CN109620380B - Mandibular double chin hole area fracture reduction fixing guide plate - Google Patents
Mandibular double chin hole area fracture reduction fixing guide plate Download PDFInfo
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- CN109620380B CN109620380B CN201910054431.9A CN201910054431A CN109620380B CN 109620380 B CN109620380 B CN 109620380B CN 201910054431 A CN201910054431 A CN 201910054431A CN 109620380 B CN109620380 B CN 109620380B
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
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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
-
- 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
- A61B17/8071—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for the jaw
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/568—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor produced with shape and dimensions specific for an individual patient
Abstract
The invention relates to the field of maxillofacial surgical medical instruments, in particular to a 3D printing personalized reset fixing guide plate capable of accurately treating mandibular double-chin-hole area comminuted fracture, which is characterized in that: the reset fixing guide plate is provided with a plate groove, parallel wings, screw small holes and reinforcing rods; the length of the plate groove is consistent with that of the formed titanium plate, and the plate groove is used for placing the titanium plate in an operation; the parallel wings are provided with upper edges and lower edges of the parallel wings, inner side surfaces of the parallel wings and outer side surfaces of the parallel wings, and the lower edges of the parallel wings enter the lower edges of the mandibles to play a role in fixing, and the inner side surfaces of the parallel wings are completely attached to the outer side surfaces of the mandibles; the reinforcing rod is connected with the parallel wings on the upper side and the lower side, plays a role in reinforcing, and the screw small holes are positioned on the two sides of the guide plate and used for fixing the guide plate in operation. The resetting and fixing guide plate has the advantages of simple structure, simple and convenient design, low 3D printing cost and simple and convenient operation, and is beneficial to a maxillofacial surgeon to reset and fix complex mandible fracture in operation, thereby achieving the aim of accurate operation, reducing the operation difficulty and shortening the operation time.
Description
Technical Field
The invention relates to the field of maxillofacial surgical medical instruments, in particular to a mandibular double chin hole area fracture reduction fixing guide plate.
Background
Mandibular fracture is mainly caused by trauma, and in recent years, the incidence of mandibular fracture is also increasing year by year with the increasing frequency of car accidents and the like. Mandibular fracture can be single or multiple, and is often a comminuted fracture when a firearm is injured, and is mainly characterized by clinical manifestations of fracture segment displacement, malocclusion, and the like. Has better treatment method and high cure rate. Early fracture redirection and fixation are critical.
Mandibular fracture, particularly complex mandibular fracture, can lead to deformity of the patient's face and loss of oromandibular system function, and the treatment gist of a mandibular fracture patient is most important to accurately restore its normal anatomical morphology to thereby reconstruct the aesthetic and normal oromandibular system physiological function of the face. Wherein, the mandibular double chin hole area comminuted fracture needs to relate to the combined use of the reconstruction plate and the small bone fracture plate because of bone block comminution, and the clinical treatment is quite difficult. How to accurately perform anatomic reduction on crushed bone blocks, accurately place bone plates and rebuild plates, rebuild correct occlusion relation, avoid damaging important anatomic structures such as chin nerves and the like, and are important points and difficulties in fracture surgery.
At present, digital surgical technology is rapidly developed and widely applied to the surgical treatment of mandibular fracture, and accurate repair and functional reconstruction are targets of the surgical accurate treatment, wherein the most applied digital medical means comprise surgical navigation, titanium plate preforming and 3D guide plate technology. The navigation technology is easy to generate certain systematic errors, the registration is likely to fail, the operation is relatively complex, and the application in the treatment of the mandible fracture is less. The titanium plate preforming technology is to perform titanium plate preforming on a preoperative 3D printing model, and the preformed titanium plate is placed at a position which is simulated and placed before the operation in the operation, so that the reduction and fixation of fracture can be accurately assisted, and the titanium plate preforming technology has been widely applied to mandibular fracture in recent years. However, in the treatment of the mandibular double chin hole area comminuted fracture, the reconstruction plate and the small bone fracture plate need to be preformed (the conventional treatment scheme is that one reconstruction plate and two small bone fracture plates are used in combination), and the reconstruction plate has large volume and high mechanical strength, so that the preforming is difficult, and under the condition of lacking an auxiliary positioning device, the actual placement position of the reconstruction plate in operation and the simulated placement position of the reconstruction plate on the model before operation often have larger deviation, and the requirement of accurate treatment cannot be met.
