JP3839387B2 - Multipurpose pelvic fixation device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention is a versatile device that fixes the pelvis, measures the accurate three-dimensional inclination of the pelvis, and accurately attaches a reference mark to the upper acetabulum of the pelvis before hip surgery (artificial hip replacement and pelvic osteotomy). The invention relates to a pelvic fixation device.
[0002]
[Prior art]
As a method of measuring the pelvic inclination, the pelvis in the supine position is X-rayed from the lateral direction, and the angle between the straight line passing through the upper edge of the first sacral vertebra on the image and the vertical line (sacral base inclination angle) (Toshito Iwahara et al., Clinical Orthopedics, 812, Vol. 23, 1988), but the upper edge of the first sacral spine is unclear and the straight line is difficult to define. There is a drawback that the inclination cannot be measured. As a clinical method of measuring the pelvic inclination, the examiner presses the upper anterior iliac spine and the pubic protuberance of the pelvis with both fingers while the patient is in a supine position on a non-uniform examination table (or operating table). Compared with the height of each surface from the base, it is roughly inaccurate, for example, roughly expressing that it is tilted to the left, etc. As a method for setting the preoperative reference mark, there is a hip replacement device (P3088685) previously developed by the inventor. However, in this method, the pelvis is operated without fixing the pelvis on a non-uniform operating table. However, there is a drawback that the direction of the reference mark tends to be distorted due to inaccuracy and inclination.
[0003]
[Problems to be solved by the invention]
However, the conventional method has the following problems. 1. The pelvis cannot be fixed. 2. The three-dimensional inclination of the pelvis cannot be measured accurately. 3. The pelvic fiducial mark cannot be placed accurately.
[0004]
[Means for Solving the Problems]
Broadly categorizing the device of the present invention, a base plate for placing a person in a supine position, a level for detecting the level of the base plate, and fixed in parallel and symmetrical positions on both sides of the pelvis at an appropriate position on the base plate The left support frame with the slits cut off in the upper part, the right support frame, the clamp that fixes the support frame to the base plate, and the left and right support frames that are installed on the upper girders of the left and right support frames Head-side bridge plate, leg-side bridge plate with a slit cut in one central location, three cursors with a hole cut in the center that can be slid and fixed along the bridge plate, and two The left and right plates that fix the bridge plate in parallel from both sides to form an assembly frame, the right plate, and the compression plate attached to the lower end and the spring-attached rod are used as the cursor hole and the dividing groove of the bridge plate. The inserted compression device and the compression plate can be placed on the left and right upper anterior iliac spines (P), (Q) and pubic ridge (R). The position fixing, the two bridge plates were fixed with parallel side plates, the left fixing plate for compressing secure the assembly frame digits on the left and right support frames, a multi-purpose pelvic fixation device consisting of a right fixing plate,
[0005]
An inclination measuring instrument for measuring the inclination of the pelvis in the left-right direction and the inclination in the front-rear direction, a T-table for placing the inclination measuring instrument, an angle meter for measuring the deflection angle of the pelvis with respect to the base plate,
[0006]
A guide wire fixing base that can be slid up and down between frame pillars of the support frame, a side guide wire that fits into a groove on both sides of the fixing base, and a side guide wire that is crimped to the fixing base A pelvis fiducial mark insertion point setting device comprising two guide wire locking clips, a central guide wire locking clip to be mounted on the fixing base, and a front and rear guide wire suspended from the clip;
[0007]
A standard guide bar to be inserted into the slits of the support frames on both sides, an outer cylindrical sleeve parallel cage suspended from one end of the standard guide bar, and a standard guide bar in the outer cylindrical sleeve insertion groove of the cursor of the parallel cage; An outer cylinder sleeve that is inserted in parallel, an outer cylinder that is inserted into the sleeve, a Kirschner steel wire that is inserted into the outer cylinder and drills the acetabulum of the pelvis, a pilot pin that is inserted from the outer cylinder, and a pilot pin that is inserted from the outer cylinder And a pelvis reference mark insertion device including a control bar for adjusting the direction of the pilot pin.
