CN111134817A - Bone moving device based on intramedullary nail system - Google Patents

Bone moving device based on intramedullary nail system Download PDF

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Publication number
CN111134817A
CN111134817A CN202010114264.5A CN202010114264A CN111134817A CN 111134817 A CN111134817 A CN 111134817A CN 202010114264 A CN202010114264 A CN 202010114264A CN 111134817 A CN111134817 A CN 111134817A
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nail
bone
traction
intramedullary nail
rope lock
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CN202010114264.5A
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Chinese (zh)
Inventor
任广凯
吴丹凯
彭传刚
袁宝明
刘贺
吴阳
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Priority to CN202010114264.5A priority Critical patent/CN111134817A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66Alignment, compression or distraction mechanisms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7216Intramedullary pins, nails or other devices for bone lengthening or compression
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564Methods for bone or joint treatment

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurology (AREA)
  • Surgical Instruments (AREA)

Abstract

A bone moving device based on an intramedullary nail system, which comprises an intramedullary nail, a traction device main nail and a traction rope lock, the intramedullary nail provides stable support for the limb with bone defect, the main nail of the retractor passes through the nail hole of the intramedullary nail or is fixed in the far-end or near-end normal bone of the bone defect through the side of the intramedullary nail, the traction device main nail is provided with a slide way for the movement of the traction rope lock in the axial direction, the head end of the traction rope lock is fixed on the traction device of the traction device main nail, the tail end of the traction rope lock is fixedly connected on the active bone block for osteotomy through a drill hole after being extended through the slide way, the movable traction device drives the traction rope lock to drive the active bone block for osteotomy to move, the device utilizes the principle that the retractor on the retractor main nail winds in a single direction, and through the traction rope lock, thereby drawing the cut active bone block to generate osteogenesis effect with the original normal bone tissue, and achieving the clinical purpose of bone transfer and bone defect treatment.

