CN112826568A - Femoral extramedullary positioning osteotomy device in knee joint replacement and using method thereof - Google Patents
Femoral extramedullary positioning osteotomy device in knee joint replacement and using method thereof Download PDFInfo
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- CN112826568A CN112826568A CN202110001270.4A CN202110001270A CN112826568A CN 112826568 A CN112826568 A CN 112826568A CN 202110001270 A CN202110001270 A CN 202110001270A CN 112826568 A CN112826568 A CN 112826568A
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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
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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
- A61B17/1657—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
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1675—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
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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
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
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Abstract
The invention belongs to the technical field of medical instruments, in particular to an external femoral bone marrow positioning osteotome in knee joint replacement and a using method thereof, and provides a scheme which comprises a sliding rod, an osteotomy femur and a second femoral bone osteotomy guide plate, wherein one end of the sliding rod is fixedly connected with a first fixing nail, the outer wall of the first fixing nail is fixedly connected with an original femur, the outer wall of the sliding rod is provided with a sliding block, and a braking component for braking the sliding rod is arranged in the sliding block. Prevent deviation from appearing in later stage osteotomy.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a femoral extramedullary positioning osteotomy device in knee joint replacement and a using method thereof.
Background
Total knee arthroplasty is a widely used and effective treatment for patients with advanced knee arthropathy. Alignment techniques are the basis for knee joint replacement and refer to the method by which the surgeon performs osteotomy and prosthesis installation in the joint replacement. The existing traditional alignment method is mechanical axis alignment, namely, the bone is cut and the prosthesis is installed according to a lower limb mechanical axis formed by a connecting line of a femoral head center, a knee joint center and an ankle joint center, so that a rotating shaft of the replaced knee joint prosthesis is perpendicular to the mechanical axis, for femoral bone cutting, the current method is to insert a medullary cavity rod into a medullary cavity to find an anatomical axis of the femur, and determine a bone cutting plane according to 5 degrees, 6 degrees or 7 degrees and other degrees (the degrees are obtained by measuring an included angle between the anatomical axis and the mechanical axis through an X-ray before operation) by taking the anatomical axis as a reference, so that the mechanical axis alignment is realized.
However, because human knee joints are naturally inverted, femurs should be maintained at the inverted position for osteotomy according to the theory of dynamic alignment, and the thighbones of patients have different wearing degrees and need to be cut off the distal ends of the femurs with different thicknesses (because most of the distal ends of the femurs of the patients are worn), and the osteotomy plane is ensured to be parallel to the joint line before the wearing occurs, so that the osteotomy plane and the joint line cannot be dislocated.
Disclosure of Invention
The invention aims to solve the defects in the prior art, and provides a femur external positioning osteotomy device which is compact in structure, can accurately determine the osteotomy thickness, ensures that an osteotomy plane is parallel to a joint line before abrasion occurs, and accords with the use of most patients in knee joint replacement, and a using method thereof.
In order to achieve the purpose, the invention adopts the following technical scheme:
the femoral extramedullary positioning osteotomy device in knee joint replacement comprises a sliding rod, a femur and a second femur osteotomy guide plate after osteotomy, wherein one end of the sliding rod is fixedly connected with a first fixing nail, the outer wall of the first fixing nail is fixedly connected with an original femur, the outer wall of the sliding rod is provided with a sliding block, a brake component for braking the sliding rod is arranged in the sliding block, the top of the sliding block is fixedly connected with a rotating box, the top inner wall and the bottom inner wall of the rotating box are rotatably connected with the same rotating shaft, the top end of the rotating shaft penetrates through the rotating box and is fixedly connected with a rotating block, a rotating component for driving the rotating block to rotate is arranged in the rotating box, the top of the rotating box is fixedly connected with an arc dial, one end of the rotating block is fixedly connected with a first pointer, and the bottom of the first pointer is slidably connected with the, a plurality of second slide bars are equidistantly arranged at one end of the rotating block, the outer walls of the second slide bars are connected with the same first femoral osteotomy guide plate in a sliding way, a moving component for moving the first femoral osteotomy guide plate is arranged in the rotating block, two symmetrical straight baffles are fixedly connected to the bottom of the rotating block, two symmetrical nail holes are arranged in the first femoral osteotomy guide plate, an osteotomy saw blade guide groove is arranged in the first femoral osteotomy guide plate, a second fixing nail is arranged in the osteotomy femur, the outer wall of the second fixing nail is rotatably connected with a rotating disc, two symmetrical positioning holes are arranged in the rotating disc, a horizontal component for adjusting the two positioning holes to be horizontal is arranged in the rotating disc, one side of the second femur osteotomy guide plate is fixedly connected with two symmetrical positioning rods, and two symmetrical horizontal osteotomy saw blade guide grooves and inclined osteotomy saw blade guide grooves are formed in the second femur osteotomy guide plate.
