CN103800067A - Steel wire guiding device for intertrochanteric fracture - Google Patents

Steel wire guiding device for intertrochanteric fracture Download PDF

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Publication number
CN103800067A
CN103800067A CN201410020890.2A CN201410020890A CN103800067A CN 103800067 A CN103800067 A CN 103800067A CN 201410020890 A CN201410020890 A CN 201410020890A CN 103800067 A CN103800067 A CN 103800067A
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China
Prior art keywords
guiding tube
handle
steel wire
main guiding
fracture
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Granted
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CN201410020890.2A
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Chinese (zh)
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CN103800067B (en
Inventor
储小兵
刘福存
童培建
陈巧玲
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Zhejiang Provincial Hospital of Traditional Chinese Medicine
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Zhejiang Provincial Hospital of Traditional Chinese Medicine
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90Guides therefor

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurology (AREA)
  • Surgical Instruments (AREA)

Abstract

Disclosed is a steel wire guiding device for an intertrochanteric fracture. A first inserting hole which allows a main guiding catheter to be inserted and a second inserting hole which allows an auxiliary guiding catheter to be inserted are formed in a handle, the near end of the main guiding catheter and the near end of the auxiliary guiding catheter are respectively in inserted connection with the handle, the far end of the main guiding catheter is in a hook shape and hooks small trochanteric fracture blocks in a sleeved mode, the far end of the main guiding catheter and the far end of the auxiliary guiding catheter are connected, and therefore a bent channel which guides a steel wire to be wound around the position of the intertrochanteric fracture is formed. A hole which allows a steel wire ejection position to penetrate is formed in one side of the main guiding catheter, a gap which allows the steel wire to pull away is formed in the other side of the main guiding catheter, the handle is further connected with a pushing mechanism, the pushing mechanism comprises a pushing rod which is inserted in the handle, a screw rod which is in threaded connection with the handle is arranged at the tail end of the pushing rod, and the fracture position is jointly fixed by the main guiding catheter and the pushing mechanism. A combined type guide steel wire or a titanium cable and a device for temporarily fixing the fracture are adopted, the tissue is rarely damaged, fracture healing is facilitated, minimally-invasive operation is achieved, use is convenient, and the operation is easy, convenient and reliable.

