CN111096808B - Peroneal muscle branch-penetrating flap branch-penetrating blood vessel fixed type positioning guide plate and manufacturing method thereof - Google Patents
Peroneal muscle branch-penetrating flap branch-penetrating blood vessel fixed type positioning guide plate and manufacturing method thereof Download PDFInfo
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- CN111096808B CN111096808B CN202010028095.3A CN202010028095A CN111096808B CN 111096808 B CN111096808 B CN 111096808B CN 202010028095 A CN202010028095 A CN 202010028095A CN 111096808 B CN111096808 B CN 111096808B
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- flap
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- positioning guide
- fixed end
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y80/00—Products made by additive manufacturing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
Abstract
The invention discloses a fixed positioning guide plate for a peroneal muscle branch-penetrating skin flap branch-penetrating blood vessel, which comprises a positioning guide plate body, fixed ends and connecting rods, wherein each fixed end comprises a knee joint fixed end and an ankle joint fixed end, two connecting rods are connected between the knee joint fixed end and the ankle joint fixed end, and the connecting rods are connected with the positioning guide plate body. The manufacturing method comprises the following steps: firstly, CTA original DICOM data are obtained; (2) Performing three-dimensional modeling according to DICOM data, and determining specific position information; (3) positioning the precise position of the skin flap; (4) determining a body surface reference position and coordinates; (5) And (5) printing the positioning guide plate through a 3D printer according to the data and the position information determined by the methods (1) to (4). The invention can realize the accurate positioning of the flap perforator, ensures that the perforator is not damaged in the flap cutting process, improves the success rate of flap transplantation, and is more accurate, safe, reliable and convenient compared with the traditional mode.
Description
Technical Field
The invention belongs to the field of medical equipment, and particularly relates to a peroneal muscle perforator flap perforator blood vessel fixed type positioning guide plate and a manufacturing method thereof.
Background
The peroneal muscle branch-penetrating skin flap is mainly used for the repair and reconstruction of various tissue defects including oral and maxillofacial parts, and is particularly suitable for the contemporaneous reconstruction of hard tissue combined with soft tissue defects. However, it is difficult to successfully prepare skin flaps because of the large variation of their perforator vessels. In order to ensure the survival of the skin flap, the success or failure of the skin flap transplantation is directly determined by accurately preserving the perforator blood vessel. At present, the positioning of the anterior-lateral femoral mosaic flap perforator still depends on the traditional method, and the defects are as follows: the position of the perforator vessel is judged manually by sonar according to the conventional standard anatomical position and an ultrasonic instrument. On one hand, the mode has higher requirement on the environment and is easy to be interfered by noise to form misjudgment, and on the other hand, the individualized anatomical characteristics of the patient, such as vascular development deformity or vascular variation, are difficult to grasp; secondly, the doctor can judge the position by the experience, even if the general position is determined, the accuracy is not enough, the incision is inaccurate, or the skin flap is accidentally injured to supply blood vessels, so that the operation fails.
Therefore, how to solve the above technical problems becomes a problem to be solved urgently by those skilled in the art.
Disclosure of Invention
The invention aims to provide a peroneal muscle perforator flap perforator blood vessel fixed type positioning guide plate and a manufacturing method thereof, which can completely solve the defects of the prior art.
The purpose of the invention is realized by the following technical scheme:
the utility model provides a peroneus wears a skin flap and wears a fixed location baffle of blood vessel, should fix a position the baffle including location baffle body, stiff end and connecting rod, the shape of location baffle body is confirmed according to the defective size of soft tissue and the size of surely getting the skin flap and the position of wearing a branch, the stiff end includes knee joint stiff end and ankle joint stiff end, and the knee joint stiff end is used for the cooperation to connect the knee joint, and the ankle joint stiff end is used for the cooperation to connect the ankle joint, be connected with two connecting rods between knee joint stiff end and the ankle joint stiff end, the location baffle body is connected to the connecting rod.
Further, the location baffle is printed through the 3D printer and is formed.
A manufacturing method of a peroneal muscle branch-penetrating skin flap branch-penetrating blood vessel fixed type positioning guide plate comprises the steps of:
(1) Firstly, performing bilateral lower limb CTA (computed tomography angiography) examination on a patient to obtain CTA original DICOM data;
(2) Performing three-dimensional modeling according to the original DICOM data of the patient, and determining specific position information including bones, muscles, blood vessels and skin;
(3) Designing a skin flap transplanting shape according to the skin flap transplanting requirement, and positioning the accurate position of the skin flap;
(4) Determining a body surface reference position and coordinates according to the personalized human anatomical physical signs;
(5) And (4) printing the fibula skin flap blood vessel fixed positioning guide plate through a 3D printer according to the data and the position information determined by the methods (1) to (4).
