CN110811809B - Medical orthopedic channel screw imbedding and adjusting system - Google Patents

Medical orthopedic channel screw imbedding and adjusting system Download PDF

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Publication number
CN110811809B
CN110811809B CN201911212831.4A CN201911212831A CN110811809B CN 110811809 B CN110811809 B CN 110811809B CN 201911212831 A CN201911212831 A CN 201911212831A CN 110811809 B CN110811809 B CN 110811809B
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transverse
vertical
needle
guide
adjusting
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CN110811809A (en
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郭志伟
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92Impactors or extractors, e.g. for removing intramedullary devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8897Guide wires or guide pins
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90Guides therefor

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention provides a medical orthopedic channel screw imbedding and adjusting system which comprises a transverse adjusting rail, clamps are arranged at two ends of the bottom of the transverse adjusting rail, one end of the transverse adjusting rail is vertically provided with a vertical adjusting rail, a vertical adjusting guide needle plate is movably arranged on the vertical adjusting rail, a transverse adjusting guide needle plate is movably arranged at the top of the transverse adjusting rail, the vertical adjusting guide needle plate and the transverse adjusting guide needle plate are both composed of a positioning arm, a guide sliding rod and a guide needle limiting plate, wherein the positioning arm is rectangular, one end of the length direction of the positioning arm is fixedly provided with the guide sliding rod, the guide sliding rod is movably provided with a guide needle positioning sliding block, and one side of the guide needle positioning sliding block extends to form the guide needle limiting plate. The positioning speed after the scheme is adopted is high, the positioning is accurate, and the using effect is good.

