A kind of ankle fusion sets nail guiderTechnical field
The present invention relates to the field of medical instrument technology, it is specifically related to a kind of ankle fusion and sets nail guider.
Background technique
Ankle-joint is the human body weight-bearing joints nearest apart from ground and whole body bears a heavy burden most joint.It is sufficient and smallHinge among leg, so function is of crucial importance.It is to stablize human body in walking and running, even in jumping, keepBalance most important joint, at the same it is but coarse unlike knee joint and hip joint lack very much muscle protection, then just becomeHuman body is easiest to injured joint.Ankle-joint is made of shin bone, fibula and astragalus, in joint and ligament injury, ankle-jointDamage disease incidence highest.Its major function is dorsiflexion and plantar flexion, also has certain rotation function.When sprain of ankle joint, violenceThe Repeated Operation of caused fracture and the past damages, and destroys the ligament and articular cartilage knot of ankle-joint to a certain extentStructure reduces the stability of ankle-joint to destroy the normal anatomy corresponding relationship of ankle-joint, these are that ankle-joint is caused to be createdThe arthritic key factor of wound property.The symptoms such as pain, seriously affect trouble when ankle joint wound arthritis causes to walk or bear a heavy burdenThe quality of life of person, conservative therapy are extremely difficult to satisfied effect.
Currently used method is treated using ankle fusion, is worked well, and can be rapidly reached the purpose for alleviating symptom, isMost patients are received.The factor for influencing ankle fusion effect mainly includes the choosing of the fixing means, operative approach performed the operationThe area of the mode, fusion select, fixed, whether abundant bone grafting etc..The selection for fixed form of wherein performing the operation be ankle fusion atOne of key factor whether function.The fixing means of ankle fusion includes fixation, Plate internal fixiation, intramedullary nail in forcing screwFixed and exterior fixing rack is fixed.Plate internal fixiation can make ankle-joint obtain strong stable fusion, but tissue damage is big, blood vesselThe risk of neurotrosis is larger, and postoperative complications are more.Intramedullary nailing is more in line with biomechanical principle strand pinning and can playThe effect of anti-torsion, fixed more stable reliable, small to surrounding soft tissue's damage, postoperative complications are less, but surgical procedure is difficultSpend it is relatively large then.Fixed clinically common outer fixed for Ilizarov annular outside ankle fusion, it can be according to patientChange of illness state adjust angulation, displacement, correction deformity, fixing-stable, and have the work of enough warping resistances and torsional rotation force at any timeWith may also function as the effect of persistent pressure., soft tissue scar nervous for skin and contracture of Achilles tendon can the minimally invasive stretching of same period row,For the patient of acute osteoarthritis and the infection of joint, outer fixation be can yet be regarded as, and one kind is preferable to be selected, but bone is easy to cause not to be curedConjunction rate increases, pin track infection and adjacent joints are tetanic, and postoperative patient brings inconvenience this also one to life because of external fixing rackDetermine to affect its use in ankle fusion in degree.In recent years, minimally-invasive treatment is increasingly used in clinic and controlsIt treats, and there are many method, and is fixed in screw also at the operation method of clinical first choice, it is according to the literature, fixed in screw to meltConjunction rate is higher than 90%.And have the advantages that notch is small, easy to operate, stability is high and few intercurrent disease.
In current ankle fusion screw in fixation procedure, generally requires 2-3 screw of implantation from different angles and incite somebody to actionAnkle-joint is fixed, and the general full experience for relying on doctor carries out fusion positioning in the course of surgery, and it is multiple to generally require guide pin in artIt fixes in the hope of optimum position, operating time is long, and wound is big；It needs to avoid fixing screws in the intracavitary friendship of ankle-joint when fixed simultaneouslyFork leads to the failure, and needs the duplicate angle for determining screw fixation to ankle-joint progress radial imaging, operating time is caused to prolongLong, radiation increases, and influences patient and medical staff's health, reduces procedure efficiency；Currently, not thering is ankle fusion to set both at home and abroadThe guider of nail.
