CN101884560B - Universal-type femur external rotation osteotomy guider - Google Patents
Universal-type femur external rotation osteotomy guider Download PDFInfo
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- CN101884560B CN101884560B CN2010101989215A CN201010198921A CN101884560B CN 101884560 B CN101884560 B CN 101884560B CN 2010101989215 A CN2010101989215 A CN 2010101989215A CN 201010198921 A CN201010198921 A CN 201010198921A CN 101884560 B CN101884560 B CN 101884560B
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Abstract
The invention belongs to a medical instrument which is used to accurately position the osteotomy line in the artificial knee joint replacement operation and ensure the osteotomy line to be parallel with transepicondylar axis (TEA). The invention provides a universal-type femur external rotation osteotomy guider. The guider comprises a flat posterior femoral condyle supporting plate, one surface of the posterior femoral condyle supporting plate is a plane; an upright is arranged on one side of the plane of the supporting plate and perpendicular to the plane; and the guider also comprises an elongated indicating needle, wherein the indicating needle can rotate on a rotation plane which is perpendicular to the plane of the supporting plate, and the indicating needle is connected with the upright in a sliding manner, namely the indicating needle is connected with the upright while the indicating needle can slide along the axial direction of the upright. The invention is mainly used in the artificial knee joint replacement operation.
Description
Technical field
The invention belongs to the assistive device of a kind of medical apparatus and instruments, particularly a kind of replacement knee in arthroplasty.
Background technology
Total knee replacement is unique effective ways of the knee joint illness in whole latter stage of treatment at present.Along with the raising of surgical technic and the improvement of prosthetic designs, its clinical efficacy and prosthese survival rate at a specified future date are moreover improved.However, in using this technical process, still have some problems effectively to be solved as yet, make the part patient can not obtain satisfied surgical effect and prosthese service life.Wherein because the bad patellofemoral joint complication that causes of femoral prosthesis outward turning is exactly one of subject matter wherein.The clinical symptoms that this complication showed comprises that pain before the knee joint, dislocation of the patella appear in postoperative and owing to the undesired stressed wearing and tearing that cause of prosthese, become flexible etc., its incidence rate is about 1.5%～12%, accounts for artificial knee joint and overhauls 50% of reason.The femoral prosthesis outward turning is bad to be meant femoral prosthesis because the factor of shape or rigging position; Make femoral prosthesis outward turning and surrounding not match, lose like patella and produce improper stress etc. between suitable event trace, femoral prosthesis and the knee-joint prosthesis miscellaneous part.
The femoral prosthesis structure is as depicted in figs. 1 and 2, and exterior contour imitates the interior condyle and the ectocondyle preparation of human femur under loading, and after the prosthese assembling, this part profile just plays a part and interior condyle of true femur and ectocondyle.Femoral prosthesis is installed to before the femur, need cut (be also referred to as the femur outward turning and cut bone) to femur, so that the femur after the cutting can match with inboard (femoral prosthesis is provided with a side of column among Fig. 1 and Fig. 2) shape of femoral prosthesis.It is the major reason that causes the femoral prosthesis outward turning bad that the femur outward turning cuts bone inaccurate; The reference line that is used to instruct the femur outward turning to cut bone has lateral epicondyle line (transepicondylar axis in the femur; TEA), the postartis line (postcondylar axis, PCA), the Whiteside line and under the prerequisite of soft tissue balance with reference to tibia osteotomy surface etc.Think after Chinese scholars is studied kneed kinesiology at present always; Lateral epicondyle line (TEA) is the most approaching with the normal flexion and extension axle of knee joint in the femur; When the femur outward turning of promptly being expert at cuts bone; Cut the bone line and then can well restore normal kneed motor pattern, can farthest reduce patella joint complication as parallel with TEA.TEA comprises two kinds: i.e. surgical epicondylar axis (SEA) and clinical epicondylar axis (CEA).SEA is meant the line between the ditch of external epicondyle of femur peak and medial epicondyle, and CEA is meant the line of external epicondyle of femur peak and medial epicondyle peak.Further research shows, carrying out the femur outward turning with reference to SEA, to cut bone the most reliable.What Fig. 3 showed is the front view of DF, promptly when human body is gone down on one's knees from the human body dead ahead along the femur axis direction observed DF profile.Sign 1 line pointed is the SEA line among Fig. 3.Cut bone at the upper and lower two parts of the femur of Fig. 3, promptly, can well restore normal kneed motor pattern to be parallel to the upper and lower two parts (two dotted lines among Fig. 3 are ideal section bone line) that the bone line excises femur shown in Figure 3 that cut of SEA line.Iconography research shows that 27% knee joint internal epicondyle of femur does not have obvious ditch; All there is soft tissue to cover simultaneously on inside and outside two condyle surfaces; So be difficult in the clinical operation the accurate location and accurately mark the TEA axis respectively of lateral epicondyle in the femur, thus greatly limited TEA as a reference line carry out the application that the femur outward turning cuts bone.Even under the computer assisted navigation system of using at present, also fail this problem is well solved.
