CN107049418B - A kind of High Tibial Osteotomy guider - Google Patents
A kind of High Tibial Osteotomy guider Download PDFInfo
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- CN107049418B CN107049418B CN201710312272.9A CN201710312272A CN107049418B CN 107049418 B CN107049418 B CN 107049418B CN 201710312272 A CN201710312272 A CN 201710312272A CN 107049418 B CN107049418 B CN 107049418B
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- guide plate
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- crossbeam
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
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- Orthopedic Medicine & Surgery (AREA)
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Abstract
A kind of High Tibial Osteotomy guider, belongs to orthopedic medical device technical field, carries out fluting for High Tibial Osteotomy and places gasket.Its technical solution is: crossbeam connects two horizontal location conduits perpendicular to crossbeam, the outer diameter of the internal diameter and Kirschner wire that position conduit matches, two parallel guide rail upper ends are vertical with the both ends of crossbeam respectively to be fixedly connected, the lower end of two guide rails is connected by pull rod, the two sides of guide plate are slidably matched with two guide rails respectively, there is horizontal pilot hole on guide plate, pilot hole is rectangle long hole, upper top surface and bottom surface of the pilot hole in guide plate are the clinoplain being parallel to each other, plate face inclined upward of the clinoplain to the side of positioning conduit, the height of pilot hole and the outer diameter of drill bit match, there are locking screw holes in the side of guide rail.Pilot hole of the invention can be oriented to and be constrained to drill bit, made drilling quickly, conveniently, accurately, greatly improved the efficiency, alleviate the operating difficulty of doctor, reduce operating time.
Description
Technical field
The present invention relates to a kind of guiders that the High Tibial Osteotomy for treating knee joint osseous arthritis uses, and belong to bone
Section's the field of medical instrument technology.
Background technique
Knee joint osseous arthritis is that a kind of knee joint differential settlement as caused by osteoporosis is the normal of pathogenesis basis
The degenerative diseases of aged seen, main clinical manifestation include arthralgia, deformity, stiff, dysfunction etc..According to knee joint bone
Property the position involved of arthritis and range, inside compartment type, outside compartment type, kneecap stock type and total joint type can be divided into, wherein
Inside compartment type accounts for the 74% of Primary Osteoarthritis.Inside compartment type knee osteoarthritis patients are often accompanied by lower limb power
Line change, Varus deformity, seriously affect quality of life.
Clinically used method is using study of high tibial osteotomy knee joint osseous arthritis, and mechanism is mainly logical
It crosses high-order wedge shape amputation shin bone and reduces the load of inside compartment to correct the lower limb line of force, alleviate Osteoarthritis to reach
Effect.The method of current clinically common High Tibial Osteotomy is that proximal tibia is amputated a triangle bone block, then to connect
Bone plate is fixed.The shortcomings that the method is that damage is big, and bleeding is more, and shin bone is broken completely, is unable to early loading, and osteotomy plate is costly,
The complication such as nonunion are more at generation neurotrosis, osteotomy, cannot usually reach satisfied surgical effect.
With the deep development of orthopaedics therapy technology, research thinks that outside differential settlement is to cause inside in tibial plateau
It is moved in the secondary knee joint line of force of compartment gap turn narrow, the deciding factor of descending genicular vessel.At present according to " knee joint unevenly sinks
Drop " is theoretical, and compartment type knee joint osseous arthritis on the inside of clinical application fibula Osteotomy for Treatment achieves good effect.But
The excessive patient of varus angle though can relieve pain after application fibula osteotomy, and cannot correct Varus deformity, this feelings
Condition is not efficiently solved so far, and document both domestic and external also without relevant targeted report, becomes clinical treatment
Middle urgent problem to be solved.
At the same time, the advanced stage of knee joint osseous arthritis often shows as tibial medial or outside platform collapses how
To this while compartment type knee joint osseous arthritis on the inside of application fibula proximal end osteotomy joint study of high tibial osteotomy
The tibial plateau compression fracture of some patientss or collapse be supported reset also it is not yet reported that, this is also not had so far
Imitate solve clinical treatment there are the problem of.
To solve the above-mentioned problems, newest research achievement is combined in High Tibial Osteotomy in fibula proximal end osteotomy,
Be implanted into gasket in proximal tibia, can effectively correct the knee joint line of force in this way, at the same can to tibial plateau compression fracture or
It collapses and is supported reset, realize the complete treatment of the knee osteoarthritis patients excessive to varus angle.It is padded in implantation
When piece, needing to be embedded in gasket after tibial medial is slotted, grooving process first has to drill on shin bone along horizontal plane,
Then drilling is connected to as elongated slot, then gasket is embedded into elongated slot.However, during surgery drilling be connected to elongated slot often and can send out
Raw bore angle inaccuracy or inconsistent phenomenon also have multiple uneven phenomenons that are arranged above and below that drill, it is last to affect elongated slot
Shape, be unfavorable for place gasket operation.It is not constrained in drilling simultaneously, needs very carefully to carry out drilling operation,
Time length, low efficiency.These situations all affect the implementation of operation, it would be highly desirable to solve.
