Percutaneous elastic distraction reduction fixing device for intra-articular fracture

Abstract

The utility model provides an intra-articular fracture percutaneous elastic distraction reduction fixing device which is characterized by comprising a sleeve (1) with one end open and the other end sealed, a pressure piston (4) is arranged in the sleeve (1), and a power piston (5) and a power ball (6) which are correspondingly matched are arranged on one side of the pressure piston (4). A plugging device (7) correspondingly matched with the open end of the sleeve (1) is arranged on one side of the power ball (6), a second sleeve (4a) is arranged at the other end of the pressure piston (4), one end of the second sleeve (4a) extends out of the sleeve (1), and the second sleeve (4a) is connected with a first screw (8) correspondingly matched with the second sleeve (4a). The utility model has the advantages of simple structure, convenience in use and simplicity in operation, and can avoid complications such as ankylosis and the like while maintaining fracture reduction.

Description

Technical field:

[0002] The utility model relates to the field of medical instruments, in particular to a percutaneous elastic distraction, reduction and fixation device for intra-articular fractures. Background technology:

[0004] Trauma is a major health problem and a major cause of death, especially among young people and adolescents. The severity and disability of post-traumatic stress syndrome are receiving increasing attention from all countries. Due to the complexity of joints and peri-articular structures, intra-articular fractures will have more or less sequelae after surgery or non-surgical treatment. For example, distal humeral fractures, distal radius fractures, and distal tibia fractures (Pilon fractures).

[0005] With the evolution of AO principles, our understanding of fracture treatment and healing has undergone important changes in the past decade. In the early days of these principles, the main goal of surgical treatment was to provide a strong fixation for intra-articular fractures. It was necessary to prioritize accurate reduction and fixation of the fracture to provide absolute stability. Mechanical stability was overemphasized at the expense of biological factors, and surgery itself was traumatic. However, the evolution of fracture treatment concepts has made us realize that mechanical factors and biological factors are equally important. Accurate reduction and absolutely stable fixation are not required for every patient, and this may come at a biological cost.

[0006] Although open reduction and rigid internal fixation are currently the main treatment method advocated for intra-articular fractures (according to AO principles, so that early joint function training can be performed), most fractures can often be treated non-surgically. The choice of treatment should be based on the needs of the patient, not the patient's need for treatment. For intra-articular fractures, as long as the displacement of the joint surface is within an acceptable range, non-surgical treatment can reduce surgical trauma. Clinical assessment shows that the appearance of the limb is normal, which can provide rapid functional recovery for fracture healing, which is the main factor in determining whether closed reduction is appropriate.

[0007] The basic methods of non-surgical treatment of fractures include traction and manual reduction of fractures, combined with simplified fixation using plaster casts, plaster splints, braces and other devices (external fixators, etc.). However, the results of the above fixation methods are either failure to effectively maintain fracture reduction, or ultimately stiffness of the joint, poor function, or even both.

[0008] The spring principle of the percutaneous elastic distraction reduction and fixation system for intra-articular fractures can not only effectively distract the joint and maintain fracture reduction, but also meet the viscoelastic needs of bone and joint tissue. The percutaneous elastic distraction reduction and fixation system can effectively distract the two bone surfaces that make up the joint, and maintain fracture reduction through the tension of soft tissues such as the joint capsule and ligaments. The "skin-and-bone technique (using ulnar olecranon steel needle bone traction above the head to treat distal humeral fractures in a bed-ridden position)" is the best proof. The significant feature of the spring principle of the percutaneous elastic distraction reduction and fixation system is that it has the elasticity of a spring, which can meet the elastic movement of the joint capsule and ligaments during joint fixation, avoid the continuous existence of creep and stress relaxation of the joint capsule and ligament tissues, thereby avoiding hardening of the joint capsule and ligament tissues, which is conducive to the recovery of joint function. The spring principle of the percutaneous elastic distraction reduction and fixation system provides an environment for movement for the healing of intra-articular fractures. Utility model content:

[0010] The utility model aims to overcome the deficiencies in the prior art and provides a percutaneous elastic distraction, reduction and fixation device for intra-articular fractures.

[0011] This application provides the following technical solutions:

[0012] A percutaneous elastic distraction, reduction and fixation device for intra-articular fractures, characterized in that it comprises a sleeve which is open at one end and sealed at the other end, a slide groove is provided at the end of one end of the sleeve, an opening is provided at the bottom of the other end of the sleeve, a pressure piston is provided in the sleeve, a corresponding power piston is also provided at one end of the pressure piston, a cavity is provided between the power piston and the pressure piston, and the cavity is filled with a filler, which is a gas or liquid or a mixture of air and hydraulic oil or a spring; a corresponding power ball is provided at one end of the power piston, a sliding block corresponding to the slide groove is provided on the power ball, a corresponding blocking device is provided at one end of the sleeve, a second sleeve is provided at the other end of the pressure piston, one end of the second sleeve extends out from the opening, and a corresponding first screw is connected to the extended end of the second sleeve.

