CN118845144B - Aiming module, intramedullary nail aiming arm and intramedullary nail aiming device - Google Patents
Aiming module, intramedullary nail aiming arm and intramedullary nail aiming device Download PDFInfo
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- CN118845144B CN118845144B CN202411336976.6A CN202411336976A CN118845144B CN 118845144 B CN118845144 B CN 118845144B CN 202411336976 A CN202411336976 A CN 202411336976A CN 118845144 B CN118845144 B CN 118845144B
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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
- A61B17/1717—Guides or aligning means for drills, mills, pins or wires for applying intramedullary nails or pins
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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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary devices, e.g. pins or nails
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—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
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
- A61B17/921—Impactors or extractors, e.g. for removing intramedullary devices for intramedullary devices
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Abstract
The invention discloses an aiming module, an intramedullary nail aiming arm and an intramedullary nail aiming device. The intramedullary nail aiming arm comprises a gear rod, an aiming module, a second aiming piece, a first guide groove, a second aiming piece, a second guide groove, a second hole site and an initial position and an aiming position, wherein the first aiming piece is provided with a first guide groove penetrating through the first aiming piece along the thickness direction of the first aiming piece, the first guide groove is provided with a plurality of first hole sites, the second aiming piece is connected with the first aiming piece in a sliding mode along the height direction of the first aiming piece, the second aiming piece is provided with a second guide groove penetrating through the second aiming piece along the thickness direction of the second aiming piece, the second guide groove is provided with the second hole site, the second aiming piece is provided with the initial position and the aiming position, when the second aiming piece is positioned at the aiming position, the center of the second hole site and the center of any first hole site are positioned on the same horizontal line, and the first aiming piece and the second aiming piece are locked and fixed. So as to reduce the times of X-ray fluoroscopy in operation, and no additional positioning holes are added on the affected limb bones of the patient, thereby reducing the trauma to the patient.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an aiming module, an intramedullary nail aiming arm and an intramedullary nail aiming device.
Background
Intramedullary nail treatment is a common way of fracture internal fixation, especially for long bones of the lower limbs, such as the femur, tibia, etc. In the intramedullary nail installation process, the steps of proximal opening, stem expansion, intramedullary nail implantation, proximal locking nail installation and distal locking nail installation are generally required, the most difficult installation of the distal locking nail in operation is that the distal end of the intramedullary nail has different degrees of deviation due to the arc-shaped difference of long bones of patients, and the most common clinical technology is to eliminate the difference of the intramedullary nail in the front-back direction in the intramedullary cavity by adopting a lateral compression bar mode so as to achieve the aim. In the prior art, once the lateral compression rod is encountered in the operation and the distal end of the intramedullary nail is not finely adjusted to a preset position, the locking nail mounting hole at the distal end of the distal end aiming arm and the locking hole of the intramedullary nail in the patient body are not in the same straight line, the distal end locking nail is difficult to mount according to the expected operation steps, and in the prior art, the adopted integrated distal end aiming arm has a challenge for the operator due to the lack of fine adjustment capability. In addition, the adjusting mechanism of the lateral bracket needs to additionally increase a lateral hole on the bone of the affected limb of the patient, and is only used for adjusting the front and back positions of the intramedullary nail so as to realize the aiming function, the lateral hole can add additional trauma to the patient, and multiple holes are formed in a certain area at the distal end of the femur, so that the risk of secondary fracture in the area can be increased.
Disclosure of Invention
The invention aims to provide a sighting module, an intramedullary nail sighting arm and an intramedullary nail sighting device, so that the number of X-ray perspective in operation is reduced, an additional positioning hole is not needed to be added on a patient affected limb bone, the trauma to the patient is reduced, and meanwhile, the pressure of autonomous fine adjustment of a doctor is reduced.
To solve the above technical problems, embodiments of the present invention provide an intramedullary nail aiming arm, including:
the gear lever is provided with a distal end and a proximal end, and the direction from the distal end to the proximal end of the gear lever is the length direction of the gear lever;
A plurality of aiming modules, each of which is detachably connected with the gear lever, each of which comprises:
The first sighting piece is detachably connected with the far end of the gear rod, a first guide groove penetrating through the first sighting piece in the thickness direction is formed in the first sighting piece, the first guide groove is provided with a plurality of first hole sites arranged in the height direction of the first sighting piece, the length direction of the gear rod and the thickness direction of the first sighting piece are perpendicular to each other, and
The second aiming piece is slidably connected with the first aiming piece along the height direction of the first aiming piece, and the first aiming piece is positioned between the gear lever and the second aiming piece; the second sighting piece is provided with a second guide groove penetrating along the thickness direction of the second sighting piece, and the second guide groove is provided with a second hole site;
When the second sighting piece is positioned at the sighting position, the center of the second hole site and the center of any first hole site are positioned on the same horizontal line, and the first sighting piece and the second sighting piece are locked and fixed;
wherein the heights of the first hole sites in different aiming modules are different.
Compared with the prior art, the embodiment of the invention has the advantages that the second sighting piece is movably connected with the first sighting piece due to the sighting module, so that the height of the second sighting piece can be adjusted. That is, after the intramedullary nail aiming arm is installed, the second aiming piece is firstly perforated on the affected limb bone through the second hole to form a pre-judging hole, a proper first hole is selected to drill on the affected limb bone to form a pre-drilling hole according to the direction that the pre-judging hole and a locking hole at the far end of the intramedullary nail are in the expected upper or lower direction, when the pre-drilling hole is communicated with a screw hole on the intramedullary nail, the pre-drilling hole is reamed to form a lock hole, and then the second aiming piece is moved to an aiming position, so that the center of the second hole and the center of the first hole forming the lock hole are on the same horizontal line, thereby realizing fine adjustment of the far-end hole in locking the intramedullary nail, reducing the number of X-ray perspective times in operation, and reducing trauma to a patient without adding an extra positioning hole on the affected limb bone of the patient, and simultaneously reducing the pressure of autonomous fine adjustment of doctors. The plurality of aiming modules are arranged, when the first hole site is locked with the distal hole of the intramedullary nail in operation, if the first hole site on one aiming module cannot correspond to the distal hole of the intramedullary nail, the aiming module of another model can be replaced immediately. The modules are exchanged according to a certain sequence, so that the operation time is shortened, and the risk of wound infection is reduced.
