CN106175911A - A kind of guider for putting nail - Google Patents
A kind of guider for putting nail Download PDFInfo
- Publication number
- CN106175911A CN106175911A CN201610655995.4A CN201610655995A CN106175911A CN 106175911 A CN106175911 A CN 106175911A CN 201610655995 A CN201610655995 A CN 201610655995A CN 106175911 A CN106175911 A CN 106175911A
- Authority
- CN
- China
- Prior art keywords
- nail
- draw
- navigation template
- sleeve
- cylinder
- Prior art date
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Classifications
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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
-
- 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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
-
- 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
-
- 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
Abstract
The invention provides a kind of guider for putting nail, wherein, this device includes navigation template and draws nail sleeve；Draw nail sleeve to mate with the outer guiding tube of navigation template, may be disposed in outer guiding tube；That draws that nail sleeve includes cylindricality draws nail body, and this post heart drawing nail body is provided with the through hole for drawing nail, thus reduces the risk brought because putting nail deviation.Additionally, this device also includes drawing drill bushing cylinder and putting nail device, and navigation template uses 3D printing technique to make.The present invention can accurately guide location, hole and put the overall process of nail, and the navigation template of Individual design can adapt to the complex environment of multiple nail to be put, and further ensure that accuracy and the safety putting nail overall process.
Description
Technical field
The present invention relates to medical instruments field, in particular to a kind of guider for putting nail.
Background technology
Nowadays, it is widely used to control for the technology (such as pedicle screw Internal fixation technology) at the built-in nail of human body
Treat in treating such as the orthopedic injuries such as spinal column, orthopedic etc..
At present, clinic generally uses navigation template guide at the built-in nail of human body bone, and implement complete putting and followed closely
3 steps of Cheng Gongyou, are location bonehew cortex respectively, hole and put nail.But existing navigation template can only guide and put nail
Front process, i.e. location cortex and boring procedure, namely specifying position to hole under the guiding of original guide plate, then existing
In spinal bone spongiosa, (putting as a example by nail by spinal column) stays next bone road, follow-up, needs healthcare givers to carry out free-hand putting along bone road
Nail operation.But, owing to spongy bone is the most fragile, the instability that bone road is suitable, the follow-up free-hand screw diameter putting nail and bone road
Internal diameter is the most inconsistent, and the free-hand personal error putting nail and operational error, all may cause follow-up put nail operation may deviation
The track being pre-designed.It is true that put nail for spinal column, the most the most frequently used free-hand rate of by mistake putting putting nail mode is the highest,
And screw is put and may be caused peripheral vessels nerve injury, produces serious complication by mistake.Nail is put for other position of human body,
Equally exist the problems referred to above, therefore precisely safety auxiliary put nail guider and have very much the value that should supply.
Put nail overall process for above-mentioned navigation template because cannot accurately guide and bring the potential problem putting nail risk, mesh
Before effective solution is not yet proposed.
Summary of the invention
In view of this, the purpose of the embodiment of the present invention is to provide a kind of guider for putting nail, it is possible to promotes and draws
Lead accuracy and the safety putting nail process.
First aspect, embodiments provides a kind of guider for putting nail, and wherein, this device includes navigation
Template and draw nail sleeve；Draw nail sleeve to mate with the outer guiding tube of navigation template, may be disposed in outer guiding tube；Draw nail sleeve bag
Include cylindricality draws nail body, and this post heart drawing nail body is provided with the through hole for drawing nail.
In conjunction with first aspect, embodiments provide the first possible embodiment of first aspect, wherein, on
Stating and draw nail sleeve and include being arranged at the annular cover drawing nail bodies top, the outside of this annular cover is provided with Handheld Division.
In conjunction with the first possible embodiment of first aspect or first aspect, embodiments provide first party
The embodiment that the second in face is possible, wherein, said apparatus also includes putting nail device, puts nail device and includes nail device and thin slice cylinder；
Above-mentioned drawing follows closely the cannelure that body also includes mating with this thin slice cylinder, and cannelure is positioned at the periphery of through hole, and has phase with through hole
Coaxial inner conductor；Upper nail device and thin slice cylinder are removable along the direction of described axial line to be connected.
In conjunction with the embodiment that the second of first aspect is possible, embodiments provide the third of first aspect
Possible embodiment, wherein, said apparatus also includes drawing drill bushing cylinder；That draws that drill bushing cylinder includes cylindricality draws brill body, and this draws brill
Sleeve mates with the outer guiding tube of navigation template, may be disposed in outer guiding tube；This post heart drawing brill body is provided with for drawing
The through hole bored.
In conjunction with the third possible embodiment of first aspect, embodiments provide the 4th kind of first aspect
Possible embodiment, wherein, above-mentioned outer guiding tube, draw nail body, draw brill body and thin slice cylinder for cylinder；Above-mentioned draw drill bushing
Cylinder also includes being arranged at the annular cover drawing brill bodies top, and the outside of this annular cover is provided with Handheld Division.
In conjunction with the third possible embodiment of first aspect, embodiments provide the 5th kind of first aspect
Possible embodiment, wherein, above-mentioned navigation template includes: the second patch that the first pasting panel is corresponding with the first pasting panel
Attached panel, and connect the first pasting panel and the handle of the second pasting panel, the first pasting panel, the second pasting panel and handle
Hands is integral type structure.
In conjunction with the third possible embodiment of first aspect, embodiments provide the 6th kind of first aspect
Possible embodiment, wherein, above-mentioned navigation template includes: the second patch that the first pasting panel is corresponding with the first pasting panel
Attached panel, and removably connect the first pasting panel and the handle of the second pasting panel.
