技术领域technical field
本发明属于人工全髋关节置换手术用模板技术领域，特别是一种定制个体化人工全髋关节置换手术股骨制备模板系统。The invention belongs to the technical field of templates for artificial total hip replacement surgery, in particular to a customized and individualized femur preparation template system for artificial total hip replacement surgery.
背景技术Background technique
人工全髋关节置换术是目前国际上治疗髋关节疾病最为有效的手段之一，其治疗效果获得了全世界范围内医生和患者的一致认可。但影响手术效果的关键因素之一在于人工全髋关节假体的位置以及假体植入体内后能否恢复正常的髋关节解剖以及生物力学特性，例如下肢长度、髋关节旋转中心、偏心距、假体大小、位置、角度以及假体与骨的接触特点等，这些都是由手术技术和患者解剖特点决定的，这些因素解决与否直接影响者手术近期乃至远期的效果。因此，针对患者固有的解剖数据制备个体化手术模板，对术中能够根据患者个体的解剖特点进行精确截骨及骨床的处理制备，可获得理想的股骨假体在体内的位置，从而极大改善术后效果，防止脱位、下肢不等长及假体不匹配所致的撞击、下沉等并发症。目前针对人工全髋关节置换术的股骨制备模板仍属空白。Total hip replacement is currently one of the most effective means of treating hip joint diseases in the world, and its therapeutic effect has been unanimously recognized by doctors and patients all over the world. However, one of the key factors affecting the effect of surgery is the position of the artificial total hip joint prosthesis and whether the normal hip joint anatomy and biomechanical characteristics can be restored after the prosthesis is implanted in the body, such as the length of the lower limb, the center of rotation of the hip joint, eccentricity, The size, position, angle of the prosthesis and the characteristics of the contact between the prosthesis and the bone are all determined by the surgical technique and the anatomical characteristics of the patient. Whether these factors are resolved will directly affect the short-term and even long-term effects of the operation. Therefore, the individualized surgical template can be prepared according to the patient's inherent anatomical data, and the precise osteotomy and bone bed can be prepared according to the patient's individual anatomical characteristics during the operation, and the ideal position of the femoral prosthesis in the body can be obtained, thereby greatly Improve the postoperative effect and prevent complications such as dislocation, unequal length of lower limbs, and impingement and subsidence caused by mismatching prostheses. Currently, the femur preparation template for total hip arthroplasty is still blank.
发明内容Contents of the invention
本发明的目的在于提供一种定制个体化人工全髋关节置换手术股骨制备模板系统，在人工全髋关节手术中，影响手术效果的关键因素之一在于股骨颈截骨面的位置，以及股骨假体置入的正确角度，例如前倾角和在髓腔中的位置以及大小、偏心距等。因此如何能正确地安放股骨假体是决定性的技术因素之一。为此，本发明设计一种能够获得理想股骨假体位置的截骨及安放模板系统。The purpose of the present invention is to provide a customized femur preparation template system for artificial total hip joint replacement surgery. In artificial total hip joint surgery, one of the key factors affecting the surgical effect is the position of the osteotomy surface of the femoral neck and the position of the femoral prosthesis. The correct angle of body placement, such as anteversion angle, position and size, eccentricity in the medullary cavity, etc. Therefore, how to place the femoral prosthesis correctly is one of the decisive technical factors. For this reason, the present invention designs a kind of osteotomy and placement template system that can obtain ideal femoral prosthesis position.
为解决上述技术问题，本发明采用以下技术方案予以实现：In order to solve the above-mentioned technical problems, the present invention adopts the following technical solutions to achieve:
一种定制个体化人工全髋关节置换手术股骨制备模板系统，所述股骨制备模板系统包括股骨颈截骨导向板和股骨假体前倾角及外侧缘导向板，A femur preparation template system for customized individual artificial total hip replacement surgery, the femur preparation template system includes a femoral neck osteotomy guide plate and a femoral prosthesis anteversion angle and lateral edge guide plate,
所述股骨颈截骨导向板的内表面与股骨头、股骨颈及股骨大小转子间区的解剖形状吻合，所述股骨颈截骨导向板上开设有截骨定位槽；The inner surface of the femoral neck osteotomy guide plate coincides with the anatomical shape of the femoral head, the femoral neck and the intertrochanteric region of the femur, and the femoral neck osteotomy guide plate is provided with an osteotomy positioning groove;
所述股骨假体前倾角及外侧缘导向板的底部形状与股骨颈截骨面吻合，所述股骨假体前倾角及外侧缘导向板包括体部，所述体部上开设有前倾角及外侧缘导向槽。The anteversion angle of the femoral prosthesis and the bottom shape of the lateral edge guide plate coincide with the osteotomy surface of the femoral neck. Edge guide groove.
