CN112716603A - Orthopedics positioning robot that resets - Google Patents
Orthopedics positioning robot that resets Download PDFInfo
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- CN112716603A CN112716603A CN202110067741.1A CN202110067741A CN112716603A CN 112716603 A CN112716603 A CN 112716603A CN 202110067741 A CN202110067741 A CN 202110067741A CN 112716603 A CN112716603 A CN 112716603A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/74—Devices for the head or neck or trochanter of the femur
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H30/00—ICT specially adapted for the handling or processing of medical images
- G16H30/20—ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H30/00—ICT specially adapted for the handling or processing of medical images
- G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
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Abstract
The invention relates to an orthopedic reduction positioning robot, which solves the technical problem of low reduction precision of the existing orthopedic operation robot during operation and comprises a reduction robot, a navigation robot and a positioning robot, wherein the reduction robot comprises a reduction platform, a far-end fixator and a far-end reference frame, and the far-end reference frame is fixed on the far-end fixator; the far-end fixer comprises a connecting base plate, a movable connecting plate, a first locker, a reference frame, a first connecting side plate, a second connecting side plate, a first fixing sleeve, a second fixing sleeve, a fixing plate, a first fixing needle, a second fixing needle, a third fixing sleeve, a fourth fixing sleeve, a third fixing needle and a fourth fixing needle. The invention is widely used for orthopedic surgery.
Description
Technical Field
The invention relates to the technical field of orthopedic surgery reduction robots, in particular to an orthopedic reduction positioning robot.
Background
In the field of orthopedics, two major aspects are involved, namely reduction and positioning. Reduction refers to the restoration of a fractured bone to a state before fracture. This step is critical and few physicians will restore the fractured bone as before, called an anatomical reduction. This step has hitherto been addressed manually without reference. It is difficult to ensure the accuracy of bone reduction. Such as length, particularly angulation of bone. The positioning is simply understood as fixing the fractured bone.
In the operation process of leg bone fracture reduction, a magnetic navigation system can be used for carrying out three-dimensional reconstruction on a CT or MRI two-dimensional image of a leg bone, a three-dimensional model of the leg bone is established, the leg bone is positioned by using a probe and a six-degree-of-freedom reference tool, the association between the leg bone and the three-dimensional model is completed, when the leg bone moves, the three-dimensional model also moves relatively, and the reduction condition of the leg bone can be embodied by observing the reduction condition of the three-dimensional model of the leg bone, so that the reduction of the leg bone fracture is completed.
Magnetic navigation system can significantly reduce complicated bone surgery's risk, bone surgery utilizes navigation system to formulate operation plan and intraoperative navigation before the art, can track the surgical instruments in the operation process to with the image of surgical instruments position before the patient or in the art update in real time and show, let the operation doctor know the relation of surgical instruments's position and sick anatomical structure at any time, obtain the navigation help again simultaneously, so make the process of operation more accurate.
Referring to the invention patent No. 201310700436.7, a magnetic navigation system is disclosed. Referring to the patent application with patent number 201711112547.0, an orthopedic positioning robot base for magnetic navigation systems is disclosed. Refer to patent application No. 201910468654.X, which discloses a fixing support for assisting fracture reduction based on electromagnetic navigation technology. Reference is made to patent application No. 201711112548 entitled navigation reference. Reference is made to patent application No. 201711113196.5 entitled orthopaedic robot.
In the orthopedic surgery system in the prior art, the broken bone is fixed and reset with lower precision.
Disclosure of Invention
The invention provides an orthopedic reposition and positioning robot with improved precision and stability, aiming at solving the technical problem of low reposition precision when the existing orthopedic surgery robot performs surgery.
The invention provides an orthopedic reposition positioning robot, which comprises a reposition robot (200), a navigation robot (300) and a positioning robot (400), wherein the reposition robot (200) comprises a reposition platform (200-1), a far-end fixer (900) and a far-end reference frame (903), and the far-end reference frame (903) is fixed on the far-end fixer (900);
the far-end fixer (900) comprises a connecting base plate (1), a movable connecting plate (2), a locker I (3), a reference frame (5), a connecting side plate I, a connecting side plate II, a fixing sleeve I, a fixing sleeve II, a fixing plate, a fixing needle I, a fixing needle II, a fixing sleeve III, a fixing sleeve IV, a fixing needle III and a fixing needle IV;
the connecting substrate 1 is provided with a positioning hole (110), a mounting hole (106), a mounting hole (107), a mounting hole (108) and a mounting hole (109), the positioning hole 110 is connected with a fixing pin (101), and the mounting hole (106), the mounting hole (107), the mounting hole (108) and the mounting hole (109) are respectively provided with a screw (102), a screw (103), a screw (104) and a screw (105);
the top surface of the connecting substrate (1) is provided with two V-shaped grooves (111) and (112) which are vertical to each other; the connection substrate 1 is provided with a rear first connection surface (120) and a second connection surface (121), wherein the second connection surface (121) is positioned at the periphery of the first connection surface (120);
