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CN114129259B - A method for preparing an osteotomy guide plate and a clamping locking sleeve based on digital medicine and 3D printing technology - Google Patents

A method for preparing an osteotomy guide plate and a clamping locking sleeve based on digital medicine and 3D printing technology
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CN114129259B
CN114129259BCN202111305373.6ACN202111305373ACN114129259BCN 114129259 BCN114129259 BCN 114129259BCN 202111305373 ACN202111305373 ACN 202111305373ACN 114129259 BCN114129259 BCN 114129259B
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osteotomy
data
locking sleeve
screw
plate
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CN114129259A (en
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张志群
王乙辛
刘逸夫
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Nanjing Children's Hospital of Nanjing Medical University
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Nanjing Spain Medical Equipment Co ltd
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Abstract

Translated fromChinese

本发明属于骨科矫形手术及骨科医疗器械技术领域,确切的来说是一种基于数字医学和3D打印技术的新型个性截骨矫形术式。针对现有的截骨矫形类手术在治疗时,由于术前仅通过单纯的二维数据测量来确定截骨平面及角度,术中往往需要多次调试,增加了手术的危险性和不确定性,并且因为肌肉牵拉、摆动偏移等各种原因往往无法达到预期效果,现提出如下方案,其步骤包括CT图像三维重建、钢板螺钉系统的数据采集、计算机模拟手术、钢板螺钉植入匹配、反向还原三维数据、截骨导板设计、夹持锁定套筒设计和术中矫形校正。本发明借助计算机模拟来指导手术,通过个性化导板和辅助工具来保障手术准确性,简化手术步骤,缩短手术时间,减少手术风险,具有广泛的临床推广意义。

The present invention belongs to the technical field of orthopedic surgery and orthopedic medical equipment. Specifically, it is a new personalized osteotomy orthopedic procedure based on digital medicine and 3D printing technology. In view of the existing osteotomy orthopedic surgery, since the osteotomy plane and angle are determined only by simple two-dimensional data measurement before the operation, multiple adjustments are often required during the operation, which increases the risk and uncertainty of the operation, and the expected effect is often not achieved due to various reasons such as muscle pulling and swing deviation. The following scheme is proposed, and its steps include three-dimensional reconstruction of CT images, data acquisition of steel plate screw system, computer simulation surgery, steel plate screw implantation matching, reverse restoration of three-dimensional data, osteotomy guide design, clamping locking sleeve design and intraoperative orthopedic correction. The present invention uses computer simulation to guide the operation, uses personalized guides and auxiliary tools to ensure the accuracy of the operation, simplifies the operation steps, shortens the operation time, reduces the risk of the operation, and has a wide range of clinical promotion significance.

Description

Translated fromChinese
一种基于数字医学和3D打印技术的截骨导板和夹持锁定套筒的制备方法A preparation method of an osteotomy guide plate and a clamping locking sleeve based on digital medicine and 3D printing technology

技术领域Technical Field

本发明涉及骨科矫形手术及骨科医疗器械技术领域,尤其涉及一种基于数字医学和3D打印技术的截骨导板和夹持锁定套筒的制备方法。The present invention relates to the technical field of orthopedic surgery and orthopedic medical equipment, and in particular to a method for preparing an osteotomy guide plate and a clamping and locking sleeve based on digital medicine and 3D printing technology.

背景技术Background Art

近年来,骨科类疾病发病率逐年递增,因骨骼包裹于人体组织内目前主要通过CT进行骨骼断层扫描来诊断。在医生与患者沟通病情及治疗方案时,因CT医学影像的平面化、专业化造成患者无法看懂,进而产生一定的沟通不畅和不信任感。In recent years, the incidence of orthopedic diseases has increased year by year. As bones are wrapped in human tissue, they are currently mainly diagnosed through bone tomography scans. When doctors communicate with patients about their condition and treatment plans, patients cannot understand the flat and specialized CT medical images, which leads to a certain degree of communication miscommunication and distrust.

现有的需要截骨矫形类骨科疾病在手术治疗时,由于术前仅通过单纯的二维数据测量来确定截骨平面及角度,术中往往需要多次调试,增加了手术的危险性和不确定性,并且因为肌肉牵拉、摆动偏移等各种原因往往无法达到预期效果,从而导致患者的病情得不到更好的治疗。In the existing surgical treatment of orthopedic diseases that require osteotomy and correction, the osteotomy plane and angle are determined only through simple two-dimensional data measurement before the operation. Multiple adjustments are often required during the operation, which increases the risk and uncertainty of the operation. In addition, the expected effect is often not achieved due to various reasons such as muscle pulling and swing deviation, resulting in the patient's condition not being better treated.

