CN104840239A - Closed reduction device for unstable pelvic fracture minimally invasive surgery - Google Patents
Closed reduction device for unstable pelvic fracture minimally invasive surgery Download PDFInfo
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- CN104840239A CN104840239A CN201510120718.9A CN201510120718A CN104840239A CN 104840239 A CN104840239 A CN 104840239A CN 201510120718 A CN201510120718 A CN 201510120718A CN 104840239 A CN104840239 A CN 104840239A
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- 206010034246 Pelvic fractures Diseases 0.000 title claims abstract description 33
- 230000009467 reduction Effects 0.000 title claims abstract description 24
- 238000002324 minimally invasive surgery Methods 0.000 title claims abstract description 14
- 238000010276 construction Methods 0.000 claims description 3
- 230000000694 effects Effects 0.000 abstract description 3
- 210000004197 pelvis Anatomy 0.000 description 46
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- 230000006378 damage Effects 0.000 description 4
- 239000000463 material Substances 0.000 description 4
- 230000007246 mechanism Effects 0.000 description 4
- 206010017076 Fracture Diseases 0.000 description 3
- 230000008901 benefit Effects 0.000 description 3
- 230000015572 biosynthetic process Effects 0.000 description 3
- 238000004519 manufacturing process Methods 0.000 description 3
- 210000004872 soft tissue Anatomy 0.000 description 3
- 238000009987 spinning Methods 0.000 description 3
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- 208000027418 Wounds and injury Diseases 0.000 description 2
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- 210000004204 blood vessel Anatomy 0.000 description 2
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- RKTYLMNFRDHKIL-UHFFFAOYSA-N copper;5,10,15,20-tetraphenylporphyrin-22,24-diide Chemical compound [Cu+2].C1=CC(C(=C2C=CC([N-]2)=C(C=2C=CC=CC=2)C=2C=CC(N=2)=C(C=2C=CC=CC=2)C2=CC=C3[N-]2)C=2C=CC=CC=2)=NC1=C3C1=CC=CC=C1 RKTYLMNFRDHKIL-UHFFFAOYSA-N 0.000 description 2
- 238000005520 cutting process Methods 0.000 description 2
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- 210000005036 nerve Anatomy 0.000 description 2
- 239000011148 porous material Substances 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 238000011946 reduction process Methods 0.000 description 2
- 210000003131 sacroiliac joint Anatomy 0.000 description 2
- 229910000838 Al alloy Inorganic materials 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
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- 238000011084 recovery Methods 0.000 description 1
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Classifications
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
-
- 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
- A61B2017/564—Methods for bone or joint treatment
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
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Abstract
The invention discloses a closed reduction device for unstable pelvic fracture minimally invasive surgery. The closed reduction device for unstable pelvic fracture minimally invasive surgery comprises a first lateral outer frame, a second lateral outer frame, a connecting outer frame, guide rails, a guide rail sliding clamp, an outer frame sliding clamp, screws and a screw clamp, wherein the second lateral outer frame is smaller than the first lateral outer frame and arranged inside the first lateral outer frame, and the first lateral outer frame and the second lateral outer frame are fixed to the guide rails through the guide rail sliding clamp; the connecting outer frame is of the structure that the arc part is connected with transverse straight rod parts, the arc part and the transverse straight rod parts are not arranged on the same plane, and the transverse straight rod parts at the two ends of the arc part are coaxially arranged in the same plane; the connecting outer fame is connected with the second lateral outer frame through the outer frame sliding clamp; the screw clamp is used for clamping the screws and fixed on the connecting outer frame. The guide rails are arranged on two sides of an operation bed. The closed reduction device for unstable pelvic fracture minimally invasive surgery can recover an unstable pelvic fracture according to a specific route, a specific angle and specific parameters, the reduction effect is good, and pain of a patient is small.
Description
Technical field
The invention belongs to surgical medical equipment field, specifically, relate to a kind of Unstable pelvic fractures Minimally Invasive Surgery closed reduction device.
Background technology
Human pelvis is a loop configuration, the rear ring being formed front ring by pubis and be made up of sacroiliac joint complex can be divided for by position, wherein, ring is the important step accepting body weight, conducting body biomechanics, and fracture of pelvis can be divided into stability fracture of pelvis and unstable fracture of pelvis by whether involving rear ring.
Be the nervus vasculairs of important organ and domination lower limb in pelvis, and the important neural blood vessel of pelvis focuses mostly near posterior ring pelvic, posterior ring pelvic once damage very easily cause patient lethal, disable.Have bibliographical information Unstable pelvic fractures lethal, disability rate can up to 10% ~ 50%.Therefore for Unstable pelvic fractures reset, fixing and patient's post-operative recovery is extremely important, to avoid as patient leaves secret worry.
