CN1145458C - Positioner for femur neck guiding needle - Google Patents
Positioner for femur neck guiding needle Download PDFInfo
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- CN1145458C CN1145458C CNB011164107A CN01116410A CN1145458C CN 1145458 C CN1145458 C CN 1145458C CN B011164107 A CNB011164107 A CN B011164107A CN 01116410 A CN01116410 A CN 01116410A CN 1145458 C CN1145458 C CN 1145458C
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- guide pin
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Abstract
The present invention relates to a targeting positioning device for a femur neck guiding needle. The positioning device comprises a guiding device. The present invention is characterized in that the positioning device is provided with a positioning needle or a positioning rod providing a positioning target for a guiding needle; further, the positioning device is composed of a positioning needle or a positioning rod, a positioning guiding barrel and a horizontal positioning instrument, and the guiding device is composed of a guiding telescopic arm, a vertical guiding sleeve, a guiding needle guiding barrel and a positioning connection sleeve; the guiding device and the positioning device form a parallelogram structure. The present invention is in simple structure; clinical use proves that the guiding needle can be accurately and rapidly injected in, and the present invention is suitable for popularization and application in hospitals at all levels.
Description
The present invention relates to a kind of medical apparatus and instruments, specifically a kind of orthopedic medical device, the targeting that is used for definite neck of femur guide pin is located.
The similar sphere of femoral head, there is articular cartilage on about 2/3 surface, and femoral head about 1/2 is contained by the hemispherical acetabular fossa, and another part is that the ambo of fibrae circulares cartilage contains.Neck of femur is elongated, and hundred meters of the about 2-3 of diameter form collodiaphyseal angle between neck of femur and the femoral shaft, is grown up about about 127 degree.Just often, femoral head slightly turns forward, and the angle that the longitudinal axis of neck of femur and femur two condyle volume shape planes form is a top rake, about 12-15 degree.
Neck of femur and rotor portions (femoral bone tuberosity) fracture is orthopaedics commonly encountered diseases, a frequently-occurring disease clinically, also is difficult point and emphasis in the treatment.Neck of femur and rotor portions fracture need be driven into guide pin to femoral head usually just can install compression screw fixation or slip gooseneck boom nail steel plate etc., because this target of femoral head blurs, the successful crux of performing the operation depends primarily on the correct direction of guide pin.At present, there is following deficiency in prior art: 1, make big incision surgery, whole femur head and neck all given together with the tuberosity part femoral shaft appear, though under the direct-view of naked eyes, can accurately be driven into guide pin, but tissue injury is excessive, cut off the blood vessel of muscle, ligation supply femur head and neck, easily cause the postoperative femur necrosis, now less employing.2, Chinese patent discloses that a kind of patent No. is 98218691.6, name is called the utility model patent of " fracture internal fixation assist location guider ", the another kind of patent No. is 99222477.2, name is called the utility model patent of " neck of femur and intertrochanteric fracture drift bolt localizer ", though these two kinds of patents are simple in structure and guide pin is had certain positioning action.But, owing to do not have clear and definite localizing objects reference point, the direction of guide pin to be difficult to the location, especially for complicated fracture mode between neck of femur and the femoral bone tuberosity, be difficult to guide pin is accurately located, thus locating accuracy low, be difficult to apply.Two kinds of patents belong to the locate mode of " passive " formula, and also just individual in essence guider does not have positioning function truly.3, many large hospitals adopt C arm X-ray machine perspective location, but the X-ray machine operation is inconvenient, X-ray radiation quantity X is bigger, and still have the example of many failures.4, the G arm X-ray machine and the x-ray fluoroscopy computer simulation neck of femur navigation system of foreign latest development, though have three-dimensional positioning action, introduction costs an arm and a leg, and still has the X-radiation human body.
In sum, how being driven into guide pin accurately and quickly is a great problem that has perplexed the several generations medical personnel.
Purpose of the present invention is intended to overcome above-mentioned the deficiencies in the prior art, proposes a kind of simple in structure, targeting positioner that can make the localized neck of femur guide pin of guide pin accurately and quickly.
Realize the above-mentioned purpose technical scheme: the targeting positioner of neck of femur guide pin, promising guide pin is set provides the positioning needle or the locating rod of location target, be provided with the horizontal location instrument that is used to adjust positioning needle or locating rod perpendicularity, positioning needle penetrates in the guide of location, by positioning needle or locating rod, location guide and horizontal location instrument are formed positioner, be provided with by the guiding telescopic arm, the vertically-guided sleeve, the guider that guide pin guide and location coupling sleeve are formed, guider constitutes parallelogram sturcutre with the location guide, the bottom of going up of parallelogram is the top rakes of 15 degree with horizontal line, limit, the left and right sides is horizontal line vertically, the right is installed with the location guide of positioning needle in being, the left side is made up of the vertically-guided sleeve of the underarm that is installed with the guiding telescopic arm, bottom is installed with the guide pin guide of guide pin in being, the top is made up of the location coupling sleeve of the right arm that is installed with the guiding telescopic arm, the horizontal location instrument is fixed on the right-hand member horizontal plane of locating coupling sleeve vertical with the location guide that passes the location coupling sleeve, and vertically-guided sleeve and location coupling sleeve are provided with adjusts bolt and set bolt.
Be carved with flexible indicating graduation on the underarm of described guiding telescopic arm and the right arm.
The cross section of described guiding telescopic arm, vertically-guided sleeve and location coupling sleeve is a rectangle.
The inventor is through for many years clinical practice experience accumulation and thinking, succeed in developing the above-mentioned neck of femur guide pin targeting positioner truly, brand-new that has: by " found " one " real target " (positioning needle) in femoral neck, allow from following " arrow " (guide pin) that penetrates of greater trochanter of femur, by " bow " of the present invention (horizontal location instrument), hit " target center " (femoral head) exactly.Adopt technique scheme, its outstanding technological progress is: 1, simple in structure, ingenious, positioning needle or locating rod, horizontal location instrument production cost are low, and whole device manufacturing cost is the hundreds of yuan only, is applicable to that hospitals at different levels carry out operation.2, prove through clinical use: accurate positioning, surgical injury is little, and is safe and reliable, and practicality is extremely strong.3, simple to operate, make a complicated operation become simple mechanically actuated, make doctor with long years of standing and rich experience in the past feel that all the young doctor of major operation of difficulty also can complete successfully, not only the doctor is benefited, and more is that the patient receives benefits.4, it does not need X line perspective navigation, avoids the harm of ray to human body.5, the present invention adopts positioning needle to bore a locating hole in femoral head, and is little to the articular surface damage on the one hand; On the other hand,, decompressing effect in the femoral head is arranged, can prevent that inside-fixture from pushing space in the femoral head and causing femur head necrosis because locating hole must communicate with compression screw fixation.6, the present invention's alternative G arm X-ray machine and x-ray fluoroscopy computer simulation neck of femur navigation system, for country saves a large amount of foreign exchanges (G arm X-ray machine and x-ray fluoroscopy computer simulation neck of femur navigation system price be more than 1,000,000 yuans, and be mainly used in the locating therapy of fracture of femoral neck).
Below by embodiment in detail, and its structure is described in detail in conjunction with the accompanying drawings:
Fig. 1 is a kind of structural representation of the present invention.
Fig. 2 is a structural representation between capital neck of femur and the femoral shaft.
Fig. 3 is the longitudinal axis of neck of femur and the structural representation that leans forward that femur two condyle volume shape planes form.
Embodiment: in conjunction with Fig. 1～Fig. 3, the targeting positioner of neck of femur guide pin is made up of positioner and guider.
Positioner comprises positioning needle 9, location guide 10 and horizontal location instrument 8, positioning needle 9 is used to penetrate femoral head 11 provides the location target for the guide pin 12 of guider, positioning needle 9 penetrates in the positioning needle guide pin bushing tube 10, horizontal location instrument 8 is used to adjust positioning needle 9 perpendicularity, horizontal location instrument 8 is fixed on the right-hand member extending level face of location coupling sleeve 5, and keeps vertical with the location guide 10 that passes location coupling sleeve 5.
Guider is made up of guiding telescopic arm 1, vertically-guided sleeve 16, guide pin guide 13 and location coupling sleeve 5.The location guide 10 of guider and positioner constitutes parallelogram sturcutre: according to Fig. 3, because the top rake that the longitudinal axis of neck of femur and femur two condyle volume shape planes form is about 15 degree, the tetragonal bottom of going up of the row of making even is the top rakes of 15 degree with horizontal line, limit, the left and right sides is horizontal line vertically, the right is installed with the location guide 10 of positioning needle 9 in being, the left side is made up of the underarm and the vertically-guided sleeve 16 of guiding telescopic arm 1, bottom is installed with the guide pin guide 13 of guide pin 12 in being, the top is made up of the right arm and the location coupling sleeve 5 of guiding telescopic arm 1, and guide pin guide 13 is fixedlyed connected with vertically-guided sleeve 16 by locating shaft 14.