Summary of the invention
Technical problem to be solved by the invention is to provide a kind of High Tibial Osteotomy guider, this guider is applied
Fibula proximal end osteotomy is combined in High Tibial Osteotomy, can quickly, specification be drilled in proximal tibia, be made bore angle one
Cause, marshalling, will drilling it is convenient, fast when being connected to as elongated slot, procedure efficiency and surgical effect can be effectively improved.
The technical solution for solving above-mentioned technical problem is:
A kind of High Tibial Osteotomy guider, it includes crossbeam, guide rail, guide plate, and crossbeam is horizontal positioned, the side of crossbeam
There are two the horizontal location conduit perpendicular to crossbeam, there is fixation hole to be connected on crossbeam with positioning conduit, position the internal diameter of conduit
Match with the outer diameter of Kirschner wire, two parallel guide rail upper ends are vertical with the both ends of crossbeam respectively to be fixedly connected, two guide rails
Lower end be connected by pull rod, guide plate is rectangular slab, and the two sides of guide plate are meshed with two guide rails respectively, guide plate with
Guide rail is to be slidably matched, and has horizontal pilot hole on guide plate, and pilot hole is rectangle long hole, and pilot hole is in guide plate two sides plate face
Opening it is identical, upper top surface and bottom surface of the pilot hole in guide plate are the clinoplain being parallel to each other, and clinoplain is to fixed
The plate face inclined upward of the side of position conduit, the outer diameter phase of the distance between the upper top surface of pilot hole and bottom surface and drill bit
Match, there are locking screw holes in the side of guide rail, locking screw holes are opposite with guide plate plate face.
Above-mentioned High Tibial Osteotomy guider, the side that the upper end of the guide plate is opposite with positioning conduit are connected with positioning
Bar, the rear end of locating rod is vertical with the midpoint of guide plate plate face to be connect, and the front end of locating rod is in contact with tibial bone face, locating rod
Front end intersect with the extended line of the guiding plate thickness direction center line between the upper top surface of pilot hole and bottom surface.
Above-mentioned High Tibial Osteotomy guider, the upper top surface of the pilot hole of the guide plate and bottom surface and horizontal plane incline
Rake angle is 10-20 degree.
Above-mentioned High Tibial Osteotomy guider, the guide rail are groove structure, and the groove of two guide rails is opposite, guide plate
Two sides difference is embedding in a groove, and locking screw holes are located at the lateral surface of the guide rail groove of the guide plate side opposite with conduit is positioned
On.
Above-mentioned High Tibial Osteotomy guider has digital scale, the zero point position of digital scale on the lateral surface of the guide rail
In below the crossbeam.
Above-mentioned High Tibial Osteotomy guider, the guide plate are muti-piece, the upper top surface of the pilot hole of each piece of guide plate
The tilt angle different from one is corresponding with the tilt angle of bottom surface.
The beneficial effects of the present invention are:
The configuration of the present invention is simple, easy to operate, Kirschner wire is by crossbeam fixation hole, positioning conduit by crossbeam and tibial prosthesis
Chamber is located by connecting, and the plate face of the guide plate of below the crossbeam is parallel with the facies medialis tibiae that needs drill opposite, and drill bit passes through guiding
The pilot hole of plate drills to tibial medial, it is ensured that the tilt angle of drilling is precisely consistent, flushes up and down, convenient for drilling
Connection is progress gasket implant procedure after elongated slot；Guide plate can move on guide rail, select optimal brill convenient for different patients
Hole site；It can choose different drill hole inclinations by replacing the guide plate for having different drill hole inclinations, adapt to different patients
Needs.
The present invention is pioneering in fibula proximal end osteotomy joint High Tibial Osteotomy, preset different inclinations on guide plate
The pilot hole of angle can be oriented to and be constrained to drill bit, made drilling quickly, conveniently, accurately, greatly improved the efficiency, and be mitigated
The operating difficulty of doctor, reduces operating time, improves the effect of operation, there is fabulous popularizing value.
Detailed description of the invention
Fig. 1 is structural schematic diagram of the invention；
Fig. 2 is the A-A cross-sectional view of Fig. 1；
Fig. 3 is use state diagram of the invention.
