CN105615979A - Auxiliary device used in PFNA (proximal femoral nail anti-rotation) internal fixation surgery - Google Patents
Auxiliary device used in PFNA (proximal femoral nail anti-rotation) internal fixation surgery Download PDFInfo
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- CN105615979A CN105615979A CN201610157916.7A CN201610157916A CN105615979A CN 105615979 A CN105615979 A CN 105615979A CN 201610157916 A CN201610157916 A CN 201610157916A CN 105615979 A CN105615979 A CN 105615979A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/74—Devices for the head or neck or trochanter of the femur
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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Abstract
The invention discloses an auxiliary device used in PFNA (proximal femoral nail anti-rotation) internal fixation surgery and relates to the technical field of minimally invasive orthopaedic surgery instruments so as to solve the problems that an existing implantation instrument can not position the PFNA entry point easily, and a screw blade can not be accurately implanted into the neck of femur at a time.The auxiliary device used in PFNA internal fixation surgery comprises a positioning and guiding base plate and a guide pin positioning and guiding mechanism connected with the positioning and guiding base plate through a positioning rod assembly.The positioning and guiding base plate is arranged above the hip joint and corresponds to a PFNA to be implanted into the femur in position in the vertical direction, and the positioning and guiding base plate can be used for preliminarily determining the implantation position, depth and diameter of the PFNA.The guide pin positioning and guiding mechanism can be used for further accurately determining the implantation position and depth of the PFNA and a screw blade.The positioning rod assembly can be used for adjusting the implantation direction of the screw blade.The auxiliary device is mainly applied to closed reduction PFNA internal fixation treatment of femoral intertrochanteric fractures.
Description
Technical field
The present invention relates to orthopaedics Minimally Invasive Surgery fixture technology field, especially relate to the supplementary unit in a kind of intramedullary nail internal fixation operation.
Background technology
The sickness rate of intertrochanteric fracture of the femur accounts for the 3%��4% of all fracture, accounts for the 35.7% of adult's Hip Fracture. Aging population and osteoporosis are the major causes that intertrochanteric fracture of the femur sickness rate is high. Along with the development of aging population, the treatment of intertrochanteric fracture of the femur faces huge challenge.
At present, Intramedullary nailing is performed the operation owing to intramedullary nail bearing load is even, and mechanics is more reasonable, through skin operation, loses blood less, is therefore usually used in treatment intertrochanteric fracture of the femur. Anti-rotation near end of thighbone intramedullary nail (proxmialfemoralnailantirotation, PFNA) is a kind of Intramedullary nail, because of its there is constant intensity height, wound is little and meets the advantages such as biomechanics and is used more and more. Existing PFNA internal fixation operation apparatus used is more scattered, generally includes: guide pin, direction finding sighting vane, drill bit, screw, C-arm roentgen machine; Wherein, guide pin is used for determining into nail point position, and side direction sighting vane is used for inserting spiral blade with fixing PFNA, and drill bit is for boring out the passage of corresponding guide pin and screw, and C-arm roentgen machine is used for fluoroscopic observation. Concrete operation method is after reduction of the fracture success, 3-5cm stringer otch is upwards made by femoral greater trochanter top, passivity is abductor and peripheral structure separately, patient's finger touch greater trochanter summit is tentatively to determine into nail point and inserts guide pin, by C-arm roentgen machine, fluoroscopic observation guide pin position and determine that ideal enters and follow closely a little; The main nail of PFNA of coupling is inserted, the degree of depth that the main nail of PFNA of perspective adjustment simultaneously is inserted and front rake after expanding marrow along guide pin; Bore in neck of femur under side direction sighting vane is guided and locate guide pin into one piece, location guide pin is made to be positioned at the central on the lower side of the neck of femur longitudinal axis, position and the degree of depth that perspective is just checking again, guide pin is located in position, side, hole along guide pin with corresponding drill bit, laterally spiral blade squeezed into by sighting vane in neck of femur, and fluoroscopic observation determines the position of spiral blade.
