CN113892999A - Thighbone perforating device - Google Patents
Thighbone perforating device Download PDFInfo
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- CN113892999A CN113892999A CN202111192630.XA CN202111192630A CN113892999A CN 113892999 A CN113892999 A CN 113892999A CN 202111192630 A CN202111192630 A CN 202111192630A CN 113892999 A CN113892999 A CN 113892999A
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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
- A61B17/1604—Chisels; Rongeurs; Punches; Stamps
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Abstract
The invention provides a femoral punching device, which comprises: the cross section of the tibial prosthesis module is basically the same as that of the tibial prosthesis to be installed, and the bottom surface is a plane suitable for being placed on the tibial osteotomy platform in a fitting mode; the femur drilling module is detachably arranged on the tibia prosthesis module and comprises an arc-shaped main body and at least two guide through holes arranged on the arc-shaped main body; the central axes of the at least two guide through holes are coplanar, and the plane of the central axes is coplanar with the longitudinal midline of the tibial prosthesis module and is vertical to the bottom surface; and the central axis of the guide through hole forms an included angle of 33-37 degrees with the bottom surface of the tibial prosthesis module. The punching device can accurately punch the femur by taking the tibia as a reference, and when the fixing bolt of the femoral prosthesis is installed and fixed in the punched hole, the central lines of the femoral prosthesis and the tibial prosthesis can be ensured to be consistent, and an included angle of 35 degrees between the extension direction of the fixing bolt of the femoral prosthesis and the posterior cortex of the femur can be ensured.
Description
Technical Field
The invention relates to the technical field of surgical instruments for replacing unicondylar joints, in particular to a femoral punching device.
Background
Unicondylar joint replacements are a particular type of artificial knee replacement, a replacement in which the range of replacement is limited to a single condyle. The goal of unicondylar joint replacement is to preserve as normal joint structure as possible in the hope of achieving better functional recovery. The knee joint can be divided into an inner part and an outer part according to the shape and the function of the knee joint. The medial portion consists of the medial femoral condyle, the medial meniscus and the medial tibial plateau, and the lateral portion consists of the lateral femoral condyle, the lateral meniscus and the lateral tibial plateau. The human knee joint has different medial and lateral condyles and different functions. Generally, the medial condyle bears a great deal of pressure, and the lateral condyle has a great deal of rotation.
In the elderly patients with high knee joint problems, the cartilage of the medial condyle of the knee joint is usually damaged and removed by decades of wear, the bone is exposed, and finally typical osteoarthritis, namely, the bones rub against each other, so that the joints are painful, swollen and difficult to walk. Since only the medial condyle of the knee is worn and the lateral condyle is still intact, a unicondylar joint replacement procedure is performed by only treating the aged wear of the medial condyle. When the artificial joint prosthesis is replaced by the medial condyle unicondylar joint replacement, structures such as the lateral condyle, the patella, the cruciate ligament and the like can be reserved, and the damage to the knee joint is small, so that after the unicondylar joint replacement, the knee joint of a patient has basically normal functions and does not have the discomfort caused by total knee replacement. The unique condylar joint replacement has the advantages of small wound, fast recovery and low cost.
The structure of the unicondylar joint prosthesis is shown in fig. 1 and comprises a femoral prosthesis 01 and a tibial prosthesis 02, wherein the femoral prosthesis 01 is provided with a femur curved surface 011, and two fixing bolts 012 are arranged on the back of the femur curved surface 011; the tibial prosthesis 02 comprises a tibial slip surface 021, and a fixed insert plate 022 is arranged on the back of the tibial slip surface 021. During surgery, the worn tibial platform needs to be cut and removed, the tibial prosthesis 02 is installed, and the tibial prosthesis is fixed through the fixing inserting plate 022; a layer of sclerotin is removed by polishing the corresponding femoral head, holes are drilled, and the fixing bolts 012 are installed in the holes to realize the installation of the femoral prosthesis 01; after the prosthesis is installed, the femur curved surface 011 of the femur prosthesis 01 can move relatively to the tibia slip surface 021 of the tibia prosthesis 02, so that the limb is flexibly matched to finish walking, bending, rotating and other actions.
