CN111513810A - Osteotomy guider - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
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Abstract
Translated fromChinese
Description
Translated fromChinese技术领域technical field
本发明涉及骨科截骨用辅助工具技术领域，具体涉及一种胫骨近端高位截骨辅助定位用截骨导向器。The invention relates to the technical field of auxiliary tools for orthopedic osteotomy, in particular to an osteotomy guide for auxiliary positioning of tibial proximal high-level osteotomy.
背景技术Background technique
有膝内翻畸形的病人，特别是胫骨近端发育异常的膝内翻年轻病人，单纯膝关节内侧疼痛时，需要行胫骨近端高位截骨矫形手术。胫骨近端高位截骨矫形手术的治疗机理是通过胫骨近端截骨，把负重力线从发生炎症和磨损的膝关节内侧间室，转移到相对正常的外侧间室，从而达到缓解关节炎症状的目的。Patients with varus deformity, especially young patients with varus knee with abnormal development of the proximal tibia, need a high proximal tibial osteotomy for orthopedic surgery when only medial knee pain is present. The treatment mechanism of high proximal tibial osteotomy is to transfer the negative gravity line from the medial compartment of the knee joint, which is inflamed and worn, to the relatively normal lateral compartment through the proximal tibial osteotomy, so as to relieve the symptoms of arthritis. the goal of.
具体来说，正常力线的膝关节，通常是内侧负重多，外侧负重少。如果胫骨存在一定程度的内翻畸形，会显著增加作用在内侧间室软骨上的压强，并超过软骨承受的范围，从而引发一系列软骨磨损和炎症的恶性循环，形成内侧骨关节炎。在骨关节炎还没有发展到外侧之前，胫骨近端高位截骨术能够通过纠正胫骨内翻畸形，把下肢力线适当转移到正常的外侧间室，从而明显减低内侧间室的压强，将其恢复到软骨能够承受的正常范围内，从而可以有效阻止软骨的磨损，缓解疼痛症状，甚至使已磨损的软骨和受伤的半月板得以自我修复。Specifically, the normal line of the knee joint usually bears more weight on the medial side and less on the lateral side. If the tibia has a certain degree of varus deformity, the pressure on the medial compartment cartilage will significantly increase and exceed the range of cartilage, thereby triggering a vicious cycle of cartilage wear and inflammation, resulting in medial osteoarthritis. Before osteoarthritis develops to the lateral side, the proximal tibial high osteotomy can correct the tibial varus deformity and properly transfer the lower extremity alignment to the normal lateral compartment, thereby significantly reducing the pressure in the medial compartment. Return to the normal range that cartilage can withstand, which can effectively prevent cartilage wear, relieve pain symptoms, and even allow worn cartilage and injured meniscus to repair itself.
胫骨近端高位截骨矫形手术需要对胫骨内侧进行开放截骨，以纠正胫骨近端的内翻角度，从而纠正整个下肢的负重力线。具体是从胫骨近端内侧固定测量位置，向着腓骨小头的方向截骨，之后进行截骨区域的撑开操作，矫正胫骨近端关节面与胫骨力线之间的角度。传统的截骨方式一般是在透视后盲打，即打入两对平行的克氏针，然后使用摆锯紧贴一对平行的克氏针截骨。传统的这种打入克氏针的方式，没有工具辅助，容易发生偏斜，打入后需要透视，一旦发生偏斜就要纠正，导致手术效率较低。Corrective orthopedic proximal tibial high osteotomy requires an open osteotomy of the medial tibia to correct the varus angle of the proximal tibia, thereby correcting the negative gravity line of the entire lower extremity. Specifically, the measurement position is fixed from the medial side of the proximal tibia, the osteotomy is cut in the direction of the fibular head, and then the osteotomy area is opened to correct the angle between the articular surface of the proximal tibia and the tibial force line. The traditional osteotomy method is usually blind punching after fluoroscopy, that is, two pairs of parallel K-wires are inserted, and then an oscillating saw is used to close the pair of parallel K-wires for osteotomy. This traditional way of inserting Kirschner wires, without the aid of tools, is prone to deflection. After inserting, fluoroscopy is required. Once deflection occurs, it must be corrected, resulting in low surgical efficiency.
