CN215349263U - An osteotomy positioning device for periacetabular osteotomy - Google Patents

Abstract

The utility model relates to an osteotomy positioning device used for acetabular osteotomy around the acetabulum. Align to realize the positioning of the plate body; guide the cutting osteotomy slot to guide the saw blade for osteotomy; a number of pinholes, through which the Junkers wire is passed to fix the plate body on the ilium. The utility model is suitable for the steps of acetabular posterior column osteotomy in peripheral acetabular osteotomy, can obviously improve the accuracy and stability of acetabular posterior column osteotomy in PAO operation, and improve the convenience of the operator's osteotomy operation It can shorten the learning curve of PAO surgical techniques for doctors, and can reduce the risk of posterior column fracture of the acetabulum and sciatic nerve injury, which has important clinical application value.

Description

A cut bone positioner for cutting bone art around acetabulum

Technical Field

The utility model relates to the field of medical instruments, in particular to an osteotomy positioning device for acetabulum periphery osteotomy.

Background

Background: developmental dysplasia of the hip (DDH) is a common developmental disease, with the progress of the disease, the dysplasia has a shallow acetabulum overall, the coverage area of the femoral head is reduced, the matching degree between the articular surfaces is lost, so that the local stress of the hip joint is abnormally concentrated and the stress is increased, the articular cartilage can not bear the stress increase finally, the hip joint osteoarthritis develops gradually, the hip joint dysplasia is one of the main causes of hip pain, the life and the work of a patient are seriously affected, and the disability rate is high. Therefore, the osteotomy around the acetabulum is carried out at the same time, and the acetabulum is rotated as a whole by using various osteotomy methods so as to achieve the purpose of strengthening the acetabulum coverage and finally correct the anatomical deformity on the acetabulum side. The reconstruction Osteotomy for treating DDH of teenagers and adults, which is popular in the world at present, is Bernese per vertebral bone Osteotomy (PAO), achieves satisfactory correction effect, the Osteotomy is polygonal near-joint Osteotomy, the posterior pelvic column keeps continuity, the sciatic nerve is protected, and the postoperative true pelvic form keeps unchanged, so that the normal delivery of female patients is allowed, the operation reduces the use of internal fixation to the maximum extent, and the patients are allowed to early keep double-crutches to move downwards, so that the reconstruction Osteotomy becomes the common operation for DDH Osteotomy hip protection operations of joint surgeons (figure 6).

Specifically, the PAO osteotomy procedure is generally divided into four main steps in the order of priority: ischial osteotomy, pubic osteotomy, iliac osteotomy, acetabular posterior column osteotomy. The osteotomy positioner designed by the utility model is suitable for a key surgical link of acetabular posterior column osteotomy, and the traditional surgical operation is as follows: the hip is bent by 45 degrees and the lower limb is rotated outwards, the ilium tetragon, the ischium greater incisure and the ischium spine are fully exposed, the acetabular posterior column osteotomy (the osteotomy line is about 1.5cm away from the ischium greater incisure) is made by a osteotome, and the osteotomy line and the ischium osteotomy line are respectively connected, so that the osteotomy block is completely dissociated so as to carry out the rotation correction of the acetabular osteotomy block.

The prior art mainly has the following defects: firstly, because no auxiliary tool suitable for positioning the post osteotomy line after the PAO operation exists at present, most of joint surgeons can only perform osteotomy operation by visually observing the angles of the ischial osteotomy line and the iliac osteotomy line when performing the post osteotomy, so that the requirements on the operation experience and the technique of the surgeons are extremely high, a long learning curve is often needed to achieve accurate post osteotomy, and the development of the operation technique is limited to a certain extent. Secondly, because the position of the acetabulum posterior column is deep, when the osteotome is used for cutting the acetabulum posterior column, the acetabulum posterior column is easy to slip, and the acetabulum posterior column is easy to split. Particularly for patients with a slightly older age (30-40 years old), the posterior acetabular column is easy to split along the osteotomy line direction during osteotomy due to hard bone, so that the posterior acetabular column is fractured. In addition, the sciatic nerve goes out of the pelvis through the inferior hole of the piriformis under most conditions, if the sciatic nerve goes out of the pelvis through the superior hole of the piriformis, the risk of injuring the nerve is greatly increased, the continuity of the posterior column of the pelvis is particularly ensured during the osteotomy operation, the surgical visual field is limited in the osteotomy around the acetabulum, the surgical space is extremely small, the visual field is shielded under the condition of protecting the bone pry, the surgical space left for the osteotome is more limited, the operational stability and accuracy of the osteotomy are difficult to ensure, and the risk of injuring the sciatic nerve is increased. Finally, if there is a large deviation between the angle of the posterior column osteotomy and the preoperative design, the osteotomy block is difficult to rotate to the correct correction position, so that an ideal surgical effect cannot be achieved, which increases the risk of surgical failure and finally affects the hip joint function and the life quality of the patient. Therefore, the acetabulum posterior column osteotomy is a key step of the PAO operation, has high requirements on osteotomy accuracy and stability, once soft tissue injury, acetabulum posterior column fracture and sciatic nerve injury occur in the osteotomy process, the limb movement of a patient is limited, and other serious adverse consequences are caused, however, the existing osteotomy tool is difficult to meet the requirements of the osteotomy on osteotomy accuracy and operation convenience, and an osteotomy auxiliary tool capable of increasing the osteotomy accuracy is urgently needed.

