CN111991070A - Knee joint cuts bone distraction device and cuts bone system - Google Patents

Knee joint cuts bone distraction device and cuts bone system Download PDF

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Publication number
CN111991070A
CN111991070A CN202010918457.6A CN202010918457A CN111991070A CN 111991070 A CN111991070 A CN 111991070A CN 202010918457 A CN202010918457 A CN 202010918457A CN 111991070 A CN111991070 A CN 111991070A
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hole
osteotomy
fixedly connected
locking
plate
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CN111991070B (en
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张佳洋
史春宝
郭静
王振国
岳术同
杨珊
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Beijing Chunlizhengda Medical Instruments Co Ltd
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Beijing Chunlizhengda Medical Instruments Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8014Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the extension or compression force being caused by interaction of the plate hole and the screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564Methods for bone or joint treatment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B2017/681Alignment, compression, or distraction mechanisms

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  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
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Abstract

The invention provides a knee joint osteotomy distraction device and an osteotomy system, comprising a locking plate, which comprises: the head part is provided with A, B, C, D holes; the upper end of the backbone part is fixedly connected with the lower end of the head part, and the backbone part is provided with a first hole, a second hole and a third hole which are vertically spaced; the tail part is fixedly connected with the lower end of the backbone part, a fourth hole is also formed in the tail part, the tail part is of a gradually-thinned structure, and the tail end is smooth; the locking plate is made of carbon fiber reinforced PEEK nonmetal material. The carbon fiber reinforced PEEK material is a non-metal material, cold welding can be stopped from the source when the locking plate is manufactured, and the carbon fiber reinforced PEEK material is an ideal insulator, cannot generate electrolytic reaction with other ions in human tissue fluid, and is not easy to corrode. The operation difficulty is reduced, the operation time is shortened, and the occurrence of operation accidents is reduced. And the carbon fiber reinforced PEEK material has the characteristics of completely comparable strength to titanium alloy, is easy to process, saves the processing cost and is beneficial to the implementation of environment-friendly work.

Description

Knee joint cuts bone distraction device and cuts bone system
Technical Field
The invention relates to the technical field of medical devices, in particular to a knee joint osteotomy distraction device and an osteotomy system.
Background
The ToMoFix knee joint osteotomy system is a set of osteotomy fixing system designed based on a locking compression steel plate system (LCP), and the steel plate has strong angle stability, so that stable internal fixation can be obtained, and the rapid bone healing of osteotomy is accelerated.
Because the conical double-line thread at the head of the locking screw is required to be connected with the locking hole of the bone plate when the locking screw is used, the pure titanium and titanium alloy materials used at present have the possibility of cold welding with the bone plate (metal is adhered at normal temperature and welded together). Because most of the existing bone fracture plates are not permanently implanted into a human body, the human body needs to be taken out after the bone is healed, the bone fracture plates can be repaired when the bone fracture plates are subjected to nail breakage and plate breakage, the difficulty in operation is increased if cold welding is generated, the bone fracture plates are not easy to take out, the operation time is prolonged, the pain is brought to a patient, and even the contradiction between doctors and patients can be caused.
For the metal implant, after the metal implant is implanted into a human body, under the corrosion action of human body fluid, metal ions are easily released to enter the human body, and have certain toxic action on the human body.
The ToMoFix knee joint osteotomy system is developed according to the physiological structure of European and American patients, the physiological structures of the Chinese and European and American patients are different to a certain extent, and the head size of the ToMoFix knee joint osteotomy system is large, foreign body sensation is generated after the operation of the Chinese, and two wings of the head cannot be well attached to bones, so that the knee joint of the patient is continuously painful due to the fact that the Chinese has a small body size and the knee joint pain continues to occur after the operation.
Disclosure of Invention
The present invention provides a knee osteotomy distraction device and an osteotomy system for solving at least one of the above technical problems.
A knee osteotomy distraction device comprising a locking plate, the locking plate comprising:
the head part is provided with a hole A, a hole B, a hole C and a hole D;
the upper end of the backbone part is fixedly connected with the lower end of the head part, and the backbone part is provided with a first hole, a second hole and a third hole which are spaced up and down;
the top end of the tail part is fixedly connected with the lower end of the backbone part, a fourth hole is also formed in the tail part, the tail part is of a gradually-thinned structure, and the tail end is smooth;
the locking plate is made of carbon fiber reinforced PEEK nonmetal materials.
Preferably, the head is T-shaped, the hole A, the hole B and the hole C are all arranged on a transverse T-shaped structure, the hole A, the hole B and the hole C are sequentially arranged horizontally at intervals, the hole D is arranged on a vertical T-shaped structure, the hole A, the hole B and the hole C are all round holes, and the hole D is an 8-shaped hole;
the bone trunk part is of a strip structure with the same width as the T-shaped vertical structure, and the width of the tail part is gradually reduced from the upper end to the lower end.
Preferably, the first hole and the second hole are both 8-shaped holes;
the first hole is a power hole, can be pressurized by using a lag screw and is used for enabling the locking plate to generate elastic prestress, and is positioned in the middle of the locking plate;
and the third hole and the fourth hole are both round holes.
Preferably, the round hole and the 8-shaped hole are threaded holes and are used for connecting a locking screw, and the thread of each threaded hole is a double-line conical thread;
the central lines of two adjacent holes and three adjacent holes in the first hole, the second hole, the third hole and the fourth hole are not positioned on the same straight line.