发明内容SUMMARY OF THE INVENTION
因此，本发明要解决的技术问题在于克服现有技术中在行胫骨近端高位截骨矫形手术时，没有专用工具，一般都是在透视后盲打，容易发生偏斜，一旦发生偏斜就要纠正，导致手术效率低的技术缺陷，从而提供一种能够提高手术效率的截骨导向器。Therefore, the technical problem to be solved by the present invention is to overcome the fact that in the prior art, when performing high-level tibial proximal tibial osteotomy and orthopaedic surgery, there is no special tool. To correct the technical defects that lead to low surgical efficiency, thereby providing an osteotomy guide capable of improving surgical efficiency.
为此，本发明提供一种截骨导向器，包括：To this end, the present invention provides an osteotomy guide, comprising:
框架，具有主杆，与所述主杆一端固定连接的第一支杆，以及可滑动地套设在所述主杆上的第二支杆，所述第一支杆与所述第二支杆平行，并与所述主杆一起形成凵字型结构；The frame has a main rod, a first support rod fixedly connected with one end of the main rod, and a second support rod slidably sleeved on the main rod, the first support rod and the second support rod The rods are parallel and form a zigzag structure together with the main rod;
定位结构，设置在所述第二支杆上，适于定位在腓骨小头位置；a positioning structure, which is arranged on the second strut and is suitable for being positioned at the head of the fibula;
第一导向套，固定设置在所述第一支杆上，具有第一中心导向孔，所述第一中心导向孔的中心轴线穿过所述定位结构的中心位置；a first guide sleeve, which is fixedly arranged on the first support rod, and has a first center guide hole, and the center axis of the first center guide hole passes through the center position of the positioning structure;
定位柱，可转动地套设在所述第一导向套上，所述定位柱上设有若干通孔；a positioning column, which is rotatably sleeved on the first guide sleeve, and a plurality of through holes are arranged on the positioning column;
第二导向套，可拆卸地安装在其中一个所述通孔内部，所述第二导向套具有第二中心导向孔，所述第一中心导向孔的中心轴线与所述第二中心导向孔的中心轴线平行。A second guide sleeve, detachably installed inside one of the through holes, the second guide sleeve has a second center guide hole, the center axis of the first center guide hole and the center axis of the second center guide hole The central axes are parallel.
作为一种优选方案，所述定位结构为定位碗，适于扣在腓骨小头位置。As a preferred solution, the positioning structure is a positioning bowl, which is suitable for being buckled at the position of the head of the fibula.
作为一种优选方案，所述主杆为多边形棱柱结构，所述第二支杆能够沿所述主杆的轴向移动，但不可绕所述主杆的周向转动。As a preferred solution, the main rod is a polygonal prism structure, and the second support rod can move along the axial direction of the main rod, but cannot rotate around the circumferential direction of the main rod.
作为一种优选方案，所述第二导向套包括第二导向套主体，和设置在所述第二导向套主体一端的环形凸缘，所述第二导向套主体的外径与所述通孔的内径大小一致。As a preferred solution, the second guide sleeve includes a second guide sleeve main body, and an annular flange disposed at one end of the second guide sleeve main body, and the outer diameter of the second guide sleeve main body is the same as the through hole. of the same inner diameter.
作为一种优选方案，还包括位置确定件，所述位置确定件一端可转动地安装在所述定位柱上，另一端具有比照端，所述第一中心导向孔的中心轴线与所述第二中心导向孔的中心轴线确定截骨参照面，所述比照端距离所述截骨参照面的距离为设定距离。As a preferred solution, it also includes a position determination member, one end of the position determination member is rotatably mounted on the positioning column, and the other end has a reference end, the central axis of the first central guide hole is connected to the second The central axis of the central guide hole determines the osteotomy reference plane, and the distance between the reference end and the osteotomy reference plane is a set distance.
