CN112971910A - Decoration assembly for tibial plateau osteotomy surface - Google Patents

Abstract

The invention relates to the technical field of medical instruments, in particular to a modifying component for a tibial plateau osteotomy surface. This decorate subassembly includes drill bit, location baffle and osteotomy ware, the profile and the shin bone platform osteotomy face phase-match of the osteotomy face limiting plate of location baffle, the medial surface of the bone side limiting plate of location baffle is laminated with one of them side of shin bone, realize the location of two at least ascending directions of shin bone through the location baffle, realize punching through the cooperation of drill bit with the location baffle, realize the cutting of slot hole through the cooperation of osteotomy ware with the location baffle, only need once install until the shin bone platform osteotomy face of location baffle is decorated and is accomplished at whole decoration in-process, it is more accurate to decorate the fixed messenger location of benchmark, and easy operation is convenient, enough supplementary accurate positioning and the installation that realizes the shin bone tray false body.

Description

Decoration assembly for tibial plateau osteotomy surface

Technical Field

The invention relates to the technical field of medical instruments, in particular to a modifying component for a tibial plateau osteotomy surface.

Background

The osteotomy of the knee joint replacement operation at the tibia side is generally divided into two main steps, namely, performing platform osteotomy to obtain an osteotomy surface for installing a tibial tray prosthesis, and performing osteotomy surface modification, wherein the osteotomy surface modification mainly comprises drilling and cutting off bone which interferes with the structure of the bottom of the tibial tray, so that the tibial tray prosthesis can be smoothly inserted into a tibial medullary cavity.

The bottom structure of the existing tibial tray prosthesis generally comprises a limiting column and two side wings, wherein the limiting column is generally cylindrical, and the side wings are positioned at two sides of the limiting column and used for enhancing the mechanical strength of the tibial tray and limiting the rotation of the prosthesis after the tibial tray prosthesis is placed in the prosthesis.

At present, in order to modify the osteotomy surface of a tibial plateau in an operation, a modular instrument is generally adopted and the personal experience of an operator is combined to complete the modification of the osteotomy surface, so that the operation is complex, the dependence on the personal experience of the operator is strong, when different operation environments or different recipient groups are faced, the positioning and mounting precision of a tibial tray prosthesis can generate great difference, and when the mounting precision cannot meet the requirement, the operation effect can be seriously influenced.

Disclosure of Invention

Technical problem to be solved

The invention aims to provide a modifying component of a tibial plateau osteotomy surface, which is convenient to operate, is used for modifying the tibial plateau osteotomy surface, assists in realizing accurate positioning and installation of a tibial tray prosthesis, and solves the problems that the operation is complex and the personal experience of an operating doctor is excessively dependent in the prior art.

(II) technical scheme

In order to achieve the above object, the present invention provides a modifying assembly for a tibial plateau osteotomy face, comprising a drill bit, further comprising:

the bone cutting surface limiting plate is provided with a protruding guide wall along the outlines of the guide hole and the long hole, the bone cutting surface limiting plate is also provided with a fixing hole for passing through a bone nail, one end of the bone side limiting plate is connected with the outer peripheral side of the bone cutting surface limiting plate, the other end of the bone side limiting plate extends towards the lower side of the bone cutting surface limiting plate, and the inner side face of the bone side limiting plate is attached to the inner side face of a tibial tubercle; and

the bone cutter comprises a guide column and two flank cutting plates, the two flank cutting plates are arranged on the periphery of the guide column, the angle between the two flank cutting plates is the same as that between the two long holes, and the distance between the root of the upper side of each flank cutting plate and the upper end of the guide column is the same as that between the upper side of the protruding guide wall and the lower side of the osteotomy surface limiting plate;

the guiding hole matches with drill bit and guide post, can supply drill bit and guide post along the axial displacement of guiding hole, and after the guide post inserted the guiding hole, two flank cutting plates can insert two slot holes respectively.

