CN112137734B - Femoral intertrochanteric fracture body surface incision positioner - Google Patents
Femoral intertrochanteric fracture body surface incision positioner Download PDFInfo
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- CN112137734B CN112137734B CN202011021055.2A CN202011021055A CN112137734B CN 112137734 B CN112137734 B CN 112137734B CN 202011021055 A CN202011021055 A CN 202011021055A CN 112137734 B CN112137734 B CN 112137734B
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- connecting rod
- guide pin
- femur
- main connecting
- projector
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- 206010020100 Hip fracture Diseases 0.000 title claims abstract description 25
- 210000000689 upper leg Anatomy 0.000 claims abstract description 64
- 210000000588 acetabulum Anatomy 0.000 claims abstract description 16
- 210000004872 soft tissue Anatomy 0.000 claims abstract description 8
- 230000000149 penetrating effect Effects 0.000 claims abstract description 7
- 208000010392 Bone Fractures Diseases 0.000 description 10
- 206010017076 Fracture Diseases 0.000 description 10
- 238000000034 method Methods 0.000 description 10
- 210000002436 femur neck Anatomy 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 210000000988 bone and bone Anatomy 0.000 description 3
- 210000003414 extremity Anatomy 0.000 description 2
- 210000004013 groin Anatomy 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 210000004417 patella Anatomy 0.000 description 2
- 230000002035 prolonged effect Effects 0.000 description 2
- 210000004061 pubic symphysis Anatomy 0.000 description 2
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 210000000527 greater trochanter Anatomy 0.000 description 1
- 210000003692 ilium Anatomy 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 210000000528 lesser trochanter Anatomy 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Medical Informatics (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Pathology (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
The invention relates to a femoral intertrochanteric fracture body surface incision positioner which comprises a femoral proximal guide pin adjuster, a femoral distal end fixer, an acetabular projector, a main connecting rod and an auxiliary connecting rod, wherein two opposite ends of the main connecting rod are respectively defined as a proximal end and a distal end; one end of the proximal femur guide pin adjuster is arranged on the proximal end of the main connecting rod, the guide pin adjuster is provided with a chute penetrating through the guide pin adjuster, and the chute is arranged in an extending way along the length direction of the main connecting rod; the femur distal end fixer is provided with a clamping part fixed on the thigh distal end soft tissue of a patient, and is arranged on the distal end of the main connecting rod; the acetabulum projector is connected to the main connecting rod through the auxiliary connecting rod, and is positioned beside the guide pin adjuster at the proximal end of the femur, and the acetabulum projector is provided with an extension rod penetrating through the chute, so as to provide a body surface locator which is easy to operate, quick and accurate to position.
Description
Technical Field
The invention relates to the field of medical appliances, in particular to a body surface incision positioner for intertrochanteric fracture.
Background
The intertrochanteric fracture refers to the fracture between the base of the femoral neck and the lesser trochanter of the femur, is good for the elderly, is a clinically common fracture type, and has higher disability rate and death rate. At present, the intertrochanteric fracture has two methods of conservative treatment and operation treatment clinically, and the conservative treatment is seldom selected generally due to more complications; at present, the active intra-operative fixation treatment under the condition of body conditions is mainly claimed clinically, and the method has the advantages of being capable of leaving the bed as early as possible and reducing bedridden complications. In recent years, for the internal fixation treatment of intertrochanteric fractures of femur, surgeons mainly use reconstructed intramedullary nails for fixation.