Mark in figure as follows: crossbeam 1, guide plate 3, positioning conduit 4, pull rod 5, pilot hole 6, locking screw holes 7, is determined guide rail 2
Position bar 8, groove 9, Kirschner wire 10, shin bone 11, articular cavity 12, femur 13, drill bit 14.
Specific embodiment
The present invention is made of crossbeam 1, guide rail 2, guide plate 3, positioning conduit 4, pull rod 5, locating rod 8.
Fig. 1,2 displays, crossbeam 1 is horizontal positioned, the side of crossbeam 1 there are two the horizontal location conduit 4 perpendicular to crossbeam 1,
There is fixation hole to be connected on crossbeam 1 with positioning conduit 4, the outer diameter for positioning the internal diameter and Kirschner wire 10 of conduit 4 matches.
Fig. 1,2 displays, two parallel 2 upper ends of guide rail are vertical with the both ends of crossbeam 1 respectively to be fixedly connected, two guide rails 2
Lower end be connected by pull rod 5.Crossbeam 1 and guide rail 2 form rigid structure, can guarantee that guide rail 2 is in after crossbeam 1 is fixed and stablize
Fixed state.
Fig. 1,2 displays, guide plate 3 is rectangular slab, and the two sides of guide plate 3 lead 2 rails with two respectively and are meshed, guide plate
3 with guide rail 2 be slidably matched.The guide rail 2 shown in figure is 9 structure of groove, and the groove 9 of two guide rails 2 is opposite, guide plate 3
Two sides are embedded in respectively in groove 9, and guide plate 3 can slide in guide rail 2.Locking screw holes 7 are located at guide plate 3 and positioning conduit 4
On the lateral surface of 2 groove 9 of guide rail of opposite side.After guide plate 3 is moved to suitable position, clamping screw passes through locking
Screw hole 7 is fixed by guide plate 3 and guide rail 2.
Fig. 1,2,3 show that guide plate 3 has certain thickness, there is horizontal pilot hole 6 on guide plate 3, and pilot hole 3 is square
Shape long hole, pilot hole 6 is identical in the opening of 3 two sides plate face of guide plate, upper top surface and bottom surface of the pilot hole 6 in guide plate 3
For the clinoplain being parallel to each other, plate face inclined upward of the clinoplain to the side of positioning conduit 4.The upper top surface of pilot hole 6
The distance between bottom surface and the outer diameter of drill bit match, and drill bit 14 drills to 11 medial surface of shin bone by pilot hole 6,
Pilot hole 6 can be oriented to and be constrained to drill bit 14, make drilling quickly, conveniently, accurately, guarantee that the tilt angle of drilling is accurate
Unanimously.
Fig. 1,2,3 show that the side that the upper end of guide plate 3 is opposite with positioning conduit 4 is connected with locating rod 8, locating rod 8
Rear end is vertical with the midpoint of 3 plate face of guide plate to be connect, and the front end of locating rod 8 is in contact with 11 bone face of shin bone, the front end of locating rod 8
The extended line of 3 thickness direction center line of guide plate between the upper top surface of pilot hole 6 and bottom surface intersects.The work of locating rod 8
With the fixed range for being to maintain guide plate 3 Yu 11 bone face of shin bone, the bore position of inclined drill bit is determined.Due to locating rod 8
The extended line of 3 thickness direction center line of guide plate between front end and the upper top surface of pilot hole 6 and bottom surface intersects, along guiding
The boring point for the drill bit that hole 6 enters is placed exactly in the front end of locating rod 8, in this way in drilling operation, as long as operator will be oriented to
The front end of the locating rod 8 of 3 upper end of plate is aligned with bore position, can accurately get into bore position by the drill bit 14 of pilot hole 6.
Due to pilot hole 6 be on the thickness direction of guide plate 3 it is acclivitous, the position of pilot hole 6 will be lower than
The last drill point of drill bit 14, gradient, guide plate 3 and the correlation at a distance from shin bone 11 of the height being lower than and pilot hole 6, that is, lead
It is equal to the distance between 3 rear end of guide plate and 11 bone face of shin bone at a distance from 3 upper end of guide plate multiplied by pilot hole to the position in hole 6
The tangent trigonometric function of 6 tilt angles.It is solid that this numerical value, which has the guide plate 3 of differing tilt angles pilot hole 6 for each,
Fixed.In actual fabrication, distance of the pilot hole 6 of each guide plate 3 apart from 3 upper end of guide plate is required according to locating rod
The tangent trigonometric function of 8 length and 6 gradient of pilot hole is calculated, obtain pilot hole 6 and 3 upper end of guide plate away from
From, the guide plate 3 is produced, does not just have to calculate when in use, after guide plate 3 is inserted into, the drill bit 14 that is pierced by pilot hole 6
Drill point must be 8 front end of locating rod 11 bone face of shin bone, it is very easy to use.
