CN114052823A - Children DDH proximal femur osteotomy navigation template and use method thereof - Google Patents
Children DDH proximal femur osteotomy navigation template and use method thereof Download PDFInfo
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- CN114052823A CN114052823A CN202111242080.8A CN202111242080A CN114052823A CN 114052823 A CN114052823 A CN 114052823A CN 202111242080 A CN202111242080 A CN 202111242080A CN 114052823 A CN114052823 A CN 114052823A
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- 210000000689 upper leg Anatomy 0.000 title claims abstract description 59
- 238000000034 method Methods 0.000 title claims description 8
- 229910000831 Steel Inorganic materials 0.000 claims description 33
- 239000010959 steel Substances 0.000 claims description 33
- 210000000988 bone and bone Anatomy 0.000 claims description 30
- 210000001694 thigh bone Anatomy 0.000 claims description 9
- 239000011148 porous material Substances 0.000 claims description 5
- 241000469816 Varus Species 0.000 claims description 4
- 238000012937 correction Methods 0.000 claims description 4
- 210000000528 lesser trochanter Anatomy 0.000 claims description 4
- 238000004904 shortening Methods 0.000 claims description 4
- 230000000149 penetrating effect Effects 0.000 claims description 3
- 238000002271 resection Methods 0.000 claims 3
- 210000002391 femur head Anatomy 0.000 claims 1
- 208000014906 developmental dysplasia of the hip Diseases 0.000 description 20
- 230000000399 orthopedic effect Effects 0.000 description 4
- 208000032170 Congenital Abnormalities Diseases 0.000 description 3
- 239000007943 implant Substances 0.000 description 3
- 210000004872 soft tissue Anatomy 0.000 description 3
- 238000010146 3D printing Methods 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 210000001624 hip Anatomy 0.000 description 2
- 238000011160 research Methods 0.000 description 2
- 241000277284 Salvelinus fontinalis Species 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012216 screening Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000001225 therapeutic effect Effects 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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- 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
- A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
- A61B17/175—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for preparing the femur for hip prosthesis insertion
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Oral & Maxillofacial Surgery (AREA)
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- Heart & Thoracic Surgery (AREA)
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Abstract
The invention relates to a children DDH proximal femur osteotomy navigation template, which is characterized by comprising the following steps: a positioning guide plate, a connecting guide plate, an inclined guide plate and a transverse guide plate which are sequentially attached to the proximal end of the femur and can be used for positioning and osteotomy, the locating guide plate is provided with a first near-end locating hole in a shape like a Chinese character 'pin', the top end of the connecting guide plate is provided with a second near-end locating hole in a shape like a Chinese character 'pin', a connecting plate is arranged between the top end and the bottom end of the connecting guide plate, a first far-end positioning hole is longitudinally arranged on the bottom end of the connecting guide plate, the top end of the inclined guide plate is provided with an inclined osteotomy groove for inclined osteotomy, the bottom end of the inclined guide plate is longitudinally provided with a second distal end positioning hole, the invention provides more accurate osteotomy guidance for a clinician, achieves the purpose of personalized treatment of the DDH of children, and reduces the disability rate of patients.
Description
Technical Field
The invention relates to a children DDH proximal femur osteotomy navigation template and a use method thereof.
Background
Developmental dysplasia of the hip (DDH) is a common orthopedic disease of children, and the incidence rate of DDH in China is 0.09-0.30%. The therapeutic principle of DDH is early detection and early treatment. However, the DDH early screening project in China is not widely popularized, and part of children patients still miss the best treatment opportunity and often need surgical treatment. The incision reduction operation treatment method is still the main means of DDH treatment in China. It is not uncommon to report on the Salter osteotomy in combination with femoral osteotomy to treat complications of developmental hip dislocation. The reduction failure rate and the re-dislocation rate of DDH after incision reduction in China are 5-10%, and the higher complication rate is mainly caused by two reasons, namely that the abnormal hip joint is incompletely evaluated before an operation, and the operation is inaccurate in the operation. In recent years, 3D printing technology has been more and more widely applied in the orthopedic field. Although the application of 3D printing individualized osteotomy navigation template (PSI) in orthopedics has made a certain progress, the research and application in the osteotomy operation of children DDH is still rare at home and abroad at present. Related researches report that the PSI provides a good auxiliary tool for the personalized operation planning and implementation of the child DDH, but the used integrated guide plate has the problems of difficult implantation, large amount of soft tissue stripping and large wound. Meanwhile, the stability of the inverted angle is realized by matching the steel plate screw hole with the positioning kirschner wire, and the error is larger because the diameter of the positioning kirschner wire is far smaller than that of the steel plate screw hole and the stability is poor after matching.