The positioning of the main nail feeding point of the proximal femur reconstruction intramedullary nail and the positioning of the head and neck axis of the femur are important to the fixation of the proximal femur reconstruction intramedullary nail, the endophytes for treating the intertrochanteric fracture of the femur need to be accurately placed in the proximal femur, and once the position of the endophytes at the proximal femur is poor, the mechanical stability of the endophytes is reduced, and even the final internal fixation fails. At present, in the clinical operation process, the main nail feeding point and the axis of the head and neck of the femur are determined by the embedded positioning guide needle, and whether the feeding point is accurate or not and whether the guide needle passes through the axis position of the femoral neck relative to the center or not are determined by observing the position of the positioning guide needle at the proximal end of the greater trochanter and the position of the inside of the head and neck of the femur. The current positioning guide needle implantation method is that a doctor is implanted by hand under the condition of no guide device under the guidance of a C-arm X-ray machine. Because of the lack of an accurate positioning device and a complex geometrical space at the proximal end of femur, the method is mainly used for judging the position of the guide needle by the experience hand feeling of a surgeon, and can ensure the accuracy and efficiency of position selection for experienced doctors, but most doctors can put the guide needle into an ideal position by repeated perspective and adjustment of the position of the guide needle in order to ensure the accuracy of positioning, so that the accuracy, the safety and the effectiveness of the positioning guide needle put process are low, the operation efficiency is seriously influenced, and the normal bone is seriously damaged. In addition, repeated adjustment of the position of the guide needle requires repeated perspective observation, and both the patient and the operator are exposed to rays, which is quite dangerous. On the other hand, the position of the operation incision is inaccurate due to the fact that body surface positioning is inaccurate clinically, operation of an operator is limited by soft tissues, deviation of guide needle positioning is indirectly caused, the operation incision is forced to be prolonged and increased, damage of the soft tissues in operation is increased, and bleeding amount is increased, operation time is prolonged, postoperative complications are increased and the like. In response to these problems, clinicians have summarized various body surface positioning techniques based on their experience, and have thus extended that various positioning devices have been developed for clinical use. However, the existing locators have the problems of insufficient locating precision, complex operation and the like, and the use of the locators is limited.
In conclusion, the body surface positioning device which is minimally invasive, simple and convenient to operate and capable of rapidly and accurately positioning is designed and has important clinical value.
Disclosure of Invention
The invention aims to provide a femoral intertrochanteric fracture body surface incision localizer which is minimally invasive, simple and convenient to operate and capable of being rapidly and accurately positioned.
The specific scheme is as follows:
the utility model provides a fracture body surface incision locator between femur trochanter, includes proximal femur guide pin adjuster, distal femur fixer, acetabulum projector, main connecting rod and auxiliary connecting rod, the opposite both ends of main connecting rod define as proximal end and distal end respectively;
one end of the proximal femur guide pin adjuster is arranged on the proximal end of the main connecting rod, the guide pin adjuster is provided with a chute penetrating through the guide pin adjuster, and the chute is arranged in an extending way along the length direction of the main connecting rod;
the femur distal end fixer is provided with a clamping part fixed on the thigh distal end soft tissue of a patient, and is arranged on the distal end of the main connecting rod;
the acetabulum projector is connected to the main connecting rod through the auxiliary connecting rod, and is positioned beside the guide pin adjuster at the proximal end of the femur, and an extension rod penetrating through the chute is arranged on the acetabulum projector.
Further, the proximal femur guide pin adjuster comprises a sheet guide pin adjuster body, one end of the guide pin adjuster body in the length direction is fixedly connected to the proximal end of the main connecting rod, and the sliding groove penetrates through the sliding groove of the guide pin adjuster body in the width direction and extends along the length direction of the guide pin adjuster body.
Further, the femur distal end fixer is movably connected to the distal end of the main connecting rod.
Further, the distal femur fixator comprises a bar and two longitudinal arms at two opposite ends of the bar, wherein the two longitudinal arms are connected to the bar in a sliding manner.
Further, the acetabulum projector is hemispherical, and is provided with auxiliary lines of 45 degrees, 90 degrees and 135 degrees.
Further, the extension rod is positioned on an auxiliary line of 90 degrees of the acetabular projector.
Further, the acetabular projector is movably connected with the auxiliary connecting rod and the auxiliary connecting rod is movably connected with the main connecting rod, so that a double-joint connecting structure is formed between the acetabular projector and the main connecting rod.
Further, the auxiliary connecting rod is slidably connected to the main connecting rod, so that the auxiliary connecting rod can slide along the length direction of the main connecting rod.
Furthermore, the proximal femur guide pin adjuster, the distal femur fixator, the acetabular projector, the main connecting rod and the auxiliary connecting rod are all integrally designed.
Furthermore, the proximal femur guide pin adjuster, the distal femur fixator, the acetabular projector, the main connecting rod and the auxiliary connecting rod are assembled and fixed in a detachable mode.