作为一种优选方案，所述比照端设有插入板，所述插入板与所述截骨参照面平行。As a preferred solution, the reference end is provided with an insertion plate, and the insertion plate is parallel to the osteotomy reference plane.
作为一种优选方案，所述插入板上设有若干插入导孔，若干个所述插入导孔的中心轴线平行并共面，且与所述截骨参照面平行。As a preferred solution, the insertion plate is provided with a plurality of insertion guide holes, and the central axes of the plurality of the insertion guide holes are parallel and coplanar, and parallel to the osteotomy reference surface.
作为一种优选方案，所述位置确定件包括底座，所述底座的一端形成U型结构，所述U型结构的两个相对侧面具有可转动套设在所述定位柱上的安装孔，所述底座的另一端设有指示杆，所述指示杆沿着内侧胫骨近端的位置弯折，所述指示杆的顶端为所述比照端。As a preferred solution, the position determining member includes a base, one end of the base forms a U-shaped structure, and two opposite sides of the U-shaped structure have mounting holes rotatably sleeved on the positioning column, so The other end of the base is provided with an indicator rod, the indicator rod is bent along the position of the proximal end of the inner tibia, and the top end of the indicator rod is the reference end.
作为一种优选方案，所述第一导向套位于所述U型结构的内侧，所有的所述通孔均位于所述U型结构外侧。As a preferred solution, the first guide sleeve is located inside the U-shaped structure, and all the through holes are located outside the U-shaped structure.
作为一种优选方案，所述主杆上设有刻度，所述刻度的0刻度位置与所述第一导向套的朝向所述定位结构的端部平齐；所述刻度从0刻度位置向着远离所述第一支杆的方向增加。As a preferred solution, a scale is provided on the main rod, and the 0 scale position of the scale is flush with the end of the first guide sleeve facing the positioning structure; the scale moves away from the 0 scale position. The direction of the first strut increases.
本发明提供的技术方案，具有以下优点：The technical scheme provided by the present invention has the following advantages:
1.本发明的截骨导向器，包括框架、定位结构、第一导向套、定位柱和第二导向套；安装在框架上的定位结构，适于定位在腓骨小头位置，安装在框架上的第一导向套，具有第一中心导向孔，其中心轴线穿过定位结构的中心位置，用于为第一克氏针的钉入进行导向；定位柱可转动地套设在第一导向套上，第二导向套安装在定位柱的通孔内部，具有第二中心导向孔，第一中心导向孔的中心轴线与第二中心导向孔的中心轴线平行，从而确定截骨参照面，由于截骨是由摆锯紧贴克氏针的边缘截骨，因此截骨参照面与实际截骨面相差约一个克氏针半径大小的距离。1. The osteotomy guide of the present invention includes a frame, a positioning structure, a first guide sleeve, a positioning column and a second guide sleeve; the positioning structure installed on the frame is suitable for positioning at the position of the fibula head, and is installed on the frame The first guide sleeve has a first center guide hole, the center axis of which passes through the center of the positioning structure, and is used to guide the nailing of the first K-wire; the positioning column is rotatably sleeved on the first guide sleeve The second guide sleeve is installed inside the through hole of the positioning column and has a second center guide hole. The center axis of the first center guide hole is parallel to the center axis of the second center guide hole, so as to determine the osteotomy reference surface. The bone is cut by the oscillating saw close to the edge of the Kirschner wire, so the difference between the reference surface of the osteotomy and the actual osteotomy surface is about a radius of the Kirschner wire.
