CN112842454B - Guider for osteotomy around knee joint and application of guider - Google Patents
Guider for osteotomy around knee joint and application of guider Download PDFInfo
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- 210000000629 knee joint Anatomy 0.000 title claims abstract description 25
- 210000000245 forearm Anatomy 0.000 claims description 11
- 210000005056 cell body Anatomy 0.000 claims 2
- 238000000034 method Methods 0.000 abstract description 15
- 238000002594 fluoroscopy Methods 0.000 abstract description 13
- 230000008569 process Effects 0.000 abstract description 8
- 238000006073 displacement reaction Methods 0.000 abstract description 7
- 210000000988 bone and bone Anatomy 0.000 description 16
- 206010017076 Fracture Diseases 0.000 description 8
- 210000002303 tibia Anatomy 0.000 description 8
- 208000010392 Bone Fractures Diseases 0.000 description 6
- 230000006378 damage Effects 0.000 description 4
- 210000003127 knee Anatomy 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 210000002082 fibula Anatomy 0.000 description 3
- 230000000399 orthopedic effect Effects 0.000 description 3
- 208000003947 Knee Osteoarthritis Diseases 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 210000001264 anterior cruciate ligament Anatomy 0.000 description 2
- 230000001174 ascending effect Effects 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 2
- 238000012937 correction Methods 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 238000003384 imaging method Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 210000002414 leg Anatomy 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 210000004417 patella Anatomy 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 210000000689 upper leg Anatomy 0.000 description 2
- 208000011708 Avulsion fracture Diseases 0.000 description 1
- 208000012659 Joint disease Diseases 0.000 description 1
- 206010034246 Pelvic fractures Diseases 0.000 description 1
- 208000019155 Radiation injury Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
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- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
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- 239000000945 filler Substances 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
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- 201000008482 osteoarthritis Diseases 0.000 description 1
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- 239000010959 steel Substances 0.000 description 1
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
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- Oral & Maxillofacial Surgery (AREA)
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Abstract
The invention belongs to the technical field of auxiliary medical instruments, and particularly relates to a guider for osteotomy around a knee joint and application thereof. The positioning device comprises a positioning base, a positioning support, a positioning front arm, a positioning rear arm, a positioning rod and a positioning hook, wherein one end of the positioning support is fixedly connected with the positioning base, the other end of the positioning support is movably connected with one end of the positioning front arm, and a sliding rail is arranged at the other end of the positioning support and used for slidably connecting one end of the positioning front arm with the positioning front arm; and a first sleeve hole and a second sleeve hole are drilled in the positioning base in parallel along the direction pointing to the positioning rod. The osteotomy line can be conveniently and quickly determined only under the guidance of two times of fluoroscopy, a doctor operating the osteotomy can accurately drive in the kirschner wire without fluoroscopy, and meanwhile, the troubles of displacement, looseness, osteotomy surface inclination and repeated fluoroscopy of the kirschner wire in the osteotomy process are avoided.
Description
Technical Field
The invention belongs to the technical field of auxiliary medical instruments, and particularly relates to a guider for osteotomy around a knee joint and application thereof.
Background
Unicondylar knee joint disease refers to the fact that among three compartments of the knee joint, knee osteoarthritis is characterized in that one compartment is seriously affected, the other two compartments are slightly affected or the disease is slowly developed, and most of the seriously affected compartments are medial compartments. The medial compartment alone accounts for about 25% of patients with osteoarthritis of the knee, while the lateral compartment accounts for only 5%. The treatment modes of the unicondylar knee joint lesion include non-operative treatment (medicament treatment, orthopedic insoles and knee joint supports) and operative treatment (arthroscopic cleaning, osteotomy, unicondylar knee joint replacement UKA and total knee joint replacement TKA). Among them, osteotomies are divided into open wedge osteotomies, closed wedge osteotomies, and fibular osteotomies. Both closed wedge osteotomies and open wedge osteotomies require consideration of the correctness of the osteotomy hinge position, the flatness of the osteotomy face, and the integrity of the hinge. OWHTO-open wedge tibial high osteotomy is an incomplete osteotomy with the following advantages: simple technique, small incision injury, accurate deformity correction and convenient force line adjustment in the operation. Due to high stress conduction in the medial compartment of the knee joint, appropriate measures need to be taken to maintain the tibial architecture stable. The key to the success of this procedure is: suitable for patient selection, safe and accurate operation technology and reliable internal fixation.
