CN106725850A - A kind of medical aid and preparation method thereof - Google Patents
A kind of medical aid and preparation method thereof Download PDFInfo
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- CN106725850A CN106725850A CN201710068093.5A CN201710068093A CN106725850A CN 106725850 A CN106725850 A CN 106725850A CN 201710068093 A CN201710068093 A CN 201710068093A CN 106725850 A CN106725850 A CN 106725850A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
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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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- Life Sciences & Earth Sciences (AREA)
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- Orthopedic Medicine & Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract
The present invention provides a kind of medical aid.Specifically, the medical aid includes at least one template, and template inner side is provided with the recessed cavity at least partly conformal with least local form of patient, and in the interior outside of one of the template through being provided with least one guide channel.The device be can be used at the joint part of four limbs position, forearm, upper arm, thigh, shank, hand, foot etc. or its neighbouring part medical aid.The invention further relates to the preparation method of the medical aid.The advantage of the invention is that：Ensure that operation is accurate, accurate；Shorten the time in operation；Reduce the radioactive ray exposure in operation；Reduce the bleeding in operation and additional wound；Low cost etc..
Description
Technical field
The present invention relates to a kind of medical aid.In particular it relates to be used for four limbs position, such as forearm, on
The medical aid of at the joint part of arm, hand, lower limb and foot etc. or its neighbouring part.The invention further relates to the doctor
Treat the preparation method of servicing unit.
Background technology
Medical surgery is performed the operation, such as, for controlling for bone in four limbs body and damage, tumour, the retrogression pathological changes of soft tissue etc.
Treatment to be generally required accurately to operate very much and bring patient's improving success rate of operation, shorten operating time and reduce operation wound
Pain.
For example, there is fracture when wrist nut bone, it is necessary in the case where skin is not cut, apply (being such as screwed into) screw pair
The fracture is fixed.However, irregular because nut bone is very small (be similar to outward the peanut of distortion, nut bone waist diameter
Only about 1cm sizes), and position cannot look at straight more deeply；The screw needs to be placed on optimum position by requirement medically again simultaneously
(for example, vertical with fracture line between two parties in nut bone), will also try one's best disposable drivescrew success, therefore practical operation requirement is
It is very high.In fact, to reach accuracy so high, then auxiliary equipment has been necessarily required.At present, in surgical procedure compared with
Conventional is the position using the continuous observation of fluoroscopic machine or adjusting screw, or using the side of real-time Positioning screw of being navigated in three-dimensional art
To.But current these technologies have respective shortcoming.
Specifically, in some cases, screw can be carried out using image documentation equipment guidance to insert.
In surgical procedure, for example, can be performed the operation in the case where x-ray machine or CT power tractions are led.By taking fracture of scaphoid as an example,
First attempt to experience and find suitable position drivescrew guide pin 2mm, the position of guide pin is had an X-rayed with X-ray machine, satisfaction is squeezed into again
2mm, adjusts guide pin (access point, angle, direction, depth etc.) if dissatisfied, so circulates repeatedly, untill satisfied.
It is obvious that above-mentioned surgical procedure has the disadvantage that：Radiation exposure risk, complex operation, it is time-consuming, repeatedly adjustment beat
Enter position and cause Accessory injury, bleeding, infection, increase needle track and operation final position are unsatisfied with.
Further, in some cases, screw implantation can be implemented under three-dimensional navigation.
Under three-dimensional navigation guiding, screw is inserted into ideal position.The preoperative 3D information for first obtaining nut bone, such as CT scan is
It is the most frequently used at present, several or multiple registration points are chosen on CT, tracer is squeezed into the hand or forearm of patient, find preoperative
Registration point is registered.Tracer is connected in operation instrument (such as power drill, guide pin), can on such navigation equipment screen
To see the image of guide pin and the relative position of nut bone, operated according to this image, guide pin is squeezed into preferable position, entered
And it is screwed into screw.
The shortcoming of this technology is as follows：
First, navigation equipment is expensive, generally wants more than million RMB；
2nd, for relatively finer operation, error rate is higher, possibly cannot such as distinguish the error within 1cm；
3rd, the operation in surgical procedure is relatively complicated.
Accordingly, it would be desirable to a kind of medical aid easy to use with aid in complete related surgical during accurate behaviour
Make, and personalized treatment can be realized.
In recent years, 3D printing is progressively being goed deep into and is being launched in applying for medical domain, and the duplication to human body position will
The product that height is customized is obtained, by 3D printing, such product can completely agree with physical shapes, will after being engaged with body
Substantially combine together.
Therefore, personalized treatment is realized in medical domain, prepares personalized therapeutic device and be possibly realized.It is specific and
Speech, according to patient's scan data in itself, is digitized analysis, then is fitted, and forms personalized data, recycles 3D
Printing technique is by designed prosthese or apparatus printing shaping.