Summary of the invention
The purpose of the present invention is to provide a kind of ankle fusions to set nail guider, the fixed behaviour in ankle fusion screwWhen making, ankle-joint position that is by guider that fixing screws are stable, being effectively fixed on fusion, while under guider effectBe able to achieve effective positioning, avoid setting nail in internal chiasma, it is reasonable in design, swift to operate efficiently, effectively improve operationEfficiency.
To realize above-mentioned technical purpose and the technique effect, the present invention is achieved through the following technical solutions:
A kind of ankle fusion sets nail guider, including guide ring, fixator, motion bar, sets nail pilot sleeve and set nailLocator；Guide ring is equipped with equally distributed 3 fixators and 3 motion bars, and motion bar is equipped with movable base, movable baseSeat is equipped with and sets nail pilot sleeve；It sets nail pilot sleeve and sets nail positioner equipped with dismountable；
The guide ring is medical stainless steel material, and guide ring is equipped with the opening that length is 3-4cm, open end and openingThe guide ring axial centre position of opposite side is equipped with fixator screw hole, and guide ring upper and lower sides are equipped with the arc chute of invagination；
The motion bar is square pole, and motion bar upper end is the installed cassette that can be stuck on arc chute, on motion barEquipped with the movable base that can be slided on bar；Dial is fixedly installed on movable base, dial center is equipped with scaleValve snail hole；
Movable base is equipped with locking bolt, and the surface of motion bar corresponding with locking screw thread is equipped with invagination card slot, activitySurface on the outside of bar is equipped with graduation mark, is equipped with scale marker from top to bottom；
The nail pilot sleeve of setting is cannulated sleeve, and upside middle position is arranged screw rod and engages connection with dial screw hole,Screw rod is equipped with lock nut, and angle positioning identifier is arranged in upper front end position；It sets and is equipped with removably on the downside of nail pilot sleeveSet nail positioner；
Described to set the hand holding handle and adjustable positioning handle that nail positioner includes arc, the positioning end of positioning handle is to set nailPilot sleeve is directed toward end；It the nail pilot sleeve and sets nail positioner and is constantly in same plane.
Further, the guiding ring diameter is 10-15cm, is open mellow and full, and the position 1cm is equipped with installed cassette behind open endMounting groove, installed cassette be equipped with locking bolt.
Further, the fixator includes that the adjusting knob of rear end, the threaded rod in middle position and front end are dismountableFixing end, fixing end are arc-shaped latex mattress.
Further, the movable pole length is 5-6cm, and movable base, the dial of movable base is arranged on motion barEvenly spaced angle is equipped with to identify.
Further, the opposite side for setting screw rod end on nail pilot sleeve is arranged rectangular connecting groove and is set on nail positioner with settingThe rectangular linking feather joint set.
Another object of the present invention is to provide the operating methods that a kind of ankle fusion sets nail guider, by 3 activitiesBar is mounted on the arc chute of guide ring by installed cassette, on the basis of the fixator screw hole of guide ring open end opposite side,So that 1 motion bar is to the left, other two motion bar is on the right side of it；By the way that the threaded rod of fixator is passed through fixator spiral shellEnd is connected and fixed behind hole, guide ring passes through aperture position by end cap on ankle-joint in guide ring, will by the fixing end of fixatorGuide ring is fixed on the position 3-5cm on ankle-joint；Movable base on motion bar is fixedly installed with dial, passes through on dialNail pilot sleeve is set in screw rod connection, under the locking of lock nut, is set on the angle positioning identifier for following closely pilot sleeve and dial0 ° of angle identify be overlapped；The opposite side for setting screw rod on nail guide sleeve is connected with by rectangular connecting groove sets nail positioner, at this point,Set nail positioner, pilot sleeve and movable base in the same plane；The position of appropriate adjustment motion bar and movable base, and lead toIt overregulates the angle of pilot sleeve and sets nail positioner and first hollow screw is implanted into ankle-joint, angle position of implantation etc. is equalIt can be controlled by setting nail positioner and pilot sleeve；Nail positioner disassembly will be set later is mounted on leading for remaining two motion barsGuide-localization and implantation hollow screw are carried out on sleeve；When being implanted into second and third hollow screw, to prevent insideIntersecting, when the initial position of implantation is higher than pedicle screw, the radian of implantation is controlled in the radian for being less than the screw being implanted into,Conversely, the radian control of implantation is in the radian for being greater than the screw being implanted into when the initial position of implantation is lower than pedicle screw.
The beneficial effects of the present invention are: ankle fusion of the invention sets nail guider, including guide ring, fixator, workLever sets nail pilot sleeve and sets nail positioner；Guide ring is equipped with equally distributed 3 fixators and 3 motion bars, activityBar is equipped with movable base, and movable base is equipped with dial and is connect by screw rod with nail pilot sleeve is set, and sets nail guide sleeveIt is arranged on cylinder and removably sets nail guider；When ankle fusion is set nail and fixed, by setting nail pilot sleeve and setting nail guidingThe adjusting positioning of device obtain it is optimal sets nail position and angle, first hollow screw is implanted into ankle-joint, it is easy to operate,Accuracy is high, can effectively shorten the time that nail is set in operation；Nail guider and is being set at pilot sleeve by remaining nail of setting laterAdjusting positioning obtain it is optimal set nail position and angle, when implantation second and third hollow screw, to prevent internal friendshipFork, when the initial position of implantation is higher than pedicle screw, the radian control of implantation is in the radian for being less than the screw being implanted into, insteadIt, when the initial position of implantation is lower than pedicle screw, the radian control of implantation is in the radian for being greater than the screw being implanted into；I.e.It also can effectively avoid fixing screws to lead to the failure in the intracavitary intersection of ankle-joint in the pedicle screw of efficient quick, and be not necessarily toRadiant image is repeatedly carried out, operating time is greatly shortened, improves procedure efficiency；It is beneficial to medical staff's health.
Certainly, it implements any of the products of the present invention and does not necessarily require achieving all the advantages described above at the same time.
Detailed description of the invention
In order to illustrate the technical solution of the embodiments of the present invention more clearly, will be described below to embodiment requiredAttached drawing is briefly described, it should be apparent that, drawings in the following description are only some embodiments of the invention, for abilityFor the those of ordinary skill of domain, without creative efforts, it can also be obtained according to these attached drawings other attachedFigure.
Fig. 1 is the structural schematic diagram that ankle fusion of the present invention sets nail guider；
Fig. 2 is the structural schematic diagram of guide ring of the present invention and fixator；
Fig. 3 is the structural schematic diagram of motion bar of the present invention and movable base；
Fig. 4 is the structural schematic diagram of movable base of the present invention and dial；
Fig. 5 is the structural schematic diagram of the present invention set nail pilot sleeve and set nail guider；
In attached drawing, parts list represented by the reference numerals are as follows:
1- guide ring, the open end 101-, 102- fixator screw hole, 103- arc chute, 104- mounting groove, 2- fixator,201- adjusting knob, 202- threaded rod, 203- fixing end, 3- motion bar, 301- installed cassette, 302- invagination card slot, 303- are carvedLine is spent, 4- sets nail pilot sleeve, 401- lock nut, 402- angle positioning identifier, the rectangular connecting groove of 403-, 404- screw rod, 5-Set nail positioner, 501- hand holding handle, 502- positioning handle, 503- positioning end, the rectangular linking tenon of 504-, 6- movable base, 601- quarterScale, 602- angle mark, 603- dial screw hole.
Specific embodiment
Following will be combined with the drawings in the embodiments of the present invention, and technical solution in the embodiment of the present invention carries out clear, completeSite preparation description, it is clear that described embodiments are only a part of the embodiments of the present invention, instead of all the embodiments.It is based onEmbodiment in the present invention, it is obtained by those of ordinary skill in the art without making creative efforts all otherEmbodiment shall fall within the protection scope of the present invention.
Embodiment 1
As shown in Figs. 1-5, a kind of ankle fusion sets nail guider, including guide ring 1, fixator 2, motion bar 3, sets nailPilot sleeve 4 and set nail positioner 5；Guide ring 1 is equipped with fixator 2 and motion bar 3, and motion bar 3 is equipped with movable base 6,Movable base 6, which is equipped with, sets nail pilot sleeve 4；It sets nail pilot sleeve 4 and sets nail positioner 5 equipped with dismountable；
Guide ring 1 is medical stainless steel material, and guide ring 1 is equipped with the opening that length is 3-4cm, open end 101 and opensThe 1 axial centre position of guide ring of mouth opposite side is equipped with fixator screw hole 102, and 1 upper and lower sides of guide ring are equipped with the arc chute of invagination103 with motion bar for connecting；
Motion bar 3 is square pole, and 3 upper end of motion bar is the installed cassette 301 that can be stuck on arc chute 103, activityBar 3 is equipped with the movable base 6 that can be slided on bar；Dial 601,601 center of dial are fixedly installed on movable base 6Position be equipped with dial screw hole 603 be used for set nail pilot sleeve 4 connect；Movable base 6 is equipped with locking bolt, with locking spiral shellThe surface of the corresponding motion bar 3 of bolt is equipped with invagination card slot 302, and the surface in 3 outside of motion bar is equipped with graduation mark 303, from top to bottomEquipped with scale marker mutual alignment distance of the movable base 6 relative to guide ring 1 for identification；
3 length of motion bar is 5-6cm, movable base 6 is arranged on motion bar 3, the dial 601 of movable base 6 is equipped withEvenly spaced angle mark 602；
Setting nail pilot sleeve 4 is cannulated sleeve, and screw rod 404 and 603 company of engagement of dial screw hole is arranged in upside middle positionIt connects, screw rod 404 is equipped with lock nut 401, and angle positioning identifier 402 is arranged in upper front end position, realizes by screw rod 404After being connect with dial 601, it can rotate and adjust the angle for setting nail pilot sleeve 4 to realize that the angle of nail is set in adjusting, and can lead toLock nut 401 is crossed to be locked；It sets to be equipped on the downside of nail pilot sleeve 4 and removably sets nail positioner 5；
Set the hand holding handle 501 and adjustable positioning handle 502 that nail positioner 5 includes arc, the positioning end of positioning handle 502503 are directed toward end to set nail pilot sleeve 4；Set 404 end of screw rod on nail pilot sleeve 4 opposite side be arranged rectangular connecting groove 403 withSet be arranged on nail positioner 5 rectangular linking tenon 504 connection after, set nail pilot sleeve 4 and set nail positioner 5 be constantly in it is samePlane sets the positioning end 503 that positioning handle 502 is directed toward in nail 4 front end of pilot sleeve, i.e., is from setting from the positioning end 503 of positioning handle 502It is directed toward end in the front end for the screw that nail pilot sleeve 4 passes through；
1 diameter of guide ring is 10-15cm, is open mellow and full, and the position 1cm is equipped with the installation of installed cassette 301 behind open end 101Slot 104, installed cassette 301 are equipped with locking bolt and are used to motion bar 3 and guide ring 1 stablizing fixation；
Fixator 2 includes the dismountable fixing end of threaded rod 202 and front end of the adjusting knob 201 of rear end, middle position203, fixing end 203 is arc-shaped latex mattress；1 set of guide ring outside ankle-joint after, pass through the adjusting knob of fixator 2201, the threaded rod 202 in middle position offsets fixing end 203 and ankle-joint upper end so that guide ring is stably fixed at ankle-jointThe upper end position 3-5cm.
Embodiment 2
As shown in Figs. 1-5, a kind of ankle fusion sets nail guider, and structure and each component interconnected relationship are for example above-mentionedDescribed in embodiment 1；When ankle fusion sets nail: 3 motion bars 3 are mounted on to the arc of guide ring 1 by installed cassette 301On sliding slot 103, on the basis of the fixator screw hole 102 of 101 opposite side of the open end of guide ring 1, so that 1 motion bar 3 is on its left sideSide, other two motion bar 3 is on the right side of it；By being connected and fixed end after the threaded rod of fixator 2 is passed through fixator screw hole 102203, guide ring 1 by aperture position by end cap on ankle-joint in guide ring 1, by the fixing end 203 of fixator 2 by guide ring1 is fixed on the position 3-5cm on ankle-joint, at this point, the aperture position of guide ring 1 is located on front side of ankle-joint；Activity on motion bar 3Pedestal 6 is fixedly installed with dial 601, after being connect by the realization of screw rod 404 with dial 601, can rotate adjusting and set nailThe angle of pilot sleeve 4 realizes that the angle of nail is set in adjusting, and can be locked by lock nut 401, and nail pilot sleeve 4 is setAngle positioning identifier 402 602 be overlapped with 0 ° of the angle mark on dial 601；Set pair of screw rod 404 on nail guide sleeve 4Side is connected with by rectangular connecting groove 403 and sets nail positioner 5, at this point, setting nail positioner 5, setting nail pilot sleeve 4 and movable base6 in the same plane；
When ankle-joint sets nail fusion, first 102 right side of appropriate adjustment fixator screw hole close motion bar 3 and movable base6, the starting point of first hollow screw of implantation is determined, after determining good position, motion bar 3 and movable base 6 are stablized solidIt is fixed, nail positioner 5 will be set later and will be connect with nail pilot sleeve 4 is set, and set nail by rotating to adjust under the auxiliary for setting nail positioner 5The angle of pilot sleeve 4: the adjustable elongation of positioning handle 502 of nail positioner 5 is set, nail pilot sleeve 4 is set by rotation, sets nailThe hand holding handle 501 of locator 5 rotates with, and sets nail 4 front end of pilot sleeve and is directed toward the positioning end 503 of positioning handle 502 to determine theThe angle of one hollow screw will set nail abutment sleeve 4 by lock nut 401 after determining and lock；By setting nail positioningSleeve 4 squeeze into steel needle to first hollow screw of implantation；After first hollow screw is squeezed into, first hollow screwThe movable base 6 squeezed into can determine with the angle of nail 4 relative scale disk 601 of pilot sleeve at a distance from guide ring 1 and (set nailFor pilot sleeve 4 counterclockwise after rotation, the angle positioning identifier 402 for setting nail pilot sleeve 4 can be directed toward graduated scale on dial 601602 are known to determine rotation angle)；The nail of setting for being mounted on remaining two motion bars 3 after nail positioner 5 is dismantled will be set later to be oriented toOn sleeve 4；It repeats aforesaid operations method and is implanted into remaining two hollow screws；In implantation second and third hollow screwWhen, to prevent internal chiasma, when being implanted into the initial position of hollow screw higher than pedicle screw, the radian of implantation is controlled smallIn the radian for the screw being implanted into, conversely, the radian of implantation is controlled big when the initial position of implantation is lower than pedicle screwIn the radian for the screw being implanted into；The present invention is when ankle fusion is set nail and fixed, by setting nail pilot sleeve 4 and setting nail guidingThe adjusting positioning of device 5 obtains optimal set and follows closely position and angle, and first hollow screw is implanted into ankle-joint, easy to operate fastPrompt, accuracy height, can effectively shorten the time that nail is set in operation；It sets nail pilot sleeve 4 by remaining later and sets nail and leadOptimal set is obtained to the adjusting of device 5 positioning and follows closely position and angle, i.e., also can effectively keep away in the pedicle screw of efficient quickExempt from fixing screws to lead to the failure in the intracavitary intersection of ankle-joint, and without repeatedly carrying out radiant image, when operation is greatly shortenedBetween, improve procedure efficiency；It is beneficial to medical staff's health.
Embodiment 3
As shown in Figs. 1-5, a kind of ankle fusion sets nail guider, the operating method base described in embodiment 1 and embodiment 2On plinth, when specific ankle-joint sets nail fusion, the opening of guide ring 1 is located at the front side of ankle-joint, guide ring 4cm on ankle-jointLeft-right position, 102 right side of appropriate adjustment fixator screw hole close motion bar 3 and movable base 6, determines first sky of implantationThe starting point of heart screw selects ligament tibia end on rear side of ankle-joint to be implanted into first hollow screw (diameter 7mm, long 55mmHollow screw), motion bar 3 and movable base 6 are stablized fix later, is adjusted under the auxiliary for setting nail positioner 5 by rotationSet nail pilot sleeve 4 angle: by set nail positioner 5 positioning handle 502 and positioning end 503 and set nail pilot sleeve 4 determine setThe angle of nail generally requires the implantation point from the shin bone of rear side is and reaches navicular bone；It (can specifically be selected according to practical operation trueFixed, setting angle direction of nail etc., there is no limit, it is only necessary to can be fixed by ankle-joint)；After angle determines, it is determinedNail abutment sleeve 4 will be set by lock nut 401 afterwards to lock；It carries out squeezing into steel needle to be implanted by setting nail abutment sleeve 4First hollow screw；After first hollow screw is squeezed into, movable base 6 and guide ring 1 that first hollow screw is squeezed intoDistance and nail 4 relative scale disk 601 of pilot sleeve angle can determine；It will set after nail positioner 5 is dismantled and install laterIn setting on nail pilot sleeve 4 for remaining two motion bars 3；It repeats aforesaid operations method and is implanted into remaining two hollow screws(one is diameter 5.5mm, long 35mm；Another diameter 5.5mm, long 45mm)；In implantation second and third hollow screwWhen, to prevent internal chiasma, when being implanted into the initial position of hollow screw higher than pedicle screw, the radian of implantation is controlled smallIn the radian for the screw being implanted into, conversely, the radian of implantation is controlled big when the initial position of implantation is lower than pedicle screwIn the screw being implanted into radian (when second hollow screw being implanted into, if implantation starting point hollow is lighted at firstThe angle of initial point position below, implantation needs to select than first hollow dots angle small in the selection process)；The present invention existsAnkle fusion set nail it is fixed when, optimal set nail position by setting nail pilot sleeve 4 and setting the adjusting positioning of nail guider 5 to obtainIt sets and angle, first hollow screw is implanted into ankle-joint, it is easy to operate, accuracy is high, it can effectively shorten operation and setThe time of nail；Nail position is being set by the way that the remaining adjusting positioning acquisition set nail pilot sleeve 4 and set nail guider 5 is optimal laterIt sets and angle, i.e., fixing screws also can effectively be avoided to cause to lose in the intracavitary intersection of ankle-joint in the pedicle screw of efficient quickIt loses, and without repeatedly carrying out radiant image, operating time is greatly shortened, improves procedure efficiency；It is strong to be beneficial to medical staffHealth.
In the description of this specification, the description of reference term " one embodiment ", " example ", " specific example " etc. meansParticular features, structures, materials, or characteristics described in conjunction with this embodiment or example are contained at least one implementation of the inventionIn example or example.In the present specification, schematic expression of the above terms may not refer to the same embodiment or example.Moreover, particular features, structures, materials, or characteristics described can be in any one or more of the embodiments or examples to closeSuitable mode combines.
Present invention disclosed above preferred embodiment is only intended to help to illustrate the present invention.There is no detailed for preferred embodimentAll details are described, are not limited the invention to the specific embodiments described.Obviously, according to the content of this specification,It can make many modifications and variations.These embodiments are chosen and specifically described to this specification, is in order to better explain the present inventionPrinciple and practical application, so that skilled artisan be enable to better understand and utilize the present invention.The present invention is onlyIt is limited by claims and its full scope and equivalent.