技术领域technical field
本发明涉及医疗器械技术领域，具体涉及一种儿童发育性髋关节发育不良股骨近端精准截骨3D打印导向板装置。The invention relates to the technical field of medical devices, in particular to a 3D printed guide plate device for precise osteotomy of the proximal end of the femur in children with developmental dysplasia of the hip.
背景技术Background technique
发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是一种幼年或儿童时期即出现的髋关节紊乱，发病率约占存活新生儿的千分之一。许多报道表明DDH截骨术操作复杂，学习曲线长，手术的成功与术式的合理选择以及主刀医生的经验密切相关，容易产生评估畸形的误差。Developmental dysplasia of the hip (DDH) is a disorder of the hip joint that appears in infancy or childhood, with an incidence of about one in a thousand surviving newborns. Many reports indicate that DDH osteotomy is complicated to operate and has a long learning curve. The success of the operation is closely related to the reasonable choice of the operation method and the experience of the surgeon, which is prone to errors in deformity assessment.
在DDH各种骨盆截骨手术术式当中，使用频率最多的要属改良Pemberton和Dega髋臼关节囊周围截骨术。但无论何种术式，均需主刀医生凭经验徒手截骨，这样做的缺点是徒手截骨用于复杂的矫形手术，误差大，操作不便且效率低。因此，为了提高手术的安全性和精确度，同时缩短手术时间，避免过多的X线辐射，一种可以为儿童DDH骨盆及股骨提供精确截骨定位和导向的医疗器械亟待研发和应用。Among the various pelvic osteotomies for DDH, the modified Pemberton and Dega acetabular pericapsular osteotomies are most frequently used. However, regardless of the operation method, the surgeon needs to cut the osteotomy by hand with his experience. The disadvantage of this method is that the osteotomy by hand is used for complex orthopedic surgery, which has large errors, inconvenient operation and low efficiency. Therefore, in order to improve the safety and accuracy of the operation, shorten the operation time, and avoid excessive X-ray radiation, a medical device that can provide precise osteotomy positioning and guidance for the DDH pelvis and femur in children needs to be developed and applied urgently.
发明内容Contents of the invention
本发明提供一种儿童DDH股骨近端截骨导板及其使用方法，目的是克服上述现有技术中的缺点，提供一种用于矫形手术中完成截骨操作的、集定位、导向、测距为一体的矫形截骨板，为临床医生提供更精准的截骨导向。The present invention provides a children's DDH proximal femur osteotomy guide plate and its use method, the purpose is to overcome the above-mentioned shortcomings in the prior art, and to provide a set of positioning, guidance, and distance measurement for completing osteotomy operations in orthopedic surgery The integrated orthopedic osteotomy plate provides clinicians with more precise osteotomy guidance.
为达到上述目的，本发明采取的技术方案是：For achieving the above object, the technical scheme that the present invention takes is:
一种儿童DDH股骨近端截骨导板，两个与股骨随形的股骨板上下布置，并在两股骨板之间具有一间隙，两股骨板在所述间隙处由连接部连接，位于上方的股骨板与股骨大粗隆的外上侧壁不规则骨面贴合，位于上方的股骨板上具有第一截骨槽，位于下方的股骨板上具有第二截骨槽，两个所述股骨板上各设有数个克氏针定位孔。A children's DDH proximal femoral osteotomy guide plate, two femoral plates conforming to the femur are arranged up and down, and there is a gap between the two femoral plates, the two femoral plates are connected by a connecting part at the gap, and the upper one is The femoral plate fits the irregular bone surface of the outer upper side wall of the greater trochanter of the femur. The upper femoral plate has a first osteotomy groove, and the lower femoral plate has a second osteotomy groove. Each board is provided with several Kirschner wire positioning holes.
所述的儿童DDH股骨近端截骨导板，其中：位于上方的所述股骨板上设有4个克氏针定位孔，该4个克氏针定位孔以菱形布置并能够使克氏针以第一方向钉入股骨干；位于下方的所述股骨板上设有3个克氏针定位孔，3个克氏针定位孔以纵向一字型布置并能够使克氏针以第二方向钉入股骨干；The children's DDH proximal femoral osteotomy guide plate, wherein: the upper femoral plate is provided with 4 Kirschner wire positioning holes, and the 4 Kirschner wire positioning holes are arranged in a diamond shape and can make the Kirschner wires The first direction is nailed into the femoral shaft; the femoral plate located below is provided with 3 Kirschner wire positioning holes, and the 3 Kirschner wire positioning holes are arranged in a vertical line and can enable the Kirschner wire to be nailed into the femur in the second direction backbone;
所述的儿童DDH股骨近端截骨导板，其中：所述克氏针定位孔的位置与锁定钢板的螺钉孔位置相匹配。The children's DDH proximal femoral osteotomy guide plate, wherein: the position of the positioning hole of the Kirschner wire matches the position of the screw hole of the locking plate.