The content of the invention
To solve can not to be broken away from drawbacks described above, especially surgical procedure present in prior art to X-ray scanning or
Relevant medical image documentation equipment depend on unduly and using not enough facilitate the problems such as, therefore, research and development one kind can accurately reach target
Point position, shortens operating time, reduces perspective radiation, reduces patients' neural, the medical aid gesture of injury of blood vessel probability and exists
Must go.
Therefore, the present invention provides a kind of medical aid.In particular it relates to be used for joint part or its near
Partial medical aid.The present invention also provides a kind of preparation method of the medical aid.
Medical aid of the invention will realize following purpose：
1. precise manipulation, is accurately positioned；
2. operation technique once succeeds, and reduces bleeding, Accessory injury, multi-pass operation and infection risk；
3. radiation exposure in operation is reduced；
4. reduces cost；
5. guided operation, reduces operating time.
Therefore, there is provided herein a kind of medical aid, it includes at least one template, the template inner side be provided with
At least partly conformal recessed cavity of at least local form of patient, and in the interior outside of one of the template through being provided with least
One guide channel.
In some embodiments, wherein the direction of at least one guide channel is aligned at the palpus operation of the patient
The sufferer area put.In some embodiments, wherein the patient is fracture patient, the direction of at least one guide channel
And the angle between the normal direction in fracture face is 0 ° to the angle less than 90 °.In some embodiments, wherein the female
Cavity is conformal with the local form of corrective surgery position.
In some embodiments, wherein being further provided with attachment structure in the template.Further, implement at some
In mode, wherein the attachment structure (without limitation) is selected from concave-convex fit structure, securing member is connected or additional conjunction.
In some embodiments, wherein the part is the part with bone anatomic landmark, the female cavity is extremely
It is few conformal with the local form with bone anatomic landmark.In some embodiments, the bone anatomic landmark is selected from
Thumb metacarpophalangeal joints, first carpo-metacarpal Joints, the 5th metacarpophalangeal joints, processus styloideus ulnae, processus styloideus radii, olecroanon, condylus medialis humeri,
Internal malleolus, external malleolus, calcaneum, head of fibula, kneecap and femoral greater trochanter.
In some embodiments, wherein the part with bone anatomic landmark includes articular portion and its neighbouring portion
Point.In some embodiments, wherein the articular portion is not limited to selected from wrist joint, knee joint, ankle-joint, elbow joint, refers to
Joint, shoulder joint or hip joint.Further, in some embodiments, wherein the articular portion is selected from wrist joint, ankle pass
Section, elbow joint or articulations digitorum manus.Further, wherein the articular portion is wrist joint.In some embodiments, the pass
Nearby part is shoulder girdle, thorax portion, pelvis, perineum and lower abdomen to section.
In some embodiments, wherein the template is at least 2.Further, wherein the template is at least 3
It is individual.
In some embodiments, wherein the medical aid is formed through 3D printing.In some embodiments, its
Described in medical aid material be medical resin material.In some embodiments, wherein the guide channel is handled
Art analogue data and build.
There is provided herein a kind of method for preparing medical aid, it includes：
I) patient is scanned, the scope of scanning includes whole affected areas, obtains scan data；
Ii) scan data is loaded into image processing software, and carries out three-dimensional reconstruction, so as to according to the result of three-dimensional reconstruction come
Screen and formulate processing scheme, and by the further clearly described processing scheme of surgical simulation；
Iii) according to the requirement of the processing scheme, the corresponding model of medical aid is designed；And
Iv) the modelling according to the medical aid goes out the medical aid.
In some embodiments, wherein the scanning is CT scan, MRI scan or similar scan mode.In some realities
Apply in mode, wherein the scanning is CT scan, the requirement of the CT scan is that thickness is less than 1 millimeter.In some implementation methods
In, wherein the CT scan data is DICOM view data.In some embodiments, wherein the image processing software bag
Include VxWork softwares.In some embodiments, wherein, the medical aid is verified, it is complete to confirm the device
Meet the positioning requirements of processing scheme.In some embodiments, wherein the medical aid is through 3D printer printing
Into.
It is obvious that medical aid of the invention possesses strong fix and feature of both accurate guiding, so that pole
The earth improves success rate of operation.Therefore, the advantage of the invention is that：Operating theater instruments can reach optimal position；Ensure operation
It is stable, accurate, accurate.Further, the present invention can also shorten the time in operation, reduce the radioactive ray exposure in operation,
The bleeding in operation and extra wound are reduced, and cost is relatively low.
According to following description, other aspects and advantage of present disclosure are to those skilled in the art
Will become obvious, illustrative embodiments of the invention only have shown and described herein.It should be appreciated that the present invention can have
There are other different implementation methods, and its some details can be modified at various obvious aspects, it is all these to repair
Change without departure from the present invention.Therefore, accompanying drawing and description will be considered as illustrative, and not restrictive in itself.