a hole (201), a hole (202), a first connecting surface (205), a second connecting surface (206), a groove (207), a threaded hole (208), a threaded hole (209), a mounting hole (210), a mounting hole (211) and a threaded hole (212) are formed in the body of the movable connecting plate (2); when the movable connecting plate (2) is connected to the connecting substrate (1), the first connecting face (120) is in contact with the second connecting face (206), and the second connecting face (121) is in contact with the first connecting face (205);
the first locker (3) comprises a fixing block (301), a locking block (302), a locking rod (303), a locking handle (304) and a fixing pin (305), wherein the fixing block (301) is provided with a threaded hole (307), a threaded hole (309) and a threaded hole (310), the locking block (302) is provided with a hole (308) and a pin hole (311), and the fixing pin (305) is inserted into the pin hole (311); wherein the fixed block (301) is fixed in the groove (207) of the movable connecting plate 2 through a threaded hole (309) and a threaded hole (310) by using a screw (203) and a screw (204) which pass through a hole (201) and a hole (202), and the locking handle (304) is connected with the locking rod (303); the locking rod (303) is provided with a thread which can be screwed into a threaded hole (307) of the fixed block (301), the tail end of the locking rod (303) can be inserted into a hole (308) of the locking block (302), and the hole (308) is communicated with the pin hole (311); after the locking rod (303) is inserted into the hole (308), the lower end of the fixing pin (305) is clamped at the groove (312) of the locking rod (303); when the locking handle (304) is rotated, the inclined surface (306) of the locking block (302) is contacted with the inclined surface (130) of the connecting substrate (1);
the reference frame (5) is connected with the movable connecting plate (2);
the fixed plate (A5) is fixedly connected with the movable connecting plate (2), and the first connecting side plate (A1) and the first connecting side plate (A2) are respectively and fixedly connected with the fixed plate (A5);
the first connecting side plate is provided with a first threaded hole and a second threaded hole, and the second connecting side plate is provided with a first threaded hole and a second threaded hole;
the rear end of the first fixing sleeve is provided with an outer hexagonal end part, the first fixing sleeve is provided with an external thread, and the external thread of the first fixing sleeve is connected and matched with the first threaded hole of the first connecting side plate;
the second fixing sleeve is provided with external threads, and the rear end of the second fixing sleeve is provided with an outer hexagonal end part; the third fixed sleeve is provided with an external thread and an external hexagonal end part, and the fourth fixed sleeve is provided with an external thread and an external hexagonal end part;
the first connecting side plate is provided with a special hole for an intramedullary nail locking nail, and the second connecting side plate is provided with a special hole for the intramedullary nail locking nail.
Preferably, the distal end fixator (900) further comprises an auxiliary locker (4), the auxiliary locker (4) comprises a movable pin (401), an auxiliary locking handle (402), a spring (405), a screw (406) and a screw (407), the movable pin (401) comprises a shell (413), a pin rod (404) and two poking rods (403), the pin rod (404) passes through the shell (413), the two poking rods (403) are connected with the rear end of the pin rod (404), the shell (413) is provided with external threads (413-1), the spring fixing seat (412) is fixed in a threaded hole (208) of the movable connecting plate (2), the screw (406) passes through a hole (409) in the auxiliary locking handle (402) and is screwed into a threaded hole (213) of the movable connecting plate (2), and the auxiliary locking handle (402) can rotate by taking the screw (406) as a center; the spring (405) is pressed on the spring fixing seat (412) by screwing the screw (407) into a threaded hole (410) on the auxiliary locking handle (402); the spring fixing seat 412 is fixed in a threaded hole (209) on the movable connecting plate (2) through a threaded structure; the slot (411) on the secondary locking handle (402) is located between the two tap levers (403).
Preferably, the reference frame (5) comprises a support rod (501), a ball frame (502) and a marking ball (503), the ball frame (502) is fixedly connected with the upper end of the support rod (501), the marking ball (503) is connected with the ball frame (502), and the lower end of the support rod (501) is fixedly connected with the movable connecting plate (2);
the supporting rod (501) is connected with a first positioning shaft (511) and a second positioning shaft (512), the first positioning shaft (511) and the second positioning shaft (512) are respectively inserted into the hole (210) and the hole (211) on the movable connecting plate (2), the first positioning shaft (511) is provided with a V-shaped groove (513), the supporting rod locking screw (505) is provided with a V-shaped head, the supporting rod locking screw (505) is screwed in from the threaded hole (212) of the movable connecting plate (2), and the V-shaped head of the supporting rod locking screw (505) is clamped into the V-shaped groove (513) of the first positioning shaft (511);
the upper end of bracing piece (501) is equipped with mounting hole (514), mounting hole (515), screw hole (516), ball frame 502 is connected with location axle three (521), location axle four (522) are equipped with V type groove, location axle three (521), location axle four (522) insert mounting hole (514), in mounting hole (515) respectively, screw in screw hole (516) with ball frame locking screw 504, ball frame locking screw (504) are equipped with V type head, the V type head card of ball frame locking screw (504) goes into the V type groove of location axle four (522).
Preferably, the front end of the first fixing sleeve is provided with a round angle, and the front end of the second fixing sleeve is provided with a round angle.
Preferably, the first threaded hole on the first connecting side plate is 100-200 mm away from the second threaded hole, and is deviated to 7-10 degrees.
The invention has the beneficial effects that:
can realize the auxiliary positioning and resetting of the orthopedic operation, and has high positioning and resetting precision.
Solves the problems of invisibility, misalignment and maladjustment in the orthopedic operation.
