CN106473801B - Tibial-calcaneal joint fusion screw imbedding guider and using method thereof - Google Patents
Tibial-calcaneal joint fusion screw imbedding guider and using method thereof Download PDFInfo
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- CN106473801B CN106473801B CN201611143264.8A CN201611143264A CN106473801B CN 106473801 B CN106473801 B CN 106473801B CN 201611143264 A CN201611143264 A CN 201611143264A CN 106473801 B CN106473801 B CN 106473801B
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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
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary 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
- A61B17/88—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 relates to a shank-heel joint fusion screw implantation guide, which comprises a screw implantation guide, wherein the screw implantation guide comprises a guide plate and a mounting bracket; the guide plate is an arc-shaped long strip plate and comprises a front guide section, a middle arc-shaped section and a rear guide section, wherein the front guide section and the rear guide section form an angle of 90 degrees, two ends of the middle arc-shaped section are respectively connected with the front guide section and the rear guide section in a bending way at an angle of 90 degrees, and a row of distributed screws are distributed in the middle of the guide plate and are placed into mounting holes; the mounting bracket is U-shaped, and two tail ends of the U-shaped are hinged to two sides of the guide plate; the guide device can accurately position on the calcaneal bone surface, is convenient to operate, can accurately connect the tibia, the talus and the calcaneal bone, and improves the success rate of the operation.
Description
Technical Field
The invention relates to the technical field of tibial-calcaneal joint fusion, in particular to a tibial-calcaneal joint screw imbedding guider and a using method thereof.
Background
Trauma to the ankle and hindfoot, arthropathy, etc. can often lead to tibial and heel arthritis, with conservative treatment methods improving only some symptoms. However, due to biomechanical imbalance, arthritis develops progressively, symptoms are aggravated progressively, and there is also a possibility of complicated ankle or hindfoot varus-valgus deformity, and satisfactory results cannot be obtained by conservative treatment. Currently, arthrodesis is the gold standard for treating such diseases by fusing the diseased joint to relieve pain and rebuild the painless plantar foot. The tibial-heel fusion can simultaneously fuse the tibial-heel joint and the ankle joint, and simultaneously solve the diseases of two pathological joints. The 'home run' screw of the shank distance and the heel axis position in the operation needs to penetrate the calcaneus, the talus and the tibia, and the proper direction needs to be ensured, so that the requirement on the operation doctor is higher.
The accurate screw of putting into of tibialis talar joint fusion art can provide reliable fixed, improves the joint fusion rate. Because the shank and the screw need to span three bones, the length is long, and the positioning of the screw is only determined by experience of an operator, human factor errors are inevitably generated, the positioning of the screw is unsatisfactory, the operation effect is affected, and the operation fails in serious cases.
Disclosure of Invention
The invention aims at providing the shank-heel joint fusion screw imbedding guider which is accurate in guiding and positioning and convenient to use and the using method thereof aiming at the defects in the prior art.
To achieve the purpose, the invention adopts the following technical scheme:
the shank-heel joint fusion screw implantation guide comprises a screw implantation guide body, wherein the screw implantation guide body comprises a guide plate and a mounting bracket;
the guide plate is an arc-shaped long strip plate and comprises a front guide section, a middle arc-shaped section and a rear guide section, wherein the front guide section and the rear guide section form an angle of 90 degrees, two ends of the middle arc-shaped section are respectively connected with the front guide section and the rear guide section in a bending way at an angle of 90 degrees, and a row of distributed screws are distributed in the middle of the guide plate and are placed into mounting holes;
the installing support is the U type, and two ends of U type hinge in the both sides of deflector.
Still further, the pliers comprise pliers bodies, wherein the pliers bodies comprise pliers handles, pliers arms and pliers heads, one ends of the pliers arms are connected with the pliers handles, the other ends of the pliers arms are connected with the pliers heads, the pliers handles, the pliers arms and the pliers heads are composed of two symmetrical parts, the middle parts of the pliers arms are connected through hinge posts, the pliers handles and the pliers arms are integrally formed, and the pliers arms and the pliers heads are of separate structures; the screw insertion guide is longitudinally fixed on the clamp body through the mounting bracket.
Still further, still be provided with the screw and put into the sleeve, the screw is put into the sleeve and is passed through the screw is put into the mounting hole demountable installation in on the deflector.
Still further, the number of the screw-in mounting holes is 6.
Still further, be provided with a plurality of director mounting hole on the tong arm, the installing support of director is put into to the screw passes through the director mounting hole is vertical to be fixed in on the tong body.