The safe and accurate operation technology needs to combine preoperative imaging examination, preoperative planning, preosteectomy fluoroscopy, kirschner wire driving, bone cutting position designing and bone cutting finally. Reliable internal fixation is usually achieved using T-shaped compression-lock steel plates. The kirschner wire is also called a bone round wire and is used as a temporary fixer and an osteotomy face position determiner in osteotomy correction as an internal fixing material commonly used in orthopaedics. In order to drive 2 kirschner wires into a satisfactory osteotomy position in the operation, 2 kirschner wires are ensured to be positioned on the same osteotomy plane as much as possible, so that a clinician needs to determine the insertion positions of the 2 kirschner wires under X-ray repeated fluoroscopy. This not only lengthens the operation time, but also exposes the doctor and patient to a great deal of X-ray radiation. Meanwhile, even if the Kirschner wire is positioned by X-ray fluoroscopy for many times, the final ideal position of the Kirschner wire cannot be accurately determined, the final ideal position of the Kirschner wire can only be determined by the hand feeling and experience of a clinician when the clinician drills into the Kirschner wire, and the drilling depth does not have intuitive measurement data to provide support for the operation. In addition, when the osteotomy is performed along the lower part of the 2 Kirschner wires, the Kirschner wires are frequently loosened or fall off, so that the problems of the change of the osteotomy direction, the fracture of the hinge and the like are caused.
More information about the above-described solutions can also be found in the following documents. Chinese utility model patent CN210330665U "a location bone tunnel device that is used for knee joint anterior cruciate ligament to damage and rebuilds" discloses a location bone tunnel device that is used for knee joint anterior cruciate ligament to damage and rebuilds, including leading drill bushing, sight handle and sight, lead the drill bushing and can be according to X-Y to be the gliding connection of straight line on the base of sight handle, the connection that the sight can slide is on the arc slide rail. Chinese utility model patent CN211534656U "an auxiliary positioning guider for osteotomy around knee joint" discloses an auxiliary positioning guider for osteotomy around knee joint, comprising a fixed rod with an arc-shaped slide rail at one end and a positioning rod with a slide block matched with the arc-shaped slide rail at one end, wherein the positioning rod is connected with the arc-shaped slide rail of the fixed rod in a sliding way through the slide block; the top end of the sliding block is provided with a first fastening screw used for fixing the sliding block on the arc-shaped sliding rail.
Disclosure of Invention
In view of the above technical problems in the prior art, there is a need to provide a guide for knee osteotomy and an application thereof, in which the number of X-ray fluoroscopy times is greatly reduced in clinical applications to reduce X-ray exposure injury of doctors and patients, the position of the osteotomy line can be accurately positioned under the condition of reducing the number of X-ray fluoroscopy times, and further, the problems of loosening of kirschner wires, displacement of the osteotomy line and inclination of the osteotomy surface during the osteotomy operation in the prior art can be solved.
To achieve the above object, in a first aspect of the present invention, the inventors provide a guide for osteotomy around a knee joint, comprising a positioner and a guide plate,
the positioner comprises a positioning base, a positioning bracket, a positioning front arm, a positioning rear arm, a positioning rod and a positioning hook;
one end of the positioning support is fixedly connected with the positioning base, the other end of the positioning support is movably connected with one end of the positioning front arm, the other end of the positioning front arm is fixedly connected with one end of the positioning rear arm, the other end of the positioning rear arm is fixedly connected with one end of the positioning rod, the other end of the positioning rod is fixedly connected with the positioning hook, and a sliding rail is arranged at the other end of the positioning support and used for slidably connecting one end of the positioning front arm with the positioning hook;
and a first sleeve hole and a second sleeve hole are drilled in the positioning base in parallel along the direction pointing to the positioning rod.