The accessory used by the reset robot can be connected quickly and safely, and the operation is simple and convenient. And the effect of electric isolation is achieved for the patient, and the electric injury to the patient is prevented. The connecting mode of the invention can effectively prevent the accessory from generating unnecessary displacement or rotation relative to the reset platform under the action of external force. The mark line which is coincident with the X, Y direction on the reset robot is arranged on the resetting robot, so that the hand-eye calibration of the reset robot can be conveniently carried out at any time. The joint locking device of the present invention effectively increases the locking reliability against a similar reference frame by the center-offset principle. The invention improves the usability of the reset robot and facilitates the aseptic operation in the operation by fixing the reference frame used by the reset robot on the external connecting device. In particular, the connection substrate cannot be replaced by new parts in order to prevent the connection substrate from being damaged when used in a special environment. The design is completely symmetrical in front and back and symmetrical in left and right. In the event of damage to the contralateral feature, a replacement installation may be performed.
The invention selects rigid fixation at the distal condyle of the femur and the peripheral bone. The invention can rigidly fix the thighbone, has good stability and high reliability, and is a good basic research for carrying out the robot operation on the thighbone. By researching the configurations of the first connecting side plate and the second connecting side plate, the X-ray perspective area is increased while the femur can be fixed to the maximum extent. Meanwhile, the lengths of the first sleeve and the second sleeve and the first fixing needle and the second fixing needle are determined according to the common size of the femur. While ensuring that there is sufficient length to secure the femur. The interference to the doctor is reduced. The space which can be operated by the doctor is enlarged.
Further features of the invention will be apparent from the description of the embodiments which follows.
Drawings
FIG. 1 is a schematic structural diagram of an orthopedic reposition positioning robot;
FIG. 2 is an enlarged view of a portion of the structure shown in FIG. 1;
fig. 3 is a partially enlarged view of the reset robot of fig. 1;
FIG. 4 is a schematic view of the positioning robot of FIG. 1 with the distal positioning sleeve, reference frame;
FIG. 5 is a front view of the distal anchor;
FIG. 6 is a left side view of the distal anchor;
FIG. 7 is a right side view of the distal anchor;
FIG. 8 is a top view of the distal anchor;
FIG. 9 is a bottom view of the distal anchor;
FIG. 10 is an exploded view of the distal anchor;
FIG. 11 is a schematic view of the arrangement of FIG. 10 with a gap between the screw and the articulating web;
FIG. 12 is a schematic view of the structure of FIG. 10 with a V-groove on the top surface of the connection substrate;
FIG. 13 is a schematic view of the construction of FIG. 10 with mounting holes in the articulating web;
FIG. 14 is a schematic view of a positioning shaft on a support rod with a V-shaped groove;
FIG. 15 is a schematic view of the connection of the lower end of the support rod to the movable connecting plate;
FIG. 16 is a schematic view of the connection of the locking screw of the support rod with the positioning shaft of the support rod;
FIG. 17 is an exploded view of the distal anchor;
FIG. 18 is a schematic view of the connection structure of the upper end of the support rod and the ball rack;
FIG. 19 is an exploded view of the secondary lock;
FIG. 20 is a schematic structural view of the movable pin;
FIG. 21 is a schematic view showing a state in which the pin of the auxiliary locker is protruded by the spring and can be inserted into the hole of the connection substrate;
FIG. 22 is a schematic view showing a state in which the auxiliary lock locking handle is pressed by hand to retract the pin lever to be unlocked;
FIG. 23 is a schematic view of the construction of the distal anchor;
FIG. 24 is an exploded view of the structure shown in FIG. 23;
FIG. 25 is a structural schematic view of a first fixing sleeve;
FIG. 26 is an enlarged partial view of a corner of the first retaining sleeve;
FIG. 27 is a schematic view of the position of the fluoroscopy region;
fig. 28 is a control flow chart.
The symbols in the drawings illustrate that:
100. operating table, 200, reset robot, 300, navigation robot, 400, positioning robot, 500, perineal column, 600, proximal end fixator, 700, proximal end universal connecting arm, 800, adaptor, 900, distal end fixator,
Detailed Description
The present invention will be described in further detail below with reference to specific embodiments thereof with reference to the attached drawings.
As shown in fig. 1-4, the orthopedic reposition and positioning robot comprises a reposition robot 200, a navigation robot 300, a positioning robot 400, a perineal column 500, a proximal fixator 600, a proximal universal connecting arm 700, a bearing device 800 and a distal fixator 900.
The operating table 100 is provided with a side rail 100-1, a near-end universal connecting arm 700 and a connector 800 need to be fixed on the side rail 100-1, and a perineum column 500 needs to be fixed at the tail of the bed board.
The front part of the resetting robot 200 is a resetting platform 200-1, the resetting platform 200-1 is the main moving part of the resetting robot, a far-end fixer 900 is fixed on the resetting platform, and a reference frame 5 is connected on the far-end fixer 900. The structure of the reset platform 200-1 can be realized by adopting the prior art, such as the six-degree-of-automation reset robot IV in the invention application with the application publication number of CN109330686A, and further such as the invention patent with the authorization publication number of CN 104000640B. The distal reference frame 903 is secured to the first attachment side panel A1 of the distal anchor 900.