The femur outward turning cuts the normal reference line femoral-posterior condyles line (PCA) that adopts of bone line in actual operation, i.e. sign 2 reference line pointed among Fig. 3.Most of knee-joint prosthesis often cut bones for 3 ° in the supporting operating theater instruments with reference to the capable outward turning of PCA, this is based on abroad determining PCA and TEA anatomy relationship.Although this section bone method is effective to most of case.But a large amount of research shows that owing to have tangible individual variation and people's species diversity at DF, the relationship change of lateral epicondyle line is bigger in femoral-posterior condyles line and the femur, can reach-1 °～12 °.Simultaneously the research report of domestic literature shows, Chinese femur outward turning angle is bigger than normal, how about 5-8 °.So cutting the bone method with reference to PCA uses unsatisfactory at home.
Summary of the invention
To cut the bone line in order in the artificial knee replacement surgery, can accurately locating, to make section bone line parallel, the invention provides a kind of universal-type femur external rotation osteotomy guider with TEA.
Technical scheme of the present invention is following:
Universal-type femur external rotation osteotomy guider comprises a tabular femoral-posterior condyles supporting plate, and a plate face of femoral-posterior condyles supporting plate is the plane; One side is provided with column perpendicular to this plane on said supporting plate plane; Also comprise the strip pointer, said pointer can rotate in perpendicular to the planar Plane of rotation of said supporting plate, and said pointer and column are slidingly connected, and promptly said pointer keeps sliding along the axis direction of column when being connected with column.
Said universal-type femur external rotation osteotomy guider also is provided with the rotational angle metrology structure; Rotational angle metrology structure indication angle with said supporting plate plane parallel the time is zero when at least one long limit of said pointer, and the rotational angle metrology structure can be indicated the value of angle between this length limit and the said supporting plate plane.
The quantity of said column is 2, and said pointer is slidingly connected with two columns respectively.
Being slidingly connected of said pointer and column is to realize through slide block and chute fit structure.
Be provided with slide locating mechanism between said pointer and the column, the scope internal fixation sliding position that can make the slip of pointer on column.
The slewing area of pointer is: to be parallel to said supporting plate plan-position is benchmark, in 10 ° of scopes of this benchmark one side.
Another preferred mode: the slewing area of pointer is: to be parallel to said supporting plate plan-position is benchmark, is in 20 ° of scopes at center with this benchmark.
Pointer is through being slidingly connected between a rectangular frame and the column, and two opposite side and two columns of said rectangular frame are slidingly connected.
Said pointer is provided with rotation positioning device, and rotation positioning device can make pointer in slewing area internal fixation turned position.
Technique effect of the present invention is:
Femur external rotation osteotomy guider of the present invention comprises femoral-posterior condyles supporting plate and pointer; Pointer can be angled with the plane of femoral-posterior condyles supporting plate; This angle can change within the specific limits and indicated; In clinical use; The femoral-posterior condyles line (PCA) and interior lateral epicondyle line (TEA) the angle a of femur that record through CT in advance prop up femoral-posterior condyles with femoral-posterior condyles supporting plate (concrete is the plane of femoral-posterior condyles supporting plate) then, and that this moment, the femoral-posterior condyles supporting plate characterized is femoral-posterior condyles line (PCA).Angle between pointer and the femoral-posterior condyles supporting plate is adjusted into a, has just realized confirming the purpose of TEA through PCA.Pointer can slide on perpendicular to femoral-posterior condyles supporting plate direction; Be pointer keep with the femoral-posterior condyles supporting plate between angle the time can parallelly move; Pointer and TEA line parallel according to parallel theorem, moved the pointer to femur shown in Figure 3 and cut a bone place demarcation section bone line this moment; This section bone line is exactly parallel with the TEA bone line that cuts, and has realized that the present invention accurately locatees the TEA line and then carries out the purpose of cutting bone with reference to this line femur outward turning.
