CN113940747B - Positioning navigation device for bone channel of nail hole of orthopedic implant - Google Patents
Positioning navigation device for bone channel of nail hole of orthopedic implant Download PDFInfo
- Publication number
- CN113940747B CN113940747B CN202010683066.0A CN202010683066A CN113940747B CN 113940747 B CN113940747 B CN 113940747B CN 202010683066 A CN202010683066 A CN 202010683066A CN 113940747 B CN113940747 B CN 113940747B
- Authority
- CN
- China
- Prior art keywords
- positioning
- laser
- line
- positioning line
- ray machine
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
- 239000007943 implant Substances 0.000 title claims abstract description 27
- 230000000399 orthopedic effect Effects 0.000 title claims abstract description 25
- 210000000988 bone and bone Anatomy 0.000 title claims description 12
- 238000000034 method Methods 0.000 abstract description 25
- 238000003780 insertion Methods 0.000 abstract description 16
- 230000037431 insertion Effects 0.000 abstract description 16
- 238000002474 experimental method Methods 0.000 abstract description 6
- 210000000689 upper leg Anatomy 0.000 description 4
- 238000010586 diagram Methods 0.000 description 3
- 230000005855 radiation Effects 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 238000011161 development Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 208000010392 Bone Fractures Diseases 0.000 description 1
- 206010017076 Fracture Diseases 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 238000013383 initial experiment Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000002787 reinforcement Effects 0.000 description 1
- 238000011160 research Methods 0.000 description 1
- 238000004088 simulation Methods 0.000 description 1
- 230000000087 stabilizing effect Effects 0.000 description 1
Classifications
-
- 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
-
- 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
- A61B2034/2051—Electromagnetic tracking systems
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Robotics (AREA)
- Apparatus For Radiation Diagnosis (AREA)
Abstract
The invention discloses a positioning navigation device for an orthopedic implant nail hole intra-osseous channel, which comprises two laser emitting pieces and binding belts, wherein the binding belts are bound on an image intensifier of a C-shaped arm X-ray machine or a G-shaped arm X-ray machine; the two laser emission parts are arranged on the binding belt and can move along the binding belt; the laser positioning device solves the problems that in the prior art, only the Kirschner wire needle insertion point can be positioned and the needle insertion path cannot be navigated. Multiple experiments prove that the navigation process of positioning the nail hole intra-osseous channel of the orthopedic implant by utilizing the Kirschner wire can be realized by only one perspective during use, namely, not only the needle insertion point can be accurately positioned, but also the needle insertion direction can be accurately navigated. The method has the advantages of high accuracy, simplicity, practicability and good clinical application prospect.
Description
Technical Field
The present disclosure relates to a positioning navigation device for an orthopedic implant nail hole intra-osseous channel, which belongs to the field of medical equipment.
Background
Currently, in the operation process of orthopedic implants such as intramedullary nails, bone plates, channel screws (hollow nails) and the like, firstly, the guide is used for positioning an intraosseous channel of the implant under the guidance of a perspective machine, and after the implant is positioned to an ideal position, the screws are implanted along a guide needle positioning path to finish the fixation of the implant. The existing operation process is generally that an operator directly performs the positioning of the intra-osseous nail hole channel by bare hands under perspective by means of a C-shaped arm X-ray machine or a G-shaped arm X-ray machine, and the specific positioning method comprises the following steps: firstly, utilizing an X-ray machine to perspective and position a nail hole, then inserting a Kirschner wire from the body surface of a human body under the perspective condition, suspending after a needle point reaches the outer surface of a bone, then, after the position of the needle point of the Kirschner wire in the middle of the nail hole is determined by perspective, gently knocking the Kirschner wire into the near bone cortex, enabling the needle point to enter the bone cortex by about 2mm, after the position of the needle point is seen in the middle of the nail hole again, adjusting the direction of the Kirschner wire, enabling the Kirschner wire to form a round dot under perspective, and keeping the position (particularly, when the experience of a surgeon is insufficient, a longer learning curve is required), driving the Kirschner wire into the near bone cortex by using an electric drill, penetrating the near bone cortex through the nail hole, and then, seeing again, and enabling the Kirschner wire to pass through the center of the nail hole to finish satisfactory positioning. If the imaging reveals that the k-wire passes out of the nail hole, the above procedure needs to be repeated again. The local bone is possibly damaged more by multiple positioning operations, and the occurrence probability of local secondary fracture and nail withdrawal is greatly increased. And this procedure requires multiple X-ray fluoroscopy, more frequently for inexperienced doctors. X-rays have radiation damage to human bodies, the operation time of orthopedic surgery is long, and doctors and patients receive excessive radiation under the condition of frequent perspective.
In order to solve the above problems, a method for assisting positioning by using laser has been proposed by those skilled in the art, wherein two linear laser lines are projected onto the skin surface of the human body to form a cross-shaped cross line, and the cross-shaped cross line is the needle insertion point of the kirschner wire. The method can position the needle insertion point, and reduces one-time perspective positioning. However, because the laser is projected on the surface of the human body, the laser can only play a role in positioning the needle insertion point, and the navigation effect in the needle insertion process can not be carried out on the intra-osseous channel of the nail hole in the human body. Thus, laser assisted positioning has significant limitations in orthopedic surgical positioning. There are also technicians that use mechanical positioning devices, such as intramedullary nails that are connected to a positioning device, but because of the torsion that occurs during the implantation of the intramedullary nail, the axis of the screw hole also changes, and the mechanical positioning device also cannot accurately position the intra-osseous canal of the nail hole.