[0008]
DETAILED DESCRIPTION OF THE INVENTION
The present invention will be described below with reference to the drawings. FIG. 1 is a view showing a rectangular wooden floor board having a thickness of 20 m / m, a width of 500 m / m, and a length of 1600 m / m, in which a patient is in a supine position. A center line 4 is formed at the center of the floor plate 1 in the width direction, and horizontal lines 5 are formed at intervals of 100 m / m in the width direction. On the left and right edges 2 of the floor board 1, the scale 3 is engraved in the longitudinal direction from the foot end 6 toward the head end 7.
[0009]
FIG. 2 is a diagram of the level 8 that detects the level of the floorboard 1.
[0010]
The left side of FIG. 3 is a diagram showing a wooden right support frame having a thickness of 14 m / m. An upper girder 17 cut out in a concave shape and a lower girder 18 are provided on the lower part of the right support frame 9, a head side frame pillar 10 and a leg side frame pillar 11 are provided on the lateral side, and the center of the bottom plate 19 in the width direction is provided. It is fixed vertically to the lower girder 18 at the position and reinforced by the support plate 20. The scale 12 is engraved in the longitudinal direction at the center position in the width direction of the frame pillars 10 and 11 with the back surface of the bottom plate 19 as a base point, and the thickness of the bridge plate to be described later will be described later from the upper edge of the upper girder 17 on the extended line. A hole 13 having a diameter of 3 m / m is drilled at a position to which half the thickness of the fixing plate is added. It is desirable that the slit groove 16 is notched in the longitudinal direction of the leg side at the center in the width direction from the center of the upper girder 17 so as to have a groove width of 7 m / m and a depth of 100 m / m. A scale 15 is engraved along the upper edge of the slit groove 16 with the outer edge of the leg-side frame column 11 as a base point. The left support frame 21 is formed symmetrically with the right support frame 9 as shown in the right of FIG. The nail 14 is constructed by installing a bridge plate, which will be described later, on the upper girder 17, pressing it with a fixed plate, which will be described later, and inserting a notch groove in the fixed plate into the tips of the head-side frame column 10 and the leg-side frame column 11. 13 is inserted.
[0011]
FIG. 4 shows a clamp 22 for fixing the left and right support frames 9 and 21 to the floor plate 1.
[0012]
The left side of FIG. 5 shows the right fixing plate. The right fixing plate 23 is formed of, for example, a substantially rectangular wooden plate having a thickness of 14 m / m, and a cutout groove 24 is formed in the longitudinal direction at both ends at the center in the width direction. The depth of the groove is formed to be the width of the frame pillars 10 and 11. The scale 26 is engraved in the longitudinal direction at the center in the width direction, and the side scale 25 is engraved in the longitudinal direction on the inner lower edge of the fixing plate 23 with the outer edge of the leg-side frame column 11 as the base point. The hole 27 is drilled with a diameter of 3 m / m at the center position in the thickness direction on both side surfaces of the fixing plate 23 and at a half of the depth of the cutout groove 24. The right side of FIG. 5 is the left fixing plate 28, which is formed symmetrically with the right fixing plate 23.
[0013]
FIG. 6 is a diagram showing elements constituting the assembly frame. The head-side bridge board 30 is formed of, for example, a substantially rectangular wooden board having a thickness of 18 m / m, a length of 504 m / m, and a width of 40 m / m. The left cutting groove 32 and the right cutting groove 31 are respectively formed, and the groove width is preferably 15 m / m into which a later-described compression rod can be inserted, and the depth of the cutting is preferably 96 m / m. The bridge plates 30 and 35 have screw holes 33 having a diameter of 6 m / m in the longitudinal direction at the center positions of both ends. The scale 34 is engraved in the longitudinal direction of the center position in the width direction with the center point of the bridge plates 30 and 35 as the base point. In the leg-side bridge plate 35, the central slit groove 36 is formed at the center position, and the width and depth thereof are formed in the same manner as the shape of the slit grooves 31 and 32 of the head-side bridge plate 30. The right side plate 37 is formed of a substantially rectangular wooden plate having a thickness of 18 m / m, a width of 40 m / m, and a length of 200 m / m, and a scale 39 is engraved in the longitudinal direction from the center point of the right side plate 37 on the inner edge. To do. A slit groove 38 having a depth of 70 m / m and a width of 6 m / m in the longitudinal direction is formed on the side surface of the right side plate 37 at the center position in the thickness direction around 55 m / m from both ends. The left side plate 41 is formed in a symmetrical structure with the right side plate 37. Both bridge plates 30 and 35 are made parallel, and side plates 37 and 41 are fastened and fixed by screws 40 to form an assembly frame 29.