发明内容Summary of the invention

本发明的目的是为了解决该类疾病在现有传统手术时容易因反复操作丢失骨量等问题,期望实现精准定位截骨部位及角度的矫形设计,而提出的一种基于数字医学和3D打印技术的截骨导板和夹持锁定套筒的制备方法。The purpose of the present invention is to solve the problem of bone loss due to repeated operations during existing traditional surgeries for such diseases, and to achieve orthopedic design that accurately locates the osteotomy site and angle. A method for preparing an osteotomy guide and a clamping locking sleeve based on digital medicine and 3D printing technology is proposed.

为了实现上述目的,本发明采用了如下技术方案:In order to achieve the above object, the present invention adopts the following technical solutions:

一种基于数字医学和3D打印技术的截骨导板的制备方法,针对3D打印的骨科矫形使用 方法,该方法包括CT图像三维重建、钢板螺钉系统的数据采集、计算机模拟手术、钢板螺钉 植入匹配、反向还原三维数据、截骨导板设计、夹持锁定套筒设计和术中矫形校正,采用上 述3D打印的骨科矫形使用方法具体操作如下:A method for preparing an osteotomy guide based on digital medicine and 3D printing technology, and a method for using 3D printing in orthopedics, the method includes 3D reconstruction of CT images, data collection of a plate and screw system, computer simulation surgery, plate and screw implant matching, reverse restoration of 3D data, osteotomy guide design, clamping and locking sleeve design, and intraoperative orthopedic correction. The specific operations of the orthopedic use method using the above 3D printing are as follows:

S1:CT图像三维重建:根据患者的螺旋CT扫入图像,保存为dicom格式,使用三维软件将CT图像处理得到并保存为stl格式的原始三维数据;S1: 3D reconstruction of CT images: Based on the patient's spiral CT scanned images, save them in dicom format, use 3D software to process the CT images and save them in stl format as original 3D data;

S2: 钢板螺钉系统的数据采集:准备好术中可能用到的钢板螺钉系统,包括各种规 格的钢板,锁定螺钉,锁定套筒,钻头,锯片,测量钢板钉孔最小内径,钻头直径,锯片厚度, 锁定套筒螺纹倾角和规格,将锁定螺钉固定在钢板上,如钢板螺钉为镜面则用着色剂喷涂表面,使用激光扫描仪扫描钢板螺钉,得到并保存为stl格式的钢板螺钉三维数据,扫描需要设备和软件;S2: Data collection of plate screw system: Prepare the plate screw system that may be used during the operation, including various specifications of plates, locking screws, locking sleeves, drill bits, and saw blades. Measure the minimum inner diameter of the plate nail hole, drill bit diameter, saw blade thickness, locking sleeve thread inclination and specifications. Fix the locking screw on the plate. If the plate screw is a mirror surface, spray the surface with a colorant. Use a laser scanner to scan the plate screw to obtain and save the three-dimensional data of the plate screw in stl format. Scanning requires equipment and software.

S3:计算机模拟手术:根据步骤1所得到的原始三维数据,按照医学矫形要求做计算机模拟,达到手术要求,记录截骨面,骨块位移数据并保存stl格式的模拟三维数据;S3: Computer simulation surgery: Based on the original three-dimensional data obtained in step 1, perform computer simulation according to medical orthopedic requirements to meet the surgical requirements, record the osteotomy surface, bone block displacement data and save the simulated three-dimensional data in stl format;

S4: 钢板螺钉植入匹配:由步骤3得到的模拟三维数据和步骤2中扫描得到的钢板螺钉三维数据,按医学要求做计算机植入匹配,帮助医生选择最优的钢板螺钉,选择最优的钢板螺钉和模拟三维数据的位置关系,确认钢板螺钉规格,配套工具参数,导板固定针直径为钻头直径,记录并保存为stl格式的三维匹配数据;S4: Plate and screw implantation matching: The simulated 3D data obtained in step 3 and the 3D data of the plate and screw scanned in step 2 are matched by computer implantation according to medical requirements to help doctors select the optimal plate and screw, select the optimal positional relationship between the plate and screw and the simulated 3D data, confirm the plate and screw specifications, supporting tool parameters, the guide plate fixing pin diameter is the drill bit diameter, and record and save the 3D matching data in stl format;

