A kind of forearm exterior fixing rack and exterior fixing rackTechnical field
The present invention relates to bone surgical operation appliances fields, in particular to a kind of forearm exterior fixing rack and outer fixationHolder.
Background technology
In modern orthopaedic trauma field, hinged external fixator is widely used in elbow joint and ankle-joint, is joint weekThe outer fixed support that damage provides movable is enclosed, tension-free reparation is provided for the reparation of soft tissue and ligamentous joint capsuleEnvironment, and the joint motion of early stage is provided, avoid the contracture of joint from ossifing.
Function of joint is saved in clinical treatment, the pivoting mechanism of forearm ulna and radius belongs to uniaxial joint, but at present stillWithout support forearm ulna and radius rotary hinge type exterior fixing rack.Lead to that (distal radioulnar ioint as above is de- being related to some forearm injuriesPosition, simple humeroradial joint fracture fixation operations Auxiliary support) usually gypsum fix, gypsum need to surmount elbow joint and wrist and closeSection causes secondary elbow joint and carpal anchylosis, the possibility of moving obstacle to occur.
Invention content
The purpose of the present invention is to provide a kind of forearm exterior fixing rack, before the patient using the forearm exterior fixing rackArm can carry out revolving preceding supination in early stage, to reduce adhesion and ligament contracture；Secondly, forearm can be made around the rotation of forearmAxis rotates；In addition, the fracture for upper and lower cubitoradial ligament reparation and simple humeroradial joint portion provides tension-free growing environment；And be used in humeroradial joint fracture (be made of capitulum radii and capitulum of humerus, simple humeroradial joint fracture actually in art inThe patient that humeroulnar joint is stablized after fixed humeroradial joint fracture) rehabilitation when, can be by radius and the longitudinal pressure and cross of wrist handIt is conducted to pulling force to ulna by exterior fixing rack.To alleviate the pressure of humeroradial joint and caput radii quilt in forearm activityCentrifugal force of the supination muscle relative to ulna, enables forearm early stage rotary moveable before rotation, effectively prevents simple upper arm oar and closesSection fracture gypsum fixes elbow joint stiffness caused by elbow joint, mitigates the pain of patient, reduces complication.
What the embodiment of the present invention was realized in：
A kind of forearm exterior fixing rack, including first support and second support；
For being connect with ulna, first support includes the first spicule group and is arranged along the extending direction of ulna first supportFirst connecting rod, one end of the first spicule group connect with ulna, and the other end of the first spicule group passes through the first connection structure and theOne connecting rod connects；
For being connect with radius, second support includes the second spicule group and is arranged along the extending direction of radius second supportSecond connecting rod, one end of the second spicule group connect with radius, and the other end of the second spicule group passes through the second connection structure and theTwo connecting rods connect；
Along the extending direction of ulna, one end of first connecting rod and one end of second connecting rod are connected by rotational structure, so thatObtaining first connecting rod and second connecting rod can rotate around the axis of rotational structure, and the rotation axis of the axis of rotational structure and forearmIt overlaps.
The forearm exterior fixing rack includes first support and second support, is applied in upper dislocation of distal radioulnar jointWhen, for first support for connect with ulna, first support includes the of the first spicule group and the extending direction setting along ulnaOne end of one connecting rod, the first spicule group is connect with ulna, and the other end of the first spicule group is connected by the first connection structure and firstBar connects.At the same time, for second support for being connect with radius, second support includes the second spicule group and the extension along radiusThe second connecting rod of direction setting, one end of the second spicule group are connect with radius, and the other end of the second spicule group passes through the second connectionStructure is connect with second connecting rod.By the final fixed-direction of the first spicule group and the second spicule group and forearm and support rotating shaftDirection is vertical.
Extending direction due to first connecting rod along ulna is arranged, and second connecting rod is arranged along the extending direction of radius, therefore is arrangedFirst connecting rod outside forearm is corresponding with the extending direction of radius with ulna respectively to second connecting rod, as a result, first connecting rod withAfter second connecting rod is relatively fixed with ulna and radius by the first spicule group and the second spicule group respectively respectively, first connecting rod andTwo connecting rods are able to rotate with ulna and radius coaxial synchronous.