In the guider provided by the invention, the positioning bracket and the positioning forearm can be circular arcs with certain radian or straight line segments, but sliding structures matched with each other are arranged between the positioning bracket and the positioning forearm. When the positioning support and the positioning front arm are matched straight line segments, the positioning support, the positioning front arm, the positioning rear arm and the positioning rod form a shape of Contraband, the positioner of the guider of the invention is continuously close to a rectangle, square or round corner rectangle/square along with the advancing of the sleeve, and the length of the Kirschner wire to be driven can be calculated according to the length of the side of the rectangle or the square and the length of the advanced sleeve. When the locating support and the locating front arm are the circular arcs matched with each other, the distance between the contact point of the sleeve and the locating base and the locating hook is the radius of the circular arc, the locator is adjusted through the sliding locating front arm to be clamped with the position of the bone to be cut, and the length of the Kirschner wire to be driven in is calculated through the radius and the length of the pushing sleeve. Compared with the traditional method, the X-ray number of times of driving the Kirschner wire into the X-ray tube is greatly reduced, and the accuracy of the driving depth is improved. The guider provided by the invention is suitable for knee joint peripheral osteotomy comprising proximal high tibial osteotomy and distal femoral osteotomy. The Kirschner wire can be accurately driven into the hinge position through the positioning support (the position of the high-position osteotomy hinge at the proximal end of the tibia is one third of the tip of the fibula, and the position of the osteotomy hinge at the distal end of the femur is positioned at the metaphysis cross point), the depth of the osteotomy required to be cut is calculated (namely the length of the Kirschner wire required to be driven in), the guide plate is sleeved into the Kirschner wire, the osteotomy direction and depth can be determined, the smoothness of an osteotomy surface is ensured, and the purposes of accurate osteotomy and quick osteotomy are achieved. The whole operation is simple and convenient, and the method is easy to popularize clinically.
The implementation of a conventional open wedge osteotomy now generally involves the following steps:
first, preoperative imaging examination
1. A full-length sheet with double lower limbs bearing load;
2. knee joint load bearing positive plate;
3. a patella tangent position sheet;
4. a 30-degree knee position sheet;
5. bend the knee 45 ° Rosenburg position tablet.
Second, transfect into kirschner wire before osteotomy
The leg is fully extended and the knee position is adjusted under fluoroscopy until a full AP image is obtained. The medial and lateral condyles are aligned at the AP site. The leg is rotated until the patella is fully in the anterior direction (so that 1/3 of the fibula is generally covered by the tibia).
2 Kirschner wires with the diameter of 2.5mm are driven into the head of the tibia under fluoroscopy, and the two Kirschner wires can indicate the osteotomy direction.
Then, the osteotomy position is designed according to the kirschner wire driving position, the ascending osteotomy surface is determined, and horizontal osteotomy and ascending osteotomy are carried out.
The Kirschner wire is a commonly used internal fixation material for orthopedics, the original specification of the Kirschner wire is generally fixed at about twenty centimeters, and the diameter of the Kirschner wire is between 0.5 and 2mm, and has different specifications. The bone fracture fixation device is used for fixing short fractures or avulsion fractures and other fractures with low stress, and is also commonly used for fixing temporary fracture blocks in orthopedic operations. Due to wide application, the maximum diameter of the kirschner wire is gradually increased to 4mm, and the kirschner wire is matched with an external fixing locking nail to fix emergent large fractures such as pelvic fracture, calcaneal fracture and the like along with the external fixing support.
The Kirschner wire fixing technique: firstly, a kirschner wire can be used for fixing the fracture at an anatomical position; then, holes are drilled perpendicular to the longitudinal axis of the phalanges at 0.5-1 cm from the proximal and distal talar fracture lines, respectively, and bilateral cortical bone is passed. The first posterior kirschner wire should be located on the upper edge of the goose-web and the anterior edge of the posterior crest of the tibia. The 2 nd k-wire should be located 2cm in front of and parallel to the first k-wire. The two k-wires form a plane that coincides with the posterior slope of the proximal articular surface. The two kirschner wires should be in a plane, and the plane should be parallel to the longitudinal axis of the phalanges.