S5: 反向还原三维数据:根据步骤4所得三维匹配数据,在满足手术入路的范围内,S5: Reverse restoration of 3D data: Based on the 3D matching data obtained in step 4, within the range of the surgical approach,

截骨面两侧各保留至少两颗在骨块内间距最大的螺钉并记录位置数据,保持螺钉在骨块内 位置不变,反向还原成保留螺钉位置信息和截骨位置信息的原始三维数据,并保存为stl格 式的还原三维数据;At least two screws with the largest distance between them are retained on both sides of the osteotomy surface and their position data are recorded, the screw positions in the bone block are kept unchanged, and the original three-dimensional data retaining the screw position information and the osteotomy position information are reversely restored and saved as restored three-dimensional data in stl format;

S6: 截骨导板设计:根据步骤5中得到含有螺钉和截骨位置信息的还原三维数据制 作截骨导板,导板结构分为固定针内管,外管,截骨槽,连接卡槽,导板主体。以骨骼表面为 导板内侧曲面,以螺钉位置为固定针位置,根据截骨位置信息确定截骨槽,截骨槽宽度大于 锯片厚度,固定针内管内径大于钻头直径,外径为钢板螺钉孔直径,固定针内管套与外管 内,外管内径大于固定针内管外径,并与导板主体相连,连接卡槽连接根据截骨槽数据设计 为可拆卸E型卡槽,将截骨槽两边导板连接固定,数据保存为截骨导板,并用3D打印机打印;S6: osteotomy guide design: according to the restored three-dimensional data containing screws and osteotomy position information obtained in step 5, an osteotomy guide is manufactured. The guide structure is divided into a fixing pin inner tube, an outer tube, an osteotomy groove, a connecting slot, and a guide body. The bone surface is used as the inner curved surface of the guide, the screw position is used as the fixing pin position, and the osteotomy groove is determined according to the osteotomy position information. The width of the osteotomy groove is greater than the thickness of the saw blade, the inner diameter of the fixing pin inner tube is greater than the drill bit diameter, and the outer diameter is the diameter of the steel plate screw hole. The fixing pin inner tube sleeve is inside the outer tube, the inner diameter of the outer tube is greater than the outer diameter of the fixing pin inner tube, and is connected to the guide body. The connecting slot is designed as a detachable E-type slot according to the osteotomy groove data, and the guide plates on both sides of the osteotomy groove are connected and fixed. The data is saved as an osteotomy guide, and printed with a 3D printer;

S7:夹持锁定套筒设计:夹持锁定套筒包括中心夹持锁定套筒和偏心夹持锁定套筒,中心夹持锁定套筒根据步骤2扫描和测绘(或由厂家提供)得到的锁定套筒三维数据,夹持锁定套筒上设有弹性槽,弹性槽为螺纹头后端做环型切除。夹持锁定套筒从螺纹端做三等分切割成三爪夹头,至弹性槽末端。偏心夹持锁定套筒在中心夹持锁定套筒的数据上将中空内径平移一定距离,最大距离为中空边缘与螺纹的相切,可根据手术需要设计不同偏心距离,并交工厂生产备用;S7: Design of clamping and locking sleeve: The clamping and locking sleeve includes a central clamping and locking sleeve and an eccentric clamping and locking sleeve. The central clamping and locking sleeve is scanned and mapped according to step 2 (or provided by the manufacturer) to obtain the three-dimensional data of the locking sleeve. An elastic groove is provided on the clamping and locking sleeve, and the elastic groove is a ring-shaped cutout at the rear end of the threaded head. The clamping and locking sleeve is cut into three equal parts from the threaded end to the end of the elastic groove. The eccentric clamping and locking sleeve translates the hollow inner diameter by a certain distance based on the data of the central clamping and locking sleeve. The maximum distance is the tangency of the hollow edge and the thread. Different eccentric distances can be designed according to surgical needs and delivered to the factory for production and standby;

S8: 医生充分暴露骨骼表面,放置截骨导板,置入固定针固定导板,取下连接卡槽, 截骨,取下固定针内管及截骨导板,矫形骨块分离,穿过固定针放置钢板贴与骨面,安装中 心夹持锁定套筒,CT或C臂机校验矫形效果,如需校正则安装偏心夹持套筒,安装螺钉,缝合伤口。S8: The doctor fully exposes the bone surface, places the osteotomy guide, inserts the fixation pin to fix the guide, removes the connecting slot, performs osteotomy, removes the inner tube of the fixation pin and the osteotomy guide, separates the orthopedic bone blocks, places a steel plate through the fixation pin to adhere to the bone surface, installs the central clamping locking sleeve, verifies the orthopedic effect with CT or C-arm, installs the eccentric clamping sleeve if correction is needed, installs the screws, and sutures the wound.