But, present inventor finds, PFNA of the prior art inserts apparatus in internal fixtion art and enters to follow closely point location difficulty for PFNA, and cannot guarantee that PFNA is positioned at femoral bone cavitas medullaris central authorities on vector position, cause spiral blade to be arranged in neck of femur partial, thus more difficult disposable accurately insert spiral blade; In addition, repeatedly adjust C-arm roentgen machine Fluoroscopy location, also can increase open-assembly time and the operating time of doctors and patients' X-ray, patient's tolerance is declined, cause the problems such as operation pollution.
Summary of the invention
It is an object of the invention to provide the supplementary unit in a kind of intramedullary nail internal fixation operation, inserting apparatus in internal fixation operation and enter to follow closely point location difficulty to solve PFNA of the prior art for PFNA, spiral blade cannot the disposable problem accurately inserted in neck of femur.
The present invention provides the supplementary unit in a kind of intramedullary nail internal fixation operation, comprising: positioning and guiding substrate, guide pin positioning guide mechanism, positioning rod component; Described positioning and guiding substrate is connected by described positioning rod component with described guide pin positioning guide mechanism; Described positioning and guiding substrate is placed in the top of hip joint and corresponding up and down with the position of the PFNA that will insert in femur, and described positioning and guiding substrate can be used in tentatively determining that described PFNA's inserts position, the degree of depth and diameter; Described guide pin positioning guide mechanism can be used in accurately determining further described PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Described positioning rod component can be used in adjusting the placing direction of described spiral blade.
Wherein, described positioning and guiding substrate comprises horizontal location plate, main nail substrate and circular knife plate base; Described horizontal location plate is positioned at the upper surface of described main nail substrate, and one end that described horizontal location plate closes on described main nail substrate near-end is provided with pointer; Described main nail substrate is positioned at far-end and is provided with pilot hole; Described circular knife plate base plugs in the close end of described main nail substrate.
Preferably, described main nail substrate is provided with the first void region; Described circular knife plate base is provided with the 2nd void region.
Specifically, described guide pin positioning guide mechanism includes spiral blade guide pin pilot sleeve, guiding guide pin pilot sleeve, spiral blade guide pin, guiding guide pin and side caster assembly therefor; Described spiral blade guide pin pilot sleeve is connected with described guiding guide pin pilot sleeve parallel side-by-side, and described spiral blade guide pin pilot sleeve is connected with described positioning rod component; Described spiral blade guide pin is fed through the axle center of the spiral blade passage of the distal portion being positioned at described side caster assembly therefor, and described guiding guide pin is fed through the fluting of the distal portion being positioned at described side caster assembly therefor; During use, described spiral blade guide pin is worn in described spiral blade guide pin pilot sleeve, and described guiding guide pin is worn in described guiding guide pin pilot sleeve.
Further, the near-end of described side caster assembly therefor is provided with main nail and connects hole, and described main nail connection hole is connected with soft tissue protection sleeve.
Further, described positioning rod component includes the first vertically orient bar and neck of femur leans forward location bar; The middle part of described first vertically orient bar is fixed with disk, and the center of described disk is provided with turning axle; Described first vertically orient bar and described neck of femur lean forward location bar be movably connected by described turning axle.
Wherein, described positioning and guiding substrate also includes vertical sleeve, and described vertical sleeve and described first vertically orient bar are fed through described horizontal location plate respectively and fix with described main nail substrate.
Specifically, described positioning rod component also includes the 2nd vertically orient bar; Described 2nd vertically orient bar lean forward with described neck of femur location bar one end be connected, the bottom of described 2nd vertically orient bar is connected with described spiral blade guide pin pilot sleeve.
Further, the angle between the near-end axis of described main nail substrate and far-end axis is 6 degree, and the angle between the far-end axis of described main nail substrate and the axis of described circular knife plate base is 130 degree or 135 degree.