Preferably, the maximum width of the head is 28mm, and the distance between every two of the holes A, B and C is 8 mm.
Preferably, the use method of the locking plate comprises the following steps:
step 1: before the locking plate is inserted, a drill bit guider is screwed into the hole A, the hole B and the hole C of the locking plate, locking gaskets are respectively arranged in the hole D and the fourth hole at the tail part, and after the locking plate is inserted, a kirschner wire is inserted into the hole B in the middle of the head part for temporary fixation;
using a 4.3mm lcp drill to drill a thread in hole A, C, and sequentially implanting screws in holes A, C and locking using a 4.0N · m torque limit wrench; then taking out the Kirschner wire in the hole B, implanting a locking screw, and fixing;
step 2: implanting a temporary lag screw in a neutral position in a power hole in a first hole, drilling threads in a lower half hole, a second hole, a third hole and a fourth hole of the first hole by using a universal drill guide, straightening the leg of a patient with the thread angle of the lower half hole facing to a far end, and implanting a self-tapping cortical bone screw in the lower half hole of the first hole;
and step 3: implanting and tightening a locking screw in the second hole and the third hole at a time, removing the locking washer in the fourth hole, and implanting and tightening a locking screw in the fourth hole;
taking out the lag screw in the first hole, implanting a locking screw and screwing;
and taking out the locking washer in the hole D, implanting a locking screw in the hole D and screwing down.
The invention also provides a knee osteotomy system comprising: a knee osteotomy distraction device as defined in any one of the preceding claims, said osteotomy system further comprising:
the first working plate and the second working plate are respectively detachably connected to the two locking plates;
the first working plate and the second working plate are respectively detachably connected to the two locking plates;
the osteotomy angle measuring device is fixedly connected to the first working plate and the second working plate;
the angle measuring device includes:
the first mounting plate is arranged on the first working plate and is fixedly connected with the first working plate;
the first extension rod is arranged on the first mounting plate, one end of the first extension rod is fixedly connected with the first mounting plate, and the first extension rod is perpendicular to the first mounting plate;
a groove disposed within the first extension rod;
the sliding block is arranged in the groove and is in sliding connection with the groove;
the limiting block is arranged at the other end of the first extension rod and is fixedly connected with the first extension rod;
the first electric telescopic rod is arranged in the groove, the telescopic end of the first electric telescopic rod is fixedly connected with the sliding block, and the fixed end of the first electric telescopic rod is fixedly connected with the groove;
the fixed end of the second electric telescopic rod is rotatably connected with the sliding block through a rotating shaft;
the alignment plate is arranged at the telescopic end of the second electric telescopic rod and is perpendicular to the second electric telescopic rod;
the second mounting plate is arranged on the second working plate and is fixedly connected with the second working plate;
the second extension rod is arranged on the second mounting plate, is fixedly connected with the second mounting plate and is perpendicular to the second mounting plate;
the pressure sensor is arranged at one end of the alignment plate close to the second extension rod;
the angle detection device is arranged on the first extension rod and used for detecting an included angle between the second electric telescopic rod and the first extension rod;
and the microcontroller is electrically connected with the pressure sensor and the angle detection device.
Preferably, the bone cutting point automatic identification device further comprises:
the image detection device is used for acquiring an image of a to-be-osteotomy part of the patient;
an image processing device, a controller, and a display; the controller is electrically connected with the image detection device, the image processing device and the display;
the image detection device transmits an image of a to-be-osteotomy part of a patient to the image processing device through the controller after acquiring the image of the to-be-osteotomy part, the image processing device processes the image of the to-be-osteotomy part, establishes two different reference planes, selects a center point of the to-be-osteotomy part as an osteotomy reference point, acquires a coordinate value of a projection of the osteotomy reference point on an osteotomy surface, and acquires a coordinate value of a projection of the osteotomy reference point on the reference plane, wherein the reference plane is a middle plane of the image of the to-be-osteotomy part;
the controller calculates the coordinate value of the osteotomy point based on the image processing device and the formula (1), and comprises the following steps;
step 1, calculating a reference coefficient k according to an image processing device and a formula (1);
Figure BDA0002665837670000051
wherein x is0,y0,z0Coordinate values, x, projected on the osteotomy plane as a reference point of the osteotomy1,y1,z1Coordinate values, x, of the projection of the osteotomy reference point on a reference plane2,y2,z2Is a coordinate value of the projection of the osteotomy reference point on the other reference plane, theta is an included angle between the osteotomy plane and the one reference plane,
Figure BDA0002665837670000052
an included angle between the reference surface and the other reference surface is defined, tan is a tangent value of the angle, and sin is sine;
step 2, calculating the target coordinate value (x) of the osteotomy point according to the formula (2)3,y3,z3);
x3=(-k)(x2-x1)+x0
y3=(-k)(y2-y1)+y0
z3=(-k)(z2-z1)+z0
And controls a display to display a target coordinate value (x) of the osteotomy point3,y3,z3)。
Preferably, the device also comprises a drainage device, a plurality of first buffer devices, a fixed seat and a plurality of second buffer devices, wherein the fixed seat is fixedly connected to the periphery of the lower end of the drainage device;
the movable support is arranged below the drainage device;
the plurality of second buffer devices are arranged along the peripheral side of the drainage device, and each second buffer device comprises: the lower end of the guide rod is fixedly connected to the upper end of the movable support; a vertical through hole is formed in the fixed seat, the upper part of the guide rod is positioned in the vertical through hole, and a limiting plate is arranged at the upper end of the guide rod;
the second spring is sleeved on the guide rod, one end of the second spring is fixedly connected with the lower end of the fixed seat, and the other end of the second spring is fixedly connected with the upper end of the movable support; the first buffer devices are fixedly connected to the lower end of the drainage device;
the first buffer device includes:
the hollow sphere consists of an upper hemisphere and a lower hemisphere, the upper hemisphere is fixedly connected in a first spherical groove at the lower end of the drainage device, and the lower end of the lower hemisphere is fixedly connected in a second spherical groove at the upper end of the movable support;
the fixed shaft is positioned between the upper hemispheroids or the lower hemispheroids;
the buffer components are uniformly arranged along the circumferential direction of the fixed shaft;
the buffer assembly includes: one end of the buffer ball is fixedly connected with one end of the first spring, and the other end of the buffer ball is fixedly connected with the upper hemisphere or the lower hemisphere; and the vertical end of the T-shaped connecting block is fixedly connected with the outer side wall of the fixed shaft, and the horizontal end of the T-shaped connecting block is fixedly connected with the other end of the first spring.
