CN109745098B - Shoulder joint replacement humerus side preparation guide plate device - Google Patents
Shoulder joint replacement humerus side preparation guide plate device Download PDFInfo
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- CN109745098B CN109745098B CN201910138439.3A CN201910138439A CN109745098B CN 109745098 B CN109745098 B CN 109745098B CN 201910138439 A CN201910138439 A CN 201910138439A CN 109745098 B CN109745098 B CN 109745098B
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
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Abstract
The invention provides a shoulder joint replacement humerus side preparation guide plate device which comprises a body part and a handle, wherein the left side and the right side are respectively connected, the middle part of the body part is connected with 1 inner cortical arm and 1 outer cortical arm, the lower end of the body part is connected with the handle, the head end of the body part is divided into 1 head concave arm, 1 head holding arm and 1 connecting part, and the structure can be used for assisting the accurate placement of a shoulder joint humerus prosthesis after being positioned and placed according to the accurate osseous anatomical marks. The shoulder joint replacement humerus side preparation guide plate device is simple in structure and operation, convenient and quick to process, visual in indication, capable of realizing accurate implantation of a humerus prosthesis, shortening operation time, improving the position of the humerus prosthesis, improving operation precision and convenient for clinical application.
Description
Technical Field
The invention belongs to the technical field of auxiliary guide plates for preparing a humerus side in a key step in an artificial shoulder joint replacement operation, and particularly relates to a guide plate device for preparing the humerus side in the shoulder joint replacement operation.
Background
Artificial total shoulder replacement is still the best way to treat end-stage disease and severe trauma of the shoulder, and proper placement of the humeral prosthesis is one of the decisive factors for good near and far-term surgical results, both conventional, forward-placed and reverse-placed total shoulder. Accurate placement of the prosthesis within the intramedullary canal is also a critical step for humeral prostheses. However, currently, in clinical practice, osteotomies, medullary expansion and prosthetic placement of the humerus rely on a simple intramedullary positioning instrument and operator experience, and the individuation and refinement are insufficient, which can easily result in varus or valgus placement of the prosthesis, thereby affecting the surgical effect and patient satisfaction. At present, no preparation guide plate system capable of assisting an operator in accurately placing a humeral prosthesis in an operation exists.
Disclosure of Invention
The invention aims to provide a shoulder joint replacement humerus side preparation guide plate device which is used for providing assistance for accurate placement of a humerus prosthesis which is one of the key steps of operation in an artificial total shoulder joint replacement operation so as to realize accurate placement of the humerus prosthesis, shorten operation time, improve the position of the humerus prosthesis, improve operation precision and facilitate clinical application.
In order to solve the technical problems, the invention is realized by adopting the following technical scheme:
the preparation guide plate device for the shoulder joint replacement humerus side is made of metal or alloy, comprises a body part and a handle, wherein the body part is connected with an inner cortical arm and an outer cortical arm in the middle, one end of the body part is connected with the handle, the handle is perpendicular to the body part, and the connecting part is in a right-angle radian; the other end is divided into a cephalopodium arm, a cephalopodium arm and a connecting part, and the connecting part can be respectively connected with the intramedullary positioning arm, the osteotomy plate and the osteotomy face positioning plate. The body part is of a solid plate-shaped structure, and 2 fixing holes are spaced apart; the head concave arm forms a certain angle with the longitudinal axis of the body part and has a certain radian, is in a semi-tubular structure with a concave downward direction, and the top end is bent; the head holding arm forms a certain angle with the longitudinal axis of the body part and has a certain radian, and the top end is bent; the connecting part is 1cm long, hollow and semicircular in section; the inner leather arm and the outer leather arm are connected to the body part at the same level, are all provided with radians, the top ends of the inner leather arm and the outer leather arm are bent, and the joints of the inner leather arm, the outer leather arm and the body part are provided with continuous graduations which gradually increase from the middle part to the two ends. The intramedullary positioning arm is provided with a certain radian, the top end is bent, a positioning hole is formed near the top end, the tail end is narrowed, and the section is semicircular; the head end and the tail end of the osteotomy plate are connected in a certain radian, the head end is a rectangular metal plate, an osteotomy groove is formed along the longitudinal axis of the rectangular metal plate, the tail end is narrowed, and the section is semicircular; after the osteotomy plate is connected with the connecting part, the osteotomy groove and the longitudinal axis of the body form a crown surface of 45 degrees and a backward inclination angle of 30 degrees. The head end of the bone cutting surface locating plate is irregularly elliptic and is connected with the tail end at a certain angle, the outer side edge and the inner side edge of the head end are respectively provided with scales which are gradually increased from the middle to the two ends, a rectangular groove is formed along one part of the longitudinal axis of the head end, the tail end is narrowed, and the section is semicircular.