In an embodiment, the first guide groove includes a plurality of round holes, one round hole forms one of the first hole sites, and the centers of the plurality of round holes are arranged along the height direction of the first aiming member.
In one embodiment, the first guide groove is in a shape of a vertical 8.
In one embodiment, the distance between the centers of two adjacent first hole sites is 9 mm-11 mm, and the diameter of the round hole in the first guide groove is 7 mm-11 mm.
In an embodiment, the second holes are multiple and are arranged along the length direction of the gear lever.
In one embodiment, the second guide groove comprises a plurality of round holes, one round hole forms one second hole site, and the second guide groove is in a horizontal "≡shape.
In one embodiment, the first sighting piece is provided with a sighting mark position and an initial mark position, and one sighting mark position corresponds to the center of one first hole position;
the second sighting piece is provided with a pointing mark, the pointing mark and the center of the second hole site are positioned on the same horizontal line, and the pointing mark is used for pointing to the initial mark position when the second sighting piece is positioned at the initial position and pointing to the sighting mark position when the second sighting piece moves to the sighting position.
In an embodiment, when the second sighting piece is located at the initial position, a distance between a center of the first hole site and a center of the second hole site in each sighting module along a height direction of the first sighting piece is a sighting hole distance;
the device comprises a plurality of sighting modules, a plurality of sighting module and a plurality of sighting module, wherein the sighting module is provided with at least two sighting hole distances, the at least two sighting hole distances of at least one sighting module in the plurality of sighting modules are identical, and the adjacent two sighting hole distances of at least one sighting module in the plurality of sighting modules are different.
In one embodiment, the same two aiming hole distances range from 4.5 mm to 5.5mm, and the adjacent two different aiming hole distances range from 3mm to 4mm and from 6mm to 7mm, respectively.
In one embodiment, the first sighting piece is provided with a plurality of limiting grooves which are arranged along the height direction of the first sighting piece, one first hole site corresponds to one limiting groove, and the second sighting piece is positioned in the first sighting piece area corresponding to the initial position and is provided with the limiting groove;
The second aiming piece is provided with a chute extending along the height direction;
the aiming module further comprises a lock for locking or unlocking the first aiming member and the second aiming member;
the lock includes:
The movable rod is arranged in the chute in a sliding way and at least partially positioned outside the second aiming piece, and an unlocking groove is formed in the movable rod;
the elastic piece is arranged in the chute, and one end of the elastic piece is propped against the bottom of the movable rod;
The second sighting device comprises a first sighting device, a second sighting device, a limiting piece, an unlocking groove, an elastic piece, a second sighting device and a second sighting device, wherein the limiting piece is arranged on the second sighting device and is used for being embedded into any limiting groove, when the movable rod is pressed to slide to the unlocking position, the limiting piece is embedded into the unlocking groove, the second sighting device is unlocked from the first sighting device, when the movable rod is loosened, the movable rod is pushed by the elastic piece to slide to the locking position, the limiting piece is embedded into the limiting groove and is located outside the unlocking groove and abuts against the side wall of the movable rod, and the second sighting device is locked and fixed with the first sighting device.
In an embodiment, the first guide groove extends in a height direction of the first sight;
The first sight includes:
the first aiming body is connected with the gear lever;
the adjusting block at least partially covers the first guide groove, is connected with the first aiming body in a sliding mode along the height direction of the first aiming piece and at least partially covers the first guide groove, is provided with a guide hole, and is communicated with the first guide groove in a superposition mode, and the first hole position is formed in the guide hole and the covered region of the first guide groove.
Embodiments of the present invention also provide an intramedullary nail sight comprising:
an intramedullary nail aiming arm as described above;
And the handle is connected with the intramedullary nail aiming arm.
The embodiment of the invention also provides an aiming module of the intramedullary nail aiming arm, which is the aiming module in the intramedullary nail aiming arm.
Drawings
One or more embodiments are illustrated by way of example and not limitation in the figures of the accompanying drawings, in which like references indicate similar elements, and in which the figures of the drawings are not to be taken in a limiting sense, unless otherwise indicated.
FIG. 1 is a schematic view of an intramedullary nail sight and intramedullary nail installation in accordance with a first embodiment of the present invention;
fig. 2 is a schematic view of the structure of an aiming arm of an intramedullary nail according to a first embodiment of the present invention;
FIG. 3 is a schematic view of a first embodiment of a second sight in an aiming position according to the present invention;
FIG. 4 is a schematic view of a first embodiment of a second sight in an initial position according to the present invention;
Fig. 5 is a schematic view showing a structure in which a second aiming feature of another aiming block is positioned at an initial position according to the first embodiment of the present invention;
Fig. 6 is a cross-sectional view of the aiming block connecting gear lever according to the first embodiment of the present invention;
FIG. 7 is a schematic view of the aiming arm of an intramedullary nail in accordance with a second embodiment of the present invention;
FIG. 8 is a schematic view of a second sight in an initial position according to a second embodiment of the present invention;
fig. 9 is a cross-sectional view of an aiming module according to a second embodiment of the present invention.