[0013] On the basis of the above technical solutions, there are also the following further technical solutions:

[0014] A threaded section is arranged on the outer cylinder wall at one end of the sleeve, and a limiting nut is sleeved on the threaded section. The limiting nut forms a corresponding fit with the sliding block.

[0015] A spherical groove corresponding to a part of the spherical surface on one side of the power ball is provided at one end of the power piston.

[0016] A first sealing ring corresponding to the inner wall of the sleeve is sleeved on the other end of the power piston.

[0017] A second sealing ring corresponding to the inner wall of the sleeve is sleeved on one end of the pressure piston.

[0018] The plugging device includes a screw sleeve corresponding to the inner cylinder wall of one end of the sleeve, a protruding handle is provided at one end of the screw sleeve, a spherical groove corresponding to the power ball is provided at the other end of the screw sleeve, and a corresponding second screw is inserted in the screw sleeve.

[0019] The first screw and the second screw have the same structure, and both include a U-shaped tail wing, a nail rod is passed through the tail wing, a ball head is provided at one end of the nail rod, a snap ring corresponding to the ball head and a locking nut corresponding to the snap ring are provided on the tail wing.

[0020] Utility model advantages:

[0021] The utility model has a simple structure, is easy to use and simple to operate. Through the principle of elastic connection, the device makes the cross-joint fixation active, which can not only effectively support the joint and maintain fracture reduction, but also meet the viscoelastic needs of bone and joint tissue, and provide a movement environment for the healing of intra-articular fractures. During the joint fixation process, it can meet the elastic movement of joint capsule and ligament, avoid the continuous existence of creep and stress relaxation of joint capsule and ligament tissue, thereby avoiding complications such as sclerosis of joint capsule and ligament tissue, and is conducive to the recovery of joint function.

[0022] In particular, the slide groove is provided with scale lines, through which the distance moved by the limit nut can be recorded, thereby avoiding secondary damage to the bone joint and the surrounding soft tissue structure. In addition, since the first screw and the second screw are both pedicle screws in the prior art, the tail wings of the first screw and the second screw can adapt to Schanz needles of different planes and angles, which facilitates the connection and fixation of the utility model with the Schanz needle.

[0023] When using the utility model, the elastic pressure in the spring sleeve is adjusted through the pressure nut according to the fracture position and the size of the joint gap as viewed through the "C-arm" perspective, the elastic pressure in the spring sleeve is calculated and the position of the pressure nut is recorded to avoid secondary damage to the bone joint and the surrounding soft tissue structure.

[0024] The utility model provides a spherical groove design of a pressure ball and one end of a power piston, which is beneficial to evenly adjust the movement of the power piston and reduce the lateral pressure between the power piston and the inner wall of the sleeve.

[0025] In addition, the utility model also has certain surgical safety and surgical effectiveness:

[0026] 1. Safety: Percutaneous insertion of Schanz needles in the safe area can effectively avoid nerves and blood vessels. Intra-articular fractures are closed reduced and fixed with elastic force, without any damage to the bone joints and surrounding soft tissue structures. The millimeter scale design of the pressurized slide is conducive to calculating the elastic pressure and avoiding secondary damage to the bone joints and surrounding soft tissue structures. The perspective of the "C-arm" can clearly determine the location of the fracture and the size of the joint gap. The bones in the joints are mostly cancellous bones. When a fracture occurs, the cancellous bones are first squeezed and inserted together (except for avulsion fractures). Elastic expansion across the joint will not increase the displacement of the fracture. Moreover, fractures can also be healed through traction treatment.