如上所述的定制个体化人工全髋关节置换手术股骨制备模板系统，所述前倾角及外侧缘导向槽的方向与根据股骨颈解剖数据测量的股骨颈前倾角相同。In the customized femoral preparation template system for individual artificial total hip replacement surgery described above, the anteversion angle and the direction of the lateral edge guide groove are the same as the anteversion angle of the femoral neck measured according to the anatomical data of the femoral neck.
如上所述的定制个体化人工全髋关节置换手术股骨制备模板系统，所述前倾角及外侧缘导向槽的外侧边缘位于股骨髓腔外侧皮质内表面的近端延长线上。In the above-mentioned custom-made individual artificial total hip replacement surgery femur preparation template system, the anteversion angle and the lateral edge of the lateral edge guide groove are located on the proximal extension line of the inner surface of the lateral cortex of the femoral medullary cavity.
如上所述的定制个体化人工全髋关节置换手术股骨制备模板系统，所述股骨颈截骨导向板包括用于贴附于大转子尖内侧的大转子定位翼、用于贴附于小转子尖顶端的小转子定位翼以及用于贴附于股骨头、股骨颈移行区的头颈移行区定位翼。According to the customized and individualized artificial total hip replacement surgery femur preparation template system described above, the femoral neck osteotomy guide plate includes a greater trochanter positioning wing for attaching to the inside of the greater trochanter tip, and a positioning wing for attaching to the lesser trochanter tip. The lesser trochanter positioning wing at the top and the head and neck transition zone positioning wing for attaching to the femoral head and femoral neck transition zone.
如上所述的定制个体化人工全髋关节置换手术股骨制备模板系统，所述股骨假体前倾角及外侧缘导向板包括设置在体部上的小转子定位翼和前侧翼，所述小转子定位翼用于根据股骨近端解剖形状贴附于股骨颈截骨面至小转子尖的骨面上，所述前侧翼用于根据股骨近端解剖形状贴附于股骨近端前方骨面上。As mentioned above, the femur preparation template system for customized individual artificial total hip replacement surgery, the anteversion angle of the femoral prosthesis and the lateral edge guide plate include the lesser trochanter positioning wing and the front flank arranged on the body, and the lesser trochanter positioning The wings are used to be attached to the bone surface from the osteotomy surface of the femoral neck to the tip of the lesser trochanter according to the anatomical shape of the proximal femur, and the anterior wings are used to be attached to the anterior bone surface of the proximal femur according to the anatomical shape of the proximal femur.
与现有技术相比，本发明的优点和积极效果是：本发明定制个体化人工全髋关节置换手术股骨制备模板系统针对患者的解剖数据进行个体化精确定制，利用股骨颈截骨导向板可对股骨颈实施精确截骨，利用股骨假体前倾角及外侧缘导向板的前倾角及外侧缘导向槽所指示的方向制备股骨髓腔，可获取假体在股骨髓腔中的理想插入位置，以便对股骨假体的位置在术中进行精确安放；可严格控制并在术中实施与术前设计相同的针对患者特定解剖数据的假体安放的各种合适的角度、深度、距离和假体大小，从而精确控制理想的人工全髋关节股骨假体在体内的位置，避免因假体位置不良所产生的髋关节脱位、假体撞击、下沉、下肢不等长、假体内外翻位放置产生的尺寸过小、大腿疼痛等并发症，进而改善手术效果。Compared with the prior art, the advantages and positive effects of the present invention are: the femur preparation template system for customizing individual artificial total hip joint replacement surgery of the present invention is individually and accurately customized for the patient's anatomical data, and the femoral neck osteotomy guide plate can be used to Perform precise osteotomy on the femoral neck, and use the anteversion angle of the femoral prosthesis and the anteversion angle of the lateral border guide plate and the direction indicated by the lateral border guide groove to prepare the femoral medullary cavity, so as to obtain the ideal insertion position of the prosthesis in the femoral medullary cavity. In order to accurately place the position of the femoral prosthesis during the operation; various suitable angles, depths, distances and prostheses can be strictly controlled and implemented intraoperatively for the same patient-specific anatomical data as the preoperative design size, so as to accurately control the position of the ideal artificial total hip femoral prosthesis in the body, and avoid hip dislocation, prosthesis impingement, sinking, unequal length of lower limbs, and valgus placement of the prosthesis due to poor prosthesis position Complications such as undersizing and thigh pain can be avoided, thereby improving surgical outcomes.