According to an exemplary embodiment of the invention, the guide plate is a structure formed by connecting a positioning plate and a limiting plate through a handheld end, the structure is provided with a groove body, the positioning plate is provided with a first surface, a second surface and a first side surface, the limiting plate is provided with a third surface, a fourth surface and a second side surface, the first surface and the second surface are arranged oppositely, the third surface and the fourth surface are arranged oppositely, the first side surface and the second side surface are respectively arranged at two sides far away from the groove body, a first positioning hole and a second positioning hole are arranged in parallel along the direction from the first surface to the second surface, and the distance between the central axes of the first positioning hole and the second positioning hole is equal to the distance between the central axes of the first sleeve hole and the second sleeve hole. Since the horizontal osteotomy plane is from the posterior tibial edge to the anterior medial tibial 1/3, it is in close proximity to the k-wire. According to the invention, the guide plate is used for covering the kirschner wires for determining the osteotomy line, so that the kirschner wires are not required to be cut off like the traditional method in order to avoid the exposed part of the kirschner wires from interfering with the osteotomy operation, and the problems of loosening and displacement of the kirschner wires in the subsequent operation process are not caused.
According to the exemplary embodiment of the invention, a limiting through hole is formed in the direction from the third surface to the fourth surface and used for driving a limiting Kirschner wire. The limiting through holes are arranged to ensure that the structure formed by the guide plate and the two Kirschner wires is more stable in the process of pushing the osteotomy saw, so that the number of the limiting through holes is preferably more than 1.
In view of simplicity of the structure of the guide of the present invention and convenience of the operation steps, according to an exemplary embodiment of the present invention, the limiting through-holes include first limiting through-holes and second limiting through-holes, and the first limiting through-holes and the second limiting through-holes are not arranged in parallel. The preferred non-parallel arrangement is also based on the assumption of a stabilizing effect brought about by the fixing structure. It can be understood that if the directions of the first limiting through hole and the second limiting through hole are parallel and exactly consistent with the directions of the first positioning hole and the second positioning hole, due to the action of the same direction, two kirschner wires inserted into the first limiting through hole and the second limiting through hole and two kirschner wires inserted into the first positioning hole and the second positioning hole are likely to be loosened, so that the position of the osteotomy surface is deviated.
Further, the distance between the groove body and the second side surface along the first side surface is 5-15 mm. The groove body provides accurate guide for the osteotomy saw and restricts the position, direction and depth of cutting, guarantees the smoothness of the osteotomy surface, and realizes the purposes of accurate osteotomy and quick osteotomy.
Furthermore, one end of the positioning front arm is arranged in the slide rail and is in sliding connection with the other end of the positioning support through a limiting pin. The positioning front arm and the positioning support are matched and mutually slide to realize the adjustment of the size of the clamping opening, when the proper size is reached, the position of the clamping opening is fixed by using a limiting pin, and both ends of the limiting pin are provided with fasteners, wherein the fasteners can be nuts, butterfly valves, rubber or fillers, but not limited to the nuts. The positions of the first sleeve hole and the second sleeve hole are adjusted by sliding a small distance so as to accurately determine the driving positions of two Kirschner wires, so that the purpose of determining an accurate osteotomy line without perspective is achieved.
Furthermore, a first external thread is arranged on the limiting pin, and the other end of the positioning support and one end of the positioning front arm are fixed through a nut matched with the limiting pin. The conventional structure is familiar to the majority of medical people, is simple and convenient to operate, has a good fastening effect, and is not easy to loosen and fall off.
Further, in the process of using the guider, sleeves for providing driving channels for the kirschner wires are needed, and the number of the sleeves is more than two. The guider also comprises a first sleeve and a second sleeve, wherein second external threads and scale marks are arranged outside the first sleeve and the second sleeve, and the length of the Kirschner wire to be driven can be measured by reading the scale marks and the arc radius on the first sleeve and the second sleeve after the sleeves are pushed, so that the ray exposure of doctors and patients can be greatly reduced. In a more preferable mode, the first sleeve and the second sleeve are matched with a kirschner wire to be driven, and scales are arranged on the kirschner wire, so that when the kirschner wire is driven, the length of the drilled kirschner wire can be directly read from the scales at one end far away from the needle point.
