CN111195146B - Multi-angle closed osteotomy guiding device with indication function - Google Patents
Multi-angle closed osteotomy guiding device with indication function Download PDFInfo
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- CN111195146B CN111195146B CN202010135397.0A CN202010135397A CN111195146B CN 111195146 B CN111195146 B CN 111195146B CN 202010135397 A CN202010135397 A CN 202010135397A CN 111195146 B CN111195146 B CN 111195146B
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- 238000009434 installation Methods 0.000 claims description 11
- 230000008878 coupling Effects 0.000 claims description 2
- 238000010168 coupling process Methods 0.000 claims description 2
- 238000005859 coupling reaction Methods 0.000 claims description 2
- 210000000988 bone and bone Anatomy 0.000 description 19
- 230000035876 healing Effects 0.000 description 5
- 238000003780 insertion Methods 0.000 description 5
- 230000037431 insertion Effects 0.000 description 5
- 238000013461 design Methods 0.000 description 4
- 238000012986 modification Methods 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- 230000000149 penetrating effect Effects 0.000 description 3
- 238000010146 3D printing Methods 0.000 description 2
- 208000006735 Periostitis Diseases 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 210000003460 periosteum Anatomy 0.000 description 2
- 230000002980 postoperative effect Effects 0.000 description 2
- 238000005452 bending Methods 0.000 description 1
- 238000012937 correction Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 238000007639 printing Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000000689 upper leg Anatomy 0.000 description 1
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- 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
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
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Abstract
The invention provides a multi-angle closed osteotomy guiding device with an indication function, which comprises a first osteotomy guiding piece, at least one pair of first guiding through holes arranged on the first osteotomy guiding piece; a second osteotomy guide, a third osteotomy guide, and at least one pair of second guide through holes disposed on the second osteotomy guide and/or the third osteotomy guide; the planes of the center lines of the paired first guide through holes and the planes of the center lines of the paired second guide through holes form a set angle; and at least one angle block; a first indicator having a first indication handle indicating an extending direction of the first guide through hole; and the second indicator is provided with a second indicator handle for indicating the extending direction of the second guide through hole. The multi-angle closed osteotomy guiding device with the indication function can realize accurate high-quality osteotomy at one time, shorten the operation time, relieve the pain of patients, and can be reused after being adjusted according to the conditions of different patients, and the adjustment is quick and has low cost.
Description
Technical Field
The invention relates to the technical field of medical instruments for osteotomies, in particular to a multi-angle closed osteotomic guide device with an indication function.
Background
In clinical orthopedic surgery, correction of skeletal deformities (e.g., angulation of bends) is one of the common procedures, and osteotomies are the necessary procedure. Osteotomies generally include open osteotomies and closed osteotomies, with the advantage of the closed osteotomies that the osteotomies are in full direct contact, facilitating osteotomic healing. For proximal tibial osteotomies, open osteotomies are mostly adopted, and postoperative healing is good; for the femur distal osteotomy, if an open osteotomy is adopted, the non-healing rate is very high, so that a closed osteotomy is mostly adopted, and the postoperative healing effect can be obviously improved.
Chinese patent document CN110251193a discloses a personalized closed osteotomy guide plate and a method of manufacturing the same, and specifically discloses the following: the individualized closed bone cutting guide plate comprises a guide plate body, wherein the guide plate body is provided with at least two guide through grooves and at least two positioning through holes; the guide grooves are arranged in parallel on the guide plate body and are used for guiding the insertion position and the cutting direction of the osteotomy saw blade; the positioning through holes are used for guiding the insertion position and the insertion direction of the Kirschner wire. The opening positions of the guide through grooves and/or the positioning through holes on the guide plate body are modeled again by extracting scanning results and using three-dimensional software, and the guide through grooves and/or the positioning through holes are individually designed according to the condition of a patient and manufactured by adopting a 3D printing technology; the design purpose is that the shape and the size of the osteotomy section of the osteotomy saw blade at the osteotomy position of the patient are matched through the guide through groove. The osteotomy guide plate disclosed in the patent document needs to extract the scanning result firstly, then uses three-dimensional software for modeling, finally adopts a 3D printing technology for printing, has long time and low efficiency, can only be used for one patient once, and has high cost.
Therefore, how to design a medical device with good universality and low cost for assisting osteotomy is an unsolved technical problem in the prior art.