After the structure is positioned and placed according to the respective correct osseous anatomical sign, the structure can be used for assisting the accurate placement of the shoulder joint humerus prosthesis.
The shoulder joint replacement humerus side preparation guide plate device is made of metal or alloy, and comprises a body part and a handle on the left side and the right side.
The shoulder joint replacement humerus side preparation guide plate device has a solid plate-shaped structure, and the body of the preparation guide plate device is provided with 2 fixing holes at intervals.
The shoulder joint replacement humerus side preparation guide plate device has the advantages that the concave head arm of the preparation guide plate device forms a certain angle with the longitudinal axis of the body part, has a certain radian, is in a concave downward semi-tubular structure, and the top end of the concave head arm is bent.
The shoulder joint replacement humerus side preparation guide plate device comprises a head holding arm, a body longitudinal axis, a head holding arm and a head holding arm.
The shoulder joint replacement humerus side preparation guide plate device has a connecting part with a length of 1cm, is hollow and has a semicircular section.
The shoulder joint replacement humerus side preparation guide plate device is characterized in that the inner cortical arm and the outer cortical arm of the preparation guide plate device are connected to the body part at the same level, and are both provided with radians, and the top ends of the preparation guide plate device are bent.
The shoulder joint replacement humerus side preparation guide device as described above is provided with continuous graduations gradually increasing from the middle to the two ends at the joints of the medial cortical arm, the lateral cortical arm and the body.
The shoulder joint replacement humerus side preparation guide plate device is characterized in that the intramedullary positioning arm of the preparation guide plate device is provided with a certain radian, the top end of the intramedullary positioning arm is bent, a positioning hole is formed near the top end of the intramedullary positioning arm, the tail end of the intramedullary positioning arm is narrowed, and the section of the intramedullary positioning arm is semicircular.
The head end and the tail end of the bone cutting plate of the preparation guide plate device are connected in a certain radian, the head end is a rectangular metal plate, a bone cutting groove is formed in the longitudinal axis of the head end, the tail end is narrowed, and the cross section is semicircular.
The preparation guide plate device for the shoulder joint replacement humerus side is characterized in that after the bone cutting plate of the preparation guide plate device is connected with the connecting part, the bone cutting groove and the longitudinal axis of the body form a crown surface of 45 degrees, and an included angle of 30 degrees is formed by backward tilting.
The head end of the bone cutting surface positioning plate of the preparation guide plate device is irregularly elliptic and is connected with the tail end at a certain angle, and the outer side edge and the inner side edge of the head end are respectively provided with scales which are gradually increased from the middle to the two ends.
The shoulder joint replacement humerus side preparation guide plate device has the advantages that the preparation guide plate device bone cutting surface positioning plate is provided with a rectangular groove along one part of the longitudinal axis of the head end, the tail end is narrowed, and the section is semicircular.
Compared with the prior art, the invention has the advantages and positive effects that:
the shoulder joint humerus side preparation guide plate device is suitable for all current artificial total shoulder joint replacement operations, and can conveniently and rapidly realize the preparation of the shoulder joint humerus side bone surface and the implantation process of the prosthesis through the auxiliary positioning of the device. Avoiding the complications of fat embolism and the like generated by the initial intramedullary positioning, and conveniently replacing the intramedullary positioning with the intramedullary positioning through connecting the intramedullary positioning arm. The scale is arranged on the inner cortical arm and the outer cortical arm of the body, so that the device can be conveniently positioned at the central part of the humerus, and the guide plate device can be fixed on the humerus through the fixing holes by using Kirschner wires and the like, so that the positioning deviation caused by the displacement of the handle is prevented. Through the joint positioning of the arm holding head and the arm concave corresponding to the body part and the inner cortical arm and the outer cortical arm, the guide plate device is well matched with the proximal anatomical structure of the specific humerus of the patient to guide, if anatomical deviation exists, the intramedullary positioning arm can be timely installed to perform intramedullary positioning so as to ensure accuracy. The middle part of the cephalic concave arm is designed with a concave section so as to accommodate the soft tissue and tendon structure at the bottom. The intramedullary positioning arm, the osteotomy plate and the osteotomy face positioning plate of the shoulder joint replacement humerus side preparation guide plate device are all of detachable and instant installation design, so that the preparation of the osteotomy and the proximal humerus osteotomy face can be completed simultaneously by one-time positioning in the operation. The outer side edge and the inner side edge of the head end of the bone-cutting surface positioning plate are respectively provided with scales which are gradually increased from the middle to the two ends, so that the positioning plate can be conveniently placed at the correct position of the bone-cutting surface, and a rectangular groove is formed in one part of the bone-cutting surface positioning plate along the longitudinal axis of the head end, so that the outer side positioning of the shoulder of the prosthesis can be correctly completed. The shoulder joint replacement humerus side preparation guide plate device is simple in structure and operation, convenient and quick to process, visual in indication, small in operation space requirement, convenient to use in minimally invasive surgery, and capable of being used for accurately assisting the preparation of the shoulder joint humerus side bone surface and the placement of a prosthesis.