优选的,所述钢板螺钉系统包括各种规格的钢板,锁定螺钉,锁定螺钉固定在钢板上。Preferably, the steel plate screw system includes steel plates of various specifications and locking screws, and the locking screws are fixed on the steel plates.

优选的,所述导板结构为导板本体、固定针内管、外管、固定针、截骨槽、连接卡槽,导板本体的中间位置设置有截骨槽,并通过连接卡槽进行连接,外管与导板本体相连,固定针内管安装在外管内,固定针通过固定针内管置入骨骼。Preferably, the guide plate structure comprises a guide plate body, an inner tube of a fixing needle, an outer tube, a fixing needle, an osteotomy groove, and a connecting slot. An osteotomy groove is provided in the middle position of the guide plate body and is connected via a connecting slot. The outer tube is connected to the guide plate body, the inner tube of the fixing needle is installed in the outer tube, and the fixing needle is inserted into the bone through the inner tube of the fixing needle.

优选的,所述夹持锁定套筒包括中心夹持锁定套筒和偏心夹持锁定套筒,中心夹持锁定套筒和偏心夹持锁定套筒上均设有三个倾角螺纹和三弹性槽形成三爪夹头。Preferably, the clamping and locking sleeve comprises a central clamping and locking sleeve and an eccentric clamping and locking sleeve, and both the central clamping and locking sleeve and the eccentric clamping and locking sleeve are provided with three inclined threads and three elastic grooves to form a three-jaw chuck.

本发明借助计算机模拟来指导手术,通过个性化导板和辅助工具来保障手术准确性,简化手术步骤,缩短手术时间,减少手术风险,具有广泛的临床推广意义。The present invention uses computer simulation to guide surgery, uses personalized guides and auxiliary tools to ensure surgical accuracy, simplifies surgical steps, shortens surgical time, and reduces surgical risks, and has broad clinical promotion significance.

附图说明BRIEF DESCRIPTION OF THE DRAWINGS

图1为本发明提出的一种基于数字医学和3D打印技术的截骨导板的制备方法的钢板螺钉结构示意图;FIG1 is a schematic diagram of a plate screw structure of a method for preparing an osteotomy guide plate based on digital medicine and 3D printing technology proposed by the present invention;

图2为本发明提出的一种基于数字医学和3D打印技术的截骨导板的制备方法的截骨导板结构示意图;FIG2 is a schematic diagram of the structure of an osteotomy guide plate according to a method for preparing an osteotomy guide plate based on digital medicine and 3D printing technology proposed by the present invention;

图3为本发明提出的一种基于数字医学和3D打印技术的截骨导板的制备方法的锁定套筒结构示意图。FIG3 is a schematic diagram of a locking sleeve structure of a method for preparing an osteotomy guide plate based on digital medicine and 3D printing technology proposed by the present invention.

图中:2、钢板螺钉系统;21、钢板;22、锁定螺钉;6、导板结构;61、导板本体;62、外管;63、固定针内管;64、固定针;71、中心夹持锁定套筒;711、偏心夹持锁定套筒;72、弹性槽;73、倾角螺纹;65、截骨槽;66、连接卡槽。In the figure: 2, plate and screw system; 21, plate; 22, locking screw; 6, guide plate structure; 61, guide plate body; 62, outer tube; 63, fixing needle inner tube; 64, fixing needle; 71, center clamping locking sleeve; 711, eccentric clamping locking sleeve; 72, elastic groove; 73, inclined thread; 65, osteotomy groove; 66, connecting slot.

具体实施方式DETAILED DESCRIPTION

下面将结合本实施例中的附图,对本实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本实施例一部分实施例,而不是全部的实施例。The technical solution in this embodiment will be clearly and completely described below in conjunction with the drawings in this embodiment. Obviously, the described embodiment is only a part of the embodiment, rather than all of the embodiments.

