CN203425013U - Ring type triangular synchronous control extender for thigh bone - Google Patents

Ring type triangular synchronous control extender for thigh bone Download PDF

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Publication number
CN203425013U
CN203425013U CN201320551340.4U CN201320551340U CN203425013U CN 203425013 U CN203425013 U CN 203425013U CN 201320551340 U CN201320551340 U CN 201320551340U CN 203425013 U CN203425013 U CN 203425013U
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China
Prior art keywords
femur
hole ring
ring
extender
bar cover
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CN201320551340.4U
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夏和桃
李刚
彭爱民
夏洪菁
王坤正
刘利民
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JIANGSU GUANGJI MEDICAL TECHNOLOGY Co Ltd
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JIANGSU GUANGJI MEDICAL TECHNOLOGY Co Ltd
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Abstract

A ring type triangular synchronous control extender for the thigh bone is composed of an extender frame body, a steel needle fixing clip connected onto the extender frame body and steel needles clamped in the steel needle fixing clip. The extender frame body comprises a thigh bone extender frame body arranged at the position of the thigh bone. The thigh bone extender frame body comprises a thigh bone lower hole ring, a thigh bone upper hole ring arranged above the thigh bone lower hole ring and a plurality of fast drawing extending rods connected between the thigh bone lower hole ring and the thigh bone upper hole ring. The extender frame body further comprises one to two tubular connection rods connected above the thigh bone upper hole ring and an arc bow connected between the tubular connection rods and the thigh bone upper hole ring. The extender frame body further comprises a thigh bone hole ring arranged at the position of the thigh bone and an elastic drawing fixing rod arranged between the thigh bone lower hole ring and the thigh bone hole ring. The extender can dynamically compensate the pressure of knee joints, enables the pressure of the knee joints to keep dynamic balance and enables the knee joints to have certain activity in the extending process.

Description

Femur ring type triangle Synchronization Control extender
Technical field
This utility model relates to a kind of bone external fixator, particularly a kind of femur extender.
Background technology
Bone lengthening (Bone lengthening) concept comes from initial callus lengthening art (Callus lengthening), refer at the two ends of osteotomy and wear and put draw point, by application bone elongation pad, bony process is executed to drafting force, the concept that bone length is increased, bone also can make limbs length appropriateness increase after extending, bone lengthening is a kind of limb lengthening mode of passive type.Existing bone elongation pad, Ilizarov ring type extender as shown in Figure 1 when implementing lengthening of femur, is threaded a needle respectively on femur and tibia, and on axis, extends or shorten sclerotin.Yet the weak point of above-mentioned femur extender is: conventionally can only be in the situation that not crossing over joint, to skeleton enforcement drafting force, cannot carry out synchronous lengthening to crossing over the soft tissues such as kneed muscle, nerve, blood vessel, especially carrying out the femur overtime of trans-articular, adopt existing bone elongation pad to carry out the traction of trans-articular, the severe complication of the limb lengthenings such as bone does not connect, joint dislocation and knee joint disorders easily occurs.The utility model people of this patent has proposed limb lengthening concept, according to Biological Principles, stress rule, Wicresoft's principle and the control theory of stress regeneration, drawing-off and the orthopaedic function of application osteotomy and external fixator, for limbs (bone) tissue provides suitable tensile stress, reappear the biological process of limb regeneration, realize the new limb lengthening concept that limbs length increases and function optimization is rebuild.By the clinical research for many years to limb lengthening dynamic equilibrium biomechanics aspect, and according to different therapeutic purposes and the difference of concrete grammar, multiple basic operative mode has been proposed.
And limbs synchronous lengthening art is research and the innovation of carrying out around solving clinical problem, the basic fundamental principle of limbs synchronous lengthening should meet: 1. blood is for good osteotomy site; 2. the osteotomy of minimally invasive; 3. the limb lengthening device of good mechanical performance and perfect in shape and function; 4. maintain the normal physiological equilibrium who closes on joint, bone and soft tissue; 5. patient carries out useful functional training and takes care of oneself under non-pain state; 6. the increase of limbs length is consistent with the recovery of normal limb function; 7. do not carry out the complementary procedures such as tendon (heel string) prolongation.Although standard bone extends engineering philosophy in limb lengthening technology, can solve the Treatment need of part shortening deformity of extremity, very difficult solution complexity shortening deformity of extremity and the clinical difficulties that significantly shortening deformity of extremity produces.Because traditional bone elongation pad can not provide direct active force for crossing over the soft tissues such as muscle in joint, its active force can only conduct indirectly by joint; Along with the sustainable growth of bone length, will inevitably cause that the soft tissue tension of crossing over joint increases, thereby bring out the disorder of corresponding joint dynamic equilibrium, very person may cause joint dislocation or cartilage infringement.For example: tibia lengthening, can there is drop foot in the lighter, and can there is cartilage lesion in severe one; Femur extends, and the lighter can cause that knee sprung is limited, and the severe complications such as dislocation of knee joint can occur severe one.Significantly overtime is all the more so.
Utility model content
The purpose of this utility model is: for above-mentioned weak point, provide a kind of prolongation amplitude high, can maintain kneed dynamic equilibrium at femur overtime, avoiding significantly extending is the dislocation of knee joint causing, the femur ring type triangle Synchronization Control extender that the increase of knee joint internal pressure causes cartilage lesion.This utility model femur ring type triangle Synchronization Control extender makes the soft tissues such as bones of extremities and neural, blood vessel and muscle under same tensile stress environment, carry out the value-added length of organizing of cell division to increase, and it is consistent with function to maintain the dynamic equilibrium in joint.Can in prolongation process, maintain joint in functional position and dynamic physiology balance, avoid to greatest extent the generation of joint complication.Effectively prevent drop foot, joint deformity, dislocation and joint load conduction disturbance, avoid significantly overtime intra-articular pressure to increase the problem that regression occurs with aclasis.Realized limb lengthening transformation to " safety " by " danger ", the security implementation of operation is become a reality.
