CN114869442B - Screw guide for open reduction of femoral neck fracture and method of use thereof - Google Patents
Screw guide for open reduction of femoral neck fracture and method of use thereof Download PDFInfo
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- CN114869442B CN114869442B CN202210460464.5A CN202210460464A CN114869442B CN 114869442 B CN114869442 B CN 114869442B CN 202210460464 A CN202210460464 A CN 202210460464A CN 114869442 B CN114869442 B CN 114869442B
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- 208000020089 femoral neck fracture Diseases 0.000 title claims description 22
- 238000000034 method Methods 0.000 title abstract description 11
- 210000002436 femur neck Anatomy 0.000 claims description 109
- 210000000988 bone and bone Anatomy 0.000 claims description 13
- 230000000149 penetrating effect Effects 0.000 claims description 4
- 239000007943 implant Substances 0.000 abstract 1
- 210000003128 head Anatomy 0.000 description 28
- 206010017076 Fracture Diseases 0.000 description 20
- 208000010392 Bone Fractures Diseases 0.000 description 19
- 210000000689 upper leg Anatomy 0.000 description 17
- 230000017074 necrotic cell death Effects 0.000 description 7
- 238000013459 approach Methods 0.000 description 6
- 210000002391 femur head Anatomy 0.000 description 6
- 230000001054 cortical effect Effects 0.000 description 5
- 210000004394 hip joint Anatomy 0.000 description 4
- 238000000338 in vitro Methods 0.000 description 4
- 238000001727 in vivo Methods 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 238000013519 translation Methods 0.000 description 3
- 229910000831 Steel Inorganic materials 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 239000002775 capsule Substances 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 210000000281 joint capsule Anatomy 0.000 description 2
- 210000003314 quadriceps muscle Anatomy 0.000 description 2
- 230000002787 reinforcement Effects 0.000 description 2
- 239000010959 steel Substances 0.000 description 2
- 206010017088 Fracture nonunion Diseases 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000011882 arthroplasty Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 210000001624 hip Anatomy 0.000 description 1
- 239000010985 leather Substances 0.000 description 1
- 210000002414 leg Anatomy 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000011164 ossification Effects 0.000 description 1
- 230000000750 progressive effect Effects 0.000 description 1
- 230000002285 radioactive effect Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000001694 thigh bone Anatomy 0.000 description 1
- 238000012795 verification Methods 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2017/564—Methods for bone or joint treatment
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
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- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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Abstract
The invention provides a screw guide and a using method thereof, the guide comprises an inner guide piece, an outer guide piece, a first positioning needle, a second positioning needle, a first guide needle, a second guide needle and a third guide needle, the inner guide piece comprises a fixing part and a measurer, the measurer comprises a connecting part, a first caliper and a second caliper, one end of the connecting part is connected to the fixing part, the other end of the connecting part is provided with the first caliper and the second caliper, a first positioning groove and a second positioning groove are formed on the fixing part for the first positioning needle and the second positioning needle to respectively penetrate through and be inserted into the joint of the femoral head and neck for fixing, a first positioning hole and a second positioning hole are formed on the outer guide piece for being sleeved on the first positioning needle and the second positioning needle, and a first adjusting hole, a second adjusting hole and a third adjusting hole are formed on the outer guide piece for respectively inserting the first guide needle, the second guide needle and the third guide needle into the femoral head. The guide device can reduce perspective times, accurately implant the hollow screw, and meet the requirements of parallelism, welting and inverted triangle.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a screw guide for open reduction of femoral neck fracture.
Background
Fracture of the femoral neck is a common frequently occurring disease, fracture nonunion or femoral head necrosis easily occurs after fracture, and although old patients can perform hip arthroplasty, for young patients, the femoral head is usually reserved as much as possible through internal fixation treatment of a closed reduction hollow screw. Classical scheme through inquiry medicine verification is that 3 parallel screws of falling "article" word distribution are fixed in the cortex edge of thighbone neck bone. For vertical fracture, a transverse screw and an inner supporting steel plate are needed. If the two femoral neck fractures are fixed, the mechanical strength is good, the healing rate is high, and the probability of femoral head necrosis is greatly reduced. The reduction quality of the fracture of the femoral neck is also a major factor of success of internal fixation treatment of the fracture of the femoral neck, most of the fracture can be well reduced in a closed traction reduction mode, a small number of the fractures can not be well reduced in a closed reduction mode, or when a supporting steel plate is required to be placed on the inner side, open reduction is required, and the anatomical reduction is realized by looking at the fracture end directly.
