Semi-automatic ilium wing bone taking tool capable of reserving ilium ridgeTechnical Field
The invention belongs to the field of autologous ilium bone grafting in bone surgery, and particularly relates to a semi-automatic ilium bone harvesting tool for reserving ilium ridges, which is used in ilium bone harvesting operation.
Background
The diseases such as delayed union or disunion of fracture, bone defect, osteonecrosis, tumor and the like usually seriously affect limb functions and need to be treated, and comprehensive operation including bone grafting is a common and effective treatment means, and can promote the repair of bone wounds or lesions so as to be beneficial to functional recovery. Autogenous bone has superior osteoinductive, osteoinductive and osteogenic properties compared to bone graft materials such as allograft, xenograft, artificial bone, and the like, and protects the recipient from immune rejection and the risk of developing infectious diseases. Thus, autogenous bone grafting remains the gold standard for treating the above-mentioned diseases. The autologous bone supply region can be selected from various parts such as skull, rib, ilium, femur, tibia, fibula, etc., and the autologous bone is selected from cortical bone, cancellous bone and cortical cancellous bone, and can be selected according to the dependence of the received region on mechanical strength and osteogenic activity. The ilium wings are the most commonly used clinical supply area because of their shallower locations, relatively simpler anatomy, and 2-3 faces of relatively strong cortical bone and abundant cancellous bone.
At present, the technique of bone extraction from ilium wings is more clinically, but has respective disadvantages. The minimally invasive bone extraction technique by trephine of the iliac crest can only extract a small amount of cancellous bone; the bone extraction amount of the bone extraction technology such as open cutting or contusion milling of ilium half plates is relatively small; the open U-shaped cutting three-sided cortical ilium bone taking technology can cut a large amount of cortical cancellous bone according to the requirements of a receiving area, but inevitably causes large-scale bone defects of the iliac crest of a supply area to lose the supporting effect on local soft tissues, obvious appearance deformity is formed, the function is influenced, meanwhile, the aesthetic trouble is brought, and even the iliac crest has to be reconstructed by operation to remodel the appearance of the supply area. In order to save the appearance of the supply area as much as possible, wolfe and Kawamoto invented an iliac wing bone harvesting technique for harvesting bones through the iliac crest in an H shape, but the iliac crest bone harvesting step is complex, the inner and outer plates of the iliac bone are required to be peeled off at the same time, and after harvesting bones, the iliac crest bone harvesting part is required to be sutured by using a steel wire, so that the wound is large.
Cai Hongmin et al, J.Chinese bone injury, showed that the ilium wing II and III regions are rich in cancellous bone and cortical bone, and provide a large amount of bone as an ideal bone extraction region. On the basis of the research, cai Hongmin et al published a technique for mainly taking bone from ilium wings (II region and III region) which retain ilium ridges on the journal of Chinese orthopaedics, the appearance of the donor region is not malformed, and the defect region is reduced by finding out that the donor region has bone regeneration capability through follow-up, so that the function of the donor region is saved to the greatest extent.
However, the most commonly used bone harvesting instruments on the market today are bone knives (also called osteotomes), which need to be coordinated with hammers to gradually harvest the desired bone mass on a blade-by-blade basis, with relatively low surgical efficiency and relatively large surgical trauma. There is a need in clinical practice for a bone harvesting tool that is compatible with existing, more advanced bone harvesting techniques, and that increases surgical efficiency and reduces surgical trauma.
Disclosure of Invention
The invention aims to provide a semi-automatic iliac wing bone taking tool for reserving iliac crests, which can efficiently drill the iliac wing bone blocks required by transplantation on the premise of reserving the iliac crests, has small operation wound and reduces the pain of patients, and has the characteristics of compact structure, simple and convenient assembly and convenient use.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows: the semiautomatic bone taking tool for holding ilium crest includes one drilling frame and one rotary drill bit with one opened cylindrical end and with saw teeth for cutting ilium crest, and the cylindrical cavity for holding bone crest; a bone block holder is also mounted on the drill bit, the bone block holder being rotatable with the drill bit to drill into the cut bone block and carry the bone block out of the body; the bone taking tool further comprises a tray assembly, the tray in the tray assembly and the saw teeth on the drill bit are oppositely arranged, the tray assembly and the drill frame are in rotary connection, a spring is arranged between the tray assembly and the drill frame, and the spring provides folding force for the tray and the drill bit.
