CN108095802A - A kind of orthopedic positioning osteotomy guide plate and a kind of osteotomy straightening method - Google Patents
A kind of orthopedic positioning osteotomy guide plate and a kind of osteotomy straightening method Download PDFInfo
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- CN108095802A CN108095802A CN201810131219.3A CN201810131219A CN108095802A CN 108095802 A CN108095802 A CN 108095802A CN 201810131219 A CN201810131219 A CN 201810131219A CN 108095802 A CN108095802 A CN 108095802A
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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
- A61B17/1657—Bone breaking devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—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
- A61B17/171—Guides or aligning means for drills, mills, pins or wires for external fixation
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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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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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
- A61B2017/00526—Methods of manufacturing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
- A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
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Abstract
The present invention provides a kind of orthopedic positioning osteotomy guide plate and based on the orthopedic method for positioning osteotomy guide plate, including percutaneous pinning guide plate and osteotomy guide plate, the percutaneous pinning guide plate includes percutaneous fence body, steel nail guide pad, the steel nail guide pad at least two, steel nail guide block sets at least two steel nail pilot holes, steel nail is set in steel nail pilot hole, and the percutaneous fence body sets steel nail guide pad locating slot, feature location column, guide plate positioning column；The steel nail guide pad is placed in steel nail guide pad locating slot, the invention has the advantages that：It is orthopedic using the three-dimensional software measurement line of force, simulation, it is threaded a needle position based on model validation exterior fixing rack after orthopedic, and design percutaneous pinning guide plate, osteotomy guide plate is fixed based on steel nail position simultaneously, osteotomy is accurately positioned, it is small to reach wound, it is orthopedic accurate, the good purpose of therapeutic effect has the characteristics of simple in structure, low manufacture cost.
Description
Technical field
The present invention relates to medical auxiliary apparatus technical field, more particularly, to a kind of orthopedic positioning osteotomy guide plate and a kind of section
Bone straightening method.
Background technology
For lower limb shorten deformity etc. cases, in the prior art usually used technology be：With outside six shaft space of Taylor
Fixed frame, Ilizarov ring stands, unilateral guide rail external fixing rack etc. treat all kinds of serious complex deformities of lower limb.Traditional positioning method needs
Perspective is iterated through in art come the implantation position and angle of the outrigger steel nail that is located by connecting, while patient need to do incision osteotomy and answer
Position, entire operating time is long and excessively complicated, and the pain of patient is also increased while increasing operating difficulty.
The content of the invention
The problem of being illustrated for above-mentioned background technology, the technical problems to be solved by the invention are to provide a kind of orthopedic fixed
Position osteotomy guide plate and a kind of osteotomy straightening method, it is orthopedic using the three-dimensional software measurement line of force, simulation, based on orthopedic rear model validation
Exterior fixing rack is threaded a needle position, and designs percutaneous pinning guide plate, while fixes osteotomy guide plate based on steel nail position, is accurately positioned and is cut
Bone, reaches that wound is small, the good purpose of therapeutic effect.
In order to achieve the above object, the present invention provides following technical solution：
A kind of orthopedic positioning osteotomy guide plate arrangement, including percutaneous pinning guide plate and osteotomy guide plate, the percutaneous pinning guide plate
Including percutaneous fence body, steel nail guide pad, the steel nail guide pad at least two, steel nail guide block sets at least two steel nails
Pilot hole, sets steel nail in steel nail pilot hole, the percutaneous fence body set steel nail guide pad locating slot, feature location column,
Guide plate positioning column；The steel nail guide pad is placed in steel nail guide pad locating slot, the feature location column, guide plate positioning column point
Not She Zhi kirschner pin hole, Kirschner wire is inserted into kirschner pin hole, the guide plate positioning column is respectively positioned at the upper and lower of percutaneous fence body
Both ends and middle part, the Kirschner wire hole axial penetration guide plate positioning column of the guide plate positioning column and percutaneous fence body, the feature
The Kirschner wire hole axle of positioning column is to shine-through feature positioning column；The osteotomy guide plate is divided into percutaneous fixing end and osteotomy guide end, by
Connecting rod connects, and the percutaneous fixing end sets skin attachment face and the steel nail hole of inner hollow, and osteotomy guide end sets to put
Put the kirschner pin hole of Kirschner wire, bone attaches face, osteotomy guide surface.
