阅读说明：本技术 一种用于髓内钉手术的下肢复位装置 (Lower limb resetting device for intramedullary nail operation ) 是由 张英泽 陈伟 侯志勇 朱燕宾 李守家 于 2019-12-12 设计创作，主要内容包括：本发明公开了一种用于髓内钉手术的下肢复位装置,其包括矩形底板、可伸缩小腿托板、大腿靠板、克氏针和张紧弓,所述矩形底板平放在手术床上,所述可伸缩小腿托板与大腿靠板的上端铰接在一起,二者的下端分别与矩形底板的两端铰接,患者的大腿和小腿分别靠在大腿靠板和可伸缩小腿托板上部,所述克氏针穿过患者的踝骨或胫骨远端,克氏针的两端分别连接在张紧弓的两端,所述张紧弓的每端通过一个可调支架与可伸缩小腿托板连接。本发明可使患者保持在曲腿状态并对其胫骨或股骨进行可靠牵引,而且所有零部件均不高于患者下肢,不影响手术操作。该装置可保证胫骨或股骨髓内钉植入手术的顺利进行,提高手术质量和效率。(The invention discloses a lower limb resetting device for intramedullary nail surgery, which comprises a rectangular base plate, a telescopic shank supporting plate, a thigh backup plate, a Kirschner wire and a tensioning bow, wherein the rectangular base plate is horizontally placed on an operating bed, the telescopic shank supporting plate is hinged with the upper end of the thigh backup plate, the lower ends of the telescopic shank supporting plate and the thigh backup plate are respectively hinged with two ends of the rectangular base plate, thighs and shanks of a patient respectively lean against the upper parts of the thigh backup plate and the telescopic shank supporting plate, the Kirschner wire penetrates through the ankle bones or the tibia far ends of the patient, two ends of the Kirschner wire are respectively connected with two ends of the tensioning bow, and each end of the tensioning bow is connected with the telescopic shank supporting. The invention can keep the patient in the leg bending state and reliably draw the tibia or the femur of the patient, and all parts are not higher than the lower limb of the patient, thereby not influencing the operation. The device can ensure the smooth operation of the tibia or femur intramedullary nail implantation operation and improve the operation quality and efficiency.)

1. The utility model provides a low limbs resetting means for intramedullary nail operation, characterized by includes rectangle bottom plate, scalable shank layer board, thigh backup plate, ke shi needle (4) and tensioning bow (5) in the constitution, the rectangle bottom plate is kept flat on the operation table, scalable shank layer board is in the same place with the articulated upper end of thigh backup plate, and the lower extreme of the two is articulated with the both ends of rectangle bottom plate respectively, and patient's thigh and shank lean on thigh backup plate and scalable shank layer board upper portion respectively, ke shi needle (4) pass patient's ankle bone or shin bone distal end, and the both ends of tensioning bow (5) are connected respectively at the both ends of kirschner needle (4), each end of tensioning bow (5) is connected with scalable shank layer board through an adjustable support.

2. The lower limb resetting device for intramedullary nail surgery according to claim 1, characterized in that the telescopic shank support plate comprises a front support plate (3), a rear support plate (9), a slide rod (7) and a support plate expansion piece (22), the front end of the front support plate (3) is hinged with a rectangular bottom plate, the front end of the rear support plate (9) is opposite to the rear end of the front support plate (3), the rear end of the rear support plate is hinged with a thigh backup plate, one end of the slide rod (7) is fixed on the front support plate (3), the other end of the slide rod is inserted into an axial hole on the rear support plate (9) and is connected with the rear support plate (9) in a sliding manner, and the support plate expansion piece (22) is connected between the front support plate (3) and the rear support plate (9).