Description of drawings
Fig. 1 is the femoral prosthesis structural representation.
Fig. 2 is the right view of Fig. 1.
Fig. 3 is knee joint DF flexing position anterior view figure.
Fig. 4 is a part of structure of universal-type femur external rotation osteotomy guider of the present invention.
Fig. 5 is another part structure of universal-type femur external rotation osteotomy guider of the present invention.
Fig. 6 is the state diagram that Fig. 4 and part shown in Figure 5 are assembled together, and the assembling back forms universal-type femur external rotation osteotomy guider of the present invention.
Fig. 7 is the state diagram after rectangular frame promotes in the universal-type femur external rotation osteotomy guider of the present invention shown in Figure 6.
Identifier declaration is following among the figure:
1, TEA line; 2, PCA line; 3, femoral-posterior condyles supporting plate; 4, column; 5, dog screw; 6, pointer; 7, rotational angle metrology structure; 8, the long limit of pointer; 9, dog screw; 10, chute.
The specific embodiment
Main purpose of the present invention is accurately to locate the femur outward turning to cut the bone line, makes section bone line parallel with TEA.Introduction through background technology can be known: be difficult in the clinical operation lateral epicondyle in the femur is accurately located and accurately mark TEA respectively.But can confirm TEA through knee joint two dimension (or three-dimensional) CT means, can also record the angle of PCA and TEA simultaneously, this angle is meant that PCA and TEA are at the angle between the projection line on the plane shown in Figure 3.
The key element that the simplest embodiment of femur external rotation osteotomy guider of the present invention (embodiment A) comprises is (with reference to figure 4 to Fig. 7): a flat femoral-posterior condyles supporting plate 3, a plate face of femoral-posterior condyles supporting plate 3 are plane (abbreviating the supporting plate plane as); The column 4 that vertical this plane of this side of supporting plate plane is provided with; With the pointer 6 that column 4 is slidingly connected, pointer 6 can rotate, and the Plane of rotation of formation is vertical with the supporting plate plane, and pointer 6 is slidingly connected with column 4 simultaneously, and promptly pointer 6 can slide along the axis direction of column 4.Such simple embodiment just can realize the object of the invention; Specify as follows: in clinical; Through conventional method DF is appeared, then femoral-posterior condyles supporting plate 3 is placed femoral-posterior condyles, concrete is that said supporting plate plane is contacted with femoral-posterior condyles; This moment, the supporting plate plane was the straight line that overlaps with PCA on view shown in Figure 3; Angle between pointer 6 (pointer 6 is as the long limit of benchmark---pointer long limit 8) and the supporting plate plane is adjusted into PCA that aforementioned CT records and the angle of TEA, and promptly pointer 6 is parallel with TEA as the long limit of benchmark on view shown in Figure 3; Behind pointer 6 these rotational angles of maintenance; Pointer 6 is slided along the axis direction of column 4; Just make the pointer 6 that is parallel to TEA move to osteotomy site (is sign with the external epicondyle of femur peak) along above-below direction among Fig. 3; At DF rule as the long limit of benchmark along pointer 6 this moment, and this line is ideal section bone line.The principle that the present invention has utilized two parallel straight line corresponding angles to equate is a benchmark with the FCA of reality, delimits and cuts a bone line (at dotted line shown in Figure 3) through moving the pointer that is parallel to TEA, makes that to cut the bone line parallel with TEA, has realized the object of the invention.
Fig. 4 to Fig. 7 has shown preferred embodiment of the present invention, on the basis of embodiment A, has increased some technical characterictics.Embodiment A that these technical characterictics are all perfect to a certain extent, one or several in these technical characterictics can be incorporated into and form various embodiment in the embodiment A, to these the possible embodiment that is combined to form explanations no longer one by one.
Below Fig. 4 to Fig. 7 is described, also the technical characterictic of above-mentioned increase is illustrated simultaneously.
