CN108403202A - For guider and its method outside the channel body of screw of pelvis fracture of acetabulum - Google Patents
For guider and its method outside the channel body of screw of pelvis fracture of acetabulum Download PDFInfo
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- CN108403202A CN108403202A CN201810135965.XA CN201810135965A CN108403202A CN 108403202 A CN108403202 A CN 108403202A CN 201810135965 A CN201810135965 A CN 201810135965A CN 108403202 A CN108403202 A CN 108403202A
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- guider
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- acetabulum
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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
- 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
- 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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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y80/00—Products made by additive 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
- A61B2034/105—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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- Prostheses (AREA)
Abstract
The present invention provides a kind of outer guider of the channel body of screw for pelvis fracture of acetabulum and its method.The outer guider of the channel body of screw of the present invention for pelvis fracture of acetabulum includes guider, the guide pin that locator, 3D printing obtain, and it is socketed in the guide pin sleeve outside guide pin, the wherein described guider is equipped with guide channel comprising acetabular anterior column screw guide channel, acetabular posterior column screw guide channel, iliac screw guide channel, acetabular bone screwing guide channel, sacroiliac screw guide channel and through the one or several kinds in sacral screw guide channel.The outer guider accurate positioning of the channel body of screw of the present invention, can be used for treating various types of pelvis fracture of acetabulum.Of the present invention to prepare the method for the outer guider of the channel body of screw of pelvis fracture of acetabulum and use the method for the outer guider of the channel body of screw simple and practicable, accurate positioning is suitable for promoting.
Description
Technical field
The present invention relates to orthopaedics medical instruments fields, relate in particular to a kind of channel spiral shell for pelvis fracture of acetabulum
The outer guider of rivet nut and its method.
Background technology
Pelvis fracture of acetabulum is because its dissection is complicated, and vital tissue, the organ adjoined is various, and classification of fracture is ever-changing.It passes
The open reduction and Kirschner wire fixation of system can look at damage field straight, be conducive to anatomical reduction, but the soft tissue in the surgical procedure of incision
Exposure is excessive, complicated for operation, is easy to damage important blood vessel and nerve, therefore pelvis, operation of fracture of acetabulum difficulty are big, time-consuming
Length, bleeding is more, risk is big.
Closed reduction pelvis fracture of acetabulum adds minimally invasive screw technique to be increasingly becoming the mainstream for the treatment of at present.Pelvis acetabular bone channel
Screw technique has biomechanical advantage, fracture site need not be completely exposed i.e. in art because it is similar to long bone Medullary fixation
It can accomplish to stablize fixation, be a kind of effective minimally invasive fixed form of pelvis acetabular bone.But channel screw requires very fluoroscopy techniques
It is high, it is difficult to accomplish precise positioning, lead to the possibility increase for damaging vitals, blood vessel, and fluoroscopy during operation is often, both extends
Operating time, and increase the radiation insult to patient and doctor.2D 3D airmanships may be implemented more accurately
Operating time is saved in positioning, reduces radiological dose, but navigation equipment is expensive, and basic hospital is difficult to popularize.In recent years, 3D is beaten
Print technology is widely used in clinic, especially formulates surgical planning, simulation surgical procedure and printing personalized medicine device in auxiliary
Material etc. plays important role, it has been reported in the application of pelvis fracture of acetabulum.Pelvis acetabular bone is led in 3D printing body
Although plate solve to a certain extent pelvis set the location difficulty of nail, perspective often, the problems such as safety is low, it makes
Premise be in art it is accurate, thoroughly expose bone mark, this increases operating difficulty and uncertainty instead.Application No. is
201620192328.2 Chinese patent application discloses a kind of pelvis front ring fracture closed reduction and sets nail guider, including sets
It follows closely guide plate and uses the pelvis model that 3D printer rapid shaping obtains according to the pelvis CT data of acquisition, set nail guide plate and be equipped with
Connected structure is simultaneously fixed on by connected structure on pelvis model, is set and is followed closely guide plate equipped with for guiding the nail guiding of setting for setting nail to lead to
Road.The guider can be used for simulating operation and the guiding for setting nail, but the guider needs to cut and bone is completely exposed
Property the region of anatomy so that it is fitted with pelvis, wound is big, poor accuracy；Guide channel does not have scale, and setting nail depth does not have
Adjust foundation；Connected structure is fixed by card slot cutting ferrule, and fixed position is difficult to determine, actual use position deviation is big, lacks essence
Parasexuality.And application No. is 201310202319.8 another Chinese patent applications then to disclose a kind of spiral shell for Minimally Invasive Surgery
Nail implantation sighting device, the sighting device include sighting device leading portion, sighting device back segment and at least one are resisted against anterior superior spine or ilium
Locating fork on front lower spine.The screw placement sighting device is simple in structure, of low cost, but it needs perspective determination repeatedly in art
Specific entry point and inserting needle direction, poor accuracy；Anchor point selection has no basis, and randomness is big.
In recent years many methods for preparing above-mentioned template are also disclosed, such as application No. is the China of 201510424640.X is special
Profit application discloses a kind of preparation method of fracture of acetabulum rear pillar lag screw 3D navigation modules, and the method is only suitable for single
Screw type, such as the rear pillar lag screw described herein, the scope of application are limited.In addition, due to not bright in preparation process
True witness marker, prepare the 3D navigation modules of gained when in use can there are gaps with modeling state, therefore accuracy is not high.
Based on existing airmanship or guider, pelvis fracture of acetabulum fixing means is accurately positioned to realize, leads to
It often needs to be completely exfoliated to expose the bone region of anatomy and/or carry out patient and have an X-rayed for several times, not only complicated for operation, operating time
It is long, great damage is all produced to the body of patient and doctor.
In conclusion there is an urgent need for design a kind of channel screw fixtation devices and methods therefor that can be solved the above problems.
Invention content
It is an object of the invention to solve, prior art midpelvis operation of fracture of acetabulum wound is big, the time is long, risk is high, difficult
Degree is big, perspective often the problems such as, provide a kind of channel body of screw for pelvis fracture of acetabulum guider and method outside.
On the one hand, the present invention provides guider outside a kind of channel body of screw for pelvis fracture of acetabulum, the guiding
Device need not cut completely through the exposed bone region of anatomy, and wound is small, accuracy is high, perspective number it is few, be it is a kind of really it is minimally invasive,
Accurately auxiliary fixing device.
