CN108652732B - Curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and preparation method thereof - Google Patents
Curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and preparation method thereof Download PDFInfo
- Publication number
- CN108652732B CN108652732B CN201810167654.1A CN201810167654A CN108652732B CN 108652732 B CN108652732 B CN 108652732B CN 201810167654 A CN201810167654 A CN 201810167654A CN 108652732 B CN108652732 B CN 108652732B
- Authority
- CN
- China
- Prior art keywords
- bone
- channel
- positioning
- nail
- acetabulum
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
A curved surface positioning type minimally invasive acetabulum anterior column nail sighting device comprises a body in a triangular truss structure, wherein the body comprises two main positioning legs, one auxiliary positioning leg, one main supporting wall and two auxiliary supporting walls. The preparation method comprises the following steps: s01, acquiring medical image data of the target hip bone; s02, obtaining a central point set of the front pillar area; s03, determining the direction of the front post nail placing channel: s04, determining the diameter of the maximum inscribed cylinder along the direction of the front post nail placing channel; s05, determining the size of the outer diameter of the bone screw and the inner diameter of the guide jig channel; s06, establishing a front pillar bottom hole drilling channel; s07, establishing a three-dimensional model of the sighting device; and S08, 3D printing and preparing the sighting device. The invention can accurately and quickly perform the acetabulum anterior column lag screw internal fixation, thereby not only improving the operation efficiency, but also ensuring the accuracy and the safety of the operation.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and a preparation method thereof.
Background
The acetabulum fracture internal fixation is called acetabulum fracture incision reduction internal fixation, which indicates that the acetabulum fracture internal fixation is suitable for patients with serious acetabulum fracture, and adopts reduction and internal fixation measures for the acetabulum through an operation method. Through the acetabulum fracture internal fixation operation, the acetabulum can obtain the anatomical reduction and reliable fixation of a bearing part again, and the biological function of the acetabulum is improved or recovered, and in the acetabulum fracture internal fixation operation, the acetabulum anterior and posterior column internal fixation operation is the most reliable fixation mode.
The method of acetabular anterior column lag screw internal fixation was proposed by Elliott et al in 1956. In 1980, Senegas et al proposed an internal fixation method of acetabulum anterior column lag screw and posterior column steel plate, which not only has reliable effect, but also can prevent the increase of anterior column crack-shaped displacement caused by the fixation of acetabulum in posterior column steel plate.
Medical research and clinical application show that the internal fixing mode of the front column nail and the combined rear column steel plate has the strongest internal fixing structure and biomechanical advantages in various internal fixing modes for treating transverse fracture of acetabulum, so that the internal fixing mode is more and more widely applied clinically.
Biomechanical experiments prove that the screw setting direction, the screw diameter and the screw setting depth of the acetabulum anterior column are scientifically and reasonably planned, and the method is the premise that the acetabulum anterior column lag screw is combined with the posterior column steel plate internal fixation to obtain ideal clinical effects.
On one hand, as the acetabulum is deep, the anatomical structure is complex, a reticular nervous system, a vascular system and complex muscle tissues are densely distributed around the acetabulum, and the cross section of the anterior column is fine and is in an arc structure, the offset of the anterior column screw easily causes the damage to hip joints, nerves, blood vessels and the like; on the other hand, because of the great individual difference of the acetabulum morphology, the clinical reports of complications such as nerve injury, coxitis, screw looseness and the like caused by improper acetabulum anterior column screw insertion position are not rare.
Therefore, the key to defeat the anterior post approach is to scientifically and reasonably plan the nail parameters and prevent the implanted screw from mistakenly entering the acetabular fossa or puncturing the cortical bone. The method helps doctors to complete surgical path planning and realize accurate implantation of endophytes by means of related medical technology and engineering technology, and is a very concerned subject of domestic and foreign basis and clinical research.
At present, the method of the acetabulum anterior column lag screw internal fixation operation comprises the following steps: anatomical landmark point method, X-ray fluoroscopy-assisted vain manipulation, CT three-dimensional image navigation method, mechanical jig guidance method, and the like.
The nail feeding point and the nail feeding angle of the anatomical landmark point method depend on the hand feeling of a doctor and the probing of a probe opposite to a nail channel, the requirement on clinical experience is high, and the precision is difficult to guarantee.
The X-ray fluoroscopy-assisted manual fluoroscopy has poor real-time performance, the matching degree of navigation data obtained before the operation and an acetabulum anatomical structure in the operation is low, the tissue relation around the acetabulum is difficult to reflect really, even doctors can be misled, the expected operation treatment effect is difficult to achieve, the operation time is long, and the radiation quantity of X-rays to medical staff and patients is large.