As shown in fig. 5 to 27, the distal anchor 900 includes a connection base plate 1, a movable connection plate 2, a first locker 3, a second locker 4, a reference frame 5, a fastening plate a5, a first connection side plate a1, and a first connection side plate a 2. The bottom of the connecting substrate 1 is provided with a positioning hole 110, the connecting substrate 1 is provided with a mounting hole 106, a mounting hole 107, a mounting hole 108 and a mounting hole 109, the fixing pin 101 is connected with the positioning hole 110 to realize the mounting of the fixing pin 101, the lower part of the fixing pin 101 is connected with the top of the reset platform 200-1, and the accurate positioning of the connecting substrate 1 and the reset platform 200-1 on the physical position is completed. The screws 102, 103, 104 and 105 pass through the corresponding mounting holes 106, 107, 108 and 109 on the connection substrate 1 to fix the connection substrate 1 on the reset platform 200-1. In order to ensure absolute electrical isolation of the patient from the device, the screw 102 is spaced apart from the articulation plate 2 by a minimum clearance distance d of 10 mm, and the other screws 103, 1104 and 1105 are likewise spaced apart by such a large distance. The top surface of the connection substrate 1 is provided with two V- grooves 111 and 112 perpendicular to each other. After the connection substrate 1 is connected with the reset platform 200-1, the V-shaped groove 111 coincides with the X axis of the reset platform 200-1, and the V-shaped groove 112 coincides with the Y axis of the reset platform 200-1. The advantage of this design is that the reset robot can be calibrated by hand and eye whenever. The movable connecting plate 2 has a hole 201, a hole 202, a first connecting surface 205, a second connecting surface 206, a groove 207, a threaded hole 208, a threaded hole 209, a mounting hole 210, a mounting hole 211 and a threaded hole 212 on its body. The movable connection plate 2 is connected to the connection base plate 1. In order to ensure that the movable connecting plate 2 and the connecting substrate 1 do not move relatively, a full circle of the first connecting surface 120 and the second connecting surface 121 is designed on the connecting substrate 1, and the second connecting surface 121 is located at the periphery of the first connecting surface 120. The movable connecting plate 2 is provided with a first connecting surface 205 and a second connecting surface 206 designed into a whole circle, the first connecting surface 205 is positioned at the periphery of the second connecting surface 206, when the movable connecting plate 2 is mounted on the connecting substrate 1, the first connecting surface 120 and the second connecting surface 206 are completely contacted, and the second connecting surface 121 and the first connecting surface 205 are completely contacted. In order to ensure the stability of the connection between the connection base plate 1 and the movable connection plate 2 during the resetting process, a first locker 3 and a second locker 4 are designed. The first locker 3 comprises a fixing block 301, a locking block 302, a locking rod 303, a locking handle 304 and a fixing pin 305. The fixing block 301 has a threaded hole 307, a threaded hole 309, and a threaded hole 310. The locking block 302 has a hole 308 and a pin hole 311, and a fixing pin 305 is inserted into the pin hole 311. Wherein the fixed block 301 is fixed in the groove 207 of the movable connecting plate 2 through a threaded hole 309 and a threaded hole 310 by using a screw 203 and a screw 204 which pass through the hole 201 and the hole 202, so that the fixed block 301 is mounted with the movable connecting plate 2. Wherein the locking handle 304 is connected to the locking bar 303. The locking bar 303 is threaded into a threaded bore 307 in the anchor block 301 and the end of the locking bar 303 is inserted into a bore 308 in the locking block 302, the bore 308 and the pin bore 311 being in communication. After the locking bar is inserted into the hole 308 at 303, the lower end of the fixing pin 305 inserted into the hole 311 is caught at the groove 312 of the locking bar 303. So that the locking block 302 can only move along the axial direction of the locking rod 303 after the locking handle 304 is turned, thereby achieving the purpose of locking. After the movable connecting plate 2 is installed, when locking is needed, the locking handle 304 is rotated clockwise, the locking handle 304 drives the locking rod 303 to rotate, and the rotation of the locking rod 303 is converted into the displacement of the locking block 302. When the latch block 302 moves forward, the inclined surface 306 of the latch block 302 contacts the inclined surface 130 of the connection substrate 1, thereby locking the swing plate 2. In order to prevent possible accidents due to the operator not being fully locked. In addition to the first lock 3, an auxiliary lock 4 is provided. In the process of installing the movable connecting plate 2, the auxiliary locking handle 402 needs to be pressed by hand, the auxiliary locking handle 402 drives the poking rod 403 outwards, the pin rod 404 moves outwards at the same time, and the movable connecting plate 2 can be installed at this time. When the auxiliary locking handle 402 is released after the movable connection plate 2 is mounted, the pin 404 is automatically inserted into the hole 131 of the connection base plate 1 by the spring 405. The secondary lock is completed. The auxiliary locker 4 comprises a movable pin 401, an auxiliary locking handle 402, a spring 405, a screw 406, a screw 407. The movable pin 401 comprises a housing 413, a pin rod 404 and two tap rods 403, wherein the pin rod 404 penetrates through the housing 413, the two tap rods 403 are connected with the rear end of the pin rod 404, and the housing 413 is provided with external threads 413-1. Wherein the movable pin 401 is fixed in the threaded hole 208 of the movable connection plate 2 by external threads 413-1 thereon so that the housing 413 of the movable pin 401 is connected with the movable connection plate 2. A screw 406 is inserted through the hole 409 of the auxiliary lock handle 402 and screwed into the screw hole 213 of the movable link plate 2 to connect the auxiliary lock handle 402 to the movable link plate 2, and the auxiliary lock handle 402 can be rotated centering on the screw 406. In order to enable the auxiliary locking handle 402 to be automatically reset after being pressed, the spring 405 is pressed on the spring fixing seat 412 by screwing the screw 407 into the threaded hole 410 on the auxiliary locking handle 402. The spring fixing seat 412 is fixed in the threaded