Disclosure of Invention
The invention provides a children DDH proximal femur osteotomy navigation template and a use method thereof, which are simple and convenient to operate, convenient to implant, short in operation time and capable of reducing operation risks to a certain extent.
In order to achieve the purpose, the invention adopts the technical scheme that:
a children DDH proximal femur osteotomy navigation template, comprising: the positioning guide plate, the connecting guide plate, the inclined guide plate and the transverse guide plate are sequentially attached to the proximal end of the femur and can be used for positioning and osteotomy on the femur;
the positioning guide plate is provided with an appearance which is attached to the proximal end of the femur, and a first proximal end positioning hole is arranged in the positioning guide plate in a shape like a Chinese character 'pin';
the top end of the connecting guide plate is provided with a second near-end positioning hole in a delta shape, a connecting plate is arranged between the top end and the bottom end of the connecting guide plate, and the bottom end of the connecting guide plate is longitudinally provided with a first far-end positioning hole in an arrayed manner;
the top end of the inclined guide plate is provided with an inclined osteotomy groove for inclined osteotomy, and the bottom end of the inclined guide plate is longitudinally provided with a second distal end positioning hole;
the top end of the transverse guide plate is provided with a transverse bone cutting groove for transverse bone cutting, and the bottom end of the transverse guide plate is longitudinally provided with a third far-end positioning hole;
the first near-end positioning hole, the second near-end positioning hole, the first far-end positioning hole, the second far-end positioning hole and the third far-end positioning hole are respectively used for inserting a Kirschner wire into and positioning the Kirschner wire, a hole sleeve on the locking steel plate is detachably fixed by a centering device, and the centering device is sleeved on the Kirschner wire and used for limiting the movement of the locking steel plate.
The children DDH thighbone near-end osteotomy navigation template, wherein: the first near-end positioning hole corresponds to the second near-end positioning hole in position.
The children DDH thighbone near-end osteotomy navigation template, wherein: the first distal end positioning hole, the second distal end positioning hole and the third distal end positioning hole correspond in position.
The children DDH thighbone near-end osteotomy navigation template, wherein: the device comprises a centering device and a hole sleeve, wherein the centering device is provided with a hole for inserting the Kirschner wire, the top end of the centering device is provided with a thread for fixedly connecting the hole sleeve, the bottom end of the centering device is provided with a hexagonal auxiliary surface, and the hexagonal auxiliary surface is provided with an auxiliary hole in a penetrating manner.
A use method of a child DDH proximal femur osteotomy navigation template comprises the following steps:
and 5, fixedly connecting the centering device with the hole sleeve on the locking steel plate by using the threads, sleeving the kirschner wire into the hole channel on the centering device to limit the movement of the locking steel plate, enabling the osteotomy surfaces of the thighbone to be involuted by using the locking steel plate, realizing the correction of the shortening, derotation and varus deformity of the proximal end of the thighbone, screwing a positioning screw into the hole sleeve which is not fixedly connected with the centering device on the locking steel plate, separating the centering device sleeved into the kirschner wire from the hole sleeve, and screwing the positioning screw into the hole sleeve separated from the centering device to fix the locking steel plate and the thighbone. .
The invention has the beneficial effects that: the baffle is implanted relatively easily, the soft tissue is peeled off fewly, the damage is little, it is more wicresoft, it is perpendicular with the femoral shaft to cut the coaptation plane, stability is better, reduce the bad risk of healing to a certain extent, newly-increased ke shi needle ware placed in the middle can make the steel sheet screw stable with the matching of location ke shi needle, avoid correcting and lose, it is more accurate, can match with current children hip steel sheet, need not additionally to customize the steel sheet, the suitability is better, the external member design, easy and simple to handle, it is convenient to implant, the operating time is short, reduce the operation risk to a certain extent.