Traditional open reduction and Kirschner wire fixation can look at damage field straight, is beneficial to anatomical reduction.Because posterior ring pelvic position is dark, in the operation process cut, soft tissue exposes too much, easily these important blood vessel and nerves of damage, and operative treatment is very thorny.Therefore closed reduction fracture of pelvis adds the main flow that Wicresoft's screw technique becomes treatment gradually.
The advantage of closed reduction fracture of pelvis is farthest to reduce the risk that cutting operation exposes the blood vesssls and nerves injuries that soft tissue causes, but closed reduction process relies on the manipulation of patient completely, high to the technical requirement of patient, and whole process is carried out under all needing the supervision of x-ray in art, expose excessive to the ray of medical personnel.
In addition the shortcoming of traditional closed reduction also has: after continuing lower limb traction, needs maneuver to maintain reset position; When carrying out other operations, reset position is easily lost; After reset completes, sacroiliac screw is inserted movable rumpbone, still need repeatedly to have an X-rayed guarantee accuracy.
Therefore, need badly at present a set of can by the resetting-mechanism of particular path, special angle and designated parameter reset Unstable pelvic fractures.
Summary of the invention
To reset defects such as needing repeatedly to have an X-rayed amount of radiation large and cutting operation exposure soft tissue is too much, the large easy infection of wound to solve traditional fracture of pelvis, the invention provides a kind of can by the resetting-mechanism of particular path, special angle and designated parameter reset Unstable pelvic fractures.
According to an aspect of the present invention, a kind of Unstable pelvic fractures Minimally Invasive Surgery closed reduction device is provided, wherein, described resetting means comprises: the first side outrigger, the second side outrigger, connect outrigger, guide rail, slide fixture, outrigger sliding clamp, screw, screw clamping fixture;
Described first side outrigger is identical with described second side outrigger shape, all adopts the structure of arch section vertical connecting straight bar part; The size of described first side outrigger is greater than described second side outrigger;
Described second side outrigger is arranged at the inside of described first side outrigger, and described first side outrigger and described second side outrigger are referred to as side outrigger;
Described side outrigger is fixed on described guide rail by described slide fixture;
Described connection outrigger adopts arch section to connect the structure walking crosswise straight bar part, its arch section and walk crosswise straight bar part and be provided with scale;
The arch section of described connection outrigger and walk crosswise straight bar part and be arranged in non-same plane, adopts short straight rod to connect therebetween; The straight bar part of walking crosswise at arch section two ends to be arranged in same plane and to be coaxial construction;
Described connection outrigger is connected with described second side outrigger by described outrigger sliding clamp;
Described screw clamping fixture for clamping described screw, and is fixed on described connection outrigger;
Described guide rail is arranged at operation table both sides, and described guide rail is provided with scale.
According to a specific embodiment of the present invention, described resetting means also comprises straight rod, and described straight rod is used for fixing described first side outrigger and/or described second side outrigger.
According to another detailed description of the invention of the present invention, when the second side outrigger is fixed on described guide rail, when described in described screw clamping holder, screw slides on the arch section connecting outrigger, and described connection outrigger is when the arch section of described second side outrigger slides, described screw passes through remote centre of motion all the time.
According to another detailed description of the invention of the present invention, remote centre of motion is the affiliated circular line in the center of circle of arch section of two described second side outriggers and the intersection point of the axis of described screw.
According to another detailed description of the invention of the present invention, the cross section walking crosswise straight bar part of described connection outrigger is non-circular.
According to another detailed description of the invention of the present invention,
The arch section radius of described first side outrigger is 2200mm ~ 2600mm;
The arch section radius of described second side outrigger is 1400mm ~ 1800mm.
According to another detailed description of the invention of the present invention, described connection outrigger walk crosswise the two ends that straight bar part is arranged at described connection outrigger, be respectively the first straight-bar and the second straight-bar;
The length of described first straight-bar is 500mm ~ 1500mm;
The length of described second straight-bar is 1500mm ~ 2500mm.
According to another detailed description of the invention of the present invention, the arch section radius of described connection outrigger is 2400mm ~ 2800mm.
According to another detailed description of the invention of the present invention, the scale precision setting of the arch section of described connection outrigger is 1 °.
According to another detailed description of the invention of the present invention, the scale precision setting walking crosswise straight bar part of described connection outrigger is 1mm.
According to another detailed description of the invention of the present invention, the length of described guide rail is 800mm ~ 1200mm, and width is 8mm ~ 12mm, is highly 22mm ~ 26mm.