[0027] 2. Effectiveness: The percutaneous elastic distraction reduction and fixation system for intra-articular fractures provides a moving environment for the healing of intra-articular fractures - it can effectively maintain fracture reduction and avoid complications such as joint stiffness. The application of the spring principle makes cross-joint fixation active, which can effectively distract the joint, maintain fracture reduction, and meet the viscoelastic needs of bone and joint tissue. The percutaneous elastic distraction reduction and fixation system can effectively distract the two bone surfaces that make up the joint, and maintain fracture reduction through the tension of soft tissues such as joint capsule and ligament. The "skin-wrapped bone technique (using ulnar olecranon steel needle bone traction above the head to treat distal humeral fractures in bed position)" is the best proof. The significant feature of the spring principle of the percutaneous elastic distraction reduction and fixation system is that it has the elasticity of the spring, which can meet the elastic movement of the joint capsule and ligament during cross-joint fixation, avoid the continuous existence of creep and stress relaxation of the joint capsule and ligament tissue, thereby avoiding hardening of the joint capsule and ligament tissue, which is conducive to the recovery of joint function. Description of the drawings:

[0029] Figure 1 This is a schematic diagram of the structure of the utility model after the embodiment 1 is assembled;

[0030] Figure 2 yes Figure 1 Schematic diagram of the structure when starting to use;

[0031] Figure 3 It is a schematic diagram of the structure when Example 2 is used. Specific implementation method:

[0033] Embodiment 1:

[0034] like Figure 1 and 2 As shown, a percutaneous elastic distraction reduction and fixation device for intra-articular fractures comprises a sleeve 1 which is open at one end and sealed at the other end. A slide groove 2 is axially arranged at one end of the sleeve 1, the slide groove 2 penetrates the sleeve wall, and a scale line 2a is arranged along the length direction of the slide groove 2 on the thickness section penetrating the sleeve.

[0035] A coaxially distributed opening 3 is provided at the bottom of the other end of the sleeve 1. A pressure piston 4 is provided in the sleeve 1, and a second sleeve 4a extends outward from one end of the pressure piston 4. One end of the second sleeve 4a extends out of the sleeve 1 from the opening 3, and a corresponding first screw 8 is connected to one end of the second sleeve 4a. The other end surface of the pressure piston 4 is spaced a certain distance from the bottom of the other end of the sleeve 1.

[0036] A second sealing ring 4b is sleeved on the end surface of the other end of the pressure piston 4 to form a corresponding sealing match with the inner wall of the sleeve 1. A corresponding power piston 5 is also provided at one end of the pressure piston 4, and a cavity 9 is provided between the power piston 5 and the pressure piston 4, and a filler 9a is provided in the cavity 9.

[0037] The filler 9a is a gas-liquid mixture, which includes hydraulic oil and air. The volume of the hydraulic oil is one fifth of the volume of the cavity 9, and the other four fifths of the cavity volume is air.

[0038] A first sealing ring 5b corresponding to the second sealing ring 4b is provided on the power piston 5. When the device is not in use, the first sealing ring 5b forms a sealing fit with the inner wall of the sleeve 1 on the right side of the chute 2, ensuring that the cavity 9 is always in a sealed state.

[0039] A power ball 6 is arranged in the sleeve 1 at one end of the power piston 5. A spherical groove 5a corresponding to the power ball 6 is arranged on the end surface of the power piston 5. A slider 6a corresponding to the slide groove 2 extends outward from the power ball 6, and one end of the slider 6a is inserted into the slide groove 2 and extends out of the sleeve 1.

[0040] A coaxially distributed thread segment 1a is provided on the outer cylinder wall at one end of the sleeve 1. The axial length of the thread segment 1a is consistent with the slide groove 2. A limiting nut 10 corresponding to the slider 6a is sleeved on the thread segment 1a.

[0041] A corresponding plugging device 7 is provided at the other end of the sleeve 1, and the plugging device 7 includes a screw sleeve 7a threadedly connected to the inner wall of the other end of the sleeve 1, and a pair of handles 7b are protruded from the outer wall of one end of the screw sleeve 7a, and the two handles 7b are symmetrically distributed, and a spherical groove 7c corresponding to the power ball 6 is provided at the other end of the screw sleeve 7a. A corresponding second screw 7d is threadedly connected to one end of the screw sleeve 7a.

[0042] The second screw 7d has the same structure as the first screw 8, and both of them include a U-shaped tail wing a. The outer wall of the tail wing a is arc-shaped, and a nail rod b is provided. A ball head c is provided at the top of the nail rod b, and a through hole corresponding to the ball head c is provided at the bottom of the tail wing a. A platform is provided on the top of the ball head c, and a snap ring d is provided in the tail wing a on one side of the platform to form a limited fit with the platform. The snap ring d can prevent the ball head c from falling off from the tail wing a, but will not limit its rotation. An internal thread section is provided on the inner wall of the tail wing a on one side of the snap ring d, and a locking nut e corresponding to the snap ring d is threadedly connected to the internal thread section. A cross-shaped or hexagonal locking groove is provided on the top of the ball head c and the locking nut d.

[0043] The second screw 7d and the first screw 8 are both pedicle screws in the prior art, and their structures are only briefly described here without repeating their detailed structures.