How to solve the above problems of the prior art is still a long-term research hotspot for those skilled in the art.
Disclosure of Invention
The technical problem to be solved by the present disclosure is to provide a positioning navigation device for realizing accurate aiming of an orthopedic implant nail hole intra-osseous channel by using laser.
In order to achieve the above object, the present disclosure adopts the following technical scheme:
A positioning navigation device of an orthopaedics implant nail hole intra-bone channel, which is used for a C-shaped arm X-ray machine or a G-shaped arm X-ray machine; the positioning navigation device comprises two laser emission parts and binding belts, wherein the binding belts are bound on an image intensifier of the C-shaped arm X-ray machine or the G-shaped arm X-ray machine; the two laser emission parts are arranged on the binding belt and can move along the binding belt;
The two laser emission parts are respectively a first laser emission part and a second laser emission part; the first laser emitting part and the second laser emitting part have the same structure and comprise a fixing seat, a laser pen fixing device and a laser pen capable of emitting linear rays, the fixing seat is connected with the binding belt, the laser pen fixing device is connected with the fixing seat, the laser pen fixing device is provided with a laser pen fixing channel, the laser pen fixing channel and the laser pen fixing device are coaxially arranged, the laser pen can freely rotate around an axis in the laser pen fixing channel, the laser pen is inserted from the top of the laser pen fixing channel, and the linear laser rays emitted by the laser pen are emitted from the bottom of the laser pen fixing channel;
the first laser emission part is arranged on the extension line of the positioning line B, and the linear laser emitted by the first laser emission part coincides with the positioning line C; the positioning line B is arranged on the end face of the image intensifier of the C-shaped arm X-ray machine or the G-shaped arm X-ray machine, and the positioning line B coincides with the positioning line A in the exposure area of the display screen during perspective; the positioning line C is arranged in parallel with the positioning line B and keeps a certain distance, and coincides with the positioning line B and the positioning line A in the exposure area of the display screen during perspective; the positioning line A is a horizontal axis of a display screen exposure area of a C-arm X-ray machine or a G-arm X-ray machine, and passes through the center point of the display screen exposure area;
The second laser emission part is arranged on the extension line of the positioning line E, and the linear laser emitted by the second laser emission part coincides with the positioning line F; the positioning line E is arranged on the end face of the image intensifier of the C-shaped arm X-ray machine or the G-shaped arm X-ray machine, and the positioning line E coincides with the positioning line D in the exposure area of the display screen during perspective; the positioning line F is arranged in parallel with the positioning line E and keeps a certain distance, and is overlapped with the positioning line E and the positioning line D in the exposure area of the display screen during perspective; the positioning line D is a vertical axis of a display screen exposure area of a C-arm X-ray machine or a G-arm X-ray machine, and passes through the center point of the display screen exposure area;
The positioning line A and the positioning line D are mutually perpendicular in the exposure area of the display screen.
The positioning navigation device also comprises a positioning plate of the display screen exposure area, wherein the positioning plate is matched with the display screen in shape and can cover the surface of the display screen, and the positioning plate is marked with a positioning line A scale and a positioning line D scale.
Preferably, the surface of the X-ray box aligner of the C-shaped arm X-ray machine or the G-shaped arm X-ray machine is also provided with a positioning line G, and the linear laser line emitted by the first laser emitting piece coincides with the positioning line G.
Preferably, a positioning line H is further provided on the surface of the X-ray box aligner of the C-arm X-ray machine or the G-arm X-ray machine, and the linear laser line emitted by the second laser emitting element coincides with the positioning line H.
Preferably, the positioning navigation device further comprises a fixing support, the fixing support comprises a fixing panel, and the positioning line C and the positioning line F are arranged on the fixing panel.
Wherein preferably, the fixing base is provided with a through hole, and the binding belt passes through the through hole.
Preferably, the positioning navigation device further comprises an angle fixing seat, and the angle fixing seat is arranged between the fixing seat and the laser pen fixing device.
Wherein, preferably, the angle fixing seat can lead an included angle of 40-60 degrees to be arranged between the laser pen fixer and the fixing seat.
Wherein preferably, the width of the linear laser line emitted by the laser pen projected on the skin surface of the human body is not more than 2mm.
Wherein, the distance between the laser pen and the projection position of the human body target is preferably 60-70 cm.
Preferably, the joint surface of the fixing seat and the image intensifier of the C-arm X-ray machine or the G-arm X-ray machine is provided with a friction force increasing structure.
Wherein, preferably, the binding belt is provided with a fixing clamping groove on the joint surface of the fixing seat.
Wherein, preferably, the binding belt is provided with an tightness adjusting piece.
The positioning navigation device for the bone channel of the nail hole of the orthopedic implant solves the problem that in the prior art, only the needle insertion point of the Kirschner wire can be positioned by laser positioning, and the needle insertion path cannot be navigated. Multiple experiments prove that the navigation process of positioning the nail hole intra-osseous channel of the orthopedic implant by utilizing the Kirschner wire can be realized by only one perspective during use, namely, not only the needle insertion point can be accurately positioned, but also the needle insertion direction can be accurately navigated. The method has the advantages of high accuracy, simplicity, practicability, great reduction of radiation damage and good clinical application prospect.