The technical solution of the present invention is further described in detail by the accompanying drawings and embodiments.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention. In the drawings:
FIG. 1 is a schematic view showing the construction of the locking screw of the present invention when it is used for osteotomy.
FIG. 2 is a schematic view of the present invention showing the locking plate not being connected to a locking screw;
FIG. 3 is a left side view of the angle measuring device of the present invention;
FIG. 4 is a schematic view of a front view of a partial structure of the angle measuring device of the present invention.
Fig. 5 is a schematic structural diagram of the drainage device provided with the first buffer device and the second buffer device.
In the figure: 1. a locking plate; 11. a head portion; 111. a hole A; 112. b hole; 113. c hole; 114. d, holes; 115. a T-shaped transverse structure; 116. a T-shaped vertical structure; 12. a backbone portion; 121. a first hole; 122. a second hole; 123. a third aperture; 13. a tail portion; 131. a fourth aperture; 001. a first mounting plate; 002. a first extension pole; 003. a groove; 004. a first electric telescopic rod; 005. a slider; 006. a rotating shaft; 007. a limiting block; 008. a second electric telescopic rod; 009. aligning the plate; 010. a second mounting plate; 011. a second extension pole; 2. a drainage device; 3. a fixed seat; 4. a mobile support; 5. a second buffer device; 51. a guide bar; 52. a limiting plate; 53. a second spring; 6. a first buffer device; 61. a hollow sphere; 611. an upper hemisphere; 612. a lower hemisphere; 62. a buffer ball; 63. a T-shaped connecting block; 64. a fixed shaft; 65. a first spring; 7. a locking screw; .
Detailed Description
The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it will be understood that they are described herein for the purpose of illustration and explanation and not limitation.
In addition, the descriptions related to the first, the second, etc. in the present invention are only used for description purposes, do not particularly refer to an order or sequence, and do not limit the present invention, but only distinguish components or operations described in the same technical terms, and are not understood to indicate or imply relative importance or implicitly indicate the number of indicated technical features. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In addition, technical solutions and technical features between various embodiments can be combined with each other, but must be realized by a person skilled in the art, and when the technical solutions are contradictory or cannot be realized, the combination of the technical solutions should be considered to be absent and not be within the protection scope of the present invention.
Example 1
An embodiment of the present invention provides a knee joint osteotomy distraction device, as shown in fig. 1-2, including a locking plate, where the locking plate includes:
the head part 11 is provided with a hole A, a hole B, a hole C and a hole D;
a stem part 12, the upper end of which is fixedly connected with the lower end of the head part 11, the stem part 12 being provided with a first hole 121, a second hole 122 and a third hole 123 which are spaced up and down;
the top end of the tail part 13 is fixedly connected with the lower end of the backbone part 12, a fourth hole 131 is also formed in the tail part 13, the tail part 13 is of a gradually-thinned structure, and the tail end is smooth;
the locking plate 1 is made of carbon fiber reinforced PEEK nonmetal materials.
PEEK: the polyether-ether-ketone is a special engineering material with excellent properties of high temperature resistance, self-lubrication, easy processing, high mechanical strength and the like. PEEK is a plastic with both toughness and rigidity and a balance, and carbon fiber reinforced PEEK plastic is a non-metallic material and is a prior art.
The working principle and the beneficial effects of the technical scheme are as follows: the raw materials used by the invention are different from the traditional metal materials (titanium and titanium alloy), and the carbon fiber reinforced PEEK nonmetal material is used. The PEEK is the material closest to human skeleton because of its advantages of no toxicity, light weight, abrasion resistance, etc., and can be organically combined with human body, and the carbon fiber reinforced PEEK has further improved mechanical property, chemical corrosion resistance, radiation resistance, high temperature resistance, etc.