Compared with the prior art, the femur intertrochanteric fracture body surface incision positioner provided by the invention has the following advantages: the intertrochanteric fracture body surface incision locator provided by the invention is applied to intertrochanteric fracture surgery, can realize accurate positioning of the positioning guide needle and determination of incision positions, can improve the accuracy, safety and effectiveness of surgery operation, simultaneously reduces the times of replacing and adjusting the guide needle in surgery and the extension and increase of surgery incisions, reduces the damage to bones and soft tissues, ensures that the position of an endophyte at the proximal end part of femur is more accurate, enhances the stability of internal fixation, and can promote fracture healing and avoid internal fixation failure; this is particularly important for elderly patients, since fracture stability is greatly improved, thus allowing early weight and functional exercise in patients.
Drawings
Fig. 1 shows a perspective view of a femoral intertrochanteric fracture body surface incision locator.
Fig. 2 shows a schematic top view of a femoral intertrochanteric fracture body surface incision locator.
Detailed Description
For further illustration of the various embodiments, the invention is provided with the accompanying drawings. The accompanying drawings, which are incorporated in and constitute a part of this disclosure, illustrate embodiments and together with the description, serve to explain the principles of the embodiments. With reference to these matters, one of ordinary skill in the art will understand other possible embodiments and advantages of the present invention. The components in the figures are not drawn to scale and like reference numerals are generally used to designate like components.
The invention will now be further described with reference to the drawings and detailed description.
As shown in fig. 1 and 2, the present embodiment provides a femoral intertrochanteric fracture body surface incision positioner, which comprises a proximal femur guide pin adjuster 1, a distal femur fixator 2, an acetabular projector 3, a main connecting rod 4 and a secondary connecting rod 5. Wherein, the opposite ends of the main connecting rod 4 are respectively defined as a proximal end and a distal end, the proximal femur guide pin adjuster 1 is fixedly connected to the proximal end of the main connecting rod 4, the distal femur fixator 2 is connected to the distal end of the main connecting rod 4, and the acetabular projector 3 is connected to the main connecting rod 4 through the auxiliary connecting rod 5.
Specifically, the proximal femoral guide pin adjuster 1 includes a sheet-shaped guide pin adjuster body, one end of the guide pin adjuster body in the length direction is fixedly connected to the proximal end of the main connecting rod 4, the guide pin adjuster body is provided with a chute 10 penetrating through the guide pin adjuster body in the width direction, and the chute 10 extends along the length direction of the guide pin adjuster body, so that the distal and proximal positions and angles of the guide pins can be adjusted as required during operation.
The distal femur fixator 2 is of a "portal" design and includes a bar 21 and two trailing arms 22 at opposite ends of the bar 21. The middle part of the cross bar 21 is movably connected to the distal end of the main connecting rod 4 through a first adjusting knob 23, and the femur distal end fixer 2 can slide on the main connecting rod 4 through the first adjusting knob 23, so that the position can be adjusted according to different patients when the femoral distal end fixer is convenient to use. Preferably, the longitudinal arms 22 on both sides are connected with the cross bar 21 by a slidable telescopic structure, so that the distance between the longitudinal arms 22 can be adjusted according to the diameter of the limbs of the patient in use. The distal end fixer is clamped on the thigh distal end soft tissue of a patient through the two longitudinal arms 22, plays a role in fixing the whole fracture body surface incision locator between the femoral trochanters, reduces the position offset in the operation process, improves the accuracy and does not increase the damage.
The auxiliary connecting rod 5 comprises a connecting section 51 which is arranged along the radial extension of the main connecting rod 4 and an extension section 52 which is arranged along the length direction of the main connecting rod 4, the free end of the connecting section 51 is fixedly connected to a rod body which is close to the proximal end and is arranged in the middle of the main connecting rod 4, and the free end of the extension section 52 is arranged in an extension way towards the direction which is close to the proximal guide needle adjuster 1 of the femur.
The acetabular projector 3 is fixedly connected to the free end of the extension 52 and the acetabular projector 3 is positioned laterally of the proximal femoral guide pin adjuster 1. An extension rod 31 is arranged on the acetabulum projector 3, and the extension rod 31 passes through the chute 10 to simulate positioning guide pins for determining the axis of the head and neck under the projection of a C-arm X-ray machine. In the embodiment, the acetabulum projector 3 is hemispherical, and is provided with auxiliary lines of 45 degrees, 90 degrees and 135 degrees so as to provide references for operators and improve positioning accuracy; and the extension rod 31 is positioned on an auxiliary line of 90 degrees of the acetabular projector so as to be beneficial to determining the axis of the head and neck under the projection of a C-arm X-ray machine.
