Fixing kit for patella transverse fracture minimally invasive surgery

Abstract

The utility model provides a fixing suite for a minimally invasive surgery of transverse patella fracture, which belongs to the field of medicine and comprises a steel wire with a needle. One end of the steel wire through hole guider is handheld and can be locked, and the other end of the steel wire through hole guider is provided with a steel wire access hole channel for guiding; the tip and the edge of one end of the anterior patellar dissection guider are sharp, a steel wire channel is arranged in the middle and used for being inserted into anterior patellar soft tissue and bringing out a steel wire, and the other end is handheld. The patella transverse fracture minimally invasive internal fixation device solves the problem that no suitable surgical instrument exists in the patella transverse fracture minimally invasive internal fixation technology, assists in completing patella steel wire conduction, achieves surgical treatment on the premise of minimally invasive surgery, avoids the problems of soft tissue contusion, incision infection, steel wire torsion fracture, too long radiation exposure and the like in the surgical process, and improves the working efficiency. And fracture reduction and fixation are completed on the premise of receiving the lowest limit value of radiation.

Description

Technical Field

[0001] The utility model belongs to the field of medicine (orthopedics) and relates to a minimally invasive surgical fixation kit for patellar transverse fractures. Background Art

[0002] The patella is the largest sesamoid bone in the human body and an important part of the patellofemoral joint connecting the quadriceps tendon and the patellar ligament. The incidence of patellar fractures accounts for 1% of all fractures in the body. The most common are horizontal and vertical fractures. Patellar fractures will destroy the function of the knee extensor mechanism, thereby causing long-term complications such as joint stiffness, joint adhesions, and patellofemoral arthritis. The treatment plans for different fracture types are very different. However, with the development of minimally invasive technology in recent years, it has become the first choice for the treatment of patellar fractures in clinical practice because of its advantages such as less trauma, shorter time, faster recovery, safety, high efficiency, and wide indications.

[0003] However, in the application of minimally invasive internal fixation technology, there is a lack of suitable surgical instruments, which leads to frequent problems such as soft tissue contusion, wound infection, wire torsion and breakage, and prolonged radiation exposure during surgery in clinical work. Therefore, completing fracture reduction and fixation under the premise of receiving the minimum radiation limit has always been a challenge faced by orthopedic clinicians. Utility Model Content

[0004] To solve this problem, the utility model provides a minimally invasive surgical fixation kit for transverse patellar fractures. After optimized design, it breaks through the problem of lack of suitable instruments for minimally invasive surgery of transverse patellar fractures in the past. So far, there have been no related reports, documents or patents at home and abroad.

[0005] The technical solution adopted by the utility model is as follows:

[0006] A minimally invasive surgical fixation kit for transverse patellar fractures comprises a steel wire through-hole guide 1, a prepatellar stripping guide 2, and a steel wire with a needle 3.

[0007] The wire hole guide 1 is a scissors-like structure as a whole, including a hand-held end and a guide end. The ends of the two hand-held ends are provided with a hollow circular hand-held ring 11 for controlling the opening and closing. The outer walls of the two hand-held rings 11 on the opposite side are provided with a holding ring lock 12, which is an elastic fixed step-type locking structure. The two holding ring locks 12 are used to lock the opening and closing angles; the front end of the guide end of the wire hole guide 1 is provided with a wire entrance and exit channel 13, and the two wire entrance and exit channels 13 are arranged opposite to each other for the needle wire 3 to pass through.

[0008] The prepatellar stripping guide 2 is strip-shaped, including a prepatellar stripper 22 at the head and a gripping handle 23 at the tail. The prepatellar stripper 22 is arc-shaped and flat, with its tip and both sides being sharp, and the tunnel formed by it is used for the steel wire 32 in the needle wire 3 to pass through; a channel with two ends opened in the arc direction is provided in the prepatellar stripper 22 as a steel wire channel 21, and the steel wire channel 21 is from the tip of the prepatellar stripper 22 to the junction of the prepatellar stripper 22 and the gripping handle 23; the gripping handle 23 is flat, thinner than the prepatellar stripper 22, and has a rough surface, which is convenient for holding.

[0009] The needle-carrying steel wire 3 comprises a steel wire guide needle 31 and a steel wire 32 inserted into the tail thereof.

[0010] Furthermore, the front ends of the two guide ends of the wire through-hole guide 1 are planar structures on the opposite side and tilted inward, and the opposite side is triangular and sloped, and the front end of the guide end is pointed; the wire entrance and exit channel 13 is circular and through, with one end opening at the planar structure on the opposite side of the front end of the guide end, and the other end opening at the slope between the top of the triangle on the opposite side and the sharp corner of the end.

[0011] Furthermore, the steel wire through-hole guide 1 and the prepatellar stripping guide 2 are both made of metal.

[0012] Furthermore, the steel wire guide needle 31 is 12 cm long.