Brief description of the drawings
Novel feature of the invention is specifically illustrated in appended claims.By reference to the example using the principle of the invention
Property the features as discussed above that is illustrated of implementation method, it will obtain the more preferable reason to the features and advantages of the present invention
Solution；In the accompanying drawings：
Fig. 1 show the schematic diagram being modeled to the wrist joint that must be performed the operation of patient.
Fig. 2 show a schematic perspective view for foundation forms in a kind of medical aid of the invention.
Fig. 3 show the schematic perspective view of another foundation forms in a kind of medical aid of the invention.
Fig. 4 A show the schematic perspective view after two foundation forms combination of the invention.
Fig. 4 B show the schematic perspective view after two foundation forms combination of the invention.
Fig. 4 C show the schematic perspective view before two foundation forms combination of the invention.
Fig. 4 D show the schematic perspective view before two foundation forms combination of the invention.
Fig. 5 A show the schematic perspective view of the guiding die plate in a kind of medical aid of the invention.
Fig. 5 B show the schematic perspective view of the guiding die plate in a kind of medical aid of the invention.
Fig. 6 show the schematic perspective view after a kind of medical aid combination of the invention.
Fig. 7 show the schematic perspective view after a kind of medical aid combination of the invention.
Fig. 8 A show the scanning perspective view of patient's nut bone.
Fig. 8 B show the close up perspective view of patient's nut bone.
Specific embodiment
Although each implementation method of the invention has been illustrated and described herein, it is aobvious for those skilled in the art and
It is clear to, such implementation method is simply provided by way of example.Those skilled in the art can be without departing from of the invention
In the case of expect various changes, change, replacement and any combination.It should be appreciated that can use to invention as described herein
The various replacements of implementation method.
The medical aid of this paper can include a template.Preferably, the medical aid may include but not limit
In two templates.Further, the medical aid may include but be not limited to three templates.Herein, term " template "
Refer to one of component or component in medical aid as herein described.In general, the template palpus in medical aid
The sufficiently large sufferer area to be performed the operation to cover patient.
Provided herein is a kind of implementation method in, the medical aid include two templates, described two template groups
A middle cavity is formed after conjunction, the middle cavity can accommodate patient's patient part, such as wrist joint, and by complete screens consolidate
It is fixed, so that being accurately positioned needed for providing operation.
Alternatively, can provide herein with one or three medical aid of template.Further, may be used also herein
To provide the medical aid with more templates.Substantially be could be aware that as those skilled in the art, as long as the medical treatment
Servicing unit can fix disease affected part, you can meet the basic fixed position requirement of operation.
Specifically, template is inner side towards the side at corrective surgery position, and remaining side is outside.Die shape profile is not
It is limited, meets operation needs.
The template inner side is provided with the recessed cavity at least partly conformal with the local form of corrective surgery position, and this is recessed
Cavity is alternatively referred to as at " junction surface ".
Herein, the implication of term " conformal " refers to that recessed cavity (also referred to as junction surface) on the inside of template must be controlled with patient
The appearance profile of the body part at the sufferer for the treatment of is substantially completely or height is consistent, and is brought into close contact.Once by template apply to
The body part, then template by it is substantially stationary live, nearly or completely there is no relative displacement.In actual applications, such as should
For wrist joint operation, then can be enclosed in the wrist joint in recessed cavity and be fixed by the template, form a tight fit
Sleeve, so as to realize the carpal good location, alternatively referred to as " stuck " state.
The part includes the various special structure at human synovial position, particularly with the body of bone anatomic landmark
Part.Specifically, the body part with bone anatomic landmark includes articular portion and its neighbouring part.Preferably, institute
State articular portion and be selected from wrist joint, knee joint, ankle-joint, elbow joint, articulations digitorum manus, shoulder joint or hip joint.Further, it is preferable to
The articular portion is selected from wrist joint, ankle-joint or elbow joint.Further, preferably described articular portion is wrist joint.
Skilled person will appreciate that, soft tissue covering in human synovial position is relatively fewer.Therefore, the junction surface is at least
It is conformal with the body part with bone anatomic landmark in order to solidly joined, be to be accurately positioned offer in surgical procedure
Good basis.Most preferably, the junction surface is completely conformal with the part, so that ensure medical aid and patient should
Local fully laminating, thus the Part portions of patient will be completely fixed by medical aid.
By taking wrist joint as an example, pendulum is needed when can in the preoperative make to be allowed during imageological examination the wrist of patient to be performed the operation after being located at
The position put.After imaging data is obtained, the form 3D printing according to wrist joint surrounding skin soft tissue goes out medical treatment auxiliary dress
Put, medical aid and the carpal skin of patient of this 3D printing can completely agree with, particularly thering is bone to dissect
The position of mark.After the medical aid of this kind of bone anatomic landmark 3D printing is fixed, then whole wrist joint just will be by
It is fixed, almost complete inertia, or referred to as " stuck " state.Can so realize that device is installed to be given tacit consent at rear sufferer
Positioning, exempts the complexity and position error of device positioning.Simultaneously, it is to avoid due to incorrect displacement at sufferer in surgical procedure
Caused operation is repositioned, operating time the extension even risk of operative failure.