The guide plate technology is convenient to operate and has small error, so that the guide plate technology is more applied in the operation, but the guide plate has certain problems in the practical operation application process. The existing fracture reduction guide plate can only be used for rechecking the reduction effect of the operation, cannot assist in fixing the mandible fracture, and is lack of a structure for guiding the titanium plate to be in place, so that the preformed titanium plate is difficult to accurately position. Therefore, how to reasonably and optimally design the digital surgical guide plate to accurately reset the fractured bone end, effectively guide the preformed reconstruction plate to accurately position, reduce errors of preoperative design and preforming, reduce operation difficulty and shorten time, thereby achieving the aim of accurately and individually treating the complex mandible fracture, and being a problem to be solved clinically urgently.
Disclosure of Invention
In order to solve the technical problems, the invention provides the 3D printing personalized reset fixing guide plate for the mandibular double-chin-hole fracture, which can accurately treat the mandibular double-chin-hole fracture, has the advantages of simple structure, low cost and simple and convenient operation, and is beneficial to a maxillofacial surgeon to reset and fix the mandibular double-chin-hole fracture in operation, thereby achieving the aim of accurate operation, reducing the operation difficulty and shortening the operation time.
The invention provides a mandibular double chin hole area fracture reduction fixing guide plate for solving the technical problems, which comprises a guide plate body and is characterized in that: the bone fracture plate clamping groove and/or the reconstruction plate clamping groove, parallel wings, screw small holes and chin hole positioning grooves are formed in the parallel wings, the inner side surfaces of the parallel wings and the outer side surfaces of the parallel wings are formed in the parallel wings, the inner side surfaces of the parallel wings are completely attached to the outer side surfaces of mandibles required by preoperative simulation, and the screw small holes are formed in the left end part and the right end part of Ping Hangyi; the parallel wings are formed by connecting an upper parallel wing and a lower parallel wing, the left end and the right end of the upper parallel wing and the left end and the right end of the lower parallel wing are respectively connected into a whole, and the reconstruction plate clamping groove is arranged between the upper parallel wing and the lower parallel wing and is used for implanting a reconstruction plate; the middle part of the upper parallel wing is provided with a bulge, and bone fracture plate clamping grooves are positioned at two sides of the bulge and are used for implanting a small bone fracture plate; the chin hole positioning groove is arranged at the end part of the upper parallel wing and corresponds to the chin hole position of the mandible.
The screw small holes are positioned at two sides of the guide plate and used for fixing the guide plate in operation; the chin hole locating slots are arranged on two sides of the upper edges of the parallel wings and used for accurately locating the chin hole in operation, so that important anatomical structures such as the chin nerve and the like are prevented from being damaged in operation, and the chin nerve and the blood vessel are required to be prevented from being damaged because the lower alveolar nerve and the blood vessel enter the mandibular duct from the mandibular hole and move forward.
According to the fracture operation type, if the fracture operation needs to use a reconstruction plate and a small bone fracture plate at the same time, a bone fracture plate clamping groove and a reconstruction plate clamping groove are simultaneously arranged.
The bone fracture plate clamping groove and the reconstruction plate clamping groove are hollow, the length and the width are consistent with the length and the width of the preformed small bone fracture plate or reconstruction plate, and the bone fracture plate clamping groove and the reconstruction plate clamping groove are used for placing the small bone fracture plate and the reconstruction plate in operation and guiding the small bone fracture plate and the reconstruction plate to be in place.
The left end and the right end of the parallel wings are edges of the rebuilding board clamping groove, the distance from the edges of the rebuilding board is 0.8 cm to 1.2cm, the stability of the guide plate is enhanced, and the whole parallel wings are designed to be attached to the bone surface. The lower edge of the human mandible is in a curve shape, and the bottom edge of the lower parallel wing is correspondingly in a curve shape.