The outer guider of the channel body of screw of the present invention for pelvis fracture of acetabulum includes locator, guider, leads
Needle, and the guide pin sleeve that is socketed in outside guide pin；
The locator includes pilot pin and the positioning body equipped with cavity；One end of the pilot pin is fixed on Ipsilateral crista iliaca
Or in strong side crista iliaca, the other end of the pilot pin is located in cavity；
The guider includes that the guide plate to match with pelvis acetabular bone skin surface, the orientation being located on guide plate are logical
Road, the outer sleeve being socketed in outside directed access, and it is located at the guide channel that guide plate one end is passed through for channel screw；It is described to lead
It is put together to plate by mainboard and auxiliary plate, the mosaic of the mainboard is equipped with main channel body, and the mosaic of the auxiliary plate is equipped with auxiliary
Channel body, the main channel body and secondary channels body split form directed access, the directed access be coated on positioning body it is outer and by
Outer sleeve is fixed.
Further, the locator includes one or two pilot pins, then the positioning body, directed access and outer sleeve
Quantity and pilot pin quantity correspondent equal.In other words, the locator includes a pilot pin, accordingly, described fixed
The quantity of position body, directed access and outer sleeve is one；Or the locator includes two pilot pins, it is accordingly, described fixed
The quantity of position body, directed access and outer sleeve is two.
Further, one end of the pilot pin is equipped with tapping screw thread, and the other end of the pilot pin is equipped with spacing head.
Further, the positioning body is made of carbon fiber, and the positioning body is in triangular prism or tetragonous rod structure.
Further, the lower surface of the guide plate is 8 millimeters -15 millimeters at a distance from pelvis acetabular bone skin surface, institute
The thickness for stating guide plate is 8 millimeters -12 millimeters；The height of the guide channel is 20 millimeters -50 millimeters.
Further, the guide channel includes acetabular anterior column screw guide channel, acetabular posterior column screw guide channel, ilium
Bone screws guide channel, acetabular bone screwing guide channel, sacroiliac screw guide channel and through sacral screw guide channel.
Further, the guide pin is equipped with scale.
Preferably, the pilot pin is made of stainless steel or titanium alloy is made, and length is not less than 80 millimeters.It is described fixed
Position needle is located at Ipsilateral crista iliaca or one end of strong side crista iliaca is equipped with the tapping screw thread that length is not less than 20 millimeters.The pilot pin
The other end in cavity is equipped with length and is not less than 15 millimeters, in the spacing head of triangular prism or tetragonous rod structure.Tapping screw thread
Body sections between spacing head are in then cylindrical structure.If Ipsilateral displacement fracture unobvious, pelvis channel, crista iliaca are still complete
Whole, the entry point of channel screw in bone block, is not needing operative reduction where pilot pin, then pilot pin is placed in Ipsilateral crista iliaca,
Shorten pilot pin at a distance from the entry point of channel screw, reduce the torque arm length of locator, is more conducive to precise positioning, reduces
Error；If patients with fractures's displacement is larger, crista iliaca integrality is lost or the entry point of channel screw divides with bone block where pilot pin
From, needed in art combine the minimally invasive closed reduction system closed reduction of pelvis, then pilot pin is placed in strong side crista iliaca so that resetted
The displacement of bone block does not influence the position of pilot pin and main body bone in journey.
Preferably, the positioning body is with material similar in bone density by being made, preferably carbon fibre material, can preferably arrange
The artifact generated when except CT scan.The positioning body is in triangular prism or tetragonous rod structure, and length is not less than 50 millimeters, and bottom surface is
Triangle or square structure, in certain embodiments, the positioning body are in rectangular parallelepiped structure.The positioning body is equipped with and is used for
The cavity of the pilot pin other end is accommodated, is equipped with and the matched structure of spacing head in the cavity.
Preferably, the guider is made of 3D printing photosensitive resin, it is ensured that it has enough toughness and rigidity, convenient
Precise positioning in operation.The guider is equipped with directed access, can be securely socketed with positioning body, one end of the guider is equipped with
Guide channel is the merging channel of channel screw.The inner circumferential structure of the directed access and the peripheral structure of positioning body match,
After directed access is socketed in positioning body periphery, you can determine the position of guide channel, so that it is determined that the direction of channel screw and
Entry point.The inner circumferential structure and the peripheral structure of guide pin sleeve of the guide channel match, and guide pin sleeve is inserted into guiding
In channel, after guide pin is inserted into guide pin sleeve, guide pin direction determines, to which channel screw be determined when channel screw is placed in
Direction.
Preferably, the lower surface of the guider, i.e. distance of the lower surface of guide plate apart from pelvis acetabular bone skin surface
About 8 millimeters -15 millimeters.Since the skin condition of human body different times difference figure will present slight variation, in order to adapt to
The lower surface of this slight change, guider will be maintained a certain distance with pelvis acetabular bone skin surface, and after keeping at a distance,
It is also convenient for the progress of Minimally Invasive Surgery.It is highly preferred that distance of the lower surface of institute's guide plate apart from pelvis acetabular bone skin surface is about
10 millimeters.
Preferably, the thickness of the guide plate is 8 millimeters -12 millimeters.The thickness not only can ensure that the stability of guider, but also
Material can be saved.
Preferably, the guide plate is put together by mainboard and auxiliary plate, and the directed access is located at the spelling of mainboard and auxiliary plate
In zygonema, the directed access is also divided into two parts, that is, is located at main channel body on mainboard and auxiliary logical on auxiliary plate
Road body, the divisional plane of the directed access and the divisional plane of guide plate are coplanar.For convenience of connecting directed access and positioning body in art,
Directed access is averagely separated on the guides, and then guide plate is separated, plate supplemented by the free fractions of gained small pieces is visual.
Preferably, be socketed with outer sleeve outside the directed access, for fixed in art split it is complete after directed access, together
The frictional force of Shi Peihe directed access inner surfaces, positioning body not will produce sliding phenomenon, so make the positioning ten of entire guider
Divide accurate.
Preferably, the length of the guide channel is 20 millimeters -50 millimeters, the direction energy one of guide channel when facilitating operation
It is straight to extend, and not will produce shaking.The internal diameter of the guide channel is matched with the outer diameter of guide pin sleeve.
Preferably, the guide pin is made of stainless steel or titanium alloy is made, and guide pin leans to one side to be equipped with scale, conveniently really
The placement length of channel screw in fixed operation.The guide pin is divided intoMillimeter andTwo kinds of models of millimeter, each model
It is respectively designed with 300 millimeters, 400 millimeters and 500 millimeters three kinds of length again.Guide pin of the present invention passes through guide pin during surgery
Sleeve, to open up bone channel and the merging of guiding channel screw.
