CN113081158A - Tibia tunnel locator for posterior cruciate ligament reconstruction operation - Google Patents
Tibia tunnel locator for posterior cruciate ligament reconstruction operation Download PDFInfo
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- CN113081158A CN113081158A CN202110338515.2A CN202110338515A CN113081158A CN 113081158 A CN113081158 A CN 113081158A CN 202110338515 A CN202110338515 A CN 202110338515A CN 113081158 A CN113081158 A CN 113081158A
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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
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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 discloses a tibia tunnel locator for posterior cruciate ligament reconstruction surgery in the technical field of medical appliances, which comprises a tibia locator and a locating guide pipe, wherein the tibia locator comprises a fixing section and a clamping section, two locating heads are arranged on the left end head of the clamping section at intervals, a locating hole is arranged at the interval position between the two locating heads, and the locating guide pipe and the tibia locator are both made of circular hollow pipes; the positioning guide pipe is fixed at the fixed section through the positioning sleeve, the positioning guide pipe is horizontally connected in the positioning sleeve in a penetrating manner, and the axis of the positioning guide pipe and the axis of the positioning hole are on the same horizontal line and in the same vertical plane; compared with the prior art, the tibial tunnel opening device has the advantages that the tibial tunnel opening device is more prepared for the posterior cruciate ligament reconstruction surgery, ligament penetration is quicker, surgery efficiency is higher, surgery is safer, the structure is simple, and use is convenient.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a tibial tunnel positioner for posterior cruciate ligament reconstruction surgery.
Background
Posterior cruciate ligament injury accounts for 3% -20% of knee ligament injury, and is often caused by anterior knee impact or fall in knee bending position. The single injury is less frequent, and other ligament injuries are easy to be complicated. The posterior cruciate ligament provides 95% of blocking force for positive posterior displacement of the tibia, limits inward and outward rotation, and relieves pressure between the patellofemoral joint and the medial tibiofemoral joint. Posterior cruciate ligament rupture will lead to patellofemoral arthritis and medial knee osteoarthritis without treatment. In order to restore the structure and the function of the knee joint, the posterior cruciate ligament needs to be actively reconstructed by arthroscopic surgery when the posterior cruciate ligament is broken and damaged.
The difficulty in reconstructing the posterior cruciate ligament under the arthroscope is that the lower dead center of the posterior cruciate ligament is deep and is positioned at the rear side of the proximal tibia and below the tibial plateau, and the visual field under the arthroscope is poor. In addition, when the posterior cruciate ligament is reconstructed, the distance between the inner opening of the tibial bone tract and the vascular nerve bundle at the popliteal fossa is short, the knee joint is in a straightening position, the average distance between the inner opening of the tibial bone tract and the vascular nerve bundle is about 6mm, and the possibility of damaging the vascular nerve bundle exists when the tibial bone tract is established in the operation. In order to solve the problem of preparation of a tibial bone tunnel in the current reconstruction of the posterior cruciate ligament, an intraoperative and posterior approach is established at present, tissues at the posterior mediastinum of the knee joint are cleaned, a lower dead point of the posterior cruciate ligament is exposed, and a guide needle and a drill bit are driven in under monitoring. Meanwhile, the knee joint is bent by 90 degrees in the operation, and research shows that the knee joint is bent by 90 degrees. The knee joint bends 90 degrees, the popliteal fossa vascular nerve bundle moves backwards, and the distance from the inner opening of the tibial bone canal can averagely exceed 24 mm. The time required to perform the operation is increased by establishing a posterior approach inside the knee joint during the operation, and the literature reports that these operations take about 20 minutes on average for the same operator. Although these procedures can further reduce the chance of vascular nerve damage during cruciate ligament surgery after arthroscopic reconstruction, vascular nerve damage remains a significant complication of such surgery in current literature reports. Once the vascular nerve injury occurs in the operation, the vascular nerve bundle needs to be cut and repaired in the operation, and the knee joint is fixed for a long time after the operation. The operation time is prolonged, the pain of the patient is increased, most importantly, the ultrasound is seriously influenced on the knee joint function of the patient after the operation, and the loss of the knee joint mobility is almost inevitable.
