CN110575221A

CN110575221A - Bone cutting guide plate for accurate treatment of tibial tubercle internal shift operation and application thereof

Info

Publication number: CN110575221A
Application number: CN201910463962.3A
Authority: CN
Inventors: 蔡秋晨
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-05-30
Filing date: 2019-05-30
Publication date: 2019-12-17

Abstract

the invention discloses a bone cutting guide plate in an operation for accurately treating tibial tubercle internal displacement, which comprises a fixing part and a bone cutting plane, wherein the fixing part and the bone cutting plane are fixed at a certain angle; the fixing part is provided with a curved surface matched with the outer contour of the tibia; the fixing part is provided with at least three pre-drilled holes which are not on the same straight line, and the disease is fixed with the tibia through hollow nails; the osteotomy plane is arranged between the tibia and the osteotomy block to form an osteotomy operation area. According to the invention, through the 3D printing osteotomy guide plate technology, the artificial error caused by the operation is reduced, the osteotomy position and the osteotomy depth are more accurate, and the osteotomy inward movement distance is more accurate; the 3D printing of the osteotomy guide plate simplifies the operation process, increases the operation efficiency, shortens the operation time, reduces the wound to the patient and is beneficial to postoperative recovery; generally speaking, use 3D to print and cut bone conduction board more accurate, individuation, the security.

Description

bone cutting guide plate for accurate treatment of tibial tubercle internal shift operation and application thereof

Technical Field

The invention relates to an auxiliary tool for the operation of internal shift of a tibial tubercle, in particular to an osteotomy guide plate for the operation of internal shift of a tibial tubercle with accurate treatment and an application thereof, belonging to the technical field of medical equipment.

Background

The three-in-one patellar dislocation surgery includes a subluxascopic knee joint lateral support band release, medial patellar ligament (MPFL) reconstruction, and tibial tubercle osteotomy. The patient with normal TT-TG interval only needs to do the anterior bigeminal operation, and the bigeminal operation can be directly finished under the arthroscope minimal invasion. The TT-TG spacing (the spacing between the tibial tubercle and the femoral trochlear groove) is the distance between a perpendicular line passing through the tibial tubercle and a perpendicular line passing through the lowest point of the femoral trochlear, the average value measured on a CT plane is that the extension position (16 +/-4) mm and the flexion position (9 +/-4) mm, and the TT-TG distance should be normally within 20mm from the extension position, when the CT plane exceeds 20mm, the patella is prompted to have larger outward stress and is easy to dislocate, the tibial tubercle needs to be moved inwards to overcome the outward stress so as to prevent the patella from moving outwards again, and the position of the tibial tubercle needs to be adjusted so that the TT-TG spacing is reduced to 12 mm.

When the distance TT-TG exceeds 20mm, a third operation, namely an osteotomy and endostasis operation of a tibial tubercle, needs to be carried out. In the past, a main surgeon usually performs osteotomy internal displacement of a tibial tubercle without any navigation assistance according to clinical experience, which may cause artificial errors, the osteotomy position and the osteotomy depth are not accurate enough, and the osteotomy internal displacement distance is not accurate enough; the operation efficiency of the osteotomy and internal transfer operation of the tibial tubercle is low, the operation time is long, the trauma to a patient is large compared with an arthroscope, and the postoperative recovery is slow.

disclosure of Invention

The invention aims to provide an osteotomy guide plate for precision treatment of tibial tubercle internal displacement surgery and application thereof, and aims to solve the problems that an osteotomy position and an osteotomy depth are not accurate enough, an osteotomy internal displacement distance is not accurate enough and the like in the prior art.

The purpose of the invention is realized by the following technical scheme.

The bone cutting guide plate for the precise treatment of the tibial tubercle internal shift operation comprises a fixing part and a bone cutting plane, wherein the fixing part and the bone cutting plane are fixed at a certain angle; the fixing part is provided with a curved surface matched with the outer contour of the tibia; the fixing part is provided with at least three pre-drilled holes which are not on the same straight line, and the disease is fixed with the tibia through hollow nails; the osteotomy plane is arranged between the tibia and the osteotomy block to form an osteotomy operation area.

The preparation method of the bone cutting guide plate comprises the following steps: (1) performing CT flat scanning on the knee joint before operation, and performing CT three-dimensional reconstruction on the knee joint in an imaging format; (2) manufacturing a bone cutting guide plate by using a 3D printer according to the CT three-dimensional bone reconstruction result; (3) the preset osteotomy depth was set at 10 mm.

The angle between the fixing part and the osteotomy plane is related to each individual; preferably 60-90 degrees.

the bone cutting guide plate using method comprises the following steps: making a longitudinal incision with the length of about 4cm at the outer side edge of a tibial tubercle, sequentially separating tissues, exposing a patellar ligament stop point, fixing a bone cutting guide plate by adopting an electric drill according to 3 point pre-drilling holes preset in the 3D printing bone cutting guide plate, then cutting bones at the patellar ligament stop point along a bone cutting plane of the 3D printing bone cutting guide plate by using a bone knife, pushing a cut bone block to move inwards (the inward movement distance is determined according to a TT-TG value measured before the operation), raising the patellar ligament stop point, and fixing by using a hollow nail after the osteotomy is moved inwards; the patella track and whether the patella has the dislocation trend are checked through the passive flexion and extension knee joint.