The distance between the bone fracture plate clamping groove and the tooth root end is more than or equal to 5mm. According to the bone fracture plate clamping groove and the reconstruction plate clamping groove, chin hole areas are needed to be avoided, two bone fracture plate clamping grooves with the lengths of the titanium nail holes are reserved at two ends of a fracture line, and the bone fracture plate clamping grooves are located at the position of at least 5mm below a tooth root.
And the two chin hole positioning grooves are respectively arranged at the left end part and the right end part of the upper parallel wing and correspond to the two chin hole positions of the mandible. The shape of the chin hole positioning grooves at two sides can be different, and the purpose is to avoid the positions of the chin holes, and the positions of the chin holes on the mandible are positioned, and the openings of the chin hole positioning grooves are positioned at the corresponding positions.
The bottom edge of the lower parallel wing is provided with a lower parallel flange which is an irregular curve, the inner buckle enters the lower edge of the mandible and extends inwards, and the shape is completely attached to the lower edge of the mandible required by preoperative simulation; playing a role of fixing. The lower parallel flange inner buckle is wound to the inner side of the mandible, so that the retention is convenient, the mandible shape is completely attached, and the width of the inner buckle wound to the inner side of the mandible is 2-3mm.
The thickness of the parallel wings is 1.8-2.1mm, and in the optimized scheme, 2.0mm. The fractured ends of the bones are fixed in an auxiliary resetting way, and the fixing of the guide plate on the jawbone can be assisted.
The diameter of the small hole of the screw is 2-2.3mm, and in the optimized scheme, the diameter of the small hole of the screw is 2.2mm. The screw small holes are positioned at two sides of the guide plate and used for fixing the guide plate in operation.
The guide plate is also provided with a reinforcing rod, one end of the reinforcing rod is connected with the upper parallel wing, and the other end of the reinforcing rod is connected with the lower parallel wing. The reinforcing rod is connected with the upper parallel wing and the lower parallel wing to play a role in reinforcing.
The reinforcing rod is in a curved cylindrical shape and is arranged in the middle of the parallel wings. The connection between the reinforcing rod and the outer side surface of the parallel wing can be fixed, namely, the two ends of the reinforcing rod and the parallel wing are fixed into a whole, and the reinforcing rod and the parallel wing are also integrated during manufacturing. Or can be a movable connection. Different parallel wings use the reinforcing rods of the same mode, save materials and reduce cost.
According to the invention, the guide plate can be fixed on the mandible model before operation, titanium plate preforming is carried out according to the length of the plate groove, time for forming the titanium plate during operation is saved, the reset fixing guide plate is placed on the mandible during operation and then is drilled on the mandible according to screw small holes on parallel wings, and then the reset fixing guide plate is fixed on the mandible by using titanium nails with the length of 9mm and the diameter of 1.5mm, so that the reset fixing guide plate and the mandible form a whole, the reset of a broken end of the bone is guided, and the broken end of the bone is fixed in an auxiliary mode. Then accurately placing the pre-formed titanium plate in the plate groove before operation, and taking down the reset fixing guide plate after the titanium nails are implanted to fix the titanium plate, thereby achieving the aim of accurate treatment.
The resetting and fixing guide plate has the advantages of simple structure, simple and convenient design, low 3D printing cost and simple and convenient operation, and is beneficial to a maxillofacial surgeon to reset and fix complex mandible fracture in operation, thereby achieving the aim of accurate operation, reducing the operation difficulty and shortening the operation time. And the clinical personnel can be designed by themselves after slightly training; in clinical use, the method is simple and easy to use, can be used skillfully by slightly adding the description, is accurate in positioning in operation, greatly improves the accuracy of operation, simultaneously can easily position a pre-formed titanium plate before operation, saves the time for pre-forming the titanium plate in operation, shortens the operation time by about 40-50 minutes on average, and obviously improves the operation efficiency.