Description

Medical orthopedic channel screw imbedding and adjusting system
Technical Field
The invention relates to the technical field of medical instruments, in particular to a medical orthopedic channel screw imbedding and adjusting system.
Background
The fracture of pelvis has various injury forms, and the operation of pelvis and acetabulum has more trauma and difficulty. The misplacement of the screw is easy to cause iatrogenic neurovascular injury, and the misplacement into the joint causes arthralgia and the development of arthritis. To avoid misplacement, the surgeon must grasp the characteristics of the normal and mutated pelvic structures, the location of the neurovascular, and various injuries. To safely insert the screw, the surgeon must be familiar with the characteristics of the intraoperative fluoroscopic image.
The difficulty of the pelvis minimally invasive surgery is further increased on the basis of the front, the requirements of the surgery on operators are further improved, and the pelvis minimally invasive surgery has the advantages of being small in bleeding, small in incision, quick in recovery, capable of performing early functional exercise and the like compared with the traditional incision reduction surgery. The defect is that the medical staff and the patient need to be repeatedly seen through, and the radiation exposure is obviously increased.
The current method for setting the surgical nails comprises the following steps:
the robot assists the lower nail, the advantage: the error can be controlled within 0.3mm, and the method is accurate, minimally invasive and obviously reduced in perspective. Disadvantages: the price is very expensive (tens of millions), registration is needed in the operation, and the operation can be carried out only by professional training of medical staff.
3D prints and puts nail template, advantage: the template in operation can give out the three-dimensional space direction of the nail, and the perspective times can be reduced. Disadvantages: before operation, the positioning spicule needs to be placed in a wound mode, three-dimensional CT scanning is carried out, thin-layer computer reconstruction is adopted, a nail placing channel is designed by computer software, a channel guide plate is printed in a 3D mode, and the channel guide plate is reversely copied to the positioning spicule of a patient to place nails. The method is complicated before operation, the prior art can not accurately copy, and the actual operation error is very large.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide the medical orthopedic channel screw imbedding and adjusting system which is high in locating speed, accurate in locating and good in using effect.
In order to achieve the above purpose, the technical scheme provided by the invention is as follows: the utility model provides a medical orthopedics passageway screw is put into governing system, it is including horizontal regulation rail, clamp is installed at horizontal regulation rail bottom both ends, vertical regulation rail is installed to horizontal regulation rail one end vertically, vertical regulation guide needle board is equipped with to movable mounting on the vertical regulation rail, horizontal regulation guide needle board is equipped with horizontal regulation guide needle board to horizontal regulation rail top movable mounting, vertical regulation guide needle board, horizontal regulation guide needle board comprises by the locating arm, the direction slide bar, the guide needle limiting plate, wherein, the locating arm is the rectangle, its length direction one end is fixed with the direction slide bar, movable mounting has the guide needle location slider on the direction slide bar, guide needle location slider one side extends and is formed with the guide needle limiting plate, be equipped with the needle cover spacing groove to wearing on the guide needle limiting plate, be equipped with the guide needle constant head, be equipped with two at least locating pinholes on the guide needle limiting plate, the locating needle is equipped with the locating needle in the interpolation of locating pinhole.
The vertical adjusting rail is movably provided with a vertical sliding seat, one side of the vertical sliding seat is movably provided with a vertical rotating seat, the vertical adjusting guide needle plate is movably arranged on the vertical rotating seat through a vertical rotating shaft, and the vertical rotating seat is provided with a vertical rotating shaft locking bolt matched with the vertical rotating shaft; the other side of the vertical sliding seat is provided with a vertical limiting groove which is embedded with the vertical adjusting rail, and the vertical sliding seat at the edge of the embedded vertical limiting groove extends to the sliding limiting groove for limiting.
The top of the transverse adjusting rail is movably provided with a transverse sliding seat, the top of the transverse sliding seat is movably provided with a front sliding rail and a rear sliding rail, the front sliding rail and the rear sliding rail are movably provided with a transverse rotating seat, a transverse adjusting guide needle plate is arranged on the transverse rotating seat through a transverse rotating shaft, and the transverse rotating seat is provided with a transverse rotating shaft locking bolt matched with the transverse rotating shaft; one side of the transverse sliding seat is provided with a transverse limiting groove which is embedded with the front and rear sliding rails, and the transverse sliding seat at the edge of the embedded transverse limiting groove extends to the front and rear sliding rails for limiting.
The guide pin positioning groove and the needle sleeve limiting groove are flat grooves, the side view of the guide pin positioning groove and the needle sleeve limiting groove is cross-shaped, and the length direction of the positioning pin hole is consistent with the width direction of the guide pin positioning groove; the guide pin positioning slide block is rectangular, connecting plates are formed by extending two ends of one side of the length direction of the guide pin positioning slide block, the outer ends of the two connecting plates are fixedly connected through the connecting plates, a pin sleeve limiting groove is formed between the connecting plates and the guide pin positioning slide block, and the positioning pin holes are oppositely penetrated on the connecting plates and the guide pin positioning slide block.
The transverse adjusting rail, the vertical adjusting rail and the front and back sliding rail are rectangular, the side view of the installed transverse adjusting rail and the vertical adjusting rail is L-shaped, the two sides of the length direction of the front and back sliding rail, the transverse adjusting rail and the vertical adjusting rail are provided with concave sliding limit grooves, the clamp is movably meshed with a height adjusting screw, and the height adjusting screw is connected with the bottom of the transverse adjusting rail.
After the scheme is adopted, the vertical adjusting rail is used for adjusting the height of the vertical sliding seat, the horizontal adjusting rail is used for adjusting the horizontal position of the front and rear sliding rails, the front and rear sliding rails are used for adjusting the front and rear positions of the horizontal rotating seat, the vertical adjusting guide needle plate and the horizontal adjusting guide needle plate are used for inserting positioning needles, the sliding rod holes are sleeved with the guide sliding rods, the length adjustment can be carried out according to the requirements so as to be convenient for patients with different statures to use, the positioning needles are inserted into the positioning needle holes and used for positioning the needle threading positions, the guide needle positioning grooves are used for positioning screws, and the operation is simple after the scheme is adopted, the whole mechanical mode adjustment is not needed, the registration is not needed, the manufacturing cost is low, the monitoring and the adjustment can be realized in operation accurately, and the operation time and the ray exposure rate are effectively reduced.