According to another detailed description of the invention of the present invention, the scale precision on described guide rail is 1mm.
According to another detailed description of the invention of the present invention, described straight excellent length is 500mm ~ 5500mm.
Unstable pelvic fractures Minimally Invasive Surgery closed reduction device provided by the invention is arranged at standard procedures bed, with the general operating theater instruments of orthopaedics with the use of, achieve the sequencing to Unstable pelvic fractures closed reduction, parametrization and automatization.The connection outrigger of this resetting means is connected with pelvis closed reduction screw (LCII screw), can the rotation displacement of auxiliary reset fracture of pelvis in LC II screw plane (approximate plane of pelvic inlet).LC II screw is the specific appellation of general Schanz screw when inserting pelvis LC II passage, and its function is the end effector of mechanism, for holding Ipsilateral pelvis.Second side outrigger be connected outrigger and connect, for the rotation displacement of auxiliary reset fracture of pelvis in sagittal plane.LC II screw can passive rotation in screw clamping fixture, with the rotation displacement of fracture of pelvis at LC II screw orientation that reset.Above spinning reduction process all can by being arranged at the second side outrigger and the scale of arch section and the accurate record of external protractor that are connected outrigger.
After second side outrigger, connection outrigger and LC II screw connect, the pelvis that can reset is longitudinal and sagittal line shifting at health, and shifting process can by guide rail and rule accurate recording; Connect outrigger to coordinate with outrigger sliding clamp, can reset the transverse shift of pelvis at short axis of body, and shifting process can walk crosswise straight bar part accurate recording by the with a scale of connection outrigger.
Resetting means provided by the invention accurately can record the shift parameters in pelvis multi-angle, many planes, when carrying out Unstable pelvic fractures Minimally Invasive Surgery, adopt resetting means better reduction provided by the invention, operative incision misery that is little, patient little, recover fast, and effectively can reduce the x-ray radiation that doctor and patient suffer.
Accompanying drawing explanation
By reading the detailed description done non-limiting example done with reference to the following drawings, other features, objects and advantages of the present invention will become more obvious:
Figure 1 shows that the structural representation of a detailed description of the invention according to a kind of Unstable pelvic fractures Minimally Invasive Surgery closed reduction device provided by the invention;
Figure 2 shows that the structural representation of a detailed description of the invention according to the first side outrigger provided by the invention;
Figure 3 shows that the structural representation of a detailed description of the invention according to connection outrigger provided by the invention;
Figure 4 shows that the structural representation of a detailed description of the invention according to outrigger sliding clamp provided by the invention;
Figure 5 shows that the structural representation of the detailed description of the invention combined according to slide fixture provided by the invention and slide clamp bolt;
Figure 6 shows that the structural representation of a detailed description of the invention according to screw clamping fixture provided by the invention;
Figure 7 shows that the structural representation of another detailed description of the invention according to screw clamping fixture provided by the invention;
Figure 8 shows that the structural representation of a detailed description of the invention according to guide rail provided by the invention.
In accompanying drawing, same or analogous Reference numeral represents same or analogous parts.
Reference numeral is as shown in following form:
| 1 -1 | First side outrigger | 1-2 | Second side outrigger |
| 2 | Connect outrigger | 3 | Outrigger sliding clamp |
| 3-1 | Outrigger sliding clamp Part I | 3-2 | Outrigger sliding clamp Part II |
| 3-3 | Outrigger sliding clamp Part III | 4 | Slide fixture |
| 5 | Slide clamp bolt | 6 | Screw clamping fixture |
| 6-1 | Screw clamping fixture Part I | 6-2 | Screw clamping fixture Part II |
| 6-3 | Screw clamping fixture Part III | 7 | Guide rail |
| 8 | Screw |
Detailed description of the invention
Disclosing hereafter provides many different embodiments or example is used for realizing different structure of the present invention.Of the present invention open in order to simplify, hereinafter the parts of specific examples and setting are described.In addition, the present invention can in different example repeat reference numerals and/or letter.This repetition is to simplify and clearly object, itself does not indicate the relation between discussed various embodiment and/or setting.It should be noted that parts illustrated in the accompanying drawings are not necessarily drawn in proportion.Present invention omits the description of known assemblies and treatment technology and process to avoid unnecessarily limiting the present invention.
With reference to figure 1, Unstable pelvic fractures Minimally Invasive Surgery closed reduction device disclosed by the invention comprises: the first side outrigger 1-1 (as shown in Figure 2), the second side outrigger 1-2, connect outrigger 2 (as shown in Figure 3), guide rail 7, slide fixture 4, outrigger sliding clamp 3, screw 8, screw clamping fixture 6.