The drill frame is provided with a hollow rod cavity for installing a transmission mechanism, the transmission mechanism comprises a transmission shaft capable of being connected with an external power mechanism and a drive bevel gear coaxially arranged on the transmission shaft, the tooth surface of the drive bevel gear is exposed from a hole on the side surface of the hollow rod cavity and is meshed with a driven bevel gear arranged at the tail end of the drill bit so as to drive the drill bit to rotate.
The drill frame is provided with a U-shaped groove which is used for being rotationally connected with the drill bit, an elastic limiting pin which can move up and down is arranged in the drill frame, and a limiting head of the elastic limiting pin pops up under the action of a spring to seal a notch of the U-shaped groove.
Further, the up-and-down movement of the elastic limiting pin is realized through a first structure and/or a second structure: in the first structure, a long hole is arranged on the side surface of the drill frame, a spanner arranged on the elastic limiting pin extends out of the long hole, and the elastic limiting pin is pulled to move up and down through the spanner so as to expose or retract the limiting head of the elastic limiting pin; in the second structure, the limiting head of the elastic limiting pin is provided with an arc surface towards one side of the U-shaped groove opening, and the tail end of the drill bit forces the elastic limiting pin to move downwards to open the U-shaped groove opening by extruding the arc surface, so that the drill bit can be quickly installed in the U-shaped groove.
The tray is a disc with a side wing plate, the disc surface of the disc is parallel to the plate surface of the side wing plate, a circular boss is arranged on the disc facing the saw tooth, and the disc surface surrounding the circular boss is lower than the circular surface of the circular boss so as to form a drill bit avoiding ring; the tray assembly further comprises a tray support, the side wing plates are connected with the tray support, the tray support is rotationally connected with the drill frame, and a first compression spring is arranged between the tray support and the drill frame.
Further, a limiting rod is arranged on the plate surface of the side wing plate at a position away from the disc, the axial direction of the limiting rod points to the drill frame, and the limiting rod is used for propping against the iliac crest to limit the reserved thickness of the iliac crest when taking bones.
The tray support is of a flat plate structure, a slot and a hollow limit column perpendicular to the plate surface of the tray support are formed in the tray support, the slot is opened on two adjacent side surfaces in the width and thickness directions of the tray support, a second compression spring is arranged in the hollow limit column and is connected with a slot sealing cover, and under the action of the second compression spring, the slot sealing cover can cover the opening of the slot in the thickness direction of the tray support; the side wing plate is inserted into the slot to realize the fixed connection between the tray and the tray support, and the convex-concave matching structure arranged on the inner walls of the side wing plate and the slot is used for realizing the fixation between the tray and the tray support.
Further, the hollow limit post is used for guaranteeing the parallel state of the drill frame and the tray support after the drill bit drills through the ilium wing or in the non-use state of the tool by abutting against the drill frame.
A connecting lug is further arranged on one side of the tray support, a connecting rod is arranged on the drill carriage, and the connecting rod is in rotary connection with the connecting lug through a pin shaft; the two ends of the first compression spring are respectively connected to the spring seats of the drill carriage and the tray bracket.
The bone block fixer comprises a rod body and a handheld part which are connected, wherein the front end of the rod body is provided with a tip and an external thread section so as to drill into and fix the bone block to be cut, and the bone block fixer is fixedly connected with the drill bit through a detachable structure.
Further, detachable construction is including setting up draw-in column and the draw-in groove of setting on the drill bit tail end connector on the body of rod, draw-in column and the body of rod be cross connection, the connector pass through a hollow shaft with driven bevel gear on the drill bit is connected, connector center and driven bevel gear center all are equipped with the through-hole of intercommunication hollow shaft, the draw-in groove sets up on the connector, after the body of rod of bone piece fixer passes through the connector and inserts the bone intracavity of getting of drill bit, the draw-in column gets into the draw-in groove to realize the axial fixity of draw-in groove to bone piece fixer through the rotation of bone piece fixer.
Compared with the prior art, the invention has the following beneficial effects:
First, the integrated assembly of drilling carriage, drill bit, tray subassembly, the integrated setting of the slot closing cap of cooperation elasticity spacer pin and spring control does benefit to according to the required bone volume in supply district, installs fast and dismantles the drill bit of required model and the tray that corresponds thereof, and then cuts the bone piece of corresponding volume in supply district, satisfies the demand of individuation bone grafting operation.