The carbon fiber reinforced PEEK material is used as a nonmetal material, cold welding can be stopped from the source when the locking plate is manufactured, and the carbon fiber reinforced PEEK material is an ideal insulator, cannot generate electrolytic reaction with other ions in human tissue fluid, and is not easy to corrode. The operation difficulty is reduced, the operation time is shortened, and the occurrence of operation accidents is reduced. And according to the characteristics of the carbon fiber reinforced PEEK material, the strength of the carbon fiber reinforced PEEK material is completely comparable to that of titanium alloy, the carbon fiber reinforced PEEK material is easy to process, the processing cost of enterprises is saved, and the carbon fiber reinforced PEEK material is beneficial to the implementation of the environment-friendly work of the enterprises.
The tail part is the tail end which is gradually thinned and smooth, so that the bone fracture plate can be better inserted in the operation.
Example 2
On the basis of example 1, as shown in FIGS. 1-2;
the head 11 is T-shaped, holes A, B and C are all arranged on a T-shaped transverse structure 115 and are sequentially arranged horizontally at intervals, a hole D114 is arranged on a T-shaped vertical structure 116, the holes A111, B112 and C113 are all round holes, and the hole D114 is an 8-shaped hole;
the backbone part 12 is a strip-shaped structure with the same width as the T-shaped vertical structure, and the width of the tail part 13 is gradually reduced from the upper end to the lower end.
The working principle and the beneficial effects of the technical scheme are as follows: the head 11 is T-shaped, the hole A, the hole B and the hole C are all arranged on a transverse T-shaped structure, the hole A, the hole B and the hole C are sequentially arranged horizontally at intervals, and the hole D114 is arranged on a vertical T-shaped structure; the arrangement is T-shaped, and the arrangement of the four holes can ensure better stability.
The backbone part 12 is a strip-shaped structure with the same width as the T-shaped vertical structure, has a longer backbone part, and can uniformly disperse the occurring stress to the tibial backbone.
Example 3
On the basis of example 1 or 2, as shown in FIGS. 1-2;
the first hole 121 and the second hole 122 are both 8-shaped holes;
the first hole 121 is a power hole and can be pressurized by using a lag screw, the locking plate is used for enabling the locking plate 1 to generate elastic prestress, and the first hole 121 is positioned in the middle of the locking plate 1;
the third hole 123 and the fourth hole 131 are both circular holes.
The working principle and the beneficial effects of the technical scheme are as follows: the first hole 121 is a power hole and can be pressed by a tension screw to slightly bend the locking plate, thereby generating elastic prestress. The tail part is a tapered and smooth tail end, so that the bone fracture plate can be better inserted in the operation process, and the first hole 121 is positioned in the middle of the locking plate 1 to ensure the stability.
Example 4
On the basis of any one of embodiments 1 to 3;
the round hole and the 8-shaped hole are threaded holes and are used for connecting a locking screw, and threads of the threaded holes are double-line conical threads;
the central lines of two adjacent holes and three adjacent holes in the first hole 121, the second hole 122, the third hole 123 and the fourth hole are not located on the same straight line.
The working principle and the beneficial effects of the technical scheme are as follows: the round hole and the 8-shaped hole are threaded holes and are used for being connected with a locking screw, and threads of the threaded holes are double-line conical threads, so that better angular stability can be provided. The central lines of two adjacent holes of the first hole 121, the second hole 122, the third hole 123 and the fourth hole and between the two adjacent holes are not located on the same straight line, so that the structural stability of the whole locking plate is improved.
Example 5
Tamping the base ram of any of embodiments 1-4;
the maximum width of the head part 11 is 28mm, and the distance between every two of the hole A, the hole B and the hole C is 8 mm.
The working principle and the beneficial effects of the technical scheme are as follows: by optimizing the size of the head, the appearance and the size of the head are reduced, so that the head can be more suitable for the bone parameters of Chinese people.
Example 6
On the basis of any one of embodiments 1 to 5;
the use method of the locking plate 1 comprises the following steps:
step 1: planning a force line before an operation, and determining an orthopedic angle;
when in operation, the osteotomy is firstly performed, the osteotomy area is expanded until the planned orthopedic angle is reached, and then the locking plate 1 is inserted in a minimally invasive way; before insertion, drill guides are screwed into the hole A, the hole B and the hole C of the locking plate 1, locking gaskets are respectively arranged in the hole D114 and the fourth hole 131 of the tail part 13, and after the locking plate 1 is inserted, a kirschner wire is inserted into the hole B112 in the middle hole of the head part 11 for temporary fixation;
using a 4.3mm lcp drill to drill a thread in hole A, C, hole 113, and sequentially implanting screws in hole A, C and locking using a 4.0N · m torque limit wrench; then taking out the kirschner wire in the hole B112, implanting a self-tapping locking screw 7 and fixing;
step 2: implanting a temporary lag screw in a neutral position in a power hole in the first hole 121, drilling threads in the lower half hole, the second hole, the third hole and the fourth hole of the first hole 121 by using a universal drill guide, straightening the leg of the patient with the thread angle of the lower half hole slightly towards the far end (tail end), and implanting a self-tapping cortical bone screw in the lower half hole of the first hole;
and step 3: implanting and tightening locking screws once in the second and third holes 122 and 123, removing the locking washer in the fourth hole 131, and implanting and tightening the locking screw 7 in the fourth hole 131;
taking out the lag screw in the first hole 121, implanting the locking screw 7 and screwing;
taking out the locking washer in the D hole 114, implanting a locking screw 7 in the D hole 114 and screwing;
and detecting the position of the implant, closing the incision and finishing the operation.