hole 209 on the movable connecting plate 2 through a threaded structure. Wherein the slot 411 on the secondary locking handle 402 is located between the two tap levers 403. When the auxiliary lock handle 402 is pressed, the movable pin 401 is driven to perform an unlocking operation. When the auxiliary locking handle 402 is released, the movable pin 401 is automatically locked by the spring 405. The reference frame 5 comprises a support rod 501, a ball frame 502, a marking ball 503, a ball frame locking screw 504 and a support rod locking screw 505, and the reference frame 5 mainly plays a role in tracking the movement position of the resetting robot in real time in the operation process. The supporting rod 501 is provided with a first positioning shaft 511 and a second positioning shaft 512, the first positioning shaft 511 and the second positioning shaft 512 can be inserted into the hole 210 and the hole 211 in the movable connecting plate 2 respectively, wherein the hole 210 is an oblong hole and mainly limits the reference frame 5 to rotate around the second positioning shaft 512. The hole 211 is a circular hole that restricts the movement of the reference frame 5 in the direction of the face of the hole. The movement of the reference frame 5 in the XY plane direction of the whole reset robot is limited by the limiting effect of the holes 210 and 211. The first positioning shaft 511 is provided with a V-shaped groove 513, and the front part of the support rod locking screw 505 is provided with a V-shaped head corresponding to the V-shaped groove 513. After the support rod locking screw 505 is screwed in from the threaded hole 212 of the movable connecting plate 2, the support rod locking screw can be screwed into the threaded hole 211 on the movable connecting plate 2, and the V-shaped head of the support rod locking screw 505 is clamped into the V-shaped groove 513 of the first positioning shaft 511, so that the first positioning shaft 511 can be locked. After the first positioning shaft 511 and the second positioning shaft 512 are completely inserted into the holes 210 and 211, respectively. The center line of the V-shaped groove 513 is slightly higher than the center line of the support rod locking screw 505. Therefore, when the support rod locking screw 505 is screwed in, a downward pulling force F is formed through the V-shaped groove 513, so that the bottom surface 510 of the lower end of the support rod 501 can be more closely attached to the upper surface of the movable connecting plate 2, and the reference frame 5 can be better locked. The connection structure of the ball rack 502 and the support rod 501 also adopts a connection mode that the support rod 501 is connected with the movable connection plate 2 through a first positioning shaft 511 and a second positioning shaft 512. The mounting holes 514, 515 and 516 on the upper end of the support rod 501 have the same structure as the mounting holes 210, 211 and 212 on the movable connecting plate 2. The third positioning shaft 521 and the fourth positioning shaft 522 connected to the ball frame 502 have the same structures as the second positioning shaft 512 and the first positioning shaft 511 on the support rod 501, and the fourth positioning shaft 522 is provided with a V-shaped groove. The third positioning shaft 521 and the fourth positioning shaft 522 are inserted into the mounting holes 514 and 515, respectively. The second positioning shaft 522 is locked by the second ball rack locking screw 504, the ball rack locking screw 504 is screwed into the threaded hole 516, the ball rack locking screw 504 is provided with a V-shaped head, and the V-shaped head of the ball rack locking screw 504 is clamped into the V-shaped groove of the fourth positioning shaft 522. A ball support 523 is coupled to the rack 502 for mounting the identification ball 503 for recognition by the infrared navigation device. When the distal end fixator is used, the fixing plate A5 is fixedly installed on the movable connecting plate 2, and then the connecting side plate A1 and the connecting side plate A2 are fixedly installed on the fixing plate A5. The first connecting side plate A1 is provided with a first threaded hole A102 and a second threaded hole A101. The second threaded hole A101 is used to secure the condyle, which is preferably defined. Much time is spent in designing the first threaded hole a102, some of which is used to look through various literature to be able to determine how to avoid blood vessels and nerves near the condyle, some of which is done with extensive bone modeling trials. A large amount of human bone experimental data are analyzed to obtain that the distance between the first threaded hole 102 and the second threaded hole 101 is 100-200 mm, and the deviation is 7-10 degrees, so that the femur can be fixed well while the operation is met. In order to carry out operations on left and right femurs, a first threaded hole A202 and a second threaded hole A201 are also arranged on the corresponding connecting side plate A2, the first threaded hole A202 and the first threaded hole A102 are coaxial, and the second threaded hole A201 and the second threaded hole A101 are coaxial. The rear end of the first fixing sleeve A3 is provided with an external hexagonal end A301 which can play a role of fixing by using a wrench. The first fixing sleeve A3 is provided with an external thread A302, and the external thread A302 and the thread on the first threaded hole A102 can be matched for use and can be screwed in so that the first fixing sleeve A3 can clamp the femur. In order to prevent damage to the tissue and femur during rotation of the first fixing sleeve A3, the front end of the first fixing sleeve A3 has a rounded corner a303 (shown in fig. 25 and 26) to minimize damage to the tissue and femur. Similarly, the second fixing sleeve a4 has the same structure as the first fixing sleeve A3. The second fixing sleeve A4 is provided with an external thread (the external thread is connected and matched with the second threaded hole A101), the front end of the second fixing sleeve A4 is provided with a fillet, and the rear end of the second fixing sleeve A4 is provided with an outer hexagonal end part. The structure of the third fixing sleeve A8 and the fourth fixing sleeve A9 is the same as that of the first fixing sleeve A3, the third fixing sleeve A8 is provided with external threads (the external threads are connected and matched with the first threaded hole A202), the front end of the third fixing sleeve A8 is provided with a fillet, and the rear end of the third fixing sleeve A8 is provided with an outer hexagonal end. The fixing sleeve IV A9 is provided with external threads (the external threads are connected and matched with the second threaded hole A201), the front end of the fixing sleeve IV A9 is provided with a fillet, and the rear end of the fixing sleeve IV A9 is provided with an outer hexagonal end part. After the first fixing sleeve A3 and the second fixing sleeve A4 clamp the distal end of the femur, the first fixing needle A6 and the second fixing needle A7 can be driven respectively to fix the distal end of the femur in one step. The first fixing needle A6 penetrates through the first fixing sleeve A3, and the second fixing needle A7 penetrates through the second fixing sleeve A4. Similarly, fixed needle three a10 passes through fixed sleeve three A8, and fixed needle four a11 passes through fixed sleeve four a 9. The first connecting side plate A1 is provided with an intramedullary nail locking special hole A103, the position and the size of the hole are determined according to different sizes of intramedullary nails which are arranged on the market and penetrate into the femur with corresponding length. The first connecting side plate A2 is also provided with a special intramedullary nail locking hole A203. The first connecting side plate a1 is provided with a fluoroscopy area (portion within the dashed box), and the first connecting side plate a2 is also provided with a fluoroscopy area. During the operation, the leg of the patient is placed between the first connecting side plate and the second connecting side plate; and then, after the distal end of the femur is clamped by the first fixing sleeve, the second fixing sleeve, the third fixing sleeve and the fourth fixing sleeve, the first fixing needle, the second fixing needle, the third fixing needle and the fourth fixing needle are respectively driven into the first fixing sleeve, the second fixing needle, the third fixing needle and the fourth fixing sleeve to fix the distal end of the femur in one step.
The optical locator 300-1 is arranged at the top of the navigation robot 300 and is used for determining the real-time position of each moving part and the broken bone of the patient in the operation. The middle rear portion of the navigation robot 300 is a display 300-2 for planning, display, etc.
The upper part of the positioning robot 400 is provided with a mechanical arm 400-1, the connecting body 400-2 is connected with the mechanical arm 400-1, the tail end positioning sleeve 400-5 is arranged on the connecting body 400-2, a tail end reference frame 400-4 for determining the position of a tail end tool of the tail end positioning sleeve 400-5 is connected with the connecting body 400-2, and a positioning robot reference frame 400-3 for determining the position of the positioning robot is connected with the connecting body 400-2.
During surgery, the patient is required to lie on the operating table 100. The perineum of the patient needs to be closely fixed on the perineal column 500 of the operating table. Proximal end holder 600 is attached to the upper end of proximal gimbal arm 700. The distal end of proximal gimbal arm 700 is attached to side rail 100-1 of operating table 100 via clutch 800. A proximal gripper 601 is connected to the proximal anchor 600, the proximal gripper 601 being provided with a hole 602. An incision of about 2 cm is made in the femoral thigh of the patient to be fixed, and the proximal gripper 601 firmly grips the long bone through the incision and is fixed through the hole 602 using a kirschner wire.
At this time, the position of the reset robot 200 is adjusted and locked. And placing the leg of the patient between the first connecting side plate and the second connecting side plate. The distal femur of the patient is fixed by a sleeve tool and k-wire on the distal fixator 900. At this time, both sides of the fractured bone of the patient are completely fixed. In order to track the state of the patient's femur in real time during the operation, a proximal reference frame 603 and a distal reference frame 903 are fixed on both sides of the fractured femur.
But in order to be able to reduce the harm to the patient. This is already taken into account when designing the proximal holder 600, the distal holder 900. The connection of the proximal and distal anchors 600, 900 to the femur is very stable through continuous trial and error on the model bone. Their connection to the femur can be considered rigid. The proximal reference frame 603 can thus be fixed to the proximal holder 600 and the distal reference frame 903 to the distal holder 900. Therefore, the trauma of the reference frame to the patient in the navigation operation is solved.
The reference frame 5 is fixed to the distal end holder 900. Referring to fig. 28, after editing of pre-operative (and intra-operative) Dicom data on the navigation robot 300 for three-dimensional reconstruction, and registration is completed, the real-time position of the femur can be displayed on the display 300-2 by the optical positioner 300-1. A reset path planning needs to be performed on the navigation robot 300. After planning is completed and path simulation is carried out, the correctness of the reset path is ensured, path information is sent to the reset robot 200, and the reset robot resets the broken bone according to the information. The reset condition can be observed in real time by the display 300-2.
The reset position is confirmed to be correct. And performing the operation of implanting the femoral intramedullary nail. The intramedullary nail is implanted in two large parts, the first part is inserted into the intramedullary nail, and the second part is called locking nail which connects the intramedullary nail with the bone. The first step is accomplished by planning the position and orientation of the insertion point of the intramedullary nail. In this case, the nail insertion point and the nail insertion direction need to be planned on the navigation robot 300. After the planning is completed, the planning data is sent to the positioning robot 400, and the mechanical arm 400-1 on the positioning robot moves according to the planned path. A red line is observed on the display 300-2 as it gradually approaches the planned driving point until the distal retaining sleeve 400-5 completely coincides with the driving point and driving direction, at which point the red line turns green. Indicating that the stapling position has been located. The physician can follow this positioning point for the implantation of the intramedullary nail. After the intramedullary nail is implanted, the intramedullary nail needs to be fixed. The planning of the positions of the locking pins is performed by the navigation robot 300. The distal retaining sleeve 400-5 is again in the position to be positionally locked. The doctor finishes the nail placing operation.