Further, the diameter of the described pilot hole of described main nail substrate is 2mm.
Relative to prior art, the supplementary unit in a kind of intramedullary nail internal fixation operation of the present invention has following advantage:
In supplementary unit in a kind of intramedullary nail internal fixation operation provided by the invention, comprising: positioning and guiding substrate, guide pin positioning guide mechanism, positioning rod component; Positioning and guiding substrate is connected by positioning rod component with guide pin positioning guide mechanism; Positioning and guiding substrate is placed in the top of hip joint and corresponding up and down with the position of the PFNA that will insert in femur, and positioning and guiding substrate can be used in tentatively determining that PFNA's inserts position, the degree of depth and diameter; Guide pin positioning guide mechanism can be used in accurately determining further PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Positioning rod component can be used in adjusting the placing direction of spiral blade. Thus analyze it will be seen that supplementary unit in a kind of intramedullary nail internal fixation operation provided by the invention, after perspective, can tentatively determine taking positioning and guiding substrate as scale that PFNA's inserts position, the degree of depth and diameter, effectively reduce the number of times of hand fluoroscopy during operation; Accurately located by guide pin positioning guide mechanism, thus can determine further PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Adjusted the placing direction of spiral blade by the position of adjustment positioning rod component, thus realize spiral blade accurately fixing PFNA. Therefore, supplementary unit in a kind of intramedullary nail internal fixation operation provided by the invention, namely corresponding location can be completed at enforcement operation consent, that accurately determines PFNA enters the placing direction and the degree of depth of following closely point, placing direction and the degree of depth and spiral blade, not only simplify surgical procedure, for Wicresoft's internal fixation treatment intertrochanteric fracture of the femur provides new departure, and the effect performing the operation and reach desirable can be ensured, reduce the perspective number of times of X-ray in operation simultaneously.
Accompanying drawing explanation
In order to be illustrated more clearly in the specific embodiment of the invention or technical scheme of the prior art, it is briefly described to the accompanying drawing used required in embodiment or description of the prior art below, apparently, accompanying drawing in the following describes is some embodiments of the present invention, for those of ordinary skill in the art, under the prerequisite not paying creative work, it is also possible to obtain other accompanying drawing according to these accompanying drawings.
The structural representation of the supplementary unit in a kind of intramedullary nail internal fixation operation that Fig. 1 provides for the embodiment of the present invention;
The plan structure schematic diagram of positioning and guiding substrate in supplementary unit in a kind of intramedullary nail internal fixation operation that Fig. 2 provides for the embodiment of the present invention;
The structural representation of side caster assembly therefor in supplementary unit in a kind of intramedullary nail internal fixation operation that Fig. 3 provides for the embodiment of the present invention.
Reference numeral:
1-positioning and guiding substrate; 2-guide pin positioning guide mechanism;
3-positioning rod component; 11-horizontal location plate;
The main nail substrate of 12-; 13-circular knife plate base;
111-pointer; 121-pilot hole;
122-first void region; 131-the 2nd void region;
21-spiral blade guide pin pilot sleeve;
22-leads guide pin pilot sleeve; 23-spiral blade guide pin;
24-leads guide pin; 25-side caster assembly therefor;
251-spiral blade passage; 252-slots;
The main nail of 26-connects hole; 27-soft tissue protection sleeve;
31-first vertically orient bar; 32-neck of femur leans forward location bar;
311-disk; 312-turning axle;
14-vertical sleeve; 33-the 2nd vertically orient bar.
Embodiment
Below in conjunction with accompanying drawing, the technical scheme of the present invention is clearly and completely described, it is clear that described embodiment is the present invention's part embodiment, instead of whole embodiments. Based on the embodiment in the present invention, those of ordinary skill in the art, not making other embodiments all obtained under creative work prerequisite, belong to the scope of protection of the invention.