Preferably, the guide pin sleeve is made of drill bushing, connecting rod, pin and handle, wherein the drill bushing is by stainless steel
Or titanium alloy is made, the outer diameter of the drill bushing is unified.According to the internal diameter parting of drill bushing, the guide pin sleeve can be divided intoMillimeter andTwo kinds of models of millimeter, each model are respectively designed with 150 millimeters and 250 millimeters of two kinds of length, work as people again
When body obese degree is more serious, can design and manufacture it is longer, be suitable for the guide pin sleeve that patient uses.Guide pin set in art
After cylinder passes through the guide channel of guider, soft tissue channel is opened up, arrives at bone face, anti-skidding and limitation guide pin direction work can be played
With.
More serious preferably for pelvis fracture of acetabulum, the patient for needing many places to be fixed can use and cover this hair more
The bright outer guider of the channel body of screw.
On the other hand, the present invention provides the sides for preparing guider outside the channel body of screw for pelvis fracture of acetabulum
Method, the method combine mechanical manufacturing technology, the three-dimensional reconstruction art of Medical Imaging, Computer-aided Design Technology, reverse
Engineering technology and 3D printing technique, the guider of preparation can ensure that setting nail guide channel is oriented to the accuracy for setting nail, uses
The preparation method make it is preoperative can predict be placed in detailed sclerotin situation around the specific location and screw of screw, fracture
The spatial relation of fragment and screw, rather than dream up.
In the method for the present invention prepared for the outer guider of the channel body of screw of pelvis fracture of acetabulum, the preparation
The method of guider includes
Step P1：Pilot pin is percutaneously inserted into Ipsilateral crista iliaca or strong side crista iliaca, upper positioning body is covered, assembles locator
After carry out CT scan；
Step P2：CT scan data is imported in MIMICS softwares and establishes pelvis acetabular bone threedimensional model, the pelvis acetabular bone
It include locator threedimensional model in threedimensional model；
Step P3：In MIMICS, Geomagic and 3-matic software, on the basis of pelvis acetabular bone threedimensional model, processing
Obtain guider threedimensional model；
Step P4：Guider three dimensional model printing is exported using 3D printer, obtains guider.
Further, further include exporting pelvis acetabular bone three dimensional model printing in step P4, obtain pelvis acetabular bone natural pattern
Type.
Further, the pelvis acetabular bone threedimensional model is that pelvis fracture of acetabulum threedimensional model or pelvis acetabular bone reset three-dimensional
Model.
Further, the pelvis acetabular bone, which resets threedimensional model, is handled on the basis of pelvis fracture of acetabulum threedimensional model
It obtains.
Preferably, if Ipsilateral displacement fracture unobvious, pelvis acetabular bone channel, crista iliaca are still complete, the entry point of channel screw
In bone block, operative reduction is not being needed where pilot pin, then pilot pin is being placed in Ipsilateral crista iliaca, is shortening pilot pin and channel screw
Entry point distance, reduce the torque arm length of locator, be more conducive to precise positioning, reduce error；If patients with fractures shifts
Larger, crista iliaca integrality is lost or the entry point of channel screw is detached with bone block where pilot pin, needs to combine pelvis in art
The minimally invasive closed reduction system closed reduction of acetabular bone, then be placed in strong side crista iliaca by pilot pin so that the displacement of bone block in reseting procedure
The position of pilot pin and main body bone is not influenced.
Preferably, the CT scan uses thin layer CT scan, and scanning thickness is about 0.5 millimeter to 1.0 millimeters.
Preferably, the original CT data of acquisition is stored with .dicom formats.
Preferably, the pelvis acetabular bone threedimensional model includes that pelvis fracture of acetabulum threedimensional model or pelvis acetabular bone reset three-dimensional
Model.
Preferably, the data obtained after CT scan are imported into .dicom formats in reverse engineering software, passes through reading
After analysis, segmentation, editor's filling, removal redundant data, using shaded surface display method, pelvis fracture of acetabulum three-dimensional mould is constructed
Type.
Preferably, when needing closed reduction to handle before pelvis acetabular bone screw placement, in pelvis fracture of acetabulum threedimensional model
On the basis of along fracture line carry out sclerite divide to obtain sclerite disjunctive model.It is grasped on the basis of pelvis fracture of acetabulum threedimensional model
It adjusts single sclerite three-dimensional space position and resets three-dimensional mould to restore to obtain pelvis acetabular bone in the form of pelvis acetabular bone normal anatomy
Type, specifically can be by the single sclerite three-dimensional space position of the operation adjustments such as translation, rotation, overturning to restore hipbone basin proper solution
It cuts open form and obtains pelvis acetabular bone reset threedimensional model.Each translation, rotation, overturning step are recorded.
Preferably, it on the basis of pelvis acetabular bone threedimensional model, is handled to obtain directed access three according to locator threedimensional model
Dimension module and outer sleeve threedimensional model handle to obtain guide channel threedimensional model according to screw conduits analogue body, then in conjunction with bone
Basin acetabular bone skin surface handles to obtain guide plate threedimensional model, by Boolean calculation, obtains three bit model of guider.
Preferably, the thickness of guide plate threedimensional model described in step P3 is 8 millimeters -12 millimeters.
Preferably, guide plate threedimensional model described in step P3 is 8 millimeter of -15 milli at a distance from pelvis acetabular bone skin surface
Rice.It is highly preferred that guide plate threedimensional model described in step P3 is 10 millimeters at a distance from pelvis acetabular bone skin surface.
Preferably, it can measure to obtain the internal length L of screw conduits in step P3.
Preferably, the printed material of 3D printing is photosensitive resin material.
Preferably, the printing precision of 3D printing is not less than 0.1mm.
Preferably, the printing laser power of 3D printing is not less than 400mw.
Preferably, the print temperature of 3D printing is not less than 20 DEG C.
Preferably, further include exporting pelvis acetabular bone three dimensional model printing in step P4, obtain pelvis acetabular bone mock-up.
The pelvis acetabular bone mock-up includes that pelvis fracture of acetabulum mock-up and pelvis acetabular bone reset mock-up.
Preferably, the guider and pelvis mock-up are in disinfection central row low-temperature plasma sterilization, in case in art
It uses.