Drawings
In order to more clearly illustrate the embodiments of the present disclosure or the technical solutions in the prior art, the drawings that are required to be used in the embodiments will be briefly described below. It will be apparent to those of ordinary skill in the art that the drawings in the following description are merely examples of the disclosure and that other drawings may be derived from them without inventive faculty.
Fig. 1 is a schematic diagram of an overall structure of a positioning navigation device provided by the present disclosure;
FIG. 2 is a schematic view of a laser emitting member according to the present disclosure;
FIG. 3 is a schematic view of a positioning plate according to the present disclosure;
FIG. 4 is a schematic view of a usage state of the positioning plate according to the present disclosure;
FIG. 5 is a schematic view of the position location of a first laser transmitter in the present disclosure;
FIG. 6 is a schematic view showing the position of the second laser emitter according to the present disclosure
FIG. 7 is a schematic view of the use state of the present disclosure;
FIG. 8 is a schematic illustration of the present disclosure in surgery using laser line navigation;
FIG. 9 is a schematic diagram II of the present disclosure using laser line navigation during surgery;
FIG. 10 is a schematic representation of a femur model used in the experiments of the present disclosure;
FIG. 11 is a schematic diagram showing a perspective view of a distal nail hole of an intramedullary nail in accordance with the present disclosure;
FIG. 12 is a schematic illustration of a pilot driven Kirschner wire using the projected laser line positioning navigation of the present disclosure;
FIG. 13 is a schematic illustration of the use of the present disclosure to separately drive K-wire into two distal nail holes of a femoral intramedullary nail;
Fig. 14 is a schematic view of a perspective view of a k-wire after positioning and placement using the present disclosure.
Reference numerals illustrate:
The laser emitting part 1, the first laser emitting part 11, the fixing base 111, the laser pen fixing device 112, the laser pen 113, the through hole 114, the laser pen fixing channel 115, the angle fixing base 116, the rib 117 and the first laser line 118;
A second laser emitting member 12, a second laser line 121;
A binding belt 2, a fixing clamping groove 21 and an tightness adjusting piece 22;
a G-arm X-ray machine 3 and an image intensifier 31;
the device comprises a circular exposure area 4, a positioning plate 5, a positioning line A scale 51, a positioning line D scale 52, a display screen 6 and an X-ray box aligner 7;
A fixing bracket 8 and a fixing panel 81;
A k-wire 9;
positioning line A, positioning line B, positioning line C, positioning line D, positioning line E, positioning line F, positioning line G and positioning line H.
Detailed Description
The following description of the technical solutions in the embodiments of the present disclosure will be made clearly and completely with reference to the accompanying drawings in the embodiments of the present disclosure, and it is apparent that the described embodiments are only some embodiments of the present disclosure, not all embodiments. Based on the embodiments in this disclosure, all other embodiments that a person of ordinary skill in the art would obtain without making inventive efforts are within the scope of this disclosure.
It should be noted that, if directional indications (such as up, down, left, right, front, and rear … …) are included in the embodiments of the present disclosure, the directional indications are merely used to explain a relative positional relationship, a movement condition, and the like between the components in a specific posture (as shown in the drawings), and if the specific posture is changed, the directional indications are correspondingly changed.
In addition, in the description of the present disclosure, the terminology used is for the purpose of illustration only and is not intended to limit the scope of the present disclosure. The terms "comprises" and/or "comprising" are used to specify the presence of stated elements, steps, operations, and/or components, but do not preclude the presence or addition of one or more other elements, steps, operations, and/or components.
The terms "first," "second," and the like may be used for describing various elements, do not represent a sequence, and are not intended to limit the elements.
Furthermore, in the description of the present disclosure, unless otherwise indicated, the meaning of "a plurality" is two and more. These terms are only used to distinguish one element from another element.
The present disclosure is used in conjunction with prior art G-arm or C-arm X-ray machines. The image intensifier 31, the X-ray box aligner 7 and the display screen related in the disclosure are all necessary components of a G-shaped arm or a C-shaped arm X-ray machine in the prior art, the image intensifier 31 and the X-ray box aligner 7 which is just opposite to the image intensifier 31 are used together, the X-ray box aligner 7 is an X-ray source, the image intensifier 31 is an X-ray receiver, and the circular exposure area of the display screen displays an image area received by the image intensifier, so that the circular exposure area is fixed on the display screen, and the image intensifier is suitable for any G-shaped arm or C-shaped arm X-ray machine in the prior art.
As shown in fig. 1 and 2, the positioning and navigation device for the bone channel of the nail hole of the orthopedic implant provided by the embodiment of the disclosure can be combined with a C-arm X-ray machine or a G-arm X-ray machine 3. The C-arm X-ray machine and the G-arm X-ray machine 3 are both in the prior art, and the two X-ray machines are provided with an image intensifier 31, the C-arm X-ray machine is provided with an image intensifier 31, the G-arm X-ray machine 3 is provided with two image intensifiers 31, and the positioning navigation device is mainly bound on the image intensifier 31 for use. Since the patient lies on the operating table, the C-arm X-ray machine is required to rotate the image intensifier 31 to a horizontal position during the orthopedic operation, and the end of the image intensifier 31 faces the patient. The G-arm X-ray machine 3 performs perspective using a horizontal image intensifier 31.