Along with going deep into of 21 century regenerative medicine research, in finding embryo development procedure, in signaling system regulating and controlling effect, also form gradually emerging science-mechanics cytology.According to new achievement in research conclusion, limb lengthening is the biological behaviour of a kind of " limb regeneration ", and the mode of regeneration is exactly stress regeneration.Union of fracture, bone transport, drawing-off is orthopedic and limb lengthening, and being all provides stress effect by femur ring type triangle Synchronization Control extender for regeneration, as fracture fixation, the mechanical function effects such as pressurization is fixing, tractive tissue and flexible fastening, realize limb regeneration.On Application of device, create conditions for the use of limb function to greatest extent.
Motion is conducive to limbs blood fortune, can bring into play to greatest extent the effect that physiological stress stimulates, and promotes osteanagenesis, realizes the optimized reconstruction of bone function.Femur ring type triangle Synchronization Control extender also contributes to improve osteanagenesis quality, has eliminated and has thought that for a long time use external fixator can not bear a heavy burden, be difficult to the prejudice such as walking, long-term inpatients and management trouble.Realize the limb lengthening that treatment and rehabilitation develop simultaneously, almost without in treatment or extend after finishing and carry out special functional rehabilitation treatment or training, and realize the object of spontaneous remission.And make knee joint have certain mobility in prolongation process, and maintain joint nutrition, avoid articular cartilage degeneration.
In order to realize above-mentioned utility model object, this utility model provides following technical scheme: a kind of femur ring type triangle Synchronization Control extender, by extender support body, be connected to the steel needle fixing clamp on extender support body, and the draw point being clipped in steel needle fixing clamp forms, it is characterized in that: described extender support body comprises the femur extender support body that is arranged at femur place, femur extender support body comprises hole ring under femur, be arranged at hole ring on the femur of the top of hole ring under femur, and be connected under femur some quick lengthening bars between hole ring on hole ring and femur.
Described extender support body also comprises being connected to one to two tubulose connecting rod of the top of hole ring on femur and being connected to the arc between hole ring on tubulose connecting rod and femur and bends.
Described extender support body also comprises and is arranged at the tibia hole ring at tibia place and is arranged on the elasticity drawing-off fixed bar between hole ring and tibia hole ring under femur, under the upper end of described elasticity drawing-off fixed bar and femur, hole ring is articulated and connected, the lower end of elasticity drawing-off fixed bar is plugged in the hole of tibia hole ring, the top of elasticity drawing-off fixed bar is provided with screw thread, and is provided with spring between screw thread and tibia hole ring.
Described extender support body also comprises threaded fixation clamp connecting rod, described threaded fixation clamp connecting rod is connected under femur on hole ring by upper and lower adjusting nut is adjustable, on threaded fixation clamp connecting rod, cover has draw point pad and draw point pressure pad, and draw point pad and draw point pressure pad are connected on threaded fixation clamp connecting rod by upper and lower adjusting nut is adjustable, between draw point pad and draw point pressure pad, accompany half pin.
The upper end of described elasticity drawing-off fixed bar is articulated and connected by hole ring under the first joint device and femur.
One end of described quick lengthening bar is fixedly connected under femur on hole ring, the other end is articulated and connected on femur on hole ring.
Described quick lengthening bar includes threaded rod, interior bar cover and outer bar cover, described threaded rod is from top to bottom inserted in interior bar cover, described interior bar cover is from top to bottom inserted in outer bar cover, and the lower end of described outer bar cover is provided with the threaded connector that is connected use with hole ring.
The upper end of described interior bar cover is provided with flanging, and be provided with pressure controller between the upper end of interior bar cover and threaded rod, described pressure controller controls cover by adjusting sleeve, pressure and Compress Spring forms, the upper end of described adjusting sleeve is threaded with threaded rod, the bottom of adjusting sleeve is controlled external threading with pressure and is connected, the interior bar that described pressure control cover is movably set in flanging downside puts, and described Compress Spring is enclosed within on the threaded rod between the upper end of adjusting sleeve and the flanging of interior bar cover.
It is uncovered that the medial wall, upper end of described outer bar cover is provided with taper, the lateral wall, upper end of outer bar cover is provided with external thread section, and be provided with lock-on connection between the upper end of outer bar cover and interior bar cover, described lock-on connection is comprised of taper elastic ring and locking nut, described locking nut is by the be threaded upper end of the cover of bar outside of external thread section, described taper elastic ring be inserted in taper uncovered in, be clipped between interior bar cover and outer bar cover, and the fixing of the upper end of taper elastic ring is on the upper end of locking nut.
Between the medial wall of the lateral wall, bottom of described interior bar cover and outer bar cover, be provided with bar cover pad.
Threaded rod on described quick lengthening bar is connected under femur on hole ring by upper and lower adjusting nut is adjustable, and the threaded connector on described quick lengthening bar is articulated and connected by hole ring on second joint device and femur.
Described tubulose connecting rod is articulated and connected on femur on hole ring by having hinged and joint device locking function.
On described femur, the top of hole ring is provided with two tubulose connecting rods, and two tubulose connecting rods are articulated and connected on femur on hole ring by two joint devices with hinged and locking function and porous plate.
One end of described arc bow is articulated and connected on femur on hole ring by having hinged and joint device locking function, and the other end of arc bow is connected with tubulose connecting rod by universal joint.
Compared with prior art the beneficial effects of the utility model are: when femur prolongation, knee joint place pressure increase, elasticity drawing-off fixed bar and spring carry out dynamic compensation to kneed pressure, make kneed pressure keep dynamic equilibrium, avoid significantly extending and be the dislocation of knee joint causing and avoid significantly overtime knee joint internal pressure to increase institute causing cartilage lesion, make knee joint have certain mobility in prolongation process, maintain joint nutrition, avoid articular cartilage degeneration, thus significantly extending sufficient safety guarantee be provided for femur.