[0013] Beneficial effects of the utility model: The utility model solves the problem of lack of suitable surgical instruments in the application of minimally invasive internal fixation technology for transverse patellar fractures. The utility model assists in the conduction of patellar wires, implements surgical treatment under the premise of minimally invasive treatment, avoids soft tissue contusion, incision infection, wire torsion fracture, prolonged radiation exposure and other problems during the operation, and completes the reduction and fixation of fractures under the premise of receiving the minimum radiation limit. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] FIG. 1( a ) is a front view of a steel wire through-hole guide structure;

[0015] FIG1( b ) is a partial side view of the guide end of the wire through-hole guide;

[0016] Figure 2 Schematic diagram of the structure of the prepatellar stripping guide, wherein (a) is an overall schematic diagram, and (b) is a side view of the head;

[0017] Figure 3 It is a schematic diagram of a wire with a needle;

[0018] In the figure: 1 steel wire through hole guide; 2 prepatellar stripping guide; 3 steel wire with needle; 11 hand-held ring; 12 holding ring lock; 13 steel wire entry and exit channel; 21 steel wire channel; 22 prepatellar stripper; 23 holding handle; 31 steel wire guide needle; 32 steel wire. DETAILED DESCRIPTION

[0019] The specific implementation of the utility model is further described below in conjunction with the accompanying drawings and technical solutions.

[0020] Embodiment 1:

[0021] A minimally invasive surgical fixation kit for transverse patellar fractures comprises a steel wire through-hole guide 1, a prepatellar stripping guide 2, and a steel wire with a needle 3.

[0022] As shown in Fig. 1(a), the steel wire through-hole guide 1 is in the form of a scissors-like structure as a whole, including a hand-held end and a guide end. The ends of the two hand-held ends are provided with a hollow circular hand-held ring 11 for controlling the opening and closing. The outer walls of the two hand-held rings 11 on the opposite side are provided with a holding ring lock 12, which is an elastic fixed step-type locking structure. The two holding ring locks 12 cooperate to lock the opening and closing angle. The front end of the guide end of the steel wire through-hole guide 1 is a plane structure on the opposite side and tilted inward. The opposite side is triangular and sloped. The front end of the guide end is sharp-angled. The front ends of the two guide ends are provided with a circular through-shaped steel wire inlet and outlet channel 13. One end of the steel wire inlet and outlet channel 13 opens to the plane structure on the opposite side of the end, and the other end opens to the slope between the top of the triangle on the opposite side of the end and the sharp corner of the end, as shown in Fig. 1(b).

[0023] like Figure 2 The prepatellar stripping guide 2 is strip-shaped, including a prepatellar stripper 22 at the head and a gripping handle 23 at the tail. The prepatellar stripper 22 is arc-shaped and flat, with its tip and both sides sharp, and the tunnel formed is used for the steel wire 32 to pass through; the prepatellar stripper 22 is provided with a channel with two ends opened along the arc direction as the steel wire channel 21, and the steel wire channel 21 is from the tip of the prepatellar stripper 22 to the junction of the prepatellar stripper 22 and the gripping handle 23; the gripping handle 23 is flat, thinner than the prepatellar stripper 22, and has a rough surface, which is convenient for holding.

[0024] like Figure 3 As shown, the needle-carrying steel wire 3 comprises a steel wire guide needle 31 and a steel wire 32 inserted into the tail thereof, wherein the steel wire guide needle 31 is 12 cm long.

[0025] The fixing kit is used as follows:

[0026] Step 1: After reducing the fracture end, fix it with fracture reduction forceps, flex the knee joint 90°, and use C-arm fluoroscopy to examine the knee joint in the anteroposterior and lateral views. The patella is well aligned in the anteroposterior view, and the patellar articular surface is flat in the lateral view.

[0027] Step 2: Use two 2.0 mm diameter Kirschner wires to insert horizontally from the inner and outer sides of the patella upward and downward, fix the fractured ends of the patella from far to near, and let the needle tip protrude 2 cm from the upper edge of the patella. C-arm fluoroscopy shows that the Kirschner wires are in the appropriate position.

[0028] Step 3: Use a sharp knife to make incisions along the Kirschner wire entry and exit points, a total of 4 incisions, each about 0.5 cm long, and use straight forceps to separate the subcutaneous soft tissue to the edge of the patella.

[0029] Step 4: insert the two guide ends of the steel wire through-hole guide 1 into the two incisions at the proximal end of the patella, respectively, until the steel wire entry and exit channel 13 exceeds the Kirschner wire. Hold the hand-held ring 11 tightly and lock the ring lock 12.

[0030] Step 5, pass the wire guide needle 31 and the wire 32 of the needle wire 3 from the lateral side of the patella along the outer side to the inner side of the knee joint, through the outer soft tissue, the outer wire entrance and exit channel 13, the deep surface of two Kirschner wires, the inner wire entrance and exit channel 13, the inner soft tissue, and out from the inner side of the knee joint, and cut off the wire guide needle 31.