Drawings
Fig. 1 is a schematic diagram of the overall structure of the present invention.
Fig. 2 is a schematic diagram of the structure of the adjusting guide plate of the present invention.
Fig. 3 is a schematic view of a sliding seat mounting structure according to the present invention.
Detailed Description
The invention is further described below with reference to all drawings, in which preferred embodiments of the invention are: referring to fig. 1 to 3, the medical orthopedic channel screw insertion adjusting system according to the present embodiment includes a transverse adjusting rail 10, two ends of the bottom of the transverse adjusting rail 10 are provided with clamps 20, one end of the transverse adjusting rail 10 is vertically provided with a vertical adjusting rail 12, the vertical adjusting rail 12 is movably provided with a vertical adjusting guide needle plate 15, the top of the transverse adjusting rail 10 is movably provided with a transverse adjusting guide needle plate 17, the vertical adjusting guide needle plate 15 and the transverse adjusting guide needle plate 17 are both composed of a positioning arm 1, a guiding slide bar 2 and a guide needle limiting plate 5, wherein the positioning arm 1 is rectangular, one end of the length direction of the positioning arm is fixed with the guiding slide bar 2, the guiding slide bar 2 is movably provided with a guide needle positioning slide block 3, one side of the guide needle positioning slide block 3 extends to form a guide needle limiting plate 5, the guide needle limiting plate 5 is provided with a through needle sleeve limiting groove 6, the positioning arm 1 is provided with a through guide needle positioning groove 4, the guide needle limiting plate 5 is provided with at least two positioning pinholes, and a positioning needle is inserted into the positioning needle hole. The guide pin positioning groove 4 and the needle sleeve limiting groove 6 are flat grooves, the side view of the guide pin positioning groove 4 and the needle sleeve limiting groove 6 is cross-shaped, and the length direction of the positioning pin hole is consistent with the width direction of the guide pin positioning groove 4; the guide pin positioning slide block 3 is rectangular, two ends of one side of the length direction of the guide pin positioning slide block extend to form a connecting plate, the outer ends of the two connecting plates are fixedly connected through the connecting plate, a needle sleeve limiting groove 6 is formed between the connecting plate and the guide pin positioning slide block 3, and a positioning needle hole is formed in the connecting plate and the guide pin positioning slide block 3 in a penetrating mode.
A vertical sliding seat 13 is movably arranged on the vertical adjusting rail 12, a vertical rotating seat 14 is movably arranged on one side of the vertical sliding seat 13, a vertical adjusting guide plate 15 is movably arranged on the vertical rotating seat 14 through a vertical rotating shaft, and a vertical rotating shaft locking bolt matched with the vertical rotating shaft is arranged on the vertical rotating seat 14; the other side of the vertical sliding seat 13 is provided with a vertical limiting groove which is embedded with the vertical adjusting rail 12, and the vertical sliding seat 13 at the edge of the embedded vertical limiting groove extends into the sliding limiting groove 18 for limiting.
The top of the transverse adjusting rail 10 is movably provided with a transverse sliding seat 11, the top of the transverse sliding seat 11 is movably provided with a front sliding rail 19 and a rear sliding rail 19, the front sliding rail 19 and the rear sliding rail 19 are movably provided with a transverse rotating seat 16, a transverse adjusting guide needle plate 17 is arranged on the transverse rotating seat 16 through a transverse rotating shaft, and the transverse rotating seat 16 is provided with a transverse rotating shaft locking bolt matched with the transverse rotating shaft; one side of the transverse sliding seat 11 is provided with a transverse limiting groove which is embedded with the front and rear sliding rails 19, and the transverse sliding seat 11 at the edge of the embedded transverse limiting groove extends to the front and rear sliding rails 19 for limiting. The transverse adjusting rail 10, the vertical adjusting rail 12 and the front and back sliding rail 19 are rectangular, the side view of the installed transverse adjusting rail 10 and the vertical adjusting rail 12 is L-shaped, the two sides of the length direction of the front and back sliding rail 19, the length direction of the transverse adjusting rail 10 and the length direction of the vertical adjusting rail 12 are provided with concave sliding limiting grooves 18, the clamp 20 is movably meshed with a height adjusting screw, and the height adjusting screw is connected with the bottom of the transverse adjusting rail.
The implementation process of the device is as follows:
each positioning needle hole on the adjusting guide needle plate is internally and fixedly provided with a positioning needle, the central lines of the two positioning needles and the central line of the guide needle positioning groove of the same adjusting guide needle are positioned on the same surface, at the moment, the vertical adjusting guide needle plate forms a vertical guide surface, the transverse adjusting guide needle plate forms a transverse guide surface, and the guide needle positioning grooves on the two positioning arms are staggered and vacant from front to back;
during operation, the clamps at the two ends of the bottom of the transverse adjusting rail are clamped at the operating table or bedside, then the height adjusting screw on the clamps is adjusted according to the fat and thin of the patient, the height of the transverse adjusting rail is adjusted,
the pelvis fracture nail placing channel is displayed through C-arm machine perspective, the vertical sliding seat is adjusted to a proper height, the vertical rotating seat is rotated, two guide pins of the vertical adjusting guide pin plate are overlapped into one under the C-arm machine and projected onto the nail placing channel, and at the moment, the position (center point) to be penetrated by the needle and the vertical guide surface are positioned on the same inclined plane;
and the transverse sliding seat is moved to enable the transverse sliding seat to move to a proper position, the transverse sliding seat and the vertical sliding seat are respectively positioned at two sides of a needle threading position of a patient and the like, and then the transverse sliding seat is rotated to enable two guide needles of the transverse adjusting guide needle plate to be overlapped into one guide needle under the C-arm machine and projected onto the nail placing channel. At this time, a cross groove is formed by the guide needle positioning groove below the horizontal adjusting guide needle plate and the vertical adjusting guide needle plate, the cross groove is a needle threading point, and a point generated by intersecting two planes (a vertical guide surface and a horizontal guide surface) which are mutually perpendicular is the needle threading point by utilizing the principle that concentric circles intersect with the vertical surface;
the puncture needle sleeve penetrates through two guide needle positioning grooves at the intersection point to realize puncture positioning, then the depth and the diameter are measured, and then the hollow screw is placed into a fracture channel along the guide needle to be fixed.
The above-mentioned embodiments are only preferred embodiments of the present invention, and are not intended to limit the scope of the present invention, so that all changes made in the shape and principles of the present invention are covered by the scope of the present invention.