[0014]
FIG. 7 shows a cursor. The right cursor 42, the left cursor 52, and the forward cursor 53 are, for example, a rectangular wooden upper sliding board 43 and lower sliding board 44 having a thickness of 14 m / m, a long side of 66 m / m, and a short side of 48 m / m, and a thickness of 13 m / m. A rectangular wooden front sliding support plate 45 and a rear sliding support plate 46 having a long side of 48 m / m and a short side of 18 m / m are formed, and the sliding support plates 45 are formed on both ends of the short sides of the sliding substrates 43 and 44. The side surface on the long side of 46 is vertically fixed substantially the same as the cross-sectional dimension of the bridge plates 30 and 35, and is fitted into the bridge plates 30 and 35 and is slidable. A hole 49 having a diameter of 15 m / m is cut out at the center of the upper sliding substrate 43 and the lower sliding substrate 44 so as to allow the later-described sliding of the rod of the compression device. A screw hole 47 having a diameter of 6 m / m is formed at the center of the front sliding support plate 45, and a screw 48 is screwed to fix the sliding of the cursors 42, 52, 53 with respect to the bridge plates 30, 35. The right cursor 42 and the left cursor 52 are at the center of the upper edge of the outer long side of the upper sliding board 43 at a right angle to the long side and at an angle of 45 ° with respect to the upper sliding board 43, and the front cursor 53 is the rear surface of the upper sliding board 43. A screw hole 50 having a diameter of 2 m / m and a screw 51 are screwed in at a center position in the thickness direction and at a half of the short side vertically to the rear surface. Fix the sliding.
[0015]
FIG. 8 is a view showing a compression device. The right compression device 54, the left compression device 61, and the front compression device 62 are a square wooden compression plate 59 having a side of 41 m / m and a thickness of 14 m / m, and a wooden rod having a diameter of 14 m / m fixed vertically at the center thereof. 55. A hole 57 having a diameter of 1.5 m / m is formed in the diameter direction at a position 5 m / m from the end of the rod 55. A scale 56 is engraved in the longitudinal direction of the bar 55 with the back surface of the compression plate 59 as a base point. The spring 60 is attached to the rod 55, and the thickness is preferably 1 m / m in diameter, 45 m / m in pitch, 20 m / m in outer diameter, and 170 m / m in length. The nail 58 has a hole 55 after a bar 55 fitted with a spring 60 passes through the hole 49 of the cursors 42, 52, 53 inserted into the bridge plates 30, 35 and the slits 31, 32, 36 of the bridge plates 30, 35. Insert into 57.
[0016]
FIG. 9 is a view of a wooden T-shaped table on which an inclination measuring instrument to be described later is mounted. A T-shaped table 63 is formed on a horizontal bar 64 straddling the tips of the bars 55 of the left and right compression units 54 and 61 and a central side surface thereof. It is formed from vertical bars 65 connected vertically. The vertical bar 65 is placed at the tip of the bar 55 of the front compressor 62. Horizontal bar 64 has a thickness of 10 m / m, length of 300 m / m, width of 30 m / m, vertical bar 65 has a thickness of 10 m / m, length of 160 m / m, width of 30 m / m, and the cross section of the bar is rectangular on the lower side Further, the upper side is formed in a substantially semicircular shape, and a scale 66 is engraved on the side surface of the horizontal bar 64 in the longitudinal direction with the center point as a base point.
[0017]
FIG. 10 is a view showing an inclination measuring instrument. The inclination measuring instrument 67 is placed on the horizontal bar 64 or the vertical bar 65 of the T-shaped base 63 and reads the inclination angle from the scale 68.
[0018]
FIG. 11 is a diagram showing an angle meter. The angle meter 69 reads the angle of the idle shaft 71 with respect to the fixed shaft 70 from the scale 72.
