CN113384339A - Acetabulum posterior column screw guider - Google Patents
Acetabulum posterior column screw guider Download PDFInfo
- Publication number
- CN113384339A CN113384339A CN202110591985.XA CN202110591985A CN113384339A CN 113384339 A CN113384339 A CN 113384339A CN 202110591985 A CN202110591985 A CN 202110591985A CN 113384339 A CN113384339 A CN 113384339A
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- CN
- China
- Prior art keywords
- support
- guide sleeve
- supporting arm
- arm
- support arm
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
Abstract
The invention discloses an acetabulum posterior column screw guider, which comprises a support, wherein a front support arm and a rear support arm are arranged on the support, a front guide sleeve and a rear guide sleeve are respectively arranged on the front support arm and the rear support arm, the front guide sleeve and the rear guide sleeve are coaxial, the front guide sleeve and/or the rear guide sleeve can move to adjust the distance between the front guide sleeve and the rear guide sleeve, a plurality of positioning holes for placing kirschner wires are arranged on the support and/or the support arms and/or the front guide sleeve and/or the rear guide sleeve, and the kirschner wires are used for fixing the support and/or the support arms and/or the front guide sleeve and/or the rear guide sleeve. The invention has the beneficial effects that: the operation is easy, the positioning is accurate, the guide pin can be subjected to perspective before being placed, and effective adjustment is carried out according to the perspective result, so that the accuracy of placing the guide pin is ensured; the screw enters from the ilium along the guide pin, the tail part of the screw is not exposed at the ischia, and the discomfort at the ischia tuberosity and the bursitis of the ischia tuberosity are not easy to cause.
Description
Technical Field
The invention belongs to the field of medical instruments, and particularly relates to an acetabulum posterior column screw guider.
Background
With the development of transportation industry and construction industry, the high-energy injury caused by the transportation industry and the construction industry is more and more, and the incidence rate of pelvis and acetabulum fracture is higher and higher. The acetabulum fracture has the characteristics of extremely irregular anatomical form, deep position, complex surrounding tissue anatomy, great preoperative treatment, great operation difficulty, long time, large amount of bleeding, large wound and the like. The surgical element for acetabular fracture is called crown surgery in orthopedic trauma surgery. The proportion of posterior column fractures involved in acetabular fractures is about 50%. At present, in the complex acetabular fracture with the posterior column, the treatment method of the posterior column fracture mainly comprises posterior K-L approach steel plate internal fixation and posterior column screw fixation. The K-L access has long incision, large wound and high cost, and the postoperative complications comprise ectopic ossification, femoral head necrosis, sciatic nerve injury and the like. And the rear column screw fixation has the advantages of small wound, low cost, firm fixation and the like, and is more and more favored by orthopedic doctors. But has the defects of great operation difficulty and high technical requirement, and the rapid and accurate nail placement is difficult, and the defects limit the application of the nail placement machine. The design of a rear column screw guide template is used for quickly placing the screw in the operation, but the accuracy is still difficult to control, the accuracy rate is about 70-80%, the accuracy of the guide pin after the guide pin is placed cannot be ensured before the guide pin is placed, the guide pin needs to be subjected to perspective evaluation after the guide pin is placed, if the guide template needs to be adjusted, the guide template is difficult to continue to be used for effective adjustment, and the situation that the bone mass of a needle entering channel is reduced due to multiple times of needle entering is met.
Disclosure of Invention
In view of the above technical problems, an object of the present invention is to provide an acetabular posterior column screw guide, which is easy to operate during surgery, and can perform fluoroscopy before the guide pin is inserted, and perform effective adjustment according to the fluoroscopy result, thereby ensuring the accuracy of inserting the guide pin.
