CN113633362A - Minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture - Google Patents
Minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture Download PDFInfo
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- CN113633362A CN113633362A CN202110915955.XA CN202110915955A CN113633362A CN 113633362 A CN113633362 A CN 113633362A CN 202110915955 A CN202110915955 A CN 202110915955A CN 113633362 A CN113633362 A CN 113633362A
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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
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
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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
- A61B2017/564—Methods for bone or joint treatment
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Abstract
The invention belongs to the field of medical instruments, and particularly relates to a minimally invasive surgery tool for knee joint posterior cruciate ligament insertion point fracture. The invention is adopted to carry out the operation, thereby avoiding the defects of large scars left by the large opening of the traditional open operation and even skin necrosis.
Description
Technical Field
The invention belongs to the field of medical instruments, and particularly relates to a minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture.
Background
The knee joint posterior cruciate ligament tibia insertion avulsion fracture is almost the deepest fracture type of the human body, the fracture block is far away from the skin of the body surface, and a large number of important nerve vessels and branches thereof are distributed at the position. The surgical treatment is very troublesome. The traditional incision procedure, regardless of which incision procedure is used, opens an operating window of at least 6-8 cm at the popliteal fossa. The popliteal fossa has tibial nerve, popliteal artery and popliteal vein and a plurality of branches thereof, which are risk factors in the operation and sometimes even cut off part of the gastrocnemius muscle bundle, and even if the internal fixation is installed, the problem that the operation is difficult to progress due to narrow operation space still exists.
In recent years, a great number of arthroscopic surgeries involving posterior cruciate ligament insertion avulsion fractures have been reported. This procedure routinely requires at least 4 surgical incisions and 2 bone tunnels on the tibia. Moreover, the operation is not completely performed in the natural lacuna, a bone-soft tissue lacuna which does not exist originally needs to be established by matching with the incision on the inner side behind the knee joint, and the real operation wound is not less than that of the traditional open operation. The operation of the arthroscope in the deep popliteal fossa is very difficult, the operation technical requirements on doctors are very high, the operation time is long, the reduction is not ideal enough usually, the fixation effect is controversial, and the postoperative rehabilitation cannot be performed early.
Based on the actual pain points, in order to meet the practical clinical requirements, the applicant develops a minimally invasive surgery tool for the fracture of the cruciate ligament insertion point behind the knee joint in a large amount of practical and groped experiences.
Disclosure of Invention
In order to make up the defects of the prior art, the invention provides a technical scheme of a minimally invasive surgery tool for cruciate ligament insertion fracture behind knee joint.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized by comprising a solid needle, a flat sleeve assembly, an inclined sleeve assembly and an inclined sleeve unit with a handle, wherein the solid needle is used for penetrating soft tissues and positioning fracture positions, the flat sleeve assembly comprises a plurality of flat sleeve units, the inclined sleeve assembly comprises a plurality of inclined sleeve units, the inclined sleeve units and the flat sleeve units are used for realizing soft tissue expansion, the head end of each inclined sleeve unit is provided with a first inclined opening structure, the head end of each flat sleeve unit is provided with a flat opening structure, the inner diameters and the outer diameters of the plurality of flat sleeve units are gradually increased and can be sequentially overlapped, the inner diameters and the outer diameters of the plurality of inclined sleeve units are also gradually increased, the smallest inclined sleeve unit is used for being sleeved on the solid needle, and the rest inclined sleeve units are used for being sleeved on the corresponding flat sleeve units, the tail end of the sleeve unit with the handle and the bevel opening is provided with a first handle structure, and the head end of the sleeve unit with the handle and the bevel opening is provided with a second bevel opening structure which is used for being inserted into the corresponding flat opening sleeve unit and used for placing an endoscope.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized in that the head end of the solid needle is provided with a conical structure, the head of the conical structure is provided with a blunt structure, when the solid needle and the beveled sleeve unit are inserted, the solid needle and the beveled sleeve unit are allowed to slide under the action of external force without blocking, and when no external force is generated, the solid needle and the beveled sleeve unit are subjected to friction blocking without sliding.