In describing the invention, it should be noted that, it is based on orientation shown in the drawings or position relation that the orientation of the instruction such as term " " center ", " on ", D score, "left", "right", " vertically ", " level ", " interior ", " outward " or position are closed; be only the present invention for convenience of description and simplified characterization; instead of the device that refers to of instruction or hint or element must have specific orientation, with specific orientation structure and operation, therefore can not be interpreted as limitation of the present invention. In addition, term " first ", " the 2nd ", " the 3rd " are only for describing object, and can not be interpreted as instruction or hint relative importance.
In describing the invention, it is necessary to explanation, unless otherwise clearly defined and limited, term " installation ", " being connected ", " connection " should be interpreted broadly, such as, it is possible to be fixedly connected with, it is also possible to be removably connect, or connect integratedly; Can be mechanically connected, it is also possible to be electrical connection; Can be directly be connected, it is also possible to be indirectly connected by intermediary, it is possible to be the connection of two element internals. For the ordinary skill in the art, it is possible to particular case understands above-mentioned term concrete implication in the present invention.
The structural representation of the supplementary unit in a kind of intramedullary nail internal fixation operation that Fig. 1 provides for the embodiment of the present invention.
As shown in Figure 1, the embodiment of the present invention provides the supplementary unit in a kind of intramedullary nail internal fixation operation, comprising: positioning and guiding substrate 1, guide pin positioning guide mechanism 2, positioning rod component 3; Positioning and guiding substrate 1 is connected by positioning rod component 3 with guide pin positioning guide mechanism 2; Positioning and guiding substrate 1 is placed in the top of hip joint and corresponding up and down with the position of the PFNA that will insert in femur, and positioning and guiding substrate 1 can be used in tentatively determining that PFNA's inserts position, the degree of depth and diameter; Guide pin positioning guide mechanism 2 can be used in accurately determining further PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Positioning rod component 3 can be used in adjusting the placing direction of spiral blade.
Relative to prior art, the supplementary unit in a kind of intramedullary nail internal fixation operation described in the embodiment of the present invention has following advantage:
In supplementary unit in a kind of intramedullary nail internal fixation operation that the embodiment of the present invention provides, as shown in Figure 1, comprising: positioning and guiding substrate 1, guide pin positioning guide mechanism 2, positioning rod component 3; Positioning and guiding substrate 1 is connected by positioning rod component 3 with guide pin positioning guide mechanism 2; Positioning and guiding substrate 1 is placed in the top of hip joint and corresponding up and down with the position of the PFNA that will insert in femur, and positioning and guiding substrate 1 can be used in tentatively determining that PFNA's inserts position, the degree of depth and diameter; Guide pin positioning guide mechanism 2 can be used in accurately determining further PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Positioning rod component 3 can be used in adjusting the placing direction of spiral blade. Thus analyze known, supplementary unit in a kind of intramedullary nail internal fixation operation that the embodiment of the present invention provides, can tentatively determine taking positioning and guiding substrate 1 as scale after perspective that PFNA's inserts position, the degree of depth and diameter, effectively reduce the number of times of hand fluoroscopy during operation; Accurately located by guide pin positioning guide mechanism 2, thus can determine further PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Adjusted the placing direction of spiral blade by the position of adjustment positioning rod component 3, thus realize spiral blade accurately fixing PFNA. Therefore, supplementary unit in a kind of intramedullary nail internal fixation operation that the embodiment of the present invention provides, namely corresponding location can be completed at enforcement operation consent, that accurately determines PFNA enters the placing direction and the degree of depth of following closely point, placing direction and the degree of depth and spiral blade, not only simplify surgical procedure, for Wicresoft's internal fixation treatment intertrochanteric fracture of the femur provides new departure, and the effect performing the operation and reach desirable can be ensured, reduce the perspective number of times of X-ray in operation simultaneously.
