CN106344143B - Damp type dentoid process of axis sighting device - Google Patents

Abstract

The invention relates to a medical instrument, in particular to a damping type axis odontoid aimer used for guiding the positioning of hollow screws in the treatment of axial odontoid process fractures. It includes a hollow guide tube and an aiming device connected to the hollow guide tube, the aiming device includes an inner collar and an outer collar arranged concentrically, and the inner collar, the outer collar and the hollow guide tube are connected by a cross shaft , the rotating shafts are all made of an inner sleeve rod and an outer sleeve sleeve that can rotate relatively and be coaxially arranged. The aimer has the advantages of simple structure, convenient use, accurate and fast positioning, and can be used to guide accurate positioning of Kirschner wires in the treatment of axial odontoid process fractures, thereby improving operation quality, reducing operation errors, and reducing patient's pain.

Description

Damped Axis Odontium Sight

technical field

The invention relates to a medical instrument, in particular to a damping type axis odontoid aimer used for guiding the positioning of hollow screws in the treatment of axial odontoid process fractures.

Background technique

Axial odontoid process fractures are common fractures of the cervical spine, accounting for 10% to 14% of cervical fractures. The nonunion rate of untreated or improperly treated odontoid fractures is 42-72%, and there is potential atlantoaxial instability at the same time, which may lead to acute or chronic damage to the brainstem, spinal cord or nerve roots, causing severe Quadriplegia, respiratory dysfunction, and even death. Therefore, patients with axial odontoid process fractures should be actively treated. Since the first report in 1981 that the use of screws for direct internal fixation of odontoid process fractures has been reported in clinical practice, compared with traditional treatment methods, this technique can not only restore the stability of the atlantoaxial joint, but also preserve the atlantoaxial joint to the greatest extent. Joint mobility, less surgical trauma, high fracture healing rate, and significantly improved quality of life of patients, it is considered that this technique is the first choice for surgical treatment of odontoid fractures. Although the curative effect of anterior screw internal fixation in the treatment of odontoid process fractures has been clinically affirmed, in the past, because the operation was mainly based on experience, the guiding Kirschner wire needed to be adjusted repeatedly, the operation was random, and serious complications may even occur. Including screw breakage, fracture displacement, fracture nonunion, or screw tapping out of the odontoid process and injury to the spinal cord. Chinese patent 2012102768399 discloses a "pivot odont screw aimer", which uses nuts to adjust two telescopic links installed on the hollow guide tube to change the direction of the hollow guide tube, and the two telescopic links are connected to the fine-tuning control On the board, the fine-tuning control board is connected with the support rod through a ball joint. The axis odontoid process screw aimer can be used to guide the accurate positioning of Kirschner wires in the treatment of axis odontoid process fractures, thereby improving operation quality, reducing operation errors, and reducing patient pain. However, during the operation, since there are many positions to be adjusted, and the adjustment points are interrelated, repeated adjustments are often required to meet the requirements, which affects the progress of the operation. In addition, the length of the telescopic link adjusted by the nut is difficult to accurately measure, and the position of the telescopic link connected to the fine-tuning control panel is also uncertain. This kind of pivot odontoid screw sight cannot record the position with coordinate data, and cannot reproduce the previous Positioning during surgery.

Contents of the invention

The purpose of the present invention is to provide a damping type axis odontoid collimator which is simple in structure, easy to use, fast in adjustment speed, and can be used to indicate the position of the axis. Thereby improving the quality of surgery, reducing surgical errors, and reducing the suffering of patients.

