CN106580422B - Bone fixator guide apparatus - Google Patents
Bone fixator guide apparatus Download PDFInfo
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- CN106580422B CN106580422B CN201611237659.4A CN201611237659A CN106580422B CN 106580422 B CN106580422 B CN 106580422B CN 201611237659 A CN201611237659 A CN 201611237659A CN 106580422 B CN106580422 B CN 106580422B
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 76
- 210000000078 claw Anatomy 0.000 claims abstract description 90
- 238000003780 insertion Methods 0.000 claims abstract description 9
- 230000037431 insertion Effects 0.000 claims abstract description 9
- 230000008878 coupling Effects 0.000 claims description 17
- 238000010168 coupling process Methods 0.000 claims description 17
- 238000005859 coupling reaction Methods 0.000 claims description 17
- 210000004417 patella Anatomy 0.000 description 144
- 238000005553 drilling Methods 0.000 description 22
- 208000010392 Bone Fractures Diseases 0.000 description 20
- 206010017076 Fracture Diseases 0.000 description 17
- 230000000694 effects Effects 0.000 description 5
- 238000000926 separation method Methods 0.000 description 5
- 238000005452 bending Methods 0.000 description 4
- 210000005069 ears Anatomy 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 238000002324 minimally invasive surgery Methods 0.000 description 3
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 208000006670 Multiple fractures Diseases 0.000 description 1
- 206010034122 Patella fracture Diseases 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000013011 mating Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
Abstract
The invention provides a bone fixator guide apparatus, which comprises a guide main body, a positioning device and a guide sleeve; the guide body is provided with two guide through grooves which can form sliding fit with the two fixed claws, and a plurality of Kirschner wire holes arranged along the extending direction of the guide through grooves are also formed in the guide body; the positioning device comprises a first sliding combination part and an extension part, wherein the first sliding combination part comprises two convex strips which are in sliding fit with the two guide through grooves, the extension part is provided with an arc-shaped structure which is matched with the outer side surface of the bone, and when the extension part is contacted with the bone, the guide body can slide along the first sliding combination part to contact the bone; after positioning the guide body, driving a kirschner wire into bone within the kirschner wire hole to fix the guide body; the guide sleeve can be inserted into the guide through groove to guide the drill bit to drill a hole in the bone; wherein the guide through slot can be used for guiding the insertion of the fixing jaw into the borehole.
Description
Technical Field
The present invention relates to medical devices, and more particularly to a bone anchor guide for assisting in the implantation of a bone anchor into bone.
Background
In the medical operation for treating patellar fracture, the patella can be pressurized and fixed by a patella fixer to accelerate the healing of the patella. Referring to fig. 10 and 11, the conventional patella fixator 5 includes a fixator body 51 and two fixing claws 52, wherein the two fixing claws 52 are located at one side of the fixator body 51, and the fixing claws 52 are bent downward to form a substantially U-shaped structure with the fixator body 51. When the patella fracture fixing device is used, two drilling holes can be formed in the patella, the two drilling holes simultaneously extend into broken bones of two parts formed by fracture of the patella, the two fixing claws are respectively inserted into the two drilling holes, and then the fractured patella can be fixed in a pressurizing mode by the aid of the fixing device body.
In the operation process, the drill bit can be guided by the guide tube during drilling, however, the drill bit is difficult to accurately position by the existing guide tube, so that deviation occurs in the drill bit position, and therefore, the fixing claw of the patella fixer is difficult to accurately insert into the drill bit, the operation difficulty is increased, and the treatment effect of the patella fixer is affected.
The above problems are also present not only in patellar surgery but also in metaphyseal fracture surgery, and the metaphyseal bone fixator is also provided with bent claw portions at the distal end thereof, so that the claw portions are difficult to insert and have a deviation in drilling.
The above information disclosed in the background section is only for enhancement of understanding of the background of the invention and therefore it may contain information that does not form the prior art that is already known to a person of ordinary skill in the art.
Disclosure of Invention
The present invention aims to overcome the above-mentioned disadvantages of the prior art and to provide a bone anchor guiding instrument capable of guiding a bone anchor when it is implanted into bone.
Additional aspects and advantages of the invention will be set forth in part in the description which follows and, in part, will be obvious from the description, or may be learned by practice of the invention.
According to one aspect of the present invention, a bone anchor guide instrument for guiding and mounting a bone anchor to a bone, the bone anchor including an anchor body and a fixation jaw extending from the anchor body, the fixation jaw being located on one side of the anchor body, the fixation jaw being arranged to bend relative to the anchor body, the bone anchor guide instrument comprising:
the guide body is provided with a guide through groove which can form sliding fit with the fixed claw, a longitudinal opening is formed in the groove wall of the guide through groove and along the extending direction of the guide through groove, the longitudinal opening penetrates through two ends of the groove wall, and the size of the longitudinal opening is suitable for the fixed claw to pass through; the guide body is also provided with a temporary fixing hole arranged along the extending direction of the guide through groove;
the positioning device is connected with the guide body and comprises an extension part, the extension part is provided with an arc-shaped structure matched with the side surface of the bone, and when the extension part is contacted with the bone, the guide body can be contacted with the bone; the positioning device positions the bone relative to the bone through the extension and positions the guide body relative to the bone; wherein, the guide through groove can be used for guiding the insertion of the fixing claw into the bone.