Drawings
FIG. 1 is a block diagram of a positioning guide.
Fig. 2 is a structural view of the connecting guide.
Fig. 3 is a structural view of the inclined guide plate.
Fig. 4 is a structural view of a horizontal guide plate.
Fig. 5 is a block diagram of a centralizer.
Description of reference numerals: 1-positioning a guide plate; 2-a first proximal end positioning hole; 3-connecting the guide plate; 4-a second proximal end positioning hole; 5-connecting plates; 6-a first distal end positioning hole; 7-an inclined guide plate; 8-an oblique osteotomy groove; 9-a second distal locating hole; 10-a transverse guide plate; 11-transverse osteotomy grooves; 12-a third distal locating hole; 13-a centralizer; 14-threads; 15-auxiliary holes; 16-hexagonal auxiliary surface; 17-channels.
Detailed Description
As shown in fig. 1 to 5, a children DDH proximal femur osteotomy navigation template comprises: the positioning guide plate 1, the connecting guide plate 3, the inclined guide plate 7 and the transverse guide plate 10 are sequentially attached to the proximal end of the femur and can be used for positioning and osteotomy on the femur.
The positioning guide plate 1 is provided with an appearance attached to the proximal end of the femur, and a first proximal positioning hole 2 is arranged in a shape like a Chinese character 'pin' on the positioning guide plate 1.
The top end of the connecting guide plate 3 is provided with a second near-end positioning hole 4 in a shape like a Chinese character 'pin', a connecting plate 5 is arranged between the top end and the bottom end of the connecting guide plate 3, the bottom end of the connecting guide plate 3 is longitudinally provided with a first far-end positioning hole 6, and the first near-end positioning hole 2 corresponds to the second near-end positioning hole 4 in position.
The top end of the inclined guide plate 7 is provided with an inclined osteotomy groove 8 for inclined osteotomy, and the bottom end of the inclined guide plate 7 is longitudinally provided with a second distal end positioning hole 9.
The top end of the transverse guide plate 10 is provided with a transverse osteotomy groove 11 for transverse osteotomy, the bottom end of the transverse guide plate 10 is longitudinally provided with a third distal end positioning hole 12, and the first distal end positioning hole 6, the second distal end positioning hole 9 and the third distal end positioning hole 12 are in corresponding positions.
The first proximal end positioning hole 2, the second proximal end positioning hole 4, the first distal end positioning hole 6, the second distal end positioning hole 9 and the third distal end positioning hole 12 are respectively used for inserting and positioning a kirschner wire on the femur.
A duct 17 is arranged in the centering device 13 for inserting the kirschner wire, a thread 14 is arranged at the top end of the centering device 13 for fixedly connecting with the hole sleeve, a hexagonal auxiliary surface 15 is arranged at the bottom end of the centering device 13, and an auxiliary hole 15 is arranged on the hexagonal auxiliary surface 15 in a penetrating way.
The hole sleeve on the locking steel plate is used for detachably fixing the centering device 13, and the hole channel 17 of the centering device 13 is sleeved on the Kirschner wire and used for limiting the movement of the locking steel plate.