Further, the skin flap in the method (3) is a peroneal muscle cross-branch skin flap, the peroneal muscle cross-branch skin flap belongs to a skin flap of a supply area, a receiving area is a soft and hard tissue defect wound surface of an oral cavity, a jaw face or other parts of a body, the size and the shape of the peroneal muscle cross-branch skin flap of the supply area need to be selected according to the size and the shape of a defect, and accurate positioning can be carried out according to skin cross-branch of a computer-assisted surgery simulated blood vessel.
Compared with the prior art, the invention has the beneficial effects that: the accurate positioning of the flap perforator can be realized, the flap incision process is guaranteed not to damage the perforator, the success rate of flap transplantation is improved, and the flap grafting device is more accurate, safe, reliable and convenient compared with the traditional mode.
Drawings
FIG. 1 is a schematic structural view of a positioning guide.
FIG. 2 is a schematic view of a positioning guide for determining the position of a guide body through a perforator.
FIG. 3 is a schematic view of a positioning guide matched to a blood vessel and soft tissue.
Reference numerals: the locating guide plate comprises a locating guide plate body 1, a connecting rod 2, a knee joint fixing end 3, an ankle joint fixing end 4, a peroneal artery puncturing branch 5 and lower limb soft tissues 6.
Detailed Description
The invention will be further described with reference to specific embodiments and the accompanying drawings.
In order to overcome the defects of the traditional method for positioning the peroneal muscle perforator flap perforator vessel at present, a peroneal muscle perforator flap perforator vessel positioning guide plate based on a 3D printing technology is designed. The advantages are that: the accurate positioning of the flap perforator can be realized, the flap incision process is guaranteed not to damage the perforator, the success rate of flap transplantation is improved, and the flap grafting device is more accurate, safe, reliable and convenient compared with the traditional mode.
As shown in fig. 1 to 3, a fixed positioning guide plate for a peroneal muscle perforator flap perforator, which is manufactured based on a 3D printing technology, comprises a positioning guide plate body 1, a fixed end and a connecting rod 2. The positioning guide plate body 1 is used for cutting the position of a flap according to the position simulated by computer aided design, the size of the flap needs to be designed according to the size and the position of soft tissue defect, and the shape of the positioning guide plate body 1 is designed by combining the position of a penetrating branch. The stiff end is also according to computer aided design, selects stable skeleton as the stiff end, and the upper end is selected at the knee joint, is connected with the knee joint cooperation, is called knee joint stiff end 3, and the lower extreme is selected at ankle joint, is connected with the ankle joint cooperation, is called ankle joint stiff end 4. Knee joint stiff end 3 is connected through two connecting rods 2 between the ankle joint stiff end 4, and location baffle body 1 is connected to connecting rod 2.
In the manufacturing process of the positioning guide plate, the fixed position of the positioning guide plate body 1 and the flap cutting position of the positioning guide plate body 1 which need to be determined are emphasized, and the method comprises the following steps:
positioning of the guide body 1: the knee joint is selected as the fixed end at the upper end of the positioning guide plate, and the ankle joint is selected as the fixed end at the lower end of the positioning guide plate. The middle part is connected with the fixed ends at the two ends and the positioning guide plate body 1 by a connecting rod 2. According to individual CT data of a patient, selecting relatively stable anatomical positions such as knee joints, ankle joints and the like from the body surface as coordinates, calculating to obtain the form of the positioning guide plate which is attached to the fixed position of the body surface, the accurate position and shape of a skin flap of the body surface, and designing the form of the positioning guide plate.
The flap cutting position of the positioning guide plate body 1 is as follows: after a perforator blood vessel is found by patient CTA data through a computer, the blood vessel, muscle, skin, bone and the like are digitally reconstructed through a three-dimensional reconstruction technology, and the initial coordinate axis position, the blood vessel cutting length and the initial blood vessel diameter of the peroneal perforator 5 are measured by a software measuring tool. The positioning points are designed according to coordinate axis position information of the blood vessel to be punctured and branched, the skin flap intercepting ring-shaped guide plate is designed by covering the area of the skin to be intercepted by taking the positioning points as the center, the blood vessel source is reversely tracked, the body surface position of the blood vessel to be punctured and branched to penetrate through the deep fascia is marked, so that the skin flap is conveniently cut, and the specific range of the positioning guide plate body 1 is designed.
The specific preparation method of the positioning guide plate in the technical scheme comprises the following steps:
(1) The patient performs bilateral lower limb CTA examination to obtain CTA original DICOM data.
(2) Three-dimensional modeling is performed according to the original CTA data of the patient, and specific position information containing bones, muscles, blood vessels and skin is determined.