At present, after reconstruction, cruciate ligament surgery is mainly performed by manually finding points to establish a tunnel, arthroscopy observation is adopted, then a doctor estimates to drill holes by self experience, so that the drilling holes are likely to cause drill point deviation due to hand trembling of the doctor or other reasons, great instability exists, the success rate of the surgery is greatly reduced, the artificial ligament is difficult to pass through the tunnel, the artificial ligament needs to be slowly conveyed inwards from a tibial tunnel, the efficiency is very low, and the time consumption is long.
In summary, the applicant proposes a tibial tunnel locator for posterior cruciate ligament reconstruction surgery.
Disclosure of Invention
Aiming at the problems of inaccurate positioning and difficult ligament threading in the prior art, the tibial tunnel positioner for the posterior cruciate ligament reconstruction surgery is provided.
In order to achieve the technical purpose, the technical scheme adopted by the invention is as follows:
the utility model provides a shin bone tunnel locator is used in operation is rebuild to posterior cruciate ligament which characterized in that: the tibia positioning device comprises a tibia positioner and a positioning guide pipe, wherein the tibia positioner comprises a fixing section and a clamping section, the fixing section is horizontally arranged, the clamping section is U-shaped, at least two positioning heads are arranged on the left end head of the clamping section at intervals, a positioning hole is formed in the interval position between the two positioning heads, and the positioning guide pipe and the tibia positioner are both made of circular hollow pipes; the positioning guide pipe is fixed on the fixed section through the positioning sleeve, external threads are arranged on the outer surface of the positioning guide pipe, internal threads matched with the external threads on the positioning guide pipe are arranged in the positioning sleeve, the positioning guide pipe is horizontally connected in the positioning sleeve in a penetrating mode, and the axis of the positioning guide pipe and the axis of the positioning hole are on the same horizontal line and in the same vertical plane.
The positioning head and the positioning guide pipe are arranged on the same horizontal line and in the same vertical plane, the positioning guide pipe is connected in the positioning sleeve in a penetrating manner, when a tibia tunnel is drilled, the position of the tunnel to be drilled on the tibia and the position of the tunnel to penetrate are found firstly, then the positioning head is placed at the position of the tunnel to penetrate, the positioning hole is coincided with the position of the tunnel to penetrate, the positioning head is fixed on the tibia in a grabbing manner, the positioning guide pipe is aligned to the position of the tunnel to be drilled on the tibia to be tightly attached to the tibia, at the moment, a drill needle is drilled in the positioning guide pipe, so that the tunnel drilling of the tibia is very accurate, the operation effect is not good due to deviation, the effect is very good, the tibia positioner and the positioning guide pipe are arranged into hollow pipes, the lead can penetrate through the positioning guide pipe and the tibia positioner, the artificial ligament is tied on the tail of the lead, the artificial ligament can be directly pulled out through the tunnel through the lead, and then the tibia positioner and the positioning catheter are withdrawn, so that the efficiency of the operation is greatly improved.
Further limiting, the positioning head is in a conical shape; the positioning head is set to be conical and can be better fixed on the tibia by penetrating into the tibia bone, so that the positioning is more accurate.
Further limiting, an internal thread matched with the external thread on the positioning guide pipe is arranged in the positioning sleeve; the positioning guide pipe moves along the axial direction of the positioning guide pipe in the positioning sleeve through the threads, and the positioning guide pipe is very stable and not easy to be cheap.
The positioning sleeve is further limited to comprise a drill point, the drill point is movably sleeved in the positioning guide pipe, the axis of the drill point and the axis of the positioning hole are on the same horizontal line and in the same vertical plane, the inner diameter of the positioning sleeve is the same as the outer diameter of the positioning guide pipe, and the positioning sleeve and the positioning guide pipe are in clearance fit; the inside diameter of location pipe is the same with the outside diameter of drill point, and clearance fit, locating hole are the round hole, and the diameter of locating hole is less than the diameter of drill point, and the inside diameter of location pipe and the outside diameter of drill point are 2.5mm, clearance fit, and the diameter of locating hole is 2mm, sets up the diameter of drill point to 2.5mm, and the diameter of locating hole sets up to 2mm, sets up like this and can make the drill point can not continue to drill out after drilling out the back tunnel and injure other tissues, unusual safety.