In order to ensure the operation effect, strict requirements are required for the installation of the tibial prosthesis and the femoral prosthesis, wherein the following three conditions are more critical: (1) the centerlines of the femoral and tibial prostheses are coincident (as shown in fig. 2); (2) when the knee is flexed by 90 degrees, the extension direction of the femoral prosthesis fixing bolt forms an angle of about 35 degrees with the posterior cortex of the femur (as shown in figure 3); (3) the femur prosthesis preferably has no internal eversion relative to the tibia prosthesis, and the maximum fault tolerance rate is 13 degrees. For the installation of the tibial prosthesis, the precise tibial plateau osteotomy can be realized by the aid of the existing tibial bone marrow external positioning rod, and the tibial prosthesis is placed in an accurate position after the osteotomy; for the femoral prosthesis, at present, no instrument for assisting in punching the femur by taking the tibia as a reference exists, the punching is completely performed by visual inspection, the deviation is large, and the three key conditions cannot be perfectly met.
Disclosure of Invention
Therefore, the technical problem to be solved by the invention is to overcome the technical defect that in the prior art, no instrument for assisting in punching the femur by taking the tibia as a reference exists, and the deviation is large due to the fact that the hole is punched by visual inspection, so that the femur punching device capable of accurately punching the femur by taking the tibia as the reference is provided.
Therefore, the invention provides a femoral punching device, which comprises:
the cross section of the tibial prosthesis module is basically the same as that of the tibial prosthesis to be installed, and the bottom surface is a plane suitable for being placed on the tibial osteotomy platform in a fitting mode;
the femur drilling module is detachably mounted on the tibia prosthesis module and comprises an arc-shaped main body and at least two guide through holes arranged on the arc-shaped main body; the central axes of the at least two guide through holes are coplanar, and the plane of the central axes is coplanar with the longitudinal midline of the tibial prosthesis module and is vertical to the bottom surface; and the central axis of the guide through hole and the bottom surface of the tibial prosthesis module form an included angle of 33-37 degrees.
Preferably, the tibial prosthesis module and the femoral hole drilling module are detachably and slidably mounted.
As a preferable scheme, a guide groove axially extending along the longitudinal midline is formed in the longitudinal midline of the tibial prosthesis module, a guide block capable of being matched and spliced with the guide groove is arranged on the femoral hole punching module, and the tibial prosthesis module and the femoral hole punching module are detachably connected in a sliding manner through the guide groove and the guide block.
Preferably, the cross section of the guide groove is in an inverted T shape, and the longitudinal centerline longitudinally bisects the groove bottom surface of the guide groove.
Preferably, the cross section of the guide block is in an inverted T shape, and the top end of the vertical part of the guide block is in contact connection with the bottom surface of the outer side of the arc-shaped main body.
Preferably, the medial surface of the arcuate body has a profile substantially corresponding to the profile of the medial surface on which the femoral prosthesis is to be mounted.
As a preferable mode, the following steps: the outer side surface of the arc-shaped main body is provided with a cylindrical column in an outward protruding mode, and the guide through hole penetrates through the axis of the cylindrical column and the arc-shaped main body at the corresponding position.
The tibia prosthesis module also comprises a strip-shaped groove arranged on the tibia prosthesis module and a strip-shaped through hole arranged at the bottom of the strip-shaped groove.
The tibial plateau is provided with a long strip-shaped through hole, and the tibial plateau is provided with a mounting groove.
The alveolar saw comprises a handheld handle and a fan-shaped sawtooth structure arranged at one end of the handheld handle; the thickness of the fan-shaped sawtooth structure is basically the same as the width of the long-strip-shaped through hole.