According to the invention, through the 3D printing osteotomy guide plate technology, the artificial error caused by the operation is reduced, the osteotomy position and the osteotomy depth are more accurate, and the osteotomy inward movement distance is more accurate; the 3D printing of the osteotomy guide plate simplifies the operation process, increases the operation efficiency, shortens the operation time, reduces the wound to the patient and is beneficial to postoperative recovery; generally speaking, use 3D to print and cut bone conduction board more accurate, individuation, the security.

Drawings

FIG. 1 is a schematic view of a viewing angle in a use state of the present invention;

FIG. 2 is a schematic view of a viewing angle in a use state of the present invention;

In the figure, 1, a fixed part; 2. a osteotomy plane; 3. pre-drilling; 4. a tibia; 5. the cut bone block.

FIG. 3 is a diagram of a TT-TG spacing measurement method of the present invention;

in the figure, A is the 1 st vertical line; b is a second vertical line and C is the distance TT-TG.

Detailed description of the invention

The technical features of the present invention will be further explained below with reference to the embodiments and the accompanying drawings.

The bone cutting guide plate for the internal shift operation of the precision treatment tibial tubercle as shown in fig. 1 and fig. 2 comprises a fixing part 1 and a bone cutting plane 2, wherein the fixing part 1 and the bone cutting plane 2 are fixed at a certain angle; the fixed part 1 is provided with a curved surface matched with the outer contour of the tibia 4; the fixing part 1 is provided with at least three pre-drilled holes 3 which are not on the same straight line, and the disease is fixed with the tibia 4 through hollow nails; the osteotomy plane 2 is arranged between the tibia 4 and the osteotomy block 5 to form an osteotomy operation area.

The bone cutting guide plate using method comprises the following steps: a longitudinal incision with the length of about 4cm is made on the outer side edge of a tibial tubercle, the patellar ligament insertion points are exposed after tissues are sequentially separated, the electric drill is adopted to print 3 points preset in the osteotomy guide plate according to 3D to pre-drill holes to fix the osteotomy guide plate, then the osteotome is used to cut bones at the patellar ligament insertion points along the osteotomy plane of the 3D printed osteotomy guide plate, and the measurement method for pushing the cut bone blocks to move inwards (the inward movement distance is determined according to TT-TG values measured before the operation) TT-TG is shown in figure 3. Lifting the patellar ligament insertion point, and fixing the patellar ligament insertion point by using a hollow nail after the osteotomy is completed; the patella track and whether the patella has the dislocation trend are checked through the passive flexion and extension knee joint.

Example (b): a patient with recurrent patellar dislocation is treated in a hospital department of orthopedics and joint surgery of the tenth people from Shanghai, knee joint CT scanning data is utilized after hospital admission, a bone cutting guide plate is manufactured through a 3D printing technology, sterile sterilization is carried out on the bone cutting guide plate in the hospital after manufacturing, the treatment of the bone cutting guide plate is combined with 3D printing according to the patellar dislocation triple operation, questionnaire investigation Lysholm scoring is carried out 3 months after the operation treatment, the improvement condition of functions of the patellar femoral joint is comprehensively evaluated, the comprehensive scoring is 87 (more than 85 is excellent), the effect is superior to that of the traditional patellar dislocation triple operation, and the occurring complications are reduced compared with the traditional patellar dislocation triple operation.

Claims

1. The utility model provides a cut bone conduction board in operation is moved inwards to accurate treatment shin bone tubercle which characterized in that: the bone cutting device comprises a fixing part and a bone cutting plane, wherein the fixing part and the bone cutting plane are fixed at a certain angle; the fixing part is provided with a curved surface matched with the outer contour of the tibia; the fixing part is provided with at least three pre-drilled holes which are not on the same straight line, and the disease is fixed with the tibia through hollow nails; the osteotomy plane is arranged between the tibia and the osteotomy block to form an osteotomy operation area.

2. The bone cutting guide plate for the precision treatment of the tibial tubercle internal shift surgery of claim 1, wherein: the angle between the fixing part and the osteotomy plane is 60-90 degrees.

3. the method for preparing a bone cutting guide plate according to claim 1, wherein: the method comprises the following steps: (1) performing CT flat scanning on the knee joint before operation, and performing CT three-dimensional reconstruction on the knee joint in an imaging format; (2) manufacturing a bone cutting guide plate by using a 3D printer according to the CT three-dimensional bone reconstruction result; (3) the preset osteotomy depth was set at 10 mm.

4. The method of using the bone cutting guide of claim 1, wherein: the method comprises the following steps:

(1) Making a longitudinal incision with the length of about 4cm on the outer side edge of a tibial tubercle, and exposing patellar ligament insertion points after sequentially separating tissues;

(2) Fixing the osteotomy guide plate by adopting an electric drill according to 3 points of pre-drilled holes preset in the 3D printing osteotomy guide plate;

(3) Then, a osteotome is used for cutting bones at the patellar ligament stopping point along the osteotomy plane of the 3D printing osteotomy guide plate, the osteotomy block is pushed to move inwards (the inward movement distance is determined according to the TT-TG value measured before the operation, the patellar ligament stopping point is lifted, the patellar ligament stopping point is fixed by a hollow nail after the osteotomy is moved inwards, and the patellar track and whether the patellar tends to dislocate or not are checked through the passive flexion and extension knee joint.