Disclosure of Invention
Therefore, the technical problem to be solved by the invention is to overcome the technical defects that the tool for osteotomy guiding in the prior art is only used for one patient once, has poor universality, and has long manufacturing period and low efficiency each time, thereby providing the multi-angle closed osteotomy guiding device with the indication function, which has low cost and good universality.
To this end, the present invention provides a multi-angle closed osteotomy guiding device with an indication function, comprising:
a first osteotomy guide having oppositely disposed first guide proximal and first guide distal ends;
At least one pair of first guide through holes, which penetrate through the proximal end of the first guide piece and the distal end of the first guide piece, and the center lines of the pairs of first guide through holes are arranged in parallel;
the second osteotomy guide piece is provided with a second guide piece proximal end and a second guide piece distal end which are oppositely arranged, and is rotatably connected with the first osteotomy guide piece through a rotary connecting structure;
A third osteotomy guide slidable toward and away from the first osteotomy guide and removably mounted to the second osteotomy guide, the third guide having oppositely disposed third guide proximal and third guide distal ends;
At least one pair of second guide through holes, which are arranged through the proximal end of the second guide and the distal end of the second guide, and/or the third guide proximal end and the distal end of the third guide, and the center lines of the paired second guide through holes are arranged in parallel;
The planes of the center lines of the paired first guide through holes form a set angle with the planes of the center lines of the paired second guide through holes;
The angle blocks are at least 1 and are installed between the first osteotomy guide piece and the second osteotomy guide piece in a pluggable manner and are used for changing the angle between the plane where the center lines of the paired first guide through holes are located and the plane where the center lines of the paired second guide through holes are located;
The first indicating piece is detachably arranged in the first guide through hole and is provided with a first indicating handle, and the extending direction of the first indicating handle is parallel to the extending direction of the first guide through hole;
the second indicating piece is detachably arranged in the second guide through hole and is provided with a second indicating handle, and the extending direction of the second indicating handle is parallel to the extending direction of the second guide through hole;
the intersection point of the first indication handle and the second indication handle is an osteotomy intersection point.
As a preferred aspect, the first indicator includes:
A first indicator body;
The first mounting shafts are at least two and are arranged on the side face of one end of the first indicator main body and are used for being correspondingly inserted into the at least two first guide through holes;
The first indication handle is arranged on the side surface of the other end of the first indication part main body, and the extending direction of the first indication handle is the same as that of the first installation shaft;
And/or the number of the groups of groups,
The second indicator includes:
A second indicator body;
the at least two second installation shafts are arranged on the side surface of one end of the second indicator main body and are used for being correspondingly inserted into the at least two second guide through holes;
the second indication handle is arranged on the side surface of the other end of the second indication part main body, and the extending direction of the second indication handle is the same as that of the second installation shaft.
As a preferred aspect, the first indicator body includes:
the side wall of the first base is provided with the first installation shaft, and the top end of the first base is provided with a first guide installation hole;
the first vertical rod is inserted into the first guide mounting hole in a pluggable manner at one end, and the first indication handle is arranged on the side wall of the other end;
And/or the number of the groups of groups,
The second indicator body includes:
the side wall of the second base is provided with the second installation shaft, and the top end of the second base is provided with a second guide installation hole;
And one end of the second vertical rod can be inserted and installed into the second guide installation hole in a pluggable manner, and the side wall of the other end of the second vertical rod is provided with the second indication handle.
Preferably, the rotary connection structure is disposed at a position of the first osteotomy guide near the distal end of the first guide, and the second osteotomy guide near the distal end of the second guide, respectively.
As a preferred aspect, the rotational connection structure includes:
The rotating shaft is arranged on the first osteotomy guide piece;
The rotating shaft hole is arranged on the second osteotomy guide piece and is connected with the rotating shaft in a rotatable fit manner.
Preferably, when the angle block is not mounted and the first osteotomy guide is in contact with the second osteotomy guide, an angle between a plane in which the center lines of the paired first guide through holes are located and a plane in which the center lines of the paired second guide through holes are located is 2-5 °.
As a preferred embodiment, the angle block is at least one, including at least one of 1 °,2 °, 4 °,8 ° and 16 °.
As a preferable scheme, the first osteotomy guide, at least one angle block and the second osteotomy guide are respectively provided with a limit groove and a limit protrusion on mutually attached surfaces.
As a preferable scheme, along the direction far away from the second osteotomy guiding piece, the first guiding through holes are provided with a plurality of rows on the first osteotomy guiding piece, each row is at least 2, and the distance between the central lines of the adjacent two rows of the first guiding through holes is 5-8mm.