[0019]
The pelvic fixation method will be described with reference to FIG. The floorboard 1 is placed on the examination table (or operating table) D, and the patient is placed on the floorboard 1 in a supine position. The level 8 is placed on the floor plate 1, the inclination of the examination table (or operating table) D is adjusted, and the floor plate 1 is made horizontal. The right support frame 9 is provided on the right side of the pelvis so that the upper right anterior iliac spine (P) and the pubic ridge (R) are located between the frame columns 10 and 11, and the edge 2 of the floorboard 1 is the edge of the bottom plate 19. The scale 3 at the end of the bottom plate 19 (the patient's leg side) at that time is read. The scale 3 on the end (the patient's leg side) of the bottom plate 19 is aligned with the right scale so that the left support frame 21 is positioned symmetrically with the right support frame 9 on the left side of the pelvis, and the left and right bottom plates 19, 19 are clamped 22, 22. Fix to the floor plate 1 with. The left and right cursors 42 and 52 are inserted into the head-side bridge plate 30, the distance between the cursors 42 and 52 is adjusted to the patient's left and right upper anterior iliac spine distance PQ, and is equidistant from the center of the head-side bridge plate. Then, the front cursor 53 is installed at the center of the leg-side bridge plate 35 and fastened by the respective front screws 48 to fix the sliding with respect to the bridge plates 30 and 35. A spring 60 is attached to the rod 55 of the compression device 54, 61, 62, and each rod 55 passes through the hole 49 of the cursors 42, 52, 53 and the slits 31, 32, 36 of the bridge plates 30, 35, and the rod. A nail 58 is inserted into the hole 57 at the tip of 55. Next, the head-side bridge plate 30 and the leg-side bridge plate 35 are made parallel to each other and the distance between them is made equal to the distance between the line PQ connecting the left and right upper anterior iliac spines and the pubic ridge R, and the left and right side plates 37, 41 are The assembly frame 29 is formed by fixing with screws 40. The examiner and assistant hold the assembly frame 29 from both sides of the pelvis, touch the compression plate 59 to the left and right upper anterior iliac spines (P), (Q), and the pubic ridge (R). The left and right fixing plates 23, 28 are inserted into the upper girders 17, 17 of the support frames 9, 21, and the nails 14 are inserted into the holes 13, 27. Finally, when the screw 51 on the side of the left and right cursors 42 and 52 and the screw 51 behind the front cursor 53 are fastened, the pelvis is fixed.
[0020]
A method for measuring the inclination of the pelvis will be described with reference to the upper right anterior iliac spine (P) with reference to FIG. The horizontal bar 64 of the T-shaped base 63 is placed on the tips of the bars 55 and 55 protruding from the left and right cursors 42 and 52 so that the scales 66 of the respective contacts are equal, and the vertical bar 65 protrudes from the front cursor 53. Place on the tip of the rod 55
[0021]
Measurement of the pelvic inclination angle in the left-right direction An inclination measuring device 67 is placed on the horizontal bar 64 of the T-table 63 and the scale 68 is read. In the case of FIG. 13a, the right forward inclination is ΔΔ degrees.
[0022]
Measurement of pelvic inclination angle in the front-rear direction An inclination measuring device 67 is placed on the vertical bar 65 of the T-shaped base 63 and the scale 68 is read. In the case of FIG.
[0023]
Measurement of the deflection angle of the pelvis relative to the floor plate The scale 72 when the fixed shaft 70 of the goniometer 69 is parallel to the right plate 37 and the floating shaft 71 is parallel to the right fixed plate 23 is read. In the case of FIG. 13c, the right outward deflection is OO degrees. As described above, the three-dimensional inclination of the pelvis can be expressed as a forward right inclination ΔΔ degree, a backward inclination □□ degree, and a right outward deflection OO degree based on the upper right anterior iliac spine.
