Navigation template for tibial high-level osteotomyTechnical Field
The invention belongs to the technical field of medical appliances, and particularly relates to a navigation template for a tibial high-level osteotomy operation.
Background
HTO is a proximal high-level osteotomy of the tibia, and one method of surgery for treating knee OA is divided into a lateral closed wedge osteotomy and a medial open wedge osteotomy. The force line is transferred from the medial compartment of the knee joint where inflammation and wear occur to the relatively normal lateral compartment through proximal tibial osteotomy, thereby achieving the goal of reducing joint inflammation. For a normal force-line knee joint, there is more medial loading and less lateral loading. If there is some varus deformity in the tibia, the pressure acting on the medial compartment cartilage is significantly increased beyond the range of cartilage bearing, causing a series of vicious cycles of cartilage wear and inflammation, forming medial osteoarthritis. Before osteoarthritis does not develop to the outside, HTO properly transfers the lower limb force lines to the normal outside compartment by correcting tibial varus deformity, thereby significantly reducing the pressure in the inside compartment, restoring it to a normal range that cartilage can withstand, effectively preventing cartilage wear, alleviating pain symptoms, and even allowing worn cartilage and injured meniscus to repair itself conditionally.
The success of HTO surgery comprises at least three elements, 1. Appropriate patient selection 2. Safe and accurate surgical technique 3. Reliable internal fixation. The operation technology of doctors has great influence on the clinical curative effect of HTO, such as insufficient correction degree, excessive correction and the like. The traditional HTO operation scheme needs to rely on doctor hand-drawing measurement and calculation of correction degrees and distraction heights, has long operation time and large radiation injury, and is easy to cause operation complications such as bone mass loss. The 3D printing technology enables HTO to be more accurate and strong in practicality, and operation errors can be well compensated.
Disclosure of Invention
In order to solve the problems, the invention discloses a hinge plate which can be matched with a patient through a 3D printing structure and joint resin for joint bones, and the hinge plate structure is movably and integrally jointed, and the hinge plate is matched with different leg bone parts of the patient to finish operation navigation and is a high-level tibia osteotomy operation navigation template with strong practicability.
In order to achieve the above purpose, the technical scheme of the invention is as follows:
the utility model provides a tibia high-order osteotomy navigation template, includes the locating pin, the through-hole that the locating pin openly opened along hinge board outside end stretches into inside patient's leg bone and fixes, and two sets of hinge boards are mirror image distribution structure along swivel mechanism, and the hinge board passes through synchronizer ring and swivel mechanism synchro connection, and the hinge joint back side between two sets of hinge boards installs the spreader, and two sets of hinge board outside end side horizontal cartridge has the plug, the plug stretches into along the direction of the vertical cartridge locating pin of hinge board and stretches out and spacing butt joint with the hinge joint from the end wall of inboard end.
Further, the plug center is offered spacing logical groove, spacing logical groove is rectangular form, spacing logical inslot wall is through the spacing extrusion contact of inflation pad and locating pin, the through-hole outside that the end openly offered outside the hinge board is led to the inflation pad along spacing logical inslot wall extension.
Furthermore, the upper end and the lower end of the bolt shaft body of the plug are respectively connected with an operation end and a screw connection end in an integrated mode, and the screw connection end is in butt joint with a screw connection hole on the outer side end face of the hinge joint.
Still further, swivel mechanism includes embedded fastening end and shaft body, movable mounting has embedded fastening end on the shaft body, the axostylus axostyle of embedded fastening end bottom stretches into to the shaft body bottom along the open top, embedded fastening end is spiro union fastening structure with the axostylus axostyle.
Furthermore, an assembly groove is longitudinally formed in the outer wall of the shaft body, and the assembly groove is fixedly butted with the hinge plate at any one end.
Still further, the hinge board front center has seted up and has been loaded the cavity, it has laminating resin board to load the cavity, laminating resin board and patient's skeleton laminating contact.
