CN106618718A - Subtalar joint fusion screw imbedding guider and use method thereof - Google Patents

Subtalar joint fusion screw imbedding guider and use method thereof Download PDF

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Publication number
CN106618718A
CN106618718A CN201611143169.8A CN201611143169A CN106618718A CN 106618718 A CN106618718 A CN 106618718A CN 201611143169 A CN201611143169 A CN 201611143169A CN 106618718 A CN106618718 A CN 106618718A
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China
Prior art keywords
screw
guider
inserts
subtalar joint
tong arm
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CN201611143169.8A
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CN106618718B (en
Inventor
李雪
朱永展
谭彩霞
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FOSHAN TRADITIONAL CHINESE MEDICINE HOSPITAL
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FOSHAN TRADITIONAL CHINESE MEDICINE HOSPITAL
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Priority to CN201611143169.8A priority Critical patent/CN106618718B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90Guides therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564Methods for bone or joint treatment

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

Abstract

The invention relates to a subtalar joint fusion screw imbedding guider comprising a screw imbedding guider; the screw imbedding guider comprises a guiding plate and a mounting support; the guiding plate is a long-strip-shaped plate which is a quarter circle; the plate is provided with screw imbedding mounting holes which are distributed in two rows; the mounting support is U-shaped; two ends of the U-shape are hinged to the two sides of the guiding plate; the screw imbedding guider is installed on a pliers body; screw imbedding sleeves are mounted and fixed through the installation of the screw imbedding mounting holes; screws are output from the screw imbedding sleeve and are imbedded in surgery positions; by means of the arc guiding plate imbedding sleeve, screws can be imbedded on sagittal planes at different angles so that proper positions can be found to carry out quick, efficient and accurate surgery; a successful surgery can be carried out.

