CN110859655A

CN110859655A - Osteotomy guider and osteotomy surgical instrument

Info

Publication number: CN110859655A
Application number: CN201911170995.5A
Authority: CN
Inventors: 樊垒; 刘超; 王超; 支海超
Original assignee: Tianjin Zhengtian Medical Instrument Co Ltd
Current assignee: Tianjin Zhengtian Medical Instrument Co Ltd
Priority date: 2019-11-26
Filing date: 2019-11-26
Publication date: 2020-03-06

Abstract

The invention provides an osteotomy guide device and an osteotomy surgical instrument, wherein an osteotomy guide module comprises a first osteotomy guide block and a second osteotomy guide block, the first osteotomy guide block and the second osteotomy guide block are fixed on a bone to be cut at intervals, the intervals comprise a first gap, a second gap and a third gap which are sequentially connected, and the first gap and the third gap are positioned on two sides of a straight line where the second gap is positioned. The osteotomy guider and the osteotomy surgical instrument have the advantages of good anti-rotation and medullary cavity concentricity, can realize osteotomy guiding and osteotomy length measurement, thereby ensuring the smoothness of an osteotomy surface, ensuring the contact stability of two ends of an osteotomy to be cut, being beneficial to effective force conduction, reducing osteoporosis, promoting bone development, enabling bones to heal as early as possible, enabling postoperative patients to walk on the ground as soon as possible, and realizing early load bearing of the patients.

Description

Osteotomy guider and osteotomy surgical instrument

Technical Field

The invention belongs to the technical field of medical instruments, and relates to an osteotomy guider and an osteotomy surgical instrument.

Background

At present, congenital hip joint dysplasia (posterior dysplasia of the hip) refers to the loss of normal positions of femoral head and hip joint, including dislocation of hip joint, subluxation and acetabulum dysplasia, unequal lower limbs and limping gait; can treat this symptom through the operation, cut the bone and correct the thighbone, realize suffering from the limb and reset, adopt the short osteotomy of thighbone among the prior art, the patient lies on the sick bed promptly, fixes suffering from the limb, adopts the mode of rear side approach to carry out the operation, can increase and expose the area, but two following problems exist more: (1) when reduction is carried out after osteotomy is finished, the distal end and the proximal end of the femur are easy to rotate, the medullary cavity at the joint is not concentric, and the original femoral anatomical axis is lost; in order to remedy the problem, most doctors may increase internal fixation to prevent rotation, increase support and guarantee concentricity, but stress shielding is generated, and osteoporosis and other conditions are easy to generate; (2) the bone cutting device is characterized in that no guide device is arranged in the operation process, and only the swing saw is used for cutting bones parallel to the coronal plane, so that the operation process mainly depends on years of clinical operation experience of doctors, but once the affected limb moves, the original bone cutting position is lost, the bone cutting surface is uneven, the length of the bone cutting cannot be determined, the bone cutting is repeatedly performed, and the operation time is wasted; after the prosthesis is installed under the condition of the two problems, the osteotomy surfaces can not be accurately connected, and the medullary cavities are not concentric, so that the prosthesis can not pass through the far end and the near end of the femur, and the stress can not be effectively transmitted to the connection part, thereby causing the problems of non-healing in the later period and non-early bearing of weight.

Disclosure of Invention

In view of the disadvantages of the prior art, an object of the present invention is to provide an osteotomy guide and an osteotomy surgical instrument, so as to solve the problems in the prior art that for the treatment of congenital hip dysplasia, osteotomy needs to be performed depending on the surgical experience of a doctor, and the optimal osteotomy angle and position are lost due to the movement of a patient during the operation.