And secondly, the drill bit can be externally connected with power through a transmission mechanism, and the rotary power is transmitted through a transmission shaft and a bevel gear pair to drive the drill bit to rotate and rapidly cut required bone pieces under the cooperation of a tray, so that the bone extraction operation efficiency can be improved.
Thirdly, according to the size of the required drill bit and the tray thereof, the incision with the corresponding length is made along the iliac crest, the soft tissue is cut, the iliac crest is exposed, the periosteum is peeled off to separate the joint of the internal and external plates of the iliac wing and the muscle, then, the drill bit and the tray are only required to be spread and clamped on the internal and external plates of the iliac wing completely, the limit rod on the lateral wings of the tray is propped against the iliac crest, the iliac crest can be reserved and the iliac wing bone pieces can be drilled, and the bone pieces can be taken out from the incision along with the spread drill bit and the tray under the action of the bone piece fixator, so that the required bone pieces are required to be chiseled after the iliac wing is exposed and directly seen through the relatively wide soft tissue, and the drill frame, the wall of the drill bit and the tray can play a protective role in isolating the muscle, thereby reducing the operation wound, reducing the bleeding amount and reducing the operation risk and complications.
Fourth, each assembly of the invention is small in volume, simple in structure, easy and convenient to assemble (the drilling frame, the transmission shaft, the elastic limiting pin, the tray support and the slot sealing cover can be assembled in an integrated way before leaving the factory), quick in assembly and disassembly of the bone taking component, convenient in packaging, sterilization and use, beneficial to clinical application and popularization by taking the early anatomical study and the bone taking technology as the basis, and obvious in economic value.
Drawings
FIG. 1 is a front perspective view of the assembled structure of the components of the present invention;
FIG. 2 is a side perspective view of the component mounting structure of the present invention;
FIG. 3 is a front view of the drill boom of the present invention;
FIG. 4 is a side view of the drill boom of the present invention;
FIG. 5 is a front view of a drill bit of the present invention;
FIG. 6 is a side view of a drill bit of the present invention;
FIG. 7 is a front view of the tray of the present invention;
FIG. 8 is a side view of the tray of the present invention;
FIG. 9 is a front view of a tray support according to the present invention;
FIG. 10 is a side view of a tray support of the present invention;
FIG. 11 is an elevation view of a bone block holder of the present invention;
FIG. 12 is a side view of a bone block holder of the present invention;
the marks in the figure: 1.2 parts of drill frame, 2 parts of drill bit, 3 parts of tray, 4 parts of tray bracket, 5 parts of bone block fixer, 6 parts of first compression spring;
101. U-shaped grooves 102, limiting heads 103, holes 104, drive bevel gears 105, wrenches 106, transmission shafts 107, triangular prisms 108, connecting rods 109 and left spring seats;
201. The device comprises a barrel bottom, a driven bevel gear, a 203, a connector, a 204, a hollow shaft, 205, saw teeth, 206, a straight-line groove, 207 and an arc groove;
301. the drill bit avoiding ring comprises a disc, 302, a side wing plate, 303, a limiting rod, 304, a cuboid groove, 305, a round boss, 306 and a drill bit avoiding ring;
401. the device comprises a slot sealing cover 402, a hollow limit column 403, a second compression spring 404, a connecting lug 405 and a right spring seat;
501. the hand-held part 502, the rod body 503, the clamping column 504 and the external thread section.
Detailed Description
The invention is described in further detail below with reference to the drawings and examples, which are not intended to be limiting.
In the following, the terms "up/down", "left/right", "inside/outside" used to indicate directions are the states of the drawings based on the description, the words "first" and "second" are used for distinguishing structural components of the same type, and are used for convenience of expression only and are not limiting of the technical solution.
Referring to fig. 1 and 2, a semi-automatic iliac crest retaining iliac wing bone harvesting tool comprises a drill frame 1, a drill bit 2, a tray 3, a tray support 4 and a bone block fixer 5, wherein the drill bit 2 is arranged at the upper end of the drill frame 1 and driven to rotate by a transmission mechanism to realize rotary cutting of iliac wing bone blocks; the tray 3 is rotatably connected with the drill frame 1 through the tray support 4, so that the tray 3 and the drill bit 2 are opened and closed, and the tray 3 can support the drill bit 2; the bone block holder 5 has a tip that can be drilled into a bone block for carrying the spun-off bone block out of the body.