In recent years, the CT three-dimensional image navigation method is gradually applied to fixing of an acetabulum anterior column screw, and the real-time acetabulum image information of a patient is used for guiding an operation, so that the operation risk is reduced, the time for the patient and the doctor to contact rays is shortened, and the CT three-dimensional image navigation method has great advantages, but navigation equipment is expensive, the operation is complex, and the clinical popularization is difficult.
The mechanical drill jig guiding method adopts a three-dimensional adjustable mechanical drill jig for positioning, aiming and navigation, theoretically, the navigation precision and flexibility are higher, and the requirement of personalized nail placement can be met, but the existing mechanical drill jig mainly has four problems:
1. in order to accurately position the drill jig, tissues such as muscles of acetabulum and ilium regions and the like are completely peeled off to find iliac tubercle mark points, angular points on the posterior line of the hip, nail feeding points and auxiliary positioning points on the surfaces of iliac wings, which are required by positioning, so that the wound is large, blood loss is high, and the operation difficulty and risk are increased;
2. the position stability of the positioning center is poor, and the drill jig is easy to slide due to vibration during drilling in an operation, so that the nail placing precision is influenced;
3. in order to plan a front column nail-placing channel, a front column central line needs to be fitted in a three-dimensional reconstruction model, and due to the particularity of the anatomical structure of the hip bone, the accurate generation of the front column central line is greatly influenced by the existence of a rear column in a complete hip bone model;
4. when planning the nail placing channel, besides medical imaging software and reverse engineering modeling software which are commonly used in the medical field, scientific computing software is required to be used skillfully, the requirements on planners are high, the operation is tedious, and the period is long.
Therefore, it is urgently needed to design and prepare a set of acetabulum anterior column nail sighting device which has stable and reliable positioning, small surgical wound, and obvious advantages of fully ensuring the accuracy and safety of the anterior column nail and the planning quality and efficiency of the nail placing channel so as to achieve the aim of safely and accurately placing the acetabulum anterior column screw by a minimally invasive means, thereby realizing the re-replication of the biomechanical characteristics of the acetabulum and improving the life quality of patients.
Disclosure of Invention
The invention aims to overcome the defects of the prior method and the prior art and provide a curved surface positioning type minimally invasive acetabulum anterior column screw sighting device and a preparation method thereof.
The technical scheme of the invention is as follows: the sighting device comprises a body in a triangular truss structure, wherein the body comprises two main positioning legs, one auxiliary positioning leg, one main supporting wall and two auxiliary supporting walls; the two main positioning legs are arranged in parallel and vertically and are connected into a whole through a main supporting wall, and the auxiliary positioning legs are arranged in parallel and vertically with the main positioning legs and are connected into a whole with the two main positioning legs through an auxiliary supporting wall respectively; the lower ends of the two main positioning feet are respectively provided with a bone binding surface for positioning; the lower end of the auxiliary positioning foot is provided with a bone binding surface for positioning; the main supporting wall is rectangular, and a guide jig channel penetrating through the inner surface and the outer surface of the main supporting wall is arranged in the main supporting wall.
The further technical scheme of the invention is as follows: the inner surface and the outer surface of the main support wall are respectively provided with a front boss and a rear boss, and openings at two ends of the guide drill jig channel respectively penetrate through the front boss and the rear boss.
The invention further adopts the technical scheme that: the lower part of the auxiliary supporting wall is provided with a reinforcing rib, one end of the reinforcing rib is connected to the main positioning foot, and the other end of the reinforcing rib is connected to the auxiliary supporting wall.
The further technical scheme of the invention is as follows: the auxiliary positioning foot is tapered from top to bottom in diameter to be frustum-shaped, the diameter of the radial section of the bottom end of the auxiliary positioning foot is 4-6 mm, the lower end of the main positioning foot is cylindrical, and the diameter of the radial section of the lower end of the main positioning foot is 11-13 mm.
The further technical scheme of the invention is as follows: the bone binding surfaces at the lower ends of the two main positioning feet are respectively in adhesive fit with the contour of the iliac nodule mark point part of the target hip bone and the contour of the posterior hip corner point part of the target hip bone, and the bone binding surfaces at the lower ends of the auxiliary positioning feet are in adhesive fit with the contour of the upper edge part of the acetabulum of the target hip bone; when the bone binding surface at the lower end of the main positioning foot is attached and inosculated with the target hip bone, the area of the extending channel of the guide drill jig channel penetrating through the target hip bone is contained by the maximum internal connection cylinder of the front column area of the target hip bone.