结合附图阅读本发明实施方式的详细描述后，本发明的其他特点和优点将变得更加清楚。Other features and advantages of the present invention will become more apparent after reading the detailed description of the embodiments of the present invention in conjunction with the accompanying drawings.
附图说明Description of drawings
图1是本发明具体实施例股骨颈截骨导向板的结构示意图。Fig. 1 is a schematic structural view of a femoral neck osteotomy guide plate according to a specific embodiment of the present invention.
图2是本发明具体实施例股骨的结构示意图。Fig. 2 is a schematic structural view of a femur according to a specific embodiment of the present invention.
图3是本发明具体实施例股骨与股骨颈截骨导向板的组合结构示意图。Fig. 3 is a schematic diagram of the combined structure of a femur and a femoral neck osteotomy guide plate according to a specific embodiment of the present invention.
图4是本发明具体实施例股骨截骨后的结构示意图。Fig. 4 is a schematic structural view of a femur after osteotomy according to a specific embodiment of the present invention.
图5是图4A向的结构示意图Fig. 5 is a schematic structural diagram of Fig. 4A
图6是本发明具体实施例股骨假体前倾角及外侧缘导向板的结构示意图。Fig. 6 is a schematic structural view of the anteversion angle of the femoral prosthesis and the lateral edge guide plate according to a specific embodiment of the present invention.
图7是本发明具体实施例股骨假体前倾角及外侧缘导向板与股骨截骨后的组合结构示意图。Fig. 7 is a schematic diagram of the combined structure of the anteversion angle of the femoral prosthesis and the lateral edge guide plate and femoral osteotomy according to a specific embodiment of the present invention.
具体实施方式detailed description
本发明提出了一种定制个体化人工全髋关节置换手术股骨制备模板系统。利用股骨制备模板系统确定对股骨颈实施精确截骨，并制备股骨髓腔，获取假体的理想插入位置，以便对股骨假体的位置在术中进行精确安放，控制人工全髋关节股骨假体在体内的理想位置，改善手术效果。The present invention proposes a custom-made and individualized artificial total hip joint replacement surgery femur preparation template system. Use the femoral preparation template system to determine the precise osteotomy of the femoral neck and prepare the femoral medullary cavity to obtain the ideal insertion position of the prosthesis, so that the position of the femoral prosthesis can be placed accurately during the operation, and the femoral prosthesis of the artificial total hip joint can be controlled Ideal position in the body to improve surgical results.