Other features and advantages of the present invention will become more apparent from the following detailed description of embodiments of the present invention, which is to be read in connection with the accompanying drawings.
Drawings
The invention will be further described with reference to the accompanying drawings and examples, in which:
FIG. 1 is a schematic view of an embodiment of a shoulder replacement humeral side preparation template device of the present invention;
FIG. 2 is a schematic structural view of a connection portion;
FIG. 3 is a schematic view of the structure of an osteotomy plate;
FIG. 4 is a schematic structural view of an osteotomy face positioning plate;
fig. 5 is a schematic view of the precise positioning performed during a procedure for preparing a guide plate device for shoulder replacement humeral side using the present invention.
Detailed Description
The present invention will be described in further detail with reference to the drawings and examples, in order to make the objects, technical solutions and advantages of the present invention more apparent. It should be understood that the embodiments described herein are merely illustrative of the present invention and are not intended to limit the present invention.
In the following description, numerous specific details are set forth in order to provide a more thorough understanding of the present invention. It will be apparent, however, to one skilled in the art that the invention may be practiced without one or more of these details. In other instances, well-known features have not been described in detail in order to avoid obscuring the invention.
In the following description, a detailed structure will be presented for a thorough understanding of the present invention. It will be apparent that the invention is not limited to the specific details set forth in the skilled artisan. Preferred embodiments of the present invention are described in detail below, however, the present invention may have other embodiments in addition to these detailed descriptions.
Embodiments of the present invention are described in detail below with reference to the accompanying drawings.
In artificial total shoulder replacement, whether conventional, cis-placed or trans-placed total shoulder replacement, is one of the key steps for proper placement of the humeral prosthesis within the intramedullary canal. If a humeral prosthesis is poorly positioned, near or mid-long term complications such as localized stress concentrations, prosthetic loosening failure, shoulder dislocation or subluxation, reduced shoulder mobility, pain, dysfunction, etc. will occur. The existing humerus prosthesis preparation devices adopted clinically are mostly manually positioned in humerus marrow, lack of an nail insertion point positioning device and have the problems of fat embolism, bleeding and the like. The proximal humerus osteotomies sometimes require manual experience osteotomies, or connect the osteotomies plate to the intramedullary positioning rod, resulting in insufficient osteotomies. And there is a risk of varus or valgus placement of the humeral prosthesis, with a risk of complications causing medial or lateral cortical penetration, fracture if the intramedullary is expanded too far inward or too far outward during preparation of the proximal humeral cavity. In the process of preparing the proximal humerus, the problems of great difference among operators, over subjectivity and over dependence on experience of operators exist, and the risk of poor position of the humerus prosthesis is very easy to occur.
There is still a lack of an auxiliary positioning device that facilitates intraoperative humeral preparation uniformity and reduces subjective deviation. The invention designs a guide plate device for preparing a shoulder joint replacement humerus side for solving the problems, which is convenient for accurately placing a humerus prosthesis.
The implementation mode of the invention is specifically described below by way of specific embodiments with reference to the accompanying drawings:
as shown in fig. 1, the present embodiment provides a shoulder joint replacement humerus side preparation guide plate device, which is made of metal or alloy with certain mechanical strength, and comprises a body 100 and a handle 200, wherein the middle part of the body 100 is connected with an inner cortical arm 101 and an outer cortical arm 102, the lower end of the body 100 is connected with the handle 200, the handle 200 is perpendicular to the body 100, and the connection part is in a right angle radian; the head end of the body 100 is divided into a head concave arm 103, a head holding arm 104 and a connecting part 105, and the connecting part 105 can be respectively connected with an intramedullary positioning arm 106, an osteotomy plate 107 and an osteotomy face positioning plate 108.