Description

Bone moving device based on intramedullary nail system
Technical Field
The invention relates to the technical field of medical instruments, in particular to a bone moving device based on an intramedullary nail system.
Background
The defects of long bones of limbs are often caused by severe open comminuted fracture, postoperative infection of fracture, osteomyelitis massive necropsy and bone resection of large bone segments in bone tumor operation, which are often accompanied by limb shortening, deformity, osteomyelitis, muscular atrophy and adjacent joint stiffness, and are one of the most difficult problems in the orthopedic field.
Bone transport technology (bone transport) was the original method of treating bone defects by the illizaloff physician in the 70 th 20 th century, and gradually used in clinic after the 80 th century, it was called one of the "three milestones of orthopedics in the twentieth century.
The existing bone moving technology provides stable support for the limb with bone defect through an external fixator or an extension system combining an intramedullary nail and the external fixator, then cuts off normal bones at the upper end or the lower end of a backbone with bone defect, depends on the fixation of a movable steel needle of an external fixing frame, moves bone blocks with bioactivity after the bone cutting at a speed of 1mm every day, leads the bone blocks to be gradually interfered with the corresponding broken ends of the bone defect, and then repairs the bone defect.
The existing external fixing bracket is heavy in design and inconvenient for postoperative care, and particularly, serious complications such as nail path infection, joint stiffness and the like easily occur when a plurality of steel needles are used for fixing the far end and the near end of a bone defect through skin. Local nerves are stimulated due to traction of the Kirschner wires or the half nails at the initial stage of bone movement, edema at the initial stage of bone movement is not resolved yet, local tension is large, and in addition, bone segment movement causes a high-tension environment of excessive traction and local compression of nerves; in the case of a large bone defect, the cutting action of the kirschner wire or the half nail on the skin during the moving process, so that the patient feels severe pain in the initial or long-term bone moving process, and even the treatment is required to be abandoned actively due to the intolerable pain.
Disclosure of Invention
The invention aims to provide a bone moving device based on an intramedullary nail system, which is used for solving the problems in the prior art.
The technical scheme adopted by the invention is as follows: the traction device main nail penetrates through a nail hole of the intramedullary nail or is fixed in a bone defect far-end or near-end normal bone through the lateral side of the intramedullary nail, a slide way for the traction rope lock to move is arranged in the axial direction of the traction device main nail, the head end of the traction rope lock is fixed on the traction device of the traction device main nail, the tail end of the traction rope lock is fixedly connected to an active bone block for osteotomy through a drill hole after being extended through the slide way, and the movable traction device drives the traction rope lock to pull the active bone block for osteotomy to move.
The working principle of the invention is as follows:
the device utilizes the principle that the retractor on the retractor main nail winds in a single direction, and pulls the cut active bone blocks through the pulling rope lock, so that the bone forming effect is generated between the active bone blocks and the original normal bone tissues, and the clinical purpose of treating bone defects by bone moving is achieved.
The far and near ends of the bone defect are fixed by adopting the center of an intramedullary nail system, the main nail of the traction device passes through a nail hole of the intramedullary nail or is fixed in the far end or near end normal bone of the bone defect through the side of the intramedullary nail, a slide way for the traction rope lock to move is arranged in the axial direction of the main nail of the traction device, the head end of the traction rope lock is fixed on the traction device of the main nail of the traction device, the tail end of the traction rope lock is bound and fixedly connected on the active bone block of the osteotomy through a drilling hole, and the movable traction device drives the traction rope lock to drive the active bone block of the osteotomy to. The soft tissue is prevented from being irritated by the traction rope lock in the whole traction osteogenesis process, and the simplification and painless treatment of the bone moving technology can be effectively realized.
The invention has the beneficial effects that:
1. the device combines the intramedullary nail and the bone traction device to maintain the stability of osteotomy, a heavy external fixing bracket is not needed to be worn in the bone moving process, and a patient can systematically carry out rehabilitation training in the bone moving process, thereby realizing a simple, effective and painless bone moving technology.
2. In order to further improve the overall stability of the device, the anti-rotation nail and the anti-rotation nail fixing device are arranged, the anti-rotation nail and the anti-rotation nail fixing device can prevent the main nail of the tractor from rotating in the traction process, the universal joint with the locking function can change the angle of the anti-rotation nail placed in the bone of a patient according to actual needs, and the device is more practical.
3. After the adjusting screw rod rotates for a certain angle, the traction rope lock can drive the osteotomy active bone block to move, the traction rope lock can be wound in the spiral winding groove, and the moving distance and speed of the active bone block can be accurately regulated and controlled through the scale adjusting disc arranged at the head end of the traction sleeve.
Drawings
FIG. 1 is a schematic view of the connection of the retractor main nail, the pull cord lock and the anti-spin nail fixture.
Fig. 2 is a cross-sectional view of the connection of the retractor main nail, the pull cord lock and the anti-spin nail fixture.
Fig. 3 is an enlarged partial cross-sectional view of the connection of the retractor main spike, the pull cord lock and the anti-spin spike fixation device.
Figure 4 is a cross-sectional view of the retractor main spike and anti-spin spike fixation device connection.
Fig. 5 is a schematic view of the structure of the adjustment lever.
Fig. 6 is a partially enlarged schematic view at a in fig. 4.
FIG. 7 is a cross-sectional view of the connection of the shank and the pulling sleeve.
Fig. 8 is a cross-sectional view of the anti-spin fastener assembly.
Figure 9 is a schematic view of the cooperation of the dial and the reference indicator.
Fig. 10 is a perspective view of the anti-spin fastener device.
Fig. 11 is a schematic structural view of the anti-spin nail fixture.
Fig. 12 is a sectional view at B-B in fig. 11.
Fig. 13 is a cross-sectional view of the present invention.
Fig. 14 is a schematic structural view of the present invention.