Alternatively, the present invention can provide a kind of medical aid, wherein junction surface and local at least partly conformal, example
Such as, the junction surface is mainly completely conformal with the bone anatomic landmark part, and remainder is then not up to completely conformal.As ability
Field technique personnel it is recognised that due to bone anatomic landmark be different from soft tissue, will not produce substantially displacement or slide, because
This, as long as the junction surface is completely conformal with the bone anatomic landmark part just can be essentially ensures that medical aid
The Part portions are fixed, so as to realize being accurately positioned required by operation.
Specifically, adoptable bone anatomic landmark of the invention is main following (including but not limited to)：Arm bone solution
Cut open mark：Such as thumb metacarpophalangeal joints, first carpo-metacarpal Joints, the 5th metacarpophalangeal joints, processus styloideus ulnae, processus styloideus radii, olecroanon,
Condylus medialis humeri；Leg bone anatomic landmark：Such as internal malleolus, external malleolus, calcaneum, head of fibula, kneecap, femoral greater trochanter.It is obvious that
As those skilled in the art it is recognised that adoptable bone anatomic landmark of the invention be not limited to it is above-mentioned enumerate, as long as can be with
The bone anatomic landmark of medical aid positioning of the invention is helped to be included within the scope of the present invention.
In fact, the present invention is for portions such as juxtra-articular part shoulder girdle, thorax portion, pelvis, perineum and lower abdomens
Position also can reach preferable effect.Because the present invention can use bone anatomic landmark auxiliary positioning, for foregoing therapeutic effect
Then more preferably.Certainly, those skilled in the art understand that range of application of the invention is clearly not limited to each portion of aforementioned list
Position.
Further, attachment structure can be provided with the template.The attachment structure includes but is not limited to male-female engagement knot
Structure, securing member is connected or additional conjunction etc., its main purpose are, in order to play position-limiting action, thus can stably to keep described
There is no relative displacement between template or between template and body.Specifically, in some embodiments, the concave-convex fit structure
Can be the template corresponding projection or shrinkage pool that are provided with.The projection or shrinkage pool section can be but be not limited to circular, oval, triangle
Shape, rectangle, pentagon, hexagon or polygon etc.；The outer surface or inner surface of the projection or shrinkage pool can such as justify for cylinder
Cylinder or prismatic surface etc., or be conical surface circular conical surface or pyramidal surface etc..The securing member is connected may include but be not limited to buckle knot
Structure, hasp structure or magnetic structure etc..The additional conjunction may include but be not limited to screw, bolt, pin, restraining or adhesive
Deng.By the attachment structure, medical aid of the invention will more firmly engage the body part of patient, further really
Protect precise positioning.In addition, skilled person will appreciate that, any of the above attachment structure can be used alone or in combination completely to reach
To the purpose of the present invention.
In order to smoothly realize surgical procedure, the interior outside that the template is additionally included in the template leads to through the guiding being provided with
Road.The guide channel is also referred to as " operation path ".The operation path can be but be not limited to one, two, three or more,
Depending on specific situation.
Preferably, at the direction alignment sufferer of the operation path.Especially, for fracture patient, the side of the operation path
It it is 0 ° to the angle less than 90 ° to the angle between the normal direction in fracture face, specific angle can be according to actual operation needs
Selected.In some cases it may be preferred to the angle is 0 °, i.e., the direction of the operation path is vertical with fracture face holding, so that
Obtain and more preferably dispose effect.
Preferably, the operation path is to template extension protruding outside.The operation path protrudes the height for extending can basis
It is main purpose in order to smoothly import operation screw depending on operation actual requirement.
The operation path to set up process as follows.By surgical simulation function, the preoperative accurate surgery planning of completion, and build
Vertical surgical pathway.Surgical pathway is built directly in operation path is formed above medical aid.
It is obvious that medical aid of the invention possesses strong fix and feature of both accurate guiding, so that pole
The earth improves success rate of operation, while shortening operating time, reduces the surgical injury of patient.
Further, in some embodiments, critical anatomical structures can be projected to above medical aid, for hand
Referred in art doctor's art.Which kind of above projection anatomical structure to medical aid, needed voluntarily according to operation by doctor
Selection.The critical anatomical structures can be blood vessel, bone or other focuses.Further, in some embodiments, should
Critical anatomical structures can be the focus that cannot be observed under direct vision, such as Partial tumors and other lesions.Can be by other shadows
It is marked on computer picture as learning to do section, and is projected to above medical aid, using preoperative ready-made operation
Planning, it is quick by medical aid and be accurately performed operative treatment.
In general, the confirmation of the positioning and Position location accuracy that need to carry out medical aid during specific implementation.In doctor
When raw application technological means carries out related surgical, will typically verify that medical aid and surgical pathway are set up accurate
Property.Such as, preoperative routine inspection confirms that its major part is verified by X-ray photographic or fluoroscopy techniques.