Another aspect, the present invention provides the sides for using guider outside the channel body of screw for pelvis fracture of acetabulum
Method, this method is simple and practicable, accurate positioning.
It is of the present invention to include using the method for guider outside the channel body of screw of pelvis fracture of acetabulum
Step U1：The directed access split of guider is coated on outside the positioning body of locator, outer sleeve is used in combination to fix；
Step U2：Guide pin sleeve is placed in guide channel, skin is cut, penetrates the through bone face of soft tissue；
Step U3：Guide pin is placed in guide pin sleeve, is squeezed into guide pin in pelvis acetabular bone with electric drill；
Step U4：Guide pin sleeve is taken out, screw is placed in guide channel, is screwed into manually in pelvis acetabular bone.
Specifically, after guider and locator being connected in art, guide pin sleeve is first placed in the guide channel on guider,
Skin is arrived at, after cutting 2cm notch on the skin, the soft tissues such as muscle, fascia is penetrated along former direction and arrives at bone face.Along guide pin
Sleeve is placed in guide pin, and electric drill squeezes into guide pin to the length L of the internal screw conduits measured in advance, and it is true that C arm machine has an X-rayed 1-2 position
Recognize it is errorless can be taken off guide pin sleeve, be screwed into lag screw manually along guide channel, have an X-rayed the confirmation of 1-2 position again.
Further, the application method further includes the pelvis acetabular bone natural pattern obtained using 3D printing before step U1
Type carries out preoperative simulation and sets nail.
Specifically, guider and locator are connected on pelvis acetabular bone mock-up, guide pin sleeve is placed in guider
Guide channel, be placed in guide pin along guide pin sleeve, electric drill squeezes into guide pin to the length L of the internal screw conduits measured in advance, instead
Multiple to confirm, guide pin is not pierced by pelvis acetabular bone.
Advantageous effect：
The outer guider of the channel body of screw of the present invention for pelvis fracture of acetabulum is without a wide range of thoroughly exposure bone
Matter confirms entry point and inserting needle direction without perspective repeatedly, and can be truly realized multiple in conjunction with the minimally invasive closed reduction system of pelvis
The microtrauma of miscellaneous pelvic fracture, micro ray, precisely guiding, safety are set nail and are stablized and fixes.
The positioning body is directly fixed with pelvis acetabular bone, may be regarded as the extension of a part for pelvis in vitro, is ginseng with it
Examination point can accurately determine the three-dimensional position of the supracotyloid various screw conduits of pelvis, and being connect with guider can make on guider
Guide channel on same straight line, coordinates guide pin and guide pin sleeve to penetrate bone to reduce with true pelvis acetabular bone screw conduits
Orientation when matter changes the interference with skin, soft tissue etc., has also just accomplished accurate guiding.Being used in combination for the present invention both solved
Pelvis acetabular bone channel is difficult to the problem being precisely oriented to, and also overcomes manually-operated unstability.
External guider of the present invention can be used for treating the forward and backward ring fracture of pelvis, including superior ramus of pubis fracture, acetabular bone
Front pillar or antetheca fracture, fracture of wing of ilium, the fracture of the posterior wall of the acetabulum, articulatio sacroiliaca fracture or dislocation, sacral fracture etc. are most several classes of
The pelvis fracture of acetabulum of type can fast, precisely squeeze into superior ramus of pubis or acetabular anterior column screw (AC), acetabular posterior column screw
(PC), iliac screw, acetabular bone screwing (LC2), sacroiliac screw (S1/S2), through sacral screw etc..
It is of the present invention to prepare the method for the outer guider of the channel body of screw of pelvis fracture of acetabulum according to be fixed
The CT three-dimensional datas of pelvis acetabular bone establish data model so that pelvis acetabular bone is accurately matched with guider, to but also by
The molding guider of 3D printing has accurate reliable guidance quality, and doctor can be helped to carry out individual character according to the concrete condition of patient
The custom design of change realizes precisely medical treatment.
The design of guider of the present invention is completed under the auxiliary of locator, the locator and pelvis hip
Mortar is directly fixed, may be regarded as the extension of a part for pelvis acetabular bone in vitro, pelvis acetabular bone can be accurately determined using it as reference point
On various screw conduits three-dimensional position.
Method of the present invention using the outer guider of the channel body of screw for pelvis fracture of acetabulum is minimally invasive, it is simple,
Fast, it is only necessary to which 2-4 times perspective can be completed and once set nail.
Description of the drawings
Fig. 1 is the front view of pilot pin in the embodiment of the present invention 1；
Fig. 2 is the faces the A-A sectional view of pilot pin in the embodiment of the present invention 1；
Fig. 3 is the faces the B-B sectional view of pilot pin in the embodiment of the present invention 1；
Fig. 4 is the front view of positioning body in the embodiment of the present invention 1；
Fig. 5 is the faces the I-I sectional view of positioning body in the embodiment of the present invention 1；
Fig. 6 is the structural schematic diagram of guide pin in the embodiment of the present invention 1；
Fig. 7 is the structural schematic diagram of guide pin sleeve in the embodiment of the present invention 1；
Fig. 8 is the schematic diagram of 1 midpelvis of embodiment of the present invention fracture threedimensional model；
Fig. 9 is the schematic diagram for simulating S2 screw conduits in the embodiment of the present invention 1 with cylinder；
Figure 10 is the cooperation figure of the threedimensional model and pelvic fracture threedimensional model of guider in the embodiment of the present invention 1；
Figure 11 is the cooperation figure of the threedimensional model and skin of pelvis surface of guider in the embodiment of the present invention 1；
Figure 12 is the positive structure schematic of guider in the embodiment of the present invention 1；
Figure 13 is the structure schematic diagram of guider in the embodiment of the present invention 1；
Figure 14 is the explosion figure of guider in the embodiment of the present invention 1；
Figure 15 is the state diagram in guider threedimensional model preparation process in the embodiment of the present invention 2；
Figure 16 is the separation figure of mainboard and subplate in the embodiment of the present invention 2；
In figure：Locator 1, pilot pin 1.1, tapping screw thread 1.1.1, spacing head 1.1.2, is determined locator threedimensional model 1M
Position body 1.2, cavity 1.2.1, guider 2, guider threedimensional model 2M, guide plate 2.1, guide plate threedimensional model 2.1M, mainboard
2.1a, auxiliary plate 2.1b, directed access 2.2, directed access threedimensional model 2.2M, main channel body 2.2a, secondary channels body 2.2b, housing
Cylinder 2.3, outer sleeve threedimensional model 2.3M, guide channel 2.4, guide channel threedimensional model 2.4M, S2 screw conduits analogue body
2.4.1C, RLC21 screw conduits analogue body 2.4.2C, RLC22 screw conduits analogue bodies 2.4.3C, guide pin 3, scale 3.1, guide pin
Sleeve 4, drill bushing 4.1, connecting rod 4.2, pin 4.3, handle 4.4, Ipsilateral crista iliaca 5A, strong side crista iliaca 5B, pelvis acetabular bone skin table
Face 6.