所述的儿童DDH股骨近端截骨导板，其中：位于上方4个克氏针定位孔中两个纵向排布的克氏针孔连线与股骨干轴线构成第一克氏针平面，位于下方的3个克氏针定位孔连线与股骨干轴线构成第二克氏针平面，所述第一克氏针平面与第二克氏针平面之间的夹角为股骨前倾角预矫正角度The children's DDH proximal femoral osteotomy guide plate, wherein: the line between the two longitudinally arranged Kirschner wire holes in the upper four Kirschner wire positioning holes and the shaft axis of the femur constitute the first Kirschner wire plane, and the lower The line connecting the three Kirschner wire positioning holes and the axis of the femoral shaft constitutes the second Kirschner wire plane, and the angle between the first Kirschner wire plane and the second Kirschner wire plane is the femoral anteversion angle pre-correction angle
所述的儿童DDH股骨近端截骨导板，其中：所述第一截骨槽的槽口连线垂直穿过第一克氏针平面，第一截骨槽的槽底连线与槽口连线构成第一截骨平面；所述第二截骨槽的槽口连线垂直穿过第二克氏针平面，第二截骨槽的槽底连线与槽口连线构成第二截骨平面；所述第一截骨平面垂直于股骨干，所述第二截骨平面与第一截骨平面之间的夹角为股骨颈干角预矫正角度。The children's DDH proximal femoral osteotomy guide plate, wherein: the notch connection line of the first osteotomy groove vertically passes through the first Kirschner wire plane, the groove bottom connection line of the first osteotomy groove is connected with the notch line constitutes the first osteotomy plane; the notch connection line of the second osteotomy groove passes through the second Kirschner wire plane vertically, and the groove bottom connection line and the notch connection line of the second osteotomy groove constitute the second osteotomy plane; the first osteotomy plane is perpendicular to the femoral shaft, and the angle between the second osteotomy plane and the first osteotomy plane is the femoral neck-shaft angle pre-correction angle.
所述的儿童DDH股骨近端截骨导板，其中：所述第一截骨槽与所述第二截骨槽最低点之间的距离为股骨缩短长度。The children's DDH proximal femoral osteotomy guide plate, wherein: the distance between the first osteotomy slot and the lowest point of the second osteotomy slot is the shortened length of the femur.
所述连接部为数个并列排布的条状体或其他便于截断的结构。The connecting part is several strips arranged side by side or other structures that are convenient for truncation.
所述的儿童DDH股骨近端截骨导板，其中：由3D打印技术加工制造而成。The children's DDH proximal femoral osteotomy guide plate is manufactured by 3D printing technology.
一种儿童DDH股骨近端截骨导板的使用方法，使用步骤为，A method for using a children's DDH proximal femoral osteotomy guide plate, the steps of use are as follows:
a.将所述股骨板贴合于患者的患侧股骨近端；A. the femoral plate is fitted to the patient's proximal femur on the affected side;
b.在位于上方股骨板和下方股骨板的克氏针定位孔内至少各钻入2枚克氏针以固定股骨板；b. Drill at least two Kirschner wires into the positioning holes of the upper femoral plate and the lower femoral plate to fix the femoral plate;
c.摆锯通过第一截骨槽和第二截骨槽进行截骨；c. Oscillating saw through the first osteotomy slot and the second osteotomy slot for osteotomy;
d.截断连接部，取下股骨板；d. Cut off the connecting part and remove the femoral plate;
e.旋转股骨，使锁定钢板相应的钉孔套入克氏针上；e. Rotate the femur so that the corresponding nail hole of the locking plate is inserted into the Kirschner wire;
f.依次拧入预测长度的螺钉进行固定锁定钢板。f. Screw in the screws of the predicted length in turn to fix the locking plate.
与现有技术相比较，本发明的有益效果是：Compared with prior art, the beneficial effect of the present invention is:
1.选取部分股骨大转子外上侧壁作为导板贴附部位，可显著提高导板定位的准确性；1. Selecting part of the outer upper side wall of the greater trochanter as the attachment site of the guide plate can significantly improve the positioning accuracy of the guide plate;
2.截骨断端为面对面吻合，接触面积增大，骨折不愈合风险降低；2. The broken ends of the osteotomy are anastomosed face-to-face, the contact area is increased, and the risk of fracture nonunion is reduced;
3.截骨对合后稳定性加强，减少钢板螺钉松动的几率；3. Stability is enhanced after osteotomy and alignment, reducing the chance of loosening of plate screws;
4.操作简便，手术效率提高；4. The operation is simple and the operation efficiency is improved;
5.学习成本低，更加易于推广。5. Low learning cost, easier to promote.