In some embodiments, operation consent is being carried out, is being needed to disappear medical aid accordingly according to operation
Poison treatment.
Embodiment
The preparation method of the medical aid of the present invention of embodiment 1.
The medical aid can be prepared by the following method.Comprise the following steps that：
1., for patient does CT scan, the requirement of CT scan is that thickness is less than 1 millimeter, and sweep limits must cover whole diseases
Suffer from region.After CT scan terminates, CT scan is obtained
DICOM view data.Grade III Class A hospital of the country can all realize CT scan at present, or meet wanting for CT scan
Ask.
2. CT scan data is loaded into VxWork softwares, carries out three-dimensional reconstruction；Auxiliary doctor carries out therapeutic scheme
Screening and formulation；And by the further clear and definite therapeutic scheme of surgical simulation.
3. according to the requirement of therapeutic scheme, medical aid is designed, and the device is verified, with the clearly dress
It is accurate to put to the positioning of therapeutic scheme.The lower section of skin and soft tissue, surgical operation are generally all located at due to operative site
Substantially skin and soft tissue are carried out otch to expose surgical field of view, be easy to doctor to observe and be operated.This
The medical aid of invention is located at body surface, and gives operation of the doctor to invisible position and guide, and auxiliary doctor is carried out
Operation positioning.
4. the medical aid will be customized according to the specific state of an illness of specific patient.The mode of customization must be according to doctor
Operation plan carry out.Therefore, the medical aid is directed to clear and definite patient and is only served in the bright of designated doctor
True therapeutic scheme.The medical aid has relative to the uniqueness of patient and ageing.
5., by the mode input 3D printer of medical aid, actual medical aid is produced.Due to medical treatment
The uniqueness of servicing unit and ageing, so needing using preparation means such as 3D printers come fast custom medical treatment auxiliary dress
Put, to reduce the operation stand-by period of patient.
It is obvious that be enumerated above medical aid formed through 3D printing, but the present invention is not limited to use 3D printing
To prepare the medical aid.
The material of the medical aid can be medical resin material.Medical resin material described herein can be current medical science
Upper available resin material.
Embodiment 2. is used for the foundation forms of medical aid of the present invention
Method according to embodiment 1 designs and produces foundation forms of the invention, in the present embodiment, using bimodulus
Hardened structure, specifically refers to Fig. 1, Fig. 2, Fig. 3, Fig. 4 A, Fig. 4 B, Fig. 4 C and Fig. 4 D.
As Figure 1-Figure 2, according to corrective surgery position wrist joint and its profile of neighbouring part 3 carries out model structure
Build, form template 11 and the (not shown) of template 21.Template 11 is provided with two lug bosses 111 and 112, and in the direction of template 11
The carpal side of patient is provided with recessed cavity 113.As shown in figure 1, the recessed cavity can be with patient's wrist joint and its neighbouring portion
Divide 3 parts for being enclosed completely conformal.
Fig. 3 then shows the concrete shape of template 21.Template 21 is provided with (not to be shown with two above-mentioned lug bosses 111 and 112
Go out) corresponding two recess 211 and 212, and it is provided with recessed cavity towards the carpal side of patient in template 21
213.The recessed cavity 213 can be completely conformal with the part that patient's wrist joint and its neighbouring part 3 are enclosed.
From Fig. 4 A, Fig. 4 B, Fig. 4 C and Fig. 4 D as can be seen that two templates 11 and 21 by with two lug bosses 111 and
112 corresponding two recess 211 and 212 are worked in coordination, and can be firmly engaged to form a similar sleeve together
The structure of shape.In the structure shown here, one is formed after recessed cavity 113 and recessed cavity 213 are engaged and encloses cavity (i.e. Fig. 4 A and figure
Central cavity in 4B), this encloses cavity and patient's wrist joint and its nearby part is completely conformal, so as to can securely fix
Patient's wrist joint and its neighbouring part.
Embodiment 3 is used for one of guiding die plate of medical aid of the present invention
Method according to embodiment 1 designs and produces guiding die plate of the invention, in the present embodiment, using bimodulus
Hardened structure, specifically refers to Fig. 5 A, Fig. 5 B, Fig. 6 and Fig. 7.
Fig. 5 A and Fig. 5 B show the concrete shape of guiding die plate 22.Guiding die plate 22 is provided with two lug bosses (not
Show) corresponding two recess 221 and 222, and it is provided with recessed cavity towards the carpal side of patient in template 22
223.The recessed cavity 223 can be completely conformal with the part that patient's wrist joint and its neighbouring part (not shown) are enclosed.Additionally,
Also extended through on the guiding die plate 22 and be provided with guide channel 224 (alternatively referred to as " operation path "), the guide channel 224 is towards mould
The outside of plate 22 can protrude extension certain altitude and be required with meeting operation.