Preferably, the osteotomy surface limiting plate is further provided with a pointing part, and the pointing part indicates directions at least in two opposite directions.

Preferably, the cutting surfaces of the side cutting plates have cutting teeth thereon.

Preferably, the cutting surface of the flank cutting plate is an inclined surface, and the inclined surface is gradually far away from the guide column from bottom to top in the axial direction of the guide column.

Preferably, the upper end of the guide post is also provided with a standard connecting block.

Preferably, the guide hole and the inner side surface of the convex guide wall corresponding to the guide hole are provided with axial sliding grooves, and the peripheral side of the guide column is provided with a sliding block matched with the axial sliding grooves.

Preferably, a portion of the convex guide wall corresponding to the elongated hole is gradually reduced in height in the axial direction of the guide hole in a direction from the guide hole to a position away from the guide hole.

Preferably, the fixing holes are three, and the three fixing holes are distributed around the periphery of the guide hole.

Preferably, the upper side surface of the osteotomy surface limiting plate is provided with a nail placing guide cylinder which is coaxial with the fixing hole.

Preferably, the axis of the guide hole is not perpendicular to the osteotomy surface limiting plate, so that when the axis of the guide hole is perpendicular to the horizontal plane, an inclination angle is formed between the osteotomy surface limiting plate and the horizontal plane; or

The axis of the guide hole is perpendicular to the osteotomy surface limiting plate.

(III) advantageous effects

The technical scheme of the invention has the following advantages: the invention provides a modification assembly for a tibial plateau osteotomy surface, which comprises a punching drill, a positioning guide plate and a bone cutter, wherein the contour of a osteotomy surface limiting plate of the positioning guide plate is matched with the tibial plateau osteotomy surface, the inner side surface of a bone side surface limiting plate of the positioning guide plate is attached to one side surface of a tibia, positioning of the tibia in at least two directions is realized through the positioning guide plate, punching is realized through the matching of the punching drill and the positioning guide plate, cutting of a long hole is realized through the matching of the bone cutter and the positioning guide plate, the positioning guide plate is only required to be installed once until the tibial plateau osteotomy surface modification is completed in the whole modification process, the modification datum is fixed so that the positioning is more accurate, the operation is simple and convenient, and accurate positioning and installation of a tibial tray prosthesis can be realized in an auxiliary manner.

Drawings

The drawings of the present invention are provided for illustrative purposes only, and the proportion and the number of the components in the drawings do not necessarily correspond to those of an actual product.

FIG. 1 is a schematic view of a bone cutter in cooperation with a positioning guide in an embodiment of the present invention;

FIG. 2 is a schematic top view of a positioning guide according to an embodiment of the present invention;

FIG. 3 is a schematic sectional view A-A of FIG. 2;

FIG. 4 is a front view of the positioning guide of FIG. 2;

FIG. 5 is a schematic view of a bone cutter according to an embodiment of the present invention;

fig. 6 is a schematic sectional view of B-B in fig. 5.

In the figure: 1: positioning the guide plate; 11: a bone-cutting surface limiting plate; 111: a guide hole; 112: a long hole; 113: a fixing hole; 12: a bone lateral limiting plate; 13: a convex guide wall; 14: placing a nail guide cylinder; 15: a pointing portion; 16: an axial chute;

2: a bone cutter; 21: a guide post; 22: cutting a side wing; 23: a slider; 24: a standard connecting block; 25: a cavity; 26: and (7) discharging holes.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, 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 some, but not all, embodiments of the present invention. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.

The tibial plateau osteotomy surface modification assembly provided by the embodiment of the invention comprises a punching drill, a positioning guide plate 1 and a bone cutter 2, wherein in the tibial plateau osteotomy surface modification process, the positioning guide plate 1 mainly plays a role in positioning and guiding, and the punching drill and the bone cutter 2 are mainly matched with the positioning guide plate 1 to perform modification operation.