附图说明Description of drawings
图1是本发明提供的儿童DDH股骨近端截骨导板的正视图；Fig. 1 is the front view of children's DDH proximal femur osteotomy guide plate provided by the present invention;
图2是本发明提供的儿童DDH股骨近端截骨导板的俯视图；Fig. 2 is the top view of children's DDH proximal femur osteotomy guide plate provided by the present invention;
图3是本发明提供的儿童DDH股骨近端截骨导板的左视图。Fig. 3 is a left view of the children's DDH proximal femoral osteotomy guide plate provided by the present invention.
附图标记说明：1-股骨板；2-连接部；3-克氏针定位孔；4-第一截骨槽；5-第二截骨槽；6-股骨前倾角预矫正角度；7-股骨颈干角预矫正角度；8-股骨缩短长度。Explanation of reference signs: 1-femoral plate; 2-connecting part; 3-Kirschner wire positioning hole; 4-first osteotomy groove; 5-second osteotomy groove; 6-femoral anteversion angle pre-correction angle; 7- Femoral neck-shaft angle pre-correction angle; 8-length of femur shortening.
具体实施方式Detailed ways
以下将参照附图以示例性而非限制性的方式详细描述本发明的一些具体实施例。附图中相同的附图标记标示了相同或类似的部件或部分。本领域技术人员应该理解，这些附图未必是按真实比例绘制的。Some specific embodiments of the present invention will be described in detail below in an exemplary and non-limiting manner with reference to the accompanying drawings. The same reference numerals in the drawings designate the same or similar parts or parts. It should be understood by those skilled in the art that these drawings are not necessarily drawn to scale.
请参阅图1，本发明提供一种儿童DDH股骨近端截骨导板，包括两个与股骨随型的股骨板1和将股骨板1连接在一起的连接部2。两个所述股骨板1上下布置，并且在两股骨板1之间具有一间隙。两股骨板1在间隙处末端向外延伸并连为一体，形成一连接部2。在所述连接部2的上侧，位于上方的股骨板1上具有第一截骨槽4，在所述连接部2的下侧位于下方的股骨板1上具有第二截骨槽5。位于上方的股骨板1与股骨大粗隆的外上侧壁不规则骨面贴合，可以起到增加定位精度的作用，在保证整体强度以及定位准确的基础上，位于上方的股骨板1的下端可以根据手术切口而适当缩窄，但不能缩窄以保证足够的贴合面积，确保定位准确。位于下方的股骨板1在保证整体强度的基础上，也可减短和缩窄。优选的，所述连接部为数个并列排布的条状体或其他便于截断的结构。Please refer to FIG. 1 , the present invention provides a children's DDH proximal femoral osteotomy guide plate, which includes two femoral plates 1 conforming to the femur and a connecting part 2 connecting the femoral plates 1 together. The two femoral plates 1 are arranged up and down, and there is a gap between the two femoral plates 1 . The ends of the two femoral plates 1 extend outward at the gap and are connected together to form a connecting portion 2 . On the upper side of the connecting portion 2 , there is a first osteotomy slot 4 on the upper femoral plate 1 , and on the lower side of the connecting portion 2 , there is a second osteotomy slot 5 on the lower femoral plate 1 . The upper femoral plate 1 fits with the irregular bone surface of the outer upper side wall of the greater trochanter, which can increase the positioning accuracy. On the basis of ensuring the overall strength and accurate positioning, the upper femoral plate 1 The lower end can be appropriately narrowed according to the surgical incision, but cannot be narrowed to ensure a sufficient fitting area and accurate positioning. The lower femoral plate 1 can also be shortened and narrowed on the basis of ensuring the overall strength. Preferably, the connection part is several strips arranged in parallel or other structures that are convenient for truncation.
位于上方的所述股骨板1上设有4个克氏针定位孔3，该4个克氏针定位孔以菱形布置。位于下方的所述股骨板1上设有3个克氏针定位孔3，3个克氏针定位孔3以纵向一字型布置。Four Kirschner wire positioning holes 3 are arranged on the upper femoral plate 1 , and the four Kirschner wire positioning holes are arranged in a rhombus shape. The lower femoral plate 1 is provided with three Kirschner wire positioning holes 3, and the three Kirschner wire positioning holes 3 are arranged in a vertical line.