In order to achieve the purpose, the invention adopts the following technical scheme:

in one aspect, the invention provides an osteotomy guide, which comprises an osteotomy guide module, wherein the osteotomy guide module comprises a first osteotomy guide block and a second osteotomy guide block, the first osteotomy guide block and the second osteotomy guide block are fixed on a bone to be cut at intervals, the intervals comprise a first gap, a second gap and a third gap, the second gap is parallel to an anatomical axis of the bone to be cut, the first gap and the third gap are parallel to each other, the first gap, the second gap and the third gap independently comprise a first end and a second end, the first end of the second gap is connected with the first end of the first gap, the second end of the second gap is connected with the first end of the third gap, and the second end of the first gap and the second end of the third gap are positioned on two sides of the second gap.

Further, the first osteotomy guide block and the second osteotomy guide block are independently L-shaped.

Further, the first osteotomy guide block is provided with a first graduation mark for measuring a first gap width, and the second osteotomy guide block is provided with a second graduation mark for measuring a third gap width.

Further, the first osteotomy guiding block and the second osteotomy guiding block are independently provided with a plurality of locking holes, wherein one locking hole is provided at the junction of the first gap or the third gap and the second gap.

Furthermore, cut bone guide module still includes the fixed block, and the fixed block can be dismantled and connect on first cut bone guide block and second cut bone guide block.

Furthermore, the fixed block is provided with a protrusion which is matched with a second gap between the first osteotomy guide block and the second osteotomy guide block, so that the fixed block can be detachably connected to the first osteotomy guide block and the second osteotomy guide block.

Further, the osteotomy guider also comprises a locking module, the locking module comprises a first locking assembly for locking the first osteotomy guide block on the bone to be osteotomy and a second locking assembly for locking the second osteotomy guide block on the bone to be osteotomy, the first locking assembly and the second locking assembly independently comprise a first locking clamp, a second locking clamp and a locking piece, and the first locking clamp and the second locking clamp are connected through the locking piece.

Furthermore, the first locking assembly and the second locking assembly independently further comprise guide rods used for guiding the first locking clamp and the second locking clamp during locking, and the guide rods are connected with the first locking clamp and the second locking clamp.

Further, the osteotomy guide further comprises an alignment module for the anatomical axis to be osteotomy, the alignment module for the anatomical axis to be osteotomy comprising a calibration rod connected to the locking module.

The present invention also provides an osteotomy surgical instrument comprising an osteotomy guide as described above.

Compared with the prior art, the invention has the beneficial effects that:

the osteotomy guider can solve the problems that in the prior art, aiming at the treatment of congenital hip joint dysplasia, osteotomy needs to be carried out by depending on the operation experience of a doctor, and the optimal osteotomy angle and position are lost due to the movement of a patient in the operation.

Drawings

FIG. 1 is a perspective view of an osteotomy guide according to one embodiment of the present invention;

FIG. 2 is a perspective view of an alternative perspective of an osteotomy guide in accordance with one embodiment of the present invention;

FIG. 3 is a front view of an osteotomy guide with an alignment rod and fixation block removed in accordance with one embodiment of the present invention;

FIG. 4 is a schematic structural view of a first osteotomy guiding block provided in accordance with one embodiment of the present invention;

fig. 5 is a schematic structural diagram of a fixing block according to an embodiment of the present invention;

FIG. 6 is a schematic structural view of a first locking clip according to one embodiment of the present invention;

FIG. 7 is a schematic structural view of a guide bar according to an embodiment of the present invention;

figure 8 is a schematic view of an osteotomy guide according to one embodiment of the present invention in use.

In the figure: the bone cutting machine comprises a first bone cutting guide block 1, a second bone cutting guide block 2, a fixing block 3, a locking module 4, a first locking clamp 5, a second locking clamp 6, a locking part 7, a guide rod 8, a calibration rod 9, a first gap 10, a second gap 11, a third gap 12, a first scale mark 13, a second scale mark 14, a locking hole 15, an intersecting hole 16, a fixing hole 17, a protrusion 18, a locking hole 19, a guide hole 20, a connecting block 21 and a bone to be cut 22.

Detailed Description

The technical scheme of the invention is further explained by the specific implementation mode in combination with the attached drawings.