This utility model has designed the trigonometric expression supporting construction being comprised of hole ring on femur, tubulose connecting rod and arc bow, has firm strong fixed structure, has well fixing, anti-shearingly and prevent rotatory power, fixes stable; In addition, according to lever principle design, the shearing force of trigonometric expression supporting construction energy antagonism near end of thighbone load, postoperatively can control collodiaphyseal angle by the adjusting (drawing-off or pressurization) in interior side lever or outside.
In this utility model, be provided with multidirectional articulation joint and there is hinged and joint device locking function, both can realize valgus deformity correcting function in ankle, can effectively be locked in orthopedic rear enforcement again.
This utility model also can follow treatment cycle to adjust structure: fixedly during the stage, this trigonometric expression supporting construction has increased the stability of bone external fixator, meets strong fixedly needs in early days; In the flexible fastening stage in mid-term, the quick lengthening bar of dismounting between near-end hole C shape ring, far-end hole C shape ring, provides flexible fastening axial and that combined stress stimulates as required, promotes union of fracture, new bone growth; In the later stage, provide fixing stage of balance, removable all quick lengthening bar, alleviate the weight of bone external fixator, be beneficial to patient and carry out mobility's rehabilitation training, promote sclerotin mineralising, realize the optimized reconstruction of bone function and healing completely), promote new bone growth, sclerotin mineralising, realizes optimized reconstruction and the actively rehabilitation of bone function, realize healing completely, facilitate management after operation simultaneously, be convenient for measuring.
This utility model is easy to adjust, screw thread half pin can by steel needle fixing clamp connecting rod axially carry out displacement adjusting, and the angle that steel needle fixing clamp also can double thread half pin regulates, and realizes flexibly pressurization and the drawing-off of draw point.
The utlity model has the functions such as good reduction, fixing and regulation and control, facilitated in art and operated to greatest extent, and the bone external fixator of movable orthopedic for hip joint, the Fracture of femur in limbs of patient and joint, especially be embodied in: features simple structure, combination flexibly, handled easily, can be according to different arthrosiss, fracture situation and treatment needs, be combined into the multiple static fixing and appropriate drawing-off pressurization function configuration that has, there is static fixing and appropriate drawing-off pressurization function, and have well fixing, anti-shearing and prevent rotatory power.
Treatment applied range of the present utility model: 1, can be according to treatment requirement, by inherent function and the adjusting device of bone external fixator, for fractures provides the function of the reduction of the fracture and adaptability rigidity; 2, for bone is damaged, the treatment of skin injury and shortening deformity of extremity provides the function of slow prolongation; 3, the treatment for B&J deformity provides progressively drawing-off orthopaedic function; 4, the comprehensive mechanical function under complex situations, provides the biomechanics adapting with bone and soft tissue regeneration environment.Above-mentioned these specific functions are that other apparatus and Therapeutic Method are not available.
This utility model has guaranteed the balanced capacity of mechanical energy and bioenergy, can guarantee the effect of orthopedic extending, effectively prevents the generation of the complication such as bone does not connect.
In this utility model, be provided with multidirectional articulation joint and there is hinged and joint device locking function, both can realize valgus deformity correcting function in ankle, can effectively be locked in orthopedic rear enforcement again.
This this utility model can make mechanical energy (mechanical environment) and bioenergy (tissue regeneration) have the good compatibility (reasonability of Mechanobiology environment), and can meet fracture early implementation strong flexible fastening, later stage fixing, that provide axially mid-term and combined stress stimulates provides balance fixing requirement.
This utility model has carried out new innovation to the mechanics effect of bone external fixator, has dynamic elasticity drawing-off function, has the structure of complying with biological requirement, makes the bone external fixator bionic boundary of marching toward become possibility, for implementing cybernetics, provides technical guarantee.
This utility model has incorporated the structural element of more Ilizarov external fixator, not only in rationale, there is again new breakthrough the aspects such as apparatus innovation, technical specification, clinical practice and treatment theory, substantially realize theoretical system, apparatus seriation, regularized operation, criterion of therapeutical effect, formed new bone External technique system.
Quick lengthening bar in this utility model is the important component of implementing overall configuration and function combinations, can carry out the optimum organization of configuration, increase practicality and the dexterity of configuration, at therapeutic process, can require to implement drawing-off, pressurization, regulation and control elasticity and adaptability rigidity according to treatment fixes, embodied highlightedly bionics function, improve the compatibility of mechanical energy and bioenergy, met the requirement of regeneration reconstruction and control theory, guaranteed curative effect.
In therapeutic process, according to treatment requirement, can control the quick lengthening bar in this utility model by pressure controller, make quick lengthening bar implement elasticity drawing-off pressurization, flexible fastening (regulation and control elasticity) and adaptability rigidity and fix.
Quick lengthening bar in this utility model can stretch, clockwise or rotate counterclockwise lock-on connection 360 degree, lengthening bar can increase or shorten fast, solved the difficult problem that the fixing rigidity of bone external fixator can not change, so can require implement the adaptability balance that gap is zero early stage strongly fixes, mid-term, gap was 1~2mm flexible fastening and later stage gap are 3~5mm according to treatment at therapeutic process, fixed.
Quick lengthening bar in this utility model has quick-expansion, slowly extend and three kinds of functions of dynamic elasticity drawing-off pressurization, there is adjusting operation convenient, configuration is optimized, practical, dexterous feature, more importantly, in the overall process for the treatment of, early, in, the difference in later stage is the stage fixedly, under the prerequisite of repertoire that keeps bone external fixator, can meet respectively early stage strong fixing, flexible fastening in mid-term, later stage balance is the treatment requirement of stage bone fixedly, promote new bone growth, sclerotin mineralising, realize optimized reconstruction and the actively rehabilitation of bone function, realize healing completely, facilitate management after operation simultaneously, be convenient for measuring.