Drawings
FIG. 1 is a schematic view of a reset fixing guide plate according to the present invention
FIG. 2 is a schematic view of the structure of the reduction fixing guide plate in the operation of the present invention
The specific identification in the figure is as follows: 1. bone plate clamping groove, 2, reconstruction plate clamping groove, 3, parallel wings, 4, screw small holes, 5, reinforcing rods, 6, upper parallel wings, 7, lower parallel wings, 8, parallel wing outer sides, 9, parallel wing inner sides, 10, mandible outer sides, 11, chin hole positioning groove, 12, lower parallel flanges, 13, small bone plate, 14, reconstruction plate, 15, chin hole
Detailed Description
The invention is further described in connection with the following embodiments:
example 1
The fracture reduction fixing guide plate for the mandibular double chin hole area is provided with a bone fracture plate clamping groove, a reconstruction plate clamping groove, parallel wings, screw small holes and chin hole positioning grooves, wherein the parallel wings are provided with parallel wing inner side surfaces and parallel wing outer side surfaces, the shapes of the parallel wing inner side surfaces are completely attached to the mandibular outer side surfaces required by preoperative simulation, and the screw small holes are positioned at left and right end parts of Ping Hangyi; the parallel wings are formed by connecting an upper parallel wing and a lower parallel wing, the left end and the right end of the upper parallel wing and the left end and the right end of the lower parallel wing are respectively connected into a whole, and the reconstruction plate clamping groove is arranged between the upper parallel wing and the lower parallel wing and is used for implanting a reconstruction plate; the middle part of the upper parallel wing is provided with a bulge, and bone fracture plate clamping grooves are positioned at two sides of the bulge and are used for implanting a small bone fracture plate; the chin hole positioning groove is arranged at the end part of the upper parallel wing and corresponds to the chin hole position of the mandible.
The bone fracture plate clamping groove and the reconstruction plate clamping groove are hollow, the length and the width are consistent with the length and the width of the preformed small bone fracture plate or reconstruction plate, and the bone fracture plate clamping groove and the reconstruction plate clamping groove are used for placing the small bone fracture plate and the reconstruction plate in operation and guiding the small bone fracture plate and the reconstruction plate to be in place.
The position of the clamping groove is changed according to the fracture type of the patient, in the embodiment, because the reconstruction plate is arranged along the lower edge of the mandible, and the small bone fracture plate is arranged at the position 5mm below the root tip, the clamping groove is also arranged at the corresponding position. The shape and size of the clamping groove are flexibly changed according to the different bone plates, and the two sides of the clamping groove are the same bone plates in the embodiment, so the shape and the size are similar, as shown in fig. 2.
The left end and the right end of the parallel wings are edges of the rebuilding board clamping groove, the distance from the edges of the rebuilding board is 0.8 cm or 1.2cm, the stability of the guide plate is enhanced, and the whole parallel wings are designed to be attached to the bone surface. The lower edge of the human mandible is in a curve shape, and the bottom edge of the lower parallel wing is correspondingly in a curve shape.
The distance between the bone fracture plate clamping groove and the tooth root end is more than or equal to 5mm. And the two chin hole positioning grooves are respectively arranged at the left end part and the right end part of the upper parallel wing and correspond to the two chin holes of the mandible.
The bottom edge of the lower parallel wing is provided with a lower parallel flange which is an irregular curve, the inner buckle enters the lower edge of the mandible and extends inwards, and the shape is completely attached to the lower edge of the mandible required by preoperative simulation; playing a role of fixing. The lower parallel flange inner buckle is wound to the inner side of the mandible, so that the retention is convenient, the mandible shape is completely attached, and the width of the inner buckle wound to the inner side of the mandible is 2 or 3mm.
The thickness of the parallel wings is 2 or 2.5mm, and the parallel wings can assist in resetting and fixing the broken end of the bone and can also assist in fixing the guide plate on the jawbone.
The diameter of the screw small hole is 2mm, and the screw small holes are positioned at two sides of the guide plate and used for fixing the guide plate in operation.