Fig. 15 is a schematic view of the present invention installed in a long bone defect.
Detailed Description
Referring to fig. 1 to 14, a bone moving device based on an intramedullary nail system comprises an intramedullary nail 1, a retractor main nail 2 and a retractor lock 3, wherein the retractor main nail 2 passes through a nail hole of the intramedullary nail or is fixed in a bone defect far end or near end normal bone through the side of the intramedullary nail, a slide way 25 for the movement of the retractor lock 3 is arranged in the axial direction of the retractor main nail 2, the head end of the retractor lock 3 is fixed on a retractor of the retractor main nail 2, the tail end of the retractor lock 3 is fixedly connected on an osteotomy active bone block through a drill hole after extending through the slide way 25, and the retractor is moved to drive the retractor lock 3 to pull the active bone block of the osteotomy for moving.
Furthermore, the main nail 2 of the retractor comprises a nail body 20, an adjusting rod 21 and a traction sleeve 22, wherein a slideway 25 is arranged in the nail body 20, the head end of the traction rope lock 3 is fixedly connected to the adjusting rod 21, the adjusting rod 21 and the traction sleeve 22 are matched to perform unidirectional irreversible movement along the axial direction of the traction sleeve 22, and the unidirectional irreversible movement refers to that the adjusting rod 21 always performs forward movement along the axial direction of the traction sleeve 22 and cannot retreat, or performs backward movement along the axial direction of the traction sleeve 22 and cannot advance.
Furthermore, the adjusting rod 21 is an adjusting screw, and the inner cavity of the pulling sleeve 22 is provided with an internal thread 220 matched with the adjusting screw.
Furthermore, the inner cavity of the tail end of the traction sleeve 22 is fixedly connected with a linear bearing 24, the inner cavity of the linear bearing 24 is axially connected with a one-way bearing 23 in a sliding manner, and the tail end of the adjusting screw rod is fixedly connected to the inner ring of the one-way bearing 23.
Furthermore, the bone traction device further comprises an anti-rotation nail 5 and an anti-rotation nail fixing device 4, the head end of the anti-rotation nail fixing device 4 is fixedly connected to the tail end of the traction sleeve 22, and the anti-rotation nail 5 penetrates through the anti-rotation nail fixing device 4 and is fixed in a nail hole of the intramedullary nail 1 or is fixed in a normal bone through the side of the intramedullary nail.
Furthermore, the anti-spin nail fixing device 4 comprises a universal joint 40 with a locking function and an anti-spin nail clamp 41, wherein the tail end of the universal joint 40 with the locking function is fixedly connected with the tail end of the traction sleeve 22, and the adjusting end of the universal joint 40 with the locking function is fixedly connected with the head end of the anti-spin nail clamp 41.
Furthermore, the universal joint 40 with the locking function is a straight rod-shaped ball head rod end joint bearing with the locking function, and is composed of a straight rod-shaped ball head 400 and a shell 401 for rotating the ball head, wherein 3 adjustable studs 402 are uniformly arranged on the shell 401 in the radial direction, and the straight rod-shaped ball head 400 is locked by the 3 adjustable studs 402 in the locking state.
Furthermore, the anti-rotation nail clamp 41 comprises a clamp base 410 and clamp arms 411, the tail ends of the clamp arms 411 and the clamp base 410 are hinged through a hinge, the clamp base 410 and the clamp arms 411 are connected through a detachable locking bolt, and a clamping groove for clamping the anti-rotation nail 5 is formed between the clamp base 410 and the clamp arms 411.
More specifically, the adjusting rod 21 includes a winding area 210 and a pulling area 211, a spiral winding groove 212 extending along the axial direction of the adjusting rod 21 is uniformly formed on the outer surface of the winding area 210, and the width of the spiral winding groove 212 is equal to the diameter of the pulling rope lock 3.
Furthermore, the traction rope lock 3 is a titanium cable, a clamping block 30 is arranged on the traction rope lock 3, and the tail end of the traction rope lock 3 is fixed on the traction rope lock 3 through the clamping block 30 after being wound on a osteotome.
Furthermore, the head end of the pulling sleeve 22 is provided with a scale adjusting disc 222, and the head end of the adjusting bolt is provided with a reference indicator 221.
The working principle and the using process of the embodiment are as follows:
when in use, the intramedullary nail 1 is fixed in a bone cavity of a patient, the far end and the near end of a bone defect are fixed at the center, the main nail 2 of the retractor penetrates through a nail hole of the intramedullary nail or is fixed in a normal bone at the far end or the near end of the bone defect through the side of the intramedullary nail, a kirschner wire is used for drilling at the far end or the near end of the bone defect, the tail end of the traction rope lock 3 penetrates through a kirschner wire hole to be wound on a bone segment to be cut off, the fixing mode can be locked by the U-shaped clamping block 30 or by other clamping mechanisms, then the bone is cut at the metaphysis end, and the bone segment fixed at the tail end of the traction rope lock 3 is dissociated into an active bone block which needs to be moved. In order to further improve the overall stability of the device, the anti-rotation nail 5 and the anti-rotation nail fixing device 4 play a role in assisting and fixing the retractor main nail 2, the retractor main nail 2 is prevented from rotating in the traction process, the universal joint 40 with the locking function can change the angle of the anti-rotation nail 5 placed in the bone of a patient according to actual needs, and the device is more practical.
After the adjusting screw rod rotates a certain angle on the tractor, the adjusting screw rod will move along the axial direction of the traction sleeve 22, the one-way bearing 23 arranged at the rear end of the adjusting screw rod can ensure that the adjusting screw rod does a single-direction irreversible rotation movement, the linear bearing 24 can ensure that the one-way bearing 23 and the adjusting screw rod can only slide along the axial direction, the axial movement distance of the one-way bearing 23 relative to the linear bearing 24 is equal to the axial movement distance of the adjusting screw rod relative to the traction sleeve 22, it should be noted that the one-way bearing 23 can only do axial movement in the linear bearing 24 and can not do radial rotation movement, this is limited by the structure of the linear bearing 24 itself, the linear bearing 24 is prior art, and after the adjusting screw rod rotates a certain angle, the pulling rope lock 3 will drive the osteotomy active bone block to move, and the pulling rope lock 3 can be wound in the spiral winding groove 212. The distance and the speed of the moving of the active bone blocks are accurately regulated and controlled by a scale adjusting disc 222 arranged at the head end of the traction sleeve 22.

