CN111772765A - Percutaneous minimally invasive positioning guider for femoral neck nail feeding point - Google Patents
Percutaneous minimally invasive positioning guider for femoral neck nail feeding point Download PDFInfo
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- CN111772765A CN111772765A CN202010808715.5A CN202010808715A CN111772765A CN 111772765 A CN111772765 A CN 111772765A CN 202010808715 A CN202010808715 A CN 202010808715A CN 111772765 A CN111772765 A CN 111772765A
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/74—Devices for the head or neck or trochanter of the femur
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8897—Guide wires or guide pins
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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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
- A61B90/06—Measuring instruments not otherwise provided for
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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
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
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Abstract
The invention discloses a femoral neck nail insertion point percutaneous minimally invasive positioning guider which comprises a needle inserting device and a calibrating device, wherein a vertical needle inserting hole and an oblique needle inserting hole are formed in the same horizontal plane of the needle inserting device, a depth adjusting slide block in the same direction as the vertical needle inserting hole is arranged on the needle inserting device, the calibrating device is arranged at the head end of the needle inserting device and is movably connected with the depth adjusting slide block, and a locking assembly is arranged on the depth adjusting slide block. The invention has simple structure and low manufacturing cost, can calibrate the nailing angle, the front and back positions and the vertical position through the matching of the needle inserting device and the calibrating device, can effectively enable the guide needle to enter the calibrated nailing point along the needle inserting device, improves the accuracy of the operation, thereby achieving the purpose of improving the success rate of the operation, and has the characteristics of high positioning accuracy, convenient operation and the like.
Description
Technical Field
The invention belongs to the technical field of surgical instruments, and relates to a positioning guider, in particular to a femoral neck nail feeding point percutaneous minimally invasive positioning guider.
Background
Femoral neck fracture refers to the continuous interruption of the bone of the femoral neck, which occurs in young and old years, often causes severe injuries such as traffic accidents or high fall, and gradually causes fracture due to over-long load bearing work or walking, which is called fatigue fracture; the fracture of the old has two basic factors, the strength of the osteoporotic bone is reduced, and the blood nourishing tube holes in the upper femoral neck area are densely distributed, so that the biomechanical structure of the femoral neck can be weakened, and the femoral neck is fragile; in addition, the aged hip peripheral muscle group degenerates and reacts slowly, so that the harmful stress of the hip cannot be effectively counteracted, and the hip is subjected to larger stress (2-6 times of body weight) and has complicated and variable local stress, so that no great violence is needed, such as flat slip, falling from the bed or sudden torsion of the lower limbs, and even the fracture can be generated without obvious trauma.
At present, in the hip protection treatment of femoral neck fracture, the hollow nail fixing operation is still the preferred scheme, the insertion of the hollow nail steel needle is the core technology and operation difficulty, no matter in the operation of inserting the hollow nail fixing or steel plate internal fixation under open reduction direct vision or minimally invasive percutaneous hollow nail fixing, the hollow nail steel needle is safe, accurate and reasonable in spatial configuration, radioactive ray radiation is avoided or reduced, and is successfully inserted into the hollow nail steel needle once, which is always the research hotspot and continuous pursuit of orthopaedics doctors, the conventional mainstream technology is that the steel needle is firstly applied to the hip skin surface by using adhesive plaster, the body surface projection position of the central axis of the femoral neck is determined and marked at the skin surface, then the stewart needle is inserted into the bone cortex outside the proximal end of the femur through visual observation and estimation until the bone cortex of the proximal end of the femur (the guide needle forms an included angle of 30-50 degrees with the femoral neck along the direction of the central axis), the guide pin is drilled into the femoral neck in parallel with the central axis, the position, the direction and the length of the guide pin are adjusted through repeated perspective until the satisfied standard is reached, and then the hole is drilled along the guide pin and the hollow screw is screwed in. The accurate positioning of the nail feeding point is the first step of the most important and is the most difficult step to control in the operation, because the entering direction of the guide pin is not vertical to the bone surface of the proximal end of the femur but forms a certain angle (the angle varies from person to person), and soft tissues with different thicknesses of 2-10 cm exist between the skin and the cortex of the lateral side of the proximal end of the femur, so after the horizontal line of the nail feeding point is determined and marked by perspective, the guide pin still cannot be inserted into the cortex of the horizontal line in an inclined way (the upper and lower positions cannot be accurately positioned), but the guide pin is inserted into the skin, and the front and rear positions of the proximal end of the femur are difficult to accurately judge; the guide pin is not perpendicular to the surface of the proximal femur bone, but forms a certain angle, the surface of the proximal femur is arc-shaped, and the guide pin is easy to slide upwards, forwards and backwards to cause great deviation, so that the operation of inserting the nail into the femoral neck not only needs to be repeatedly perspective and adjusted in the operation, but also has obvious blindness and randomness, poor operation precision and high failure rate, and currently, the technology and the device which can accurately position the nail inserting point and stably insert the guide pin are clinically lacked.