Example 2
The fracture reduction fixing guide plate for the mandibular double chin hole area is provided with a bone fracture plate clamping groove or a reconstruction plate clamping groove, parallel wings, screw small holes, a reinforcing rod and chin hole positioning grooves, wherein the parallel wings are provided with parallel wing inner side surfaces and parallel wing outer side surfaces, the shapes of the parallel wing inner side surfaces are completely attached to the mandibular outer side surfaces required by preoperative simulation, and the screw small holes are formed in left and right end parts of Ping Hangyi; the parallel wings are formed by connecting an upper parallel wing and a lower parallel wing, the left end and the right end of the upper parallel wing and the left end and the right end of the lower parallel wing are respectively connected into a whole, and the reconstruction plate clamping groove is arranged between the upper parallel wing and the lower parallel wing and is used for implanting a preformed reconstruction plate; the middle part of the upper parallel wing is provided with a bulge, and the clamping grooves of the small bone fracture plate are positioned at two sides of the bulge and are used for implanting the small bone fracture plate; the chin hole positioning groove is arranged at the end part of the upper parallel wing and corresponds to the chin hole position of the mandible; one end of the reinforcing rod is connected with the upper parallel wing, and the other end is connected with the lower parallel wing. The reinforcing rod is connected with the upper parallel wing and the lower parallel wing to play a role in reinforcing. The reinforcing rod is in a curved cylindrical shape and is arranged in the middle of the parallel wings. The connection between the reinforcing rod and the outer side surface of the parallel wing can be fixed, namely, the two ends of the reinforcing rod and the parallel wing are fixed into a whole, and the reinforcing rod and the parallel wing are also integrated during manufacturing. Or can be a movable connection. Different parallel wings use the reinforcing rods of the same mode, save materials and reduce cost.
The bone fracture plate clamping groove and the reconstruction plate clamping groove are hollow, the length and the width are consistent with the length and the width of the preformed small bone fracture plate and the preformed reconstruction plate, and the small bone fracture plate clamping groove and the reconstruction plate clamping groove are used for placing the small bone fracture plate and the reconstruction plate in operation and guiding the small bone fracture plate and the reconstruction plate to be in place.
The left end and the right end of the parallel wings are edges of the rebuilding board clamping groove, the distance from the edges of the rebuilding board is 1cm, the stability of the guide plate is enhanced, and the whole parallel wings are in joint bone surface design. The lower edge of the human mandible is in a curve shape, and the bottom edge of the lower parallel wing is correspondingly in a curve shape.
The distance between the bone fracture plate clamping groove and the tooth root end is more than or equal to 5mm. According to the bone fracture plate clamping groove and the reconstruction plate clamping groove, chin hole areas are needed to be avoided, two bone fracture plate clamping grooves with the lengths of the titanium nail holes are reserved at two ends of a fracture line, and the bone fracture plate clamping grooves are located at the position of at least 5mm below a tooth root.
And the two chin hole positioning grooves are respectively arranged at the left end part and the right end part of the upper parallel wing and correspond to the two chin holes of the mandible. The shape of the chin hole positioning grooves at two sides can be different, so that the positions of the chin holes are avoided, and the positions of the positioning grooves are consistent with the positions of the chin holes on the mandible.
The bottom edge of the lower parallel wing is provided with a lower parallel flange which is an irregular curve, the inner buckle enters the lower edge of the mandible and extends inwards, and the shape is completely attached to the lower edge of the mandible required by preoperative simulation; playing a role of fixing. The lower parallel flange inner buckle is wound to the inner side of the mandible, is convenient to keep, is completely attached to the shape of the mandible, and the width of the inner buckle wound to the inner side of the mandible is 3mm.
The parallel wings have a thickness of 2.0mm. The fractured ends of the bones are fixed in an auxiliary resetting way, and the fixing of the guide plate on the jawbone can be assisted.
The diameter of the screw small hole is 2.2mm. The screw small holes are positioned at two sides of the guide plate and used for fixing the guide plate in operation.
The guide plate is a 3D printing personalized reset fixing guide plate capable of accurately assisting in treating the mandibular double-chin hole area comminuted fracture, the groove for placing the preformed titanium plate is designed on the guide plate, the preformed titanium plate can be preformed on the groove and the jaw model before operation, the placement of the titanium plate can be guided by the plate groove during operation, the error is reduced, the purpose of assisting in accurate resetting of the fracture is achieved, and the method is beneficial to reconstructing good facial and physiological functions of a patient.
The two chin hole positioning grooves are formed in that each person has left and right chin holes. The mandibular duct is penetrated with a hole between the first premolars and the second premolars, called chin hole. The chin nerve blood tube bundle runs at the chin hole, and the position must be avoided during operation.