On the basis of fig. 1 and 2, referring to fig. 3 and 4, the whole drilling frame 1 is cuboid, a section of U-shaped groove 101 is formed at the upper end of the drilling frame, three sides of the U-shaped groove 101 are opened on the surface of the drilling frame 1, the notch of the U-shaped groove is positioned at one side of the drilling frame 1 in the thickness direction, a mounting cavity communicated with the U-shaped groove 101 is formed at the edge part in the drilling frame 1, an elastic limiting pin capable of moving up and down and a spring for providing elasticity for the elastic limiting pin are arranged in the mounting cavity, a limiting head 102 of the elastic limiting pin can pop up the mounting cavity under the action of the spring to seal the notch of the U-shaped groove 101, and the limiting head 102 of the elastic limiting pin and the bottom of the U-shaped groove 101 can clamp the tail end of the drilling bit 2 but allow the whole drilling bit 2 to rotate; the up-and-down movement of the elastic limiting pin can be realized in various structural forms, and in the embodiment, a composite structure is adopted, and comprises a first structure and a second structure, wherein in the first structure, a long hole is formed in the side surface of the drilling frame 1 in the installation cavity, a spanner 105 arranged on the elastic limiting pin extends out of the long hole, and the elastic limiting pin is pulled to move up and down through the spanner 105; in the second structure, the limiting head 102 of the elastic limiting pin is provided with an arc surface towards one side of the notch of the U-shaped groove 101, and the tail end of the drill bit 2 forces the limiting head 102 to move downwards by extruding the arc surface to open the notch of the U-shaped groove 101, so that the drill bit 2 is installed in the U-shaped groove 101; a hollow rod cavity is further arranged in the drill frame 1, the hollow rod cavity is used for accommodating a transmission shaft 106 and a drive bevel gear 104 fixed at the upper end of the transmission shaft 106, the lower end of the transmission shaft 106 extends out of the drill frame 1 and is provided with a triangular prism 107 so as to be connected with an external power drill, the tooth surface of the drive bevel gear 104 can be exposed from a hole 103 at the side surface of the drill frame 1 and meshed with a driven bevel gear 202 arranged at the tail end of the drill bit 2 so as to drive the drill bit 2 to rotate; the drill carriage 1 is further provided with a connecting rod 108 for connecting the tray support 4 and a left spring seat 109 for mounting the first compression spring 6.
On the basis of fig. 1 and 2, the structure of the drill bit 2 is shown in fig. 5 and 6, the whole drill bit is a cylinder with one end open and one end provided with a cylinder bottom 201, and a cavity in the cylinder is a bone taking cavity for accommodating bone blocks, so that the drill bit 2 can be set into various models with different diameters in order to meet the requirements of clinical different bone grafting amounts. The open end edge of the drill bit 2 is provided with saw teeth 205 which are uniformly distributed along the circumferential direction to form a trephine for rotary cutting bone blocks. The driven bevel gear 202 is fixed on the outer side of the barrel bottom 201, the center of the driven bevel gear 202 and the center of the barrel bottom 201 are both provided with communicated center holes, the end face of the driven bevel gear 202 is also fixed with a hollow shaft 204, the other end of the hollow shaft 204 is provided with a connector 203, the center holes axially arranged on the connector 203 are communicated with the driven bevel gear 202 and the center holes of the barrel bottom 201 through the hollow shaft 204, and the diameters of the center holes of the connector 203 and the barrel bottom 201 are equal and are smaller than or equal to the inner diameter of the hollow shaft 204.
Further, the diameters of the connector 203 and the driven bevel gear 202 at two ends of the hollow shaft 204 are larger than the outer diameter of the hollow shaft 204, and the outer diameter of the hollow shaft 204 is matched with the up-down width of the U-shaped groove 101 on the drill frame 1, so that the hollow shaft 204 can rotate after being clamped in the U-shaped groove 101, the distance between the connector 203 and the driven bevel gear 202 is matched with the thickness of the drill frame 1, and the hollow shaft 204 can be axially positioned through the connector 203 and the driven bevel gear 202 after the hollow shaft 204 is clamped in the U-shaped groove 101, so that axial movement of the drill bit 2 during rotation is avoided.
Still further, a clamping groove connected with the bone block holder 5 is provided on the connector 203, so as to realize rapid disassembly and assembly of the bone block holder 5.
