CN108814774A - 股骨假体3d安装导向定位器 - Google Patents

股骨假体3d安装导向定位器 Download PDF

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CN108814774A
CN108814774A CN201810673723.6A CN201810673723A CN108814774A CN 108814774 A CN108814774 A CN 108814774A CN 201810673723 A CN201810673723 A CN 201810673723A CN 108814774 A CN108814774 A CN 108814774A
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top rake
angle
femur
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femoral prosthesis
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CN108814774B (zh
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李建文
杨永博
叶锋
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Shaoxing Shangyu Hospital Of Traditional Chinese Medicine
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3859—Femoral components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4601—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

本发明公开了一种股骨假体3D安装导向定位器，包括腘窝杆、股骨杆、前倾角角度标尺、前倾角定位尺；腘窝杆与股骨杆成横向垂直匹配，前倾角角度标尺与股骨杆之间具有倾斜角，该前倾角角度标尺与股骨杆成纵向垂直匹配，该前倾角角度标尺上具有角度平面，该角度平面具有角度刻度线，前倾角定位尺活动旋转的与角度平面平行。本发明可解决如何提供一种结构简单、能准确、快捷的使用定位器对胫骨假体进行定位的装置。

Description

股骨假体3D安装导向定位器
技术领域
本发明涉及一种医疗器械，具体的说是一种骨科医疗器械，用于确定股骨颈前倾角的耙向定位。
背景技术
人体股骨颈的中轴线与股骨内外髁中点间的连线形成的夹角即为前倾角。股骨头类似球形，约2/3表面有光节软管，股骨头约1/2被半球形髋臼窝包容，另一部分为环状纤维软骨性的关节包容。股骨颈细长，股骨颈与股骨干之间形成颈干角，成人约127度左右。正常时，股骨头略向前倾，股骨颈的纵轴线与股骨两颗额状平面形成的角度为前倾角，约12-15度。
股骨颈和转子部粉碎性骨折，既是骨科临床上的常见病，多发病，也是治疗上的难点和重点。GardenIII、IV型股骨颈，股骨头坏死，无法手术重建的转子部粉碎性骨折，以及股骨近端恶性肿瘤行骨切除等，通常需要重建下肢力学的稳定性，需要行人工髋关节置换，由于股骨头这个耙是模糊的，手术成功的关键主要在于掌控好安装股骨颈假体的前倾角，这就取决于股骨颈前倾角导针正确的方向。目前，现有技术存在如下不足：1、作大切口手术，将整个股骨头颈连同粗隆部股骨干都予显露，虽然在肉眼的直视下能较为准确击入导向针，但组织损伤过大，要切断肌肉，结扎供应股骨头颈的血管，容易导致术后股骨坏死，现已较少采用。2、股骨颈前倾角的掌握，在临床操作中，比较模糊，不够具体化和形象化，容易过大或过小，导致假体磨损加大，使用寿命缩短，并发症较多。3、中国专利公开了一种专利号982186916，名称为“骨折内固定辅助定位导向装置”的发明专利，另一种专利号为992224772，名称为“股骨颈和粗隆间骨折穿枕定位器”的发明专利。这两种专利虽然结构简单，且对导向针具有一定的定位作用，但是，由于没有明确的定位目标参考点，导向针的方向难以定位，特别是用于股骨颈和股骨粗隆之间错综复杂的骨折方式，骨肿瘤致使解剖结构的破坏，难以对导向针进行精确定位，因此定位准确率低，难以推广应用，不是真正意义上的定位功能，这也是我院在实际医疗救治中碰到的问题，如何准确、快捷的击入导向针是困扰了几代医务工作者的一大难度，我院资深医师经过多次尝试最终获得解决上述技术问题的技术方案。
发明内容
本发明的目的是提供一种股骨假体3D安装导向定位器，解决如何提供一种结构简单、能准确、快捷的使用定位器对胫骨假体进行定位的装置。
股骨假体3D安装导向定位器，包括腘窝杆、股骨杆、前倾角角度标尺、前倾角定位尺；腘窝杆与股骨杆成横向垂直匹配，前倾角角度标尺与股骨杆之间具有倾斜角，该前倾角角度标尺与股骨杆成纵向垂直匹配，该前倾角角度标尺上具有角度平面，该角度平面具有角度刻度线，前倾角定位尺活动旋转的与角度平面平行。
所述股骨杆为伸缩式股骨杆。
所述股骨杆包括内固定套和外活动套，内固定套固定在腘窝杆上，内固定套与外活动套活动配合，外活动套固定在前倾角角度标尺上。
所述内固定套上具有定位条，外活动套上具有定位槽，上述定位条与定位槽匹配或者内固定套上具有定位槽，外活动套上具有定位条，上述定位槽与定位条匹配。
所述腘窝杆上具有缺口的腘窝套。
所述前倾角定位尺活动转动固定在股骨杆上或者活动转动固定在前倾角定位尺上。
本发明的有益效果是：在使用本医疗器械前，患者保持侧躺体位，将股骨头取出，将腘窝杆放置在患者的腘窝处同时将患者的小腿保持与床面垂直，股骨杆保持与股骨干对齐使前倾角的角度平面与股骨颈的纵向平面对齐，通过观察，使前倾角定位尺上的指针调整到与患者的股骨颈的前倾角对齐，从而将肉眼观察的角度实时显示为前倾角定位尺上的刻度值，从而提高安装定位精度。本案件还特别适用于当小转子结构破坏，采用传统导向定位无法准确定位的情况，从而弥补目前的定位缺陷问题。
附图说明
图1是安装导向定位器的示意图；
图2是图1中的安装导向定位器的A向示意图；
图3是股骨的示意图；
图4是显示股骨杆采用收缩式结构的示意图；
图5是安装导向定位器实际应用中的应用示意图；
图中 1. 腘窝杆、2. 股骨杆、21. 内固定套、22. 外活动套、3. 前倾角角度标尺、31.角度平面、4. 前倾角定位尺、5.股骨、51.腘窝、52.股骨干、53.股骨颈、54. 大腿、55.、小腿。
具体实施方式
请参考图1至图5，图中的股骨假体3D安装导向定位器，包括一个腘窝杆1、一个股骨杆2、一个前倾角角度标尺3、一个前倾角定位尺4。腘窝杆1用于给整个定位器在患者的腘窝处51提高定位点，腘窝处51为患者的大腿54与小腿55之间的位置；股骨杆2用于保持股骨杆2与患者的股骨干52平齐；前倾角角度标尺3用于给前倾角定位尺4提供测量用的角度刻度线；前倾角定位尺4用于实施测量患者的股骨颈前倾角的角度。
腘窝杆1为圆杆或者方杆或者其他形状，只要将其放置在处于侧躺体位的患者的腘窝处51即可，该腘窝杆1的材质也可根据需要进行选择，为了能牢固的使腘窝杆1固定在患者的腘窝处51，可在腘窝杆1上加上一个具有方便穿戴的缺口的腘窝套，该腘窝套可采用软质材料制成，如硅胶材质，在此提示，腘窝套并不一定是必须要使用的。该腘窝杆1与股骨杆2成横向垂直固定在一起，所谓横向垂直固定可以理解为腘窝杆1为X轴，股骨杆2为Y轴，腘窝杆1与股骨杆2为一体式结构或者分体式结构。
股骨杆2为圆杆或者方杆或者其他形状，只要将其放置在处于侧躺体位的患者的股骨干52并保持与其平行即可，该股骨杆2为不能伸缩的结构或者为伸缩的结构。当股骨杆2为伸缩式结构时，可将股骨杆2设计成包括内固定套21和外活动套22两个结构，内固定套21固定在腘窝杆1上，外活动套22固定在前倾角角度标尺3上，内固定套21上具有定位条，外活动套22上具有定位槽，上述定位条与定位槽匹配。在实际应用中还可以在内固定套21上设计定位槽，外活动套22上设计定位条，上述定位槽与定位条匹配。在实际应用中，股骨杆2的伸缩结构也可以采用现有常规的伸缩结构。
前倾角角度标尺3与股骨杆2之间具有倾斜角，该倾斜角为一个常规值；该前倾角角度标尺3与股骨杆2成纵向垂直匹配，该前倾角角度标尺3上具有角度平面31，该角度平面31具有角度刻度线。所谓纵向垂直匹配可理解为角度平面31为Z轴，股骨杆2为Y轴，这样与患者股骨5的股骨颈53与股骨杆2的位置配合关系对应。
前倾角定位尺4具有一个指针，该指针活动旋转即摆动的角度与平面31平行，该指针活动转动固定在股骨杆2上或者活动转动固定在前倾角定位尺3上，通过观察，使指针保持与患者的股骨颈53的中轴线保持对齐，此时指针在角度平面上指示出的刻度线即为患者的股骨颈53的前倾角角度值。上述活动转动可理解为两者间隙式配合或者通过轴承等常规配合方式匹配在一起。
为使本发明实施例的目的、技术方案和优点更加清楚，上面结合本发明实施例中的附图，对本发明实施例中的技术方案进行了清楚、完整地描述，显然，所描述的实施例是本发明一部分实施例，而不是全部的实施例。通常在此处附图中描述和示出的本发明实施例的组件可以以各种不同的配置来布置和设计。
因此，以上对在附图中提供的本发明的实施例的详细描述并非旨在限制要求保护的本发明的范围，而是仅仅表示本发明的选定实施例。基于本发明中的实施例，本领域普通技术人员在没有作出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。

