CN114601550A

CN114601550A - Orthopedic operation guide plate device and using method

Info

Publication number: CN114601550A
Application number: CN202210236247.8A
Authority: CN
Inventors: 谭培勇; 胡广; 刘洋
Original assignee: First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine
Current assignee: First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine
Priority date: 2022-03-11
Filing date: 2022-03-11
Publication date: 2022-06-10

Abstract

The invention discloses an orthopedic operation guide plate device which comprises a guide plate, a first fixing needle base, a second fixing needle base, a positioning assembly, a first fixing needle and a second fixing needle, wherein the first fixing needle base and the second fixing needle base are fixed on the same side of the guide plate, the first fixing needle is matched with the first fixing needle base, the second fixing needle base is matched with the second fixing needle, and the positioning assembly is matched with the first fixing needle and the second fixing needle. The invention also provides a method for using the guide plate fixing device, wherein the guide plate is fixed by two fixing pins, and the fixing pins and the positioning assembly are matched to play a role of positioning screws. After the screw is positioned by the positioning component, the screw can be accurately placed to a preset screw feeding point. The nail feeding positioning port can expose the nail feeding point, so that the observation and the operation in the operation are convenient. The device and the method break through the limitation that only hollow nails can be adopted in the prior art, and have the advantages of wide application range, convenient operation and high operation accuracy.

Description

Orthopedic operation guide plate device and using method

Technical Field

The invention relates to the technical field of medical instruments, in particular to an orthopedic operation guide plate device and a using method thereof.

Background

In the orthopedic surgery, the screws are often required to be placed in the bone to fix the fracture or dislocation, and the accuracy requirement for placing the screws in certain parts is very high, for example, the deviation of the screw direction and the screw feeding point can penetrate out of the vertebral pedicle to damage the nerve and blood vessels. The screw placing guide plate is an auxiliary device for accurate screw placing and positioning in orthopedic surgery. The nail placing guide plate is usually manufactured by adopting a 3D printing technology, firstly, thin-layer CT scanning is carried out on a surgical part of a patient before an operation to obtain related imaging data, on the basis of the imaging data, a proper screw placing mode including a nail entering position, an angle, a length and the like is determined in a virtual operation mode, and then the nail placing guide plate is manufactured on the basis. The nail placing guide plate can confirm that the nail feeding parameters of the actually placed screws are completely consistent with those of the virtual operation in the actual operation, so that the aim of precise operation is fulfilled.

At present, all conventional nail placing guide plates can only be used for placing hollow nails, and when the nail placing guide plates are used, guide needles are firstly driven into the nail placing guide plates under the assistance of the nail placing guide plates, and then the hollow nails are sleeved outside the guide needles and screwed into bone tissues. The current clinical hollow nail has the following disadvantages: 1. the processing is difficult and the price is high; 2. the screw has poor mechanical strength, the diameter cannot be too thin, the application range is narrow, and for example, the too thick hollow nail is used for the position of the pedicle of vertebral arch, and the like, so that the bone is easy to burst; 3. the hollow nail placing guide plate is used, a nail placing point cannot be seen directly, and when the position of the guide plate is not accurate, errors cannot be found according to experience of an operating doctor. 4. After the nail placing guide plate assists in driving the guide pin, the guide plate needs to be taken down, and the accuracy of the operation can be affected if the patient is osteoporosis or the guide pin is bent and loosened.

Disclosure of Invention

In view of this, the present invention provides an orthopedic surgery guide plate device with precise positioning and easy operation, which can be used for setting a solid screw and a method for using the same.

According to one aspect of the invention, an orthopedic surgery guide plate device is provided and comprises a guide plate, a first fixing needle base, a second fixing needle base, a positioning assembly, a first fixing needle and a second fixing needle, wherein the first fixing needle base and the second fixing needle base are fixed on the same side of the guide plate, the first fixing needle is matched with the first fixing needle base, the second fixing needle is matched with the second fixing needle base, and the positioning assembly is matched with the first fixing needle and the second fixing needle.

Further, the guide plate is provided with a nail feeding positioning hole penetrating through the guide plate.

