CN112914642B

CN112914642B - Nail placing guider

Info

Publication number: CN112914642B
Application number: CN202110127228.7A
Authority: CN
Inventors: 王健全; 黄洪杰; 张辛; 徐雁; 王成; 鞠晓东; 印钰
Original assignee: Peking University Third Hospital Peking University Third Clinical Medical College
Current assignee: Peking University Third Hospital Peking University Third Clinical Medical College
Priority date: 2021-01-29
Filing date: 2021-01-29
Publication date: 2022-11-25
Anticipated expiration: 2041-01-29
Also published as: CN112914642A

Abstract

The invention provides a screw placing guider, which comprises a guide tube, an eccentric part and a fulcrum part, wherein the eccentric part is arranged on the guide tube; the guide tube comprises a head end and a tail end, the head end is used for placing the anchor, and the tail end is used for being held by an operator; the eccentric part is arranged close to the head end and extends from the outer wall of the guide pipe to the head end in an outward inclined manner; the fulcrum portion is connected to an extending end of the eccentric portion extending outward, and the fulcrum portion extends beyond the head end. According to the nail placing guide device, the eccentric part and the fulcrum part are arranged, so that the guide device can be firmly positioned, and the acetabulum cartilage is prevented from being damaged. At the same time, a receiving space for receiving the labrum is formed between the eccentric portion and the guide tube to protect the labrum and facilitate suture repair of the labrum.

Description

Nail placing guider

Technical Field

The invention relates to a medical instrument for labrum repair, in particular to a nail-placing guide for labrum repair.

Background

Acetabular labral injury is one of the most common causes of hip pain. The prevalence of labral lesions is high and literature reports indicate that the prevalence of labral lesions in the population with a hip pain visit varies from 22% to 55%.

The labrum plays a crucial role in the stability, lubricity and kinematics of the hip joint. Tearing of the labral lesion or surgical resection may result in loss of labral function, which may further cause instability, subluxation, or dislocation of the hip joint. Therefore, restoring and maintaining the normal anatomy of the labrum using a glenoid lip prosthesis is critical in relieving pain, enhancing function, and regaining motor capacity.

Currently, labral repair may employ labral sutures or reconstructions, but both involve labral fixation, i.e., fixation within the acetabular bone using a number of suture anchors. The necessary step of placing the anchor is to drill a bone tunnel at the corresponding position of the acetabular bone margin by using a guide and then to knock the anchor in. In clinical practice, the complex acetabular bone structure increases the difficulty of drilling bone paths, and the conditions of slippage, perforation and the like often occur, so that iatrogenic injury is caused, and the firmness of anchoring nails cannot be guaranteed.

Disclosure of Invention

The invention provides a screw placing guider, which comprises a guide pipe, an eccentric part and a fulcrum part; the guide tube comprises a head end and a tail end, the head end is used for placing the anchor, and the tail end is used for being held by an operator; the eccentric part is arranged close to the head end and extends from the outer wall of the guide pipe to the head end in an outward inclined mode; the fulcrum portion is connected to an extending end of the eccentric portion extending outward, and the fulcrum portion extends beyond the head end.

In one embodiment, the eccentric portion extends from an outer wall of the guide tube in a curved manner towards the head end.

In one embodiment, the extended end of the eccentric portion is 6mm from the outer wall of the guide tube.

In one embodiment, the extended end of the eccentric portion is on the same plumb line as the head end.

In one embodiment, the fulcrum portion extends 15mm beyond the head end.

In one embodiment, the extended tip of the fulcrum portion has an arcuate surface.

In one embodiment, the junction of the eccentric and the guide tube is 8mm from the head end.

In one embodiment, the trailing end is provided with a handle for an operator to hold.

In one embodiment, the guide tube is made of a metal material.

According to the nail placing guide device, the guide device can be firmly positioned by arranging the eccentric part and the fulcrum part, so that the acetabulum cartilage is prevented from being damaged. At the same time, a receiving space for receiving the labrum is formed between the eccentric portion and the guide tube, and the space can also protect the labrum, facilitating repair of the sutured labrum.

The foregoing summary is provided for the purpose of description only and is not intended to be limiting in any way. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features of the present application will be readily apparent by reference to the drawings and following detailed description.

Drawings

The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention. In the drawings:

FIG. 1 is a schematic front view of a nail guide according to an embodiment of the present invention;

FIG. 2 is an enlarged view of portion A of FIG. 1; and

figures 3A-3D are schematic illustrations of a labral repair procedure using a stapling guide in one embodiment of the present invention.

Detailed Description

The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it should be understood that they are presented herein only to illustrate and explain the present invention and not to limit the present invention.

Referring to fig. 1-2, the present invention staple guide 100, in one embodiment, includes a guide tube 1, an eccentric portion 2, and a fulcrum portion 3. The guide tube 1 may be made of metal, and includes a head end 11 and a tail end 12. The head end 11 is used for drilling bone canals and placing anchors in labral repair operations, and the tail end 12 can be held by an operator for operation. Preferably, the trailing end 12 may be provided with a handle 13 to enable the operator to comfortably hold it.

Meanwhile, the eccentric portion 2 is disposed near the head end 11, and the eccentric portion 2 extends outward from the guide tube 1, so that the eccentric portion 2 is deviated from the axis of the guide tube 1 to achieve "eccentricity". The eccentric portion 2 extends obliquely toward the head end 11, and in one embodiment, an extending end of the eccentric portion 2 may be on the same vertical line as the head end 11. In this way, a labrum-containing space can be formed between the guide tube 1 and the eccentric portion 2, and this space can also protect the labrum and also facilitate suturing the repair of the labrum.