In summary, compared with the prior art, the combined connecting hinge structure is adopted, the guide plate structure of the transmission split charging up and down is converted into the integrated angle adjusting mechanism, the integrated angle adjusting mechanism is matched with the patient osteotomy position, the 3D printing technology is matched with the fitting angle processing structure of the patient one by one, the technical problem that the patient cannot accurately adapt to the osteotomy end in the guide plate positioning process in the past is solved, and the integrated angle adjusting mechanism can adapt to any angle of the osteotomy end of the patient to complete the fitting process, so that the operation is simple and one-step.
The invention has the beneficial effects that the combined connecting hinge structure is adopted, the guide plate structure of the transmission split charging up and down is converted into the integrated angle adjusting mechanism, the integrated angle adjusting mechanism is matched with the osteotomy position of a patient, the 3D printing technology is matched with the joint angle processing structure of the patient one by one, the technical problem that the patient cannot accurately adapt to the osteotomy end in the guide plate positioning process in the past is solved, and the integrated angle adjusting mechanism can adapt to any angle of the osteotomy end of the patient to finish the joint process, so that the operation is simple and one-step.
Drawings
Fig. 1 is a rear view of a tibial plateau osteotomy navigation template of the present invention.
Fig. 2 is a front view of a tibial plateau osteotomy navigation template of the present invention.
Fig. 3 is a schematic structural view of a navigation template plug for tibial high osteotomy.
Fig. 4 is a schematic structural view of a navigation template swivel mechanism for tibial high osteotomy.
The reference number list comprises a positioning needle 1, a laminating resin plate 2, a spreader 3, a synchronous ring 4, an expansion pad 5, a hinge plate 6, a hinge joint 7, a swivel mechanism 8, a plug 9 and a filling cavity 10;
8-1 is an embedded fastening end, 8-2 is an assembly groove, and 8-3 is a shaft body;
9-1 is an operation end, 9-2 is a bolt shaft body, 9-3 is a limiting through groove, and 9-4 is a screw connection end.
Detailed Description
The present invention is further illustrated in the following drawings and detailed description, which are to be understood as being merely illustrative of the invention and not limiting the scope of the invention.
As shown in figures 1,2, 3 and 4, the tibia high-position osteotomy navigation template comprises positioning pins, wherein the positioning pins 1 extend into the leg bones of a patient along through holes formed in the front face of the outer end of a hinge plate 6 and are fixed, two groups of hinge plates 6 are in mirror image distribution structures along a swivel mechanism 8, the hinge plate 6 is synchronously connected with the swivel mechanism 8 through a synchronizing ring 4, a spreader 3 is mounted on the back of a hinge joint 7 between the two groups of hinge plates 6, bolts 9 are horizontally inserted into the side faces of the outer end of the two groups of hinge plates 6, and the bolts 9 extend into the direction of the hinge plate 6 along which the positioning pins 1 are vertically inserted and extend out of the end wall of the inner end and are in limiting butt joint with the hinge joint 7. The hinge plates 6 can adapt to the leg bone structure of a patient and match with the 3D printer to finish one-to-one manufacturing, the structure is different, and the two sets of hinge plates 6 take the swivel mechanism 8 as a rotating structure, so that the fit angle is adjusted by adapting to the bone cutting of the patient. The hinge plate 6 utilizes the synchronizer ring 4 to cooperate with the swivel mechanism 8 to complete the angle adjustment procedure, and simultaneously, two groups of hinge plates 6 and the swivel mechanism 8 are of an integrated assembly structure, and compared with the prior grouping type installation structure, the operation is simple and convenient, and the osteotomy position of a patient is not easy to damage. After the angle is adjusted, the hinge plate 6 is fixed at the upper end and the lower end of the osteotomy by using the positioning needle 1. Meanwhile, due to the flexible rotating structure of the swivel mechanism 8, the hinge plate 6 is temporarily fixed inside the swivel mechanism 8 by using a method of horizontally inserting and limiting the plug 9 so as to support and expose the end of the osteotomy to be matched with the subsequent operation.