The device comprises 100 intramedullary nail aiming arms, 1 gear rods, 11, hole sites, 2, aiming modules, 700, handles, 21, first aiming members, 22 and second aiming members, 210, first guide grooves, 211, first hole sites, 220, second guide grooves, 221, second hole sites, 212, aiming mark positions, 213, initial mark positions, 222, pointing marks, 3, locking members, 31, movable rods, 310, unlocking grooves, 32, elastic members, 33, limiting members, 214, limiting grooves, 500, intramedullary nails, 4, aiming modules, 411, first hole sites, 421, second hole sites, 300, intramedullary nail aiming arms, 5, aiming modules, 51, first aiming members, 511, first aiming bodies, 512, adjusting blocks, 5110, first guide grooves, 510, first hole sites, 5120, guide holes, 5121, adjusting mark members, 5111, hollow grooves, 5112, aiming mark positions, 5113, initial mark positions, 52, second pieces, 521, second hole sites, 521, second mark positions, 521, locking members, 516, locking members, 5123, locking connecting blocks, 516 and limiting blocks.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present application more apparent, the following detailed description of the embodiments of the present application will be given with reference to the accompanying drawings. However, those of ordinary skill in the art will understand that in various embodiments of the present application, numerous technical details have been set forth in order to provide a better understanding of the present application. The claimed application may be practiced without these specific details and with various changes and modifications based on the following embodiments.
In the following description, for the purposes of explanation of various disclosed embodiments, certain specific details are set forth in order to provide a thorough understanding of the various disclosed embodiments. One skilled in the relevant art will recognize, however, that an embodiment may be practiced without one or more of the specific details. In other instances, well-known devices, structures, and techniques associated with the present application may not be shown or described in detail to avoid unnecessarily obscuring the description of the embodiments.
Throughout the specification and claims, unless the context requires otherwise, the word "comprise" and variations such as "comprises" and "comprising" will be understood to be open-ended, meaning of inclusion, i.e. to be interpreted to mean "including, but not limited to.
The following detailed description of various embodiments of the present invention will be provided in connection with the accompanying drawings to provide a clearer understanding of the objects, features and advantages of the present invention. It should be understood that the embodiments shown in the drawings are not intended to limit the scope of the invention, but rather are merely illustrative of the true spirit of the invention.
Reference throughout this specification to "one embodiment" or "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases "in one embodiment" or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.
As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. It should be noted that the term "or" is generally employed in its sense including "and/or" unless the context clearly dictates otherwise.
In the following description, for the purposes of clarity of presentation of the structure and manner of operation of the present invention, the description will be made with the aid of directional terms, but such terms as "forward," "rearward," "left," "right," "outward," "inner," "outward," "inward," "upper," "lower," etc. are to be construed as convenience, and are not to be limiting.
Embodiments of the present invention are described below with reference to the accompanying drawings.
A first embodiment of the present invention relates to an intramedullary nail aiming arm 100. As shown in fig. 1,2 and 3, the intramedullary nail aiming arm 100 comprises a gear lever 1 and an aiming block 2. The gear lever 1 is made of stainless steel or carbon fiber materials, the gear lever 1 is formed by a plurality of hole sites 11 which are arranged along the length direction of the gear lever, the gear lever 1 is respectively used correspondingly to intramedullary nails with different length specifications, the gear lever 1 is provided with a distal end and a proximal end, the proximal end is connected with a handle 700, and the distal end is connected with the aiming module 2. The direction from the distal end to the proximal end of the gear lever 1 is the length direction of the gear lever 1. The aiming module 2 comprises a first aiming member 21 and a second aiming member 22, wherein the first aiming member 21 is connected with the distal end of the gear lever 1, and a first guide groove 210 penetrating along the thickness direction of the first aiming member 21 is formed on the first aiming member 21. The first guide groove 210 has a plurality of first hole sites 211 aligned in the height direction of the first sight 21. The height direction of the first sight 21, the length direction of the gear lever 1, and the thickness direction of the first sight 21 are perpendicular to each other. The thickness direction is the direction of arrow Z in fig. 2, the height direction is the direction of arrow Y in fig. 2, and the length direction is the direction of arrow X in fig. 2. The second sight 22 is slidably connected to the first sight 21 in the height direction of the first sight 21, and the first sight 21 is located between the gear lever 1 and the second sight 22. The second aiming block 22 is provided with a second guide groove 220 penetrating in the thickness direction, and the second guide groove 220 is provided with a second hole site 221. The second sight 22 has an initial position and a sight position. When the second sighting piece 22 is positioned at the sighting position, the center of the second hole site 221 and the center of any first hole site 211 are positioned on the same horizontal line, and the first sighting piece 21 and the second sighting piece 22 are locked and fixed.
Since the sighting module 2 is arranged, and the second sighting member 22 is movably connected with the first sighting member 21, the second sighting member 22 can be adjusted in height. That is, after the intramedullary nail aiming arm 100 is installed, the second aiming member 22 is firstly perforated on the affected limb bone through the second hole site 221 to form a pre-judging hole, and according to the pre-judging hole and the direction of the locking nail hole at the distal end of the intramedullary nail 500 in the expected upper or lower direction, the proper first hole site 211 is selected to drill on the affected limb bone to form a pre-drilling hole, when the pre-drilling hole is communicated with the screw hole on the intramedullary nail 500, the pre-drilling hole is reamed to form a lock hole, and then the second aiming member 22 is moved to an aiming position, so that the center of the second hole site 221 and the center of the first hole site 211 forming the lock hole are on the same horizontal line, thereby realizing the fine adjustment of the distal hole site in locking the intramedullary nail 500, reducing the number of X-ray perspective in operation, and reducing the trauma to the patient without adding an additional positioning hole on the affected limb bone of the patient, and simultaneously reducing the pressure of autonomous fine adjustment of the doctor.
Further, the first guide groove 210 includes a plurality of circular holes, one of which forms one first hole site 211, and the centers of the plurality of circular holes are aligned in the height direction of the first sight 21.
Further, the first guide groove 210 is in a vertical 8 shape. As shown in fig. 4, two adjacent circular holes are connected, and in this embodiment, two circular holes may not be connected.
In addition, as shown in fig. 4, the distance between the centers of the adjacent two first hole sites 211 is in the range of 9mm to 11mm, alternatively, the distance between the centers of the adjacent two first hole sites 211 may be 10mm or the like. Thus, after one first hole position 211 is selected to be unsuitable for drilling the affected limb bone, the hole formed by selecting another suitable first hole position 211 for drilling and reaming the affected limb bone can be expanded to the hole drilled on the affected limb bone for the first time, and excessive damage to the affected limb bone can be avoided.
Further, the diameter of the circular hole in the first guide groove 210 ranges from 7mm to 11mm. Alternatively, the distance between the centers of two adjacent first hole sites 211 may be 8mm or 10mm, or the like.
As shown in fig. 2 and 4, the plurality of second hole sites 221 are arranged in the longitudinal direction of the shift lever 1, that is, in the arrow X direction in fig. 2.
Further, as shown in fig. 2 and 4, the second guide groove 220 includes a plurality of circular holes arranged along the length direction of the gear lever. Preferably, one circular hole forms one second hole site 221. The second guide groove 220 is in a horizontal "≡shape. The horizontal 'infinity' shaped hole is arranged on the second aiming part to support the requirement of two holes in simultaneous use, namely, when the second guide groove 220 is used, the second hole on one side is used as a reference hole, the second hole on the other side can be directly used as a locking nail mounting hole under the condition that fine adjustment is not needed, and finally, the locking nail mounting hole is separated from the positioning reference hole, so that the reference hole is prevented from being enlarged secondarily, and the fracture risk of a punching area is increased. Specifically, the clinical requirement intramedullary nail distal end locking nail mounting hole is elongated slot type key groove hole, and the primary operation locking nail is preferentially installed in the position of the key groove far away, prevents that the locking nail from having certain slip clearance in the key groove when the delayed healing of bone appears in patient postoperative to realize the secondary pressurization, promote bone healing. In the operation, the reference hole of predrilled is beaten in the opposite side of keyway hole preferentially, namely use the first hole site on the right side of the structure of horizontal "+" word hole in fig. 1, finely tune according to the position of reference hole, after the fine setting, through the structure of horizontal "fact" word hole, use the second hole site that is close to outside (distal end) to beat the locking nail mounting hole, namely the second hole site on the leftmost side in fig. 1, two second hole sites are mutually independent, when the patient stands, the second hole site is not on same horizontal plane, the loss of bone strength is minimum. The existing second hole site generally has only one single hole, and the pre-drilled reference hole position and the final locking pin mounting hole are not effectively separated. The horizontal 'infinity' shaped hole is arranged on the second aiming part to support the requirement of two holes in simultaneous use, namely, when the second guide groove 220 is used, the second hole on one side is used as a reference hole, the second hole on the other side can be directly used as a locking nail mounting hole under the condition that fine adjustment is not needed, and finally, the locking nail mounting hole is separated from the positioning reference hole, so that the reference hole is prevented from being enlarged secondarily, and the fracture risk of a punching area is increased. Specifically, the clinical requirement intramedullary nail distal end locking nail mounting hole is elongated slot type key groove hole, and the primary operation locking nail is preferentially installed in the position of the key groove far away, prevents that the locking nail from having certain slip clearance in the key groove when the delayed healing of bone appears in patient postoperative to realize the secondary pressurization, promote bone healing. In the operation, the reference hole of predrilled is beaten in the opposite side of keyway hole preferentially, namely use the first hole site on the right side of the structure of horizontal "+" word hole in fig. 1, finely tune according to the position of reference hole, after the fine setting, through the structure of horizontal "fact" word hole, use the second hole site that is close to outside (distal end) to beat the locking nail mounting hole, namely the second hole site on the leftmost side in fig. 1, two second hole sites are mutually independent, when the patient stands, the second hole site is not on same horizontal plane, the loss of bone strength is minimum. The existing second hole site generally has only one single hole, and the pre-drilled reference hole position and the final locking pin mounting hole are not effectively separated. It is understood that the number of the second hole sites is not limited thereto, and the plurality of second hole sites may be provided at intervals.
In addition, as shown in fig. 2, 3 and 4, the first sight 21 is provided with an aiming mark position 212 and an initial mark position 213, and one aiming mark position 212 corresponds to the center of one first hole position 211. The aiming mark position 212 and the initial mark position 213 may be scale marks, the second aiming member 22 is provided with an aiming mark 222, the aiming mark 222 may be delta, the aiming mark 222 and the center of the second hole 221 are positioned on the same horizontal line, and the aiming mark 222 is used for pointing to the initial mark position 213 when the second aiming member 22 is positioned at the initial position and pointing to the aiming mark position 212 when the second aiming member 22 moves to the aiming position.