In this embodiment, the specific structure and the method of using the positioning and navigation device are described by taking the G-arm X-ray machine 3 as an example. The positioning navigation device can be bound on a C-shaped arm X-ray machine by the same method, and the technical effect is consistent with that of a G-shaped arm X-ray machine 3.
The positioning navigation device comprises two laser emitting parts 1 and a binding belt 2. The binding belt 2 is bound to the image intensifier 31 of the G-arm X-ray machine 3. Two laser emitting members 1 are provided on the binding band 2 and movable along the binding band 2. The specific structure of the laser emitting member 1 is described as follows:
as shown in fig. 2, the two laser emitters 1 are a first laser emitter 11 and a second laser emitter 12, respectively. In the present embodiment, the first laser emitting member 11 is taken as an example to describe a specific structure, and the second laser emitting member 12 is identical in structure thereto.
The first laser emitting member 11 includes a fixing base 111, a laser pen holder 112, and a laser pen 113 that emits linear light. The fixing base 111 is connected with the binding belt 2 in a specific connection mode, the fixing base 111 is provided with a through hole 114, the shape of the through hole 114 is matched with that of the binding belt 2, so that the binding belt 2 can pass through the through hole 114, and the fixing base 111 can reciprocate with the binding belt 2 as a track. The laser pen holder 112 is connected to the holder 111, in this embodiment fixedly, preferably integrally. The laser pen holder 112 is in a cylindrical structure in the embodiment, two ends of the laser pen holder are open, a laser pen fixing channel 115 is arranged in the laser pen holder 112, the laser pen fixing channel 115 and the laser pen holder 112 are coaxially arranged, the laser pen 113 can freely rotate around the axis of the laser pen 113 in the laser pen fixing channel 115, the emitting end of the laser pen 113 is inserted into the channel from the top of the laser pen fixing channel 115, and a linear laser line emitted by the laser pen 113 is emitted from the bottom of the laser pen fixing channel 115; the top and bottom described herein can be interpreted as that when the laser pen 113 is inserted into the laser pen fixing channel 115, the end of the pen tail is the top, and the end opposite to the top, i.e. the end of the pen head is the bottom, so that the laser light of the laser pen 113 is emitted from the pen head. The laser pen 113 has a limited irradiation range when the axis is parallel to the axis of the image intensifier 31, and in order to make the irradiation range of the laser beam larger, the embodiment further includes an angle fixing base 116, where the angle fixing base 116 is disposed between the fixing base 111 and the laser pen holder 112. In this embodiment, the angle fixing base 116 may make an included angle between the laser pen holder 112 and the fixing base 111 of 40-60 degrees, and the laser irradiation area is feasible within the included angle range, and 45 degrees are adopted in this embodiment.
The present embodiment focuses on the positions of the first laser emitting member 11 and the second laser emitting member 12.
As shown in fig. 4 to 6, the position of the first laser emitting member 11 is set on the extension line of the positioning line B, and the line-shaped laser light emitted by the first laser emitting member coincides with the positioning line C; the positioning line B is arranged on the end face of the image intensifier 31 of the G-shaped arm X-ray machine 3, and the positioning line B is overlapped with the positioning line A in the circular exposure area 4 of the display screen 6 during the perspective; the positioning line C is arranged in parallel with the positioning line B and keeps a certain distance, and is overlapped with the positioning line B and the positioning line A in the circular exposure area 4 of the display screen 6 in perspective; the positioning line A is the horizontal axis of the circular exposure area 4 of the display screen 6 of the G-shaped arm X-ray machine 3, and passes through the center point of the circular exposure area 4 of the display screen 6.
The method for determining the position is as follows:
(1) Determining a positioning line A: as shown in fig. 4, the display screen 6 of the G-arm X-ray machine 3 has a circular exposure area 4. As shown in fig. 5 (c), the circular exposure field 4 is a perspective development field of the image intensifier 31, and is fixed in position in the display screen 6. Firstly, finding a horizontal axis of the circular exposure region 4, wherein the horizontal axis passes through the center point of the circular exposure region 4, and the horizontal axis is a positioning line A;
(2) Determining a positioning line B: as shown in fig. 5 (B), a positioning line B is provided on the end surface of the image intensifier 31 of the G-arm X-ray machine 3, and the position of the positioning line B in the circular exposure area 4 of the display screen 6 coincides with the positioning line a when seen through;
(3) Determining a positioning line C: as shown in fig. 5 (C), the positioning line C is parallel to the positioning line B, and is spaced apart from the positioning line B by a certain distance, and the positioning line C coincides with the positioning line B and the positioning line a in the circular exposure area 4 of the display screen 6 in perspective. The positioning line C is preferably arranged in the middle of the image intensifier 31 and the X-ray box aligner 7, that is, the distance between the positioning line C and the positioning line B is equal to the distance between the positioning line C and the positioning line G, and the positioning line C can be biased to some extent, but the positioning line C is not too close to the positioning line G, so that the enlargement is avoided and the positioning is affected.