Example 7
On the basis of any of examples 1 to 6, as shown in FIGS. 3 to 4,
the present invention also provides a knee osteotomy system comprising: a knee osteotomy distraction device as defined in any one of the preceding claims, said osteotomy system further comprising: the first working plate and the second working plate are respectively detachably connected to the two locking plates 1;
an osteotomy angle measuring device 204 fixedly connected to the first working plate and the second working plate;
the angle measuring device includes:
the first mounting plate 001 is arranged on the first working plate, and the first mounting plate 001 is fixedly connected with the first working plate;
the first extension rod 002 is arranged on the first mounting plate 001, one end of the first extension rod 002 is fixedly connected with the first mounting plate 001, and the first extension rod 002 is perpendicular to the first mounting plate 001;
a groove 003, the groove 003 disposed within the first elongated rod 002;
the sliding block 005 is arranged in the groove 003 and is connected with the groove 003 in a sliding manner;
the limiting block 007 is arranged at the other end of the first extension rod 002 and fixedly connected with the first extension rod 002;
the first electric telescopic rod 004 is arranged in the groove 003, the telescopic end of the first electric telescopic rod 004 is fixedly connected with the sliding block 005, and the fixed end of the first electric telescopic rod 004 is fixedly connected with the groove 003;
the fixed end of the second electric telescopic rod 008 is rotatably connected with the sliding block 005 through a rotating shaft 006;
the alignment plate 009, the alignment plate 009 is arranged at the telescopic end of the second electric telescopic rod 008 and is perpendicular to the second electric telescopic rod 008;
the second mounting plate 010 is arranged on the second working plate and fixedly connected with the second working plate;
a second extension rod 011, the second extension rod 011 disposed on the second mounting plate 010, fixedly connected to the second mounting plate 010, and perpendicular to the second mounting plate 010;
the pressure sensor is arranged at one end, close to the second extension rod 011, of the alignment plate 009;
the angle detection device is arranged on the first extension rod 002 and used for detecting an included angle between the second electric telescopic rod 008 and the first extension rod 002;
and the microcontroller is electrically connected with the pressure sensor and the angle detection device.
The working principle and the beneficial effects of the technical scheme are as follows:
in the osteotomy, in order to realize the osteotomy locking more reliably, sometimes a plurality of locking plates need to be used, and in order to better ensure the locking effect, the included angle between the locking plates needs to be proper;
before the locking plates need to be used, the first working plate and the second working plate are respectively connected to the two locking plates through bolts; when the angle does not need to be fixed or the angle does not need to be measured, the angle measuring device is convenient to use;
after the first working plate and the second working plate are installed, the pressure sensor is used for detecting the pressure value between the alignment plate 009 and the second extension rod 011, when the device is used, the lengths of the first electric telescopic rod 004 and the second electric telescopic rod 008 are adjusted, so that the detection value of the pressure sensor is within a preset range, namely, the alignment plate 009 is tightly attached to the second extension rod 011, at the moment, the first electric telescopic rod 004 and the second electric telescopic rod 008 and the second extension rod 011 form a right triangle, the angle detection device is used for detecting the included angle between the second electric telescopic rod 008 and the first extension rod 002, the angle and the distance between the two locking plates can be calculated according to the elongation of the first electric telescopic rod 004 and the second electric telescopic rod 008 and the detection value of the angle detection device, and in the using process, the lengths of the first electric telescopic rod 004 and the second electric telescopic rod 008 can be fixed, the included angle is ensured to be fixed so as to ensure the locking effect; through the scheme, the osteotomy angle can be conveniently calculated, the use method is simple, the simplicity and the practicability are realized, the inaccuracy of manual measurement or angle estimation is avoided, the limiting block 007 is used for preventing the sliding block 005 from sliding out of the groove 003, and the angle measuring device is more durable.