Specifically, taking fig. 4 as an example, the center line of the horizontal "≡" hole is marked by "Δ", the center line of the vertical "8" hole is provided with corresponding graduation marks, that is, three graduation marks, where the graduation mark of the center of the symmetry of the module in which the vertical "8" hole is located is the initial marking position 213, and the graduation mark corresponding to the center line of the two circular holes is the aiming marking position 212. In this embodiment, the symmetry center of the module where the vertical "8" hole is located may be the center of the vertical "8" hole, and in another embodiment, the vertical "8" hole is located on the center of the module where it is located, where the symmetry center of the module where the vertical "8" hole is located and the center of the vertical "8" hole are not on the same horizontal line. Of course, the tick mark used as the initial mark bit 213 may not be at the center of symmetry of the module where the vertical "8" shaped hole is located. The alignment positions of the delta and the three scale marks are three positions supporting immediate locking, and when the delta is aligned with the scale marks on two sides, the positions of the two groups of holes are in a relationship that the center line of the horizontal-infinity-shaped hole and the center line of the vertical-shaped hole are on the same straight line. In use, when the intramedullary nail aiming arm 100 is mounted to a patient's bone of a patient, the second aiming feature 22 is initially positioned, i.e., the directional marker 222 is aligned with the initial marker position 213. The method comprises the steps of firstly drilling a horizontal 'infinity' hole at the tail end of a second aiming member 22, which is a pre-judging hole, shooting X-ray films along the sagittal position of a patient limb, checking that the locking nail hole at the far end of an intramedullary nail 500 is in the expected upward or downward direction, secondly selecting a first hole position 211 in the first aiming member 21, firstly drilling a pre-drilled hole in the patient limb bone by using a 2.5mm drill bit through the first hole position 211, checking that the 2.5mm drill bit smoothly passes through a screw hole on the intramedullary nail 500, then reaming the hole to the expected diameter of 4-4.5mm by using a step drill, and completing the installation of a locking screw in the vertical '8' hole, and thirdly adjusting the center connecting line of the far end horizontal 'infinity' hole of the second aiming member 22 and the center of the first hole position 211 drilled by the drill bit in the second step to be in the same straight line, as in the state in fig. 3, and finally installing the locking screw at the far end.
Further, as shown in fig. 6, the first sight 21 is detachably connected to the gear lever 1. Specifically, the distal end of the gear lever 1 may be provided with a groove in the form of a dovetail groove, the first aiming member 21 is provided with a dovetail groove protrusion structure, the protrusion structure may be inserted into the groove, and is locked by the locking connector, so that the connection is easy to disassemble, and after the unlocking, the aiming module slides to enable the aiming module to slide away from the gear lever. It will be appreciated that the detachable connection structure is not limited thereto, as other structures are possible. In other embodiments, the first sighting member 21 may also be fixedly connected to the gear lever 1, and the first sighting member and the gear lever are integrated and not detachable.
As shown in fig. 6, in order to quickly adjust the height of the second sight 22 and fix the second sight 22 with the first sight 21, the sight module 2 further includes a lock 3 that locks or unlocks the first and second sights 21 and 22. The first aiming member 21 is provided with a plurality of limiting grooves 214 arranged along the height direction of the first aiming member 21, one first hole site 211 corresponds to one limiting groove 214, and the second aiming member 22 is provided with limiting grooves 214 in the corresponding first aiming member 21 area at the initial position. The second aiming block 22 is provided with a chute extending in the height direction thereof. The lock 3 includes a movable lever 31, an elastic member 32, and a stopper 33. The movable rod 31 is slidably disposed in the chute and is at least partially located outside the second sight 22. The movable rod 31 is provided with an unlocking groove 310. The elastic piece 32 is arranged in the chute, and one end of the elastic piece 32 is propped against the bottom of the movable rod 31. The limiting member 33 is disposed on the second aiming member 22, and the limiting member 33 is configured to be inserted into any one of the limiting grooves 214. When the movable rod 31 is pressed to slide to the unlocking position, the limiting piece 33 is aligned to the unlocking groove 310, at this time, the second aiming piece 22 can be moved, the second aiming piece 22 drives the limiting piece 33 to move, the side wall of the first aiming piece pushes the limiting piece 33 to enter the unlocking groove more, and the second aiming piece 22 is unlocked with the first aiming piece 21. When the second aiming member 22 drives the limiting member to move in place, the limiting member 33 aligns to the proper limiting groove 214, the movable rod 31 is released, the movable rod 31 is pushed by the elastic member 32 to slide to the locking position, the limiting member 33 is pushed by the movable rod 31 to be embedded into the limiting groove 214 and located outside the unlocking groove 310 to abut against the side wall of the movable rod 31, and the second aiming member 22 is locked and fixed with the first aiming member 21. Specifically, in this embodiment, as shown in fig. 6, the limiting grooves 214 have three limiting grooves, which correspond to the centers of the two second holes 221, respectively, and the symmetry center of the module where the vertical "8" holes are located (the symmetry center of the first aiming device 21). When the second sight 22 is positioned at the initial position and fixed to the first sight 21, the second sight 22 is aligned with the stopper 33 to the stopper groove 214 at the center of symmetry of the first sight 21, and the lever side wall of the movable lever 31 pushes the stopper 33 to be inserted into the stopper groove 214, in which state the second sight 22 is positioned at the initial position and locked to the first sight 21. when unlocking is needed, the movable rod 31 is pressed, the limiting piece 33 is aligned to the unlocking groove 310, the second aiming piece 22 is slightly moved, the limiting piece 33 is pushed into the unlocking groove by the side wall of the first aiming piece, the first aiming piece 21 and the second aiming piece 22 can flexibly move, and the second aiming piece 22 is moved to a position needing to be moved. When the movable rod 31 is released, the elastic member 32 can be a spring or a spring sheet to push the movable rod 31 to enable the limiting member 33 to slide out of the unlocking slot 310, so that the freedom degree of the first aiming member 21 and the second aiming member 22 in the sliding direction is limited, and locking can be realized. The surface of the limiting member 33 which is integrally formed as a ball member or is inserted into the unlocking groove 310 and the limiting groove 214 is a rounded corner surface. By means of the structural design, the first sighting piece 21 and the second sighting piece 22 can be locked, and operation is convenient. In addition, in order to facilitate sliding of the second aiming member 22 relative to the first aiming member 21, a notch is provided at the distal end of the first aiming member 21, and a protrusion block is provided at the proximal end of the second aiming member 22, which is embedded in the notch, and the mating sliding structure of the first aiming member 21 and the second aiming member 22 may be a dovetail groove structure, which is identical to the mating structure of the first aiming member 21 and the gear lever 1. Through movable rod and elastic component cooperation, press the movable rod and realize the unblock, loosen the movable rod and can realize locking, whole regulation simple structure is convenient, reduces operation time.