The method can realize three-line superposition, namely, the positioning line A, the positioning line B and the positioning line C are in superposition state in the circular exposure area 4 of the display screen 6. At this time, the first laser emitting element 11 is disposed on the extension line of the positioning line B, the positioning line B is located on the end face of the image intensifier 31, and the intersection point between the extension line and the edge of the image intensifier 31 is the position of the first laser emitting element 11, and the axis of the laser pen 113 and the positioning line B are located on the same plane.
The linear laser line irradiated by the laser pen 113 coincides with the positioning line C.
The position of the second laser emitting element 12 is arranged on the extension line of the positioning line E, and the linear laser emitted by the second laser emitting element 12 coincides with the positioning line F; the positioning line E is arranged on the end face of the image intensifier 31 of the G-shaped arm X-ray machine 3, and the positioning line E coincides with the positioning line D in the circular exposure area 4 of the display screen 6 during perspective; the positioning line F is arranged in parallel with the positioning line E and keeps a certain distance, and is overlapped with the positioning line E and the positioning line D in a circular exposure area of the display screen 6 in perspective; the positioning line D is a vertical axis of the circular exposure area 4 of the display screen 6 of the G-shaped arm X-ray machine, and passes through the round dots of the circular exposure area 4 of the display screen 6.
The method for determining the position of the second laser emitting element 12 is the same as the method for determining the first laser emitting element 11, and specifically includes the following steps:
(1) Determining a positioning line D: as shown in fig. 6 (c), the display screen 6 of the G-arm X-ray machine 3 has a circular exposure area 4, and the circular exposure area 4 is a perspective development area of the image intensifier 31, and the area is fixed in position in the display screen 6. Firstly, finding a vertical axis of the circular exposure region 4, wherein the vertical axis passes through the center point of the circular exposure region 4, and the horizontal axis is a positioning line D;
(2) Determining a positioning line E: as shown in fig. 6 (b), a positioning line E is provided on the end surface of the image intensifier 31 of the G-arm X-ray machine 3, and the position of the positioning line E in the circular exposure area 4 of the display screen 6 coincides with the positioning line D when seen through;
(3) Determining a positioning line F: as shown in fig. 6 (c), the positioning line F is parallel to the positioning line E, and is spaced apart from the positioning line E by a certain distance, and the positioning line F coincides with the positioning line E and the positioning line D in the circular exposure area 4 of the display screen 6 in perspective. The positioning line F is preferably arranged at the middle position of the image intensifier 31 and the X-ray box aligner 7, i.e. the distance between the positioning line F and the positioning line E is equal to the distance between the positioning line F and the positioning line H, and can be deviated to the positioning line B, but is not suitable to be separated from the positioning line G
The method can realize three-line superposition, namely, the positioning line D, the positioning line E and the positioning line F are in superposition state in the circular exposure area 4 of the display screen 6.
The positioning line a and the positioning line D are perpendicular to each other in the circular exposure area of the display screen 6, and the intersection point of the two is the dot of the circular exposure area 4.
As shown in fig. 3 and 4, to facilitate determination of the horizontal axis and the vertical axis of the circular exposure field 4, the present embodiment further includes a positioning plate 5 (fig. 4 (a)) of the display screen exposure field (i.e., the circular exposure field) of the display screen 6, the positioning plate 5 is shape-matched with the display screen 6 to cover the surface of the display screen 6 (see fig. 4 (b) and 4 (c)), and the positioning plate 5 is marked with a positioning line a scale 51 and a positioning line D scale 52. When in use, the positioning lines A and D of the circular exposure area 4 can be found by only covering the display screen 6 with the positioning plate 5.
As shown in fig. 7, the surface of the X-ray box aligner 7 of the G-arm X-ray machine 3 is further provided with a positioning line G, and the laser line generated by the first laser emitting member 11 when the linear laser line emitted by the position is projected on the surface of the X-ray box aligner 7 is the positioning line G. The surface of the X-ray box aligner 7 of the G-shaped arm X-ray machine 3 is also provided with a positioning line H, and the laser line generated when the linear laser line emitted by the second laser emitting piece 12 is projected on the surface of the X-ray box aligner 7 is the positioning line H.
The positioning lines G and H are used for secondary positioning of the laser line position in operation.
In order to find the positions of the positioning lines C and F, the embodiment further includes a fixing bracket 8, where the fixing bracket 8 includes a fixing panel 81, and the positioning lines C and F are disposed on the fixing panel 81.
Since the diameter of the nail hole of the orthopedic implant is about 3-5 mm, the width of the line-type laser line emitted from the laser pen 113 in this embodiment projected on the skin surface of the human body is not more than 2mm, preferably 2mm in this embodiment, for the convenience of positioning. The width of the laser line is directly related to the distance of the laser pen 113 from the projection object, and the distance can be adjusted according to the actual operation condition, so long as the width of the laser line projected on the skin surface of the human body is ensured to be no more than 2mm. The distance of the laser pen 113 from the human body in this embodiment is 60 to 70cm, preferably 60cm. The projection distance of the laser pen is within 1 meter, and the line width is not more than 2 millimeters. Therefore, the positioning guide needle is optimally selected from 2 mm-diameter Kirschner wires.
In order to increase the stability of the laser pen 113 when emitting light, the contact surface between the fixing base 111 and the image intensifier 31 of the G-arm X-ray machine 3 is provided with a friction-increasing structure, in this embodiment a rib 117.