The technical scheme of the invention is as follows: the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device comprises the following preparation method:
s01, acquiring medical image data of the target hip bone: calling spiral CT examination data before diagnosis of a patient, selecting data of a target hip bone in an operation region, and storing the data in a DICOM file format;
s02, obtaining a central point set of the front pillar region: importing medical image data of a target hip into medical image software Mimics, and reconstructing an independent and complete 3D model of the hip by sequentially using the functions of region growing, segmenting and resetting; removing the rear column of the 3D hip bone model along the direction parallel to the iliopectineal line and through the center of the acetabulum fossa by using a mask editing function to obtain the 3D hip bone model only containing the front column region, and storing the 3D hip bone model in an STL file format; finally, automatically fitting a central point set of the hip bone 3D model only containing the front column region by using a fitting central line function, wherein the central point set consists of a series of discrete points with the distance of a, and the point set is stored in an IGS file format;
in the step, the value range of a is 0.01 mm-0.1 mm;
s03, determining the direction of the front post nail placing channel: importing a 3D hip model only containing a front column region and a central point set data file thereof into reverse engineering software Imageware, intercepting a central point set of a target hip front column region according to nail setting requirements, and then applying a straight line fitting function to establish a least square straight line of the front column central point set, wherein the least square straight line is the direction of a target hip front column nail setting channel;
s04, determining the maximum inscribed cylinder diameter along the direction of the front post nail channel: making an orthogonal section perpendicular to the direction of the front column nail placing channel through the center point of the acetabulum fossa; the right section is taken as a middle plane, n parallel planes with equal distance are respectively made towards the two ends of the right section in the full-length range of the front column area along the direction of the front column nail placing channel; extracting outer contour lines of the 2n +1 normal sections, projecting the outer contour lines on the outermost normal section closest to the pubis along the channel vector direction, and forming a closed space inside the projections after superposition; making a maximum inscribed circle of the closed area, wherein the diameter of the maximum inscribed circle is the diameter of a maximum inscribed cylinder along the direction of the front post nail placing channel;
in the step, n is more than or equal to 5;
s05, determining the sizes of the outer diameter of the bone screw and the inner diameter of the guide jig channel: drawing a concentric circle of the maximum inscribed circle of the closed area inwards by taking x + y as an offset distance value, comparing the diameter of the concentric circle with the external thread diameter size of the metal bone screw specified by the pharmaceutical industry standard YY0018-2002, and rounding downwards to determine the external thread diameter d1 of the bone screw; the diameter d2 of the threaded bottom hole corresponding to d1 is found, and d2 is used as the basic size of the inner diameter of the guide drill jig channel;
in this step, x is a statistical value of the cortical bone thickness of the acetabulum anterior column region; y is the drilling offset distance of the curved surface positioning type minimally invasive acetabulum anterior column screw sighting device, and the value range of y is 0.3-0.5 mm;
s06, establishing a front pillar bottom hole drilling passage: on the target hip bone 3D model, a front column bottom hole drilling channel is established along the direction of a front column nail placing channel by taking the circle center of the maximum inscribed circle of the closed area as the center and D2 as the diameter;
s07, establishing a three-dimensional model of the nail-placing sighting device: leading the complete 3D model of the hip bone and the drilling channel file of the front pillar bottom hole into PRO/E or Solidworks; according to the specific shape and size of the target hip bone and the position relation of a drilling channel of a hip bone anterior column bottom hole, a structural model of a curved surface positioning type minimally invasive acetabulum anterior column nail sighting device is established; guiding the structural model and the complete 3D hip bone model into Mimics, matching the spatial positions of the structural model and the complete 3D hip bone model, generating a reverse bone binding surface of a target hip bone positioning surface at the lower ends of two main positioning pins and one auxiliary positioning pin by utilizing Boolean operation, and generating a guide jig channel on a main support wall to complete the establishment of the three-dimensional model of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device;
s08, preparing and placing the nail sight by 3D printing: importing an STL format file of a three-dimensional model of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device generated in the Mimics into 3D printing layer cutting software, and preparing the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device by 3D printing; and meanwhile, a 3D model of the target hip bone is printed, so that preoperative test and evaluation of doctors are facilitated.
Compared with the prior art, the invention has the following advantages:
1. by applying the method, the curve positioning type minimally invasive acetabulum front column nail sighting device which is well attached and matched with the target hip positioning curve and has a high-precision guide jig channel can be designed and manufactured. The operator can accurately and quickly perform the acetabulum anterior column lag screw internal fixation by means of the sighting device, thereby not only improving the operation efficiency, but also ensuring the accuracy and the safety of the operation.
2. The curve positioning type minimally invasive acetabulum anterior column nail sighting device is successfully positioned at one time by the contour of an iliac nodule mark point part, the contour of a posterior hip line corner point part and the contour of an acetabulum upper edge part near a nail feeding point.
When the existing mechanical drill jig is used, a large knife edge is required to be formed, the tissues such as the muscles of the acetabulum and the ilium region are completely stripped, so that a nail feeding point is exposed for first positioning, an auxiliary positioning point is exposed for second positioning, and the large knife edge inevitably brings secondary damage to a patient.