The brake assembly is including setting up two symmetrical spouts in the slider, two the inside and bottom inner wall sliding connection in top of spout has two symmetrical second sliders, two the inside and bottom inner wall sliding connection in top of spout has same first slider, two the inside and bottom inner wall fixedly connected with two symmetrical dead levers of top of spout, two the equal first spring of fixedly connected with of one side inner wall of spout, two the one end that first spring kept away from each other all with first slider fixed connection, the outer wall of dead lever rotates and is connected with the rotation connecting rod, the one end and the first slider rotation connection of second slider are kept away from to the rotation connecting rod, the one end and the second slider rotation connection of keeping away from first slider are rotated to the rotation connecting rod, the one end fixedly connected with splint that the second slider is close to the slide bar.
The runner assembly is including rotating the worm of connecting at the rotation case both sides inner wall, the one end of worm extends to the one side of rotating the case, the fixed cover of outer wall of pivot is equipped with the worm wheel, the one side of rotating the case is equipped with the circular slot, sliding connection has first slide bar in the circular slot, first slide bar is close to the one end fixedly connected with latch of pivot, latch and worm wheel mesh mutually, the outer wall cover of first slide bar is equipped with the second spring, the second spring is close to the one end and the latch fixed connection of pivot, the one end of latch and the inner wall fixed connection who rotates the case are kept away from to the second spring, the outer wall of first slide bar rotates and is connected with the rotation cover.
The moving assembly comprises a rectangular groove arranged in a rotating block, the top inner wall and the bottom inner wall of the rectangular groove are rotatably connected with the same rotating rod, the top end of the rotating rod extends to the upper part of the rotating block, a first bevel gear is fixedly sleeved on the outer wall of the rotating rod, a rotating groove is arranged in the rotating block, the inner walls on two sides of the rotating groove are rotatably connected with the same screw rod, one end of the screw rod extends into the rectangular groove and is fixedly connected with a second bevel gear, the second bevel gear is meshed with the first bevel gear, the outer wall of the screw rod is in threaded connection with a nut, the bottom of the nut is in sliding connection with the top of the rotating block, a bolt is arranged at the top of the nut, the bottom end of the bolt penetrates through the nut and extends into a first bone cutting guide plate, the bolt is in threaded connection with the first bone cutting guide plate, and a bone, and a second pointer is fixedly connected to one side of the nut, and the top of the second pointer is in sliding connection with the top of the osteotomy thickness dial.
The horizontal component comprises a circular dial embedded in the rotating disc, the outer wall of the second fixing nail is wound with a perpendicular line, the bottom end of the perpendicular line is fixedly connected with a drop block, and the perpendicular line and the rotating disc are touched.
One side of the rotating box is fixedly embedded with a rotating bearing, one end of the worm penetrates through an inner ring of the rotating bearing and is fixedly connected with the inner ring of the rotating bearing, and the friction resistance of the rotating box to the worm can be reduced through the rotating bearing.
One end of the worm is fixedly connected with an anti-slip block, so that the friction force between the palm and the worm can be increased through the anti-slip block, and the phenomenon of hand slip during operation is prevented.
One side fixedly connected with slipmat of splint near the slide bar can increase the frictional force of splint to the slide bar through the slipmat, prevents that the sliding block from sliding on the slide bar.
The one end fixedly connected with fixed plate of second staple, one side of fixed plate is rotated and is connected with the axis of rotation, the one end that the axis of rotation is close to the thighbone after cutting bone runs through fixed plate and fixedly connected with gear, the outer wall fixed cover of rolling disc is equipped with the ring gear, ring gear and gear mesh mutually.
The use method of the femoral extramedullary positioning osteotomy device in knee joint replacement comprises the following steps:
s1, firstly, a first fixing nail is nailed into the medullary cavity of the original femur, the first sliding rod and the rotating sleeve are pulled outwards, the brake of the latch on the worm wheel is relieved, the second spring starts to compress, the rotating sleeve is rotated, the protruding part of the rotating sleeve deviates from the circular groove, the rotating sleeve can prevent the first sliding rod and the latch from retracting, the rotating anti-skid block drives the worm to rotate, the worm is meshed with the worm wheel, the worm drives the worm wheel, the rotating shaft and the rotating block to rotate, the rotating block can be rotated by a certain angle through the first pointer and the arc dial, the rotating sleeve is rotated to align the rotating sleeve with the circular groove, and the latch brakes the worm wheel again under the action of the second spring;
s2, pressing the two first sliding blocks, compressing the first spring, rotating the two rotating connecting rods to drive the second sliding block and the clamping plate to move outwards, pushing the sliding blocks, the rotating box and the rotating blocks to move towards the original femur direction, enabling the straight baffle plate to be in contact with the original femur, releasing the extrusion force on the first sliding blocks, and clamping and fixing the sliding rods again by the second sliding blocks under the action of the first spring;
s3, rotating a rotating rod, wherein the rotating rod drives a first bevel gear, a second bevel gear and a screw to rotate, a nut is in threaded connection with the screw, the nut drives a first femoral osteotomy guide plate to move to the left side along with the rotation of the screw, the thickness of a bone to be osteotomed is determined through a second pointer and an osteotomy thickness dial, the first femoral osteotomy guide plate is fixed on an original femur by a steel nail penetrating through a nail hole, then a bolt is unscrewed, then the nut, a rotating block, a rotating box, a sliding rod and a first fixing nail are taken away, a osteotome penetrates into an osteotomy saw blade guide groove, and the femur is relieved;
s4, nailing a second fixing nail into a medullary cavity of the resected femur to enable the rotating disc to be tightly attached to one side of the resected femur, then rotating the rotating shaft, enabling the gear to be meshed with the toothed ring, driving the gear, the toothed ring and the rotating disc to rotate by the rotating shaft, ensuring the horizontal state of the two positioning holes through the vertical line, the weight block and the circular dial, and nailing two holes at one side of the resected femur through the positioning holes by using steel nails;
s5, the two positioning rods penetrate into two holes on the femur after osteotomy and position the second femur osteotomy guide plate, then the osteotome penetrates into the horizontal osteotomy saw blade guide groove and the inclined osteotomy saw blade guide groove respectively, and the femur is resected again.