The locking connecting piece 6 for locking the first aiming piece 21 and the gear lever 1 is basically the same as the locking piece 3 for locking the first aiming piece 21 and the second aiming piece 22, and unlocking is realized by pressing, so that the first aiming piece 21 and the gear lever 1 are conveniently and rapidly disassembled, the operation time is saved, only one gear is locked, a limit groove is formed in the gear lever 1, and other movable levers, elastic pieces and limit pieces are the same as those described above and are not described herein.
In other embodiments, the immediate locking structure between the first and second sight, the first sight and the gear lever may be of other types, or the module in which the movable lever is located may be different from that in the present embodiment.
Further, the aiming module is provided with a plurality of first hole sites in different aiming modules. The plurality of aiming modules are arranged, when the first hole site is locked with the distal hole of the intramedullary nail in operation, if the first hole site on one aiming module cannot correspond to the distal hole of the intramedullary nail, the aiming module of another model can be replaced immediately. The modules are exchanged according to a certain order, and the learning curve is short, so that the operation time is shortened, and the risk of wound infection is reduced.
Further, when the second sight 22 is in the initial position, the distance between the center of the first hole site 211 and the center of the second hole site 221 in each of the sight modules along the height direction of the first sight 21 is the sight pitch. One aiming module has at least two aiming hole distances, and at least two aiming hole distances of at least one aiming module in the plurality of aiming modules are the same. Two adjacent aiming holes of at least one aiming module in the plurality of aiming modules are different in distance. Specifically, two interchangeable aiming modules are taken as an example, as shown in fig. 4, aiming hole distances h1 and h2 in one aiming module 2 are the same and are 4.5 mm, and as shown in fig. 5, aiming hole distances h3 and h4 in the other aiming module 4 are different and are 3mm and 6mm respectively, and in the same-sized aiming module, the first guide grooves 210 are the same in shape and size but are different in position height in the aiming module. In use, the aiming module 2 with the aiming hole distance of 4.5mm can be firstly used, and the operation is carried out according to the following steps that firstly, the aiming module 2 with the aiming hole distance of 4.5mm is installed on the gear lever 1, a transverse ' infinity ' hole at the tail end of the second aiming piece 22 is drilled, the hole is a pre-judging hole, an X-ray film is shot along the sagittal position of a patient limb, and the locking nail hole at the far end of the intramedullary nail 500 is checked in the expected upward or downward direction; secondly, selecting a first hole site 211 in the first aiming component 21, firstly punching a hole in the affected bone of a patient through the first hole site 211 by using a 2.5mm drill bit to form a pre-drilled hole, checking whether the 2.5mm drill bit passes through a screw hole on the intramedullary nail 500 successfully, and if so, not needing to replace another aiming module 4, but operating according to the using steps of the aiming module described above, but if the 2.5mm drill bit does not pass through the screw hole on the intramedullary nail 500, starting the aiming module of another model at the moment, pressing the locking connecting piece by utilizing the aiming hole distance to realize fine adjustment, unlocking the combination of the aiming module with the aiming hole distance of 4.5mm and the gear lever 1, quickly connecting the other aiming module 4 in fig. 5 with the gear lever 1 in the same way, releasing the locking connecting piece to form an intramedullary nail aiming arm with a new position relation, and directly jumping to a second step (firstly, judging that the aiming module 411 and the second hole site 421 on the aiming module 4 is used in a horizontal ' word ' hole site ' and the aiming hole distance is the pre-drilled hole distance of which is the expected to be the aimed hole distance of 500 or the aimed hole distance of the 3.35 is the expected 2.375); i.e., directly selecting the appropriate first hole 411 in the vertical "8" shaped hole of the newly replaced aiming block 4, pre-drilling with a 2.5mm drill, checking that it has successfully passed through the screw hole in the intramedullary nail 500, thirdly, pressing the locking piece, adjusting the central connecting line of the second hole position 421 at the far end to be in the same line with the center of the first hole position 411 of the locking nail installed in the second step, and then performing the steps of pre-drilling, reaming and installing the locking screw to complete the installation of the second locking screw at the far end. In this embodiment, two types of aiming modules are taken as an example, more types of aiming modules can be used, and the appropriate types can be replaced in operation according to the implementation and use requirements, and the above size data can be replaced according to the actual requirements, not limited to the above.
Further, the same two aiming hole distances h1 and h2 in the aiming block 2 as in fig. 4 range from 4.5 mm to 5.5mm, and the adjacent two different aiming hole distances h3 and h4 in the aiming block 4 as in fig. 5 range from 3mm to 4mm and from 6mm to 7mm, respectively. Alternatively, the two different aiming hole distances h3 and h4 may be a combination of 3mm and 6mm, or a combination of 4mm and 5mm, respectively. Thus, after the first hole site 211 in one aiming module is selected to be unsuitable for drilling the affected limb bone, the hole formed by the first hole site 211 in the other suitable aiming module after drilling and reaming the affected limb bone can be expanded to the hole drilled on the affected limb bone for the first time, so that excessive damage to the affected limb bone can be avoided.
When one aiming module is provided with at least two aiming hole distances, the aiming module supports the overturning of 180 degrees for use, and the overturning process is the operation of switching the eccentric distance. For example, in the vertical '8' holes, the offset distances between the two holes and the center are different, for example, the offset distances between the upper hole and the lower hole and the center are respectively 6mm and 4mm, and after the vertical holes are turned 180 degrees, the offset distances between the upper hole and the lower hole and the center are converted into 4mm and 6mm, so that aiming adjustment is realized quickly, and the vertical hole has better clinical value.