Further, the fulcrum portion 3 is connected to the extending end of the eccentric portion 2 extending outward, and the fulcrum portion 3 extends beyond the head end 11, so that a guiding function can be performed when drilling the bone canal to avoid puncturing the acetabular cartilage.

Reference is now made in conjunction with figures 3A-3D, wherein figure 3A shows the damaged labrum 4, acetabular bone 5 and acetabular cartilage 6. Fig. 3B shows the positioning of the labrum repair operation, and the operator can hold the handle 13 of the guide 100, orient the head end 12 toward the patient receiving the labrum repair, and abut the fulcrum portion 3 at the position of the acetabular cartilage 6, with the acetabular cartilage as the positioning fulcrum. At this time, since a receiving space is formed between the guide tube 1 and the eccentric portion 2, the damaged labrum 4 can be received therein to be protected. Fig. 3C shows the drilled bone tunnel 51, and the eccentric portion 2 and fulcrum portion 3 cooperate to apply a clamping force to the acetabulum when the bone tunnel 51 is drilled, securely positioning the guide tube 1, preventing the guide 100 from sliding backwards to cut through the acetabular bone 5 or break through the ilio-psoas fossa (not shown). And, because the clamping force that eccentric part 2 and fulcrum portion 3 provided, can realize drilling the bone way and nailing steadily, guaranteed the integrality of bone way and anchor and held power. Additionally, the fulcrum portion 3 extends beyond the head end 11, and in one embodiment, a length H3 (see fig. 2) of the fulcrum portion 3 extending beyond the head end 11 may be 15mm. In this way, the fulcrum portion 3 may serve as a guide when drilling the bone tunnel and may also position the longitudinal distance of the bone tunnel, thereby avoiding punching through the acetabular cartilage 6 when placing the nail. Fig. 3D shows the suture labrum 7 after suturing with a suture anchor with the aid of the guide 100.

In one embodiment, the distance H1 (see fig. 2) from the head end 11 at the connection of the eccentric 2 to the guide tube 1 may be 8mm and the distance H2 (see fig. 2) of the extended tip of the eccentric 2 from the outer wall of the guide tube 1 may be 6mm, according to the normal size of the labrum (4.23-5.6 mm). In this way, the receiving space is not only large enough to receive the labrum, but also not so large as to be inconvenient for use of the guide.

Furthermore, the length of the H2 is designed to be 6mm, the H2 is larger than the thickness of normal cartilage, and the radius of a lower bone tunnel can be compatible, so that the damage to the acetabular cartilage caused by bone tunnel puncture can be avoided.

In one embodiment, the eccentric portion 2 extends from the outer wall of the guide tube 1 towards the tip 11 in a curved shape, so that the curved surface does not damage nearby soft tissue during insertion and extraction of the guide, reducing iatrogenic injuries.

In one embodiment, the extended end of the fulcrum portion 3 has an arc surface 31, so that the arc surface 31 can be attached to different types of hip cartilage surfaces, and can protect the cartilage so as not to damage the articular cartilage while the guide is firmly positioned.

It will be apparent to those skilled in the art that various changes and modifications may be made in the present invention without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims of the present invention and their equivalents, the present invention is also intended to include such modifications and variations.

Claims

1. A nail-placing guider is characterized by comprising a guide tube, an eccentric part and a fulcrum part; the guide tube comprises a head end and a tail end, the head end is used for placing the anchor, and the tail end is used for being held by an operator; the eccentric part is arranged close to the head end and extends from the outer wall of the guide pipe to the head end in an outward inclined mode; the fulcrum part is connected with the extending tail end of the eccentric part extending outwards, and the fulcrum part extends beyond the head end; the connecting position of the eccentric part and the guide pipe is 8mm away from the head end; the extending tail end of the eccentric part is 6mm away from the outer wall of the guide pipe; the length of the supporting point part extending beyond the head end is 15mm;

the eccentric part extends from the outer wall of the guide pipe to the head end in a bent shape;

the extending tail end of the eccentric part and the head end are positioned on the same plumb line;

the extended end of the fulcrum portion has an arc-shaped surface;

the tail end is provided with a handle which is used for being held by an operator;

the guide pipe is made of metal materials; in the operation of repairing the labrum, an operator holds the handle of the guide, faces the head end of a patient receiving the labrum repair, and abuts the fulcrum part at the position of the acetabular cartilage, and the acetabular cartilage is used as a positioning fulcrum; at this time, since a housing space is formed between the guide tube and the eccentric portion, the labrum of the injured pelvis is housed therein to be protected; the eccentric part is matched with the fulcrum part, so that clamping force is applied to the acetabulum when a bone tunnel is drilled, the guide tube is firmly positioned, and the condition that the guider slides backwards to puncture the bone of the acetabulum or break through into an ilium psoas fossa is avoided; due to the clamping force provided by the eccentric part and the fulcrum part, stable bone tract drilling and nailing can be realized, and the integrity of the bone tract and the holding force of the rivet are ensured; in addition, the fulcrum part extends beyond the head end, so that the fulcrum part can play a guiding role in drilling a bone tunnel and can position the longitudinal distance of the bone tunnel, thereby avoiding puncturing the acetabulum cartilage in nail placing.