Still further, the binding clip still is provided with vertical protruding piece, vertical protruding piece longitudinal distribution is in the inboard of binding clip, vertical protruding piece is triangle-shaped structure.
Further, the included angle between the screw insertion sleeve and the calcaneus axis ranges from 15 DEG to 45 deg.
Further, a tightening piece is arranged on the clamp handle, one end of the tightening piece is fixed on the inner side of one clamp arm, and the other end of the tightening piece penetrates through the other clamp arm to be fixed through a bolt.
A method for implanting a guide using the tibial-calcaneal fusion screw described above, comprising the steps of:
step one: the forceps body is fixed on the operation position, a Kirschner wire is driven into the sleeve by a screw at a proper angle on the sagittal plane, about 2-3 forceps are driven into the sleeve, and then X-ray films are taken;
step two: observing an X-ray film, judging which angle is optimal in the position of the Kirschner wire, determining the applicable Kirschner wire, reserving the Kirschner wire, and removing the rest Kirschner wires;
step three: 1 hollow screw with the diameter of 6.5 is placed into the sleeve through the Kirschner wire, the calcaneus, the talus and the tibia are fixed, then an X-ray film is taken, and the completion of the screw placement is confirmed.
The invention has the beneficial effects that: 1. the guide device can accurately position on a smooth bone surface, is convenient to operate, can better master the angle, avoids the deviation of screw positions caused by improper angles, has lower technical experience requirements, can accurately connect tibia, talus and calcaneus, improves the fusion success rate, reduces operation wounds, shortens operation time and reduces the probability of wound infection, and is quick to recover; 2. through be provided with 6 screws on the deflector and put into the mounting hole, be used for installing the sleeve is put into to the screw, looks for suitable nailing position in the operation in-process, then the best position of visual observation obtained carries out accurate high-efficient nailing, provides a plurality of screw guiding positions for carry out abundant preparation and preliminary treatment before the operation, improve the success rate of operation.
Drawings
The invention will be further described with reference to the drawings and examples.
FIG. 1 is a schematic view of the overall construction of a tibial-calcaneal fusion screw insertion guide in accordance with one embodiment of the present invention;
FIG. 2 is a front view of the overall structure of a screw insertion guide according to one embodiment of the present invention;
fig. 3 is a side view showing a combined state of a guide plate and a screw insertion sleeve according to an embodiment of the present invention.
Wherein: the screw insertion guide 1, the guide plate 11, the screw insertion mounting hole 111, the front guide section 112, the middle arc section 113, the rear guide section 114, the mounting bracket 12, the clamp body 2, the clamp handle 21, the tightening piece 211, the clamp arm 22, the guide mounting hole 221, the clamp head 23, the longitudinal boss 231, and the screw insertion sleeve 3.
Detailed Description
The technical scheme of the invention is further described below by the specific embodiments with reference to the accompanying drawings.
A tibial-calcaneal joint fusion screw insertion guide, as shown in fig. 1-3, comprises a screw insertion guide 1, wherein the screw insertion guide 1 comprises a guide plate 11 and a mounting bracket 12;
the guide plate 11 is a long strip plate with an arc shape, the guide plate 11 comprises a front guide section 112, a middle arc section 113 and a rear guide section 114, the front guide section 112 and the rear guide section 114 form an angle of 90 degrees, two ends of the middle arc section 113 are respectively connected with the front guide section 112 and the rear guide section 114 in a bending way at an angle of 90 degrees, and a row of screw placement mounting holes 111 are distributed in the middle of the plate;
the mounting bracket 12 is U-shaped, and two tail ends of the U-shaped are hinged to two sides of the guide plate 11.
Through setting up deflector 11 is used for the screw emission in the operation, sets up installing support 12 will deflector 11 installs and is fixed in on the pincers body 2, presss from both sides operation calcaneus position with the pincers body 2, the screw put-in sleeve 3 install in on the screw put-in mounting hole 111 of deflector 11, according to human heel structural feature, the design deflector 11 is the arc for cover tibia, talus and calcaneus most department of linking to each other, the screw put-in mounting hole 111 is the matrix and distributes, can cover tibia, talus and calcaneus most department of linking to the same, thereby make the screw that sends out cover tibia, talus and calcaneus most department of linking to each other, be U-shaped installing support 12 and be used for installing deflector 11 on the pincers body 2, the fixed deflector 11's of operation in-process position of being convenient for.