In above-mentioned technical proposal, the bone attaches face, osteotomy guide surface partially overlaps.
In above-mentioned technical proposal, the axle center spacing of the steel nail diameter and pilot hole in steel nail guide pad is by matching
The parameter of exterior fixing rack determined that its numerical value can do corresponding variation for different outriggers.
In above-mentioned technical proposal, the percutaneous fence body and the integral printing shaping of osteotomy guide plate difference.
Based on a kind of bone malformation antidote of orthopedic positioning osteotomy guide plate arrangement, step is：
Q1：Before osteotomy, each line of force angle of patient's bone is measured；
Q2：It determines osteotomy site, osteotomy and orthopedic, the bone mould after orthopedic is simulated by three-dimensional software computer numeralization
In type, according to exterior fixing rack used, design steel nail position；
Q3：Design percutaneous guide plate, by three-dimensional software will be orthopedic after skeleton model and steel nail recover to orthopedic preceding shape
State, it is ensured that the position and direction that steel nail penetrates in bone in moving process remain unchanged, based on after recovery bone, steel nail position
It puts and skin model, designs percutaneous fence body, percutaneous fence body is made by 3D printing, and produce steel nail guiding
Block；
Q4：Design osteotomy guide plate, osteotomy site and steel nail Position Design osteotomy guide plate based on bone, by 3D printing system
Make osteotomy guide plate；
Q5：Surgical procedure：Kirschner wire is first inserted into the kirschner pin hole of feature location column, forms feature location Kirschner wire,
As Intraoperative position surface, affected part location feature is found by fluoroscopy during operation, adjustment guide plate make feature location Kirschner wire with
Affected part location feature overlaps, and to determine the placement location of percutaneous fence body, is then beaten by the kirschner pin hole of guide plate positioning column
Enter Kirschner wire to bone, fix percutaneous fence body position, steel nail guide pad is placed in steel nail guide pad locating slot, lead to
It crosses steel nail guiding pilot hole in the block accurately to squeeze into steel nail in bone, removes Kirschner wire successively after the completion of plant steel nail, steel nail is led
To block, percutaneous fence body, steel nail is stayed in patient's surgical field；According to definite osteotomy site, cut and meet in surgical field
Osteotomy guide plate by the steel nail hole of the percutaneous fixing end of osteotomy guide plate is fixed on and is previously implanted in bone by the edge of a knife that osteotomy guide plate is inserted
On the steel nail of bone, osteotomy is carried out, steel nail adjustment bone direction is utilized after the completion of osteotomy, steel nail is fixed on corresponding outer fixed
On frame, orthopedic completion.
In above-mentioned technical proposal, the axle center spacing of the steel nail diameter and pilot hole in steel nail guide pad is by matching
The parameter of exterior fixing rack determined that its numerical value can do corresponding variation for different exterior fixing racks.
The invention has the advantages that：It is orthopedic using the three-dimensional software measurement line of force, simulation, based on fixed outside orthopedic rear model validation
Stent is threaded a needle position, and designs percutaneous pinning guide plate, while fixes osteotomy guide plate based on steel nail position, is accurately positioned osteotomy, is reached
Small to wound, orthopedic accurate, the good purpose of therapeutic effect has the characteristics of simple in structure, low manufacture cost.
Description of the drawings
It in order to illustrate more clearly about the embodiment of the present invention or technical scheme of the prior art, below will be to embodiment or existing
There is attached drawing needed in technology description to be briefly described, it should be apparent that, the accompanying drawings in the following description is only this
Some embodiments of invention, for those of ordinary skill in the art, without having to pay creative labor, may be used also
To obtain other attached drawings according to these attached drawings.
Fig. 1 is invention percutaneous pinning guide plate structure schematic diagram.
Fig. 2 is invention percutaneous pinning guide plate structure schematic diagram.
Fig. 3 is invention osteotomy guide plate structure schematic diagram.