In order to achieve the purpose, the invention provides the following technical scheme:
the utility model provides a post screw director behind acetabular bone which includes a support, its characterized in that: be provided with preceding supporting arm and back supporting arm on the support, preceding guiding sleeve and a back guiding sleeve set up respectively on preceding supporting arm and the back supporting arm, preceding guiding sleeve is coaxial with back guiding sleeve, preceding guiding sleeve and/or back guiding sleeve are portable in order to adjust preceding guiding sleeve and back spacing between the guiding sleeve, be provided with the locating hole that a plurality of is used for placing the kirschner wire on support and/or support arm and/or preceding guiding sleeve and/or the back guiding sleeve, the kirschner wire is used for fixing support and/or support arm and/or preceding guiding sleeve and/or back guiding sleeve.
Preferably, the support is a rod-shaped structure, and the front support arm and/or the rear support arm are movably arranged on the support along the support.
Preferably, still include a slider, transversely set up a first horizontal slide that runs through and vertically set up a vertical slide that runs through on the slider, preceding support arm activity sets up in the first horizontal slide, the support activity sets up in the vertical slide.
Preferably, one end of the rear supporting arm is provided with the rear guide sleeve, and the other end of the rear supporting arm is provided with a limiting rod parallel to the support; one end of the front support arm is provided with the front guide sleeve, and the other end of the front support arm is provided with a limiting ring sleeved in the limiting rod.
Preferably, still be provided with two screw holes on the slider, threaded hole difference threaded connection has and is used for fixing the first fastening screw of preceding supporting arm with fixed the second fastening screw of support, transversely set up a second cross slide that runs through on the support, back supporting arm activity sets up in the second cross slide, still set up a screw hole on the support, screw hole female connection has and is used for fixing the third fastening screw of back supporting arm.
Preferably, transversely set up a second cross slide that runs through on the support, back supporting arm activity sets up in the second cross slide, still set up a screw hole on the support, screw hole female connection has and is used for fixing the third fastening screw of back supporting arm.
Preferably, scales are arranged on the front supporting arm and the rear supporting arm.
Preferably, a first nut is rotatably arranged on the sliding block coaxially with the first transverse sliding channel, an external thread is arranged on the front support arm, and the front support arm is in threaded connection with the first nut; a second nut is coaxially arranged on the sliding block and the longitudinal slide way in a rotatable mode, an external thread is arranged on the support, and the support is in threaded connection with the second nut.
Preferably, the length of the front guide sleeve is greater than or equal to 120 mm.
Preferably, the front support arm is non-rotatably disposed in the first cross slide; the rear supporting arm is non-rotatably arranged in the second transverse slideway.
The invention has the beneficial effects that: the operation is easy, the positioning is accurate, the guide pin can be subjected to perspective before being placed, and effective adjustment is carried out according to the perspective result, so that the accuracy of placing the guide pin is ensured; the screw enters from the ilium along the guide pin, and the tail part of the screw is not exposed at the ischial tuberosity, so that discomfort and bursitis of the ischial tuberosity are not easy to cause.
Drawings
FIG. 1 is a schematic diagram of the principle of use of a first embodiment of the present invention
FIG. 2 is a schematic perspective view of a first embodiment of the present invention;
FIG. 3 is a schematic perspective view of a second embodiment of the present invention;
fig. 4 is an exploded view of the slider and the front support arm.
Detailed Description
The technical solution of the present patent will be described in further detail with reference to the following embodiments.