Described first side outrigger 1-1 is identical with described second side outrigger 1-2 shape, all adopts the structure of arch section vertical connecting straight bar part.The size of described first side outrigger 1-1 is greater than the size of described second side outrigger 1-2.Preferably, the arch section radius of described first side outrigger 1-1 is 2200mm ~ 2600mm, such as: 2200mm, 2400mm or 2600mm.Preferably, the arch section radius of described second side outrigger 1-2 is 1400mm ~ 1800mm, such as: 1400mm, 1600mm or 1800mm.
Described first side outrigger 1-1 and described second side outrigger 1-2 non-concentric are arranged.First side outrigger 1-1 and described second side outrigger 1-2 can be referred to as side arc outrigger.Described side arc outrigger is fixed on described guide rail 7 by described slide fixture 4.Described guide rail 7 is arranged at operation table both sides, and described guide rail 7 is provided with scale, as shown in Figure 8.In order to make resetting means disclosed by the invention have more versatility, optionally, described guide rail 7 is arranged at standard procedures bed both sides by standard procedures bed rail clamp.Therefore in order to mate with standard procedures bed, preferably, the length of described guide rail 7 is 800mm ~ 1200mm, such as: 800mm, 1000mm or 1200mm; Width is 8mm ~ 12mm, such as: 8mm, 10mm or 12mm; Be highly 22mm ~ 26mm, such as: 22mm, 24mm or 26mm.
Preferably, described resetting means also comprises straight rod, and described straight rod is used for fixing described first side outrigger 1-1 and/or described second side outrigger 1-2.When being fixed, usually adopt general universal joint.It should be noted that and directly do not connect between the first side outrigger 1-1 and the second side outrigger 1-2.When straight rod is for connecting the first side outrigger 1-1 of the first side outrigger 1-1 of operation table both sides or operation table side, the stability in the large of the first side outrigger 1-1 can be made better; In like manner, when straight rod is for connecting the second side outrigger 1-2 of the first side outrigger 1-2 of operation table both sides or operation table side, the stability in the large of the second side outrigger 1-2 can be made better.Preferably, straight rod and the perpendicular or parallel setting of guide rail 8, now bed knife is strong, and resetting means can be made more neatly attractive in appearance.As required, straight rod can also arrange scale.
First side outrigger 1-1 and the second side outrigger 1-2, all under the clamping of slide fixture 4, can slide along guide rail 7.In a specific embodiment, the first side outrigger 1-1 is fixed on guide rail 7 by slide fixture 4; Second side outrigger 1-2 then slides along guide rail 7 under the clamping of slide fixture 4.Due to guide rail 7 having scale, as required, after the second side outrigger 1-2 is slided into suitable position, guide rail clamping fixture 4 can be re-used and is fixed on guide rail 7.
Described slide fixture 4 can be set to the shape that can be used for fixing such as square, circular.Preferably, as shown in Figure 5, described slide fixture 4 is set to squarish structure.Wherein, 1 square groove, 1 special-shaped slot and 2 silk holes are provided with.Square groove and the straight hole of special-shaped slot are set to vertical travel structure mutually.Wherein, special-shaped slot is made up of 1 straight hole and 1 rectangle straight trough.Square groove is set to and described guide rail 7 exact matching, and straight hole is set to the vertical straight bar part exact matching connecting vertical straight-bar outrigger with described arc.Described slide fixture 4 adopts slide clamp bolt 5 to be fixed.
Described connection outrigger 2 adopts arch section to connect and walks crosswise the structure of straight bar part, its arch section and walk crosswise straight bar part and be provided with scale.Preferably, the arch section radius of described connection outrigger 2 is 2400mm ~ 2800mm, such as: 2400mm, 2600mm or 2800mm.Preferably, the scale precision setting of the arch section of described connection outrigger 2 is 1 °.
With reference to figure 3, described connection outrigger 2 walk crosswise the two ends that straight bar part is arranged at the arch section of described connection outrigger 2, be respectively the first straight-bar and the second straight-bar.The arch section of described connection outrigger 2 and walk crosswise straight bar part and be arranged in non-same plane.Wherein, one end of arch section adopts short straight rod to be connected with between the first straight-bar, and the other end and second straight-bar of arch section also adopt short straight rod to be connected.First straight-bar and the second straight-bar to be arranged in same plane and to be coaxial construction.Preferably, described first straight-bar and the second straight-bar are all parallel with the string of the arch section of described connection outrigger 2.
Preferably, the length of described first straight-bar is 500mm ~ 1500mm, such as: 500mm, 1000mm or 1500mm.Preferably, the length of described second straight-bar is 1500mm ~ 2500mm, such as: 1500mm, 2000mm or 2500mm.Preferably, described connection outrigger walk crosswise straight bar part, namely the scale precision setting of the first straight-bar and/or the second straight-bar is 1mm.