Compare with traditional extension rod (Chinese patent application that application publication number is CN102860861A), the quick lengthening bar in this utility model is use better, specific as follows:
What 1, traditional extension rod adopted is the structure of two-stage nitration bar, there is the problem that dilatability is little, and quick lengthening bar in this utility model has adopted the structure of three sections of bars, so tensile elongation has increased a lot (collapsing length is larger) than traditional extension rod, can reach 160mm~350mm, adjusting range is wider, to ankle is orthopedic, has a very large advantage, has avoided the drawback of the limited length of traditional extension rod.
2, traditional extension rod is carried while shrinking locking jaw, is easily made the screw thread in locking jaw fasten threaded rod, make threaded rod and bar cover locking on lock sleeve, simultaneously, after traditional extension rod is locked by locking jaw, the fit clearance between threaded rod and bar cover can cause extension rod to occur that slight rolling is dynamic.Quick lengthening bar in this utility model has been cancelled locking jaw, so there will be stuck problem while having avoided threaded rod and locking jaw flexible, simultaneously, quick lengthening bar in this utility model has designed outer bar cover and the cooperation of interior bar cover gapless is free to slide, and control by lock-on connection the slip that outer bar overlaps and interior bar overlaps, with this, realize fast significantly length adjustment, owing to being being free to slide of gapless cooperation between interior bar cover and outer bar cover, so locking is rear without rocking.
3, avoided traditional extension rod inconvenient problem with use.Rigidity controller on traditional extension rod is to place separately, when it withstands locking jaw, could realize rigidity and control, during use, adjust complexity and lose time, if while not needing rigidity controller, must be unloaded, so while using not isomorphism type, must add to consider, and this utility model has adopted the built-in principle of rigidity controller, rename as pressure controller, by the pressure in rotational pressure controller, control cover, can adjust the pressure of this utility model to art bone, by the adjusting sleeve in integral-rotation pressure controller, can make to realize flexible fine setting between threaded rod and interior bar cover, so both improved and regulated the speed, guaranteed again the degree of accuracy of adjusting, if while not needing rigidity to control, can directly pressure be controlled to cover and rotate the bosom to adjusting sleeve, Compress Spring is depressed into the shortest (the inelastic state in Compress Spring place), now pressure controller is inoperative.
4, traditional extension rod is when processing locking jaw, difficulty of processing is large, finished product rate is low, production cost is high, become the bottleneck that affects product promotion, and quick lengthening bar in this utility model has been cancelled locking jaw, has reduced difficulty of processing and production cost, improved working (machining) efficiency, the problem of having avoided processing locking jaw to bring.
5, traditional bone external fixator all adopts rustless steel, in therapeutic process, can affect x-ray fluoroscopy, and in this utility model, except threaded rod, all can adopt lightweight duralumin, hard alumin ium alloy, titanium alloy or carbon fibre material, so expanded x-ray fluoroscopy scope, increase the perspective rate of bone external fixator, be convenient to therapeutic effect to carry out accurate assessment, also be more conducive to diagnose exactly the situation of fracture, reduce significantly in addition the weight of bone external fixator, be convenient to functional training.
Accompanying drawing explanation
The structural representation of the Ilizarov ring type extender that Fig. 1 is in prior art, lengthening of femur is conventional.
Fig. 2 is structural representation of the present utility model.
Fig. 3 is decomposition texture schematic diagram of the present utility model.
Fig. 4 is that the master of quick lengthening bar looks schematic diagram.
Fig. 5 is the decomposing schematic representation of quick lengthening bar.
Fig. 6 is the assembling schematic diagram of quick lengthening bar.
Fig. 7 is the schematic diagram of the external thread section on the lateral wall, upper end of lock-on connection and outer bar cover.
Fig. 8 is the structural representation of quick lengthening bar.
Fig. 9 is the enlarged diagram at I place in Fig. 8.
Figure 10 is the enlarged diagram at II place in Fig. 8.
Labelling in figure: 1-femur; 2-tibia; Hole ring under 3a-femur-; Hole ring on 3b-femur-; The quick lengthening bar of 3c-; 4-tibia hole ring; 5-elasticity drawing-off fixed bar; 6-spring; 7-the first joint device; 8-second joint device; 9-threaded rod; Bar cover in 10-; The outer bar cover of 11-; 12-adjusting sleeve; 13-Compress Spring; 14-pressure is controlled cover; 15-taper is uncovered; 16-taper elastic ring; 17-external thread section; 18-locking nut; 19-bar cover pad; 20-threaded connector; 21-flanging; 22-tubulose connecting rod; 23-arc bow; The threaded fixation clamp connecting rod of 24-; 25-draw point pad; 26-draw point pressure pad; The upper and lower adjusting nut of 27-; 28-steel needle fixing clamp; 29-half pin; 30-has hinged and joint device locking function; 31-porous plate; 32-universal joint.
The specific embodiment
Below in conjunction with test example and the specific embodiment, this utility model is described in further detail.But this should be interpreted as to the scope of the above-mentioned theme of this utility model only limits to following embodiment, all technology realizing based on this utility model content all belong to scope of the present utility model.
Embodiment is as shown in Fig. 2 to Figure 10, and this femur ring type triangle Synchronization Control extender, by extender support body, be connected to the steel needle fixing clamp 28 on extender support body and the draw point that is clipped in steel needle fixing clamp forms.
Described extender support body comprises the femur extender support body that is arranged at femur 1 place, and femur extender support body comprises hole ring 3a under femur, be arranged at hole ring 3b on the femur of hole ring 3a top under femur and be connected under femur some quick lengthening bar 3c between hole ring 3b on hole ring 3a and femur.
Described extender support body also comprises being connected to one to two tubulose connecting rod 22 of the top of hole ring 3b on femur and being connected to the arc between hole ring 3b on tubulose connecting rod 22 and femur and bends 23.
Described extender support body also comprises and is arranged at the tibia hole ring 4 at tibia 2 places and is arranged on the elasticity drawing-off fixed bar 5 between hole ring 3a and tibia hole ring 4 under femur, under the upper end of described elasticity drawing-off fixed bar 5 and femur, hole ring 3a is articulated and connected, the lower end of elasticity drawing-off fixed bar 5 is plugged in the hole of tibia hole ring 4, the top of elasticity drawing-off fixed bar 5 is provided with screw thread, and is provided with spring 6 between screw thread and tibia hole ring 4.
Described spring 6 can be at hole ring 3a under femur, when the spacing of tibia hole ring 4 reaches preset range, dynamically apply propulsive thrust, when femur 1 extends, when knee joint place pressure increases, 6 pairs of kneed pressure of spring in elasticity drawing-off fixed bar 5 carry out dynamic compensation, make kneed pressure keep dynamic equilibrium, avoid significantly extending is the dislocation of knee joint causing, and avoid significantly overtime knee joint internal pressure to increase cause cartilage lesion, make knee joint have certain mobility in prolongation process, maintain joint nutrition, avoid articular cartilage degeneration, thereby significantly extending sufficient safety guarantee be provided for femur 1.
It should be noted that, on femur in this utility model, under hole ring, femur, hole ring and tibia hole ring can be the structures that adopts loopful, on femur, under hole ring, femur, hole ring and tibia hole ring can also adopt C type ring structure, that is: half-turn, the form of not sealing, reduce deadweight to play, make the beneficial effect that structure is lighter and handier.
Described extender support body also comprises threaded fixation clamp connecting rod 24, described threaded fixation clamp connecting rod 24 is connected under femur on hole ring 3a by upper and lower adjusting nut 27 is adjustable, on threaded fixation clamp connecting rod 24, cover has draw point pad 25 and draw point pressure pad 26, and draw point pad 25 and draw point pressure pad 26 are connected on threaded fixation clamp connecting rod 24 by upper and lower adjusting nut 27 is adjustable, accompany half pin 29 between draw point pad 25 and draw point pressure pad 26.
The upper end of described elasticity drawing-off fixed bar 5 is articulated and connected by hole ring 3a under the first joint device 7 and femur.
One end of described quick lengthening bar 3c is fixedly connected under femur that hole ring 3a is upper, the other end is articulated and connected on femur on hole ring 3b.
In the present embodiment, lengthening bar 3c includes threaded rod 9, interior bar cover 10 and outer bar cover 11 fast, described threaded rod 9 is from top to bottom inserted in interior bar cover 10, described interior bar cover 10 is from top to bottom inserted in outer bar cover 11, and the lower end of described outer bar cover 11 is provided with the threaded connector 20 that is connected use with hole ring.
The upper end of described interior bar cover 10 is provided with flanging 21, and be provided with pressure controller between the upper end of interior bar cover 10 and threaded rod 9, described pressure controller controls cover 14 by adjusting sleeve 12, pressure and Compress Spring 13 forms, the upper end of described adjusting sleeve 12 is threaded with threaded rod 9, the bottom of adjusting sleeve 12 is controlled cover 14 with pressure and is threaded, described pressure control cover 14 is movably set on the interior bars cover 10 of flanging 21 downsides, and described Compress Spring 13 is enclosed within on the threaded rod 9 between the upper end of adjusting sleeve 12 and the flanging 21 of interior bar cover 10.
The medial wall, upper end of described outer bar cover 11 is provided with taper uncovered 15, the lateral wall, upper end of outer bar cover 11 is provided with external thread section 17, and be provided with lock-on connection between the upper end of outer bar cover 11 and interior bar cover 10, described lock-on connection is comprised of taper elastic ring 16 and locking nut 18, described locking nut 18 is by the be threaded upper end of the cover of bar outside 11 of external thread section 17, described taper elastic ring 16 is inserted in taper uncovered 15, is clipped between interior bar cover 10 and outer bar cover 11, and the upper end of taper elastic ring 16 fixes on the upper end of locking nut 18.Between the medial wall of the lateral wall, bottom of described interior bar cover 10 and outer bar cover 11, be provided with bar cover pad 19.
Adjustable to be connected under femur hole ring 3a upper by upper and lower adjusting nut 27 for threaded rod 9 on described quick lengthening bar 3c, and the threaded connector 20 on described quick lengthening bar 3c is articulated and connected by hole ring 3b on second joint device 8 and femur.Adopt in such a way, overall structure is dexterous, easy accessibility.
In other embodiments, lengthening bar also can replace with traditional extension rod fast, and certainly, lengthening bar can also adopt other more existing connecting rods fast.
Described tubulose connecting rod 22 can be articulated and connected on femur on hole ring 3b by having hinged and joint device 30 locking function.In the present embodiment, on femur, the top of hole ring 3b is provided with 22, two tubulose connecting rods 22 of two tubulose connecting rods and is articulated and connected on femur on hole ring 3b by two joint devices 30 with hinged and locking function and porous plate 31.
One end of described arc bow 23 is articulated and connected on femur on hole ring 3b by having hinged and joint device 30 locking function, and the other end of arc bow 23 is connected with tubulose connecting rod 22 by universal joint 32.
It is described that to have hinged and joint device locking function can be any one or more the combination in spherical universal joint (Chinese patent application that application publication number is CN103006302A), damping joint (Chinese patent application that application publication number is CN103006303A) or self-locking joint (Chinese patent application that application publication number is CN103006301A).
In the present embodiment, except threaded rod, all can adopt lightweight duralumin, hard alumin ium alloy, titanium alloy, carbon fibre material to make.