请参阅图2，位于上方股骨板1的4个克氏针定位孔3与位于下方股骨板1的3个克氏针定位孔3并非处于同一面片内，从俯视图中可以看出，位于上方股骨板1上的4个克氏针定位孔3中两个纵向排布的克氏针孔3连线与股骨干轴线构成第一克氏针平面，位于下方的3个克氏针定位孔3连线与股骨干轴线构成第二克氏针平面，所述第一克氏针平面与第二克氏针平面之间存在一夹角，该夹角为股骨前倾角预矫正角度6。Please refer to Figure 2, the four Kirschner wire positioning holes 3 on the upper femoral plate 1 and the three Kirschner wire positioning holes 3 on the lower femoral plate 1 are not in the same patch. Among the four Kirschner wire positioning holes 3 on the femoral plate 1, the line connecting the two longitudinally arranged Kirschner wire holes 3 and the shaft axis of the femur constitutes the first Kirschner wire plane, and the three Kirschner wire positioning holes 3 located below The connecting line and the shaft axis of the femur form a second Kirschner wire plane, and there is an included angle between the first Kirschner wire plane and the second Kirschner wire plane, and the included angle is the femoral anteversion angle pre-correction angle 6 .
第一截骨槽4的槽口连线垂直穿过第一克氏针平面，第二截骨槽5的槽口连线垂直穿过第二克氏针平面，也就是说，在摆据伸入第一截骨槽4和第二截骨槽5进行截骨时，两摆据平面在俯视方向上是呈一定角度的。The connecting line of the notch of the first osteotomy groove 4 vertically passes through the first Kirschner wire plane, and the connecting line of the notch of the second osteotomy groove 5 vertically passes through the second Kirschner wire plane, that is to say, when the pendulum extends When entering the first osteotomy groove 4 and the second osteotomy groove 5 for osteotomy, the two pendulum planes are at a certain angle in the direction of looking down.
请参阅图3，位于上方的所述股骨板1上的4个克氏针定位孔3能够使克氏针以第一方向钉入股骨干，位于下方股骨板1上的3个克氏针定位孔能够使克氏针以第二方向钉入股骨干。所述第一方向和第二方向的设置是为了与锁定钢板的螺钉钉入方向一致，便于术后股骨干的固定。克氏针定位孔3除了固定导板，辅助螺钉及锁定钢板定位以外，还具有矫正前倾角过大的去旋转作用。Please refer to Fig. 3, the 4 Kirschner wire positioning holes 3 on the upper femoral plate 1 can make the Kirschner wires be nailed into the femoral shaft in the first direction, and the 3 Kirschner wire positioning holes on the lower femoral plate 1 The Kirschner wire can be driven into the femoral shaft in a second direction. The setting of the first direction and the second direction is to be consistent with the screw driving direction of the locking plate, so as to facilitate postoperative fixation of the femoral shaft. Kirschner wire locating hole 3 is except fixing guide plate, auxiliary screw and locking plate positioning, also has the de-rotation effect that correction anteversion angle is too large.
第一截骨槽4的槽底连线与槽口连线构成第一截骨平面，第二截骨槽的槽底连线与槽口连线构成第二截骨平面，所述第一截骨平面垂直于股骨干，所述第二截骨平面与第一截骨平面之间的夹角为股骨颈干角预矫正角度7。第一截骨槽4与所述第二截骨槽5最低点之间的距离为股骨缩短长度8。需要说明的是，本发明是通过3D打印技术加工制造而成。在加工制造之前预先通过三维CT扫描获得患者的骨盆及双侧股骨的DICOM数据，再将数据导入mimics软件中对患者的骨盆及双侧股骨进行三维重建。在三维模型中测量股骨的颈干角、前倾角及需要短缩的长度，从而计算得出需要矫正的内翻角度、去旋转角度及短缩长度。The line connecting the groove bottom of the first osteotomy groove 4 and the connecting line of the notch constitute the first osteotomy plane, and the connecting line of the groove bottom of the second osteotomy groove and the connecting line of the notch constitute the second osteotomy plane. The bone plane is perpendicular to the femoral shaft, and the included angle between the second osteotomy plane and the first osteotomy plane is the femoral neck-shaft angle pre-correction angle 7 . The distance between the lowest point of the first osteotomy slot 4 and the second osteotomy slot 5 is the femur shortening length 8 . It should be noted that the present invention is manufactured through 3D printing technology. Before processing and manufacturing, the DICOM data of the patient's pelvis and bilateral femurs were obtained through 3D CT scanning, and then the data were imported into the mimics software for 3D reconstruction of the patient's pelvis and bilateral femurs. Measure the neck-shaft angle, anteversion angle, and shortened length of the femur in the three-dimensional model, so as to calculate the varus angle, derotation angle, and shortened length that need to be corrected.