The body 100 is a solid plate-like structure, and is provided with 2 fixing holes 109 at intervals; the concave head arm 103 forms a certain angle with the longitudinal axis of the body 100, has a certain radian, is in a concave downward semi-tubular structure, and is bent at the top end; the arm 104 forms a certain angle with the longitudinal axis of the body and has a certain radian, and the top end is bent; as shown in fig. 2, the connecting portion 105 is 1cm long, hollow, and semicircular in cross section;
the medial cortical arm 101 and the lateral cortical arm 102 are connected to the body 100 at the same level, each with an arc, a curved tip, and a continuous scale 110 gradually increasing from the middle to both ends at the connection of the medial cortical arm 101, the lateral cortical arm 102 and the body 100.
The intramedullary positioning arm 106 has a certain radian, the top end is bent, a positioning hole 111 is formed near the top end, the tail end is narrowed, and the section is semicircular;
as shown in fig. 3, the head end and the tail end of the osteotomy plate 107 are connected in a certain radian, the head end is a rectangular metal plate 112, the longitudinal axis part of the head end is provided with an osteotomy groove 113, the tail end is narrowed, and the cross section is semicircular; after the osteotomy plate 107 is connected to the connection portion 105, the osteotomy groove 113 is at a coronal plane 45 ° to the longitudinal axis of the body, and is inclined backward at an angle of 30 °.
As shown in FIG. 4, the head end of the osteotomy face positioning plate 108 is irregularly elliptical, is connected at an angle to the tail end, has graduations 114 increasing from the middle to both ends on the outer and inner edges of the head end, and has a rectangular slot 115 along a portion of the longitudinal axis of the head end, with the tail end being narrowed and the cross section being semicircular.
After the shoulder joint replacement humerus side preparation guide plate device is connected and applied to the proximal humerus end, accurate placement of a humerus prosthesis can be guided, and risks of poor humerus prosthesis position, humerus cortex penetration, fracture and the like are avoided.
As shown in fig. 1 and 5, in use, the proximal humerus a is exposed and dislocated. The handle 200 positions the shoulder replacement humeral side preparation guide device in the center of the proximal face of the humerus a, and the medial and lateral cortical arms 101 and 102 of the body are respectively wrapped around the medial and lateral 1/3 of the proximal humerus so that the central scale "0" of the body is located in the center of the proximal humerus face. The guide plate device is adjusted to the far and near ends so that the arc-shaped top end of the head concave arm 103 covers the joint of the head and neck of the humerus, and the concave surface of the head concave arm 103 covers the long head tendon of biceps brachii and the surrounding soft tissues. The arm 104 is wrapped around the inferior medial humeral head. After the position is clearly satisfied, the shoulder replacement humeral side preparation guide device is fixed to the proximal humeral surface by two kirschner wires through the body fixation hole 109. The stability of the guide plate device was checked. At this time, if the intramedullary positioning of the humerus prosthesis is to be performed simultaneously, the trailing end of the intramedullary positioning arm 106 is inserted into the connecting portion 105 of the body, and the trailing end semicircular section of the intramedullary positioning arm 106 matches the semicircular section of the connecting portion 105. The intramedullary positioning needle is longitudinally drilled into the humeral cavity through the intramedullary positioning arm tip positioning hole 111, and is centered in the humeral cavity.
When proximal humerus resection is performed, the semicircular tail end of the resection plate 107 is inserted into the connecting part 105 of the body, and after the resection plate 107 is connected with the connecting part 105, the resection groove 113 forms a coronal plane 45 degrees with the longitudinal axis of the body, and is inclined backwards by 30 degrees. The saw blade is inserted into the osteotomy groove 113 to check whether the direction and the osteotomy amount of the osteotomy line meet the requirements, and then the osteotomy operation can be performed along the osteotomy groove 113.
After the proximal humerus resection is completed, the semicircular tail end of the resection surface positioning plate 108 is inserted into the connecting part 105 of the body part, so that the head end of the resection surface positioning plate 108 well covers the proximal humerus resection surface, and according to the outer side edge and the inner side edge of the head end, the scales gradually increasing from the middle to the two ends are respectively arranged, so that the position of the head end of the resection surface positioning plate 108 can be assisted to judge whether the position meets the requirement. At this time, the rectangular groove 115 along the head end of the osteotomy face positioning plate 108 is grooved with a reciprocating saw or a narrow bone knife, the osteotomy face positioning plate 108 is disassembled, and the humeral prosthesis is placed along the groove, so that the shoulder of the prosthesis is positioned at the outer edge of the rectangular groove 115, and a good position of the humeral prosthesis in the humeral cavity can be obtained. The Kirschner wire in the body fixing hole 109 is detached, and the shoulder joint replacement humerus side preparation guide plate device can be detached, so that the operation is completed.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present invention, and are not limiting; although the invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit and scope of the technical solutions of the embodiments of the present invention.
