AU2021101287A4 - Adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room - Google Patents

Adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room Download PDF

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Publication number
AU2021101287A4
AU2021101287A4 AU2021101287A AU2021101287A AU2021101287A4 AU 2021101287 A4 AU2021101287 A4 AU 2021101287A4 AU 2021101287 A AU2021101287 A AU 2021101287A AU 2021101287 A AU2021101287 A AU 2021101287A AU 2021101287 A4 AU2021101287 A4 AU 2021101287A4
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Australia
Prior art keywords
universal joint
locking
ball
locking structure
joint
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Ceased
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AU2021101287A
Inventor
Xuyong CAO
Yuncen CAO
Mingxing LEI
Shubin Liu
Yaosheng Liu
Peifu TANG
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Fourth Medical Center General Hospital of Chinese PLA
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Fourth Medical Center General Hospital of Chinese PLA
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/171Guides or aligning means for drills, mills, pins or wires for external fixation

Abstract

The present disclosure discloses an adjustable minimal-invasive decompression guiding device for femoral head necrosis in an operating room, and relates to the technical field of 5 medical instruments. The device includes a supporting arm, a guider and a locking structure, wherein one end of the supporting arm is connected with an operating table, the other end of the supporting arm is connected with one end of the locking structure through a first universal joint, the other end of the locking structure is connected with the guider through a second universal joint, the locking structure is used for locking the first universal joint and the second universal 10 joint, and the guider is used for placing a kirschner wire. The adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room can achieve the purposes of accurately positioning drill holes and quickly completing multi-channel drilling, thereby greatly shortening the fluoroscopy time, the operation time and the anesthesia time, and being beneficial to the development of daytime outpatient surgery under local anesthesia, the 15 saving of medical expenses and the rapid recovery after surgery. DRAWINGS 2 21 00 00000 17 0 0 18 16 22 4 15 3 13 S114 23 FIG. 1 6 9 8 10 12 FIG. 2

Description

DRAWINGS
2 21 00
00000 17 0 0 18 16
22 4 15 3
13
S114 23
FIG. 1
6 9 8 10
12
FIG. 2
ADJUSTABLE MINIMAL-INVASIVE DECOMPRESSION GUIDING DEVICE FOR FEMORAL HEAD NECROSIS IN OPERATING ROOM
TECHNICAL FIELD The present disclosure relates to the technical field of medical instruments, and in particular to an adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room.
BACKGROUND Femoral head necrosis, also known as aseptic necrosis of femoral head or ischemic necrosis of femoral head , is a kind of disease caused by poor local blood supplement of the femoral head due to various reasons, which leads to further ischemia and necrosis of bone cells, fracture of bone trabecula, and collapse of the femoral head. Femoral head necrosis has a high disability rate. If it is not treated in time, artificial total hip arthroplasty is needed in the late stage of disease progression. A core decompression technology can effectively reduce an intramedullary pressure of the femoral head, improve local blood supplement, and promote osteogenic repair, thereby cutting off and reversing femoral head necrosis in early and middle stages. At the same time, the operation cost is low, the surgical operation is simple, and thus it is easy to popularize and carry out. However, the decompression needs to be accurately located in a necrotic zone, otherwise it will not only seriously affect the therapeutic effect, but also cause additional damages. Furthermore, in the minimal-invasive fine-needle multi-channel core decompression surgery in most hospitals, a doctor needs to drill holes after repeatedly positioning all paths of the fine needle in an adem position under the perspective of an X-ray machine. Such an operation not only has higher technical requirements for the doctor, but also greatly prolongs the operation time, especially the repeated fluoroscopy under the X ray can cause an radiation damage to the human body and greatly harm the health of medical staffs and patients.
SUMMARY An objective of the present disclosure is to provide an adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room, so as to achieve the purposes of accurately positioning drill holes and quickly completing multi-channel drilling, thereby greatly shortening the fluoroscopy time, the operation time and the anesthesia time, and being beneficial to the development of daytime outpatient surgery under local anesthesia, the saving of medical expenses and the rapid recovery after surgery. To achieve the above purpose, the present disclosure provides the following solution. The present disclosure provides an adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room, which includes a supporting arm, a guider and a locking structure, wherein one end of the supporting arm is connected with an operating table, the other end of the supporting arm is connected with one end of the locking structure through a first universal joint, the other end of the locking structure is connected with the guider through a second universal joint, the locking structure is used for locking the first universal joint and the second universal joint, and the guider is used for placing a kirschner wire. Preferably, the first universal joint and the second universal joint have the same structure, the first universal joint and the second universal joint each includes a ball joint and a ball head arranged in the ball joint, the ball head of the first universal joint is fixedly connected with an end portion of the supporting arm, a first locking portion of the locking structure extends into the ball joint of the first universal joint, a second locking portion of the locking structure extends into the balljoint of the second universaljoint, and the first locking portion and the second locking portion are used for locking the ball head. Preferably, the first locking portion and the second locking portion have the same structure, and the first locking portion and the second locking portion each includes a motion bar and an inner ball seat part arranged at one end of the motion bar, and the shape of the inner ball seat part matches the shape of the ball head. Preferably, the locking structure further includes a gear lever through which a driving gear passes, the driving gear is engaged with driven gears arranged on two sides of the driving gear, and each of the driven gear is connected with one of the motion bars. Preferably, the locking structure further includes a gear lever through which two driving gears pass, each of the driving gears is engaged with a driven gear, and each of the driven gears is connected with one of the motion bars. Preferably, the locking structure further includes a first rotating part and a second rotating part, wherein both a bottom portion of the first rotating part and a top portion of the second rotating part are provided with teeth which are mutually engaged with each other, the first rotating part and the ball joint of the first universal joint, and the second rotating part and the ball joint of the second universal joint are each connected through a hollow sleeve, and the first locking portion and the second locking portion pass through respective ones of the hollow sleeves and extend into each of the ball joints. Preferably, the guider is connected with the second universal joint through an extension arm which is a retractable bar, the retractable bar includes a sleeve and a slide bar arranged in the sleeve, a locking bolt is arranged on a side wall of the sleeve and achieves the fixation of the sleeve and the slide bar, the sleeve is connected with the second universal joint, and the slide bar is connected with the guider. Preferably, the guider includes a cubic structure on which several parallel through holes are opened, a guiding sleeve passes through the through holes, and the guiding sleeve is used for placing the kirschner wire. Preferably, the supporting arm is connected with an edge of the operating table through a fixator which includes a first fixing portion and a second fixing portion, the supporting arm passes through the first fixing portion and is fixed by a tightening bolt, and the edge of the operating table is arranged in a groove of the second fixing portion and fixed by another tightening bolt. The present disclosure achieves the following technical effects compared to the prior art. During use of the present disclosure, the supporting arm is connected with the operating table, the angle of the guider is adjusted through the first universal joint and the second universal joint, and then the first universal joint and the second universal joint are locked by the locking structure, and the Kirschner wire is put into the guider and is inserted into the femoral head. In the present disclosure, multi-plane orientations such as retraction, adduction, abduction, forward inclination and head tilting of the guider are realized through the first universal joint and the second universal joint, and corresponding adjustments can be quickly made according to possible changes of the posture of the patient during the operation; the present disclosure greatly simplifies the surgical process, is simple to operate, is suitable for any operating table and patients of different body sizes, and the surgery can be operated under local anesthesia combined with intravenous anesthesia, and is easy to popularize.
BRIEF DESCRIPTION OF THE DRAWINGS To describe the technical solutions in the embodiments of the present disclosure or in the prior art more clearly, the following briefly introduces the accompanying drawings required for describing the embodiments. Apparently, the accompanying drawings in the following description show merely some embodiments of the present disclosure, and a person of ordinary skill in the art may still derive other drawings from these accompanying drawings without creative efforts. FIG. 1 is a schematic diagram of an adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room of the present disclosure; FIG. 2 is a schematic diagram of the internal structure of the locking structure of the present disclosure; FIG. 3 is a schematic diagram of the guider of the present disclosure; Wherein, 1 - supporting arm, 2 - guider, 3 - locking structure, 4 - first universal joint, 5 second universal joint, 6 - ball joint, 7 - ball head, 8 - motion bar, 9 - inner ball seat part, 10 gear lever, 11 - driving gear, 12 - driven gear, 13 - first rotating part, 14 - second rotating part, 15 - hollow sleeve, 16 - sleeve, 17 - slide bar, 18 - locking bolt, 19 - cubic structure, 20 through hole, 21 - guiding sleeve, 22 - first fixing portion, 23 - second fixing portion.
DETAILED DESCRIPTION The following clearly and completely describes the technical solutions in the embodiments of the present disclosure with reference to the accompanying drawings in the embodiments of the present disclosure. Apparently, the described embodiments are merely a part rather than all of the embodiments of the present disclosure. All other embodiments obtained by a of person of ordinary skill in the art based on the embodiments of the present disclosure without creative efforts briefly fall within the protection scope of the present disclosure. An objective of the present disclosure is to provide an adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room, so as to achieve the purposes of accurately positioning drill holes and quickly completing multi-channel drilling, thereby greatly shortening the fluoroscopy time, the operation time and the anesthesia time, and being beneficial to the development of daytime outpatient surgery under local anesthesia, the saving of medical expenses and the rapid recovery after surgery. To make the foregoing objective, features, and advantages of the present disclosure clearer and more comprehensible, the present disclosure is further described in detail below with reference to the accompanying drawings and specific embodiments. Embodiment 1 As shown in FIGs. 1-3, this embodiment provides an adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room, which includes a supporting arm 1, a guider 2 and a locking structure 3, wherein one end of the supporting arm 1 is connected with an operating table, the other end of the supporting arm 1 is connected with one end of the locking structure 3 through a first universal joint 4, the other end of the locking structure 3 is connected with the guider 2 through a second universal joint 5, the locking structure 3 is used for locking the first universal joint 4 and the second universal joint 5, and the guider 2 is used for placing a kirschner wire. During use of this embodiment, the supporting arm 1 is connected with the operating table, the angle of the guider 2 is adjusted through the first universal joint 4 and the second universal joint 5, and then the first universal joint 4 and the second universal joint 5 are locked by the locking structure 3, and the Kirschner wire is put into the guider 2 and is inserted into the femoral head. In this embodiment, multi-plane orientations such as retraction, adduction, abduction, forward inclination and head inclination of the guider 2 are realized through the first universal joint 4 and the second universal joint 5, and corresponding adjustments can be quickly made according to possible changes of the posture of the patient during the operation; this embodiment greatly simplifies the surgical process, is simple to operate, is suitable for any operating table and patients of different body sizes, and the surgery can be operated under local anesthesia combined with intravenous anesthesia, and is easy to popularize. In this embodiment, the first universal joint 4 and the second universal joint 5 have the same structure, the first universal joint 4 and the second universal joint 5 each includes a ball joint 6 and a ball head 7 arranged in the ball joint 6, the ball head 7 of the first universal joint 4 is fixedly connected with an end portion of the supporting arm 1, a first locking portion of the locking structure 3 extends into the ball joint 6 of the first universal joint 4, a second locking portion of the locking structure 3 extends into the ball joint 6 of the second universal joint 5, and the first locking portion and the second locking portion are used for locking the ball head 7. In this embodiment, the first locking portion and the second locking portion have the same structure, and the first locking portion and the second locking portion each includes a motion bar 8 and an inner ball seat part 9 arranged at one end of the motion bar 8, and the shape of the inner ball seat part 9 matches the shape of the ball head 7. The ball head 7 can be locked by the contact between the inner ball seat part 9 and the ball head 7 which are separated from each other, and the first universal joint 4 and the second universal joint 5 can be used for angle adjustment. In this embodiment, the locking structure 3 further includes a gear lever 10 through which two driving gears 11 pass, each of the driving gears 11 is engaged with a driven gear 12, and each of