In a second aspect of the invention, the inventors provide a guiding application of a guide according to the first aspect of the invention in a peri-knee osteotomy.
Preferably, the guide application comprises the step of sleeving the guide plate on an exposed kirschner wire. More specifically, when the guide plate is sleeved on the kirschner wire, attention should be paid to sleeving the first positioning hole and the second positioning hole on the two exposed kirschner wires correspondingly, and the kirschner wire can be driven into the limiting through hole to achieve a good fixing effect.
Different from the prior art, the technical scheme at least has the following beneficial effects:
by adopting the guider for osteotomy around the knee joint, provided by the invention, 2 Kirschner wires can be quickly and accurately drilled into an ideal osteotomy position by only one to two times of auxiliary positioning of X-ray transmission, and the 2 Kirschner wires are ensured to be positioned on the same osteotomy surface. Meanwhile, the invention can conveniently guide the osteotomy saw and restrict the cutting position, direction and depth. In addition, the guide plate covers the kirschner wire to protect the kirschner wire from being loosened and displaced randomly, so that the smoothness of a bone cutting surface is ensured, the aims of accurate bone cutting and quick bone cutting are fulfilled, the operation time is shortened, and the radiation injury of a doctor and a patient exposed to X rays is reduced.
Drawings
FIG. 1 is a schematic view of a positioning guide for a peri-knee osteotomy according to one embodiment;
FIG. 2 is a top view of a guide plate of an embodiment of a positioning guide for osteotomies around a knee joint;
FIG. 3 is a cross-sectional view of a positioning plate of a positioning guide for osteotomies around a knee joint in accordance with an exemplary embodiment;
FIG. 4 is a cross-sectional view of a positioning guide of an embodiment of a positioning guide for osteotomies around a knee joint;
FIG. 5 is a schematic diagram of a stop pin slidably connecting one end of a positioning forearm to a slide rail in an embodiment;
FIG. 6 is a schematic view of a nut adapted to fit the first external thread of the stop pin in accordance with one embodiment.
Description of reference numerals:
1. a positioner;
101. positioning a base; 102. positioning the bracket; 1021. a slide rail; 103. positioning the forearm; 104. positioning the rear arm; 105. positioning a rod; 106. a positioning hook; 107. a limit pin; 1071. a first external thread; 1072. A nut;
11. a first sleeve bore; 12. a second sleeve bore;
2. a guide plate;
21. positioning a plate;
211. a first side; 212. a second face; 213. a first side surface; 214. a first positioning hole; 215. a second positioning hole;
22. a limiting plate;
221. a third side; 222. a fourth surface; 223. a second side surface; 224. a limiting through hole; 2241. a first limiting through hole; 2242. a second limiting through hole;
31. a first sleeve; 32. a second sleeve.
311. A second external thread; 312. and (5) scale marking.
Detailed Description
To explain technical contents, structural features, and objects and effects of the technical solutions in detail, the following detailed description is given with reference to the accompanying drawings in conjunction with the embodiments. It should be understood that these examples are for illustrative purposes only and are not intended to limit the scope of the present application.
Referring to fig. 1 and 2, the present embodiment provides a guide for osteotomy around knee joint, which comprises a positioner 1 and a guide plate 2, wherein the positioner includes a positioning base 101, a positioning bracket 102, a positioning forearm 103, a positioning rear arm 104, a positioning rod 105 and a positioning hook 106.