在进行开放截骨时，确定好截骨位置后，将本发明截骨导向器的第一导向套抵在需要截骨位置，使截骨位置与第一中心导向孔相切，滑动第二支杆，使定位结构抵在腓骨小头位置，在定位柱的合适的通孔位置插入第二导向套，调整定位柱的方向，使第二中心导向孔的中心轴线与第一中心导向孔的中心轴线确定的平面与胫骨平台的后倾角度一致，然后在确定好的位置，将第二克氏针穿过第二中心导向孔后钉入胫骨，两个克氏针钉入后，去除截骨导向器，使用摆锯紧贴两个克氏针进行截骨，直至截至对侧，不能完全截断，保留单侧皮质，形成合页，使得截骨处能够尽快愈合。When performing an open osteotomy, after the osteotomy position is determined, the first guide sleeve of the osteotomy guide of the present invention is pressed against the position where the osteotomy needs to be cut, so that the osteotomy position is tangent to the first central guide hole, and the second guide is slid. rod to make the positioning structure abut the fibula capitulum, insert the second guide sleeve at the appropriate through hole position of the positioning column, and adjust the direction of the positioning column so that the center axis of the second center guide hole is aligned with the center of the first center guide hole. The plane determined by the axis is consistent with the posterior inclination angle of the tibial plateau, and then at the determined position, the second Kirschner wire is screwed into the tibia after passing through the second central guide hole. After the two Kirschner wires are screwed in, the osteotomy is removed. Guider, use the oscillating saw to stick to the two Kirschner wires for osteotomy until it reaches the opposite side and cannot be completely cut off. The unilateral cortex is preserved to form a hinge, so that the osteotomy can heal as soon as possible.
本发明的截骨导向器，能够在确定截骨位置后，使用第一导向套、第二导向套限定克氏针的入针位置及进针方向，不会发生偏斜，一次性完成高质量就截骨，手术效率高；另外，第一导向套、第二导向套和定位柱互相配合，还能保证进针后的第一克氏针和第二克氏针保持平行，方便摆锯紧贴第一克氏针和第二克氏针截骨。The osteotomy guide of the present invention can use the first guide sleeve and the second guide sleeve to limit the needle insertion position and needle insertion direction of the K-wire after determining the osteotomy position, without deflection, and complete high-quality at one time In addition, the first guide sleeve, the second guide sleeve and the positioning column cooperate with each other, which can also ensure that the first K-wire and the second K-wire after needle insertion remain parallel, which is convenient for sawing and tightening. Paste the first K-wire and the second K-wire for osteotomy.
2.本发明的截骨导向器，定位结构为定位碗，适于扣在腓骨小头位置；碗状结构便于按压固定，操作方便。2. In the osteotomy guide of the present invention, the positioning structure is a positioning bowl, which is suitable for being buckled at the position of the fibula capitellum; the bowl-shaped structure is convenient for pressing and fixing, and the operation is convenient.
3.本发明的截骨导向器，主杆为多棱柱结构，第二支杆只能沿主杆的轴向移动，而不能绕主杆的周向转动，如此设置，使得定位结构只能在靠近或远离第一导向套的方向来回移动，在移动过程中，定位结构始终与第一导向套相对，从而可以提高调节效率。3. In the osteotomy guide of the present invention, the main rod is a polygonal column structure, and the second support rod can only move along the axial direction of the main rod, but cannot rotate around the circumferential direction of the main rod. Moving back and forth in the direction close to or away from the first guide sleeve, during the moving process, the positioning structure is always opposite to the first guide sleeve, so that the adjustment efficiency can be improved.
4.本发明的截骨导向器，第二导向套包括第二导向套主体和环形凸缘，第二导向套插入定位柱上的通孔后，向着定位结构的方向按压，不致整个没入通孔内部，操作方便。4. In the osteotomy guide of the present invention, the second guide sleeve includes a second guide sleeve main body and an annular flange. After the second guide sleeve is inserted into the through hole on the positioning column, it is pressed in the direction of the positioning structure, so as not to completely submerge the through hole. Inside, easy to operate.