The binding belt 2 and the binding surface of the fixing seat 111 are provided with a fixing clamping groove 21, and the fixing clamping groove 21 is mainly used for stabilizing the position of the fixing seat 111 on the binding belt 2.
In order to facilitate the binding of the binding band 2 to the impact reinforcement 31, the binding band 2 is provided with a slack adjuster 22. The adjustment member may be of the prior art. In this embodiment, the tightness adjusting member 22 is a binding belt, and the end portion is provided with a buckle structure.
In the initial experiment of the inventor, only the positioning line C is overlapped with the positioning line A, the positioning line F is overlapped with the positioning line D to position the laser pen, the positioning line B and the positioning line E are not needed, and the accuracy of the laser pen positioned by the double-line integrated positioning method in the model experiment is slightly poor, the success rate is low, and the repeated debugging is needed, so that the later adjustment is a three-line integrated method, and the accuracy is greatly improved. On the other hand, the laser pen fixing channel of the laser pen fixing device is matched with the outline dimension of the laser pen. After the laser pen is inserted, the laser pen can be stably fixed in the laser pen fixer, the laser pen fixer is further provided with a stop part at the transmitting end of the laser pen, the laser pen is prevented from falling out, and in order to increase the stability of the laser pen, the elastic rubber band can be additionally arranged for secondary fixation in practical application.
Hereinafter, the use of the present disclosure will be described with respect to the distal locking nail hole of an intramedullary nail, and other implant nail holes may be used in the same manner as the present disclosure to achieve positioning navigation.
(1) Before operation, determining the positions of the first laser emitting part 11 and the second laser emitting part 12 and the positions of the emitted linear laser lines by using the method, removing the fixed support 8, starting the laser pen 113 of the first laser emitting part 11 and the laser pen of the second laser emitting part, projecting the laser lines emitted by the first laser emitting part 11 on the surface of the X-ray box aligner 7 to form a positioning line G, projecting the laser lines emitted by the second laser emitting part 12 on the surface of the X-ray box aligner 7 to form a positioning line H, and marking the positioning line G and the positioning line H by using a marking pen;
(2) In operation, the affected limb position of a patient is adjusted by utilizing one-time perspective, so that the far-end nail hole of the intramedullary nail presents a perfect circle on the display screen 6, and the center of the perfect circle coincides with the center of the circular exposure area 4 of the display screen 6 (the intersection point of the positioning line A and the positioning line D);
(3) Opening the laser pen 113 of the first laser emitting part 11 and the laser pen of the second laser emitting part 12, overlapping the first laser line 118 of the first laser emitting part 11 with the positioning line G marked in the step (1), overlapping the second laser line 121 of the second laser emitting part 12 with the positioning line H marked in the step (1), forming crisscrossed laser lines on the body surface of the patient at the moment, driving the kirschner wire 9 into the human body through the intersection point of the two laser lines, and always keeping the plane of the first laser line 118 and the plane of the second laser line 121 at the tail of the kirschner wire 9 in the driving process, namely, when the kirschner wire 9 is kept on the plane of the first laser line 118, the laser line is shot on the needle body, and if the kirschner wire 9 deviates from the plane of the first laser line 118, the laser line is far away from the kirschner wire 9 needle body. The second laser line 121 is always irradiated on the needle body of the k-wire 9. Thus, the laser line is utilized to realize the navigation of the intraosseous channel of the Kirschner wire 9 in the driving process;
(4) And (3) confirming the position of the driven Kirschner wire 9 by utilizing perspective, expanding an intraosseous channel along the Kirschner wire 9 by using a drill bit with specific specification, and placing a screw with proper length to finish locking of a distal nail hole of the intramedullary nail.
The inventor proves through many times of femur model experiments that the positioning navigation device can accurately position the needle insertion point and accurately realize the whole navigation function in the Kirschner wire implantation process. As shown in fig. 10, the femur model is placed in a simulation box so as to be invisible, and an intramedullary nail is built in the femur model to simulate the real situation of a human body. As shown in fig. 11, through one perspective, the distal nail hole of the intramedullary nail presents a right circular image on the display screen, and the circular dots coincide with the intersection points of the positioning line A and the positioning line D or only need to ensure that the dots are positioned near the intersection points, in the case of displaying a circular exposure area on the display screen. As shown in fig. 12, two laser emitting elements are used to emit two intersecting laser lines, and the intersection point and the plane of the two laser lines are used to locate the k-wire insertion point and the plane of the k-wire during insertion to navigate the intra-osseous canal of the k-wire insertion. As shown in fig. 12, two k-wires are respectively driven into two nail holes at the distal end of the femoral intramedullary nail by the positioning and navigation device. As shown in fig. 13, after the kirschner wire is driven in under the condition of no perspective by using the positioning and navigation device, the position of the kirschner wire is confirmed by utilizing perspective, so that the positioning and navigation device accurately navigates the kirschner wire to drive in an intraosseous channel by utilizing a laser line under the condition of no perspective. The inventor confirms that the result is consistent through many times of experiments, and the success rate is high, and the operation is simple and accurate.