Claims (6)

1.股骨假体3D安装导向定位器，其特征在于：包括腘窝杆、股骨杆、前倾角角度标尺、前倾角定位尺；腘窝杆与股骨杆成横向垂直匹配，前倾角角度标尺与股骨杆之间具有倾斜角，该前倾角角度标尺与股骨杆成纵向垂直匹配，该前倾角角度标尺上具有角度平面，该角度平面具有角度刻度线，前倾角定位尺活动旋转的与角度平面平行。
2.根据权利要求1中所述的股骨假体3D安装导向定位器，其特征在于：所述股骨杆为伸缩式股骨杆。
3.根据权利要求2中所述的股骨假体3D安装导向定位器，其特征在于：所述股骨杆包括内固定套和外活动套，内固定套固定在腘窝杆上，内固定套与外活动套活动配合，外活动套固定在前倾角角度标尺上。
4.根据权利要求3中所述的股骨假体3D安装导向定位器，其特征在于：所述内固定套上具有定位条，外活动套上具有定位槽，上述定位条与定位槽匹配或者内固定套上具有定位槽，外活动套上具有定位条，上述定位槽与定位条匹配。
5.根据权利要求1中所述的股骨假体3D安装导向定位器，其特征在于：所述腘窝杆上具有缺口的腘窝套。
6.根据权利要求1中所述的股骨假体3D安装导向定位器，其特征在于：所述前倾角定位尺活动转动固定在股骨杆上或者活动转动固定在前倾角定位尺上。
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