5.本发明的截骨导向器，还包括位置确定件，一端可转动地安装在定位柱上，另一端具有比照端，第一中心导向孔的中心轴线与第二中心导向孔的中心轴线确定截骨参照面(比实际截骨面高或低一个中心导向孔的半径大小)，然后设定比照端距离所述截骨参照面的距离，保证真实截骨位置距离内侧胫骨平台为约3.5cm，从而满足相关手术要求(一般情况下，在远离腓骨一侧，截骨位置要求位于胫骨平台下约3.5cm)。5. The osteotomy guide of the present invention also includes a position determining member, one end is rotatably mounted on the positioning column, the other end has a reference end, and the center axis of the first center guide hole and the center axis of the second center guide hole are determined. Osteotomy reference surface (one radius of the central guide hole higher or lower than the actual osteotomy surface), and then set the distance between the reference end and the osteotomy reference surface to ensure that the actual osteotomy position is about 3.5cm from the medial tibial plateau , so as to meet the relevant surgical requirements (generally, on the side away from the fibula, the osteotomy position is required to be about 3.5cm below the tibial plateau).
6.本发明的截骨导向器，比照端设有插入板，插入板与截骨参照面平行；由于在截骨时，要求截骨面要与胫骨平台的后倾角相同；设置与截骨参照面平行的插入板后，在手术过程中，将插入板插入至胫骨平台位置，使插入板与胫骨平台后倾角相同，此时可保证第一导向套和第二导向套对于克氏针的导向与上述后倾角相同，从而保证紧贴克氏针截出的骨平面也与上述倾角相同。6. In the osteotomy guide of the present invention, the reference end is provided with an insertion plate, and the insertion plate is parallel to the osteotomy reference surface; because during the osteotomy, the osteotomy surface is required to be the same as the posterior inclination angle of the tibial plateau; the setting is the same as the osteotomy reference surface. After the insertion plate is parallel to the surface, during the operation, insert the insertion plate to the position of the tibial plateau, so that the insertion plate and the tibial plateau have the same posterior inclination angle. At this time, the guide of the first guide sleeve and the second guide sleeve for the Kirschner wire can be guaranteed. It is the same as the above-mentioned backward inclination angle, so as to ensure that the bone plane cut out close to the Kirschner wire is also the same as the above-mentioned inclination angle.
7.本发明的截骨导向器，插入板上设有若干插入导孔，若干个插入导孔的中心轴线平行并共面，且与所述截骨参照面平行；由于内侧胫骨平台位置关节囊和韧带的影响，插入板的插入较为费劲，此时可通过在插入导孔位置插入至少两个克氏针将插入板固定，并使插入板的倾斜角度与胫骨平台的后倾角相同，从而降低插入板的插入难度。7. In the osteotomy guide of the present invention, the insertion plate is provided with several insertion guide holes, and the central axes of the several insertion guide holes are parallel and coplanar, and are parallel to the osteotomy reference surface; Due to the influence of ligaments, the insertion of the insertion plate is more laborious. At this time, the insertion plate can be fixed by inserting at least two Kirschner wires at the position of the insertion guide hole, and the inclination angle of the insertion plate is the same as that of the tibial plateau. Insertion difficulty of the insert board.
8.本发明的截骨导向器，位置确定件包括底座，底座的一端形成U型结构，U型结构的两个相对侧面通过安装孔可转动地安装在定位柱上；底座的另一端设有指示杆，指示杆沿着内侧胫骨近端的位置弯折，顶端为比照端；这种结构设计，能够适应胫骨平台至胫骨近端位置的人体骨骼结构，方便比照端比较，也方便定位柱位置第一导向套和第二导向套的抵靠。8. In the osteotomy guide of the present invention, the position determining member includes a base, one end of the base forms a U-shaped structure, and two opposite sides of the U-shaped structure are rotatably installed on the positioning column through the installation holes; the other end of the base is provided with a U-shaped structure. The indicator rod is bent along the position of the proximal end of the inner tibia, and the top is the reference end; this structural design can adapt to the human bone structure from the tibial plateau to the proximal end of the tibia, which is convenient for the comparison of the comparison end and the position of the positioning column. The abutment of the first guide sleeve and the second guide sleeve.