Referring to fig. 1-4, the positioning guide plate 1 includes a osteotomy surface limiting plate 11 and a bone side surface limiting plate 12, the profile of the osteotomy surface limiting plate 11 matches with the osteotomy surface of the tibial plateau, so that the lower side surface of the osteotomy surface limiting plate 11 can be attached to cover the osteotomy surface of the tibial plateau, a guide hole 111 and two long holes 112 penetrating through the osteotomy surface limiting plate 11 are further arranged on the osteotomy surface limiting plate 11, each of the two long holes 112 has one end communicated with the guide hole 111, and the two long holes 112 are arranged at an angle, the positioning guide plate 1 adopts a thin plate structure, and protruding guide walls 13 are arranged at the guide hole 111 and the two long holes 112 to increase the guiding length. Still be equipped with the fixed orifices 113 that is used for passing the bone nail on the osteotomy face limiting plate 11, the one end of bone side limiting plate 12 is connected with the periphery side of osteotomy face limiting plate 11, and the other end extends to the below of osteotomy face limiting plate 11, and the medial surface of bone side limiting plate 12 laminates with the medial surface of shin bone tubercle mutually, realizes fixing a position two at least ascending location of orientation baffle 11 and shin bone. In other embodiments, the medial surface of the bone side restriction plate may be configured to engage the anterior, left, or right side of the tibia, as desired.

Referring to fig. 5 and 6, the osteotome 2 includes a guide post 21 and two side wing cutting plates 22, the two side wing cutting plates 22 are disposed on the outer peripheral side of the guide post 21, and the angle between the two side wing cutting plates 22 is the same as the angle between the two long holes 112. The distance H between the root of the upper side of the lateral cutting plate 22 (where the upper end of the lateral cutting plate 22 is connected to the guide post 21) and the upper end of the guide post 21 is the same as the distance H between the upper side of the convex guide wall 13 and the lower side of the osteotomy face limiting plate 11 to ensure that the lateral cutting plate 22 is fully inserted into the tibial plateau and that the depth of insertion is just suitable. For example, if the force is applied by directly hitting the guide post 21, the upper end surface of the guide post 21 may be flush with the upper surface of the boss guide wall 13.

In this embodiment, the positioning guide plate 1 and the bone cutter 2 can be obtained by reverse design according to the tibial plateau osteotomy surface data of the person to be provided with the tibial tray prosthesis and the data of the tibial tray prosthesis to be provided, that is, the contour of the osteotomy surface limiting plate 11 is completely the same as the shape and size of the tibial plateau osteotomy surface of the person to be provided with the tibial tray prosthesis, and can completely cover the tibial plateau osteotomy surface. The inner side surface of the bone side surface limiting plate 12 and the inner side surface of the tibial tubercle of the person to be provided with the tibial tray prosthesis have the same changes in angle, curvature and the like. It should be noted that the contour of the bone lateral restriction plate 12 can be determined according to the range of the intact bone surface area of the patient, and does not interfere with the soft tissue. When fixing a position, on only needing to place tibial plateau osteotomy face with osteotomy face limiting plate 11, the profile phase-match of osteotomy face limiting plate 11 and tibial plateau osteotomy face to the downside and the tibial plateau of osteotomy face limiting plate 11 laminate mutually, the medial surface of bone side limiting plate 12 and the medial surface laminating of tibial tubercle can realize the location of location baffle 1, pass fixed orifices 113 through the bone nail and can realize the fixed of location baffle 1 and tibial plateau osteotomy face.