In conjunction with the 6th kind of possible embodiment of first aspect, embodiments provide the 7th kind of first aspect
Possible embodiment, wherein, said apparatus include multiple navigation template and respectively with the outer guiding tube phase of multiple navigation templates
Drawing of coupling is followed closely sleeve and draws drill bushing cylinder.
In conjunction with the 7th kind of possible embodiment of first aspect, embodiments provide the 8th kind of first aspect
Possible embodiment, wherein, above-mentioned drawing follows closely sleeve and draws drill bushing cylinder by metal, alloy, pottery, resin, nylon, modified nylon
One or more in compound are made.
In conjunction with first aspect, embodiments provide the 9th kind of possible embodiment of first aspect, wherein, lead
Model plane plate is made up of 3D printing technique.
Embodiments providing a kind of guider for putting nail, including navigation template and draw nail sleeve, this draws
The outer guiding tube of nail sleeve and navigation template matches, and draws and follow closely sleeve and include that the cylindricality being provided with the through hole for drawing nail draws nail
Body, operator can draw the through hole in nail body by this and carry out putting nail operation, and accuracy is higher；Operate with prior art
Person cannot utilize existing navigation template and guiding completely to put nail operation and exist and put the problem of nail risk and compare, by above-mentioned dress
Putting, operator accurately can draw by means of the through hole drawing nail sleeve that the outer guiding tube with navigation template matches
Nail process, reduces because of the free-hand risk drawing nail error and bring.
Further, the device that the embodiment of the present invention is provided also includes putting nail device, and above-mentioned cylinder draws nail body also
Including the cannelure matched with the thin slice cylinder putting nail device, by moving in thin slice cylinder is limited to cannelure, thus only
The one conduct direction defining nail so that enter nail process the most accurate.
Further, the device that the embodiment of the present invention is provided also includes the handle being arranged on navigation template, and this handle can
Think integral type, it is simple to hand-held navigation template；Can also be detachable, it is simple to build navigation according to the actual requirements and flexibly
Template, thus decrease conventional navigation template and fix pattern and restriction to operation.
Further, the navigation template in the device that the embodiment of the present invention is provided is made up of 3D printing technique, it is possible to achieve
Individual design, and then can adapt to the complex environment of multiple nail to be put.
For making the above-mentioned purpose of the present invention, feature and advantage to become apparent, preferred embodiment cited below particularly, and coordinate
Appended accompanying drawing, is described in detail below.
Accompanying drawing explanation
In order to be illustrated more clearly that the technical scheme of the embodiment of the present invention, below by embodiment required use attached
Figure is briefly described, it will be appreciated that the following drawings illustrate only certain embodiments of the present invention, and it is right to be therefore not construed as
The restriction of scope, for those of ordinary skill in the art, on the premise of not paying creative work, it is also possible to according to this
A little accompanying drawings obtain other relevant accompanying drawings.
Fig. 1 shows the schematic perspective view of a kind of navigation template that the embodiment of the present invention provided；
Fig. 2 shows the application schematic diagram of a kind of navigation template that the embodiment of the present invention provided；
Fig. 3 shows a kind of schematic perspective view drawing nail sleeve that the embodiment of the present invention is provided；
Fig. 4 shows the generalized section drawing nail sleeve shown in Fig. 3 that the embodiment of the present invention is provided；
Fig. 5 shows the peace drawing nail sleeve shown in the navigation template shown in Fig. 1 that the embodiment of the present invention is provided and Fig. 3
Dress schematic diagram；
The section that the outer guiding tube of what Fig. 6 showed that the embodiment of the present invention provided draw nail sleeve and navigation template agrees with mutually
Schematic diagram；
Fig. 7 shows a kind of schematic perspective view drawing drill bushing cylinder that the embodiment of the present invention is provided；
Fig. 8 shows the generalized section drawing drill bushing cylinder shown in Fig. 7 that the embodiment of the present invention is provided；
The section that the outer guiding tube of what Fig. 9 showed that the embodiment of the present invention provided draw drill bushing cylinder and navigation template agrees with mutually
Schematic diagram；
Figure 10 shows the schematic perspective view putting nail device that the embodiment of the present invention is provided；
Figure 11 shows the generalized section putting nail device shown in Figure 10 that the embodiment of the present invention is provided；
Figure 12 shows the peace putting nail device drawn shown in nail sleeve and Figure 10 shown in Fig. 3 that the embodiment of the present invention is provided
Dress schematic diagram；
Figure 13 shows the schematic perspective view of the detachable handle that the embodiment of the present invention provided；
Illustrate:
The 10 outer guiding tubes of navigation template 11
12 first pasting panel 13 second pasting panels
14 handle 100 pedicles of vertebral arch
20 draw nail sleeve 21 draws nail body
The 22 first first annular covers of through hole 23
24 first Handheld Division 25 cannelures
30 draw drill bushing cylinder 31 draws brill body
32 second through hole 33 second annular covers
34 second Handheld Division 4 nails
40 put nail device on nail device 41
42 thin slice cylinder 141 first in command
142 second in command
Detailed description of the invention
For making the purpose of the embodiment of the present invention, technical scheme and advantage clearer, below in conjunction with the embodiment of the present invention
Middle accompanying drawing, is clearly and completely described the technical scheme in the embodiment of the present invention, it is clear that described embodiment is only
It is a part of embodiment of the present invention rather than whole embodiments.Generally real with the present invention illustrated described in accompanying drawing herein
The assembly executing example can be arranged with various different configurations and design.Therefore, below to the present invention's provided in the accompanying drawings
The detailed description of embodiment is not intended to limit the scope of claimed invention, but is merely representative of the selected reality of the present invention
Execute example.Based on embodiments of the invention, the institute that those skilled in the art are obtained on the premise of not making creative work
There are other embodiments, broadly fall into the scope of protection of the invention.