Example 8
On the basis of embodiment 7, the present invention further includes an automatic osteotomy point confirmation device, including:
the image detection device is used for acquiring an image of a to-be-osteotomy part of the patient;
an image processing device, a controller, and a display; the controller is electrically connected with the image detection device, the image processing device and the display;
the image detection device transmits an image of a to-be-osteotomy part of a patient to the image processing device through the controller after acquiring the image of the to-be-osteotomy part, the image processing device processes the image of the to-be-osteotomy part, establishes two different reference planes, selects a center point of the to-be-osteotomy part as an osteotomy reference point, acquires a coordinate value of a projection of the osteotomy reference point on an osteotomy surface, and acquires a coordinate value of a projection of the osteotomy reference point on the reference plane, wherein the reference plane is a middle plane of the image of the to-be-osteotomy part;
the controller calculates the coordinate value of the osteotomy point based on the image processing device and the formula (1), and comprises the following steps;
step 1, calculating a reference coefficient k according to an image processing device and a formula (1);
Figure BDA0002665837670000131
wherein x is0,y0,z0Coordinate values, x, projected on the osteotomy plane as a reference point of the osteotomy1,y1,z1Coordinate values, x, of the projection of the osteotomy reference point on a reference plane2,y2,z2Is a coordinate value of the projection of the osteotomy reference point on the other reference plane, theta is an included angle between the osteotomy plane and the one reference plane,
Figure BDA0002665837670000132
an included angle between the reference surface and the other reference surface is defined, tan is a tangent value of the angle, and sin is sine;
step 2, calculating the target coordinate value (x) of the osteotomy point according to the formula (2)3,y3,z3);
x3=(-k)(x2-x1)+x0
y3=(-k)(y2-y1)+y0
z3=(-k)(z2-z1)+z0
And controls a display to display a target coordinate value (x) of the osteotomy point3,y3,z3)。
The image mid-plane of the bone to be cut is a first reference plane and a second reference plane; if the patient lies in the operating table, the image detection device is used for acquiring the image, the first reference plane can be the bed surface of the operating table, and the second reference plane can be other planes on the body of the patient; the first reference plane and the second reference plane can also be middle planes of other images to be osteotomy;
the working principle and the beneficial effects of the technical scheme are as follows:
the image detection device transmits an image of a to-be-osteotomy part of a patient to the image processing device through the controller after acquiring the image of the to-be-osteotomy part, the image processing device processes the image of the to-be-osteotomy part, establishes two different reference planes, selects a center point of the to-be-osteotomy part as an osteotomy reference point, acquires a coordinate value of a projection of the osteotomy reference point on an osteotomy surface, and acquires a coordinate value of a projection of the osteotomy reference point on the reference plane, wherein the reference plane is a middle plane of the image of the to-be-osteotomy part; the controller is based onAn image processing apparatus, and formula (1) first calculates a reference coefficient k; the coordinate value projected by the osteotomy reference point on the osteotomy surface, the coordinate value projected by the osteotomy reference point on one reference plane, the difference value between the coordinate values projected by the osteotomy reference point on the other reference plane, the included angle between the osteotomy surface and the one reference plane and the included angle between the one reference plane and the other reference plane are considered during the calculation of the coefficient K to construct a reference coefficient which is used as a correction coefficient, so that the correction coefficient is adaptive to the environment of the to-be-osteotomy position (including the operating bed reference and other plane reference factors of the patient body); then, formula (2) calculates the target coordinate value (x) of the osteotomy point using the reference coefficient3,y3,z3) The operator performs the operation based on the target coordinate value (x) of the osteotomy point3,y3,z3) The osteotomy is more conveniently and reliably carried out; the scheme can automatically determine the position of the osteotomy point, so that the osteotomy operation is more accurate during the operation, and the problem of inaccurate positioning of manual direct operation is avoided.
Example 9
On the basis of any one of embodiments 7 or 8, as shown in fig. 5, the device further comprises a drainage device 2, a plurality of first buffer devices 6, a fixed seat 3 and a plurality of second buffer devices 5, wherein the fixed seat 3 is fixedly connected to the periphery of the lower end of the drainage device 2;
the movable support 4 is arranged below the drainage device 2;
the plurality of second buffer devices 5 are arranged along the peripheral side of the drainage device 2, and the second buffer devices 5 include: the lower end of the guide rod 51 is fixedly connected to the upper end of the movable support 4; a vertical through hole is formed in the fixed seat 3, the upper part of the guide rod 51 is positioned in the vertical through hole, and a limiting plate 52 is arranged at the upper end of the guide rod 51; the second spring 53 is sleeved on the guide rod 51, one end of the second spring 53 is fixedly connected with the lower end of the fixed seat 3, and the other end of the second spring 53 is fixedly connected with the upper end of the movable support 4; the first buffer devices 6 are fixedly connected to the lower end of the drainage device 2;
the first buffer 6 includes:
the hollow sphere 61 is composed of an upper hemisphere 611 and a lower hemisphere 612, the upper hemisphere 611 is fixedly connected in a first spherical groove at the lower end of the drainage device, and the lower end of the lower hemisphere 612 is fixedly connected in a second spherical groove at the upper end of the movable support;
a fixed shaft 64 located between the upper hemisphere 611 or the lower hemisphere 612;
a plurality of buffer assemblies uniformly arranged along the circumferential direction of the fixed shaft 64;
the buffer assembly includes: one end of each buffer ball 62 is fixedly connected with one end of the first spring 65, and the other end of each buffer ball 62 is fixedly connected with the upper hemisphere 611 or the lower hemisphere 612;
and the vertical end of the T-shaped connecting block 63 is fixedly connected with the outer side wall of the fixed shaft 64, and the horizontal end of the T-shaped connecting block 63 is fixedly connected with the other end of the first spring 65.
The mobile support 4 is shown as being moved by wheels; the drainage device 2 is prior art and will not be described in detail herein.
The working principle and the beneficial effects of the technical scheme are as follows: in the first buffer device 6, when vibration is generated on the movable support 4 (for example, due to uneven road when the wheels move), the vibration is transmitted to the first spring 65 through the lower end of the lower hemisphere 612, and is buffered by the first spring 65, so that the vibration is prevented from being directly transmitted to the drainage device 2, and the work of the drainage device 2 is prevented from being influenced; when the drainage device 2 generates vibration, the vibration is transmitted to the first spring 65 through the upper hemisphere 611, and is buffered through the first spring 65, so that the vibration is prevented from being directly transmitted to the movable support 4 to influence wheels on the movable support 4, and the service life of the wheels is shortened; in addition, set up second buffer 5, cushion the shock attenuation to drainage device 2 outside all around, through first buffer 6 and second buffer 5 better to drainage device 2's cushioning effect to prolong the life of whole device.