As shown in fig. 1 to 4, the acetabular posterior column screw guide of the invention comprises a support 10, a front support arm 12 and a rear support arm 14 are arranged on the support 10, a front guide sleeve 16 and a rear guide sleeve 18 are respectively arranged on the front support arm 12 and the rear support arm 14, and the front guide sleeve 16 and the rear guide sleeve 18 are coaxial. When in use, a doctor touches the ischia artificially, pushes the rear guide sleeve 18 against the obvious ischial process, and fixes the position through the kirschner wire 20; the front guide sleeve 16 is selected to be the standard nail insertion point (1 cm in front of the sacroiliac joint on the arcuate margin, 2.5cm lateral), which can be positioned accurately under direct view during surgery, with the oblique k-wire 20 securing the position. The front guide sleeve 16 and the rear guide sleeve 18 cooperate to ensure co-axial alignment to provide for later needle insertion. The support 10 is then fixed by the kirschner wire 20, so that the acetabulum posterior column screw guide is fixed on the whole pelvis 21 for X-ray transmission to see whether the position is proper or not, after the position is determined to be proper, the kirschner wire 20 is placed in the front guide sleeve 16 and a rear guide sleeve 18, and finally, the screw is placed along the kirschner wire 20, and the operation is completed. In this manner, the k-wire 20 is threaded through the bone and the screws are placed from the pelvis to the ischial direction, which is designated as antegrade. Compared with the forward arranged nails, the nail heads of the backward arranged nails protrude out of the ischia, so that the normal sitting posture of a patient is affected, ischial tuberosity bursitis is easy to form, and discomfort is caused; and for the common retrograde nail placing mode, one end of the Kirschner wire 20 enters and the other end does not expose, so that the position of the screw is not accurate when the nail is placed. The invention adopts the forward screw arrangement, the positioning is accurate, the screw head without screws can not influence the sitting posture, and the rehabilitation effect is good.
Further, either the front guide sleeve 16 or the rear guide sleeve 18 may be movable to adjust the spacing between the front guide sleeve 16 and the rear guide sleeve 18, although both the front guide sleeve 16 and the rear guide sleeve 18 may be movable. The distance between the front guide sleeve 16 and the rear guide sleeve 18 is adjusted according to the size and the fat-thin of the patient, so as to meet different requirements. The front guide sleeve 16 and the rear guide sleeve 18 need to be able to be moved or moved while being aligned with each other to ensure needle insertion.
Further, the support 10 and/or the support arm and/or the front guide sleeve 16 and/or the rear guide sleeve 18 are provided with a plurality of positioning holes (not shown) for placing the k-wire 20, and the k-wire 20 is used for fixing the support 10 and/or the support arm and/or the front guide sleeve 16 and/or the rear guide sleeve 18. In the embodiment of the present invention, the front and rear guide sleeves 16 and 18 are provided with protruding projections (not shown) on the side walls thereof, positioning holes are provided on the projections, and then the front and rear guide sleeves 16 and 18 are fixed to the pelvis by inserting the kirschner wire 20 after the positions of the front and rear guide sleeves 16 and 18 are determined, and there may be a separate kirschner wire 20 for fixing the bracket 10.
Further, the stand 10 is a rod-shaped structure, and the front support arm 12 and/or the rear support arm 14 are movably disposed on the stand 10 along the stand 10. Of course, one skilled in the art may also use, for example, an articulated anterior support arm 12 and/or posterior support arm 14, such that the brace 10 may use a single anchor block for pivotally connecting the anterior support arm 12 and the posterior support arm 14. The above-described modified structure, although the present invention is not described in detail, should also be considered as an embodiment of the present invention.
Further, the device also comprises a slide block 22, a first transverse slide way 24 which penetrates through the slide block 22 is transversely arranged on the slide block, and a longitudinal slide way (not shown) which penetrates through the slide block is longitudinally arranged on the slide block, the front support arm 12 is movably arranged in the first transverse slide way 24, and the support 10 is movably arranged in the longitudinal slide way. A second cross slideway (not shown) is transversely arranged on the bracket 10, and the rear supporting arm 14 is movably arranged in the second cross slideway.
The slide block 22 is further provided with two threaded holes (not shown), the threaded holes are respectively in threaded connection with a first fastening screw 28 for fixing the front support arm 12 and a second fastening screw 30 for fixing the support 10, the support 10 is provided with a fixed block 31, a second cross slideway (not shown) which penetrates through the fixed block 31 is transversely arranged, the rear support arm 14 is movably arranged in the second cross slideway, the support 10 is further provided with a threaded hole, and the threaded hole is internally threaded connected with a third fastening screw 32 for fixing the rear support arm 14. The structure of the slideway enables the front support arm 12, the rear support arm 14 and the bracket 10 to be adjusted in position and fixed by fastening screws.