As shown in Figure 6 and Figure 7, similarly, guiding die plate 22 can with template 12 by with two lug boss (not shown) phases
Corresponding two recess (not shown) are worked in coordination, and can be firmly engaged to form a knot for similar sleeve-shaped together
Structure.In the structure shown here, form one after two recessed cavity engagements and enclose cavity (central cavity i.e. in Fig. 6 and Fig. 7), this encloses
Cavity is closed complete with patient's wrist joint and its nearby part conformal, so as to patient's wrist joint and its neighbouring portion can be securely fixed
Point.
Embodiment 4 is used for the two of the guiding die plate of medical aid of the present invention
Method according to embodiment 1 designs and produces guiding die plate of the invention, in the present embodiment, using three moulds
Hardened structure.
Specifically, the guiding die plate 22 shown by Fig. 5 A and Fig. 5 B can be designed as the direction along recessed cavity 223
(i.e. orientation arm) is substantially divided into two template parts of separation.To be respectively equipped with two template parts of guiding die plate 22
Two recess 221 and 222 corresponding with two lug boss (not shown).That is, each there is one in each template part
Recess.The recessed cavity 223 can be completely conformal with the part that patient's wrist joint and its neighbouring part (not shown) are enclosed.
Also extended through in one of two template parts of the guiding die plate 22 and be provided with guide channel 224 (alternatively referred to as " operation path "), should
Guide channel 224 can protrude extension certain altitude and be required with meeting operation towards the outside of template 22.
Similarly, the guiding die plate 22 being made up of two template parts can be with template 12 by corresponding with two lug bosses
Two recess work in coordination, and can be firmly engaged to form a structure for similar sleeve-shaped together.In the structure
In, forming one after two recessed cavity engagements and enclose cavity (i.e. similar to the central cavity in Fig. 6 and Fig. 7), this encloses sky
With patient's wrist joint and its nearby, part is completely conformal in chamber, so as to patient's wrist joint and its neighbouring part can be securely fixed.
Embodiment 5 is used for the three of the guiding die plate of medical aid of the present invention
Method according to embodiment 1 designs guiding die plate of the invention, in the present embodiment, will be using single mode plate
Structure.Specifically, single formwork structure can be substantially similar with the structure in Fig. 5 A, Fig. 5 B, but template thickness will be significantly greater than
Foregoing template, at least above patient's wrist size.
Fig. 5 A and Fig. 5 B show the concrete shape of guiding die plate 22.The guiding die plate 22 is provided with and two lug bosses
Corresponding two recess 221 and 222 of (not shown), and it is provided with recessed sky towards the carpal side of patient in template 22
Chamber 223.The part that the recessed cavity 223 can be enclosed with patient's wrist joint and its neighbouring part (not shown) is substantially completely common
Shape.Also extended through on the guiding die plate 22 and be provided with guide channel 224 (alternatively referred to as " operation path "), the court of guide channel 224
Prominent can extend certain altitude to the outside of template 22 to be required to meet operation.
In the present embodiment, can be by the guiding die plate of single formwork structure and a surgical platform for being provided with lug boss
Or the like coordinate.Specifically, guiding die plate 22 can be with the operating platform by corresponding with two lug boss (not shown)
Two recess (not shown) are worked in coordination, and can be firmly engaged to form a structure for similar sleeve-shaped together.
In the structure, the recessed cavity forms one and encloses cavity after being engaged with the operating platform, because this encloses cavity and the patient
Wrist joint and its neighbouring part (in addition to the part being in contact with surgical platform) are substantially completely conformal and its is complete
It is complete to surround, therefore patient's wrist joint and its neighbouring part can be securely fixed.
Embodiment 6. carries out the preparation of related medical servicing unit and uses for fracture of scaphoid patient
1. it is preoperative that CT or other types of imageological examinations are carried out to operating position, image data on flows is directed into operation
Plan and simulation system software VxWork 4.0 (Beijing Zhuo lattice Products, FDA identification sequences number：510K), using the software
Receive such as CT scan and obtain DICOM data, by retraction (Erode) function (making object uniformly reduce) in VxWork softwares
Set up " central area " of nut bone.It is for the definition of central area herein, by nut bone resurfacing as inwardly uniformly indentation is obtained
3-D view.When the axis of nut bone screw is completely in this image, the position of the screw is just bound to three in nut bone
In/mono-.Comprise the following steps that：
(threshold value is rebuild under volume reconstruction (Volume Rendering, abridge VR) pattern：116), nut bone is closed from wrist
Intactly separated in section, carry out resurfacing (Surface rendering) and (rebuild threshold value：116).
Erode functions in application software are inwardly retracted (Fig. 8 A) to nut bone resurfacing image, until waist is proper
It is good to disappear, record be now retracted apart from L (Fig. 8 A)；
Again the distance of 2/3L is retracted to nut bone resurfacing image, in nut bone waist 1/3rd region is obtained；
/ 3rd regions in nut bone waist are inwardly indented with the distance (Herbert nail (manufacturers of 1.5mm again：
Zimmer radius)) obtain the central area (Fig. 8 B) of nut bone.