The small bone fracture plate and the reconstruction plate are preformed before operation according to the plate groove and the mandible model, time for forming a titanium plate in operation is saved, a reset fixing guide plate is placed on the mandible in operation and then is drilled on the mandible according to screw small holes on parallel wings, and then the reset fixing guide plate is fixed on the mandible by using titanium nails with the length of 7mm and the diameter of 1.5mm, so that the reset fixing guide plate and the mandible form a whole, the reset of a broken end of a bone is guided, and the broken end of the bone is fixed in an auxiliary mode. Then accurately placing the pre-formed titanium plate in the plate groove before operation, and taking down the reset fixing guide plate after the titanium nails are implanted to fix the titanium plate, thereby achieving the aim of accurate treatment.
Test one
The male patient is 41 years old, the facial form of the male patient is asymmetric, the lower jaw of the two sides is obviously swollen, the lower part of the face is elongated, the lower jaw body is pressed to be painful (+), the male patient can feel the bone step, the mouth opening is limited, the mouth opening degree is about two transverse fingers, the occlusion relation is disordered, the rear teeth of the two sides are contacted early, and Yu Ya is opened and closed. After the initial dissection and reduction of the mandible fracture of a patient in operation, the reduction fixing guide plate is placed on the mandible on both sides, and the preformed small bone fracture plate and the reconstruction plate before the operation are implanted, so that the titanium plate is in place well and can be attached to the mandible surface. And (3) re-splicing the occlusion relation, implanting an occlusion guide plate, and pulling the occlusion guide plate between jaws to ensure that the occlusion of a patient is recovered well. The swelling of the face of the patient after 1 month of operation is basically resolved, the wound heals, the appearance of the face is basically symmetrical, the occlusion relationship is well restored, and the review CT indicates that all titanium plates are well positioned.
Test II
The invention was used by a total of 19 patients in the jaw double chin hole area fracture patients treated in the oral hospital of university of Sichuan Hua Xi, 6 months to 2018 months 2016. In the postoperative review follow-up, no obvious symptoms such as lower lip numbness and the like appear after the operation of 19 patients. The occlusion relationship of 19 patients is recovered well after 1 month of postoperative review, wherein the wound of 18 patients is well healed, the surface shape is basically symmetrical, and only 1 patient has the symptoms of wound infection in the operative area and continuous swelling and pus discharge. The medical history of the patient is tracked, and the mucous membrane in the mouth is damaged when the patient is injured, so that the through injury inside and outside the mouth is formed, and the wound is obviously infected with pus symptom before operation because local medical conditions are limited and debridement and suturing are not performed in time.
The test result shows that the personalized reset fixing guide plate greatly improves the operation success rate of the fracture of the chin hole area of the mandible and reduces the occurrence probability of postoperative complications (such as chin nerve symptoms, infection of the operation area and the like).
The personalized reset fixed guide plate manufacturing process comprises the steps of obtaining the spiral CT data of the jawbone of a patient, designing a virtual operation, designing the reset fixed guide plate, rapidly printing the reset fixed guide plate and the like.
(1) Acquiring patient jaw spiral CT data: the thickness of the patient spiral CT scan layer is at most 1mm, the scan range includes the whole craniomaxillofacial skeleton, and the data storage format is DICOM format.
(2) Virtual surgery design: importing the obtained jawbone DICOM data into three-dimensional modeling software MIMCS17.0 (materials, belgium) to reconstruct a jawbone three-dimensional model; performing an operation on the CT fault to segment the mandible; anatomically reposition the mandible; and storing the two-sided mandible block three-dimensional model as an STL format file.
(3) Design of a reset fixed guide plate: the STL format file is imported into 3-Matic 9.0, the region, close to the broken end bone blocks, of the mandible on two sides is selected as the region of interest, the region is divided independently, the surface data are converted into volume data with the thickness of 2mm by using an Offset function, the volume data are stored into STL, and then the STL file is imported into MIICS 17.0. In MIMIICS 17.0 software, a model matched with the lengths of a bone fracture plate and a reconstruction plate is designed by using a Medcad function, a plate groove is designed by subtracting the model from a guide plate by using a Brownian operation function, and the upper edge and the lower edge of a parallel wing are connected by using a Medcad function.