As shown in fig. 5 and 6, the clamping groove on the connector 203 includes a straight groove 206 disposed on the end surface of the connector 203, and two circular arc grooves 207 disposed on the upper semicircle and the lower semicircle of the cylindrical surface of the connector 203, where the radian of each circular arc groove 207 is 90 °, the two circular arc grooves 207 are centrosymmetric, and the circular arc grooves 207 are communicated with the straight groove 206.
Based on fig. 1 and 2, the structure of the tray 3 is shown in fig. 7 and 8, the tray 3 is a disc 301 with a side wing plate 302, the main body of the tray 3 is the disc 301, the diameter of the disc 301 is slightly larger than that of the drill bit 2, so as to support the drill bit 2 and protect saw teeth 205 at the cutting edge of the drill bit 2, and during the bone taking process, the disc 301 can separate the ilium wing from muscles on the surface of the ilium wing to protect the muscles, and can also provide the drill bit with the folding force from the first compression spring 6 between the drill frame 1 and the tray support 4 on the surface of the bone which is not cut through so as to facilitate the cutting of bone fragments; the side wing plate 302 is arranged on one side of the disc 301, the plate surface of the side wing plate 302 is parallel to the plate surface of the disc 301, and the side wing plate 302 is used for connecting the tray support 4.
Further, in order to avoid the saw teeth 205 being damaged by friction with the tray 3 after the bone plate is penetrated by the end bit 2 in the bone taking process, the center of the disc 301 of the tray 3 may be further provided with a convex circular boss 305, and since the area of the circular boss 305 is smaller than that of the disc 301, an annular concave portion can be formed around the circular boss 305, and the annular concave portion is used as a bit avoiding ring 306 to avoid the tip of the saw teeth 205 of the bit 2 from contacting the disc 301, thereby playing a role of protecting the saw teeth 205. In use, the serrations 205 of the drill bit 2 may be flush with the circular face of the circular boss 305, or may be further extended down to the region of the drill bit relief ring 306 without contacting the relief ring face.
Further, a limiting rod 303 perpendicular to the plate surface is arranged on the central line of the side wing plate 302, and the limiting rod 303 and the disc 301 keep a certain distance, so that the limiting rod 303 can be abutted against the iliac crest in the process of rotary cutting and bone taking, and the thickness of the iliac crest to be reserved is limited.
Further, the lower portion of the side wing plate 302 is further provided with a rectangular parallelepiped-shaped groove 304 perpendicular to the long axis of the side wing plate 302 and having the same width as the side wing plate 302.
On the basis of fig. 1 and 2, the structure of the tray support 4 is shown in fig. 9 and 10, the tray support 4 is integrally in a rectangular flat plate shape, a slot and a hollow limit column 402 perpendicular to the surface of the tray support 4 are arranged on the side surface of the tray support 4 in the thickness direction, a second compression spring 403 is arranged in the hollow limit column 402, one end of the second compression spring 403 is connected with the inner wall of the hollow limit column 402, the other end of the second compression spring is connected with a slot cover 401, the slot cover 401 can cover the opening of the slot under the action of the spring, and the outer side surface of the slot cover 401 is flush with the surface of the tray support 4; the slot cover 401 is slid leftwards (shown in fig. 10) by overcoming the elastic force of the second compression spring 403 through the external force so as to open the slot, then the side wing plate 302 of the tray 3 is inserted into the slot, when the slot is inserted, the cuboid-shaped groove 303 on the side wing plate 302 is aligned with the cuboid-shaped bulge arranged on the inner wall of the slot, the positioning between the tray 3 and the tray support 4 is realized through the convex-concave matching of the groove and the bulge, then the slot cover 401 is loosened, the slot cover 401 is pushed by the second compression spring 403 to close the slot, and the side wing plate 302 can be prevented from falling off from the side face of the slot. The slot cover 401 is provided with a bump which is convenient for pushing and pulling the slot cover 401.
Further, after the bone harvesting tool drills through the ilium wings in the non-use state or in the use process, the bone harvesting tool can be propped against the drill frame 1 through the hollow limiting column 402 so as to keep the parallel state of the tray support 4 and the drill frame 1 and further protect the saw teeth 205 on the drill bit 2; thus, the length of the hollow stopper 402 is equal to the distance between the tray support 4 and the drill stand 1 in the parallel state.