In addition, along the extending direction of ulna, one end of first connecting rod and one end of second connecting rod are connected by rotational structure,So that first connecting rod and second connecting rod can be rotated around the axis of rotational structure, and the axis of rotational structure and radius are around ulnaThe axis of rotation overlaps.Since one end of first connecting rod and one end of second connecting rod are rotatablely connected, and first connecting rod and secondThe axis that connecting rod relatively rotates is overlapped with the axis that radius is rotated around ulna, so that by by first support and secondAfter frame is fixed with ulna and radius, before rotation under the pulling force effect of supination muscle, ulna and radius can be done coaxially together with holderRotary motion, by ulna and radius control before their rotation on the movement locus of supination, when being pulled by muscle when supination before radius rotationGenerate the centrifugal tension relative to ulna can be canceled out through stent system, for upper dislocation of distal radioulnar joint soft tissue,Capsular ligament and ligament reparation provide tension-free growing environment, make distal radioulnar ioint early recovery rotary motion, whileThe contracture of gypsum fixing joint and the incidence of dysfunction caused by forearm is reduced during using gypsum to fix outside.
In an embodiment of the present invention：
First spicule group includes at least two spicules with the second spicule group.
In an embodiment of the present invention：
The sliding connection structure being connect with the second connection structure is additionally provided on second connecting rod, sliding connection structure is for makingObtaining the second spicule group can slide relative to the body of rod of second connecting rod.
In an embodiment of the present invention：
First connection structure includes bottom plate and briquetting, is provided between bottom plate and briquetting for clamping the first spiculeThe accommodating chamber of group；
Bottom plate is connect with first connecting rod.
In an embodiment of the present invention：
Sliding connection structure includes the threaded rod being arranged in second connecting rod, and the second connection structure is matched with threaded rod screw threadIt closes, threaded rod is for driving the second connection structure to shift one's position relative to second connecting rod.
In an embodiment of the present invention：
Second connection structure includes bottom plate and briquetting, is provided between bottom plate and briquetting for clamping the second spiculeThe accommodating chamber of group；
Bottom plate with second connecting rod for connecting.
In an embodiment of the present invention：
First connecting rod and second connecting rod include multiple sub bars, are connected by universal joint between adjacent sub bar, so that adjacentSub bar have the first state that can mutually rotate, and the second state being fixed to each other.
In an embodiment of the present invention：
Rotational structure is arranged in first support and second support close to one end of hand.It can also be close to one end of ancon.
In an embodiment of the present invention：
Rotational structure includes rotation axis and card-tight part, and one end of first connecting rod and one end of second connecting rod are and rotation axisRotation connection, and card-tight part is used to that first connecting rod and second connecting rod to be made to have the rotary state rotated relative to rotation axis,And the lock-out state relative to rotation shaft locking；
It is provided with location hole on the rotating shaft, location hole is for installing pilot pin, the rotation of the axis and forearm of location holeAxis overlaps.
A kind of exterior fixing rack, including first support and second support；
First support includes the first spicule group and the first connecting rod that extends along preset direction, one end of the first spicule group and boneBone connects, and the other end of the first spicule group is connect by the first connection structure with first connecting rod；
Second support includes the second spicule group and the second connecting rod that extends along preset direction, one end of the second spicule group withBone connects, and the other end of the second spicule group is connect by the second connection structure with second connecting rod；
Along preset direction, one end of first connecting rod and one end of second connecting rod are connected by rotational structure, so that firstConnecting rod and second connecting rod can be rotated around the axis of rotational structure.
Technical scheme of the present invention at least has the advantages that：
A kind of forearm exterior fixing rack provided by the invention can help patient carrying out revolving preceding supination in early days,The gypsum support for substituting part forearm injury (as above dislocation of distal radioulnar joint, simple humeroradial joint fracture fixation operations) is madeWith to reduce the incidence that joint gypsum fixes posterior synechia and ligament contracture；Secondly, forearm can be made to be revolved around the rotary shaft of forearmTurn；In addition, the fracture for upper and lower cubitoradial ligament reparation and simple humeroradial joint portion provides tension-free growing environment；AndHumeroradial joint fracture is used in (to be made of capitulum radii and capitulum of humerus, actually upper arm oar closes simple humeroradial joint fracture in artSave the patient that elbow joint after Fracture internal fixaiion is stablized) rehabilitation when, can be by supination before the longitudinal pressure of radius and wrist hand and rotationLateral pull conducted to ulna through stent system.It is effective anti-to alleviate the pressure of the humeroradial joint in forearm activityStop simple humeroradial joint fracture gypsum and fixed elbow joint stiffness caused by elbow joint, mitigates the pain of patient.