the driven gear 12 is connected with one of the motion bars 8. In this embodiment, the locking structure 3 further includes a first rotating part 13 and a second rotating part 14, wherein both a bottom portion of the first rotating part 13 and a top portion of the second rotating part 14 are provided with teeth which are mutually engaged with each other, the first rotating part 13 and the ball joint 6 of the first universal joint 4, and the second rotating part 14 and the ball joint 6 of the second universal joint 5 are each connected through a hollow sleeve 15, and the first locking portion and the second locking portion pass through respective ones of the hollow sleeves 15 and extend into each of the ball joints 6. The gear lever 10 passes through a housing formed by the first rotating part 13 and the second rotating part 14, and is rotationally connected with the first rotating part 13 and the second rotating part 14, and a rotating handle is also arranged at the upper end of the gear lever 10. By rotating the handle, the gear lever 10 drives the driving gear 11 to rotate, thereby driving the driven gear 12 to rotate. The driven gear 12 drives the inner ball seat part 9 at the end of the motion bar 8 to achieve the separation and locking of the inner ball seat part and the ball head 7. In this embodiment, the guider 2 is connected with the second universal joint 5 through an extension arm which is a retractable bar, the retractable bar includes a sleeve 16 and a slide bar 17 arranged in the sleeve 16, a locking bolt 18 is arranged on a side wall of the sleeve 16 and achieves the fixation of the sleeve 16 and the slide bar 17. The sleeve 16 is connected with the ball head 7 of the second universal joint 5 through a fulcrum bar perpendicular to the sleeve 16, and the slide bar 17 is connected with the guide 2. By adjusting the locking bolt 18, the retraction and rotation of the slide bar 17 can be realized. In this embodiment, the guider 2 includes a cubic structure 19 on which several parallel through holes 20 are opened, a guiding sleeve 21 passes through the through holes 20, and the guiding sleeve 21 is used for placing the kirschner wire. In this embodiment, the supporting arm 1 is connected with an edge of the operating table through a fixator which includes a first fixing portion 22 and a second fixing portion 23, the supporting arm 1 passes through the first fixing portion 22 and is fixed by a tightening bolt, and the edge of the operating table is arranged in a groove of the second fixing portion 23 and fixed by another tightening bolt. When decompression surgery is conducted with this embodiment, under the auxiliary fluoroscopy of an X-ray machine, a doctor first locks the supporting arm 1 with the edge of the operating table through the fixator, preliminarily adjusts the distance between the cubic structure 19 of the guide 2 and the outside of the proximal end of a thigh of the patient through the supporting arm 1, and adjusts the rotating handle so that the first universal joint 4 and the second universal joint 5 can rotate freely. By adjusting the first universal joint 4 and the second universal joint 5, forward flexion, rear protraction, adduction, abduction, internal rotation and external rotation of the cubic structure 19 of the guider 2 are realized. The direction of the through holes 20 of the cubic structure 19 of the guider 2 located at the outside of the proximal end of the thigh of the patient is adjusted to moderate forward inclination and head inclination, such that the femoral head neck of the affected side is aimed at. The rotating handle is tightened, so that the first rotating part 13 and the second rotating part 14 of the locking structure 3 are engaged and fixed, and meanwhile, the inner ball seat part 9 locks the ball head 7 to realize the locking of the first universal joint 4 and the second universal joint 5. By inserting the Kirschner wire into the guiding sleeve 21, the simulated positioning of a core decompression channel within the femoral head and neck is completed. Then, several Kirschner wires are drilled into a targeted necrotic zone of the femoral head and neck through the guiding sleeve 21 in the through holes 20, and then the percutaneous multi-channel minimal-invasive fine-needle decompression operation is completed. In this embodiment, the first universal joint 4, the second universal joint 5 and the locking structure 3 can be quickly adjusted according to the change of the patient's posture during the surgery. The use of this embodiment greatly simplifies the surgical process, is simple to operate, and is suitable for any operating table and patients of different body sizes, the surgery can be operated under local anesthesia combined with intravenous anesthesia, and is easy to popularize; in addition, the operation steps are greatly saved, the operation time and the fluoroscopy time under the X-ray machine are shortened, and meanwhile, the medical staff do not need to hold the guiding device by hand during the operation process, and the operation gap can be far away from the operating table and the X-ray machine, which is beneficial for the medical staff to avoid X-ray irradiation, thereby greatly reducing the iatrogenic damage of X-ray irradiation to the medical staff and the patient. This embodiment has a reasonable structure, convenient operation, flexible adjustment, accurate guidance, low requirements for operating room environment and anesthesia, and is suitable for popularization and development of minimal-invasive core decompression technology for femoral head necrosis. Embodiment 2 The difference between this embodiment and embodiment 1 lies in that the locking structure 3 further includes a gear lever 10 through which a driving gear 11 passes, the driving gear 11 is engaged with driven gears 12 arranged on both sides of the driving gear 11, and each of the driven gears 12 is connected with one of the motion bars 8. Specific embodiments are applied in this specification to describe the principle and implementations of the present disclosure. The description of the aforementioned embodiments is only used for facilitating understanding of the method and the core idea of the present disclosure; and meanwhile, for those of ordinary skills in the art, there will be changes in specific implementations and application scope in accordance with the concept of the present disclosure. In conclusion, the content of this specification shall not be construed as a limitation to the present invention.