The invention has the following advantages:
1. firstly, a first fixing nail is nailed into a medullary cavity of an original femur, a first sliding rod and a rotating sleeve are pulled outwards, the brake of a clamping tooth on a worm wheel is removed, a second spring starts to compress, the rotating sleeve is rotated, the protruding part of the rotating sleeve deviates from a circular groove, the rotating sleeve can prevent the first sliding rod and the clamping tooth from retracting, a rotating anti-slip block drives a worm to rotate, the worm and the worm wheel are meshed, the worm drives the worm wheel, a rotating shaft and the rotating block to rotate, then the rotating block can rotate by a certain angle through a first pointer and an arc dial, the rotating sleeve is rotated, the rotating sleeve and the circular groove are aligned, and the clamping tooth brakes the worm wheel again under the action of the second spring.
2. Pressing two first sliders, first spring begins to compress, and two rotation connecting rods begin to rotate, drive second slider and splint and move to the outside, promote the sliding block after that, rotate case and turning block and move to original thighbone direction, make straight baffle and original thighbone touch mutually, loosen the extrusion force to first slider, under the effect of first spring, the second slider carries out the centre gripping again to the slide bar and fixes.
3. Rotatory dwang, the dwang drives first bevel gear, second bevel gear and screw rod rotate, and nut and screw rod threaded connection, along with the rotation of screw rod, the nut drives first stock bone and cuts the bone baffle and remove to the left side, confirm the thickness that needs to cut the bone through second pointer and cut bone thickness calibrated scale, pass the nail hole through the steel nail and cut first stock bone and cut the bone baffle and fix on original thighbone, then unscrew the bolt, take away the nut after that, the turning block, the rotation case, slide bar and first staple, penetrate the osteotome and cut in the bone saw bit guide slot, relieve the thighbone.
4. The second fixing nail is nailed into the medullary cavity of the resected femur to enable the rotating disc to be tightly attached to one side of the resected femur, then the rotating shaft is rotated, the gear is meshed with the toothed ring, the rotating shaft drives the gear, the toothed ring and the rotating disc to rotate, the horizontal state of the two positioning holes is guaranteed through the vertical line, the weight block and the circular dial, and then the two holes are nailed out through the positioning holes on one side of the resected femur through the steel nail.
5. The two positioning rods penetrate into two holes in the thighbone after osteotomy and position the second thighbone osteotomy guide plate, and then the osteotomy knife penetrates into the horizontal osteotomy saw blade guide groove and the inclined osteotomy saw blade guide groove respectively to osteotomy the thighbone again.
6. Be equipped with the slipmat in one side of splint, can increase the frictional force of splint to the slide bar through the slipmat, prevent that the sliding block from sliding on the slide bar.
The bone cutting device is simple in structure and convenient to operate, the front and back positions and the deflection angle of the bone cutting module are obtained by rotating the worm and the kicking moving sliding block, then the rotating rod is rotated to drive the first femoral bone cutting guide plate to move, the thickness of a bone to be cut is determined, then the gear ring and the rotating disc are driven to rotate through the rotating shaft, the level of two positioning holes is guaranteed by means of the circular dial, the vertical line and the falling block, and deviation of the later bone cutting is prevented.
Description of the figures and
FIG. 1 is a front sectional view of a rotary block and a rotary box of an extra-femoral bone marrow positioning osteotome in a knee joint replacement according to the present invention;
FIG. 2 is a front cross-sectional view of a femoral extramedullary positioning osteotomy device in a knee replacement in accordance with the present invention;
FIG. 3 is a top view of a rotating block and rotating box of the extra-femoral bone marrow positioning osteotomy device in a knee replacement in accordance with the present invention;
FIG. 4 is a top cross-sectional view of a rotating box of the extra-femoral bone positioning osteotome in a knee replacement as set forth in the present invention;
FIG. 5 is a side cross-sectional view of a rotating block of an extra-femoral bone positioning osteotomy for a knee replacement in accordance with the present invention;
FIG. 6 is a top cross-sectional view of a sliding block of the extra-femoral bone marrow positioning osteotome in a knee replacement as set forth in the present invention;
FIG. 7 is a front view of a sliding block of the extra-femoral bone marrow positioning osteotome in a knee replacement in accordance with the present invention;
FIG. 8 is a rear view of the rotating box of the extra-femoral bone marrow positioning osteotome in the knee replacement proposed by the present invention;
FIG. 9 is a front cross-sectional view of a second fixation pin of the extra-femoral bone marrow positioning osteotome in a knee replacement in accordance with the present invention;
FIG. 10 is a side view of a second fixation pin of the extrafemoral positioning osteotomy device in a knee replacement as set forth in the present invention;
FIG. 11 is a side view of a second femoral osteotomy guide of the extrafemoral positioning osteotomy device in a knee replacement proposed by the present invention;
FIG. 12 is a front cross-sectional view of a second femoral osteotomy guide of the extrafemoral positioning osteotomy device in a knee replacement in accordance with the present invention;
FIG. 13 is a top view of a second femoral osteotomy guide of the extrafemoral positioning osteotomy device in a knee replacement proposed by the present invention;
FIG. 14 is a front sectional view of a rotary disk in the second embodiment;
fig. 15 is a side view of the rotary disk in the second embodiment.
