CN104799930A - Flail chest treatment device - Google Patents
Flail chest treatment device Download PDFInfo
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- CN104799930A CN104799930A CN201510261209.8A CN201510261209A CN104799930A CN 104799930 A CN104799930 A CN 104799930A CN 201510261209 A CN201510261209 A CN 201510261209A CN 104799930 A CN104799930 A CN 104799930A
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- rib
- substrate
- gripper shoe
- bottom plate
- flail chest
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
- A61B17/8076—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for the ribs or the sternum
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses a flail chest treatment device. The flail chest treatment device comprises a rib supporting plate and an outer fixing mechanism, wherein the rib supporting plate is vertically arranged at inner side of a fracture rib and the upper and lower ends of the rib supporting plate are fixed on a normal rib respectively; the outer fixing mechanism covers the outer wall of a chest; the rib supporting plate comprises a long-strip-shaped base plate; an upper fixed plate is arranged at the upper end of the base plate and a lower fixed plate is arranged at the lower end of the base plate; the upper fixed plate is provided with a dragging hole for dragging the base plate; at least three threaded holes for mounting self-tapping screws are transversely formed in the lower fixed plate. According to the flail chest treatment device, the rib supporting plate is matched with the outer fixing mechanism, and the fracture rib can be reset as soon as possible and is fixed, so that paradoxical respiration is effectively eliminated and flail chest is rapidly treated.
Description
Technical field
The present invention relates to technical field of medical equipment, particularly a kind of device being used for the treatment of flail chest.
Background technology
In clinical medicine, serious closed thoracic trauma can cause many many places fractures of rib, and make local thoracic wall lose rib and support and soften, and occur paradoxical breathing, namely during air-breathing, softened zone thoracic wall caves in, evagination during expiration, and this kind of sign is called flail chest.Because flail chest is often associated with contusion of lung, and be again the key factor of bringing out adult respiratory distress syndrome (ARDS), therefore its prevention and therapy comes particularly important for patient.
The therapeutic modality of current flail chest mainly adopts rib fixation.The method that operating theater instruments fixes flail chest fracture of rib originates from the seventies in last century.Through the change of clinical demand, increasing fixed apparatus is applied.
Opening breast, to fix rib be the Main Means for the treatment of flail chest at present, is open surgery, has fixed mount to the utensil that rib is fixed, Kirschner wire, thin type steel plate, absorbable bone peg etc.Opening intrathoracic fixing mode is: at chest posteriolateral incision, exposes the rib of damage, and by all-round for periosteum before and after fracture line stripping 3 ~ 4cm, the fracture site of the displacement of reduction afterwards, has during free fracture fragments and reset as far as possible.As selected Judet fixed mount, then according to the situation of fracture of rib, select being bent by rib form of suitable types, 2 pawls of fixed mount acute side (55 °) or 3 pawls are placed in the lower edge of rib, then with special vice, fixed mount is tightly fixed on fracture of rib place, fracture rib is fixed; As selected Kirschner wire, then respectively bore an aperture at the forward and backward rib broken ends of fractured bone place of fracture, by the Kirschner wire of diameter 1.5 ~ 2.0mm, penetrate from the aperture of one end, then by the pulp cavity in the fracture segment floated, then pass from the aperture of another broken ends of fractured bone, it is long that Kirschner wire two ends respectively expose about 1cm outward at aperture, and bend slightly, make it to be securely fixed on rib; As selected steel plate, then according to fracture of rib situation, selecting length to exceed the stainless-steel sheet of fracture of rib section, being bent by the radian of rib; Walk around rib 4 points with stainless steel silk through the eyelet of steel plate to tie up, wherein on the broken ends of fractured bone of front and back fracture, respectively tie up 1 point, another 2 on the floating rib of central authorities, rib and steel plate are closely fixed together.Above-mentioned three kinds of modes are all open surgery methods of internal fixation, and operation is complicated, and operation easier is large, and injury of chest wall is large, free large area muscle and rib, injured nerve, postoperative pain, and fixing utensil needs second operation to take out, and increases damage; And every root fracture rib all needs operation separately, and once, patient suffering is large.
