A kind of proximal tibia osteotomy guide plate in orthopaedic knee operationTechnical field
The utility model relates to a kind of osteotomy guiding device of bone surgery, in specially a kind of orthopaedic knee operationProximal tibia osteotomy guide plate.
Background technique
Proximal tibia osteotomy is the common modus operandi of orthopaedic knee, simple and effective, particularly with shin bone lateral jointThe patient of outer deformity can effectively correct the deformity of lower limb especially knee joint position, improve the lower limb line of force, and adjustment knee joint is negativeWeight position, alleviate because the lower limb line of force it is bad caused by knee joint regression.In the operation of knee joint Varus deformity, proximal tibia osteotomy pointOsteotomy is closed for outside and inside struts osteotomy.
It is biplane osteotomy that inside, which struts common osteotomy method in bone-culting operation,.First by design osteotomy horizontal direction outsideKirschner wire is squeezed into capitulum fibulae direction, and same level is adjacent after confirmation angle position is satisfied reenters one piece of Kirschner wire, makes two needles justIt is overlapped in the fluoroscopic image of position.It is close to guide pin lower edge, is that the osteotomy of horizontal plane laterally from inside to outside is done in guidance with guide pin.Osteotomy line is notCan exceed that the 2/3 of the horizontal anteroposterior diameter of Tibial osteotomy line, in its front end diagonally forward on do the second plane coronal-plane osteotomy, two plane holdersAbout 110 ° of angle, until tibial tubercle proximal position.
Biplane bone-culting operation operation complexity is not counting too high, but there are a little problems in true operation.First firstPiece guide pin is extremely difficult to two needles in normotopia perspective as being completely coincident when squeezing into second piece of guide pin after determining, and position suitable；Secondly,Osteotomy is difficult that it is made strictly to move ahead along two pieces of guide pin lower edges using goose saw in operation, often deviates, osteotomy line moves down, angleSituations such as degree variation；Third, the range of the first Osteotomy are generally limited in anteroposterior diameter preceding 1/3 position, and in art,Since shin bone anteroposterior diameter and goose saw different widths are not very greatly, to cause easily to cause to accidentally injure to 1/3 sclerotin of front side very in osteotomy operation,Serious person may fracture；4th, the angle of two plane of osteotomy is about 110 ° ideal, and this angle is mostly by artPerson's naked eyes complete measurement, limited accuracy.
There is company's design customization version proximal tibia osteotomy guide plate in Taiwan at present, can accomplish accurate osteotomy operation, mistake hairRaw rate is substantially reduced.But it is higher to customize bone plate cost, is difficult in basic medical unit popularity application.
Summary of the invention
In order to overcome the defects of the prior art described above and insufficient, the utility model provides a kind of close to skin on the inside of proximal tibiaThe osteotomy guide plate of matter anatomic form can more accurately carry out the osteotomy operation of horizontal plane transverse direction, effectively control osteotomy range,The osteotomy operation for accurately carrying out 110 ° of second osteotomy surface can overcome simple Kirschner wire use and guiding role operating difficulties originallyThe technical issues of.
The following technical solution is employed for the utility model: the proximal tibia osteotomy guide plate in a kind of operation of orthopaedic knee,Including guide plate, transparent and closed at both ends osteotomy cutter groove is set in the median plane of the guide plate thickness direction, described sectionOsteotome slot leading portion is respectively set symmetrical No. two pin holes up and down along its two sides from the front to the back, is respectively set up and downSymmetrical No.1 pin hole, No. two pin holes and No.1 pin hole are obliquely installed each parallel to osteotome groove center face and mutually put downRow；On the No.1 pin hole and No. two pin hole two sides opposite positions, it is respectively perpendicular symmetrical No. five needles of setting up and downHole is successively uniformly arranged in the osteotomy cutter groove latter end slot along osteotome groove center face and multiple transparent is parallel to oneNo. three pin holes of number pin hole inclined direction, No. three pin holes symmetrically intersect with osteotomy cutter groove two sides inner wall to be communicated, latter endOsteotomy cutter groove two sides be symmetrical arranged transparent No. four pin holes for being parallel to No.1 pin hole, No. four pin holes described in every rowIdentical as the number of No. three pin holes, No. three pin holes and No. four two hole wire length n of pin hole on identical sorting position are equalIt is equal；
Each No. three pin holes are equal with two neighboring No. two pin hole spacing m with corresponding No. four pin hole wire length n.