(4) 3D prints fixed baffle that resets: the guide plate data is led into 3D printing equipment, and the printing material is a high polymer nontoxic material capable of carrying out cold light low temperature disinfection, and is processed into a reset fixed guide plate entity.
The foregoing description of the preferred embodiments of the present invention is merely illustrative, and not restrictive, of the invention. It will be appreciated by those skilled in the art that many variations, modifications and even equivalent changes may be made thereto within the spirit and scope of the invention as defined in the appended claims, but are still within the scope of the invention.
While the basic principles and main features of the present invention and advantages thereof have been shown and described, the foregoing embodiments and description are merely illustrative of the principles of the present invention, and various changes and modifications can be made therein without departing from the spirit and scope of the invention, which is defined in the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (10)
1. The utility model provides a jaw double chin hole district fracture reduction fixed baffle, includes baffle body, its characterized in that: the bone fracture plate clamping groove, the reconstruction plate clamping groove, the parallel wings, the screw small holes and the chin hole positioning groove are arranged, the parallel wings are provided with parallel wing inner side surfaces and parallel wing outer side surfaces, the shapes of the parallel wing inner side surfaces are completely attached to the outer side surfaces of mandibles required by preoperative simulation, and the screw small holes are positioned at left and right ends of Ping Hangyi; the parallel wings are formed by connecting an upper parallel wing and a lower parallel wing, the left end and the right end of the upper parallel wing and the left end and the right end of the lower parallel wing are respectively connected into a whole, and the reconstruction plate clamping groove is arranged between the upper parallel wing and the lower parallel wing and is used for implanting a reconstruction plate; the middle part of the upper parallel wing is provided with a bulge, and bone fracture plate clamping grooves are positioned at two sides of the bulge and are used for implanting a small bone fracture plate; the chin hole positioning groove is arranged at the end part of the upper parallel wing and corresponds to the chin hole position of the mandible; the bone fracture plate clamping groove and the reconstruction plate clamping groove are hollow, and the length and the width are consistent with the length and the width of the preformed small bone fracture plate or reconstruction plate; the distance between the left end and the right end of the parallel wing and the edge of the reconstruction plate is 0.8 cm to 1.2cm.
2. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 1, wherein: the distance between the bone fracture plate clamping groove and the tooth root end is more than or equal to 5mm.
3. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 1, wherein: and the two chin hole positioning grooves are respectively arranged at the left end part and the right end part of the upper parallel wing and correspond to the two chin hole positions of the mandible.
4. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 1, wherein: the bottom edge of the lower parallel wing is provided with a lower parallel flange, the inner buckle enters the lower edge of the mandible and extends inwards, and the shape is completely attached to the lower edge of the mandible required by preoperative simulation.
5. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 4, wherein: the thickness of the parallel wings is 1.8-2.1mm.
6. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 4, wherein: the thickness of the parallel wings is 2.0mm.
7. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 1, wherein: the diameter of the screw small hole is 2-2.3mm.
8. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 1, wherein: the diameter of the screw small hole is 2.2mm.
9. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 1, wherein: the guide plate is also provided with a reinforcing rod, one end of the reinforcing rod is connected with the upper parallel wing, and the other end of the reinforcing rod is connected with the lower parallel wing.