本发明在使用时具体步骤如下：Concrete steps of the present invention are as follows when in use:
1.将本发明贴合于患者的患侧股骨近端，以大转子外上侧壁为贴附点，可实现紧密贴附；1. Attach the present invention to the patient's proximal femur on the affected side, and use the outer superior side wall of the greater trochanter as the attachment point to achieve close attachment;
2.于第一截骨槽上端以及第二截骨槽下端的克氏针定位孔处至少各钻入2枚克氏针用以固定股骨板；2. Drill at least two Kirschner wires at the upper end of the first osteotomy slot and the lower end of the second osteotomy slot at the Kirschner wire positioning holes to fix the femoral plate;
3.摆锯通过第一截骨槽和第二截骨槽进行截骨；3. The oscillating saw performs osteotomy through the first osteotomy groove and the second osteotomy groove;
4.截断连接部，取下导板；4. Cut off the connecting part and remove the guide plate;
5.通过旋转股骨，使锁定钢板相应的钉孔套入定位克氏针上，即可使两侧骨端的对合，实现了股骨近端的短缩、去旋转及内翻畸形的矫正；5. By rotating the femur, the corresponding nail hole of the locking plate can be inserted into the positioning Kirschner wire, so that the bone ends on both sides can be aligned, and the shortening, derotation and varus correction of the proximal femur can be realized;
6.依次拧入预测长度的螺钉进行固定锁定钢板。6. Screw in the screws of the predicted length in turn to fix the locking plate.
需要说明的是，锁定钢板配合本发明使用，用于在矫形后固定患者股骨，起到在患者股骨愈合期间提供牢固支撑的作用。锁定钢板具有与患者股骨贴合的外形，且锁定钢板上的螺钉孔与本发明的股骨板上的克氏针定位孔位置相同方向一致。It should be noted that the locking plate is used in conjunction with the present invention to fix the patient's femur after correction and provide firm support during the healing of the patient's femur. The locking plate has a shape fit to the patient's femur, and the screw holes on the locking plate are in the same position and in the same direction as the Kirschner wire positioning holes on the femoral plate of the present invention.
本发明的优点是：The advantages of the present invention are:
本发明提供了一种用于矫形手术中完成截骨操作的，集定位、导向、测距为一体的矫形截骨板系统及操作方法，不但可以提高手术的安全性和精确度，同时缩短了手术时间，并且可以避免过多的X线辐射，为临床医生提供更精准的截骨导向，达到个性化治疗儿童DDH的目的，改善患者髋关节功能，促进髋臼再次发育，达到治愈髋关节畸形或推迟髋关节骨关节炎的发生，减少患者病残率。The present invention provides an orthopedic osteotomy plate system and operation method for completing osteotomy in orthopedic surgery, which integrates positioning, guidance and distance measurement, which can not only improve the safety and accuracy of the operation, but also shorten the The operation time can be reduced, and excessive X-ray radiation can be avoided, providing clinicians with more accurate osteotomy guidance, achieving the purpose of personalized treatment of DDH in children, improving the hip joint function of patients, promoting the redevelopment of the acetabulum, and achieving the cure of hip joint deformity Or delay the occurrence of hip osteoarthritis and reduce the disability rate of patients.
以上说明对本发明而言只是说明性的，而非限制性的，本领域普通技术人员理解，在不脱离权利要求所限定的精神和范围的情况下，可作出许多修改、变化或等效，但都将落入本发明的保护范围之内。The above description is only illustrative of the present invention, rather than restrictive. Those of ordinary skill in the art understand that many modifications, changes or equivalents can be made without departing from the spirit and scope defined in the claims, but All will fall within the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911322777.9ACN111067587B (en) | 2019-12-20 | 2019-12-20 | Children DDH femur near-end osteotomy guide plate and use method thereof |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911322777.9ACN111067587B (en) | 2019-12-20 | 2019-12-20 | Children DDH femur near-end osteotomy guide plate and use method thereof |
| Publication Number | Publication Date |
|---|---|
| CN111067587A CN111067587A (en) | 2020-04-28 |
| CN111067587Btrue CN111067587B (en) | 2023-08-01 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201911322777.9AActiveCN111067587B (en) | 2019-12-20 | 2019-12-20 | Children DDH femur near-end osteotomy guide plate and use method thereof |
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