The specific process of the processing algorithm is as follows:
dicom data processing:
the system imports image data and stores the data into corresponding folders according to types. Image processing operations such as image-by-image display, translation, scaling, rotation, modifying window width levels, etc. may be performed on the image data. The image data is reconstructed and displayed in a volume rendering mode, a surface rendering mode and the like, and an axial vector crown view is provided.
The image is segmented by thresholding, region growing, box cutting, etc. to generate 3D objects for registration. The 3D object may be displayed for translation, zoom, rotation, etc., and the screenshot saved. The object generation formula is as follows:
Pd=Spd(Dmq(Dm,Di))
where Dm is the layer data set, Dm is the original image data set, Dmq is DxMarchingCubes, Spd is vtkSmoothPolyDataFilter, and Pd is polydata.
The generated 3D object may be edited, including filling and erasing, etc., to accommodate surgical needs such as specific registration. And carrying out registration of the healthy side bone and the affected side bone in a visual mode, and configuring according to bone structure characteristic points selected by a doctor on the image, point clouds selected at corresponding positions and the like. The formula is as follows:
S(T)=S(A(x),B(T(x)))
T’=arg max S(T)
wherein S is a similarity measure, a process for finding an optimal spatial transformation. It needs to be implemented by an iterative process. The physician may select the number of iterations. The increment may be implemented by a method of calculating a gradient. For the registration result, the doctor can select a translational and rotational mode to perform fine adjustment, and the fine adjustment step can be set.
The start of the procedure requires an intraoperative registration, receiving Dicom data images of the X-ray device. The corresponding image data in the storage device can also be imported according to actual needs. To refine the registration result, the physician gives the contour of the relevant bone on the image, with which the software registers the previously generated 3D object. The formula is as follows:
Pt=T*PtO
T’=LT(Pt1,Pts2)
wherein PtO is a 3D object point, T is a transformation matrix, Pts1 is a source image point set, Pts2 is a target image point set, and LT is vtkLinearTransform.
The path planning of the affected side resetting enables a doctor to design a resetting motion path in a visual mode, the resetting motion path comprises translation control, rotation control and the like, the moving stride can be finely adjusted, and each section of moving path is gradually added. The software can monitor the legality of the path, and collision is avoided. The formula is as follows:
Tf=R(angle,A)
T=Tn*Tf
where R is used to calculate the transformation matrix by angle and A is the axis. Tn is the affected side proximal transform matrix, Tf is the affected side distal transform matrix.
After the reset robot is connected, the upper computer software sends a motion command to the lower computer software, and the reset machine moves along a path through the control card interface and can move in a single step or send commands at intervals in a mode of starting a timer to achieve the effect of continuous reset.
The design of the nailing points and paths can also be done visually. The pin points can be point-fetched on the image or used with the aid of an NDI optical tracking positioner for actual probe selection. After the positioning robot is connected, the robot arm is moved to a specified position by sending a positioning command, and then the fixing operation is completed.
The state can be saved in real time for each step of operation for field recovery after abnormal exit. The physician may also be given the option to save the current operating state to a file to restore to a designated state if necessary.
The present invention and its embodiments have been described above schematically, without limitation, and what is shown in the drawings is only one of the embodiments of the present invention, and the actual structure is not limited thereto. Therefore, if the person skilled in the art should be informed by the teachings of the present invention, other configurations of the components, the driving device and the connection means, which are similar to the technical solution and are not designed creatively, shall fall within the protection scope of the present invention without departing from the inventive spirit of the present invention.