Further limiting, the length of the positioning guide pipe is the length of the positioning sleeve from the positioning hole; the outer surface of the positioning guide pipe is provided with scales, and a zero scale point of the scales is arranged at the right end of the positioning guide pipe; the scale is arranged on the outer surface of the positioning guide pipe, so that the depth of the hole to be drilled can be conveniently checked and estimated, and the hole drilling is safer.
The clamping section is further limited, is split and comprises a left clamping section and a right clamping section, an installation support lug is fixedly arranged on the left clamping section, two installation seats are fixedly arranged on the right clamping section at intervals, the interval between the two installation seats is matched with the installation support lug, a through hole is formed in the installation support lug, an adjusting hole is formed in the installation seat corresponding to the position of the installation support lug, and the left clamping section and the right clamping section are fixed by penetrating a bolt through the adjusting hole and the through hole; we articulate left centre gripping section and right centre gripping section through the bolt like this can be to left centre gripping section with the relative angle of right centre gripping section adjusts, when we fix a position, we can unscrew the bolt, with left centre gripping section with the below opening of right centre gripping section is expanded, conveniently blocks into the shin bone, and the shin bone is blocked and is adjusted the relative angle of left centre gripping section and right centre gripping section into a straight line after again, then screw up the bolt can, set up like this and can make things convenient for us to use more.
Compared with the prior art, the tibial tunnel opening device has the advantages that the tibial tunnel opening device is more prepared for the posterior cruciate ligament reconstruction surgery, ligament penetration is quicker, surgery efficiency is higher, surgery is safer, the structure is simple, and use is convenient.
Drawings
FIG. 1 is a schematic view of the positioning state of the present invention;
FIG. 2 is a schematic diagram of the punching state of the present invention.
The designations in the figures correspond respectively to: 1-fixing section, 2-clamping section, 21-left clamping section, 22-right clamping section, 23-mounting support lug, 24-mounting seat, 3-positioning conduit, 4-positioning sleeve, 5-positioning head, 6-positioning hole, 7-drilling needle and 8-scale.
Detailed Description
In order that those skilled in the art can better understand the present invention, the following technical solutions are further described with reference to the accompanying drawings and examples.
Example (b):
as shown in fig. 1 and 2, a tibia tunnel locator for posterior cruciate ligament reconstruction surgery comprises a tibia locator and a locating guide tube 3, wherein the tibia locator comprises a fixing section 1 and a clamping section 2, the fixing section 1 is horizontally arranged, the clamping section 2 is U-shaped, two locating heads 5 are arranged at the left end of the clamping section 2 at intervals, the locating heads are conical, locating holes 6 are arranged at the interval position between the two locating heads 5, and the locating guide tube 3 and the tibia locator are both made of circular hollow tubes; the positioning device also comprises a positioning sleeve 4, the positioning sleeve 4 is fixed on the fixed section 1, the outer surface of the positioning conduit 3 is provided with an external thread, the positioning sleeve 4 is internally provided with an internal thread matched with the external thread on the positioning conduit 3, the positioning conduit 3 is fixed on the fixed section 1 through the positioning sleeve 4, the positioning conduit 3 is horizontally connected in the positioning sleeve 4 in a penetrating manner, and the axis of the positioning conduit 3 and the axis of the positioning hole 6 are on the same horizontal line and in the same vertical plane; the device also comprises a drill point 7, the diameter of the drill point 7 is 2.5mm, and the drill point 7 is arranged in the positioning conduit 3; the length of the positioning guide pipe 3 is the length of the positioning sleeve 4 from the positioning hole 6; the outer surface of the positioning catheter 3 is provided with a scale 8, and a zero scale point of the scale 8 is arranged at the right end of the positioning catheter 3; the inner diameter of the positioning guide pipe 3 is the same as the outer diameter of the drill point 7, the positioning guide pipe and the drill point are in clearance fit, the diameter of the positioning hole 6 is smaller than that of the drill point 7, the inner diameter of the positioning guide pipe 3 and the outer diameter of the drill point 7 are both 2.5mm, the positioning hole 6 is a round hole, and the diameter of the positioning hole 6 is 2 mm; the clamping section 2 is split and comprises a left clamping section 21 and a right clamping section 22, an installation support lug 23 is fixedly arranged on the left clamping section 21, two installation bases 24 are fixedly arranged on the right clamping section 22 at intervals, the interval between the two installation bases 24 is matched with the thickness of the installation support lug 23, a through hole is formed in the installation support lug 23, an adjusting hole is formed in the installation base 24 corresponding to the installation support lug 23, and the relative positions of the left clamping section 21 and the right clamping section 22 penetrate through the adjusting hole and the through hole through bolts to be connected and fixed; preferably, the tibia locator and the locating guide tube 3 are made of stainless steel, the locating sleeve 4 is also made of stainless steel, the locating sleeve 4 is fixed on the fixing section 1 of the tibia locator through welding, and the locating head 5 is also fixed with the left clamping section 21 through welding.