For those parts of the fracture that require direct vision of the fracture end to effect anatomic reduction, the current market mature products require additional incisions or extensive fluoroscopy to effect the surgical procedure. The traditional operation of other parts does not need excessive perspective due to the direct vision fracture end during open reduction, but is in a special axial intramedullary fixation mode of femoral neck fracture, and even if the open reduction is performed, a large amount of perspective is needed to determine the good position of the guide pin/screw. Thus, the difficulty of the operation is high, the operation time is long, the learning curve is long, and the requirement of high eye-hand coordination degree can possibly lead to multiple drilling operations on the femur, increase the auxiliary injury and increase the ray exposure of doctors and patients. The whole-course perspective operation has radioactive injury to patients and operators. Even if the operation in the perspective is adopted, the operator can hardly meet the requirements of parallel, cortical bone edge pasting and inverted triangle arrangement. If the requirement is not met, the problem that the femoral neck is not healed and the femoral head is necrotized due to poor screw positions easily occurs.
Disclosure of Invention
In view of the above, the invention provides a screw guide for open reduction of femoral neck fracture, which is used for reducing perspective times, accurately implanting a hollow screw and meeting the requirements of parallelism, welting and inverted triangle, thereby improving the reduction and fixation quality and reducing the probability of non-union of femoral neck and femoral head necrosis.
The technical scheme of the invention is as follows:
The invention provides a screw guider for open reduction of femoral neck fracture, which comprises an inner guide piece, an outer guide piece, a first positioning needle, a second positioning needle, a first guide needle, a second guide needle and a third guide needle, wherein the inner guide piece comprises a fixing part and a measurer, the fixing part is used for being fixed at the position of a rotor interline of a femoral neck, the measurer comprises a connecting part, a first caliper and a second caliper, one end of the connecting part is connected to the fixing part, the other end of the connecting part is provided with the first caliper and the second caliper, the connecting part is arranged at the midpoint position of the first caliper and the second caliper, the first caliper and the second caliper can synchronously and telescopically regulate towards the two ends relative to the midpoint position to clamp the upper pole and the lower pole of the femoral neck, so as to measure the width value of the femoral neck, a first positioning groove and a second positioning groove which are arranged in parallel and are perpendicular to the rotor interline are formed on the fixing part, the first positioning needle and the second positioning needle are respectively penetrated and inserted into the junction of the neck of the femur to fix, so as to determine the forward inclination angle and the abduction angle of the neck of the femur to the first positioning needle and the second positioning needle, a first positioning hole and a second positioning hole are formed in the outer guide member, the outer guide member is respectively sleeved on the first positioning needle and the second positioning needle through the first positioning hole and the second positioning hole and is positioned at the outer side of the neck of the femur to realize positioning, a first adjusting hole, a second adjusting hole and a third adjusting hole are formed in the outer guide member, the first adjusting hole and the second adjusting hole are positioned on the same adjusting direction line, the adjusting direction line of the third adjusting hole is perpendicular to the adjusting direction line of the first adjusting hole and the second adjusting hole and is positioned at the midpoint position between the first adjusting hole and the second adjusting hole, the corresponding hole position of the first adjusting hole is selected to be inserted into the femoral head according to the measured width value of the neck of the femur, and selecting a corresponding hole position of a second adjusting hole to be inserted into the second guide pin and a corresponding hole position of a third adjusting hole to be inserted into the femoral head, wherein the first guide pin, the second guide pin and the third guide pin are arranged on the outer guide piece in an isosceles right triangle.
The invention also provides a screw guider for open reduction of femoral neck fracture, which comprises an inner guide piece, an outer guide piece, a first positioning needle, a second positioning needle, a first guide needle, a second guide needle and a third guide needle, wherein the inner guide piece comprises a fixing part and a measurer, the fixing part is used for being fixed at the position of a trochanter line of a femoral neck, the measurer comprises a connecting part, a first caliper and a second caliper, one end of the connecting part is connected to the fixing part, the other end of the connecting part is provided with the first caliper and the second caliper, the connecting part is arranged at the midpoint position of the first caliper and the second caliper, the first caliper and the second caliper can synchronously stretch and adjust towards the two ends relative to the midpoint position to clamp the upper pole and the lower pole of the femoral neck, a first positioning groove is formed on the fixing part, the central line of the first positioning groove vertically bisects the measuring distance of the first caliper and the second caliper, and the first positioning needle passes through the first positioning groove and is inserted into the junction of the femoral neck to be fixed, so as to determine the front dip angle and the abduction angle of the first positioning needle;
The first caliper is vertically connected with a guide sleeve, a second positioning groove perpendicular to a line between rotors is formed in the guide sleeve, and the guide sleeve is used for penetrating into a second positioning needle to be fixed at the junction of the head and neck of the femur, so that the anteversion angle and the abduction angle of the femur neck to the second positioning needle are determined, and the distance between the second positioning needle and the clamping foot of the first caliper is equal to the thickness of the upper cortex;
the outer guide piece is sleeved on the first positioning needle and the second positioning needle respectively through the first positioning hole and the second positioning hole and is positioned at the outer side of the femoral neck so as to realize positioning, and the second positioning hole is a strip-shaped adjusting hole for enabling the second positioning needle to have a corresponding movable space when the first caliper and the second caliper adjust the measuring distance;
The outer guide piece is provided with a first adjusting hole, a second adjusting hole and a third adjusting hole, the first adjusting hole and the second adjusting hole are located on the same adjusting direction line and extend, the adjusting direction line of the third adjusting hole is perpendicular to the adjusting direction line of the first adjusting hole and the second adjusting hole and located at the midpoint position between the first adjusting hole and the second adjusting hole, the corresponding hole position of the first adjusting hole is selected to be inserted into the first guide pin to the femoral head according to the position of the second positioning pin, the corresponding hole position of the second adjusting hole is selected to be inserted into the second guide pin to the femoral head, the corresponding hole position of the third adjusting hole is selected to be inserted into the third guide pin to the femoral head, and the first guide pin, the second guide pin and the third guide pin are arranged on the outer guide piece in an isosceles right triangle.