Further, locating component includes first fixed needle sleeve, the fixed needle sleeve of second, screwdriver sleeve and connecting piece, first fixed needle sleeve passes through connecting piece and screwdriver sleeve fixed connection, the fixed needle sleeve of second passes through connecting piece and screwdriver sleeve fixed connection.

Furthermore, the first fixed needle sleeve is sleeved outside the first fixed needle and is in close sliding fit with the first fixed needle, and the second fixed needle sleeve is sleeved outside the second fixed needle and is in close sliding fit with the second fixed needle.

Further, the sleeve is opposite to the nail feeding positioning opening.

Further, orthopedic surgery baffle device still includes screw and screwdriver, the screw includes continuous screw rod and end cap, the tip of end cap is equipped with the hexagonal shrinkage pool, the screwdriver includes consecutive handle, cutter arbor, tool bit and jack catch, the cutter arbor cooperatees with the screwdriver sleeve, the tool bit is the hexagonal type and cooperatees with the hexagonal shrinkage pool in order to ensure screwdriver screw rod and screw axis on a straight line.

Furthermore, the screwdriver further comprises a clamping jaw, the clamping jaw is detachably connected with the screwdriver rod, and the clamping jaw is matched with the end cap.

According to another aspect of the present invention, there is provided a method of using an orthopedic surgical guide plate device, comprising the steps of:

s1, attaching the guide plate to the bone surface and exposing the nail feeding point in the nail feeding positioning opening;

s2, inserting a first fixing pin and a second fixing pin into the first fixing pin base and the second fixing pin base respectively, wherein the first fixing pin and the second fixing pin penetrate through the guide plate and fix the guide plate on bone tissues;

s3, respectively sleeving the first fixing needle sleeve and the second fixing needle sleeve outside the first fixing needle and the second fixing needle, and enabling the screwdriver sleeve to face the nail feeding point;

s4, enabling a tool bit and a tool bar of the screwdriver to penetrate through the screwdriver sleeve, and installing the clamping jaw on the screw rod at one end of the tool bit;

s5, inserting the cutter head into the hexagonal concave hole of the screw, grasping the end cap of the screw by the claw, and placing the screw into the bone tissue from the screw feeding point.

Further, the screw is a solid screw.

The invention has the beneficial effects that: the adoption is equipped with two fixed needle bases on the baffle and fixes two fixed targets to the baffle, and fixed needle and locating component cooperation can play set screw's effect. After the screw is positioned by the positioning component, the screw can be accurately placed on a preset screw feeding point on the bone. The nail feeding positioning opening is formed in the guide plate, so that a nail feeding point can be exposed, observation and operation in an operation are facilitated, and the accuracy of the operation and the convenience of operation are improved. The device and the method of the invention adopt the positioning component which is designed separately from the guide plate to position the screw, and the cooperation of the hollow screw and the guide pin is not needed to carry out the screw placing operation. Therefore, the device and the method can adopt the solid nail to carry out nail placing operation, break through the technical limitation that only the hollow nail can be adopted in the prior art, have small screw diameter, high strength and wide applicable range, and simultaneously improve the accuracy of the operation and the convenience of the operation.

Drawings

FIG. 1 is a schematic view of an orthopedic surgical guide plate assembly according to an embodiment of the present invention;

FIG. 2 is a schematic view of a screwdriver of the orthopedic guide plate device shown in FIG. 1;

FIG. 3 is a schematic view of the structure of a screw of the orthopedic guide plate device shown in FIG. 1;

FIG. 4 is a schematic structural view of another embodiment of a screwdriver;

FIG. 5 is a partial schematic view of the screwdriver of FIG. 4;

FIG. 6 is a schematic structural diagram of a positioning assembly according to another embodiment of the present invention;

FIG. 7 is a schematic view of the screwdriver sleeve of the positioning assembly of FIG. 6;

FIG. 8 is a schematic view of the first and second positioning snaps of the positioning assembly of FIG. 6;

FIG. 9 is a view showing the effect of the physical structure of the guide plate device for orthopedic surgery in cooperation with bone tissue according to the present invention;

FIG. 10 is an exploded perspective view of a guide plate assembly for use in orthopedic surgery in accordance with an embodiment of the present invention;