下面结合附图，通过具体实施例对本发明的实现方式进行具体说明：Below in conjunction with accompanying drawing, the realization mode of the present invention is described in detail by specific embodiment:
如图1-7所示，本实施例提出了一种定制个体化人工全髋关节置换手术股骨制备模板系统，包括股骨颈截骨导向板1和股骨假体前倾角及外侧缘导向板2。股骨颈截骨导向板1用于确定股骨3的截骨位置，股骨颈截骨导向板1通过大转子定位翼101、小转子定位翼102和头颈移行区定位翼103进行定位，并通过截骨定位槽104确定截骨位置进行截骨。截骨后，股骨假体前倾角及外侧缘导向板2用于确定假体在股骨髓腔内的理想插入位置，通过小转子定位翼201和前侧翼202将股骨假体前倾角及外侧缘导向板2定位在股骨颈截骨面4上，通过体部203上的前倾角及外侧缘导向槽204获取假体的理想插入位置。As shown in FIGS. 1-7 , this embodiment proposes a customized and individualized template system for preparing femur in total hip replacement surgery, including a femoral neck osteotomy guide plate 1 and a femoral prosthesis anteversion angle and lateral edge guide plate 2 . The femoral neck osteotomy guide plate 1 is used to determine the osteotomy position of the femur 3. The femoral neck osteotomy guide plate 1 is positioned through the positioning wing 101 of the greater trochanter, the positioning wing 102 of the lesser trochanter, and the positioning wing 103 of the transition zone of the head and neck. The positioning slot 104 determines the osteotomy position for osteotomy. After osteotomy, the femoral prosthesis anteversion angle and the lateral edge guide plate 2 are used to determine the ideal insertion position of the prosthesis in the femoral medullary cavity, and guide the femoral prosthesis anteversion angle and the lateral edge through the lesser trochanter positioning wing 201 and the anterior lateral wing 202 The plate 2 is positioned on the osteotomy surface 4 of the femoral neck, and the ideal insertion position of the prosthesis is obtained through the anteversion angle on the body 203 and the guide groove 204 on the lateral edge.
本实施例的股骨颈导向板1的内表面与股骨头31、股骨颈32及股骨大小转子间区33的解剖形状吻合，股骨颈截骨导向板1包括大转子定位翼101、小转子定位翼102和头颈移行区定位翼103，股骨颈截骨导向板1上还开设有截骨定位槽104。下面进行具体说明：The inner surface of the femoral neck guide plate 1 of the present embodiment coincides with the anatomical shape of the femoral head 31, the femoral neck 32, and the intertrochanteric area 33 of the femur. 102 and head and neck transition zone positioning wings 103, the osteotomy positioning slot 104 is also opened on the femoral neck osteotomy guide plate 1. Specific instructions are given below:
大转子定位翼101，用于贴附于大转子34尖内侧，与大转子34相配合以进行定位；The greater trochanter positioning wing 101 is used to be attached to the inside of the tip of the greater trochanter 34 and cooperate with the greater trochanter 34 for positioning;
小转子定位翼102，用于贴附于小转子35尖顶端，与小转子35相配合以进行定位；The lesser trochanter positioning wing 102 is used to be attached to the tip of the lesser trochanter 35 and cooperate with the lesser trochanter 35 for positioning;
头颈移行区定位翼103，用于贴附于股骨头、股骨颈移行区36，与股骨头、股骨颈移行区36相配合以进行定位；The head and neck transition zone positioning wing 103 is used to attach to the femoral head and the femoral neck transition zone 36, and cooperate with the femoral head and the femoral neck transition zone 36 for positioning;
股骨颈导向板1上还开设有截骨定位槽104，优选的，截骨定位槽104设置在头颈移行区定位翼103上，用于确定截骨位置。An osteotomy positioning groove 104 is also provided on the femoral neck guide plate 1 , preferably, the osteotomy positioning groove 104 is provided on the head and neck transition zone positioning wing 103 for determining the osteotomy position.
股骨假体前倾角及外侧缘导向板2用于将股骨头31截掉后，贴附定位在股骨颈截面4上。股骨假体前倾角及外侧缘导向板2的底部形状与股骨颈截骨面4吻合，股骨假体前倾角及外侧缘导向板2包括体部203、设置在体部203上的小转子定位翼201和前侧翼202，体部203上开设有前倾角及外侧缘导向槽204。下面进行具体说明：The anteversion angle of the femoral prosthesis and the lateral edge guide plate 2 are used to attach and position the femoral head 31 on the femoral neck section 4 after cutting off the femoral head 31 . The anteversion angle of the femoral prosthesis and the bottom shape of the lateral edge guide plate 2 coincide with the osteotomy surface 4 of the femoral neck. 201 and the front side wings 202, the body 203 is provided with a forward angle and an outer edge guide groove 204. Specific instructions are given below:
小转子定位翼201，用于根据股骨近端解剖形状贴附于股骨颈截骨面4至小转子35尖的骨面上，与小转子35相配合以进行定位；The lesser trochanter positioning wing 201 is used to attach to the bone surface from the femoral neck osteotomy surface 4 to the tip of the lesser trochanter 35 according to the anatomical shape of the proximal femur, and cooperate with the lesser trochanter 35 for positioning;
前侧翼202，用于根据股骨近端解剖形状贴附于股骨近端前方骨面上，与股骨近端前方骨面相配合以进行定位。The front flank 202 is used to attach to the anterior bone surface of the proximal femur according to the anatomical shape of the proximal femur, and cooperate with the anterior bone surface of the proximal femur for positioning.