In the figure: 1. a slide bar; 2. a first staple; 3. a virgin femur; 4. a slider; 5. a chute; 6. a first slider; 7. a second slider; 8. a first spring; 9. fixing the rod; 10. rotating the connecting rod; 11. a splint; 12. a rotating box; 13. a rotating shaft; 14. a worm gear; 15. a worm; 16. a circular groove; 17. a first slide bar; 18. a second spring; 19. rotating the sleeve; 20. clamping teeth; 21. rotating the block; 22. a first pointer; 23. an arc-shaped dial; 24. a rectangular groove; 25. rotating the rod; 26. a first bevel gear; 27. a rotating groove; 28. a screw; 29. a second bevel gear; 30. a nut; 31. a non-slip mat; 32. a first femoral osteotomy guide plate; 33. a bolt; 34. a second slide bar; 35. a flat baffle plate; 36. nailing holes; 37. a second pointer; 38. a osteotomy thickness dial; 39. a bone cutting saw blade guide groove; 40. resected femur; 41. a second staple; 42. rotating the disc; 43. a circular dial; 44. a vertical line; 45. a pendant block; 46. positioning holes; 47. a fixing plate; 48. a rotating shaft; 49. a gear; 50. a toothed ring; 51. a second femoral resection guide; 52. positioning a rod; 53. a horizontal osteotomy saw blade guide slot; 54. the guide groove of the bone cutting saw blade is inclined; 55. a rotating bearing; 56. and (4) anti-skid blocks.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments.
Example one
Referring to fig. 1-13, the external femoral bone positioning osteotome for knee joint replacement comprises a sliding rod 1, an osteotomed femur 40 and a second femoral bone cutting guide plate 51, wherein one end of the sliding rod 1 is fixedly connected with a first fixing nail 2, the outer wall of the first fixing nail 2 is fixedly connected with a primary femur 3, the outer wall of the sliding rod 1 is provided with a sliding block 4, the sliding block 4 is internally provided with a braking component for braking the sliding rod 1, the top of the sliding block 4 is fixedly connected with a rotating box 12, the top inner wall and the bottom inner wall of the rotating box 12 are rotatably connected with a same rotating shaft 13, the top end of the rotating shaft 13 penetrates through the rotating box 12 and is fixedly connected with a rotating block 21, the rotating box 12 is internally provided with a rotating component for driving the rotating block 21 to rotate, the top of the rotating box 12 is fixedly connected with an arc dial 23, one end of the rotating block 21 is fixedly connected with a first pointer 22, and, a plurality of second slide bars 34 are equidistantly arranged at one end of the rotating block 21, the outer wall of each of the second slide bars 34 is slidably connected with the same first femoral resection guide plate 32, a moving assembly for moving the first femoral resection guide plate 32 is arranged in the rotating block 21, two symmetrical straight baffle plates 35 are fixedly connected to the bottom of the rotating block 21, two symmetrical nail holes 36 are arranged in the first femoral resection guide plate 32, a femoral resection saw blade guide groove 39 is arranged in the first femoral resection guide plate 32, a second fixing nail 41 is arranged in the femur 40 after bone resection, a rotating disc 42 is rotatably connected to the outer wall of the second fixing nail 41, two symmetrical positioning holes 46 are arranged in the rotating disc 42, a horizontal assembly for adjusting the level of the two positioning holes 46 is arranged in the rotating disc 42, two symmetrical positioning rods 52 are fixedly connected to one side of the second femoral resection guide plate 51, and two symmetrical horizontal resection saw blades 53 and an inclined resection saw blade guide groove 54 are arranged in the second femoral resection guide plate 51.
According to the invention, the brake assembly comprises two symmetrical sliding grooves 5 arranged in a sliding block 4, two symmetrical second sliding blocks 7 are connected to the inner top and inner bottom walls of the two sliding grooves 5 in a sliding manner, the same first sliding block 6 is connected to the inner top and inner bottom walls of the two sliding grooves 5 in a sliding manner, two symmetrical fixing rods 9 are fixedly connected to the inner top and inner bottom walls of the two sliding grooves 5, first springs 8 are fixedly connected to the inner wall of one side of each of the two sliding grooves 5, the ends, far away from each other, of the two first springs 8 are fixedly connected to the first sliding block 6, the outer wall of each fixing rod 9 is rotatably connected to a rotating connecting rod 10, one end, far away from the second sliding block 7, of the rotating connecting rod 10 is rotatably connected to the first sliding block 6, one end, far away from the first sliding block 6, of the rotating connecting rod 10 is rotatably connected to the second sliding block 7.