In the first embodiment, the front support arm 12 and the rear support arm 14 are provided with scales, and the scales can ensure that the protruding lengths of the front support arm 12 and the rear support arm 14 on the support 10 are consistent, so as to ensure that the front guide sleeve 16 and the rear guide sleeve 18 are on the same axis.
In the second embodiment, the rear support arm 14 is provided with a rear guide sleeve 18 at one end and a limiting rod 34 parallel to the support 10 at the other end; the front support arm 12 is provided with a front guide sleeve 16 at one end and a stop collar 36 at the other end, which is received in the stop rod 34. This arrangement allows the front and rear support arms 12, 14 to move synchronously as they move back and forth, thereby ensuring that the front and rear guide sleeves 16, 18 are on the same axis.
Further, a first nut 38 is coaxially and rotatably arranged on the slide block 22 and the first cross slideway 24, an external thread is arranged on the front support arm 12, and the front support arm 12 is in threaded connection with the first nut 38; a second nut 40 is arranged on the sliding block 22 coaxially with the longitudinal slideway in a rotatable manner, an external thread is arranged on the bracket 10, and the bracket 10 is in threaded connection with the second nut 40. With this construction, the positions of the front support arm 12 and the stand 10 can be adjusted by rotating the nut.
Further, the front support arm 12 is non-rotatably disposed in the first cross slide 24; the rear support arm 14 is non-rotatably disposed within the second cross runner. This is to avoid that the front guide sleeve 16 or the rear guide sleeve 18 rotates, resulting in the front guide sleeve 16 and the rear guide sleeve 18 not being on the same axis. The concrete structure is that the front guide sleeve 16 and the rear guide sleeve 18 both adopt screw rod structures, one or more planes are cut along the axis, and holes which are consistent with the shapes of the front guide sleeve 16 and the rear guide sleeve 18 are arranged in the sliding block 22 for limiting, so that the screw cap rotates on the screw rod, and the screw rod keeps not rotating and only moves back and forth.
The length of the front guide sleeve 16 is more than or equal to 120mm, and the data is determined according to the human body structure, so that the surgical incision can be conveniently deeply inserted and positioned on the pelvis; the length of the front guide sleeve 16 is sufficient to also ensure that the k-wire does not change course.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein. Any reference sign in a claim should not be construed as limiting the claim concerned.
Furthermore, it should be understood that although the present description refers to embodiments, not every embodiment may contain only a single embodiment, and such description is for clarity only, and those skilled in the art should integrate the description, and the embodiments may be combined as appropriate to form other embodiments understood by those skilled in the art.
Claims (10)
1. The utility model provides a post screw director behind acetabular bone which includes a support, its characterized in that: be provided with preceding supporting arm and back supporting arm on the support, preceding guiding sleeve and a back guiding sleeve set up respectively on preceding supporting arm and the back supporting arm, preceding guiding sleeve is coaxial with back guiding sleeve, preceding guiding sleeve and/or back guiding sleeve are portable in order to adjust preceding guiding sleeve and back spacing between the guiding sleeve, be provided with the locating hole that a plurality of is used for placing the kirschner wire on support and/or support arm and/or preceding guiding sleeve and/or the back guiding sleeve, the kirschner wire is used for fixing support and/or support arm and/or preceding guiding sleeve and/or back guiding sleeve.
2. The acetabular posterior column screw guide of claim 1, wherein: the support is a rod-shaped structure, and the front support arm and/or the rear support arm are movably arranged on the support along the support.
3. The acetabular posterior column screw guide of claim 2, wherein: still include a slider, transversely set up a first horizontal slide that runs through and vertically set up a vertical slide that runs through on the slider, preceding support arm activity sets up in the first horizontal slide, the support activity sets up in the vertical slide.
