CN100463650C - Lower limbs isometric measuring device used for all-hip joint displacement operation - Google Patents
Lower limbs isometric measuring device used for all-hip joint displacement operation Download PDFInfo
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- CN100463650C CN100463650C CNB2007100711592A CN200710071159A CN100463650C CN 100463650 C CN100463650 C CN 100463650C CN B2007100711592 A CNB2007100711592 A CN B2007100711592A CN 200710071159 A CN200710071159 A CN 200710071159A CN 100463650 C CN100463650 C CN 100463650C
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Abstract
The present invention discloses a lower extremities isometric measuring device used for total hip replacement and pertains to the technical field of medical equipments, including a connecting rod, two sleeves which are arranged on the connecting rod and are movably connected with the connecting rod, and four positioning pins which are detachably arranged on the two sleeves; when in total hip replacement, the lower extremities isometric measuring device is arranged at the femur side and acetabulum side, so as to respectively read the scale values at the junctions of the positioning pins which are positioned below the connecting sleeves and calculate the difference of the two values, then the connecting rod, the connecting sleeves and the positioning pins at the femur side are removed, after the installation of the hip prosthesis for standard trying mold, the hip joint is arranged at the first measuring position for measurement, the measurement value is compared with the measurement value before the dislocation, furthermore the present invention can reduce the degree and the incidence of the non-isometric low extremities to the greatest extent under the premise of not affecting the balance of the surrounding soft tissues of the hip joint by the adjustment of the insertion depth of the femoral prosthesis, the adjustment of the neck length and the usage of the prosthesis with the eccentric distance.
Description
Technical field
The present invention relates to a kind of measuring device of the usefulness of performing the operation, be meant a kind of isometric measuring device of lower limb that is used for replacement of total hip especially, belong to technical field of medical instruments.
Background technology
Hip replacement, limping are one of symptoms that is prone to most, also are to cause one of unsatisfied major reason of patient.Cause that the reason of walking lamely behind the replacement of total hip is a lot, as prosthetic loosening, infection, unusual, the two leg length discrepancy of structural remodeling, hip joint surrounding soft tissue imbalance, ectopic ossification, neuromuscular imbalance, and the factor beyond the hip joint such as the degeneration of spinal column, knee joint and ankle joint etc., and modal former because the two leg length discrepancys of postoperative.Behind the domestic hydrops pool Zhang Hong of hospital etc. the report artificial total hip arthroplasty, two leg length discrepancy incidence rates can reach 47%, and limb shortening is the longest to be 15mm, and prolonging maximum is 20mm.The two leg length discrepancys of foreign literature report artificial full-hip joint postoperative, can reach 27mm at most, limb lengthening (average 9mm) person accounts for 62%, limbs shorten (average 6.5mm) person and account for 32%, two lower limb wait elder only 6% fully, the thoughts leg length discrepancy can appear when leg length discrepancy surpasses 7mm, the thoughts leg length discrepancy not only can cause subject discomfort, symptoms such as limping and low back pain, and postoperative also may be because hip joint surrounding soft tissue imbalance, the prosthese dislocation occurs, make prosthese bear ABNORMAL STRESS, cause prosthese loosening too early, influence the service life of artificial joint, even overhaul too early.
Why two leg length discrepancys very easily appear behind the artificial total hip arthroplasty? main cause is that the femoral prosthesis collodiaphyseal angle is generally a fixed value (present employed femoral prosthesis collodiaphyseal angle mostly is 135 ° greatly, 127 ° of normal human's femoral neck shaft angle average out to), hip joint surrounding soft tissue balance is directly related with the neck of femur eccentric throw, and eccentric throw is relevant with neck of femur length under the changeless situation of femoral neck shaft angle, neck of femur is long more, lower limb are long more, the femur eccentric throw is just big more, otherwise neck of femur is short more, lower limb are short more, the femur eccentric throw is just more little, so just exists inherent dependency between the balance of hip joint surrounding soft tissue and the lower limb length.After operation side limbs obviously prolong, not only make the patient that the significant discomfort sense is arranged, and the increase of neck of femur eccentric throw, soft tissue tension are increased, though hip joint is comparatively stable, can cause that the stress that hip joint limitation of activity, prosthese bear increases, the prosthese wearing and tearing speed; And after the obvious shortening of the side limbs of performing the operation, the neck of femur eccentric throw reduces, soft tissue is loose, increase neck of femur prosthese and greater trochanter of femur and acetabular bone collision possibility, has strengthened the danger of dislocation of hip joint simultaneously.Therefore, if do not adopt suitable way in replacement of total hip, it is isometric to want both to obtain limbs, makes hip joint surrounding soft tissue reach well balanced very difficulty again simultaneously.