In order to can in connection procedure, obtain and better connect effect, the cross section walking crosswise straight bar part of described connection outrigger 2 be non-circular.Preferably, the polymorphic structure being similar to isosceles triangle is set to.If the plane at the place, base of the polymorphic structure of above-mentioned approximate isosceles triangle is called the first plane, the plane perpendicular to this arch section place plane at the string place of the arch section of described connection outrigger 2 is called the second plane; More preferred, described first plane and described second co-planar.
Described connection outrigger 2 is connected with described second side outrigger 1-2 by described outrigger sliding clamp 3.Preferably, described outrigger sliding clamp 3 is set to approximate trapezoid tetragonal body structure, and it is made up of 3 parts, as shown in Figure 4.For being welded to connect between outrigger sliding clamp Part I 3-1 and outrigger sliding clamp Part III 3-3.In order to enable outrigger sliding clamp Part II 3-2 rotate, therefore preferably, be pinned connection between outrigger sliding clamp Part II 3-2 and outrigger sliding clamp Part III 3-3.Be provided with through hole cambered surface in outrigger sliding clamp Part I 3-1 and outrigger sliding clamp Part III 3-3, circular arc through hole can be formed; This arc-shaped through-hole needs the arch section exact matching with described second side outrigger 1-2.
Due to outrigger sliding clamp 3 need carry out exact matching with the described straight bar part of walking crosswise being connected outrigger 2, therefore when connect outrigger 2 walk crosswise straight bar part employing polymorphic structure time, the internal gutter structure of outrigger sliding clamp 3 also should be the polymorphic structure matched.Such as: when the cross section walking crosswise straight bar part connecting outrigger 2 is the polymorphic structure being similar to isosceles triangle, the pore passage structure arranged in outrigger sliding clamp 3 is also the special-shaped pore passage structure of approximate isosceles triangle.The axis of the internal gutter of outrigger sliding clamp 3 and the centrage place plane orthogonal of the circular arc through hole be made up of outrigger sliding clamp Part I 3-1 and outrigger sliding clamp Part II 3-2.
Outrigger sliding clamp 3 is provided with 2 silk holes, for the contents in the internal gutter of locking outrigger sliding clamp 3 and circular arc through hole.
Described screw clamping fixture 6 for clamping described screw 8, and is fixed on described connection outrigger 2.Preferably, described screw 8 adopts pelvis Minimally Invasive Surgery LC II screw.With reference to figure 6 and Fig. 7, described screw clamping fixture 6 is set to approximate tetragonal body structure, is made up of screw clamping fixture Part I 6-1, screw clamping fixture Part II 6-2 and screw clamping fixture Part III 6-3 tri-part.Adopt between screw clamping fixture Part I 6-1 and screw clamping fixture Part III 6-3 and be welded to connect.Be by pinned connection between screw clamping fixture Part II 6-2 and screw clamping fixture Part III 6-3, to make screw clamping fixture Part II 6-2 can rotate along bearing pin.Be provided with through hole cambered surface in screw clamping fixture Part I 6-1 and screw clamping fixture Part II 6-2, circular arc through hole can be formed.This circular arc through hole and the described arch section exact matching being connected outrigger 2.
Described screw clamping fixture 6 is provided with 1 special-shaped slot and 2 silk holes.The fixtures such as screw can be inserted for the contents in the special-shaped groove of screw clamping fixture 6 described in locking and circular arc through hole by 2 silk holes of described screw clamping fixture 6.The special-shaped slot of described screw clamping fixture 6 is made up of 1 circular straight hole and 1 square groove.Wherein, the centrage of circular straight hole is parallel with the place plane of the centrage of the circular arc through hole of described screw clamping fixture 6.
The described screw clamping fixture 6 upper plane tangent with circular arc through hole is set to stepped ramp type structure.This stepped ramp type structure is positioned at screw clamping fixture Part I 6-1 upper surface, and perpendicular with the centrage of the circular straight hole of the special-shaped slot of screw clamping fixture 6.
The circular straight hole of the special-shaped slot of described screw clamping fixture 6 is arranged at the first straight-bar side of described connection outrigger 2, for clamp screws 8.Screw 8 can rotation in the circular straight hole of the special-shaped slot of described screw clamping fixture 6.