The technical scheme provided by the invention has the following advantages:
1. the femur perforating device comprises a tibia prosthesis module and a femur perforating module, wherein the cross section of the tibia prosthesis module is basically the same as that of a tibia prosthesis to be installed, so that the longitudinal midline of the tibia prosthesis module is basically superposed with that of the tibia prosthesis to be installed, and the bottom surface of the tibia prosthesis module is a plane suitable for being attached to a tibia osteotomy platform; the femur drilling module is detachably mounted on the tibia prosthesis module and comprises an arc-shaped main body and at least two guide through holes arranged on the arc-shaped main body, the central axes of the at least two guide through holes are coplanar, and the plane where the central axes of the at least two guide through holes are positioned is coplanar with the longitudinal central line of the tibia prosthesis module and is perpendicular to the bottom surface, so that after the femur prosthesis and the tibia prosthesis are drilled through the at least two guide through holes and the fixing bolts of the femur prosthesis are mounted, the central lines of the femur prosthesis and the tibia prosthesis can be ensured to be consistent; the central axis of the guiding through hole and the bottom surface of the tibial prosthesis module form an included angle of 33-37 degrees, preferably 35 degrees, so that when the knee is bent by 90 degrees, the extending direction of the femoral prosthesis fixing bolt and the posterior side of the femur form an included angle of 35 degrees; that is, by using the femoral hole punching device of the invention, the femur can be precisely punched by taking the tibia as a reference, and when the fixing bolt of the femoral prosthesis is installed and fixed in the punched hole, the central lines of the femoral prosthesis and the tibial prosthesis can be ensured to be consistent, and the extending direction of the fixing bolt of the femoral prosthesis and the posterior cortex of the femur can be ensured to form an included angle of 35 degrees.
2. The femur perforating device comprises a tibia prosthesis module and a femur perforating module, wherein the tibia prosthesis module is detachably connected with the femur perforating module in a sliding manner, specifically, a guide groove extending along the longitudinal midline is formed in the longitudinal midline of the tibia prosthesis module, a guide block capable of being inserted into the guide groove in a matching manner is arranged on the femur perforating module, and the guide groove is matched with the guide block, so that the detachable sliding connection of the tibia prosthesis module and the femur perforating module is realized, and the femur perforating module is limited not to be turned inside out or turned left and right relative to the tibia prosthesis module, therefore, a hole punched by a guide through hole arranged on the femur perforating module can be ensured, after a fixing bolt of the femur prosthesis is installed, the femur prosthesis cannot be turned inside out at a large angle relative to the tibia prosthesis, and the range of 13 degrees can be ensured.
3. According to the femur perforating device, the cross section of the guide groove is inverted T-shaped, the cross section of the guide block is inverted T-shaped, the femur perforating module can be better limited not to turn inwards or swing left and right relative to the tibia prosthesis module, and the tibia prosthesis module and the femur perforating module can not be easily separated.
4. According to the femoral punching device, the shape of the inner side surface of the arc-shaped main body is basically consistent with that of the inner side surface of the femoral prosthesis to be installed, so that when the inner side surface of the arc-shaped main body is attached to a polished femoral bone, the femoral prosthesis can be simulated to the maximum extent, and the punching position is accurately positioned; in addition, the cylindrical column is arranged on the outer side face of the arc-shaped main body in an outward protruding mode, the guide through hole penetrates through the axis of the cylindrical column and the arc-shaped main body at the corresponding position to be arranged in a penetrating mode, and the operation that the inner side face of the arc-shaped main body is attached to the ground femur bone cannot be affected.
Drawings
To more clearly illustrate the technical solutions in the prior art or the embodiments of the present invention, the drawings used in the description of the prior art or the embodiments are briefly introduced below.
FIG. 1 is a schematic view of a prior art unicondylar joint prosthesis.
Fig. 2 is a schematic view of the femoral prosthesis and the tibial prosthesis in a configuration in which the centerlines are aligned up and down after installation.
FIG. 3 is a schematic representation of the extension of the femoral prosthetic spline in 90 knee flexion at an angle of about 35 to the posterior cortex of the femur.
FIG. 4 is a perspective view of the femoral punch device of the present invention.