How to keep its surrounding soft tissue's balance and two lower limb isometric behind the artificial total hip arthroplasty, the method that adopts has at present: picked-up normal bit plain film before art, carrying out the art front template measures, though before art, can roughly determine the length of employed prosthese size in the art, bigelow's septum osteotomy plane, femur eccentric throw and the neck of femur that uses, but the patient is fat or thin because of being subjected to, the influence of some concrete conditions in the amplification of X-ray film and the art, and its accuracy is limited.Therefore different authors has adopted diverse ways again respectively in art, with concordance and the hip joint surrounding soft tissue balance of keeping lower limb length as far as possible, location technology in the art of two pieces of Kirschner wires 40 as shown in Figure 1, adopt two pieces of Kirschner wires 40 to add with L shaped connecting rod 50, two pieces of Kirschner wires 40 are separately fixed on the outside greater trochanter 30 of hip joint 10 and femur 20, keep connecting rod 50 parallel during measurement with femur 20 longitudinal axis, but this device is subject to the influence of joint motion, be that the patient is after measurement, hip joint generation activity causes measurement front and back joint position to change, thus the measurement result of having influence on, and the Chang Buyu femur longitudinal axis parallels, and its accuracy is limited.Therefore interference how to avoid the change because of joint position before and after measuring to bring, the accuracy before and after guaranteeing to measure, make the patient carry out replacement of total hip after lower limb isometric, be the problem of studying at present.
Summary of the invention
The object of the present invention is to provide a kind of concordance that can keep the total hip replacement fore-and-aft survey, reduce the incidence rate that full hip-joint is put the two leg length discrepancys of postoperative, be used for the isometric measuring device of lower limb of replacement of total hip.
The technical scheme that the present invention takes is as follows, a kind of isometric measuring device of lower limb that is used for replacement of total hip, comprise the connecting rod that is vertical bar shaped, the connecting rod subscript is shown with scale, and two sleeves are installed on connecting rod, laterally is provided with chute on every sleeve, two sleeves flexibly connect by chute and connecting rod, longitudinally be provided with two circular holes that run through on every sleeve, positioning needle is provided with four, is removably mounted on respectively in two telescopic four circular holes.
The further setting of the present invention is: also be fixed with sleeve pipe at each circular hole lower openings place, it is one that Socket welding is connected on the sleeve with sleeve, on the sleeve pipe of left side, tie down screw is installed, tie down screw can be fixed on the positioning needle in the circular hole of sleeve left side in the sleeve pipe of left side, and the lower end of the positioning needle in the circular hole of sleeve right side is marked with scale.
Described positioning needle is provided with and is the screw-shaped needle point.
Also be provided with locking nut on the position that is positioned on the right hand sleeves above the chute, locking nut can be fixed on right hand sleeves on the connecting rod.
On every sleeve between two circular holes spacing be 1～2 centimetre, Circularhole diameter is selected 3～4 millimeters.
Described positioning needle length is 10～15 centimetres, 3.5 millimeters of external diameters, and the needle point reach is 1～1.5 centimetre.
Screw thread near-end at the needle point of positioning needle is provided with step.
Described connecting rod, sleeve, locating rod all adopt 316L type rustless steel to make.
Operation principle of the present invention and beneficial effect are as follows: because in the total hip replacement operation process, the position of lower limb constantly changes, as not using labelling and special tool(s), the hip joint position is consistent before dislocation with after the displacement when being difficult to guarantee to measure, the concordance of hip joint position as can not keep measuring the time, the accuracy of its measurement must be affected, therefore also just will inevitably produce tangible measurement error, after adopting the present invention, by having used two pieces of locating pins respectively in acetabular bone side and femur side, after having the connecting rod connection that indicates rule, measure the lower limb length variations, thereby guarantee that hip joint all is fixed in same position (promptly neutral position) before dislocation and after prosthese is installed, make measured value more accurate, have only hip joint to be positioned under definite position, just can make measurement more accurate, as occur 5 the degree interior receipts or abductions, can cause that lower limb length reaches the error of 8mm, in addition, owing to also be marked with scale value on the positioning needle, when total hip replacement is performed the operation, after exposing hip joint, before the dislocation of hip joint, keep hip joint to stretch in the wrong, the interior abduction of receiving, the neutral position of supination before revolving is in the femur side, the isometric measuring device of lower limb is installed on the acetabular bone side, is read the scale value of positioning needle junction, branch sleeve below respectively, calculate the difference of two values, and record; Remove connecting rod, branch sleeve and femur side positioning needle, proceed hip replacement surgery, after the hip prosthesis standard to be installed die trial, positioning needle is installed in pin hole place, the former location of femur side once more, again hip joint is positioned over and measures the position first (as different with original position, then connecting rod and branch sleeve can't be connected with positioning needle), read the scale value of two branch sleeves below and fixed value junction this moment once more, calculate the difference of two values, record simultaneously, the preceding difference of measuring of this difference and dislocation is compared, this moment can be by adjusting the insertion depth of femoral prosthesis, regulate neck length and use the eccentric throw prosthese, the balance that as far as possible keeps hip joint surrounding soft tissue, thereby do not influencing under the equilibrated prerequisite of hip joint surrounding soft tissue, can reduce the degree and the incidence rate of two leg length discrepancys as far as possible,, increase the satisfaction of patient the whole coxa substitution operation in the hope of prolonging artificial hip joint service life.
Description of drawings
Fig. 1 is applied to user mode figure in the replacement of total hip for Kirschner wire;
Fig. 2 is a structural representation of the present invention;
Fig. 3 is the user mode figure (when for the first time measuring) of the present invention in replacement of total hip;
Fig. 4 is that the present invention is at another user mode figure of replacement of total hip (after pulling down positioning needle and connecting rod).
The specific embodiment
As shown in Figure 2, the present invention includes a connecting rod 1, the sleeve 2 with connecting rod 1 flexibly connects reaches the positioning needle 3 that detachably is installed on the sleeve 2.
Connecting rod 1 is designed to vertical bar shaped, indicate above scale 11 is arranged, in the present embodiment, the connecting rod 1 preferred 316L type rustless steel that adopts, connecting rod 1 connects the usefulness of sleeve 2 on the one hand, makes the usefulness of measurement on the one hand, can measure the variation of whole coxa substitution front and back lower limb length exactly, measure according to measurement and the standard form to patient's lower limb before the art, in art, accurately regulate the length of lower limb, to reduce the generation of leg length discrepancy.
The sleeve 2 same 316L of employing type rustless steels are made, be provided with two, on every sleeve 2, laterally be provided with a chute 21, chute 21 preferably is arranged on the rear portion of sleeve 2, the size of chute 21 is big or small consistent with connecting rod 1, to guarantee that connecting rod 1 can insert in the chute 21 of sleeve 2 smoothly, above chute 21, be provided with locking nut 23, after connecting rod 1 insertion sleeve 2 positions are determined, can be fixing by locking nut 23, also be provided with two circular holes that vertically run through 22 in the front portion of every sleeve 2, spacing is 1.5 centimetres between two circular holes 22, and circular hole 22 diameters are selected 4 millimeters, are connected with sleeve pipe 25 at the lower openings place of every circular hole 22, sleeve pipe 25 is welded on the sleeve 2 with sleeve 2 and is one, on left side sleeve pipe 25, be equipped with tie down screw 24 and with the suitable hole of tie down screw 24.
Positioning needle 3 is provided with four, be removably mounted on respectively in four circular holes 22 of two sleeves 2, positioning needle 3 length are 12 centimetres, 3.5 millimeters of external diameters, the needle point 33 of positioning needle 3 is a screw-like, purpose is to install and remove in order to be convenient in art, when row is installed again after the dismounting, loosening because of there being screw thread not to be prone to relatively, in addition according to the thickness of greater trochanter outside sclerotin behind the thickness of ala of ilium and the femur side implanting prosthetic, the design reach is 1.2cm, and the screw thread near-end designs the implantation depth that a step 32 is convenient to control and be maintained fixed pin 3, so that when measuring the neck of femur eccentric throw, more accurate, the positioning needle 3 that is installed in the sleeve left side can be fixing by tie down screw 24, and the positioning needle 3 on right side is active, on the surface of the positioning needle 3 on right side, be marked with scale 31, by to before and after the replacement of total hip, the variation of positioning needle 3 high scales 31, the variation that can measure the neck of femur eccentric throw, measure in conjunction with standard form before the art again, guarantee the balance of hip joint surrounding soft tissue as far as possible.