Chinese patent CN101502455B discloses a kind of external fixing rack for flail chest, for giving treatment to the flail chest of chest fracture of rib, comprise the left fixed mount being provided with rib, right fixed mount, gripper clamp, chest-protector plate and braces, the front end of left fixed mount and right fixed mount is hinged with chest-protector plate respectively, rear end is connected through velcro, upper end is connected with braces, together with being strapped in by fracture rib, forms flail effect during use by gripper clamp with the rib on external fixer.The breast external fixer of this kind of structure, therapeutic process is not open breast therapeutic modality, can reduce patient suffering, but it is only applicable to well-bedded situation of fracturing, and then cannot play the effect of fracture rib reset for comminuted fracture; And this exterior fixation bracket in use, its gripper clamp needs to be inserted into clamping fracture rib in thoracic cavity from thoracic cavity, still there is larger misery, and the dismounting of postoperative gripper clamp is also comparatively difficult in patient treatment and rehabilitation course.
Summary of the invention
The technical issues that need to address of the present invention are to provide a kind of flail chest therapy equipment easy to use, under the prerequisite of rapid, effective treatment flail chest, greatly can reduce patient suffering.
For solving the problems of the technologies described above, the technical solution used in the present invention is as follows.
Flail chest therapy equipment, comprise to be vertically set on inside fracture rib, up and down two ends be separately fixed at normal epicostal rib gripper shoe and wrap up in the extenal fixation mechanism be attached on the outer wall of thoracic cavity; Described rib gripper shoe is inverted T shape, comprise strip substrate, the upper end of substrate is provided with upper mounted plate, and the lower end of substrate is provided with bottom plate, upper mounted plate offers the towing pad for drawing substrate, bottom plate laterally offers at least three screwed holes for installing tapping screw.
Above-mentioned flail chest therapy equipment, described rib gripper shoe substrate and upper mounted plate, bottom plate shift to install, and substrate is arranged on the inner side of fracture fracture of rib section, and upper mounted plate and bottom plate are arranged on outside normal rib; Rib gripper shoe lower end is fixed on normal rib by the tapping screw of cross-under in bottom plate screwed hole, and rib gripper shoe upper end is fixed in the surrounding tissue of normal rib by the stitching lead-in wire through towing pad.
Above-mentioned flail chest therapy equipment, the width of described bottom plate is greater than substrate width.
Above-mentioned flail chest therapy equipment, the width of described substrate is 5 ~ 10mm, and thickness is 1mm, and the width of bottom plate is 10 ~ 15mm.
Above-mentioned flail chest therapy equipment, described rib gripper shoe is titanium alloy substrate or absorbable material substrate.
Above-mentioned flail chest therapy equipment, described extenal fixation mechanism is exterior fixation bracket, and exterior fixation bracket comprises the locating dowel that is arranged on patient's spinal column position and is arranged in locating dowel for locating some tightenings of rib.
Above-mentioned flail chest therapy equipment, in the locating dowel of described exterior fixation bracket, entire body is provided with screw thread, and one end of tightening is connected with the buckle for the fixing tightening other end, and described snap thread is screwed in locating dowel.
Owing to have employed above technical scheme, the invention technological progress is as follows.
The present invention by rib gripper shoe and extenal fixation mechanism with the use of, rib gripper shoe from thoracic cavity inner support flail chest, and combines the fixing thoracic wall floated with the extenal fixation mechanism outside skin of chest, fracture rib can be made to reset as early as possible and fix, effective elimination paradoxical breathing, treats flail chest rapidly.Rib gripper shoe of the present invention can complete placement under thoracoscope, performs the operation without the need to opening breast, operative incision is little, Wicresoft, and operating time is short, not muscle injury, blood vessel, nerve, and postoperative patient pain is light, and wound healing is attractive in appearance; After rib gripper shoe places, most importantly can the thoracic wall of support floating, not fixing fracture rib itself; Coordinate extenal fixation mechanism, fracture rib can be made to reset as early as possible; And in therapeutic process, almost not damaged is organized to chest muscle; Rib gripper shoe can be taken out under local anaesthesia, simple to operate, without secondary damage.
Accompanying drawing explanation
Fig. 1 is the structural representation of rib gripper shoe of the present invention;
Fig. 2 is the side view of Fig. 1;
Fig. 3 is rib gripper shoe using state schematic diagram;
Fig. 4 is the structural representation of exterior fixation bracket of the present invention;
Wherein: 1. rib gripper shoe, 11. substrates, 12. upper mounted plates, 13. bottom plates, 14. towing pads, 15. screwed holes, 2. exterior fixation bracket, 21. locating dowels, 22. tightenings, 23. buckles, 3. rib, 31. normal ribs, 32. fracture ribs, 321. fracture segments.