According to one embodiment of the invention, the bone anchor is provided with two fixing claws, and the guide body is provided with two guide through grooves which can form a sliding fit with the two fixing claws respectively.
According to an embodiment of the present invention, there is further provided a guide auxiliary member detachably mounted on the guide body; the guide auxiliary piece is provided with arc grooves, the number of the arc grooves is consistent with that of the guide through grooves and the arc grooves are correspondingly arranged, when the guide auxiliary piece is installed on the guide main body, the arc grooves are located at the longitudinal openings of the corresponding guide through grooves, and a closed through hole structure is formed by the arc grooves and the groove walls of the guide through grooves.
According to an embodiment of the present invention, the positioning device includes a first coupling portion and an extension portion, and the first coupling portion is assembled with the guide body in a mating manner through a detachable connection structure.
According to an embodiment of the present invention, the connecting structure includes a protruding strip disposed on the first combining portion, and the protruding strip is suitable for being nested in the guiding through groove and assembled in a sliding fit with the guiding through groove.
According to an embodiment of the present invention, the number of the protruding strips is the same as that of the guide through grooves, and the protruding strips are provided with drill guide holes; when the convex strips are nested in the corresponding guide through grooves, the extending direction of the drill guide holes is consistent with the extending direction of the guide through grooves so as to guide the drill to drill holes in bones.
According to an embodiment of the invention, a guide sleeve is also provided, which can be inserted into the guide channel to guide the drill bit in drilling the bone.
According to an embodiment of the present invention, the bone anchor further comprises a driving device slidably engaged with the guide through groove and pushing the bone anchor to drive the fixing claw to insert into the drill hole.
According to an embodiment of the present invention, the driving device further includes a projection that can be inserted between the two fixing claws to limit the fixing claws.
According to one embodiment of the invention, the cross section of the guide through groove is circular, one end of the guide through groove is a protruding end protruding out of the guide body, and the front end of the protruding end is arranged in a shrinking mode.
According to an embodiment of the present invention, the front end portion of the protruding end and the front end portion of the guide sleeve are provided with a latch capable of being engaged with bone.
According to the technical scheme, the invention has the advantages and positive effects that:
the bone fixator guide instrument can be positioned by the positioning device, and can realize the guide effect on the bone fixator by sliding fit of the guide through groove and the bone fixator, so that the bone fixator can be smoothly inserted into the drilled hole. And utilize the direction logical groove that sets up on the director main part to combine together with the guide sleeve to realize the locate function to the drilling, process the accurate drilling of position on the bone, can also avoid mincing other soft tissue when the drill bit drills through the guide sleeve.
Drawings
The above and other features and advantages of the present invention will become more apparent by describing in detail exemplary embodiments thereof with reference to the attached drawings.
FIG. 1 is a schematic view of the patella fixator guide apparatus according to embodiment 1 of the invention;
fig. 2 is a schematic structural view of a guide body of embodiment 1 of the present invention;
FIG. 3 is a schematic view of the positioning device according to embodiment 1 of the present invention;
FIG. 4 is a schematic view showing the structure of a guide sleeve according to embodiment 1 of the present invention;
FIG. 5 is a schematic view of the patella fixator guide apparatus according to embodiment 1 of the present invention in the hole;
fig. 6 is a schematic structural view of a driving device according to embodiment 1 of the present invention;
FIG. 7 is a schematic view of the driving apparatus of FIG. 6 in combination with a guide body;
FIG. 8 is a left side schematic view of the driving device in combination with the patella fastener;
FIG. 9 is a schematic front view of the driving device in combination with the patella fastener;
FIG. 10 is a left side schematic view of a prior art patella fixator;
FIG. 11 is a schematic front view of a prior art patella fixator;
FIG. 12 is a schematic view showing the structure of a positioning device with drill guide holes on the convex strips in the embodiment 2 of the present invention;
fig. 13 is a schematic structural view of a guide body in embodiment 3 of the present invention;
fig. 14 is a schematic view showing the connection of the guide main body and the guide auxiliary member in embodiment 3 of the present invention;
fig. 15 is a schematic view of the guide body and guide aid shown in fig. 14 from another angle.
In the figure: 1. a guide body; 11. a guide through groove; 12. a k-wire pinhole; 13. a front end portion; 14. latch teeth; 15. an ear; 2. a positioning device; 21. a first sliding joint; 22. an extension; 23. a handle; 24. drill guide holes; 3. a guide sleeve; 31. latch teeth; 4. a driving device; 41. a second sliding joint; 42. a pushing part; 43. a bump; 44. a handle; 5. a patella fixator; 51. a holder body; 52. a fixed claw; 6. a patella; 61. a bone fracture line; 7. a k-wire; 8. a drill bit; 9. a guide auxiliary; 91. an arc-shaped groove; 92. a k-wire channel; 93. and a sliding groove.
Detailed Description
Example embodiments will now be described more fully with reference to the accompanying drawings. However, the exemplary embodiments can be embodied in many forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of the example embodiments to those skilled in the art. The same reference numerals in the drawings denote the same or similar structures, and thus detailed descriptions thereof will be omitted.