It will be apparent to those skilled in the art that various changes and modifications may be made in the present invention without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims of the present invention and their equivalents, the present invention is also intended to include such modifications and variations.

Claims (10)

1. A knee osteotomy distraction device comprising a locking plate, said locking plate comprising:
the head part (11), the head part (11) is provided with a hole A (111), a hole B (112), a hole C (113) and a hole D (114);
the upper end of the backbone part (12) is fixedly connected with the lower end of the head part (11), and the backbone part (12) is provided with a first hole (121), a second hole (122) and a third hole (123) which are spaced up and down;
the top end of the tail part (13) is fixedly connected with the lower end of the backbone part (12), a fourth hole (131) is also formed in the tail part (13), the tail part (13) is of a gradually-thinned structure, and the tail end is smooth;
the locking plate (1) is made of carbon fiber reinforced PEEK nonmetal materials.
2. The knee osteotomy distraction device of claim 1,
the head (11) is T-shaped, the hole A (111), the hole B (112) and the hole C (113) are all formed in a T-shaped transverse structure (115), the hole A (111), the hole B (112) and the hole C (113) are sequentially arranged horizontally at intervals, the hole D (114) is formed in a T-shaped vertical structure (115), the hole A (111), the hole B (112) and the hole C (113) are all round holes, and the hole D (114) is an 8-shaped hole;
the backbone part (12) is of a strip structure with the same width as the T-shaped vertical structure (115), and the width of the tail part (13) is gradually reduced from the upper end to the lower end.
3. The knee osteotomy distraction device of claim 2,
the first hole (121) and the second hole (122) are both 8-shaped holes;
the first hole (121) is a power hole, can be pressurized by using a lag screw and is used for enabling the locking plate (1) to generate elastic prestress, and the first hole (121) is positioned in the middle of the locking plate (1);
the third hole (123) and the fourth hole (131) are both round holes.
4. The knee osteotomy distraction device according to claim 3, wherein said round hole and said 8-shaped hole are threaded holes for connection of a locking screw (7), and the threads of said threaded holes are double-start threads;
the central lines of two adjacent holes in the first hole (121), the second hole (122), the third hole (123) and the fourth hole (131) and the central lines of three adjacent holes are not located on the same straight line.
5. Knee osteotomy distraction device according to claim 1, wherein said head (11) has a maximum width of 28mm and the distance between each two of said holes A (111), B (112) and C (113) is 8 mm.
6. A knee osteotomy distraction device according to claim 3, wherein said locking plate (1) method of use comprises:
step 1: before the locking plate (1) is inserted, drill bit guides are screwed into the hole A (111), the hole B (112) and the hole C (113) of the locking plate (1), locking gaskets are respectively installed in the hole D (114) and the fourth hole (131) of the tail part (13), and after the locking plate (1) is inserted, a kirschner wire is inserted into the hole B (112) in the middle of the head part (11) for temporary fixation;
using a 4.3mm lcp drill to drill a thread in the A, C hole (113), and sequentially implanting screws in the A, C hole (113) and locking using a 4.0N · m torque limit wrench; then taking out the Kirschner wire in the hole B (112), implanting a locking screw (7) and fixing;
step 2: implanting a temporary lag screw in a neutral position in a power hole in a first hole (121), drilling threads in a lower half hole of the first hole (121) and a second hole (122), a third hole (123) and a fourth hole (131) by using a universal drill guide, straightening the leg of a patient with the thread angle facing to a far end, and implanting a self-tapping cortical bone screw in the lower half hole of the first hole;
and step 3: implanting and tightening a locking screw (7) once in the second hole (122) and the third hole (123), removing the locking washer in the fourth hole (131), and implanting and tightening a locking screw (7) in the fourth hole (131);
taking out the lag screw in the first hole (121), implanting a locking screw (7) and screwing;
and (3) taking out the locking washer in the D hole (114), implanting a locking screw (7) into the D hole (114) and tightening.
7. A knee osteotomy system, comprising: a knee osteotomy distraction device of any one of claims 1-6.
8. The knee osteotomy system of claim 7, further comprising:
the first working plate and the second working plate are respectively detachably connected to the two locking plates (1);
the first working plate and the second working plate are respectively detachably connected to the two locking plates (1);
the osteotomy angle measuring device is fixedly connected to the first working plate and the second working plate;
the angle measuring device includes:
the first mounting plate (001), the first mounting plate (001) is arranged on the first working plate and fixedly connected with the first working plate;
the first extension rod (002) is arranged on the first mounting plate (001), one end of the first extension rod (002) is fixedly connected with the first mounting plate (001), and the first extension rod (002) is perpendicular to the first mounting plate (001);
a groove (003) disposed within the first elongate bar (002);
the sliding block (005) is arranged in the groove (003) and is connected with the groove (003) in a sliding manner;
the limiting block (007) is arranged at the other end of the first extension rod (002) and fixedly connected with the first extension rod (002);
the first electric telescopic rod (004), the first electric telescopic rod (004) is arranged in the groove (003), the telescopic end of the first electric telescopic rod (004) is fixedly connected with the sliding block (005), and the fixed end of the first electric telescopic rod (004) is fixedly connected with the groove (003);
the fixed end of the second electric telescopic rod (008) is rotatably connected with the sliding block (005) through a rotating shaft (006);
the alignment plate (009) is arranged at the telescopic end of the second electric telescopic rod (008) and is perpendicular to the second electric telescopic rod (008);
the second mounting plate (010), the said second mounting plate (010) is set up on the said second work board, with the said second work board fixed connection;
a second extension bar (011) disposed on the second mounting plate (010), fixedly connected with the second mounting plate (010), and perpendicular to the second mounting plate (010);
the pressure sensor is arranged at one end, close to the second extension rod (011), of the alignment plate (009);
the angle detection device is arranged on the first extension rod (002) and used for detecting an included angle between the second electric telescopic rod (008) and the first extension rod (002);
and the microcontroller is electrically connected with the pressure sensor and the angle detection device.