The effect of the lock-on connection in lengthening bar is fast: make interior bar cover and outer bar overlap rapid drawing-off and locking, make interior bar cover and the locking at an arbitrary position of outer bar cover.Specifically, the medial wall, upper end of described exactly outer bar cover is provided with taper uncovered (the medial wall, upper end of outer bar cover is the pyramidal structure that the diameter of axle diminishes gradually) from top to bottom, during locking nut in tightening lock-on connection, taper is uncovered can be compressed taper elastic ring, make bar cover in the locking of taper elastic ring, now interior bar overlaps and outer bar cover locking, when unscrewing locking nut, the reinstatement of taper elastic ring, makes interior bar cover external bar cover free-extension mutually.
Treatment stage in early days, when operative reduction, when this utility model is fixed on art bone, locking nut on quick lengthening bar is unclamped, make quick lengthening bar in the quick adjustable state of length (interior bar cover with outer bar cover can relative sliding), simultaneously fast fast lengthening bar is in free movement state under the effect of the various joint devices with hinged and locking function, and this utility model now can carry out three-dimensional adjustment neatly, carries out drawing-off, rotation, pressurization, reset.After art bone resets substantially, by the joint device locking with hinged and locking function in this utility model, by the adjusting sleeve in rotational pressure controller, carry out the micro stretching contracting (adjusting sleeve can be controlled the relative position of interior bar cover and threaded rod) of threaded rod, the reduction of the fracture is finely tuned.After the adjustment of art bone resets, pressure in pressure controller can be controlled to cover and rotate the bosom to adjusting sleeve, now Compress Spring is compressed into the shortest, pressure controller inoperative (Compress Spring is inoperative), now lengthening bar will fully be fixed art bone fast fast, for union of fracture, new bone mineralising provide strong fixing, guarantee that knitting initial stage is desired strong fixing, avoided inaccurate due to the stable poor dislocation causing, angulation, the problem such as heal bad.
When the mid-term of knitting, need to be to the flexible fastening that art bone provides axially and combined stress stimulates, pressure is controlled to cover rotation to be unclamped, make Compress Spring in elastic force state, now under the effect of the Compress Spring in pressure controller, lengthening bar can have certain telescopic resilience (threaded rod is connected with interior bar cover elasticity) fast, by rotational pressure, control cover, can regulate the elastic force of Compress Spring, realize thus and adjust the elastic force of controlling quick lengthening bar, thereby reach the object of the pressure size of controlling quick lengthening pole pair art bone, now, can control bone external fixator, implement drawing-off, pressurization function, drawing-off pressurization scope 0~200 handkerchief (unit) of adjusting sleeve on quick lengthening bar to knochenbruch.Clockwise rotate adjusting sleeve 360 degree, increase 1mm, rotate counterclockwise and shorten 1mm, this regulation and control, the flexible fastening rigidity of the best combined stress stimulation of knitting mid-term stage is provided, has given full play to the adaptability of bone counter stress, the growth of capable of regulating bone and absorption, promote the process of union of fracture, the optimized reconstruction of complete osteogenesis function.
The anaphase stage: this utility model will provide balance to fix, under the prerequisite of function that keeps bone external fixator, can reduce fast at random the quantity of the quick lengthening bar on this utility model, so both kept support strength of the present utility model, alleviated again the weight of bone external fixator, and facilitate management after operation, be beneficial to positive rehabilitation.
Operational approach of the present utility model and step are as follows.
1. conventional preoperative preparation: (1) bone surgery laboratory routine examination.(2) the conventional total length X-ray film of taking limbs.(3) limbs length and function are carried out to physical examination.
2. formulate wholistic therapy scheme: (1) classifies to shortening deformity of extremity.(2) according to classification, determine concrete therapeutic scheme and position.(3), according to X-ray film, should draw by hand or computer carries out Programmed Design or simulation.
3. apparatus is joined type: according to shortening deformity of extremity and the amplitude of prolongation scheme, assembling femur ring type triangle Synchronization Control extender, and first on probation on patient's limbs, when selecting, should follow configuration the principle of " peaceful short not long, rather slightly thinless ", so that the adjustment of configuration.
4. select osteotomy site and osteotomy: (1) selects osteotomy site according to the concrete situation of shortening deformity of extremity, be followed successively by metaphysis, metaphysis and combine the key position that osteotomy site and blood have supplied with backbone.(2) according to the concrete situation of shortening deformity of extremity, selected different osteotomy method.
5. operation technique: the operation technique of limb lengthening, mainly contains osteotomy, apparatus location, places draw point and adjust and fixing etc. substantially place step and form.In operation, both may there is the problem same with conventional bone surgery, as osteotomy and the accidental injury that the operation of threading a needle causes, can settle because of apparatus the problem of unreasonable initiation again, as apparatus is oppressed limbs etc.With tibial metaphysis osteotomy, be extended for example below, introduce the basic outline of operation technique.
(1) step 1-selection Wicresoft connects hole osteotomy method.Osteotomy is the operation link of limb lengthening operation wound maximum, should select best osteotomy site, as long bone metaphysis or blood are transported better backbone.Operating strict orthopaedics basic operative routine carries out; also to note avoiding the clinical problems such as the prolongation difficulty that causes because of osteotomy misoperation and osteanagenesis obstacle; the whole process of operation will be established Wicresoft's consciousness; should strive for accomplishing that otch minimizes; and protect to greatest extent periosteum, be conducive to maintain to line para-position and operation below.
(2) step 2---settle femur ring type triangle Synchronization Control extender, being arranged on when guaranteeing to complete smoothly prolongation task of extender, with do not affect row, sleeping, sit, and limbs and joint motion are principle.The two ends of extender are as far as possible near joint, with guarantee two ends thread a needle position accurately.The minimum range of its internal diameter and skin can not be less than a horizontal finger, and thigh extender is consistent with mechanical axis.If malposition, not only can affect the location of draw point position, also can cause postoperative prolongation obstacle, secondary deformity, affects joint motion.