[0044] Embodiment 2:

[0045] like Figure 3 As shown, a percutaneous elastic distraction reduction and fixation device for intra-articular fractures comprises a sleeve 1 which is open at one end and sealed at the other end. A slide groove 2 is axially arranged at one end of the sleeve 1, the slide groove 2 penetrates the sleeve wall, and a scale line 2a is arranged along the length direction of the slide groove 2 on the thickness section penetrating the sleeve.

[0046] A coaxially distributed opening 3 is provided at the bottom of the other end of the sleeve 1. A pressure piston 4 is provided in the sleeve 1, and a second sleeve 4a extends outward from one end of the pressure piston 4. One end of the second sleeve 4a extends out of the sleeve 1 from the opening 3, and a corresponding first screw 8 is connected to one end of the second sleeve 4a. The other end surface of the pressure piston 4 is spaced a certain distance from the bottom of the other end of the sleeve 1.

[0047] A second sealing ring 4b is sleeved on the end surface of the other end of the pressure piston 4 to form a corresponding sealing match with the inner wall of the sleeve 1. A corresponding power piston 5 is also provided at one end of the pressure piston 4. A cavity 9 is provided between the power piston 5 and the pressure piston 4. A filler 9a is provided in the cavity 9. The filler 9a is a spring coaxially distributed with the sleeve 1. One end of the spring contacts the pressure piston 4, and the other end contacts the power piston 5.

[0048] A first sealing ring 5b corresponding to the second sealing ring 4b is provided on the power piston 5. When the device is not in use, the first sealing ring 5b forms a sealing fit with the inner wall of the sleeve 1 on the right side of the slide groove 2.

[0049] A power ball 6 is arranged in the sleeve 1 at one end of the power piston 5. A spherical groove 5a corresponding to the power ball 6 is arranged on the end surface of the power piston 5. A slider 6a corresponding to the slide groove 2 extends outward from the power ball 6, and one end of the slider 6a is inserted into the slide groove 2 and extends out of the sleeve 1.

[0050] A coaxially distributed thread segment 1a is provided on the outer cylinder wall at one end of the sleeve 1. The axial length of the thread segment 1a is consistent with the slide groove 2. A limiting nut 10 corresponding to the slider 6a is sleeved on the thread segment 1a.

[0051] A corresponding plugging device 7 is provided at the other end of the sleeve 1, and the plugging device 7 includes a screw sleeve 7a threadedly connected to the inner wall of the other end of the sleeve 1, and a pair of handles 7b are protruded from the outer wall of one end of the screw sleeve 7a, and the two handles 7b are symmetrically distributed, and a spherical groove 7c corresponding to the power ball 6 is provided at the other end of the screw sleeve 7a. A corresponding second screw 7d is threadedly connected to one end of the screw sleeve 7a.

[0052] The second screw 7d has the same structure as the first screw 8, and both of them include a U-shaped tail wing a. The outer wall of the tail wing a is arc-shaped, and a nail rod b is provided. A ball head c is provided at the top of the nail rod b, and a through hole corresponding to the ball head c is provided at the bottom of the tail wing a. A platform is provided on the top of the ball head c, and a snap ring d is provided in the tail wing a on one side of the platform to form a limited fit with the platform. The snap ring d can prevent the ball head c from falling off from the tail wing a, but will not limit its rotation. An internal thread section is provided on the inner wall of the tail wing a on one side of the snap ring d, and a locking nut e corresponding to the snap ring d is threadedly connected to the internal thread section. A cross-shaped or hexagonal locking groove is provided on the top of the ball head c and the locking nut d.

[0053] The second screw 7d and the first screw 8 are both pedicle screws in the prior art, and their structures are only briefly described here without repeating their detailed structures.

[0054] Working process:

[0055] First, after the patient is successfully anesthetized, he or she is placed in a supine position on the orthopedic operating table.

[0056] Routine disinfection and draping were performed. Schanz pins were fixed to the bones on both sides of the joint (for distal humeral fractures, Schanz pins were fixed to the humerus and olecranon of the ulna respectively; for distal radius fractures, Schanz pins were fixed to the radius and second metacarpal bone respectively; for distal tibia fractures, Schanz pins were fixed to the tibia and calcaneus respectively).

[0057] According to the distance between the two Schanz pins across the joint, the tightening depth of the screw rod b in the first screw 8 and the second screw 7d is adjusted by a tool (such as a hexagonal prism or a screwdriver), that is, the distance between the two ball heads c in the first screw 8 and the second screw 7d is adjusted.