The minimally invasive surgical tool for knee joint posterior cruciate ligament insertion fracture is characterized in that when the flat sleeve unit and the other flat sleeve unit are sleeved, the two flat sleeve units are allowed to slide without blocking under the action of external force, and the friction block does not slide without external force; when the beveled casing unit and the plain casing unit are sleeved, the beveled casing unit and the plain casing unit are allowed to slide without retardation under the action of external force, and the friction retardation does not slide without external force.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized in that when the inclined-opening sleeve unit with the handle is inserted into the corresponding flat-opening sleeve unit, the inclined-opening sleeve unit and the flat-opening sleeve unit are allowed to slide without blocking under the action of external force, and the friction block does not slide without external force.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized in that the outer walls of the solid needle, the flat sleeve unit, the bevel sleeve unit and the handle bevel sleeve unit are all full of anti-skid grains.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized in that the length of a flat sleeve unit with larger inner diameter and outer diameter is smaller in the plurality of flat sleeve units; the length of the beveled sleeve unit with larger inner diameter and outer diameter is smaller.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized by further comprising a toothed sleeve unit with a handle, wherein the toothed sleeve unit with the handle is inserted into the flat sleeve unit, the tail end of the toothed sleeve unit with the handle is provided with a second handle structure, the head end of the toothed sleeve unit with the handle is provided with an annular first toothed structure, the first toothed structure comprises a plurality of continuous annularly-distributed sawteeth, and the toothed sleeve unit with the handle can replace the flat sleeve unit when the flat sleeve unit is unstably slid and displaced on a bone fragment; when the serrated mouth sleeve unit with the handle is inserted into the corresponding plain end sleeve unit, the serrated mouth sleeve unit with the handle and the plain end sleeve unit are allowed to slide without blocking under the action of external force, and the serrated mouth sleeve unit with the handle and the plain end sleeve unit are friction-blocked without sliding without external force.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized in that the sleeve unit further comprises a tooth-column-mouth sleeve with a handle, the tooth-column-mouth sleeve with the handle is inserted into the corresponding flat-mouth sleeve unit and used for placing an endoscope, the tail end of the tooth-column-mouth sleeve with the handle is provided with a third handle structure, the head end of the tooth-column-mouth sleeve with the handle is provided with an annular second sawtooth structure, the second sawtooth structure comprises a plurality of tooth columns which are distributed at intervals in a surrounding manner, and a notch structure is formed between every two adjacent tooth columns; when the handle tooth column port sleeve and the corresponding flat port sleeve unit are plugged, the two sleeves are allowed to slide without blocking under the action of external force, and the friction blocking does not slide without external force.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized by further comprising a spoon-shaped stripper for stripping subcutaneous soft tissues, wherein the tail of the spoon-shaped stripper is provided with a fourth handle structure, and the head of the spoon-shaped stripper is provided with a spoon-shaped snake head structure.
The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized by further comprising a perspective scale used for estimating the length of the hollow screw, wherein the perspective scale is provided with comb-shaped scale lines.
Compared with the prior art, the invention has the beneficial effects that:
1) the invention is adopted to carry out the operation, thereby avoiding the defects of large scar left by a large opening and even skin necrosis of the traditional open operation;
2) the invention greatly reduces the possibility of neurovascular injury;
3) the invention simplifies the operation of the operation, reduces the operation difficulty and is convenient for orthopedic doctors to master;
4) the tool set is designed to be blunt, so that the puncture of nerves, blood vessels and other soft tissues is avoided;
5) the tool is designed into a double-sleeve pipe, one tool is an inclined opening, the other tool is a flat opening, the inclined opening is used for being inserted to a destination more conveniently, but the gap part of the inclined opening sleeve pipe is easily interfered by extruded soft tissues when a guide pin is used for opening an electric drill bit and screwing a hollow screw, the extruded soft tissues are easily twisted by a rotating guide pin, the flat opening sleeve pipe can completely block the soft tissues, but the insertion is not smooth, and the length of each part of the inclined opening is hidden;
6) the reticulate pattern design prevents the sleeve from accidentally sliding and polluting;
7) the tool with the handle is beneficial to holding;
8) the tool set can perfectly match with an endoscope system to establish a channel for the endoscope system, and the channel of the endoscope system which is viewed from the back is originated by the invention and completely different from the existing knee arthroscope which is commonly used, and the existing knee arthroscope system is not in the direct viewing direction no matter from the front or the inner side;
9) even if the computer-aided technology or the mixed reality technology is mature and applied to the orthopedic surgery in the future, the invention can perfectly adapt to the requirements of the future technology;
10) if the surgical tool and the matched surgical method are not smooth, the surgical tool and the matched surgical method can be suspended at any stage, and if the surgical mode is changed back to the traditional incision surgery, the original incision is still enlarged, and no additional surgical trauma is increased.
Drawings
FIG. 1 is a schematic view of a solid needle structure according to the present invention;
FIG. 2 is a schematic view of a flat-nose sleeve assembly according to the present invention;
FIG. 3 is a schematic structural view of a plain end bushing unit according to the present invention;
FIG. 4 is a schematic view of a bevel sleeve assembly according to the present invention;
FIG. 5 is a schematic structural diagram of a bevel connection bushing unit according to the present invention;
FIG. 6 is a schematic structural view of a sleeve unit with a handle and a bevel opening according to the present invention;
FIG. 7 is a schematic structural view of a serrated port sleeve unit with a shank according to the present invention;
FIG. 8 is a schematic view of a shank-toothed collar structure of the present invention;
FIG. 9 is a schematic view of a perspective scale according to the present invention;
FIG. 10 is a schematic view of the construction of the spoon-shaped detacher of the present invention.
Detailed Description
In the description of the present invention, it is to be understood that the terms "one end", "the other end", "outside", "upper", "inside", "horizontal", "coaxial", "central", "end", "length", "outer end", and the like, indicate orientations or positional relationships based on those shown in the drawings, and are used only for convenience in describing the present invention and for simplicity in description, and do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed in a particular orientation, and be operated, and thus, should not be construed as limiting the present invention.