The use method of the child DDH proximal femur osteotomy navigation template is characterized by comprising the following steps:
In the embodiment, a lesser trochanter on a femur is taken as an attachment point, a positioning guide plate 1 is attached to the proximal end of the femur, a Kirschner wire is inserted into the proximal end of the femur by using a first proximal end positioning hole 2, the positioning guide plate 1 is taken down, a second proximal end positioning hole 4 on a connecting guide plate 3 is sleeved on the Kirschner wire fixed on the proximal end, the connecting guide plate 3 is attached to the bone surface of the femur, the Kirschner wire is inserted into the bone surface by using a first distal end positioning hole 6, the connecting guide plate 3 is taken down after fixed positioning, an oblique guide plate 7 is sleeved on the Kirschner wire fixed on the bone surface by using a second distal end positioning hole 9, the oblique guide plate 7 is attached to the bone surface of the femur, a swing saw carries out oblique osteotomy through an oblique osteotomy groove 8, the top surface of the oblique osteotomy groove 8 is inclined at a certain angle with the cross section of the femur, the osteotomy direction is from the outer part to the inner part of the femur, the oblique guide plate 7 is taken down after the osteotomy is finished, the transverse guide plate 10 is sleeved on the kirschner wire fixed on the bone surface through the third distal end positioning hole 12, the transverse guide plate 10 is attached on the bone surface of the femur, the swing saw carries out transverse osteotomy through the transverse osteotomy groove 11, the osteotomy direction is vertical to the longitudinal direction of the femur, the transverse guide plate 10 is taken down after the osteotomy is finished, a bone block with one end in a right triangle or right trapezoid shape is cut through the two osteotomy, the height on the right-angle side of the bone block is the length of the short shrinkage of the osteotomy, the corresponding angle is the inward turning angle required by adjusting the overlarge cervical shaft angle, if the forward turning angle needs to be adjusted, the kirschner wire at the distal end can be parallel to be finished through adjustment, after the orthopedic is finished, the centering device 13 is fixedly connected with the hole sleeve on the locking steel plate through the screw thread 14, the kirschner wire is sleeved in a pore channel 17 on the centering device 13 to limit the movement of the locking steel plate and enable the osteotomy surface of the femur to be involuted, so that the shortening, derotation and correction of varus deformity of the proximal end of the femur are realized, a positioning screw is screwed in the pore sleeve which is not fixedly connected with the centering device 13 on the locking steel plate, the centering device 13 sleeved in the kirschner wire is separated from the pore sleeve, and the positioning screw is screwed in the pore sleeve separating the centering device 13 to fix the locking steel plate and the femur.
The invention has the advantages that:
the baffle is implanted relatively easily, the soft tissue is peeled off fewly, the damage is little, it is more wicresoft, it is perpendicular with the femoral shaft to cut the coaptation plane, stability is better, reduce the bad risk of healing to a certain extent, newly-increased ke shi needle ware placed in the middle can make the steel sheet screw stable with the matching of location ke shi needle, avoid correcting and lose, it is more accurate, can match with current children hip steel sheet, need not additionally to customize the steel sheet, the suitability is better, the external member design, easy and simple to handle, it is convenient to implant, the operating time is short, reduce the operation risk to a certain extent.
The foregoing description is intended to be illustrative rather than limiting, and it will be appreciated by those skilled in the art that many modifications, variations or equivalents may be made without departing from the spirit and scope of the invention as defined in the appended claims.
Claims (5)
1. A children DDH proximal femur osteotomy navigation template, comprising: the femur head positioning guide plate comprises a positioning guide plate (1), a connecting guide plate (3), an inclined guide plate (7) and a transverse guide plate (10), wherein the positioning guide plate, the connecting guide plate, the inclined guide plate and the transverse guide plate are sequentially attached to the proximal end of a femur and can be used for positioning and osteotomy on the femur;
the positioning guide plate (1) is provided with an appearance which is attached to the proximal end of the femur, and a first proximal end positioning hole (2) is arranged in a delta shape on the positioning guide plate (1);
a second near-end positioning hole (4) is arranged at the top end of the connecting guide plate (3) in a delta shape, a connecting plate (5) is arranged between the top end and the bottom end of the connecting guide plate (3), and first far-end positioning holes (6) are longitudinally arranged at the bottom end of the connecting guide plate (3);
an oblique osteotomy groove (8) is formed in the top end of the oblique guide plate (7) and used for oblique osteotomy, and second distal end positioning holes (9) are longitudinally arranged at the bottom end of the oblique guide plate (7);
a transverse bone cutting groove (11) is formed in the top end of the transverse guide plate (10) and used for transverse bone cutting, and third far-end positioning holes (12) are longitudinally arranged at the bottom end of the transverse guide plate (10);
the first near-end positioning hole (2), the second near-end positioning hole (4), the first far-end positioning hole (6), the second far-end positioning hole (9) and the third far-end positioning hole (12) are respectively used for inserting and positioning a Kirschner wire on the femur, a hole sleeve on the locking steel plate is detachably fixed by a centering device (13), and the centering device (13) is sleeved on the Kirschner wire and used for limiting the movement of the locking steel plate.