(3) step 3---wear and put draw point, threading a needle is the of paramount importance operation link of limb lengthening.Draw point is rationally distributed, implements the draw point layout principle of " stablizing two ends ".The order of threading a needle is as follows: (3.1) extender carries out after basic fixed position, wears and wears respectively two screw thread half pins, and be connected with the steel needle fixing clamp on two-tube tubulose connecting rod near end of thighbone, in distal femur, wears one piece of full pin; At proximal tibia, wear two pieces of full pins, and mix up position, be then separately fixed under femur on hole ring and tibia hole ring, near end of thighbone coronalplane place, wear one piece of screw thread half pin and be fixed on the steel needle fixing clamp of arc bow, strong fixing to form triangle.(3.2) position of accurate adjustment extender and limbs, the correct position of maintenance extender and limbs, wears and puts one piece of draw point at near-end, checks errorless following the threading a needle of continuing again; (3.3) by the draw point layout of design, place the draw point of distal tibial section, full pin is implemented to tension and fix; (3.4) in the thread a needle rear inner side of plane and rear outside of proximal tibia section, respectively wear 1 piece of half pin and fix, to implement dynamic elasticity, fix; (3.5) draw point and extender fixedly time, be fixed in the proximal most position in draw point and ring and hole, after avoiding draw point fixing, because tension distortion causes displacement, angulation and the spatium interosseum broadening etc. of bone section.Also to check that each position draw point has or not tension force, if any draw point compressing skin, should subtract and open, eliminate the relative influence to joint motion; (4) step 4---adjust and fix, after extender being installed and being threaded a needle, available osteotome or maneuver make bone fracture.Generally, with maneuver folding bone, confirm that bone ruptures completely, clamping screw, lower osteotomy site and the gap of checking of direct-view.As spatium interosseum is greater than 3mm, answer adjustable telescopic rod, dwindle spatium interosseum.Drainage tube drain, then carry out wound suture wrapping.
6. operation assessment: the degree of the whether unobstructed and limb swelling of (1) drain.(2) draw point has or not tension force.(3) position of extender how.(4) limbs and joint motion have or not impact, as confirm errorless, i.e. available wet alcohol gauze wrapping pin hole.
7. management after operation.From operation, finish to remove during this period of time to extender, be called the aftertreatment stage.Aftertreatment is the key link of limb lengthening, should be realized that treatment does not finish.In the process for the treatment of, must pay attention to management after operation after surgery, overcome the consciousness of " heavily operation, gently management ".
8. postoperative conventional therapy: with reference to the basic demand of conventional bone surgery and the outer fixing operation of bone, treat and nurse.
9. the pre-management of delaying: postoperative 8 to 12 days be pre-extended period (waiting period of prolongation).
(1) conventional pin hole nursing, avoids the generation of serious pin tract infection.
(2) instruct and assisting patients carries out the upper functional training of bed, as the motion of lower limb muscle contraction, ankle is movable and directly lower limb raise etc.
(3) assisting patients is stood, and correctly uses walking aid, walks voluntarily.
(4) x-ray inspection, the certainty of assessment osteotomy, apparatus is connected and stability with limbs (bone).
10. extended period management: this phase is to control to extend the most effective critical period of quality, is again the high-incidence season of limb lengthening complication, easily develops complications, need early to find, early regulation and control, avoid the generation of serious pin tract infection, eliminate and extend obstacle, process in time osteotomy and entirely or in advance do not heal.After extending one week, carry out x-ray inspection, assessment osteotomy and drawing-off effect.As found, osteotomy does not heal entirely or in advance, should implement in time enclosed osteotomy, makes to extend and carries out smoothly.
11. control with developing simultaneously, should implement " control with developing simultaneously, with practice in conjunction with, doctors and patients coordinate, spontaneous remission " the treatment principle of synchronizeing with rehabilitation, fully use suffering limb, promote tissue regeneration and function optimization reconstruction.
(1) control with developing simultaneously: apparatus configuration and draw point layout will facilitate limb activity, as be convenient to patient and take care of oneself, being conducive to functional training does not affect walking as configuration, and draw point does not cause motion pain etc.
(2) with practicing combination: encourage patient to take care of oneself under painless condition, fully use suffering limb, accomplish " stand want straight, seat will be just, row main point ".Amplitude and the dynamics of motion vary with each individual, incremental, progressively increase.Instruct training, in the time of can not stretching completely as extended period knee joint, should strengthen in time active training, passive exercise or sandbag and press the measures such as knee joint; While standing, heel can not land will increase the standing exercise time, and the while is the elastic device at scalable ankle joint rear also, suitably increases drafting force etc.
(4) spontaneous remission: be under the outer fixing condition of phalanges, do not take dedicated functions rehabilitation treatment measure and special functional training.Due to technological innovation and rules perfect, the management after operation work that needs doctor to complete before a lot, can transfer to patient to complete now relievedly.Patient's hospital stays can significantly shorten, and after most patients several days after surgery or a few week, just can leave hospital and implement voluntarily lengthening, pin hole nursing and functional training.