10. The mandibular double chin hole area fracture reduction fixing guide plate according to claim 9, wherein: the reinforcing rod is in a curved cylindrical shape and is arranged in the middle of the parallel wings.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910054431.9A CN109620380B (en) | 2019-01-21 | 2019-01-21 | Mandibular double chin hole area fracture reduction fixing guide plate |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910054431.9A CN109620380B (en) | 2019-01-21 | 2019-01-21 | Mandibular double chin hole area fracture reduction fixing guide plate |
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Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6325803B1 (en) * | 1998-02-18 | 2001-12-04 | Walter Lorenz Surgical, Inc. | Method and apparatus for mandibular osteosynthesis |
| CN101524288A (en) * | 2009-03-31 | 2009-09-09 | 施更生 | Titanium plate for internal fixation |
| AU2012100561A4 (en) * | 2012-05-09 | 2012-06-14 | George Dimitroulis | The Melbourne TMJ Prosthesis |
| CN104490451A (en) * | 2014-12-31 | 2015-04-08 | 北京爱康宜诚医疗器材股份有限公司 | Combined osteotomy guide |
| CN104771231A (en) * | 2015-04-27 | 2015-07-15 | 四川大学 | Navigation device for bone block directional movement in orthognathic surgery and manufacturing method thereof |
| CN105078586A (en) * | 2015-09-28 | 2015-11-25 | 四川大学 | Digitized template used for orthognathic surgery and manufacturing method thereof |
| CN105342702A (en) * | 2015-12-17 | 2016-02-24 | 四川大学 | 3D printing-based individual mandible fixing guide plate |
| CN205286449U (en) * | 2015-11-30 | 2016-06-08 | 上海交通大学医学院附属第九人民医院 | Jaw cuts bone conduction board on titanium alloy |
| CN106580394A (en) * | 2016-11-30 | 2017-04-26 | 北京爱康宜诚医疗器材有限公司 | Osteotomy guide plate assembly |
| CN108261221A (en) * | 2016-12-30 | 2018-07-10 | 广州迈普再生医学科技有限公司 | A kind of Mandible Osteotomy guide plate |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8246663B2 (en) * | 2006-04-10 | 2012-08-21 | Scott Lovald | Osteosynthesis plate, method of customizing same, and method for installing same |
| US8167891B2 (en) * | 2008-07-21 | 2012-05-01 | Osteomed Llc | System and method for fracture reduction |
| US8551107B2 (en) * | 2009-10-15 | 2013-10-08 | Biomet, C.V. | Bending tool and method for reshaping a bone plate |
| CA2781155C (en) * | 2009-12-11 | 2017-12-19 | Synthes Usa, Llc | Mandibular fixation plate |
| US9066733B2 (en) * | 2010-04-29 | 2015-06-30 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| US20150230843A1 (en) * | 2011-09-22 | 2015-08-20 | Mx Orthopedics, Corp. | Controlling the unloading stress of nitinol devices and/or other shape memory material devices |
| CN210204896U (en) * | 2019-01-21 | 2020-03-31 | 四川大学 | Fracture reduction fixing guide plate for mandible double chin area |
-
2019
- 2019-01-21 CN CN201910054431.9A patent/CN109620380B/en active Active
Patent Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6325803B1 (en) * | 1998-02-18 | 2001-12-04 | Walter Lorenz Surgical, Inc. | Method and apparatus for mandibular osteosynthesis |
| CN101524288A (en) * | 2009-03-31 | 2009-09-09 | 施更生 | Titanium plate for internal fixation |
| AU2012100561A4 (en) * | 2012-05-09 | 2012-06-14 | George Dimitroulis | The Melbourne TMJ Prosthesis |
| CN104490451A (en) * | 2014-12-31 | 2015-04-08 | 北京爱康宜诚医疗器材股份有限公司 | Combined osteotomy guide |
| CN104771231A (en) * | 2015-04-27 | 2015-07-15 | 四川大学 | Navigation device for bone block directional movement in orthognathic surgery and manufacturing method thereof |
| CN105078586A (en) * | 2015-09-28 | 2015-11-25 | 四川大学 | Digitized template used for orthognathic surgery and manufacturing method thereof |
| CN205286449U (en) * | 2015-11-30 | 2016-06-08 | 上海交通大学医学院附属第九人民医院 | Jaw cuts bone conduction board on titanium alloy |
| CN105342702A (en) * | 2015-12-17 | 2016-02-24 | 四川大学 | 3D printing-based individual mandible fixing guide plate |
| CN106580394A (en) * | 2016-11-30 | 2017-04-26 | 北京爱康宜诚医疗器材有限公司 | Osteotomy guide plate assembly |
| CN108261221A (en) * | 2016-12-30 | 2018-07-10 | 广州迈普再生医学科技有限公司 | A kind of Mandible Osteotomy guide plate |
Non-Patent Citations (1)
| Title |
|---|
| 上下颌骨联合骨折小钛板坚固内固定的临床应用;王涛, 李声伟, 郑长泰, 廖天安;口腔医学(03);第159-160页 * |
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