指骨牵引与穿刺导向装置的设计及模拟试验  

The Design and Simulation Experiment of Phalangeal Traction and Puncture Guidance Device

作　　者：李希萌 顾清源 李岳 邓云蛟 闫江涛 曾达幸 侯雨雷[1] Li Ximeng;Gu Qingyuan;Li Yue;Deng Yunjiao;Yan Jiangtao;Zeng Daxing;Hou Yulei(School of Mechanical Engineering,Yanshan University,Qinhuangdao Hebei 066000,China;School of Mechanical Engineering,Dongguan University of Technology,Dongguan Guangdong 523808,China;The First Hospital of Qinhuangdao,Qinhuangdao Hebei 066099,China)

机构地区：[1]燕山大学机械工程学院,河北秦皇岛066000 [2]东莞理工学院机械工程学院,广东东莞523808 [3]秦皇岛市第一医院,河北秦皇岛066099

出　　处：《医疗装备》2024年第9期9-15,共7页Medical Equipment

基　　金：广东省基础与应用基础研究基金自然科学基金(2023A1515012103);广东高校科研平台和项目-创新团队项目(自科)(2022KCXTD033);广东省重点建设学科科研能力提升项目(2021ZDJS084)。

摘　　要：目的研制一种用于指骨骨折克氏针内固定的指骨牵引与穿刺导向装置,并设计模拟试验测试装置的穿刺精确性、安全性和使用便利性。方法针对当前指骨骨折克氏针内固定存在的穿刺精确性低、穿刺次数多及手术辐射性强等弊端,依据现存问题、手术需求和实际工况,结合医院指骨骨折案例,以模块化思路设计指骨牵引与穿刺导向装置。遵照手术流程,设计试验模拟装置的工作过程,初步验证其可靠性,为后续开展临床试验奠定基础。结果模拟试验结果显示,试制的指骨牵引与穿刺导向装置样机可进行手指前端的直针穿刺与手指两侧的交叉穿刺,适用于不同手指尺寸的患者,可辅助医师进行穿刺定位,节省1~2名医护人员,定位误差<1 mm。结论与传统指骨骨折克氏针内固定操作相比,指骨牵引与穿刺导向装置通过持续牵引及稳定的锁紧与精准的定位功能可辅助医师准确选择入针点和穿刺角度,提供克氏针穿刺导向通道,提高穿刺的稳定性,降低手术强度,并有助于减少对患者的二次伤害及手术过程中对医护人员的辐射。Objective To develop a phalangeal traction and puncture guidance device for internal fixation of phalangeal fractures using Kirschner wires,and to design a simulation experiment to test the puncture accuracy,safety,and convenience of use of the device.Methods In response to the shortcomings of the current Kirscher-wire internal fixation of phalanx fracture,such as low puncture accuracy,large number of punctures and strong surgical radiation,according to the existing problems,surgical requirements and actual working conditions,combined with the case of phalanx fracture in the hospital,the phalanx traction and puncture guidance device was designed by modular thinking.Following the surgical procedure,the working process of the experimental simulation device was designed,and its reliability was preliminarily verified,which laid the foundation for the subsequent clinical experiments.Results The simulation experiment results showed that the prototype of the finger bone traction and puncture guidance device can perform straight needle puncture at the front end of the finger and cross puncture on both sides of the finger,suitable for patients with different finger sizes,and can assist physicians in puncture positioning and save 1-2 medical staff,with positioning error of less than 1 mm.Conclusion Compared with traditional Kirschner wire internal fixation for phalangeal fractures,the phalangeal traction and puncture guidance device can assist physicians in accurately selecting the insertion point and puncture angle through continuous traction,stable locking,and precise positioning functions,providing Kirschner wire puncture guidance channels,improving puncture stability,reducing surgical intensity,and helping to reduce secondary injury to patients and radiation to medical staff during the surgical process.

关 键 词：指骨骨折 牵引固定 穿刺定位 模拟试验 

分 类 号：TH781[机械工程—仪器科学与技术]