Claims (10)

1. a femur ring type triangle Synchronization Control extender, by extender support body, be connected to the steel needle fixing clamp (28) on extender support body and the draw point being clipped in steel needle fixing clamp forms, is characterized in that:
Described extender support body comprises and is arranged at the femur extender support body that femur (1) is located, and femur extender support body comprises hole ring (3a) under femur, be arranged at hole ring (3b) on the femur of hole ring (3a) top under femur and be connected under femur the some quick lengthening bars (3c) between hole ring (3b) on hole ring (3a) and femur;
Described extender support body also comprises being connected to one to two tubulose connecting rod (22) of the top of hole ring (3b) on femur and being connected to the arc between hole ring (3b) on tubulose connecting rod (22) and femur and bends (23);
Described extender support body also comprises and is arranged at the tibia hole ring (4) that tibia (2) locates and is arranged on the elasticity drawing-off fixed bar (5) between hole ring (3a) and tibia hole ring (4) under femur, under the upper end of described elasticity drawing-off fixed bar (5) and femur, hole ring (3a) is articulated and connected, the lower end of elasticity drawing-off fixed bar (5) is plugged in the hole of tibia hole ring (4), the top of elasticity drawing-off fixed bar (5) is provided with screw thread, and is provided with spring (6) between screw thread and tibia hole ring (4).
2. femur ring type triangle Synchronization Control extender according to claim 1, it is characterized in that: described extender support body also comprises threaded fixation clamp connecting rod (24), described threaded fixation clamp connecting rod (24) is connected under femur on hole ring (3a) by upper and lower adjusting nut (27) is adjustable, the upper cover of threaded fixation clamp connecting rod (24) has draw point pad (25) and draw point pressure pad (26), and draw point pad (25) and draw point pressure pad (26) are connected on threaded fixation clamp connecting rod (24) by upper and lower adjusting nut (27) is adjustable, between draw point pad (25) and draw point pressure pad (26), accompany half pin (29).
3. femur ring type triangle Synchronization Control extender according to claim 1, is characterized in that: the upper end of described elasticity drawing-off fixed bar (5) is articulated and connected by hole ring (3a) under the first joint device (7) and femur.
4. femur ring type triangle Synchronization Control extender according to claim 1, is characterized in that: one end of described quick lengthening bar (3c) is fixedly connected under femur that hole ring (3a) is upper, the other end is articulated and connected on femur on hole ring (3b).
5. femur ring type triangle Synchronization Control extender according to claim 1, it is characterized in that: described quick lengthening bar (3c) includes threaded rod (9), interior bar cover (10) and outer bar cover (11), described threaded rod (9) is from top to bottom inserted in interior bar cover (10), described interior bar cover (10) is from top to bottom inserted in outer bar cover (11), and the lower end of described outer bar cover (11) is provided with the threaded connector (20) that is connected use with hole ring;
The upper end of described interior bar cover (10) is provided with flanging (21), and be provided with pressure controller between the upper end of interior bar cover (10) and threaded rod (9), described pressure controller is by adjusting sleeve (12), pressure controls cover (14) and Compress Spring (13) forms, the upper end of described adjusting sleeve (12) is threaded with threaded rod (9), the bottom of adjusting sleeve (12) is controlled cover (14) with pressure and is threaded, described pressure is controlled cover (14) and is movably set on the interior bar cover (10) of flanging (21) downside, described Compress Spring (13) is enclosed within on the threaded rod (9) between the upper end of adjusting sleeve (12) and the flanging (21) of interior bar cover (10),
The medial wall, upper end of described outer bar cover (11) is provided with taper uncovered (15), the lateral wall, upper end of outer bar cover (11) is provided with external thread section (17), and be provided with lock-on connection between the upper end of outer bar cover (11) and interior bar cover (10), described lock-on connection is comprised of taper elastic ring (16) and locking nut (18), described locking nut (18) is by external thread section (17) upper end of bar cover (11) outside that is threaded, described taper elastic ring (16) is inserted in taper uncovered (15), be clipped between interior bar cover (10) and outer bar cover (11), and the upper end of taper elastic ring (16) fixes on the upper end of locking nut (18).
6. femur ring type triangle Synchronization Control extender according to claim 5, is characterized in that: between the lateral wall, bottom of described interior bar cover (10) and the medial wall of outer bar cover (11), be provided with bar cover pad (19).
7. femur ring type triangle Synchronization Control extender according to claim 5, it is characterized in that: adjustable to be connected under femur hole ring (3a) upper by upper and lower adjusting nut (27) for the threaded rod (9) on described quick lengthening bar (3c), and the threaded connector (20) on described quick lengthening bar (3c) is articulated and connected by hole ring (3b) on second joint device (8) and femur.
8. femur ring type triangle Synchronization Control extender according to claim 1, is characterized in that: described tubulose connecting rod (22) is articulated and connected on femur on hole ring (3b) by having hinged and joint device (30) locking function.
9. femur ring type triangle Synchronization Control extender according to claim 1, it is characterized in that: on described femur, the top of hole ring (3b) is provided with two tubulose connecting rods (22), two tubulose connecting rods (22) are articulated and connected on femur on hole ring (3b) by two joint devices (30) with hinged and locking function and a porous plate (31).
10. femur ring type triangle Synchronization Control extender according to claim 1, it is characterized in that: one end of described arc bow (23) is upper by having hinged and joint device (30) locking function the hole ring (3b) that is articulated and connected on femur, and the other end of arc bow (23) is connected with tubulose connecting rod (22) by universal joint (32).
CN201320551340.4U 2013-09-06 2013-09-06 Ring type triangular synchronous control extender for thigh bone Withdrawn - After Issue CN203425013U (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103417277A (en) * 2013-09-06 2013-12-04 江苏广济医疗科技有限公司 Ring type triangular synchronous control extender for thighbone
CN109567914A (en) * 2018-11-16 2019-04-05 四川大学华西医院 A kind of scalable bone defect healing external fixer

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103417277A (en) * 2013-09-06 2013-12-04 江苏广济医疗科技有限公司 Ring type triangular synchronous control extender for thighbone
CN103417277B (en) * 2013-09-06 2015-09-09 江苏广济医疗科技有限公司 Femur ring type triangle Synchronization Control extender
CN109567914A (en) * 2018-11-16 2019-04-05 四川大学华西医院 A kind of scalable bone defect healing external fixer

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