CN108236491A - The adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between a kind of bone block - Google Patents
The adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between a kind of bone block Download PDFInfo
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- CN108236491A CN108236491A CN201611211363.5A CN201611211363A CN108236491A CN 108236491 A CN108236491 A CN 108236491A CN 201611211363 A CN201611211363 A CN 201611211363A CN 108236491 A CN108236491 A CN 108236491A
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 61
- 239000013013 elastic material Substances 0.000 claims abstract description 26
- 239000002184 metal Substances 0.000 claims abstract description 25
- 230000011218 segmentation Effects 0.000 claims abstract description 7
- 229910000831 Steel Inorganic materials 0.000 claims description 32
- 239000010959 steel Substances 0.000 claims description 32
- 230000005540 biological transmission Effects 0.000 claims description 19
- 239000007788 liquid Substances 0.000 claims description 18
- 238000006073 displacement reaction Methods 0.000 claims description 12
- 238000000926 separation method Methods 0.000 claims description 10
- 230000000712 assembly Effects 0.000 claims description 5
- 238000000429 assembly Methods 0.000 claims description 5
- 230000033228 biological regulation Effects 0.000 abstract description 3
- 238000013139 quantization Methods 0.000 abstract description 3
- 230000006641 stabilisation Effects 0.000 abstract description 3
- 238000011105 stabilization Methods 0.000 abstract description 3
- 208000010392 Bone Fractures Diseases 0.000 description 78
- 206010017076 Fracture Diseases 0.000 description 77
- 230000033001 locomotion Effects 0.000 description 21
- 208000005214 Poroma Diseases 0.000 description 8
- 201000001013 eccrine acrospiroma Diseases 0.000 description 8
- 239000011148 porous material Substances 0.000 description 6
- 230000006835 compression Effects 0.000 description 5
- 238000007906 compression Methods 0.000 description 5
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- 238000010586 diagram Methods 0.000 description 4
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- 208000027418 Wounds and injury Diseases 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 230000001969 hypertrophic effect Effects 0.000 description 2
- 206010003694 Atrophy Diseases 0.000 description 1
- 208000024779 Comminuted Fractures Diseases 0.000 description 1
- 208000006670 Multiple fractures Diseases 0.000 description 1
- 208000001132 Osteoporosis Diseases 0.000 description 1
- 208000006735 Periostitis Diseases 0.000 description 1
- 230000004520 agglutination Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000037444 atrophy Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6441—Bilateral fixators, i.e. with both ends of pins or wires clamped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/645—Devices extending alongside the bones to be positioned comprising a framework
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6491—Devices extending alongside the bones to be positioned allowing small-scale motion of bone ends
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
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Abstract
The present invention relates to a kind of outside fixed frame for external osteosynthesis, more particularly to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between a kind of bone block, belong to fractures external fixation device, when solving to carry out firm fixation to fracture using existing fracture fixation instrument, the problem of Chang Wufa makes moderately to pressurize between sclerite, it is characterized in that the hack lever segmentation of this external fixing rack, every section of one or both ends carry plug or interface；Spring assembly is carried in plug or interface（One or more of metal spring, gas spring, elastic material pad）, adjustable bone block countershaft is formed after grafting to stressed attachment device, the hack lever of segmentation is made up of to the combined mounting rod of globality this attachment device.By the elastic force for adjusting whole spring assembly, thus it is possible to vary the size of active force of this attachment device to two sections of hack levers of its both sides on long axis direction, and then adjust axial plus-pressure between bone block.The present invention fixed to fracture stabilization meanwhile, it is capable to avoid excessive stress shielding, can realize the axial pressure power bone block flexible quantization regulation and control, be at meeting the optimal level needed for union, promote union for fracture fixation.
Description
Technical field
The invention belongs to medical apparatus and instruments technical fields, and in particular to the adjustable fracture of axial plus-pressure between a kind of bone block
External fixing rack.