Example 1
Referring to fig. 1 to 9, the embodiment of the present invention discloses a bone fixator guide apparatus for installing the patella fixator 5 shown in fig. 10 and 11 in a patella (patella) 6 fracture surgery. Referring to fig. 5, 10 and 11, when the patella 6 is fractured, the patella fixator 5 is placed in the patella 6 to re-fix the fractured patella 6 together so that the patella 6 heals along the fracture line 61. The patella fixator 5 comprises a fixator body 51 and two fixing claws 52, wherein the fixing claws 52 are positioned on one side of the fixator body 51, and the fixing claws 52 and the fixator body 51 form a U-shaped structure after being bent downwards relative to the fixator body 51. After two holes are drilled on one side of the patella 6, the fixing claw 52 may be inserted into the holes and cross over the fracture line to pierce two or more parts of the fractured patella 6, at this time, the fixing body 51 is located on the outer side of the patella 6 (the surface of the patella 6 facing the observer when the patient stands in front of the patient), and is also disposed across the fracture line, and screw holes are formed in the fixing body, which may be locking screw holes or pressing screw holes, and as a preferred embodiment, may be optionally provided as pressing screw holes, or the locking screw holes may be simultaneously provided with the pressing screw holes, and the fixing body may be fixed on the patella by pressing with screws to promote healing of the fracture site. When the patella fixator 5 is fixed on the patella, the bending positions of the screw hole and the fixing claw 52 are respectively located at two sides of the fracture line. Preferably, two fixing claws 52 are provided in the present embodiment, and the two fixing claws have an anti-rotation effect compared with one fixing claw, but alternatively, the number of the fixing claws may be set to one or more than two to adapt to different fracture situations.
Referring to fig. 1 to 5, the patella fixator guide apparatus of the present embodiment includes a guide body 1, a positioning device 2, and a guide sleeve 3. Referring to fig. 2, the guide body 1 is generally block-shaped with two guide channels 11, the two guide channels 11 extending completely through the guide body 1, the two guide channels 11 being capable of forming a sliding fit with two holding claws 52 to guide the holding claws 52 into the borehole. Since the fixing claws 52 are provided to be bent with respect to the fixing body 51, in order to enable the fixing claws to pass through the guide through grooves, longitudinal openings are provided in the groove walls of the guide through grooves and along the extending direction of the guide through grooves, the longitudinal openings are provided to penetrate through both ends of the groove walls, and the size of the longitudinal openings is suitable for the fixing claws to pass through; the guide body 1 is further provided with a plurality of temporary fixing holes provided along the extending direction of the guide through groove 11, and the temporary fixing holes in the present embodiment are k-pin holes 12. Two ears 15 may also be provided on the guide body 1, the two ears 15 being located on either side of the guide body 1 and perpendicular to the guide body 1. Two guide channels 11 are located between the two ears 15. The ear 15 can protect other parts and has a certain limiting guiding function to prevent the other parts from shaking greatly when moving.
Referring to fig. 3, the positioning device 2 includes a first coupling portion 21 and an extension portion 22. In the present embodiment, the first coupling portion 21 includes two protruding strips corresponding to the two guide through grooves 11, the two protruding strips are slidably engaged with the two guide through grooves 11, respectively, and the extending portion 22 is a substantially arc-shaped sheet-like body, and the extending portion 22 has an arc-shaped structure adapted to the lateral surface of the patella 6. A handle 23 may also be provided on the positioning device 2 for gripping. As shown in fig. 1, when the extension 22 is in contact with the patella 6, the extension 22 is able to substantially conform to the patella 6, and thus the positioning device positions the patella 6 with respect to the extension. After the guide through groove 11 of the guide body 1 is combined with the convex strip of the first combining part 21, the convex strip is nested and inserted into the guide through groove 11 to form a detachable connecting structure, and the guide body 1 can slide along the first combining part 21 and contact the patella 6, so that the positioning device positions the guide body 1 relative to the patella 6 by the first combining part 21. After positioning the guide body 1, the kirschner wire 7 may be driven into the patella 6 by using the kirschner wire 12, the broken patella 6 may be fixed in the early stage by using the kirschner wire 7, and the guide body 1 may be fixed to the patella 6. In the present embodiment, the number of the k-wire holes 12 is 4, and the k-wire 7 may be inserted into any two of the k-wire holes 12, and those skilled in the art will understand that the number of the k-wire holes 12 is not limited and may be other numbers. After driving the kirschner wire 7 into the patella 6 within the kirschner wire hole 12, the positioning device 2 may be separated from the guide body 1. At this time, only the guide body 1 remains on the patella 6.
Referring to fig. 4 and 5, the guide sleeve 3 is cylindrical and can be inserted into the guide through slot 11 to guide the drill bit 8 to drill a hole in the patella 6. Since the guide sleeve 3 is located in the guide through groove 11, and the guide through groove 11 and the fixing jaw 52 are mutually matched, two holes drilled by the drill bit 8 are corresponding to the fixing jaw 52 under the guidance of the guide sleeve 3, and the two fixing jaws 52 can be respectively inserted into the two holes. The use of the guide sleeve 3 may improve the accuracy of the drilling position, but alternatively the guide sleeve 3 may be omitted and the drill bit may be inserted directly into the guide through slot 11 for drilling.