The invention will be further explained with reference to the drawings.
Referring to fig. 1 to 10, a minimally invasive surgical tool for cruciate ligament insertion fracture behind knee joint comprises a solid needle 1 and cannula units, wherein the solid needle 1 is used for penetrating soft tissues and positioning fracture positions, the cannula units comprise a plurality of flat cannula units 2 and bevel cannula units 3 with the same number, the bevel cannula units 3 and the flat cannula units 2 are used for realizing soft tissue expansion, the head ends of the bevel cannula units 3 are provided with first bevel structures 300, the head ends of the flat cannula units 2 are provided with flat structures 200, the inner diameters and the outer diameters of the flat cannula units 2 are increased one by one and can be sequentially overlapped, the inner diameters and the outer diameters of the bevel cannula units 3 are also increased one by one, the smallest bevel cannula unit 3 is used for being sleeved on the solid needle 1, and the rest bevel cannula units 3 are used for being sleeved on the corresponding flat cannula units 2, but also the smallest flat cannula unit 2 can be used to fit over a solid needle 1.
With continued reference to fig. 1, the head end of the solid needle 1 has a tapered structure 100, the head of the tapered structure 100 has a blunt structure 101, preferably a bulb structure, and the outer wall is covered with anti-slip threads 4. Specifically, the solid needle 1 has a total length of 150mm, a main body part with a diameter of 3mm, a ball head at the tail end, and a conical tip with a diameter of 20mm, and gradually reduces to a ball head structure with a diameter of 1mm at the most tip end.
Function of the solid needle 1: the pioneer opens a way, positions the fracture position by perspective, guides the cannula to enter, and the blunt structure 101 can avoid stabbing tissues.
With continued reference to fig. 2 and 3, the flat-nose bushing assembly comprises five flat-nose bushing units 2, the smallest flat-nose bushing unit 2 having an inner diameter of about 3mm, an outer diameter of about 5mm, a wall thickness of about 1mm, and so on, each flat-nose bushing unit 2 having an inner diameter 2mm larger than the outer diameter of the previous flat-nose bushing unit 2. A tiny gap is reserved between the pipes, and the outer sides of the pipe walls are provided with reticular anti-slip lines 4 with proper thickness, so that the pipes are allowed to slide without blocking under the action of small external force, and the pipes are not blocked by friction without external force. Moreover, the 5 flat-mouth sleeve units 2 are designed in a bidirectional flat-mouth manner, the two ends are rounded, wherein the inner edge of the tube cavity is small in rounded range and only does not cut hands, and the outer edge of the tube wall is large in rounded range, so that the requirements of hydrodynamic streamline shape are met, and soft tissues can freely move in and out of soft tissue gaps and can not cut the soft tissues. The five flat-mouth sleeve units 2 are named as a flat-mouth No. 1, a flat-mouth No. 2, a flat-mouth No. 3, a flat-mouth No. 4 and a flat-mouth No. 5 in sequence from small to large, and the tube lengths of the five flat-mouth sleeve units 2 are reduced in sequence. Specifically, the length of the flat-end No. 1 pipe is 104 mm, the length of the flat-end No. 2 pipe is 102 mm, the length of the flat-end No. 3 pipe is 100mm, the length of the flat-end No. 4 pipe is 98 mm, and the length of the flat-end No. 5 pipe is 96 mm, so that the inner-layer casing pipe can be conveniently drawn out after the outer-layer casing pipe is placed in the inner-layer casing pipe.
With continued reference to fig. 4 and 5, the beveled casing assembly includes five beveled casing units 3, the smallest flat casing unit 2 has an inner diameter of about 3mm, an outer diameter of about 5mm, and a wall thickness of about 1mm, and so on, each flat casing unit 2 has an inner diameter and an outer diameter which are 2mm larger than those of the previous flat casing unit 2, the outer wall of the beveled casing unit 3 also has mesh-shaped anti-slip lines 4 with a suitable thickness, when the flat casing unit 2 is sleeved on the beveled casing unit 3, a small gap is reserved between the two, the pipe and the pipe are allowed to slide without being blocked under the action of a small external force, and the friction block does not slide without external force. And 5 bevel sleeve units 3 are all designed to be flat at one end, and have 30-degree bevel openings at the other end, the edge treatment of the flat end is the same as that of the inner and outer two-way flat openings, the tail end of the bevel end is not required to be treated, but the tip is polished to a streamline round and smooth tip with a high inner edge and a low outer edge, the side edge part is completely polished to be round and smooth, the tail end is named as bevel opening 1, bevel opening 2, bevel opening 3, bevel opening 4 and bevel opening 5 from small to large, and the tube lengths of five bevel sleeve units 3 are reduced in sequence. Specifically, the length of the No. 1 pipe of the bevel opening is 104 mm, the length of the No. 2 pipe of the bevel opening is 102 mm, the length of the No. 3 pipe of the bevel opening is 100mm, the length of the No. 4 pipe of the bevel opening is 98 mm, and the length of the No. 5 pipe of the bevel opening is 96 mm, so that the inner sleeve can be conveniently drawn out after the outer sleeve is placed in the sleeve. The flat-mouth sleeve unit 2 and the bevel-mouth sleeve unit 3 of the same type have the same size.