Claims (10)

1. A bone moving device based on an intramedullary nail system is characterized in that: the bone cutting device comprises an intramedullary nail (1), a retractor main nail (2) and a retractor rope lock (3), wherein the retractor main nail (2) penetrates through a nail hole of the intramedullary nail or is fixed in a bone defect far-end or near-end normal bone through the side of the intramedullary nail, a slide way (25) for the movement of the retractor rope lock (3) is arranged in the axial direction of the retractor main nail (2), the head end of the retractor rope lock (3) is fixed on a retractor of the retractor main nail (2), the tail end of the retractor rope lock (3) is fixedly connected to a bone cutting active bone block through a drill hole after being extended through the slide way (25), and the movable retractor drives the retractor rope lock (3) to pull the bone cutting active bone block to move.
2. The intramedullary nail system based bone mobilization device of claim 1, wherein: the traction device main nail (2) comprises a nail body (20), an adjusting rod (21) and a traction sleeve (22), a slideway (25) is arranged in the nail body (20), the head end of a traction rope lock (3) is fixedly connected to the adjusting rod (21), and the adjusting rod (21) and the traction sleeve (22) are matched to do single-direction irreversible rotation movement along the axial direction of the traction sleeve (22).
3. The intramedullary nail system based bone mobilization device of claim 2, wherein: the adjusting rod (21) is an adjusting screw rod, an inner cavity of the traction sleeve (22) is provided with an internal thread (220) matched with the adjusting screw rod, the head end of the traction sleeve (22) is provided with a scale adjusting disc (222), and the head end of the adjusting bolt is provided with a reference indicator (221).
4. The intramedullary nail system based bone mobilization device of claim 2, wherein: the inner cavity of the tail end of the traction sleeve (22) is fixedly connected with a linear bearing (24), the inner cavity of the linear bearing (24) is axially and slidably connected with a one-way bearing (23), and the tail end of the adjusting screw rod is fixedly connected to an inner ring of the one-way bearing (23).
5. The intramedullary nail system based bone mobilization device of claim 2, wherein: the adjusting rod (21) comprises a winding area (210) and a drawing area (211), wherein spiral winding grooves (212) extending along the axial direction of the adjusting rod (21) are uniformly formed in the outer surface of the winding area (210), and the width of each spiral winding groove (212) is equal to the diameter of the drawing rope lock (3).
6. A bone migration device based on an intramedullary nail system according to any one of claims 1 to 5, characterized in that: still including preventing soon nail (5) and preventing soon nail fixing device (4), prevent soon nail fixing device (4) head end link firmly at the end of tractive sleeve (22), prevent soon nail (5) pass and prevent soon nail fixing device (4) and fix in intramedullary nail (1) nail hole or be fixed in normal sclerotin through intramedullary nail side.
7. The intramedullary nail system based bone mobilization device of claim 6, wherein: the anti-rotation nail fixing device (4) comprises a universal joint (40) with a locking function and an anti-rotation nail clamp (41), the tail end of the universal joint (40) with the locking function is fixedly connected with the tail end of the traction sleeve (22), and the adjusting end of the universal joint (40) with the locking function is fixedly connected with the head end of the anti-rotation nail clamp (41).
8. The intramedullary nail system based bone mobilization device of claim 7, wherein: universal joint (40) of area locking function for taking locking function's straight rod-shaped bulb rod end joint bearing, constitute by straight rod-shaped bulb (400) and supply bulb pivoted casing (401), evenly be provided with 3 adjustable double-screw bolts (402) in casing (401) radial direction, 3 adjustable double-screw bolts (402) die straight rod-shaped bulb (400) lock when locking state.
9. The intramedullary nail system based bone mobilization device of claim 7, wherein: the anti-rotation nail clamp (41) comprises a clamp base body (410) and clamping arms (411), the tail ends of the clamping arms (411) and the clamp base body (410) are hinged through a hinge shaft, the clamp base body (410) and the clamping arms (411) are connected through detachable locking bolts, and a clamping groove for clamping the anti-rotation nail (5) is formed between the clamp base body (410) and the clamping arms (411).
10. A bone mover device based on an intramedullary nail system, according to any one of claims 1, 2, 3, 4, 5, 7, 8 or 9, wherein: the traction rope lock (3) is a titanium cable, a clamping block (30) is arranged on the traction rope lock (3), and the tail end of the traction rope lock (3) is wound on the osteotomy and then fixed on the traction rope lock (3) through the clamping block (30).
CN202010114264.5A 2020-02-25 2020-02-25 Bone moving device based on intramedullary nail system Pending CN111134817A (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024199090A1 (en) * 2023-03-29 2024-10-03 熊海阔 Intramedullary guide device