[0024]
FIG. 14 is a diagram of an apparatus for setting a pelvis reference mark insertion point. The guide wire fixing base 73 is formed of, for example, a substantially rectangular wooden board having a thickness of 14 m / m, and a notch groove 74 is formed in the longitudinal direction at both ends at the center in the width direction. As for the depth of the groove, the length of the front leg 75 corresponds to the width of the frame columns 10 and 11, and the length of the rear leg 76 corresponds to the distance from the inner edge of the frame columns 10 and 11 to the support plate 20. It is desirable that it can be slid in the vertical direction along the frame pillars 10 and 11 on both sides. A scale 77 is engraved in the longitudinal direction. A semi-cylindrical wire groove 78 having a diameter of 3 m / m is formed in the width direction adjacent to the notch grooves 74 at both ends. An insertion point altitude indicator plate 79 is fixed on the front leg 75 adjacent to the wire groove 78. The size is preferably 3.5 m / m in height, 8 m / m in width, and 16 m / m in length. In order to fix the sliding of the guide wire fixing base 73 by forming a screw hole 80 having a diameter of 3 m / m at the center position in the thickness direction of the side surface of the front leg 75 and at a half position of the width of the frame pillars 10 and 11. Screw 81 is inserted. (FIG. 14a) The side guide wire 82 is formed by first forming a steel wire having a diameter of 3 m / m into a long and narrow “b” shape having a distance of 7 m / m and a length of 370 m / m, and then It can be inserted in between and be inserted into the wire grooves 78, 78 and bend 90 degrees with respect to the "B" -shaped surface at approximately 90m / m from both ends so that it can slide. To form. (Fig. 14b)
The side guide wire left locking clip 83 is, for example, a rectangular aluminum plate having a thickness of 0.5 m / m, with a cross-sectional “U” shape, a width of 25 m / m, a length of 32 m / m, and a height of 15 m / m. A notch 85 is formed in a shape that can be attached to the bending guide wire fixing base 73 and that includes the side guide wire 82 at the left bending angle of the upper surface and the side surface. The side guide wire right locking clip 84 is formed symmetrically with the side guide wire left locking clip 83. (Fig. 14c)
The front / rear guide wire 86 includes a vertical wire 87, a horizontal wire 88, and a connection portion 89. The vertical wire 87 is formed by bending a steel wire having a diameter of 2 m / m into a “U” shape with an interval of 7 m / m and further bending by 90 degrees with respect to the “U” surface. The horizontal wire 88 is formed of a steel wire having a diameter of 2 m / m. The connecting portion 89 is formed of an approximately “convex” -shaped aluminum plate having a thickness of 0.5 m / m, and both edges of the upper half of the “convex” character are bent into a cylindrical shape, and one end of the horizontal wire 88 is held and fixed. The remaining lower half is bent so that both edges are flattened so that the “U” -shaped portion of the vertical wire 87 can be held. The center guide wire locking clip 90 is 4 m / m longer than the guide wire locking clips 83 and 84 described above, and a notch 92 is formed in a trapezoidal shape at the center of the upper surface to install an outer cylinder sleeve to be described later. A hole 91 having a diameter of 2 m / m is formed in order to insert the vertical wire 87 at the left and right ends of the upper surface and the lower surface. (Fig. 14d)
[0025]
FIG. 15 shows a standard guide bar. The standard guide bar 93 is formed of a steel rod having a circular cross section of a diameter of 7 m / m and a length of 600 m / m, and is inserted into the slits 16 and 16 of the support frames 9 and 21 on both sides.
[0026]
FIG. 16 is a schematic view of the outer sleeve parallel holder 94. The guide bar suspension plate 95 is formed of a substantially rectangular aluminum plate, and one end portion on the short side is bent into a semicircular shape to form a U-shaped holding surface 96 so that it can be fitted into the standard guide bar 93. The cursor 97 is formed such that both end portions of a substantially rectangular aluminum plate are folded inward in a U shape to form holding surfaces 98 and 98, and a guide bar suspension plate 95 is held to be slidable. The outer sleeve fitting groove 99 is formed so that the holding surfaces 98 and 98 are notched in a U shape, and an outer sleeve to be described later is closely fitted and parallel to the U-shaped holding surface 96.
[0027]
FIG. 17 is a view showing an acetabular perforation instrument. The drilling instrument 100 is made of a Kirschner steel wire 101, an outer cylinder 103, and an outer cylinder sleeve 104. The Kirschner steel wire 101 is formed of a steel wire that can be inserted into the inner diameter portion of the outer cylinder 103, and the insertion tip 102 is formed with one end sharpened. The outer cylinder 103 is formed of a cylindrical steel pipe having an inner diameter of 3 m / m and an outer diameter of 5 m / m. The outer cylinder sleeve 104 is desirably 7 m / m in which the outer cylinder 103 can be inserted into the inner diameter portion and the outer diameter can be fitted in the insertion groove 99 of the cursor 97 described above.
[0028]
FIG. 18 is a view showing a bar fixing clamp for fixing the standard guide bar 93 to the slit grooves 16 and 16 of the support frames 9 and 21. The bar fixing clamp 105 is formed with a semicircular cutout 106 having a diameter of 7 m / m at the center of a compression edge of a commercially available stainless steel clamp.