Straight line is introduced in image program as the axis of nut bone screw, observes whether the straight line can be put completely
Put in central area without deflecting away from.As long as this screw axis does not deflect away from central area, the screw is just in nut bone 1/3rd
Region, that is, be considered as placed in the middle.The shape of central area is observed, and using the measurement function of software, it is remote in nut bone to central area
The position (back side and side are observed) most wide of pole, waist and proximal pole carries out size and measures and note down numerical value for such as W1, W2, W3
And H1, H2, H3 etc., as the substantially understanding of the size to central area.
1.0 Kirschner wire images are imported from resurfacing image library, Kirschner wire is placed into boat by the position according to fracture line
It is in the corresponding central area of bone photo and as far as possible vertical with fracture line.Along the position of this Kirschner wire as screw guide pin such as in art
Position, then just think it is placed in the middle and substantially vertical with fracture face in nut bone in the position of screw.At the same time, Kirschner wire is measured
Length in nut bone as screw needed for operation length.After determining position of the guide pin in nut bone, resurfacing is adjusted
Threshold value reconstructs the image of the guiding die plate and sleeve being brought into close contact with skin to show skin soft tissue.
2. guiding die plate is printed using 3D printer.In order to test the accuracy of guiding die plate, can before surgery by mould
Plate is worn to patient's wrist joint, can cross imageological examination (X-ray or CT) and confirm that the orientation indicated by guiding die plate is operation doctor
The raw position for needing.
3. template is sterilized, patient's wrist joint is worn in the middle of operation, squeeze into hollow nail from the guide channel of 3D printing.
Can again be added their confirmation by film making in art.
Embodiment 7. carries out the preparation of related medical servicing unit and uses for forearm soft tissue tumors patient
The present embodiment is related to carry out the puncture sampling of forearm soft tissue neoplasm using corresponding medical aid, specifically such as
Under.
Preoperative MRI scan tumor locus；Tumour concrete position is positioned by MRI data in VxWork softwares, is chosen
Puncture target area；According to target area, suitable puncture channel is chosen with reference to superficial tissues situation；Set up skin surface positioning mould
Plate and puncture channel；3D printing template and passage；Preoperative iconography verifies the accuracy of passage；Template is sterilized, and is laid in art, is worn
Thorn operation.
Embodiment in specification provides the explanation to specific embodiment of the invention, and is not necessarily to be construed as
Limitation the scope of the present invention.It will be readily appreciated by those skilled in the art that the present invention covers many other embodiments.This area skill
Art personnel will recognize that or just be can determine using only normal experiment many of invention as described herein specific embodiment
Equivalent technical solutions.It is intended to cover such equivalent technical solutions by claim.
It should be understood that it is only to be given by way of illustration to specifically describe with specific embodiment, so thus specifically retouching
The various changes and modifications stated within the spirit and scope of the present invention will be apparent to those skilled in the art.This
Art personnel will also appreciate that some features of the invention, although for the sake of clarity herein with each single implementation
The form of scheme is described by, but they also can in a joint manner be provided in single embodiment.In contrast, the present invention
The various features described with single embodiment in order to succinct can also be provided separately or in any appropriate sub-portfolio form
There is provided.
Claims (26)
1. a kind of medical aid, it includes at least one template, and the template inner side is provided with least local outer with patient
Shape at least partly conformal recessed cavity, and in the interior outside of one of the template through being provided with least one guide channel.
2. medical aid as claimed in claim 1, wherein the direction of at least one guide channel is directed at the trouble
The sufferer area of the disposal that must perform the operation of person.
3. the medical aid as any one of claim 1-2, wherein at least one guide channel is from described
Template outer surface outwardly extends.
4. medical aid as claimed in claim 3, wherein the patient is fracture patient, described at least one be oriented to it is logical
Angle between the direction in road and the normal direction in fracture face is 0 ° to the angle less than 90 °.
5. the medical aid as any one of claim 1-2, wherein the female cavity and corrective surgery position
Local form it is conformal.
6. medical aid as claimed in claim 5, wherein the part is the part with bone anatomic landmark, it is described
Recessed cavity is at least conformal with the local profile with bone anatomic landmark.
7. medical aid as claimed in claim 6, wherein the bone anatomic landmark is selected from thumb metacarpophalangeal joints, first
Articulatio carpometacarpicus communis, the 5th metacarpophalangeal joints, processus styloideus ulnae, processus styloideus radii, olecroanon, condylus medialis humeri, internal malleolus, external malleolus, calcaneum, calf
Bone, kneecap and femoral greater trochanter.
8. medical aid as claimed in claim 6, wherein the part with bone anatomic landmark includes joint portion
Divide and its neighbouring part.
9. medical aid as claimed in claim 8, wherein the articular portion be selected from wrist joint, knee joint, ankle-joint,
Elbow joint, articulations digitorum manus, shoulder joint or hip joint.