Specific implementation mode
Below in conjunction with the attached drawing performance that the present invention will be described in detail, but they do not constitute limitation of the invention, only make
Citing.Simultaneously by the way that the present invention is described in further detail with specific implementation.
Unless otherwise stated, all scientific and technical terminologies used in the present invention have with those skilled in the art of the invention's
It is generally understood identical meaning.All patents of the present invention and public publication are integrally incorporated this hair by reference
It is bright.Term "comprising" or " comprising " are open language, that is, include the content specified by the present invention, but other aspects are not precluded
Content.In the present invention, wordings such as " about " or " about " whether or not using, all numbers being disclosed that are approximation
Value.The numerical value of each number is possible to the rational difference that will appear 10% difference below or those skilled in the art think,
Such as 1%, 2%, 3%, 4% or 5% difference.
The external guider for S2 screws as represented in figures 1 through 14 comprising fixed by a pilot pin 1.1 and one
The locator 1 of the position composition of body 1.2, guider 2 and guide pin 3 and guide pin sleeve 4 by 3D printing acquisition.
The pilot pin 1.1 is titanium alloy system, 120 millimeters long, 6 millimeters of diameter.As shown in Figs. 1-3, the one of pilot pin 1.1
End is equipped with the spacing head 1.1.2 in triangular prism structure equipped with 25 millimeters long of tapping screw thread 1.1.1, the other end.
The positioning body 1.2 is the carbon fiber cuboid of 70 millimeters of 15 millimeters of x, 15 millimeters of x.As illustrated in figures 4-5, it positions
Length of the one end of body 1.2 equipped with cavity 1.2.1, the cavity 1.2.1 is about 50 millimeters, empty by cylindrical cavity and triangular prism
Chamber forms.The spacing head 1.1.2 is located in triangular prism cavity, and a part for the cylindrical needle body of pilot pin 1.1 is located at cylinder
In cavity.
As shown in fig. 6, guide pin 3 is stainless steel, the length of 500 millimeters, 1.0 millimeters a diameter of.As shown in fig. 7, leading
Needle sleeve 4 is made of drill bushing 4.1, connecting rod 4.2, pin 4.3 and handle 4.4, and the present embodiment is selectedMillimeter model is led
Needle sleeve 4, the outer diameter of drill bushing is 7.5 millimeters, length is 250 millimeters.
It is placed in pilot pin 1.1 in the Ipsilateral crista iliaca 5A of pelvis fracture of acetabulum, before the thicker ilium of crista iliaca sclerotin is chosen under local anaesthesia
It is the merging point of pilot pin 1.1 between upper spine and gluteus medius column, electric drill squeezes into pilot pin 1.1 along ilium pulp cavity merging about 40~50
Millimeter, about 70~80 millimeters in addition of skin.Cover upper positioning body 1.2.
Pelvis acetabular bone row CT thin layers (0.5 millimeters thick) scanning of locator 1 is put into, gained DICOM format CT data are led
Enter MIMICS Research17.0, the pelvis acetabular bone with locator threedimensional model 1M as shown in Figure 8 is obtained by 3D modeling
Fracture threedimensional model.
A diameter of 25 millimeters of cylinder is set according to the direction of locator threedimensional model 1M, obtains directed access simulation
Body.A diameter of 30 millimeters of cylinder is set according to the direction of directed access analogue body, obtains outer sleeve analogue body.Such as Fig. 9 institutes
Show, in 7.0 millimeters of cylinder simulation right side S2 screw conduits merging pelvis fracture of acetabulum threedimensional models of diameter, to adjust cylinder
Spatial position, confirm that it has certain space completely in sclerotin and with cortex of bone repeatedly through sagittal plain, Coronal and cross-section position
Afterwards, S2 screw conduits analogue bodies 2.4.1C is obtained.S2 screw conduits analogue body 2.4.1C are extended to both sides, cover skin, really
It protects S2 screw conduits analogue bodies 2.4.1C and is pierced by skin, measure the bone length L1 of S2 screw conduits analogue bodies 2.4.1C(S2)It is (single
Position：Millimeter) and bone face to skin soft tissue length L2(S2)(unit：Millimeter), obtain the internal length of S2 screw conduits
L(S2)=L1(S2)+L2(S2).Cylinder is set according to the direction of S2 screw conduits analogue bodies 2.4.1C, obtains guide channel simulation
Body.
It imports data in GeomagicStudio12.0 softwares, by pelvis fracture of acetabulum threedimensional model protective epithelium
Skin, the position that skin is pierced by with directed access analogue body, outer sleeve analogue body and guide channel analogue body are reference, and design is oriented to
Plate plane, and make 10 millimeters of guide plate plan range skin.It is 8 millimeters by guide plate planar thickening in 3-matic softwares,
Obtain guide plate primary mold.Directed access analogue body and outer sleeve analogue body are blocked from guide plate primary mold lower surface and are adjusted
They whole height, obtains directed access primary mold and outer sleeve primary mold.It is blocked from guide plate primary mold lower surface
Guide channel analogue body and adjust its height be 50 millimeters, obtain guide channel primary mold.To guide plate primary mold, orientation
Channel primary mold, outer sleeve primary mold and guide channel primary mold carry out Boolean calculation, obtain such as Figure 10 and Figure 11 institutes
Guider the threedimensional model 2M, the guider threedimensional model 2M shown includes guide plate threedimensional model 2.1M, directed access three-dimensional
Model 2.2M, outer sleeve threedimensional model 2.3M and guide channel threedimensional model 2.4M (S2 screw guide channels threedimensional model).
Using 3D printer, using photosensitive resin as file printing guider threedimensional model 2M, be arranged printing precision 0.1mm,
Using the high precisely solidification printing of 400mw laser, guider 2 is obtained.Pelvis fracture of acetabulum threedimensional model is similarly printed, pelvis is obtained
Fracture of acetabulum mock-up.Guider 2 and pelvis fracture of acetabulum mock-up to printing carry out low-temperature plasma sterilization, with
It is used in standby art.