Fig. 4 is invention osteotomy guide plate structure schematic diagram.
Wherein：Percutaneous pinning guide plate 1, percutaneous fence body 11, steel nail guide pad 12, steel nail pilot hole 13, steel nail are oriented to
Block locating slot 14, feature location column 15, Kirschner wire 16, kirschner pin hole 17, steel nail 18, guide plate positioning column 19, patient's human epidermal
20th, percutaneous fixing end 21, skin attachment face 22, steel nail hole 23, osteotomy guide end 24, bone attach face 25, osteotomy guide surface 26, connect
Bar 27.
Specific embodiment
Below in conjunction with the attached drawing of the present invention, technical scheme is clearly and completely described, it is clear that institute
The embodiment of description is only part of the embodiment of the present invention, instead of all the embodiments.Based on the embodiments of the present invention,
Those of ordinary skill in the art's all other embodiments obtained without creative efforts, belong to this hair
The scope of bright protection.
According to Fig. 1-Fig. 4, a kind of orthopedic positioning osteotomy guide plate arrangement, including percutaneous pinning guide plate and osteotomy guide plate.
Percutaneous pinning guide plate includes percutaneous fence body, steel nail guide pad, and steel nail guide pad is two, and steel nail guide block is set
Three steel nail pilot holes, each steel nail pilot hole are inserted into steel nail, and percutaneous fence body sets steel nail guide pad locating slot, feature fixed
Position column, guide plate positioning column；Feature location column, guide plate positioning column set kirschner pin hole, the Kirschner wire hole axle of feature location column respectively
To shine-through feature positioning column, feature location Kirschner wire, the Kirschner wire being inserted into kirschner pin hole, as special outside Intraoperative position are formed
Sign, the Kirschner wire hole axial penetration guide plate positioning column of guide plate positioning column and percutaneous fence body, the kirschner pin hole of guide plate positioning column
Middle insertion Kirschner wire forms positioning Kirschner wire, affected part location feature is found by fluoroscopy during operation, adjust until inside subjects bones
Guide plate makes feature location Kirschner wire be overlapped with affected part location feature, to determine the placement location of percutaneous fence body, squeezes into positioning
Kirschner wire, resting guide position, guide plate positioning column are located at upper/lower terminal and the middle part of percutaneous fence body respectively.
Feature location column applies art purposes difference according to percutaneous pinning guide plate, positioned at different positions, is such as rectified as shin bone
Shape bone-culting operation, then positioned at percutaneous fence body top, such as femur bone-culting operation, then positioned at percutaneous fence body lower part.
Osteotomy guide plate is divided into percutaneous fixing end and osteotomy guide end, is connected by connecting rod, and percutaneous fixing end sets skin attachment
Face and the steel nail hole of three inner hollows, steel nail is inserted in steel nail hole, and osteotomy guide end sets to place the kirschner of Kirschner wire
Pin hole, bone attach face, osteotomy guide surface, and bone attaches face, osteotomy guide surface partially overlaps.
Percutaneous fence body and the integral printing shaping of osteotomy guide plate difference
In steel nail diameter and steel nail guide pad the axle center spacing of pilot hole by matching used exterior fixing rack parameter
It is determined, for different outriggers, its numerical value can do corresponding variation.