前倾角及外侧缘导向槽204的方向与根据股骨颈解剖数据测量的股骨颈前倾角相同。The anteversion angle and the direction of the lateral edge guide groove 204 are the same as the anteversion angle of the femoral neck measured according to the anatomical data of the femoral neck.
前倾角及外侧缘导向槽204的外侧边缘位于股骨髓腔外侧皮质内表面的近端延长线上。The outer edge of the anteversion angle and outer edge guide groove 204 is located on the proximal extension line of the inner surface of the outer cortex of the femoral medullary canal.
本实施例的股骨颈截骨导向板1和股骨假体前倾角及外侧缘导向板2需要根据个体化股骨3的解剖形状分别加工，股骨颈截骨导向板1和股骨假体前倾角及外侧缘导向板2的获取过程如下：The femoral neck osteotomy guide plate 1 and the femoral prosthesis anteversion angle and the lateral edge guide plate 2 of the present embodiment need to be processed respectively according to the anatomical shape of the individual femur 3, and the femoral neck osteotomy guide plate 1 and the femoral prosthesis anteversion angle and the lateral edge The acquisition process of edge guide plate 2 is as follows:
先将患者的髋关节影像数据资料，例如CT或MRI数据利用特定软件进行三维重建，确定股骨头旋转中心、股骨颈干角、前倾角、偏心距、股骨髓腔宽度等解剖数据。确定合适的股骨颈截骨角度、偏心距、股骨假体的近端及远端尺寸大小、前倾角等数据。在软件中选取手术中可以确定显露的骨性解剖标志，逆向求得反向模型，设计生成模板文件，在3D打印设备中利用特定材料如医用塑料或金属材料进行3D打印，制作股骨制备模板系统。First, the imaging data of the patient's hip joint, such as CT or MRI data, is reconstructed using specific software to determine anatomical data such as the center of rotation of the femoral head, femoral neck-shaft angle, anteversion angle, eccentricity, and width of the femoral canal. Determine the appropriate femoral neck osteotomy angle, eccentricity, proximal and distal dimensions of the femoral prosthesis, anteversion angle and other data. Select the bony anatomical landmarks that can be identified during the operation in the software, reversely obtain the reverse model, design and generate template files, use specific materials such as medical plastic or metal materials for 3D printing in the 3D printing equipment, and make a femur preparation template system .
手术当中对股骨3脱位显露股骨头31、股骨颈32及股骨近端37，将定制的股骨颈截骨导向板1安放在股骨头颈区，使大转子定位翼101贴附于大转子34尖内侧解剖标志；小转子定位翼102贴附于小转子35尖顶端解剖标志；头颈移行区定位翼103贴附于股骨头、股骨颈移行区36。根据股骨颈截骨导向板1上的截骨定位槽104实施股骨颈截骨。During the operation, the femoral head 31, the femoral neck 32 and the proximal femur 37 were exposed during the dislocation of the femur 3, and the custom-made femoral neck osteotomy guide plate 1 was placed on the femoral head and neck area, so that the greater trochanter positioning wing 101 was attached to the inner side of the greater trochanter 34 tip Anatomical landmarks; the lesser trochanter positioning wing 102 is attached to the anatomical landmark at the tip of the lesser trochanter 35; the head and neck transition zone positioning wing 103 is attached to the femoral head and the femoral neck transition zone 36. The femoral neck osteotomy is implemented according to the osteotomy positioning groove 104 on the femoral neck osteotomy guide plate 1 .
