一种骨折微创可调式锁定复位固定系统的设计

Design of a minimally invasive adjustable locking reduction fixation system for fracture

目的 探讨一种新型的骨折复位固定系统,为临床寻找一种新的骨折复位固定的治疗方法。方法 通过对现有骨折固定技术的理念与临床各种骨折类型的分析,研发一种全新的长骨骨折可调式锁定复位固定系统。以锁定板的锁定结构为原型,将固定系统拆分为二,综合现有固定理念与机械原理,连接杆具有调节长度功能;骨折端复位采用提拉钉,结合临床透视辅助骨折线对位。外架长度设计参考选取南京大学医学院附属苏州医院2019年1月至2022年7月期间部分正常成人四肢全长X线片,测量其骨性标志间的长度,作为本设计的长度参考。结果 本复位固定系统以一种新的视角治疗长骨骨折。操作上以体表骨性标志为固定点,提拉钉的经皮隔空对骨折端复位:主螺母对骨折端的长度调节,复位架可对骨折端复位,实现对骨折端的空间三维的复位与固定的设计方法。结论 可调式锁定复位固定系统在设计上具有操作方便、微创固定、一次性手术固定长骨骨折、骨愈合后不必二次手术的设计优点。

Objective To explore a new type of fracture reduction and fixation system and to find a new treatment method for clinical fracture reduction and fixation.Methods A new type of adjustable locking reduction fixation system for long bone fractures was developed by analyzing the concept of existing fracture fixation techniques and various clinical fracture types.Taking the locking structure of the locking plate as a prototype,the fixing system was divided into two parts.Combining the existing fixing technology concept and mechanical principle,the connecting rod had the function of adjusting the length.The fracture end was reduced by lifting nail,combined with clinical fluoroscopy assisted fracture line alignment.Full-length X-rays of partial normal adult limbs of the Suzhou Hospital of Medical College,Nanjing University,from January 2019 to July 2022 were selected to measure the length between their bony markers,which was used as the length reference for this design.The data were measured by the ruler of the imaging system.Results The reduction fixation system could treat long bone fracture from a new perspective.During surgery,the surface bony mark was used as the fixation point.The percutaneous septum of the lifting nail was used to reduce the fracture:The length of the fracture end was adjusted by the main nut,and the reduction rack could reduce the fracture,thus realizing the design method of threedimensional reduction and fixation of the fractures.Conclusion The adjustable locking reduction fixation system had the advantages of convenient operation such as minimally invasive fixation and one-time operation to fix long bone fractures.There was no need for a second operation after bone healing.