CN111110313A - Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement - Google Patents
Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement Download PDFInfo
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- CN111110313A CN111110313A CN202010034049.4A CN202010034049A CN111110313A CN 111110313 A CN111110313 A CN 111110313A CN 202010034049 A CN202010034049 A CN 202010034049A CN 111110313 A CN111110313 A CN 111110313A
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- 210000000689 upper leg Anatomy 0.000 claims abstract description 34
- 238000003780 insertion Methods 0.000 claims description 6
- 230000037431 insertion Effects 0.000 claims description 6
- 230000000149 penetrating effect Effects 0.000 claims description 4
- 208000010392 Bone Fractures Diseases 0.000 description 10
- 206010017076 Fracture Diseases 0.000 description 7
- 210000004394 hip joint Anatomy 0.000 description 7
- 210000000988 bone and bone Anatomy 0.000 description 6
- 239000002639 bone cement Substances 0.000 description 5
- 210000002436 femur neck Anatomy 0.000 description 4
- 238000004140 cleaning Methods 0.000 description 3
- 210000000527 greater trochanter Anatomy 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 210000001694 thigh bone Anatomy 0.000 description 3
- 238000005452 bending Methods 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 108010048734 sclerotin Proteins 0.000 description 2
- 238000009966 trimming Methods 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 208000024779 Comminuted Fractures Diseases 0.000 description 1
- 206010011985 Decubitus ulcer Diseases 0.000 description 1
- 206010020100 Hip fracture Diseases 0.000 description 1
- 241000489861 Maximus Species 0.000 description 1
- 208000001132 Osteoporosis Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000002692 epidural anesthesia Methods 0.000 description 1
- 210000003195 fascia Anatomy 0.000 description 1
- 239000012634 fragment Substances 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 210000001624 hip Anatomy 0.000 description 1
- 238000011540 hip replacement Methods 0.000 description 1
- 210000003692 ilium Anatomy 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000000281 joint capsule Anatomy 0.000 description 1
- 210000003127 knee Anatomy 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 238000010030 laminating Methods 0.000 description 1
- 210000000528 lesser trochanter Anatomy 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 206010033675 panniculitis Diseases 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 210000004304 subcutaneous tissue Anatomy 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000003437 trachea Anatomy 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Dentistry (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
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- Surgical Instruments (AREA)
Abstract
The invention relates to an osteotomy navigation tool for trochanter-style artificial femoral head replacement, which comprises a positioning rod, a guide piece and a connecting piece, wherein the positioning rod can be inserted into a medullary cavity of a femur to be operated, the guide piece is arranged on the positioning rod and is opposite to the positioning rod, and the osteotomy navigation tool has the advantages that: the positioning rod is inserted into the medullary cavity of the femur to be operated, so that the guide piece arranged opposite to the positioning rod is attached to the rear wall of the femur to be operated, the guide piece is conveniently arranged to extend into the femur from the first cutting groove and the second cutting groove respectively, and the part of the femur corresponding to the femur to be cut is intercepted.
Description
Technical Field
The invention relates to the field of medical operation tools, in particular to an osteotomy navigation tool for trochanter-shaped artificial femoral head replacement.
Background
The femur is the largest long tubular bone in the human body and can be divided into two ends, namely a middle femoral shaft and end parts positioned at the two ends of the femoral shaft, the top end of the femur is a spherical femoral head, the thinner part below the outer side of the femoral head is an upward bulge at the junction of a femoral neck and the femoral shaft and is also called as a greater trochanter 102, and the smaller bulge below the greater trochanter is a smaller trochanter and is also called as a smaller trochanter 101. The femoral intertrochanteric fracture of old age is the most common fracture caused by osteoporosis, and the adoption of artificial hip joint replacement is one of means for treating the fracture, such as bone cement type hip joint replacement, so that the affected hip joint can move early and get a load from the bed, and complications caused by long-term bed rest can be avoided.