(3) According to the requirements of skin flap transplantation, the shape of the skin flap transplantation is designed, and the accurate position of the skin flap is positioned. The skin flap is a peroneal muscle branch-penetrating skin flap, the peroneal muscle branch-penetrating skin flap belongs to a supply area skin flap, a receiving area is a soft and hard tissue defect wound surface of an oral jaw face or other parts of a body, and the size and the shape of the supply area peroneal muscle branch-penetrating skin flap are selected according to the size and the shape of the defect. The precise location of the flap requires precise positioning based on the skin perforator of the simulated vessel in computer assisted surgery.
(4) And determining the body surface reference position and coordinates according to the personalized human anatomical physical signs.
(5) The positioning guide plate containing the fixed position, the cutting position and the like is printed through the 3D printer.
The fixed end position is determined by mainly selecting hard tissues other than soft tissues as the fixed positions to prevent the positioning guide plate from displacing along with the change of body positions or the displacement of the soft tissues, and the grey parts in figure 3 are lower limb soft tissues 6 simulated by a computer.
The above description is intended to be illustrative of the preferred embodiment of the present invention and should not be taken as limiting the invention, but rather, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention.
Claims (2)
1. A fibula-piercing flap-piercing blood vessel fixed type positioning guide plate is characterized by comprising a positioning guide plate body, a fixed end and connecting rods, wherein the shape of the positioning guide plate body is determined according to the size of soft tissue defect, the size of a cut flap and the position of piercing, the fixed end comprises a knee joint fixed end and an ankle joint fixed end, the knee joint fixed end is used for being connected with a knee joint in a matched mode, the ankle joint fixed end is used for being connected with an ankle joint in a matched mode, two connecting rods are connected between the knee joint fixed end and the ankle joint fixed end, and the connecting rods are connected with the positioning guide plate body; the location baffle is printed through the 3D printer and is formed.
2. A method for manufacturing a fixed positioning guide plate for a peroneal muscle perforator flap perforator vessel, which is characterized by comprising the fixed positioning guide plate for the peroneal muscle perforator flap perforator vessel of the claims, and the manufacturing method comprises the following steps:
(1) Firstly, performing bilateral lower limb CTA (computed tomography angiography) examination on a patient to obtain CTA original DICOM data;
(2) Performing three-dimensional modeling according to the original DICOM data of the patient, and determining specific position information including bones, muscles, blood vessels and skin;
(3) Designing a skin flap transplanting shape according to the skin flap transplanting requirement, and positioning the accurate position of the skin flap;
(4) Determining a body surface reference position and coordinates according to the individualized human anatomical signs;
(5) Printing a peroneal muscle perforator flap blood vessel fixed type positioning guide plate through a 3D printer according to the data and the position information determined by the methods (1) to (4);
the skin flap in the method (3) is a peroneal muscle branch-crossing skin flap, the peroneal muscle branch-crossing skin flap belongs to a supply region skin flap, a receiving region is a soft and hard tissue defect wound surface of an oral jaw face or other parts of a body, the size and the shape of the supply region peroneal muscle branch-crossing skin flap need to be selected according to the size and the shape of the defect, and accurate positioning can be carried out according to the skin branch-crossing of a computer-assisted surgery simulated blood vessel.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010028095.3A CN111096808B (en) | 2020-01-10 | 2020-01-10 | Peroneal muscle branch-penetrating flap branch-penetrating blood vessel fixed type positioning guide plate and manufacturing method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010028095.3A CN111096808B (en) | 2020-01-10 | 2020-01-10 | Peroneal muscle branch-penetrating flap branch-penetrating blood vessel fixed type positioning guide plate and manufacturing method thereof |
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| Publication Number | Publication Date |
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| CN111096808A CN111096808A (en) | 2020-05-05 |
| CN111096808B true CN111096808B (en) | 2023-04-14 |
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| CN202010028095.3A Active CN111096808B (en) | 2020-01-10 | 2020-01-10 | Peroneal muscle branch-penetrating flap branch-penetrating blood vessel fixed type positioning guide plate and manufacturing method thereof |
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| CN114246691B (en) * | 2021-11-24 | 2024-03-15 | 中山大学孙逸仙纪念医院 | Threading and supporting positioning device |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US10219742B2 (en) * | 2008-04-14 | 2019-03-05 | Novadaq Technologies ULC | Locating and analyzing perforator flaps for plastic and reconstructive surgery |
| CN201701311U (en) * | 2010-06-23 | 2011-01-12 | 徐云钦 | Device for repairing sacrococcygeal soft tissue defect |
| CN107616839A (en) * | 2017-11-10 | 2018-01-23 | 岳春华 | A kind of flap perforating artery localization method rebuild based on 3D printing |
| CN108670362B (en) * | 2018-01-09 | 2020-11-24 | 浙江省肿瘤医院 | Cutting guide plate prepared by digital space reconstruction and 3D printing technology |
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