As shown in fig. 1, 2, 3 and 4, the center of the plug 9 is provided with a limiting through groove 9-3, the limiting through groove 9-3 is in a strip shape, the inner wall of the limiting through groove 9-3 is in limiting extrusion contact with the positioning needle 1 through the expansion pad 5, and the expansion pad 5 extends to the outer side of a through hole formed in the front face of the outer end of the hinge plate 6 along the inner wall of the limiting through groove 9-3. Wherein, the plug 9 and the positioning needle 1 belong to a vertical connection structure. The positioning needle 1 can further fix the horizontal inserting position of the plug 9, and the plug 9 is prevented from moving randomly in the horizontal direction. In order to effectively limit the plug 9 by the positioning needle 1, the outer wall of the positioning needle 1 is temporarily and vertically inserted into the limit through groove 9-3 through the expansion pad 5, and the expansion pad 5 can increase the pressure between the positioning needle 1 and the inner wall of the limit through groove 9-3.
As shown in fig. 1, 2, 3 and 4, the upper end and the lower end of the bolt shaft body of the plug 9 are respectively connected with an operation end 9-1 and a screw connection end 9-4 in an integrated manner, and the screw connection end 9-4 is in butt joint with a screw connection hole on the outer side end face of the hinge joint 7. Wherein, the operation end 9-1 can be matched with a medical spanner or other operation instruments to complete the screwing assembly process. The screw connection end 9-4 is further in butt joint with a screw connection hole on the outer side end face of the hinge joint 7, so that the hinge plate 6 is prevented from rotating along the rotary joint mechanism 8 in the operation process.
As shown in fig. 1,2, 3 and 4, the swivel mechanism 8 includes an embedded fastening end 8-1 and a shaft body 8-3, the shaft body 8-3 is movably provided with the embedded fastening end 8-1, a shaft rod at the bottom of the embedded fastening end 8-1 extends into the bottom of the shaft body 8-3 along an opening at the top, and the embedded fastening end 8-1 and the shaft rod are in a screw-connection fastening structure. The embedded fastening end 8-1 is used as a horizontal telescopic compressing structure, and can be matched with an embedded operation wrench to complete the fastening process, so that the rotation of the synchronizing ring 4 and the hinge plate 6 is further limited. The method is also a secondary prevention means matched with stable operation of the operation.
As shown in fig. 1,2,3 and 4, the outer wall of the shaft body 8-3 is longitudinally provided with an assembly groove 8-2, and the assembly groove 8-2 is fixedly abutted with the hinge plate 6 at any end. Wherein the hinge plate 6 at either end is synchronously connected with the shaft body 8-3 along the assembly groove 8-2, and the hinge plate 6 at the other side is rotated along the shaft body 8-3 through the synchronizing ring 4. Thus, the healthcare worker need only limit the movably mounted one-sided hinge plate 6 to control the change in position of the entire navigation template.
As shown in fig. 1, 2, 3 and 4, a filling cavity 10 is formed in the front center of the hinge plate 6, the filling cavity 10 is filled with a laminating resin plate 2, and the laminating resin plate 2 is in laminating contact with the bone of a patient. The resin plate 2 can avoid hard contact between metal and patient bone, and the secondary damage is often caused in the conventional hard contact process, so that the resin plate 2 can be manufactured by 3D printing technology, and the cavity 10 is matched and filled to complete later assembly and to be adhered to the upper and lower bone end surfaces of the osteotomy end part of the patient.
It should be noted that the foregoing merely illustrates the technical idea of the present invention and is not intended to limit the scope of the present invention, and that a person skilled in the art may make several improvements and modifications without departing from the principles of the present invention, which fall within the scope of the claims of the present invention.