No. three pin holes and No. four two hole lines of pin hole and the osteotome slot length side on identical sorting positionTo angle theta be 105 °~115 °.
The angle theta is preferably 110 °.
The guide plate is the inclined parallelogram plate of front and rear end forward end, and the anteversion and retroversion inclined-plane of the guide plate is flatFor row in No.1 pin hole inclined direction, osteotomy cutter groove both ends groove face is parallel to guide plate inclined surface.
The No.1 pin hole and No. two pin holes and the osteotomy cutter groove are tangent.
The No.1 pin hole and No. two pin holes and osteotomy cutter groove are crossed to form gap, the No.1 pin hole and No. two pin holesThe center of circle is on the outside of osteotomy cutter groove.
The No.1 pin hole is at least a pair of mirror symmetry, and No. two pin holes are at least two pairs of mirror symmetry, instituteNo. five pin holes are stated to be at least two pairs of mirror symmetry and correspond to the No.1 pin hole and adjacent No. two pin hole two sides distribution, it is describedNo. three pin holes are at least four and are spacedly distributed, and No. four pin holes are at least four pairs of mirror symmetry and are spacedly distributed.
The No.1 pin hole is a pair, and No. two pin holes are two pairs, and No. five pin holes are two couples and corresponding described oneNumber pin hole and No. two adjacent pin hole two sides distribution, No. three pin holes are four, and No. four pin holes are four pairs.
The No.1 pin hole, No. two pin holes, No. three pin holes, the aperture of No. four pin holes and No. five pin holes are identical.
Each No. three pin holes communicate or tangent, and each No. four pin holes communicate or tangent.
The utility model has following positive beneficial effect:
1) the relatively accurate proximal tibia of biplane can be completed by a simple osteotomy steering tool and struts osteotomyOperation；
2) easy to operate, osteotomy complication rate is low, be suitable for different building shape patient, and left and right sides can make it is samePart tool will make operating time effectively shorten, and improve osteotomy success rate.
Detailed description of the invention
Fig. 1 is guide plate structure schematic diagram；
Fig. 2 is the top view of guide plate；
Fig. 3 is the position the A-A cross-sectional view of Fig. 2；
Fig. 4 is the position the B-B cross-sectional view of Fig. 2；
Fig. 5 is the status diagram that saw blade cooperates osteotomy guide plate to use；
Fig. 6 is the first osteotomy surface operation chart；
Fig. 7 is the second osteotomy surface operation chart.
Accompanying drawing number: 1- No.1 pin hole, No. bis- pin holes of 2-, No. tri- pin holes of 3-, No. tetra- pin holes of 4-, No. five pin holes of 5-, 6- are ledPlate, 7- osteotomy cutter groove, 8- saw blade, 9- shin bone, A~E: the first to the 5th piece of Kirschner wire, the α: the first osteotomy surface, the β: the second osteotomyFace.
Specific embodiment
Specific embodiments of the utility model will be further explained with reference to the accompanying drawing.
Following embodiment is only examples for clearly illustrating the present invention to clearly illustrate, and the implementation not to the utility modelThe restriction of mode.For those of ordinary skill in the art, other can also be made not on the basis of the following descriptionWith the variation or variation of form, and these belong to obvious changes or variations that the spirit of the present invention is drawn still inAmong the protection scope of the utility model.