The problem that the auxiliaring effect of operation is the best, the embodiment of the present invention is followed closely in view of utilizing the guiding of existing navigation template to put
Provide a kind of guider for putting nail, make operator can accurately draw nail process by this device, enter
And improve the safety putting nail.
For ease of the present embodiment is understood, first to a kind of navigation for putting nail disclosed in the embodiment of the present invention
Device describes in detail.
It should also be noted that similar label and letter represent similar terms, therefore, the most a certain Xiang Yi in following accompanying drawing
Individual accompanying drawing is defined, then need not it be defined further and explains in accompanying drawing subsequently.
Embodiments providing a kind of guider for putting nail, see Fig. 1 and Fig. 3, this guider includes:
Navigation template 10 follows closely sleeve 20 with drawing；
Draw nail sleeve 20 to mate with the outer guiding tube 11 of navigation template 10, may be disposed in outer guiding tube 11；
Drawing nail sleeve 20 and include that drawing of cylindricality follows closely body 21, the post heart drawing nail body 21 is provided with the through hole for drawing nail,
For the ease of subsequent descriptions, the first through hole 22 that this through hole drawing nail is referred to as in the first through hole, i.e. figure.
Wherein, shown in FIG navigation template 10 specifically includes: outer guiding tube the 11, first pasting panel 12, second pastes
Attached panel 13 and handle 14；First annular cover the 23, first Handheld Division is may further comprise: at the nail sleeve 20 that draws shown in Fig. 3
24 and cannelure 25.
It should be noted that, the exterior contour drawing nail this body of ontology representation of above-mentioned cylindricality can be cylindrical, Rhizoma Sparganii
The multiple cylindrical form such as post, quadrangular, six prisms, illustrate with cylinder in Fig. 3, and draw the post heart (the specially cylinder of nail body
Y direction) through hole that run through is the most preferably cylindrical.Additionally, the cannelure 25 drawn in nail sleeve 20 shown in Fig. 3 is also
Triangular prism that the exterior contour can being set to accordingly and draw nail body matches, the flute profile such as quadrangular.
Navigation template 10 and the relation drawing nail sleeve 20 specifically can be found in Fig. 5 and Fig. 6.In figure 5 it is possible to nail sleeve will be drawn
20 go deep into the outer guiding tube 11 of navigation template 10 along arrow A direction；Should be with it should be noted that, draw nail sleeve 20
Outer guiding tube 11 mates, such as, draw the external diameter internal diameter equal to outer guiding tube 11 of nail body 21, draw nail sleeve 20 simultaneously and draw outward
Conduit 11 coaxial line such that it is able to good agrees with.Fig. 6 then for according to the mounting means shown in Fig. 5 will draw nail sleeve 20 insert
After to outer guiding tube 11, the generalized section to this assembly, it is noted that the navigation template 10 shown in Fig. 6 is only
Simply illustrative, do not represent true navigation template profile.Prominent the drawing that focus on of Fig. 6 follows closely sleeve 20 and navigation template 10
Outer guiding tube 11 phase agree with after generalized section, in order to be better understood from.
Embodiments providing a kind of guider for putting nail, including navigation template and draw nail sleeve, this draws
The outer guiding tube of nail sleeve and navigation template matches, and draws and follow closely sleeve and include that the cylinder being provided with the through hole for drawing nail is drawn
Nail body, operator can draw the post heart through hole in nail body by above-mentioned cylinder and carry out putting nail operation, and accuracy is higher；With
Prior art cannot utilize navigation template and guiding completely put nail operation and exist and put the problem of nail risk and compare, by above-mentioned
Device, operator can be carried out accurately by means of the through hole drawing nail sleeve that the outer guiding tube with navigation template matches
Draw nail process, reduce because of the free-hand risk drawing nail error and bring.
The application schematic diagram of a kind of navigation template that Fig. 2 is provided by the embodiment of the present invention, wherein to wait to put position, nail local
Illustrating as a example by being set to pedicle of vertebral arch 100, the non-index portion (i.e. dash area in figure) beyond pedicle of vertebral arch 100 is that the present invention is real
Execute the schematic diagram of a kind of navigation template that example provides.Corresponding with pedicle of vertebral arch 100 for navigation template spinal column dorsal part sclerotin is agreed with mutually,
The outer guiding tube of this navigation template is directed at pedicle of vertebral arch 100 wait put nail position, it is simple to follow-up puts nail operation, wherein, dotted line X
Be the axial line of outer guiding tube, be also design previously according to actual demand most preferably put nail route, follow-up puts nail process
Carry out putting nail operation each along this route, specifically can be found in described hereinafter, do not repeat them here.It should be noted that, in fig. 2
The extended line of dotted line X should be the axle along pedicle of vertebral arch 100, and by the midpoint of pedicle of vertebral arch.What Fig. 2 only readily appreciated shows
It is intended to, is not construed as limiting.
See Fig. 3 and Fig. 4, it is contemplated that the nail sleeve that draws being only bar shape needs when the most matched outer guiding tube
Limit and draw the degree of depth that nail sleeve is deep, simultaneously after drawing the nail outer guiding tube of sleeve, be also not easy to the follow-up general of operator
It takes out, and the nail sleeve 20 that draws in the present embodiment includes that being arranged at cylinder draws the annular cover at nail body 21 top, i.e. in figure
First annular cover 23, the outside of first annular cover 23 is provided with Handheld Division, i.e. the first Handheld Division 24 in figure.Pass through ring
Shape cover card guiding tube outer outside, thus limit and draw the degree of depth that nail sleeve is deep, by the first Handheld Division 24, behaviour can be made
Author is the most hand-held draws nail sleeve 20, consequently facilitating be put in the outer guiding tube 11 of navigation template 10, also allows for simultaneously
This is drawn nail sleeve 20 and takes out in the outer guiding tube 11 of navigation template 10 putting by operator after nail terminates.