The auxiliary positioning leg of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device is positioned at the upper edge part of the acetabulum near the nail feeding point, the diameter of the radial section at the bottom end of the frustum is only 4-6 mm, and positioning can be carried out only by forming a small incision at the part and using an expanding forceps in a matched manner, so that the positioning process is simplified undoubtedly, and the requirement of minimally invasive surgery is met.
3. Compared with the three-center positioning mode of the existing mechanical jig, the curved surface positioning type minimally invasive acetabulum anterior column nail setting sighting device adopts the curved surface positioning mode, so that the positioning is more accurate, the stability is better, the positioning foot of the sighting device is difficult to slide even if the sighting device is vibrated by drilling, and the nail setting precision is effectively guaranteed.
4. In the preparation method, the front column nail placing channel is planned, and the planning principle of the front column nail placing channel is that more bone mass is penetrated and the diameter of the cross section circle of the channel is as large as possible on the premise of ensuring that the wall of the nail is not broken (the wall is not broken, namely that the screw is not penetrated and exposed in the whole length range of the channel after the nail is placed). The preparation method of the invention is based on the central point set obtained from the 3D hip bone model without the rear column, and establishes the least square straight line of the central point set of the front column by means of intercepting and fitting the straight line, so as to determine the direction and the diameter of the nail channel of the front column. Compared with the anterior column screw channel obtained without excluding the posterior column, the anterior column screw channel obtained without excluding the posterior column has more bone penetration amount (namely, longer channel length), and in the actual operation process, the implanted screw has longer thread length, thereby obtaining better internal fixation effect.
The explanation of the disadvantages: numerous virtual experiments have shown that due to the particularity of the hip anatomy, the presence of the posterior column in the full hip model can seriously affect the precise generation of the anterior column centerline, particularly in the section near the top of the acetabulum, which can be very disadvantageous for determining the channel orientation of the anterior column peg.
5. By adopting the straight line fitting function and the section constructing function in the nail placing channel planning method, the least square straight line of the front column central point set can be quickly established in the full-length range of the front column area of the hip bone model, and a closed area formed by more compact external contour line projections of the positive section can be obtained, so that the overall optimization can be carried out on the diameter of the maximum internal connection cylinder of the front column nail placing channel. The planner can complete the above work only by mastering the medical image software and the reverse engineering modeling software which are commonly used in the medical field, and does not need to spend a long time on performing tedious programming calculation by using scientific calculation software. The invention improves the planning quality and the automation degree of the nail placing channel, simplifies the operation, reduces the difficulty, saves the time, reduces the skill requirement on a planner and is convenient for popularization and promotion.
The invention is further described below with reference to the figures and examples.
Drawings
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is a top view of FIG. 1;
FIG. 3 is a left side view of FIG. 1;
FIG. 4 is a perspective view of the present invention;
FIG. 5 is a schematic view of the present invention in use;
FIG. 6 is a schematic view of the positional relationship between the target hip bone curved surface positioning area and the nail insertion point;
FIG. 7 is a state diagram of the generation of a center point set of a hip 3D model containing only the anterior column region;
FIG. 8 is a least square straight line generation state diagram of a center point set of a target hip anterior column region;
FIG. 9 is a state diagram of 2n +1 positive section outer contour lines generated perpendicular to the direction of the front post staple channel;
FIG. 10 is a generated state diagram of the largest inscribed cylinder in the direction of the leading stud channel.
Illustration of the drawings: a main positioning leg 1; an auxiliary positioning pin 2; a main support wall 3; a pilot jig passage 31; a front boss 32; a rear boss 33; an auxiliary support wall 4; a reinforcing rib 41; a target hip bone 5; a central axis 51; iliac nodule landmark 52; posterior hip line angle point 53; an acetabular upper rim 54; a nail feeding point 55; a least squares line 56; a right section 57; the maximum inscribed circle 58; concentric circles 59.
Detailed Description
Example 1:
as shown in fig. 1-5, the curved surface positioning minimally invasive acetabulum anterior column nail sighting device comprises a body in a triangular truss structure, wherein the body comprises two main positioning legs 1, one auxiliary positioning leg 2, one main supporting wall 3 and two auxiliary supporting walls 4.
Two main location feet 1 are parallelly and vertically arranged and are connected as an organic whole through main braced wall 3, assist location foot 2 with main location foot 1 parallelly and vertically arranged and with respectively be connected as an organic whole through an auxiliary braced wall 4 between two main location feet 1.