The flat-mouth sleeve unit 2 and the bevel-mouth sleeve unit 3 have the following functions: both are used for tissue expansion, and the bevel connection design is more advantageous in the aspect of tissue expansion than the flat connection design, and the flat connection design is more comprehensive in soft tissue protection than the bevel connection design, and then the spoon-shaped stripper is matched to achieve the purpose of complete expansion according to requirements. The bevel cannula unit 3 is opened and then the flat cannula unit 2 is used for consolidating the expansion result. The two types of sleeves are designed to be round and blunt heads, so that the stabbing, cutting and soft tissue rolling are avoided.
With continuing reference to fig. 6, the present invention further includes two sleeve units 5 with handles and bevel connection, the two sleeve units 5 with handles and bevel connection are named as "1 with handle" and "2 with handle" in sequence from small to large, the tail end of the sleeve unit 5 with handles and bevel connection has a first handle structure 500, and the head end has a second bevel connection 501, which is used to be inserted into the corresponding flat sleeve unit 2 and used for the endoscope to be inserted; the outer wall of the sleeve unit 5 with the handle and the bevel is also provided with reticular anti-slip lines 4 with proper thickness, when the sleeve unit 5 with the handle and the corresponding flat sleeve unit 2 are inserted, the sleeve unit and the flat sleeve unit are allowed to slide without blocking under the action of external force, and the sleeve unit with the handle and the bevel is not blocked by friction without external force. Specifically, the inner and outer diameter sizes and the pipe wall thickness of two sleeve units 5 with handles are completely equal to that of the bevel 3 and the bevel 4 in the bevel sleeve unit 3, the same bevel treatment and the same reticulate pattern treatment are only slightly longer than the corresponding bevel sleeve unit 3 in length, 4 transverse handles which are perpendicular to each other and the long axis of the sleeve are added at the tail end part of the extra sleeve to serve as a first handle structure 500, the handle thickness of the first handle structure 500 is 2mm, the handle length and width are equal to the outer diameter of the sleeve, and the tail end of the handle is in semicircular treatment.
With continuing reference to fig. 7, the present invention further comprises two handled serrated jaw cannula units 6 inserted into the flat cannula unit 2, wherein the second handle structure 600 is provided at the tail end of the handled serrated jaw cannula unit 6, the first annular serrated structure 601 is provided at the head end of the handled serrated jaw cannula unit 6, the first serrated structure 600 comprises a plurality of continuous annularly distributed serrations, and the handled serrated jaw cannula unit 6 can replace the flat cannula unit 2 when the flat cannula unit 2 is unstably slid and displaced on a bone fragment; the outer wall of the sleeve unit 6 with the handle and the sawtooth opening is also provided with reticular anti-slip lines 4 with proper thickness, when the sleeve unit 6 with the handle and the sleeve unit 2 with the flat opening are plugged, the sleeve unit and the sleeve unit are allowed to slide without blocking under the action of external force, and the sleeve unit with the handle and the sawtooth opening is not blocked by friction without external force. Specifically, the inner diameter and the outer diameter of the handle serrated port casing unit 6 and the thickness of the pipe wall are completely equal to those of a plain end No. 3 in the plain end casing unit 1, the same reticulate pattern treatment is performed, the length of the handle serrated port casing unit is 12mm longer than that of the plain end No. 3, the serrated treatment is performed at one end of the plain end, the depth and the width of teeth are set according to the requirements of an endoscope system, 4 transverse handles which are perpendicular to each other and the long axis of the casing are added to the tail end of the handle serrated port casing unit 6 to form a second handle structure 600, the thickness of the handle is 2mm, the length and the width of the handle are equal to the outer diameter of the casing, and the tail end of the handle is processed in a semicircular shape.
With continued reference to fig. 8, the present invention further includes a handled-toothed-post-port sleeve 9 for being inserted into the corresponding flat-port sleeve unit 2 and for being placed into an endoscope, the handled-toothed-post-port sleeve 9 has a third handle structure 900 at the tail end and a second annular sawtooth structure at the head end, the second sawtooth structure includes a plurality of toothed posts 901 annularly arranged at intervals, the toothed posts 901 are in arc transition and do not damage tissues, preferably three toothed posts 901, and a notch structure 902 is formed between adjacent toothed posts 901; the outer wall of the column port sleeve 9 with the handle teeth is also provided with the reticular anti-slip grains 4 with proper thickness, when the column port sleeve 9 with the handle teeth is inserted into the corresponding flat port sleeve unit 2, the column port sleeve and the flat port sleeve unit are allowed to slide without blocking under the action of external force, and the column port sleeve and the flat port sleeve unit are not blocked by friction without external force. Specifically, the inside and outside diameter and the wall thickness of the handled tooth post mouth sleeve 9 are completely equal to those of the flat mouth No. 4 in the flat mouth sleeve unit 1, the same reticulate pattern treatment is carried out, the length of the handled tooth post mouth sleeve is 12mm longer than that of the flat mouth No. 4, the sawtooth treatment is carried out at one end of the flat mouth, the tooth depth and the tooth width are set according to the requirement of an endoscope system, 4 transverse handles which are perpendicular to each other and the long axis of the sleeve are added at the tail end part of the handled tooth post mouth sleeve 9 to form a second handle structure 900, the handle thickness is 2mm, the handle length and the handle width are equal to the outside diameter of the sleeve, and the tail end of the handle is in semicircular treatment.