As a preferable scheme, along the direction far away from the first osteotomy guide piece, the second guide through holes are provided with a plurality of rows of at least 2 second osteotomy guide pieces and/or third osteotomy guide pieces, and the distance between the central lines of two adjacent rows of second guide through holes is 5-8mm;
The distance between the circle center connecting line of the pair of the first guide through holes closest to the second osteotomy guide and the circle center connecting line of the pair of the second guide through holes closest to the first osteotomy guide and the circle center connecting line of the second guide through holes closest to the second guide and/or the third guide distal opening is 1-5mm.
As a preferable scheme, the third osteotomy guide is a U-shaped block, and the opening end of the U-shaped block is the proximal end of the third guide; the second guide through holes are arranged on two opposite side walls of the U-shaped block.
As a preferable scheme, the side wall of the U-shaped block is provided with a fixed threaded hole; a fixed chute is arranged on the side wall of the second osteotomy guide piece; after passing through the fixing threaded hole, the fixing bolt is abutted against the inside of the fixing chute, so that the second osteotomy guide piece can be slidably and detachably mounted.
The technical scheme provided by the invention has the following advantages:
1. The invention relates to a multi-angle closed osteotomy guiding device with an indication function, which comprises a first osteotomy guiding piece, a second osteotomy guiding piece, a third osteotomy guiding piece, a first indication piece and a second indication piece, wherein the first osteotomy guiding piece is firstly propped against or fixed at a corresponding position of a bone to be osteotomy, the first indication piece is arranged in a pair of first guiding through holes, and the indication direction of a first indication handle is parallel to the extension direction of the first guiding through holes; then the second osteotomy guiding piece and the third osteotomy guiding piece are abutted against corresponding positions of the bones to be osteotomy, the second indication piece is installed into the second guiding through hole, and the indication direction of the second indication handle is parallel to the extending direction of the second guiding through hole; the first indication handle and the second indication handle are just crossed at the target position by adjusting the relative position of the second osteotomy guide piece and the third osteotomy guide piece (the inserting position of the second indication piece is also adjustable) and the angle of the inserting angle block between the first osteotomy guide piece and the second osteotomy guide piece, and then the second osteotomy guide piece and the third osteotomy guide piece are fixed; removing the first indicator and the second indicator, using two Kirschner wires to penetrate out of the pair of first guide through holes (penetrating from the proximal end of the first guide to the distal end of the first guide) and nailing on the bone to be resected; two other kirschner wires are used to pierce through a pair of second guide through holes (also penetrating from the proximal end of the second guide to the distal end of the second guide or penetrating from the proximal end of the third guide to the distal end of the third guide) and are nailed on the bone to be resected; the first osteotomy guide piece and the second osteotomy guide piece can be removed (the first osteotomy guide piece and the second osteotomy guide piece are detached firstly), and then an osteotomy knife can be used for cutting bones close to the Kirschner wire, so that the accuracy of the osteotomy angle is ensured, and two osteotomy lines which are respectively cut from the upper position and the lower position of the Kirschner wire can be connected at a preset intersection point, so that high-quality osteotomy is completed at one time. The multi-angle closed osteotomy guiding device with the indication function can realize accurate high-quality osteotomy at one time, shorten the operation time, relieve the pain of patients, and can be reused after being adjusted according to the conditions of different patients, and the adjustment is quick and has low cost.
2. According to the guiding device, the first indicator comprises the first indicator main body, the first mounting shaft and the first indicator handle, and the first indicator is fixedly mounted by inserting the first mounting shaft into the first guiding through hole; the first indication handle is arranged at a position so that the extending direction of the first indication piece is the same as the extending direction of the first guide through hole after the first indication piece is installed, and therefore the first indication handle can be used for indicating the extending direction of the first guide through hole; in the same arrangement mode, the second indication handle can represent the extending direction of the second guide through hole, and the position and the angle of the second guide through hole are selected to reasonably adjust the position of the intersection point of the first indication handle and the second indication handle to the target position, so that the high-quality osteotomy can be completed at one time. Preferably, the first indicator main part includes first base and first montant, and the top of first base is equipped with first direction mounting hole, and the one end of first montant is installed into inside the first direction mounting hole with pluggable, and this kind of structural design can guarantee that the extending direction of first instruction handle is correct, and can adjust the upper and lower height of first instruction handle, avoids being located same height with the second instruction handle.