Description

A kind of subtalar joint screw inserts guider and its using method
Technical field
The present invention relates to the technical field of fusion of subtalar joint, and in particular to a kind of subtalar joint screw is inserted and led To device and its using method.
Background technology
Subtalar joint is to maintain the stable pivot of foot.It bears and conducts the body weight of human body, and the rotation for changing lower limb should Power, collaboration and the motion of auxiliary ankle-joint, arrange the activity of joint and front foot in instep.Astragalus, fracture of calcaneus patient usually occur Subtalar joint traumatic arthritis, aging population is also easily caused subtalar joint degenerative arthritis patient increase.Calcaneum, astragalus Expectant treatment or operative treatment are dissatisfied after fracture often results in malunion, subtalar joint out-of-flatness can be caused more, under Articular trauma joint, can clinically cause heel pain, difficulty in walking, have a strong impact on life and work.
Fusion of subtalar joint is accurately inserted and provide by screw strong gripping point, can avoid again it is artificial it is iatrogenic simultaneously In sending out the generation routine operation of disease, but the positioning of screw is only empirically determined with operative doctor, and direction is difficult to hold, and need to repeatedly taste Examination, thus inevitably results from the error of human factor.Drill repeatedly, operation wound is big, is easily caused calcaneum bone amount and loses Lose, the stability of screw is inserted in impact.Repeatedly adjustment direction causes operating time to extend, and increases infection risk, so as to affect Surgical effect, operative failure when serious.
The content of the invention
Present invention aims to weak point of the prior art, there is provided a kind of accurate guide-localization, user Just the subtalar joint screw for, realizing quick operative treatment inserts guider and its using method.
It is that, up to this purpose, the present invention is employed the following technical solutions:
A kind of subtalar joint screw inserts guider, including screw inserts guider, and the screw inserts guider Including guide plate and mounting bracket;
The guide plate is the strip plate in 1/4 circle, and being covered with plate has the screw in two rows distribution to insert installing hole;
The mounting bracket is U-shaped, and two U-shaped ends are articulated with the both sides of the guide plate.
Further, also including caliper, the caliper includes clamp handle, tong arm and binding clip, one end and the pincers of the tong arm Handle is connected, and the other end of the tong arm is connected with binding clip, and the clamp handle, tong arm and binding clip are all made up of symmetrical two parts, and two The middle part of tong arm described in two is connected by hinge post;The screw insert guider be vertically fixed on by the mounting bracket it is described On caliper.
Further, it is additionally provided with screw and inserts sleeve, the screw is inserted sleeve and inserts installation by the screw Hole is removably mounted on the guide plate.
Further, the screw is inserted installing hole and is symmetrically distributed on the guide plate into two rows, often arranges the spiral shell It is 6 that nail inserts the quantity of installing hole, and sagittal plain upper angle is at intervals of 15 °.
Further, several guider installing holes are provided with the tong arm, the screw inserts the peace of guider Dress support is vertically fixed on the caliper by the guider installing hole.
Further, the binding clip is additionally provided with longitudinally convex piece, and the longitudinally convex piece of genesis analysis are in the pincers The inner side of head, the longitudinally convex piece of semicircular in shape structure or three-legged structure.
Further, the angular range value that the screw is inserted between sleeve and calcaneum axis is 15 ° -45 °.
Further, it is provided with the clamp handle and tightens part, the interior of tong arm described in is fixed in the described part one end that tightens Side, the other end is fixed through another tong arm by bolt.
A kind of method for inserting guider using above-mentioned subtalar joint screw, comprises the steps:
Step one:Caliper is fixed on operative site, sleeve is inserted by screw with appropriate angle in sagittal plain and is squeezed into Kirschner wire, about 2-3 roots, then claps X-ray;
Step 2:Observation X-ray, judges that the Kirschner wire position which angle is thrown into is optimal, it is determined that applicable Kirschner wire is simultaneously Retain, remove remaining Kirschner wire;
Step 3:The parallel hollow spiral shell that sleeve inserts two pieces of diameters 6.5 is inserted by screw along the Kirschner wire direction for retaining Nail, then claps X-ray, confirms that operation is completed.
Beneficial effects of the present invention:1. the guider of the present invention can be accurately positioned in sagittal plane, easy to operate, energy Preferably grasp angle, it is to avoid angle is improper easily to make location dislocation of having an injection, and technical experience requirement is relatively low, can accurately along astragalus Axis fixes calcaneum and astragalus, improves success rate of operation, reduces operation wound, recovers fast, can only appear entry point and Realize in the case of going out pin mark it is minimally invasive, beneficial to operative incision healing, improve fusion rate, reduce wound infection probability, while Reduce operative scar;2. guider is inserted by being provided with screw on caliper, installing hole is inserted to institute by arranging screw Stating screw and inserting sleeve carries out installation fixation, and screw is inserted sleeve and sent in implantation surgery position from the screw, by 1/4 Insert cylinder on round guide plate, realize multi-angle and insert screw, so as to find optimum position carry out it is quick, efficient, accurately Operation, reaches the purpose of successful surgery.
Description of the drawings
With reference to the accompanying drawings and examples the present invention is further described.
Fig. 1 is the overall structure diagram that the subtalar joint screw of one embodiment of the present of invention inserts guider;