As shown in figs. 12-14, the guider 2 that 3D printing obtains includes guide plate 2.1, the orientation being located on guide plate 2.1
Channel 2.2, the outer sleeve 2.3 being socketed in outside directed access 2.2, and it is located at the guide channel 2.4 of 2.1 one end of guide plate.
The guide plate 2.1 is put together by mainboard 2.1a and auxiliary plate 2.1b, and the mosaic of the mainboard 2.1a is equipped with master
The mosaic of channel body 2.2a, the auxiliary plate 2.1b are equipped with secondary channels body 2.2b, the main channel body 2.2a and the secondary channels
Body 2.2b splits form directed access 2.2.The outer diameter of the directed access 2.2 is 25 millimeters, channel inner section is 15 millimeters of x
15 millimeters of square.The outer sleeve 2.3 is in hollow cylindrical structure, and internal diameter is 25 millimeters, outer diameter is 30 millimeters.
The guide channel 2.4 is S2 screw guide channels, it belongs to one kind of sacroiliac screw guide channel, can be used in and control
In the fixed operation for treating sacral fracture.The outer diameter of the guide channel 2.4 is 15 millimeters, internal diameter is 7.5 millimeters.
Operation consent is being carried out, guider 2 is being connected on the locator mock-up of pelvis fracture of acetabulum mock-up, edge
The guide channel 2.4 on guider 2, simulates and is put into artThe guide pin sleeve 4 of millimeter model, then along 4 electricity of guide pin sleeve
Brill squeezes into a diameter of 1.0 millimeters of guide pin 3.After repeatedly confirming, start to perform the operation.
Guider 2 and locator 1 are connected in art, first guide pin sleeve 4 is placed in guide channel 2.4, are arrived at skin, are made
After cutting 1 centimetre of notch on the skin with scalpel, penetrates the soft tissues such as muscle, fascia along former direction and arrive at bone face.It leads on edge
Needle sleeve 4 is placed in guide pin 3, and electric drill squeezes into guide pin 3 to the internal length L of the S2 screw conduits measured in advance(S2), C arm machine perspective
1-2 position confirms that errorless is that can be taken off guide pin sleeve 4, is changed to S2 screws, is screwed into manually, it is true to have an X-rayed 1-2 position again
Recognize.
Guider 2 is inversely removed according to 1 Connection Step of guider 2 and locator, removes the positioning body 1.2 of locator 1,
Pilot pin 1.1 is taken out in electric drill counter-rotating, sews up the incision.
Embodiment 2：External guider for LC2 screws
The external guider for LC2 screws described in the present embodiment includes being positioned by two pilot pins 1.1 and two
The locator 1 of the composition of body 1.2, guider 2 and guide pin 3 and guide pin sleeve 4 by 3D printing acquisition.
The structure and their connection type of two pilot pins 1.1 and two positioning bodies 1.2 with implementation
Example 1 is identical.
The guide pin 3 be stainless steel, the length of 300 millimeters, a diameter of 2.5 millimeters.The guide pin sleeve 4 is selectedMillimeter model, the outer diameter of drill bushing is 7.5 millimeters, length is 150 millimeters.
The preparation method of the guider 2 is similar to Example 1.
Two pilot pins 1.1 are placed in the strong side crista iliaca 5B of pelvis fracture of acetabulum, it is thicker to choose crista iliaca sclerotin under local anaesthesia
It is the merging point of pilot pin 1.1 between anterior superior spine and gluteus medius column, electric drill squeezes into pilot pin 1.1 along ilium pulp cavity merging about 40
~50 millimeters, about 70~80 millimeters in addition of skin.Opposite, right side displacement fracture is apparent, needs operative reduction, then is defined as suffering from
Side, left side displacement is smaller, is defined as strong side.Two positioning bodies 1.2 are put on later.
After putting into pelvis acetabular bone row CT thin layers (0.5 millimeters thick) scanning of two locators 1, by gained DICOM format
CT data import MIMICS Research17.0, and the pelvis fracture of acetabulum three-dimensional mould with locator 1 is obtained by 3D modeling
Type.Sclerite is carried out on the basis of pelvis fracture of acetabulum threedimensional model along fracture line to divide to obtain sclerite disjunctive model.
The single sclerite three-dimensional space position of operation adjustment is normal to restore pelvis acetabular bone on the basis of pelvis fracture of acetabulum threedimensional model
Anatomic form obtains pelvis acetabular bone and resets threedimensional model, can specifically pass through the single sclerite of the operation adjustments such as translation, rotation, overturning
Three-dimensional space position resets threedimensional model to restore pelvis, obtain pelvis acetabular bone in the form of acetabular bone normal anatomy.By each translation, rotation
Turn, overturning step is recorded.It includes fixed that the pelvis fracture of acetabulum threedimensional model and pelvis acetabular bone, which reset on threedimensional model,
Position device threedimensional model 1M.
On the basis of pelvis acetabular bone resets threedimensional model, guider three-dimensional is prepared according to method described in embodiment 1
Model 2M.Figure 15 is one of the state diagram in preparation process, in particular guide plate threedimensional model 1M, two directed access three-dimensionals
Model 2.2M, RLC21 screw conduits analogue body 2.4.2C, RLC22 screw conduits analogue body 2.4.3C and corresponding two guiding
Channel threedimensional model 2.4M (being respectively RLC21 screw guide channel threedimensional models and RLC22 screw guide channels threedimensional model)
The cooperation figure of threedimensional model is resetted with pelvis acetabular bone.
Using 3D printer, using photosensitive resin as file printing guider threedimensional model 2M, be arranged printing precision 0.1mm,
Using the high precisely solidification printing of 400mw laser, guider 2 is obtained.Pelvis fracture of acetabulum threedimensional model is similarly printed, pelvis is obtained
Fracture of acetabulum mock-up.Guider 2 and pelvis fracture of acetabulum mock-up to printing carry out low-temperature plasma sterilization, with
It is used in standby art.
The guider 2 that 3D printing obtains includes guide plate 2.1, two directed access 2.2, two being located on guide plate 2.1
A outer sleeve 2.3 being socketed in respectively outside two directed access 2.2, and it is located at two guide channels of 2.1 one end of guide plate
2.4。
As shown in figure 16, the guide plate 2.1 is put together by mainboard 2.1a and auxiliary plate 2.1b, the spelling of the mainboard 2.1a
It is set at conjunction there are two main channel body 2.2a, the mosaic of the auxiliary plate 2.1b sets that there are two secondary channels body 2.2b, two masters
Channel body 2.2a and two secondary channels body 2.2b splits form two directed access 2.2.Two directed access 2.2
Outer diameter is 25 millimeters, their channel cross-section is the square of 15 millimeters of 15 millimeters of x.