Proximal tibia osteotomy guide plate in a kind of operation of orthopaedic knee, including guide plate 6, in 6 thickness direction of guide plateMedian plane in transparent and closed at both ends the osteotomy cutter groove 7 of setting, 7 leading portion of osteotomy cutter groove is from the front to the back along its two sidesSymmetrical No. two pin holes 2 up and down are respectively set, symmetrical No.1 pin hole 1 up and down is respectively set, described No. twoPin hole 2 and No.1 pin hole 1 are obliquely installed and are parallel to each other each parallel to osteotome groove center face；The No.1 pin hole 1 and No. twoOn 2 two sides opposite position of pin hole, it is respectively perpendicular symmetrical No. five pin holes 5 of setting up and down, 7 latter end of osteotomy cutter grooveMultiple transparent 1 inclined directions of No.1 pin hole that are parallel to successively are uniformly arranged along 7 median plane of osteotomy cutter groove in slotNo. three pin holes 3, No. three pin holes 3 symmetrically intersect with the 7 two sides inner wall of osteotomy cutter groove to be communicated, the osteotomy cutter groove of latter end7 two sides are symmetrical arranged transparent No. four pin holes 4 for being parallel to No.1 pin hole 1, No. four pin holes 4 and No. three pin holes described in every row3 number is identical, and No. three pin holes 3 on identical sorting position are equal with 4 liang of hole wire length n of No. four pin holes；
Each No. three pin holes 3 and corresponding 4 wire length n of No. four pin holes are equal with two neighboring No. two pin hole spacing m.
No. three pin holes 3 and 4 liang of hole lines of No. four pin holes and 7 length of osteotomy cutter groove on identical sorting positionThe angle theta in direction is 105 °~115 °.
The angle theta is preferably 110 °.
The guide plate 6 is the inclined parallelogram plate of front and rear end forward end, the anteversion and retroversion inclined-plane of the guide plate 6It is parallel to 1 inclined direction of No.1 pin hole, the 7 both ends groove face of osteotomy cutter groove is parallel to 6 inclined surface of guide plate.
The No.1 pin hole 1 and No. two pin holes 2 and the osteotomy cutter groove 7 are tangent.
The No.1 pin hole 1 and No. two pin holes 2 and osteotomy cutter groove 7 are crossed to form gap, the No.1 pin hole 1 and No. twoThe center of circle of pin hole 2 is in 7 outside of osteotomy cutter groove.
The No.1 pin hole 1 is at least a pair of mirror symmetry, and No. two pin holes 2 are at least two pairs of mirror symmetry,No. five pin holes 5 are at least two pairs of mirror symmetry and the corresponding No.1 pin hole 1 and No. two adjacent 2 two sides of pin hole are dividedCloth, No. three pin holes 3 are at least four and are spacedly distributed, and No. four pin holes 4 are at least four pairs of mirror symmetry and waitIt is spaced apart.
The No.1 pin hole 1 is a pair, and No. two pin holes 2 are two pairs, No. five pin holes 5 be two pairs and it is corresponding described inNo.1 pin hole 1 and No. two adjacent 2 two sides of pin hole distribution, No. three pin holes 3 are four, and No. four pin holes 4 are four pairs.
3, No. four pin holes 4 of pin hole of pin hole 2, three of the No.1 pin hole 1, two are identical with the aperture of No. five pin holes 5.
Each No. three pin holes 3 communicate or tangent, and each No. four pin holes 4 communicate or tangent.
Embodiment one
The present apparatus cooperates more pieces of Kirschner wires to use, and it is more succinct accurate can to make surgical procedure, and osteotome guide plate can fitAnswer the operation of different shin bone diameter crowds.Osteotomy guide plate 6 is parallelogram block, and osteotomy closed at both ends is arranged in through-thicknessCutter groove 7 and many places Kirschner wire guiding and fixation hole.No.1 pin hole 1 is set and is located at two sides of the osteotomy cutter groove 7 compared with middle position, No.1Pin hole 1 is consistent with the inclined direction on 6 front and back ends inclined-plane of guide plate.No. two 2 two pairs of pin hole, it is parallel to No.1 pin hole 1, is located at osteotomyCutter groove 7 leans on the two sides of front position, and 1, No. two pin hole 2 of No.1 pin hole is closely adjacent or tangent with osteotomy cutter groove 7, intersects.OsteotomyOnesize No. three pin holes 3 of 7 latter end close-packed arrays of cutter groove four, in its two sides No. four pin holes 4 of position close-packed arrays rearward, No. fourNumber, spacing, the size of pin hole 4 are identical as No. three pin holes 3.In addition the two sides outer in 7 leading portion of osteotomy cutter groove are arranged two pairsNo. five pin holes 5.Each kirschner pin hole is that middle line is symmetrically arranged in mirror surface with osteotomy cutter groove 7.Wherein two adjacent No. two pin holes 2Spacing m is equal with corresponding No. three pin holes 3 and No. four 4 spacing n of pin hole.