An osteotomy surgical instrument comprising an osteotomy guide, see figures 1 to 7, comprises an osteotomy guide module, the osteotomy guide module comprises a first osteotomy guide block 1 and a second osteotomy guide block 2, the first osteotomy guide block and the second osteotomy guide block are fixed on a bone to be cut at intervals, the intervals comprise a first gap 10, a second gap 11 and a third gap 12, the second gap is parallel to an anatomical axis of the bone to be cut, the first gap and the third gap are parallel to each other, the first gap, the second gap and the third gap independently comprise a first end and a second end, the first end of the second gap is connected with the first end of the first gap, the second end of the second gap is connected with the first end of the third gap, and the second end of the first gap and the second end of the third gap are positioned on two sides of the second gap (or a straight line on which the second gap is positioned).

The osteotomy guide may include two osteotomy guide blocks, or may include three osteotomy guide blocks or more than three osteotomy guide blocks, as long as the first gap, the second gap, and the third gap are formed after combination. The osteotomy is performed along the first gap, the second gap, and the third gap.

The osteotomy guide can realize Z-shaped osteotomy, has the functions of rotation resistance and medullary cavity concentricity guarantee, and can be used for preventing a doctor who does not have experience of osteotomy from losing the optimal osteotomy angle and position due to the movement of a patient in the operation.

Further, to facilitate assembly of the osteotomy guide and to ensure a fine simplification of the first and second osteotomy guide blocks, said first and second osteotomy guide blocks are independently L-shaped, i.e. preferably both the first and third gaps are perpendicular to the second gap. The first osteotomy guide block and the second osteotomy guide block independently comprise "|" and "-", "|" and "-" each have an arc shape so as to be attached to the surface of the bone to be osteotomy, and preferably, the arc length of the first osteotomy guide block and the second osteotomy guide block is 1/3 to 1/2 of the circumference of the bone to be osteotomy.

Further, in order to facilitate measurement of the width of the resected bone, the first osteotomy guide block is provided with a first graduation mark 13 for measuring the width of the first gap, i.e. the first graduation mark is located on one side of the first osteotomy guide block adjacent to the second gap, and the first graduation mark is also adjacent to the intersection of the first gap and the second gap, and the second osteotomy guide block is provided with a second graduation mark 14 for measuring the width of the third gap, i.e. the second graduation mark is located on one side of the second osteotomy guide block adjacent to the second gap, and the second graduation mark is also adjacent to the intersection of the third gap and the second gap.

The first osteotomy guide block and the second osteotomy guide block are independently provided with a plurality of locking holes 15, each locking hole comprises an intersecting hole 16 and at least two fixing holes 17, the intersecting holes are formed in the intersecting positions of the first gap or the third gap and the second gap, the at least two fixing holes are symmetrically arranged by taking a straight line where the second gap is located as a symmetry axis, and locking members such as headless nails are arranged in the locking holes. The fixing hole can be set up to the inclined hole, makes the mounting setting in the fixed orifices of slope, and the mounting of slope this moment is crisscross but the disjunctor in the space for further fixed bone guide block of cutting with wait to cut the bone, avoid the mounting to jump out because the pendulum saw shakes, avoid losing original position relation. The length of the fixing member may be 3-3.2 mm. The fixing pieces are arranged in the intersecting holes to avoid the condition of excessive osteotomy during osteotomy.

Further, in order to fix the laminating and cut bone guide block and the second of bone face at the first bone guide block that cuts of waiting to cut, cut bone guide module still includes fixed block 3, and the fixed block can be dismantled and connect on first bone guide block that cuts and the second bone guide block that cuts, and the guide block will originally not have first bone guide block and the second bone guide block that cuts of connecting to be connected promptly. The fixed block can be set to be circular-arc structure to with the outline laminating of cutting the bone guide block.