In the present embodiment, the fixing claws 52 of the patella fixator 5 have a regular octagonal prism shape, and an inscribed circle thereof is 2.5mm. The cross section of the guiding slot 11 is a part of a circle, and the diameter of the guiding slot is 3.5mm, in this embodiment, in order to enable the protruding strip of the first combining portion 21 and the guiding sleeve 3 to be embedded into the guiding slot 11 and not to fall off, the radian of the slot wall of the guiding slot 11 should be greater than 180 °, that is, the slot wall of the guiding slot 11 should be greater than a semicircular slot. And, one end of the guiding slot 11 is a protruding end protruding out of the guiding body 1, and the front end 13 of the protruding end is retracted inwards and can hold the convex strip and the guiding sleeve 3, so that easy separation between the guiding body 1 and the positioning device 2 can be avoided, and in order to enable the patella fixer 5 to slide in the guiding slot 11 and insert the patella, a longitudinal opening is arranged at the side surface of the guiding slot 11, and the width of the longitudinal opening is larger than the width of the patella claw. The front end 13 may further be provided with a latch 14 capable of being snapped into the patella 6, and the longitudinal opening formed in the guide through groove 11 may have a width not smaller than 2.5mm, that is, not smaller than the width of the fixing claw, so as to ensure that the fixing claw 52 can enter the guide through groove 11 from the opening and be inserted into the patella through the longitudinal opening. The guide sleeve 3 has an outer diameter of 3.5mm and an inner diameter slightly larger than 2.5mm, and the drill bit 8 has a diameter of 2.5mm when drilling. After the fixing claws 52 enter the guide through grooves 11, the guide through grooves 11 can guide the insertion of the fixing claws 52 into the drilled holes.
In the process that the fixing claw 52 enters the drill hole, the fixing claw 52 can be pushed in by hand directly, and in the embodiment, the size of the fixing claw 52 is slightly larger than that of the drill hole, so that the fixing claw can generate a certain expansion force after being inserted into the drill hole, and the stability of the fixing claw is improved. In order to allow the holding jaw 52 to enter the borehole more efficiently, it is therefore also provided that, with reference to fig. 6 to 9, driving is carried out with an additional driving device 4, with the driving device 4 striking the holding jaw 52 into the borehole. The driving device 4 can form sliding fit with the guide through groove 11 and push the patella fixer 5 to move.
In the present embodiment, the driving device 4 includes the second coupling portion 41 and the pushing portion 42, and the second coupling portion 41 is two protruding strips provided on the side surface of the driving device 4. The second coupling portion 41 has a circular cross section, and is slidably engaged with the guide through groove 11 provided in the guide body 1, so that the driving device 4 and the guide body 1 can slide relative to each other, and the fixing claw 52 is struck by the two pushing portions 42. The pushing portion 42 is located at the end of the driving device 4 and has an arcuate contact surface adapted to the patella holder 5. A handle 44 may also be provided on the driving device 4 for gripping. Because the pushing portion 42 has an arc contact surface structure, when the pushing portion 42 contacts the fixed jaw 52, the bending portion of the fixed jaw 52 can be partially attached, separation between the fixed jaw 52 and the pushing portion 42 can be avoided, and stability is improved.
Further, the driving device 4 may further include a protrusion 43, where the protrusion 43 can be inserted between the two fixing claws 52 to limit the fixing claws 52, so as to avoid the fixing claws 52 from being offset during the driving of the patella. The bump 43 may be located at a central position of the pushing portion 42. The height of the protruding block 43 should be smaller than the thickness of the fixing claws 52, so that the protruding block 43 does not protrude from the fixing claws 52 when being located between the two fixing claws 52, and does not contact the patella 6 before the fixing claws 52. It should be understood by those skilled in the art that the structure of the driving device 4 is not limited as long as it can slide relative to the guide body 1 and push the patella fixator 5 to move, for example, the pushing portion 42 may not be provided as an arc-shaped contact surface, but may be simply a planar structure.
Referring again to fig. 1-9, the patella fixator guide apparatus according to embodiments of the invention is used as follows.
First, the guide body 1 and the positioning device 2 are combined together, and in the minimally invasive surgery, the extension 22 of the positioning device 2 is attached to the outer side surface of the patella 6, and at this time, the latch 14 of the front end portion 13 of the guide body 1 contacts the patella 6, thereby positioning the guide through groove 11 of the guide body 1 on the patella 6. The k-wire 7 is driven from the k-wire hole 12 onto the patella 6 to achieve the early fixation of the patella 6, and then the positioning device 2 is separated from the guide body 1. The guide body 1 is now temporarily fixed to the patella surface by the k-wire 7.
Subsequently, the guide sleeve 3 is inserted into the guide through slot 11, the drill bit 8 is inserted into the guide sleeve 3, and a hole is drilled in the patella 6. After the drilling is completed, the guide sleeve 3 is withdrawn from the guide through groove 11, and then the fixing claw 52 of the patella fixator 5 is inserted into the guide through groove 11, with the fixing claw 52 aligned with the drilling.
Next, the fixing jaw 52 is introduced into the borehole by hand or the driving device 4. Finally, the patella fixator 5 can be pressed and fixed on the patella by using screws according to the use requirement of the patella fixator.
