CN114569231A - Guide plate for guiding femoral guide pin and manufacturing method thereof - Google Patents

Guide plate for guiding femoral guide pin and manufacturing method thereof Download PDF

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Publication number
CN114569231A
CN114569231A CN202210206063.7A CN202210206063A CN114569231A CN 114569231 A CN114569231 A CN 114569231A CN 202210206063 A CN202210206063 A CN 202210206063A CN 114569231 A CN114569231 A CN 114569231A
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CN
China
Prior art keywords
femoral
guide plate
femur
guide pin
lateral
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CN202210206063.7A
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CN114569231B (en
Inventor
陈亮
王钟
王颖博
陈俊
吴畏
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Chinese Peoples Liberation Army Army Specialized Medical Center
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Chinese Peoples Liberation Army Army Specialized Medical Center
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B33ADDITIVE MANUFACTURING TECHNOLOGY
    • B33YADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y80/00Products made by additive manufacturing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526Methods of manufacturing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101Computer-aided simulation of surgical operations
    • A61B2034/105Modelling of the patient, e.g. for ligaments or bones
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02PCLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
    • Y02P10/00Technologies related to metal processing
    • Y02P10/25Process efficiency

Abstract

The invention belongs to the technical field of medical instruments, and relates to a guide plate for guiding a femur guide pin and a manufacturing method thereof.

Description

Guide plate for guiding femoral guide pin and manufacturing method thereof
Technical Field
The invention belongs to the technical field of medical instruments, and relates to a guide plate for a guide pin of a femur and a manufacturing method thereof.
Background
The accurate guide needle is arranged in a femoral head necrosis focal area, which is the basis for treating early femoral head ischemic necrosis, and the positioning accuracy is a key factor for determining the success or failure of the operation. However, the focus area of early femoral head necrosis is located below the articular cartilage, and the positioning cannot be completed under direct vision, and the surgeon is often required to perform spatial positioning under the assistance of experience and intraoperative C-arm fluoroscopy. The perspective of the C-shaped arm is a multi-angle plane positioning, and the femoral head is in a spherical space, so that the positioning is not very accurate, and the driving of the guide pin has greater subjectivity. Anatomical parameters such as the diameter of the femoral head, the neck shaft angle, the anteversion angle and the like are different, and the traditional guide device manufactured based on the standardized geometric anatomical form cannot be designed individually.
Disclosure of Invention
In view of this, the present invention provides a femoral guide pin guiding guide plate and a manufacturing method thereof, aiming to solve the problems of precise spatial positioning and individual customization of a femoral head necrosis focal zone positioning guide plate.
In order to achieve the purpose, the invention provides the following technical scheme:
a guide plate for guiding a guide pin of a femur comprises a guide plate body and a bone nail guide hole arranged on the guide plate body, wherein the inner side of the guide plate body is provided with a binding surface used for binding with the femur, and the binding surface comprises a first positioning surface and a second positioning surface used for binding and positioning; the first locating surface is used for being attached to a naturally-existing femoral lateral oblique surface area below the lateral femoral lateral muscle of the greater trochanter of the femur of a patient; the second positioning surface is used for being attached to a triangular area formed on the outer side surface of the patient's femoral proximal gluteus tuberosity.
Further, the baffle body all adopts 3D printing material to make with the guiding hole.
The handle is detachably connected with the guide plate body through the threaded hole.
Further, the number of the threaded holes is at least 1. The installation position of the handle has a plurality of choices by the plurality of threaded holes, so that the visual field is prevented from being shielded in the operation process.
Further, the handle is made of stainless steel materials. The stainless steel material can be repeatedly used, and the cost is reduced.
A method for manufacturing a femoral guide pin guide plate is used for manufacturing the femoral guide pin guide plate and comprises the following steps:
s1, obtaining a femur three-dimensional digital model: scanning the femur through a medical diagnosis scanning device to obtain a medical image of the femur; obtaining a three-dimensional digital model of the femur based on the medical image data of the femur;
s2, modeling a femoral guide pin guide plate: dividing the surface of the three-dimensional digital model of the femur into areas according to the curvature change rate, identifying a femur external inclined surface area naturally existing below the external femur muscle of the greater trochanter, and using the femur external inclined surface area as a fitting surface of a first positioning surface; identifying a triangular area formed on the outer side surface of the femoral proximal gluteus tuberosity, using the triangular area as a fitting surface of a second positioning surface, and performing reverse modeling through the two fitting surfaces to obtain a binding surface attached to the femur; manufacturing a bone nail guide hole according to the focus position in the medical image data; generating a three-dimensional digital model of the femur guide pin guide plate;
and S3, manufacturing the femoral guide pin guide plate through additive manufacturing equipment according to the three-dimensional digital model of the femoral guide pin guide plate.
Further, the medical diagnostic scanning device is a CT scanning device or an MR scanning device.
Further, in step S2, at least two regions with different curvatures are selected as fitting surfaces on the triangular region formed by the outer oblique surface region of the femur naturally existing under the outer femoral lateral muscle of the greater trochanter and the outer lateral surface of the femoral proximal gluteal tuberosity.
The invention has the beneficial effects that:
1. the femur guide pin guide plate adopts two binding surfaces, the two binding surfaces adopt a triangular area formed by a femur outer oblique surface area naturally existing below femur outer side muscles of a femur greater trochanter and a lateral surface of a femur proximal gluteus tuberosity, the two areas have no muscle stop points and tendon attachment and are convenient to operate, the femur outer side muscles are pulled forwards by using a Hofmann hook, and a periosteum can be stripped in a limited way to expose the bone surface. And the femoral greater trochanter and the gluteus tuberosity behind the proximal femur, which are positioned at the outer side of the proximal femur, are in an intersection region, and the femoral greater trochanter and the gluteus tuberosity have specific structures with characteristic anatomy, so that the anatomical variation is less, and the positioning in the operation is facilitated.
2. According to the invention, the guide plate suitable for the patient is manufactured by utilizing the three-dimensional digital model through the scanning data of the patient, and the guide plate is customized individually, so that the problem of positioning accuracy caused by individual difference is avoided; meanwhile, a three-dimensional digital model is adopted, the femur is subjected to region division according to fitting of planes with different curvatures, a femur binding surface with unique binding property is obtained, and the binding surface realizes positioning by utilizing a triangular region formed by a femur outer oblique surface region and a femur proximal gluteus tuberosity outer side surface which naturally exist below femur greater trochanter outer thigh outer side muscles, so that the positioning accuracy is improved. Meanwhile, the guide plate is processed by adopting an additive manufacturing mode, and the guide plate has the advantages of high speed and low cost.
Additional advantages, objects, and features of the invention will be set forth in part in the description which follows and in part will become apparent to those having ordinary skill in the art upon examination of the following or may be learned from practice of the invention. The objectives and other advantages of the invention may be realized and attained by the means of the instrumentalities and combinations particularly pointed out hereinafter.
Drawings
For the purposes of promoting a better understanding of the objects, aspects and advantages of the invention, reference will now be made to the following detailed description taken in conjunction with the accompanying drawings in which:
FIG. 1 is a schematic view of a femoral guide pin guiding guide plate according to the present invention;
fig. 2 is a schematic diagram of femoral region segmentation in the present invention.
Reference numerals: 1-a guide plate body; 2-guiding holes for bone nails; 3-a handle; 4-femur; 5-a threaded hole; 41-triangular area; 42-lateral femoral oblique area.
Detailed Description
The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention. It should be noted that the drawings provided in the following embodiments are only for illustrating the basic idea of the present invention in a schematic way, and the features in the following embodiments and embodiments may be combined with each other without conflict.
Wherein the showings are for the purpose of illustrating the invention only and not for the purpose of limiting the same, and in which there is shown by way of illustration only and not in the drawings in which there is no intention to limit the invention thereto; to better illustrate the embodiments of the present invention, some parts of the drawings may be omitted, enlarged or reduced, and do not represent the size of an actual product; it will be understood by those skilled in the art that certain well-known structures in the drawings and descriptions thereof may be omitted.
The same or similar reference numerals in the drawings of the embodiments of the present invention correspond to the same or similar components; in the description of the present invention, it should be understood that if there is an orientation or positional relationship indicated by terms such as "upper", "lower", "left", "right", "front", "rear", etc., based on the orientation or positional relationship shown in the drawings, it is only for convenience of description and simplification of description, but it is not an indication or suggestion that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and therefore, the terms describing the positional relationship in the drawings are only used for illustrative purposes, and are not to be construed as limiting the present invention, and the specific meaning of the terms may be understood by those skilled in the art according to specific situations.
Referring to fig. 1-2, a guiding plate for guiding a femur guide pin includes a guiding plate body 1, and a bone nail guiding hole 2 disposed on the guiding plate body 1, wherein a fitting surface for fitting with a femur 4 is disposed on an inner side of the guiding plate body 1, and the fitting surface includes a first positioning surface and a second positioning surface for fitting and positioning; the first locating surface is for engaging a naturally occurring lateral femoral oblique surface zone 42 underlying the lateral femoral lateral muscle of the greater trochanter of the patient's femur; the second locating surface is adapted to engage a triangular area 41 formed by the lateral surface of the patient's proximal femoral gluteal tuberosity. Guide plate body 1 and guiding hole all adopt 3D to print the material and pass through vibration material disk mode integrated into one piece.
Be provided with screw hole 5 on the baffle body 1, the handle 3 of stainless steel passes through screw hole 5 and is connected with the baffle body 1 is detachable. Threaded hole 5 has 3, and 3 threaded hole 5 make the mounted position of handle 3 have a plurality of selections, avoid the operation process field of vision to shelter from.
A method for manufacturing a femoral guide pin guide plate is used for manufacturing the femoral guide pin guide plate in the embodiment, and comprises the following steps:
s1, obtaining a femur three-dimensional digital model: scanning the femur 4 by a CT scanning device or an MR scanning device to obtain a medical image of the patient's femur; obtaining a three-dimensional digital model of the femur through reverse modeling software based on the medical image data of the femur;
s2, modeling a femoral guide pin guide plate: the surface of the three-dimensional digital model of the femur is divided into areas according to the curvature change rate, and the area division boundary can be highlighted by adjusting the curvature change range in the process, so that the recognition degree is increased; identifying a naturally occurring femoral lateral oblique surface region 42 below the lateral femoral lateral muscle of the greater trochanter of the femur, comprising 5 regions of different curvature, as a fitting surface for the first locating surface; identifying a triangular area 41 formed on the outer side surface of the femoral proximal gluteus tuberosity, wherein the triangular area comprises 5 areas with different curvatures, the areas are used as fitting surfaces of a second positioning surface, and a binding surface attached to the femur is obtained by performing reverse modeling on the two fitting surfaces; manufacturing a bone nail guide hole according to the focus position in the medical image data; generating a three-dimensional digital model of the femur guide pin guide plate;
and S3, manufacturing the femoral guide pin guide plate through additive manufacturing equipment according to the three-dimensional digital model of the femoral guide pin guide plate.
The using process of the femoral guide pin guiding guide plate in the embodiment is as follows:
the skin was incised 3-5cm distally at the lateral margin of greater trochanter, the subcutaneous tissue of the skin was isolated, and fascia lata was incised arcuately. The gap between the lateral femoral muscle and the facet was touched with a finger from the rear, and the lateral femoral muscle was pulled forward using a hoffman hook. Periosteal connective tissue is separated using a periosteal elevator, backwards to the lateral border of the gluteal trochanter, and the musculature is pulled apart using another hofmann hook. And at the moment, the surface condition of the exposed bone tissue is checked again, the guide plate is completely attached to the bone surface after no residual soft tissue is determined, and a 2.0mm kirschner wire is used for driving the guide plate into the femoral head direction from a guide hole of the guide device by 5-7 cm. The guide needle is completely driven into a specific area of the femoral head as a guide needle according to preoperative planning after the position of the guide needle is determined to be correct through intraoperative C-shaped arm perspective. And the guide pin is determined to be correct in position through intraoperative C-shaped arm perspective, and then the guide plate is withdrawn for other operations.
Finally, the above embodiments are only intended to illustrate the technical solutions of the present invention and not to limit the present invention, and although the present invention has been described in detail with reference to the preferred embodiments, it will be understood by those skilled in the art that modifications or equivalent substitutions may be made on the technical solutions of the present invention without departing from the spirit and scope of the technical solutions, and all of them should be covered by the claims of the present invention.

Claims (8)

1. The utility model provides a thighbone guide pin guide baffle, includes the baffle body, locates the bone nail guiding hole on the baffle body, its characterized in that: the inner side of the guide plate body is provided with a binding surface used for binding with the femur, and the binding surface comprises a first positioning surface and a second positioning surface used for binding and positioning; the first locating surface is used for being attached to a naturally-existing femoral lateral oblique surface area below the lateral femoral lateral muscle of the greater trochanter of the femur of a patient; the second positioning surface is used for being attached to a triangular area formed on the outer side surface of the patient's femoral proximal gluteus tuberosity.
2. The femoral guide pin guide plate of claim 1, wherein: the guide plate body and the guide hole are both made of 3D printing materials.
3. The femoral guide pin guide plate of claim 1, wherein: the guide plate is characterized by further comprising a handle, wherein a threaded hole is formed in the guide plate body, and the handle is detachably connected with the guide plate body through the threaded hole.
4. The femoral guide pin guide plate of claim 1, wherein: the number of the threaded holes is at least 1.
5. A femoral guide pin guide plate according to claim 3, characterized in that: the handle is made of stainless steel materials.
6. A method for manufacturing a femoral guide pin guide plate, which is used for manufacturing the femoral guide pin guide plate as claimed in any one of claims 1 to 5, comprising the following steps:
s1, obtaining a femur three-dimensional digital model: scanning the femur through a medical diagnosis scanning device to obtain a medical image of the femur; obtaining a three-dimensional digital model of the femur based on the medical image data of the femur;
s2, modeling a femoral guide pin guide plate: dividing the surface of the three-dimensional digital model of the femur into areas according to the curvature change rate, identifying a femur external inclined surface area naturally existing below the external femur muscle of the greater trochanter, and using the femur external inclined surface area as a fitting surface of a first positioning surface; identifying a triangular area formed on the outer side surface of the femoral proximal gluteus tuberosity, using the triangular area as a fitting surface of a second positioning surface, and performing reverse modeling through the two fitting surfaces to obtain a binding surface attached to the femur; manufacturing a bone nail guide hole according to the focus position in the medical image data; generating a three-dimensional digital model of the femur guide pin guide plate;
and S3, manufacturing the femoral guide pin guide plate through additive manufacturing equipment according to the three-dimensional digital model of the femoral guide pin guide plate.
7. The method for making a femoral guide pin guide plate according to claim 6, wherein: the medical diagnostic scanning device is a CT scanning device or an MR scanning device.
8. The method of making a femoral guide pin guide plate according to claim 6, wherein: in step S2, at least two regions of different curvatures are selected as fitting surfaces on a triangular region formed by a femoral lateral oblique region naturally existing below the femoral greater trochanter lateral femoral lateral muscle and the lateral side of the femoral proximal gluteal tuberosity.
CN202210206063.7A 2022-02-28 2022-02-28 Femur guide pin guide plate and manufacturing method thereof Active CN114569231B (en)

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CN215384548U (en) * 2021-05-27 2022-01-04 宁夏医科大学总医院 Individualized 3D prints nail board of thighbone neck fracture FNS internal fixation and puts into baffle
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US20220047278A1 (en) * 2003-11-25 2022-02-17 Conformis, Inc. Patient Selectable Joint Arthroplasty Devices and Surgical Tools
US20140358152A1 (en) * 2011-04-08 2014-12-04 Sara Condino Drilling mask for implanting a transpedicular screw
CN113208687A (en) * 2013-12-09 2021-08-06 穆罕默德·R·马赫福兹 Bone reconstruction and orthopedic implant
US20160279877A1 (en) * 2015-03-24 2016-09-29 Orthotaxy Method for constructing a patient-specific surgical guide
CN104799950A (en) * 2015-04-30 2015-07-29 上海昕健医疗技术有限公司 Personalized minimally-invasive knee joint positioning guide plate based on medical image
CN205215346U (en) * 2015-10-23 2016-05-11 郑朋飞 Children femoral neck fracture baffle of performing operation
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CN108030532A (en) * 2017-11-22 2018-05-15 华南理工大学 Astragalus dummy, bone-culting operation guide plate and its design method of personalized loose structure
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