Claims (5)

1. A medical orthopedics passageway screw is put into governing system, its characterized in that: the automatic needle positioning device comprises a transverse adjusting rail (10), clamps (20) are arranged at two ends of the bottom of the transverse adjusting rail (10), a vertical adjusting rail (12) is vertically arranged at one end of the transverse adjusting rail (10), a vertical adjusting needle guide plate (15) is movably arranged on the vertical adjusting rail (12), a transverse adjusting needle guide plate (17) is movably arranged at the top of the transverse adjusting rail (10), the vertical adjusting needle guide plate (15) and the transverse adjusting needle guide plate (17) are both composed of a positioning arm (1), a guiding slide rod (2) and a needle guide limiting plate (5), wherein the positioning arm (1) is rectangular, one end of the length direction of the positioning arm is fixedly provided with the guiding slide rod (2), a needle guide positioning slide block (3) is movably arranged on the guiding slide rod (2), one side of the needle guide positioning slide block (3) extends to form a needle guide limiting plate (5), a needle sleeve limiting groove (6) for passing through is formed in the needle guide limiting plate (5), at least two positioning pinholes are formed in the needle guide limiting plate (5), and positioning needles are inserted in the positioning pinholes;
a vertical sliding seat (13) is movably arranged on the vertical adjusting rail (12), a vertical rotating seat (14) is movably arranged on one side of the vertical sliding seat (13), a vertical adjusting guide needle plate (15) is movably arranged on the vertical rotating seat (14) through a vertical rotating shaft, and a vertical rotating shaft locking bolt matched with the vertical rotating shaft is arranged on the vertical rotating seat (14);
the top of the transverse adjusting rail (10) is movably provided with a transverse sliding seat (11), the top of the transverse sliding seat (11) is movably provided with a front and rear sliding rail (19), the front and rear sliding rail (19) is movably provided with a transverse rotating seat (16), the transverse adjusting needle guide plate (17) is arranged on the transverse rotating seat (16) through a transverse rotating shaft, and the transverse rotating seat (16) is provided with a transverse rotating shaft locking bolt matched with the transverse rotating shaft;
every locating needle hole on the adjusting guide needle plate is internally provided with a locating needle, the central line of the locating needle of the same adjusting guide needle and the central line of the guide needle locating groove are positioned on the same surface, at the moment, the vertical adjusting guide needle plate forms a vertical guide surface, the transverse adjusting guide needle plate forms a transverse guide surface, and the guide needle locating grooves on the two locating arms are staggered and vacant from front to back.
2. The medical orthopedic channel screw insertion adjustment system of claim 1, wherein: the other side of the vertical sliding seat (13) is provided with a vertical limiting groove, the vertical limiting groove is embedded with the vertical adjusting rail (12), two sides of the length direction of the vertical adjusting rail (12) are provided with inward concave sliding limiting grooves (18), and the vertical sliding seat (13) at the edge of the embedded vertical limiting groove extends to the inner limit of the sliding limiting grooves (18).
3. The medical orthopedic channel screw insertion adjustment system of claim 1, wherein: one side of the transverse sliding seat (11) is provided with a transverse limiting groove which is embedded with the front and rear sliding rails (19), and the transverse sliding seat (11) at the edge of the embedded transverse limiting groove extends to the front and rear sliding rails (19) for limiting.
4. The medical orthopedic channel screw insertion adjustment system of claim 1, wherein: the guide pin positioning groove (4) and the needle sleeve limiting groove (6) are in flat groove shapes, the guide pin positioning groove (4) and the needle sleeve limiting groove (6) are cross-shaped when being seen from side view, and the length direction of the positioning pin hole is consistent with the width direction of the guide pin positioning groove (4); the guide pin positioning slide block (3) is rectangular, two ends of one side of the length direction of the guide pin positioning slide block extend to form a connecting plate, the outer ends of the two connecting plates are fixedly connected through the connecting plate, a needle sleeve limiting groove (6) is formed between the connecting plate and the guide pin positioning slide block (3), and a positioning needle hole is formed in the connecting plate and the guide pin positioning slide block (3) in a penetrating mode.
5. The medical orthopedic channel screw insertion adjustment system of claim 1, wherein: the transverse adjusting rail (10), the vertical adjusting rail (12) and the front and back sliding rail (19) are rectangular, the side view of the installed transverse adjusting rail (10) and the vertical adjusting rail (12) is L-shaped, the two sides of the length direction of the front and back sliding rail (19) and the length direction of the transverse adjusting rail (10) are provided with concave sliding limiting grooves (18), the clamp (20) is movably meshed with a height adjusting screw, and the height adjusting screw is connected with the bottom of the transverse adjusting rail.
CN201911212831.4A 2019-12-02 2019-12-02 Medical orthopedic channel screw imbedding and adjusting system Active CN110811809B (en)