3. The lower limb resetting device for intramedullary nail surgery is characterized in that the thigh backup plate comprises a front backup plate (11), a rear backup plate (16), a guide rod (15) and a backup plate expansion piece (19), the front end of the front backup plate (11) is hinged with the rear supporting plate (9), the front end of the rear backup plate (16) is opposite to the rear end of the front backup plate (11), the rear end of the rear backup plate is hinged with the rectangular bottom plate, one end of the guide rod (15) is fixed on the front backup plate (11), the other end of the guide rod is inserted into an axial hole in the rear backup plate (16) and is in sliding connection with the rear backup plate (16), and the backup plate expansion piece (19) is connected between the front backup plate (11) and the rear backup plate (16).

4. The lower limb reduction device for intramedullary nail surgery according to claim 3, characterized in that the front backup plate (11) is provided with a femur far-end fixing device, the femur far-end fixing device comprises two mutually parallel Steiner (30) which passes through the patella or the femur far end of the patient, each end of the two Steiner (30) is connected with the front backup plate (11) through a connecting frame, the connecting frame comprises an L-shaped bent arm (12), a bracket (13) and a locking screw (14), the bracket (13) is fixed on the front backup plate (11), one straight arm of the L-shaped bent arm (12) passes through a through hole on the bracket (13) and is fixed by the locking screw (14), and the other straight arm is fixedly connected with the Steiner (30).

5. The lower limb resetting device for intramedullary nail surgery is characterized in that the structure of the backup plate expansion device (19) and the structure of the supporting plate expansion device (22) are the same and each comprises a stud bolt (28), four movable arms (25), four hinge shafts (26) and two nuts (27), the four movable arms (25) are sequentially connected end to end through the four hinge shafts (26) to form a four-bar structure, the two non-adjacent hinge shafts (26) are respectively fixed on the front supporting plate (3) and the rear supporting plate (9) or respectively fixed on the front backup plate (11) and the rear backup plate (16), the other two hinge shafts (26) are respectively connected with the two nuts (27), two ends of the stud bolt (28) are respectively matched with the two nuts (27) through threads with opposite rotation directions, and one end of the stud bolt (28) is provided with a knob.

6. The lower limb resetting device for intramedullary nail surgery is characterized in that the rectangular bottom plate comprises a front bottom plate (1), a rear bottom plate (18), a guide rail (21) and a locking bolt (20), the front end of the front bottom plate (1) is hinged with the front supporting plate (3), the front end of the rear bottom plate (18) is opposite to the rear end of the front bottom plate (1), the rear end of the rear bottom plate is hinged with the rear backup plate (16), one end of the guide rail (21) is fixed on the front bottom plate (1), the other end of the guide rail (21) is inserted into an axial hole in the rear bottom plate (18) and is in sliding connection with the rear bottom plate (18), and the locking bolt (20) is screwed into a threaded hole in the rear bottom plate (18) and is opposite to the guide rail (21).

7. The lower limb reduction device for intramedullary nail surgery according to claim 6, wherein the adjustable support comprises an upright post (6), a set screw (23) and a push rod (24), the lower end of the upright post (6) is vertically fixed on the front supporting plate (3), the push rod (24) is vertical to the upright post (6), one end of the push rod (24) is fixedly connected with the tension bow (5), and the other end is slidably sleeved on the upright post (6) through a radial through hole and is fixedly connected with the upright post (6) through the set screw (23).

8. The lower limb reduction device for intramedullary nail surgery according to claim 7, characterized in that it further comprises a socket bracket (10), said socket bracket (10) being cylindrical and laterally fixed to the upper end of the front rest plate (11).

9. The lower limb reduction device for intramedullary nail surgery according to claim 8, wherein the front support plate (3) and the rear support plate (9) are provided with a plurality of jacking bolt holes (8), and the jacking bolt holes (8) are uniformly distributed along the center line of the front support plate (3) and the rear support plate (9).

10. The lower limb reduction device for intramedullary nail surgery according to claim 9, characterized in that the lower part of the rectangular base plate is provided with adjustable legs (2).

Technical Field

The invention relates to a lower limb resetting device suitable for a femoral and tibial intramedullary nail implantation operation, belonging to the technical field of orthopedic medical instruments.