The technical scheme that the present invention adopts for solving technical problems is:

The damping type pivot odontoid aimer of the present invention comprises a hollow guide tube and an aiming device connected on the hollow guide tube, the aiming device comprises an inner collar and an outer collar arranged concentrically, and a connecting collar is arranged on the outer collar. plate and connecting seat, the outer diameter of the inner collar is smaller than the inner diameter of the outer collar, the outer diameter of the hollow guide tube is smaller than the inner diameter of the inner collar, and the outer wall of the hollow guide tube is symmetrical to the inner ring surface of the inner collar A left half shaft and a right half shaft are provided, the left half shaft and the right half shaft are coaxially arranged and the axes of the left half shaft and the right half shaft pass through the center of the inner collar; An upper half shaft and a lower half shaft are arranged between the inner ring surfaces of the ring, the upper half shaft and the lower half shaft are coaxially arranged and the axes of the upper half shaft and the lower half shaft pass through the center of the inner ring; the upper half shaft and the lower half shaft The axis of the lower half shaft is perpendicular to the axes of the left half shaft and the right half shaft; the upper half shaft, the lower half shaft, the left half shaft and the right half shaft are all composed of an inner sleeve rod and an outer sleeve that are relatively rotatable and coaxially arranged One end of the inner sleeve rod is fixedly connected to the inner sleeve ring and communicates with the lumen of the inner sleeve ring, and the other end of the inner sleeve rod is fixedly connected with a shaft located in the inner cavity of the outer sleeve, and the shaft rod The middle section of the outer sleeve is provided with a U-shaped annular groove, one end of the outer sleeve is fixedly connected to the hollow guide tube or the outer ring, the other end of the outer sleeve is sleeved on the shaft, and the inner wall of the outer sleeve is provided with a corresponding shaft. The annular groove of the ring groove on the rod; the bottom of the annular groove has a through hole that runs through the wall of the outer casing, and a connecting rod is inserted in the through hole, and the inner end of the connecting rod is fixedly connected with a matching ring The arc-shaped friction plate of the groove, the arc-shaped friction plate is arc-shaped as a whole, and its cross-section is a U-shaped structure matching the ring groove; the outer end of the connecting rod is fixedly connected to the middle section of the spring leaf, and the two ends of the spring leaf are respectively It is connected to the outer wall of the outer casing through a support.

The outer tube wall at the junction of the inner sleeve rod and the outer sleeve is provided with a scale indicating the relative position; the spring piece is an arc-shaped thin piece, and the middle section of the spring piece and the other side corresponding to the connection point of the connecting rod are fixedly connected with a push-pull handle .

After adopting the above-mentioned technical solution, the aimer adjusts the direction of the guide tube through the double-ring aiming device. It has a simple structure, is convenient to use, and can be adjusted quickly. The position can be represented by coordinates, which is convenient for quantitatively recording the details of the operation, and the operation can be reproduced repeatedly by using the coordinates. positioning; use the hollow guide to make most of the positioning Kirschner wires in the guide, which is convenient to control the direction and avoid the illusion of proper needle insertion due to its bending; use the friction force of the spring to fix the hollow guide, and the positioning action is fast and fixed. Reliable, accurate positioning and fixed position after positioning, reducing repeated needle insertion and improving the accuracy of screw entry; no need to implant fixation screws on the lower cervical spine and the fixation link is firmly fixed on the operating bed, and the fixation is reliable.

Description of drawings

Fig. 1 is a schematic diagram of the front structure of an embodiment of the present invention.

Fig. 2 is a schematic cross-sectional structure diagram of the upper half shaft.

FIG. 3 is a partially enlarged schematic view of part A of FIG. 2 .