Claims (11)
1. The positioning navigation device of the bone channel of the nail hole of the orthopedic implant is connected with a C-shaped arm X-ray machine or a G-shaped arm X-ray machine (3) and is characterized by comprising two laser emitting pieces (1) and a binding belt (2), wherein the binding belt (2) is bound on an image intensifier (31) of the C-shaped arm X-ray machine or the G-shaped arm X-ray machine (3); the two laser emission parts (1) are arranged on the binding belt (2) and can move along the binding belt (2);
The two laser emission parts (1) are a first laser emission part (11) and a second laser emission part (12) respectively; the first laser emission part (11) and the second laser emission part (12) have the same structure and comprise a fixed seat (111), a laser pen fixing device (112) and a laser pen (113) capable of emitting linear rays, the fixed seat (111) is connected with the binding belt (2), the laser pen fixing device (112) is connected with the fixed seat (111), the laser pen fixing device (112) is provided with a laser pen fixing channel (115), the laser pen fixing channel (115) and the laser pen fixing device (112) are coaxially arranged, the laser pen (113) can freely rotate around an axis in the laser pen fixing channel (115), the laser pen (113) is inserted from the top of the laser pen fixing channel (115), and the linear laser rays emitted by the laser pen (113) are emitted from the bottom of the laser pen fixing channel (115);
The first laser emission part (11) is arranged on the extension line of the positioning line B, and the linear laser emitted by the first laser emission part (11) coincides with the positioning line C; the positioning line B is arranged on the end face of an image intensifier (31) of the C-arm X-ray machine or the G-arm X-ray machine (3), and is overlapped with the positioning line A in a circular exposure area (4) of the display screen (6) during perspective; the positioning line C is arranged in parallel with the positioning line B and keeps a certain distance, and is overlapped with the positioning line B and the positioning line A in a circular exposure area (4) of the display screen (6) in perspective; the positioning line A is a horizontal axis of a circular exposure area (4) of a display screen (6) of the C-arm X-ray machine or the G-arm X-ray machine (3), and passes through round dots of the circular exposure area (4) of the display screen (6);
The second laser emitting part (12) is arranged on the extension line of the positioning line E, and the linear laser emitted by the second laser emitting part (12) coincides with the positioning line F; the positioning line E is arranged on the end face of an image intensifier (31) of the C-arm X-ray machine or the G-arm X-ray machine (3), and is overlapped with the positioning line D in a circular exposure area (4) of the display screen (6) during perspective; the positioning line F is arranged in parallel with the positioning line E and keeps a certain distance, and is overlapped with the positioning line E and the positioning line D in a circular exposure area (4) of the display screen (6) in perspective; the positioning line D is a vertical axis of a circular exposure area (4) of a display screen (6) of the C-arm X-ray machine or the G-arm X-ray machine (3), and passes through round dots of the circular exposure area (4) of the display screen;
the positioning line A and the positioning line D are mutually perpendicular in a display screen circular exposure area (4);
The positioning plate (5) is used for displaying the screen (6), the positioning plate (5) is matched with the display screen (6) in shape and can cover the surface of the display screen (6), and a positioning line A scale (51) and a positioning line D scale (52) are marked on the positioning plate (5) and are used for marking a positioning line A and a positioning line D of the circular exposure area (4);
The fixing seat (111) is provided with a through hole (114), and the binding belt (2) passes through the through hole (114).
2. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 1, wherein:
The surface of an X-ray box aligner (7) of the C-arm X-ray machine or the G-arm X-ray machine (3) is also provided with a positioning line G, and the linear laser line emitted by the first laser emitting piece (11) coincides with the positioning line G.
3. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 2, characterized in that:
The surface of an X-ray box aligner (7) of the C-arm X-ray machine or the G-arm X-ray machine (3) is also provided with a positioning line H, and the linear laser line emitted by the second laser emitting piece (12) coincides with the positioning line H.
4. The positioning and navigation device of an orthopedic implant nail hole intra-osseous channel according to claim 1, further comprising a fixation bracket (8), said fixation bracket (8) comprising a fixation panel (81), said positioning wire C and said positioning wire F being arranged on said fixation panel (81).
5. The positioning and navigation device of an orthopedic implant nail hole intra-osseous canal according to claim 1, further comprising an angle fixation seat (116), said angle fixation seat (116) being arranged between said fixation seat (111) and said laser pen holder (112).
6. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 5, wherein:
The angle fixing seat (116) can enable an included angle of 40-60 degrees to be arranged between the laser pen fixing device (112) and the fixing seat (111).
7. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 1, wherein:
the width of the linear laser line emitted by the laser pen (113) projected on the skin surface of the human body is not more than 2mm.
8. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 1, wherein:
The distance between the laser pen (113) and the projection position of the human body target is 60-70 cm.
9. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 1, wherein:
The joint surface of the fixing seat (111) and the image intensifier (31) of the C-shaped arm X-ray machine or the G-shaped arm X-ray machine (3) is provided with a friction force increasing structure.
10. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 1, wherein:
The binding belt (2) and the binding surface of the fixing seat (111) are provided with fixing clamping grooves (21).