Preferably, the acetabular projector 3 is movably connected with the auxiliary connecting rod 5 and the auxiliary connecting rod 5 is movably connected with the main connecting rod 4, so that a double-joint connecting structure is formed, and the projection position of the acetabular projector 3 is conveniently adjusted. More preferably, the auxiliary connecting rod 5 can slide on the main connecting rod 4 along the length direction of the main connecting rod 4, so that the acetabular projector 3 can be accurately positioned according to different patient adjustment positions when in use.
All parts such as proximal femur guide pin adjuster 1, distal femur fixer 2, acetabular projector 3, main connecting rod 4 and auxiliary connecting rod 5 in this embodiment all adopt the integral type design to increase the location accuracy, adopt detachable mode to assemble fixedly between each part simultaneously, in order to conveniently carry, disinfect.
The operation process of the femur intertrochanteric fracture body surface incision positioner provided by the embodiment is as follows: before use, the anterior superior iliac spine, pubic symphysis, the medial 1/3 junction in the groin, the mechanical axis of the thigh (the line connecting the medial 1/3 junction in the groin to the key point of the patella), the anterior lateral thigh line (the line connecting the anterior superior iliac spine to the lateral patella), and the lateral thigh midline (the lateral thigh midline) are determined according to the 3-2-1 positioning technique. When in use, the parts are assembled into a whole, the femur distal end fixer is adjusted according to the length and the diameter of the affected side limb of a patient, and the whole device is connected with the affected side thigh into a stable whole through the femur distal end fixer; the acetabulum projector is projected on the acetabulum at the affected side by the C-arm X-ray machine, the guide needle is adjusted to be horizontally arranged at the front upper spine level of the ilium in the chute of the proximal guide needle adjuster, the guide needle is projected on the midline of the outer side of the thigh, the incision of the nail feeding point can be determined, and an incision (namely '3') of about 3cm is obliquely formed; projecting the auxiliary line extension rod at 90 degrees on the middle line outside the thigh to form a femoral head and neck axis locating point, and obliquely forming an incision (namely '2') of about 2 cm; the guide needle is adjusted on the sliding groove of the proximal guide needle adjuster to be horizontally arranged at the lower edge of pubic symphysis, the guide needle is projected on the front outer side line of the thigh to determine the position of an auxiliary reduction incision, an incision of about 1cm can be obliquely formed if necessary, an instrument is placed to assist in reduction of the fracture end (namely '1'), and after the reduction of the fracture is satisfied, the endophyte can be placed along the preset incision and the positioning point.
The device for positioning the surface incision of the intertrochanteric fracture, which is provided by the embodiment, is applied to the intertrochanteric fracture operation, can realize the accurate positioning of the positioning guide needle and the determination of the incision position, can improve the accuracy, safety and effectiveness of the operation, simultaneously reduces the times of replacing and adjusting the guide needle in the operation and the extension and the increase of the operation incision, reduces the damage to bones and soft tissues, ensures that the position of an endophyte at the proximal end part of the femur is more accurate, enhances the stability of internal fixation, and can promote fracture healing and avoid internal fixation failure; this is particularly important for elderly patients, since fracture stability is greatly improved, thus allowing early weight and functional exercise in patients.
While the invention has been particularly shown and described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.