Description of the drawings
In order to illustrate the technical solution of the embodiments of the present invention more clearly, below will be to needed in the embodiment attachedFigure is briefly described, it should be understood that the following drawings illustrates only certain embodiments of the present invention, therefore is not construed as pairThe restriction of range for those of ordinary skill in the art without creative efforts, can also be according to thisA little attached drawings obtain other relevant attached drawings.
Fig. 1 is the structural schematic diagram of forearm exterior fixing rack in the embodiment of the present invention；
Fig. 2 is the enlarged diagram at II in Fig. 1；
Fig. 3 is the enlarged diagram at III in Fig. 1；
Fig. 4 is the structural schematic diagram of the first connection structure in the embodiment of the present invention.
Icon：200- forearm exterior fixing racks；210- first supports；211- the first spicule groups；212- first connecting rods；220-First connection structure；230- second supports；231- the second spicule groups；232- second connecting rods；The second connection structures of 240-；260- turnsDynamic structure；261- axis；262- rotation axis；263- card-tight parts；264- pilot pins；201- spicules；270- sliding connection structures；221- bottom plates；222- briquettings；223- accommodating chambers；271- threaded rods.
Specific implementation mode
In order to make the object, technical scheme and advantages of the embodiment of the invention clearer, below in conjunction with the embodiment of the present inventionIn attached drawing, technical scheme in the embodiment of the invention is clearly and completely described, it is clear that described embodiment isA part of the embodiment of the present invention, instead of all the embodiments.The present invention being usually described and illustrated herein in the accompanying drawings is implementedThe component of example can be arranged and be designed with a variety of different configurations.
Therefore, below the detailed description of the embodiment of the present invention to providing in the accompanying drawings be not intended to limit it is claimedThe scope of the present invention, but be merely representative of the present invention selected embodiment.Based on the embodiments of the present invention, this field is commonThe every other embodiment that technical staff is obtained without creative efforts belongs to the model that the present invention protectsIt encloses.
It should be noted that：Similar label and letter indicate similar terms in following attached drawing, therefore, once a certain Xiang YiIt is defined, then it further need not be defined and explained in subsequent attached drawing in a attached drawing.
In the description of embodiment of the present invention, it should be noted that the orientation or position of the instructions such as term "inner", "lower"Relationship be based on the orientation or positional relationship shown in the drawings or the invention product using when the orientation or position usually putRelationship is merely for convenience of description of the present invention and simplification of the description, and not indicating or implying the indicated device or element must haveThere is specific orientation, with specific azimuth configuration and operation, therefore is not considered as limiting the invention.In addition, term " theOne ", " second " etc. is only used for distinguishing description, is not understood to indicate or imply relative importance.
In the description of embodiment of the present invention, it is also necessary to which explanation is unless specifically defined or limited otherwise, term" setting ", " connection " shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or integrally connectIt connects；It can be mechanical connection, can be directly connected, can also can be indirectly connected through an intermediary in two elementsThe connection in portion.For the ordinary skill in the art, the tool of above-mentioned term in the present invention can be understood with concrete conditionBody meaning.
Embodiment
Since China's wounded patient is more and more, as above, dislocation of distal radioulnar joint and simple fracture of head of radius and listPure capitellum fracture is more and more or caput radii merges capitellum fracture.Acute dislocation of distal radioulnar joint needs supinationPosition gypsum fixes 4-6 weeks, and after fracture of head of radius or capitellum fracture open reduction and Kirschner wire fixation and capitulum of humerus merges radiusUsually because fixing rear region in fracture site because the conductance of forearm is through the cup-and-ball joint of upper arm oar microcephaly after being fixed in head fractureIt is transferred to upper arm, and second fracture end shifts after causing fracture region to be fixed, therefore usually clinically avoid that this situation occurs, it need to goThe gypsum of limb is fixed, fixed elbow joint and wrist joint, so that upper arm is braked.
For being humeroradial joint fracture that elbow joint humeroulnar joint is stablized, because shoulder joint is not fixed, usually shoulder jointBeing lifted on section makes wrist portion have longitudinal gravity load-bearing to be transferred to elbow joint in forearm, further humeroradial joint is made to squeeze, increasedThe postoperative secondary displacement of fracture, cannot reach the real decompression of humeroradial joint.For dislocation of distal radioulnar joint and simple upper arm oarProlonged upper limb gypsum braking results in elbow joint and the increased risk of wrist joint stiffness when articular fracture treatment, influencesSuffering limb function increases the risk of joint movement disorder.For simple dislocation of distal radioulnar joint, the only supination of clinical treatment methodPosition gypsum is fixed or will be fixed in lower ruler oar Kirschner wire.Cannot early stage rotary motion, early stage cannot be provided for distal radioulnar iointRotary motion cannot provide tension-free ligament and soft tissue repair environment.Prolonged gypsum fixes the lower ruler oar of braking treatmentAbarticulation presence causes by the risk of the fixed anchylosis of gypsum.
For these reasons, the present invention provides a kind of forearm exterior fixing racks 200.
Referring to FIG. 1, Fig. 1 shows the concrete structure of the forearm exterior fixing rack 200 provided in embodiment.
From figure 1 it appears that the forearm exterior fixing rack 200 includes first support 210 and second support 230.
Wherein, Fig. 1 and Fig. 2 is please referred to, for first support 210 for being connect with ulna, first support 210 includes the first spiculeThe first connecting rod 212 of 211 and the extending direction setting along ulna is organized, one end of the first spicule group 211 is connect with ulna, and firstThe other end of spicule group 211 is connect by the first connection structure 220 with first connecting rod 212.
Fig. 1 and Fig. 3 is please referred to, for second support 230 for being connect with radius, second support 230 includes the second spicule group 231And the second connecting rod 232 of the extending direction setting along radius, one end of the second spicule group 231 are connect with radius, the second spiculeThe other end of group 231 is connect by the second connection structure 240 with second connecting rod 232.
Along the extending direction of ulna, one end of first connecting rod 212 passes through rotational structure 260 with one end of second connecting rod 232Connection, so that first connecting rod 212 and second connecting rod 232 can be rotated around the axis 261 of rotational structure 260, and rotational structure260 axis 261 is overlapped with the rotation axis 261 (axis 261 that i.e. radius is rotated around ulna) of forearm.
It should be noted that in the present embodiment, first support 210 for connect with ulna, second support 230 forRadius connects, and in other embodiments of the invention, first support 210 can also be with radius or other bones of human body companyIt connects, same second support 230 can also be connect with ulna or human body other bones.
The forearm exterior fixing rack 200 includes first support 210 and second support 230, is applied and is closed in upper and lower ruler oarWhen in section dislocation, dislocate under reset state in upper and lower ulnoradial joint, first support 210 is including the first spicule group 211 and along rulerThe first connecting rod 212 of the extending direction setting of bone, one end of the first spicule group 211 connect with ulna, the first spicule group 211 it is anotherOne end is connect by the first connection structure 220 with first connecting rod 212.At the same time, second support 230 is used to connect with radius,Second support 230 includes the second connecting rod 232 of the second spicule group 231 and the extending direction setting along radius, the second spicule group231 one end is connect with radius, and the other end of the second spicule group 231 is connected by the second connection structure 240 with second connecting rod 232It connects.Extending direction due to first connecting rod 212 along ulna is arranged, and second connecting rod 232 is arranged along the extending direction of radius, therefore is arrangedFirst connecting rod 212 outside forearm is corresponding with the extending direction of radius with ulna respectively to second connecting rod 232, as a result, firstConnecting rod 212 is opposite with ulna and radius respectively by the first spicule group 211 and the second spicule group 231 respectively with second connecting rod 232After fixation, first connecting rod 212 is able to rotate synchronously with ulna and radius with second connecting rod 232.In addition, along the extension of ulnaThe one end in direction, first connecting rod 212 is connect with one end of second connecting rod 232 by rotational structure 260, so that first connecting rod212 and second connecting rod 232 can be rotated around the axis 261 of rotational structure 260, and the axis 261 of rotational structure 260 and radius aroundThe axis 261 of ulna rotation overlaps.Since one end of first connecting rod 212 and one end of second connecting rod 232 are rotatablely connected, and theThe axis 261 that one connecting rod 212 and second connecting rod 232 relatively rotate is overlapped with the axis 261 that radius is rotated around ulna, so thatAfter by the way that first support 210 and second support 230 are fixed with ulna and radius, while before forearm capable of being assisted to be revolvedOr supination, to reduce adhesion and the ligament contracture in a period of forearm exterior fixing rack 200 is fixed on forearm.
In the present embodiment, the first spicule group 211 and the second spicule group 231 include at least two spicules 201, are please referred toFig. 1, there are two the second spicule groups 231 for setting on second connecting rod 232, that is, include four spicules 201, thus in practical applicationIn the process, can be by specific applicable cases, and select 201 quantity of specific spicule.Pass through the company of at least two spicules 201Connect mode, it is therefore an objective to improve the connective stability with ulna or radius, the especially connective stability at spicule 201.
It is additionally provided with the sliding connection structure 270 being connect with the second connection structure 240 on second connecting rod 232, is slidably connectedStructure 270 is for so that the second spicule group 231 can be slided relative to the body of rod of second connecting rod 232.It should be noted that sliding connectsThe set-up mode that there are many binding structures 270, the purpose is to by changing phase of second connection structure 240 on second connecting rod 232To position, so that the position of the second spicule 201 changes simultaneously, slid up and down along oar side lever with radius with driving, with rightRadius plays the role of drawing, to increase or decrease the pressure of humeroradial joint.Specifically, sliding connection structure 270 includes settingThe threaded rod 271 in first connecting rod 212 is set, the first connection structure 220 and 271 screw-thread fit of threaded rod, threaded rod 271 are used forThe first connection structure 220 is driven to shift one's position relative to first connecting rod 212.Also, the sliding connection structure 270 may include settingThe compression screw (not shown) on second connecting rod 232 is set, the above-mentioned knot that is slidably connected is enabled to by compression screwStructure 270 has active state and impaction state.Impaction state：I.e. when compression screw screws (with the threaded rod in the present embodiment271 cooperations, and limit the rotation of threaded rod 271), sliding connection structure 270 is immovable, and it is on second connecting rod 232Position be relatively fixed；Active state：(it is spaced with the threaded rod 271 in the present embodiment, threaded rod when compression screw unscrews271 can rotate), sliding connection structure 270 can move, and its position on second connecting rod 232 can convert.
Fig. 4 is please referred to, the first connection structure 220 includes bottom plate 221 and briquetting 222, in bottom plate 221 and briquetting 222Between be provided with accommodating chamber 223 for clamping the first spicule group 211, by stretching into spicule 201 in accommodating chamber 223, and lead toThe fixation of spicule 201 and the first connection structure 220 can be completed by crossing clamping platen, and bottom plate 221 connects with first connecting rod 212It connects.Second connection structure 240 includes bottom plate 221 and briquetting 222, is provided between bottom plate 221 and briquetting 222 for pressing from both sidesThe accommodating chamber 223 of tight second spicule group 231, by the way that spicule 201 is stretched into accommodating chamber 223, and can be complete by clamping platenAt the fixation of spicule 201 and the second connection structure 240, and bottom plate 221 with second connecting rod 232 for connecting.
Further, in the present embodiment, first connecting rod 212 and second connecting rod 232 may each comprise multiple sub bars, adjacentSub bar between connected by universal joint so that adjacent sub bar has the first state that can mutually rotate, and be fixed to each otherThe second state, to adjacent sub bar be in can mutually rotate first state when, can be to first connecting rod 212 and secondThe body of rod extending direction and angle of connecting rod 232 are adjusted, and are used so that the forearm exterior fixing rack 200 is more convenient, andAfter adjustment is completed, it is required that the second state that adjacent sub bar is fixed to each other.In addition, it is necessary to explanation, due to theOne end of one connecting rod 212 and second connecting rod 232 is connected by rotational structure 260, therefore can be by first connecting rod 212 and second connecting rod232 are disposed as l-shaped rod part, in order to be connect with rotational structure 260.Secondly, and rotational structure 260 can be arranged firstHolder 210 and second support 230 can also be arranged in the other end in other embodiments close to one end of hand.
Further, in the present embodiment, rotational structure 260 includes rotation axis 262 and card-tight part 263, first connecting rod212 one end and one end of second connecting rod 232 are rotatablely connected with rotation axis 262, and card-tight part 263 is for so that first connectsBar 212 and second connecting rod 232 have the rotary state rotated relative to rotation axis 262, and locked relative to rotation axis 262Lock-out state.
Location hole (not shown) is provided in rotation axis 262, it should be noted that location hole is through rotation axis262 through-hole, the purpose is to be used to install pilot pin 264, so that the axis 261 of location hole was rotated with radius around ulnaAxis 261 overlaps, in order to during using the forearm exterior fixing rack 200, determine forearm exterior fixing rack 200Position, in order to make the axis 261 that first connecting rod 212 and second connecting rod 232 are rotated around rotational structure 260 turn around ulna with radiusDynamic axis 261 overlaps.
Based on above-mentioned forearm exterior fixing rack 200, the invention also discloses a kind of exterior fixing racks comprising above-mentionedForearm exterior fixing rack 200.
It should be noted that the forearm exterior fixing rack 200 can be applied not only to distal radioulnar ioint fractures, alsoIt can be applied to simple humeroradial joint fracture fixation operations and provide a kind of postoperative support.
Concrete application is as follows：
When the forearm exterior fixing rack 200 is applied to the dislocation of upper and lower ruler oar, with above application in upper dislocation of distal radioulnar jointWhen middle the difference is that, when the load-bearing of radius and wrist portion or radius can be rotated while not influencing forearm rotationCentrifugal force relative to ulna is transferred to ulna through first support 210 and second support 230, offsets radius and is rotated relative to ulnaWhen the centrifugal force that generates.Radius can be fixed in the rotary shaft of forearm by the forearm exterior fixing rack 200 to be rotated, while being alsoThe reparation of distal radioulnar ioint soft tissue and ligament provides tension-free repairing environment, while being unlikely to allow because being unable to early ambulantLigament contracture, the outer fixed hinge of early period, which is adjusted to static state, to be fixed, when the state of an illness allows forearm to rotate recovery functional trainingIt is loosened again rotary gemel, so that forearm is rotated, by the stretching force effect of forearm exterior fixing rack 200, radius can be revolvedTurn TRAJECTORY CONTROL on original rotational trajectory of forearm.
In addition, the forearm exterior fixing rack 200 is humeroradial joint fracture (simple fracture of head of radius, simple humerusAt the composition humeroradial joint capitulum of humerus and capitulum radii two of head fracture or elbow joint) Ineffective internal fixation provide one kindThe outer fixed support that forearm can rotate in early days, is fixed with substituting gypsum.(the same dislocation of distal radioulnar joint of specific embodiment, but needKeep radius and the second connection structure 240 mobile to distal end on the screw thread turned in the second connecting rod, makes capitulum radii to reachGap is generated between capitulum of humerus, and humeroradial joint tension is made to be substantially reduced even up to tension-free effect) humeroulnar joint is steadyThe fracture fixation operations of fixed humeroradial joint, early stage upper limb reactivate, and are easy to cause fracture end because of humeroradial joint pressure initiationShift again, this forearm exterior fixing rack 200 can restore the weight warp that forearm is transmitted by forearm rotation through humeroradial joint simultaneouslyOuter first support 210 and second support 230 are transferred to ulna, and upper arm is transferred to through humeroulnar joint, to reduce humeroradial joint stressInfluence.Reach and pull radius and wrist portion to distal end, mitigates the pressure of humeroradial joint, oar side section supination muscle before rotationIt pulls to transmit strength when radius and is transferred to the half side first support 210 of oar and second support 230 through spicule 201 to realize forearmThe pressure that humeroradial joint is alleviated while rotating jointly, reach and load-bearing be transferred to ulna through forearm exterior fixing rack 200,The purpose of upper arm is further transferred to through humeroulnar joint.
The foregoing is only a preferred embodiment of the present invention, is not intended to restrict the invention, for the skill of this fieldFor art personnel, the invention may be variously modified and varied.All within the spirits and principles of the present invention, any made by repairChange, equivalent replacement, improvement etc., should all be included in the protection scope of the present invention.