Detailed description of the invention
In order to make technical problem to be solved by this invention, technical scheme and beneficial effect clearly understand, below in conjunction with drawings and Examples, the present invention will be described in detail.It should be noted that specific embodiment described herein only in order to explain the present invention, be not intended to limit the present invention.
Flail chest therapy equipment, comprises rib gripper shoe 1 and extenal fixation mechanism; For under thoracoscope, by built-in rib gripper shoe, and coordinate Xiong Wai extenal fixation mechanism, patient is carried out to the treatment of flail chest.Rib gripper shoe 1 is arranged on inside intrathoracic multiple fracture rib, and arranges with rib intersecting vertical, and the two ends up and down of rib gripper shoe 1 are separately fixed on normal rib, and rib gripper shoe is used for the fracture segment of fracture rib to prop up, and avoids thoracic cavity to subside; Extenal fixation mechanism wraps up in and is attached to thoracic cavity outer wall, for coordinating fixing rib of fracturing with rib gripper shoe.
embodiment 1
In the present embodiment, the structure of rib gripper shoe 1 as depicted in figs. 1 and 2, in inverted T shape structure.Specifically comprise strip substrate 11, the upper end of substrate 11 is provided with upper mounted plate 12, and the lower end of substrate 11 is provided with bottom plate 13, and substrate and upper mounted plate 12 and bottom plate 13 shift to install, on the basis ensureing substrate toughness, avoid substrate damage Thoracic Organs.
Upper mounted plate 12 offers towing pad 14, after draught line is passed towing pad, substrate is drawn out in thoracic cavity the normal rib of top.Bottom plate 13 laterally offers at least two screwed holes, for by installing tapping screw in screwed hole substrate being fixed on the surrounding tissue of the normal rib of below.In the present invention, rib gripper shoe adopts titanium alloy material to make, and being convenient in use moulding according to thoracic cavity situation, can certainly be other absorbable materials.
In the present invention, the width of bottom plate 13 is greater than the width of substrate, and to ensure in operation process and in post operative recovery procedures, rib gripper shoe is not moved.The width of substrate is 5 ~ 10mm, and thickness is 1mm, and the width of bottom plate is 10 ~ 15mm, long 10mm, and the length of substrate can be determined according to the injured quantity of rib, and the width of substrate is preferably 5mm in the present embodiment, the preferred 10mm of width of bottom plate.
When rib gripper shoe uses, substrate 11 is arranged on the inner side of fracture rib 32 fracture segment 321, and upper mounted plate 12 and bottom plate are separately positioned on outside normal rib 31; Rib gripper shoe 1 lower end is fixed on the normal rib in below by the tapping screw of cross-under in fixing head screwed hole; Above rib gripper shoe 1 upper end is fixed on by the draught line of cross-under in towing pad normal rib surrounding tissue on, as shown in Figure 3, to ensure that the position of rib gripper shoe is fixed, can not be shifted.
In the present embodiment, extenal fixation mechanism adopts exterior fixation bracket 2, the structure of exterior fixation bracket 2 as shown in Figure 4, comprise locating dowel 21 and some tightenings 22, in locating dowel 21, entire body is provided with screw thread, one end of tightening 22 is connected with the buckle 23 for the fixing tightening other end, and buckle 23 screw thread is screwed in locating dowel 21, so that according to patient's figure adjustment tightening position.
The using method that the present invention is applied to treatment flail chest is as follows.
First, Thoracic CT scan is carried out to the patient of flail chest, determine to damage the degree of the position of rib, scope and intrathoracic damage, select suitable surgical indication, determine the length of rib gripper shoe.
Secondly, general anesthesia, cuts skin respectively at the upper and lower normal rib place of floating chest wall, exposes normal rib.