In conjunction with Fig. 3, shown in Figure 4, the application of the present invention in replacement of total hip is as follows:
1, before the operation: give non-fracture of femoral neck, need the patient of row total hip replacement to take normal bit pelvis plain film, size, neck of femur neck length (neck of femur eccentric throw), the acetabular bone rasion degree of depth, the acetabular component size of neck of femur osteotomy plane, use type femoral bone end prosthesis in the predicting surgical, measure patient's bilateral anterior superior iliac spine to internal malleolus point distance, and link to vertical dimension between the inboard summit of little commentaries on classics in conjunction with the measured bilateral ischial tuberosity lower edge level of pelvis plain film, determine lower limb difference in length value before patient's art.
2, operation: the patient is in lateral position, get posteriolateral incision, after exposing hip joint, before dislocation of hip joint, keep hip joint in anteflexion with after stretch, the interior receipts and abduction, before revolving and the neutral position of supination, respectively at the femur side, the acetabular bone side is respectively got two place's entry points, growth devices such as lower limb are installed, when cause is carried out the whole coxa substitution operation at present, its otch is all less, be everlasting about 9-15cm, exposure to the acetabular bone surrounding bone is limited, when therefore using measuring device, all need it to be fixed 2 of otch treatment with external measures, dissection according to hip joint 10 and ilium, entry point is selected in two positions up and down and hip joint 10 nearsides---the posterosuperior surface of bone of anterior superior iliac spine of the highlight in greater trochanter of femur 30 outsides respectively, locking nut on the sleeve 2 24 is unscrewed, by T shape screwdriver, four positioning needles 3 are separately fixed at the position of entry point, after positioning needle 3 fixes, after connecting rod 1 connection, make the anteflexion of hip joint and after stretch, the interior receipts and abduction, medial rotation all can not take place with revolving outward, therefore guaranteed that hip joint is before and after displacement, measure the concordance of position, thereby guaranteed the accuracy of measuring, note respectively on positioning needle 3 and the connecting rod 1 scale value, remove connecting rod 1 then, sleeve 2 and two positioning needles 3 that are positioned on the femur side 30, take out femoral head 20, bore the mill acetabular bone, carrying out the prosthese die trial earlier installs, can be according to patient's practical situation choice criteria type or bigger than normal, type femoral prosthesis less than normal carries out die trial and installs, after the installation in former entry point, the positioning needle 3 and the connecting rod 1 that take off are reinstalled, after reinstalling and finish, measure once more growth devices such as lower limb, the preceding measured value of numerical value after measuring and installation is compared, lower limb length and neck of femur eccentric throw are adjusted in the scope of predicted value before the art (be before the art before standard form measured value and the art two lower limb anterior superior iliac spine to internal malleolus point distance measure), because adopting four positioning needles 3 fixes femur 20 and hip joint 10, therefore, if before the dislocation with prosthese is installed after the hip joint position inconsistent, then four positioning needles 3 of installing once more can't enter into original entry point, accuracy before and after so just obtaining to guarantee to measure, after measurement finishes, connecting rod 1 is taken out in sleeve 2, locking nut on the sleeve 2 24 is back-outed, take out on the sleeve 2 self-align pins 3, reuse T shape screwdriver takes out four positioning needles 2, thereby growth devices such as lower limb are removed.
Postoperative: all patients of second day after operation take normal bit pelvis plain film, measure the neck of femur eccentric throw, and measurement patient bilateral anterior superior iliac spine to internal malleolus point distance, and link to vertical dimension between the inboard summit of little commentaries on classics in conjunction with bilateral ischial tuberosity lower edge level, determine patient's postoperative lower limb difference in length value.
Claims (8)
1. isometric measuring device of lower limb that is used for replacement of total hip, comprise the connecting rod (1) that is vertical bar shaped, connecting rod (1) subscript is shown with scale (11), two sleeves (2) are installed on connecting rod (1), on every sleeve (2), laterally be provided with chute (21), two sleeves (2) flexibly connect by chute (21) and connecting rod (1), on every sleeve (2), longitudinally be provided with two circular holes that run through (22), positioning needle (3) is provided with four, is removably mounted on respectively in four circular holes (22) of two sleeves (2).
2. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 1, it is characterized in that: the lower openings place also is fixed with sleeve pipe (25) at each circular hole (22), sleeve pipe (25) is welded on the sleeve (2) and sleeve (2) is one, tie down screw (24) is installed on left side sleeve pipe (25), tie down screw (24) can be fixed on the positioning needle (3) in sleeve (2) the left side circular hole (22) in the left side sleeve pipe (25), and the lower end of the positioning needle (3) in sleeve (2) right side circular hole (22) is marked with scale (31).
3. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 1 is characterized in that: described positioning needle (3) is provided with and is screw-shaped needle point (33).
4. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 1, it is characterized in that: also be provided with locking nut (23) on the position that is positioned at chute (21) top on the right hand sleeves (2), locking nut (23) can be fixed on right hand sleeves (2) on the connecting rod (1).
5. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 1, it is characterized in that: spacing is 1～2 centimetre between last two circular holes of every sleeve (2) (22), circular hole (22) diameter is selected 3～4 millimeters.
6. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 1, it is characterized in that: described positioning needle (3) length is 10～15 centimetres, 3.5 millimeters of external diameters, needle point (33) reach is 1～1.5 centimetre.
7. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 6 is characterized in that: the screw thread near-end at the needle point (33) of positioning needle (3) is provided with step (32).
8. a kind of isometric measuring device of lower limb that is used for replacement of total hip according to claim 1, it is characterized in that: described connecting rod (1), sleeve (2), locating rod (3) all adopt 316L type rustless steel to make.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2007100711592A CN100463650C (en) | 2007-09-21 | 2007-09-21 | Lower limbs isometric measuring device used for all-hip joint displacement operation |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2007100711592A CN100463650C (en) | 2007-09-21 | 2007-09-21 | Lower limbs isometric measuring device used for all-hip joint displacement operation |
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| Publication Number | Publication Date |
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| CN101125085A CN101125085A (en) | 2008-02-20 |
| CN100463650C true CN100463650C (en) | 2009-02-25 |
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| Application Number | Title | Priority Date | Filing Date |
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| CNB2007100711592A Expired - Fee Related CN100463650C (en) | 2007-09-21 | 2007-09-21 | Lower limbs isometric measuring device used for all-hip joint displacement operation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101632586B (en) * | 2009-07-06 | 2011-05-04 | 中国人民解放军第三军医大学第一附属医院 | Measurer of eccentric distance of hip joint and extended limb length |
Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102697542B (en) * | 2012-07-18 | 2014-04-23 | 绍兴市人民医院 | Acetabulum installing and adjusting device in total hip arthroplasty |
| CN107334476A (en) * | 2017-06-27 | 2017-11-10 | 苏州奥特科然医疗科技有限公司 | A kind of distance-measuring device |
| CN107981866A (en) * | 2018-01-10 | 2018-05-04 | 中山大学附属第医院 | Measuring device for hip joint replacement |
| CN108567510A (en) * | 2018-05-17 | 2018-09-25 | 西南医科大学附属医院 | Leg length measuring instrument in replacement of total hip |
| CN108937944A (en) * | 2018-07-03 | 2018-12-07 | 中国人民解放军第二军医大学第二附属医院 | A kind of measuring appliance in orthopaedics replacement of total hip |
| CN113017942B (en) * | 2021-03-17 | 2022-08-23 | 山东大学齐鲁医院(青岛) | Device for measuring length change of lower limb |
| CN113017943B (en) * | 2021-03-17 | 2024-01-09 | 山东大学齐鲁医院(青岛) | Acetabular position change measuring device |
| CN113558831A (en) * | 2021-07-26 | 2021-10-29 | 晋江市医院 | Femoral side prosthesis implantation limiting measurer in hip replacement and using method thereof |
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| US6027507A (en) * | 1998-04-30 | 2000-02-22 | Innomed, Inc. | Leg length gauge for total hip surgery |
| CN2432896Y (en) * | 2000-08-01 | 2001-06-06 | 陈德路 | Hip measuring instrument |
| CN1494397A (en) * | 2001-03-05 | 2004-05-05 | ���ŷƿ�˹���ʹ�˾ | External fixation device for reducing bone fractures |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6027507A (en) * | 1998-04-30 | 2000-02-22 | Innomed, Inc. | Leg length gauge for total hip surgery |
| CN2432896Y (en) * | 2000-08-01 | 2001-06-06 | 陈德路 | Hip measuring instrument |
| CN1494397A (en) * | 2001-03-05 | 2004-05-05 | ���ŷƿ�˹���ʹ�˾ | External fixation device for reducing bone fractures |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101632586B (en) * | 2009-07-06 | 2011-05-04 | 中国人民解放军第三军医大学第一附属医院 | Measurer of eccentric distance of hip joint and extended limb length |
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| CN101125085A (en) | 2008-02-20 |
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