The functions of the sleeve unit 5 with the handle bevel opening, the sleeve unit 6 with the handle sawtooth opening and the sleeve 9 with the handle sawtooth opening are as follows: after the common sleeve finishes tissue expansion, the sleeve with the handle does not generally play a role in expansion, only maintains the expansion result, blocks soft tissue reduction, and provides an operation space and a channel for the next operation in the sleeve. The handle is designed to facilitate the operator to hold the cannula during longer operation. The sleeve unit 5 with the handle and the bevel opening is an observation window (the bevel opening is an observation window) for the next step of entering a visual endoscope system (such as an intervertebral foramen mirror), and the tip can stand the sleeve to a certain degree. Of course, the troffer tube unit 5 can also be used as a dilating tube, since the presence of the handle also provides a greater rotational force. The handle design of the sleeve unit 6 with the handle serrated port and the sleeve 9 with the handle serrated port is also for holding, the design of the serrated port and the serrated port is beneficial to the stable holding of the working sleeve on the bone surface, and the serrated port on the other side can also provide an observation window for an endoscope system (the serrated port design of the sleeve 9 with the handle serrated port is particularly suitable for the use of the endoscope system, three serrated columns do not hurt tissues, the heel is stabilized, and three large notches keep enough observation fields as much as possible). The effect of the sleeve unit 6 with the shank and the sawtooth port is that when the flat sleeve unit 2 slides in the lateral direction due to unstable falling foot on a bone block, the sleeve unit 6 with the shank and the sawtooth port with the same size can be used for replacing the flat sleeve unit, and the sawteeth of the sleeve unit 6 with the shank and the sawtooth port provide anti-sliding friction force and are not easy to slide.
With continued reference to FIG. 10, the present invention further includes a spoon-like dissector 7 for dissecting subcutaneous soft tissue, the spoon-like dissector 7 having a fourth handle structure 700 at its tail, an elongated neck 702 at its front, and a spoon-like snake head 701 at its head. Specifically, the spoon-shaped dissector 7 has a total length of 150mm, a handle length of 100mm, a neck length of 20mm, a spoon-shaped part of 30mm, a handle width of 10mm, a thickness of 2mm, a neck width of 2mm, a thickness of 1.5mm, a spoon-shaped part width of 3mm and a thickness of 1.5mm, and a handle wave-shaped protrusion is convenient to hold. The spoon-shaped part is slightly arc-shaped and is a bidirectional rounded protrusion.
The spoon-shaped stripper 7 has the function that after the blade cuts the skin, all subcutaneous soft tissues including nerve vessels are arranged around in a blunt separation way, and a blunt-ended needle and a cannula are opened. The blunt design does not stab the tissue.
With continued reference to fig. 9, the present invention also includes a perspective scale 8 for estimating the length of the cannulated screw, the perspective scale 8 having comb-like graduation marks 800. Specifically, the entire perspective scale 8 is designed in a comb shape. The difference of the penetration rate of the X-ray to the air and the metal substance forms images with different densities (shadows with different depths) on the receiver, the penetration force of the X-ray to the air is strong, the penetration force to the metal plate is weak, the perspective imaging of the perspective graduated scale 8 is also in an obvious comb shape, and a doctor can read the width of the measured object according to the comb-shaped graduated scale 800.
Role of the perspective scale 8: when the guide pin is drilled and X-ray machine perspective is carried out, the perspective dividing ruler 8 is stuck on the inner side or the outer side surface of the knee joint through sterile mucosa, is close to and parallel to the guide pin, and the length of the hollow screw required by estimation in one step is in place, so that the defects that the traditional depth measurement method is inaccurate in measurement and wastes time and energy are avoided. The accuracy of the required cannulated screws in this case generally needs to be accurate enough to be half a centimeter. The scale is designed to be a long tooth column of half centimeter, so that the scale is convenient for rapid counting and rapid estimation.