Claims (5)
1. The orthopedic reduction positioning robot is characterized by comprising a reduction robot (200), a navigation robot (300) and a positioning robot (400), wherein the reduction robot (200) comprises a reduction platform (200-1), a far-end fixator (900) and a far-end reference frame (903), and the far-end reference frame (903) is fixed on the far-end fixator 900;
the far-end fixer (900) comprises a connecting base plate (1), a movable connecting plate (2), a locker I (3), a reference frame (5), a connecting side plate I, a connecting side plate II, a fixing sleeve I, a fixing sleeve II, a fixing plate, a fixing needle I, a fixing needle II, a fixing sleeve III, a fixing sleeve IV, a fixing needle III and a fixing needle IV;
the connecting substrate 1 is provided with a positioning hole (110), a mounting hole (106), a mounting hole (107), a mounting hole (108) and a mounting hole (109), the positioning hole 110 is connected with a fixing pin (101), and the mounting hole (106), the mounting hole (107), the mounting hole (108) and the mounting hole (109) are respectively provided with a screw (102), a screw (103), a screw (104) and a screw (105);
the top surface of the connecting substrate (1) is provided with two V-shaped grooves (111) and two V-shaped grooves (112) which are vertical to each other; the connection substrate 1 is provided with a rear first connection surface (120) and a second connection surface (121), and the second connection surface (121) is positioned at the periphery of the first connection surface (120);
a hole (201), a hole (202), a first connecting surface (205), a second connecting surface (206), a groove (207), a threaded hole (208), a threaded hole (209), a mounting hole (210), a mounting hole (211) and a threaded hole (212) are formed in the body of the movable connecting plate (2); when the movable connecting plate (2) is connected to the connecting substrate (1), the first connecting face (120) and the second connecting face (206) are in contact, and the second connecting face (121) and the first connecting face (205) are in contact;
the first locker (3) comprises a fixing block (301), a locking block (302), a locking rod (303), a locking handle (304) and a fixing pin (305), wherein the fixing block (301) is provided with a threaded hole (307), a threaded hole (309) and a threaded hole (310), the locking block (302) is provided with a hole (308) and a pin hole (311), and the fixing pin (305) is inserted into the pin hole (311); wherein the fixed block (301) is fixed in the groove (207) of the movable connecting plate 2 through a threaded hole (309) and a threaded hole (310) by using a screw (203) and a screw (204) which pass through a hole (201) and a hole (202), and the locking handle (304) is connected with the locking rod (303); the locking rod (303) is provided with a thread which can be screwed into a threaded hole (307) of the fixed block (301), the tail end of the locking rod (303) can be inserted into a hole (308) of the locking block (302), and the hole (308) is communicated with the pin hole (311); after the locking rod (303) is inserted into the hole (308), the lower end of the fixing pin (305) is clamped at the groove (312) of the locking rod (303); when the locking handle (304) is rotated, the inclined surface (306) of the locking block (302) is contacted with the inclined surface (130) of the connecting substrate (1);
the reference frame (5) is connected with the movable connecting plate (2);
the fixing plate (A5) is fixedly connected with the movable connecting plate (2), and the first connecting side plate (A1) and the first connecting side plate (A2) are respectively and fixedly connected with the fixing plate (A5);
the first connecting side plate is provided with a first threaded hole and a second threaded hole, and the second connecting side plate is provided with a first threaded hole and a second threaded hole;
the rear end of the first fixing sleeve is provided with an outer hexagonal end part, the first fixing sleeve is provided with an external thread, and the external thread of the first fixing sleeve is connected and matched with the first threaded hole of the first connecting side plate;
the second fixing sleeve is provided with external threads, and the rear end of the second fixing sleeve is provided with an outer hexagonal end part; the fixing sleeve III is provided with an external thread and an external hexagonal end part, and the fixing sleeve IV is provided with an external thread and an external hexagonal end part;
the first connecting side plate is provided with a special hole for an intramedullary nail locking nail, and the second connecting side plate is provided with a special hole for an intramedullary nail locking nail.
2. The orthopaedic reduction positioning robot according to claim 1, wherein the distal fixator (900) further comprises an auxiliary lock (4), the auxiliary locking device (4) comprises a movable pin (401), an auxiliary locking handle (402), a spring (405), a screw (406) and a screw (407), the movable pin (401) comprises a shell (413), a pin rod (404) and two poke rods (403), the pin rod (404) penetrates through the shell (413), the two poke rods (403) are connected with the rear end of the pin rod (404), the shell (413) is provided with external threads (413-1), the spring fixing seat (412) is fixed in a threaded hole (208) of the movable connecting plate (2), the screw (406) passes through the hole (409) on the auxiliary locking handle (402) and is screwed into the threaded hole (213) of the movable connecting plate (2), and the auxiliary locking handle (402) can rotate by taking the screw (406) as a center; the spring (405) is pressed on the spring fixing seat (412) by screwing the screw (407) into a threaded hole (410) on the auxiliary locking handle (402); the spring fixing seat 412 is fixed in a threaded hole (209) on the movable connecting plate (2) through a threaded structure; the slot (411) on the secondary locking handle (402) is located between the two tap levers (403).
3. The orthopedic reposition and positioning robot according to claim 1, characterized in that the reference frame (5) comprises a support rod (501), a ball frame (502) and an identification ball (503), the ball frame (502) is fixedly connected with the upper end of the support rod (501), the identification ball (503) is connected with the ball frame (502), and the lower end of the support rod (501) is fixedly connected with the movable connection plate (2);
the supporting rod (501) is connected with a first positioning shaft (511) and a second positioning shaft (512), the first positioning shaft (511) and the second positioning shaft (512) are respectively inserted into a hole (210) and a hole (211) on the movable connecting plate (2), the first positioning shaft (511) is provided with a V-shaped groove (513), the supporting rod locking screw (505) is provided with a V-shaped head, the supporting rod locking screw (505) is screwed in from a threaded hole (212) of the movable connecting plate (2), and the V-shaped head of the supporting rod locking screw (505) is clamped into the V-shaped groove (513) of the first positioning shaft (511);
the upper end of bracing piece (501) is equipped with mounting hole (514), mounting hole (515), screw hole (516), ball frame 502 is connected with location axle three (521), location axle four (522) are equipped with V type groove, insert mounting hole (514), mounting hole (515) respectively in location axle three (521), location axle four (522), screw in screw hole (516) with ball frame locking screw 504, ball frame locking screw (504) are equipped with V type head, and the V type groove of location axle four (522) is blocked into to the V type head of ball frame locking screw (504).
4. The orthopedic reposition positioning robot of claim 1, wherein the front end of the first fixing sleeve has a round corner, and the front end of the second fixing sleeve has a round corner.
5. The orthopedic reposition positioning robot of claim 1, wherein the first threaded hole on the first connecting side plate is 100-200 mm away from the second threaded hole and is biased by 7-10 °.
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