Background

The tibia fracture is a common clinical fracture, and due to strong muscle strength of legs, the tibia of a patient is often shortened and deformed under the traction of muscles after being fractured, and the reduction, the length recovery and the effective maintenance in the operation are difficult. If the patient can not be anatomically reduced during the operation, complications such as malformation healing and poor lower limb force line can occur after the operation, thereby causing traumatic arthritis or osteoarthritis and seriously affecting the limb function and the life quality of the patient.

Intramedullary nail fixation is a common treatment method for fracture of tibia or femur, and intraoperative traction is an important means for reducing fracture of tibia or femur and recovering length of lower limb. At present, two assistants are generally needed to help traction a patient during an intramedullary nail implanting operation, the two assistants respectively hold the near end and the far end of a tibia or a femur to restore the tibia or the femur, however, the method cannot stably maintain fracture restoration and lower limb length, the restoration effect is not ideal, and the treatment effect is affected; moreover, the two assistants can crowd the space of the operator and influence the operation of the operator.

The traction device is adopted to reset the fractured tibia or femur to overcome the defects, but the existing traction device generally needs to occupy the upper space of the lower limb of a patient to influence the operation, the existing traction device straightens the lower limb, the intramedullary nail is implanted from the end part of the tibia or the femur, and the patient can only carry out the operation by keeping the leg bending posture. Therefore, it is necessary to design a lower limb reduction device suitable for intramedullary nail operation.

Disclosure of Invention

The invention aims to provide a lower limb reduction device for intramedullary nail operation, aiming at the defects of the prior art, so that a tibia or a femur can be stably kept in a reduction state required by implanting an intramedullary nail under the condition of not influencing operation.

In order to achieve the purpose, the invention adopts the following technical scheme:

the utility model provides a low limbs resetting means for intramedullary nail operation, includes rectangle bottom plate, scalable shank layer board, thigh backup plate, ke shi needle and tensioning bow in the constitution, the rectangle bottom plate is kept flat on the operation table, scalable shank layer board is in the same place with the articulated upper end of thigh backup plate, and the lower extreme of the two is articulated with the both ends of rectangle bottom plate respectively, and patient's thigh and shank lean on respectively on thigh backup plate and scalable shank layer board upper portion, ke shi needle passes patient's ankle bone or shin bone distal end, and the both ends of ke shi needle are connected respectively at the both ends of tensioning bow, each end of tensioning bow is connected with scalable shank layer board through an adjustable support.

The lower limb resetting device for intramedullary nail operation comprises a telescopic shank supporting plate, a front supporting plate, a rear supporting plate, a sliding rod and a supporting plate expansion piece, wherein the front end of the front supporting plate is hinged with a rectangular bottom plate, the front end of the rear supporting plate is opposite to the rear end of the front supporting plate, the rear end of the rear supporting plate is hinged with a thigh backing plate, one end of the sliding rod is fixed on the front supporting plate, the other end of the sliding rod is inserted into an axial hole in the rear supporting plate and is in sliding connection with the rear supporting plate, and the supporting plate expansion piece is connected between the front supporting plate and the rear supporting.

The aforesaid a low limbs resetting means for intramedullary nail operation, the thigh backup plate includes preceding backup plate, back backup plate, guide bar and backup plate expansion bend, the front end and the back layer board of preceding backup plate are articulated, the front end of back backup plate is relative with the rear end of preceding backup plate, and the rear end is articulated with the rectangle bottom plate, the one end of guide bar is fixed on preceding backup plate, and the other end inserts in the axial hole on the backup plate after and with back backup plate sliding connection, the backup plate expansion bend is connected in the front between backup plate and the back backup plate.

The utility model provides a low limbs resetting means for intramedullary nail operation, be equipped with thighbone distal end fixing device on the preceding backup plate, thighbone distal end fixing device includes two schlieren needles that are parallel to each other, and the two passes patient's patella or thighbone distal end, and each end of two schlieren needles is connected with preceding backup plate through a link, the link includes L type curved arm, support and locking screw, the support is fixed on preceding backup plate, a straight arm of L type curved arm passes the through-hole on the support and is fixed by locking screw, another straight arm and schlieren needle fixed connection.