Can fix by fixture (as: screw) after the circular straight hole clamp screws 8 of the special-shaped slot of described screw clamping fixture 6, after fixing, form the first combinative structure; First combinative structure can slide and can fixture temporary fixed formation second combinative structure on the arch section of described connection outrigger 2; Second combinative structure can form the 3rd combinative structure with described outrigger sliding clamp 3; 3rd combinative structure is slided and the temporary fixed formation of fixture the 4th combinative structure at the arch section of described second side outrigger 1-2 by the circular arc through hole of described outrigger sliding clamp 3; 4th combinative structure can form the 5th combinative structure with slide fixture 4; 5th combinative structure slides on described guide rail 7 by the square groove of slide fixture 4, and by described slide clamp bolt 5 temporary fixed formation the 6th combinative structure.Wherein, when the second side outrigger 1-2 is fixed on described guide rail 7, when first combinative structure slides on the arch section of described connection outrigger 2, and the 3rd combinative structure described second side outrigger 1-2 arch section slide time, the screw 8 clamped by described screw clamping fixture 6, all the time by the fixing virtual point of in three dimensions, is called remote centre of motion.Wherein, remote centre of motion is the affiliated circular line in the center of circle of arch section of two described second side outrigger 1-2 and the intersection point of the axis of described screw 8.
Preferably, the manufactured materials of above-mentioned Unstable pelvic fractures Minimally Invasive Surgery closed reduction device includes but not limited to: metal, medical plastic and/or its combination.Metal material mainly adopts: aluminium alloy or rustless steel etc. meet the metal of medical standard.
Illustrate resetting means provided by the invention how practical application below.When carrying out pelvis-repositioning to patients with pelvis fracture, patient be allowed to be that horizontal position lies on standard procedures bed, carrying out routine disinfection paving aseptic towel list.Insert screw 8 at Ipsilateral pelvis anterior inferior iliac spine, preferably, this screw 8 is the LC II screw of diameter 6mm, long 260mm; And at Ipsilateral condyle of femur, lower limb traction device is installed.
Next resetting means is connected.First guide rail 7 is connected and fixed in the slide fixture 4 of standard procedures bed both sides.With screw clamping fixture 6, screw 8 is fixed on the arch section connecting outrigger 2, and locked screw clamping fixture 6.The entirety of screw clamping fixture 6, the arch section connecting outrigger 2, screw 8 and Ipsilateral pelvis composition geo-stationary.The second side outrigger 1-2 is connected to by connecting outrigger 2 with outrigger sliding clamp 3.Locked outrigger sliding clamp 3, makes outrigger sliding clamp 3, second side outrigger 1-2, screw clamping fixture 6, connects the entirety of outrigger 2, screw 8 and Ipsilateral pelvis composition geo-stationary.With multiple (as 4) slide fixture 4, a pair second side outriggers 2 are connected to the guide rail 7 of standard procedures bed both sides, and with outrigger sliding clamp 3 be connected outrigger 2 and connect.The suitable general Schanz screw of one piece to two pieces length is inserted as the operation of holding screw auxiliary reset at Ipsilateral ala of ilium.
So far, namely Ipsilateral pelvis connects into the relative motionless entirety in position by resetting means provided by the invention and standard procedures bed, but now strong side seam basin is still in not fixed position.
A pair first side outrigger 1-1 are striden across the guide rail 7 that above-mentioned second side outrigger 1-2 is connected to standard procedures bed both sides with slide fixture 4 by next step.Strong side seam basin is fixed on the first side outrigger 1-1 of strong side by the general Schanz screw grown with 2 ~ 4 240mm ~ 260mm.Namely strong side seam basin connects into the relatively-stationary entirety in position by resetting means and standard procedures bed.
Through aforesaid operations, the Ipsilateral pelvis of patient and the position of the strong side seam basin device that has all been reset is fixed on standard procedures bed, but connects multiple assembly of the resetting means of Ipsilateral pelvis and to be connected multiple assemblies of the resetting means of being good for side seam basin still separate and can independent activities separately.