3. The guide device is characterized in that the rotary connecting structure is arranged at a position, close to the distal end of the first guide piece, of the first osteotomy guide piece and a position, close to the distal end of the second guide piece, of the second osteotomy guide piece, so that an angle block is convenient to install, after the angle block is installed, a circle center connecting line of a pair of first guide through holes closest to the second osteotomy guide piece at the distal end opening of the first guide piece and a circle center connecting line of a pair of second guide through holes closest to the first osteotomy guide piece at the distal end of the second guide piece and/or the distal end opening of the third guide piece are connected, and the influence of the interval distance between the two pairs of kirschner wires is very small or almost insignificant, so that the interval distance between the two pairs of kirschner wires can be conveniently grasped.
4. When the angle block is not installed, and the first osteotomy guide piece is in fit contact with the second osteotomy guide piece, the angle between the planes of the central lines of the paired first guide through holes and the planes of the central lines of the paired second guide through holes is 2-5 degrees, and when the included angle between the two pairs of Kirschner wires is 2-5 degrees, the angle block can be omitted; the angle blocks can be multiple, the adjusting angles of the angle blocks are 1 degree, 2 degrees, 4 degrees, 8 degrees and 16 degrees respectively, when the angle blocks are not installed, the 5 angle blocks are used when the included angle between the planes is 2 degrees, the continuous angle of 2-33 degrees can be adjusted, and the requirements on the angle under most conditions can be met.
5. The guide device is also provided with the limiting groove and the limiting protrusion, and is auxiliary in limiting and fixing, and convenient to use.
6. According to the guiding device, the first guiding through holes and the second guiding through holes are arranged in a plurality of rows, and the distance is set at intervals, so that the proper first guiding through holes and second guiding through holes can be selected for use according to the actual situation of bones to be cut, and the guiding device is more convenient and wider in applicability.
7. According to the guide device, the third osteotomy guide piece is a U-shaped block, when the distance between the third osteotomy guide piece and the second osteotomy guide piece needs to be adjusted, the fixing bolt is unscrewed, the third osteotomy guide piece can be moved relative to the second osteotomy guide piece, and after adjustment, the fixing bolt is screwed tightly, so that fixation can be realized; when all the Kirschner wires are completely nailed, the whole guide device needs to be taken down, the fixing bolt can be thoroughly unscrewed, so that the third osteotomy guide piece is separated from the second osteotomy guide piece, and the whole guide device can be conveniently taken down at the moment.
Drawings
In order to more clearly illustrate the technical solutions in the prior art or in the embodiments of the present invention, the following brief description is given of the drawings used in the description of the prior art or the embodiments.
Fig. 1 is a schematic diagram of a closed osteotomy.
Fig. 2 is a perspective view of a multi-angle closed osteotomy guide device of the present invention with an indication function.
Fig. 3 is a schematic exploded view of the first, second and third osteotomy guides.
Fig. 4 is another view from the perspective of fig. 3.
Reference numerals: 1. a first osteotomy guide; 11. a first guide proximal end; 12. a first guide distal end; 2. a second osteotomy guide; 21. a second guide proximal end; 22. a second guide distal end; 3. a third osteotomy guide; 31. a third guide proximal end; 32. a third guide distal end; 41. a first guide through hole; 42. a second guide through hole; 5. an angle block; 61. a rotating shaft; 62. a rotation shaft hole; 71. a limit groove; 72. a limit protrusion; 81. fixing the threaded holes; 82. a fixed chute; 83. a fixing bolt; 91. a first indicator; 911. a first indication handle; 912. a first base; 913. a first mounting shaft; 914. a first vertical rod; 915. a first guide mounting hole; 92. a second indicator; 921. a second indication handle; 922. a second base; 923. a second mounting shaft; 924. a second vertical rod; 925. a second guide mounting hole; 01. bone to be cut; 02. bone is removed; 03. a first osteotomy position; 04. a second osteotomy position; 05. and (5) a junction point.
Detailed Description
In order to more clearly describe the present invention, a brief description of the osteotomy principle of a closed osteotomy is necessary. Fig. 1 shows the principle of closing an osteotomy, specifically, on a bone 01 to be osteotomy, using an osteotomy knife to cut the bone from a first osteotomy position 03 and a second osteotomy position 04, and finally to a junction 05 position, cutting the bone 02 to be removed, and then breaking the upper and lower sections to fit, thereby correcting the osteotomy of the bent bone. In order to accurately correct bone bending after osteotomy, the angle between the first osteotomy position 03 and the second osteotomy position 04 needs to be accurately determined, and the angle needs to be ensured not to deviate during osteotomy; for rapid healing after osteotomies, the junction 05 needs to be just cut to the edge of the bone and does not destroy the periosteum. The difficulty in the prior art is that the first osteotomy angle is not accurate enough, and the second is that the position of the intersection point is not well controlled, but the invention aims to accurately control the osteotomy angle, ensure that the position of the intersection point 05 is right cut to the bone edge, and not hurt periosteum.