The method comprises the following steps:
1. before an operation, firstly measuring the size of a torn bone block at a posterior cruciate ligament insertion point, the length of the inner edge of the bone block from the inner edge of a tibial plateau and the length of the outer edge of the bone block from the outer edge of the tibial plateau on an X-ray film and a CT film, after anesthesia is successful, taking a patient in a prone position, properly heightening the ankle part to enable the knee joint to be in a slightly flexed knee state, relieving the tension and the resistance of skin, soft tissue and nerve muscle tendon of a popliteal fossa part, and positioning and finding a body surface projection position of the fracture block by a body surface cross Kirschner needle method under C-shaped arm X perspective before a formal incision scalpel;
2. the blade cuts a small opening at the head side direction of the projection of the body surface of the bone block, and the length of the small opening is not more than 10 mm;
3. the spoon-shaped stripper 7 is used for separating soft tissues under the skin in a blunt manner, particularly pushing away potential nerve blood vessels, and opening a relatively deep but small soft tissue channel;
4. the spoon-shaped stripper 7 is withdrawn, and the solid-replacing needle 1 enters from the back upper part of the popliteal fossa along the opened soft tissue channel to reach the bone end. Confirming the finding of the fracture block by using an X-ray fluoroscopy machine;
5. when the C-arm machine confirms that the solid needle is found and reaches a fracture block through fluoroscopy, the bevel 1 is sleeved at the tail end of the solid needle with the bevel facing downwards, the solid needle enters soft tissues, the tip of the bevel is slightly rotated when the tip of the bevel touches resistance, if the solid needle can continue to advance, the solid needle advances, if the solid needle can still not continue to advance, the solid needle stops advancing, a small amount of the bevel 1 exits properly, the spoon-shaped stripper 7 finds a blocked place, the spoon-shaped stripper 7 pushes aside the soft tissues blocking the advance of the bevel 1 blunt to block, and the insertion of the bevel 1 is continuously tried, so that the bevel 1 reaches the fracture block;
6. after the bevel 1 confirms that the fracture block is reached, the bevel 1 can be considered to be withdrawn, then the bevel 1 is sleeved with the plain 1 until one end of the plain 1 reaches the fracture block, and then a bevel sleeve with a larger diameter is inserted, according to the method, the insertion of the bevel sleeve and the plain sleeve is continuously increased until the inner diameter of the sleeve is larger than the diameter of a tail cap of a hollow screw planned to be used, namely the increase of the sleeve is stopped, at the moment, the solid needle 1 is pulled out, and all the used flat sleeves are reserved;
7. a hollow screw guide pin which is planned to be used is driven into the inner diameter channel of the flat opening No. 1, and then, after the C-arm machine confirms that the fracture block is accurately punctured by the guide pin and is fixed at the original fracture tearing-off position of the tibial plateau without errors through perspective, all flat opening sleeves except the maximum flat opening sleeve are pulled out;
8. electrically opening the hollow opening electric drill head along the direction of the guide pin and withdrawing the opening electric drill head;
9. rotating a fracture block by a proper hollow screw along the direction of the guide needle;
10. keeping the guide pin, and withdrawing the screwdriver and the maximum flat sleeve;
11. c-arm machine perspective verifies that the fracture block is properly fixed, then pulls out the guide pin, if the fracture block is large enough to allow the fracture block to be suitable for driving a second hollow nail or even a third hollow nail, continues to drive nails according to the method, and if the fracture block is only enough to drive one screw, the operation is ended;
12. when the suture is flushed, only one to two needles need to be sutured when the opening is small, the diameter of the tail cap of most hollow screws is less than five millimeters, the number of the flat sleeves finally used is between 2 and 4, and not all the flat sleeves are completely used up. Even if the flat port 5 is used, the diameter is only 13mm, and only two needle ports are needed to be sewed.
In the process, when the fluoroscopic reduction fixation of the guide pin is not good, the position can be properly adjusted for retesting, if the position is not good for the second fluoroscopy prompt, the flat-mouth 1-3 sleeve can be withdrawn, and the sleeve unit 6 with the handle 1 or the handle sawtooth-mouth is put in under the condition of keeping the flat-mouth 4 sleeve (the purpose of keeping the flat-mouth 4 is to protect the soft tissue from being injured by the sleeve unit 6 with the handle sawtooth-mouth). The flat port 1-4 can be withdrawn, and the column port sleeve 9 with the handle 2 or the handle teeth is put in under the condition of keeping the flat port 5 (the purpose of keeping the flat port 5 is also to protect the soft tissue from being injured by the column port sleeve 9 with the handle teeth). The specific sleeve used depends on the needs of the endoscope, and a working channel of the conventional endoscope of 9-11mm is sufficient. At the moment, the surgical assistant holds the sleeve handle still, slightly pulls out the flat port No. 4 or the flat port No. 5 of the outer layer to the position below the handle, and fully exposes the window with the handle bevel or the sawtooth window. The main scalpel is connected with the start endoscope system, and the fracture block is reset and fixed under the direct vision of the endoscope. The rest of the fixing methods are the same as the previous ones or the best operation method is selected according to the endoscopic observation. The cannula system now provides a working channel for the endoscope.
It should be noted that the invention is applicable to bone fragments with a planar diameter of 10mm or more, and is recommended to be used with caution for bone fragments with a diameter of less than 10mm, and is recommended to be not used for bone fractures with a diameter of less than 6mm or with a maximum bone fragment of less than 6mm in comminuted fractures. Fortunately, most of the bone blocks of the posterior cruciate ligament tibial insertion avulsion fracture are flat and massive, the diameters of the bone blocks are more than or equal to 10mm, and the bone blocks with the diameter less than 6mm are rarely fractured.