According to the invention, the rotating assembly comprises a worm 15 which is rotatably connected to the inner walls of two sides of the rotating box 12, one end of the worm 15 extends to one side of the rotating box 12, a worm wheel 14 is fixedly sleeved on the outer wall of the rotating shaft 13, a circular groove 16 is arranged on one side of the rotating box 12, a first sliding rod 17 is slidably connected in the circular groove 16, a latch 20 is fixedly connected to one end, close to the rotating shaft 13, of the first sliding rod 17, the latch 20 is meshed with the worm wheel 14, a second spring 18 is sleeved on the outer wall of the first sliding rod 17, one end, close to the rotating shaft 13, of the second spring 18 is fixedly connected with the latch 20, one end, far away from the latch 20, of the second spring 18 is fixedly connected with the inner wall of the rotating box.
In the invention, the moving component comprises a rectangular groove 24 arranged in a rotating block 21, the top inner wall and the bottom inner wall of the rectangular groove 24 are rotatably connected with a same rotating rod 25, the top end of the rotating rod 25 extends to the upper part of the rotating block 21, the outer wall of the rotating rod 25 is fixedly sleeved with a first bevel gear 26, a rotating groove 27 is arranged in the rotating block 21, the inner walls at two sides of the rotating groove 27 are rotatably connected with a same screw 28, one end of the screw 28 extends into the rectangular groove 24 and is fixedly connected with a second bevel gear 29, the second bevel gear 29 is meshed with the first bevel gear 26, the outer wall of the screw 28 is in threaded connection with a nut 30, the bottom of the nut 30 is in sliding connection with the top of the rotating block 21, the top of the nut 30 is provided with a bolt 33, the bottom end of the bolt 33 penetrates through the nut 30 and extends into a first osteotomy guide plate 32, the bolt 33 is in threaded connection with, a second pointer 37 is fixedly connected to one side of the nut 30, and the top of the second pointer 37 is slidably connected with the top of the osteotomy thickness dial 38.
In the present invention, the horizontal assembly includes a circular scale 43 embedded in the rotating disc 42, a vertical line 44 is wound around the outer wall of the second fixing nail 41, a weight block 45 is fixedly connected to the bottom end of the vertical line 44, and the vertical line 44 and the rotating disc 42 are touched.
In the present invention, a rotating bearing 55 is fixedly embedded on one side of the rotating box 12, one end of the worm 15 penetrates through the inner ring of the rotating bearing 55 and is fixedly connected with the inner ring of the rotating bearing 55, and the frictional resistance of the rotating box 12 to the worm 15 can be reduced through the rotating bearing 55.
In the invention, one end of the worm 15 is fixedly connected with the anti-slip block 56, and the friction force between the palm and the worm 15 can be increased through the anti-slip block 56, so that the hand slip phenomenon is prevented during the operation.
In the invention, the non-slip pad 31 is fixedly connected to one side of the clamping plate 11 close to the sliding rod 1, and the friction force of the clamping plate 11 on the sliding rod 1 can be increased through the non-slip pad 31, so that the sliding block 4 is prevented from sliding on the sliding rod 1.
The use method of the femoral extramedullary positioning osteotomy device in knee joint replacement comprises the following steps:
s1, firstly, the first fixing nail 2 is driven into the medullary cavity of the original femur 3, the first sliding rod 17 and the rotating sleeve 19 are pulled outwards, the brake of the latch 20 on the worm wheel 14 is released, the second spring 18 starts to compress, the rotating sleeve 19 is rotated, the protruding part of the rotating sleeve 19 deviates from the circular groove 16, the rotating sleeve 19 can prevent the first sliding rod 17 and the latch 20 from retracting, the rotating anti-skid block 56 drives the worm 15 to rotate, the worm 15 is meshed with the worm wheel 14, the worm 15 drives the worm wheel 14, the rotating shaft 13 and the rotating block 21 to rotate, the rotating block 21 can be rotated by a certain angle through the first pointer 22 and the arc dial 23, the rotating sleeve 19 is rotated to align the rotating sleeve 19 with the circular groove 16, and the latch 20 brakes the worm wheel 14 again under the action of the second spring 18;
s2, pressing the two first sliders 6, compressing the first spring 8, and rotating the two rotating links 10 to drive the second slider 7 and the clamp plate 11 to move outward, and then pushing the slider 4, the rotating box 12, and the rotating block 21 to move toward the original femur 3, so that the flat baffle 35 contacts the original femur 3, releasing the extrusion force on the first slider 6, and clamping and fixing the sliding rod 1 by the second slider 7 under the action of the first spring 8;
s3, rotating the rotating rod 25, wherein the rotating rod 25 drives the first bevel gear 26, the second bevel gear 29 and the screw 28 to rotate, the nut 30 is in threaded connection with the screw 28, the nut 30 drives the first femoral resection guide plate 32 to move to the left along with the rotation of the screw 28, the thickness of a bone to be resected is determined through the second pointer 37 and the resection thickness dial 38, the first femoral resection guide plate 32 is fixed on the original femur 3 through the steel nail passing through the nail hole 36, then the bolt 33 is unscrewed, then the nut 30, the rotating block 21, the rotating box 12, the sliding rod 1 and the first fixing nail 2 are taken away, the osteotome penetrates into the resection saw blade guide groove 39, and the femur is relieved;
s4, nailing a second fixing nail 41 into a medullary cavity of the resected femur 40, enabling the rotating disc 42 to be tightly attached to one side of the resected femur 40, then rotating the rotating shaft 48, enabling the gear 49 to be meshed with the toothed ring 50, enabling the rotating shaft 48 to drive the gear 49, the toothed ring 50 and the rotating disc 42 to rotate, ensuring the horizontal state of the two positioning holes 46 through the vertical line 44, the weight block 45 and the circular scale 43, and then nailing two holes on one side of the resected femur 40 through the positioning holes 46 by using steel nails;
s5, the two positioning rods 52 are inserted into the two holes of the resected femur 40 and the second femur osteotomy guide plate 51 is positioned, and then the osteotomes are inserted into the horizontal osteotomy saw blade guide groove 53 and the inclined osteotomy saw blade guide groove 54, respectively, to resect the femur again.
