阅读说明：本技术 一种可撑开固定的髓内钉 (Intramedullary nail capable of being unfolded and fixed ) 是由 孙磊 邢文钊 孙梁 孔志刚 于 2019-10-22 设计创作，主要内容包括：一种可撑开固定的髓内钉,其包括一髓内钉主体,及在髓内钉腔体内移动的可支撑骨腔壁的支撑组件；其中,所述髓内钉主体内设置有空腔,在髓内钉侧壁上设置多个纵向窗口；所述支撑组件在纵向窗口处撑开；所述纵向窗口均匀的围绕髓内钉设置,支撑组件包括对应数目的在纵向窗口伸出的支撑板,每个支撑板上设置上下两个撑开支撑板的支撑杆；每个支撑杆设置在相互分开的两段中心杆上；支撑杆与支撑板及支撑杆与中心杆处为可转动活动的连接方式；在髓内钉底部设置限制前段中心杆移动的阻挡结构；在后段中心杆后端设置保证后段中心杆下移但不转动的移动段,移动段后端设置保证移动段移动的操作结构。通过撑开支撑板使其贴紧骨腔壁,达到固定髓内钉的目的。(An intramedullary nail capable of being fixed in an opening mode comprises an intramedullary nail main body and a supporting component which can move in a cavity of the intramedullary nail and support the wall of the bone cavity; wherein, a cavity is arranged in the intramedullary nail main body, and a plurality of longitudinal windows are arranged on the side wall of the intramedullary nail; the support assembly is spread apart at the longitudinal window; the longitudinal windows are uniformly arranged around the intramedullary nail, the support assembly comprises a corresponding number of support plates extending out of the longitudinal windows, and each support plate is provided with an upper support rod and a lower support rod for expanding the support plates; each supporting rod is arranged on two sections of central rods which are separated from each other; the support rod and the support plate and the support rod and the center rod are in rotatable and movable connection; a blocking structure for limiting the movement of the front section center rod is arranged at the bottom of the intramedullary nail; and the rear end of the rear section center rod is provided with a moving section which ensures that the rear section center rod moves downwards but does not rotate, and the rear end of the moving section is provided with an operating structure which ensures that the moving section moves. The supporting plate is spread to be tightly attached to the wall of the bone cavity, so that the purpose of fixing the intramedullary nail is achieved.)

1. An intramedullary nail capable of being fixed in an opening mode comprises an intramedullary nail main body (1) and a supporting component capable of supporting the wall of a bone cavity and moving in a cavity of the intramedullary nail; it is characterized in that a cavity (11) is arranged in the intramedullary nail main body (1), and a plurality of longitudinal windows (12) are arranged on the side wall of the intramedullary nail; the support assembly is distracted at the longitudinal window (12); the longitudinal window (12) is uniformly arranged around the intramedullary nail, the support component comprises a corresponding number of support plates (21) extending out of the longitudinal window (12), and an upper support rod and a lower support rod (22) for expanding the support plates (21) are arranged on each support plate (21); each supporting rod (22) is arranged on two sections of central rods which are separated from each other; the support rod (22) and the support plate (21) and the support rod (22) and the center rod are in rotatable and movable connection; the bottom of the intramedullary nail is provided with a blocking structure for limiting the movement of the front section central rod (23); in addition, a moving section (25) which ensures that the rear section center rod (24) moves downwards but does not rotate is arranged at the rear end of the rear section center rod (24), and an operation structure (26) which ensures that the moving section (25) moves is arranged at the rear end of the moving section (25).

2. The distractible intramedullary nail according to claim 1, wherein the moving portion (25) comprises a threaded section (251), the threaded section (251) is disposed on the inner sidewall of the intramedullary nail corresponding to the threaded section (251), the moving portion (25) is provided with a notch (261) or a protrusion (262) at the rear end, and the operation structure (26) is provided with a protrusion (262) or a notch (261) at the front end corresponding to the notch (261) or the protrusion (262).

3. The distractible intramedullary nail according to claim 2, wherein the mobile segment (25) is less than 1cm in length; the thread section (251) of the inner side wall of the intramedullary nail is arranged at the rear end of the longitudinal window (12) which is less than 1 cm.

4. The distractible intramedullary nail according to claim 1, wherein the mobile portion (25) is connected in combination with a posterior central rod (24), the front end of the mobile portion (25) being provided with a swivel (252) extending into the central rod, the central rod being provided with a swivel groove (253) for receiving the swivel (252).

5. The distractible intramedullary nail according to claim 1, wherein the distance between the anterior central rod (23) and the posterior central rod (24) is greater than the size required to distract the support plates (21).

6. The distractible intramedullary nail according to claim 1, wherein a return spring (3) is provided between the anterior central rod (23) and the posterior central rod to ensure that each support plate (21) encloses a diameter smaller than the diameter of the intramedullary nail cavity (11) when the support assembly needs to be withdrawn.

7. The distractible intramedullary nail according to claim 1, wherein the blocking structure is a foraminous blocking plate (13) disposed within the intramedullary nail cavity (11) and at a forward end of the longitudinal window (12).

8. The distractible intramedullary nail according to claim 1, wherein 3-6 longitudinal windows (12) are provided around the intramedullary nail sidewall; wherein preferably 3 longitudinal windows (12) are provided.

9. The distractible intramedullary nail according to any one of claims 1 to 8, wherein the support plate (21) is provided as an arc having a length smaller than the longitudinal window (12) and is extendable from the longitudinal window (12).

10. The distractible intramedullary nail according to any one of claims 1-8, wherein the posterior end of the intramedullary nail is provided with a detachable handle structure (4), the handle structure (4) being provided with a curved shape.

Technical Field

The invention belongs to the technical field of medical instruments for orthopedic surgery, in particular relates to a surgical instrument for treating fracture through a medullary cavity, and particularly relates to an intramedullary nail capable of being unfolded and fixed.

Background

Fracture refers to the continuous complete or partial breakdown of bone structure. It is common to children and the elderly, and occurs in the middle-aged and young. Patients often have one site fractured and a few multiple fractures. After timely and proper treatment, most patients can recover the original functions, and a few patients can leave sequelae with different degrees.

The method of fracture fixation is divided into external fixation and internal fixation, and fracture internal fixation refers to an operation in which a broken bone is directly connected and fixed in the broken bone by using metal screws, steel plates, intramedullary nails, steel wires or bone plates and the like when fracture occurs.

Intramedullary nail internal fixation is often used for long-tube bone (such as femur, humerus, ulna, tibia, radius, etc.) diaphysis fracture. The advantages are that: the intramedullary nail is firm and firm, can be fixed with little or no external fixation after operation, and is beneficial to the early movement and exercise of injured limbs; the skin incision is small, the periosteum stripping range is limited, and the damage is small; the intramedullary nail is long and has edges and corners with different shapes, and is embedded into a medullary cavity, so that firm internal fixation can be achieved, the occurrence of rotation, lateral movement and angular displacement can be avoided, and the clinical effect is better.

However, the operation difficulty of the current clinical intramedullary nail internal fixation is high and depends on the operation experience of an operator, in the operation process, the operation instrument needs to be frequently replaced, the operation process is complicated, the operation time is long, and the operation risk of a patient is increased. In addition, because of individual difference of patients and different thickness of bone cavities, intramedullary nails fixed in the bone cavities are easy to slightly move to form bone nonunion; the broken end in the bone cavity is easy to form an angle due to different thicknesses in the cavity, for the angle, the problem is solved by using a blocking nail or a kirschner wire at present, but the use of the blocking nail and the kirschner wire is invasive operation, the skin needs to be broken, the operation is carried out under the radiation irradiation, and both a patient and a doctor need to be injured by the rays; in addition, the operation requirements on the doctor are very high, the doctor does not always succeed at one time, in addition, the desired reduction effect cannot be achieved, the error operation is easy to cause, and finally, the patient is greatly injured, and the prognosis is influenced.

Aiming at the problems that in the prior art, surgical instruments are frequently replaced in the process of intramedullary nail internal fixation, the operation process is complicated; and because of individual difference of patients, the thickness of the bone cavity is different, the intramedullary nail fixed in the bone cavity is not easy to be fixed, thereby forming the problem of bone nonunion or angulation of the broken end, and providing the intramedullary nail which can be unfolded and fixed.

Disclosure of Invention

In order to overcome the problems that the intramedullary nail in the prior art is easy to shake in a bone cavity, has high operation difficulty and multiple steps, the invention provides the expandable and fixable intramedullary nail.

An intramedullary nail capable of being fixed in an opening mode comprises an intramedullary nail main body and a supporting component which can move in a cavity of the intramedullary nail and support the wall of the bone cavity; it is characterized in that a cavity is arranged in the intramedullary nail main body, and a plurality of longitudinal windows are arranged on the side wall of the intramedullary nail; the support assembly is spread apart at the longitudinal window; the longitudinal windows are uniformly arranged around the intramedullary nail, the support assembly comprises a corresponding number of support plates extending out of the longitudinal windows, and an upper support rod and a lower support rod for expanding the support plates are arranged on each support plate; each supporting rod is arranged on two sections of central rods which are separated from each other; the support rod and the support plate and the support rod and the center rod are in rotatable and movable connection; a blocking structure for limiting the movement of the front section center rod is arranged at the bottom of the intramedullary nail; in addition, a moving section which ensures that the rear section center rod moves downwards but does not rotate is arranged at the rear end of the rear section center rod, and an operation structure which ensures that the moving section moves is arranged at the rear end of the moving section. The operation structure drives the moving section to move forwards, so that the rear section center rod is driven to move forwards, the supporting plate is propped open, the supporting plate is tightly attached to the wall of the bone cavity, the purpose of preventing the intramedullary nail from moving is effectively achieved, and frequent operation can be reduced in the operation.

Furthermore, the movable section comprises a thread section, the thread section corresponding to the thread section is arranged on the inner side wall of the intramedullary nail, a notch or a protrusion is arranged at the rear end of the movable section, and the front end of the operation structure is arranged in the protrusion or the notch corresponding to the notch or the protrusion, so that the operation of the operation structure on the movable section is ensured.

Further, the length of the moving segment is less than 1 cm; the rear end of the longitudinal window arranged on the thread section of the inner side wall of the intramedullary nail is less than 1cm, the arrangement can ensure that the front and the rear of the intramedullary nail are kept in a cavity arrangement on the premise of fixing the intramedullary nail, and after the operation structure is withdrawn, other structures are arranged at the front end or the rear end of the intramedullary nail.

Furthermore, the front end of the operation structure and the rear end of the moving section are provided with corresponding magnetic sheets, and the arrangement can ensure that the support assembly is adsorbed and taken out when withdrawn.

Furthermore, the rear end of the operation structure is provided with a cylindrical handle which is convenient to operate, and the cylindrical handle extends out of the rear end of the intramedullary nail, so that the movable section is convenient to adjust.

Furthermore, the rear end of the operation structure is provided with an extending scale, and the position and the opening condition of the front supporting plate can be known through the observation of the scale.

Furthermore, the rear end of the moving section is provided with a cross or hexagonal notch, and the front end of the operation structure is provided with a cross or hexagonal protrusion, so that the structure is convenient to arrange.

Furthermore, remove section and back end in the well core rod built-up connection, remove the section front end and set up the swivel that stretches into in the well core rod, set up the rotary trough that supplies the swivel to put into in the well core rod, through the connected mode of swivel rotary trough, can effectively realize rotating the antedisplacement of removal section through operation structure, and drive back end in the well core rod antedisplacement and the purpose that does not rotate. The whole operation is smoother.

Or the moving section is adhered to the middle rod at the rear section together, the moving section is made of a material with certain elasticity, the moving section is provided with a protruding structure, the intramedullary nail is provided with a small recess for the protruding structure to enter, and the moving section is pushed forward by the operating structure under the action of large force so as to drive the middle rod at the rear section to move, so that the supporting plate is propped open.

Furthermore, the connection between the support rod and the support plate and between the support rod and the front section and the rear section center rods are connected through correspondingly arranged hanging rings. The design of the corresponding hanging ring can ensure that the supporting rod is rotatably connected with the supporting plate and the supporting rod is rotatably connected with the front section and the rear section center rods, so that the supporting plate is effectively unfolded.

Or the connection between the support rod and the support plate and between the support rod and the central rods of the front section and the rear section are connected in an anchoring and rotating connection mode, and a small short plate for the arrangement of the anchoring rod is arranged at the connection position.

Further, the distance between the front section central rod and the rear section central rod is larger than the size required by the support plate to be propped open.

Furthermore, a reset spring is arranged between the front section center rod and the rear end center rod, so that the diameter enclosed by each supporting plate is smaller than the diameter of the intramedullary nail cavity when the supporting component needs to be withdrawn, and the supporting component is conveniently withdrawn.

Furthermore, the blocking structure is a perforated blocking plate which is arranged in the cavity of the intramedullary nail and is arranged at the front end of the longitudinal window; the arrangement can effectively ensure the stop motion of the center rod at the front end, and the unsmooth movement of the intramedullary nail caused by the negative pressure action is avoided due to the arrangement of the holes.

Further, 3-6 longitudinal windows are arranged around the side wall of the intramedullary nail; wherein preferably 3 longitudinal windows are provided.

Furthermore, the supporting plate is arranged to be an arc-shaped plate which can extend out of the longitudinal window, the length of the arc-shaped plate is smaller than that of the longitudinal window, the supporting plate can be guaranteed to pass in and out through the arrangement, and the bone cavity can be effectively contacted and supported.

Furthermore, the back end of the intramedullary nail is provided with a detachable handle structure, the handle structure is provided with a bent shape, the intramedullary nail is convenient to hold by hands and operate, and the detachable intramedullary nail is convenient to detach after use.

Furthermore, the front side and the rear side of the intramedullary nail are also provided with fixing nail holes, so that the intramedullary nail is convenient to further fix, and the number of the nail holes is obviously less than that of the existing intramedullary nail.

Further, the longitudinal opening may be extended backwards by means of the threaded section, which is arranged to allow irrigation, administration, implantation of material etc. through the longitudinal opening.

When in use, the supporting component is firstly extended into the intramedullary nail, then the detachable handle structure is arranged at the rear end of the intramedullary nail, and then the supporting plate is inserted into the longitudinal window by utilizing the operation structure and cannot exceed the outer side wall of the intramedullary nail; combining the moving section of the support component with the corresponding part of the intramedullary nail, then placing the intramedullary nail into a bone cavity and reaching a proper position, then controlling the moving section to move forwards through an operation structure to open the support component, supporting the wall of the bone cavity by a support plate, placing the swinging and the front-back movement of the intramedullary nail, and withdrawing the operation structure for other operations when other operation chambers are needed; after the fracture part is healed, the moving section is driven to retreat through the operation structure, the aim of retracting the supporting component is achieved, and the intramedullary nail is taken out by utilizing the conventional means.

Compared with the intramedullary nail instrument in the prior art, the technical scheme of the invention fully utilizes the space of the inner cavity of the intramedullary nail, solves the problem of the intramedullary nail shaking in the marrow cavity by arranging the internal fixing structure in the intramedullary nail, and can carry out operations of flushing, medicine application, material implantation and the like on the marrow cavity by arranging the extension of the longitudinal opening. When in use, the fixing nail can be less implanted or not implanted, so that the surgical instrument does not need to be frequently replaced, the surgical steps are simplified, the surgical time is shortened, the pain of a patient is relieved, and the multifunctional surgical instrument integrates multiple functions, has low cost and is convenient for wide popularization.

Drawings

FIG. 1 is a schematic view of the entire structure of an expandable and fixable intramedullary nail of the present invention;

FIG. 2 is a schematic longitudinal sectional view of an intramedullary nail for distraction fixation according to the present invention;

FIG. 3 is a schematic longitudinal sectional view of the entire internal non-operative structure of the distractible and fixable intramedullary nail of the present invention;

FIG. 4 is a longitudinal sectional view of a non-operative structure and a handle structure in an intramedullary nail for distraction fixation according to the present invention;

FIG. 5 is a schematic cross-sectional view of a longitudinal opening of an expandable intramedullary nail according to the present invention;

FIG. 6 is a partial longitudinal cross-sectional structural schematic view of an distractible intramedullary nail support assembly of the present invention;

FIG. 7 is a partial overall view of a distractible and fixable intramedullary nail support assembly of the present invention;

FIG. 8 is a schematic view of a distracting and fixing intramedullary nail support plate and a partially enlarged central rod structure of the present invention;

FIG. 9 is a partially enlarged structural view of the rear end of the expandable intramedullary nail support assembly and the front end of the operation structure according to the present invention;

FIG. 10 is an enlarged partial longitudinal cross-sectional structural view of the posterior end of the expandable intramedullary nail support assembly and the anterior end of the operation structure in accordance with the present invention;

FIG. 11 is a partially enlarged structural view of the rear end of the distracting and fixing intramedullary nail support assembly with magnetic plates and the front end of the operation structure according to the present invention;

FIG. 12 is an overall structure view of an operation structure with an extension scale;

in the drawings, 1, an intramedullary nail main body; 11. a cavity; 12. a longitudinal window; 13. a perforated barrier plate; 21. a support plate; 22. a support bar; 23. a front section center rod; 24. a rear section center rod; 25. a moving section; 251. a threaded segment; 252. rotating the ring; 253. rotating the groove; 254. hanging a ring; 26. an operating structure; 261. a notch; 262. bulging; 263. a magnetic sheet; 264. a cylindrical handle; 265. stretching into the scale; 3. a return spring; 4. a handle structure.

Detailed Description