[0029]
FIG. 19 is a view showing a pilot pin and a fixing device. One end of the pilot pin 107 has a conical sharpened point 109, and a notched groove 108 is formed in the diametrical direction at the other end. For example, the pilot pin 107 is preferably formed in a sharp rod shape having a length of 70 m / m and a diameter of 3 m / m, and the notch groove 108 is preferably formed with a groove width of 1 m / m and a depth of 7 m / m. The driving bar 110 is formed of a steel wire that can be inserted into the inner diameter portion of the outer cylinder 103. The control bar 111 is formed of a steel wire that can be inserted into the inner diameter portion of the outer cylinder 103, and one end side is bent in an L shape to form a turning handle 112, and the other end is parallel to the longitudinal direction at the center position. A turning surface 113 is formed so as to be inserted into the notch groove 108 of the pilot pin 107 in a planar shape parallel to the turning handle 112.
[0030]
A method of inserting the reference mark into the pelvis will be described with reference to FIG. Since the method of leveling the floor plate 1 and the method of fixing the pelvis have been described in [0019], they will be omitted. When performing the fiducial mark insertion operation, the left and right upper anterior iliac spines (P) and (Q) of the pelvis fixed by the above-described operation need to be at the same height. When the heights are different, the screws 51, 51 on the sides of the left and right cursors 42, 52 are loosened to release the fixation of the bar 55. Put a cloth underlay on the lower heel of the upper anterior iliac spine (P) and (Q) and operate manually so that the scales of the bars 55 and 55 protruding from the left and right cursors 42 and 52 are equal. When the side screws 51, 51 are fastened and the bars 55, 55 are fixed, the left and right upper anterior iliac spines (P), (Q) are at the same height.
The right hip joint will be described as the affected side. A guide wire fixing base 73 is inserted between the frame pillars 10 and 11 of the right support frame 9. Side guide wires 82 are fitted into the wire grooves 78 on both sides, and are further slid in the groove direction to contact the crotch skin. The guide wire left locking clip 83 and the guide wire right locking clip 84 are inserted into the guide wire fixing base 73 and slid in the directions of the left and right frame pillars 10 and 11, respectively, and the side guide wire 82 is embraced by the notch 85. Fix it. Under X-ray side fluoroscopy, the guide wire fixing base 73 is slid in the vertical direction (up and down arrow in FIG. 20) of both frame pillars 10 and 11 with both hands, and the image of the side guide wire 82 is shown on the monitor image (right side). The height is determined so as to be located at the center of the image, and the height is read from the scale 12 of the frame column 11 at the upper edge of the insertion point height indicator plate 79 and recorded. Here, the screw 81 of the front leg 75 of the guide wire fixing base 73 is fastened to fix the sliding.
Next, the X-ray fluoroscopic apparatus is changed in the front-rear direction (indicated by a dotted line in FIG. 20), and the guide wire center locking clip 90 is inserted into the guide wire fixing base 73. The front / rear guide wire 86 is assembled by inserting a vertical wire 87 into the hole 91, inserting a U-shaped portion into a flat portion of the connecting portion 89, and inserting a horizontal wire 88 into a cylindrical portion of the connecting portion 89. In the monitor image (left side), while observing the positional relationship between the image (thin line) of the horizontal wire 88 and the acetabulum image, guide wire center locking clip 90 along the guide wire fixing base 73 in the longitudinal direction (left and right arrows in FIG. 20) The level of the insertion point from the tip of the acetabulum is determined, and the scale 77 at this time is read and recorded at the center of the notch 92. The standard guide bar 93 is inserted into the slits 16 and 16 of the left and right support frames 9 and 21, and the edge (thick line) of the standard guide bar 93 is in contact with the lower end of both crotch tear marks on the monitor image in the X-ray fluoroscopy longitudinal direction. The bar is fixed to the upper girders 17 and 17 so that the notch 106 is fitted to the standard guide bar 93 by the bar fixing clamp 105 (FIG. 20).