The diameter of the guide post 21 of the osteotomy device 2 is the same as that of the limit post of the tibial tray prosthesis, and the shape of the two flank cutting plates 22 and the position and the angle between the two flank cutting plates relative to the guide post 21 are the same as those of the two flanks of the tibial tray prosthesis relative to the limit post. Certainly, the tibial tray prosthesis can also be obtained through reverse design, so that the positioning, the installation and the installed prosthesis can be customized individually, and the success rate and the effect of the operation are improved. The shapes of the guide hole 111 and the guide column 21 are determined according to the shape of a limit column of the tibial tray prosthesis, the size of the punching drill is matched with that of the guide hole 111 to process the required guide hole 111, the size of the long hole 112 is matched according to a side wing of the tibial tray prosthesis, and the specific size and shape are not limited in the embodiment.

During the use, after installing location baffle 1 location at tibial plateau section bone face, the drill bit that punches passes guiding hole 111 and punches on tibial plateau section bone face under the spacing of guiding hole 111, the hole of punching is the mounting hole of the spacing post of tibial tray prosthesis, later take out the drill bit, then see as shown in figure 1, insert guiding hole 111 with guide post 21 of osteotomy ware 2, two flank cutting plates 22 can insert two slot holes 112 respectively this moment, the guiding post 21 can insert the mounting hole, two flank cutting plates 22 cut out two slot holes on tibial plateau section bone face, accomplish the decoration to tibial plateau section bone face, take out the bone nail and remove location baffle 1 and can carry out the installation of tibial tray prosthesis. The modifying component for the tibial plateau osteotomy surface has the advantages of simple structure, accurate positioning and convenient operation, and can assist in realizing the accurate positioning and installation of the tibial tray prosthesis.

In order to facilitate the positioning and installation of the positioning guide 1, referring to fig. 2 and 4, in some preferred embodiments, a pointing portion 15 is provided on the osteotomy surface limiting plate 11, the pointing portion 15 indicates directions in at least two opposite directions, such as indicating a front side and a rear side simultaneously, or indicating a left side and a right side simultaneously, preferably, the pointing portion 15 indicates that the front side is the front side and the rear side simultaneously, the pointing portion 15 can be used to determine a general direction during the installation of the positioning guide 1, and then fine adjustment can be performed according to the shape of the positioning guide, so that precise positioning and installation can be achieved.

The pointing portion 15 may be a pointing plate distributed on both sides of the guide hole 111, or may be a line indicating on both sides of the guide hole 111 in a split manner, or may be other indicating marks, such as pointing by letters, which is not limited herein. Preferably, a directional plate structure is used to facilitate a clear and quick orientation during surgery. More preferably, the two directing plates are arranged coplanar.

Preferably, the guide posts 21 are clearance fit with the guide holes 111. More preferably, the gap is 0.1-0.5 mm.

In order to facilitate the rotation or shaking of the guide post 21 during the guiding process and to assist the positioning of the guide post 21 relative to the guide hole 111, referring to fig. 2 and 3, an axial sliding slot 16 is provided on the inner side surface of the protruding guide wall 13 corresponding to the guide hole 111 and the guide hole 111, and a slider 23 matching with the axial sliding slot 16 is provided on the outer peripheral side of the guide post 21. Referring to fig. 5 and 6, the outer periphery of the guide post 21 is provided with a slider 23 that matches the axial slide groove 16.

Referring to fig. 5 and 6, in some preferred embodiments, the cutting surfaces of the flanking cutting plates 22 have cutting teeth thereon. Of course, in other embodiments, the cutting surface may also have a cutting edge structure.

In order to facilitate better cutting, the cutting surface (a side surface far away from the guide post 21) of the side wing cutting plate 22 is an inclined surface, and the inclined surface is gradually far away from the guide post 21 from bottom to top in the axial direction of the guide post 21, so that the side wing cutting plate 22 is integrally triangular or approximately triangular, and when cutting is performed, cutting is started from a tip first and gradually expanded, and the cutting is relatively labor-saving.

In order to further save material costs, referring to fig. 1, in some preferred embodiments, the portion of the convex guide wall 13 corresponding to the long hole 112 is gradually reduced in height in the axial direction of the guide hole 111 in the direction from the guide hole 111 to the direction away from the guide hole 111.