[0031] Step 6, pull out the steel wire through-hole guide 1, and at the same time, the steel wire 32 is led out from the incision. At this time, the two ends of the steel wire 32 are respectively located at the two incisions at the proximal end of the patella.

[0032] Step 7, use the prepatellar stripping device 22 of the prepatellar stripping guide 2 to perform subcutaneous stripping from the lateral incision at the distal end of the patella to the opposite incision at the proximal end of the patella, flip it over and pass it out from the medial incision at the proximal end of the patella; pass the steel wire 32 at the medial incision at the proximal end of the patella from the tip of the prepatellar stripping device 2 into the steel wire channel 21 and pass it out from the other side of the channel; withdraw the prepatellar stripping device 22, and bring the steel wire 32 out from the lateral incision at the distal end of the patella.

[0033] Step 8, the prepatellar stripper 22 is inserted from the medial incision at the distal end of the patella to the lateral incision at the proximal end of the patella, the steel wire 32 at the lateral incision at the proximal end of the patella is passed through the steel wire channel 21 and then withdrawn from the prepatellar stripper 22, and the steel wire 32 is brought out from the medial incision at the distal end of the patella. At this time, the two ends of the steel wire 32 are respectively led out from the two incisions at the distal end of the patella.

[0034] Step 9, insert the surgical vascular clamp from the medial incision at the distal end of the patella, extend it from the lateral incision at the distal end of the patella along the deep surface of the patellar ligament, clamp the end of the steel wire 32 at the lateral incision at the distal end of the patella, then pull out the vascular clamp and take out the steel wire 32, at this time, both ends of the steel wire 32 are at the medial incision at the distal end of the patella.

[0035] Step 9, use Kirschner forceps to tighten the steel wire 32, and at the same time pull out the Kirschner wire until it exceeds the upper edge of the patella by 0.5 cm.

[0036] Step 10, using a bender to bend the Kirschner wire, using Kirschner forceps to cut off the remaining end of the steel wire 32 and the tail of the Kirschner wire and rotating and burying them.

[0037] Step 11, suture the 4 incisions.

[0038] The above-described embodiments merely express the implementation methods of the present invention, but they cannot be understood as limiting the scope of the patent of the present invention. It should be pointed out that for those skilled in the art, several modifications and improvements can be made without departing from the concept of the present invention, which all belong to the protection scope of the present invention.

Claims

1. A minimally invasive surgical fixation kit for transverse patellar fractures, characterized in that: The fixing kit comprises a steel wire through-hole guide (1), a prepatellar stripping guide (2), and a steel wire with a needle (3); The steel wire through-hole guide (1) is in the form of a scissors-like structure as a whole, comprising a hand-held end and a guide end, the ends of the two hand-held ends are provided with a hollow circular hand-held ring (11) for controlling opening and closing, and the outer walls of the two hand-held rings (11) on the opposite sides are provided with a holding ring lock (12), and the two holding ring locks (12) cooperate to lock the opening and closing angle; the front end of the guide end of the steel wire through-hole guide (1) is provided with a steel wire entry and exit channel (13), and the two steel wire entry and exit channels (13) are arranged opposite to each other for the steel wire to pass through; The prepatellar stripping guide (2) is strip-shaped, including a prepatellar stripper (22) at the head and a gripping handle (23) at the tail; the prepatellar stripper (22) is arc-shaped and flat, with a sharp tip and two side edges, and the tunnel formed by it is used for the steel wire (32) in the needle wire (3) to pass through; the prepatellar stripper (22) is provided with a channel with two ends opened along the arc direction, which serves as a steel wire channel (21), and the steel wire channel (21) extends from the tip of the prepatellar stripper (22) to the junction of the prepatellar stripper (22) and the gripping handle (23); the gripping handle (23) is flat; The needle-carrying steel wire (3) comprises a steel wire guide needle (31) and a steel wire (32) inserted into the tail thereof.

2. A minimally invasive surgical fixation kit for transverse patellar fracture according to claim 1, characterized in that: The ring-holding lock (12) is an elastic fixed step-type locking structure.

3. A minimally invasive surgical fixation kit for transverse patellar fracture according to claim 1, characterized in that: The front ends of the two guide ends of the wire through-hole guide (1) are planar structures on the opposite side and tilted inward, and the opposite side is triangular and sloped, and the front end of the guide end is pointed; the wire inlet and outlet channel (13) is circular and through, with one end opening at the planar structure on the opposite side of the front end of the guide end, and the other end opening at the slope between the top of the triangle on the opposite side and the tip of the end.

4. The minimally invasive surgical fixation kit for transverse patellar fracture according to claim 1, characterized in that: The gripping handle (23) is thinner than the prepatellar peeling device (22) and has a rough surface.

5. The minimally invasive surgical fixation kit for transverse patellar fracture according to claim 1, characterized in that: The steel wire through-hole guide (1) and the prepatellar stripping guide (2) are both made of metal.

6. The minimally invasive surgical fixation kit for transverse patellar fracture according to claim 1, characterized in that: The steel wire guide needle (31) is 12 cm long.

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