One end of the positioning bracket 102 is fixedly connected with the positioning base (101), the other end of the positioning bracket 102 is movably connected with one end of the positioning front arm 103, the other end of the positioning front arm 103 is fixedly connected with one end of the positioning rear arm 104, the other end of the positioning rear arm 104 is fixedly connected with one end of the positioning rod 105, the other end of the positioning rod 105 is fixedly connected with the positioning hook 106, wherein the other end of the positioning bracket 102 is provided with a slide rail 1021 for slidably connecting one end of the positioning front arm 103; therefore, along with the application of the positioner at different positions, the clamping size of the positioning bracket and the positioning forearm can be adjusted by sliding, so that the positioning bracket is suitable for bone structures at different positions and the operation of doctors. In different specific embodiments, the positioning support and the positioning front arm can be circular arcs with certain radian or straight line segments, when the positioning support and the positioning front arm are matched with the straight line segments, the positioning support, the positioning front arm, the positioning rear arm and the positioning rod form an Contraband shape, along with the advancing of the sleeve, the positioner of the guider disclosed by the invention continuously approaches a rectangle, square or rounded rectangle/square shape, and at the moment, the length of the Kirschner wire to be driven can be calculated through the length of the side of the rectangle, the width of the square or the square and the length of the advanced sleeve. When the locating support and the locating front arm are the circular arcs matched with each other, the distance between the contact point of the sleeve and the locating base and the locating hook is the radius of the circular arc, the locator is adjusted through the sliding locating front arm to be clamped with the position of the bone to be cut, and the length of the Kirschner wire to be driven in is calculated through the radius and the length of the pushing sleeve. For example, before the kirschner wire is driven, under the guidance of perspective data, the positioning base (101) of the positioner 1 according to the embodiment is placed at the positions of the first sleeve hole 11 and the second sleeve hole 12 according to the determined osteotomy line, the first sleeve 31 is pushed towards the tibia, when the first sleeve 31 just touches the tibia, the depth of the pushed first sleeve 31 is read and recorded, for example, the pushed depth is 6cm, the length of the kirschner wire to be driven in the first sleeve hole 11 is obtained by subtracting the depth of the pushed first sleeve 31 from the radius (13-15cm) of the positioning support 102, and the length of the kirschner wire to be driven in the second sleeve 32 can be calculated by analogy. The depth of the first sleeve 31 that has been advanced here refers to the distance between the forward advancing point of the first sleeve 31 and the intersection of the first sleeve 31 and the edge of the positioning base (101) away from the advancing direction.
A first sleeve hole 11 and a second sleeve hole 12 are drilled in the positioning base in parallel along the direction pointing to the positioning rod.
Referring to fig. 3-4, the guide plate 2 is formed by connecting a positioning plate 21 and a limiting plate 22 through a handheld end 23, and has a structure with a slot 24, the positioning plate 21 is provided with a first surface 211, a second surface 212 and a first side surface 213, the limiting plate 22 is provided with a third surface 221, a fourth surface 222 and a second side surface 223, the first surface 211 and the second surface 212 are arranged oppositely, the third surface 221 and the fourth surface 222 are arranged oppositely, the first side surface 213 and the second side surface 223 are respectively arranged at two sides far away from the slot 24, a first positioning hole 214 and a second positioning hole 215 are arranged in parallel along a direction from the first surface 211 to the second surface 212, and a distance between central axes of the first positioning hole 214 and the second positioning hole 215 is equal to a distance between central axes of the first sleeve hole 11 and the second sleeve hole 12.
After two kirschner wires are driven to determine the osteotomy line, the exposed kirschner wires are extremely easy to form osteotomy obstacles in subsequent osteotomy operations, and have the risk of displacement in the osteotomy process. Therefore, the guide plate provided by the invention can be correspondingly sleeved on the two exposed kirschner wires by using the first positioning hole 214 and the second positioning hole 215. Moreover, the groove body 24 on the guide plate actually provides a limit space for osteotomy operation, and guides the osteotomy advancing direction of the osteotomy saw. The distance between the channel 24 and the second side 223 along the first side 213 is 5-15 mm. Namely, the width of the groove body for the movement of the osteotomy saw is 5-15 mm.
In order to form a more stable structure for the guide plate sleeved on the exposed kirschner wire, more than 1 limiting through hole 224 is formed in the limiting plate along the direction from the third surface 221 to the fourth surface 222 for driving in the limiting kirschner wire. In a more preferred embodiment, in order to enhance the stability of the guide plate, prevent undesired displacement, looseness, etc. during the osteotomy, the stopper through-holes include first and second stopper through- holes 2241 and 2242, and the first and second stopper through- holes 2241 and 2242 are not arranged in parallel.