In order to more easily put nail, this device also includes putting nail device, sees shown in Figure 10 and Figure 11, puts nail device 40
Including upper nail device 41 and thin slice cylinder 42；
Wherein, in order to be better understood upon drawing the structure of nail sleeve 20, can be found in the section drawing nail sleeve shown in Fig. 4
Figure.Cylinder draws the cannelure 25 that nail body 21 also includes mating with thin slice cylinder 42, and cannelure 25 is positioned at outside the first through hole 22
Enclose, and with the first through hole 22, there is identical axial line；Upper nail device 41 and the removable connection of thin slice cylinder 42.By thin slice cylinder 42 is limited
Move in being scheduled on cannelure 25, thus uniquely define the conduct direction of nail 4 so that enter nail process the most accurate.
Specifically can be found in drawing nail sleeve and putting the scheme of installation of nail device shown in Figure 12, along the arrow in B direction, will put
Nail device 40 agrees with drawing nail sleeve 20 phase.It is specially and the thin slice cylinder 42 putting nail device 40 is inserted into the cannelure 25 drawing nail sleeve 20
In, upper nail device 41 be then inserted simultaneously into draw nail sleeve 20 in the first through hole 22 drawing nail.Because upper nail device 41 and thin
Sheet cylinder 42 is connected, so thin slice cylinder 42 can move in cannelure 25 along with upper nail device 41, thus is limited in annular
Thin slice cylinder 42 in groove 25 can also the mobile route of simultaneously defined upper nail device 41, and then define the conduct direction of nail 4, just
Put nail in the most accurately, reduce tradition and put nail deviation that may be present.
Accordingly, when draw nail body cannelure be with draw nail body exterior contour match be set to triangular prism,
During the flute profiles such as quadrangular, above-mentioned thin slice cylinder also should be set to the flute profile matched with cannelure such that it is able to accurate with cannelure
Agree with.
In order to put the accurate of nail, it is necessary to being accurately positioned bore position and navigation boring direction, institute is for drilling guide boat portion
It is consistent with putting nail direction that the design divided must assure that boring direction.In order to pilot bore hole process accurately, and can be right
Those extra fine pedicles of vertebral arch are holed, and occur without destroying the accident in bone road because of deviation, use such as Fig. 7 and Fig. 8 institute
Showing, said apparatus also includes drawing drill bushing cylinder 30；
That draws that drill bushing cylinder 30 comprises cylindricality draws brill body 31, draws the outer guiding tube 11 of drill bushing cylinder 30 and navigation template 10
Join, may be disposed in outer guiding tube 11；
The post heart drawing brill body 31 is provided with the second through hole 32 for drawing brill.
Wherein, further comprise at the drill bushing cylinder 30 that draws shown in Fig. 7 and Fig. 8: the second annular cover 33 and second is hand-held
Portion 34.
It should be noted that, in order to the most nested, the external diameter drawing drill bushing cylinder 30 should be equal to the outer guiding of navigation template 10
The internal diameter of pipe 11, simultaneously in order to ensure the accuracy of boring, the internal diameter (i.e. for drawing the through-hole diameter of brill) drawing drill bushing cylinder 30 should
When the boring external diameter with boring bar tool (such as stiletto or boring electric drill etc.) matches, so that boring procedure is more accurate, will not
The situations such as borehole throw occur.
It is referred to above-mentioned installation by drawing the concrete steps that drill bushing cylinder 30 installs to the outer guiding tube 11 of navigation template 10
Draw the step of nail sleeve 20, do not repeat them here.Shown in Figure 9 will draw after drill bushing cylinder 30 is inserted in outer guiding tube 11,
Generalized section to this assembly, it is noted that the navigation template 10 shown in Fig. 9 is the most simply illustrative, not generation
Table true navigation template profile.Prominent outer guiding tube 11 phase drawing drill bushing cylinder 30 and navigation template 10 that focuses on of Fig. 9 is agreed with
After generalized section, in order to be better understood from.
To draw nail sleeve similar, above-mentioned cylindricality draw bore this body of ontology representation exterior contour can be cylinder, three
The multiple cylindrical form such as prism, quadrangular, six prisms, illustrate with cylinder in Fig. 7, and draw the post heart (the specially post boring body
The y direction of body) through hole that run through is the most preferably cylindrical.
To sum up, above-mentioned outer guiding tube, draw nail body, draw brill body and thin slice cylinder be cylindricality, can be cylinder, in this reality
Executing in Fig. 1～Figure 12 shown by example and all illustrate with cylinder, but be not construed as limiting, concrete cylindricality can be according to reality
Demand and arrange flexibly, but need to ensure outer guiding tube, draw nail body, draw bore the exterior contour of body and thin slice cylinder can mutual
Join, and there is identical axial line, to guarantee that screw can be advanced along this axial line (i.e. entering to follow closely route) accurately.
Shown in Figure 7, draw drill bushing cylinder 30 and also comprise to be arranged at and draw the annular cover boring body 31 top, annular cover
Outside is provided with Handheld Division.For the ease of describing, this annular cover drawing brill body 31 top is referred to as the second annular cover, i.e. schemes
In second annular cover 33；The second outside Handheld Division arranged of annular cover 33 is referred to as the second Handheld Division, the be in figure
Two Handheld Divisions 34, the second annular cover 33 and the effect of the second Handheld Division 34 may refer to above-mentioned first annular cover and first-hand
Hold portion, do not repeat them here.It should be noted that, the second Handheld Division 34 of Fig. 7 protrusions is only a kind of realization side of Handheld Division
Formula, can arrange the Handheld Division of multiple pattern according to the actual requirements, not repeat them here.