Furthermore, a connecting lug 404 and a right spring seat 405 are further arranged on one side of the tray support 4, and the connecting rod 108 and the connecting lug 404 on the drill frame 1 are in rotational connection through a pin shaft; the two ends of the first compression spring 6 are respectively connected to the left spring seat 109 of the drill frame 1 and the right spring seat 405 of the tray support 4.
On the basis of fig. 1 and 2, the bone block fixer 5 is shown in fig. 11 and 12, the bone block fixer 5 mainly comprises two parts, namely a hand-held part 501 and a rod body 502 which are connected, one end of the rod body 502 is fixedly connected with the hand-held part 501, the other end of the rod body 502 is provided with a tip, an external thread section 504 is arranged above the tip, the diameter of the large diameter end of the tip is matched with the diameter of a central hole of a connector 203 at the tail part of the drill bit 2, and the diameter of the rest part of the rod body 502 is slightly smaller than the diameter of the external thread section 504, so that the rod body 502 can be inserted from the connector 203 at the tail part of the drill bit 2 until entering a bone taking cavity of the drill bit 2. The holding portion 501 is cylindrical, a clamping post 503 is further disposed at one end of the rod body 502 near the holding portion 501, and the clamping post 503 is connected with the rod body 502 in a crisscross manner. The clamping posts 503 and the clamping grooves arranged on the connector 203 form a detachable structure capable of being quickly detached.
When the bone block fixator 5 is inserted into the connector 203, the clamping columns 503 on the bone block fixator 5 are aligned with the linear grooves 206 on the end face of the connector 203, after the clamping columns 503 are inserted into the linear grooves 206, the clamping columns rotate 90 degrees along the direction of the circular grooves 207, the parts of the clamping columns 503 on two sides of the rod body 502 can respectively enter the two circular grooves 207 to realize axial positioning, so that the bone block fixator 5 and the drill bit 2 can be fixedly connected, and the bone block fixator 5 can synchronously rotate along with the drill bit 2.
For convenience of operation, the lower part of the drill stand 1 may be provided with an oval cylinder or cylindrical shape for convenience of holding, and the surface may be roughened or scratched, and the lower part of the tray support 4 may be provided with a device for convenience of pulling to facilitate rotation along a pin shaft and opening the tray 3. The first compression spring 6 and the second compression spring 403 are cylindrical helical springs. The peripheral wall of the hand-held part of the bone block holder 5 can be roughened, and the drill bit 2 and the corresponding tray 3 are marked with model numbers, so that rapid pairing is facilitated. All the other parts except the drill bit 2, the corresponding tray 3 and the bone block fixator 5 of the tool can be assembled integrally when leaving the factory, and the tool can be used only by selecting and installing the corresponding drill bit 2, tray 3 and bone block fixator 5 according to clinical bone grafting needs.
The procedure for performing the iliac wing bone harvesting procedure for retaining the iliac crest using the present invention is as follows:
step one, installing the drill bit 2 with the selected model and the corresponding tray 3.
1.1 Method of mounting drill bit 2: the hollow shaft 204 at the tail part of the drill bit 2 is propped against the arc surface of the limit head 102 of the elastic limit pin on the drill frame 1, the drill bit 2 is forcefully pushed to the depth of the U-shaped groove 101, and the limit head 102 of the elastic limit pin is forced to retract into the drill frame 1; or directly pulling the spanner 105 at the tail end of the elastic limiting pin to compress the spring, so that the limiting head 102 of the elastic limiting pin is retracted into the drill frame 1; and thus the hollow shaft 204 of the drill bit 2 is brought into the U-groove 101, and then the elastic limit pin is reset under the action of the spring to close the notch of the U-groove 101, defining the hollow shaft 204 of the drill bit 2, but allowing the rotation of the hollow shaft 204.
1.2 Mounting of tray 3: the side wing plate 302 of the tray 3 is inserted into the slot along the side opening of the slot on the tray support 4, before the insertion, the slot cover 401 needs to be pushed open to open the side opening of the slot, the cuboid-shaped groove 304 on the inserted side wing plate 302 is matched with the cuboid-shaped bulge in the slot to prevent the side wing plate 302 from axially separating, and after the insertion, the slot cover 401 is loosened to reset to close the side opening of the slot to prevent the side wing plate 301 from laterally separating.
1.3 Mounting of bone block holder 5: the rod body 502 of the bone block fixer 5 is inserted into the central hole of the tail connector 203 of the drill bit 2 from the tip end, enters the bone taking cavity of the drill bit 2 through the hollow shaft 204, and when the bone block fixer is inserted, the clamping column 503 on the rod body 502 is ensured to be aligned with the straight slot 206 on the connector 203, after the clamping column 503 enters the straight slot 206, the hand-held part 501 is rotated, so that the clamping column 503 enters the arc slot 207, and the connection between the bone block fixer 5 and the drill bit 2 is realized. When the drill 2 rotates, the bone block holder 5 rotates synchronously, so that the tip end of the rod body 502 and the external thread section 504 drill into and fix the iliotibial bone block, and the bone block is taken out from the body together with the bone taking tool after the bone block is cut in a rotary mode.
Step two, cutting a sample incision along the iliac crest at a position which is away from the anterior superior iliac spine and is from the first transverse finger to the second transverse finger according to the model of the drill bit 2 and the tray 3 corresponding to the required bone grafting amount, and cutting the iliac crest by a knife which is equivalent to the model of the drill bit 2 and the tray 3 until the iliac crest is cut, and stripping the periosteum of the iliac crest and the periosteum from the lower part of the periosteum, so as to separate the periosteum and the muscle attached on the surfaces of the inner plate and the outer plate of the iliac bone wing.
Step three, the drill bit 2 and the tray 3 thereof are opened, the drill bit 2 and the tray 3 thereof are placed through the incisions and respectively abutted against the inner and outer plates of the ilium wing at a certain distance from the front edge of the ilium wing, a limiting rod 303 on a flank 302 of the tray 3 is abutted against the surface of the ilium ridge, a triangular prism 107 at the tail end of a transmission shaft 106 is connected with a power drill, a bone taking tool is held stably, the power drill is started, the rotating force of the power drill drives the drill bit 2 through the triangular prism 107, the transmission shaft 106, a driving bevel gear 104 and a driven bevel gear 202, a first compression spring 6 between the drill frame 1 and the tray support 4 provides folding force for the drill bit 2 and the tray 3, and cutting of ilium wing bone blocks is completed under the combined action of the rotating force and the folding force.
After the bone piece of the ilium wing is cut, because of the fixing function of the external thread section 504 of the bone piece fixer 5 to the bone piece, the clamping post 503 of the bone piece fixer 5 is matched with the clamping groove on the connector 203, the tray 3 is propped against the ilium wing, the drill frame 1 and the tray support 4 are opened by external force, the drill 2 and the cut bone piece are separated from the ilium wing, and then the tool is withdrawn from the incision.
And fifthly, conventionally suturing the incision (the bone taking surface of the ilium wing is not smeared with bone wax and the bone regeneration capacity can be maintained), and taking out the bone blocks from the drill. The clamping column 503 of the bone block fixer 5 is separated from the clamping groove on the connector 203 of the drill bit 2, then the bone block fixer 5 is rotated anticlockwise to separate the external thread section 504 and the tip from the bone block, or the insertion state of the clamping column 503 of the bone block fixer 5 and the clamping groove on the connector 203 is kept, the bone block is directly rotated anticlockwise to separate from the external thread section 504 and the tip of the bone block fixer 5, and finally the bone block is taken out from the drill bit bone taking cavity and used for bone grafting.
According to the semi-automatic iliac crest retaining bone taking tool, the iliac crest retaining and quick cutting of the required bone blocks on the iliac crest can be realized by the aid of the integrated tool main body (the drill frame 1 and the tray support 4), the drill bits 2 with different types and the corresponding trays 3 which can be quickly installed and detached and the bone block retainers 5 which are installed later, the drill bits 2 with the corresponding types and the trays 3 thereof are selected and installed according to the required bone grafting amount.
The tool provided by the invention is used for performing the bone-taking operation of the ilium wing, and the required ilium wing bone blocks can be cut out according to the bone grafting amount of the receiving area in a semi-automatic manner under the premise of keeping the ilium ridge and not causing the appearance deformity of the receiving area without widely peeling soft tissues, retracting and exposing the ilium wing, so that the operation efficiency can be improved, the operation wound can be reduced, the bleeding amount can be reduced, the operation time can be shortened, and the complications can be reduced.
The above embodiments are only for illustrating the technical solution of the present invention and not for limiting it, and it should be understood by those skilled in the art that modifications and equivalents may be made to the specific embodiments of the present invention with reference to the above embodiments, and any modifications and equivalents not departing from the spirit and scope of the present invention are within the scope of the claims appended hereto.