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Application Number Priority Date Filing Date Title
CN201911212831.4A CN110811809B (en) 2019-12-02 2019-12-02 Medical orthopedic channel screw imbedding and adjusting system

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CN110811809A CN110811809A (en) 2020-02-21
CN110811809B true CN110811809B (en) 2023-12-12

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US6097994A (en) * 1996-09-30 2000-08-01 Siemens Corporate Research, Inc. Apparatus and method for determining the correct insertion depth for a biopsy needle
CN104905870A (en) * 2015-03-11 2015-09-16 北京德康健医药科技有限公司 Sighting device for pelvis internal fixation
CN105266875A (en) * 2015-11-27 2016-01-27 广东工业大学 Gliding and swinging type orthopaedics positioning guide needle guider
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CN110063780A (en) * 2019-05-22 2019-07-30 陈聚伍 Digitize neck of femur guide pin machinery guidance pointing instrumentation
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US6097994A (en) * 1996-09-30 2000-08-01 Siemens Corporate Research, Inc. Apparatus and method for determining the correct insertion depth for a biopsy needle
CN104905870A (en) * 2015-03-11 2015-09-16 北京德康健医药科技有限公司 Sighting device for pelvis internal fixation
CN105266875A (en) * 2015-11-27 2016-01-27 广东工业大学 Gliding and swinging type orthopaedics positioning guide needle guider
CN108433804A (en) * 2018-04-09 2018-08-24 河北医科大学第三医院 A kind of intramedullary nail openings lead device
CN209186987U (en) * 2018-06-13 2019-08-02 北京积水潭医院 A kind of orthopaedics art stereopsis position indicator
CN110063780A (en) * 2019-05-22 2019-07-30 陈聚伍 Digitize neck of femur guide pin machinery guidance pointing instrumentation
CN211381728U (en) * 2019-12-02 2020-09-01 郭志伟 Medical orthopedic channel screw imbedding adjusting system

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