It should be noted that, in actual mechanical process, it should first by the above-mentioned drill bushing cylinder that draws to assist broken skin and to draw
Bore operation, after brill terminates, this is drawn the taking-up of drill bushing cylinder drawing, follow-up use is drawn nail sleeve and completed to put nail operation, concrete operations
Order is not described by foregoing and is limited.
Meanwhile, in actual applications, above-mentioned navigation template outer guiding tube, draw drill bushing cylinder, draw nail sleeve and putting
Nail device is and supports the use.Outer guiding tube, draw that drawing of drill bushing cylinder bores body and the second through hole, the cylinder of drawing nail sleeve draws nail
Body, the first through hole, cannelure and put the thin slice cylinder of nail device there is same axial line in use, and stretch into when put nail device
After drawing nail sleeve, thin slice cylinder and the screw (being fixed by upper nail device) of putting nail device slide also along above-mentioned same axial line.This axle
Heart line is and set in advance enters to follow closely route, specifically can be found in described hereinafter.Additionally, the internal diameter drawing nail sleeve should be more than screw
The external diameter of nut, therefore after putting nail, above-mentioned device all can take out from outer guiding tube smoothly.
Under normal circumstances, the navigation template in correlation technique is by following closely reversely pasting of position (the such as spinal column back side) with waiting to put
Attached forms interconnection, but can cannot avoid, in view of this mode, the region that part is difficult to effectively attach, and because of original
This body structure of navigation template is easily subject to ordering about of external force and produces a certain degree of deformation and existence is difficult to hand-held fixing
Etc. problem, referring again to shown in Fig. 1, the navigation template 10 in the present embodiment includes: the first pasting panel 12 and first attaches face
Second pasting panel 13 of plate 12 correspondence, and connect the first pasting panel 12 and handle 14 of the second pasting panel 13；Pass through
Handle 14 assists the stability of enhanced navigation template 10, thus reduces the passive deformation of guide plate when operating in art.First attaches
Panel the 12, second pasting panel 13 and handle 14 are integral type structure.Wherein, handle 14 respectively with the first pasting panel 12 and
Two ends of two pasting panel 13 phase linkings can extend respectively along the surface of pasting panel, and the end of handle 14 even may be used
To extend at the outer guiding tube 11 of navigation template 10, thus constitute the integral structure that intensity is higher.By utilizing handle end
End and the pressing effect of pasting panel, strengthen the intensity between handle and pasting panel and ability of anti-deformation so that navigation
Template is more firm.
Application navigation template flexibly may be needed according to actual bone conditions in view of in art, and allow as far as possible and lead
Model plane plate can adapt to the unsmooth sclerotin of kinds of surface including including complicated spinal contexts etc., and what the present embodiment provided is used for
The navigation template 10 put in the guider of nail can also include: the first pasting panel 12 is corresponding with the first pasting panel 12
Second pasting panel 13, and first pasting panel 12 and the handle of the second pasting panel 13 that removably connect.
It should be noted that, in actual applications, a navigation template can include multiple pasting panel, and multiple pasting panels can
To be overlapped by multiple palmistrys, thus the good multiple discontinuous attaching face waiting to put nail site environment being attached to complexity
On, and multiple pasting panel is by handle one firm entirety of composition, thus wait with such as spinal column and put the three of nail position
Dimension well-formed is fitted together to.
Preferably, shown in Figure 13, handle includes the first in command 141 being arranged on the first pasting panel and is arranged on
The second in command 142 on second pasting panel；The end of the first in command 141 is hollow hexagonal prism, the end of the second in command 142
For hexa-prism body, hollow hexagonal prism and hexa-prism body clamping, thus good by the first in command 141 and the second in command
142 are connected, and effectively avoid issuable relative slip when two handles connect so that the connection of two handles is more
For firm.
In a particular application, the hollow hexagonal prism that the end of the above-mentioned first in command is presented may be replaced by hollow three
Prism or hollow circular cylinder etc., it is possible at hollow cylinder disposed thread so that fixing, to prevent the phase between two handles
To slip.The end of the second in command can also do corresponding conversion thus agree with good with the first in command, and then with multiple side
Formula realizes removably connecting between handle.Do not repeat them here.
It should be noted that, Figure 13 is only symbolistic schematic diagram, being not to be construed as is the restriction to handle types, simultaneously
The local showing the first navigation template being connected with the first in command and be connected with the second in command of being diagrammatically only by property in Figure 13
The local of two navigation templates, is not construed as actual navigation template and the restriction of connected mode, thus the realization of handle
The connected mode of form and handle and navigation template can be specified flexibly according to practical situation.The present embodiment is by navigation
Handle is set in template, navigation template can be enable preferably to adapt to multiple sclerotin situation, it is to avoid because of by traditional in art
The restriction of integration navigation template and patient waits to put the stripping of the nail unnecessary tissue of site boundary, such as, use above-mentioned setting
There is the navigation template connecting handle, by handle, the pasting panel of multiple discontinuous navigation templates can be connected to one
Rising, multiple pasting panels overlap according to the actual requirements and by handle, can not only constitute the entirety of a firm stable,
It is easy to actual to wait to put nail position the most chimeric, and can adapt to more complicated spinal column and other osseous part environment (such as spinal column
Deformity, bone tumor etc.), avoid supraspinous ligament attachment region flexibly, thus reduce such as interspinous ligament and supraspinal ligament
Peel off etc. unnecessary tissue, thus the ligamentary system of the most more preservation spinal, the integrity of protection spine structure.Enter
One step, the handle on navigation template is also convenient for operator and stablizes guide plate in art, so that art centering guide is more firm, is more conducive to put
Nail.
Waiting to put nail position in view of different patients different, some patient may have only to that local is the most single puts nail, some patient
May need to dispose nail more, and the requirement putting nail is the most different, in order to adapt to complicated situation, thus said apparatus includes many
What individual navigation template and respectively outer guiding tube with multiple navigation templates matched draws nail sleeve and draws drill bushing cylinder.Wherein, each
Guide plate mainly guides side, multiple guide plate can be selected according to practical situation flexibly to guide many sides to carry out differentiation and put nail,
This repeats no more.
In view of in actual applications, navigation template uses traditional 3D printing technique (being rapid shaping technique) and base
Originally being single use, based on cost factor, existing technique does not the most use the metal 3D printing and making navigation template of costliness,
But using photosensitive resin or other organic polymer is that main material makes.But existing boring bar tool is mostly metal,
But metal boring bar tool can directly contact friction with the outer guiding tube of navigation template, thus causes the outer guiding tube of navigation template to be sent out
Give birth to deformation, rupture, and then the guidance accuracy of navigation template is declined, and metal boring bar tool is produced with the friction of outer guiding tube
Raw chip even can endanger the health of patient.In like manner, during putting nail, put nail device and nail also likely to be present navigation
The Latent destruction impact that template is identical, based on this, draws nail sleeve and draws drill bushing cylinder by metal, alloy, pottery, resin, nylon, Buddhist nun
One or more in dragon modified compound are made, so that sleeve is in use more resistant to mill, it is simple to repeatedly make
With.As a example by this sentences metal, the sleeve that metal is made is inserted in the outer guiding tube of navigation template, protects outer guiding tube not holed
Instrument and the impact putting nail device so that the outer guiding tube of navigation template is difficult to wreck and deform or wear and tear, and also avoids simultaneously
The chip produced because boring bar tool rubs outer guiding tube in art.Draw nail sleeve additionally, metal and draw drill bushing cylinder self
The firmest, it is unlikely to deform, also will not suffer breakage because rubbing mutually with boring bar tool, thus metal draws nail sleeve and metal draws
Drill bushing cylinder can be used for multiple times, more economical effectively.Thus use drawing nail sleeve and drawing made by above-mentioned firm wear-resisting material
Drill bushing cylinder, preferably improves reliability and the ruggedness of guider.
Because different human body needs the position putting nail different, in order to make navigation template be applied to difference targetedly
On human body, the navigation template that the present embodiment is provided is made up of 3D printing technique, it is possible to produces and waits that putting nail position matches
Individuation navigation template.When being embodied as, computer can be advanced with and construct and wait to put the three-dimensional that nail position matches
Phantom, according to this phantom, the navigation template utilizing 3D printing technique to print is individuation the most targetedly
Design, such that it is able to wait to put nail position according to diversity individuality and differentiation and produce individuation navigation template, wherein, should
Individuation navigation template on the basis of the individuation printed by 3D, can also ensure patient as single use parts
Use safety and health, and in the manufacturing process of navigation template, can be by artificial or utilize computer to calculate to determine
Good puts nail path, and according to the outer guiding tube of this path Design Navigation template, the axial line of outer guiding tube follows closely path with putting
Axial line is consistent, and this axial line is and follow-up enters to follow closely route, thus during actual broken skin is holed and put nail, draws drill bushing
Cylinder, draw nail sleeve and put nail device axial line all consistent with above-mentioned axial line, ensure that the accuracy of guider
And reliability, it is ensured that screw can be advanced along this axial line (i.e. entering to follow closely route) accurately.
In sum, the guider for putting nail that the present embodiment is provided, make operator draw brill by this device
Sleeve, draw nail sleeve match with the navigation template with outer guiding tube, can accurately guide the overall process putting nail, fall
Low put nail risk.Concrete, this guider being used for putting nail has a feature highlighted below:
(1) navigation template be for wait to put nail position concrete condition (anatomical structure and with the organ such as peripheral nerve blood vessel
Position relationship etc.) Individual design, simultaneously can select safe accurately to use the modes such as artificial or computer disposal
Most preferably enter to follow closely route, and enter to follow closely the outer guiding tube of highway route design according to this, it is determined that follow-up location broken skin, hole and put nail overall process
Path, ensured accuracy and safety；
(2) be configured with match with navigation template draw drill bushing cylinder, it is possible to navigator fix broken skin and boring procedure accurately,
Improve broken skin and the reliability of boring and accuracy；
(3) be configured with match with navigation template draw nail sleeve, it is possible to accurately navigation put nail operation, promote put nail can
By property and accuracy；
(4) be configured with draw that nail sleeve matches put nail device, be limited in draw nail sleeve at the thin slice cylinder putting nail device
Cannelure in when sliding, it is ensured that the upper nail device putting nail device moves only along in advance the entering to follow closely path of design, thus really
Protect the accuracy putting nail path, greatly reduced and put nail deviation, improve the safety and reliability putting nail further；
(5) print navigation template from individuation 3D, design most preferably is entered to follow closely path and is drawn drill bushing with navigation template matches
Cylinder, draw nail sleeve and put the assistance of nail device, broken skin can be guided accurately, hole, put nail overall process, improve safe and reliable
Property.
(6) by the 3D printing technique of individuation and the multiple pasting panels that can be built by handle, it is possible to adapt to various
Complicated sclerotin environment, such as, be applied to deformity of spine, and the design of this great-leap-forward can be crossed some and is unfavorable for what guide plate attached
Chimeric region, but can simultaneously keep the globality of guide plate and specificity synestotic with spinal column, can be so that navigation template
Optionally cross some regions that need not peel off (such as interspinal ligaments and supraspinal ligament) so that unnecessary stripping such as such as ligament etc.