In a preferred embodiment, there are three fixing holes 113, and the three fixing holes 113 are distributed around the circumference of the guide hole 111. Preferably, the fixing hole 111 is provided in a dotted area as shown in fig. 2. Of course, in other embodiments, two, four, etc. fixing holes 113 may be adopted, and only the fixing of the positioning guide plate 1 needs to be achieved, which is not limited herein. Preferably, a nail guide 14 coaxial with the fixing hole 113 is provided on the upper side surface of the osteotomy surface limiting plate 11.

In one embodiment, referring to fig. 3, the axis of the guiding hole 111 is not perpendicular to the osteotomy surface limiting plate 11, so that when the axis of the guiding hole 111 is perpendicular to the horizontal plane, the osteotomy surface limiting plate and the horizontal plane 11 have an inclination angle α (corresponding to the posterior inclination angle of the tibial tray prosthesis) to be suitable for the operation in which the osteotomy surface of the tibial plateau is inclined. In another embodiment, the axis of the guiding hole 111 is perpendicular to the plane of the osteotomy limiting plate 11 for the operation with the plane of the tibial plateau osteotomy.

In one embodiment, the guide post 21 is provided at its upper end with a standard connector block 24 for connecting other standardized basic instruments, for example, for connecting a handle for facilitating the application of force, extraction, etc. In this embodiment, defining the depth of insertion of the guide post 21 may be accomplished using other standardized basic instruments. For example, other standardized base instruments such as handles have an outer diameter that is larger than the inner diameter of the corresponding raised guide wall 13 of the guide hole, thereby limiting the axial insertion depth of the guide post 21. At this time, according to the concept of the present invention, it will be understood by those skilled in the art that the distance H between the root of the upper side of the lateral cutting plate 22 (where the upper end of the lateral cutting plate 22 is connected to the guide post 21) and the lower end of other standardized basic instruments such as a handle (where the lateral cutting plate is blocked) is equal to the distance H between the upper side of the convex guide wall 13 and the lower side of the osteotomy surface limiting plate 11, so as to ensure that the lateral cutting plate 22 is fully inserted into the tibial plateau and that the insertion depth is just suitable.

In one embodiment, the positioning guide 1 and the osteotome 2 are machined using 3D printing techniques. Preferably, the guide post 21 has a cavity 25 to save materials and processing time, and a discharging hole 26 communicating with the cavity 25 is provided on the guide post 21 to discharge printing residue (waste). Preferably, the wall thickness of the guide post 21 is 0.5-3mm, and the diameter of the discharge hole 26 is 0.3-4 mm.

Of course, in other embodiments, the processing may also be performed in a conventional machining manner, which is not limited herein.

In one embodiment, the osteotomy limiting plate 11 has a thickness of 1-3mm, the lateral bone limiting plate 12 has a thickness of 0.5-2mm, and the raised guide wall 13 has a wall thickness of 1.2-3mm and a height of 5-15 mm. The width of the axial sliding groove 16 is 0.3-2mm, and the depth is 0.2-1 mm.

It should be noted that the slot 112 is a slot structure with a long cross section.

It should be further understood that the references to upper, lower, etc. in the present invention to upper and lower indicated orientations or positional relationships are based on the orientations or positional relationships illustrated in the drawings, and are intended to facilitate the description of the present invention and to simplify the description, but do not indicate or imply that the device or component so referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus should not be considered as limiting the present invention.

It should be noted that the drill bit may be a drill bit in the prior art, and therefore, the detailed description is omitted in this application.

It should be further explained that the reverse design and the 3D printing technology involved in this embodiment are both mature technologies, and are not described herein again.

Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: each embodiment does not include only one independent technical solution, and in the case of no conflict between the solutions, the technical features mentioned in the respective embodiments can be combined in any way to form other embodiments which can be understood by those skilled in the art.