The patella fixer guiding apparatus of the embodiment of the invention can be positioned by a positioning device, and the positioning function of drilling holes is realized by combining the guiding through groove 11 arranged on the guider main body 1 and the guiding sleeve 3, so that the accurate drilling holes are processed on the patella 6, and other soft tissues can be prevented from being minced when the drill bit 8 drills through the guiding sleeve 3. Through the sliding fit of the guide through groove 11 and the patella fixer, the guiding effect on the patella fixer can be realized, the patella fixer is smoothly inserted into the drill hole, the patella fixer is pushed by the driving device, the installation efficiency of the patella fixer can be improved, and the fixing claw can be smoothly introduced into the drill hole under the condition of similar size of the drill hole.
Example 2
As shown in fig. 10 and 11, the patella fixator 5 in this embodiment includes a fixator body 51 and two fixing claws 52, where the fixing claws 52 are located on one side of the fixator body 51, and the fixing claws 52 are bent downward to form a U-shaped structure with the fixator body 51. After two bores have been drilled in one side of the patella 6, the fixing jaw 52 may be inserted into the bores and spanned across the fracture line to pass two or more portions of the fractured patella 6 together, with the fixator body 51 positioned on the outer side of the patella 6 and likewise positioned across the fracture line, with screw holes provided thereon, optionally as compression screw holes or with locking screw holes simultaneously with compression screw holes, as a preferred embodiment.
The patella fixator guide apparatus of the present embodiment comprises a guide body 1 and a positioning device. Referring to fig. 2, the guide body 1 is generally block-shaped, having two guide through grooves 11, the two guide through grooves 11 completely penetrate the guide body 1, the two guide through grooves 11 can form a sliding fit with two fixing claws 52 to guide the fixing claws 52 to insert the patella 6, and a plurality of k-pin holes 12 provided along the extending direction of the guide through grooves 11 are further provided on the guide body 1. Two lugs 15 are provided on the guide body 1, and the two lugs 15 are respectively located on both sides of the guide body 1 and perpendicular to the guide body 1. Two guide channels 11 are located between the two ears 15.
The positioning device 2 comprises a first coupling portion 21 and an extension portion 22. In this embodiment, the first coupling portion 21 includes two protruding strips that are nestably mounted in the two guide through grooves 11 and slidably fit with the two guide through grooves 11, and the protruding strips and the guide through grooves 11 form a detachable connection structure. While the extension 22 is a generally arcuate sheet-like body, the extension 22 having an arcuate configuration that accommodates the lateral side of the patella 6. A handle 23 may also be provided on the positioning device 2 for gripping. As shown in fig. 1, when the extension 22 is in contact with the patella 6, the extension 22 is able to substantially conform to the patella 6, and thus the positioning device positions the patella 6 with respect to the extension. After the guide through groove 11 of the guide body 1 is combined with the convex strip of the first combining part 21, the guide body 1 can slide along the first sliding combining part 21 so as to contact the patella 6, so that the positioning device positions the guide body 1 relative to the patella 6 by the first combining part 21. After positioning the guide body 1, the kirschner wire 7 can be driven into the patella 6 by using the kirschner wire 12, the broken patella 6 can be fixed in advance by using the kirschner wire 7, and the guide body 1 can be temporarily fixed on the patella 6. In the present embodiment, the number of k-wire holes 12 is 4.
The guide instrument described in the present embodiment is not provided with the guide sleeve 3, and as an alternative embodiment, the present embodiment is provided with a drill guide hole 24 on each convex strip of the first joint portion 21, as shown in fig. 12, the drill guide hole 24 is disposed along the extending direction of the guide through slot to guide the drill to drill the patella. The drill guide hole 24 has an inner diameter slightly larger than 2.5mm and the convex strip has an outer diameter of 3.5mm.
In the present embodiment, the fixing claws 52 of the patella fixator 5 have a regular octagonal prism shape, and an inscribed circle thereof is 2.5mm. The cross section of the guiding slot 11 is a part of a circle, and the diameter of the guiding slot is 3.5mm, in this embodiment, in order to enable the protruding strip of the first combining portion 21 to be embedded into the guiding slot 11 and not to fall off, the radian of the slot wall of the guiding slot 11 should be greater than 180 °, that is, the slot wall of the guiding slot 11 should be greater than a semicircular slot. And, one end of the guiding through groove 11 is a protruding end protruding out of the guiding body 1, and the front end 13 of the protruding end is contracted inwards and can hug the raised strip, so that easy separation between the guiding body 1 and the positioning device 2 can be avoided, and a longitudinal opening is arranged on the side surface of the guiding through groove 11, and the width of the longitudinal opening is not less than 2.5mm, namely not less than the width of the fixing claw. The front end 13 can be further provided with a latch 14 capable of being clamped into the patella 6, the diameter of the drill bit 8 is 2.5mm when drilling is performed, so that the section size of the fixing claw 52 is slightly larger than the size of the drilling hole, and when the fixing claw 52 is inserted into the drilling hole on the patella, a certain expansion effect can be achieved on the hole wall, and the fixing stability is improved.
