CN116058950A - Tibia plateau fracture reduction fixing device and reduction method - Google Patents

Abstract

The invention discloses a tibia plateau fracture reduction fixing device and a reduction method, which relate to the technical field of fracture reduction and aim at providing a tibia plateau fracture reduction fixing device and a reduction method for realizing rapid jacking of collapsed bone blocks, reducing operation trauma and accelerating operation recovery speed, wherein the device is technically characterized by comprising a positioner, the positioner comprises a positioning arm and a guiding arm, the positioning arm and the guiding arm are connected into a whole, the end part of the positioning arm is a positioning end, and the positioning end is used for pointing to a fracture position; the guide arm is provided with two movable parts in a sliding manner, and the two movable parts are provided with connecting parts in a detachable manner; simultaneously, the top surface of the collapsed bone block and the top surface of the tibia platform are positioned on the same horizontal line.

Description

Tibia plateau fracture reduction fixing device and reduction method

Technical Field

The invention relates to the technical field of fracture reduction, in particular to a tibial plateau fracture reduction fixing device and a reduction method.

Background

The difficulty in treating the fracture of the tibial plateau is mainly that the subsided bone blocks of the joint surfaces are subjected to reduction treatment, after the fracture of the traditional tibial plateau, large openings are cut, skin and flesh are peeled off, fracture positions are found, the subsided bone blocks are pried and reduced above the fracture positions, then steel plates are put into the fracture positions to support the subsided bone blocks, and then the subsided bone blocks can be fixed.

It can be found that the existing fracture reduction technology is not mature enough, the cut-out opening is too large, the cartilage of the tibial plateau is severely worn, the postoperative recovery of a patient is not facilitated, and the existing prying reduction method cannot guarantee the reduction effect of the collapsed bone blocks.

Disclosure of Invention

(one) solving the technical problems

Aiming at the defects of the prior art, the invention provides a tibial plateau fracture reduction fixing device and a reduction method for realizing rapid jacking of a collapsed bone block, reducing operation trauma and accelerating operation recovery speed.

(II) technical scheme

In order to achieve the above purpose, the present invention provides the following technical solutions: a method for reduction of tibial plateau fractures, comprising the steps of:

s1, arranging an observation port, and placing the observation port into an arthroscope to observe the fracture position;

s2, enabling a positioning arm of the universal positioner to point to a fracture position, enabling the thimble to automatically point to the tibia platform, and arranging an operation port at the pointing position of the thimble;

s3, enabling a thimble of the positioner to penetrate through the operation opening to enter the lower portion of the tibia platform and jack up the collapsed bone block, so that the top surface of the collapsed bone block and the top surface of the tibia platform are positioned on the same horizontal line;

s4, driving a positioning needle below the tibia platform, and supporting the collapsed bone blocks by using the positioning needle;

s5, driving an internal object into the collapsed bone piece, and fixing the collapsed bone piece by using the internal object;

the positioning needle is arranged on the positioner through the positioning block, and the positioning block is also used for guiding the built-in object.

Preferably, in S3, the collapsed bone pieces are lifted up using a plurality of pins simultaneously entering the operation port.

Preferably, in S4, it is determined to drive a plurality of positioning pins 5mm-1cm below the positioning end of the positioner, and support the collapsed bone pieces using the plurality of positioning pins.

Preferably, in S5, the collapsed bone pieces are secured using absorbable screws as the inserts.

The tibia plateau fracture reduction fixing device comprises a positioner, wherein the positioner comprises a positioning arm and a guide arm, the positioning arm and the guide arm are connected into a whole, the end part of the positioning arm is a positioning end, and the positioning end is used for pointing to a fracture position; two movable pieces are slidably arranged on the guide arm, and connecting pieces are detachably arranged on the two movable pieces;

one movable piece is a reset piece, a connecting piece arranged on the reset piece is an ejector piece, the other movable piece is a positioning piece, the connecting piece arranged on the positioning piece is a positioning piece, a plurality of ejector pins are fixedly arranged on the ejector piece, the ejector pins are always directed to the positioning ends after being arranged, the ejector pins are used for ejecting the collapsed bone pieces, and positioning pins are fixedly arranged on the positioning piece;

when the resetting piece and the positioning piece are installed, the ends of the thimble and the positioning needle are gradually close to the positioning end.

Preferably, the movable piece is provided with a plurality of through holes penetrating through the body of the movable piece, the through holes are distributed on the movable piece at equal intervals, and the through holes are used for guiding the thimble or the positioning needle;

the outside of the movable piece is attracted to the connecting piece through magnetic force.

Preferably, the connecting piece includes location portion and fixed part, the mounting groove has been seted up on the moving part, the mounting groove is used for spacing to the location portion, and during the connecting piece installation, the inside of location portion entering mounting groove, fixed part is fixed with the outer wall actuation of moving part.

Preferably, the movable piece is provided with a sliding hole penetrating through the body of the movable piece, and the guide arm penetrates through the movable piece through the sliding hole;

clamping plates are mounted on two opposite side walls of the sliding hole through elastic pieces, the clamping plates penetrate through the sliding hole and extend to the outer sides of the movable pieces, the two clamping plates are symmetrically distributed with respect to the guide arm, and anti-skid patterns are formed on one sides, close to the guide arm, of the clamping plates.

Preferably, the positioning block is further used for positioning the built-in object, a guide hole is formed in the positioning block, and the built-in object passes through the guide hole and enters the human body to position the collapsed bone block.

(III) beneficial effects

Compared with the prior art, the invention provides a tibia plateau fracture reduction fixing device and a reduction method, which have the following beneficial effects:

1. the international universal positioner is utilized to position the collapsed bone blocks, and an operation port through which the ejector pins on the positioner pass is formed, so that the collapsed bone blocks can be quickly jacked up, the operation wound is reduced, and the operation recovery speed is increased; meanwhile, the top surface of the collapsed bone block and the top surface of the tibia platform are located on the same horizontal line, and the resetting effect of the collapsed bone block is improved.

2. The collapsed bone blocks are supported by positioning, so that cartilage abrasion can be reduced, and the operation safety is greatly improved; the positioning block is used for guiding the built-in object, so that the nailing position of the built-in object is determined, and the bone block fixing effect is improved.

Drawings

FIG. 1 is a schematic view of the overall structure of a tibial plateau fracture reduction device of the present invention;

FIG. 2 is a schematic cross-sectional view of a positioning block according to the present invention;

fig. 3 is a schematic cross-sectional view of a movable member according to the present invention.

In the figure: 100. a positioner; 101. a positioning arm; 102. a guide arm; 103. a positioning end; 200. a movable member; 201. a reset block; 202. a positioning block; 300. a connecting piece; 301. a push member; 302. a positioning piece; 400. a thimble; 500. a positioning needle; 600. a through hole; 700. a mounting groove; 800. a sliding hole; 900. a clamping plate; 1000. an elastic member; 1100. and a guide hole.

Detailed Description

The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.

Example 1

A method for reduction of tibial plateau fractures, comprising the steps of:

s1, arranging an observation port, and placing the observation port into an arthroscope to observe the fracture position;

s2, enabling apositioning arm 101 of theuniversal positioner 100 to point to a fracture position, enabling athimble 400 to automatically point to a tibia platform, and arranging an operation port at the pointing position of thethimble 400;

s3, enabling theejector pin 400 of thepositioner 100 to penetrate through the operation opening to enter the lower portion of the tibia platform and jack up the collapsed bone block, so that the top surface of the collapsed bone block and the top surface of the tibia platform are positioned on the same horizontal line;

s4, driving apositioning needle 500 below the tibia platform, and supporting the collapsed bone blocks by using thepositioning needle 500;

s5, driving an internal object into the collapsed bone piece, and fixing the collapsed bone piece by using the internal object;

thepositioning needle 500 is mounted on thepositioner 100 through thepositioning block 202, and thepositioning block 202 is also used for guiding the built-in object.

In the method, the internationaluniversal positioner 100 is utilized to position the collapsed bone blocks, and an operation port for the ejector pins 400 on thepositioner 100 to pass through is formed, so that the rapid jacking of the collapsed bone blocks can be realized, the top surfaces of the collapsed bone blocks and the top surfaces of the tibia platforms are ensured to be positioned on the same horizontal line, and the resetting effect of the collapsed bone blocks is improved.

Further, in S3, the collapsed bone pieces are lifted up by simultaneously entering the operation port with a plurality of ejector pins 400.

Further, it is determined that a plurality of positioning pins 500 are driven 5mm-1cm below thepositioning end 103 of thepositioner 100, and the collapsed bone pieces are supported by the plurality of positioning pins 500.

Further, in S5, the collapsed bone pieces are fixed using the absorbable screw as a built-in.

As a preferred embodiment of the method of the present invention, a row ofpins 400 may be provided during actual use to avoid tilting and chipping of the bone pieces due to stress concentrations.

Of course, a plurality of positioningneedles 500 can be arranged, the positioning needles 500 are used for supporting the collapsed bone blocks after the reduction, and compared with the prior art that the positioning needles 500 are directly made of steel plates, the cartilage abrasion can be reduced, and the operation safety is greatly improved.

In the conventional operation, the internal object is required to be irradiated to the human body by using the X-ray, the staff is required to drive the internal object into the tibial plateau by experience under the perspective condition, the internal object is generally a screw, and it can be seen that the conventional method is not only troublesome, but also too much depends on the experience ability of the staff, once the staff drives in the position deviation, the screw is required to be driven again, the abrasion is large, and in the actual operation, although the screw is seen in a regular row in the perspective view, the actual situation is not the same, and the fixing effect is not ideal.

Therefore, the invention is used as a complete fracture reduction method, and thepositioning block 202 is used for guiding the built-in objects, so that a plurality of screws are orderly nailed on the bone blocks, and the fixing effect on the collapsed bone blocks is ensured.

In the embodiment, the position of thepositioning needle 500 is also limited, so that thepositioning needle 500 is fixed between 5mm and 1cm below thepositioning end 103 of thepositioner 100, and the distance can ensure the supporting effect and can not drive thepositioning needle 500 into the joint cavity.

In addition, as a preferred embodiment of the present invention, absorbable screws are used as the built-in articles, and the screws are not required to be taken out later, so that surgical wounds are reduced, and surgical procedures are simplified.

Example 2

Referring to fig. 1-3, a tibial plateau fracture reduction fixing device is applied to the tibial plateau fracture reduction method, and comprises apositioner 100, wherein thepositioner 100 comprises apositioning arm 101 and a guiding arm 102, thepositioning arm 101 and the guiding arm 102 are connected into a whole, the end part of thepositioning arm 101 is apositioning end 103, and thepositioning end 103 is used for pointing to a fracture position; twomovable pieces 200 are slidably arranged on the guide arm 102, and connectingpieces 300 are detachably arranged on the twomovable pieces 200;

onemovable piece 200 is areset block 201, a connectingpiece 300 arranged on thereset block 201 is anejector piece 301, the othermovable piece 200 is apositioning block 202, the connectingpiece 300 arranged on thepositioning block 202 is apositioning piece 302, a plurality of ejector pins 400 are fixedly arranged on theejector piece 301, the ejector pins 400 are always directed to the positioning ends 103 after being arranged, the ejector pins 400 are used for ejecting collapsed bone blocks, andpositioning pins 500 are fixedly arranged on thepositioning piece 302;

wherein, when the reset andpositioning members 302 are installed, the ends of theejector pin 400 and thepositioning pin 500 gradually approach thepositioning end 103.

Thelocator 100 in the device of the invention can be an internationalgeneral locator 100 which is generally used in ligament reconstruction, in the invention, the locatingend 103 is pointed to the tibia platform firstly by utilizing the characteristic that thethimble 400 in thelocator 100 points to the locatingend 103 all the time after being installed, then theejector 301 is installed, when theejector 301 is installed, thethimble 400 on theejector 301 is gradually close to the locatingend 103, and along with the installation of theejector 301, thethimble 400 gradually jacks up the collapsed bone block, and finally, the top surface of the collapsed bone block and the tibia platform are positioned on the same horizontal line.

Of course, in the whole reduction method, the collapsed bone block needs to be fixed after being jacked up, so that thepositioning block 202 is further arranged on the existingpositioning device 100, thepositioning piece 302 is arranged on thepositioning block 202, and thepositioning needle 500 is arranged on thepositioning piece 302.

When theejector 301 and thereset block 201 are fixed together, theejector pin 400 on theejector 301 ejects the collapsed bone block so that the top surface of the collapsed bone block and the tibial plateau are positioned on the same horizontal line, then thepositioning block 202 is moved, thepositioning block 302 is continuously installed after a proper position is found, thepositioning needle 500 on thepositioning block 302 is gradually inserted into the human body while thepositioning block 302 is installed until thepositioning block 302 and thepositioning block 202 are fixed together, and thepositioning needle 500 completes the support of the collapsed bone block.

In the whole device, the installation position of thepositioning needle 500 is determined by using thepositioner 100, so that the supporting effect of thepositioning needle 500 is improved.

It should be noted that, during the operation, theejector pin 400 and thepositioning pin 500 need to be gradually pushed into the human body, thereby realizing the reduction and support of the bone block.

Specifically, themovable member 200 is provided with a plurality of through holes 600 penetrating through the body thereof, the plurality of through holes 600 are distributed on themovable member 200 at equal intervals, and the through holes 600 are used for guiding thethimble 400 or thepositioning needle 500;

the outside of themovable member 200 attracts the connectingmember 300 by magnetic force.

It can be clear that, in order to improve the use effect, theejector pin 400 and thepositioning needle 500 can be provided in plurality, and the through holes on themovable member 200 are also required to be provided in plurality, so that the arrangement of the positioning needles 500 can reduce cartilage abrasion and greatly improve the operation safety; the arrangement of the plurality ofpins 400 can prevent the bone fragments from tilting and chipping due to stress concentration.

It should be further noted that the detachable connection is a conventional arrangement in existing mechanical structures, and the present invention provides an embodiment in which themovable member 200 and the connectingmember 300 are mounted and separated by magnetic force engagement.

Specifically, the connectingpiece 300 includes a positioning portion and a fixing portion, themovable piece 200 is provided with a mountinggroove 700, the mountinggroove 700 is used for limiting the positioning portion, when the connectingpiece 300 is mounted, the positioning portion enters the mountinggroove 700, and the fixing portion is fixed to the outer wall of themovable piece 200 in a suction manner.

In order to improve the stability of the connectingpiece 300 and the movingpiece 200 after being mounted, in this embodiment, a mountinggroove 700 is formed on the movingpiece 200, when the connectingpiece 300 needs to be mounted with the movingpiece 200, theejector pin 400 or thepositioning needle 500 passes through the through hole 600, then the connectingpiece 300 gradually approaches the movingpiece 200, the end of theejector pin 400 or thepositioning needle 500 gradually approaches thepositioning end 103 until the positioning part of the connectingpiece 300 enters the mountinggroove 700, at this time, theejector pin 400 can jack up the collapsed bone block, thepositioning needle 500 can support the collapsed bone block, and the mountinggroove 700 can limit the positioning part on the connectingpiece 300, so that the sliding of the connectingpiece 300 is prevented, and the stability is improved.

Specifically, themovable member 200 can be slidably adjusted and locked along the guide arm 102, a slidinghole 800 penetrating through the body of themovable member 200 is formed in themovable member 200, and the guide arm 102 penetrates through themovable member 200 through the slidinghole 800;

two opposite side walls of the slidinghole 800 are provided with clampingplates 900 throughelastic members 1000, the clampingplates 900 penetrate through the slidinghole 800 to extend to the outer side of themovable member 200, the two clampingplates 900 are symmetrically distributed with respect to the guide arm 102, and one side of the clampingplates 900 close to the guide arm 102 is provided with anti-skid patterns.

In theconventional positioner 100, after the position of themovable member 200 provided with theejector pin 400 is determined, themovable member 200 can be positioned by being held by a hand, and in order to improve convenience, in the embodiment of the present invention, themovable member 200 is determined to be slidably adjustable and lockable along the guide arm 102.

In order to achieve this, in the embodiment of the present invention, the clampingplate 900 is installed by theelastic member 1000, when in use, the clampingplate 900 is pressed to apply a pressure to theclamping plate 900, after theclamping plate 900 is pressed, theelastic member 1000 is compressed, after theelastic member 1000 is compressed, the clampingplate 900 is separated from the side surface of the guide arm 102, and at this time, themovable member 200 can be driven to slide along the sliding guide arm 102; after the position of themovable member 200 is determined, the pressing on theclamping plate 900 is released, and since theelastic member 1000 has elastic capability, theelastic member 1000 returns to the original position, and theelastic member 1000 returns to the original position and moves with the clampingplate 900, so that the clampingplate 900 again abuts against the side surface of the guide arm 102, and the two clampingplates 900 clamp the guide arm 102, thereby fixing themovable member 200.

Of course, theelastic member 1000 is generally composed of a plurality of telescopic springs, and has good elastic effect, larger pressure after recovery and stable clamping.

Thepositioning block 202 is also used for positioning the built-in object, thepositioning block 202 is provided with aguide hole 1100, and the built-in object passes through theguide hole 1100 and enters the human body to position the collapsed bone block.

Working principle: when in use, thepositioning end 103 points to the tibia platform, then thethimble 400 is installed, and the collapsed bone block is gradually jacked up in the installation process of thethimble 400 until the top surface of the collapsed bone block and the tibia platform are positioned on the same horizontal line;

determining the installation position of thepositioning needle 500, driving a row of positioningneedles 500 below the collapsed bone pieces, and supporting the collapsed bone pieces by using the positioning needles 500;

driving the built-in object into the collapsed bone piece, fixing the collapsed bone blocks by using the built-in object.

The above is only a specific embodiment of the present invention, but the technical features of the present invention are not limited thereto. Any simple changes, equivalent substitutions or modifications and the like made on the basis of the present invention to solve the substantially same technical problems and achieve the substantially same technical effects are included in the scope of the present invention.

Claims (9)

1. A method for reducing fracture of a tibial plateau, which is characterized in that: the method comprises the following steps:

s1, arranging an observation port, and placing the observation port into an arthroscope to observe the fracture position;

s2, enabling a positioning arm (101) of the universal positioner (100) to point to a fracture position, enabling a thimble (400) to automatically point to a tibia platform, and arranging an operation port at the pointing position of the thimble (400);

s3, enabling a thimble (400) of the positioner (100) to penetrate through the operation opening to enter the lower portion of the tibia platform and jack up the collapsed bone block, so that the top surface of the collapsed bone block and the top surface of the tibia platform are positioned on the same horizontal line;

s4, driving a positioning needle (500) below the tibia platform, and supporting the collapsed bone block by using the positioning needle (500);

s5, driving an internal object into the collapsed bone piece, and fixing the collapsed bone piece by using the internal object;

the positioning needle (500) is arranged on the positioner (100) through the positioning block (202), and the positioning block (202) is also used for guiding the built-in object.

2. A method of tibial plateau fracture reduction according to claim 1, wherein: in S3, the collapsed bone pieces are jacked up by using a plurality of ejector pins (400) to enter the operation port at the same time.

3. A method of tibial plateau fracture reduction according to claim 2, wherein: in S4, a plurality of positioning needles (500) are driven into a position 5mm-1cm below the positioning end (103) of the positioner (100), and the collapsed bone pieces are supported by the plurality of positioning needles (500).

4. A method of tibial plateau fracture reduction according to claim 3, wherein: in S5, the collapsed bone pieces are fixed using the absorbable screw as a inlay.

5. A tibial plateau fracture reduction fixation device applied to the tibial plateau fracture reduction method of claim 4, characterized in that: the fracture positioning device comprises a positioner (100), wherein the positioner (100) comprises a positioning arm (101) and a guide arm (102), the positioning arm (101) and the guide arm (102) are connected into a whole, the end part of the positioning arm (101) is a positioning end (103), and the positioning end (103) is used for pointing to a fracture position; two movable pieces (200) are slidably mounted on the guide arm (102), and connecting pieces (300) are detachably mounted on the two movable pieces (200);

one movable piece (200) is a reset block (201), a connecting piece (300) arranged on the reset block (201) is an ejector piece (301), the other movable piece (200) is a positioning block (202), the connecting piece (300) arranged on the positioning block (202) is a positioning piece (302), a plurality of ejector pins (400) are fixedly arranged on the ejector piece (301), the ejector pins (400) are always directed to a positioning end (103) after being arranged, the ejector pins (400) are used for jacking up collapsed bone blocks, and positioning pins (500) are fixedly arranged on the positioning piece (302);

when the reset piece and the positioning piece (302) are installed, the ends of the thimble (400) and the positioning needle (500) are gradually close to the positioning end (103).

6. A tibial plateau fracture reduction fixation device as claimed in claim 5, wherein: the movable part (200) is provided with a plurality of through holes (600) penetrating through the body of the movable part, the through holes (600) are distributed on the movable part (200) at equal intervals, and the through holes (600) are used for guiding the thimble (400) or the positioning needle (500);

the outer side of the movable piece (200) is attracted to the connecting piece (300) through magnetic force.

7. The tibial plateau fracture reduction fixation device of claim 6, wherein: the connecting piece (300) comprises a positioning part and a fixing part, wherein the movable piece (200) is provided with a mounting groove (700), the mounting groove (700) is used for limiting the positioning part, when the connecting piece (300) is mounted, the positioning part enters the mounting groove (700), and the fixing part is fixed with the outer wall of the movable piece (200) in a suction mode.

8. A tibial plateau fracture reduction fixation device as claimed in claim 7, in which: the movable piece (200) is provided with a sliding hole (800) penetrating through the body of the movable piece, and the guide arm (102) penetrates through the movable piece (200) through the sliding hole (800);

clamping plates (900) are mounted on two opposite side walls of the sliding hole (800) through elastic pieces (1000), the clamping plates (900) penetrate through the sliding hole (800) to extend to the outer sides of the movable pieces (200), the two clamping plates (900) are symmetrically distributed with respect to the guide arms (102), and anti-slip patterns are formed in one sides, close to the guide arms (102), of the clamping plates (900).

9. A tibial plateau fracture reduction fixation device of claim 8, wherein: the positioning block (202) is also used for positioning the built-in object, the positioning block (202) is provided with a guide hole (1100), and the built-in object passes through the guide hole (1100) and enters the human body to position the collapsed bone block.

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