The main support wall 3 is rectangular and has a pilot jig passage 31 formed therein and extending through both the inner and outer surfaces thereof. The lower ends of the two main positioning feet 1 are respectively provided with a bone binding surface for positioning, and the bone binding surfaces at the lower ends of the two main positioning feet 1 are respectively attached and matched with the contour of the ilium nodule mark point 52 part and the contour of the hip back line corner point 53 part of the target hip bone 5 (see fig. 5 and 6). When the bone contact surface at the lower end of the main positioning foot 1 is attached and inosculated with the target hip bone 5, the area of the extending channel of the guide jig channel 31 penetrating the target hip bone 5 is contained by the maximum inscribed cylinder of the front column area of the target hip bone 5. The lower end of the auxiliary positioning foot 2 is provided with a bone binding surface for positioning, and the bone binding surface at the lower end of the auxiliary positioning foot 2 is in adhesive fit with the contour of the upper edge 54 of the acetabulum of the target hip bone 5 (see fig. 5 and 6). The bone binding surface of the auxiliary positioning foot 2 and the bone binding surface of the main positioning foot 1 play a positioning role together, so that the body can obtain a firmer positioning effect on the target hip bone.
Preferably, the main support wall 3 is provided with a front boss 32 and a rear boss 33 on the inner and outer surfaces thereof, respectively, and openings at both ends of the pilot jig passage 31 penetrate the front boss 32 and the rear boss 33, respectively. The arrangement of the front boss and the rear boss prolongs the depth of the guide drill jig channel 31, and further ensures the accuracy of the guide.
Preferably, the auxiliary support wall 4 is a truss structure, the lower part of the auxiliary support wall is provided with a reinforcing rib 41, one end of the reinforcing rib 41 is connected to the main positioning leg 1, and the other end is connected to the auxiliary support wall 4. The reinforcing ribs 41 can avoid interference with hip muscle tissues during use and can also meet the rigidity requirement of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device.
Preferably, the auxiliary positioning foot 2 is tapered from top to bottom in diameter and is frustum-shaped, the diameter of the radial section of the bottom end of the auxiliary positioning foot is 4-6 mm, the lower end of the main positioning foot 1 is cylindrical, and the diameter of the radial section of the lower end of the main positioning foot is 11-13 mm. The size can not only ensure the rigidity requirement, but also meet the requirement of minimally invasive surgery.
The preparation method of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device comprises the following steps:
s01, acquiring medical image data of the target hip bone: calling spiral CT examination data before diagnosis of a patient, selecting data of a target hip bone of an operation region, and storing the data in a DICOM file format.
S02, obtaining a central point set of the front pillar region: importing medical image data of a target hip into medical image software Mimics, and reconstructing an independent and complete 3D model of the hip by sequentially using the functions of region growing, segmenting and resetting; removing the rear column of the 3D hip bone model along the direction parallel to the iliopectineal line and through the center of the acetabulum fossa by using a mask editing function to obtain the 3D hip bone model only containing the front column region, and storing the 3D hip bone model in an STL file format; and finally, automatically fitting a central point set (see fig. 7) of the hip bone 3D model only containing the anterior column region by using a function of fitting a central line, wherein the central point set consists of a series of discrete points with the distance a, and the discrete points are target hip bone central points, and the point set is stored in an IGS file format.
In the step, the value range of a is 0.01 mm-0.1 mm.
S03, determining the direction of the front post nail placing channel: importing a hip 3D model only containing a front column region and a central point set data file thereof into reverse engineering software Imageware, intercepting a central point set of a target hip 5 front column region according to nail setting requirements, and then applying a straight line fitting function to create a least square straight line 56 (refer to figure 8) of the front column central point set, wherein the least square straight line 56 is the direction of a target hip front column nail setting channel.
S04, determining the maximum inscribed cylinder diameter along the direction of the front post nail channel: making a right section 57 perpendicular to the direction of the front column nail placing channel through the center point of the acetabulum fossa; taking the right section 57 as a middle plane, making five parallel planes with equal distance to both ends of the right section 57 along the front column nail placing channel direction and in the whole length range of the front column area (see fig. 9); the outer contour lines of the eleven normal sections are extracted and projected on the outermost normal section closest to the pubis along the direction of the channel vector, the projections are superposed to form a closed space inside, a maximum inscribed circle 58 of the closed region is made, and the diameter of the maximum inscribed circle 58 is the diameter of the maximum inscribed cylinder along the direction of the anterior post nail channel (see fig. 10).
S05, determining the sizes of the outer diameter of the bone screw and the inner diameter of the guide jig channel: drawing a concentric circle 59 (see fig. 10) of the maximum inscribed circle 58 of the closed region inwards with an offset value of x + y, comparing the diameter of the concentric circle 59 with the external thread diameter size of the metal bone screw specified by the pharmaceutical industry standard YY0018-2002, and rounding downwards to determine the external thread diameter d1 of the bone screw; the diameter d2 of the threaded bottom hole corresponding to d1 is searched, and d2 is used as the basic size of the inner diameter of the guide jig channel 31.