Disclosure of Invention

The utility model aims to provide an osteotomy positioning device for acetabulum periphery osteotomy aiming at the defects of the existing PAO technology and an osteotomy tool, which is suitable for the step of acetabulum posterior column osteotomy in the acetabulum periphery osteotomy, can obviously improve the accuracy and stability of acetabulum posterior column osteotomy in the PAO operation, improve the convenience of osteotomy operation of an operator, shorten the learning curve of a doctor to the PAO operation technology, reduce the risk of acetabulum posterior column fracture and sciatic nerve injury, and has important clinical application value.

The purpose of the utility model is realized by the following steps: an osteotomy positioning device for osteotomy around acetabulum comprises a plate body 1, wherein the plate body 1 is provided with a plurality of holes

A positioning osteotomy slot 11 for aligning with an already cut osteotomy line to effect positioning of the plate body 1;

a guide cutting osteotomy groove 12 for guiding the saw blade to perform osteotomy;

a plurality of needle holes 13, through which the Rogowski needle passes to fix the plate body 1 on the ilium.

The utility model has the following advantages:

1. compared with the traditional operation, the utility model can more accurately position the position of the posterior column osteotomy line by a doctor without completely depending on visual inspection, thereby greatly improving the accuracy of the acetabular posterior column osteotomy.

2. The utility model can be used as a pre-osteotomy positioning tool in the acetabulum posterior column osteotomy operation of a patient with thick pelvis bone thickness (the thickness of the bone cortex is larger than that of the reciprocating saw blade), and particularly, an electric reciprocating saw can be used for pre-cutting the pelvis inner plate part under the positioning of the utility model, then the utility model is taken down, and the osteotomy lines are connected together by using an osteotome, so that the accuracy and the safety of the acetabulum posterior column osteotomy are obviously improved.

3. The two osteotomy slots are designed to enable an operator to conveniently observe the positions of the iliac osteotomy line and the ischial osteotomy line, and meanwhile, the reciprocating saw blade can be inserted into the posterior column osteotomy slot of the positioner to perform in-slot osteotomy, so that the saw blade can stably perform posterior column osteotomy under the protection of the osteotomy slot, and the accuracy and the operation convenience of the acetabular posterior column osteotomy are obviously improved.

4. The osteotomy can enable a doctor to operate in the guide osteotomy cutting groove, so that an osteotomy path of the posterior column osteotomy can be seen without excessively pressing or pulling surrounding soft tissues in the osteotomy, the acetabulum posterior column osteotomy is completed, the operation space of an operator is increased, meanwhile, the soft tissues such as blood vessels, nerves, muscles and the like in an operation area are effectively protected, the recovery and rehabilitation exercise of a patient are facilitated, and the incidence rate of complications such as sciatic nerve injury and the like is reduced.

Drawings

FIG. 1 is a schematic view of the overall structure of the present invention;

FIG. 2 is a cross-sectional view taken at A-A of FIG. 1;

FIG. 3 is a cross-sectional view taken at B-B of FIG. 1;

FIG. 4 is a left side view of FIG. 1;

FIG. 5 is a bottom view of FIG. 1;

FIG. 6 is a schematic diagram of PAO osteotomy principle. Wherein, A is the sciatic part and is cut; b, cutting the pubic bone; c, cutting the ilium; d, acetabular posterior column osteotomy.

Description of reference numerals: 1 plate body, 11 positioning osteotomy grooves, 12 guide cutting osteotomy grooves, 13 pinholes and 14 bending parts.

Detailed Description

The utility model is described in detail below with reference to the following description of the drawings:

as shown in fig. 1-5: an osteotomy positioning device for osteotomy around acetabulum comprises a plate body 1, wherein the plate body 1 is provided with a plurality of holes

A positioning osteotomy slot 11 for aligning with an already cut osteotomy line to effect positioning of the plate body 1;

a guide cutting osteotomy groove 12 for guiding the saw blade to perform osteotomy;

a plurality of needle holes 13, through which the Rogowski needle passes to fix the plate body 1 on the ilium.