10. medical aid as claimed in claim 9, wherein the articular portion is selected from wrist joint, ankle-joint, elbow joint
Or articulations digitorum manus.
11. medical aids as claimed in claim 10, wherein the articular portion is wrist joint.
12. medical aids as claimed in claim 8, wherein the juxtra-articular part is shoulder girdle, thorax portion, bone
Basin, perineum and lower abdomen.
13. medical aid as any one of claim 1-2, wherein the template is at least 2.
14. medical aids as claimed in claim 13, wherein the template is at least 3.
15. medical aids as claimed in claim 13, wherein being further provided with attachment structure in the template.
16. medical aids as claimed in claim 15, wherein the attachment structure is selected from concave-convex fit structure, connection tightly
Firmware or additional conjunction.
17. medical aid as any one of claim 1-2, wherein the medical aid is through 3D printing
Into.
18. medical aid as any one of claim 1-2, wherein the material of the medical aid is doctor
Use resin material.
19. medical aid as any one of claim 1-2, wherein the guide channel is according to surgical simulation number
According to built-up.
A kind of 20. methods for preparing any described medical aid in preceding claims, it includes：
I) patient is scanned, obtains scan data, the scope of the scanning includes whole affected areas；
Ii) scan data is loaded into image processing software, and carries out three-dimensional reconstruction, so as to according to the result of three-dimensional reconstruction come
Screen and formulate processing scheme, and by the further clearly described processing scheme of surgical simulation；
Iii) according to the requirement of the processing scheme, the corresponding model of the medical aid is designed；And
Iv) the modelling according to the medical aid goes out the medical aid.
21. methods as claimed in claim 20, wherein the scanning is CT scan, MRI scan or similar scan mode.
22. method as described in claim 20 or 21, wherein the scanning is CT scan, the requirement of the CT scan is thickness
Less than 1 millimeter.
23. methods as claimed in claim 22, wherein the CT scan data is DICOM view data.
24. method as described in claim 20 or 21, wherein the image processing software includes VxWork softwares.
25. method as described in claim 20 or 21, wherein the medical aid is verified, to confirm the doctor
Treat the positioning requirements that servicing unit complies fully with the processing scheme.
26. method as described in claim 20 or 21, wherein the medical aid is formed through 3D printer printing.
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| CN201710068093.5A CN106725850A (en) | 2017-02-06 | 2017-02-06 | A kind of medical aid and preparation method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710068093.5A CN106725850A (en) | 2017-02-06 | 2017-02-06 | A kind of medical aid and preparation method thereof |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108309429A (en) * | 2018-02-06 | 2018-07-24 | 中国人民解放军陆军军医大学第附属医院 | A kind of individuation fusion of subtalar joint guide plate and its manufacturing method |
| CN108354663A (en) * | 2018-04-16 | 2018-08-03 | 中国人民解放军陆军军医大学第附属医院 | A kind of individuation ankle fusion guide plate and preparation method thereof |
| CN108720923A (en) * | 2018-04-02 | 2018-11-02 | 王成功 | Householder method is fixed in fracture of calcaneus closed reduction based on digitlization 3D printing tool |
| CN109978831A (en) * | 2019-02-28 | 2019-07-05 | 成都真实维度科技有限公司 | A kind of acquisition methods of the normal reference value of the non-sclerotin modeling subregion volume ratio in joint |
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| CN105963009A (en) * | 2016-06-07 | 2016-09-28 | 复旦大学附属华山医院 | Operation guide plate and method for wrist fracture percutaneous fixation |
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| WO2007046938A2 (en) * | 2005-10-19 | 2007-04-26 | Percutaneous Scaphoid, Llc | Percutaneous scaphoid fixation method and device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108309429A (en) * | 2018-02-06 | 2018-07-24 | 中国人民解放军陆军军医大学第附属医院 | A kind of individuation fusion of subtalar joint guide plate and its manufacturing method |
| 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 |
| CN108720923A (en) * | 2018-04-02 | 2018-11-02 | 王成功 | Householder method is fixed in fracture of calcaneus closed reduction based on digitlization 3D printing tool |
| CN108720923B (en) * | 2018-04-02 | 2019-10-08 | 王成功 | Householder method is fixed in fracture of calcaneus closed reduction based on digitlization 3D printing tool |
| CN108354663A (en) * | 2018-04-16 | 2018-08-03 | 中国人民解放军陆军军医大学第附属医院 | A kind of individuation ankle fusion guide plate and preparation method thereof |
| CN108354663B (en) * | 2018-04-16 | 2019-09-03 | 中国人民解放军陆军军医大学第一附属医院 | A kind of individuation ankle fusion guide plate and preparation method thereof |
| CN109978831A (en) * | 2019-02-28 | 2019-07-05 | 成都真实维度科技有限公司 | A kind of acquisition methods of the normal reference value of the non-sclerotin modeling subregion volume ratio in joint |
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Application publication date: 20170531 |