In this step, x is a statistical value of the cortical bone thickness of the acetabulum anterior column region; y is a drilling offset distance possibly caused by manufacturing and using errors of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device, and the value range of y is 0.3-0.5 mm.
S06, establishing a front pillar bottom hole drilling passage: on the target hip bone 3D model, a front column bottom hole drilling channel is established along the direction of the front column nail placing channel (namely the direction of the least square straight line 56) by taking the circle center 58 of the maximum inscribed circle of the closed area as the center and the D2 as the diameter.
S07, establishing a three-dimensional model of the nail-placing sighting device: leading the complete 3D model of the hip bone and the drilling channel file of the front pillar bottom hole into PRO/E or Solidworks; according to the specific shape and size of the target hip bone and the position relation of a drilling channel of a hip bone anterior column bottom hole, a structural model of a curved surface positioning type minimally invasive acetabulum anterior column nail sighting device is established; and then guiding the structural model and the complete 3D model of the hip bone into Mimics, matching the spatial positions of the structural model and the complete 3D model of the hip bone, generating a reverse bone binding surface of a target hip bone positioning surface at the lower ends of two main positioning pins and one auxiliary positioning pin by utilizing Boolean operation, and generating a guide jig channel on a main support wall, thus completing the establishment of the three-dimensional model of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device.
S08, preparing and placing the nail sight by 3D printing: importing an STL format file of a three-dimensional model of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device generated in the Mimics into 3D printing layer cutting software, and preparing the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device by 3D printing; and meanwhile, a 3D model of the target hip bone is printed, so that preoperative test and evaluation of doctors are facilitated.
Claims (2)
1. Curved surface location type wicresoft acetabulum anterior column nail sighting device, characterized by: the main body comprises two main positioning legs, one auxiliary positioning leg, one main supporting wall and two auxiliary supporting walls; the two main positioning legs are arranged in parallel and vertically and are connected into a whole through a main supporting wall, and the auxiliary positioning legs are arranged in parallel and vertically with the main positioning legs and are connected into a whole with the two main positioning legs through an auxiliary supporting wall respectively; the lower ends of the two main positioning feet are respectively provided with a bone binding surface for positioning; the lower end of the auxiliary positioning foot is provided with a bone binding surface for positioning; the main supporting wall is rectangular, and a guide drill jig channel penetrating through the inner surface and the outer surface of the main supporting wall is arranged in the main supporting wall;
the inner surface and the outer surface of the main support wall are respectively provided with a front boss and a rear boss, and openings at two ends of the guide drill jig channel respectively penetrate through the front boss and the rear boss;
the lower part of the auxiliary supporting wall is provided with a reinforcing rib, one end of the reinforcing rib is connected to the main positioning foot, and the other end of the reinforcing rib is connected to the auxiliary supporting wall;
the diameter of the auxiliary positioning leg is gradually reduced from top to bottom to form a frustum shape, the diameter of the radial section of the bottom end of the auxiliary positioning leg is 4-6 mm, the lower end of the main positioning leg is cylindrical, and the diameter of the radial section of the lower end of the main positioning leg is 11-13 mm;
the bone binding surfaces at the lower ends of the two main positioning feet are respectively in adhesive fit with the contour of the iliac nodule mark point part of the target hip bone and the contour of the posterior hip corner point part of the target hip bone, and the bone binding surfaces at the lower ends of the auxiliary positioning feet are in adhesive fit with the contour of the upper edge part of the acetabulum of the target hip bone; when the bone binding surface at the lower end of the main positioning foot is attached and inosculated with the target hip bone, the area of the extending channel of the guide drill jig channel penetrating through the target hip bone is contained by the maximum internal connection cylinder of the front column area of the target hip bone.