Fig. 5 is another perspective view of fig. 4.
Fig. 6 is a perspective view of the tibial prosthetic module of fig. 4.
Fig. 7 is a perspective view of the femoral punch module of fig. 4.
Fig. 8 is a schematic structural view of the punching apparatus of fig. 4 after an elongated groove is added.
Fig. 9 is a schematic view of the structure of the alveolar saw.
Reference numerals: 01. a femoral prosthesis; 011. femoral curve; 012. a fixing bolt; 02. a tibial prosthesis; 021. a tibial sliding surface; 022. fixing the inserting plate;
1. a tibial prosthetic module; 10. a longitudinal centerline; 11. a bottom surface; 12. a guide groove; 13. the bottom surface of the groove; 14. a strip-shaped groove; 15. strip-shaped through holes; 16. a tooth groove saw; 17. a handle; 18. a fan-shaped sawtooth structure; 2. a femoral punching module; 20. a guide through hole; 21. an arc-shaped main body; 22. a guide block; 23. a cylindrical column.
Detailed Description
The technical solution of the present invention is described in detail below with reference to the accompanying drawings.
Example 1
The present embodiment provides a femoral hole drilling device, as shown in fig. 4-6, including a tibial prosthesis module 1 and a femoral hole drilling module 2, wherein the cross-sectional profile of the tibial prosthesis module 1 is substantially the same as the cross-sectional profile of the tibial prosthesis to be installed, and the bottom surface 11 is a plane suitable for being placed on the tibial osteotomy platform in a fitting manner; the femur drilling module 2 is detachably mounted on the tibia prosthesis module 1 and comprises an arc-shaped main body 21 and two guide through holes 20 arranged on the arc-shaped main body 21; the central axes of the two guide through holes 20 are coplanar, and the plane of the central axes is coplanar with the longitudinal midline 10 of the tibial prosthesis module 1 and perpendicular to the bottom surface 11; and the central axis of the guide through hole 20 forms an included angle of 35 degrees with the bottom surface 11 of the tibial prosthesis module 1.
The femoral hole punching device comprises a tibial prosthesis module 1 and a femoral hole punching module 2, wherein the cross-sectional outline of the tibial prosthesis module 1 is basically the same as that of a tibial prosthesis to be installed, so that the longitudinal midline 10 (shown by reference to fig. 6) of the tibial prosthesis module is basically coincident with that of the tibial prosthesis to be installed, and the bottom surface 11 of the femoral hole punching device is a plane suitable for being fittingly placed on a tibial osteotomy platform; the femur drilling module 2 is detachably mounted on the tibia prosthesis module 1, and comprises an arc-shaped main body 21 and two guide through holes 20 arranged on the arc-shaped main body 21, and after drilling holes through the two guide through holes 20 and mounting fixing bolts of the femur prosthesis, the central lines of the femur prosthesis and the tibia prosthesis can be ensured to be consistent; the central axis of the guide through hole 20 and the bottom surface of the tibial prosthesis module 1 form an included angle of 35 degrees, so that when the knee is bent by 90 degrees, the extending direction of the femoral prosthesis fixing bolt and the posterior side of the femur form an included angle of 35 degrees; that is, use the thighbone perforating device of this embodiment, can use the shin bone as the contrast, carry out the accuracy and punch to the thighbone, and when entering into the inside fixed of punching with the gim peg installation of thighbone prosthesis, can guarantee that the central line of thighbone prosthesis and shin bone prosthesis is unanimous, and can guarantee that the extending direction of thighbone prosthesis gim peg becomes 35 contained angles with thighbone rear side skin.
As a variant, the central axis of the guide through-hole 20 may be arranged at an angle of 33 to 37 ° to the bottom surface 11 of the tibial prosthetic module 1.
As shown in fig. 6 to 7, a guide groove 12 axially extending along the longitudinal centerline 10 is formed in the longitudinal centerline 10 of the tibial prosthesis module 1, a guide block 22 capable of being inserted into the guide groove 12 in a matching manner is provided on the femoral hole drilling module 2, and the tibial prosthesis module 1 and the femoral hole drilling module 2 are detachably and slidably connected through the guide groove 12 and the guide block 22.