实施例Example

参照图1-3,一种基于数字医学和3D打印技术的截骨导板的制备方法,针对3D打印的骨 科矫形使用方法,该方法包括CT图像三维重建、钢板螺钉系统的数据采集、计算机模拟手 术、钢板螺钉植入匹配、反向还原三维数据、截骨导板设计、夹持锁定套筒设计和术中矫形 校正,采用上述3D打印的骨科矫形使用方法具体操作如下:Referring to Figures 1-3, a method for preparing an osteotomy guide based on digital medicine and 3D printing technology, and a method for using 3D printed orthopedics, the method includes 3D reconstruction of CT images, data collection of a plate and screw system, computer simulation surgery, plate and screw implantation matching, reverse restoration of 3D data, osteotomy guide design, clamping and locking sleeve design, and intraoperative orthopedic correction. The specific operations of the orthopedic use method using the above 3D printing are as follows:

S1:CT图像三维重建:根据患者的螺旋CT扫入图像,保存为dicom格式,使用三维软件将CT图像处理得到并保存为stl格式的原始三维数据;S1: 3D reconstruction of CT images: Based on the patient's spiral CT scanned images, save them in dicom format, use 3D software to process the CT images and save them in stl format as original 3D data;

S2: 钢板螺钉系统的数据采集:准备好术中可能用到的钢板螺钉系统,包括各种规格的钢板,锁定螺钉,锁定套筒,钻头,锯片,测量钢板钉孔最小内径,钻头直径,锯片厚度, 锁定套筒螺纹倾角和规格,将锁定螺钉固定在钢板上,如钢板螺钉为镜面则用着色剂喷涂表面,使用激光扫描仪扫描钢板螺钉,得到并保存为stl格式的钢板螺钉三维数据,扫描需要设备和软件;S2: Data collection of plate and screw system: prepare the plate and screw system that may be used during the operation, including various specifications of plates, locking screws, locking sleeves, drill bits, and saw blades. Measure the minimum inner diameter of the plate nail hole, drill bit diameter, saw blade thickness, locking sleeve thread inclination and specifications. Fix the locking screw on the plate. If the plate screw is a mirror surface, spray the surface with a colorant. Use a laser scanner to scan the plate screw to obtain and save the three-dimensional data of the plate screw in stl format. Scanning requires equipment and software.

S3: 计算机模拟手术:根据步骤1所得到的原始三维数据,按照医学矫形要求做计算机模拟,达到手术要求,记录截骨面,骨块位移数据并保存stl格式的模拟三维数据;S3: Computer simulation surgery: Based on the original three-dimensional data obtained in step 1, perform computer simulation according to medical orthopedic requirements to meet the surgical requirements, record the osteotomy surface, bone block displacement data and save the simulated three-dimensional data in stl format;

S4: 钢板螺钉植入匹配:由步骤3得到的模拟三维数据和步骤2中扫描得到的钢板螺钉三维数据,按医学要求做计算机植入匹配,帮助医生选择最优的钢板螺钉,选择最优的钢板螺钉和模拟三维数据的位置关系,确认钢板螺钉规格,配套工具参数,导板固定针直径为钻头直径,记录并保存为stl格式的三维匹配数据;S4: Plate and screw implantation matching: The simulated 3D data obtained in step 3 and the 3D data of the plate and screw scanned in step 2 are matched by computer implantation according to medical requirements to help doctors select the optimal plate and screw, select the optimal positional relationship between the plate and screw and the simulated 3D data, confirm the plate and screw specifications, supporting tool parameters, the guide plate fixing pin diameter is the drill bit diameter, and record and save the 3D matching data in stl format;

S5: 反向还原三维数据:根据步骤4所得三维匹配数据,在满足手术入路的范围内, 截骨面两侧各保留两颗在骨块内间距最大的螺钉并记录位置数据,保持螺钉在骨块内位置不变,反向还原成保留螺钉位置信息和截骨位置信息的原始三维数据,并保存为stl格式的还原三维数据;S5: Reverse restoration of three-dimensional data: according to the three-dimensional matching data obtained in step 4, within the scope of the surgical approach, two screws with the largest spacing in the bone block are retained on both sides of the osteotomy surface and the position data are recorded, the screw positions in the bone block are kept unchanged, and reverse restoration is performed to the original three-dimensional data retaining the screw position information and the osteotomy position information, and the data is saved as restored three-dimensional data in stl format;