The technical scheme of the invention is described in detail below with reference to the accompanying drawings.
This embodiment provides a multi-angle closed osteotomy guiding device with indication function, as shown in fig. 2-4, comprising: a first osteotomy guide 1 having oppositely disposed first guide proximal and distal ends 11, 12; at least one pair of first guide through holes 41, which are provided through the first guide proximal end 11 and the first guide distal end 12, and the center lines of the pairs of first guide through holes 41 are arranged in parallel; a second osteotomy guide 2 having oppositely disposed second guide proximal and distal ends 21, 22 and rotatably coupled to the first osteotomy guide 1 by a rotational coupling structure; a third osteotomy guide 3, slidably movable toward and away from the first osteotomy guide 1, removably mounted to the second osteotomy guide 2, having oppositely disposed third guide proximal and distal ends 31, 32; a second guide through hole 42, at least a pair, disposed through said second guide proximal end 21 and said second guide distal end 22, and disposed through said third guide proximal end 31 and said third guide distal end 32, with the center lines of said second guide through holes 42 in pairs disposed in parallel; the planes of the center lines of the paired first guide through holes 41 and the planes of the center lines of the paired second guide through holes 42 form a set angle; at least 1 angle block 5, which is installed between the first osteotomy guide 1 and the second osteotomy guide 2in a pluggable manner, and is used for changing the angle between the plane of the center line of the paired first guiding through holes 41 and the plane of the center line of the paired second guiding through holes 42; a first indicator 91 detachably mounted inside the first guide through hole 41 and having a first indicator handle 911, the first indicator handle 911 extending in a direction parallel to the first guide through hole 41; a second indicating member 92 detachably installed inside the second guide through hole 42, having a second indicating handle 921, the second indicating handle 921 extending in a direction parallel to the second guide through hole 42; the intersection point of the first indication handle 911 and the second indication handle 921 is an osteotomy intersection point.
The multi-angle closed osteotomy guiding device with indication function of the embodiment comprises a first osteotomy guiding piece 1, a second osteotomy guiding piece 2, a third osteotomy guiding piece 3, a first indication piece 91 and a second indication piece 92, wherein when osteotomy is performed, the first osteotomy guiding piece 1 is firstly abutted against or fixed at the corresponding position of the to-be-osteotomy, the first indication piece 91 is installed into the inside of a pair of first guiding through holes 41, and at the moment, the indication direction of a first indication handle 911 is parallel to the extension direction of the first guiding through holes 41; then the second osteotomy guide 2 and the third osteotomy guide 3 are abutted against the corresponding positions of the bones to be osteotomized, the second indicator 92 is installed into the second guide through hole 42, and the indication direction of the second indicator stem 921 is parallel to the extending direction of the second guide through hole 42; by adjusting the relative positions of the second osteotomy guide 2 and the third osteotomy guide 3 (the insertion position of the second indicator 92 is also adjustable), and the angle of the insertion angle block 5 between the first osteotomy guide 1 and the second osteotomy guide 2, the first indicator stem 911 and the second indicator stem 921 are made to intersect exactly at the target position, and then the second osteotomy guide 2 and the third osteotomy guide 3 are fixed; the first indicator 91 and the second indicator 92 are detached, two kirschner wires are used to penetrate through the pair of first guide through holes 41 (penetrate from the first guide proximal end 11 to the first guide distal end 12) and are nailed on the bone to be resected; two additional kirschner wires are used to punch through a pair of second guide throughholes 42 (again, from the second guide proximal end 21 toward the second guide distal end 22, or from the third guide proximal end 31 toward the third guide distal end 32), and staple onto the bone to be resected; the first osteotomy guiding piece 1 and the second osteotomy guiding piece 2 can be removed (the first osteotomy guiding piece 1 and the second osteotomy guiding piece 2 are detached firstly), and then an osteotomy knife can be used for osteotomy close to a kirschner wire, so that the accuracy of the osteotomy angle is ensured, and two osteotomy lines which are respectively started from the positions of the upper and lower kirschner wires are communicated at the preset intersection point, so that high-quality osteotomy is completed at one time. The multi-angle closed osteotomy guiding device with the indication function can realize accurate high-quality osteotomy at one time, shorten operation time, relieve pain of patients, and can be reused after adjustment according to the conditions of different patients, and the adjustment is quick and low in cost.