Two guide channels 2.4 are respectively RLC21 screws guide channel and RLC22 screw guide channels, they are all
Belong to acetabular bone screwing guide channel, can be used in the fixed operation for the treatment of fracture of ilium.The RLC21 screws guide channel and
The outer diameter of RLC22 screw guide channels is 15 millimeters, internal diameter is 7.5 millimeters.
Operation consent is being carried out, according to the sclerite for resetting shift separation the step of computer simulation, guider 2 is being connected to
On the locator mock-up of pelvis fracture of acetabulum threedimensional model, along the guide channel 2.4 on guider 2, simulates and put in art
EnterThe guide pin sleeve 4 of millimeter model, then squeeze into a diameter of 2.5 millimeters of guide pin 3 along 4 electric drill of guide pin sleeve.Confirm repeatedly
Afterwards, start to perform the operation.
According to the sclerite for resetting shift separation the step of computer simulation in art, guider 2 and locator 1 are connected
Afterwards, guide pin sleeve 4 is first placed in the RLC21 guide channels on guider, arrives at skin, 1 is cut on the skin using scalpel
After centimetre notch, penetrates the soft tissues such as muscle, fascia along former direction and arrive at bone face.It is placed in guide pin 3, electric drill along guide pin sleeve 4
Guide pin 3 is squeezed into the internal length L of the RLC21 screw conduits measured in advance(RLC21), it is errorless that C arm machine has an X-rayed 1-2 position confirmation
Guide pin sleeve 4 is can be taken off, RLC21 screws is changed to, is screwed into manually, 1-2 position is had an X-rayed again and confirms.It similarly can be with
It is implanted into RLC22 screws.
After the completion of waiting for RLC21 screws and RLC22 screw placements, inversely taken according to guider 2 and the Connection Step of locator 1
Lower guider 2, removes the positioning body 1.2 of locator, and electric drill counter-rotating takes out pilot pin 1.1, sews up the incision.
Embodiment 3：External guider for anterior column lag screw
External guider, preparation method and the application method for anterior column lag screw described in the present embodiment with implementation
Example 1 is similar, the difference is that：
The guide channel 2.4 is anterior column lag screw guide channel, can be used in the fixed operation of spinous process of the seventh cervical vertebra folding before the treatment.It is described
A diameter of 1.0 millimeters of guide pin 3, length be 400 millimeters, the guide pin sleeve 4 is selectedMillimeter model, outer diameter 7.5
Millimeter, length are 150 millimeters.
Embodiment 4：It can be used for the external guider of anterior column lag screw and S1/S2 screws simultaneously
External guider, the preparation method that can be used for anterior column lag screw and S1/S2 screws simultaneously described in the present embodiment
It is similar with embodiment 1, embodiment 3 with application method, the difference is that：
Include three guide channel 2.4M simultaneously on the guider 2, respectively anterior column lag screw guide channel, S1 screws is led
To channel and S2 screw guide channels, can be passed through respectively for anterior column lag screw, S1 screws and S2 screws.The guide pin 3 it is a diameter of
1.0 millimeters, length be 400 millimeters, the guide pin sleeve 4 is selectedMillimeter model, its outer diameter are 7.5 millimeters, length is
150 millimeters.
Claims (13)
1. the outer guider of the channel body of screw for pelvis fracture of acetabulum, it is characterised in that：Including locator (1.1), it is oriented to
Device (2), guide pin (3), and it is socketed in the guide pin sleeve (4) of guide pin (3) outside；
The locator (1) includes pilot pin (1.1) and the positioning body (1.2) equipped with cavity (1.2.1)；The pilot pin
(1.1) one end is fixed in Ipsilateral crista iliaca (5A) or strong side crista iliaca (5B), and the other end of the pilot pin (1.1) is located at cavity
In (1.2.1)；
The guider (2) includes the guide plate (2.1) to match with pelvis acetabular bone skin surface (6), is located at guide plate (2.1)
On directed access (2.2), be socketed in the outer sleeve (2.3) of directed access (2.2) outside, and be located at guide plate (2.1) one end
The guide channel (2.4) passed through for channel screw；The guide plate (2.1) by mainboard (2.1a) and (2.1b) split of auxiliary plate and
At the mosaic of the mainboard (2.1a) is equipped with main channel body (2.2a), and the mosaic of the auxiliary plate (2.1b) is equipped with secondary channels
Body (2.2b), the main channel body (2.2a) and secondary channels body (2.2b) split form directed access (2.2), described directed access
(2.2) it is outside and fixed by outer sleeve (2.3) to be coated on positioning body (1.2).
2. the outer guider of the channel body of screw according to claim 1 for pelvis fracture of acetabulum, it is characterised in that：Institute
It states locator (1) and includes one or two pilot pins (1.1), then the positioning body (1.2), directed access (2.2) and outer sleeve
(2.3) the quantity correspondent equal of quantity and pilot pin (1.1).
3. the outer guider of the channel body of screw according to claim 1 or 2 for pelvis fracture of acetabulum, feature exist
In：One end of the pilot pin (1.1) is equipped with tapping screw thread (1.1.1), and the other end of the pilot pin (1.1) is equipped with spacing head
(1.1.2)。
4. the outer guider of the channel body of screw according to claim 3 for pelvis fracture of acetabulum, it is characterised in that：Institute
It states positioning body (1.2) to be made of carbon fiber, the positioning body (1.2) is in triangular prism or tetragonous rod structure.
5. the outer guider of the channel body of screw according to claim 4 for pelvis fracture of acetabulum, it is characterised in that：Institute
The lower surface for stating guide plate (2.1) is 8 millimeters -15 millimeters at a distance from pelvis acetabular bone skin surface (6), the guide plate
(2.1) thickness is 8 millimeters -12 millimeters；The height of the guide channel (2.4) is 20 millimeters -50 millimeters.
6. the outer guider of the channel body of screw according to claim 4 for pelvis fracture of acetabulum, it is characterised in that：Institute
State guide channel (2.4) include acetabular anterior column screw guide channel, acetabular posterior column screw guide channel, iliac screw be oriented to it is logical
Road, acetabular bone screwing guide channel, sacroiliac screw guide channel and through the one or several kinds in sacral screw guide channel.