Claims (7)
1. A femoral intertrochanteric fracture body surface incision locator which is characterized in that: the device comprises a femur proximal guide pin adjuster, a femur distal end fixer, an acetabulum projector, a main connecting rod and an auxiliary connecting rod, wherein the opposite two ends of the main connecting rod are respectively defined as a proximal end and a distal end;
one end of the proximal femur guide pin adjuster is arranged on the proximal end of the main connecting rod, the guide pin adjuster is provided with a chute penetrating through the guide pin adjuster, and the chute is arranged in an extending way along the length direction of the main connecting rod;
the femur distal end fixer is provided with a clamping part fixed on the thigh distal end soft tissue of a patient, and is arranged on the distal end of the main connecting rod;
the acetabulum projector is connected to the main connecting rod through the auxiliary connecting rod and is positioned beside the guide pin adjuster at the proximal end of the femur, and an extension rod penetrating through the chute is arranged on the acetabulum projector;
the proximal femur guide pin adjuster comprises a sheet guide pin adjuster body, one end of the guide pin adjuster body in the length direction is fixedly connected to the proximal end of the main connecting rod, and a sliding groove penetrates through the sliding groove of the guide pin adjuster body in the width direction and extends along the length direction of the guide pin adjuster body;
the acetabulum projector is movably connected with the auxiliary connecting rod and the auxiliary connecting rod is movably connected with the main connecting rod, so that a double-joint connecting structure is formed between the acetabulum projector and the main connecting rod;
the auxiliary connecting rod is connected to the main connecting rod in a sliding manner, so that the auxiliary connecting rod can slide along the length direction of the main connecting rod.
2. The intertrochanteric fracture body surface incision locator according to claim 1, wherein: the femur distal end fixer is movably connected to the distal end of the main connecting rod.
3. The intertrochanteric fracture body surface incision locator according to claim 1, wherein: the femur distal end fixer comprises a transverse bar and two longitudinal arms positioned on two opposite ends of the transverse bar, wherein the two longitudinal arms are connected to the transverse bar in a sliding manner.
4. The intertrochanteric fracture body surface incision locator according to claim 1, wherein: the acetabulum projector is hemispherical, and is provided with auxiliary lines of 45 degrees, 90 degrees and 135 degrees.
5. The intertrochanteric fracture body surface incision locator according to claim 4, wherein: the extension rod is located on an auxiliary line of 90 ° of the acetabular projector.
6. The intertrochanteric fracture body surface incision locator according to claim 1, wherein: the proximal femur guide pin adjuster, the distal femur fixator, the acetabular projector, the main connecting rod and the auxiliary connecting rod are all integrally designed.
7. The intertrochanteric fracture body surface incision locator according to claim 6, wherein: the proximal femur guide pin adjuster, the distal femur fixator, the acetabular projector, the main connecting rod and the auxiliary connecting rod are assembled and fixed in a detachable mode.
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CN202011021055.2A CN112137734B (en) | 2020-09-25 | 2020-09-25 | Femoral intertrochanteric fracture body surface incision positioner |
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CN202011021055.2A CN112137734B (en) | 2020-09-25 | 2020-09-25 | Femoral intertrochanteric fracture body surface incision positioner |
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Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN202060860U (en) * | 2011-04-20 | 2011-12-07 | 马台 | Navigator of intramedullary nail at near end of thighbone |
CN103961175A (en) * | 2014-06-01 | 2014-08-06 | 赵全明 | Guider for fixing dynamic hip screws for proximal femoral fractures |
WO2016072954A2 (en) * | 2014-11-04 | 2016-05-12 | Tst Rakor Ve Tibbi̇ Aletler Sanayi̇ Ve Ti̇caret Li̇mi̇ted Şi̇rketi̇ | High tibial osteotomy external fixator |
CN107789050A (en) * | 2017-11-22 | 2018-03-13 | 陈立军 | Femoral interlocking nail entry point quick positioner |
WO2019119052A1 (en) * | 2017-12-21 | 2019-06-27 | PMSW Research Pty Ltd | Minimally invasive hip arthroplasty techniques and apparatus |
-
2020
- 2020-09-25 CN CN202011021055.2A patent/CN112137734B/en active Active
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN202060860U (en) * | 2011-04-20 | 2011-12-07 | 马台 | Navigator of intramedullary nail at near end of thighbone |
CN103961175A (en) * | 2014-06-01 | 2014-08-06 | 赵全明 | Guider for fixing dynamic hip screws for proximal femoral fractures |
WO2016072954A2 (en) * | 2014-11-04 | 2016-05-12 | Tst Rakor Ve Tibbi̇ Aletler Sanayi̇ Ve Ti̇caret Li̇mi̇ted Şi̇rketi̇ | High tibial osteotomy external fixator |
CN107789050A (en) * | 2017-11-22 | 2018-03-13 | 陈立军 | Femoral interlocking nail entry point quick positioner |
WO2019119052A1 (en) * | 2017-12-21 | 2019-06-27 | PMSW Research Pty Ltd | Minimally invasive hip arthroplasty techniques and apparatus |
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