Be carved with flexible indicating graduation 2 on the underarm of guiding telescopic arm 1 and the right arm.
According to different femorals head 11 sizes, the right arm of adjusting guiding telescopic arm 1 by regulation cock 4 stretches into the dilatability of locating coupling sleeve 5, is shown by the indicating graduation on the right arm 2, adjusts the back and fixes with hold-down screw 3; The underarm of adjusting guiding telescopic arms 1 by regulation cock 18 stretches into the dilatability of vertically-guided sleeve 16, is shown that by the indicating graduation on the underarm 2 it is fixing with hold-down screw 17 to adjust the back.
In order to improve setting accuracy of the present invention, the cross section of guiding telescopic arm 1, vertically-guided sleeve 16 and location coupling sleeve 5 is a rectangle.
In Fig. 2, the A point is the greater trochanter tuberosity of femoral head 11, and AB is the slope, and the B point is the point of interface of slope AB and femoral shaft L, and collodiaphyseal angle is about 127 degree herein, and the B point is the entry point of guide pin 12.
Because the location guide 10 of guider of the present invention and positioner constitutes parallelogram sturcutre, therefore, stretching of top do not influence guide pin aiming positioning needle, is applicable to the patient that the hip thickness does not wait; Stretching of the left side regulated guide pin and entered patient's femoral head that diameter does not wait.The length of location guide 10 adds that capital radius is an important parameter of regulating parallelogram left side length, can make guide pin 12 accurately enter the femoral head mid point along the neck of femur longitudinal axis.
Using method of the present invention:
1, lumbar anesthesia or continuous epidural anesthesia;
2, the patient lies on the back on operating-table, and parallel bolster is raised behind the both arms, makes anteversion of femoral neck keep normal and be convenient to position finder to install, and Ipsilateral lower limb traction and strong side are isometric and put neutral of abduction;
3, routine disinfection drape is made the oblique otch in Ipsilateral hip joint the place ahead, extends about 5 centimetres from hip Ant sup lower edge sartorius m. direction;
4, cut skin, subcutaneous, deep fascia along otch, flap is retracted to both sides are free, appear tensor fasciae latae, sartorius m., lateral femoral cutaneous nerve and blood vessel, cut sarolemma along sartorial lateral border, and free leading to the inside, rectus femoris is appeared, cut between rectus femoris sarolemma inner edge and the iliopsoas crack and retract, the place ahead that appears capsula articularis coxae, then femoral head, acetabular bone leading edge are appeared to cut joint capsule;
5, with after the reduction of the fracture, under the help of horizontal location instrument 8, location guide 10 is vertically inserted in the mid point of the femoral head 11 that appears, according to femoral head 11 diameters that record on the X-ray film, positioning needle 9 pierces fixing;
6, make the vertical little otch of shape in Ipsilateral greater trochanter tuberosity place (A point among Fig. 2), cut iliotibial tract, vastus lateralis can be laid one's hand on and greater trochanter " slope ", " slope " is entry point with the femoral shaft intersection, and promptly the point of the B among Fig. 2 is the entry point of guide pin 12;
7, according to the size of femoral head 11, the right arm of adjusting guiding telescopic arm 1 by regulation cock 4 stretches into the dilatability of locating coupling sleeve 5, and fixing with hold-down screw 3;
8, rotate horizontal location instrument 8 and reach the dilatability that stretches into vertically-guided sleeve 16 by the underarm of regulation cock 18 adjustment guiding telescopic arms 1, make guide pin guide 13 aim at entry points, fix with hold-down screw 17 then;
9, pierce guide pin 12, after guide pin was deep into femoral head 11 heads and brushes up against positioning needle 9, can contact positioning needle 9 this moment had the vibration sense, and positioning needle 9 is withdrawed from, and position finder 8 foldings remove;
10, according to measure length continue to go deep into guide pin 12 a little, at this moment, probe into from the locating hole on the femoral head 11 with probe and can touch guide pin 12;
11, guide pin 12 correctly is driven into and finishes, and compression screw fixation or gooseneck boom nail steel plate is installed.
If near greater trochanter tuberosity place (the A point) syntripsis, anatomic landmark is unclear, then can determine entry point with the angle (about about 53 degree) of femoral shaft L by measuring guide pin guide 13.
For the base of nebk ot femur fracture, behind the installation horizontal location instrument 8, can pierce many guide pins from different collodiaphyseal angles position, guide many pieces of hollow screw groups to fix, easy and simple to handle, quick.