Description

Intertrochanteric fracture wire introducer
Technical field
The present invention relates to a kind of intertrochanteric fracture wire introducer.
Background technology
Intertrochanteric fracture, refers to that base of nebk ot femur is to the fracture between lesser trochanter of femur, is one of modal fracture of old people, especially sees 70 years old above man at an advanced age and serious sufferers of osteoporosis face, and Bone fracture characteristics is that syntripsis is many, osteoporosis.
Clinically, the operative treatment mode of intertrochanteric fracture is more, comprise various internal fixation operations or prosthetic replacement's operation, but the intertrochanteric fracture of pulverizing need to add and fix sclerite, to avoid after interior fixing or artificial joint operation because the support that loses rotor portions bone leads to the failure, technically can select the methods such as screw, steel wire, titanium cable, but the fixed effect of tying up with steel wire or titanium cable is the most reliable.
Steel wire or titanium cable need to be walked around all footpaths of intertrochanteric fracture and can implement to tie up, prior art is to send and draw or guide to reach this object with traveller depending on lower dependence operating forceps blind, owing to having a large amount of muscle and joint capsule tissue apposition at fracture end, need to be by peeling off muscle and joint capsule tissue, steel wire is walked around to fracture end to carry out cerclage and fixes, need large otch to appear, operating difficulties, and larger to tissue injury, cannot realize the function of Wicresoft's guide wire or titanium cable and interim auxiliary fixing fracture
The for example patent No. is the Orthopedic wire guiding device of announcing in 200620080153.2, can guiding steel wire cerclage fissure fracture piece, but in the time that reality is used, steel wire bracing wire is not very convenient, and does not arrange and grip structure and carry out assisted surgery and operate to guarantee good surgical effect.
Summary of the invention
Not good shortcoming in order to overcome the use inconvenience of existing fracture wire introducer and effect, the invention provides a kind of intertrochanteric fracture wire introducer.
The technical solution used in the present invention is:
Intertrochanteric fracture wire introducer, handle, main guiding tube and secondary guiding tube, described handle is provided with the first jack inserting for main guiding tube and the second jack inserting for secondary guiding tube, the near-end of described main guiding tube is connected with handle, the near-end of secondary guiding tube and handle are pegged graft, the far-end of described main guiding tube is hook solid cover hook lesser trochanter sclerite, the far-end of described main guiding tube is connected with the far-end of secondary guiding tube, and formation guiding steel wire is walked around the bending passage of inner side, intertrochanteric fracture position;
Described secondary guiding tube is connected with the second jack by the intubate connecting on it, and the length of intubate connecting handle and angle are adapted to the described far-end of main guiding tube and the connection of the far-end of secondary guiding tube;
One side of described main guiding tube is provided with the hole of passing for steel wire ejector member, and opposite side has the gap of allowing that steel wire is deviate from;
Described handle also connects a top-pushing mechanism, and top-pushing mechanism comprises that is inserted a push rod for handle, and push rod tail end is provided with the screw rod being spirally connected with handle, and described push rod head end is provided with the pad of pushing of outside surface of bone after pushing tow greater trochanter; The far-end of described main guiding tube and described pushing are padded and are fixed fracture site.
After steel wire is deviate from secondary guiding tube and shifted out secondary guiding tube, the push rod of described top-pushing mechanism inserts the second described jack.
The first jack of described handle and the second jack are all along the length direction of handle, and described main guiding tube and secondary guiding tube are parallel to each other.
Intubate on described secondary guiding tube is U font, and one end of described intubate is connected with the second through hole, and the other end and secondary guiding tube UNICOM are also provided with steel wire outlet in bending place.
On described screw rod, manual knob is housed, the screw front end of described knob is provided with projection, and described pushing ram end is provided with the slot that forms joinery and its construction with described projection; The front end of described projection is provided with the ring-type draw-in groove around described projection, and described pushing ram is provided with the backing pin that can insert described ring-type draw-in groove.
The both sides of described handle are provided with non slip surface.
For preserving femoral intertrochanteric bone amount, maintain the supporting function of rotor portions bone, need to add steel wire or titanium cable is tied up the comminuted fracture piece of intertrochanteric fracture, increase fracture fixation intensity.By mini-invasive incision technology outside hip joint, utilize the substep operation of guiding tube, pushing ram, can realize two of intertrochanteric fracture large main sclerites---after lesser trochanter sclerite and greater trochanter, interim reset, the fixing and guiding wire rope of outside sclerite tied up, and operation technique is easy to be reliable.
Intertrochanteric fracture wire introducer, comprise a main guiding tube, its handle total length has 2 through holes, wherein 1 the first jack for being connected with main guiding tube inner duct that diameter is less, the first jack cross section is rounded, for running through guiding steel wire or titanium cable.Larger the second jack of another 1 diameter is at its opposite side, and the second jack is rounded at handle rear cross section, at handle head section ovalize, for inserting secondary guiding tube and pushing ram.The far-end of main guiding tube is smaller part circle, diameter and femoral intertrochanteric skeleton width adapt, tip is 30 ° of acute angle designs, be convenient to pierce through by tissue, main guiding tube completes after cover hook lesser trochanter sclerite, secondary guiding tube inserts in second jack of handle afterbody at main guiding tube place, after being advanced to the end, be just in time connected with the tip of main guiding tube, the tip of secondary guiding tube far-end is the 30 ° acute angle designs contrary with main guiding tube tip direction, thread eye by main guiding tube handle tail side imports steel wire or titanium cable, main guiding tube veutro total length has gap, and have aperture in main guiding tube tail side one end, after steel wire or titanium cable are combined by main guiding tube and secondary guiding tube and are guided successfully, use draw point by aperture, steel wire or titanium cable to be pushed and depart from main guiding tube.Remove secondary guiding tube, in the second jack, insert pushing ram, the additional pad of pushing of pushing ram head end, adapts with outside surface of bone arc after greater trochanter, pushes pad and is asymmetrical design, relatively greater trochanter of femur rear direction.Pushing ram tail side is a circular knob, by turning knob, pushing ram is advanced (in the middle of pushing ram, having rotation-propelling transformational structure), and the interior lateral direction that matches with main guiding tube clamps reset, fixing fracture temporarily.Tighten up steel wire or titanium cable completes tying up of intertrochanteric fracture.
Beneficial effect of the present invention is embodied in: the present invention adopts the device of combination type guiding steel wire or titanium cable and temporary fixed fracture, only need to be in hip joint outside by mini-invasive incision technology, by the cooperation of guiding tube, pushing ram, can realize two of intertrochanteric fracture large main sclerites---after lesser trochanter sclerite and greater trochanter, outside sclerite resets, temporary fixed and guiding wire rope ties up, can protect to greatest extent the complete of periosteum and fracture surrounding soft tissue, tissue injury is little, be beneficial to union of fracture, realize Micro-operation; Simple in structure, easy to use, operation technique is easy to be reliable.
Accompanying drawing explanation
Fig. 1 is the main guiding tube guiding wire rope schematic diagram that is connected with secondary guiding tube.
Fig. 2 is the main guiding tube guiding wire rope cross-sectional view that is connected with secondary guiding tube.
Fig. 3 is the structural representation of secondary guiding tube while shifting out from handle.
Fig. 4 is main guiding tube and pushing ram connection diagram.
Fig. 5 is that main guiding tube is connected generalized section with pushing ram.
Fig. 6 is pushing ram rotation-push structure (Fig. 5 centre circle inner structure details) schematic diagram.
Fig. 7 is the main traveller assembling schematic diagram that is connected with pushing ram.
Fig. 8 is pushing ram tail side schematic diagram enlarged drawing.
Fig. 9 is that (wherein a is that main guiding tube head end makes it hook lesser trochanter sclerite to intertrochanteric fracture traveller work enforcement schematic diagram, imports steel wire or titanium cable by the first through hole port of handle afterbody, passes from secondary guiding tube steel wire outlet; B is that the second through hole handle afterbody end inserts pushing ram, the additional pad of pushing of pushing ram head end, and rotation advances pushing ram is advanced, and the interior lateral direction that matches with main guiding tube resets temporarily and grips bone; C tightens up steel wire or titanium cable completes tying up of intertrochanteric fracture; D is the structural solid figure that removes main guiding tube and pushing ram complete operation).
The specific embodiment
With reference to accompanying drawing, intertrochanteric fracture wire introducer, handle 1, main guiding tube 3 and secondary guiding tube 4, described handle 1 is provided with the first jack 11 inserting for main guiding tube 3 and the second jack 12 inserting for secondary guiding tube 4, the near-end of described main guiding tube 3 is connected with handle, near-end and the handle 1 of secondary guiding tube 4 are pegged graft, the far-end of described main guiding tube 3 is hook solid cover hook lesser trochanter sclerite, the far-end of described main guiding tube 3 is connected with the far-end of secondary guiding tube 4, and formation guiding steel wire 2 is walked around the bending passage of inner side, intertrochanteric fracture position;
Described secondary guiding tube 4 is connected with the second jack 12 by the intubate 41 connecting on it, and the length of intubate 41 connecting handles 1 and angle are adapted to the described far-end of main guiding tube 3 and the connection of the far-end of secondary guiding tube 4;
One side of described main guiding tube 3 is provided with the hole 32 of passing for steel wire ejector member, and opposite side has the gap 31 of allowing that steel wire 2 is deviate from;
Described handle 1 also connects a top-pushing mechanism, and top-pushing mechanism comprises a push rod 5 that inserts handle, and push rod 5 tail ends are provided with the screw rod 6 being spirally connected with handle 1, and after described push rod 5 head ends are provided with pushing tow greater trochanter, pushing of outside surface of bone pads 52; The far-end of described main guiding tube 3 and described pushing are padded 52 and are fixed fracture site.
After steel wire 2 is deviate from secondary guiding tube 4 and shifted out secondary guiding tube 4, the push rod 5 of described top-pushing mechanism inserts the second described jack 12.
The first jack 11 of described handle 1 and the second jack 12 are all along the length direction of handle 1, and described main guiding tube 3 and secondary guiding tube 4 are parallel to each other.
Intubate 41 on described secondary guiding tube 4 is U font, and one end of described intubate 41 is connected with the second through hole 12, and the other end and secondary guiding tube 4 UNICOMs are also provided with steel wire outlet 411 in bending place.
On described screw rod 6, manual knob 62 is housed, screw rod 6 front ends of described knob 62 are provided with projection 61, and described pushing ram 5 ends are provided with the slot 51 that forms joinery and its construction with described projection 61; The front end of described projection 61 is provided with the ring-type draw-in groove 611 around described projection 61, and described pushing ram 5 is provided with the backing pin 511 that can insert described ring-type draw-in groove 611, to limit the stroke of described knob 62.
The both sides of described handle 1 are provided with non slip surface 13.
Orientation of the present invention statement adopts the medically direction statement of human body.Take human body median line as mark, take close median line as " inner side ", be " outside " away from median line.Health veutro direction is " front side ", and health dorsal part direction is " rear side ".Guiding tube is " side " near human body median line, is " tail side " away from human body median line.Guiding tube is " veutro " near surface of bone side, is " dorsal part " away from surface of bone side.
For preserving femoral intertrochanteric bone amount, maintain the supporting function of rotor portions bone, need to add steel wire or titanium cable is tied up the comminuted fracture piece of intertrochanteric fracture, increase fracture fixation intensity.In operation technique by mini-invasive incision outside hip joint, press close to femoral intertrochanteric skeleton below carries out soft tissue and peels off and form one and allow the passage that main guiding tube 3 is worked with elevator in front side, insert main guiding tube 3 to head end and cross femur inner edge, 90 ° of main guiding tube 3 head ends of upset make it hook lesser trochanter sclerite 81, now can under perspective, confirm that whether cover hook lesser trochanter sclerite 81 is successful, after success, secondary guiding tube 4 is inserted in the second through hole 12 of handle, and be advanced to the end and be connected with main guiding tube 3.The first through hole 11 ports by handle 1 afterbody import steel wire 2 or titanium cable, after the steel wire outlet 411 of secondary guiding tube 4 passes, remove secondary guiding tube 4.One side of described main guiding tube 3 is provided with the hole 32 of passing for steel wire ejector member, opposite side has the gap 31 of allowing that steel wire 2 is deviate from, by aperture 32, steel wire 2 or titanium cable are ejected to main guiding tube 3 with draw point, steel wire 2 or titanium cable depart from for subsequent use from gap 31 with main guiding tube 3.Pushing ram 5 is run through in described the second through hole 12, described push rod 5 head ends are provided with pushing of the rear outside of pushing tow greater trochanter 82 surface of bone and pad 52, the described pad 52 of pushing is the cambered surface suitable with the rear outside of greater trochanter 82 surface of bone 82, the described pad 52 of pushing, for being partial to the dissymmetrical structure in outside, is partial to greater trochanter of femur 82 rear direction.Manual rotation knob 62, advances pushing ram 5, matches and resets temporarily and grip fracture together with main guiding tube 3 from interior lateral direction.Finally tighten up steel wire 2 or titanium cable completes tying up of intertrochanteric fracture, removing main guiding tube 3 and pushing ram 5 is complete operation.
Content described in this description embodiment is only enumerating of way of realization to inventive concept; protection scope of the present invention should not be regarded as only limiting to the concrete form that embodiment states, protection scope of the present invention also and conceive the equivalent technologies means that can expect according to the present invention in those skilled in the art.