S6:截骨导板设计:根据步骤5中得到含有螺钉和截骨位置信息的还原三维数据制作截骨导板,导板结构分为固定针内管,外管,截骨槽,连接卡槽,导板主体。以骨骼表面为导板内侧曲面,以螺钉位置为固定针位置,根据截骨位置信息确定截骨槽,截骨槽宽度大于锯片厚度,固定针内管内径大于钻头直径,外径为钢板螺钉孔直径,固定针内管套与外管内,外管内径大于固定针内管外径,并与导板主体相连,连接卡槽根据截骨槽数据设计为可拆卸E型卡槽,将截骨槽两边导板连接固定,数据保存为截骨导板,并用3D打印机打印;S6: Osteotomy guide design: The osteotomy guide is made according to the restored three-dimensional data containing the screw and osteotomy position information obtained in step 5. The guide structure is divided into a fixing pin inner tube, an outer tube, an osteotomy groove, a connecting slot, and a guide body. The bone surface is used as the inner curved surface of the guide, and the screw position is used as the fixing pin position. The osteotomy groove is determined according to the osteotomy position information. The width of the osteotomy groove is greater than the thickness of the saw blade. The inner diameter of the fixing pin inner tube is greater than the drill bit diameter, and the outer diameter is the diameter of the steel plate screw hole. The fixing pin inner tube sleeve is inside the outer tube, and the inner diameter of the outer tube is greater than the outer diameter of the fixing pin inner tube, and is connected to the guide body. The connecting slot is designed as a detachable E-type slot according to the osteotomy slot data. The guide plates on both sides of the osteotomy groove are connected and fixed. The data is saved as an osteotomy guide and printed with a 3D printer.

S7: 夹持锁定套筒设计:夹持锁定套筒包括中心夹持锁定套筒和偏心夹持锁定套筒,中心夹持锁定套筒根据步骤2扫描和测绘(或由厂家提供)得到的锁定套筒三维数据,夹持锁定套筒上设有弹性槽,弹性槽为螺纹头后端做环型切除。夹持锁定套筒从螺纹端做三等分切割成三爪夹头,至弹性槽末端。偏心夹持锁定套筒在中心夹持锁定套筒的数据上将中空内径平移一定距离,最大距离为中空边缘与螺纹的相切,可根据手术需要设计不同偏心距离,并交工厂生产备用;S7: Design of clamping and locking sleeve: The clamping and locking sleeve includes a central clamping and locking sleeve and an eccentric clamping and locking sleeve. The central clamping and locking sleeve is scanned and mapped according to step 2 (or provided by the manufacturer) to obtain the three-dimensional data of the locking sleeve. The clamping and locking sleeve is provided with an elastic groove, and the elastic groove is a ring-shaped cutout at the rear end of the thread head. The clamping and locking sleeve is cut into three equal parts from the thread end to the end of the elastic groove. The eccentric clamping and locking sleeve translates the hollow inner diameter by a certain distance based on the data of the central clamping and locking sleeve. The maximum distance is the tangency between the hollow edge and the thread. Different eccentric distances can be designed according to surgical needs and delivered to the factory for production and standby;

S8: 医生充分暴露骨骼表面,放置截骨导板,置入克氏针固定导板,取下连接卡槽, 截骨,取下固定针内管及截骨导板,矫形骨块分离,穿过固定针放置钢板贴与骨面,安装中心夹持锁定套筒,CT或C臂机校验矫形效果,如需校正则安装偏心夹持套筒,安装螺钉,缝合 伤口。S8: The doctor fully exposes the bone surface, places the osteotomy guide, inserts the Kirschner wire fixation guide, removes the connecting slot, performs osteotomy, removes the inner tube of the fixation pin and the osteotomy guide, separates the orthopedic bone blocks, places the steel plate on the bone surface through the fixation pin, installs the center clamping locking sleeve, verifies the orthopedic effect with CT or C-arm, installs the eccentric clamping sleeve if correction is needed, installs the screws, and sutures the wound.

本实施例中,钢板螺钉系统2包括配套工具和各种规格的钢板21,锁定螺钉22,锁定螺钉22固定在钢板21上。In this embodiment, the steel plate screw system 2 includes matching tools and steel plates 21 of various specifications, and locking screws 22 , and the locking screws 22 are fixed on the steel plates 21 .