Furthermore, modifications may be made to the technical solutions described in the foregoing embodiments, or equivalents may be substituted for some of the technical features thereof, without departing from the scope of the present invention, and the essence of the corresponding technical solutions does not depart from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims (10)

1. A subassembly is decorated to tibial plateau osteotomy face, includes the drill bit, its characterized in that still includes:

the positioning guide plate comprises a bone-cutting surface limiting plate and a bone-side surface limiting plate, the contour of the bone-cutting surface limiting plate is matched with the bone-cutting surface of the tibial plateau, the lower side surface of the osteotomy surface limiting plate is jointed and covers the tibial plateau osteotomy surface, the osteotomy surface limiting plate is also provided with a guide hole and two long holes which penetrate through the osteotomy surface limiting plate, one end of each of the two long holes is communicated with the guide hole, and the two long holes are arranged in an angle, a convex guide wall is arranged on the upper side surface of the osteotomy surface limiting plate along the contour of the guide hole and the long hole, the osteotomy surface limiting plate is also provided with a fixing hole for a bone nail to pass through, one end of the bone lateral surface limiting plate is connected with the outer peripheral side of the osteotomy surface limiting plate, the other end of the bone lateral surface limiting plate extends towards the lower part of the osteotomy surface limiting plate, and the inner lateral surface of the bone lateral surface limiting plate is attached to the inner lateral surface of the tibial tubercle; and

the bone cutter comprises a guide column and two flank cutting plates, the two flank cutting plates are arranged on the periphery side of the guide column, the angle between the two flank cutting plates is the same as the angle between the two long holes, and the distance between the root of the upper side of each flank cutting plate and the upper end of the guide column is the same as the distance between the upper side of the convex guide wall and the lower side of the osteotomy surface limiting plate;

the guiding hole with the drill bit with the guide post phase-match can supply the drill bit with the guide post is followed the axial displacement of guiding hole, the guide post inserts behind the guiding hole, two flank cutting plates can insert two respectively the slot hole.

2. The tibial plateau resection surface modification assembly of claim 1, wherein: the osteotomy surface limiting plate is further provided with a pointing part, and the pointing part at least indicates directions in two opposite directions.

3. The tibial plateau resection surface modification assembly of claim 1, wherein: the cutting surfaces of the side wing cutting plates are provided with cutting teeth.

4. The tibial plateau resection surface modification assembly of claim 1 or 3, wherein: the cutting surface of the flank cutting plate is an inclined surface, and the inclined surface is gradually away from the guide post from bottom to top in the axial direction of the guide post.

5. The tibial plateau resection surface modification assembly of claim 1, wherein: and the upper end of the guide post is also provided with a standard connecting block.

6. The tibial plateau resection surface modification assembly of claim 1, wherein: the inner side surfaces of the guide hole and the convex guide wall corresponding to the guide hole are provided with axial sliding grooves, and the peripheral side of the guide column is provided with a sliding block matched with the axial sliding grooves.

7. The tibial plateau resection surface modification assembly of claim 1, wherein: the height of the portion of the convex guide wall corresponding to the long hole in the axial direction of the guide hole is gradually reduced in the direction from the guide hole to the direction away from the guide hole.

8. The tibial plateau resection surface modification assembly of claim 1, wherein: the number of the fixing holes is three, and the three fixing holes are distributed around the periphery of the guide hole.

9. The tibial plateau resection surface modification assembly of claim 8, wherein: and the upper side surface of the osteotomy surface limiting plate is provided with a nail placing guide cylinder which is coaxial with the fixing hole.

10. The tibial plateau resection surface modification assembly of claim 1, wherein: the axis of the guide hole is not perpendicular to the osteotomy surface limiting plate, so that when the axis of the guide hole is perpendicular to the horizontal plane, an inclined angle is formed between the osteotomy surface limiting plate and the horizontal plane; or

The axis of the guide hole is perpendicular to the osteotomy surface limiting plate.

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