Disclosure of Invention
The invention provides a femoral neck nail feeding point percutaneous minimally invasive positioning guider aiming at the defects of the prior art, which can calibrate the nail feeding angle, the front and back positions and the vertical position through the matching of a needle inserting device and a calibrating device, can effectively enable a guide needle to enter the calibrated nail feeding point along the needle inserting device, improves the precision of an operation and further achieves the aim of improving the success rate of the operation.
The technical scheme adopted by the invention is as follows:
a femoral neck nail insertion point percutaneous minimally invasive positioning guider comprises a needle inserting device and a calibrating device, wherein a vertical needle inserting hole and an oblique needle inserting hole are formed in the same horizontal plane of the needle inserting device and used for guiding a guide needle to enter, a depth adjusting slide block which is in the same direction with the vertical needle inserting hole is arranged on the needle inserting device, the calibrating device is arranged at the head end of the needle inserting device and movably connected with the depth adjusting slide block, a locking assembly is arranged on the depth adjusting slide block, and after the calibrating device calibrates and positions the depth, the front and the back and the vertical positions of a guide needle entry point, the position of the calibrating device is fixed through the locking assembly, so that the calibrating device cannot slide, and the positioning accuracy of the nail insertion point is ensured;
the calibration device comprises a depth adjusting piece, a vertical adjusting piece, an adjusting mechanism and a bone hook, wherein the depth adjusting piece is provided with scales and used for matching with a guide pin to measure and calibrate the needle inserting depth, a sliding groove matched with a depth adjusting sliding block is arranged on the depth adjusting piece, and the depth adjusting piece is connected with the depth adjusting sliding block through the sliding groove, so that the depth adjusting piece can slide on the needle inserting device and can be fixed in position through a locking assembly; the adjusting mechanism is movably connected with the depth adjusting piece through a vertical adjusting piece arranged at the head end of the depth adjusting piece, so that the adjusting mechanism can vertically move along the vertical adjusting piece, the bone hook is arranged on the adjusting mechanism, after the depth adjustment is carried out through the depth adjusting piece, the position of a nail feeding point is adjusted through the adjusting mechanism, and finally, the femur is hooked through the bone hook, the position of the nail feeding point is determined, so that an error is prevented from being generated when the guide pin is inserted, and the dislocation of the nail feeding point is avoided;
the adjusting mechanism consists of a vertical sliding block, a transverse adjusting piece and a transverse sliding block, wherein a locking assembly is arranged on the vertical sliding block, the vertical sliding block is connected with a vertical adjusting piece arranged on a depth adjusting piece, namely, the vertical sliding block is movably connected with the vertical adjusting piece through a sliding groove arranged on the vertical adjusting piece, after the vertical sliding block moves to a corresponding position, the vertical sliding block can be locked and positioned on the vertical adjusting piece through the locking assembly, the transverse adjusting piece is horizontally arranged on the vertical sliding block, the transverse adjusting piece is provided with a sliding groove matched with the transverse sliding block, the transverse sliding block is arranged in the sliding groove of the transverse adjusting piece, the transverse sliding block is provided with the locking assembly, the locking assembly can be locked and positioned through moving the transverse sliding block, the transverse sliding block is provided with an installation seat, and the installation seat can be driven by the transverse sliding block to horizontally move in the transverse adjusting piece, the detachable setting of bone hook is on the mount pad, behind the adjustment mount pad according to thighbone position, can catch on the thighbone with the bone hook, can advance to follow the nail location, all is equipped with the scale on vertical slider and horizontal regulating part for adjustment degree of depth regulating part height position and mount pad lateral displacement distance.
The needle inserting device is provided with a plurality of inclined needle inserting holes, so that the nail inserting points can be conveniently positioned from different angles.
The angle of the slant needle inlet hole is respectively set to be various angles, so that the slant needle inlet hole can be conveniently matched with patients with different cervical vertebra angles for positioning.
When the device is used, the longitudinal position of a nail feeding point (namely the horizontal position of the nail feeding point on the far end and the near end of a human body) and the anteroposterior position (namely the distance from the nail feeding point to the front of the near end of the femur) are set according to CT data before a patient operation. Vertically inserting a bone hook from a cut at the outer side of the proximal end of the femur, passing through the front side and the inner side of the femur, rotating by 90 degrees to enable the tip end of the bone hook to hook cortex at the inner side and enable a bone hook cross arm to be closely attached to the front cortex of the proximal end of the femur in parallel, adjusting the vertical position of a nail inserting point through the matching sliding of a transverse adjusting piece and a transverse sliding piece, adjusting the front and rear positions of the nail inserting point through the matching sliding of the vertical sliding piece and the vertical adjusting piece, adjusting the position of a mounting seat and the front and rear and vertical positions of a needle inserting device through the scales on the vertical sliding piece and the transverse adjusting piece to reach the accurate nail inserting point position, positioning the nail inserting point through a locking assembly to enable a vertical needle inserting hole to be parallel to the bone hook and to be perpendicular to the femur, inserting a steel needle through the vertical needle inserting hole to enable a needle point to reach the cortex at the nail inserting point and to, the needle head of the two guide needles is butted, and the needle point of the oblique guide needle enters a drill hole vertical to the guide needle. The nail feeding guiding and positioning can be completed.
The invention has simple structure and low manufacturing cost, can calibrate the nailing angle, position and depth by matching the needle inserting device with the calibrating device, can effectively lead the guide needle to enter the calibrated nailing point along the needle inserting device, improves the precision of the operation, thereby achieving the purpose of improving the success rate of the operation, and has the characteristics of high positioning accuracy, convenient operation and the like.
Drawings
FIG. 1 is a schematic view of the structure of the present invention.
FIG. 2 is a schematic view of the structure of the needle inserting device of the present invention.
Fig. 3 is a schematic structural view of the depth calibration adjusting member of the present invention.
Fig. 4 is a schematic structural diagram of the adjusting mechanism of the present invention.
In the figure: 1. inserting a needle into the needle; 2. a depth adjustment slider; 3. a bolt locking member; 4. a depth adjustment member; 5. a lateral adjustment member; 6. a vertical adjustment member; 7. a bone hook; 8. a mounting seat; 9. a needle inlet hole is inclined; 10. vertically feeding a pinhole; 11. a vertical slide block; 12. and a transverse sliding block.
Detailed Description
The invention will now be further described, by way of example only, with reference to the accompanying drawings, without limiting the invention thereto.
In the structures shown in fig. 1, 2, 3 and 4, the femoral neck nailing point percutaneous minimally invasive positioning guider provided by the invention comprises a needle inserting device 1 and a calibrating device, wherein a vertical needle inserting hole 10 and an oblique needle inserting hole 9 are arranged on the same horizontal plane of the needle inserting device 1, a plurality of oblique needle inserting holes 9 are arranged on the needle inserting device 1, the angles of the oblique needle inserting holes 9 are respectively set to various angles, a depth adjusting slide block 2 in the same direction as the vertical needle inserting hole 10 is arranged on the needle inserting device 1, the calibrating device is arranged at the head end of the needle inserting device 1 and is movably connected with the depth adjusting slide block 2, a locking assembly is arranged on the depth adjusting slide block 2, and the locking assembly is a bolt locking piece 3;
the calibration device comprises a depth adjusting piece 4, a vertical adjusting piece 6, an adjusting mechanism and a bone hook 7, wherein scales are arranged on the depth adjusting piece 4, a sliding groove matched with the depth adjusting sliding block 2 is arranged on the depth adjusting piece 4, and the depth adjusting piece 4 is connected with the depth adjusting sliding block 2 through the sliding groove; the adjusting mechanism is movably connected with the depth adjusting piece 4 through a vertical adjusting piece 6 arranged at the head end of the depth adjusting piece 4, and a bone hook 7 is arranged on the adjusting mechanism;
adjustment mechanism is by vertical slider 11, horizontal regulating part 5 and horizontal slider 12 are constituteed, set up bolt retaining member 3 on vertical slider 11, vertical slider 11 is connected with the vertical regulating part 6 of setting on degree of depth regulating part 5, vertical slider 11 is through setting up spout and the 6 swing joint of vertical regulating part on vertical regulating part 6 promptly, 4 levels of horizontal regulating part set up on vertical slider 11, be equipped with on horizontal regulating part 6 with horizontal slider 12 assorted spout, and horizontal slider 12 sets up in the spout of horizontal regulating part 6, and set up bolt retaining member 3 on horizontal slider 12, set up mount pad 8 on horizontal slider 12, bone hook 7 is detachable to be set up on mount pad 8, all be equipped with the scale on vertical slider 12 and horizontal regulating part 6.
When the needle inserting device is installed, the needle inserting device 1 is firstly inserted into the depth adjusting piece 4 along the sliding groove through the depth adjusting sliding block 2, so that the needle inserting device 1 is movably connected with the depth adjusting piece 4 and is positioned through the locking component 3; then, inserting the vertical sliding block 11 into the vertical adjusting piece 6 arranged on the depth adjusting piece 4 through the sliding groove, so that the vertical sliding block 11 is movably connected with the depth adjusting piece 4 and is positioned through the locking assembly 3; and finally, inserting the transverse sliding block 12 provided with the mounting seat 8 into the transverse adjusting piece 5 arranged on the vertical sliding block 11, movably connecting the mounting seat 8 with the transverse adjusting piece 5, and mounting the bone hook 7 on the mounting seat 8, thus finishing the mounting.
When in use, the position of the mounting seat and the position of the needle inserting device are adjusted through the scale according to the condition of a patient through the matching of the transverse adjusting part and the transverse sliding block and the matching of the vertical sliding block and the vertical adjusting part, the needle inserting device is positioned through the locking component, the vertical needle inserting hole is parallel to the bone hook, then the bone hook is hooked on the inner cortex of the femur of the patient, the depth condition is known according to the scale of the bone hook, the position of the needle inserting device is adjusted through the depth adjusting part and the depth adjusting sliding block to enable the needle inserting device to reach the length corresponding to the length of the guide needle, the needle guiding device is positioned through the locking component, finally the guide needle is inserted from the vertical needle inserting hole, the guide needle enters the leg of the patient along the direction of the bone hook and is propped against the outer cortex of the femur, if the insertion depth of the guide needle perpendicularly entering the needle hole is large, another guide needle guiding, on the contrary, if the insertion depth of the guide pin which vertically enters the needle hole is shallow, another guide pin can be inserted into the inclined needle entering hole with a corresponding angle (small angle) to enable the needle heads of the two guide pins to be in butt joint, and then the nail entering guiding positioning can be completed.
The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the technical principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.
Claims (3)
1. The utility model provides a thighbone neck point of nailing percutaneous wicresoft location director which characterized in that: the needle inserting device comprises a needle inserting device and a calibrating device, wherein a vertical needle inserting hole and an oblique needle inserting hole are formed in the same horizontal plane of the needle inserting device, a depth adjusting slide block which is in the same direction with the vertical needle inserting hole is arranged on the needle inserting device, the calibrating device is arranged at the head end of the needle inserting device and is movably connected with the depth adjusting slide block, and a locking assembly is arranged on the depth adjusting slide block;
the calibration device comprises a depth adjusting piece, a vertical adjusting piece, an adjusting mechanism and a bone hook, wherein the depth adjusting piece is provided with scales, the depth adjusting piece is provided with a sliding groove matched with the depth adjusting sliding block, and the depth adjusting piece is connected with the depth adjusting sliding block through the sliding groove; the adjusting mechanism is movably connected with the depth adjusting piece through a vertical adjusting piece arranged at the head end of the depth adjusting piece, and the bone hook is arranged on the adjusting mechanism;
adjustment mechanism comprises vertical slider, horizontal regulating part and horizontal slider, set up locking Assembly on vertical slider, vertical slider is connected with the vertical regulating part of setting on the degree of depth regulating part, vertical slider is through setting up spout and vertical regulating part swing joint on vertical regulating part promptly, horizontal regulating part level sets up on vertical slider, be equipped with on horizontal regulating part with horizontal slider assorted spout, and horizontal slider sets up in the spout of horizontal regulating part, and set up locking Assembly on horizontal slider, set up the mount pad on horizontal slider, the detachable setting of bone hook is on the mount pad, all be equipped with the scale on vertical slider and horizontal regulating part.
2. The femoral neck nail insertion point percutaneous minimally invasive positioning guide according to claim 1, characterized in that: the needle inserting device is provided with a plurality of inclined needle inlet holes.
3. The femoral neck nail insertion point percutaneous minimally invasive positioning guide according to claim 2, characterized in that: the angle of the inclined needle inlet hole is set to be various angles respectively.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010808715.5A CN111772765A (en) | 2020-08-12 | 2020-08-12 | Percutaneous minimally invasive positioning guider for femoral neck nail feeding point |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010808715.5A CN111772765A (en) | 2020-08-12 | 2020-08-12 | Percutaneous minimally invasive positioning guider for femoral neck nail feeding point |
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| Publication Number | Publication Date |
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| CN111772765A true CN111772765A (en) | 2020-10-16 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010808715.5A Pending CN111772765A (en) | 2020-08-12 | 2020-08-12 | Percutaneous minimally invasive positioning guider for femoral neck nail feeding point |
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| CN (1) | CN111772765A (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113303866A (en) * | 2021-06-04 | 2021-08-27 | 中南大学湘雅医院 | Thighbone near-end kirschner wire drilling location and many needles drilling auxiliary device |
| CN115444569A (en) * | 2022-09-20 | 2022-12-09 | 吉林大学 | Series-parallel fracture reduction surgical robot |
-
2020
- 2020-08-12 CN CN202010808715.5A patent/CN111772765A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113303866A (en) * | 2021-06-04 | 2021-08-27 | 中南大学湘雅医院 | Thighbone near-end kirschner wire drilling location and many needles drilling auxiliary device |
| CN113303866B (en) * | 2021-06-04 | 2022-05-10 | 中南大学湘雅医院 | Thighbone near-end kirschner wire drilling location and many needles drilling auxiliary device |
| CN115444569A (en) * | 2022-09-20 | 2022-12-09 | 吉林大学 | Series-parallel fracture reduction surgical robot |
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