Fig. 2 is the overall structure front view that the screw of one embodiment of the present of invention inserts guider;
Fig. 3 is the assembled state side view that the guide plate of one embodiment of the present of invention and screw insert sleeve.
Wherein:Screw is inserted guider 1, guide plate 11, screw and inserts installing hole 111, mounting bracket 12, caliper 2, clamp handle 21st, tighten part 211, tong arm 22, guider installing hole 221, binding clip 23, longitudinally convex piece 231, screw insert sleeve 3.
Specific embodiment
Further illustrate technical scheme below in conjunction with the accompanying drawings and by specific embodiment.
A kind of subtalar joint screw inserts guider, and as Figure 1-3, including screw inserts guider 1, the spiral shell Nail inserts guider 1 including guide plate 11 and mounting bracket 12;
The guide plate 11 is the strip plate in 1/4 circle, and being covered with plate has the screw in two rows distribution to insert installing hole 111;
The mounting bracket 12 is U-shaped, and two U-shaped ends are articulated with the both sides of the guide plate 11.
Inserted by the screw for arranging the guide plate 11 and being used in operation, the mounting bracket 12 is set the guiding Plate 11 is mounted on caliper 2, and with caliper 2 operation heel is clamped, and screw is inserted sleeve 3 and is installed on the guide plate 11 Screw insert on installing hole 111, according to human body heel architectural feature, it is arc to design the guide plate 11, for cover with Most of connecting place of bone and astragalus, the screw inserts installing hole 111 in matrix distribution, can equally cover calcaneum and astragalus Most of connecting place so that the screw inserted out covers most of connecting place of calcaneum and astragalus, U-shaped installation Frame 12 is used to guide plate 11 be arranged on the caliper 2, is easy to the position of fixed guide plate 11 in surgical procedure.
In use, the Kirschner wire of 2-3 piece of 2.0mm diameter is first squeezed into, X-ray is then clapped, looks at what which group was thrown into Kirschner wire meets the needs of operation, is that lateral projection fixes calcaneum and astragalus, and axle position piece Kirschner wire direction meets astragalus axis, really Determine to insert behind direction after screw sleeve 3, along Kirschner wire the hollow screw of diameter 6.5mm is inserted, using applicable screw set is inserted Cylinder 3 is parallel again to play the 2nd nail, then claps X-ray, confirms that calcaneum and astragalus fix definite, and screw orientation is good, successful surgery knot Beam.
Further, also including caliper 2, the caliper 2 includes clamp handle 21, tong arm 22 and binding clip 23, the tong arm 22 One end be connected with clamp handle 21, the other end of the tong arm 22 is connected with binding clip 23, and the clamp handle 21, tong arm 22 and binding clip 23 are all It is made up of symmetrical two parts, two-by-two the middle part of the tong arm 22 is connected by hinge post, and the clamp handle 21 is integrated with tong arm 22 Shaping, the tong arm 22 is isolating construction with binding clip 23;It is solid by the longitudinal direction of the mounting bracket 12 that the screw inserts guider 1 On the caliper 2.
Guider 1 is inserted by being provided with screw on caliper 2, the guide plate 11 is by the longitudinal direction of the mounting bracket 12 The inner side of the tong arm 22 is fixed on, foot can be fixed by the binding clip 23 of caliper 2, according to human body heel, if The guide plate 11 of arc is put, the shape in 1/4 circle meets the operation requirement that subtalar joint screw is inserted;By arranging spiral shell Nail is inserted 111 pairs of screws of installing hole and inserts sleeve 3 and carries out installation fixation, and screw is inserted sleeve 3 and sent and penetrates from the screw Enter in surgery location, by inserting cylinder on the guide plate 11 of arc, realize multi-angle and insert screw, so as to find suitable position Putting carries out high efficiency, the operation of high-accuracy.
Further, it is additionally provided with screw and inserts sleeve 3, the screw is inserted sleeve 3 and inserts peace by the screw Dress hole 111 is removably mounted on the guide plate 11.
In routine operation, it is determining, thus inevitably with operative doctor experience to incorporate screw operation away from joint The error of human factor can be produced, causes screw positioning dissatisfied, ideal position is difficult to hold, and guide pin is generally required in art multiple Fixed in the hope of optimum position, operating time is long, and wound is big, so as to affect surgical effect, or even causes operative failure.But doctor The bimanualness guider, can be accurately positioned on smooth bone face, easy to operate, can preferably grasp Kirschner wire angle Degree, it is to avoid angle is improper easily to make screw position improper, technical experience require it is relatively low, reduce operation wound, can accurately along away from Axis of bone line fixes calcaneum and astragalus, improves success rate of operation.
By right crus of diaphragm with as a example by, it is inclined to the left side that the screw inserts installing hole 111, because the screw inserted away is For connecting calcaneum and astragalus, and astragalus is inner side inclined in calcaneum, and the angle of introversion can change, while each human body Structure has a technicality, thus the screw insert sleeve 3 have different inclined angles relative to calcaneum axis (15 °, 30 °, 45 °), the screw is inserted sleeve 3 and makes the accessory that can change, the inclination angles of how many degree are needed, as long as grip wound packages Enter, meet the requirement of different client need and operation.
Further, the screw is inserted the row of 111 one-tenth of installing hole two and is symmetrically distributed on the guide plate 11, often arranges institute State screw insert installing hole 111 quantity be 6, sagittal plain upper angle is at intervals of 15 °.By arranging on the guide plate 11 There are 6 groups, the screw of 2 per group inserts installing hole 111, for installing the screw sleeve 3 is inserted, every group of screw inserts installing hole Radian between 111 is 15 degree, and the screw inserts the size of installing hole 111 can be with difference, therefore the screw inserts sleeve 3 Big I it is different.In surgical procedure, Kirschner wire is inserted sleeve 3 by 6 groups of the screw and is sent finding Suitable nailing position, then the optimum position as obtained by observing C arm machine image carry out accurately and efficiently nailing, there is provided multiple spiral shells Nail is oriented to position, improves the success rate of operation.