The plan structure schematic diagram of positioning and guiding substrate in supplementary unit in a kind of intramedullary nail internal fixation operation that Fig. 2 provides for the embodiment of the present invention.
Wherein, in order to tentatively determine that PFNA's inserts position, the degree of depth and diameter, as depicted in figs. 1 and 2, positioning and guiding substrate 1 comprises horizontal location plate 11, main nail substrate 12 and circular knife plate base 13; Wherein, the long axis of the long axis of horizontal location plate 11 and the near-end of main nail substrate 12 overlaps, thus can be entered the position of nail point according to a preliminary estimate by the long axis overlapped, and circular knife plate base 13 is for locating the position of spiral blade. Horizontal location plate 11 is positioned at the upper surface of main nail substrate 12, and one end that horizontal location plate 11 closes on main nail substrate 12 near-end is provided with pointer 111, and pointer 111 is positioned on the long axis of horizontal location plate 11, is used in reference to the position being shown into nail point; Main nail substrate 12 is positioned at far-end and is provided with pilot hole 121, can be bored into kirschner pin with fixing main nail substrate by pilot hole 121; Circular knife plate base 13 plugs in the close end becoming owner of nail substrate 12. During use, positioning and guiding substrate 1 is placed in the top of patient's hip joint, in hip joint positive position image under C-arm roentgen machine is had an X-rayed, circular knife plate base 13 is positioned at 1/3rd place below neck of femur, the distal portions of main nail substrate 12 is positioned at femur marrow lacuna central authorities, and positioning and guiding substrate 1 can play the effect of scale such that it is able to that tentatively determines PFNA inserts position, the degree of depth and diameter.
It should be added that, the near-end of main nail substrate 12 refers to that main nail substrate 12 is near the direction of patient's hip joint, and the far-end of main nail substrate 12 refers to the direction of main nail substrate 12 away from patient's hip joint herein.
Preferably, in order to be marked by the locating point on patient body when performing the operation, as shown in Figure 2, main nail substrate 12 is provided with the first void region 122; Circular knife plate base 13 is provided with the 2nd void region 131. Therefore, after main nail substrate 12 and circular knife plate base 13 complete location, namely by the first void region 122 on main nail substrate 12 and the 2nd void region 131 on circular knife plate base 13, make marks on the skin of the patient with Viola crystallina respectively, in case positioning and guiding substrate 1 position is again located after moving and increased the X line exposed amount of patient.
The structural representation of side caster assembly therefor in supplementary unit in a kind of intramedullary nail internal fixation operation that Fig. 3 provides for the embodiment of the present invention.
Specifically, position, direction and the degree of depth is inserted in order to what determine spiral blade, as shown in figures 1 and 3, guide pin positioning guide mechanism 2 includes spiral blade guide pin pilot sleeve 21, guiding guide pin pilot sleeve 22, spiral blade guide pin 23, guiding guide pin 24 and side caster assembly therefor 25; Spiral blade guide pin pilot sleeve 21 is connected with guiding guide pin pilot sleeve 22 parallel side-by-side, and spiral blade guide pin pilot sleeve 21 is connected with positioning rod component 3; Spiral blade guide pin 23 is fed through the axle center of the spiral blade passage 251 of the distal portion being positioned at side caster assembly therefor 25, and guiding guide pin 24 is fed through the fluting 252 of the distal portion being positioned at side caster assembly therefor 25; During use, spiral blade guide pin 23 is worn in spiral blade guide pin pilot sleeve 21, guiding guide pin 24 is worn in guiding guide pin pilot sleeve 22, the plane determined along spiral blade guide pin 23 and guiding guide pin 24 can adjust side caster assembly therefor 25, so that the near-end of side caster assembly therefor 25 is near pointer 111 place of horizontal location plate 11. And when performing the operation, spiral blade can be squeezed into after holing along spiral blade guide pin 23 and lock PFNA with near-end. Specifically, the axle center place that spiral blade guide pin 23 is positioned on side caster assembly therefor 25 spiral blade passage 251, guiding guide pin 24 is arranged in the fluting 252 of side caster assembly therefor 25 far-end, and the diameter of guiding guide pin 24 mates with the width of far-end fluting 252; The degree of depth of guiding guide pin 24 and the degree of depth of spiral blade guide pin 23 are as the criterion so that corresponding guide pin is fixing, (can also remove corresponding guide pin when expanding marrow) to not affecting and expanding marrow. Therefore, insert position, direction and the degree of depth by what spiral blade guide pin 23 and guiding guide pin 24 can determine spiral blade, the plane at side caster assembly therefor 25 place can also be determined simultaneously.