The lower limb resetting device for intramedullary nail operation is characterized in that the structure of the backup plate expansion piece and the structure of the supporting plate expansion piece are the same, the backup plate expansion piece and the supporting plate expansion piece are all composed of a stud bolt, four movable arms, four hinged shafts and two nuts, the four movable arms are sequentially connected into a four-bar structure through the four hinged shafts, the two non-adjacent hinged shafts are respectively fixed on the front supporting plate and the rear supporting plate or are respectively fixed on the front backup plate and the rear backup plate, the other two hinged shafts are respectively connected with the two nuts, the two ends of the stud bolt are respectively matched with the two nuts through rotating to opposite threads, and a knob is arranged at one end of the stud.

The lower limb resetting device for intramedullary nail surgery is characterized in that the rectangular bottom plate comprises a front bottom plate, a rear bottom plate, a guide rail and a locking bolt, the front end of the front bottom plate is hinged to the front supporting plate, the front end of the rear bottom plate is opposite to the rear end of the front bottom plate, the rear end of the rear bottom plate is hinged to the rear backing plate, one end of the guide rail is fixed to the front bottom plate, the other end of the guide rail is inserted into an axial hole in the rear bottom plate and is in sliding connection with the rear bottom plate, and the locking bolt is screwed into a threaded hole in the rear bottom plate and is.

Above-mentioned a low limbs resetting means for intramedullary nail operation, adjustable support includes stand, holding screw and ejector pin, the lower extreme vertical fixation of stand is on preceding layer board, the ejector pin is perpendicular with the stand, the one end and the tensioning bow fixed connection of ejector pin, and the other end passes through radial through-hole slip suit and passes through holding screw and stand fixed connection on the stand.

The lower limb resetting device for intramedullary nail surgery comprises a knee socket bracket which is cylindrical and is transversely fixed at the upper end of the front backup plate.

According to the lower limb resetting device for intramedullary nail surgery, the front supporting plate and the rear supporting plate are provided with the plurality of jacking bolt holes, and the jacking bolt holes are uniformly distributed along the central lines of the front supporting plate and the rear supporting plate.

According to the lower limb resetting device for the intramedullary nail operation, the lower part of the rectangular bottom plate is provided with the adjustable supporting legs.

The invention can keep the patient in the leg bending state and reliably draw the tibia or the femur of the patient, and all parts are not higher than the lower limb of the patient, thereby not influencing the operation. The device can ensure the smooth operation of the tibia or femur intramedullary nail implantation operation and improve the operation quality and efficiency. In addition, the invention has the advantages of simple structure, low cost, reliable performance and the like.

Drawings

The present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a schematic view of the structure of the backup plate retractor and the pallet retractor;

FIG. 3 is a schematic view of a tibial intramedullary nail procedure utilizing the present invention;

fig. 4 is a schematic view of a femoral intramedullary nail surgery utilizing the present invention.

The reference numbers in the figures are as follows: 1. front bottom plate, 2, adjustable supporting legs, 3, front supporting plate, 4, Kirschner wire, 5, tensioning bow, 6, upright post, 7, sliding rod, 8, jacking bolt hole, 9, rear supporting plate, 10, knee socket bracket, 11, front backup plate, 12, L-shaped bent arm, 13, support, 14, locking screw, 15, guide rod, 16, backup plate, 17, rotating shaft, 18, rear bottom plate, 19, backup plate expansion piece, 20, locking bolt, 21, guide rail, 22, supporting plate expansion piece, 23, fastening screw, 24, ejector rod, 25, movable arm, 26, hinge shaft, 27, nut, 28, stud, 29, patient lower limb, 30, Kirschner wire, 31 and binding band.

Detailed Description

Referring to fig. 1 and 2, the adjustable leg support mainly comprises a front bottom plate 1, an adjustable leg support 2, a front supporting plate 3, a kirschner wire 4, a tensioning bow 5, a stand column 6, a sliding rod 7, a rear supporting plate 9, a knee socket bracket 10, a front backup plate 11, an L-shaped bent arm 12, a support 13, a locking screw 14, a guide rod 15, a backup plate 16, a rotating shaft 17, a rear bottom plate 18, a backup plate expansion device 19, a locking bolt 20, a guide rail 21, a supporting plate expansion device 22, a set screw 23, a top rod 24 and a schner wire 30, wherein the backup plate expansion device 19 and the supporting plate expansion device 22 have the same structure and are composed of a movable arm 25, a hinge shaft 26, a nut 27 and a stud 28.

The front bottom plate 1, the rear bottom plate 18, the locking bolt 20 and the guide rail 21 form a rectangular bottom plate with adjustable length, and the rectangular bottom plate is placed on an operating bed and can be adjusted in height through the four adjustable legs 2 at the lower part of the rectangular bottom plate so as to adapt to different patients. The two guide rails 21 are arranged and are parallel to the length direction of the rectangular bottom plate, one ends of the two guide rails are fixed on the front bottom plate 1, the other ends of the two guide rails are inserted into holes in the rear bottom plate 18, the guide rails 21 and the rear bottom plate 18 can slide relatively to adjust the length of the whole rectangular bottom plate, and the two guide rails are locked by the locking bolts 20 after the length is adjusted. The purpose of adjusting the length of the rectangular bottom plate is to change the included angle between the telescopic shank supporting plate and the thigh backing plate, so that the lower limbs of the patient are more comfortable.

The front supporting plate 3, the sliding rods 7, the rear supporting plate 9 and the supporting plate expansion device 22 form a telescopic shank supporting plate, the two sliding rods 7 are parallel to each other, one ends of the two sliding rods 7 are fixed on the front supporting plate 3, the other ends of the two sliding rods are inserted into holes in the rear supporting plate 9, the sliding rods 7 and the rear supporting plate 9 can slide relatively to adjust the length of the telescopic shank supporting plate, the length is adjusted by the supporting plate expansion device 22, and the structure of the supporting plate expansion device 22 is shown in fig. 2. In fig. 2, four movable arms 25 constitute a four-bar linkage, and by rotating a stud 28, the distance between two nuts 27 can be changed, and thus the shape of the four-bar linkage can be changed, and the four-bar linkage can cause relative sliding between a slide bar 7 and a rear blade 9 through two hinge shafts 26, thereby changing the length of a retractable lower leg blade. The supporting plate expansion piece 22 not only can provide enough driving force to realize traction on the lower leg of the patient, but also can arrange the operation knob at the side part of the resetting device, so that the use is more convenient.

The front backup plate 11, the guide rods 15, the rear backup plate 16 and the backup plate expansion piece 19 form a thigh backup plate with adjustable length, the two guide rods 15 are parallel to each other, one ends of the two guide rods 15 are fixed on the front backup plate 11, the other ends of the two guide rods are inserted into holes in the rear backup plate 16, relative sliding can be generated between the guide rods 15 and the rear backup plate 16 to adjust the length of the thigh backup plate, the adjustment of the length is driven by the backup plate expansion piece 19, and the structure of the backup plate expansion piece 19 is shown in fig. 2. The purpose of adjusting the length of the thigh backup plate is two, wherein the length of the thigh backup plate is matched with the length of the thigh of the patient, and the thigh of the patient can be pulled when the femoral intramedullary nail operation is performed.

When traction is performed on the lower leg of a patient, the kirschner wire 4, the tensioning bow 5, the upright post 6, the set screw 23 and the mandril 24 are used for fixing the far end of the tibia or the ankle of the patient, the kirschner wire 4 penetrates through the far end of the tibia or the ankle of the patient, and the tensioning bow 5 is used for tensioning the kirschner wire 4 and prevents the kirschner wire 4 from bending and deforming under the pushing of external force. The upright post 6, the set screw 23 and the mandril 24 form an adjustable bracket, and the height of the tension bow 5 can be adjusted (the mandril 24 slides up and down along the upright post 6) so as to adapt to patients with different body types. The tension bow 5 is the traction bow in a common traction device.

The L-shaped bent arm 12, the support 13, the locking screw 14 and the Steiner 30 form a femur far-end fixing device, when the thigh of a patient is dragged, the femur far-end fixing device can fix the patella or the femur far end of the patient and the front backup plate 11 together, so that the femur far end is lifted together with the front backup plate 11, and the dragging effect is improved.

Jacking bolts can be screwed into the jacking bolt holes 8 in the front supporting plate 3 and the rear supporting plate 9, and when the tibia intramedullary nail operation is performed, the jacking bolts can locally apply upward jacking force to crus of a patient, so that staggered broken ends of the tibia are reset.

The method for performing the tibial intramedullary nail operation by utilizing the invention comprises the following steps:

1. the device is placed on an operating table and placed on the lower part of the lower limb 29 of a patient, the lengths of a thigh backup plate and a telescopic shank supporting plate are adjusted through a backup plate expansion piece 19 and a supporting plate expansion piece 22, meanwhile, a rectangular base plate is adjusted to a proper length and then a locking bolt 20 is screwed, so that a tripod formed by the thigh backup plate, the telescopic shank supporting plate and the rectangular base plate is matched with the size of the lower limb of the patient, and the heights of four adjustable supporting legs 2 are adjusted, so that the rectangular base plate is stable. Finally, the thigh and the shank of the patient lean against the thigh backup plate and the telescopic shank supporting plate respectively;

2. the kirschner wire 4 is passed through the far end of the ankle bone or the tibia of a patient (as shown in figure 3), two ends of the kirschner wire 4 are respectively connected with two ends of a tensioning bow 5, the tensioning bow 5 is made to have enough tensioning force, and a mandril 24 is fixed with an upright post 6 through a set screw 23 after being adjusted to a proper height;

3. the stud bolts 28 in the supporting plate expansion device 22 are rotated to increase the length of the telescopic shank supporting plate, the Kirschner wire 4 and the tensioning bow 5 move towards the direction far away from the thigh backing plate to realize traction on the shank of the patient, and after the original length of the shank of the patient is recovered, the stud bolts 28 in the supporting plate expansion device 22 are stopped rotating;

4. the staggered broken ends of the shin bones are reset by methods of additionally installing jacking bolts, binding belts and the like;

5. performing intramedullary nail implantation operation.

The method for performing the femoral intramedullary nail operation by utilizing the invention comprises the following steps:

1. the device is placed on an operating table and placed on the lower part of the lower limb 29 of a patient, the lengths of a thigh backup plate and a telescopic shank supporting plate are adjusted through a backup plate expansion piece 19 and a supporting plate expansion piece 22, meanwhile, a rectangular base plate is adjusted to a proper length and then a locking bolt 20 is screwed, so that a tripod formed by the thigh backup plate, the telescopic shank supporting plate and the rectangular base plate is matched with the size of the lower limb of the patient, and the heights of four adjustable supporting legs 2 are adjusted, so that the rectangular base plate is stable. Finally, the thigh and the shank of the patient lean against the thigh backup plate and the telescopic shank supporting plate respectively;

2. two Steiner pins 30 are inserted through the patella or the far end of femur of a patient (as shown in figure 4), each end of the two Steiner pins 30 is fixed with the front backup plate 11 through a connecting frame consisting of an L-shaped bent arm 12, a bracket 13 and a locking screw 14, and the lower leg of the patient is fixed on the telescopic lower leg supporting plate through a binding belt 31;

3. the stud bolt 28 in the backup plate expansion piece 19 is rotated to increase the length of the thigh backup plate, the Steiner 30 is lifted to realize the traction of the thigh of the patient, and when the thigh of the patient returns to the original length, the stud bolt 28 in the backup plate expansion piece 19 stops rotating;

4. performing intramedullary nail implantation operation.

The device can ensure that the tibia or the femur stably keeps a reset state required by implanting the intramedullary nail and does not occupy an operation space, is favorable for improving the operation quality and the operation efficiency, and is suitable for popularization and application in various medical institutions.