The axes of the positioning head 5 and the positioning guide pipe 3 are arranged on the same horizontal line and in the same vertical plane, the positioning guide pipe 3 is connected in the positioning sleeve 4 in a penetrating way, when the opening of the tibial tunnel is carried out, a position needing to be provided with the tunnel opening on the tibia and a position needing to be penetrated out of the tunnel can be found by a medical instrument, then the positioning head 5 is placed at the position penetrated out of the tunnel, so that the positioning hole 6 is coincided with the position penetrated out of the tunnel, the positioning head 5 is grabbed on the tibia to be fixed, then the positioning guide pipe 3 is aligned with the position of the tunnel opening on the tibia to be tightly attached to the tibia, at the moment, a drill needle 7 is drilled from the positioning guide pipe 3, so that the tunnel opening is very accurately established, the tibia cannot deviate, the operation effect is poor, the effect is very good, and the tibia positioner and the positioning guide pipe 3 are arranged into a hollow pipe, so that a lead can pass through the, the artificial ligament is bound on the tail part of the lead, the artificial ligament can be directly pulled out through the tunnel through the lead, and then the tibia positioner and the positioning catheter 3 are withdrawn, so that the operation efficiency is greatly improved; the positioning head 5 is arranged to be conical, and the positioning head 5 can be better fixed on the tibia by penetrating into the tibia bone, so that the positioning is more accurate; the positioning guide pipe 3 moves along the axial direction of the positioning guide pipe 3 in the positioning sleeve 4 through the threads, so that the positioning guide pipe is very stable and is not easy to deviate; the diameter of the drill point 7 is set to be 2.5mm, and the diameter of the positioning hole 6 is set to be 2mm, so that the drill point 7 can not drill any more to hurt other tissues after drilling the tunnel, and the tunnel drilling device is very safe; the left clamping section 21 and the right clamping section 22 are hinged through the bolts, so that the relative angle of the left clamping section 21 and the right clamping section 22 can be adjusted, when people position, the bolts can be unscrewed, openings below the left clamping section 21 and the right clamping section 22 are enlarged, a tibia can be clamped conveniently, the relative angle of the left clamping section 21 and the right clamping section 22 is adjusted to be a straight line after the tibia is clamped, and then the bolts are tightened, so that the arrangement is more convenient for people to use; therefore, the scales are arranged on the outer surface of the positioning guide pipe 3, so that the depth of the drilled hole can be conveniently checked and estimated, and the drilling is safer.
When in use, the positioning head 5 is arranged at the tunnel exit, namely the tibia attachment of the posterior cruciate ligament, the positioning head 5 is embedded into the tibia attachment of the posterior cruciate ligament for fixation, then the positioning guide tube 3 is aligned to the position where the tunnel drilling is needed, after the position is found, the drill needle 7 is used for drilling the hole in the positioning guide tube 3 on the anterior bone cortex of the tibia at the corresponding position until the drill needle 7 drills the bone at the position where the cruciate ligament tibia is attached to reach the positioning hole 6, then the drill needle 7 is taken out, a thinner steel wire is used as a lead wire, the artificial ligament is fixed to go up at the steel wire afterbody, inserts the lead wire by location pipe 3, through locating hole 6, wears out through clamping section 2 rethread fixed segment 1 earlier in the follow shin bone locator, draws out the lead wire until artificial ligament comes out and can remove shin bone locator and location pipe 3, rebuilds can artificial ligament.