The intramedullary nail aiming arm in the embodiment has simple structure and reduced number of parts, omits the installation step of the lateral bracket in the prior equipment, and saves operation time for doctors. In addition, the lateral compression bar holes are not required to be drilled on the femur of a patient in operation, so that the trauma to the affected limb bones is reduced, and the risk of secondary fracture in the distal femur locking pin installation area is reduced. The second sighting piece is provided with a specific offset distance, so that offset adjustment of a sighting hole can be rapidly realized in operation, the operation of active fine adjustment in operation is saved, and the times of X-ray perspective of doctors and patients are effectively reduced.
A second embodiment of the invention relates to an intramedullary nail aiming arm 300. This second embodiment is substantially identical to the first embodiment described above, with the main difference that the first sight 51 in this second embodiment differs from the above-described embodiment in that the sight module 5 comprises a first sight 51 and a second sight 52 as shown in fig. 7 and 8. The first sight 51 includes a first sight body 511 coupled to the distal end of the gear lever and an adjustment block 512 movably coupled to the first sight body 511. The first aiming body 511 is provided with a first guide groove 5110 penetrating in the thickness direction thereof, and the first guide groove 5110 extends in the height direction of the first aiming body 511. The adjusting block 512 is provided with a guide hole 5120, the aperture of the guide hole 5120 is smaller than the slot length of the first guide slot 5110, the guide hole 5120 can be configured to be overlapped and communicated with any area of the first guide slot 5110 in the length direction, and the guide hole 5120 and the covered area of the first guide slot 5110 form a first hole site 510. The height direction of the first aiming body 511, the length direction of the gear lever, and the thickness direction of the first aiming body 511 are perpendicular to each other. The height direction of the first sight body 511, that is, the height direction of the first sight 51, the height direction of the second sight 52, and the height direction of the gear lever. The second sight 52 has the same structure as the above embodiment, and will not be described again.
Further, as shown in fig. 8 and 9, the adjusting block 512 at least partially covers the first guide groove 5110, is slidably connected to the first aiming body 511 along the height direction of the first aiming body 511, and at least partially covers the first guide groove 5110.
In addition, as shown in fig. 8 and 9, the adjusting block 512 includes a block 5122 having a guide hole 5120 and a guide rod 5123 movably connected to the block 5122. The guide rod 5123 is screw-coupled with the first aiming body 511. When the guide rod 5123 is matched with the first aiming body 511 to rotate, the guide rod 5123 moves towards the inside of the first guide groove 5110 so as to push the block 5122 to move along the height direction of the first aiming body 511, and when the guide rod 5123 rotates reversely, the guide rod 5123 moves towards the direction of unscrewing the first guide groove 5110 and drives the block 5122 to move so as to change the height of the guide hole 5120 on the first aiming body 511. The guide rod 5123 is movably connected with the block 5122, so that the block 5122 is not driven to rotate by the rotation of the guide rod 5123. In addition, the block 5122 is embedded in the first aiming body 511, and is abutted against the first aiming body 511, and is driven to move by the guide rod 5123.
As shown in fig. 8 and 9, the first hole site 510 is formed in the area where the guide hole 5120 covers the first guide groove 5110, and in this embodiment, the guide hole 5120 is a circular hole, the diameter of the guide hole 5120 is the same as the groove width of the guide groove, and the dimension of the guide groove extending along the length direction of the gear lever is the groove width. The diameter of the guide hole 5120 ranges from 7mm to 11mm, and the groove width of the first guide groove 5110 ranges from 7mm to 11mm, i.e., the size of the first hole site 510 in the above-described embodiment. In other embodiments, the slot width of the first guide slot 5110 may be different from the diameter of the guide hole 5120, so that the guide hole 5120 is overlapped to form a hole after the first guide slot 5110 is covered by the guide hole 5120 to be the first hole site 510, and the hole diameter of the guide hole 5120 may be any value of 7mm-11mm, such as 10mm, 9mm or 8mm, so that the width of the first guide slot 5110 is the same, and the guide hole 5120 is not necessarily circular, and the first hole site 510 is not necessarily circular, as the actual situation is set.
As shown in fig. 8 and 9, the first guide groove 5110 has a groove length ranging from 14mm to 16mm, and the optional first guide groove 5110 has a groove length ranging from 15mm or 15.5mm. The groove length of the first guide groove 5110 is a length extending in the height direction of the first aiming body 511.
In this example, as shown in fig. 7 and 8, an aiming mark position 5112 and an initial mark position 5113 are provided on the first aiming body 511. The specific embodiments are described in the above embodiments, and are not described herein.
In addition, as shown in fig. 9, a limiting groove 5114 is also disposed on the first aiming body 511, and the matching between the lock member 7 and the limiting groove 5114 is as in the above embodiment, which is specifically described in the above embodiment, and is not described herein again.
In addition, the first aiming body 511 is connected with the gear lever 1 through the locking connector 8, so that the first aiming body 511 and the gear lever 1 can be conveniently and rapidly locked or disassembled, and the structure is the same as that of the first embodiment and will not be described herein.
Further, as shown in fig. 7 and 8, an adjustment flag 5121 is provided on the adjustment block 512. The adjusting mark 5121 is disposed on the block 5122, the first aiming body 511 is provided with a hollow groove 5111, and the adjusting mark 5121 is at least partially located in the hollow groove 5111. The adjustment marker 5121 is used to point to the aiming marker bit 5112 or the initial marker bit 5113 when the adjustment block 512 is moved. Specifically, if the first hole site 510 is desired to be located at the aiming site, the adjustment block 512 may be moved to direct the adjustment marker 5121 toward the aiming marker site 5112, and the adjustment marker 5121 may be a triangular mark arrow. In this embodiment, there may be a plurality of aiming sites arranged along the length of the first guide groove 5110, thereby forming a plurality of first hole sites 510. Specifically, in use, when the drill bit is used to punch a pre-drilled hole in a patient's affected bone through the first hole site 510, if the drill bit is checked to pass through the screw hole in the intramedullary nail smoothly, the reaming is continued, but if the drill bit is checked to pass through the screw hole in the intramedullary nail smoothly, the adjusting block 512 is moved, the adjusting mark 5121 is pointed to the other aiming site to form another first hole site 510, and the drill bit is punched through the other first hole site 510.