Claims (4)
1. A shoulder replacement humerus side preparation guide plate device, which is characterized in that: the device comprises a body part and a handle, wherein the left side and the right side are respectively provided with 1 inner cortical arm and 1 outer cortical arm, the lower end of the body part is connected with the handle, the head end of the body part is divided into 1 head concave arm, 1 head holding arm and 1 connecting part, and the structure can be used for assisting the accurate placement of shoulder joint humeral prosthesis after being positioned and placed according to the accurate osseous anatomical marks;
the head concave arm forms a certain angle with the longitudinal axis of the body part and has a certain radian, is in a semi-tubular structure with a concave downward direction, and the top end is bent; the head holding arm forms a certain angle with the longitudinal axis of the body part and has a certain radian, and the top end is bent; the connecting part is 1cm long, hollow and semicircular in section;
the inner leather arm and the outer leather arm are connected to the body part on the same horizontal plane, are all provided with radians, the top ends of the inner leather arm and the outer leather arm are bent, and the joints of the inner leather arm, the outer leather arm and the body part are provided with continuous scales which gradually increase from the middle part to the two ends;
the intramedullary positioning arm also comprises 1 intramedullary positioning arm with a certain radian, the top end is bent, a positioning hole is formed near the top end, the tail end is narrowed, and the section is semicircular;
the device also comprises 1 osteotomy plate, wherein the head end and the tail end are connected in a certain radian, the head end is a rectangular metal plate, the longitudinal axis part of the head end is provided with an osteotomy groove, the tail end is narrowed, and the section is semicircular; after the osteotomy plate is connected with the connecting part, the osteotomy groove and the longitudinal axis of the body form a crown surface of 45 degrees, and the osteotomy groove is inclined backwards by an included angle of 30 degrees;
the bone cutting face positioning device also comprises 1 bone cutting face positioning plates, wherein the head end is irregularly elliptic and is connected with the tail end at a certain angle, the outer side edge and the inner side edge of the head end are respectively provided with scales which are gradually increased from the middle to the two ends, a rectangular groove is formed along one part of the longitudinal axis of the head end, the tail end is narrowed, and the section is semicircular.
2. The shoulder replacement humeral side preparation guide device of claim 1, wherein: the shoulder joint replacement humerus side preparation guide plate device is of a metal or alloy structure.
3. The shoulder replacement humeral side preparation guide device of claim 1, wherein: the body is of a solid plate-shaped structure, and 2 fixing holes are formed in the body at intervals.
4. The shoulder replacement humeral side preparation guide device of claim 1, wherein: the handle is perpendicular to the body, and the joint is in a right-angle radian.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910138439.3A CN109745098B (en) | 2019-02-25 | 2019-02-25 | Shoulder joint replacement humerus side preparation guide plate device |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910138439.3A CN109745098B (en) | 2019-02-25 | 2019-02-25 | Shoulder joint replacement humerus side preparation guide plate device |
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| CN109745098A CN109745098A (en) | 2019-05-14 |
| CN109745098B true CN109745098B (en) | 2023-07-18 |
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| CN201910138439.3A Active CN109745098B (en) | 2019-02-25 | 2019-02-25 | Shoulder joint replacement humerus side preparation guide plate device |
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Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN205107831U (en) * | 2015-10-21 | 2016-03-30 | 贵州省人民医院 | 3D prints percutaneous shoulder joint puncture baffle |
| US9408616B2 (en) * | 2014-05-12 | 2016-08-09 | Biomet Manufacturing, Llc | Humeral cut guide |
| CN108124422A (en) * | 2015-06-25 | 2018-06-05 | 拜欧米特制造有限责任公司 | The specific humerus guide design of patient |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10959742B2 (en) * | 2017-07-11 | 2021-03-30 | Tornier, Inc. | Patient specific humeral cutting guides |
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2019
- 2019-02-25 CN CN201910138439.3A patent/CN109745098B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9408616B2 (en) * | 2014-05-12 | 2016-08-09 | Biomet Manufacturing, Llc | Humeral cut guide |
| CN108124422A (en) * | 2015-06-25 | 2018-06-05 | 拜欧米特制造有限责任公司 | The specific humerus guide design of patient |
| CN205107831U (en) * | 2015-10-21 | 2016-03-30 | 贵州省人民医院 | 3D prints percutaneous shoulder joint puncture baffle |
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