Show and the said technical characterictic of explanation for clear, two-part structure in the femur external rotation osteotomy guider of the present invention is shown (Fig. 4 and Fig. 5) separately.
The part-structure of the femur external rotation osteotomy guider that Fig. 4 shows comprises the dog screw 5 that is provided with on femoral-posterior condyles supporting plate 3, column 4 and the column 4.Femoral-posterior condyles supporting plate 3 is a flat board, and this flat board is a plane (supporting plate plane) towards the plate face of Fig. 3 top direction, this side on this plane, and vertically this plane is provided with column 4, and the quantity of column is 2.Pointer 6 can be slidingly connected with two columns 4 respectively, has increased the stability that pointer 6 slides.
The part of the femur external rotation osteotomy guider that Fig. 5 shows comprises pointer 6 and rotational angle metrology structure 7.Visible in conjunction with Fig. 6; Pointer 6 can rotate in the certain angle scope; Here said angle is the angle between pointer 6 and the supporting plate plane, and explanation more accurately should be: the long limit 8 of pointer (the long limit 8 of pointer is 6 one sections straight limits of pointer) is as the datum line of angle and the angle between the supporting plate plane between tolerance pointer 6 and the supporting plate plane.Dog screw 9 is set on the pointer 6 can makes as rotation positioning device and turn at any angle that pointer 6 is fixed on this position, this is convenient to the angle between the fixed pointers 6 and supporting plate plane in the clinical manipulation.
Rotational angle metrology structure 7 is an angle dial; Value on the graduated disc that pointer 6 points to is exactly the angle between long limit 8 of pointer and the supporting plate plane; When the angle between long limit 8 of pointer and the supporting plate plane is 0 °; The angle degree that rotational angle metrology structure 7 shows is 0 °, by that analogy other angles.
The rotating shaft that pointer 6 rotates is arranged on the rectangular frame, and rotational angle metrology structure 7 also is arranged on this rectangular frame.Two opposite side of this rectangular frame are slidingly connected with two columns 4 respectively, and pointer 6 is arranged on the stability that can utilize rectangular frame on the rectangular frame, have improved the stability of pointer 6 in parallel moving process.The tolerance scope of rotational angle metrology structure 7, pointer 6 effective scopes of rotating are for being parallel to supporting plate plane (being that the rotational angle metrology structure 7 angles of display number of degrees are 0 °) in 10 ° of scopes of top, supporting plate plane (top among Fig. 5) rotation from the long limit 8 of pointer in other words.The femur external rotation osteotomy guider that pointer 6 only rotates to top, supporting plate plane (top among Fig. 5); Should have two kinds; The main distinction of these two kinds of femur external rotation osteotomy guiders lays respectively on two columns 4 with regard to the center of rotation that is pointer 6, to be applied to left and right replacement knee in arthroplasty respectively.
The scope that pointer 6 effectively rotates among another embodiment is in 20 ° of scopes of the upper and lower both direction of benchmark for being parallel to place, supporting plate plane with the long limit 8 of pointer, is in ° scope of benchmark ± 10 to be parallel to place, supporting plate plane in other words.Adopt the femur external rotation osteotomy guider of this technical scheme can be used for left and right replacement knee in arthroplasty simultaneously.
Fig. 6 and Fig. 7 have shown that Fig. 4 and two parts shown in Figure 5 are assembled together the universal-type femur external rotation osteotomy guider that the back forms, and can see the matching relationship of Fig. 4 and two parts shown in Figure 5.Be respectively arranged with chute 10 on two relative limits of the rectangular frame at rotational angle metrology structure 7 places; This chute cooperates with dog screw 5 on the column 4; Realize the effect that rectangular frame slides along column 4 axis directions; Dog screw 5 also plays the effect of slide locating mechanism, and promptly the rectangular frame screw 5 that in sliding scale, can be positioned is fixed on the optional position.Be provided with the relation of being slidingly connected between rectangular frame and two columns, two columns give rectangular frame (pointer 6 in other words) more firm support.Rectangular frame is done two the columns slips in as a whole edge can be more stable, avoided two asynchronous slips of junction point of pointer 6 and column 4 to cause pointer 6 to refer to that deviation appears in the angle that causes demarcating partially.In addition; Cooperate preferably cooperating of slide block and chute between dog screw 5 places and the chute 10; This make to slide and to be difficult for departing from the axis direction of column 4, and this all is provided with under the situation of slide block more favourable at two columns, make that the slip on two columns equally steadily avoids deviation to cause pointer to refer to partially.