Further, several guider installing holes 221 are provided with the tong arm 22, the screw inserts guider 1 mounting bracket 12 is vertically fixed on the caliper 2 by the guider installing hole 221.By arranging several guiding Device installing hole 221, the screw is inserted guider 1 and can be adjusted appropriate position by the guider installing hole 221, The mounting bracket 12 carries out being arranged on the tong arm 22 by the guider installing hole 221, is easy to adjusting screw to insert The installation site of guider 1, so as to change the distance of the calcaneum of guide plate 11, the angle of inserting for making screw has adjusted change.
Further, the binding clip 23 is additionally provided with longitudinally convex piece 231, longitudinally convex piece of 231 genesis analysis In the inner side of the binding clip 23, described longitudinally convex piece 231 semicircular in shape structures or three-legged structure.It is convex by arranging the longitudinal direction Bittiness 231 so that the binding clip 23 carries out passivity with heel calcaneum according to clinical needs or sharp property is contacted, described longitudinally convex piece 231 semicircular in shape structures or triangular structure, are fully contacted, while increasing the frictional force of contact surface between the two, are risen To strong fix, sliding position phenomenon is not resulted in, improve guider and be fixedly mounted on human body heel efficiency.
Further, the angular range value that the screw is inserted between sleeve and calcaneum axis is 15 ° -45 °.Due to people Body structure has differences, therefore adopts the angular range value (with the inside within angle of calcaneum axis) for 15 ° -45 °, can meet spiral shell The different angles inserted of nail, if surgical procedure need it is different insert angle, can be by the spiral shell with different inclined angles Nail is inserted sleeve 3 and carries out screw and sends, and the requirement of different client need and operation pretreatment is met, so as to judge to be best suitable for The position of having an injection of subtalar joint screw implantation surgery, carries out high-accuracy, efficient operation.
Further, it is provided with the clamp handle 21 and tightens part 211, the described one end of part 211 that tightens is fixed on described in one The inner side of tong arm 22, the other end is fixed through another tong arm 22 by bolt.By tightening part 211 described in setting, After doctor judges the position of the guider fixed placement, both hands are held with a firm grip the clamp handle 21, are easy to grasp dynamics, control dynamics The binding clip 23 is fixed on heel position, then carries out fastening by bolt, prevent the binding clip 23 in surgery location Shaken, it is to avoid be not easy to the phenomenon of operation technique.
A kind of method for inserting guider using above-mentioned subtalar joint screw, comprises the steps:
Step one:Caliper 2 is fixed on operative site, sleeve is inserted by screw with appropriate angle in sagittal plain and is squeezed into Kirschner wire, about 2-3 roots, then claps X-ray;
Step 2:Observation X-ray, judges that the Kirschner wire position which angle is thrown into is optimal, it is determined that applicable Kirschner wire is simultaneously Insert and marked after sleeve 3;
Step 3:The parallel hollow spiral shell that sleeve 3 inserts two pieces of diameters 6.5 is inserted by screw along the Kirschner wire direction for retaining Nail, then claps X-ray, confirms that operation is completed.
First with the Kirschner wire of diameter 2.0mm, screw described in 6 groups of guider 1 is inserted from the screw insert sleeve 3 and select Take 2-3 suitable angle to squeeze into, then clap X-ray, look at that the Kirschner wire which group is thrown into meets the needs performed the operation, be side position Piece fixes calcaneum and astragalus, and axle position piece Kirschner wire direction meets astragalus axis, determines and insert behind direction after screw sleeve 3, edge gram Family name's pin inserts the hollow screw of diameter 6.5mm, and using applicable screw the parallel nailing again of sleeve 3 is inserted, then claps X-ray, really Recognize calcaneum and astragalus fixes definite, screw orientation is good, and successful surgery terminates.
The present invention inserts guider 1 by being provided with screw on caliper 2, and the guide plate 11 is by the mounting bracket 12 inner sides for being vertically fixed on the tong arm 22, can be fixed, according to human body with osseous part by the binding clip 23 of caliper 2 to calcaneum Position, arranges the guide plate 11 of arc, meets the operation requirement that subtalar joint screw is inserted;Installation is inserted by arranging screw 111 pairs, the hole screw is inserted sleeve 3 and carries out installation fixation, and screw is inserted sleeve 3 and sends implantation surgery position from the screw It is interior, by inserting cylinder on the guide plate 11 of arc, realize multi-angle and insert screw, carry out efficiently so as to find suitable position Rate, the operation of high-accuracy reaches the purpose of successful surgery.
The guider of the present invention can be accurately positioned on smooth bone face, easy to operate, can preferably grasp dynamics, Avoid that angle is improper easily to deviate screw position, technical experience requires relatively low, can accurately fix calcaneum and astragalus, improves hand Art success rate, reduces operation wound, recovers fast, can only appear entry point and realize in the case of going out pin mark minimally invasive, is beneficial to Operative incision heals, and improves fusion rate, reduces the probability of wound infection, while also reducing operative scar, plays work attractive in appearance With.
Above content is only presently preferred embodiments of the present invention, for one of ordinary skill in the art, according to the present invention's Thought, will change in specific embodiments and applications, and this specification content should not be construed as to the present invention Restriction.