By orthopedic positioning osteotomy guide plate arrangement for a kind of bone malformation antidote, step is：
Q1：Before osteotomy, each line of force angle of patient's bone is measured；
Q2：It determines osteotomy site, osteotomy and orthopedic, the bone mould after orthopedic is simulated by three-dimensional software computer numeralization
In type, according to exterior fixing rack used, design steel nail position；
Q3：Design percutaneous guide plate, by three-dimensional software will be orthopedic after skeleton model and steel nail recover to orthopedic preceding shape
State, it is ensured that the position and direction that steel nail penetrates in bone in moving process remain unchanged, based on after recovery bone, steel nail position
It puts and skin model, designs percutaneous fence body, percutaneous fence body is made by 3D printing, and produce steel nail guiding
Block；
Q4：Design osteotomy guide plate, osteotomy site and steel nail Position Design osteotomy guide plate based on bone, by 3D printing system
Make osteotomy guide plate；
Q5：Surgical procedure：Kirschner wire is first inserted into the kirschner pin hole of feature location column, forms feature location Kirschner wire,
As Intraoperative position surface, affected part location feature is found by fluoroscopy during operation, adjustment guide plate make feature location Kirschner wire with
Affected part location feature overlaps, and to determine the placement location of percutaneous fence body, is then beaten by the kirschner pin hole of guide plate positioning column
Enter Kirschner wire to bone, fix percutaneous fence body position, steel nail guide pad is placed in steel nail guide pad locating slot, lead to
It crosses steel nail guiding pilot hole in the block accurately to squeeze into steel nail in bone, removes Kirschner wire successively after the completion of plant steel nail, steel nail is led
To block, percutaneous fence body, steel nail is stayed in patient's surgical field；According to definite osteotomy site, cut and meet in surgical field
Osteotomy guide plate by the steel nail hole of the percutaneous fixing end of osteotomy guide plate is fixed on and is previously implanted in bone by the edge of a knife that osteotomy guide plate is inserted
On the steel nail of bone, osteotomy is carried out, steel nail adjustment bone direction is utilized after the completion of osteotomy, steel nail is fixed on corresponding outer fixed
On frame, orthopedic completion.
The above description is merely a specific embodiment, but protection scope of the present invention is not limited thereto, any
Those familiar with the art in the technical scope disclosed by the present invention, can readily occur in change or replacement, should all contain
Lid is within protection scope of the present invention.Therefore, protection scope of the present invention should be described with scope of the claims.
Claims (4)
1. a kind of orthopedic positioning osteotomy guide plate arrangement, it is characterised in that：It is described percutaneous including percutaneous pinning guide plate and osteotomy guide plate
Guide plate of threading a needle includes percutaneous fence body, steel nail guide pad, the steel nail guide pad at least two, and steel nail guide block is set at least
Two steel nail pilot holes, steel nail is set in steel nail pilot hole, and the percutaneous fence body sets steel nail guide pad locating slot, feature
Positioning column, guide plate positioning column；The steel nail guide pad is placed in steel nail guide pad locating slot, the feature location column, guide plate
Positioning column sets kirschner pin hole respectively, and Kirschner wire is inserted into kirschner pin hole, and the guide plate positioning column is located at percutaneous guide plate master respectively
The upper/lower terminal of body and middle part, the Kirschner wire hole axial penetration guide plate positioning column of the guide plate positioning column and percutaneous fence body,
The Kirschner wire hole axle of the feature location column is to shine-through feature positioning column；The osteotomy guide plate is divided into percutaneous fixing end and osteotomy is led
Xiang Duan is connected by connecting rod, and the percutaneous fixing end sets skin attachment face and the steel nail hole of inner hollow, and osteotomy guide end is set
For placing the kirschner pin hole of Kirschner wire, bone attaches face, osteotomy guide surface.
2. the orthopedic positioning osteotomy guide plate arrangement of one kind according to claim 1, it is characterised in that：The bone attaches face, cuts
Bone conduction partially overlaps to face.
3. the orthopedic positioning osteotomy guide plate arrangement of one kind according to claim 1, it is characterised in that：The percutaneous fence body
With the integral printing shaping of osteotomy guide plate difference.