Referring to fig. 5-6, the other end of the positioning bracket 102 is movably connected to one end of the positioning forearm 103, and the movable connection may be a common movable connection manner such as clamping, screwing or sleeving. Furthermore, one end of the positioning front arm 103 is disposed in the slide rail 1021, and is slidably connected to the other end of the positioning bracket 102 through a limit pin 107. The positioning bracket 102 and the positioning forearm can slide mutually to adjust the distance so as to be beneficial to adapt the positioner to tibial osteotomy or other osteotomy with different sizes. More preferably, the limit pin 107 is provided with a first external thread 1071, and the other end of the positioning bracket 102 and one end of the positioning forearm 103 are fixed by a nut 1072 matched with the first external thread.
More preferably, the guide further comprises a first sleeve 31 and a second sleeve 32, and the first sleeve 31 and the second sleeve 32 are externally provided with a second external thread 311 and a scale mark 312.
The guide device provided by the invention is specifically operated when in application, and comprises the steps of driving two kirschner wires to determine a osteotomy line, and then sleeving the guide plate on the exposed kirschner wires, so that the possible situations of kirschner wire displacement, looseness or osteotomy surface deviation in the propelling process of the osteotomy saw are avoided.
The positioning guider provided by the invention can conveniently and quickly determine the osteotomy line under the guidance of two times of fluoroscopy, enables a doctor operating the osteotomy to accurately drive in the kirschner wire under the condition of no fluoroscopy, and simultaneously avoids the troubles of displacement, looseness, osteotomy surface inclination and repeated fluoroscopy of the kirschner wire in the osteotomy process. The positioning guide provided by the invention is suitable for knee joint peripheral osteotomy comprising proximal tibia high-position osteotomy and distal femur osteotomy. Can accurately squeeze into the hinge position (shin bone near-end high-order osteotomy hinge position is located the upper third of fibula tip through the locating support, and thighbone distal end osteotomy hinge position is located metaphysis crosspoint), through the scale on the sleeve, the support radius can calculate the degree of depth that needs cut the bone, then will cut the bone baffle and embolia the kirschner pin, just can confirm and cut bone direction, degree of depth, guarantee the planarization of osteotomy face, realize accurate osteotomy and cut the bone mesh fast. The whole operation is simple and convenient, and the method is easy to popularize clinically.
It should be noted that, although the above embodiments have been described herein, the invention is not limited thereto. Therefore, based on the innovative concepts of the present invention, the technical solutions of the present invention can be directly or indirectly applied to other related technical fields by making changes and modifications to the embodiments described herein, or by using equivalent structures or equivalent processes performed in the content of the present specification and the attached drawings, which are included in the scope of the present invention.
Claims (7)
1. A guide for osteotomy around a knee joint, characterized by comprising a positioner (1) and a guide plate (2),
the positioner comprises a positioning base (101), a positioning bracket (102), a positioning front arm (103), a positioning rear arm (104), a positioning rod (105) and a positioning hook (106);
one end of the positioning support (102) is fixedly connected with the positioning base (101), the other end of the positioning support (102) is movably connected with one end of the positioning front arm (103), the other end of the positioning front arm (103) is fixedly connected with one end of the positioning rear arm (104), the other end of the positioning rear arm (104) is fixedly connected with one end of the positioning rod (105), the other end of the positioning rod (105) is fixedly connected with the positioning hook (106), wherein a sliding rail (1021) is arranged at the other end of the positioning support (102) and used for slidably connecting one end of the positioning front arm (103) with the positioning front arm, and the positioning support and the positioning front arm are arcs matched with each other;
a first sleeve hole (11) and a second sleeve hole (12) are drilled in the positioning base in parallel along the direction pointing to the positioning rod;
guide plate (2) are for being connected the structure that forms through handheld end (23) and have cell body (24) by locating plate (21) and limiting plate (22), locating plate (21) are provided with first face (211), second face (212) and first side (213), limiting plate (22) are provided with third face (221), fourth face (222) and second side (223), first face (211) and second face (212) set up relatively, third face (221) and fourth face (222) set up relatively, first side (213) and second side (223) set up respectively in keeping away from the both sides of cell body (24), follow first face (211) lead to the direction parallel of second face (212) and seted up first locating hole (214) and second locating hole (215), distance between first locating hole (214) and second locating hole (215) the central axis with distance between first sleeve hole (11) and the second sleeve hole (12) the central axis equals .