It should be added that, side caster assembly therefor 25 far-end refers on side caster assembly therefor 25 direction away from patient's hip joint herein, and side caster assembly therefor 25 near-end refers on side caster assembly therefor 25 direction near patient's hip joint.
Further, for the ease of installing main nail guide pin and the PFNA of PFNA, as shown in Figure 1, the near-end of side caster assembly therefor 25 is provided with main nail and connects hole 26, and main nail connects hole 26 place and is connected with soft tissue protection sleeve 27. During operation; main nail at side caster assembly therefor 25 near-end connects hole 26 place insertion soft tissue protection sleeve 27; the internal diameter of soft tissue protection sleeve 27 is consistent with the diameter of the main nail guide pin of PFNA; the internal diameter that the external diameter of soft tissue protection sleeve 27 connects hole 26 with main nail is consistent such that it is able to connect the main nail guide pin of PFNA more easily. After near end of thighbone opening, implant the main nail guide pin of PFNA through soft tissue protection sleeve 27, expand marrow along main nail guide pin, then insert PFNA.
It should be added that, the near-end of side caster assembly therefor 25 refers to the direction of close patient's hip joint on side caster assembly therefor 25 herein.
Further, for the ease of adjusting the placing direction of spiral blade, as shown in Figure 1, positioning rod component 3 includes the first vertically orient bar 31 and neck of femur leans forward location bar 32; The middle part of the first vertically orient bar 31 is fixed with disk 311, and the center of disk 311 is provided with turning axle 312; First vertically orient bar 31 and the neck of femur location bar 32 that leans forward is movably connected by turning axle 312; When specifically assembling, the first vertically orient bar 31 can be fed through horizontal location plate 11 and fix with main nail substrate 12. During use, by rotate the first vertically orient bar 31 with adjust neck of femur lean forward location bar 32, neck of femur is leaned forward and locates the axis co-planar of bar 32 with circular knife plate base 13 on positioning and guiding substrate 1, then by turning axle 312 adjust neck of femur lean forward location bar 32, make neck of femur lean forward the near-end part of location bar 32 in operation during the image of perspective side position and the axis being parallel of the neck of femur of patient, thus can accurately determine the placing direction of spiral blade.
It should be added that, the lean forward near-end part of location bar 32 of neck of femur refers to the part that neck of femur leans forward on the bar 32 of location and leans forward with the tie point of the first vertically orient bar 31 locate bar 32 near one end of patient's hip joint to neck of femur herein.
Wherein, in order to ensure the fixing of positioning and guiding substrate 1, accurately to locate the position of PFNA, as shown in Figure 1, positioning and guiding substrate 1 also includes vertical sleeve 14, and vertical sleeve 14 can be fed through horizontal location plate 11 and fix with main nail substrate 12. During operation, 2mm kirschner pin can bore in the femur of patient through vertical sleeve 14 (internal diameter 2mm), thus plays the effect of fixing main nail substrate 12; After vertical sleeve 14 and the first vertically orient bar 31 are fixed on horizontal location plate 11 and main nail substrate 12, the plane at horizontal location plate 11 place can be determined, the major axis of horizontal location plate 11 overlaps with the major axis of main nail substrate 12 near-end, pointer 111 on horizontal location plate 11 is positioned on its major axis, as long as thus the main nail making side caster assembly therefor 25 connects hole 26 towards pointer 111, namely can determine that PFNA enters the position of nail point.