Tissue saved from damage, thus protect the integrity of spine structure as much as possible, thus there is good application effect.
(7) draw nail sleeve, draw drill bushing cylinder and put nail device due to use Wear-resistant corrosion-resistant material make, can reduce metal operation
Apparatus wear and tear in operation guide plate produce chip, reduce guide plate deformation effect put nail navigation accuracy.And nail set will be drawn
Cylinder, draw drill bushing cylinder and have into standard component made to order with the thin slice cylinder etc. put on nail device, size with hole and pedicle screw device matches.
Thus draw nail sleeve, draw drill bushing cylinder and put nail device on thin slice cylinder can be used for multiple times with same set of pedicle screw device repeated disinfection,
The most cost-effective, the most readily replaceable.
As it has been described above, the guider that the present embodiment is provided, put nail (include by Individual design, the navigation of full step
Formulation most preferably is entered to follow closely route, broken skin, is holed and put nail) and adapt to complex environment and protect unnecessary strippings the such as ligament to organize
Aspect, brings safe and reliable good effect.
Concrete, the specific make step of above-mentioned navigation template can be found in as described below (as a example by patient spine is put nail
Illustrate):
1.1 gather initial data: patient spine carries out thin-layer CT scanning, gathers original CT data；
1.2 set up threedimensional model: by being read out spinal column tomographic data and analyzing, successively in reconstruction software
Carry out bone threshold value choose segmentation, editor fills, remove after redundant data, use shaded surface display, construct patient spine
Threedimensional model；
1.3 determine and put nail path: by the spinal three-dimensional model of CT tomography and structure and surrounding anatomical structures etc. by people
Work chooses the path putting nail；Or use the reverse engineering softwares such as UG to wait to put nail position by matching and calculate optimal path.
I.e. choose put the optimal path of nail can be by manually selecting, it is also possible to selected by computed in software.
1.4 Design Navigation templates: the threedimensional model of the spinal column of structure before using three-dimensional software to import, extract spinal column dorsal part
Surface texture, sets up the navigation template with spinal bone surface anatomy mating shapes in systems.This navigation template is left and taken
Putting the path of nail, this is put nail path and is and most preferably putting nail path selected by above-mentioned steps 1.3, and draws according to the design of this path is outer
Conduit (axial line of outer guiding tube is consistent with putting nail path axial line), and design the handle connecting each navigation template；
1.5 make navigation masterplates: utilize the rapid laser-shaping technique (being above-mentioned 3D printing technique) will be with outer guiding
Pipe becomes in kind with the navigation stamp fabrication of handle.
The making drawing drill bushing cylinder and draw nail sleeve does not repeats them here, it is noted that in manufacturing process, draw drill bushing
The internal diameter (i.e. for drawing the through-hole diameter of brill) of cylinder should be with the boring external diameter phase of boring bar tool (such as stiletto or boring electric drill)
Joining, the internal diameter drawing the external diameter of drill bushing cylinder and the outer guiding tube on navigation template matches.Draw external diameter and the navigation template of nail sleeve
The internal diameter of outer guiding tube match while, the cannelure drawing nail sleeve should match with the thin slice cylinder put on nail device.Cause
This, design the axis into nail path in advance, by the outer sleeve of guide plate and draw drill bushing cylinder, navigated location and hole this two
Individual step；By guide plate and draw nail sleeve, and with the use of the upper nail device of band thin slice cylinder, navigate the step for put nail.
In order to the clearer use process illustrating the guider that the present embodiment provides, can be found in following step
(so that this device is applied as a example by vertebral arch pedicle of vertebral column puts nail):
1, guide plate need the soft tissue of the spinal column dorsal part bone surface attached be stripped clean；
2, navigation template is placed in predeterminated position so that navigation template is put nail position and formed specific chimeric with band, helps
Guide plate can be stablized on spinal column by hands or patient by the handle on navigation template；
3, it is inserted into drawing drill bushing cylinder in the outer guiding tube of navigation template, and uses corresponding boring bar tool (Kirschner wire, brill
Hole cone or electric drill etc.), navigation guide plate and draw drill bushing cylinder navigation under treat and put nail position and carry out positioning broken skin matter and boring
Operation；
4, take out boring bar tool when boring completes and draw drill bushing cylinder, nail sleeve will be drawn and be inserted in outer guiding tube, will put
The thin slice cylinder of nail device is inserted in the cannelure drawing nail sleeve so that this thin slice cylinder can only slide in cannelure, because
The thin slice cylinder putting nail device is connected with upper nail device, therefore when thin slice cylinder is limited in cannelure, the most just also defines
Path is followed closely in putting of upper nail device, thus defines the exclusive path into nail, and then performs to put nail operation accurately.Owing to drawing nail sleeve
Inner via hole diameter is greater than the maximum gauge of the nut of screw, therefore when after screw success dropping place, upper nail device, draw nail sleeve, with
And guide plate can take out smoothly.
Additionally, in use, the individuation navigation template using 3D printing technique to make can be as disposably making
With parts, preoperative by plasma ion disinfection, navigation masterplate is not easy to deformation and decomposes, to guarantee safety and health.And draw nail set
Cylinder, draw drill bushing cylinder and put nail device due to use Wear-resistant corrosion-resistant material make, metallic surgical instrument can be reduced in operation
Abrasion guide plate produces chip, and makes guide plate deformation effect put the problem such as accuracy of nail navigation.And nail sleeve will be drawn, draw brill
Sleeve has into standard component made to order with putting nail device, and size matches with boring and pedicle screw device.Thus draw nail sleeve, draw drill bushing cylinder
Can be used for multiple times with same set of pedicle screw device repeated disinfection, with cost-effective.