本实施例中,导板结构6为导板本体61、固定针内管63、外管62、固定针64、截骨槽65、连接卡槽66,导板本体61的中间位置设置有截骨槽65,并通过连接卡槽66进行连接,外管62与导板本体61相连,固定针内管63安装在外管62内,固定针64通过固定针内管置入骨骼。In this embodiment, the guide plate structure 6 is composed of a guide plate body 61, a fixing needle inner tube 63, an outer tube 62, a fixing needle 64, an osteotomy groove 65, and a connecting slot 66. The osteotomy groove 65 is provided in the middle position of the guide plate body 61 and is connected through the connecting slot 66. The outer tube 62 is connected to the guide plate body 61, the fixing needle inner tube 63 is installed in the outer tube 62, and the fixing needle 64 is inserted into the bone through the fixing needle inner tube.

本实施例中,夹持锁定套筒包括中心夹持锁定套筒71和偏心夹持锁定套筒711,中心夹持锁定套筒71和偏心夹持锁定套筒711上均设有三个倾角螺纹73和三弹性槽72形成三爪夹头。In this embodiment, the clamping and locking sleeve includes a central clamping and locking sleeve 71 and an eccentric clamping and locking sleeve 711. The central clamping and locking sleeve 71 and the eccentric clamping and locking sleeve 711 are both provided with three inclined threads 73 and three elastic grooves 72 to form a three-jaw chuck.

以上所述,仅为本实施例较佳的具体实施方式,但本实施例的保护范围并不局限于此,任何熟悉本技术领域的技术人员在本实施例揭露的技术范围内,根据本实施例的技术方案及其发明构思加以等同替换或改变,都应涵盖在本实施例的保护范围之内。The above description is only a preferred specific implementation manner of this embodiment, but the protection scope of this embodiment is not limited thereto. Any technician familiar with the technical field can make equivalent replacements or changes according to the technical scheme and inventive concept of this embodiment within the technical scope disclosed in this embodiment, and they should be covered by the protection scope of this embodiment.

Claims (1)