Claims (5)
1. universal-type femur external rotation osteotomy guider is characterized in that comprising a tabular femoral-posterior condyles supporting plate, and a plate face of femoral-posterior condyles supporting plate is the plane; One side is provided with column perpendicular to this plane on said supporting plate plane; Also comprise the strip pointer, said pointer can rotate in perpendicular to the planar Plane of rotation of said supporting plate, and said pointer and column are slidingly connected, and promptly said pointer keeps sliding along the axis direction of column when being connected with column; Also be provided with the rotational angle metrology structure, rotational angle metrology structure indication angle with said supporting plate plane parallel the time is zero when at least one long limit of said pointer, and the rotational angle metrology structure can be indicated the value of angle between this length limit and the said supporting plate plane; The quantity of said column is 2, and said pointer is through being slidingly connected between a rectangular frame and the column, and two opposite side and two columns of said rectangular frame are slidingly connected; Said being slidingly connected realized through slide block and chute fit structure.
2. according to the said universal-type femur external rotation osteotomy guider of claim 1, it is characterized in that being provided with slide locating mechanism between said pointer and the column scope internal fixation sliding position that can make the slip of pointer on column.
3. according to the said universal-type femur external rotation osteotomy guider of one of claim 1 to 2, it is characterized in that the slewing area of pointer is: to be parallel to said supporting plate plan-position is benchmark, in 10 ° of scopes of this benchmark one side.
4. according to the said universal-type femur external rotation osteotomy guider of one of claim 1 to 2, it is characterized in that the slewing area of pointer is: to be parallel to said supporting plate plan-position is benchmark, is in 20 ° of scopes at center with this benchmark.
5. according to the said universal-type femur external rotation osteotomy guider of one of claim 1 to 2, it is characterized in that said pointer is provided with rotation positioning device, rotation positioning device can make pointer in slewing area internal fixation turned position.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010101989215A CN101884560B (en) | 2010-06-04 | 2010-06-04 | Universal-type femur external rotation osteotomy guider |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010101989215A CN101884560B (en) | 2010-06-04 | 2010-06-04 | Universal-type femur external rotation osteotomy guider |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101884560A CN101884560A (en) | 2010-11-17 |
| CN101884560B true CN101884560B (en) | 2012-02-29 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN2010101989215A Expired - Fee Related CN101884560B (en) | 2010-06-04 | 2010-06-04 | Universal-type femur external rotation osteotomy guider |
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Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104546087B (en) * | 2015-01-07 | 2017-03-15 | 北京爱康宜诚医疗器材有限公司 | Front ankle bone cutting device |
| CN104665934B (en) * | 2015-02-05 | 2017-08-25 | 中国人民解放军第四军医大学 | A kind of children femoral Subtrochanteric osteotomy positioning instrument |
| CN109009477B (en) * | 2018-09-03 | 2023-10-31 | 苏州微创关节医疗科技有限公司 | Femur measuring device |
| CN114209390A (en) * | 2022-01-21 | 2022-03-22 | 世康数字(北京)科技有限公司 | Positioning and mounting method and system of bone cutting guide plate, electronic device and storage medium |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101288597A (en) * | 2008-06-20 | 2008-10-22 | 周一新 | Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof |
| CN101420915A (en) * | 2006-02-08 | 2009-04-29 | G·林·拉斯姆森 | Guide assembly for guiding cuts to a femur and tibia during a knee arthroplasty |
-
2010
- 2010-06-04 CN CN2010101989215A patent/CN101884560B/en not_active Expired - Fee Related
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101420915A (en) * | 2006-02-08 | 2009-04-29 | G·林·拉斯姆森 | Guide assembly for guiding cuts to a femur and tibia during a knee arthroplasty |
| CN101288597A (en) * | 2008-06-20 | 2008-10-22 | 周一新 | Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof |
Non-Patent Citations (1)
| Title |
|---|
| 陈坚锋，冯宗权等.骨关节炎患者股骨后髁角与股骨髁外翻角、胫骨平台内翻角、股胫角的相关关系.《中国矫形外科杂志》.2010,第18卷(第5期),417-420. * |
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| CN101884560A (en) | 2010-11-17 |
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