Claims (9)

1. a kind of subtalar joint screw inserts guider, it is characterised in that:Guider is inserted including screw, the screw is put Enter guider including guide plate and mounting bracket;
The guide plate is the strip plate in 1/4 circle, and being covered with plate has the screw in two rows distribution to insert installing hole;
The mounting bracket is U-shaped, and two U-shaped ends are articulated with the both sides of the guide plate.
2. subtalar joint screw according to claim 1 inserts guider, it is characterised in that:Also include caliper, institute Caliper is stated including clamp handle, tong arm and binding clip, one end of the tong arm is connected with clamp handle, the other end and the binding clip phase of the tong arm Even, the clamp handle, tong arm and binding clip are all made up of symmetrical two parts, and two-by-two the middle part of the tong arm is connected by hinge post;Institute State screw and insert guider and be vertically fixed on the caliper by the mounting bracket.
3. subtalar joint screw according to claim 1 inserts guider, it is characterised in that:It is additionally provided with screw to put Enter sleeve, the screw is inserted sleeve and inserts installing hole by the screw and is removably mounted on the guide plate.
4. subtalar joint screw according to claim 1 inserts guider, it is characterised in that:The screw inserts peace Dress hole be symmetrically distributed on the guide plate into two rows, often arrange the screw insert installing hole quantity be 6, angle in sagittal plain Degree is at intervals of 15 °.
5. subtalar joint screw according to claim 2 inserts guider, it is characterised in that:Arrange on the tong arm There are several guider installing holes, the screw is inserted the mounting bracket of guider and vertically fixed by the guider installing hole On the caliper.
6. subtalar joint screw according to claim 2 inserts guider, it is characterised in that:The binding clip also sets up There is longitudinally convex piece, the longitudinally convex piece of genesis analysis in the inner side of the binding clip, tie by the longitudinally convex piece of semicircular in shape Structure or three-legged structure.
7. subtalar joint screw according to claim 3 inserts guider, it is characterised in that:The screw inserts set Angular range value between cylinder and calcaneum axis is 15 ° -45 °.
8. subtalar joint screw according to claim 2 inserts guider, it is characterised in that:Arrange in the clamp handle Part is tightened, described to tighten the inner side that tong arm described in is fixed in part one end, the other end passes through bolt through another tong arm It is fixed.
9. a kind of usage right requires the method that the subtalar joint screw described in 1-8 any one inserts guider, and it is special Levy and be:Comprise the steps:
Step one:Caliper is fixed on operative site, sleeve is inserted by screw with appropriate angle in sagittal plain and is squeezed into kirschner Pin, about 2-3 roots, then claps X-ray;
Step 2:Observation X-ray, judges that the Kirschner wire position which angle throws into is optimal, it is determined that applicable Kirschner wire and retain, Remove remaining Kirschner wire;
Step 3:The parallel hollow screw that sleeve inserts two pieces of diameters 6.5 is inserted by screw along the Kirschner wire direction for retaining, so After clap X-ray, confirm that operation is completed.
CN201611143169.8A 2016-12-13 2016-12-13 Subtalar joint fusion screw imbedding guider and using method thereof Active CN106618718B (en)

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Application Number Priority Date Filing Date Title
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CN106618718B CN106618718B (en) 2023-09-26

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Citations (6)

* Cited by examiner, † Cited by third party
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
CN203483500U (en) * 2013-08-29 2014-03-19 顾剑辉 Pincer type krischner needle guiding device
CN204072305U (en) * 2014-09-11 2015-01-07 中国人民解放军南京军区南京总医院 A kind of fracture of medial malleolus replacement and fixation guider
CN205458978U (en) * 2016-03-28 2016-08-17 刘君 Subtalar joint fuses device
CN207041575U (en) * 2016-12-13 2018-02-27 朱永展 A kind of subtalar joint screw inserts guider

Patent Citations (6)

* Cited by examiner, † Cited by third party
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
CN203483500U (en) * 2013-08-29 2014-03-19 顾剑辉 Pincer type krischner needle guiding device
CN204072305U (en) * 2014-09-11 2015-01-07 中国人民解放军南京军区南京总医院 A kind of fracture of medial malleolus replacement and fixation guider
CN205458978U (en) * 2016-03-28 2016-08-17 刘君 Subtalar joint fuses device
CN207041575U (en) * 2016-12-13 2018-02-27 朱永展 A kind of subtalar joint screw inserts guider

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