[0058] Then, two Schanz pins are inserted into the first screw 8 and the second screw 7d between the clamping ring d and the locking nut e in the tail a, respectively, and then the locking nut d is screwed into by a tool (such as a hexagonal prism or a screwdriver), and the tool is pressed down to lock the Schanz pin with the clamping ring d and the ball head c. The method of connecting the Schanz pin with the first screw 8 and the second screw 7d is the same as the method of using the pedicle screw in the prior art, and will not be described in detail here.

[0059] Under the "C-arm" fluoroscopy, determine whether the fracture has been reduced, and then rotate the limit nut 10 to push the slider 6a and then push the power ball 6 to squeeze the power piston 5, thereby squeezing the filler 9a (gas-liquid mixture or spring) in the cavity 9, and then squeeze the pressure piston 4, thereby driving the first screw 8 to move, which has the effect of adjusting the joint gap and making the joint moderately enlarged.

[0060] In this way, after the patient recovers for a period of time, the fracture situation can be judged under the "C-arm" perspective, and then the position of the limit nut 10 can be rotated again to adjust the pressure of the filler 9a in the cavity 9 on the pressure piston 4, and then adjust the gap between the joints. In the whole fracture recovery process, the distance between the joints can be adjusted according to the recovery situation, the fracture reduction can be maintained, and the viscoelasticity requirements of the bone and joint tissue can be met, providing a movement environment for the healing of the intra-articular fracture, and the elastic movement of the joint capsule and ligament can be met during the joint fixation process, avoiding the continuous existence of creep and stress relaxation of the joint capsule and ligament tissue, thereby avoiding complications such as sclerosis of the joint capsule and ligament tissue, which is conducive to the recovery of joint function.

Claims

1. A percutaneous elastic distraction reduction and fixation device for intra-articular fractures, characterized by: It comprises a sleeve (1) with an opening at one end and a sealing at the other end, a slide groove (2) being provided at one end of the sleeve (1), an opening (3) being provided at the bottom of the other end of the sleeve (1), a pressure piston (4) being provided in the sleeve (1), a corresponding power piston (5) being provided at one end of the pressure piston (4), a cavity (9) being provided between the power piston (5) and the pressure piston (4), and a filler (9a) being filled in the cavity (9), and the filler (9a) being a gas-liquid mixture or a spring; A corresponding power ball (6) is provided at one end of the power piston (5), a sliding block (6a) corresponding to the slide groove (2) is provided on the power ball (6), a corresponding blocking device (7) is provided at one end of the sleeve (1), and a second sleeve (4a) is provided at the other end of the pressure piston (4), one end of the second sleeve (4a) protrudes from the opening (3), and a corresponding first screw (8) is connected to the protruding end of the second sleeve (4a).

2. The percutaneous elastic distraction reduction and fixation device for intra-articular fractures according to claim 1, characterized in that: A threaded section (1a) is provided on the outer cylinder wall at one end of the sleeve (1), and a limiting nut (10) is sleeved on the threaded section (1a), wherein the limiting nut (10) forms a corresponding fit with the slider (6a).

3. The percutaneous elastic distraction reduction and fixation device for intra-articular fractures according to claim 1, characterized in that: A spherical groove (5a) corresponding to and matching a portion of the spherical surface of one side of the power ball (6) is provided at one end of the power piston (5).

4. The percutaneous elastic distraction reduction and fixation device for intra-articular fractures according to claim 1, characterized in that: A first sealing ring (5b) corresponding to the inner wall of the sleeve (1) is sleeved on the other end of the power piston (5).

5. The percutaneous elastic distraction reduction and fixation device for intra-articular fractures according to claim 1, characterized in that: A second sealing ring (4b) is sleeved on one end of the pressure piston (4) and corresponds to the inner wall of the sleeve (1).

6. The percutaneous elastic distraction reduction and fixation device for intra-articular fractures according to claim 1, characterized in that: The plugging device (7) comprises a screw sleeve (7a) corresponding to the inner cylinder wall at one end of the sleeve (1), a protruding handle (7b) is provided at one end of the screw sleeve (7a), a spherical groove (7c) corresponding to the power ball (6) is provided at the other end of the screw sleeve (7a), and a corresponding second screw (7d) is inserted in the screw sleeve (7a).

7. The percutaneous elastic distraction reduction and fixation device for intra-articular fractures according to claim 1, characterized in that: The first screw (8) and the second screw (7d) have the same structure, and both comprise a U-shaped tail wing (a), a nail rod (b) passing through the tail wing (a), a ball head (c) being provided at one end of the nail rod (b), and a snap ring (d) corresponding to the ball head (c) and a locking nut (e) corresponding to the snap ring (d) being provided on the tail wing (a).

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