Again, electric knife cuts Intercostal muscle and enters thoracic cavity.Under thoracoscope is observed, to guide through the traction belt in the towing pad of rib gripper shoe upper end, rib gripper shoe is inserted inside chest wall, and making the substrate of rib gripper shoe be positioned at the fracture segment of fracture rib, the upper mounted plate of rib gripper shoe and bottom plate lay respectively at outside the normal rib in top and outside the normal rib in below; Electric drill boring on the normal rib in lower end again, adopts self-tapping screw through after the screw hole of bottom plate, is fixed on the lower end of rib gripper shoe on fractured beneath rib; Adjustment traction belt, is fixed on upper mounted plate in the surrounding tissue of the normal rib in top by the mode of suture.
Then, incision skin is sewed up.
Finally, according to the patient's figure adjustment position of tightening in locating dowel, locating dowel is placed on patient's spinal column position, after the other end of tightening is walked around thoracic cavity outer wall, is fixed on buckle internal fixtion.Tightening, in winding process, with flail chest position to corresponding, should coordinate with rib gripper shoe the effect played and locate rib, is convenient to fracture rib symphysis.
The foregoing is only preferred embodiment of the present invention, be not limited to the present invention, extenal fixation mechanism can also be other structures.Therefore all do within principle of the present invention and spirit any amendment, equivalent to replace and improvement etc., be all just included within protection scope of the present invention.
Claims (7)
1. flail chest therapy equipment, is characterized in that: comprise to be vertically set on inside fracture rib, up and down two ends be separately fixed at normal epicostal rib gripper shoe (1) and wrap up in the extenal fixation mechanism be attached on the outer wall of thoracic cavity; Described rib gripper shoe (1) is in inverted T shape, comprise strip substrate (11), the upper end of substrate (11) is provided with upper mounted plate (12), the lower end of substrate (11) is provided with bottom plate (13), upper mounted plate (12) offers the towing pad (14) for drawing substrate, bottom plate (13) laterally offers at least three screwed holes (15) for installing tapping screw.
2. flail chest therapy equipment according to claim 1, it is characterized in that: described rib gripper shoe substrate (11) and upper mounted plate (12), bottom plate (13) shift to install, substrate (11) is arranged on the inner side of fracture rib (32) fracture segment (321), and upper mounted plate (12) and bottom plate (13) are arranged on normal rib (31) outside; Rib gripper shoe (1) lower end is fixed on normal rib by the tapping screw of cross-under in bottom plate screwed hole, and rib gripper shoe (1) upper end is fixed in the surrounding tissue of normal rib by the stitching lead-in wire through towing pad.
3. flail chest therapy equipment according to claim 2, is characterized in that: the width of described bottom plate (13) is greater than substrate width.
4. flail chest therapy equipment according to claim 3, is characterized in that: the width of described substrate is 5 ~ 10mm, and thickness is 1mm, and the width of bottom plate is 10 ~ 15mm.
5. the flail chest therapy equipment according to any one of Claims 1-4, is characterized in that: described rib gripper shoe is titanium alloy substrate or absorbable material substrate.
6. flail chest therapy equipment according to claim 1, it is characterized in that: described extenal fixation mechanism is exterior fixation bracket (2), exterior fixation bracket (2) comprises the locating dowel (21) that is arranged on patient's spinal column position and is arranged in locating dowel (21) for locating some tightenings (22) of rib.