In the case of artificial hip replacement surgery, the following procedure is generally used:
taking the lateral position after anesthesia, adopting a posterior lateral approach of a hip joint, keeping the gluteus medius at a bone block at the point of the greater tuberosity, turning upwards, taking out a femoral head and a broken bone block, removing and crushing small tuberosity bone fragments which are difficult to fix, or performing spacious placement without fixation; the bone fracture blocks such as the greater tuberosity and the lesser tuberosity are reserved, the osteotomy template is used for vertically osteotomy of the inner side of the greater tuberosity to the height of the lesser tuberosity, the pendulum saw is used for trimming the sclerotin at the lesser tuberosity position vertically on the plane of the lesser tuberosity and the longitudinal axis of the femur, the lateral cortex of the greater tuberosity is reserved, and then the anteversion angle is positioned by the axis of the knee joint for sequential reaming. The artificial femoral head prosthesis with the tuberosity handle is adopted in the operation, a proper femoral handle is selected, the lower part of the prosthesis neck support is flush with an osteotomy plane, the anteversion angle is about 15 degrees, bone cement is filled after the position is determined, and the femoral handle is inserted for fixation. After the bone cement is hardened, the big tuberosity bone block is fixed at the big tuberosity round hole of the prosthesis by using an absorbable wire or a steel wire, and the ilium lumbar muscle insertion point is fixed at the small tuberosity round hole by using the absorbable wire. Selecting proper double acting heads, repositioning hip joint, setting drainage and suturing incision layer by layer.
In the operation, the most critical operation step is the osteotomy operation of the upper end of the femur, referring to fig. 1, the existing operation process is to realize the osteotomy of the broken bone of the greater tuberosity 102 through the osteotomy template according to the shape of the implanted prosthesis, the existing osteotomy template is in a sheet shape, and the following problems can be encountered in the actual operation of the operation:
1. the osteotomy template is difficult to place in the center of the upper end of the femur, the oblique placement is likely to cause that the resected greater tuberosity section cannot be attached to the tuberosity handle, even if the template is placed to be consistent with the central axis of the medullary cavity, the situation of deviation from inside or outside can occur, the prosthesis can be inserted in an inverted manner, or the greater tuberosity bone is excessively cut, and the fracture can be caused in serious cases;
2. because the template is arranged outside the femur, the template can not be completely attached to the inner side edge of the femoral greater trochanter for cutting during vertical cutting, and because the template is not fixed, the swing track and the planned cutting path form an angle during actual cutting, so that the situation of excessive or insufficient cutting is caused, the operation time is prolonged, and the operation wound is increased;
3. the anteversion angle is difficult to control during osteotomy, the osteotomy needs to be adjusted for a plurality of times to prolong the operation time, the operation trauma is aggravated, and the sclerotin of a large and tuberosity part is often removed too much after the plurality of osteotomy operations, so that the power of the gluteus medius attachment point is reduced.
Disclosure of Invention
The invention aims to solve the technical problem of the prior art, and provides an osteotomy navigation tool for trochanter-shaped artificial femoral head replacement, which does not need to be held by hands during cutting and can accurately guide a lower cutter.
The technical scheme adopted by the invention for solving the technical problems is as follows: the osteotomy navigation tool for trochanter-shaped artificial femoral head replacement comprises
The positioning rod can be inserted into a medullary cavity of a femur to be operated;
the guide piece is arranged on the positioning rod and is opposite to the positioning rod, when the positioning rod is inserted into the marrow cavity of the femur to be operated, the guide piece is positioned on the back wall corresponding to the upper end of the femur to be operated, the guide piece is provided with a first cutting groove and a second cutting groove, the first cutting groove and the second cutting groove are used for allowing the guide piece to pass through and cutting the upper end of the femur, the first cutting groove and the second cutting groove are arranged in a penetrating mode along the wall thickness direction of the guide piece, the extending direction of the inner edge of the femoral tuberosity to be cut of the first cutting groove is consistent, and the second cutting groove is perpendicular to the first cutting groove; and
and a connecting member for mounting the guide member on the positioning rod, the connecting member being disposed between the positioning rod and the guide member and connecting corresponding ends of the positioning rod and the guide member, respectively.
In order to further clarify the cutting direction and ensure that cutting in both directions does not interfere with each other, it is preferable that the second cut groove be disposed below the first cut groove in the insertion direction of the detent lever, and the first cut groove and the second cut groove be not communicated with each other.
In order to facilitate the selection of a suitable cutting position without moving the entire navigation tool, the second slots are two and are arranged side by side and spaced apart.
In order to further ensure that the pendulum datum during cutting is guided, preferably, a guide groove for the pendulum datum penetrating out of the first cutting groove to pass through is formed in the position, corresponding to the first cutting groove, of the positioning rod.
In order to further position the placing angle of the guide piece relative to the femur to be operated, the guide piece is also provided with a pointing part for positioning the femoral greater tuberosity to be operated.