By above-mentioned steps, operator can facilitate by the guider that the present embodiment provides and guiding accurately is fixed
Position, broken skin matter, hole and put the overall process of nail, reducing and put nail deviation because of free-hand and be the potential risk brought of patient.
In sum, embodiments provide a kind of guider for putting nail, specifically can as orthopaedics or
The surgery assistor tool of person's spinal column, including navigation template, draws drill bushing cylinder, draws nail sleeve and be used in combination with drawing nail sleeve
Put nail device, this draw drill bushing cylinder and draw nail sleeve all can match with the outer guiding tube of navigation template, and draw nail sleeve include use
Following closely body (having through hole at the post heart) in drawing drawing of nail, operator can carry out putting nail by this post heart through hole that draw in nail body
Operation, accuracy is higher；Compared with existing navigation template, existing navigation template can only navigate boring, it is impossible to nail is put in navigation.Pass through
Said apparatus, operator can be carried out relatively by means of the post heart through hole drawing nail sleeve that the outer guiding tube with navigation template matches
For drawing nail process accurately, thus make to put the location of nail, boring further and put each step of nail all there is the auxiliary of navigation,
Reduce and put, because of free-hand, the risk that nail error is brought.Additionally, the navigation template in this device uses 3D printing technique to make.Individual
The navigation template changing design can adapt to the complex environment of multiple nail to be put, further ensure that put nail overall process accuracy and
Safety.
It should be noted that in describing the invention, term " " center ", " on ", D score, "left", "right", " vertically ",
Orientation or the position relationship of the instruction such as " level ", " interior ", " outward " they are based on orientation shown in the drawings or position relationship, merely to
It is easy to describe the particular orientation that the present invention and simplifying describes rather than instruction or the hint device of indication or element must have,
And specifically azimuth configuration and operation, therefore it is not considered as limiting the invention.Additionally, term " first ", " second ",
" the 3rd " is only used for describing purpose, and it is not intended that indicate or hint relative importance.
It addition, in describing the invention, unless otherwise clearly defined and limited, term " install ", " being connected ", " even
Connect " should be interpreted broadly, connect for example, it may be fixing, it is also possible to be to removably connect, or be integrally connected；It can be machine
Tool connects, it is also possible to be electrical connection；Can be to be joined directly together, it is also possible to be indirectly connected to by intermediary, can be two units
Connection within part.For the ordinary skill in the art, above-mentioned term can be understood in the present invention with concrete condition
Concrete meaning.
It should be noted that in the case of not conflicting, the feature in the embodiment of the present invention can be combined with each other.
The above, the only detailed description of the invention of the present invention, but protection scope of the present invention is not limited thereto, and any
Those familiar with the art, in the technical scope that the invention discloses, can readily occur in change or replace, should contain
Cover within protection scope of the present invention.Therefore, protection scope of the present invention should described be as the criterion with scope of the claims.
Claims (10)
1. the guider being used for putting nail, it is characterised in that include navigation template and draw nail sleeve；
The described nail sleeve that draws mates with the outer guiding tube of described navigation template, may be disposed in described outer guiding tube；
Described draw that nail sleeve includes cylindricality draw nail body, described in draw the post heart of nail body and be provided with the through hole for drawing nail.
Device the most according to claim 1, it is characterised in that described in draw nail sleeve include being arranged at described in draw nail body top
The annular cover in portion, the outside of described annular cover is provided with Handheld Division.
Device the most according to claim 1 and 2, it is characterised in that described device also includes putting nail device, described in put nail device bag
Include nail device and thin slice cylinder；
Described drawing follows closely the cannelure that body also includes mating with described thin slice cylinder, and described cannelure is positioned at the periphery of described through hole,
And with described through hole, there is identical axial line；Described upper nail device and described thin slice cylinder are removable even along the direction of described axial line
Connect.
Device the most according to claim 3, it is characterised in that described device also includes drawing drill bushing cylinder；
Described draw that drill bushing cylinder includes cylindricality draw brill body, described in draw drill bushing cylinder and mate with the outer guiding tube of described navigation template,
May be disposed in described outer guiding tube；
The described post heart drawing brill body is provided with the through hole for drawing brill.
Device the most according to claim 4, described outer guiding tube, described in draw nail body, described in draw brill body and described thin
Sheet cylinder is cylindrical；Described draw drill bushing cylinder also include being arranged at described in draw the annular cover boring bodies top, described annular cover
Outside be provided with Handheld Division.
Device the most according to claim 4, it is characterised in that described navigation template includes: the first pasting panel is with described
The second pasting panel that first pasting panel is corresponding, and connect described first pasting panel and the handle of described second pasting panel
Hands, described first pasting panel, described second pasting panel and described handle are integral type structure.
Device the most according to claim 4, it is characterised in that described navigation template includes: the first pasting panel is with described
The second pasting panel that first pasting panel is corresponding, and removably connect described first pasting panel and described second attaching face
The handle of plate.
Device the most according to claim 7, it is characterised in that described device include multiple described navigation template and respectively with
What the outer guiding tube of multiple described navigation templates matched draws nail sleeve and draws drill bushing cylinder.
Device the most according to claim 8, it is characterised in that described in draw nail sleeve and the described drill bushing cylinder that draws by metal, conjunction
One or more in gold, pottery, resin, nylon, modified nylon compound are made.
Device the most according to claim 1, it is characterised in that described navigation template is made up of 3D printing technique.
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| CN201610655995.4A CN106175911B (en) | 2016-08-11 | 2016-08-11 | It is a kind of for setting the navigation device of nail |
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| CN201610655995.4A CN106175911B (en) | 2016-08-11 | 2016-08-11 | It is a kind of for setting the navigation device of nail |
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| CN106175911B CN106175911B (en) | 2019-01-22 |
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