7. flail chest therapy equipment according to claim 6, it is characterized in that: the upper entire body of locating dowel (21) of described exterior fixation bracket (2) is provided with screw thread, one end of tightening (22) is connected with the buckle (23) for the fixing tightening other end, and described buckle (23) screw thread is screwed in locating dowel (21).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510261209.8A CN104799930B (en) | 2015-05-21 | 2015-05-21 | Flail chest therapeutic system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510261209.8A CN104799930B (en) | 2015-05-21 | 2015-05-21 | Flail chest therapeutic system |
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| Publication Number | Publication Date |
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| CN104799930A true CN104799930A (en) | 2015-07-29 |
| CN104799930B CN104799930B (en) | 2017-05-31 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201510261209.8A Active CN104799930B (en) | 2015-05-21 | 2015-05-21 | Flail chest therapeutic system |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107951553A (en) * | 2017-11-24 | 2018-04-24 | 沈卫民 | Rib cage maker |
| CN108095813A (en) * | 2017-12-22 | 2018-06-01 | 皖南医学院弋矶山医院 | For fixing the inner fixing device of posterior cruciate ligament of knee stop avulsion fracture |
| CN108742818A (en) * | 2018-07-13 | 2018-11-06 | 王忠义 | A kind of outer fixture of wall of the chest for medical treatment |
| CN109875666A (en) * | 2019-01-14 | 2019-06-14 | 魏海峰 | A kind of backbone chest profile forming system |
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| CN2113757U (en) * | 1992-01-23 | 1992-08-26 | 刘永谦 | Crossbow-type external fixator of spine fracture |
| CN2683047Y (en) * | 2004-03-11 | 2005-03-09 | 杨佐治 | Flail chest fixing steel plate |
| US20080027360A1 (en) * | 2006-07-25 | 2008-01-31 | Smith George K | Medical device for temporarily treating flail chest injury |
| CN203244446U (en) * | 2013-05-13 | 2013-10-23 | 田慧中 | Memory alloy intercostals strutting device |
| RU2497475C1 (en) * | 2012-10-01 | 2013-11-10 | Владимир Дмитриевич Шатохин | Method and device for fixation and reposition of multiple fractures of ribs and sternum |
| RU2503424C1 (en) * | 2012-12-10 | 2014-01-10 | Владимир Дмитриевич Шатохин | Method and device for treating multiple ribs and breastbone fractures |
| US20140214032A1 (en) * | 2012-11-12 | 2014-07-31 | Graeme A. Browne | Device for treating flail chest |
| WO2015003061A1 (en) * | 2013-07-03 | 2015-01-08 | The Charlotte Mecklenburg Hospital Authority D/B/A Carolinas Healthcare System | Device and system for supporting and approximating ribs |
| CN204683752U (en) * | 2015-05-21 | 2015-10-07 | 柳立军 | Flail chest therapy equipment |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| SU1107841A1 (en) * | 1982-04-28 | 1984-08-15 | Ленинградский Научно-Исследовательский Институт Скорой Помощи Им.И.И.Доанелидзе | Method of osteosynthesys in case of multiple rib fractures |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2113757U (en) * | 1992-01-23 | 1992-08-26 | 刘永谦 | Crossbow-type external fixator of spine fracture |
| CN2683047Y (en) * | 2004-03-11 | 2005-03-09 | 杨佐治 | Flail chest fixing steel plate |
| US20080027360A1 (en) * | 2006-07-25 | 2008-01-31 | Smith George K | Medical device for temporarily treating flail chest injury |
| RU2497475C1 (en) * | 2012-10-01 | 2013-11-10 | Владимир Дмитриевич Шатохин | Method and device for fixation and reposition of multiple fractures of ribs and sternum |
| US20140214032A1 (en) * | 2012-11-12 | 2014-07-31 | Graeme A. Browne | Device for treating flail chest |
| RU2503424C1 (en) * | 2012-12-10 | 2014-01-10 | Владимир Дмитриевич Шатохин | Method and device for treating multiple ribs and breastbone fractures |
| CN203244446U (en) * | 2013-05-13 | 2013-10-23 | 田慧中 | Memory alloy intercostals strutting device |
| WO2015003061A1 (en) * | 2013-07-03 | 2015-01-08 | The Charlotte Mecklenburg Hospital Authority D/B/A Carolinas Healthcare System | Device and system for supporting and approximating ribs |
| CN204683752U (en) * | 2015-05-21 | 2015-10-07 | 柳立军 | Flail chest therapy equipment |
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107951553A (en) * | 2017-11-24 | 2018-04-24 | 沈卫民 | Rib cage maker |
| CN108095813A (en) * | 2017-12-22 | 2018-06-01 | 皖南医学院弋矶山医院 | For fixing the inner fixing device of posterior cruciate ligament of knee stop avulsion fracture |
| CN108095813B (en) * | 2017-12-22 | 2021-05-11 | 皖南医学院弋矶山医院 | Internal fixing device for fixing posterior cruciate ligament insertion avulsion fracture |
| CN108742818A (en) * | 2018-07-13 | 2018-11-06 | 王忠义 | A kind of outer fixture of wall of the chest for medical treatment |
| CN109875666A (en) * | 2019-01-14 | 2019-06-14 | 魏海峰 | A kind of backbone chest profile forming system |
Also Published As
| Publication number | Publication date |
|---|---|
| CN104799930B (en) | 2017-05-31 |
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