The targeting module 5 in this embodiment may be used independently or in combination with the targeting module in the above embodiment during the same procedure. When the intramedullary nail aiming arm 300 includes only the aiming block 5 of the present embodiment, i.e., the aiming block 5 of the present embodiment is used independently, the method of use is specifically the method of use of the intramedullary nail aiming arm 300 of the first embodiment, and in use, as shown in fig. 7 and 8, when the intramedullary nail aiming arm 300 is mounted to the bone of the patient's limb, the second aiming member 52 is in the initial position in the initial state, i.e., the pointing indicia 522 is aligned with the initial marking position 5113. The method comprises the steps of firstly drilling a horizontal 'infinity' hole at the tail end of a second aiming member 52, namely a second hole 521, which is a pre-judging hole, shooting an X-ray film along the sagittal position of a patient limb, checking that a locking hole at the far end of an intramedullary nail is in an expected upward or downward direction, secondly selecting a first hole 510 in the first aiming member 51, firstly drilling a pre-drilling hole in the bone of the patient limb through the first hole 510 by using a 2.5mm drill bit, checking that the 2.5mm drill bit smoothly passes through a screw hole on the intramedullary nail, then reaming the hole to the expected diameter of 4-4.5mm by using a step drill, and completing the installation of a locking screw in the first hole 510, thirdly, adjusting that the central connecting line of the horizontal 'infinity' hole at the far end of the second aiming member 52 is on the same straight line with the center of the first hole 510 drilled by the drill bit in the second step, and finally installing the locking screw according to the steps of pre-drilling and reaming the hole. However, when the selected first hole site 510 is found to be unsuitable, the adjustment block 512 needs to be moved to form a new first hole site 510, and the above second and third steps are repeated. The size of the drilling holes can be adjusted according to implementation requirements.
The aiming module of the embodiment is replaced and installed on the gear lever, and the second step and the third step are repeated when the aiming module is not suitable in the use drawing and the drawing.
It is to be noted that the related technical details mentioned in the first embodiment are still valid in this embodiment, and are not repeated here for the sake of reducing repetition. Accordingly, the related-art details mentioned in the present embodiment can also be applied to the first embodiment.
A third implementation of the invention relates to an aiming module, which is an aiming module in the first embodiment or an aiming module in the second embodiment.
A fourth embodiment of the invention is directed to an intramedullary nail sight comprising an intramedullary nail sight arm and a handle 700 of either the first or second embodiment. The handle 700 is attached to the intramedullary nail aiming arm either indirectly through an adjustable connecting rod or directly.
It is to be noted that this embodiment is a system embodiment corresponding to the first embodiment, and this embodiment can be implemented in cooperation with the first embodiment. The related technical details mentioned in the first embodiment are still valid in this embodiment, and in order to reduce repetition, they are not described here again. Accordingly, the related-art details mentioned in the present embodiment can also be applied to the first embodiment.
While the preferred embodiments of the present invention have been described in detail above, it should be understood that aspects of the embodiments can be modified, if necessary, to employ aspects, features and concepts of the various patents, applications and publications to provide yet further embodiments.
These and other changes can be made to the embodiments in light of the above detailed description. In general, in the claims, the terms used should not be construed to be limited to the specific embodiments disclosed in the specification and the claims, but should be construed to include all possible embodiments along with the full scope of equivalents to which such claims are entitled.
It will be understood by those of ordinary skill in the art that the foregoing embodiments are specific examples of carrying out the invention and that various changes in form and details may be made therein without departing from the spirit and scope of the invention.
Claims (13)
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111904577A (en) * | 2020-08-17 | 2020-11-10 | 天津正天医疗器械有限公司 | Intramedullary nail sight and surgical instrument case containing the same |
| CN115137461A (en) * | 2022-07-19 | 2022-10-04 | 常州市康辉医疗器械有限公司 | Distal aiming system for femoral intramedullary nail |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7056322B2 (en) * | 2002-03-28 | 2006-06-06 | Depuy Orthopaedics, Inc. | Bone fastener targeting and compression/distraction device for an intramedullary nail and method of use |
| US8968324B2 (en) * | 2011-10-27 | 2015-03-03 | Kettering University | Adjustable jig and method for targeting interlocking holes of an intramedullary nail |
| WO2014194965A1 (en) * | 2013-06-07 | 2014-12-11 | Stryker Trauma Gmbh | Targeting adjustment system for an intramedullary nail |
| TWI678184B (en) * | 2014-04-25 | 2019-12-01 | 德派信迪思產品公司 | Aiming device system |
| CN214387632U (en) * | 2020-12-29 | 2021-10-15 | 北京市春立正达医疗器械股份有限公司 | Intramedullary nail distal aiming arm |
| CN215349374U (en) * | 2021-01-15 | 2021-12-31 | 宿迁市浩欣机械有限公司 | A suprapatellar approach tibial intramedullary nail stent |
| CN116831712A (en) * | 2022-03-25 | 2023-10-03 | 浙江德康医疗器械有限公司 | Intramedullary nail imbedding system and method |
| CN217696798U (en) * | 2022-05-31 | 2022-11-01 | 北京市春立正达医疗器械股份有限公司 | Telescopic femoral retrograde intramedullary nail aiming arm |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111904577A (en) * | 2020-08-17 | 2020-11-10 | 天津正天医疗器械有限公司 | Intramedullary nail sight and surgical instrument case containing the same |
| CN115137461A (en) * | 2022-07-19 | 2022-10-04 | 常州市康辉医疗器械有限公司 | Distal aiming system for femoral intramedullary nail |
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