Example two: as shown in fig. 14 to 15, this embodiment differs from the first embodiment in that the external femoral positioning osteotome in the knee replacement is: one end of the second fixing nail 41 is fixedly connected with a fixing plate 47, one side of the fixing plate 47 is rotatably connected with a rotating shaft 48, one end of the rotating shaft 48, which is close to the resected femur 40, penetrates through the fixing plate 47 and is fixedly connected with a gear 49, a toothed ring 50 is fixedly sleeved on the outer wall of the rotating disc 42, and the toothed ring 50 is meshed with the gear 49.
The working principle is as follows: firstly, a first fixing nail 2 is driven into a medullary cavity of an original femur 3, a first sliding rod 17 and a rotating sleeve 19 are pulled outwards to release the brake of a latch 20 on a worm wheel 14, a second spring 18 starts to compress, the rotating sleeve 19 is rotated to enable the protruding part of the rotating sleeve 19 to deviate from a circular groove 16, the rotating sleeve 19 can prevent the first sliding rod 17 and the latch 20 from retracting, a rotating anti-skid block 56 drives a worm 15 to rotate, the worm 15 is meshed with the worm wheel 14, the worm 15 drives the worm wheel 14, a rotating shaft 13 and a rotating block 21 to rotate, the rotating block 21 can rotate for a certain angle through a first pointer 22 and an arc dial 23, the rotating sleeve 19 is rotated to enable the rotating sleeve 19 to be aligned with the circular groove 16, the latch 20 brakes the worm wheel 14 again under the action of the second spring 18, secondly, two first sliding blocks 6 are pressed, a first spring 8 starts to compress, two rotating connecting rods 10 start to rotate, driving the second sliding block 7 and the clamping plate 11 to move outwards, then pushing the sliding block 4, the rotating box 12 and the rotating block 21 to move towards the original femur 3, making the straight baffle 35 touch the original femur 3, releasing the extrusion force on the first sliding block 6, under the action of the first spring 8, the second sliding block 7 clamps and fixes the sliding rod 1 again, and in the third step, rotating the rotating rod 25, the rotating rod 25 drives the first bevel gear 26, the second bevel gear 29 and the screw 28 to rotate, and the nut 30 and the screw 28 are in threaded connection, and as the screw 28 rotates, the nut 30 drives the first osteotomy guide plate 32 to move towards the left, the thickness to be osteotomy is determined by the second pointer 37 and the osteotomy thickness dial 38, the first osteotomy guide plate 32 is fixed on the original femur 3 by the steel nail passing through the nail hole 36, then the bolt 33 is unscrewed, and then the nut 30 and the rotating block 21 are taken away, Rotating the box 12, the sliding bar 1 and the first fixing nail 2, inserting a osteotome into the osteotomy saw blade guide slot 39 to remove the femur, fourth, driving the second fixing nail 41 into the medullary cavity of the osteotomy femur 40 to make the rotating disc 42 closely contact with one side of the osteotomy femur 40, then rotating the rotating shaft 48 with the gear 49 engaging with the toothed ring 50, the rotating shaft 48 driving the gear 49, the toothed ring 50 and the rotating disc 42 to rotate, ensuring the horizontal state of the two positioning holes 46 through the vertical line 44, the weight block 45 and the circular scale 43, then nailing two holes on one side of the osteotomy femur 40 through the positioning holes 46 with steel nails, fifth, inserting two positioning rods 52 into the two holes on the osteotomy femur 40 and positioning the second femur osteotomy guide plate 51, then inserting the osteotome into the horizontal osteotomy saw blade guide slot 53 and the inclined osteotomy saw blade guide slot 54, the femur was again osteotomized.
The above description is only for the preferred embodiment of the present invention, but the scope of the present invention is not limited thereto, and any person skilled in the art should be considered to be within the technical scope of the present invention, and the technical solutions and the inventive concepts thereof according to the present invention should be equivalent or changed within the scope of the present invention.