Detailed ways

As shown in Fig. 1, the damping type axis odontoid process aimer of the present invention includes a hollow guide tube 1 and an aiming device connected to the hollow guide tube 1, and the aiming device includes an inner collar 2 and an outer sleeve arranged concentrically. ring 3, the outer diameter of the inner collar 2 is smaller than the inner diameter of the outer collar 3, the outer diameter of the hollow guide tube 1 is smaller than the inner diameter of the inner collar 2, the outer wall of the hollow guide tube 1 and the inner ring of the inner collar 2 A left semi-axis 5 and a right semi-axis are arranged symmetrically between the surfaces, the left semi-axis 5 and the right semi-axis are coaxially arranged and the axes of the left semi-axis 5 and the right semi-axis pass through the center of the inner collar 2; An upper half shaft 6 and a lower half shaft 7 are arranged between the outer ring surface of the collar 2 and the inner ring face of the outer ring 3, the upper half shaft 6 and the lower half shaft 7 are coaxially arranged and the upper half shaft 6 and the lower half shaft The axis of half shaft 7 passes through the center of circle of inner collar 2; The axis of upper half shaft 6 and lower half shaft 7 is perpendicular to the axis of left half shaft 5 and right half shaft; Said upper half shaft 6, lower half shaft 7, left half shaft Both the half shaft 5 and the right half shaft are made of an inner sleeve rod 8 and an outer sleeve 9 that are relatively rotatable and coaxially arranged.

During use, the hollow guide tube 1 can swing up and down on the inner collar 2 centered on the left semi-axis 5 and the right semi-axis, and the inner collar 2 can swing left and right centered on the upper semi-axis 6 and the lower semi-axis 7, so that Realize the omni-directional guide setting of the hollow guide pipe 1.

Of course, for the convenience of use, a connecting plate 10 and a connecting seat 11 may also be provided on the outer ring 3 for fixed connection to various supports.

The structures of the upper half shaft 6, the lower half shaft 7, the left half shaft 5 and the right half shaft are the same, taking the upper half shaft 6 as an example, as shown in Figure 2, one end of the inner sleeve rod 8 is fixedly connected to the inner sleeve ring 2 The other end of the inner sleeve rod 8 is fixedly connected with a shaft 81 located in the inner cavity of the outer sleeve 9, and the middle section of the shaft 81 is provided with a U-shaped ring groove One end of the outer sleeve 9 is fixedly connected to the hollow guide tube 1 or the outer ring 3, the other end of the outer sleeve 9 is set on the shaft 81, and the inner wall of the outer sleeve 9 is provided with an upper ring groove corresponding to the shaft 81. The annular groove 91; the bottom of the annular groove 91 has a through hole through the wall of the outer casing 9, a connecting rod 92 is inserted in the through hole, and the inner end of the connecting rod 92 is fixedly connected with a matching The arc-shaped friction plate 93 of the ring groove, the arc-shaped friction plate 93 is arc-shaped as a whole, and its cross section is a U-shaped structure matching the ring groove. The outer end of the connecting rod 92 is fixedly connected to the middle section of the spring leaf 94, and the two ends of the spring leaf 94 are respectively connected to the outer wall of the outer sleeve 9 through a support. As shown on the left side of Figure 2, when the spring piece 94 is pressed, the middle section of the spring piece 94 is close to the outer sleeve 9, and the connecting rod 92 is pushed inward, and the arc-shaped friction piece 93 is pressed against the ring groove of the middle section of the shaft rod 81 In this process, the frictional force of the relative rotation between the inner sleeve rod 8 and the outer sleeve 9 is increased, so that the positioned hollow guide tube 1 is not easy to loosen. Conversely, as shown in the right side of Figure 2 and Figure 3, when the spring leaf 94 is pulled out, the middle section of the spring leaf 94 is away from the outer casing 9, the connecting rod 92 is pushed outward, and the arc-shaped friction plate 93 leaves the ring groove and retreats In the annular groove 91 of the outer sleeve 9, at this moment, the inner sleeve rod 8 and the outer sleeve 9 can rotate freely, and the inner sleeve rod 8 can be pulled out from the outer sleeve 9, which is convenient for maintenance.

A scale indicating the relative position is provided on the outer tube wall at the junction of the inner sleeve rod 8 and the outer sleeve 9 . After the pointing position of the hollow guide tube 1 is fixed, the position coordinates of the hollow guide tube 1 can be determined by recording the relative rotation angles of the inner sleeve rod 8 and the outer sleeve tube 9 on each half axis. The spring leaf 94 is an arc-shaped sheet, and the middle section of the spring leaf 94 is fixedly connected with a push-pull handle 95 on the other side corresponding to the connection point of the connecting rod 92. The spring leaf 94 can be pressed by the handle 95 so that its middle section is close to the outer sleeve 9 , the spring leaf 94 can also be pulled out so that its middle section is away from the outer casing 9.