Claims (6)

1. intertrochanteric fracture wire introducer, it is characterized in that: handle, main guiding tube and secondary guiding tube, described handle is provided with the first jack inserting for main guiding tube and the second jack inserting for secondary guiding tube, the near-end of described main guiding tube is connected with handle, the near-end of secondary guiding tube and handle are pegged graft, the far-end of described main guiding tube is hook solid cover hook lesser trochanter sclerite, the far-end of described main guiding tube is connected with the far-end of secondary guiding tube, and formation guiding steel wire is walked around the bending passage of inner side, intertrochanteric fracture position;
Described secondary guiding tube is connected with the second jack by the intubate connecting on it, and the length of intubate connecting handle and angle are adapted to the described far-end of main guiding tube and the connection of the far-end of secondary guiding tube;
One side of described main guiding tube is provided with the hole of passing for steel wire ejector member, and opposite side has the gap of allowing that steel wire is deviate from;
Described handle also connects a top-pushing mechanism, and top-pushing mechanism comprises that is inserted a push rod for handle, and push rod tail end is provided with the screw rod being spirally connected with handle, and described push rod head end is provided with the pad of pushing of outside surface of bone after pushing tow greater trochanter; The far-end of described main guiding tube and described pushing are padded and are fixed fracture site.
2. wire introducer as claimed in claim 1, is characterized in that: after steel wire is deviate from secondary guiding tube and shifted out secondary guiding tube, the push rod of described top-pushing mechanism inserts the second described jack.
3. wire introducer as claimed in claim 1 or 2, is characterized in that: the first jack of described handle and the second jack are all along the length direction of handle, and described main guiding tube and secondary guiding tube are parallel to each other.
4. wire introducer as claimed in claim 3, is characterized in that: the intubate on described secondary guiding tube is U font, and one end of described intubate is connected with the second through hole, and the other end and secondary guiding tube UNICOM are also provided with steel wire outlet in bending place.
5. wire introducer as claimed in claim 4, is characterized in that: on described screw rod, manual knob is housed, the screw front end of described knob is provided with projection, and described pushing ram end is provided with the slot that forms joinery and its construction with described projection; The front end of described projection is provided with the ring-type draw-in groove around described projection, and described pushing ram is provided with the backing pin that can insert described ring-type draw-in groove.
6. intertrochanteric fracture wire introducer as claimed in claim 5, is characterized in that: the both sides of described handle are provided with non slip surface.
CN201410020890.2A 2014-01-17 2014-01-17 Intertrochanteric fracture wire introducer Expired - Fee Related CN103800067B (en)

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CN103800067B CN103800067B (en) 2015-11-18

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107157618A (en) * 2017-05-26 2017-09-15 王俊 Coracoclavicular ligament titanium cable rebuilds the method for reconstructing of guider and coracoclavicular ligament
CN115486925A (en) * 2022-09-05 2022-12-20 无锡科恩智造科技有限公司 Hallux valgus correction guide device and correction method

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2214814A (en) * 1988-01-28 1989-09-13 Bio Medical Eng Surgical apparatus for guiding a wire or suture in a loop
US6086596A (en) * 1999-04-21 2000-07-11 Durham; Alfred A. Magnetically assisted surgical wiring and cabling passer devices
CN202113160U (en) * 2011-04-08 2012-01-18 王桂新 Steel wire guiding machine
CN202920331U (en) * 2012-11-28 2013-05-08 全球安联科技股份有限公司 Wire guide
US20130116733A1 (en) * 2011-11-07 2013-05-09 Edward Jordan Stoll, JR. Bone Clamp and Method
CN203089326U (en) * 2013-02-04 2013-07-31 上虞市中医院 Thighbone lesser trochanter fracture fixation repositor
CN203208105U (en) * 2012-12-05 2013-09-25 唐佩福 Sliding guide-rotation steel wire guide

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2214814A (en) * 1988-01-28 1989-09-13 Bio Medical Eng Surgical apparatus for guiding a wire or suture in a loop
US6086596A (en) * 1999-04-21 2000-07-11 Durham; Alfred A. Magnetically assisted surgical wiring and cabling passer devices
CN202113160U (en) * 2011-04-08 2012-01-18 王桂新 Steel wire guiding machine
US20130116733A1 (en) * 2011-11-07 2013-05-09 Edward Jordan Stoll, JR. Bone Clamp and Method
CN202920331U (en) * 2012-11-28 2013-05-08 全球安联科技股份有限公司 Wire guide
CN203208105U (en) * 2012-12-05 2013-09-25 唐佩福 Sliding guide-rotation steel wire guide
CN203089326U (en) * 2013-02-04 2013-07-31 上虞市中医院 Thighbone lesser trochanter fracture fixation repositor

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107157618A (en) * 2017-05-26 2017-09-15 王俊 Coracoclavicular ligament titanium cable rebuilds the method for reconstructing of guider and coracoclavicular ligament
CN107157618B (en) * 2017-05-26 2023-09-15 王俊 Coracoid ligament titanium cable reconstruction guide and coracoid ligament reconstruction method
CN115486925A (en) * 2022-09-05 2022-12-20 无锡科恩智造科技有限公司 Hallux valgus correction guide device and correction method
CN115486925B (en) * 2022-09-05 2023-09-26 无锡科恩智造科技有限公司 Hallux valgus correction guiding device and correction method

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Granted publication date: 20151118