2. A method for preparing the minimally invasive acetabular anterior column nail sight of claim 1, comprising the steps of:
s01, acquiring medical image data of the target hip bone: calling spiral CT examination data before diagnosis of a patient, selecting data of a target hip bone in an operation region, and storing the data in a DICOM file format;
s02, obtaining a central point set of the front pillar region: importing medical image data of a target hip into medical image software Mimics, and reconstructing an independent and complete 3D model of the hip by sequentially using the functions of region growing, segmenting and resetting; removing the rear column of the 3D hip bone model along the direction parallel to the iliopectineal line and through the center of the acetabulum fossa by using a mask editing function to obtain the 3D hip bone model only containing the front column region, and storing the 3D hip bone model in an STL file format; finally, automatically fitting a central point set of the hip bone 3D model only containing the front column region by using a fitting central line function, wherein the central point set consists of a series of discrete points with the distance of a, and the point set is stored in an IGS file format;
in the step, the value range of a is 0.01 mm-0.1 mm;
s03, determining the direction of the front post nail placing channel: importing a 3D hip model only containing a front column region and a central point set data file thereof into reverse engineering software Imageware, intercepting a central point set of a target hip front column region according to nail setting requirements, and then applying a straight line fitting function to establish a least square straight line of the front column central point set, wherein the least square straight line is the direction of a target hip front column nail setting channel;
s04, determining the maximum inscribed cylinder diameter along the direction of the front post nail channel: making an orthogonal section perpendicular to the direction of the front column nail placing channel through the center point of the acetabulum fossa; taking the right section as a middle plane, and respectively making n parallel planes with equal distance to two ends of the right section in the full-length range of a front column area along the direction of a front column nail placing channel; extracting outer contour lines of the 2n +1 normal sections, projecting the outer contour lines on the outermost normal section closest to the pubis along the channel vector direction, and forming a closed space inside the projections after superposition; making a maximum inscribed circle of the closed area, wherein the diameter of the maximum inscribed circle is the diameter of a maximum inscribed cylinder along the direction of the front post nail placing channel;
in the step, n is more than or equal to 5;
s05, determining the sizes of the outer diameter of the bone screw and the inner diameter of the guide jig channel: drawing a concentric circle of the maximum inscribed circle of the closed area inwards by taking x + y as an offset distance value, comparing the diameter of the concentric circle with the external thread diameter size of the metal bone screw specified by the pharmaceutical industry standard YY0018-2002, and rounding downwards to determine the external thread diameter d1 of the bone screw; the diameter d2 of the threaded bottom hole corresponding to d1 is found, and d2 is used as the basic size of the inner diameter of the guide drill jig channel;
in this step, x is a statistical value of the cortical bone thickness of the acetabulum anterior column region; y is the drilling offset distance of the curved surface positioning type minimally invasive acetabulum anterior column screw sighting device, and the value range of y is 0.3-0.5 mm;
s06, establishing a front pillar bottom hole drilling passage: on the target hip bone 3D model, a front column bottom hole drilling channel is established along the direction of a front column nail placing channel by taking the circle center of the maximum inscribed circle of the closed area as the center and D2 as the diameter;
s07, establishing a three-dimensional model of the nail-placing sighting device: leading the complete 3D model of the hip bone and the drilling channel file of the front pillar bottom hole into PRO/E or Solidworks; according to the specific shape and size of the target hip bone and the position relation of a drilling channel of a hip bone anterior column bottom hole, a structural model of a curved surface positioning type minimally invasive acetabulum anterior column nail sighting device is established; guiding the structural model and the complete 3D hip bone model into Mimics, matching the spatial positions of the structural model and the complete 3D hip bone model, generating a reverse bone binding surface of a target hip bone positioning surface at the lower ends of two main positioning pins and one auxiliary positioning pin by utilizing Boolean operation, and generating a guide jig channel on a main support wall to complete the establishment of the three-dimensional model of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device;
s08, preparing and placing the nail sight by 3D printing: importing an STL format file of a three-dimensional model of the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device generated in the Mimics into 3D printing layer cutting software, and preparing the curved surface positioning type minimally invasive acetabulum anterior column nail sighting device by 3D printing; and meanwhile, a 3D model of the target hip bone is printed, so that preoperative test and evaluation of doctors are facilitated.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810167654.1A CN108652732B (en) | 2018-02-28 | 2018-02-28 | Curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and preparation method thereof |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810167654.1A CN108652732B (en) | 2018-02-28 | 2018-02-28 | Curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and preparation method thereof |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN108652732A CN108652732A (en) | 2018-10-16 |