Claims (5)

1. An adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room, comprising a supporting arm, a guider and a locking structure, wherein one end of the supporting arm is connected with an operating table, the other end of the supporting arm is connected with one end of the locking structure through a first universal joint, the other end of the locking structure is connected with the guider through a second universal joint, the locking structure is used for locking the first universal joint and the second universal joint, and the guider is used for placing a kirschner wire.
2. The adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room according to claim 1, wherein the first universal joint and the second universal joint have the same structure, the first universal joint and the second universal joint each comprises a ball joint and a ball head arranged in the ball joint, the ball head of the first universal joint is fixedly connected with an end portion of the supporting arm, a first locking portion of the locking structure extends into the ball joint of the first universal joint, a second locking portion of the locking structure extends into the ball joint of the second universal joint, and the first locking portion and the second locking portion are used for locking the ball head.
3. The adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room according to claim 2, wherein the first locking portion and the second locking portion have the same structure, and the first locking portion and the second locking portion each comprises a motion bar and an inner ball seat part arranged at one end of the motion bar, and the shape of the inner ball seat part matches the shape of the ball head.
4. The adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room according to claim 3, wherein the locking structure further comprises a gear lever through which a driving gear passes, the driving gear is engaged with driven gears arranged on two sides of the driving gear, and each of the driven gear is connected with one of the motion bars;
or, wherein the locking structure further comprises a gear lever through which two driving gears pass, each of the driving gears is engaged with a driven gear, and each of the driven gears is connected with one of the motion bars.
5. The adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room according to claim 2, wherein the locking structure further comprises a first rotating part and a second rotating part, wherein both a bottom portion of the first rotating part and a top portion of the second rotating part are provided with teeth which are mutually engaged with each other, the first rotating part and the ball joint of the first universal joint, and the second rotating part and the ball joint of the second universal joint are each connected through a hollow sleeve, and the first locking portion and the second locking portion pass through respective ones of the hollow sleeves and extend into each of the ball joints.
AU2021101287A 2020-11-06 2021-03-12 Adjustable minimal-invasive decompression guiding device for femoral head necrosis in operating room Ceased AU2021101287A4 (en)

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CN202011227104.8A CN112220524A (en) 2020-11-06 2020-11-06 Adjustable minimally invasive decompression guiding device for femoral head necrosis in operating room
CN202011227104.8 2020-11-06

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CN114176800B (en) * 2022-01-04 2024-01-30 上海交通大学 Femoral head marrow core decompression operation positioner and decompression method thereof
CN114224513A (en) * 2022-01-11 2022-03-25 华中科技大学同济医学院附属协和医院 Adjustable minimally invasive decompression guiding device for femoral head necrosis in operating room

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