In order to ensure that the guide member does not deflect again after being swung, the guide member is provided with a positioning hole which is penetrated along the wall thickness direction and used for fixing the guide member and a positioning needle of the femur to be operated.
In order to ensure that the positioning rod and the guide piece are relatively fixed, the corresponding ends of the positioning rod and the guide piece are both arranged on the connecting piece in a penetrating manner, and mounting holes for the positioning rod and the guide piece to penetrate through are correspondingly formed in the two sides of the connecting piece; still be equipped with the retaining member that restriction locating lever and the relative connecting piece of guide removed on the connecting piece the locating lever and guide all install under the state of connecting piece, the retaining member respectively with locating lever and guide offset.
Compared with the prior art, the invention has the advantages that: this a cut bone navigation tool for artifical femoral head replacement of tuberosity handle type includes locating lever and guide, inserts through the locating lever and treats the medullary cavity of operation thighbone to make the guide laminating of arranging with the locating lever relatively treat the operation thighbone on the back wall, thereby make things convenient for the pendulum to stretch into from first grooving and second grooving respectively, and then with corresponding partial intercepting of treating the cutting on the thighbone.
Drawings
FIG. 1 is a schematic view of a femur after cleaning the medullary cavity according to an embodiment of the present invention;
FIG. 2 is a schematic view of a navigation tool in cooperation with an osteotomy anterior femur according to an embodiment of the present invention;
FIG. 3 is a schematic view of a navigation tool engaged with a resected femur according to an embodiment of the present invention;
FIG. 4 is a schematic diagram of an overall structure of a navigation tool according to an embodiment of the present invention;
FIG. 5 is an exploded view of a navigation tool according to an embodiment of the present invention.
Detailed Description
The invention is described in further detail below with reference to the accompanying examples.
As shown in fig. 1 to 5, which are a preferred embodiment of the present invention, in this embodiment, the osteotomy navigation tool for trochanter-style artificial femoral head replacement comprises a positioning rod 1 and a guide member 2, the guide member 2 is mounted on the positioning rod 1 through a connecting member 3, corresponding ends of the positioning rod 1 and the guide member 2 are respectively inserted into the connecting member 3, and mounting holes 31 for the positioning rod 1 and the guide member 2 to pass through are correspondingly formed on both sides of the connecting member 3, although there are various connection manners for the positioning rod 1 and the guide rod 2, which are not to be taken as an example. Still be equipped with retaining member 4 that restriction locating lever 1 and 2 relative connecting piece 3 of guide part removed on connecting piece 3 in this embodiment, all install under connecting piece 3 state at locating lever 1 and guide part 2, retaining member 4 offsets with locating lever 1 and guide part 2 respectively.
In this embodiment, the positioning rod 1 can be inserted into the medullary cavity 100 of the femur to be operated, and the guide 2 is arranged opposite to the positioning rod 1 after being mounted on the positioning rod 1, and the guide 2 is located on the corresponding posterior wall of the upper end of the femur to be operated in a state that the positioning rod 1 is inserted into the medullary cavity 100 of the femur to be operated; the guide member 2 of the present embodiment has a first incision 21 and a second incision 22 for allowing the upper end of the femur to be cut therethrough, the first incision 21 and the second incision 22 are both provided along the wall thickness direction of the guide member 2, the first incision 21 extends along the direction of the femoral trochanter to be cut, the second incision 22 is disposed perpendicular to the first incision 21, the second incision 22 is disposed below the first incision 21 along the insertion direction of the positioning rod 1, and the first incision 21 and the second incision 22 are not connected to each other, such that the first incision 21 and the second incision 22 are disposed so as to ensure that the two directions do not interfere with each other during cutting, thereby ensuring the precision of the operation. The two second cutting grooves 22 in the embodiment are arranged side by side and at intervals, so that the design of the two second cutting grooves 22 can ensure that the position to be cut according to needs can be accurately selected to swing the extending position of the navigation tool without adjusting the position of the whole navigation tool, and meanwhile, the guide groove 11 for the swing passing through the first cutting groove 21 is formed in the position, corresponding to the first cutting groove 21, of the positioning rod 1.
In this embodiment, the guide 2 is further provided with a pointing portion 23 for positioning the femoral trochanter 102 to be operated, and the guide 2 is provided with a positioning hole 24 for passing a positioning pin for fixing the guide 2 and the femur to be operated.
The navigation tool using method of the invention is as follows:
before operation, the trachea is general anesthesia or epidural anesthesia, a lateral decubitus position is taken, a back and outside incision is made, after a piece of towel is spread through conventional disinfection, skin and subcutaneous tissues are incised, gluteus maximus and fascia thereof are incised, external rotation muscle groups such as piriformis and the like are incised, a joint capsule is incised, comminuted fracture between femoral tuberosity can be seen, the femoral head and the femoral neck are taken out, and the femoral head is reset and fixed according to the fracture condition of the femoral head so as to judge the rotation center of the whole femoral head.
① according to the specific situation of fracture, using the minimum femoral medullary cavity file to find the medullary cavity 100 entrance at the upper end of femur, expanding medullary cavity along the axis of medullary cavity 100, expanding medullary cavity with thin to thick femoral file, and cleaning proximal medullary cavity of femoral shaft;
② selecting a positioning rod 1 in the osteotomy navigation tool according to the maximum femoral medullary cavity, assembling the osteotomy navigation tool with a guide 2, mounting the guide 2 on the positioning rod 1 through a connecting piece 3, and locking by using a locking piece 4;
③ inserting the positioning rod 1 along the medullary cavity, the whole navigation tool moving synchronously with the insertion of the positioning rod 1, the insertion depth of the positioning rod 1 is that the femoral head rotation center of the femoral neck indicating rod is parallel to the femoral greater tuberosity vertex;
④ bending hip 45 degrees, bending knee 90 degrees, making sole upward, making the femoral neck indicating rod of the guiding component 2 vertically intersect with shank, then rotating forward 15 degrees as anteversion angle of artificial femoral head prosthesis, then fixing the guiding component 2 on the upper end of femur by positioning pin through positioning hole 24;
⑤ cutting the first slot 21 of the guide 2 with a swing saw, selecting one of the two second slots 22 to cut according to the fracture of the lesser trochanter, then removing the navigation tool, further trimming the cut along the cut line, obtaining mutually perpendicular cut surfaces on the upper end of the femur to accommodate the tuberosity of the artificial prosthesis;
⑥ inserting prosthesis handle after reaming marrow at proximal end, checking whether the osteotomy height is correct, that is, whether the femoral head center is at the same level with the greater tuberosity peak, and resetting hip joint to check its tightness and whether dislocation exists in each direction;
⑦ cleaning femoral medullary cavity, filling bone cement, placing into the prosthesis handle until the bone cement is dried, sheathing the prosthesis head to complete artificial half hip joint replacement, and tightening and fixing fracture block with Kirschner wire tension band.
Claims (7)
1. An osteotomy navigation tool for trochanter-style artificial femoral head replacement, comprising: comprises that
A positioning rod (1) which can be inserted into the medullary cavity (100) of the femur to be operated; and
a guide member (2) mounted on the positioning rod (1) and arranged opposite to the positioning rod (1), wherein when the positioning rod (1) is inserted into the femoral medullary cavity (100) to be operated, the guide member (2) is arranged on the rear wall corresponding to the upper end of the femur to be operated, the guide member (2) is provided with a first cutting groove (21) and a second cutting groove (22) for allowing the guide member to pass through to cut the upper end of the femur, the first cutting groove (21) and the second cutting groove (22) are both arranged in a penetrating manner along the wall thickness direction of the guide member (2), the first cutting groove (21) is consistent with the extending direction of the inner edge of the femur to be cut, and the second cutting groove (22) is arranged perpendicular to the first cutting groove (21); and
a connecting piece (3) for mounting the guide piece (2) on the positioning rod (1), the connecting piece (3) being arranged between the positioning rod (1) and the guide piece (2) and connecting the corresponding ends of the positioning rod (1) and the guide piece (2) respectively.
2. The osteotomy navigation tool of claim 1, wherein: the second cut groove (22) is arranged below the first cut groove (21) in the insertion direction of the positioning rod (1), and the first cut groove (21) and the second cut groove (22) are not communicated with each other.
3. The osteotomy navigation tool of claim 2, wherein: the number of the second cutting grooves (22) is two, and the two second cutting grooves (22) are arranged side by side and at intervals.
4. The osteotomy navigation tool of claim 3, wherein: the positioning rod (1) is provided with a guide groove (11) which is corresponding to the first cutting groove (21) and is used for the pendulum passing through the first cutting groove (21).
5. The osteotomy navigation tool of claim 1, wherein: the guide piece (2) is also provided with a pointing part (23) for positioning the femoral greater tuberosity (102) to be operated.
6. The osteotomy navigation tool of claim 1, wherein: the guide piece (2) is provided with a positioning hole (24) which is penetrated along the wall thickness direction and used for fixing the guide piece (2) and a positioning needle of the femur to be operated.
7. The osteotomy navigation tool of any one of claims 1-6, wherein: mounting holes (31) for the positioning rods (1) and the guide pieces (2) to penetrate through are correspondingly formed in the two sides of the connecting piece (3); still be equipped with retaining member (4) that restriction locating lever (1) and guide (2) removed relative connecting piece (3) on connecting piece (3) locating lever (1) and guide (2) are all installed under the state of connecting piece (3), retaining member (4) respectively with locating lever (1) and guide (2) offset.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010034049.4A CN111110313A (en) | 2020-01-13 | 2020-01-13 | Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010034049.4A CN111110313A (en) | 2020-01-13 | 2020-01-13 | Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN111110313A true CN111110313A (en) | 2020-05-08 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010034049.4A Pending CN111110313A (en) | 2020-01-13 | 2020-01-13 | Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement |
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| CN (1) | CN111110313A (en) |
Citations (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1633265A (en) * | 2002-02-14 | 2005-06-29 | Iql利万特外科工业有限公司 | Method and instrumentation for patello-femoral joint replacement |
| US20050267484A1 (en) * | 2005-08-18 | 2005-12-01 | Jeff Menzner | Extended trochanteric osteotomy guide |
| CN2745524Y (en) * | 2003-09-20 | 2005-12-14 | 马卫华 | Intramedullary positioning guide device for neck of femur osteotomy |
| CN102525690A (en) * | 2012-01-13 | 2012-07-04 | 南方医科大学 | Improved artificial femoral stem and nail implanting guide frame thereof |
| CN102551921A (en) * | 2012-01-13 | 2012-07-11 | 南方医科大学 | Artificial femoral stem for fracture surgery around hip joint prosthesis |
| CN203447322U (en) * | 2013-04-12 | 2014-02-26 | 德普伊（爱尔兰）公司 | Distal femoral clamp assembly and distal femoral cutting instrument comprising the same |
| CN107149490A (en) * | 2017-05-18 | 2017-09-12 | 汤向阳 | A kind of complete positioner of artificial full hip-joint replacement |
| CN110141299A (en) * | 2019-06-17 | 2019-08-20 | 中山市中医院 | A kind of cutting neck of femur rotary head hip-preserving surgery device |
| CN211704751U (en) * | 2020-01-13 | 2020-10-20 | 陈立军 | Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement |
-
2020
- 2020-01-13 CN CN202010034049.4A patent/CN111110313A/en active Pending
Patent Citations (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1633265A (en) * | 2002-02-14 | 2005-06-29 | Iql利万特外科工业有限公司 | Method and instrumentation for patello-femoral joint replacement |
| CN2745524Y (en) * | 2003-09-20 | 2005-12-14 | 马卫华 | Intramedullary positioning guide device for neck of femur osteotomy |
| US20050267484A1 (en) * | 2005-08-18 | 2005-12-01 | Jeff Menzner | Extended trochanteric osteotomy guide |
| CN102525690A (en) * | 2012-01-13 | 2012-07-04 | 南方医科大学 | Improved artificial femoral stem and nail implanting guide frame thereof |
| CN102551921A (en) * | 2012-01-13 | 2012-07-11 | 南方医科大学 | Artificial femoral stem for fracture surgery around hip joint prosthesis |
| CN203447322U (en) * | 2013-04-12 | 2014-02-26 | 德普伊（爱尔兰）公司 | Distal femoral clamp assembly and distal femoral cutting instrument comprising the same |
| CN107149490A (en) * | 2017-05-18 | 2017-09-12 | 汤向阳 | A kind of complete positioner of artificial full hip-joint replacement |
| CN110141299A (en) * | 2019-06-17 | 2019-08-20 | 中山市中医院 | A kind of cutting neck of femur rotary head hip-preserving surgery device |
| CN211704751U (en) * | 2020-01-13 | 2020-10-20 | 陈立军 | Osteotomy navigation tool for trochanter-shaped artificial femoral head replacement |
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