The guide plate 11 is respectively composed of three sections, namely the front guide section 112, the middle arc section 113 and the rear guide section 114, so that the shank-heel joint fusion of all people can be facilitated, a doctor can conveniently adjust the position of the screw inserted into the sleeve 3, and the device is used for feet with different sizes. The front guide section 112 and the rear guide section 114 can fix the position better, so that the device is not easy to rotate in the operation process; during the operation, only the screw is driven into the screw and is put into the sleeve 3; the guide plate 11 is used for guiding and screwing, and the screw can directly and accurately nail the ankle joint and the shank-heel joint after penetrating through the sleeve, so that three bones of the tibia, the talus and the calcaneus are fused, the operation time is short, and the wound is small.
In the use process, firstly, a sleeve is placed on the sagittal plane at a proper angle through a screw, about 2-3 are driven into the Kirschner wire, then X-ray films are taken, the best Kirschner wire is determined, namely, tibia, talus and calcaneus are connected, the applicable screw is determined to be placed in the sleeve 3, then the sleeve is placed along the Kirschner wire through a hollow screw with the thickness of 6.5mm, then X-ray films are taken, and the exact fixation of the tibia, talus and calcaneus by the screw is confirmed, and the screw placement is finished.
Still further, the pliers further comprises a pliers body 2, wherein the pliers body 2 comprises pliers handles 21, pliers arms 22 and pliers heads 23, one end of each pliers arm 22 is connected with the pliers handle 21, the other end of each pliers arm 22 is connected with each pliers head 23, each pliers handle 21, each pliers arm 22 and each pliers head 23 are composed of two symmetrical parts, the middle parts of the pliers arms 22 are connected through hinge posts, the pliers handles 21 and the pliers arms 22 are integrally formed, and the pliers arms 22 and the pliers heads 23 are of a separation structure; the screw insertion guide 1 is longitudinally fixed to the forceps body 2 by the mounting bracket 12.
The guide device 1 is arranged on the forceps body 2 through the screws, the guide plate 11 is longitudinally fixed on the inner side of the forceps arms 22 through the mounting bracket 12, feet can be fixed through forceps heads 23 of the forceps body 2, and the arc-shaped guide plate 11 is arranged according to the heel part of a human body and is in a half-moon shape, so that the surgical requirements of the placement of tibia, talus and calcaneus fusion screws are met; the screw imbedding sleeve 3 is installed and fixed by arranging the screw imbedding mounting holes 111, the screw is sent out from the screw imbedding sleeve 3 to be shot into the operation position, and the multi-angle screw imbedding is realized by the transmitting cylinder on the arc-shaped guide plate 11, so that a proper position is searched for high-efficiency and high-accuracy operation.
Still further, a screw insertion sleeve 3 is provided, and the screw insertion sleeve 3 is detachably mounted on the guide plate 11 through the screw insertion mounting hole 111.
In the conventional operation, the tibial-heel joint fusion screw operation is determined by experience of an operator, so that errors of human factors are inevitably generated, the screw positioning is unsatisfactory, the ideal position is not easy to grasp, a guide needle is often required to be fixed for multiple times in the operation to obtain the optimal position, the operation time is long, the wound is large, the operation effect is affected, and even the operation is lost. However, the doctor can operate the guide device with both hands, can accurately position on a smooth bone surface, is convenient to operate, can better grasp the angle, avoids the deviation of the screw position caused by improper angle, has lower technical experience requirements, reduces surgical wounds, can accurately fix calcaneus, talus and tibia, and improves the success rate of the surgery.
Taking the right heel as an example, the screw-inserting mounting hole 111 is inclined to the left, because the emitted screw is used for connecting the tibia, the talus and the calcaneus, and the talus is on the inner side of the calcaneus, the inward inclination angle can be changed, and meanwhile, each human body structure can be slightly different, so the screw-inserting sleeve 3 has different inward inclination angles (15 DEG, 30 DEG and 45 DEG), the screw-inserting sleeve 3 is made into a replaceable accessory, and the sleeve is only required to be inserted in, thereby meeting the requirements of different patients and operations.
Further, the number of the screw-inserted mounting holes 111 is 6, and the angular interval is 15 °. Through be provided with 6 screw and put into mounting hole 111 on deflector 11, be used for installing screw is put into sleeve 3, and the radian between the two liang of screw is put into mounting hole 111 is 15 degrees, the size of mounting hole 111 can be different is put into to the screw, consequently the size of sleeve 3 can be different is put into to the screw. In the operation process, a proper angle is selected, the Kirschner wire is driven into the sleeve 3 through the screw imbedding sleeve, about 2-3 are arranged, then the best nail feeding point is determined by observing the X-ray film, the accurate and efficient nailing is carried out according to the obtained position, a plurality of screw guiding positions are provided, the full preparation and pretreatment are carried out before the operation, and the success rate of the operation is improved.