Compared with the prior art, the tibial tunnel opening device has the advantages that the tibial tunnel opening device is more prepared for the posterior cruciate ligament reconstruction surgery, ligament penetration is quicker, surgery efficiency is higher, surgery is safer, the structure is simple, and use is convenient.
The tibial tunnel locator for posterior cruciate ligament reconstruction surgery provided by the invention is described in detail above. The description of the specific embodiments is only intended to facilitate an understanding of the method of the invention and its core ideas. It should be noted that, for those skilled in the art, it is possible to make various improvements and modifications to the present invention without departing from the principle of the present invention, and those improvements and modifications also fall within the scope of the claims of the present invention.
Claims (8)
1. The utility model provides a shin bone tunnel locator is used in operation is rebuild to posterior cruciate ligament which characterized in that: the tibia positioning device comprises a tibia positioner and a positioning guide pipe, wherein the tibia positioner comprises a fixing section and a clamping section, the fixing section is horizontally arranged, the clamping section is U-shaped, at least two positioning heads are arranged on the left end head of the clamping section at intervals, a positioning hole is formed in the interval position between the two positioning heads, and the positioning guide pipe and the tibia positioner are both made of circular hollow pipes;
the positioning device is characterized by further comprising a positioning sleeve, the positioning sleeve is fixed on the fixed section, the positioning guide pipe is fixed on the fixed section through the positioning sleeve, external threads are arranged on the outer surface of the positioning guide pipe, internal threads matched with the external threads on the positioning guide pipe are arranged in the positioning sleeve, the positioning guide pipe is horizontally connected in the positioning sleeve in a penetrating mode, and the axis of the positioning guide pipe and the axis of the positioning hole are on the same horizontal line and in the same vertical plane.
2. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 1, wherein: the positioning head is conical.
3. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 1, wherein: the positioning device is characterized by further comprising a drill point, wherein the drill point is movably sleeved in the positioning guide pipe, and the axis of the drill point and the axis of the positioning hole are on the same horizontal line and in the same vertical plane.
4. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 1, wherein: the length of the positioning guide pipe is the length of the positioning sleeve from the positioning hole.
5. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 3, wherein: the inner diameter of the positioning sleeve is the same as the outer diameter of the positioning conduit, and the positioning sleeve and the positioning conduit are in clearance fit; the inner diameter of the positioning guide pipe is the same as the outer diameter of the drill point, the positioning guide pipe and the drill point are in clearance fit, the positioning hole is a circular hole, and the diameter of the positioning hole is smaller than that of the drill point.
6. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 5, wherein: the inner diameter of the positioning guide pipe and the outer diameter of the drill point are both 2.5mm, the positioning guide pipe and the drill point are in clearance fit, and the diameter of the positioning hole is 2 mm.
7. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 1, wherein: the centre gripping section is split type, including left centre gripping section and right centre gripping section, the fixed installation journal stirrup that is equipped with in the left centre gripping section, fixed interval is equipped with two mount pads in the right centre gripping section, two mount pads between the interval with installation journal stirrup phase-match, the cross-under hole has been seted up on the installation journal stirrup, the regulation hole has been seted up to the position that corresponds the installation journal stirrup on the mount pad, left side centre gripping section with right centre gripping section passes through the bolt the regulation hole with the cross-under hole is fixed.
8. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery of claim 4, wherein: the outer surface of the positioning guide pipe is provided with scales, and a zero scale point of the scales is arranged at the right end of the positioning guide pipe.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110338515.2A CN113081158B (en) | 2021-03-30 | 2021-03-30 | Tibia tunnel positioner for posterior cruciate ligament reconstruction operation |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110338515.2A CN113081158B (en) | 2021-03-30 | 2021-03-30 | Tibia tunnel positioner for posterior cruciate ligament reconstruction operation |
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| CN113081158A true CN113081158A (en) | 2021-07-09 |
| CN113081158B CN113081158B (en) | 2022-07-19 |
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| US20020099269A1 (en) * | 1999-01-24 | 2002-07-25 | Martin Thomas E. | Surgical retractor and tissue stabilization device having an adjustable sled member |
| CN201426740Y (en) * | 2009-06-19 | 2010-03-24 | 南京医科大学附属南京第一医院 | Reconstruction positioner for posterior cruciate ligament of knee joint |
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| CN113081158B (en) | 2022-07-19 |
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