Translated fromChinese
1.一种基于数字医学和3D打印技术的截骨导板和夹持锁定套筒的制备方法,其特征在于包括如下步骤:1. A method for preparing an osteotomy guide plate and a clamping and locking sleeve based on digital medicine and 3D printing technology, characterized in that it comprises the following steps:S1:CT图像三维重建:根据患者的螺旋CT扫入图像,重建三维数据,并保存为st1 格式的 原始三维数据;S1: CT image 3D reconstruction: Reconstruct 3D data based on the patient's spiral CT scanned image and save it as original 3D data in st1 format;S2: 钢板螺钉系统的数据采集:准备好术中用到的钢板螺钉系统,使用激光扫描仪扫描S2: Data collection of the plate and screw system: Prepare the plate and screw system used during the operation and scan it using a laser scanner钢板螺钉,得到并保存为st1 格式的钢板螺钉三维数据;Plate screws, obtain and save the three-dimensional data of plate screws in st1 format;S3:根据步骤1所得到的原始三维数据,按照医学矫形要求做计算机模拟,达到手术要求,记录截骨面,骨块位移数据并保存st1 格式的模拟三维数据;S3: Based on the original three-dimensional data obtained in step 1, perform computer simulation according to medical orthopedic requirements to meet surgical requirements, record the osteotomy surface and bone block displacement data, and save the simulated three-dimensional data in st1 format;S4: 钢板螺钉植入匹配:由步骤3得到的模拟三维数据和步骤2中扫描得到的钢板螺钉三维数据,按医学要求,选择钢板螺钉做计算机植入匹配,数据保存st1 格式的三维匹配数据;S4: Plate and screw implantation matching: Based on the simulated three-dimensional data obtained in step 3 and the three-dimensional data of the plate and screw scanned in step 2, the plate and screw are selected for computer implantation matching according to medical requirements, and the data is saved as three-dimensional matching data in st1 format;S5:反向还原三维数据:根据步骤4所得三维匹配数据,在满足手术入路的范围内,截骨面两侧各保留至少两颗在骨块内间距最大的螺钉并记录位置数据,保持螺钉在骨块内位置不变,反向还原成保留螺钉位置信息和截骨位置信息的原始三维数据,并保存为st1 格式的 还原三维数据;S5: Reverse restoration of three-dimensional data: According to the three-dimensional matching data obtained in step 4, within the scope of the surgical approach, at least two screws with the largest spacing in the bone block are retained on both sides of the osteotomy surface and the position data are recorded, the screw positions in the bone block are kept unchanged, and reverse restoration is performed to the original three-dimensional data retaining the screw position information and the osteotomy position information, and the data is saved as restored three-dimensional data in st1 format;S6: 截骨导板设计:根据步骤5中得到含有螺钉和截骨位置信息的还原三维数据制作截骨导板;以骨骼表面为导板本体(61)内侧曲面,以锁定螺钉(22)位置为固定针位置,根据截骨位置信息确定截骨槽,截骨槽宽度大于锯片厚度,固定针内管(63)内径大于钻头直径,外径为钢板螺钉孔直径,固定针内管(63)套于外管(62)内,外管(62)内径大于固定针内管(63)外径,并与导板本体(61)相连,连接卡槽(66)根据截骨槽数据设计为可拆卸E型卡槽,将截骨槽(65)两边的导板本体(61)连接固定,数据保存为截骨导板,并用3D打印机打印;S6: osteotomy guide design: an osteotomy guide is produced according to the restored three-dimensional data containing screw and osteotomy position information obtained in step 5; the bone surface is used as the inner curved surface of the guide body (61), the position of the locking screw (22) is used as the fixing pin position, and the osteotomy groove is determined according to the osteotomy position information, the width of the osteotomy groove is greater than the thickness of the saw blade, the inner diameter of the fixing pin inner tube (63) is greater than the drill bit diameter, and the outer diameter is the diameter of the steel plate screw hole, the fixing pin inner tube (63) is sleeved in the outer tube (62), the inner diameter of the outer tube (62) is greater than the outer diameter of the fixing pin inner tube (63), and is connected to the guide body (61), the connecting slot (66) is designed as a detachable E-type slot according to the osteotomy slot data, the guide body (61) on both sides of the osteotomy slot (65) is connected and fixed, the data is saved as an osteotomy guide, and printed with a 3D printer;S7:夹持锁定套筒设计:所述夹持锁定套筒包括中心夹持锁定套筒(71)和偏心夹持锁定套筒(711),中心夹持锁定套筒根据步骤2扫描和测绘得到的锁定套筒数据设计并制作;术前采集钢板螺钉系统三维数据,所述钢板螺钉系统(2)包括配套工具和各种规格的钢板(21)和锁定螺钉(22),锁定螺钉(22)固定在钢板(21)上;导板结构(6)为导板本体(61)、固定针内管(63)、外管(62)、固定针(64)、截骨槽(65)、连接卡槽(66),固定针内管(63)安装在外管(62)内,固定针 (64)通过固定针内管(63)植入骨骼,固定针(64)位置数据与还原三维数据中的螺钉位置数 据一致;中心夹持 锁定套筒(71)和偏心夹持锁定套筒(711)上均设有三个倾角螺纹(73)和三弹性槽(72)形成 三爪夹头。S7: Design of clamping and locking sleeve: the clamping and locking sleeve comprises a central clamping and locking sleeve (71) and an eccentric clamping and locking sleeve (711), and the central clamping and locking sleeve is designed and manufactured according to the locking sleeve data obtained by scanning and mapping in step 2; the three-dimensional data of the plate screw system is collected before the operation, and the plate screw system (2) comprises matching tools and various specifications of steel plates (21) and locking screws (22), and the locking screws (22) are fixed on the steel plates (21); the guide plate structure (6) comprises a guide plate body (61), a fixing needle inner tube (63), an outer tube (62), a fixing needle (64), an osteotomy groove (65), and a connecting card groove (66), the fixing needle inner tube (63) is installed in the outer tube (62), the fixing needle (64) is implanted into the bone through the fixing needle inner tube (63), and the fixing needle (64) position data is consistent with the screw position data in the restored three-dimensional data; the central clamping The locking sleeve (71) and the eccentric clamping locking sleeve (711) are both provided with three angled threads (73) and three elastic grooves (72) to form a three-jaw chuck.
CN202111305373.6A2021-11-052021-11-05 A method for preparing an osteotomy guide plate and a clamping locking sleeve based on digital medicine and 3D printing technologyActiveCN114129259B (en)

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CN109700501A (en)*2018-12-212019-05-03上海交通大学医学院附属第九人民医院A kind of making and use method of the split type osteotomy guide plate in Mandibular Rumas area

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