2. The guide device as claimed in claim 1, wherein a limit through hole (224) is opened along the direction from the third surface (221) to the fourth surface (222) for driving a limit kirschner wire.
3. The guide of claim 2, wherein the stopper through hole (224) includes a first stopper through hole (2241) and a second stopper through hole (2242), and the first stopper through hole (2241) and the second stopper through hole (2242) are not arranged in parallel.
4. The guide of claim 1, wherein the distance between the channel (24) leading along the first side to the second side is 5-15 mm.
5. The guide according to claim 1, characterized in that one end of the positioning forearm (103) is arranged inside the slide rail (1021) and is slidingly connected to the other end of the positioning bracket (102) by means of a stop pin (107).
6. The guide according to claim 5, characterized in that the stop pin (107) is provided with a first external thread (1071), and the other end of the positioning bracket and one end of the positioning forearm (103) are fixed by a nut (1072) adapted thereto.
7. The guide device according to claim 1, further comprising a first sleeve (31) and a second sleeve (32), wherein the first sleeve (31) and the second sleeve (32) are externally provided with a second external thread (311) and a scale mark (312).
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011618431.6A CN112842454B (en) | 2020-12-31 | 2020-12-31 | Guider for osteotomy around knee joint and application of guider |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202011618431.6A CN112842454B (en) | 2020-12-31 | 2020-12-31 | Guider for osteotomy around knee joint and application of guider |
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| CN112842454A CN112842454A (en) | 2021-05-28 |
| CN112842454B true CN112842454B (en) | 2022-05-10 |
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| CN202011618431.6A Expired - Fee Related CN112842454B (en) | 2020-12-31 | 2020-12-31 | Guider for osteotomy around knee joint and application of guider |
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Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA1193509A (en) * | 1982-05-20 | 1985-09-17 | Douglas B. Mains | Tibial osteotomy guide assembly and method |
| CN101155559A (en) * | 2005-02-08 | 2008-04-02 | I平衡医疗公司 | Method and apparatus for forming a wedge-like opening in a bone for an open wedge osteotomy |
| CN207721848U (en) * | 2017-04-28 | 2018-08-14 | 首都医科大学宣武医院 | A cut bone baffle for high-order osteotomy of shin bone |
| CN108635016A (en) * | 2018-05-31 | 2018-10-12 | 武汉嘉三维技术应用有限公司 | A kind of High Tibial biplane osteotomy navigation guide plate |
| CN111513810A (en) * | 2020-04-29 | 2020-08-11 | 山东大学齐鲁医院(青岛) | Osteotomy guider |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102335033B (en) * | 2011-07-01 | 2013-06-19 | 白石柱 | Individual craniofacial bone piece auxiliary positioning guide plate system and preparation method thereof |
| CN104000634B (en) * | 2014-06-16 | 2016-01-13 | 南通舟可信息科技有限公司 | A kind of combination unit of interotrochanteric osteotomy and using method thereof |
-
2020
- 2020-12-31 CN CN202011618431.6A patent/CN112842454B/en not_active Expired - Fee Related
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA1193509A (en) * | 1982-05-20 | 1985-09-17 | Douglas B. Mains | Tibial osteotomy guide assembly and method |
| CN101155559A (en) * | 2005-02-08 | 2008-04-02 | I平衡医疗公司 | Method and apparatus for forming a wedge-like opening in a bone for an open wedge osteotomy |
| CN207721848U (en) * | 2017-04-28 | 2018-08-14 | 首都医科大学宣武医院 | A cut bone baffle for high-order osteotomy of shin bone |
| CN108635016A (en) * | 2018-05-31 | 2018-10-12 | 武汉嘉三维技术应用有限公司 | A kind of High Tibial biplane osteotomy navigation guide plate |
| CN111513810A (en) * | 2020-04-29 | 2020-08-11 | 山东大学齐鲁医院(青岛) | Osteotomy guider |
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| CN112842454A (en) | 2021-05-28 |
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