FIG. 11 shows the effect of the screw and the driver on the engagement;

FIG. 12 is a schematic view illustrating a procedure for using an orthopedic surgical guide plate assembly in accordance with an embodiment of the present invention;

in the figure: the nail-inserting positioning device comprises a guide plate-1, a nail-inserting positioning hole-11, a first fixing needle base-2, a second fixing needle base-3, a positioning assembly-4, a first fixing needle sleeve-41, a second fixing needle sleeve-42, a screwdriver sleeve-43, a flange-431, a clamping block-432, a connecting piece-44, a first positioning clamping piece-45, a second positioning clamping piece-46, a pushing block-461, a through groove-47, a first fixing needle-5, a second fixing needle-6, a screw-7, a screw-71, an end cap-72, a hexagonal concave hole-73, a screwdriver-8, a handle-81, a cutter bar-82, a cutter head-83, a clamping claw-84, a connecting part-85 and a fastening part-86.

Detailed Description

The invention is described in further detail below with reference to the accompanying drawings.

Fig. 1 to 11 schematically show an orthopedic surgical guide plate device according to an embodiment of the present invention.

Example 1

Referring to fig. 1 to 3 and 10, an orthopedic surgery guide plate apparatus includes a guide plate 1, a first fixing pin base 2, a second fixing pin base 3, a positioning assembly 4, a first fixing pin 5, a second fixing pin 6, a screw 7, and a screwdriver 8. First fixed needle base 2 and second fixed needle base 3 all are fixed in the same one side of baffle 1, and first fixed needle base 2 and second fixed needle base 3 are the tube structure. First fixed needle 5 and the inseparable sliding fit of first fixed needle base 2, the inseparable sliding fit of second fixed needle base 3 and the fixed needle 6 of second, locating component 4 and the cooperation of first fixed needle 5 and the fixed needle 6 of second. The first fixing pin 5 and the second fixing pin 6 may be kirschner pins.

The guide plate 1 is provided with a nail feeding positioning hole 11 penetrating through the guide plate 1, and the nail feeding positioning hole 11 can be positioned between the first fixing needle base 2 and the second fixing needle base 3. Referring to fig. 9, in use, the bone surface of the other side of the guide plate 1, on which the nail needs to be placed, is attached, so that the predetermined nail feeding point on the bone is positioned in the nail feeding positioning opening 11. The guide plate 1 may be fixed to the bone by inserting the first fixing pins 5 through the first fixing pin bases 2 and the guide plate 1 and inserting the second fixing pins 6 through the second fixing pin bases 3 and the guide plate 1 and into the bone tissue. The first fixing pin base 2 and the second fixing pin base 3 play a role in guiding and positioning.

The positioning assembly 4 includes a first fixing needle sleeve 41, a second fixing needle sleeve 42, a screwdriver sleeve 43 and a connector 44, and the first fixing needle sleeve 41, the second fixing needle sleeve 42 and the screwdriver sleeve 43 are all in a barrel shape. The first fixing needle sleeve 41 is fixedly connected to the driver sleeve 43 by a connecting element 44, and the second fixing needle sleeve 42 is fixedly connected to the driver sleeve 43 by a connecting element 44. The first fixing needle sleeve 41, the second fixing needle sleeve 42 and the screwdriver sleeve 43 are rigidly connected, and any angle can be set among the first fixing needle sleeve 41, the second fixing needle sleeve 42 and the screwdriver sleeve 43 according to requirements.

The first fixing needle sleeve 41, the second fixing needle sleeve 42 and the screwdriver sleeve 43 are rigidly connected, the first fixing needle sleeve 41 can be in close sliding fit with the first fixing needle 5, and the second fixing needle sleeve 42 can be in close sliding fit with the second fixing needle 6. When in use, the first fixing needle sleeve 41 is sleeved outside the first fixing needle 5, and the second fixing needle sleeve 42 is sleeved outside the second fixing needle 6, and the screwdriver sleeve 43 is opposite to the nail feeding point in the nail feeding positioning hole 11.

Referring to fig. 2 and 11, the screw 7 is a solid screw, and the screw 7 includes a shank 71 and an end cap 72 connected to each other. The end of the end cap 72 is provided with a hexagonal recess 73, the screwdriver 8 comprises a handle 81, a screwdriver rod 82 and a screwdriver head 83, and the handle 81, the screwdriver rod 82 and the screwdriver head 83 are connected in sequence. The tool shaft 82 is in close sliding fit with the screwdriver sleeve 43 and the tool bit 83 is hexagonal and in close fit with the hexagonal recess 73, so that when the tool bit 83 is inserted into the hexagonal recess 73, the central line of the screwdriver 8 is aligned with the central line of the screw 7.

The screwdriver 8 further comprises a catch 84, the catch 84 being removably secured to the arbor 82 adjacent one end of the bit 83, the catch 84 engaging the end cap 72 and being capable of gripping the end cap 72. Thus, the engagement of the bit 83 with the hexagonal recess 73 ensures that the driver 8 is in line with the screw 7 and the jaws 84 grip the end cap of the screw to ensure that the screw does not fall off during installation. The latch 84 may be a latch 84 of the prior art.

Example 2

Fig. 4 and 5 schematically show a screwdriver 8 according to another embodiment of the present invention.

Referring to fig. 4 and 5, in embodiment 1, the screwdriver 8 includes a handle 81, a blade bar 82, a bit 83, a jaw 84, a connecting portion 85, and a gripping portion 86, and the handle 81, the blade bar 82, and the bit 83 are connected in this order. The shank 82 is a close sliding fit with the screwdriver sleeve 43 and the cutting head 83 is hexagonal and fits into the hexagonal recess 73. A catch 84 is removably secured to the arbor 82 near one end of the cutter head 83 by a coupling 85, the catch 84 engaging the end cap 72 and being capable of gripping the end cap 72.

The connecting portion 85 is cylindrical, the connecting portion 85 is sleeved outside the end portion of the cutter bar 82 and is in threaded fit with the cutter bar 82, one end of each clamping jaw 84 is elastically connected with the outer edge of the connecting portion 85, and the clamping jaws 84 are arranged in a plurality and surround the connecting portion 85. The clamping portion 86 is sleeved outside the connecting portion 85 and is in threaded fit with the connecting portion 85. The clamping portion 86 is in the shape of a nut, a threaded hole penetrating the clamping portion 86 is formed in the center of the clamping portion 86, and an inclined surface 861 capable of abutting against the outer side of the claw 84 is formed at one end of the threaded hole. Rotation of the gripping portion 86 causes the gripping portion 86 to move axially along the connecting portion 85, causing the ramp 861 to abut the outer side of one end of the jaws 84, pushing the other end of the jaws 84 to converge toward the center to grip the end cap 72. Reverse rotation of the catch 86 releases the catch 84 to release the end cap 72.

Example 3

This example is based on the method of use of the orthopedic surgical guide plate device of examples 1 and 2.

FIG. 12 schematically shows pictorial steps of a method of using an orthopedic surgical guide plate apparatus in accordance with an embodiment of the present invention.

Referring to fig. 12, a method of using an orthopedic surgical guide plate device includes the steps of:

s1, attaching the guide plate 1 to the bone surface and exposing the nail feeding point on the bone scheduled by the operation to the nail feeding positioning port 11;

the method comprises the steps of carrying out three-dimensional scanning on a pathological region of a patient before operation, such as MRI and/or CT, obtaining scanning data, then carrying out three-dimensional reconstruction on the scanning data to obtain a three-dimensional digital model containing the pathological region, analyzing the reconstructed three-dimensional digital model, identifying a pathological part, then determining an operation path, and determining a proper screw placing mode: advance nail position, angle, length etc to make operation baffle 1, first fixed needle base 2, second fixed needle base 3 and locating component 4 through the mode of 3D printing. The guide plate 1 is integrally fixed with a first fixing needle base 2 and a second fixing needle base 3 on one side, the other side of the guide plate 1 can be completely attached to the bone surface of the operation position, the shape of the guide plate 1 is determined according to the shape of the bone according to different operation positions, and the guide plate 1 in the drawing is only schematically illustrated. The shape of the nail feeding positioning opening 11 on the guide plate 1 can be determined according to actual requirements.

S2, inserting the first fixing pin 5 and the second fixing pin 6 into the first fixing pin base 2 and the second fixing pin base 3, respectively, and driving the first fixing pin 5 and the second fixing pin 6 into the bone tissue through the guide plate 1, thereby fixing the guide plate 1 to the bone tissue;

s3, respectively sleeving the first fixing needle sleeve 41 and the second fixing needle sleeve 42 outside the first fixing needle 5 and the second fixing needle 6, and enabling the screwdriver sleeve 43 to be opposite to a nail feeding point; the first and second fixed

needle sleeves

41, 42 can slide along the first and second fixed needles 5, 6, whereby the distance between the screwdriver sleeve 43 and the feed point can be adjusted to facilitate the stapling operation.

S4, passing the bit 83 and the shank 82 of the driver 8 through the driver socket 43, and mounting the jaw 84 on the screw at one end of the bit 83;

s5, insert the bit 83 of the screwdriver 8 into the hexagonal recess 73 of the screw 7 and cause the jaws 84 to grip the end cap 72 of the screw 7. Thereby, it is ensured that the screwdriver 8 is in line with the screw 7 and does not fall off during the screw mounting process. The screw 7 is placed from the feed point onto the bone tissue to complete the stapling operation.

After the screw 7 is inserted, the guide plate 1 can be removed by removing the positioning assembly 4 and removing the first fixing pin 5 and the second fixing pin 6 from the bone.

Example 4

Fig. 6-8 schematically illustrate a positioning assembly according to another embodiment of the invention.

On the basis of embodiment 1, referring to fig. 4 to 6, the positioning assembly 4 includes a first fixing pin sleeve 41, a second fixing pin sleeve 42, a screwdriver sleeve 43, a connector 44, a first positioning jaw 45 and a second positioning jaw 46. The first fixing pin bush 41, the second fixing pin bush 42, and the driver bush 43 are all in a cylindrical shape. The first fixing needle sleeve 41 is fixedly connected to the driver sleeve 43 by means of a connecting element 44, and the second fixing needle sleeve 42 is fixedly connected to the driver sleeve 43 by means of a connecting element 44.

An annular flange 431 is arranged in the screwdriver sleeve 43, and two clamping blocks 432 protruding towards the center of the screwdriver sleeve 43 are symmetrically arranged on the inner side edge of the upper end of the screwdriver sleeve 43. The first positioning clamping piece 45 and the second positioning clamping piece 46 can surround to form a cylinder to be sleeved outside the cutter bar 82, the outer diameter of the first positioning clamping piece 45 and the second positioning clamping piece 46 after surrounding is matched with the inner diameter of the screwdriver sleeve 43, and the inner diameter of the first positioning clamping piece 45 and the second positioning clamping piece 46 after surrounding is matched with the outer diameter of the cutter bar 82. The length of the first and second positioning catches 45, 46 is equal to the distance between the catch 432 and the ledge 431. The peripheral surface of the first positioning clamping piece 45 and the peripheral surface of the second positioning clamping piece 46 are both provided with a through groove 47 which is longitudinally communicated, and the two through grooves 47 can be correspondingly matched with the two clamping blocks 432. One end of the second positioning latch 46 is provided with a push block 461 projecting axially. During the use, in stretching into screwdriver sleeve 43 with the cutter arbor 82 of screwdriver 8, surround first location fastener 45 and second location fastener 46 outside cutter arbor 82, push first location fastener 45 and second location fastener 46 after leading to groove 47 and fixture block 432 relatively in screwdriver sleeve 43, promote ejector pad 461 laterally again and make fixture block 432 stagger with leading to the groove 47 position, then can install first location fastener 45 and second location fastener 46 between screwdriver sleeve 43 and cutter arbor 82. The first positioning clamping piece 45 and the second positioning clamping piece 46 can be used for stabilizing the effect of the screwdriver 8, so that the positioning accuracy of the device is improved.

The device and the method can be applied to various parts of a human body needing nail placing operation, including but not limited to various areas such as shoulders, elbows, hips, knees, spines and the like, and have wide application range. The screw can be a solid screw, and has the advantages of small volume, high strength, accurate positioning and convenient operation.

What has been described above are merely some embodiments of the present invention. It will be apparent to those skilled in the art that various changes and modifications can be made without departing from the inventive concept herein, and it is intended to cover all such modifications and variations as fall within the scope of the invention.

Claims

1. The utility model provides an orthopedic operation baffle device, its characterized in that, includes baffle (1), first fixed needle base (2), the fixed needle base of second (3), locating component (4), first fixed needle (5) and the fixed needle of second (6), the fixed needle base of first fixed needle base (2) and second (3) all are fixed in with one side of baffle (1), first fixed needle (5) and the cooperation of first fixed needle base (2), the fixed needle of second (6) and the cooperation of the fixed needle base of second (3), locating component (4) and the fixed needle of first fixed needle (5) and second (6) cooperation.

2. An orthopedic guide plate device according to claim 1, characterized in that the guide plate (1) is provided with a nail feeding positioning opening (11) extending through the guide plate (1).

3. An orthopedic surgical guide plate device according to claim 2, characterized in that the positioning assembly (4) comprises a first fixing needle sleeve (41), a second fixing needle sleeve (42), a screwdriver sleeve (43) and a connector (44), the first fixing needle sleeve (41) is fixedly connected with the screwdriver sleeve (43) through the connector (44), and the second fixing needle sleeve (42) is fixedly connected with the screwdriver sleeve (43) through the connector (44).

4. An orthopedic guide device according to claim 3, characterized in that the first fixing pin sleeve (41) is fitted over the first fixing pin (5) and is in close sliding engagement with the first fixing pin (5), and the second fixing pin sleeve (42) is fitted over the second fixing pin (6) and is in close sliding engagement with the second fixing pin (6).

5. An orthopedic surgical guide plate apparatus according to claim 4, characterized in that the screwdriver sleeve (43) is opposite the nail insertion positioning port (11).

6. The guide plate device for the orthopedic surgery according to any one of claims 2 to 5, characterized by further comprising a screw (7) and a screwdriver (8), wherein the screw (7) comprises a screw rod (71) and an end cap (72) which are connected, a hexagonal concave hole (73) is formed in the end portion of the end cap (72), the screwdriver (8) comprises a handle (81), a screwdriver rod (82) and a screwdriver head (83) which are sequentially connected, the screwdriver rod (82) is in close sliding fit with a screwdriver sleeve (43), and the screwdriver head (83) is hexagonal and is matched with the hexagonal concave hole (73) to ensure that the central axes of the screw rod and the screw (7) of the screwdriver (8) are in a straight line.

7. An orthopedic guide device according to claim 6, characterized in that the screwdriver (8) further comprises a jaw (84), the jaw (84) being detachably connected to the screwdriver rod (82), the jaw (84) being engaged with the end cap (72).

8. A method of using an orthopedic surgical guide plate device, comprising the steps of:

s1, attaching the guide plate (1) to the bone surface and exposing the nail feeding point in the nail feeding positioning opening (11);

s2, inserting a first fixing needle (5) into the first fixing needle base (2) and inserting a second fixing needle (6) into the second fixing needle base (3), wherein the first fixing needle (5) and the second fixing needle (6) penetrate through the guide plate (1) to fix the guide plate (1) on bone tissues;

s3, respectively sleeving a first fixing needle sleeve (41) and a second fixing needle sleeve (42) outside a first fixing needle (5) and a second fixing needle (6) and enabling a screwdriver sleeve (43) to be opposite to a nail feeding point;

s4, a tool bit (83) and a tool bar (82) of the screwdriver (8) penetrate through the screwdriver sleeve (43), and the claw (84) is installed on a screw rod at one end of the tool bit (83);

s5, inserting the cutter head (83) into the hexagonal concave hole (73) of the screw (7), grasping the end cap (72) of the screw (7) by the claw (84), and placing the screw (7) into the bone tissue from the screw feeding point.

9. Use of an orthopedic guide according to claim 8, characterized in that the screws (7) are solid screws.