As a preferable technical scheme, one side of the fixing block, which is jointed with the first osteotomy guide block and the second osteotomy guide block, is provided with a bulge 18, and the thickness of the bulge is determined according to the thickness of the osteotomy tool. The projection is disposed in a second gap between the first osteotomy guide block and the second osteotomy guide block for determining a width of the second gap, the width of the second gap corresponding to a size of the osteotomy. Preferably, the fixed block is arc-shaped, can be attached to the surfaces of the first osteotomy guide block and the second osteotomy guide block, and has a certain guiding function due to the arc-shaped arrangement.

Further, the osteotomy guide further comprises a locking module 4 for locking the osteotomy guide module to the bone surface, the locking module being fixedly connected to the osteotomy guide module, e.g. by welding. The locking module may surround the bone to be osteotomy, or the locking module may have an arc length of 1/3 to 1/2 of the circumference of the bone to be osteotomy. The locking module comprises a first locking assembly for locking the first osteotomy guide block on the osteotomy to be treated and a second locking assembly for locking the second osteotomy guide block on the osteotomy to be treated, the first locking assembly and the second locking assembly independently comprise a first locking clamp 5, a second locking clamp 6 and a locking piece 7, the first locking clamp and the second locking clamp are connected through the locking piece, the first locking clamp and the second locking clamp are arranged around the bone surface, and the first locking clamp or the second locking clamp is fixed on the osteotomy guide module. Correspond respectively on first locking clamp and the second locking clamp and be formed with a plurality of locking holes 19, first locking clamp and the every relative a set of locking downthehole locking that sets up of second locking clamp all are provided with the retaining member, and first locking clamp and second locking clamp form integratively through the fixed connection of retaining member with the locking hole, can make first locking clamp and second locking clamp locking treat the osteotomy face through rotating the retaining member during in-service use. Preferably, the anti-skidding teeth are arranged on one side, attached to the bone surface, of the first locking clamp and one side, attached to the bone surface, of the second locking clamp, so that the locking module is prevented from sliding, the locking of the osteotomy is achieved, and the effect of strengthening and fixing is achieved.

Further, in order to facilitate the directional movement of the first locking clamp and the second locking clamp during locking, the first locking assembly and the second locking assembly independently further comprise a guide rod 8 connected between the first locking clamp and the second locking clamp. The first locking clamp and the second locking clamp are correspondingly provided with guide holes between the locking holes respectively, and a group of guide holes oppositely arranged in the first locking clamp and the second locking clamp are connected with guide rods through threads.

Further, in order to ensure that the osteotomy is performed along the dissecting axis to be resected, the osteotomy guide further comprises a dissecting axis to be resected aligning module, the dissecting axis to be resected aligning module comprises a calibrating rod 9 connected to the locking module, two ends of the calibrating rod respectively penetrate through connecting blocks 21, and the connecting blocks are connected to the locking member 7 and the guide rod 8 of the first locking assembly or the second locking assembly and can be adjusted in position.

A method of using an osteotomy guide, comprising the steps of:

(1) combining and connecting the first osteotomy guide block 1 and the second osteotomy guide block 2 to be jointed with the osteotomy 22 through the fixing block 3, the locking module 4 and the to-be-osteotomy dissection axis alignment module; the fixing block 3 enables the first osteotomy guide block 1 and the second osteotomy guide block 2 to keep relative position relation, so that the gap between the first osteotomy guide block and the second osteotomy guide block comprises a first gap, a second gap and a third gap, the second gap is parallel to the anatomical axis of the bone to be cut, the first gap and the third gap are parallel to each other, the first gap, the second gap and the third gap independently comprise a first end and a second end, the first end of the second gap is connected with the first end of the first gap, the second end of the second gap is connected with the first end of the third gap, the second end of the first gap and the second end of the third gap are positioned on two sides of a straight line where the second gap is positioned, namely the first gap, the second gap and the third gap are Z-shaped;

(2) adjusting the osteotomy length to a desired length through the first scale line 13 and the second scale line 14;