Further, the forceps arm 22 is provided with a plurality of guide mounting holes 221, and the mounting bracket 12 of the screw insertion guide 1 is vertically fixed to the forceps body 2 through the guide mounting holes 221.
Through setting up a plurality of director mounting hole 221, the screw is put into director 1 accessible director mounting hole 221 is adjusted suitable position, the installing support 12 passes through director mounting hole 221 is installed on the tong arm 22, be convenient for adjust the mounted position that the screw was put into director 1 to change deflector 11 and heel calcaneus's distance, make the launch angle of screw adjust the change to some extent.
Still further, the clamp head 23 is further provided with a longitudinal protruding block 231, the longitudinal protruding block 231 is longitudinally distributed on the inner side of the clamp head 23, and the longitudinal protruding block 231 has a triangular structure. Through setting up vertical protruding piece 231 for binding clip 23 carries out sharp contact with the heel calcaneus, vertical protruding piece 231 is semi-circular structure, obtains fully contacting, increases simultaneously the frictional force of contact surface between the two, plays firm location, can not cause the slide phenomenon, improves director fixed mounting at human heel position efficiency.
Further, the arc value between every two screw insertion sleeves 3 is 15-45 degrees. Because the human body structure is different, the radian range value is 15-45 degrees, different angles of screw emission can be met, if different emission angles are needed in the operation process, screws can be emitted through the screw insertion sleeve 3 with different inward inclination angles, different patient needs and the requirement of operation pretreatment are met, and therefore the injection position most suitable for the shank-heel joint fusion screw insertion operation is judged, and the injection operation with high accuracy and high efficiency is performed.
Further, the grip 21 is provided with a tightening member 211, one end of the tightening member 211 is fixed to the inner side of one of the jawarms 22, and the other end passes through the other of the jawarms 22 to be fixed by bolts. Through setting up the piece 211, after this director is fixed to be placed's position is judged to the doctor, both hands grasp pincers handle 21 is convenient for master the dynamics, and control the dynamics is good to binding clip 23 is fixed in the heel position, then goes up the fastening through the bolt and fix, prevents binding clip 23 shakes in the operation position, avoids the phenomenon of being inconvenient for operation.
A method for implanting a guide using the tibial-calcaneal fusion screw described above, comprising the steps of:
step one: the forceps body is fixed on the operation position, a Kirschner wire is driven into the sleeve by a screw at a proper angle on the sagittal plane, about 2-3 forceps are driven into the sleeve, and then X-ray films are taken;
step two: observing an X-ray film, judging which angle is optimal in the position of the Kirschner wire, determining the applicable Kirschner wire, reserving the Kirschner wire, and removing the rest Kirschner wires;
step three: 1 hollow screw with the diameter of 6.5 is placed into the sleeve through the Kirschner wire, the calcaneus, the talus and the tibia are fixed, then an X-ray film is taken, and the completion of the screw placement is confirmed.
Firstly, inserting a sleeve into a sagittal plane at a proper angle through a screw, driving a Kirschner wire with the diameter of 2.0mm by about 2-3, then taking X-ray films, determining the best Kirschner wire, namely connecting tibia, talus and calcaneus, marking the sleeve 3 after the proper screw is inserted, inserting a hollow screw with the diameter of 6.5mm along the Kirschner wire through the sleeve, taking X-ray films, and confirming that the screw is used for fixing the tibia, talus and calcaneus exactly, and finishing the screw insertion.
According to the invention, the screw placement guide device 1 is arranged on the forceps body 2, the guide plate 11 is longitudinally fixed on the inner side of the forceps arm 22 through the mounting bracket 12, the feet can be fixed through the forceps head 23 of the forceps body 2, and the arc-shaped guide plate 11 is arranged according to the heel part of a human body, so that the surgical requirements of tibia, talus and calcaneus fusion screw placement are met; the screw imbedding sleeve 3 is installed and fixed by arranging the screw imbedding mounting hole 111, the screw is emitted from the screw imbedding sleeve 3 to be shot into the operation position, and the screw is emitted from the arc-shaped guide plate 11 to realize multi-angle screw emission, so that a proper position is searched for high efficiency and high accuracy operation, and the purpose of successful operation is achieved.