Claims (10)
1. The femoral extramedullary positioning osteotomy device in knee joint replacement comprises a sliding rod (1), a femur (40) after osteotomy and a second femur osteotomy guide plate (51), and is characterized in that one end of the sliding rod (1) is fixedly connected with a first fixing nail (2), the outer wall of the first fixing nail (2) is fixedly connected with an original femur (3), the outer wall of the sliding rod (1) is provided with a sliding block (4), a brake component for braking the sliding rod (1) is arranged in the sliding block (4), the top of the sliding block (4) is fixedly connected with a rotating box (12), the top inner wall and the bottom inner wall of the rotating box (12) are rotatably connected with a same rotating shaft (13), the top end of the rotating shaft (13) penetrates through the rotating box (12) and is fixedly connected with a rotating block (21), a rotating component for driving the rotating block (21) to rotate is arranged in the rotating box (12), the top fixedly connected with arc calibrated scale (23) of case (12) rotates, the first pointer (22) of one end fixedly connected with of turning block (21), the bottom and the arc calibrated scale (23) top sliding connection of first pointer (22), a plurality of second slide bars (34) have been arranged to the one end equidistance of turning block (21), and it is a plurality of the outer wall sliding connection of second slide bar (34) has same first share bone cutting baffle (32), be equipped with the removal subassembly that is used for first share bone cutting baffle (32) to remove in turning block (21), the bottom fixedly connected with of turning block (21) has two symmetrical straight baffle (35), be equipped with two symmetrical nail holes (36) in first share bone cutting baffle (32), be equipped with in first share bone cutting baffle (32) and cut bone saw bit (39), be equipped with second staple (41) in thighbone (40) after the osteotomy, the outer wall of the second fixing nail (41) is rotatably connected with a rotating disc (42), two symmetrical positioning holes (46) are formed in the rotating disc (42), a horizontal component used for adjusting the two positioning holes (46) to be horizontal is arranged in the rotating disc (42), two symmetrical positioning rods (52) are fixedly connected to one side of the second femur osteotomy guide plate (51), and two symmetrical horizontal osteotomy saw blade guide grooves (53) and an inclined osteotomy saw blade guide groove (54) are formed in the second femur osteotomy guide plate (51).
2. The extrafemoral bone marrow positioning osteotome for knee replacement according to claim 1, wherein said brake assembly comprises two symmetrical sliding grooves (5) disposed inside a sliding block (4), two symmetrical second sliding blocks (7) slidably connected to the top inner portion and the bottom inner wall of the two sliding grooves (5), the same first sliding block (6) slidably connected to the top inner portion and the bottom inner wall of the two sliding grooves (5), two symmetrical fixing rods (9) fixedly connected to the top inner portion and the bottom inner wall of the two sliding grooves (5), a first spring (8) fixedly connected to the inner wall of one side of the two sliding grooves (5), a rotating connecting rod (10) fixedly connected to the end of the two first springs (8) far away from each other and the first sliding block (6), the one end and the first slider (6) that rotate connecting rod (10) and keep away from second slider (7) rotate to be connected, rotate connecting rod (10) and keep away from the one end and the second slider (7) rotation connection of first slider (6), one end fixedly connected with splint (11) that second slider (7) are close to slide bar (1).
3. The femoral extramedullary positioning osteotome device in knee joint replacement according to claim 1, wherein the rotating component comprises a worm (15) rotatably connected to inner walls of two sides of the rotating box (12), one end of the worm (15) extends to one side of the rotating box (12), a worm wheel (14) is fixedly sleeved on the outer wall of the rotating shaft (13), a circular groove (16) is arranged on one side of the rotating box (12), a first sliding rod (17) is slidably connected in the circular groove (16), a latch (20) is fixedly connected to one end of the first sliding rod (17) close to the rotating shaft (13), the latch (20) is meshed with the worm wheel (14), a second spring (18) is sleeved on the outer wall of the first sliding rod (17), one end of the second spring (18) close to the rotating shaft (13) is fixedly connected with the latch (20), one end of the second spring (18) far away from the latch (20) is fixedly connected with the inner wall of the rotating box (12), the outer wall of the first sliding rod (17) is rotatably connected with a rotating sleeve (19).
4. The femoral extramedullary positioning osteotome device in knee joint replacement according to claim 3, wherein the moving component comprises a rectangular groove (24) arranged in the rotating block (21), the top inner wall and the bottom inner wall of the rectangular groove (24) are rotatably connected with the same rotating rod (25), the top end of the rotating rod (25) extends to the upper side of the rotating block (21), the outer wall of the rotating rod (25) is fixedly sleeved with a first bevel gear (26), a rotating groove (27) is arranged in the rotating block (21), the inner walls at two sides of the rotating groove (27) are rotatably connected with the same screw rod (28), one end of the screw rod (28) extends to the rectangular groove (24) and is fixedly connected with a second bevel gear (29), the second bevel gear (29) is engaged with the first bevel gear (26), and the outer wall of the screw rod (28) is in threaded connection with a nut (30), the bottom of nut (30) and the top sliding connection of turning block (21), the top of nut (30) is equipped with bolt (33), the bottom of bolt (33) runs through nut (30) and extends to in first bone cuts bone conduction board (32), bolt (33) and first bone cut bone conduction board (32) threaded connection, the top fixedly connected with of turning block (21) cuts bone thickness calibrated scale (38), one side fixedly connected with second pointer (37) of nut (30), the top of second pointer (37) and the top sliding connection of cutting bone thickness calibrated scale (38).