(3) carrying out alignment measurement of the axis of the bone to be cut: inserting the calibrating rod 9 into the connecting block 21, so that the calibrating rod 9 coincides with the anatomical axis of the bone to be cut 22, adjusting the positions of the first cutting guide block 1 and the second cutting guide block 2 to enable the second gap to coincide with the anatomical axis of the bone to be cut, and enabling the first gap and the third gap to be parallel to each other (preferably enabling the first gap and the third gap to be perpendicular to the anatomical axis of the bone to be cut 22), so that the phenomena that the stress is uneven at the bone cutting position in the later period, the bone healing is not facilitated, and the osteoporosis is prone to occurring are avoided, and then detaching the calibrating rod 9;

(4) locking of the locking module 4 is performed: firstly, rotating the guide rod to move in the guide hole to drive the first locking clamp and the second locking clamp to slide on the locking part, so as to adjust the inner diameter size of the first locking clamp and the second locking clamp after being assembled, and locking the first osteotomy guide block 1 and the second osteotomy guide block 2 on the osteotomy 22;

(5) and performing alignment measurement of the anatomical axis to be osteotomy again: the alignment rod 9 is inserted into the connecting block 21, and with the locking of the locking module 4, if the first osteotomy guide block 1 and the second osteotomy guide block 2 deflect, the first locking clamp and the second locking are adjusted, so that the positions of the first osteotomy guide block and the second osteotomy guide block are adjusted, and the alignment rod 9 and the second gap are ensured to be coincident with the anatomical axis of the osteotomy 22.

(6) Fixing the first osteotomy guiding block 1 and the second osteotomy guiding block 2 on the bone surface: inserting the fixing member into the locking holes 15 (the intersecting hole 16 and the fixing hole 17) of the first and second osteotomy guide blocks, respectively; the fixing piece in the fixing hole 17 is used for fixing the first osteotomy guide block 1 and the second osteotomy guide block 2, and the positions of the first osteotomy guide block and the second osteotomy guide block are prevented from being changed due to vibration of the oscillating saw; the fixing piece in the intersecting hole 16 is used for preventing the oscillating saw from passing through the intersecting situation during the bone cutting, avoiding saw cuts at the intersecting position of the oscillating saw, and preventing the occurrence of stress concentration and fracture;

(7) taking down the fixed block 3 for Z-shaped osteotomy: firstly, transverse osteotomy (four cutters in total) is carried out, and then longitudinal osteotomy (one cutter) is carried out.

According to the osteotomy guide device and the osteotomy surgical instrument provided by the invention, the first osteotomy guide block and the second osteotomy guide block can be used for osteotomy at two ends of a bone to be osteotomed after being connected through the fixing block, the locking module and the to-be-osteotomy dissection axis aligning module, the osteotomy guide device has the functions of rotation resistance and marrow cavity concentricity guarantee, the rotation resistance and the guide function can be realized during later fixing, internal fixation can be reduced during resetting, the medullary cavity concentricity is guaranteed, bone development is stimulated, the stress shielding condition is avoided, osteotomy depending on the surgical experience of a doctor is avoided, and the optimal osteotomy angle and position of a patient are also avoided losing due to movement in an operation.

The use methods of the osteotomy guider, such as length measurement, osteotomy axis measurement, parallel osteotomy, locking mode and the like, can solve the problems existing in the prior art in clinic; the osteotomy guide block is provided with an axis calibration hole, namely a hole on the connecting block through which the calibration rod passes, and a second gap between the first osteotomy guide block and the second osteotomy guide block is calibrated by assembling the calibration rod in the use process, so that the second gap can be ensured to be superposed with the anatomical axis to be osteotomy, and the first gap and the third gap can also be ensured to be vertical to the anatomical axis to be osteotomy (when the first gap and the third gap of the osteotomy guide are both vertical to the second gap), so that the first gap and the third gap are stressed in a balanced manner, osteoporosis is reduced, the development of bones is promoted, and the early-stage load bearing of a patient is realized;

the first gap and the third gap of the osteotomy guide are in parallel relation, and the oscillating saw carries out osteotomy along the first gap, the second gap and the third gap, so that the later-stage resetting stable connection can be realized;