The guide device can accurately position on a smooth bone surface, is convenient to operate, can better master the angle, avoids the deviation of screw positions caused by improper angles, has lower technical experience requirements, can accurately fix tibia, talus and calcaneus, improves the success rate of fusion, reduces operation wounds, and reduces the probability of wound infection, and is quick to recover.
The foregoing is merely exemplary of the present invention, and those skilled in the art should not be considered as limiting the invention, since modifications may be made in the specific embodiments and application scope of the invention in light of the teachings of the present invention.
Claims (6)
1. The utility model provides a director is put into to tibiofemoral joint fusion screw which characterized in that: the screw insertion guide comprises a guide plate and a mounting bracket;
the guide plate is an arc-shaped long strip plate and comprises a front guide section, a middle arc-shaped section and a rear guide section, wherein the front guide section and the rear guide section form an angle of 90 degrees, two ends of the middle arc-shaped section are respectively connected with the front guide section and the rear guide section in a bending way at an angle of 90 degrees, and a row of distributed screws are distributed in the middle of the guide plate and are placed into mounting holes;
the number of the screw embedded mounting holes is 6, and the angle interval is 15 degrees;
the mounting bracket is U-shaped, and two tail ends of the U-shaped are hinged to two sides of the guide plate;
the pliers body comprises pliers handles, pliers arms and pliers heads, one end of each pliers arm is connected with each pliers handle, the other end of each pliers arm is connected with each pliers head, each pliers handle, each pliers arm and each pliers head are composed of two symmetrical parts, the middle parts of the two pliers arms are connected through a hinge post, the pliers handles and the pliers arms are integrally formed, and the pliers arms and the pliers heads are of a separation structure; the screw insertion guide is longitudinally fixed on the clamp body through the mounting bracket.
2. The tibial calcaneal joint fusion screw insertion guide of claim 1, wherein: the guide plate is also provided with a screw imbedding sleeve, and the screw imbedding sleeve is detachably arranged on the guide plate through the screw imbedding mounting hole.
3. The tibial calcaneal joint fusion screw insertion guide of claim 1, wherein: the pliers are characterized in that a plurality of guide device mounting holes are formed in the pliers arms, and the mounting bracket of the screw embedded guide device is vertically fixed on the pliers body through the guide device mounting holes.
4. The tibial calcaneal joint fusion screw insertion guide of claim 1, wherein: the pliers head is characterized in that the pliers head is further provided with longitudinal protruding blocks, the longitudinal protruding blocks are longitudinally distributed on the inner side of the pliers head, and the longitudinal protruding blocks are of triangular structures.
5. The tibial calcaneal joint fusion screw insertion guide of claim 2, wherein: the included angle between the screw inserting sleeve and the calcaneus axis ranges from 15 degrees to 45 degrees.
6. The tibial calcaneal joint fusion screw insertion guide of claim 1, wherein: the clamp handle is provided with a tightening piece, one end of the tightening piece is fixed on the inner side of one clamp arm, and the other end of the tightening piece penetrates through the other clamp arm to be fixed through a bolt.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611143264.8A CN106473801B (en) | 2016-12-13 | 2016-12-13 | Tibial-calcaneal joint fusion screw imbedding guider and using method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611143264.8A CN106473801B (en) | 2016-12-13 | 2016-12-13 | Tibial-calcaneal joint fusion screw imbedding guider and using method thereof |
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| CN106473801B true CN106473801B (en) | 2023-07-25 |
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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN107007344B (en) * | 2017-05-31 | 2020-09-01 | 上海光韵达数字医疗科技有限公司 | Percutaneous nail-placing guide plate |
| CN108309429B (en) * | 2018-02-06 | 2019-09-10 | 中国人民解放军陆军军医大学第一附属医院 | A kind of individuation fusion of subtalar joint guide plate and its manufacturing method |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1853582A (en) * | 2005-02-07 | 2006-11-01 | 青岛市骨伤科医院 | Fracture reduced fixed guider |
| CN203001015U (en) * | 2013-01-06 | 2013-06-19 | 湖北医药学院附属太和医院 | Retractor special for craniocerebral operation |
| CN203138653U (en) * | 2013-04-05 | 2013-08-21 | 翟延荣 | Multifunctional fracture reduction oriented pliers |
| CN205458978U (en) * | 2016-03-28 | 2016-08-17 | 刘君 | Subtalar joint fuses device |
| CN207055543U (en) * | 2016-12-13 | 2018-03-02 | 朱永展 | A kind of pollex inserts guider with joint fusion screw |
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