Background technology
It is needed during fracture clinical treatment by the reduction of the fracture and fixation, restores the anatomy relationship between sclerite, rebuild bone
Stability restores physiological function of the bone as human body support；It needs to provide suitable biological environment for union simultaneously,
Such as reduce the destruction to soft tissue and periosteum, the blood circulation for keeping abundance to the greatest extent, keep moderately pressurizeing between sclerite, to promote
Into union.Modern fractures propose new BO on the basis of AO principles（Biological Osteosynthesis）
Theory while the Mechanics of Machinery characteristic for paying attention to fracture fixation, more payes attention to fixed biological characteristics, uses Indirect reduction
Mode reduces operation wound, promotes the formation of poroma with the fixed form of more resilient.The early stage AO principle of fractures will
Strong fixation, absolute stability are asked, new AO principles are changed into the fixation to be aspired for stability, stablized relatively, it is believed that bone in flexible fastening
The fine motion at folding end can stimulate poroma fast-growth, and reduce complication caused by excessively strong fixation.With existing fracture
Fixation device（Fracture external fixing rack, intramedullary nail or interior fixation bone fracture plate）When carrying out flexible fastening to fracture, if fixed strong
Degree appropriateness while fracture acquisition stablizes fixed, generates appropriate fine motion between sclerite, can stimulate poroma formation and then fracture and be cured
It closes；If fixing intensity is too low, stability is insufficient, and mobility is excessive between sclerite, although there is a large amount of poroma, still will appear bone
Roll over disunion（Hypertrophic nonunion）；If fixing intensity is excessively high, excessively stablize between sclerite, it is impossible to generate effectively micro-
It is dynamic, then can not effective stimulus growth of spur, form nonunion（Atrophic fracture disunion）.Using these existing fracture
Fixation device to fracture carry out flexible fastening when, improve fracture fixation stability and preserve bone block between fine motion the two between be
Contradiction.Common practice is to sacrifice segmental stability to make to obtain certain fine motion, such as be widely used at present between sclerite
Locking bone fracture plate（LCP）When applied to fracture fixation, since the fixed stability of locking nail is high, with shorter steel plate to fracture
It is excessively strong to the fixation of fracture when carrying out small span and fixing, stress shielding can be caused, atrophy occurs in fine motion deficiency between sclerite
Property nonunion, while stress concentration increase Plate break chance.To reduce stress shielding, make to obtain centainly between bone block
Fine motion mostly using bridging technology, that is, selects longer steel plate, increases span, reduces fixing screws.Since in this way, increased in span
Afterwards, by the deformation of bone plate, allow fracture fine motion, this technology actually sacrifices the stabilization come using longer steel plate strip
A part for property, to obtain a degree of fine motion between sclerite, but actually also increases operation using longer steel plate
Wound.The way of this compromise is not but that can succeed, and is difficult to take into account fracture stabilization often in the case of increasingly complex
Property and keep both fine motion between sclerite, such as the complicated comminuted fracture of long bone is fixed with existing axial external fixation
When, the stability of fracture end is often insufficient, is susceptible to lateral displacement, angulation displacement and rotation displacement, some orthopedist's meetings
Add while fixing and fracturing with external fixing rack with limited interior fixation（With having for shorter built-in Interal fixation fracture end both sides
Limit region）To strengthen stability, this is because in the case where fracture is very unstable in itself, even if not taking sclerite into account completely
Between fine motion, the stability for rebuilding bone is extremely difficult, but adds and with simple internal fixation necessarily also limit fracture end
Fine motion between bone block easily causes the nonunion of atrophic.There is doctor to attempt to be positioned over LCP as support arm in recent years
It is external to fracture for fixed, preferable therapeutic effect is also obtained, but appropriateness is micro- between improving fixed stability and retaining bone block
Contradiction between dynamic equally exists.Using existing exterior fixing rack fix fracture when situation with by locking bone fracture plate as
Support arm using when situation be similar.It should be noted that in fracture fixation, the axial compressive force between bone block makes between sclerite
It is appropriate to be pressurized with being conducive to stimulation growth of spur, promote union, and (lateral displacement, separation move the displacement of other forms tendency
Position, rotation displacement) it is considered being unfavorable for poroma formation union；Such as the research group of Uhthoff leaders thinks：
The method that union under plate can uniquely be improved is the fine motion of structure fracture point, but fine motion must be limited on long axis direction,
Want limit flexion, torsion, shearing motion（Backman D,Uhthoff H,Poitras P,et al.Mechanical
performance of a fracture plate incorporating bioresorbable inserts[J].J Bone
Joint Surg Proceed Br,2004,86(Suppl):300.）；Appropriate fine motion, is to protect between so-called holding sclerite
Stay the appropriate axial pressure between sclerite.Repugnance when fracture being fixed using existing fracture fixation equipment is：
If fracture end is firmly fixed, stress shielding can be generated；Harmful transverse direction between bone block is limited, separation and
While rotation displacement, axial plus-pressure equally reduces between sclerite, can not effective stimulus growth of spur, poroma production quantity is insufficient
Nonunion will be caused（Atrophic fracture disunion）；If sacrifice segmental stability make to obtain between the bone block of fracture end it is micro-
It is dynamic, and lateral, separation and rotation displacement tendency can be increased, gap increases between easily causing bone block, fracture reduction then occurs not
It is good, although there is poroma to be formed, can not heal（Hypertrophic nonunion）.In conclusion using existing fracture fixing apparatus
Tool to fracture carry out flexible fastening when, improve fracture fixation stability and preserve bone block between fine motion the two between be contradiction
, appropriate axial pressure between the bone block of fracture end is often cannot keep while remaining fixed sufficiently stable, fracture is caused to be not easy
Healing.
Invention content
When carrying out firm fixation to fracture using existing fracture fixation equipment to solve, Chang Wufa makes to fit between sclerite
This problem of degree pressurization.The present invention provides the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between a kind of bone block, is carried out to fracture
To stablize fixed meanwhile, it is capable to avoid excessive stress shielding, the axial pressure power between bone block realizes flexible quantization regulation and control,
Optimal level is at, promotes union.
The technical solution adopted by the present invention to solve the technical problems is：By hack lever（Can be steel plate or connecting rod）Segmentation
（It is divided into two or more）, with plug or interface, plug or interface are interior with spring for the one or both ends of every section of hack lever
Device（One or more of metal spring, gas spring, elastic material pad）, plug is with forming adjustable bone block after interface grafting
Between axial stressed attachment device, the hack lever of segmentation is made up of to the combined mounting rod of globality this attachment device, by this
Combined mounting rod is used as the main support of external fixing rack.Using steel plate as the external fixing rack of hack lever, the trepanning on steel plate is lock
Determine hole, the screw used is lock screw, by the way that lock screw tail portion is tightened against lock hole, screw is made to be connect with steel plate solid
It is fixed.Fixation is connect with connecting rod by clip using connecting rod as the external fixing rack of hack lever, screw.Pass through the bullet of adjustment spring device
Power size can adjust active force of this attachment device to two sections of hack levers of its both sides on long axis direction, and then adjust bone block
Between axial plus-pressure.Spring assembly can be metal spring, can be gas spring, can be elastic material pad, can also will be upper
The two or three stated in three kinds of spring assemblies are applied in combination, and form knockdown spring assembly.Spring assembly can not be with biography
Dynamic device is connected and is used alone（Such as in Fig. 5, Fig. 6, Figure 11 gas spring as spring assembly, no transmission device）；It can also
It is connect with transmission device（Such as metal spring as spring assembly, connects hydraulic transmission in Fig. 7；Metal spring is made in Fig. 8
For spring assembly, mechanical driving device is connected；Elastic material pad connects hydraulic transmission as spring assembly in Fig. 9；Figure 10
Middle elastic material pad connects mechanical driving device as spring assembly）, the conduction of power is completed by transmission device, and pass through biography
The elastic force of the more convenient adjustment spring assembly of dynamic device.The shape of plug is non-circular with the shape of interface inner wall
（Preferred octagonal in Figure 12）, contact surface is smooth and fits closely, and to eliminate mutual rotation displacement and angulation displacement, allows
It is slided on long axis direction each other；The outer wall of interface is circle, is threaded, outer diameter and the lid shape positioning screw cap 5 of interface
Internal diameter is adapted, and lid shape positioning screw cap 5 is a nut with cover, with trepanning on capping, inner thread with outside interface
The screw thread of wall is adapted, and the trepanning on lid shape positioning screw cap capping allows hack lever to pass through, and larger plug can not pass through, and work as plug
After interface grafting, lid shape positioning screw cap is made to be moved to the appropriate position along screw thread, lid shape positioning screw cap will limit plug with
The relative position of interface, limitation plug is more than the shift separation of this position relative to interface, without limitation plug and interface
Between slide in opposition.The combined mounting rod of the globality formed is combined by attachment device by the hack lever being segmented, it can as main support
To be used alone（Such as Fig. 3）, used after secondary support can also be installed（Such as Fig. 4）, to increase the fixed angle of screw, expand
Fixed range increases fixing intensity.After fracture is completed to reset and completes fixed with combined mounting rod, born according to fracture negative
The size of lotus adjusts the elastic force of spring assembly in attachment device to proper level, makes to pressurize between the bone block of fracture end（Such as limbs
The tranquillization rest period after fracture operation, the load that limbs are born is small, can make two sections of hack levers using the elastic force of adjustment spring device as pulling force
Between pressurize, you can make moderately to pressurize between bone block；Such as functional training phase after limb fracture operation, limbs bear the negative of larger intensity
Lotus, can be using the elastic force of adjustment spring device as pressure, when the axial pressure load that limbs are born is less than spring pressure, spring dress
Put no compression, load is all conducted by one end of limbs to the limbs other end by hack lever, without pressurization between fracture end bone block, and is worked as
The axial pressure load that bone is born be more than spring pressure when, spring devices compress, the load exceeded can part conduction extremely
Between the bone block of fracture end, make axial pressure between bone block, according to the intensity for the axial load that limbs are born, the pressure of adjustment spring,
The load that can make conduction to fracture end is in suitable level, so that it may so that the axial compressive force between bone block is maintained at suitable for water
It is flat）.
The invention has the advantages that it carries out stablizing fixed meanwhile, it is capable to excessive stress shielding be avoided, to bone to fracture
Axial pressure power between block realizes flexible quantization regulation and control, is at optimal level, promotes union.Both it can make fracture
The fixation of high stability is obtained, and keeps the appropriate fine motion between sclerite simultaneously（Appropriate axial pressure）.It keeps fitting between sclerite
Fracture is kept to obtain high stability while spending fine motion, enable the bone early ambulant fractured, after mitigating fracture fixation
Limbs give up with caused muscular atrophy, anchylosis, disuse osteoporosis.Fracture obtains will not while high stability is fixed
There is the stress shielding of fracture end, make moderately to pressurize between the bone block of fracture end, the poroma of generation is high-quality, and intensity is high, reduces
The risk of fracture is sent out after being fixed in removal again.Since plus-pressure axial between bone block is adjustable, the intensity of functional training can't influence
Axial pressure between sclerite, rehabilitation training amount can be according to the individual difference flexible arrangements of different patients.It is fixed with the present invention
During the multiple fracture that same limbs occur, since plus-pressure axial between bone block is adjustable, after everywhere fracture can be according to fixation
Stability and growth of spur situation setting varying strength axial pressure power, the limb functional exercise under same intensity will not draw
Rise different fracture sites different agglutinations between interfere with each other.It is high steady due to obtaining fracture during fracture fixed with the present invention
Appropriate fine motion between sclerite will not be lost while qualitative, the fixation of higher intensity can be allowed, can add is increased with secondary support
Fixed angle expands fixed range, increases stability maintenance.
Below by drawings and examples, technical scheme of the present invention is described in further detail.
Description of the drawings
Fig. 1：Outside drawing for the external fixing rack connected using steel plate as hack lever, with attachment device；
Fig. 2：Outside drawing for the external fixing rack connected using connecting rod as hack lever, with attachment device；
Fig. 3：To use combined mounting rod of three sections of steel plate combinations for globality（As main support）It fixes at two on same long bone
The schematic diagram of the embodiment of fracture；
Fig. 4：For the combined mounting rod using two sections of steel plate combinations as globality（As main support）, place secondary support（Increase fixed angles
Degree expands fixed range）The schematic diagram of the embodiment of the fixed fracture close to metaphysis；
Fig. 5：To connect two sections of steel plates using the attachment device with gas spring, it is combined as the outer fixation of the combined mounting rod of globality
The sectional view of frame；
Fig. 6：For the sectional view using gas spring as the attachment device of spring assembly；
Fig. 7：Sectional view to use hydraulic drive and using metal spring as the attachment device of spring assembly；
Fig. 8：Sectional view to use machine driving and using metal spring as the attachment device of spring assembly；
Fig. 9：Sectional view to use hydraulic drive and using elastic material pad as the attachment device of spring assembly；
Figure 10：Sectional view to use machine driving and using elastic material pad as the attachment device of spring assembly；
Figure 11：To use knockdown spring assembly（Gas spring combines composition with elastic material pad）Attachment device section
Figure；Figure 12：Schematic diagram for the cross section after plug and interface grafting；
Figure 13：Capping schematic diagram for lid shape positioning screw cap；
Figure 14：For the main support cross-sectional view using steel plate as the external fixing rack of hack lever；
Figure 15：For the secondary support cross-sectional view using steel plate as the external fixing rack of hack lever；
Figure 16：Cross-sectional view when being applied in combination for the main support using steel plate as the external fixing rack of hack lever and secondary support.
Reference sign：
The interface of 1-attachment device；The plug of 2-attachment device；3-gas spring（Pneumatic cylinder filled with air）；
3.1-the hydraulic cylinder filled with liquid；4-inflation（Liquid）Hole；5-lid shape positioning screw cap；
6-metal spring；6.1-elastic material pad；7-driver plate；The driver plate of 7.1-mechanical driving device
8-pressurizing nut；9-pressure-bearing ball bearing；10-using steel plate as the main support of the external fixing rack of hack lever；
11-using steel plate as the secondary support of the external fixing rack of hack lever；12-screw；13-bone；
14-using connecting rod as the master connecting-rod of hack lever；15-connecting the clip of connecting rod and screw；16-screw.
Specific embodiment：
In embodiment 1, the main support 10 using steel plate as hack lever（Two sections of steel plates are combined with carrying the attachment device of gas spring
The combined mounting rod of integral property）, it is connect with screw 16, referring to Fig. 1, Fig. 5, collectively forms external fixing rack.Steel plate is divided into two sections, point
Not Dai You attachment device interface 1 and attachment device plug 2, form attachment device after plug and interface grafting, it is therein close
Space is closed as the pneumatic cylinder 3 filled with air, due to the compressibility of air, the pneumatic cylinder 3 filled with air of closing becomes empty
Gas spring device by air-filled pore 4, can be filled with or extract out air, change the elastic force of air spring, pass through air-filled pore（
It can the other trepanning on pneumatic cylinder）Barometer can be connected, the indoor gas pressure intensity of air is measured, with reference to gas spring cross section
Product can estimate the elastic force of gas spring, so as to carry out quantitative control to elastic force.The outer wall of interface is circle, is threaded, interface
The internal diameter of outer diameter and lid shape positioning screw cap 5 be adapted, lid shape positioning screw cap 5 is a nut with cover, is carried on capping
Trepanning, the screw thread of inner thread and interface outer wall are adapted, and the trepanning on lid shape positioning screw cap capping allows hack lever to pass through, compared with
Big plug can not pass through, and after plug and interface grafting, lid shape positioning screw cap be made to be moved to the appropriate position along screw thread, lid shape
Positioning screw cap will limit the relative position of plug and interface, and limitation plug is moved relative to the separation that interface is more than this position
Position, without limiting sliding in opposition, therefore air spring cannot further be extended beyond this position between plug and interface, only
To shorten.The steel plate of segmentation is combined into the combined mounting rod of globality by attachment device, and combined mounting rod is used for as main support
During fixed fracture, a certain amount of air is reserved first in pneumatic cylinder, completes to reset when fracturing, as used other external fixing racks
Bone and combined mounting rod are fixed by screws in together like that during fixed fracture（The tail portion of lock screw is screwed into the lock on steel plate
Determine hole）, complete to fix（It should be noted that by the long axis of hack lever and the long axis keeping parallelism of bone）, the axis that is then born according to limbs
To payload, the elastic force of air spring is adjusted, makes the pressurization between the sclerite of fracture end.Such as suffering limb keeps quiet after surgery
During breath state（Limbs are not subject to axial load or bear a small amount of axial load）, can be made by air-filled pore extraction section air
Air spring exports pulling force, and two sections of steel plates for pulling attachment device both sides are close to each other on long axis direction, after can making reset
Fracture end bone block between more strict pairing, and obtain axial pressure, at this moment suitably tighten lid shape positioning screw cap, it is fixed
The position of plug, it is ensured that the shift separation more than this position will not occur between plug and interface, pass through air-filled pore（It can also be
Other trepanning on pneumatic cylinder）Barometer can be connected, measures atmospheric pressure, extrapolates the pulling force size of spring assembly output, it is real
The now axial stressed quantitative control between sclerite.Such as when fracture starts limb functional exercise（Limbs are held
By a certain amount of axial pressure load）, first confirm that lid shape positioning screw cap has been tightened, the steel plate at attachment device both ends is moved without separation
Then position adjusts the elastic force of air spring, is filled with air by air-filled pore, makes air spring output pressure（Since lid shape positions
The limitation of nut, the pressure of air spring output will not make the steel plate at attachment device both ends that shift separation occur, between sclerite
Shift separation would not occur）, when the axial pressure load that limbs are born is less than gas-spring pressure, air spring without compression,
Load is all conducted by one end of limbs to the limbs other end by hack lever, without pressurization between fracture end bone block, and when bone is born
Axial pressure load when being more than gas-spring pressure, air spring compression, the load exceeded can part conduction to fracture end
Bone block between, make axial pressure between bone block, according to the intensity for the axial load that limbs are born, adjust the pressure of air spring, can
So that the load of conduction to fracture end is in suitable level, so that it may so that the axial compressive force between bone block is maintained at optimal level.
In example 2, the main support 10 using steel plate as hack lever（Two sections of steel plates are combined into globality with attachment device
Combined mounting rod, the spring assembly carried in attachment device can be gas spring 3, referring to Fig. 5, Fig. 6；Can be metal spring 6,
Referring to Fig. 7, Fig. 8；Can be elastic material pad 6.1, referring to Fig. 9, Figure 10；It can also be by the two in above-mentioned three kinds of spring assemblies
Or three is applied in combination, and forms knockdown spring assembly, participates in Figure 11）, it connect with screw 16, referring to Fig. 1, collectively forms outer
Fixed frame.
In embodiment 3, the main support 10 using connecting rod as hack lever（Two sections of connecting rods are combined into globality with attachment device
Combined mounting rod, the spring assembly carried in attachment device can be gas spring 3, referring to Fig. 5, Fig. 6；Can be metal spring 6,
Referring to Fig. 7, Fig. 8；Can be elastic material pad 6.1, referring to Fig. 9, Figure 10；It can also be by the two in above-mentioned three kinds of spring assemblies
Or three is applied in combination, and forms knockdown spring assembly, participates in Figure 11）, it connect with screw 16, referring to Fig. 2, collectively forms outer
Fixed frame.
In example 4, it is metal spring 6 to connect the spring assembly carried in the attachment device of two sections of hack levers, uses liquid
Transmission device is pressed, referring to Fig. 7, filled with liquid in hydraulic cylinder 3.1, because liquid is incompressible, is injected by filling liquid hole or Extract
During body, 7 shift in position of driver plate makes metal spring compress or extend, and then changes its elastic force.Extract liquid out into hydraulic pressure chamber
When, metal spring elongation exports pulling force, and two sections of steel plates for pulling attachment device both sides are close to each other on long axis direction；To liquid
In pressure chamber during injection liquid, metal spring shortens, output pressure.Pass through filling liquid hole（It can also the other trepanning on hydraulic cylinder）It can
To connect hydraulic ga(u)ge, the elastic force between two sections of hack levers is measured.The setting and use of lid shape positioning screw cap and phase in embodiment 1
Together.
In embodiment 5, it is metal spring 6 to connect the spring assembly carried in the attachment device of two sections of hack levers, uses machine
Tool transmission device, referring to Fig. 8, after pressurizing nut 8 is located at interface, inner wall is threaded, and is adapted with the screw thread on hack lever, can
To be moved along hack lever, pressurizing nut and driver plate 7.1（It is different from the simple driver plate of hydraulic transmission, mechanical driving device
Driver plate it is increasingly complex, be made of two pieces of parallel metal sheets with the support column of three or more, support column passes through interface bottom
Hole）Between be pressure-bearing ball bearing 9, by the linear motion for being changed into driver plate of pressurizing nut, rotate pressurizing nut, pass
Movable plate shift in position makes metal spring extend or compress, and then changes its elastic force.It, can by changing the position of pressurizing nut
So that the length of metal spring changes, its elastic force is adjusted；When rotation pressurizing nut makes it away from the center of attachment device, metal elastic
Spring extends, and exports pulling force, and two sections of steel plates for pulling attachment device both sides are close to each other on long axis direction；Rotation pressurizing nut makes
During its center close to attachment device, metal spring shortens, output pressure.The setting and use of lid shape positioning screw cap and embodiment
It is identical in 1.
In embodiment 6, it is elastic material pad 6.1 to connect the spring assembly carried in the attachment device of two sections of hack levers, is made
With hydraulic transmission, referring to Fig. 9, hydraulic cylinder 3.1 is interior filled with liquid, because liquid is incompressible, injects or takes out by filling liquid hole
When going out liquid, 7 shift in position of driver plate makes elastic material pad compress or extend, and then changes its elastic force.It is taken out into hydraulic pressure chamber
When going out liquid, the elongation of elastic material pad exports pulling force, two sections of steel plates of attachment device both sides is pulled mutually to be leaned on long axis direction
Closely；When liquid is injected into hydraulic pressure chamber, the compression of elastic material pad, output pressure.Pass through filling liquid hole（It can also be another on hydraulic cylinder
Exterior open cell）Hydraulic ga(u)ge can be connected, measures the elastic force between two sections of hack levers.The setting and use and implementation of lid shape positioning screw cap
It is identical in example 1.
In embodiment 7, it is elastic material pad to connect the spring assembly carried in the attachment device of two sections of hack levers, uses machine
Tool transmission device, referring to Figure 10, after pressurizing nut 8 is located at interface, inner wall is threaded, and is adapted with the screw thread on hack lever,
It can be moved along hack lever, pressurizing nut and driver plate 7.1（It is different from the simple driver plate of hydraulic transmission, machine driving dress
The driver plate put is increasingly complex, is made of two pieces of parallel metal sheets with the support column of three or more, support column passes through interface bottom
Hole）Between be pressure-bearing ball bearing 9, by the linear motion for being changed into driver plate of pressurizing nut, turn pressurizing nut,
Driver plate shift in position makes elastic material pad extend or compress, and then changes its elastic force.By the position for changing pressurizing nut
It puts, can deform elastic material pad, adjust its elastic force；When turning pressurizing nut and making it away from the center of attachment device, elasticity
Substance pad extends, and exports pulling force, and two sections of steel plates for pulling attachment device both sides are close to each other on long axis direction；Turn pressurization spiral shell
When mother makes its center close to attachment device, the compression of elastic material pad, output pressure.The setting and use of lid shape positioning screw cap with
It is identical in embodiment 1.
In embodiment 8, referring to Figure 11, it is elastic material to connect the spring assembly carried in the attachment device of two sections of hack levers
Pad and its spring assembly are formed, and by air-filled pore 4, can be filled with or be extracted out air, change the elastic force of air spring, therewith
Connected elastic material pad deforms upon simultaneously, is equivalent to two kinds of spring assemblies of air spring and elastic material pad and connects, and forms
Knockdown spring assembly.The setting and use of lid shape positioning screw cap are in the same manner as in Example 1.
In embodiment 9, referring to Fig. 3, bone has double fracture, and the sectional shelf-unit that the hack lever to be divided into three sections forms is fixed
Fracture, can be according to the degree of stability after exercise intensity and the reduction of the fracture when limbs carry out the functional training of some strength
With growth of spur situation, the elastic force of the spring assembly of two attachment devices is adjusted respectively, makes to obtain not between the bone block of double fracture
With the axial pressure power of degree.
In embodiment 10, referring to Fig. 4, backbone is fixed in one end of hack lever, and the other end is fixed on bone after installing secondary support additional
Metaphysis, secondary support provides the fixed range and fixed angle of bigger, and fixation is more firm.
Claims (7)
1. a kind of adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block, including hack lever（Can be steel plate or connecting rod）With spiral shell
Nail, it is characterised in that the hack lever segmentation（It is divided into two or more）, the one or both ends of every section of hack lever carry plug
Or interface, plug or interface are interior with spring assembly（One or more of metal spring, gas spring, elastic material pad）, insert
Head is with forming adjustable bone block countershaft to stressed attachment device after interface grafting, by this attachment device by the frame of segmentation
Bar forms the combined mounting rod of globality, the main support as external fixing rack.
2. according to according to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block described in claim 1, it is characterised in that：Institute
The hack lever stated is divided into multistage（Two or more）, every section of hack lever with plug or interface, can be one end with plug or
Interface or at its both ends with plug or interface, the shape and the shape of interface inner wall of plug are adapted, phase interfix
The attachment device is formed after connecing.
3. according to according to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block described in claim 1, it is characterised in that：Institute
The shape for the plug told is non-circular with the shape of interface inner wall（Preferred octagonal in Figure 12）, contact surface is smooth and closely pastes
It closes, to eliminate mutual rotation displacement and angulation displacement, permission is slided on long axis direction each other；The outer wall of interface is circle
Shape is threaded, and the internal diameter of the outer diameter and lid shape positioning screw cap of interface is adapted, and has trepanning on the cap of lid shape positioning screw cap,
Hack lever is allowed to pass through, larger plug can not pass through, and after plug and interface grafting, lid shape positioning screw cap be made to be moved along screw thread
To appropriate location, lid shape positioning screw cap will limit the relative position of plug and interface, and limitation plug is more than relative to interface
The shift separation of this position, without limiting sliding in opposition between plug and interface.
4. according to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block described in claim 1, it is characterised in that：Described
The spring assembly carried in plug and interface, can be metal spring, can be gas spring, can be elastic material pad, also may be used
The two in above-mentioned three kinds of spring assemblies or three to be applied in combination, knockdown spring assembly is formed.
5. according to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block described in claim 1, it is characterised in that：Described
In the attachment device formed after plug and interface grafting, spring assembly can not connect with transmission device and is used alone（Such as
Gas spring is as spring assembly, no transmission device in Fig. 5, Fig. 6）；It can also be connect with transmission device（Such as metal elastic in Fig. 7
Spring connects hydraulic transmission as spring assembly；Metal spring connects mechanical driving device as spring assembly in Fig. 8；Figure
Elastic material pad connects hydraulic transmission as spring assembly in 9；Elastic material pad is as spring assembly, connection in Figure 10
Mechanical driving device）, the conduction of power is completed by transmission device, and pass through the more convenient adjustment spring assembly of transmission device
Elastic force.
6. according to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block described in claim 1, it is characterised in that：Described
Gas spring has been used as spring assembly（Including gas spring is used alone or uses the combined type spring assembly containing gas spring）
Attachment device with using hydraulic transmission be driven attachment device,（Can with and it is nonessential）Pass through inflation（Liquid）Hole connection pressure
Power meter, the elastic force of quantitative measurment spring assembly.
7. according to the adjustable outside fixed frame for external osteosynthesis of axial plus-pressure between bone block described in claim 1, it is characterised in that：Described
The combined mounting rod of the globality formed is combined by attachment device by the hack lever being segmented, can be used alone as main support（Example
Such as Fig. 3）, used after secondary support can also be installed（Such as Fig. 4）, to increase the fixed angle of screw, expand fixed range, increase
Fixing intensity.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611211363.5A CN108236491B (en) | 2016-12-24 | 2016-12-24 | Fracture external fixation frame with adjustable axial stress between bone blocks |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611211363.5A CN108236491B (en) | 2016-12-24 | 2016-12-24 | Fracture external fixation frame with adjustable axial stress between bone blocks |
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| CN108236491B CN108236491B (en) | 2021-07-13 |
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| CN201611211363.5A Expired - Fee Related CN108236491B (en) | 2016-12-24 | 2016-12-24 | Fracture external fixation frame with adjustable axial stress between bone blocks |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109124747A (en) * | 2018-11-02 | 2019-01-04 | 山东中医药大学 | A kind of fracture external fixing rack of variable rigidity |
| CN109350207A (en) * | 2018-11-09 | 2019-02-19 | 创辉医疗器械江苏有限公司 | A kind of flexible connecting rod and exterior fixing rack |
| CN112022315A (en) * | 2020-09-24 | 2020-12-04 | 北华大学 | Fracture external fixation support with external fixation nail |
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| CN201182643Y (en) * | 2008-03-03 | 2009-01-21 | 张长青 | Continuous compression external fixator with lock |
| CN201684003U (en) * | 2010-06-07 | 2010-12-29 | 曾义成 | Continuous-pressurization combined external fixed bracket |
| CN102271601A (en) * | 2008-10-31 | 2011-12-07 | 米卢克斯控股股份有限公司 | Device and method for bone adjustment using wireless energy transmission |
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| WO1994006364A1 (en) * | 1992-09-15 | 1994-03-31 | Dynastab Limited Partnership | Dynamic compensating stabilizer |
| US6176860B1 (en) * | 1995-07-24 | 2001-01-23 | Hadasit Medical Research Services & Development Company, Ltd. | Orthopaedic fixator |
| CN201182643Y (en) * | 2008-03-03 | 2009-01-21 | 张长青 | Continuous compression external fixator with lock |
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| CN109124747A (en) * | 2018-11-02 | 2019-01-04 | 山东中医药大学 | A kind of fracture external fixing rack of variable rigidity |
| CN109124747B (en) * | 2018-11-02 | 2023-08-25 | 山东中医药大学 | A Fracture External Fixation Bracket with Variable Rigidity |
| CN109350207A (en) * | 2018-11-09 | 2019-02-19 | 创辉医疗器械江苏有限公司 | A kind of flexible connecting rod and exterior fixing rack |
| CN112022315A (en) * | 2020-09-24 | 2020-12-04 | 北华大学 | Fracture external fixation support with external fixation nail |
| CN112022315B (en) * | 2020-09-24 | 2022-09-16 | 北华大学 | Fracture external fixation support with external fixation nail |
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| CN108236491B (en) | 2021-07-13 |
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