It should be noted that: in whole position finder operating process, patient's limbs must remain static, otherwise fracture moves, and the guide pin of spraining makes the bent partially misalignment of needle track.
Must be earlier with guider with could pass through the telescopic arm of adjusting guider with cortical bone under the guide pin guide aligning greater trochanter after positioner is connected, can not be earlier under greater trochanter cortical bone hole to clear the way and connect two bigger devices by force after inserting the guide pin guide, otherwise, to make displacement fracture and the guide pin guide of spraining, and make the location misalignment.
After the correct connection of position finder, under the level of horizontal location instrument, aim at entry point under the greater trochanter by the telescopic arm of regulating guider, and can not aim at entry point by force, otherwise will make the positioning needle bending and the guiding misalignment.
In the above-described embodiments, the also available locating rod of positioning needle replaces, and at this moment, locating rod need not to insert in the femoral head, according to the parallelogram sturcutre that the location guide of guider and positioner constitutes, locating rod still has for guide pin provides locatees the target effect accurately and fast.
Claims (3)
1, the targeting positioner of neck of femur guide pin, comprise guider, it is characterized in that: positioning needle or locating rod that promising guide pin provides the location target are set, be provided with the horizontal location instrument that is used to adjust positioning needle or locating rod perpendicularity, positioning needle penetrates in the guide of location, by positioning needle or locating rod, location guide and horizontal location instrument are formed positioner, described guider is by the guiding telescopic arm, the vertically-guided sleeve, guide pin guide and location coupling sleeve are formed, guider constitutes parallelogram sturcutre with the location guide, the bottom of going up of parallelogram is the top rakes of 15 degree with horizontal line, limit, the left and right sides is horizontal line vertically, the right is installed with the location guide of positioning needle in being, the left side is made up of the vertically-guided sleeve of the underarm that is installed with the guiding telescopic arm, bottom is installed with the guide pin guide of guide pin in being, the top is made up of the location coupling sleeve of the right arm that is installed with the guiding telescopic arm, the horizontal location instrument is fixed on the right-hand member horizontal plane of locating coupling sleeve vertical with the location guide that passes the location coupling sleeve, and vertically-guided sleeve and location coupling sleeve are provided with adjusts bolt and set bolt.
2, according to the targeting positioner of the described neck of femur guide pin of claim 1, it is characterized in that: be carved with flexible indicating graduation on the underarm of guiding telescopic arm and the right arm.
3, according to the targeting positioner of the described neck of femur guide pin of claim 1, it is characterized in that: the cross section of guiding telescopic arm, vertically-guided sleeve and location coupling sleeve is a rectangle.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB011164107A CN1145458C (en) | 2001-04-11 | 2001-04-11 | Positioner for femur neck guiding needle |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB011164107A CN1145458C (en) | 2001-04-11 | 2001-04-11 | Positioner for femur neck guiding needle |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1322518A CN1322518A (en) | 2001-11-21 |
| CN1145458C true CN1145458C (en) | 2004-04-14 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB011164107A Expired - Fee Related CN1145458C (en) | 2001-04-11 | 2001-04-11 | Positioner for femur neck guiding needle |
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| Country | Link |
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| CN (1) | CN1145458C (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101027010B (en) * | 2004-09-30 | 2011-09-07 | 直观外科手术操作公司 | Offset remote center manipulator |
Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102090919B (en) * | 2009-12-12 | 2012-10-03 | 张纯 | Disposable femoral neck fracture operation repositor |
| CN102499752B (en) * | 2011-09-30 | 2013-12-04 | 中国人民解放军第三军医大学第一附属医院 | In vitro aiming device for minimally invasive screw internal fixation of femoral neck fracture |
| CN103961166B (en) * | 2014-05-19 | 2017-01-25 | 山东中医药大学 | Locating assembly for parallel needle penetration and angle rotation of femoral osteotomy of hip dislocation and locating method |
| CN104146798B (en) * | 2014-09-02 | 2016-06-01 | 北京纳通科技集团有限公司 | A kind of tail rod locating device |
| CN109106423B (en) * | 2018-10-08 | 2020-06-05 | 四川大学华西医院 | Femoral head drilling pressure reduction external limiting plate |
-
2001
- 2001-04-11 CN CNB011164107A patent/CN1145458C/en not_active Expired - Fee Related
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101027010B (en) * | 2004-09-30 | 2011-09-07 | 直观外科手术操作公司 | Offset remote center manipulator |
Also Published As
| Publication number | Publication date |
|---|---|
| CN1322518A (en) | 2001-11-21 |
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