In the present embodiment, a driving device 4 is also provided, and the driving device 4 strikes the fixing claw 52 and inserts the same into the drilled hole. As shown in fig. 6 to 9, the driving device 4 can form a sliding fit with the guide through groove 11 and push the patella fixator 5 to move. The driving device 4 includes a second coupling portion 41 and a pushing portion 42, and the second coupling portion 41 is two protruding strips provided on a side surface of the driving device 4. The second coupling portion 41 has a circular cross section, and is capable of forming a sliding fit with the guide through groove 11 provided in the guide body 1, so that the driving device 4 and the guide body 1 can slide relatively. The pushing portion 42 is located at the end of the driving device 4 and has an arcuate contact surface adapted to the patella holder 5. A handle 44 may also be provided on the driving device 4 for gripping. Because the pushing part 42 is of an arc contact surface structure, when the pushing part 42 contacts the fixed jaw 52, the bending part of the fixed jaw 52 can be partially covered, the separation of the fixed jaw 52 and the pushing part 42 can be avoided, and the stability is improved.
Further, the driving device 4 may further include a protrusion 43, where the protrusion 43 can be inserted between the two fixing claws 52 to limit the fixing claws 52, so as to ensure that the fixing claws 52 do not deviate during the insertion process. The bump 43 may be located at a central position of the pushing portion 42. The front end of the projection 43 does not protrude from the fixing claw 52, and does not contact the patella 6 before the fixing claw 52. The patella fixator guide apparatus of this embodiment is used as follows.
First, the guide body 1 and the positioning device 2 are combined together, and in the minimally invasive surgery, the extension 22 of the positioning device 2 is attached to the outer side surface of the patella 6, and at this time, the latch 14 of the front end portion 13 of the guide through groove 11 contacts the patella 6, thereby positioning the guide through groove 11 of the guide body 1 on the patella 6. The kirschner wire 7 is driven into the patella 6 from the kirschner wire hole 12 to realize the early fixation of the broken bone blocks of the patella 6, and then the drill is guided by the drill guide holes on the convex strips of the positioning device 2 to drill two drill holes on the patella. After the drilling is completed, the positioning device 2 is pulled so that the convex strips slide outwards along the guide through grooves 11 and are finally separated from the guide body 1. The guide body 1 is still temporarily fixed to the patella by the k-wire 7.
The fixing jaw 52 of the patella fixator 5 is then inserted into the guide channel 11, the fixing jaw 52 being aligned with the bore. Next, the fixing claws 52 are driven into the drilled hole by the driving device 4. Finally, the patella fixator 5 can be pressed and fixed on the patella by using screws according to the use requirement of the patella fixator.
Example 3
The patella fixator 5 comprises a fixator body 51 and two fixing claws 52, wherein the fixing claws 52 are positioned on one side of the fixator body 51, and the fixing claws 52 and the fixator body 51 form a U-shaped structure after being bent downwards. After two holes are drilled on one side of the patella 6, the fixing claw 52 may be inserted into the holes and cross over the fracture line to penetrate two or more parts of the fractured patella 6, where the fixing body 51 is located on the outer side of the patella 6 and also crosses over the fracture line, and a screw hole is provided on the fixing body, where the screw hole may be a locking screw hole or a pressing screw hole, and as a preferred embodiment, the locking screw hole may be optionally provided with a pressing screw hole, or the locking screw hole may be provided simultaneously with the pressing screw hole.
The patella fixator guide apparatus of the present embodiment comprises a guide body 1 and a positioning device. The guide body 1 is substantially block-shaped, and as shown in fig. 13, has two guide through grooves 11, the guide through grooves 11 completely penetrate the guide body 1, the two guide through grooves 11 can form sliding fit with two fixing claws 52 to guide the fixing claws 52 to insert the patella 6, and 1 k-pin hole 12 arranged along the extending direction of the guide through grooves 11 is also provided on the guide body 1. A handle is arranged in connection with the guide body 1 for holding.
As shown in fig. 14, the positioning means is an extension 22. The extension 22 is a generally arcuate sheet-like body, the extension 22 having an arcuate configuration that is compatible with the lateral side of the patella 6. In this embodiment, the extension 22 is fixedly connected to the guide body 1 in an integrally formed manner, and the guide apparatus in this embodiment is further provided with a guide auxiliary member 9, and the guide auxiliary member 9 is detachably mounted on the guide body; in this embodiment, two sliding grooves 93 are provided on the guide body, two sides of the guide auxiliary member 9 are respectively and nested in the two sliding grooves 93, the extending direction of the sliding grooves 93 is the same as that of the guide through groove 11, and the guide auxiliary member 9 is suitable for sliding along the sliding grooves 93. As an alternative, the guide aid 9 may also be mounted on the guide body in other ways, for example by clamping means such as clips, provided that a temporary fixation of the two is achieved. The guide auxiliary piece 9 is provided with two arc grooves 91, the two arc grooves 91 are in one-to-one correspondence with the two guide through grooves, when the guide auxiliary piece 9 is installed on the guide main body, each arc groove 91 is located at the corresponding longitudinal opening of the guide through groove, and a closed through hole structure is formed by the arc grooves 91 and the groove walls of the guide through grooves and used for guiding drilling. For easy gripping, the guide aid 9 is also provided with a handle in this embodiment, and when the guide aid 9 is mounted on the guide body, the handle of the guide aid 9 is on the same side as the handle of the guide body. In this embodiment, the guide auxiliary member 9 is located on the insertion channel of the k-wire hole of the guide body 1, so that a k-wire channel 92 is also required to be provided on the guide auxiliary member 9, so that the k-wire is conveniently inserted into the k-wire hole of the guide body 1 through the k-wire channel 92.
When the extension 22 is in contact with the patella 6, the extension 22 can substantially conform to the patella 6, and the guide body is positioned relative to the patella 6 via the extension. After positioning the guide body 1, the kirschner wire 7 can be driven into the patella 6 by using the kirschner wire 12, the broken patella 6 can be fixed in advance by using the kirschner wire 7, and the guide body 1 can be temporarily fixed on the patella 6.
In the present embodiment, the fixing claws 52 of the patella fixator 5 have a regular octagonal prism shape, and an inscribed circle thereof is 2.5mm. The guide through groove 11 has a circular cross section of 3.5mm in diameter, and one end of the guide through groove 11 is a protruding end protruding from the guide body 1. In order to enable the patella holder 5 to slide in the guide channel 11 and insert the patella, a longitudinal opening is provided in the side of the guide channel 11, the width of which is not less than 2.5mm, i.e. not less than the width of the patella jaw. A latch 14 which can be snapped into the patella 6 can also be provided on the front end 13, the diameter of the drill bit 8 being slightly less than 2.5mm when drilling. In this embodiment, the diameter of the arc-shaped groove 91 of the guiding auxiliary member 9 is also 3.5mm, so that when the guiding auxiliary member 9 is mounted on the guiding device main body, each arc-shaped groove 91 is located at the longitudinal opening of the corresponding guiding through groove, and forms a closed circular through hole structure with the groove wall of the guiding through groove.
In order to improve the accuracy of the perforation, the guide instrument described in this embodiment is provided with a guide sleeve 3 as shown in fig. 4, which is adapted to be inserted into a closed circular through hole formed by the arc-shaped groove 91 and the groove wall of the guide through groove. The inner diameter of the guide sleeve is 2.5mm. Alternatively, the guide sleeve 3 may be omitted and holes may be formed directly in the closed circular through hole formed by the arc-shaped groove 91 and the groove wall of the guide through groove.
In the present embodiment, the driving device 4 shown in fig. 6 is also provided, and the driving device 4 drives the fixing claw 52 to be inserted into the drilled hole. The driving device 4 can form sliding fit with the guide through groove 11 and push the patella fixer 5 to move. The driving device 4 includes a second coupling portion 41 and a pushing portion 42, and the second coupling portion 41 is two protruding strips provided on a side surface of the driving device 4. The second coupling portion 41 has a circular cross section, and is capable of forming a sliding fit with the guide through groove 11 provided in the guide body 1, so that the driving device 4 and the guide body 1 can slide relatively. The pushing portion 42 is located at the end of the driving device 4 and has an arcuate contact surface adapted to the patella holder 5. A handle 44 may also be provided on the driving device 4 for gripping. Because the pushing part 42 is of an arc contact surface structure, when the pushing part 42 contacts the fixed jaw 52, the bending part of the fixed jaw 52 can be partially covered, the separation of the fixed jaw 52 and the pushing part 42 can be avoided, and the stability is improved.
Further, the driving device 4 may further include a protrusion 43, where the protrusion 43 can be inserted between the two fixing claws 52 to limit the fixing claws 52, so as to avoid the fixing claws 52 from being dislocated with the drill hole due to the mutual approach. The bump 43 may be located at a central position of the pushing portion 42. The height of the protruding block 43 should be smaller than the thickness of the fixing claws 52, so that the protruding block 43 does not protrude from the fixing claws 52 when being located between the two fixing claws 52, and does not contact the patella 6 before the fixing claws 52. It will be appreciated by those skilled in the art that the structure of the driving device 4 is not limited as long as it can slide relative to the guide body 1 and push the patella fixator 5 into motion.
The patella fixator guide apparatus of this embodiment is used as follows.
First, the guide body 1 and the guide auxiliary 9 are combined together, and in the minimally invasive surgery, the extension 22 is fitted to the outer side surface of the patella 6, at which time the front end portion 13 of the guide through groove 11 is brought into contact with the patella 6, thereby positioning the guide through groove 11 of the guide body 1 on the patella 6. The kirschner wire 7 is driven into the patella 6 from the kirschner wire hole 12 to realize the early fixation of the patella 6, then two guide sleeves are respectively inserted into two closed circular through holes formed by the arc-shaped groove 91 and the groove wall of the guide through groove, and a drill bit is inserted into the guide sleeves to drill holes. After the drilling is completed, the guide sleeve is removed, and the guide aid 9 is pulled to slide outwards along the chute 93 and finally separated from the guide body 1. The guide body 1 is still fixed to the patella by the k-wire 7.
The fixing jaw 52 of the patella fixator 5 is then inserted into the guide channel 11, the fixing jaw 52 being aligned with the bore. Next, the fixing claws 52 are driven into the drilled hole by the driving device 4. Finally, the patella fixator 5 can be pressed and fixed on the patella by using screws according to the use requirement of the patella fixator.
In addition to being used in patella, the guide instrument of the present invention may also be used in metaphyseal fracture surgery to guide the insertion of a metaphyseal bone anchor, which also includes an anchor body and a fixation jaw extending from the anchor body, the fixation jaw being positioned on one of the sides of the anchor body, the fixation jaw being folded relative to the anchor body, the fixation jaw being inserted into the bone and spanning a fracture line when the metaphyseal bone anchor is secured to the metaphyseal bone, the anchor body then being fitted to the side of the bone outside the bone and likewise spanning the fracture line. As will be appreciated by those skilled in the art, the present invention defines the "extension of the bone anchor guide having an arcuate configuration that accommodates the bone side," where the "bone side" is the side relative to the insertion location of the fixation jaw, i.e., the side on which the anchor body is located when the fixation jaw is inserted into bone.
The exemplary embodiments of the present invention have been particularly shown and described above. It is to be understood that the invention is not to be limited to the disclosed embodiments, but on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims.
Claims (11)
1. A bone anchor guide instrument for guiding and mounting a bone anchor to a bone, the bone anchor comprising an anchor body and a fixation jaw extending from the anchor body, the fixation jaw being positioned on one of the sides of the anchor body, the fixation jaw being positioned in a bent relation to the anchor body, the bone anchor guide instrument comprising:
the guide body is provided with a guide through groove which can form sliding fit with the fixed claw, a longitudinal opening is formed in the groove wall of the guide through groove and along the extending direction of the guide through groove, the longitudinal opening penetrates through two ends of the groove wall, and the size of the longitudinal opening is suitable for the fixed claw to pass through; the guide body is also provided with a temporary fixing hole arranged along the extending direction of the guide through groove;
the positioning device is connected with the guide body and comprises an extension part, the extension part is provided with an arc-shaped structure matched with the side surface of the bone, and when the extension part is contacted with the bone, the guide body can be contacted with the bone; the positioning device positions the bone relative to the bone through the extension and positions the guide body relative to the bone; wherein, the guide through groove can be used for guiding the insertion of the fixing claw into the bone.
2. The bone anchor guide as in claim 1 wherein the bone anchor has two fixation claws and the guide body has two guide channels that are capable of sliding engagement with the two fixation claws, respectively.
3. The bone anchor guide instrument of claim 1 or 2, further provided with a guide aid removably mounted on the guide body; the guide auxiliary piece is provided with arc grooves, the number of the arc grooves is consistent with that of the guide through grooves and the arc grooves are correspondingly arranged, when the guide auxiliary piece is installed on the guide main body, the arc grooves are located at the longitudinal openings of the corresponding guide through grooves, and a closed through hole structure is formed by the arc grooves and the groove walls of the guide through grooves.
4. The bone anchor guide instrument of claim 1 or 2, wherein the positioning device includes a first coupling portion and an extension portion, the first coupling portion cooperatively assembled with the guide body via a detachable connection structure.
5. The bone anchor guide as in claim 4 wherein the connecting structure comprises a tab disposed on the first engagement portion, the tab adapted to nest within the guide channel and form a slip fit assembly with the guide channel.
6. The bone anchor guide instrument according to claim 5, wherein the number of the protruding strips is the same as the number of the guide through grooves and the protruding strips are provided with drill guide holes; when the convex strips are nested in the corresponding guide through grooves, the extending direction of the drill guide holes is consistent with the extending direction of the guide through grooves so as to guide the drill to drill holes in bones.
7. The bone anchor guide as in claim 6, further comprising a guide sleeve insertable into the guide channel to guide a drill bit to drill a hole in bone.
8. The bone anchor guide as in claim 7 further comprising a driving device that slidingly engages the guide channel and urges the bone anchor to drive the insertion of the fixation pawl into the bore.
9. The bone anchor guide as in claim 8 wherein the driving device further comprises a tab insertable between two of the fixation jaws to limit the fixation jaws.
10. The bone anchor guide instrument of claim 7 wherein the guide channel is circular in cross-section and wherein one end of the guide channel is a protruding end protruding from the guide body, the protruding end having a forward end portion that is inwardly tapered.
11. The bone anchor guide as in claim 10 wherein the forward end of the protruding end and the forward end of the guide sleeve are provided with a latch that is capable of engaging bone.
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| CN201611237659.4A CN106580422B (en) | 2016-12-28 | 2016-12-28 | Bone fixator guide apparatus |
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| CN201611237659.4A CN106580422B (en) | 2016-12-28 | 2016-12-28 | Bone fixator guide apparatus |
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| CN106580422B true CN106580422B (en) | 2024-04-09 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN108969061B (en) * | 2017-06-01 | 2024-05-28 | 崔家鸣 | Surgical instrument bridge crossing device and surgical instrument assembly using same |
| CN108969029B (en) * | 2017-06-01 | 2024-03-12 | 崔家鸣 | Bridge crossing device for shoulder arthroscopy operation |
| CN108969028B (en) * | 2017-06-01 | 2023-12-05 | 崔家鸣 | Bridge guide for long neck instruments in shoulder arthroscopic surgery |
| CN110974391A (en) * | 2019-12-29 | 2020-04-10 | 长春圣博玛生物材料有限公司 | A kind of auxiliary positioning sleeve with wire anchor |
| CN113384338B (en) * | 2020-03-11 | 2023-02-24 | 西安交通大学医学院第一附属医院 | Automatic guiding device for calcaneus sustentaculum talus screw |
| CN111904587B (en) * | 2020-09-18 | 2025-04-11 | 徐顺利 | A Kirschner wire guide based on patella thickness |
| CN113081408B (en) * | 2021-04-02 | 2024-07-02 | 上海市杨浦区中心医院(同济大学附属杨浦医院) | Single-condyle replacement femoral prosthesis implantation positioner |
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