The positioning osteotomy slots 11 are intended to be aligned with the osteotomy lines that have been cut, and in practice, the positioning osteotomy slots 11 are intended to be aligned primarily in registration with the ischial osteotomy lines.

The left side part region of plate body 1 is inwards buckled and is formed bending portion 14, the contained angle of buckling is 20 ~ 25 degrees, the bending portion 14 is with the recess laminating bow line that plate body 1 formed.

The pinholes 13 are distributed on the bending part 14 on the left side of the plate body 1 from front to back in sequence.

The positioning osteotomy grooves 11 are distributed on the right part of the plate body 1 in the front-back direction; the guide cutting osteotomy groove 12 is distributed on the plate body 1 in the left-right direction, the right end of the guide cutting osteotomy groove 12 is connected to the positioning osteotomy groove 11, and the end of the positioning osteotomy groove 11 extends to the left edge of the plate body 1.

The specific use mode of the utility model is as follows:

when in use, the utility model is attached to a designated area, the positioning osteotomy groove 11 is adjusted to be aligned with the ischial osteotomy line in a superposition way, simultaneously, the rear edge of the utility model is attached to the ischial major incisal trace, and the bending part 14 is attached to the arc line of the groove formed by the plate body 1;

then, a kirschner wire is driven into a hole position to penetrate through the ilium to realize the fixation of the utility model, and the position of the guide cutting osteotomy groove 12 is the corresponding position of the posterior column osteotomy line;

and then using an electric reciprocating saw to perform acetabulum posterior column osteotomy operation through the osteotomy groove.

Compared with the traditional operation, the position of the acetabulum posterior column osteotomy line can be more accurately positioned by a doctor without completely depending on visual inspection, so that the acetabulum posterior column osteotomy accuracy is greatly improved.

In addition, the utility model can also be applied to the acetabulum posterior column osteotomy operation of a patient with thick pelvis bone (the thickness of the bone cortex is larger than that of the reciprocating saw blade). The bone cutting device can be used as a pre-cutting positioning tool, during operation, the bone cutting device is positioned in advance, the electric reciprocating saw is used for cutting off the inner plate part of the pelvis in advance, then the bone cutting device is taken down, and the bone cutting lines are connected together by using the osteotome, so that the accuracy and the safety of the acetabulum posterior column bone cutting are obviously improved.

The front direction, the rear direction, the left direction and the right direction recorded in the scheme are relative positions, and can be adjusted according to the limb of the affected side, specifically, mirror symmetry design can be performed according to the expression of the scheme, namely the limb of the affected side which needs to be corrected is divided into a left side positioner and a right side positioner.

In conclusion, the utility model can be applied to the step of acetabulum posterior column osteotomy in the acetabulum periphery osteotomy, can obviously improve the accuracy and stability of the acetabulum posterior column osteotomy in the operation, can simultaneously reduce the risks of acetabulum posterior column fracture and sciatic nerve injury, is beneficial to improving the osteotomy and hip protection operation effects of developmental hip joint dysplasia patients, and has important clinical application value and social value.

While the utility model has been illustrated and described with respect to specific embodiments and alternatives thereof, it will be understood that various changes and modifications can be made without departing from the spirit and scope of the utility model. It is understood, therefore, that the utility model is not to be in any way limited except by the appended claims and their equivalents.

Claims (4)

1. An osteotomy positioning device for a periacetabular osteotomy, comprising: it comprises a plate body (1), wherein the plate body (1) is provided with

A positioning osteotomy slot (11) for aligning with an already cut osteotomy line to effect positioning of the plate body (1);

a guide cutting osteotomy groove (12) for guiding the saw blade to perform osteotomy;

a plurality of needle holes (13), the Korotkoff's needles penetrate to fix the plate body (1) on the ilium.

2. An osteotomy positioning device for a periacetabular osteotomy as defined in claim 1, wherein:

the left side part region incurving of plate body (1) forms bending portion (14), the contained angle of buckling is 20 ~ 25 degrees, the recess laminating bow line that bending portion (14) and plate body (1) formed.

3. An osteotomy positioning device for a periacetabular osteotomy as defined in claim 2, wherein:

the plurality of pinholes (13) are sequentially distributed on the bending part (14) on the left side of the plate body (1) from front to back.

4. An osteotomy positioning device for a periacetabular osteotomy as defined in claim 1, wherein:

the positioning osteotomy grooves (11) are distributed on the right part of the plate body (1) in the front-back direction; the guide cutting osteotomy groove (12) is distributed on the plate body (1) in the left-right direction, the right end of the guide cutting osteotomy groove (12) is connected to the positioning osteotomy groove (11), and the left end of the positioning osteotomy groove (11) extends to the left side edge of the plate body (1).

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