Next, to CT scan in the patients with pelvis fracture row art being connected to resetting means, obtain the CT-DICOM formatted data of fracture of pelvis, and utilize Mimics software three-dimensional reconstruction to fracture pelvis 3D model.With screw 8 (LC II screw) place plane set up with short axis of body for X-axis, with screw 8 planar vertical with X-axis axle for Z axis, and with the axle perpendicular to XZ axle for Y-axis, composition space coordinates, remote centre of motion is defined as zero.With strong side seam basin for masterplate, health sagittal plane is minute surface, utilizes 3-Matic software to simulate the mirror image model of strong side seam basin, and in this, as the reset position of Ipsilateral pelvis.3ds-Max or Geomagic software is utilized to calculate the transformation matrix needed for reset Ipsilateral pelvis and the anglec of rotation around XYZ axle according to transformation matrix.Virtual operation is implemented in 3-Matic software, copy reservation Ipsilateral pelvis and LC II screw 3D model and after being designated as pelvis 1+LC II screw 1, by the spinning reduction angle calculated, the 3D model rotating Ipsilateral pelvis and LC II screw completes spinning reduction, position is now designated as pelvis 2+LC II screw 2; Calculate LC II screw 1 and 2 at sagittal angle, be recorded as angle 1; Rotate pelvis 1+LC II screw 1 with angle 1 and move LC II screw 1.So far, under the virtual surgical environment of 3-Matic software, the LC II screw 2 of the LC II screw of Ipsilateral pelvis 11 and reset pelvis 2 can residing in two planes being parallel to each other, and in this plane, calculate the angle of above-mentioned LC II screw 1 and 2, be recorded as angle 2; After rotating pelvis 2+LC II screw 2 with angle 2, LC II screw 2 is parallel to each other in three dimensions with LC II screw 1 but does not overlap, export the location parameter of pelvis 1 and 2 now, and with 3ds-Max or Geomagic computed in software transformation matrices T between the two.Utilize the mathematical formulae calculating any rotating shaft anglec of rotation in space:
Calculate pelvis 1 around LC II screw 1 (or 2) to the anglec of rotation θ of pelvis 2, be designated as angle 3, and rotate pelvis 1 by this angle.Now pelvis 1 and pelvis 2 are parallel to each other in three dimensions, that is the anglec of rotation needed for reset Ipsilateral pelvis has all calculated, and is respectively: angle 1, angle 3 and angle 2 by the rotational order of X-axis, LC II screw, Y-axis.With the line shifting between 3-Matic software measurement displacement pelvis 2 and pelvis 1, and decompose to long axis of body, Z axis and X-axis, by the reseting sequence of long axis of body, Z axis and X-axis, be designated as displacement 1, displacement 2 and displacement 3 respectively.
After above-mentioned calculating simulation, actual reset operation can be carried out.When locked screw clamping fixture 6, connecting outrigger 2, screw 8 and Ipsilateral pelvis is relatively-stationary entirety.Loosen outrigger sliding clamp 3, make screw clamping fixture 6 at the arch section of the second side outrigger 1-2 by the angle and direction move angle 1 calculated.Locked outrigger sliding clamp 3, releasing screw clamping fixture 6, holds the general Schanz screw of inserting Ipsilateral pelvis, under the instruction of external protractor, rotates Ipsilateral Pelvic angle 3, now locked screw clamping fixture 6 by the angle and direction calculated.Finally, releasing screw clamping fixture 7, moves Ipsilateral Pelvic angle 2 by the angle and direction calculated along the arch section connecting outrigger 2.So far, namely the rotation displacement of Ipsilateral pelvis has resetted.
Next, when loosening the slide fixture 4 of the second side outrigger 1-2, utilize lower limb traction device along long axis of body and Z axis, by displacement 1 and displacement 2 row lower limb longitudinal traction and the traction of lower limb enuflex position respectively, locked slide fixture 4 afterwards, fixes the second side outrigger 1-2.Now, loosen the outrigger sliding clamp 3 connecting outrigger 2 both sides, use pelvic surgery apparatus, as pushed up rod or Schanz screw, the transverse shift of the Ipsilateral pelvis that resets by displacement 3.
So far, the rotation of Ipsilateral pelvis and line shifting have all resetted.Whole fixture on locked resetting means and universal joint, the fixed position of hold reset device, utilizes Wicresoft's screw at sacroiliac joint lag screw or other positions of pelvis to fix fracture of pelvis.
Ipsilateral pelvis and strong side seam basin are individually fixed in standard procedures bed by each assembly by resetting means provided by the invention, be good for side pelvic position and fix when effectively can remain on all kinds of displacement of reset Ipsilateral pelvis.CT scan three-dimensional reconstruction in art, the computer aided design softwares such as Mimics, 3-Matic, 3ds-Max or Geomagic can accurately calculate the reset path of fracture of pelvis, and adopt resetting means provided by the invention can realize the accurate reset of fracture of pelvis along the reset path calculated.Namely resetting means provided by the invention can press particular path, special angle and designated parameter reset Unstable pelvic fractures, and better reduction, patient suffering is little.
Although describe in detail about example embodiment and advantage thereof, being to be understood that when not departing from the protection domain of spirit of the present invention and claims restriction, various change, substitutions and modifications can being carried out to these embodiments.For other examples, those of ordinary skill in the art should easy understand maintenance scope in while, the order of processing step can change.