11. The positioning and navigation device for the nail hole intra-osseous channel of an orthopedic implant according to claim 1, wherein:
the binding belt (2) is provided with an tightness adjusting piece (22).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010683066.0A CN113940747B (en) | 2020-07-15 | 2020-07-15 | Positioning navigation device for bone channel of nail hole of orthopedic implant |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010683066.0A CN113940747B (en) | 2020-07-15 | 2020-07-15 | Positioning navigation device for bone channel of nail hole of orthopedic implant |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN113940747A CN113940747A (en) | 2022-01-18 |
| CN113940747B true CN113940747B (en) | 2024-04-16 |
Family
ID=79326179
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010683066.0A Active CN113940747B (en) | 2020-07-15 | 2020-07-15 | Positioning navigation device for bone channel of nail hole of orthopedic implant |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN113940747B (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114983569B (en) * | 2022-08-02 | 2022-10-25 | 首都医科大学附属北京友谊医院 | Femoral neck channel screw intraosseous channel positioning navigation device with positioning support |
Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2017027577A1 (en) * | 2015-08-10 | 2017-02-16 | Fusmobile Inc. | Image guided focused ultrasound treatment device and aiming apparatus |
| WO2017070523A1 (en) * | 2015-10-22 | 2017-04-27 | Straight Shot, LLC | Surgical implant alignment device |
| CN206183369U (en) * | 2016-04-08 | 2017-05-24 | 李军 | Bone surgery navigation positioning device and C shape arm X optical equipment |
| CN108056810A (en) * | 2016-11-08 | 2018-05-22 | 高雄医学大学 | A kind of alignment system and method for non-intrusion type locking bone |
| CN109481018A (en) * | 2018-12-29 | 2019-03-19 | 上海联影医疗科技有限公司 | A kind of navigation equipment and method applied in medical care precess |
| CN213489223U (en) * | 2020-07-15 | 2021-06-22 | 首都医科大学附属北京友谊医院 | Positioning and navigation device for orthopedic implant nail hole intraosseous passage |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20100030219A1 (en) * | 2007-07-01 | 2010-02-04 | L.R.S. Ortho Ltd. | Orthopedic navigation system and method |
-
2020
- 2020-07-15 CN CN202010683066.0A patent/CN113940747B/en active Active
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2017027577A1 (en) * | 2015-08-10 | 2017-02-16 | Fusmobile Inc. | Image guided focused ultrasound treatment device and aiming apparatus |
| WO2017070523A1 (en) * | 2015-10-22 | 2017-04-27 | Straight Shot, LLC | Surgical implant alignment device |
| CN206183369U (en) * | 2016-04-08 | 2017-05-24 | 李军 | Bone surgery navigation positioning device and C shape arm X optical equipment |
| CN108056810A (en) * | 2016-11-08 | 2018-05-22 | 高雄医学大学 | A kind of alignment system and method for non-intrusion type locking bone |
| CN109481018A (en) * | 2018-12-29 | 2019-03-19 | 上海联影医疗科技有限公司 | A kind of navigation equipment and method applied in medical care precess |
| CN213489223U (en) * | 2020-07-15 | 2021-06-22 | 首都医科大学附属北京友谊医院 | Positioning and navigation device for orthopedic implant nail hole intraosseous passage |
Also Published As
| Publication number | Publication date |
|---|---|
| CN113940747A (en) | 2022-01-18 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US4848327A (en) | Apparatus and procedure for blind alignment of fasteners extended through transverse holes in an orthopedic locking nail | |
| US10952751B2 (en) | Surgical targeting systems and methods | |
| JP5198271B2 (en) | Sighting device | |
| JP3280631B2 (en) | Orthopedic targeting device, arm-like device and angular guide device for the device | |
| Whatling et al. | Literature review of current techniques for the insertion of distal screws into intramedullary locking nails | |
| CN101584598B (en) | Ray-penetrable aiming arm used for the position of at least one horizontal hole in embedded intramedullary nail | |
| JP4920749B2 (en) | Distal targeting device | |
| US10327861B2 (en) | Surgical implant alignment device | |
| US20110077657A1 (en) | Drill-aiming method and apparatus | |
| US20110184477A1 (en) | Aiming Arm for Locking of Bone Nails | |
| EP3473203B1 (en) | End effector having line laser mounted therein | |
| WO2016121209A1 (en) | Surgical measurement instrument | |
| CN213489223U (en) | Positioning and navigation device for orthopedic implant nail hole intraosseous passage | |
| CN113940747B (en) | Positioning navigation device for bone channel of nail hole of orthopedic implant | |
| CN110680494A (en) | Three-dimensional adjustable locking nail guider for long bone intramedullary nail | |
| CN114983569B (en) | Femoral neck channel screw intraosseous channel positioning navigation device with positioning support | |
| EP3318203B1 (en) | A non-invasive positioning system for screwing and fixing a bone | |
| US20200222116A1 (en) | Systems and methods for laser-assisted placement of orthopedic implants | |
| CN114948260B (en) | Positioning device and positioning method for bone channel of nail hole of orthopedic implant | |
| JP4709996B2 (en) | Bone tracking device fixation member | |
| CN108697472B (en) | Positioning and alignment instrument for introducing a surgical device into a bone | |
| CN114948158B (en) | Positioning navigation device and method for femoral neck channel screw intraosseous channel | |
| US8308733B1 (en) | Device and method for locking intramedullary nails | |
| WO2018226224A1 (en) | Surgical targeting systems and methods | |
| US10952754B2 (en) | Orthopedic surgical guide for tunnel placement |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |