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WO2018228432A1 - Pince multifonctionnelle de repositionnement et de guidage de fracture - Google Patents

Pince multifonctionnelle de repositionnement et de guidage de fracture Download PDF

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Publication number
WO2018228432A1
WO2018228432A1 PCT/CN2018/091062 CN2018091062W WO2018228432A1 WO 2018228432 A1 WO2018228432 A1 WO 2018228432A1 CN 2018091062 W CN2018091062 W CN 2018091062W WO 2018228432 A1 WO2018228432 A1 WO 2018228432A1
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WO
WIPO (PCT)
Prior art keywords
jaw
sleeve
forceps
caliper
hinged
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2018/091062
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English (en)
Chinese (zh)
Inventor
翟延荣
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Individual
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Individual
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Filing date
Publication date
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Publication of WO2018228432A1 publication Critical patent/WO2018228432A1/fr
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Ceased legal-status Critical Current

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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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/282—Jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/2841—Handles
    • 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
    • A61B2017/564—Methods for bone or joint treatment

Definitions

  • the invention relates to the field of medical instruments, in particular to a medical device for guiding drilling and assisting fracture reduction.
  • MIPPO minimally invasive percutaneous plate osteosynthesis
  • Patent Publication No.: 203138653U discloses a reset guide pliers for pairing, the embracing clamp is composed of two mutually intersecting calipers through a rotating shaft, and the jaws and the caliper body are in a "Z" shape, so that the jaws are The inner sleeve is on the same plane.
  • the disadvantages of this type of resetting pliers are as follows: 1. The caliper structure of the resetting pliers is not in the same plane as the control center structure, and the stability is not good; 2. Due to the structural reasons, the front and back of the resetting pliers are relatively large. The resetting pliers cannot be placed on the adjacent screw holes of the bone plate; 3.
  • the jaws and the caliper body are in a "Z" shape so that the jaws and the inner sleeve are on the same plane, which is prone to deformation when the force is restored, affecting the fracture reduction. ; 4.
  • the two inverted “L”-shaped fasteners of the quick-pressure cylinder are easily slipped when they are pressed into the square thread.
  • a multifunctional fracture reduction guide pliers includes a central guiding sleeve, a surface of the central guiding sleeve is movably provided with a sliding sleeve, and the sliding sleeve is provided with a pair of caliper hinged ends, the central guiding sleeve A pair of jaw hinge ends corresponding to the hinge end of the caliper body are arranged, and a caliper body is hinged on each of the hinged ends of the two caliper bodies to form a telescopic caliper body, and the jaw joints of the two jaws are respectively hinged with a jaw to form an arc embracing a jaw, the same side of the caliper body and the jaws are hinged together by a common hinge end, the tong body is rotated around the hinged end of the caliper body, and the jaw is hinged through the common hinge end driving jaw
  • the central rotation is hovering or unfolding, and the jaws and the central guiding sleeve cooperate such that the central
  • the two clamp body hinge ends are symmetric along the center of the sliding sleeve, the two jaw hinge ends are symmetric along the center of the center guide sleeve, and the clamp body hinge end is coplanar with the jaw hinge end .
  • the tong body hinge end, the jaw hinge end and the common hinge end are a rotating auxiliary structure
  • the tong body is provided with a tong body bending section at one end
  • the jaw end is provided with a jaw bending section at the end of the tong body.
  • the intersection of the caliper body and the tong body bending section is rotatably disposed on the tong body hinge end
  • the intersection of the jaw and the jaw bending section is rotatably disposed on the jaw hinge end
  • the tong body is folded
  • One end of the curved section and the jaw bending section are rotatably coupled together by a common hinge end.
  • the jaw is an arc-shaped embracing structure, and a longitudinal triangular-shaped structure groove is disposed inside the arc of the jaw.
  • the front end of the jaw is a conical converging structure, and a circular arc transition section is provided at a tip end of the conical converging structure.
  • the caliper body and the tong body bending section are an integral structure
  • the jaws and the jaw bending section are an integral structure
  • the two tongs are respectively provided with a long rack and a buckle ring that cooperate with each other.
  • the fastener structure is composed of a mating block, a bolt and a spring piece, and the bottom of the mating block is fixed on the central guiding sleeve, and the upper part of the mating block is provided with a groove, and the bolt is disposed at the upper part of the mating block In the groove, and the pin is rotatably connected to the mating block through the rotating shaft, and the spring piece is fixed on the outer side of the mating block, and one end of the spring piece presses the back of the tooth of the pin and presses the tooth of the pin A pre-thrust is applied to the back, and the outer surface of the pressing sleeve is provided with a helical tooth thread, and the tooth tip portion of the bolt tooth cooperates with the helical tooth thread of the outer surface of the pressure sleeve.
  • the upper end of the pressing sleeve is provided with a flat key surface, and the flat key surface is matched with a T-type wrench, and the inner side of the T-type wrench is provided with a convex block, and the T-shaped wrench passes through the convex block and The flat key surface cooperates to twist the pressure sleeve to rotate.
  • the fracture reduction guiding plier structure of the invention fits the theory of "reciprocal tangential axis reduction", and the fracture reduction is good and reliable, the operation is simple, the difficulty of closed reduction in clinical operation is solved, and the fixation can be temporarily fixed, the operation time is short, and the operation is short. Less, the incision is small.
  • the fracture reduction guide pliers of the present invention can be combined with the MIPPO (minimally invasive percutaneous plate fixation) technique, and the fracture end closure is not performed during the operation, the soft tissue and periosteal injury at the fracture end are small, and the fracture healing is fast, which is beneficial to reduce infection. occur.
  • MIPPO minimally invasive percutaneous plate fixation
  • Fracture reduction is reliable and reliable. There is no need for multiple fluoroscopy adjustments during surgery to reduce the radiation exposure of doctors and patients. In principle, as long as the traction is sufficient, the fracture can be reset well.
  • Fracture reduction guide jaws are curved and embracing structures. The jaws only need to extend beyond the semi-circum of the femoral shaft to fix the backbone. It is not necessary to completely surround the femoral shaft. It is easy to place and has less trauma, so as to avoid damage to important vascular nerves deep in the bone. Safe and reliable.
  • Reset fixation is fixed by elastic bridge, allowing the fracture end to be slightly fretting, stimulating bone regeneration, which is conducive to the formation of callus.
  • Figure 1 is a front view of the present invention
  • Figure 2 is a side elevational view of the present invention
  • Figure 3 is a top plan view of the present invention (vertical);
  • Figure 4 is a perspective view of the off-axis stereotype of the present invention.
  • Figure 5 is a perspective view of the caliper body of the present invention.
  • Figure 6 is a perspective view of the jaw of the present invention.
  • Figure 7 is a structural view of the front end portion of the jaw of the present invention.
  • Figure 8 is a schematic structural view of a fastener of the present invention.
  • Figure 9 is a front view of the pressure sleeve of the present invention.
  • FIG. 10 is a perspective view of the T-type wrench of the present invention.
  • FIG. 11 is a bottom view of the T-wrench of the present invention.
  • Figure 12 is a perspective view showing the structure of the inner locking sleeve of the present invention.
  • the figures indicate: 1, center guiding sleeve, 2, sliding sleeve, 3, tong body hinged end, 4, jaw hinged end, 5, caliper body, 51, caliper bending section, 6, jaw, 61 , jaw bending section, 62, vertical triangular structure groove, 63, tapered converging structure, 64, arc transition section, 7, common hinged end, 8, pressurized sleeve, 81, flat key surface, 9, with the block, 10, bolt, 11, spring, 12, helical thread, 13, long rack, 14, buckle ring, 15, T-wrench, 151, raised block, 16, inner locking sleeve cylinder.
  • a multifunctional fracture reduction guide pliers includes a central guiding sleeve 1 , and a surface of the central guiding sleeve 1 is movably provided with a sliding sleeve 2, and the sliding sleeve 2 is provided There is a pair of caliper hinged ends 3, and the central guiding sleeve 1 is provided with a pair of jaw hinge ends 4 corresponding to the caliper hinged ends 3, in the present embodiment, the two caliper hinged ends 3 are in the sliding sleeve 2
  • the upper side is symmetrically disposed with the center line of the sliding sleeve 2, and the two jaw hinged ends 4 are symmetrically disposed on the center guiding sleeve 1 with the center line of the center guiding sleeve 1, and the two jaw body hinge ends 3 and the jaw joint ends 4 coplanar setting, two tong body hinged ends 3 are respectively hinged with a caliper body 5 to form a folding caliper body
  • the two jaw body hinge ends 3 are symmetric along the center of the sliding sleeve 2, the two jaw hinge ends 4 are symmetrically centered along the center guiding sleeve 1, and the jaw body hinge end 3 and the jaw hinge end 4 are Coplanar settings.
  • the caliper hinge end 3, the jaw hinge end 4 and the common hinge end 7 are rotating sub-structures, and the caliper body 5 is provided with a caliper bending section 51 at one end, the tongs One end of the mouth 6 is provided with a jaw bending section 61, and the intersection of the caliper body 5 and the tong body bending section 51 is rotatably disposed on the tong body hinge end 3, and the jaw 6 and the jaw bending section 61 The junction is rotatably disposed on the jaw hinge end 4, and one end of the caliper bend section 51 and the jaw bend section 61 are rotatably coupled together by a common hinge end 7.
  • the jaws 6 are arcuately embracing, and the inner side of the arc of the jaws 6 is provided with a longitudinal triangular structure groove 62, which can prevent slip and reduce soft tissue damage.
  • the front end of the jaw 6 is a conical converging structure 63, and a circular transition portion 64 is provided at the tip of the conical converging structure.
  • the conical converging structure facilitates the reduction of the jaw 6 to penetrate the soft tissue outside the bone, and the circle
  • the arc transition section 64 easily slides over the rough surface of the bone, preventing the tip of the jaw 6 from snapping into the bone, maximally protecting the bone and surrounding soft tissue.
  • the caliper body 5 and the caliper bending section 51 are of a unitary structure, and the jaws 6 and the jaw bending section 61 are of a unitary structure.
  • the two caliper bodies 5 are respectively provided with a long rack 13 and a sprocket ring 14 which are engaged with each other.
  • the fastener structure is composed of a mating block 9 , a bolt 10 and a spring piece 11 .
  • the bottom of the mating block 9 is fixed on the central guiding sleeve 1 , and the upper part of the mating block 9 is provided with a groove.
  • the pin 10 is disposed in a recess in the upper portion of the mating block 9, and the pin 10 is rotatably coupled to the mating block via a rotating shaft, and the spring piece 11 is fixed on the outer side of the mating block 9, one end of the spring piece 11 Pressing the back of the tooth of the pin 10 and applying a pre-thrust to the back of the tooth of the pin 10, the outer surface of the press sleeve 8 is provided with a helical thread 12, the tip of the pin 10 and the pressurization The helical thread 12 of the outer surface of the sleeve 8 cooperates.
  • the upper end of the pressing sleeve 8 is provided with a flat key surface 81 , and the flat key surface 81 is fitted with a T-shaped wrench 15 , and the T-shaped wrench 15 is provided with a convex block inside. 151, the T-type wrench 15 is rotated by the cooperation of the convex block 151 and the flat key surface 81 to rotate the pressure sleeve 8.
  • an inner locking sleeve 16 for engaging with the bone plate is further disposed. Referring to FIG.
  • the upper end of the inner locking sleeve 16 is also provided with a flat key surface, and the lower end of the inner locking sleeve 16 is tapered, and the tapered surface is provided with a surface thread to cooperate with the locking hole thread on the bone plate.
  • the inner locking sleeve 16 is screwed into the locking hole thread of the bone plate and fixed as a unitary structure. During the process of being twisted by the T-wrench 15, the lower end is positioned to abut the bone plate.
  • the specific use process is as follows: after the patient's anesthesia is effective, the supine position is taken, the surgical area is routinely disinfected and the towel is cut, the C-arm machine is used to determine the fracture end, and the proximal end and the distal end of the fracture are each made into a 4 cm incision, and the skin is cut and subcutaneously separated.
  • a subcutaneous tunnel is established outside the periosteum, a locking anatomical locking bone plate is inserted from the subcutaneous tunnel, two inner locking sleeves 16 are mounted at each end, and then a resetting forceps is placed at each inner locking sleeve 16, first tightening Two reduction clamps at the distal end of the fracture, using a T-wrench 15 to tighten the rapid compression cylinder 8, tow the distal end of the fracture, and then install the two proximal reduction clamps, also tighten the two proximal reduction clamps at the proximal end of the fracture, using a T-type The wrench 15 tightens the rapid compression tube 8 at this time, and the proximal and distal bones of the fracture are parallel to the bone plate.
  • the interaction between the reduction clamp, the anatomical locking bone plate and the backbone is performed without any screws.
  • fixation the fracture can be reset and temporarily fixed firmly.
  • the inner locking sleeve 16 is drilled, and then the inner locking sleeve 16 is screwed out from the pressure sleeve 8 in the pressure sleeve 8 Fix the screw to prevent the screw from slipping into the deep part of the muscle, which may cause difficulty in fixing.
  • the screw passes through the center of the backbone, and finally the incision is flushed and the incision is closed.
  • the resetting jaw structure of the present invention can be in any state, the central guiding sleeve 1, the pressing sleeve 8 and the inner locking sleeve 16 are on the bisector of the jaw 6, the bone plate locking hole is perpendicular to the axis of the bone plate
  • the center guiding sleeve 1, the pressing sleeve 8 and the inner locking sleeve 16 are perpendicular to the axis of the bone plate, and the resetting clamp embracing the backbone, the inner locking sleeve 16
  • the extension line passes through the center of the cross section of the backbone, and the compression sleeve 8 is screwed to pull the backbone toward the bone plate.
  • the cross section of the backbone phase is tangent to the bone plate, and the two points determine the straight line.
  • the two proximal reduction clamps are fixed at the proximal end and the distal end of the fracture, the circular long trunk axis and the long axis of the anatomical locking bone plate are in a parallel relationship in space, and the fracture can be reset.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Ophthalmology & Optometry (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne une pince multifonctionnelle de repositionnement et de guidage de fracture, comprenant : un manchon de guidage central (1) ayant un manchon coulissant (2) disposé de façon mobile sur une surface de celui-ci; le manchon coulissant (2) est pourvu d'une paire d'extrémités articulées de corps de pince (3) sur celui-ci; le manchon de guidage central (1) comporte sur celui-ci une paire d'extrémités articulées d'ouverture de pince (4) correspondant aux extrémités articulées de corps de pince (3); chacune des deux extrémités articulées de corps de pince (3) comporte un corps de pince (5) articulé sur celles-ci pour former un corps de pince extensible; chacune des deux extrémités articulées de bras de pince (4) comporte un bras de pince (6) articulé à celles-ci pour former une embouchure de pince encerclante en forme d'arc; le corps de pince (5) et le bras de pince (6) situés sur le même côté sont articulés ensemble au moyen d'une extrémité articulée commune (7); lorsque le corps de pince (5) est tourné et étendu avec les extrémités articulées de corps de pince (3) en tant que centre, le corps de pince (5) entraîne, par l'intermédiaire de l'extrémité articulée commune (7), le bras de pince (6) pour qu'il tourne ou s'étende avec les extrémités articulées de bras de pince (4) en tant que centre, de telle sorte que le manchon de guidage central (1) soit toujours situé sur une ligne coupant les deux bras de pince (6), déterminant ainsi le centre de la section transversale d'une diaphyse; le manchon de guidage central (1) comporte un manchon de pression (8) disposé de façon mobile à l'intérieur de celui-ci; et le manchon de guidage central (1) est en outre pourvu de structures de mise en prise pour limiter les positions de mouvement du manchon de pression (8). Les pinces de guidage sont simples à utiliser lorsqu'elles sont utilisées pour aider au repositionnement de fractures.
PCT/CN2018/091062 2017-06-16 2018-06-13 Pince multifonctionnelle de repositionnement et de guidage de fracture Ceased WO2018228432A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201710455369.5 2017-06-16
CN201710455369.5A CN107496008B (zh) 2017-06-16 2017-06-16 一种多功能骨折复位导向钳

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CN107496008B (zh) * 2017-06-16 2021-06-15 荣科(苏州)医疗科技有限公司 一种多功能骨折复位导向钳
CN108186104A (zh) * 2018-02-02 2018-06-22 谢志进 可调节持骨复位钳
CN108784819A (zh) * 2018-07-12 2018-11-13 常州市康辉医疗器械有限公司 骨科跟骨板折弯器
CN109730744A (zh) * 2019-01-30 2019-05-10 首都医科大学附属北京康复医院（北京工人疗养院） 截骨工具

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WO1993015680A1 (fr) * 1992-02-07 1993-08-19 Hillway Surgical Limited Dispositif servant a resserrer une boucle dans un fil metallique ou autre
CN202604997U (zh) * 2012-05-11 2012-12-19 常州康鼎医疗器械有限公司 蛙式钳
GB2506373A (en) * 2012-09-26 2014-04-02 Tejas Kiran Yarashi Bone and plate holding forceps
CN203138653U (zh) * 2013-04-05 2013-08-21 翟延荣 多功能骨折复位导向钳
CN205072961U (zh) * 2015-10-13 2016-03-09 魏志玄 一种可调式神经外科手术用夹骨器
CN107496008A (zh) * 2017-06-16 2017-12-22 翟延荣 一种多功能骨折复位导向钳

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CN107496008A (zh) 2017-12-22

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