2. The children DDH proximal femoral resection navigation template of claim 1, wherein: the first near-end positioning hole (2) corresponds to the second near-end positioning hole (4).
3. The children DDH proximal femoral resection navigation template of claim 1, wherein: the first distal end positioning hole (6), the second distal end positioning hole (9) and the third distal end positioning hole (12) correspond in position.
4. The children DDH proximal femoral resection navigation template of claim 1, wherein: a pore channel (17) is arranged in the centering device (13) and used for inserting the Kirschner wire, a thread (14) is arranged at the top end of the centering device (13) and used for fixedly connecting the hole sleeve, a hexagonal auxiliary surface (15) is arranged at the bottom end of the centering device (13), and an auxiliary hole (15) is arranged on the hexagonal auxiliary surface (15) in a penetrating manner.
5. The use method of the child DDH proximal femur osteotomy navigation template is characterized by comprising the following steps:
step 1, attaching the positioning guide plate (1) to the proximal end of the femur on the affected side, using a small trochanter as an attachment point, inserting the Kirschner wire into the proximal end of the femur by using the first proximal end positioning hole (2), and taking down the positioning guide plate (1) after fixing and positioning;
step 2, the second near-end positioning hole (4) is sleeved on the Kirschner wire fixed at the near end, so that the connecting guide plate (3) is attached to the bone surface of the femur, the Kirschner wire is inserted into the bone surface by using the first far-end positioning hole (6), and the connecting guide plate (3) is taken down after the fixing and positioning;
step 3, the second far-end positioning hole (9) is sleeved on the Kirschner wire fixed on the bone surface, the inclined guide plate (7) is attached to the bone surface of the femur, a swing saw carries out inclined osteotomy through the inclined osteotomy groove (8), the osteotomy direction is from the outer part to the inner part of the femur, and the inclined guide plate (7) is taken down after the osteotomy is finished;
step 4, the third far-end positioning hole (12) is sleeved on the Kirschner wire fixed on the bone surface, so that the transverse guide plate (10) is attached to the bone surface of the femur, the swing saw carries out transverse osteotomy through the transverse osteotomy groove (11), the osteotomy direction is vertical to the longitudinal direction of the femur, and the transverse guide plate (10) is taken down after the osteotomy is finished;
and 5, fixedly connecting the centering device (13) with the hole sleeve on the locking steel plate by using the threads (14), sleeving the kirschner wire into the hole channel (17) on the centering device (13) for limiting the movement of the locking steel plate, enabling the osteotomy surfaces of the thighbone to be matched by using the locking steel plate, realizing the correction of shortening, derotation and varus deformity of the proximal end of the thighbone, screwing a positioning screw into the hole sleeve which is not fixedly connected with the centering device (13) on the locking steel plate, separating the centering device (13) sleeved into the kirschner wire from the hole sleeve, and screwing the positioning screw into the hole sleeve which is separated from the centering device (13) for fixing the locking steel plate and the thighbone.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111242080.8A CN114052823A (en) | 2021-10-25 | 2021-10-25 | Children DDH proximal femur osteotomy navigation template and use method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111242080.8A CN114052823A (en) | 2021-10-25 | 2021-10-25 | Children DDH proximal femur osteotomy navigation template and use method thereof |
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| CN114052823A true CN114052823A (en) | 2022-02-18 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2024257100A3 (en) * | 2023-06-12 | 2025-01-23 | Sheba Impact Ltd. | Methods and apparatus for varus de rotation osteotomy operation (vdro) using a guiding jig |
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2021
- 2021-10-25 CN CN202111242080.8A patent/CN114052823A/en active Pending
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2024257100A3 (en) * | 2023-06-12 | 2025-01-23 | Sheba Impact Ltd. | Methods and apparatus for varus de rotation osteotomy operation (vdro) using a guiding jig |
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