Specifically, the cross section of the guide groove 12 is an inverted T shape, and the longitudinal centerline 10 longitudinally bisects the groove bottom surface 13 of the guide groove 12. The cross section of the guide block 22 is of an inverted T shape, and the top end of the vertical part of the guide block 22 is in contact connection with the bottom surface of the outer side of the arc-shaped main body 21.
Through the cooperation of guide way 12 and guide block 22, not only realized the dismantled sliding connection of tibial prosthetic module 1 and thighbone module 2 that punches, it can not go on turning up or controlling the pendulum for tibial prosthetic module 1 to have limited thighbone module 2 that punches moreover, therefore can guarantee the hole of punching through setting up the guide through hole 20 on thighbone module 2 that punches, after the gim peg installation with femoral prosthetic gets into, femoral prosthetic can not have the interior turning up of great angle for tibial prosthetic, can ensure that the fault-tolerant rate is in 13 within ranges.
In this embodiment, the inner side surface of the arc-shaped main body 21 is substantially identical to the inner side surface of the femoral prosthesis to be installed; the outer side surface of the arc-shaped main body 21 is provided with a cylindrical column 23 in an outward protruding mode, and the guide through hole 20 penetrates through the axis of the cylindrical column 23 and the arc-shaped main body 21 at the corresponding position.
The shape of the inner side surface of the arc-shaped main body 21 is basically consistent with that of the inner side surface of the femoral prosthesis to be installed, so that when the inner side surface of the arc-shaped main body 21 is attached to the ground femoral bone, the femoral prosthesis can be simulated to the maximum degree, and the punching position can be accurately positioned; in addition, the outer side surface of the arc-shaped main body 21 is provided with the cylindrical column 23 in an outward protruding mode, the guide through hole 20 penetrates through the axis of the cylindrical column 23 and the arc-shaped main body 21 at the corresponding position, and the operation of attaching the inner side surface of the arc-shaped main body 21 to the ground femur bone cannot be affected.
The femoral drilling device in the embodiment is used as follows:
firstly, accurate tibial plateau osteotomy is realized by means of the existing tibial bone marrow external positioning rod, and the thighbone at the corresponding position is polished;
accurately placing the tibial prosthesis module 1 provided with the femoral punching module 2 at the osteotomy platform position;
adjusting the femur drilling module 2 to slide relative to the tibia prosthesis module 1, so that the inner side surface of the arc-shaped main body 1 is attached to the polished femur bone;
bending the knee of the affected limb of the patient to expose the two guide through holes 20, and punching the femur by means of the two guide through holes 20; or after the affected limb of the patient is bent and the two guide through holes 20 are exposed, the tibial prosthesis module 1 is pulled away, and the femur is punched by the two guide through holes 20;
and after the drilling is finished, the tibial prosthesis module 1 and the femoral drilling module 2 are removed, and subsequent installation and debugging of the tibial prosthesis and the femoral prosthesis are carried out.
Example 2
The embodiment provides a femoral punching device, which is an improvement on the basis of embodiment 1, and is characterized in that an elongated groove 14 is formed in a tibial prosthesis module 1, the elongated groove 14 is arranged substantially parallel to a guide groove 12, and an elongated through hole 15 is formed in the bottom of the elongated groove 14, and the position of the elongated through hole is matched with that of a fixing inserting plate 022 fixedly arranged on the back surface of a tibial prosthesis 02, as shown in fig. 8-9.
And further comprises a slot saw 16, wherein the slot saw 16 comprises a handle 17 and a fan-shaped saw tooth structure 18, wherein the fan-shaped saw tooth structure 18 has a thickness substantially equal to the width of the elongated through hole 15.
The advantage of the femur perforating device in this embodiment is that, given the opening position of the mounting hole for fixing the mounting position of the inserting plate 022 at the same time, by using the slot saw 16 to open the slot at the position of the elongated through hole 15, the operation can be completed with precise position and convenient operation.