In addition, range of application of the present invention is not limited to the technique of the specific embodiment described in description, mechanism, manufacture, material composition, means, method and step.From disclosure of the present invention, to easily understand as those of ordinary skill in the art, for the technique existed at present or be about to develop, mechanism, manufacture, material composition, means, method or step later, wherein their perform the identical function of the corresponding embodiment cardinal principle that describes with the present invention or obtain the identical result of cardinal principle, can apply according to the present invention to them.Therefore, claims of the present invention are intended to these technique, mechanism, manufacture, material composition, means, method or step to be included in its protection domain.
Claims (13)
1. a Unstable pelvic fractures Minimally Invasive Surgery closed reduction device, wherein, described resetting means comprises: the first side outrigger, the second side outrigger, connects outrigger, guide rail, slide fixture, outrigger sliding clamp, screw, screw clamping fixture;
Described first side outrigger is identical with described second side outrigger shape, all adopts the structure of arch section vertical connecting straight bar part; The size of described first side outrigger is greater than described second side outrigger;
Described second side outrigger is arranged at the inside of described first side outrigger, and described first side outrigger and described second side outrigger are referred to as side outrigger;
Described side outrigger is fixed on described guide rail by described slide fixture;
Described connection outrigger adopts arch section to connect the structure walking crosswise straight bar part, its arch section and walk crosswise straight bar part and be provided with scale;
The arch section of described connection outrigger and walk crosswise straight bar part and be arranged in non-same plane, adopts short straight rod to connect therebetween; The straight bar part of walking crosswise at arch section two ends to be arranged in same plane and to be coaxial construction;
Described connection outrigger is connected with described second side outrigger by described outrigger sliding clamp;
Described screw clamping fixture for clamping described screw, and is fixed on described connection outrigger;
Described guide rail is arranged at operation table both sides, and described guide rail is provided with scale.
2. device according to claim 1, wherein, described resetting means also comprises straight rod, and described straight rod is used for fixing described first side outrigger and/or described second side outrigger.
3. device according to claim 1 and 2, wherein, when the second side outrigger is fixed on described guide rail, when described in described screw clamping holder, screw slides on the arch section connecting outrigger, and described connection outrigger is when the arch section of described second side outrigger slides, described screw passes through remote centre of motion all the time.
4. device according to claim 3, wherein, remote centre of motion be two described second side outriggers arch section belonging to the intersection point of the circular line in the center of circle and the axis of described screw.
5. device according to claim 1, wherein, the cross section walking crosswise straight bar part of described connection outrigger is non-circular.
6. device according to claim 1, wherein,
The arch section radius of described first side outrigger is 2200mm ~ 2600mm;
The arch section radius of described second side outrigger is 1400mm ~ 1800mm.
7. device according to claim 1, wherein, described connection outrigger walk crosswise the two ends that straight bar part is arranged at described connection outrigger, be respectively the first straight-bar and the second straight-bar;
The length of described first straight-bar is 500mm ~ 1500mm;
The length of described second straight-bar is 1500mm ~ 2500mm.
8. device according to claim 1, wherein, the arch section radius of described connection outrigger is 2400mm ~ 2800mm.
9. device according to claim 1, wherein, the scale precision setting of the arch section of described connection outrigger is 1 °.
10. device according to claim 1, wherein, the scale precision setting walking crosswise straight bar part of described connection outrigger is 1mm.
11. devices according to claim 1, wherein, the length of described guide rail is 800mm ~ 1200mm, and width is 8mm ~ 12mm, is highly 22mm ~ 26mm.
12. devices according to claim 1, wherein, the scale precision on described guide rail is 1mm.
13. devices according to claim 2, wherein, described straight excellent length is 500mm ~ 5500mm.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201510120718.9A CN104840239A (en) | 2015-03-20 | 2015-03-20 | Closed reduction device for unstable pelvic fracture minimally invasive surgery |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201510120718.9A CN104840239A (en) | 2015-03-20 | 2015-03-20 | Closed reduction device for unstable pelvic fracture minimally invasive surgery |
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| CN201510120718.9A Pending CN104840239A (en) | 2015-03-20 | 2015-03-20 | Closed reduction device for unstable pelvic fracture minimally invasive surgery |
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| CN106726314A (en) * | 2017-03-03 | 2017-05-31 | 中国人民解放军总医院 | A kind of pelvis/lower limb traction is reset bed and multifunction traction reset system |
| CN108553152A (en) * | 2018-05-11 | 2018-09-21 | 石家庄高新区亿成科技有限公司 | Orthopaedics arbitrarily has an X-rayed replacement and fixation frame |
| CN111317554A (en) * | 2020-03-26 | 2020-06-23 | 北京市春立正达医疗器械股份有限公司 | Pelvis reduction tractor |
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