The first indicator 91 includes: a first indicator body; two first mounting shafts 913, provided on a side surface of one end of the first indicator body, for inserting at least two first guide through holes 41, respectively; the first indication handle 911 is provided on a side surface of the other end of the first indication body, and extends in the same direction as the first mounting shaft 913.
The second indicator 92 includes: a second indicator body; two second mounting shafts 923, which are disposed at a side surface of one end of the second indicator main body, and are used for being inserted into at least two second guiding through holes 42 respectively; the second indication handle 921 is disposed on a side surface of the other end of the second indication member body, and extends in the same direction as the second mounting shaft 923.
The first indicator body includes: a first base 912 having the first mounting shaft 913 provided on a side wall thereof and a first guide mounting hole 915 provided at a top end thereof; and one end of the first vertical rod 914 is inserted into the first guide mounting hole 915 in a pluggable manner, and the side wall of the other end of the first vertical rod is provided with the first indication handle 911.
The second indicator body includes: a second base 922, the side wall of which is provided with the second mounting shaft 923, and the top end of which is provided with a second guiding mounting hole 925; and one end of the second vertical rod 924 is inserted into the second guide mounting hole 925 in a pluggable manner, and the second indication handle 921 is arranged on the side wall of the other end.
The guide device of the present embodiment realizes the fixed mounting of the first indicator 91 by inserting the first mounting shaft 913 into the first guide through hole 41; the first indication handle 911 is disposed at a position such that the extending direction of the first indication member 91 is the same as the extending direction of the first guide through hole 41 after the installation is completed, thereby being capable of indicating the extending direction of the first guide through hole 41; in the same manner, the second indication handle 921 can represent the extending direction of the second guide through hole 42, and the position and angle of the second guide through hole 42 are selected to reasonably adjust the position of the crossing point of the first indication handle 911 and the second indication handle 921 to the target position, thereby helping to achieve the one-time completion of high-quality osteotomy. The first indicator main body comprises a first base 912 and a first vertical rod 914, a first guide mounting hole 915 is formed in the top end of the first base 912, one end of the first vertical rod 914 is installed in the first guide mounting hole 915 in a pluggable mode, the extending direction of the first indicator handle 911 can be guaranteed to be correct through the structural design, the upper and lower heights of the first indicator handle 911 can be adjusted, and the first indicator handle is prevented from being located at the same height with the second indicator handle 921.
The rotary connecting structure is respectively arranged at the position of the first osteotomy guide 1 close to the first guide distal end 12 and the position of the second osteotomy guide 2 close to the second guide distal end 22; not only is the angle block 5 convenient to install, but also after the angle block 5 is installed, the distance between the connecting line of the circle centers of the openings of the first guide far ends 12 of the pair of first guide through holes 41 closest to the second osteotomy guide 2 and the connecting line of the circle centers of the openings of the second guide far ends 22 of the pair of second guide through holes 42 closest to the first osteotomy guide 1 has little or no influence, so that the distance between two pairs of kirschner wires can be conveniently grasped.
The rotational connection structure includes: a rotation shaft 61 provided on the first osteotomy guide 1; a rotation shaft hole 62 is arranged on the second osteotomy guiding piece 2 and is connected with the rotation shaft 61 in a rotatable fit manner.
In the guide device of this embodiment, when the angle block 5 is not mounted and the first osteotomy guide 1 is in contact with the second osteotomy guide 2, an angle between a plane in which the center lines of the paired first guide through holes 41 are located and a plane in which the center lines of the paired second guide through holes 42 are located is 2 °; the number of the angle blocks 5 is 5, and the adjustable angles are 1 degree, 2 degrees, 4 degrees, 8 degrees and 16 degrees respectively. With the 5 angle blocks, the continuous angles of 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32 and 33 degrees can be adjusted, and the requirements of angles in most cases can be met.
As a modification, when the angle block 5 is not mounted and the first osteotomy guide 1 is in contact with the second osteotomy guide 2, the angle between the plane on which the center lines of the paired first guide through holes 41 are located and the plane on which the center lines of the paired second guide through holes 42 are located may be 2 to 5 °, and the number of the angle blocks 5 may be selected as needed.
The first osteotomy guide piece 1, at least one angle block 5 and the second osteotomy guide piece 2 are respectively provided with a limit groove 71 and a limit protrusion 72 on mutually attached surfaces, and the auxiliary limit and fixing are convenient to use.
Along the direction far away from the second osteotomy guide 2, the first guiding through holes 41 are arranged in 10 rows on the first osteotomy guide 1, 2 or 7 of each row are arranged, and the distance between the central lines of the two adjacent rows of the first guiding through holes 41 is 5-8mm. In the present embodiment, the radii of the first guide through hole 41 and the second guide through hole 42 are each 1.5mm.
Along the direction far away from the first osteotomy guide piece 1, the second guide through holes 42 are provided with 1 row on the second osteotomy guide piece 2, the third osteotomy guide piece 3 is provided with 8 rows, each row is 4, and the distance between the central lines of the two adjacent rows of the second guide through holes 42 is 5-8mm.
The distance between the line of the circle centers of the openings of the first guide through holes 41 closest to the second osteotomy guide 2 at the distal end 12 of the first guide and the line of the circle centers of the openings of the second guide through holes 42 closest to the first osteotomy guide 1 at the distal end 22 of the second guide is 2mm. As a variant, the distance can also be another distance in the range of 2-5 mm.
Above-mentioned setting for doctor can be according to the actual conditions of waiting to cut the skeleton, selects suitable first direction through-hole and second direction through-hole to use, and is more convenient, and the suitability is also wider.
The third osteotomy guide 3 is a U-shaped block, the open end of the U-shaped block being the third guide proximal end 31; the second guide through holes 42 are provided on both opposite side walls of the U-shaped block.
The side wall of the U-shaped block is provided with a fixed threaded hole 81; a fixed chute 82 is arranged on the side wall of the second osteotomy guide 2; after passing through the fixing threaded hole 81, the fixing bolt 83 abuts against the inside of the fixing chute 82, so that the second osteotomy guide 2 can be slidably and detachably mounted.
When the distance between the third osteotomy guide 3 and the second osteotomy guide 2 needs to be adjusted, the fixing bolt 83 is unscrewed, the third osteotomy guide 3 can be moved relative to the second osteotomy guide 2, and the fixing bolt 83 can be screwed after adjustment is finished, so that fixation can be realized; when all the kirschner wires are completely nailed, the fixing bolts 83 can be thoroughly unscrewed to separate the third osteotomy guide 3 from the second osteotomy guide 2, and the whole guide can be conveniently removed at this time.
It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. While still being apparent from variations or modifications that may be made by those skilled in the art are within the scope of the invention.
Claims (8)
1. Multi-angle closed osteotomy guiding device with indication function, characterized in that: comprising the following steps:
a first osteotomy guide (1) having oppositely disposed first guide proximal (11) and first guide distal (12) ends;
At least one pair of first guide through holes (41) which penetrate through the first guide proximal end (11) and the first guide distal end (12), and the center lines of the pairs of first guide through holes (41) are arranged in parallel;
A second osteotomy guide (2) having a second guide proximal end (21) and a second guide distal end (22) disposed opposite each other and rotatably coupled to the first osteotomy guide (1) by a rotational coupling structure;
a third osteotomy guide (3) slidable in a direction toward or away from the first osteotomy guide (1) and removably mounted to the second osteotomy guide (2) with oppositely disposed third guide proximal (31) and third guide distal (32) ends;
-at least one pair of second guiding through holes (42) arranged through said second guiding element proximal end (21) and said second guiding element distal end (22) and/or through said third guiding element proximal end (31) and said third guiding element distal end (32), and the centre lines of said pairs of second guiding through holes (42) being arranged in parallel;
The planes of the central lines of the paired first guide through holes (41) form a set angle with the planes of the central lines of the paired second guide through holes (42);
At least 1 angle block (5) which is installed between the first osteotomy guide (1) and the second osteotomy guide (2) in a pluggable manner and is used for changing the angle between the plane of the center line of the paired first guide through holes (41) and the plane of the center line of the paired second guide through holes (42);
a first indicator (91) detachably mounted inside the first guide through hole (41) and provided with a first indicator handle (911), wherein the extending direction of the first indicator handle (911) is parallel to the extending direction of the first guide through hole (41);
A second indicating member (92) detachably mounted inside the second guide through hole (42) and having a second indicating handle (921), the second indicating handle (921) extending in a direction parallel to the second guide through hole (42);
an intersection point of the first indication handle (911) and the second indication handle (921) is an osteotomy intersection point;
The first indicator (91) includes:
A first indicator body;
At least two first mounting shafts (913) provided on a side surface of one end of the first indicator body for inserting at least two first guide through holes (41) respectively;
a first indication handle (911) arranged on the side surface of the other end of the first indication member main body, and having the same extending direction as the first mounting shaft (913);
And/or the number of the groups of groups,
The second indicator (92) includes:
A second indicator body;
at least two second mounting shafts (923) arranged on the side surface of one end of the second indicator main body and used for being correspondingly inserted into at least two second guide through holes (42);
A second indication handle (921) provided on a side surface of the other end of the second indication member main body, the extension direction of the second indication handle being the same as the extension direction of the second mounting shaft (923);
The rotary connecting structure is respectively arranged at a position of the first osteotomy guide (1) close to the distal end (12) of the first guide member and a position of the second osteotomy guide (2) close to the distal end (22) of the second guide member; the rotational connection structure includes: a rotating shaft (61) arranged on the first osteotomy guide (1); the rotating shaft hole (62) is arranged on the second osteotomy guide piece (2) and is connected with the rotating shaft (61) in a rotatable fit manner.
2. The guide device according to claim 1, wherein: the first indicator body includes:
A first base (912) having the first mounting shaft (913) provided on a side wall thereof and a first guide mounting hole (915) provided on a top end thereof;
A first vertical rod (914), one end of which is inserted and installed in the first guide installation hole (915) in a pluggable manner, and the side wall of the other end of which is provided with the first indication handle (911);
And/or the number of the groups of groups,
The second indicator body includes:
A second base (922) provided with the second mounting shaft (923) on the side wall and a second guide mounting hole (925) on the top end;
And one end of the second vertical rod (924) is inserted and installed into the second guide installation hole (925) in a pluggable manner, and the second indication handle (921) is arranged on the side wall of the other end.
3. The guide device according to claim 1, wherein: when the angle block (5) is not installed and the first osteotomy guide piece (1) is in fit contact with the second osteotomy guide piece (2), the angle between the planes of the central lines of the paired first guide through holes (41) and the planes of the central lines of the paired second guide through holes (42) is 2-5 degrees; the angle block (5) is at least one and comprises at least one of 1 DEG, 2 DEG, 4 DEG, 8 DEG and 16 deg.
4. The guide device according to claim 1, wherein: the first osteotomy guide piece (1), at least one angle block (5) and the second osteotomy guide piece (2) are respectively provided with a limiting groove (71) and a limiting protrusion (72) on mutually attached surfaces.
5. The guide device according to claim 1, wherein: along the direction far away from the second osteotomy guide piece (2), the first guide through holes (41) are provided with a plurality of rows on the first osteotomy guide piece (1), each row is at least 2, and the distance between the central lines of the adjacent two rows of the first guide through holes (41) is 5-8mm.
6. The guide device according to claim 5, wherein: along the direction far away from the first osteotomy guide piece (1), the second guide through holes (42) are provided with a plurality of rows of at least 2 second and/or third osteotomy guide pieces (2, 3), and the distance between the central lines of two adjacent rows of second guide through holes (42) is 5-8mm;
A pair of first guide through holes (41) closest to the second osteotomy guide (2) are connected with the circle center of the opening of the distal end (12) of the first guide, and a distance between the pair of second guide through holes (42) closest to the first osteotomy guide (1) and the circle center of the opening of the distal end (22) of the second guide and/or the distal end (32) of the third guide is 1-5mm.
7. The guide device according to claim 1, wherein: the third osteotomy guide (3) is a U-shaped block, and the open end of the U-shaped block is the proximal end (31) of the third guide; the second guide through holes (42) are arranged on two opposite side walls of the U-shaped block.
8. The guide device according to claim 7, wherein: the side wall of the U-shaped block is provided with a fixed threaded hole (81); a fixed chute (82) is arranged on the side wall of the second osteotomy guide (2); after passing through the fixing threaded hole (81), the fixing bolt (83) is abutted against the inside of the fixing chute (82), so that the second osteotomy guide (2) can be slidably and detachably mounted.
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| JP2004298259A (en) * | 2003-03-28 | 2004-10-28 | Zimmer Kk | Tool for upper tibia osteotomy |
| JP2014030536A (en) * | 2012-08-02 | 2014-02-20 | Tokifumi Majima | Osteotomy support device and osteotomy guide tool |
| CN110251193A (en) * | 2019-07-23 | 2019-09-20 | 中国人民解放军陆军军医大学第一附属医院 | An individualized closed osteotomy guide plate and its manufacturing method |
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