The invention has the following characteristics and improvements:
1) the defects that a large scar is left in a large opening of the traditional open surgery and even the skin is necrotic are avoided;
2) greatly reducing the possibility of neurovascular injury;
3) the operation of the operation is simplified, the operation difficulty is reduced, and the orthopedic doctor can conveniently master the operation;
4) the tool set is designed to be blunt, so that the puncture of nerves, blood vessels and other soft tissues is avoided;
5) the tool is designed into a double-sleeve pipe, one tool is an inclined opening, the other tool is a flat opening, the inclined opening is used for being inserted to a destination more conveniently, but the gap part of the inclined opening sleeve pipe is easily interfered by extruded soft tissues when a guide pin is used for opening an electric drill bit and screwing a hollow screw, the extruded soft tissues are easily twisted by a rotating guide pin, the flat opening sleeve pipe can completely block the soft tissues, but the insertion is not smooth, and the length of each part of the inclined opening is hidden;
6) the reticulate pattern design prevents the sleeve from accidentally sliding and polluting;
7) the tool with the handle is beneficial to holding;
8) the tool set can perfectly match with an endoscope system to establish a channel for the endoscope system, and the channel of the endoscope system which is viewed from the back is originated by the invention and completely different from the existing knee arthroscope which is commonly used, and the existing knee arthroscope system is not in the direct viewing direction no matter from the front or the inner side;
9) in addition, even if the future computer-aided technology or Mixed-Reality technology (MR) is mature and applied to the orthopedic surgery, the invention can perfectly adapt to the requirements of the future technology;
10) if the surgical tool and the matched surgical method are not smooth, the surgical tool and the matched surgical method can be suspended at any stage, and if the surgical mode is changed back to the traditional incision surgery, the original incision is still enlarged, and no additional surgical trauma is increased.
Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the scope of the technical solutions of the embodiments of the present invention.
Claims (10)
1. The minimally invasive surgery tool for knee joint posterior cruciate ligament insertion fracture is characterized by comprising a solid needle (1), a flat sleeve assembly, an oblique sleeve assembly and a handle oblique sleeve unit (5), wherein the solid needle (1) is used for penetrating soft tissues and positioning fracture positions, the flat sleeve assembly comprises a plurality of flat sleeve units (2), the oblique sleeve assembly comprises a plurality of oblique sleeve units (3), the oblique sleeve units (3) and the oblique sleeve units (2) are used for realizing soft tissue expansion, the head end of each oblique sleeve unit (3) is provided with a first oblique structure (300), the head end of each flat sleeve unit (2) is provided with a flat structure (200), the inner diameter and the outer diameter of each flat sleeve unit (2) are enlarged one by one and can be sequentially overlapped, and the inner diameter and the outer diameter of each oblique sleeve unit (3) are also enlarged one by one, the smallest beveled cannula unit (3) is used for being sleeved on the solid needle (1), the other beveled cannula units (3) are used for being sleeved on the corresponding plain cannula unit (2), the tail end of the sleeve unit (5) with the handle is provided with a first handle structure (500), and the head end of the sleeve unit with the handle is provided with a second beveled structure (501) which is used for being inserted into the corresponding plain cannula unit (2) and used for placing an endoscope.
2. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to claim 1, wherein the head end of the solid needle (1) is provided with a conical structure (100), the head of the conical structure (100) is provided with a blunt structure (101), when the solid needle (1) is inserted into the beveled cannula unit (3), the solid needle and the beveled cannula unit are allowed to slide under the action of external force without blocking, and when no external force exists, the friction block does not slide.
3. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to claim 1, wherein when the flat sleeve unit (2) is sleeved with the other flat sleeve unit (2), the two flat sleeve units are allowed to slide without blocking under the action of external force, and the friction block does not slide without external force; when the beveled casing unit (3) and the plain casing unit (2) are sleeved, the beveled casing unit and the plain casing unit are allowed to slide without retardation under the action of external force, and the friction retardation is not allowed to slide without external force.
4. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to claim 1, wherein when the sleeve unit (5) with the handle and the corresponding sleeve unit (2) with the flat mouth are inserted, the sleeve unit and the sleeve unit are allowed to slide under the action of external force without blocking, and the friction block does not slide without external force.
5. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to claim 1, characterized in that the outer walls of the solid needle (1), the flat cannula unit (2), the oblique cannula unit (3) and the oblique cannula unit with a handle (5) are all covered with anti-skid grains (4).
6. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to claim 1, characterized in that the length of the flat sleeve unit (2) with larger inner diameter and outer diameter is smaller in the plurality of flat sleeve units (2); among the plurality of beveled sleeve units (3), the beveled sleeve units (3) with larger inner diameters and outer diameters have smaller lengths.
7. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to any one of claims 1-6, characterized in that the surgical tool further comprises a handled serrated jaw cannula unit (6) for being inserted and matched in the flat cannula unit (2), the handled serrated jaw cannula unit (6) has a second handle structure (600) at the tail end and a first annular serrated structure (601) at the head end, the first serrated structure (600) comprises a plurality of serrations which are continuously distributed annularly, and the handled serrated jaw cannula unit (6) can replace the flat cannula unit (2) when the flat cannula unit (2) is unstably displaced by falling feet on bone fragments; when the serrated mouth sleeve unit with the handle (6) is inserted into the corresponding plain mouth sleeve unit (2), the serrated mouth sleeve unit with the handle and the plain mouth sleeve unit are allowed to slide without blocking under the action of external force, and the serrated mouth sleeve unit with the handle and the plain mouth sleeve unit are not allowed to slide due to friction blocking without external force.
8. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to any one of claims 1-6, characterized in that the sleeve unit further comprises a toothed sleeve (9) with a handle for being inserted into the corresponding flat sleeve unit (2) and being used for endoscope insertion, the toothed sleeve (9) with a handle has a third handle structure (900) at the tail end and a second saw tooth structure with a ring shape at the head end, the second saw tooth structure comprises a plurality of tooth columns (901) distributed in a ring shape at intervals, and a notch structure (902) is formed between the adjacent tooth columns (901); when the handle tooth post opening sleeve (9) is inserted into the corresponding flat opening sleeve unit (2), the two sleeves are allowed to slide without blocking under the action of external force, and the friction blocking does not slide without external force.
9. The minimally invasive surgical tool for the cruciate ligament insertion fracture behind the knee joint according to any one of claims 1-6, wherein the surgical tool further comprises a spoon-shaped stripper (7) for stripping soft subcutaneous tissues, the tail of the spoon-shaped stripper (7) is provided with a fourth handle structure (700), and the head is provided with a spoon-shaped snake head structure (701).
10. Minimally invasive surgical tool of an ATD fracture of the knee joint according to any of claims 1 to 6, characterized in that the surgical tool further comprises a perspective scale (8) for estimating the length of the cannulated screw, the perspective scale (8) having comb-like graduation marks (800).
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN115137451A (en) * | 2022-09-05 | 2022-10-04 | 北京博海康源医疗器械有限公司 | Releaser for cutting soft tissue around external bone fixing needle channel or fixing nail channel |
| WO2023173470A1 (en) * | 2022-03-18 | 2023-09-21 | 杭州市富阳中医骨伤医院 | Intubation-type tissue expansion orthopedic minimally invasive surgery tool |
Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1618848A1 (en) * | 1988-06-13 | 2006-01-25 | Gary Karlin Michelson | Apparatus including a guard member having a passage with a non-circular cross section for providing protected access to the spine |
| CN101002694A (en) * | 2005-12-20 | 2007-07-25 | 贺新宁 | Trans-vertebral arch pedicle type hollow vertebra centrum bone-grafting apparatus |
| CN101810506A (en) * | 2010-01-29 | 2010-08-25 | 李冀 | Percutaneous bone grafting apparatus |
| CN208640670U (en) * | 2018-02-06 | 2019-03-26 | 南昌大学第二附属医院 | Treated via arthroscope ligamentum intraarticulare stop avulsion fracture soft lens device |
| CN208851594U (en) * | 2017-11-07 | 2019-05-14 | 杭州市余杭区第一人民医院 | Tissue expander tool and minimal access bone external member |
| CN209122412U (en) * | 2018-01-22 | 2019-07-19 | 马鞍山市人民医院 | A kind of guide type bone cement propeller and combinations thereof |
| CN113208722A (en) * | 2021-05-26 | 2021-08-06 | 郑伟 | Fixing and suspending device for posterior cruciate ligament avulsion fracture reduction operation and operation method |
-
2021
- 2021-08-10 CN CN202110915955.XA patent/CN113633362B/en active Active
Patent Citations (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1618848A1 (en) * | 1988-06-13 | 2006-01-25 | Gary Karlin Michelson | Apparatus including a guard member having a passage with a non-circular cross section for providing protected access to the spine |
| CN101002694A (en) * | 2005-12-20 | 2007-07-25 | 贺新宁 | Trans-vertebral arch pedicle type hollow vertebra centrum bone-grafting apparatus |
| CN101810506A (en) * | 2010-01-29 | 2010-08-25 | 李冀 | Percutaneous bone grafting apparatus |
| CN208851594U (en) * | 2017-11-07 | 2019-05-14 | 杭州市余杭区第一人民医院 | Tissue expander tool and minimal access bone external member |
| CN209122412U (en) * | 2018-01-22 | 2019-07-19 | 马鞍山市人民医院 | A kind of guide type bone cement propeller and combinations thereof |
| CN208640670U (en) * | 2018-02-06 | 2019-03-26 | 南昌大学第二附属医院 | Treated via arthroscope ligamentum intraarticulare stop avulsion fracture soft lens device |
| CN113208722A (en) * | 2021-05-26 | 2021-08-06 | 郑伟 | Fixing and suspending device for posterior cruciate ligament avulsion fracture reduction operation and operation method |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2023173470A1 (en) * | 2022-03-18 | 2023-09-21 | 杭州市富阳中医骨伤医院 | Intubation-type tissue expansion orthopedic minimally invasive surgery tool |
| CN115137451A (en) * | 2022-09-05 | 2022-10-04 | 北京博海康源医疗器械有限公司 | Releaser for cutting soft tissue around external bone fixing needle channel or fixing nail channel |
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|---|---|
| CN113633362B (en) | 2023-02-28 |
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