| CN108652732B true CN108652732B (en) | 2020-03-13 |
Family
ID=63784172
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810167654.1A Active CN108652732B (en) | 2018-02-28 | 2018-02-28 | Curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and preparation method thereof |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN108652732B (en) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109199565B (en) * | 2018-10-23 | 2024-02-13 | 常州工业职业技术学院 | Orthopedic nail-setting guide locking plate and rapid forming and using method thereof |
| CN112315561B (en) * | 2020-11-24 | 2024-06-25 | 井波 | Medical three-dimensional guiding system based on three-dimensional reconstruction |
| CN116763394B (en) * | 2023-08-25 | 2023-10-27 | 正宁县人民医院 | Drilling sighting device for orthopedic operation |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2652336Y (en) * | 2003-08-27 | 2004-11-03 | 许远海 | Guide device for skull oriented drilling |
| CN104546111A (en) * | 2015-01-27 | 2015-04-29 | 南京医科大学第一附属医院 | Individualized guiding template assisting in setting pedicle screw into small incision and manufacturing method of individualized guiding template |
| CN106156511A (en) * | 2016-07-07 | 2016-11-23 | 华南理工大学 | A kind of preparation method for complicated pelvis fracture of acetabulum personalization blade plate |
Family Cites Families (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE60117377T2 (en) * | 2000-05-25 | 2006-10-12 | Orthoplex Llc, Boston | ANCHORING SYSTEM FOR FIXING OBJECTS TO BONE |
| US8162950B2 (en) * | 2007-12-17 | 2012-04-24 | Stryker Leibinger Gmbh & Co. Kg | Bone plate instrument and method |
| CN105078559B (en) * | 2015-09-25 | 2017-06-23 | 李明 | A kind of universal posterior wall of acetabulum dissects locking bone fracture plate |
| CN106510833B (en) * | 2016-11-17 | 2017-10-13 | 南华大学 | Bilateral location type pedicle of vertebral arch puts nail sight and preparation method thereof |
-
2018
- 2018-02-28 CN CN201810167654.1A patent/CN108652732B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2652336Y (en) * | 2003-08-27 | 2004-11-03 | 许远海 | Guide device for skull oriented drilling |
| CN104546111A (en) * | 2015-01-27 | 2015-04-29 | 南京医科大学第一附属医院 | Individualized guiding template assisting in setting pedicle screw into small incision and manufacturing method of individualized guiding template |
| CN106156511A (en) * | 2016-07-07 | 2016-11-23 | 华南理工大学 | A kind of preparation method for complicated pelvis fracture of acetabulum personalization blade plate |
Non-Patent Citations (2)
| Title |
|---|
| The safe screw path along inferior border;Chun Bi, Jiandong Wang, Xiaoxi Ji, Zhijian Ma, Fang Wang;《BME Musculoskeletal Disorders》;20170220;全文 * |
| 基于CT下对于髋臼四边体骨折采用直接固定置钉相对安全区的测量研究;程鑫葵;《中国优秀硕士论文电子期刊》;20160229;全文 * |
Also Published As
| Publication number | Publication date |
|---|---|
| CN108652732A (en) | 2018-10-16 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US10307174B2 (en) | Apparatus and method for providing a reference indication to a patient tissue | |
| TWI397397B (en) | Method of manufacturing guide device | |
| US20180153558A1 (en) | Tools for assisting in osteotomy procedures, and methods for designing and manufacturing osteotomy tools | |
| JP5354234B2 (en) | How to design a surgical kit for repairing joint cartilage | |
| EP2501281B1 (en) | Coordinate mapping system for joint treatment | |
| US10617434B2 (en) | Methods and devices for positioning a patient-specific acetabulum reaming and cup positioning guide | |
| CN108652732B (en) | Curved surface positioning type minimally invasive acetabulum anterior column nail sighting device and preparation method thereof | |
| JP2022546381A (en) | Robotic Surgical System for Augmented Hip Arthroplasty Procedures | |
| CN110478090A (en) | CAD pelvic tumor is precisely cut off with personalized prosthese and preparation method thereof | |
| WO2013055203A1 (en) | Method to provide at least one patient specific device to be used for bone correction, a treatment kit, a method of operating a data-processing system, a computer program, and a correction and fixation device and a cutting assisting device for bone correction. | |
| CN109498158B (en) | Acetabulum navigation guide plate designed by 3D printing, preparation method and use method | |
| CN111388088A (en) | Operation guide plate, three-dimensional model, manufacturing and constructing method, computer and storage medium | |
| CN108403202B (en) | Channel screw external guiding device for pelvis acetabulum fracture and method thereof | |
| CN111728689A (en) | Pelvic fracture posterior ring minimally invasive stabilization system guide plate | |
| CN107320174A (en) | The pedicle for cervical vertebra arch guide plate of customization | |
| CN116630400A (en) | Hollow nail head accurate positioning method based on femur neck axis position safety target zone boundary registration | |
| CN111000620A (en) | Guide template for percutaneous vertebroplasty and manufacturing and resetting method thereof | |
| CN113244516B (en) | Non-coplanar puncture template manufacturing method based on bony multipoint positioning and template | |
| CN213098282U (en) | Operation guide plate | |
| CN209984275U (en) | Aiming positioner for fracture stripping | |
| CN108888330B (en) | Combined guide plate and accurate positioning method thereof | |
| CN107303200B (en) | Femur side marking system in hip joint replacement operation and manufacturing method thereof | |
| CN108420530B (en) | The personalized acetabular posterior column of 3D printing sets nail bit mould and preparation method thereof | |
| CN212369125U (en) | Computer-aided design individualized prosthesis for accurate resection of pelvic tumors | |
| CN117860375A (en) | Preoperative planning and intraoperative navigation method for reverse shoulder joint replacement and implementation device thereof |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |