CN111839657A - Latarjet operation accurate displacement guide plate and using method thereof - Google Patents
Latarjet operation accurate displacement guide plate and using method thereof Download PDFInfo
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- CN111839657A CN111839657A CN202010803756.5A CN202010803756A CN111839657A CN 111839657 A CN111839657 A CN 111839657A CN 202010803756 A CN202010803756 A CN 202010803756A CN 111839657 A CN111839657 A CN 111839657A
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking 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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1778—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the shoulder
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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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- 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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Abstract
The invention discloses a Latarjet operation accurate displacement guide plate and a using method thereof, and a manufacturing method of the Latarjet operation accurate displacement guide plate comprises the following steps: the method comprises the following steps: establishing a scapula model; step two: simulating a Latarjet technique; step three: establishing a guide plate model; step four: printing a guide plate model; the use method of the Latarjet surgical precise displacement guide plate comprises the following steps: the method comprises the following steps: sterilizing the guide plate; step two: peel-off and trim the coracoid process and mate with the guide plate; step three: attaching the glenoid guide plate to the glenoid, fitting the matching surface of the guide plate with the front lower edge of the glenoid, and placing the guide pin along the guide tube; step four: a guide pin is arranged in the glenoid canal, so that the back lower surface of the coracoid bone block is attached to the front surface of the glenoid, and a hollow screw is tapped along the guide pin; step five: the coracoid shift fixation is finished and the wound is closed by layer-by-layer suturing. The invention belongs to the technical field of medical instruments, and particularly relates to a high-precision and standardized Latarjet operation accurate displacement guide plate and a manufacturing and using method thereof.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a Latarjet operation accurate displacement guide plate and a using method thereof.
Background
The shoulder joint is the joint most prone to dislocation, with more than 95% of them being anterior dislocations, and again more than 22% of patients have a glenoid bone defect. Latarjet surgery is the only option for patients who have a glenoid bone defect that is greater than 20% or who simply have shoulder joint stabilization post-surgical dislocation. However, this procedure requires a high degree of precision for the physician's technical operation, and has strict limitations on the location of the coracoid osteotomy, the location of the glenoid fixation, the direction and length of the fixation screw placement, and the like. The operation is difficult to be accurate by the experience of the physician, which may affect the effect of the operation and even lead to irreversible complications.
Disclosure of Invention
In view of the above situation, in order to overcome the defects of the prior art, the present invention aims to provide an Latarjet operation precise displacement guide plate and a use method thereof, which can realize the precision of coracoid osteotomy, coracoid displacement fixed position, and fixed screw implantation direction and length, reduce the technical requirements on the operating physicians, improve the operation quality, and reduce the operation failure rate.
The technical scheme adopted by the invention is as follows: the invention provides a Latarjet operation accurate displacement guide plate which comprises a coracoid guide plate and a glenoid guide plate, wherein the coracoid guide plate comprises a matching surface of the coracoid guide plate, a guide tube of the coracoid guide plate and a bone cutting surface of the coracoid guide plate, and the glenoid guide plate comprises a matching surface of the glenoid guide plate and a guide tube of the glenoid guide plate.
The invention relates to a Latarjet operation accurate displacement guide plate, which comprises the following steps:
the method comprises the following steps: establishing a scapula model: collecting CT image data of the affected shoulder joint of the patient, importing the data into operation design simulation software, and reconstructing a three-dimensional scapula model;
step two: simulation of Latarjet technique: determining an osteotomy plane at the coracoid elbow, simulating and shifting the intercepted coracoid block to a front lower defect area of the glenoid to form a reconstructed expected glenoid model, repeatedly determining the displacement and fixation positions of the coracoid block from a plurality of planes, designing two long cylindrical pipe model simulation screws after the positions are determined, adjusting the positions of cylindrical pipes, and measuring the lengths of the cylindrical pipes in sclerotin to determine the lengths of the screws;
step three: establishing a guide plate model: respectively determining the covered areas of the guide plate on the coracoid process and the glenoid according to the reconstructed expected glenoid model, respectively manufacturing curved surfaces which are matched with the front upper surface of the coracoid process and the front lower surface of the glenoid as the bottom surfaces of the guide plate by using computer software according to the covered areas of the guide plate, stretching the curved surfaces to respectively obtain original three-dimensional models of the coracoid process and the glenoid guide plate, and then respectively carrying out Boolean operation on the original three-dimensional models of the coracoid process and the glenoid guide plate and the two cylindrical tube three-dimensional models to obtain a final three-dimensional model with a guide tube;
step four: printing a guide plate model: and importing the three-dimensional data of the guide plate model into a 3D printer to manufacture the entity guide plate.
Furthermore, the coracoid osteotomy surface in the second step needs to guarantee that the coracoid elbow is not exceeded under the condition of ensuring the maximum length of the osteotomy, and the osteotomy surface in the second step is perpendicular to the centerline of the coracoid body.
Furthermore, the second beak protruding block is arranged at the position of the front lower edge of the glenoid, the height of the second beak protruding block is lower than the plane position of the glenoid, and the height of the second beak protruding block is lower than the horizontal position of the upper and lower middle lines of the glenoid.
Further, a Latarjet surgical precision displacement guide plate according to claim 3, wherein: and in the second step, the cylindrical tube penetrates through the sclerotin, the cylindrical tube is far away from the deformed region of the inferior and superior nerves of the scapula, and the inner diameter of the cylindrical tube in the second step is larger than or equal to 1.5 mm.
The invention relates to a use method of a Latarjet operation accurate displacement guide plate, which comprises the following steps:
the method comprises the following steps: the guide plate needs to be disinfected and sterilized before use;
step two: exposing coracoid process during operation, stripping coracoid ligament and pectoralis minor muscle from the coracoid process, removing soft tissue on the front upper surface of the coracoid process, keeping the attachment of joint tendon, attaching coracoid process guide plate on the coracoid process, fitting the matching surface of the guide plate with the front upper surface, respectively placing two guide pins with the diameter of 1.5 mm along the guide tube, penetrating through bilateral cortex, and cutting the coracoid process along the osteotomy surface of the guide plate by using a swing saw; taking down the guide plate, respectively drilling a bone passage with the diameter of 3.5-4.5 mm along the guide pin by using a hollow drill for standby, and trimming the rear lower surface of the coracoid bone block;
step three: separating and exposing the front lower edge of the glenoid cavity in the operation, stripping soft tissues on the glenoid cavity along the periosteum, attaching a glenoid guide plate to the glenoid cavity, fitting a guide plate matching surface with the front lower edge of the glenoid cavity, respectively placing two guide pins with the diameter of 1.5 mm along a guide tube, penetrating the skin on the rear side of the glenoid cavity, taking down the guide plate, and respectively drilling a bone canal with the diameter of 3.5-4.5 mm along the guide pins by using a hollow drill for later use;
step four: respectively placing a guide pin with the diameter of 1.5 mm in a bone channel of the glenoid, respectively inserting the two guide pins into the two bone channels of the coracoid bone block, attaching the rear lower surface of the coracoid bone block to the front surface of the glenoid, respectively tapping two hollow screws with the diameter of 3.5-4.5 mm along the guide pins, wherein the length of the screws is determined when a guide plate is designed;
step five: the coracoid shift fixation is finished and the wound is closed by layer-by-layer suturing.
After the technical scheme is adopted, the invention has the following beneficial effects: the invention aims to provide a Latarjet operation accurate displacement guide plate and a using method thereof, which have the advantages that: firstly, the accuracy of coracoid osteotomy is realized, namely, the coracoid bone block with the maximum length can be intercepted without damaging coracoid clavicle; secondly, the accuracy of the coracoid process fixing position is realized, namely the maximum osseous blocking effect at the front lower part of the glenoid is ensured, and the impact effect caused by the fact that the coracoid process bone block is higher than the articular surface is avoided; thirdly, the accuracy of the direction and the length of the screw is realized, and the damage of suprascapular nerves and blood vessels caused by overlong screw or improper direction is avoided; and fourthly, the operation steps are simplified, the technical requirements on doctors are reduced, the operation quality is improved, and the operation failure rate is reduced.
Drawings
FIG. 1 is a flow chart of the fabrication of the guide plate of the present invention;
FIG. 2 is a schematic view of the overall structure of a Latarjet surgical precision displacement guide plate according to the present invention;
FIG. 3 is a schematic view of a coracoid guide plate structure of a Latarjet surgical precise displacement guide plate according to the present invention;
fig. 4 is a schematic view of a glenoid guide plate structure of the Latarjet surgical precision displacement guide plate of the present invention.
The artificial bone comprises a coracoid guide plate 1, a coracoid guide plate 2, a glenoid guide plate 3, a coracoid guide plate 4, a glenoid, a coracoid guide plate matching surface 5, a coracoid guide plate guiding pipe 6, a coracoid guide plate guiding pipe 7, a coracoid guide plate osteotomy surface 8, a glenoid guide plate matching surface 9 and a glenoid guide plate guiding pipe.
Detailed Description
The technical solutions in the embodiments of the present invention are clearly and completely described below, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all embodiments; all other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
It is noted that, herein, relational terms such as first and second, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Also, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus.
As shown in fig. 1-4, the present invention provides a Latarjet surgical precision displacement guide comprising a coracoid guide 1 and a glenoid guide 2, the coracoid guide 1 comprising a mating face 5 of the coracoid guide, a guide tube 6 of the coracoid guide and a osteotomy face 7 of the coracoid guide, the glenoid guide 2 comprising a mating face 8 of the glenoid guide and a guide tube 9 of the glenoid guide.
Example 1: a Latarjet operation accurate displacement guide plate and a using method thereof comprise the following steps:
the method comprises the following steps: establishing a scapula model: collecting CT image data of the affected shoulder joint of the patient, importing the data into operation design simulation software, and reconstructing a three-dimensional scapula model;
step two: simulation of Latarjet technique: determining an osteotomy plane at the coracoid elbow, simulating and shifting the intercepted coracoid block to a front lower defect area of the glenoid to form a reconstructed expected glenoid model, repeatedly determining the displacement and fixation positions of the coracoid block from a plurality of planes, designing two long cylindrical pipe model simulation screws after the positions are determined, adjusting the positions of cylindrical pipes, and measuring the lengths of the cylindrical pipes in sclerotin to determine the lengths of the screws;
step three: establishing a guide plate model: and respectively determining the covered areas of the guide plate on the coracoid process and the glenoid according to the reconstructed expected glenoid model, respectively manufacturing curved surfaces which are matched with the front upper surface of the coracoid process and the front lower surface of the glenoid by using computer software according to the covered areas of the guide plate, taking the curved surfaces as the bottom surfaces of the guide plate, stretching the curved surfaces, and respectively obtaining the original three-dimensional models of the coracoid process and the glenoid guide plate. Respectively carrying out Boolean operation on the original three-dimensional models of the coracoid process guide plate and the glenoid guide plate and the two cylindrical tube three-dimensional models to obtain a final three-dimensional model with a guide tube;
step four: printing a guide plate model: and importing the three-dimensional data of the guide plate model into a 3D printer to manufacture the entity guide plate.
And in the second step, the coracoid osteotomy surface is ensured not to exceed the coracoid elbow under the condition of ensuring the maximum length of the coracoid osteotomy surface, and the coracoid osteotomy surface is perpendicular to the centerline of the coracoid body in the second step.
The second beak protruding block is arranged at the position of the front lower edge of the glenoid, the height of the second beak protruding block is lower than the plane position of the glenoid, and the height of the second beak protruding block is lower than the horizontal position of the upper middle line and the lower middle line of the glenoid.
And in the second step, the cylindrical tube penetrates through the sclerotin, the cylindrical tube is far away from the deformed region of the inferior and superior nerves of the scapula, and the inner diameter of the cylindrical tube in the second step is larger than or equal to 1.5 mm.
A use method of a Latarjet surgical accurate displacement guide plate comprises the following steps:
the method comprises the following steps: the guide plate needs to be disinfected and sterilized before use;
step two: exposing coracoid process during operation, stripping coracoid ligament and pectoralis minor muscle from coracoid process, removing soft tissue on the front upper surface of coracoid process, and keeping the attachment of joint tendon; as shown in fig. 4, the coracoid guide plate 1 is attached to the coracoid process 3, the mating surface 5 of the coracoid guide plate is fitted to the front upper surface, two guide pins with a diameter of 1.5 mm are respectively inserted along the guide tube 6 of the coracoid guide plate, the coracoid process 3 is cut off along the osteotomy surface 7 of the coracoid guide plate by a swing saw; the coracoid guide plate 1 is taken down, a bone passage with the diameter of 3.5 mm is drilled along the guide pin by a hollow drill for standby, and simultaneously the back lower surface of the coracoid 3 bone block is trimmed.
Step three: the front lower edge of the glenoid cavity 4 is exposed in the separation of the operation, the soft tissues on the glenoid cavity are stripped along the periosteum, as shown in figure 4, the glenoid guide plate 2 is attached to the glenoid cavity 4, the matching surface 8 of the glenoid guide plate is matched with the front lower edge of the glenoid cavity 4, two guide pins with the diameter of 1.5 mm are respectively placed into the guide tubes 9 of the glenoid guide plate, the skin on the back side of the glenoid cavity 4 is penetrated, the glenoid guide plate 2 is taken down, and the bone paths with the diameter of 3.5 mm are respectively drilled along the guide pins by hollow drills for standby.
Step four: a guide pin with the diameter of 1.5 mm is respectively arranged in each bone channel of the glenoid 4, two guide pins are respectively inserted into the two bone channels of the coracoid process 3 bone block, the back lower surface of the coracoid process 3 bone block is attached to the front surface of the glenoid 4, two hollow screws with the diameter of 3.5 mm are respectively tapped along the guide pins, and the length of each screw is determined when the glenoid guide plate 2 is designed.
Step five: the coracoid 3 displacement fixation is finished and the wound is sutured closed layer by layer.
Example 2: a Latarjet operation accurate displacement guide plate and a using method thereof comprise the following steps:
the method comprises the following steps: establishing a scapula model: collecting CT image data of the affected shoulder joint of the patient, importing the data into operation design simulation software, and reconstructing a three-dimensional scapula model;
step two: simulation of Latarjet technique: determining an osteotomy plane at the coracoid elbow, simulating and shifting the intercepted coracoid block to a front lower defect area of the glenoid to form a reconstructed expected glenoid model, repeatedly determining the displacement and fixation positions of the coracoid block from a plurality of planes, designing two long cylindrical pipe model simulation screws after the positions are determined, adjusting the positions of cylindrical pipes, and measuring the lengths of the cylindrical pipes in sclerotin to determine the lengths of the screws;
step three: establishing a guide plate model: and respectively determining the covered areas of the guide plate on the coracoid process and the glenoid according to the reconstructed expected glenoid model, respectively manufacturing curved surfaces which are matched with the front upper surface of the coracoid process and the front lower surface of the glenoid by using computer software according to the covered areas of the guide plate, taking the curved surfaces as the bottom surfaces of the guide plate, stretching the curved surfaces, and respectively obtaining the original three-dimensional models of the coracoid process and the glenoid guide plate. Respectively carrying out Boolean operation on the original three-dimensional models of the coracoid process guide plate and the glenoid guide plate and the two cylindrical tube three-dimensional models to obtain a final three-dimensional model with a guide tube;
step four: printing a guide plate model: and importing the three-dimensional data of the guide plate model into a 3D printer to manufacture the entity guide plate.
And in the second step, the coracoid osteotomy surface is ensured not to exceed the coracoid elbow under the condition of ensuring the maximum length of the coracoid osteotomy surface, and the coracoid osteotomy surface is perpendicular to the centerline of the coracoid body in the second step.
The second beak protruding block is arranged at the position of the front lower edge of the glenoid, the height of the second beak protruding block is lower than the plane position of the glenoid, and the height of the second beak protruding block is lower than the horizontal position of the upper middle line and the lower middle line of the glenoid.
And in the second step, the cylindrical tube penetrates through the sclerotin, the cylindrical tube is far away from the deformed region of the inferior and superior nerves of the scapula, and the inner diameter of the cylindrical tube in the second step is larger than or equal to 1.5 mm.
A use method of a Latarjet surgical accurate displacement guide plate comprises the following steps:
the method comprises the following steps: the guide plate needs to be disinfected and sterilized before use;
step two: exposing coracoid process during operation, stripping coracoid ligament and pectoralis minor muscle from coracoid process, removing soft tissue on the front upper surface of coracoid process, and keeping the attachment of joint tendon; as shown in fig. 4, the coracoid guide plate 1 is attached to the coracoid process 3, the mating surface 5 of the coracoid guide plate is fitted to the front upper surface, two guide pins with a diameter of 1.5 mm are respectively inserted along the guide tube 6 of the coracoid guide plate, the coracoid process 3 is cut off along the osteotomy surface 7 of the coracoid guide plate by a swing saw; the coracoid guide plate 1 is taken down, a bone passage with the diameter of 4 mm is drilled along the guide pin by a hollow drill for standby, and simultaneously the posterior and inferior surfaces of 3 coracoid bone blocks are trimmed.
Step three: the front lower edge of the glenoid cavity 4 is exposed in the separation of the operation, the soft tissues on the glenoid cavity are stripped along the periosteum, as shown in figure 4, the glenoid guide plate 2 is attached to the glenoid cavity 4, the matching surface 8 of the glenoid guide plate is matched with the front lower edge of the glenoid cavity 4, two guide pins with the diameter of 1.5 mm are respectively placed into the guide tubes 9 of the glenoid guide plate, the skin on the back side of the glenoid cavity 4 is penetrated, the glenoid guide plate 2 is taken down, and the bone passages with the diameter of 4 mm are respectively drilled along the guide pins by hollow drills for standby.
Step four: a guide pin with the diameter of 1.5 mm is respectively arranged in each bone channel of the glenoid 4, two guide pins are respectively inserted into the two bone channels of the coracoid process 3 bone block, the back lower surface of the coracoid process 3 bone block is attached to the front surface of the glenoid 4, two hollow screws with the diameter of 4 mm are respectively tapped along the guide pins, and the length of each screw is determined when the glenoid guide plate 2 is designed.
Step five: the coracoid 3 displacement fixation is finished and the wound is sutured closed layer by layer.
Example 3: a Latarjet operation accurate displacement guide plate and a using method thereof comprise the following steps:
the method comprises the following steps: establishing a scapula model: collecting CT image data of the affected shoulder joint of the patient, importing the data into operation design simulation software, and reconstructing a three-dimensional scapula model;
step two: simulation of Latarjet technique: determining an osteotomy plane at the coracoid elbow, simulating and shifting the intercepted coracoid block to a front lower defect area of the glenoid to form a reconstructed expected glenoid model, repeatedly determining the displacement and fixation positions of the coracoid block from a plurality of planes, designing two long cylindrical pipe model simulation screws after the positions are determined, adjusting the positions of cylindrical pipes, and measuring the lengths of the cylindrical pipes in sclerotin to determine the lengths of the screws;
step three: establishing a guide plate model: and respectively determining the covered areas of the guide plate on the coracoid process and the glenoid according to the reconstructed expected glenoid model, respectively manufacturing curved surfaces which are matched with the front upper surface of the coracoid process and the front lower surface of the glenoid by using computer software according to the covered areas of the guide plate, taking the curved surfaces as the bottom surfaces of the guide plate, stretching the curved surfaces, and respectively obtaining the original three-dimensional models of the coracoid process and the glenoid guide plate. Respectively carrying out Boolean operation on the original three-dimensional models of the coracoid process guide plate and the glenoid guide plate and the two cylindrical tube three-dimensional models to obtain a final three-dimensional model with a guide tube;
step four: printing a guide plate model: and importing the three-dimensional data of the guide plate model into a 3D printer to manufacture the entity guide plate.
And in the second step, the coracoid osteotomy surface is ensured not to exceed the coracoid elbow under the condition of ensuring the maximum length of the coracoid osteotomy surface, and the coracoid osteotomy surface is perpendicular to the centerline of the coracoid body in the second step.
The second beak protruding block is arranged at the position of the front lower edge of the glenoid, the height of the second beak protruding block is lower than the plane position of the glenoid, and the height of the second beak protruding block is lower than the horizontal position of the upper middle line and the lower middle line of the glenoid.
And in the second step, the cylindrical tube penetrates through the sclerotin, the cylindrical tube is far away from the deformed region of the inferior and superior nerves of the scapula, and the inner diameter of the cylindrical tube in the second step is larger than or equal to 1.5 mm.
A use method of a Latarjet surgical accurate displacement guide plate comprises the following steps:
the method comprises the following steps: the guide plate needs to be disinfected and sterilized before use;
step two: exposing coracoid process during operation, stripping coracoid ligament and pectoralis minor muscle from coracoid process, removing soft tissue on the front upper surface of coracoid process, and keeping the attachment of joint tendon; as shown in fig. 4, the coracoid guide plate 1 is attached to the coracoid process 3, the mating surface 5 of the coracoid guide plate is fitted to the front upper surface, two guide pins with a diameter of 1.5 mm are respectively inserted along the guide tube 6 of the coracoid guide plate, the coracoid process 3 is cut off along the osteotomy surface 7 of the coracoid guide plate by a swing saw; the coracoid guide plate 1 is taken down, a bone passage with the diameter of 4.5 mm is drilled along the guide pin by a hollow drill for standby, and simultaneously the back lower surface of the coracoid 3 bone block is trimmed.
Step three: the front lower edge of the glenoid cavity 4 is exposed in the separation of the operation, the soft tissues on the glenoid cavity are stripped along the periosteum, as shown in figure 4, the glenoid guide plate 2 is attached to the glenoid cavity 4, the matching surface 8 of the glenoid guide plate is matched with the front lower edge of the glenoid cavity 4, two guide pins with the diameter of 1.5 mm are respectively placed into the guide tubes 9 of the glenoid guide plate, the skin on the back side of the glenoid cavity 4 is penetrated, the glenoid guide plate 2 is taken down, and the bone paths with the diameter of 4.5 mm are respectively drilled along the guide pins by hollow drills for standby.
Step four: a guide pin with the diameter of 1.5 mm is respectively arranged in each bone channel of the glenoid 4, two guide pins are respectively inserted into the two bone channels of the coracoid process 3 bone block, the back lower surface of the coracoid process 3 bone block is attached to the front surface of the glenoid 4, two hollow screws with the diameter of 4.5 mm are respectively tapped along the guide pins, and the length of each screw is determined when the glenoid guide plate 2 is designed.
Step five: the coracoid 3 displacement fixation is finished and the wound is sutured closed layer by layer.
Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that changes, modifications, substitutions and alterations can be made in these embodiments without departing from the principles and spirit of the invention, the scope of which is defined in the appended claims and their equivalents. In summary, those skilled in the art should appreciate that they can readily use the disclosed conception and specific embodiments as a basis for designing or modifying other structures for carrying out the same purposes of the present invention without departing from the spirit and scope of the invention as defined by the appended claims.
Claims (5)
1. A manufacturing method of a Latarjet operation accurate displacement guide plate is characterized by comprising the following steps:
the method comprises the following steps: establishing a scapula model: collecting CT image data of the affected shoulder joint of the patient, importing the data into operation design simulation software, and reconstructing a three-dimensional scapula model;
step two: simulation of Latarjet technique: determining an osteotomy plane at the coracoid elbow, simulating and shifting the intercepted coracoid block to a front lower defect area of the glenoid to form a reconstructed expected glenoid model, repeatedly determining the displacement and fixation positions of the coracoid block from a plurality of planes, designing two long cylindrical pipe model simulation screws after the positions are determined, adjusting the positions of cylindrical pipes, and measuring the lengths of the cylindrical pipes in sclerotin to determine the lengths of the screws;
step three: establishing a guide plate model: respectively determining the covered areas of the guide plate on the coracoid process and the glenoid according to the reconstructed expected glenoid model, respectively manufacturing curved surfaces which are matched with the front upper surface of the coracoid process and the front lower surface of the glenoid by using computer software according to the covered areas of the guide plate, taking the curved surfaces as the bottom surfaces of the guide plate, stretching the curved surfaces to respectively obtain original three-dimensional models of the coracoid process and the glenoid guide plate, and respectively carrying out Boolean operation on the original three-dimensional models of the coracoid process and the glenoid guide plate and the two cylindrical tube three-dimensional models to obtain a final three-dimensional model with a guide tube;
step four: printing a guide plate model: and importing the three-dimensional data of the guide plate model into a 3D printer to manufacture the entity guide plate.
2. The Latarjet surgical precision displacement guide plate of claim 1, wherein: and in the second step, the coracoid osteotomy surface is ensured not to exceed the coracoid elbow under the condition of ensuring the maximum length of the coracoid osteotomy surface, and the coracoid osteotomy surface is perpendicular to the centerline of the coracoid body in the second step.
3. The Latarjet surgical precision displacement guide plate of claim 2, wherein: the second beak protruding block is arranged at the position of the front lower edge of the glenoid, the height of the second beak protruding block is lower than the plane position of the glenoid, and the height of the second beak protruding block is lower than the horizontal position of the upper middle line and the lower middle line of the glenoid.
4. The Latarjet surgical precision displacement guide plate of claim 3, wherein: and in the second step, the cylindrical tube penetrates through the sclerotin, the cylindrical tube is far away from the deformed region of the inferior and superior nerves of the scapula, and the inner diameter of the cylindrical tube in the second step is larger than or equal to 1.5 mm.
5. The method for using the Latarjet surgical precision displacement guide plate according to claims 1-4, which is characterized by comprising the following steps:
the method comprises the following steps: the guide plate needs to be disinfected and sterilized before use;
step two: exposing coracoid process during operation, stripping coracoid ligament and pectoralis minor muscle from the coracoid process, removing soft tissue on the front upper surface of the coracoid process, keeping the attachment of joint tendon, attaching coracoid process guide plate on the coracoid process, fitting the matching surface of the guide plate with the front upper surface, respectively placing two guide pins with the diameter of 1.5 mm along the guide tube, penetrating through bilateral cortex, and cutting the coracoid process along the osteotomy surface of the guide plate by using a swing saw; taking down the guide plate, respectively drilling a bone passage with the diameter of 3.5-4.5 mm along the guide pin by using a hollow drill for standby, and trimming the rear lower surface of the coracoid bone block;
step three: separating and exposing the front lower edge of the glenoid cavity in the operation, stripping soft tissues on the glenoid cavity along the periosteum, attaching a glenoid guide plate to the glenoid cavity, fitting a guide plate matching surface with the front lower edge of the glenoid cavity, respectively placing two guide pins with the diameter of 1.5 mm along a guide tube, penetrating the skin on the rear side of the glenoid cavity, taking down the guide plate, and respectively drilling a bone canal with the diameter of 3.5-4.5 mm along the guide pins by using a hollow drill for later use;
step four: respectively placing a guide pin with the diameter of 1.5 mm in a bone channel of the glenoid, respectively inserting the two guide pins into the two bone channels of the coracoid bone block, attaching the rear lower surface of the coracoid bone block to the front surface of the glenoid, respectively tapping two hollow screws with the diameter of 3.5-4.5 mm along the guide pins, wherein the length of the screws is determined when a guide plate is designed;
step five: the coracoid shift fixation is finished and the wound is closed by layer-by-layer suturing.
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| CN112914676A (en) * | 2021-03-30 | 2021-06-08 | 成都博思达康医疗科技有限公司 | Combined elbow joint osteotomy orthopedic guide plate and manufacturing method thereof |
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