A method for drilling a mark insertion point will be described with reference to FIG. The U-shaped holding surface 96 of the outer cylinder sleeve parallel cage 94 is fitted into one end of the standard guide bar 93, the outer cylinder sleeve 104 is inserted into the outer cylinder sleeve insertion groove 99, and the cursor 97 is slid to move the outer cylinder sleeve. 104 is installed at the center of the notch 92 of the guide wire center locking clip 90. The outer sleeve 104 is first passed between the vertical wires 87 and then between the side guide wires 82. Here, the outer cylinder 103 is inserted into the outer cylinder sleeve 104, is slid to the skin of the patient's crotch, is inserted into the upper acetabulum of the pelvis after skin incision with a scalpel. When the Kirschner steel wire 101 is inserted into the outer tube 103 from the insertion tip 102 under drilling and connected to a drill for drilling, a reference mark hole is formed on the acetabulum parallel to the standard guide bar 93. As shown in FIG. 22, the outer cylinder 103 is held with one hand of the operator, the Kirschner steel wire 101 is pulled out, the pilot pin 107 is inserted into the outer cylinder 103, and is driven into the hole in the upper part of the mortar formed by the driving bar 110. The insertion turning surface 113 of the control bar 111 is inserted into the cutout groove 108 and turned so that the turning handle 112 is vertical. When the outer cylinder 103 is removed, the notch groove 108 of the pilot pin 107 installed at the upper part of the acetabulum of the pelvis correctly faces in the front-rear direction.
[0031]
【The invention's effect】
As described above, when the present invention is carried out, the pelvis can be fixed, the inclination of the pelvis can be accurately measured three-dimensionally, and hip surgery (pelvic osteotomy and hip replacement) The anterior reference mark can be accurately fixed in the pelvis, and the angle of osteotomy and the installation angle of the socket of the artificial hip joint can be accurately determined.
[Brief description of the drawings]
FIG. 1 is a perspective view showing a floor board.
FIG. 2 is a perspective view showing a spirit level.
FIG. 3 is a perspective view showing a support frame for a right pelvis and a left pelvis.
FIG. 4 is a perspective view showing a clamp.
FIG. 5 is a perspective view showing a fixing plate for a right support frame and a left support frame.
FIG. 6 is a perspective view showing an assembly frame.
FIG. 7 is a perspective view showing a cursor.
FIG. 8 is a perspective view showing a compression device.
FIG. 9 is a perspective view showing a T-table.
FIG. 10 is a perspective view showing an inclination measuring instrument.
FIG. 11 is a perspective view showing an angle meter.
FIG. 12 is a diagram showing how the support frame, the assembly frame, the cursor, the compressor, and the fixing plate are attached.
FIG. 13 is a perspective view showing a measurement state (a) of the pelvic tilt angle in the left-right direction, a measurement state (b) of the pelvic tilt angle in the front-rear direction, and a measurement state (c) of the deflection angle of the pelvis relative to the floorboard.
FIG. 14 is a perspective view of a reference mark insertion point setting device.
FIG. 15 is a perspective view of a standard guide bar.
FIG. 16 is a perspective view of an outer sleeve parallel holder.
FIG. 17 is a perspective view of a drilling instrument.
FIG. 18 is a perspective view of a bar fixing clamp.
FIG. 19 is a perspective view of a pilot pin and a fixing device.
FIG. 20 is a diagram showing a manner of determining the position of a mark insertion point under X-ray fluoroscopy.
FIG. 21 is a diagram showing a state of drilling the outer side of the acetabulum at the mark insertion point.
FIG. 22 is a diagram showing an aspect of an operation in which the notch groove is accurately directed in the front-rear direction after the pilot pin is driven into the hole formed in the outer portion of the acetabulum. (The enlarged view shows the outer cylinder sleeve, the outer cylinder, and the control bar partially cut away.)