7. the outer guider of the channel body of screw according to claim 5 or 6 for pelvis fracture of acetabulum, feature exist
In：The guide pin (3) is equipped with scale (3.1).
8. preparing the side of the outer guider of the channel body of screw described in any one of claim 1-7 for pelvis fracture of acetabulum
Method, it is characterised in that：The method for preparing the guider (2) includes
Step P1：Pilot pin (1.1) is percutaneously inserted into Ipsilateral crista iliaca (5A) or strong side crista iliaca (5B), upper positioning body is covered
(1.2), it assembles locator (1) and carries out CT scan afterwards；
Step P2：CT scan data is imported in MIMICS softwares and establishes pelvis acetabular bone threedimensional model, the pelvis acetabular bone is three-dimensional
It include locator threedimensional model (1M) in model；
Step P3：In MIMICS, Geomagic and 3-matic software, on the basis of pelvis acetabular bone threedimensional model, processing obtains
Guider threedimensional model (2M)；
Step P4：Guider threedimensional model (2M) is printed out using 3D printer, obtains guider (2).
9. according to claim 8 prepare the channel spiral shell for being used for pelvis fracture of acetabulum described in any one of claim 1-7
The method of the outer guider of rivet nut, it is characterised in that：Further include exporting pelvis acetabular bone three dimensional model printing in step P4, obtains
Pelvis acetabular bone mock-up.
10. for the logical of pelvis fracture of acetabulum described in any one of preparation claim 1-7 according to claim 8 or claim 9
The method of the outer guider of the road body of screw, it is characterised in that：The pelvis acetabular bone threedimensional model is pelvis fracture of acetabulum three-dimensional mould
Type or pelvis acetabular bone reset threedimensional model.
11. preparation method according to claim 10, it is characterised in that：It is in bone that the pelvis acetabular bone, which resets threedimensional model,
Processing obtains on the basis of basin fracture of acetabulum threedimensional model.
12. using the side for the outer guider of the channel body of screw of pelvis fracture of acetabulum described in any one of claim 1-7
Method, it is characterised in that：Including
Step U1：The positioning body (1.2) that directed access (2.2) split of guider (2) is coated on locator (1) outside, is used in combination
Outer sleeve (2.3) is fixed；
Step U2：By in guide pin sleeve (4) merging guide channel (2.4), skin is cut, penetrates the through bone face of soft tissue；
Step U3：By in guide pin (3) merging guide pin sleeve (4), guide pin (3) is squeezed into pelvis acetabular bone with electric drill；
Step U4：Guide pin sleeve (4) is taken out, by screw merging guide channel (2.4), is screwed into manually in pelvis acetabular bone.
13. according to claim 12 use the channel for being used for pelvis fracture of acetabulum described in any one of claim 1-7
The method of the outer guider of the body of screw, it is characterised in that：It further include the pelvis acetabular bone obtained using 3D printing before step U1
Mock-up carries out preoperative simulation and sets nail.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810135965.XA CN108403202B (en) | 2018-02-09 | 2018-02-09 | Channel screw external guiding device for pelvis acetabulum fracture and method thereof |
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|---|---|---|---|
| CN201810135965.XA CN108403202B (en) | 2018-02-09 | 2018-02-09 | Channel screw external guiding device for pelvis acetabulum fracture and method thereof |
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| CN108403202B CN108403202B (en) | 2023-07-28 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810135965.XA Active CN108403202B (en) | 2018-02-09 | 2018-02-09 | Channel screw external guiding device for pelvis acetabulum fracture and method thereof |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN111728689A (en) * | 2020-07-24 | 2020-10-02 | 川北医学院附属医院 | Pelvic fracture posterior ring minimally invasive stabilization system guide plate |
| CN113681895A (en) * | 2021-08-20 | 2021-11-23 | 宜宾显微智能科技有限公司 | Guide pin positioning guide plate customization and simulation verification system and method |
| CN117481772A (en) * | 2023-12-22 | 2024-02-02 | 山东航维骨科医疗器械股份有限公司 | Nail-planting drilling correction device for acetabular posterior column screw |
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| CN102657553A (en) * | 2012-05-02 | 2012-09-12 | 王钢 | Navigation template for implanting acetabulum posterior column screw |
| CN104887301A (en) * | 2015-06-26 | 2015-09-09 | 陈伟 | Pelvic fracture microinvasive intramedullary fixation device |
| US20150289913A1 (en) * | 2013-11-16 | 2015-10-15 | Rahul Vaidya | Method and Apparatus for Minimally Invasive Treatment of Unstable Pelvic Ring Injuries Combined with Hip Arthroplasty |
| CN105769319A (en) * | 2016-03-19 | 2016-07-20 | 王钢 | Posterior fixing steel plate for fracture of acetabular anterior and posterior columns |
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|---|---|---|---|---|
| CN102657553A (en) * | 2012-05-02 | 2012-09-12 | 王钢 | Navigation template for implanting acetabulum posterior column screw |
| US20150289913A1 (en) * | 2013-11-16 | 2015-10-15 | Rahul Vaidya | Method and Apparatus for Minimally Invasive Treatment of Unstable Pelvic Ring Injuries Combined with Hip Arthroplasty |
| CN104887301A (en) * | 2015-06-26 | 2015-09-09 | 陈伟 | Pelvic fracture microinvasive intramedullary fixation device |
| CN105769319A (en) * | 2016-03-19 | 2016-07-20 | 王钢 | Posterior fixing steel plate for fracture of acetabular anterior and posterior columns |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN111728689A (en) * | 2020-07-24 | 2020-10-02 | 川北医学院附属医院 | Pelvic fracture posterior ring minimally invasive stabilization system guide plate |
| CN113681895A (en) * | 2021-08-20 | 2021-11-23 | 宜宾显微智能科技有限公司 | Guide pin positioning guide plate customization and simulation verification system and method |
| CN113681895B (en) * | 2021-08-20 | 2023-03-10 | 宜宾显微智能科技有限公司 | Guide pin positioning guide plate customization and simulation verification system and method |
| CN117481772A (en) * | 2023-12-22 | 2024-02-02 | 山东航维骨科医疗器械股份有限公司 | Nail-planting drilling correction device for acetabular posterior column screw |
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| Publication number | Publication date |
|---|---|
| CN108403202B (en) | 2023-07-28 |
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