When in use, place the patient in a supine position and keep the neck extended; under continuous skull traction, the C-arm X-ray machine is used to observe the odontoid process fracture reduction; Install the sight in place; X-ray anterior view, lateral fluoroscopy, manipulate the hollow guide tube to be positioned at the central axis of the odontoid process, and the lateral position is facing the rear apex of the odontoid process, and turn on the air pump to lock the position of the hollow guide tube; use an electric drill to The 1.2 mm Kirschner wire was driven into the odontoid process under the guidance of the guide. After the positive and lateral projections were correct, a hollow drill bit with an outer diameter of 3.0 mm was used to expand the hole along the Kirschner wire, and screwed into a hollow loose drill bit with a diameter of 3.5 mm. Bone Compression Titanium Screws.

Claims (1)

1. The damping type axis odontoid aimer, including a hollow guide tube (1) and an aiming device connected to the hollow guide tube (1), is characterized in that: the aiming device includes a concentrically arranged inner collar (2 ) and the outer ring (3), the connecting plate (10) and the connecting seat (11) are arranged on the outer ring (3), the outer diameter of the inner ring (2) is smaller than the inner diameter of the outer ring (3), the The outer diameter of the hollow guide tube (1) is smaller than the inner diameter of the inner collar (2), and a left semi-axis (5) and The right half shaft, the left half shaft (5) and the right half shaft are coaxially arranged and the axes of the left half shaft (5) and the right half shaft pass through the center of the inner collar (2); the inner collar (2) An upper half shaft (6) and a lower half shaft (7) are arranged between the outer ring surface of the outer ring and the inner ring face of the outer ring (3), and the upper half shaft (6) and the lower half shaft (7) are coaxially arranged And the axes of upper half shaft (6) and lower half shaft (7) pass through the center of circle of inner collar (2); The axis of the half shaft is vertical; the upper half shaft (6), the lower half shaft (7), the left half shaft (5) and the right half shaft are all composed of an inner sleeve rod (8) and an outer sleeve rod (8) which are relatively rotatable and coaxially arranged The tube (9) is set; one end of the inner sleeve rod (8) is fixedly connected to the inner sleeve ring (2) and communicated with the lumen of the inner sleeve ring (2), and the other end of the inner sleeve rod (8) A shaft (81) located in the inner cavity of the outer sleeve (9) is fixedly connected, the middle section of the shaft (81) is provided with a U-shaped ring groove in section, and one end of the outer sleeve (9) is fixedly connected to the On the hollow guide tube (1) or the outer ring (3), the other end of the outer sleeve (9) is set on the shaft (81), and the inner wall of the outer sleeve (9) is provided with an upper ring corresponding to the shaft (81). The annular groove (91) of the groove; the bottom of the annular groove (91) has a through hole penetrating through the wall of the outer casing (9), and a connecting rod (92) is inserted in the through hole, and the connecting rod (92) is inserted into the through hole. The inner end of the rod (92) is fixedly connected with an arc-shaped friction plate (93) that matches the ring groove. The arc-shaped friction plate (93) is arc-shaped as a whole, and its cross-section is a U-shaped structure that matches the ring groove; the connecting rod ( The outer end of 92) is fixedly connected to the middle section of the spring leaf (94), and the two ends of the spring leaf (94) are respectively connected to the outer wall of the outer sleeve (9) through the support; the inner sleeve rod (8) and The outer tube wall at the junction of the outer casing (9) is provided with a scale indicating the relative position; the spring piece (94) is an arc-shaped thin piece, and the middle section of the spring piece (94) corresponds to the other connecting point of the connecting rod (92). One side is fixedly connected with push-pull handle (95).