[Explanation of symbols]
1 flooring
2 edge
3 scales
4 Centerline
5 horizontal lines
6 feet
7 Head
8 Level
9 Right support frame
10 head side frame pillar
11 Leg side column
12 scales
13 holes
14 Nails
15 scales
16 slitting groove
17 Upper digit
18 Lower digit
19 Bottom plate
20 Support plate
21 Left support frame
22 Clamp
23 Right fixing plate
24 Notch groove
25 scale
26 Scale
27 holes
28 Left fixed plate
29 Assembly frame
30 head side bridge board
31 Right cut groove
32 Left cut groove
33 Screw holes
34 Scale
35 Leg side bridge board
36 Center cutting groove
37 Right side plate
38 Slotting groove
39 scale
40 screws
41 Left side plate
42 Right cursor
43 Top sliding board
44 Lower sliding board
45 Front sliding support plate
46 Rear sliding support plate
47 Screw hole
48 Screw
49 holes
50 Screw hole
51 Screw
52 Left cursor
53 Forward cursor
54 Right press
55 sticks
56 Scale
57 holes
58 nails
59 Pressure plate
60 Spring
61 Left compression device
62 Forward compression device
63 T-shaped
64 horizontal bar
65 vertical bar
66 Scale
67 Tilt measuring instrument
68 scales
69 Angle meter
70 Fixed shaft
71 idle shaft
72 scale
73 Guide wire fixing base
74 Notch groove
75 front legs
76 hind legs
77 Scale
78 wire groove
79 Insertion point altitude indicator
80 Screw hole
81 screw
82 Side guide wire
83 Guide wire left locking clip
84 Guide wire right locking clip
85 Notch groove
86 Guide wire for front and rear
87 Vertical wire
88 horizontal wire
89 Connection
90 Center guide wire locking clip
91 holes
92 Notches
93 Standard guide bar
94 Outer sleeve parallel cage
95 Guide bar suspension plate
96 U-shaped holding surface
97 Cursor
98 holding face
99 Outer sleeve insertion groove
100 Drilling instruments
101 Kirschner steel wire
102 Tip
103 outer cylinder
104 outer sleeve
105 Bar fixing clamp
106 Notch
107 Pilot pin
108 Notch
109 sharp
110 Driving bar
111 Control bar
112 Swivel handle
113 Turning surface

Claims (3)

A base plate for placing a person in the supine position, a level for detecting the level of the base plate, and a slit in the upper part that is fixed in parallel and symmetrically on both sides of the pelvis at an appropriate position on the base plate. Cut left support frame, right support frame, clamp to fix the support frame to the base plate, head side bridge plate with two slots on the left and right sides installed on the upper girders of the left and right support frames, and the center A leg-side bridge plate with a cut groove cut in one place, three cursors with a hole cut in the center that can be slid and fixed along the bridge plate, and two bridge plates in parallel at both ends A left side plate that is fixed from the side and forms an assembly frame, a right side plate, a compression plate with a compression plate connected to the lower end and a spring mounted rod inserted into the hole of the cursor and the slit of the bridge plate, and compression The position of the cursor on the bridge board is fixed so that the instrument can contact the left and right upper anterior iliac spines (P), (Q) pubic ridge (R), and two bridges A left fixing plate plate fixed with parallel side plates, compressing secure the assembled frame to the digit on the left and right support frames, multipurpose pelvic fixation device consisting of a right fixing plate.   Further, the line connecting the left and right upper anterior iliac spines (P), (Q) with respect to the floor plate (the inclination of the pelvis in the horizontal direction) and the midpoint of the PQ and the pubic protuberance (R) Inclination measuring instrument that measures the inclination relative to the floorboard (tilt in the anteroposterior direction of the pelvis), a T-shaped base straddling the tips of the three compressors to mount it, and the deflection of the side plate relative to the support frame ( The multipurpose pelvis fixation device according to claim 1, further comprising an angle meter that measures pelvic deflection.   Furthermore, a pelvis reference mark insertion point setting device and a pelvis reference mark insertion device are included, and the pelvis reference mark insertion point setting device includes a guide wire fixing base capable of sliding and fixing vertically between the support frames, Side guide wires to be fitted in the grooves on both sides of the fixing base, two guide wire locking clips for crimping the side guide wires to the fixing base, and a central guide wire locking clip to be mounted on the fixing base And a front / rear guide wire suspended from the central guide wire locking clip, and the pelvis reference mark insertion device includes a standard guide bar inserted into the slits of the support frames on both sides, and a standard guide bar An outer cylinder sleeve parallel cage suspended at one end, an outer cylinder sleeve that is inserted in parallel with the standard guide bar in the outer cylinder sleeve insertion groove of the cursor of the parallel cage, and an outer cylinder inserted into the outer cylinder sleeve It was inserted into the outer cylinder, a Kirschner wire drilling acetabulum of the pelvis, and a pilot pin to be inserted from the outer cylinder, multipurpose pelvic fixation device of claim 1 comprising a control bar to adjust the direction of the pilot pin.

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