将股骨假体前倾角及外侧缘导向板2安放在股骨颈截骨面4上，使导向板体部203贴附在股骨颈截骨面4上；小转子定位翼201贴附于股骨颈截骨面4至小转子35尖端的骨面上；前侧翼202贴附于股骨近端37前方骨面上；利用体部203的前倾角及外侧缘导向槽204所指示的方向和假体外侧缘的位置，使用各人工全髋关节假体系统自带的股骨髓腔锉制备股骨髓腔，即可选取术前测量大小的股骨假体按照前倾角及外侧缘导向槽204所指示的方向进行安放，导向槽204的外侧边缘即为假体外侧缘的理想插入位置。然后选取术前测量的合适偏心距的股骨头假体安放、复位完成全部假体的植入。Place the femoral prosthesis anteversion angle and lateral edge guide plate 2 on the femoral neck osteotomy surface 4, so that the guide plate body 203 is attached to the femoral neck osteotomy surface 4; the lesser trochanter positioning wing 201 is attached to the femoral neck osteotomy surface. Bone surface 4 to the bone surface of the tip of the lesser trochanter 35; the anterior wing 202 is attached to the bone surface in front of the proximal end of the femur 37; the direction indicated by the anteversion angle of the body 203 and the lateral edge guide groove 204 and the lateral edge of the prosthesis Use the femoral canal rasp that comes with each artificial total hip joint prosthesis system to prepare the femoral medullary canal, and then select the femoral prosthesis measured before operation and place it in the direction indicated by the anteversion angle and the guide groove 204 on the lateral edge , the outer edge of the guide groove 204 is the ideal insertion position of the outer edge of the prosthesis. Then select the femoral head prosthesis with the appropriate eccentricity measured before operation, place it, and reset to complete the implantation of all prostheses.
最后应说明的是：以上实施例仅用以说明本发明的技术方案，而非对其限制；尽管参照前述实施例对本发明进行了详细的说明，本领域的普通技术人员应当理解：其依然可以对前述各实施例所记载的技术方案进行修改，或者对其中部分技术特征进行等同替换；而这些修改或者替换，并不使相应技术方案的本质脱离本发明各实施例技术方案的精神和范围。Finally, it should be noted that: the above embodiments are only used to illustrate the technical solutions of the present invention, rather than to limit them; although the present invention has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that: it can still be Modifications are made to the technical solutions described in the foregoing embodiments, or equivalent replacements are made to some of the technical features; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the various embodiments of the present invention.
| Application Number | Priority Date | Filing Date | Title |
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| CN201510244810.6ACN104983486B (en) | 2015-05-14 | 2015-05-14 | Customization individuation artificial full hip-joint replacement operation femur prepares template system |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510244810.6ACN104983486B (en) | 2015-05-14 | 2015-05-14 | Customization individuation artificial full hip-joint replacement operation femur prepares template system |
| Publication Number | Publication Date |
|---|---|
| CN104983486A CN104983486A (en) | 2015-10-21 |
| CN104983486Btrue CN104983486B (en) | 2017-01-04 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201510244810.6AActiveCN104983486B (en) | 2015-05-14 | 2015-05-14 | Customization individuation artificial full hip-joint replacement operation femur prepares template system |
| Country | Link |
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| CN (1) | CN104983486B (en) |
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| CN201168001Y (en)* | 2008-01-24 | 2008-12-24 | 马卫华 | Guider for cutting neck of femur |
| CN102283726A (en)* | 2011-05-26 | 2011-12-21 | 祝桂涛 | Positioning device for bone-cutting angle and anteversion angle of femoral neck |
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| TR01 | Transfer of patent right | Effective date of registration:20181019 Address after:201203 Pudong New Area, Shanghai, China (Shanghai) free trade pilot area, 1690 2, Cai Lun Road, 311 room. Patentee after:Shanghai longhui Medical Technology Co., Ltd. Address before:266000 joint surgery, Affiliated Hospital of Qiingdao University, 59 Haier Road, Qingdao, Shandong Patentee before:Affiliated Hospital of University Of Qingdao |