No.1 pin hole 1 is directed toward capitulum fibulae, squeezes into first piece of Kirschner wire A along this hole to determine horizontal plane osteotomy direction.It adjustsWhole 6 position of osteotomy guide plate keeps osteotomy cutter groove 7 parallel with joint line and is directed toward capitulum fibulae direction.In No. two pin holes 2 and No. five needlesHole 5, which is respectively selected first, squeezing into second piece of Kirschner wire B and third piece Kirschner wire C, fixes 6 direction of osteotomy guide plate, to determine first sectionBone face α.According to shin bone anteroposterior diameter size, select it is one of suitable in No. three pin holes 3 squeeze into the 4th piece of Kirschner wire D, using it as puttingObstacle is sawed, avoids accidentally injuring front side sclerotin when operation.Selected 3 corresponding No. four pin holes 4 of No. three pin holes are selected to squeeze into five piece gramFamily name's needle E is as the second osteotomy surface mark.Osteotomy guide plate 6 is removed after the completion of first osteotomy surface α osteotomy, makes the 4th piece of Kirschner wire D of originalNo. two adjacent pin holes 2 are passed through with the 5th piece of Kirschner wire E.The operation of the second osteotomy surface β osteotomy is completed along deep slot.Due to adjacentTwo 2 spacing m of No. two pin holes are equal with corresponding No. three pin holes and No. four pin hole spacing n, so the 4th piece of Kirschner wire D of original andFive pieces of Kirschner wire E may pass through No. two adjacent pin holes 2 of same row just.
The design of this utility model, which is only applied to knee joint varus patient, to strut osteotomy patient on the inside of row proximal tibia.It is clinicalIt in practice, clarifies a diagnosis first, determines that operation plan is to strut osteotomy on the inside of proximal tibia.It is preoperative to primarily determine in proximal tibiaSide cortex position osteotomy line level is about 4cm under joint line.Soft tissue takes this utility model osteotomy guide plate 6 to stick after the completion of appearingIn side seam face in proximal tibia.Make osteotomy cutter groove 7 tentatively and after predetermined osteotomy line is overlapped and 6 front end of osteotomy guide plate slightly exceeds shin boneSide cortex.Appropriate inclination osteotomy guide plate 6 makes No.1 pin hole 1 towards capitulum fibulae tip direction.Kirschner is squeezed into along No.1 pin hole 1Needle A, it is accurate that perspective confirmation coronal-plane Kirschner wire is directed toward.In No. two pin holes 2, one of them squeezes into second piece of Kirschner wire B.For into oneIt walks and stablizes osteotomy guide plate 6, third piece Kirschner wire C can be squeezed into any No. five pin holes 5.To limit the first Osteotomy length, withPreceding 1/3 (retaining front side cortex distance 1.0-1.5cm) position is standard in shin bone anteroposterior diameter, selects one of No. three pin holes 3Squeeze into the 4th piece of Kirschner wire D.And one corresponding with No. three 3 positions of pin hole is selected in No. four pin holes 4 of osteotomy line nearside, it squeezes into5th piece of Kirschner wire E.The first Osteotomy osteotomy is carried out under soft tissue on rear side of protection shin bone.Retain the 4th piece of Kirschner wire D andFive pieces of Kirschner wire E, remove other Kirschner wires, remove osteotomy guide plate 6.Oblique placement osteotomy guide plate 6, make the 4th piece of Kirschner wire D and5th piece of Kirschner wire E is penetrated in two adjacent the second kirschner pin holes 2 of same row.Kneecap tendon is protected to carry out second along osteotomy cutter groove 7The operation of osteotomy surface β osteotomy.