a fixing piece, such as a headless nail, is arranged in the intersecting hole of the osteotomy guider to play a role in preventing the osteotomy;

the osteotomy guider is attached to the surface of a bone to be osteotomed, and two sides of the osteotomy guider are chamfered, so that the separation and the cutting injury of tissues can be reduced;

the osteotomy guider is provided with scale lines, and can be directly adjusted to a size limit preset by a preoperative scheme during osteotomy and then is used for osteotomy, so that the osteotomy is in place once, repeated osteotomy is avoided, the operation time is saved, the pain of a patient is reduced, and the smooth operation is facilitated;

the osteotomy guider holds the bone to be osteotomed through the locking module, locks two ends of the bone to be osteotomed through the guide rod, and then drives the locking piece into the fixing hole of the locking hole, so that the osteotomy guider can still be firmly fixed even under the vibration of the osteotomy; in addition, the fixing block of the osteotomy guide can play a role in guiding the assembly of the osteotomy guide block, ensure the relative position relation of the osteotomy guide block, ensure the clearance between the first osteotomy guide block and the second osteotomy guide block, and is more convenient to operate.

The applicant declares that the above description is only a specific embodiment of the present invention, but the scope of the present invention is not limited thereto, and it should be understood by those skilled in the art that any changes or substitutions that can be easily conceived by those skilled in the art within the technical scope of the present invention are within the scope and disclosure of the present invention.

Claims

1. The utility model provides an osteotomy guider, includes osteotomy guide block, its characterized in that cuts the bone guide block and includes first osteotomy guide block and second osteotomy guide block, and first osteotomy guide block is fixed on waiting to cut the bone with second osteotomy guide block interval, the interval includes first clearance, second clearance and third clearance, and the second clearance is parallel with waiting to cut the bone and dissect the axis, and first clearance and third clearance are parallel to each other, and first clearance, second clearance and third clearance independently include first end and second end, and the first end of second clearance is connected with the first end of first clearance, and the second end of second clearance is connected with the first end of third clearance, and the second end of first clearance and the second end of third clearance are located second clearance both sides.

2. The osteotomy guide of claim 1, wherein said first and second osteotomy guide blocks are independently L-shaped.

3. The osteotomy guide of claim 1 or 2, wherein said first osteotomy guide block is provided with a first graduation mark for measuring a first gap width and said second osteotomy guide block is provided with a second graduation mark for measuring a third gap width.

4. The osteotomy guide of any one of claims 1-3, wherein said first and second osteotomy guide blocks are independently provided with a plurality of locking holes, one of which is provided at the juncture of the first or third gap and the second gap.

5. The osteotomy guide of any one of claims 1-4, wherein said osteotomy guide module further comprises a fixation block removably attached to said first osteotomy guide block and said second osteotomy guide block.

6. The osteotomy guide of claim 5, wherein the fixation block includes a protrusion configured to engage a second gap between the first osteotomy guide block and the second osteotomy guide block to removably attach the fixation block to the first osteotomy guide block and the second osteotomy guide block.

7. The osteotomy guide of any one of claims 1-6, further comprising a locking module comprising a first locking assembly for locking the first osteotomy guide block to the bone to be resected and a second locking assembly for locking the second osteotomy guide block to the bone to be resected, the first and second locking assemblies independently comprising a first locking clip, a second locking clip, and a locking member, the first and second locking clips being connected by the locking member.

8. The osteotomy guide of claim 7, wherein the first and second locking assemblies independently further comprise a guide rod for guiding the first and second locking clamps when locked, the guide rod being coupled to both the first and second locking clamps.

9. The osteotomy guide of one of claims 1-8, further comprising a to-be-osteotomy dissection axis alignment module, the to-be-osteotomy dissection axis alignment module comprising a calibration rod coupled to the locking module.

10. An osteotomy surgical instrument comprising the osteotomy guide of any one of claims 1-9.