4. a kind of osteotomy straightening method, it is characterised in that：Any orthopedic positioning osteotomy guide plate arrangement of usage right requirement 1 to 4,
Step is：
Q1：Before osteotomy, each line of force angle of patient's bone is measured；
Q2：It determines osteotomy site, osteotomy and orthopedic, the skeleton model after orthopedic is simulated by three-dimensional software computer numeralization
On, according to exterior fixing rack used, design steel nail position；
Q3：Design percutaneous guide plate, by three-dimensional software will be orthopedic after skeleton model and steel nail recover to orthopedic preceding state, really
The position that penetrates in bone of steel nail and direction in moving process is protected to remain unchanged, based on after recovery bone, steel nail position with
And skin model, percutaneous fence body is designed, percutaneous fence body is made by 3D printing, and produces steel nail guide pad；
Q4：Osteotomy guide plate is designed, osteotomy site and steel nail Position Design osteotomy guide plate based on bone are made by 3D printing and cut
Bone conduction plate；
Q5：Surgical procedure：Kirschner wire is first inserted into the kirschner pin hole of feature location column, forms feature location Kirschner wire, as
Intraoperative position surface finds affected part location feature by fluoroscopy during operation, and adjustment guide plate makes feature location Kirschner wire and affected part
Location feature overlaps, and to determine the placement location of percutaneous fence body, is then squeezed into gram by the kirschner pin hole of guide plate positioning column
Family name's pin fixes percutaneous fence body position, steel nail guide pad is placed in steel nail guide pad locating slot, passes through steel to bone
Nail is oriented to pilot hole in the block and accurately squeezes into steel nail in bone, plant remove successively after the completion of steel nail Kirschner wire, steel nail guide pad,
Percutaneous fence body stays steel nail in patient's surgical field；According to definite osteotomy site, meet osteotomy in surgical field incision and lead
Osteotomy guide plate is fixed on the steel being previously implanted in bone by the edge of a knife that plate is inserted by the steel nail hole of the percutaneous fixing end of osteotomy guide plate
It nails on, carries out osteotomy, steel nail adjustment bone direction is utilized after the completion of osteotomy, steel nail is fixed on corresponding exterior fixing rack i.e.
Can, orthopedic completion.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810131219.3A CN108095802B (en) | 2018-02-09 | 2018-02-09 | Orthopedic positioning osteotomy guide plate device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810131219.3A CN108095802B (en) | 2018-02-09 | 2018-02-09 | Orthopedic positioning osteotomy guide plate device |
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| CN108095802A true CN108095802A (en) | 2018-06-01 |
| CN108095802B CN108095802B (en) | 2023-09-08 |
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ID=62221047
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| CN201810131219.3A Active CN108095802B (en) | 2018-02-09 | 2018-02-09 | Orthopedic positioning osteotomy guide plate device |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109512484A (en) * | 2018-09-20 | 2019-03-26 | 上海昕健医疗技术有限公司 | The orthopedic osteotomy guide device of shin bone |
| CN110613499A (en) * | 2019-10-17 | 2019-12-27 | 中国医学科学院北京协和医院 | Osteotomy guide plate for body surface lower limb deformity correction operation and preparation method thereof |
| CN111388088A (en) * | 2020-04-26 | 2020-07-10 | 深圳市鑫君特智能医疗器械有限公司 | Operation guide plate, three-dimensional model, manufacturing and constructing method, computer and storage medium |
| CN113208721A (en) * | 2021-05-21 | 2021-08-06 | 宁波市杭州湾医院 | Percutaneous positioning method for internal fixing nail channel of femoral neck fracture screw |
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Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109512484A (en) * | 2018-09-20 | 2019-03-26 | 上海昕健医疗技术有限公司 | The orthopedic osteotomy guide device of shin bone |
| CN109512484B (en) * | 2018-09-20 | 2021-03-16 | 上海昕健医疗技术有限公司 | Tibia orthopedic osteotomy guiding device |
| CN110613499A (en) * | 2019-10-17 | 2019-12-27 | 中国医学科学院北京协和医院 | Osteotomy guide plate for body surface lower limb deformity correction operation and preparation method thereof |
| CN110613499B (en) * | 2019-10-17 | 2020-10-09 | 中国医学科学院北京协和医院 | Osteotomy guide plate for body surface lower limb deformity correction operation and preparation method thereof |
| CN111388088A (en) * | 2020-04-26 | 2020-07-10 | 深圳市鑫君特智能医疗器械有限公司 | Operation guide plate, three-dimensional model, manufacturing and constructing method, computer and storage medium |
| CN111388088B (en) * | 2020-04-26 | 2024-03-29 | 深圳市鑫君特智能医疗器械有限公司 | Surgical guide, three-dimensional model, manufacturing and constructing method, computer and storage medium |
| CN113208721A (en) * | 2021-05-21 | 2021-08-06 | 宁波市杭州湾医院 | Percutaneous positioning method for internal fixing nail channel of femoral neck fracture screw |
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