Figure 4 yes Figure 3 The enlarged illustration shows in detail the surgical site of the mandibular condyle fracture and the traction device used in the surgery. Figure 5 This is a diagram illustrating the second state of the traction device for mandibular condyle fracture surgery according to the present invention during mandibular condyle fracture surgery. Figure 6 yes Figure 5 The enlarged illustration shows in detail the surgical site of the mandibular condyle fracture and the traction device used in the surgery.

[0033] like Figure 3 and Figure 4 As shown, after exposing the fracture ends through the surgical approach, a fixation device 4 is inserted approximately 5 mm below the fracture ends of the mandibular ramus. The traction line 3 attached to the fixation device 4 is then untied and pulled outwards in one direction. Then, as... Figure 5 and Figure 6 As shown, the periosteum is dissected and dissected along the surface of the mandibular ramus to the angle of the mandible. The skin-penetrating device 1 is used to penetrate the skin. After removing the skin-penetrating device 1, the holding device 2 is held with the hand, clamps, forceps, etc., and traction is applied in the appropriate direction. While applying continuous traction, the fracture ends are fixed with a titanium plate 6 to achieve ideal surgical reduction.

[0034] The main improvement of this invention compared to the prior art is as follows: • Use a fixation device as a stable traction base to avoid directly clamping the fracture segment; • Establishing a controllable traction path through traction lines improves traction stability; • A skin-penetrating guide structure is installed to allow for flexible adjustment of the traction direction; • Achieves low-trauma, multi-directional, and controllable traction, suitable for full exposure and anatomical reduction of condylar fractures.

[0035] This invention uses a fixation device implanted in the mandibular ramus segment as a traction base point, allowing the traction force to act directly on the bone tissue, thus avoiding slippage or instability problems caused by traditional bone clamps. Compared with manual traction, traction stability is significantly improved, which is beneficial for maintaining continuous and controllable movement of the fracture segment during the reduction process.

[0036] By combining the traction line with the skin-guided structure, traction paths can be established at different skin exit points, thereby adjusting the direction and angle of the traction force to better match the spatial orientation required for condylar fracture reduction. Compared to manual or indirect traction in a single direction, this invention achieves traction control closer to three-dimensional space, thus improving the accuracy of fracture reduction. Under reasonable operating conditions, fracture reduction deviation can be controlled within approximately 1-2 mm.

[0037] This invention establishes a traction path through the fixation points of the fixation device, avoiding the risks of local compression or fragmentation caused by directly clamping the fracture fragment with traditional bone clamps due to insufficient exposure of the surgical area. It is particularly suitable for condylar fractures with small fracture fragments or thin bone. This structure helps reduce the probability of secondary fractures or cortical bone damage during surgery.

[0038] The device of this invention has a simple structure and a clear installation method. A traction system can be quickly established by pre-implanting a fixation device and connecting a traction line, avoiding the need for repeated adjustments to the traction instrument or the temporary construction of a traction device during surgery. Compared with existing methods that require repeated adjustments to the retractor or on-site fabrication of the traction system, this can reduce related operation time by approximately 10%-30%, thereby improving surgical efficiency.

[0039] This invention establishes a traction path using a narrow-diameter percutaneous transdermal device. Compared to the traditional method of establishing a traction channel through percutaneous incision, it avoids the preparation of additional surgical incisions, significantly reduces the scope of soft tissue dissection, lowers the risk of additional surgical trauma and postoperative scarring, and helps improve the patient's postoperative recovery.

[0040] This invention standardizes the direction and force transmission of traction through a structured traction path and a clearly defined traction method, reducing reliance on experience and manual judgment during surgery. Different surgeons can achieve more consistent traction effects when using this device, thereby improving the repeatability and stability of surgical procedures.

[0041] Because the traction process is more stable and controllable, it can reduce the tissue damage caused by repositioning deviation and repeated operations, thereby reducing the risk of postoperative joint dysfunction, poor repositioning and other complications, and helping to improve the recovery of the patient's occlusal relationship and temporomandibular joint function after surgery.

[0042] The device of this invention has a simple structure, can be fabricated from conventional medical materials, has low cost, and is easy to promote and apply. At the same time, by shortening operation time, reducing the incidence of complications, and minimizing additional operational steps, it can improve the utilization efficiency of operating rooms and reduce overall medical costs, thus possessing good social and economic benefits.

[0043] In summary, this invention achieves a stable, directionally adjustable, minimally invasive, and easy-to-operate reduction method for mandibular condylar fracture surgery by constructing a traction system with a fixation device as the fixation base, a traction line as the traction medium, and a skin-penetrating device as the path adjustment means.

[0044] In the description of this invention, it should be understood that the terms "center", "longitudinal", "lateral", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", etc., indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings. They are only for the convenience of describing this invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be construed as limiting the scope of protection of this invention.

[0045] The embodiments of the present invention have been described in detail above with reference to the accompanying drawings, but the present invention is not limited to the described embodiments.

[0046] For those skilled in the art, various changes, modifications, substitutions, and variations can be made to these embodiments without departing from the principles and spirit of the present invention, and these variations still fall within the protection scope of the present invention.

Claims

1. A traction device for mandibular condylar fracture surgery, comprising: The device includes a fixation device, a traction line, a holding device, and a skin-penetrating device. One end of the fixation device is fixed to the surgical site, and the other end is connected to the traction line. The end of the traction line opposite to the fixation device is connected to the holding device, and the end of the holding device opposite to the traction line is connected to the skin-penetrating device. The traction line is omnidirectionally rotatable relative to the fixation device.

2. The traction device for mandibular condylar fracture surgery as claimed in claim 1, wherein the fixation device includes a screw, the tip of the screw is fixed to the surgical site, the head of the screw is provided with a groove, and the traction line is disposed in the groove in a manner that allows it to rotate omnidirectionally along the circumferential direction of the head of the screw.

3. The traction device for mandibular condylar fracture surgery as described in claim 1, wherein the skin-penetrating device is provided with external threads and the inner cavity of the holding device is provided with internal threads, thereby the skin-penetrating device and the holding device are detachably connected by a threaded connection.

4. The traction device for mandibular condylar fracture surgery as described in claim 1, wherein the holding device is rigidly connected to the traction line.

5. The traction device for mandibular condylar fracture surgery as described in claim 1, wherein the skin-penetrating device includes a curved structure, the curved angle being 15-20°.

6. The traction device for mandibular condylar fracture surgery as described in claim 1, wherein the traction wire is a single-strand or multi-strand metal wire or a high-tensile wire.

7. The traction device for mandibular condylar fracture surgery as described in claim 6, wherein the metal wire comprises Ti6Al4V medical titanium alloy or 316L surgical grade stainless steel.

8. The traction device for mandibular condylar fracture surgery as described in claim 1, wherein the fixation device comprises multiple fixation devices, and the traction line comprises multiple traction lines.

9. The traction device for mandibular condylar fracture surgery as described in claim 2, wherein the screw comprises a medical cortical bone screw.

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