5. The external femoral head positioning osteotome in knee replacement according to claim 1, wherein said horizontal component comprises a circular dial (43) embedded in a rotating disc (42), the outer wall of said second fixing nail (41) is wound with a vertical line (44), the bottom end of said vertical line (44) is fixedly connected with a drop block (45), and said vertical line (44) and said rotating disc (42) are intended to touch.
6. The external femoral bone marrow positioning osteotome in knee joint replacement according to claim 3, wherein a rotary bearing (55) is fixedly embedded in one side of said rotary box (12), and one end of said worm (15) penetrates through an inner ring of said rotary bearing (55) and is fixedly connected with the inner ring of said rotary bearing (55).
7. The extrafemoral bone marrow positioning osteotomy device in knee replacement according to claim 3, characterized in that one end of said worm (15) is fixedly connected with an anti-skid block (56).
8. The external femur intramedullary positioning osteotomy device in knee joint replacement according to claim 2, characterized in that a non-slip pad (31) is fixedly connected to one side of the splint (11) near the sliding rod (1).
9. The external femur external positioning osteotome in knee joint replacement according to claim 1, wherein one end of the second fixing nail (41) is fixedly connected with a fixing plate (47), one side of the fixing plate (47) is rotatably connected with a rotating shaft (48), one end of the rotating shaft (48) close to the resected femur (40) penetrates through the fixing plate (47) and is fixedly connected with a gear (49), the outer wall of the rotating disc (42) is fixedly sleeved with a toothed ring (50), and the toothed ring (50) is meshed with the gear (49).
10. Use of an extrafemoral bone marrow positioning osteotomy device according to anyone of claims 1-9 for knee replacement characterized by: it comprises the following steps:
s1, firstly, a first fixing nail (2) is nailed into a medullary cavity of an original femur (3), a first sliding rod (17) and a rotating sleeve (19) are pulled outwards, the brake of a latch (20) on a worm wheel (14) is released, a second spring (18) starts to compress, the rotating sleeve (19) is rotated, the protruding part of the rotating sleeve (19) deviates from a circular groove (16), the rotating sleeve (19) can prevent the first sliding rod (17) and the latch (20) from retracting, a rotating anti-slip block (56) drives a worm (15) to rotate, the worm (15) is meshed with the worm wheel (14), the worm (15) drives the worm wheel (14), a rotating shaft (13) and a rotating block (21) to rotate, the rotating sleeve (19) is rotated by a certain angle of the rotating block (21) through a first pointer (22) and an arc dial (23), the rotating sleeve (19) is aligned with the circular groove (16), and under the action of the second spring (18), the latch (20) brakes the worm wheel (14) again;
s2, pressing the two first sliding blocks (6), compressing the first spring (8), rotating the two rotating connecting rods (10) to drive the second sliding block (7) and the clamping plate (11) to move outwards, pushing the sliding block (4), the rotating box (12) and the rotating block (21) to move towards the original femur (3), enabling the straight baffle (35) to be in contact with the original femur (3), releasing the extrusion force on the first sliding blocks (6), and clamping and fixing the sliding rod (1) by the second sliding block (7) under the action of the first spring (8);
s3, rotating the rotating rod (25), wherein the rotating rod (25) drives the first bevel gear (26), the second bevel gear (29) and the screw rod (28) to rotate, the nut (30) is in threaded connection with the screw rod (28), the nut (30) drives the first femoral osteotomy guide plate (32) to move towards the left side along with the rotation of the screw rod (28), the thickness needing osteotomy is determined through the second pointer (37) and the osteotomy thickness dial (38), the first femoral osteotomy guide plate (32) is fixed on the original femur (3) through the steel nail penetrating through the nail hole (36), then the bolt (33) is unscrewed, then the nut (30), the rotating block (21), the rotating box (12), the sliding rod (1) and the first fixing nail (2) are taken away, the osteotome penetrates into the osteotomy saw blade guide groove (39), and the femur is relieved;
s4, a second fixing nail (41) is nailed into a medullary cavity of the resected femur (40), so that the rotating disc (42) is tightly attached to one side of the resected femur (40), then the rotating shaft (48) is rotated, the gear (49) is meshed with the toothed ring (50), the rotating shaft (48) drives the gear (49), the toothed ring (50) and the rotating disc (42) to rotate, the horizontal state of the two positioning holes (46) is guaranteed through the vertical line (44), the drop block (45) and the circular dial (43), and then two holes are nailed on one side of the resected femur (40) through the positioning holes (46) by steel nails;
s5, two positioning rods (52) penetrate into two holes on the resected femur (40) and position a second femur osteotomy guide plate (51), then osteotomes respectively penetrate into the horizontal osteotomy saw blade guide groove (53) and the inclined osteotomy saw blade guide groove (54) to resect the femur again.
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