9. The knee osteotomy system of claim 7,
still include the automatic affirmation device of osteotomy point, the automatic affirmation device of osteotomy point includes:
the image detection device is used for acquiring an image of a to-be-osteotomy part of the patient;
an image processing device, a controller, and a display; the controller is electrically connected with the image detection device, the image processing device and the display:
the image detection device transmits an image of a to-be-osteotomy part of a patient to the image processing device through the controller after acquiring the image of the to-be-osteotomy part, the image processing device processes the image of the to-be-osteotomy part, establishes two different reference planes, selects a center point of the to-be-osteotomy part as an osteotomy reference point, acquires a coordinate value of a projection of the osteotomy reference point on an osteotomy surface, and acquires a coordinate value of a projection of the osteotomy reference point on the reference plane, wherein the reference plane is a middle plane of the image of the to-be-osteotomy part;
the controller calculates the coordinate value of the osteotomy point based on the image processing device and the formula (1), and comprises the following steps;
step 1, calculating a reference coefficient k according to an image processing device and a formula (1);
Figure FDA0002665837660000041
wherein x is0,y0,z0Coordinate values, x, projected on the osteotomy plane as a reference point of the osteotomy1,y1,z1Coordinate values, x, of the projection of the osteotomy reference point on a reference plane2,y2,z2Is a coordinate value of the projection of the osteotomy reference point on the other reference plane, theta is an included angle between the osteotomy plane and the one reference plane,
Figure FDA0002665837660000042
an included angle between the reference surface and the other reference surface is defined, tan is a tangent value of the angle, and sin is sine;
step 2, calculating the target coordinate value (x) of the osteotomy point according to the formula (2)3,y3,z3);
x3=(-k)(x2-x1)+x0
y3=(-k)(y2-y1)+y0
z3=(-k)(z2-z1)+z0
And controls a display to display a target coordinate value (x) of the osteotomy point3,y3,z3)。
10. The knee osteotomy system of claim 7,
the drainage device is characterized by further comprising a drainage device (2), a plurality of first buffer devices (6), a fixed seat (3) and a plurality of second buffer devices (5), wherein the fixed seat (3) is fixedly connected to the periphery of the lower end of the drainage device (2);
the movable support (4) is arranged below the drainage device (2);
the plurality of second buffer devices (5) are arranged along the peripheral side of the drainage device (2), and each second buffer device (5) comprises: the lower end of the guide rod (51) is fixedly connected to the upper end of the movable support (4); a vertical through hole is formed in the fixed seat (3), the upper part of the guide rod (51) is positioned in the vertical through hole, and a limiting plate (52) is arranged at the upper end of the guide rod (51);
the second spring (53) is sleeved on the guide rod (51), one end of the second spring (53) is fixedly connected with the lower end of the fixed seat (3), and the other end of the second spring (53) is fixedly connected with the upper end of the movable support (4); the first buffer devices (6) are fixedly connected to the lower end of the drainage device (2);
the first damping device (6) comprises:
the hollow sphere (61) consists of an upper hemisphere (611) and a lower hemisphere (612), the upper hemisphere (611) is fixedly connected into a first spherical groove at the lower end of the drainage device (2), and the lower end of the lower hemisphere (612) is fixedly connected into a second spherical groove at the upper end of the movable support (4);
a fixed axis (64) located between the upper hemisphere (611) or the lower hemisphere (612);
a plurality of buffer components which are uniformly arranged along the circumferential direction of the fixed shaft (64);
the buffer assembly includes: one end of each buffer ball (62) is fixedly connected with one end of a first spring (65), and the other end of each buffer ball (62) is fixedly connected with the upper hemisphere (611) or the lower hemisphere (612);
and the vertical end of the T-shaped connecting block (63) is fixedly connected with the outer side wall of the fixed shaft (64), and the horizontal end of the T-shaped connecting block (63) is fixedly connected with the other end of the first spring (65).
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CN208598501U (en) * 2017-12-25 2019-03-15 大博医疗科技股份有限公司 A kind of knee joint peripheral osteotomy lockplate
CN110101919A (en) * 2019-06-10 2019-08-09 浙江德康医疗器械有限公司 A kind of high-strength, fatigue-resistant low elastic modulus orthopaedics implant
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CN105615966A (en) * 2009-08-27 2016-06-01 科特拉有限公司 Method and apparatus for force redistributon in articular joints
US20160346020A1 (en) * 2010-09-27 2016-12-01 Acumed Llc Bone plate supported by a leg member and used as a lever
CN107842558A (en) * 2017-11-16 2018-03-27 江苏丰禾食品有限公司 A kind of electromechanics bearing of strong shock resistance
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