9.本发明的截骨导向器，第一导向套位于U型结构内侧，通孔位于U型结构外侧，整个截骨导向器结构紧凑，方便第二导向套的拆卸，且使得指示杆位于居中位置，方便比照端的比照。9. In the osteotomy guide of the present invention, the first guide sleeve is located on the inside of the U-shaped structure, and the through hole is located on the outside of the U-shaped structure. The entire osteotomy guide has a compact structure, which facilitates the disassembly of the second guide sleeve, and makes the indicator rod in the center. The location is convenient for the comparison of the comparison end.
10.本发明的截骨导向器，主杆上设有刻度，0刻度位置与第一导向套的朝向定位结构的端部平齐；钉入克氏针时，可采用具有刻度的克氏针，通过观察钉入克氏针上面的刻度，即可知晓克氏针钉入的大致位置，避免穿透胫骨。10. In the osteotomy guide of the present invention, a scale is provided on the main rod, and the 0 scale position is flush with the end of the first guide sleeve toward the positioning structure; when nailing a Kirschner wire, a Kirschner wire with a scale can be used. , By observing the scale above the K-wire, you can know the approximate position of the K-wire to avoid penetrating the tibia.
附图说明Description of drawings
为了更清楚地说明现有技术或本发明具体实施方式中的技术方案，下面对现有技术或具体实施方式描述中所使用的附图作简单介绍。In order to more clearly illustrate the technical solutions in the prior art or the specific embodiments of the present invention, the accompanying drawings used in the description of the prior art or the specific embodiments are briefly introduced below.
图1是本发明截骨导向器的整体结构示意图。FIG. 1 is a schematic diagram of the overall structure of the osteotomy guide of the present invention.
图2是图1的另一立体视图。FIG. 2 is another perspective view of FIG. 1 .
图3是图1中位置确定件的改进结构图。FIG. 3 is a modified structural diagram of the position determining member in FIG. 1 .
附图标记：1、框架；10、主杆；11、第一支杆；12、第二支杆；2、定位结构；31、第一导向套；310、第一中心导向孔；32、第二导向套；320、第二中心导向孔；321、第二导向套主体；322、环形凸缘；4、定位柱；41、通孔；5、位置确定件；50、底座；51、比照端；52、插入板；53、安装孔；54、指示杆；55、侧面；56、插入导孔。Reference numerals: 1, frame; 10, main rod; 11, first support rod; 12, second support rod; 2, positioning structure; 31, first guide sleeve; 310, first center guide hole; 32, first Two guide sleeves; 320, the second center guide hole; 321, the second guide sleeve main body; 322, the annular flange; 4, the positioning column; 41, the through hole; 5, the position determination piece; 50, the base; 52. Insert plate; 53. Mounting hole; 54. Indicator rod; 55. Side face; 56. Insert guide hole.
具体实施方式Detailed ways
下面结合附图对本发明的技术方案进行详细描述。The technical solutions of the present invention will be described in detail below with reference to the accompanying drawings.
实施例Example
本实施例提供一种截骨导向器，如图1-2所示，包括：框架1，具有主杆10，与所述主杆10一端固定连接的第一支杆11，以及可滑动地套设在所述主杆10上的第二支杆12，所述第一支杆11与所述第二支杆12平行，并与所述主杆10一起形成凵字型结构；定位结构2，设置在所述第二支杆12上，适于定位在腓骨小头位置；第一导向套31，固定设置在所述第一支杆11上，具有第一中心导向孔310，所述第一中心导向孔310的中心轴线穿过所述定位结构2的中心位置；定位柱4，可转动地套设在所述第一导向套31上，所述定位柱4上设有若干通孔41；第二导向套32，可拆卸地安装在其中一个所述通孔41内部，所述第二导向套32具有第二中心导向孔320，所述第一中心导向孔310的中心轴线与所述第二中心导向孔320的中心轴线平行。This embodiment provides an osteotomy guide, as shown in Figs. 1-2, comprising: a
第一中心导向孔310的中心轴线与第二中心导向孔320的中心轴线平行，可以确定截骨参照面，由于截骨是由摆锯紧贴克氏针的边缘截骨，因此截骨参照面与实际截骨面相差约一个克氏针半径大小的距离。The central axis of the first
在进行开放截骨时，确定好截骨位置后，将本实施例截骨导向器的第一导向套31抵在需要截骨位置，使截骨位置与第一中心导向孔310相切，滑动第二支杆12，使定位结构2抵在腓骨小头位置，在定位柱4的合适的通孔41位置插入第二导向套32，调整定位柱4的方向，使第二中心导向孔320的中心轴线与第一中心导向孔310的中心轴线确定的平面与胫骨平台的后倾角度一致，然后在确定好的位置，将第二克氏针穿过第二中心导向孔320后钉入胫骨，两个克氏针钉入后，去除截骨导向器，使用摆锯紧贴两个克氏针进行截骨，直至截至对侧，不能完全截断，保留单侧皮质，形成合页，使得截骨处能够尽快愈合。When performing an open osteotomy, after the osteotomy position is determined, the
本实施例的截骨导向器，能够在确定截骨位置后，使用第一导向套31、第二导向套32限定克氏针的入针位置及进针方向，不会发生偏斜，一次性完成高质量的截骨，手术效率高；另外，第一导向套31、第二导向套32和定位柱4互相配合，还能保证进针后的第一克氏针和第二克氏针保持平行，方便摆锯紧贴第一克氏针和第二克氏针截骨。The osteotomy guide of this embodiment can use the
所述定位结构为定位碗，适于扣在腓骨小头位置；碗状结构便于按压固定，操作方便。The positioning structure is a positioning bowl, which is suitable for being buckled at the position of the head of the fibula; the bowl-shaped structure is convenient for pressing and fixing, and the operation is convenient.
所述主杆10为多边形棱柱结构，所述第二支杆12能够沿所述主杆10的轴向移动，但不可绕所述主杆10的周向转动。具体在本实施例中，主杆10为四边形棱柱，第二支杆12通过具有四边形内腔的滑动套可滑动地套设在主杆10上。The
如此设置，使得定位结构2只能在靠近或远离第一导向套31的方向来回移动，在移动过程中，定位结构2始终与第一导向套31相对，从而可以提高调节效率。In this way, the
所述第二导向套32包括第二导向套主体321，和设置在所述第二导向套主体321一端的环形凸缘322，所述第二导向套主体321的外径与所述通孔41的内径大小一致。第二导向套32插入定位柱4上的通孔41后，向着定位结构2的方向按压，不致整个没入通孔41内部，操作方便。The
还包括位置确定件5，所述位置确定件5一端可转动地安装在所述定位柱4上，另一端具有比照端51，所述第一中心导向孔310的中心轴线与所述第二中心导向孔320的中心轴线确定截骨参照面(比实际截骨面高或低一个中心导向孔的半径大小)，所述设定比照端51距离所述截骨参照面的距离，保证真实截骨位置距离胫骨平台为约3.5cm；从而满足相关手术要求(一般情况下，在远离腓骨一侧，截骨位置要求位于胫骨平台下约3.5cm)。It also includes a
所述比照端51设有插入板52，所述插入板52与所述截骨参照面平行。由于在截骨时，要求截骨面要与胫骨平台的倾角相同；设置与截骨参照面平行的插入板52后，在手术过程中，将插入板52插入至胫骨平台位置，使插入板52与胫骨平台后倾角相同，此时可保证第一导向套31和第二导向套32对于克氏针的导向与上述倾角相同，从而保证紧贴克氏针截出的骨平面也与上述倾角相同。The
作为改进方案，参考图3所示，所述插入板52上设有若干插入导孔56，若干个所述插入导孔56的中心轴线平行并共面，且与所述截骨参照面平行。由于内侧胫骨平台处关节囊和韧带的影响，插入板52的插入较为费劲，此时可通过在插入导孔56位置插入至少两个克氏针将插入板52固定，并使插入板52的倾斜角度与骨平台的倾角相同，从而降低插入板52的插入难度。As an improved solution, as shown in FIG. 3 , the
所述位置确定件5包括底座50，所述底座50的一端形成U型结构，所述U型结构的两个相对侧面55具有可转动套设在所述定位柱4上的安装孔53，所述底座50的另一端设有指示杆54，所述指示杆54沿着内侧胫骨近端的位置弯折，所述指示杆54的顶端为所述比照端51。这种结构设计，能够适应胫骨平台至胫骨近端位置的人体骨骼结构，方便比照端比较，也方便定位柱4位置第一导向套31和第二导向套32的抵靠。The
所述第一导向套31位于所述U型结构的内侧，所有的所述通孔41均位于所述U型结构外侧。使得整个截骨导向器结构紧凑，方便第二导向套32的拆卸，且使得指示杆54位于居中位置，方便比照端的比照。The
所述主杆10上设有刻度，所述刻度的0刻度位置与所述第一导向套31的朝向所述定位结构2的端部平齐；所述刻度从0刻度位置向着远离所述第一支杆11的方向增加。钉入克氏针时，可采用具有刻度的克氏针，通过观察钉入克氏针上面的刻度，即可知晓克氏针钉入的大致位置，避免穿透胫骨。另外，也可以设置当克氏针插入到第一导向套31或第二导向套32内部至尖部与0刻度平齐时，克氏针的位于第一导向套31或第二导向套32的另一端的刚好未插入位置为0刻度，然后刻度数值向着远离第一导向套31或第二导向套32的方向增加，这样当钉入克氏针时，可以更方便地知晓克氏针的钉入深度。The
本实施例中截骨导向器的使用方法如下：The use method of the osteotomy guide in this embodiment is as follows:
首先确定好截骨位置，将本实施例截骨导向器的插入板52放置到与胫骨平台平齐的位置，然后使用两根克氏针穿过插入导孔56将插入板52固定，并使插入板52的倾斜角度与胫骨平台的后倾角相同；First determine the position of the osteotomy, place the
使第一导向套31抵靠在胫骨上，滑动第二支杆12，使定位结构2抵在腓骨小头位置，在定位柱4的合适的通孔41位置插入第二导向套32，将第二克氏针穿过第二导向套32的第二中心导向孔320后钉入胫骨，两个克氏针钉入后，去除截骨导向器，使用摆锯紧贴两个克氏针进行截骨，直至截至对侧。Make the
显然，上述实施例仅仅是为清楚地说明所作的举例，而并非对实施方式的限定。对于所属领域的普通技术人员来说，在上述说明的基础上还可以做出其它不同形式的变化或变动。这里无需也无法对所有的实施方式予以穷举。而由此所引伸出的显而易见的变化或变动仍处于本发明创造的保护范围之中。Obviously, the above-mentioned embodiments are only examples for clear description, and are not intended to limit the implementation manner. For those of ordinary skill in the art, changes or modifications in other different forms can also be made on the basis of the above description. There is no need and cannot be exhaustive of all implementations here. And the obvious changes or changes derived from this are still within the protection scope of the present invention.
Claims (10)
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| CN116172653A (en)* | 2022-09-08 | 2023-05-30 | 方超华 | Bone cutting guide plate around knee joint and bone cutting device |
| CN116492006A (en)* | 2022-01-19 | 2023-07-28 | 苏州微创关节医疗科技有限公司 | Patella osteotomy guider |
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| CN112842454B (en)* | 2020-12-31 | 2022-05-10 | 福州市第二医院（福建省福州中西医结合医院、福州市职业病医院） | A guide for osteotomy around the knee joint and its application |
| CN116492006A (en)* | 2022-01-19 | 2023-07-28 | 苏州微创关节医疗科技有限公司 | Patella osteotomy guider |
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