Specifically, in order to adjust the placing direction of spiral blade, as shown in Figure 1, positioning rod component 3 also includes the 2nd vertically orient bar 33; 2nd vertically orient bar 33 lean forward with neck of femur location bar 32 one end be connected by square nut, the bottom of the 2nd vertically orient bar 33 is connected by double-hole nut with spiral blade guide pin pilot sleeve 21. After installing positioning rod component 3, make neck of femur lean forward location bar 32 mutually vertical and coplanar with the 2nd vertically orient bar 33,2nd vertically orient bar 33 is mutually vertical and coplanar with spiral blade guide pin pilot sleeve 21, and spiral blade guide pin pilot sleeve 21 is vertical with the 2nd vertically orient bar 33 with the plane at guiding guide pin pilot sleeve 22 place. The distance between square nut and double-hole nut is adjusted by rotating the 2nd vertically orient bar 33, spiral blade guide pin pilot sleeve 21 is made to point to the middle part of position, neck of femur side, wear into spiral blade guide pin 23 in spiral blade guide pin pilot sleeve 21, placing direction and the position of spiral blade can be determined according to the position of spiral blade guide pin 23.
Further, in order to make positioning and guiding substrate 1 mate with the section of PFNA, as shown in Figure 2, the angle between the near-end axis of main nail substrate 12 and far-end axis is 6 degree, and the angle between the far-end axis of main nail substrate 12 and the axis of circular knife plate base 13 is 130 degree or 135 degree.
Further, in order to be that the kirschner pin of 2mm mates with diameter, main nail substrate 12 being fixed by 2mm kirschner pin, as shown in Figure 2, the diameter of the pilot hole 121 of main nail substrate 12 also should be 2mm mutually.
Last it is noted that above each embodiment is only in order to illustrate the technical scheme of the present invention, it is not intended to limit; Although with reference to foregoing embodiments to invention has been detailed description, it will be understood by those within the art that: the technical scheme described in foregoing embodiments still can be modified by it, or wherein some or all of technology feature is carried out equivalent replacement; And these amendments or replacement, do not make the scope of the essence disengaging various embodiments of the present invention technical scheme of appropriate technical solution.
Claims (10)
1. the supplementary unit in an intramedullary nail internal fixation operation, it is characterised in that, comprising: positioning and guiding substrate, guide pin positioning guide mechanism, positioning rod component; Described positioning and guiding substrate is connected by described positioning rod component with described guide pin positioning guide mechanism;
Described positioning and guiding substrate is placed in the top of hip joint and corresponding up and down with the position of the PFNA that will insert in femur, and described positioning and guiding substrate can be used in tentatively determining that described PFNA's inserts position, the degree of depth and diameter; Described guide pin positioning guide mechanism can be used in accurately determining further described PFNA insert position and the degree of depth and spiral blade insert position and the degree of depth; Described positioning rod component can be used in adjusting the placing direction of described spiral blade.
2. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 1, it is characterised in that, described positioning and guiding substrate comprises horizontal location plate, main nail substrate and circular knife plate base;
Described horizontal location plate is positioned at the upper surface of described main nail substrate, and one end that described horizontal location plate closes on described main nail substrate near-end is provided with pointer; Described main nail substrate is positioned at far-end and is provided with pilot hole; Described circular knife plate base plugs in the close end of described main nail substrate.
3. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 2, it is characterised in that, described main nail substrate is provided with the first void region; Described circular knife plate base is provided with the 2nd void region.
4. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 2, it is characterized in that, described guide pin positioning guide mechanism includes spiral blade guide pin pilot sleeve, guiding guide pin pilot sleeve, spiral blade guide pin, guiding guide pin and side caster assembly therefor;
Described spiral blade guide pin pilot sleeve is connected with described guiding guide pin pilot sleeve parallel side-by-side, and described spiral blade guide pin pilot sleeve is connected with described positioning rod component; Described spiral blade guide pin is fed through the axle center of the spiral blade passage of the distal portion being positioned at described side caster assembly therefor, and described guiding guide pin is fed through the fluting of the distal portion being positioned at described side caster assembly therefor;
During use, described spiral blade guide pin is worn in described spiral blade guide pin pilot sleeve, and described guiding guide pin is worn in described guiding guide pin pilot sleeve.
5. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 4, it is characterised in that, the near-end of described side caster assembly therefor is provided with main nail and connects hole, and described main nail connection hole is connected with soft tissue protection sleeve.
6. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 4, it is characterised in that, described positioning rod component includes the first vertically orient bar and neck of femur leans forward location bar;
The middle part of described first vertically orient bar is fixed with disk, and the center of described disk is provided with turning axle; Described first vertically orient bar and described neck of femur lean forward location bar be movably connected by described turning axle.
7. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 6, it is characterized in that, described positioning and guiding substrate also includes vertical sleeve, and described vertical sleeve and described first vertically orient bar are fed through described horizontal location plate respectively and fix with described main nail substrate.
8. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 6, it is characterised in that, described positioning rod component also includes the 2nd vertically orient bar; Described 2nd vertically orient bar lean forward with described neck of femur location bar one end be connected, the bottom of described 2nd vertically orient bar is connected with described spiral blade guide pin pilot sleeve.
9. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 2, it is characterized in that, angle between the near-end axis of described main nail substrate and far-end axis is 6 degree, and the angle between the far-end axis of described main nail substrate and the axis of described circular knife plate base is 130 degree or 135 degree.
10. the supplementary unit in a kind of intramedullary nail internal fixation operation according to claim 2 or 9, it is characterised in that, the diameter of the described pilot hole of described main nail substrate is 2mm.
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| CN201610157916.7A CN105615979B (en) | 2016-03-18 | 2016-03-18 | A kind of servicing unit in intramedullary nail internal fixation operation |
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| CN201610157916.7A CN105615979B (en) | 2016-03-18 | 2016-03-18 | A kind of servicing unit in intramedullary nail internal fixation operation |
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| CN105615979A true CN105615979A (en) | 2016-06-01 |
| CN105615979B CN105615979B (en) | 2018-01-02 |
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| CN106725820A (en) * | 2017-01-11 | 2017-05-31 | 邓迎生 | Torsion angle reference system fixed point is wrong before neck of femur aims at hollow nail fixed system away from guide pin |
| CN107669328A (en) * | 2017-11-20 | 2018-02-09 | 陈聚伍 | 2 Multi-dimensional positioning devices of femoral interlocking nail and localization method |
| CN111000615A (en) * | 2019-12-05 | 2020-04-14 | 张希江 | Intramedullary nail positioning drill jig frame |
| WO2020117148A3 (en) * | 2018-04-04 | 2020-09-03 | Tst Rakor Ve Tibbi̇ Aletler Sanayi̇ Ve Ti̇caret Li̇mi̇ted Şi̇rketi̇ | Proximal femoral de-rotation nail |
| CN112515730A (en) * | 2020-12-17 | 2021-03-19 | 郝晓艳 | Drilling guide for intramedullary nail |
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| CN105615979B (en) | 2018-01-02 |
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Inventor after: Gao Kaituo Inventor after: Bi Rongxiu Inventor after: Zhou Song Inventor after: Zhao Qiang Inventor before: Gao Kaituo Inventor before: Zhou Song Inventor before: Ye Qinghe Inventor before: Zhao Qiang Inventor before: Cang Jianguo Inventor before: Guo Fengbo |
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