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0383419A1 (en) * 1989-02-15 1990-08-22 Johnson & Johnson Professional Products GmbH Orthopaedic fixator
US5429638A (en) * 1993-02-12 1995-07-04 The Cleveland Clinic Foundation Bone transport and lengthening system
US5626579A (en) * 1993-02-12 1997-05-06 The Cleveland Clinic Foundation Bone transport and lengthening system
CN101543425A (en) * 2009-02-18 2009-09-30 曹莹莹 Anti-rotary automatic-lock intramedullary nail of primary-secondary type
DE202010012927U1 (en) * 2010-11-18 2011-01-20 Matveev, Anatoly L. Apparatus for the endoprosthesis of the hip joint with replacement of the joint surfaces and for the operative prophylaxis of thigh fractures in the proximal region in osteoporosis
US20110060336A1 (en) * 2009-09-04 2011-03-10 Ellipse Technologies, Inc. Bone growth device and method
CN205597995U (en) * 2015-12-14 2016-09-28 重庆医科大学附属永川医院 Be used for damaged bone handling device of big section bone of osteoporosis patient's thighbone
US20180078290A1 (en) * 2016-09-22 2018-03-22 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
CN108498149A (en) * 2018-07-13 2018-09-07 任广凯 A kind of titanium cable drawing bone Filtting device and its application method
CN109157276A (en) * 2018-09-26 2019-01-08 深圳市龙华区中心医院 It is a kind of to digitize controllable constant force bone Filtting device
CN211610018U (en) * 2020-02-25 2020-10-02 吴丹凯 Bone moving device based on intramedullary nail system

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0383419A1 (en) * 1989-02-15 1990-08-22 Johnson & Johnson Professional Products GmbH Orthopaedic fixator
US5429638A (en) * 1993-02-12 1995-07-04 The Cleveland Clinic Foundation Bone transport and lengthening system
US5626579A (en) * 1993-02-12 1997-05-06 The Cleveland Clinic Foundation Bone transport and lengthening system
CN101543425A (en) * 2009-02-18 2009-09-30 曹莹莹 Anti-rotary automatic-lock intramedullary nail of primary-secondary type
US20110060336A1 (en) * 2009-09-04 2011-03-10 Ellipse Technologies, Inc. Bone growth device and method
DE202010012927U1 (en) * 2010-11-18 2011-01-20 Matveev, Anatoly L. Apparatus for the endoprosthesis of the hip joint with replacement of the joint surfaces and for the operative prophylaxis of thigh fractures in the proximal region in osteoporosis
CN205597995U (en) * 2015-12-14 2016-09-28 重庆医科大学附属永川医院 Be used for damaged bone handling device of big section bone of osteoporosis patient's thighbone
US20180078290A1 (en) * 2016-09-22 2018-03-22 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
CN108498149A (en) * 2018-07-13 2018-09-07 任广凯 A kind of titanium cable drawing bone Filtting device and its application method
CN109157276A (en) * 2018-09-26 2019-01-08 深圳市龙华区中心医院 It is a kind of to digitize controllable constant force bone Filtting device
CN211610018U (en) * 2020-02-25 2020-10-02 吴丹凯 Bone moving device based on intramedullary nail system

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024199090A1 (en) * 2023-03-29 2024-10-03 熊海阔 Intramedullary guide device

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