The tilt angle of the display of Fig. 1,2,3, the upper top surface of the pilot hole 6 of guide plate 3 and bottom surface and horizontal plane is 10-20
Degree.Guide plate 3 is muti-piece, and the upper top surface of the pilot hole 6 of each piece of guide plate 3 and the tilt angle of bottom surface are different from one
Tilt angle is corresponding.Operator can have the guide plate 3 of different drill hole inclinations different to select by replacement in this way
Drill hole inclination adapts to the needs of different patients.It is 12 degree, 15 degree, 18 that one embodiment of the present of invention has tilt angle respectively
Degree, several pieces of guide plates 3 such as 20 degree.
Fig. 1,2,3 show there is digital scale on the lateral surface of guide rail 2, and the zero point of digital scale is located at 1 lower section of crossbeam.Number
The effect of word scale is easy for the position that operator determines guide plate 3, and specific practice is that after crossbeam 1 is fixed, measurement is horizontal
The distance that 1 lower section of beam needs to drill apart from shin bone 11, then the guide plate 3 on moving guide rail 2, leads the alignment of 3 upper end of guide plate
Identical digital scale on rail 2, fixed guide plate 3, the front end of the locating rod 8 at this moment connected on guide plate 3 should just with
The position for needing to drill is opposite, and drill bit 14, which is carried out drilling by the pilot hole 6 of guide plate 3, accurately to be drilled.
It is of the invention use process is as follows:
Patient takes dorsal position, and right lower extremity disinfection paving is single.Progress fibula osteotomy first, the row longitudinal incision at 6cm under head of fibula,
It is about 3cm, cuts deep fascia, the exposure fibula between musculus soleus and musculus peroneus longus, amputation is about 2cm fibula.
Then in pes anserinus edge row longitudinal incision, it is about 4cm, subperiosteum is removed on front side of pes anserinus, Osteotomy choosing
It is selected as away from articular cartilage sending down the fishbone 3cm or so.
Crossbeam 1 and tibial prosthesis chamber 12 are located by connecting by Kirschner wire 10 by crossbeam fixation hole, positioning conduit 4, crossbeam 1
The plate face of the guide plate 3 of lower section and 11 medial surface of shin bone that needs drill are parallel opposite.Measure 1 lower section of crossbeam needs apart from shin bone 11
The distance to be drilled, then the guide plate 3 on moving guide rail 2, carves the identical number on 3 upper end of guide plate alignment guide rail 2
The front end of degree, fixed guide plate 3, the locating rod 8 at this moment connected on guide plate 3 should be just opposite with the position for needing to drill.
The guide plate 3 of different drill hole inclinations is selected, to adapt to the needs of different patients.Drill bit 14 is passed through to the pilot hole 6 of guide plate 3
It is carried out continuously drilling along the length direction of pilot hole 6, multiple drillings is made to traverse tibial surface arrangement.Passed through after drilling using osteotome
Drilling is connected to as elongated slot by pilot hole 6.Then absorbable pad is knocked in into shin bone from tibial medial elongated slot.Operation terminates, and rinses
It sews up the incision, postoperative shooting double lower limb overall length Weight carrying position X-ray film and preoperative comparison.
Claims (6)
1. a kind of High Tibial Osteotomy guider, it is characterised in that: it includes crossbeam (1), guide rail (2), guide plate (3), crossbeam
(1) it is horizontally arranged, there are two the horizontal location conduit (4) perpendicular to crossbeam (1), crossbeam has fixation on (1) for the side of crossbeam (1)
Hole is connected with positioning conduit (4), and the outer diameter of internal diameter and Kirschner wire (10) for positioning conduit (4) matches, two leading in parallel
Rail (2) upper end is vertical with the both ends of crossbeam (1) respectively to be fixedly connected, and the lower end of two guide rails (2) is connected by pull rod (5), is led
It is rectangular slab to plate (3), the two sides of guide plate (3) are meshed with two guide rails (2) respectively, and guide plate (3) is with guide rail (2)
It is slidably matched, has on guide plate (3) horizontal pilot hole (6), pilot hole (6) is rectangle long hole, and pilot hole (6) is in guide plate
(3) opening of two sides plate face is identical, and upper top surface and bottom surface of the pilot hole (6) in guide plate (3) are the inclination being parallel to each other
Plane, clinoplain to positioning conduit (4) side plate face inclined upward, between the upper top surface and bottom surface of pilot hole (6)
Distance and the outer diameter of drill bit (14) match, have locking screw holes (7) in the side of guide rail (2), locking screw holes (7) and guide plate
(3) plate face is opposite.
2. High Tibial Osteotomy guider according to claim 1, it is characterised in that: the upper end of the guide plate (3) with
The opposite side of positioning conduit (4) is connected with locating rod (8), and the rear end of locating rod (8) is vertical with the midpoint of guide plate (3) plate face
Connection, the front end of locating rod (8) is in contact with shin bone (11) bone face, the front end of locating rod (8) and the upper top surface of pilot hole (6) and
The extended line of guide plate (3) thickness direction center line between bottom surface intersects.
3. High Tibial Osteotomy guider according to claim 2, it is characterised in that: the pilot hole of the guide plate (3)
(6) tilt angle of upper top surface and bottom surface and horizontal plane is 10-20 degree.
4. High Tibial Osteotomy guider according to claim 3, it is characterised in that: the guide rail (2) is groove (9) knot
Structure, relatively, the two sides of guide plate (3) are embedded in groove (9) groove (9) of two guide rails (2) respectively, and locking screw holes (7) are located at
On the lateral surface of guide rail (2) groove (9) of guide plate (3) side opposite with positioning conduit (4).
5. High Tibial Osteotomy guider according to claim 4, it is characterised in that: on the lateral surface of the guide rail (2)
There is digital scale, the zero point of digital scale is located at below crossbeam (1).
6. High Tibial Osteotomy guider according to claim 5, it is characterised in that: the guide plate (3) is muti-piece, often
The upper top surface of the pilot hole (6) of one piece of guide plate (3) and the tilt angle of bottom surface it is different from one tilt angle it is corresponding.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710312272.9A CN107049418B (en) | 2017-05-05 | 2017-05-05 | A kind of High Tibial Osteotomy guider |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710312272.9A CN107049418B (en) | 2017-05-05 | 2017-05-05 | A kind of High Tibial Osteotomy guider |
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| Publication Number | Publication Date |
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| CN107049418A CN107049418A (en) | 2017-08-18 |
| CN107049418B true CN107049418B (en) | 2018-12-18 |
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| CN201710312272.9A Active CN107049418B (en) | 2017-05-05 | 2017-05-05 | A kind of High Tibial Osteotomy guider |
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Families Citing this family (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108433779A (en) * | 2018-03-23 | 2018-08-24 | 河北医科大学第三医院 | A kind of accurate guider of gonitis High Tibial Osteotomy plane |
| CN109091198B (en) * | 2018-10-19 | 2023-11-10 | 常州健力邦德医疗器械有限公司 | Tibia high-level osteotomy block |
| CN109770995A (en) * | 2019-03-07 | 2019-05-21 | 苏州欣荣博尔特医疗器械有限公司 | Guide pad for the operation of proximal tibia osteotomy |
| CN110151253A (en) * | 2019-05-24 | 2019-08-23 | 西安市红会医院 | Osteotomy guide plate |
| CN110464417B (en) * | 2019-08-22 | 2024-03-29 | 河北医科大学第三医院 | Drill guide for high-level tibia osteotomy |
| CN113288330B (en) * | 2021-06-30 | 2022-06-03 | 中南大学湘雅医院 | High-position tibial osteotomy device |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN207654199U (en) * | 2017-05-05 | 2018-07-27 | 河北医科大学第三医院 | A kind of High Tibial Osteotomy guider |
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| US4901711A (en) * | 1988-12-27 | 1990-02-20 | Marlowe Goble E | Drill guide |
| US7846165B2 (en) * | 2004-03-29 | 2010-12-07 | Depuy Products, Inc. | Method and apparatus for arthroscopic bone preparation |
| CN103945780B (en) * | 2011-02-22 | 2016-12-07 | 齐默尔膝部创造物公司 | Navigation and alignment system and for the guide instrument of joint repair |
| CN203183021U (en) * | 2013-01-25 | 2013-09-11 | 王刚 | Novel fixing and guiding device in femur neck |
| CN105434009B (en) * | 2015-11-26 | 2019-05-17 | 南京医科大学附属南京儿童医院 | For the navigation template of femoral osteotomies, application method and production method |
| CN205924106U (en) * | 2016-06-27 | 2017-02-08 | 湖南华翔增量制造股份有限公司 | Cut orthopedic baffle of bone based on 3D prints |
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| CN207654199U (en) * | 2017-05-05 | 2018-07-27 | 河北医科大学第三医院 | A kind of High Tibial Osteotomy guider |
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