4. The acetabular posterior column screw guide of claim 3, wherein: one end of the rear supporting arm is provided with the rear guide sleeve, and the other end of the rear supporting arm is provided with a limiting rod parallel to the bracket; one end of the front support arm is provided with the front guide sleeve, and the other end of the front support arm is provided with a limiting ring sleeved in the limiting rod.
5. The acetabular posterior column screw guide of claim 4, wherein: still be provided with two screw holes on the slider, threaded hole difference threaded connection has and is used for fixing the first fastening screw of preceding supporting arm with fixed the second fastening screw of support, transversely set up a second cross slide that runs through on the support, back supporting arm activity sets up in the second cross slide, still set up a screw hole on the support, threaded hole internal thread connection has and is used for fixing the third fastening screw of back supporting arm.
6. The acetabular posterior column screw guide of claim 3, wherein: transversely set up a second sideslip that runs through on the support, back supporting arm activity sets up in the second sideslip, still set up a screw hole on the support, screw hole female connection has and is used for fixing the third fastening screw of back supporting arm.
7. The acetabular posterior column screw guide of claim 3, wherein: and scales are arranged on the front supporting arm and the rear supporting arm.
8. The acetabular posterior column screw guide of any one of claims 3-7, wherein: a first nut is arranged on the sliding block coaxially with the first transverse sliding channel in a rotatable manner, an external thread is arranged on the front support arm, and the front support arm is in threaded connection with the first nut; a second nut is coaxially arranged on the sliding block and the longitudinal slide way in a rotatable mode, an external thread is arranged on the support, and the support is in threaded connection with the second nut.
9. The acetabular posterior column screw guide of claim 1, wherein: the length of the front guide sleeve is more than or equal to 120 mm.
10. The acetabular posterior column screw guide of claim 6, wherein: the front support arm is non-rotatably arranged in the first cross slideway; the rear supporting arm is non-rotatably arranged in the second transverse slideway.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110591985.XA CN113384339A (en) | 2021-05-28 | 2021-05-28 | Acetabulum posterior column screw guider |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110591985.XA CN113384339A (en) | 2021-05-28 | 2021-05-28 | Acetabulum posterior column screw guider |
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| Publication Number | Publication Date |
|---|---|
| CN113384339A true CN113384339A (en) | 2021-09-14 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202110591985.XA Pending CN113384339A (en) | 2021-05-28 | 2021-05-28 | Acetabulum posterior column screw guider |
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| CN (1) | CN113384339A (en) |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2661117Y (en) * | 2003-09-05 | 2004-12-08 | 王庆贤 | Alignment device for acetabulum anterior column pull screw |
| CN207755368U (en) * | 2017-07-05 | 2018-08-24 | 骆苏红 | A kind of adjustable Kirschner wire guider |
| CN208492221U (en) * | 2017-11-22 | 2019-02-15 | 张如意 | Bit guide is precisely adjusted in bone surgery |
| CN208989110U (en) * | 2018-08-29 | 2019-06-18 | 宁波市第六医院 | A kind of ilium front and back column intramedullary nail guider |
| WO2021091576A1 (en) * | 2019-11-08 | 2021-05-14 | Avalon Biomedical (Management) Limited | Devices and methods for orienting a surgical device |
-
2021
- 2021-05-28 CN CN202110591985.XA patent/CN113384339A/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2661117Y (en) * | 2003-09-05 | 2004-12-08 | 王庆贤 | Alignment device for acetabulum anterior column pull screw |
| CN207755368U (en) * | 2017-07-05 | 2018-08-24 | 骆苏红 | A kind of adjustable Kirschner wire guider |
| CN208492221U (en) * | 2017-11-22 | 2019-02-15 | 张如意 | Bit guide is precisely adjusted in bone surgery |
| CN208989110U (en) * | 2018-08-29 | 2019-06-18 | 宁波市第六医院 | A kind of ilium front and back column intramedullary nail guider |
| WO2021091576A1 (en) * | 2019-11-08 | 2021-05-14 | Avalon Biomedical (Management) Limited | Devices and methods for orienting a surgical device |
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