It should be understood that the above examples are only for clarity of illustration and are not intended to limit the embodiments. Other variations and modifications will be apparent to persons skilled in the art in light of the above description. And are neither required nor exhaustive of all embodiments. And obvious variations or modifications therefrom are within the scope of the invention.
Claims (10)
1. A femoral hole punch device, comprising:
the cross section of the tibial prosthesis module (1) is basically the same as that of a tibial prosthesis to be installed, and the bottom surface (11) is a plane suitable for being placed on a tibial osteotomy platform in a fitting mode;
the femur drilling module (2) is detachably mounted on the tibia prosthesis module (1) and comprises an arc-shaped main body (21) and at least two guide through holes (20) arranged on the arc-shaped main body (21); the central axes of at least two of the guide through holes (20) are coplanar, and the plane of the guide through holes is coplanar with the longitudinal midline (10) of the tibial prosthesis module (1) and is vertical to the bottom surface (11); and the central axis of the guide through hole (20) and the bottom surface (11) of the tibial prosthesis module (1) form an included angle of 33-37 degrees.
2. The femoral burr hole device of claim 1, wherein: the tibia prosthesis module (1) and the femur drilling module (2) are detachably and slidably mounted.
3. The femoral burr hole device of claim 2, wherein: the utility model discloses a femur drilling machine, including tibia prosthesis module (1) the edge has been seted up to longitudinal midline (10) position longitudinal midline (10) axial extension's guide way (12), be equipped with on femur drilling module (2) can with guide block (22) that guide way (12) match the grafting, tibia prosthesis module (1) with femur drilling module (2) passes through guide way (12) with sliding connection can be dismantled in guide block (22).
4. The femoral burr hole device of claim 3, wherein: the cross section of the guide groove (12) is of an inverted T shape, and the longitudinal center line (10) longitudinally bisects the groove bottom surface (13) of the guide groove (12).
5. The femoral burr hole device of claim 4, wherein: the cross section of the guide block (22) is of an inverted T shape, and the top end of the vertical part of the guide block (22) is in contact connection with the bottom surface of the outer side of the arc-shaped main body (21).
6. The femoral burr hole device of claim 1, wherein: the inner side surface of the arc-shaped main body (21) is basically consistent with the shape of the inner side surface of the femoral prosthesis to be installed.
7. The femoral burr hole device of claim 6, wherein: the outer side surface of the arc-shaped main body (21) is provided with a cylindrical column (23) in an outward protruding mode, and the guide through hole (20) penetrates through the axis of the cylindrical column (23) and the arc-shaped main body (21) at the corresponding position to be arranged in a penetrating mode.
8. The femoral burr hole device of claim 3, wherein: the tibia prosthesis module also comprises a strip-shaped groove (14) formed in the tibia prosthesis module (1) and a strip-shaped through hole (15) formed in the bottom of the strip-shaped groove (14).
9. The femoral broach apparatus according to claim 8, in which: the tibia platform is characterized by further comprising a dental notch saw (16), wherein the dental notch saw (16) is suitable for penetrating through the long-strip-shaped through hole (15) to form an installation groove in the tibia platform.
10. The femoral broach apparatus according to claim 9, in which: the dental groove saw (16) comprises a handheld handle (17) and a fan-shaped sawtooth structure (18) arranged at one end of the handheld handle (17); the thickness of the fan-shaped sawtooth structure (18) is basically the same as the width of the long-strip-shaped through hole (15).
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CN113397651A (en) * | 2021-07-21 | 2021-09-17 | 袁海浪 | Method for positioning longitudinal tibial osteotomy position in unicondylar replacement |
CN215960125U (en) * | 2021-10-13 | 2022-03-08 | 山东大学齐鲁医院(青岛) | Thighbone perforating device for single condyle replacement |
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CN102006839A (en) * | 2008-02-18 | 2011-04-06 | 麦克斯外科整形公司 | Total knee replacement prosthesis |
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