Further, a fixing groove matched with the intertrochanter line is formed in one surface of the fixing portion, the fixing groove is perpendicular to the first locating groove and the second locating groove, and the fixing portion is clamped on the intertrochanter line of the femoral neck through the fixing groove.
Further, the inner guide piece further comprises a fixing screw, a fixing hole is formed in the fixing portion, and the fixing screw penetrates through the fixing hole and is screwed into a bone.
Further, the inner guide piece further comprises an adjusting screw, a screw hole is formed in one side, opposite to the fixing hole, of the fixing portion, the adjusting screw is in threaded connection with the screw hole of the fixing portion and abuts against the surface of the bone, and the forward tilting directions of the first positioning needle and the second positioning needle are finely adjusted through screwing in and screwing out.
Further, the caliber further comprises an adjusting gear, the adjusting gear is rotationally connected to the connecting portion, racks are arranged at one ends, close to the connecting portion, of the first caliper and the second caliper, the two racks are meshed with two sides of the adjusting gear in parallel, and the first caliper and the second caliper are arranged on the connecting portion in a sliding mode.
Further, the device comprises a fourth guide pin, the outer guide piece is provided with a fourth adjusting hole above the first adjusting hole, the second adjusting hole and the third adjusting hole, the fourth adjusting hole comprises a plurality of hole sites, and the fourth guide pin is arranged in a percutaneous manner to be parallel to the first guide pin, the second guide pin and the third guide pin in the forward dip angle dimension and points to the midpoint positions of the first caliper and the second caliper in the abduction angle.
Further, the first positioning needle and the second positioning needle are both the Kirschner wire, and the first guide needle, the second guide needle and the third guide needle are all the Kirschner wire.
The invention also provides a using method of the screw guide for the open reduction of the fracture of the femoral neck, which comprises the following steps:
The method comprises the steps that an inner guide piece is arranged at a position, close to a femoral neck, in a body, on a rotor line of the femoral neck, a fixing part is clamped and fixed on the position, close to the rotor line, of the femoral neck, a measurer is arranged at the position of the femoral neck, measures the width value of the femoral neck, respectively passes through a first positioning groove and a second positioning groove, is inserted into a femoral neck junction, is fixed, respectively sleeved on the first positioning needle and the second positioning needle through a first positioning hole and a second positioning hole, is positioned at the outer side of the femoral neck, so that positioning is achieved, on an axial perspective phase of the femoral neck, the front side wall of the femoral neck is an oblique line with the rotor line, after the first positioning needle is placed close to the rotor line, the directions of a first guide needle, a second guide needle and a third guide needle to be placed are determined, the first positioning needle is positioned at the middle point position of a first caliper and a second caliper, the sum of the thickness of an upper cortex and the radius of a hollow screw to be implanted is calculated to be a first distance, the sum of the thickness of the lower cortex and the radius of the hollow screw to be implanted is calculated, and the two sides of the width value of the upper leather are respectively translated to the first guide needle and the first distance are distributed on the upper guide needle and the first distance; calculating the thickness of the front cortex and the radius sum of the hollow screw to be implanted as a third distance, translating the oblique line inwards by a third distance to obtain the front-rear distribution position of the first guide pin and the second guide pin, respectively selecting two intersection points formed by the boundary line between the width value of the translated femur neck and the oblique line after translation as the corresponding hole positions of the first regulation hole and the second regulation hole, respectively passing the first guide pin and the second guide pin through the corresponding hole positions of the first regulation hole and the second regulation hole and inserting the first guide pin and the second guide pin into the femur head, and respectively screwing the first guide pin, the second guide pin and the third guide pin into the hollow screw along the first guide pin, the second guide pin and the third guide pin after removing the inner guide piece and the outer guide piece because the first guide pin, the second guide pin and the third guide pin are arranged in an isosceles right triangle, taking the connecting line of the first guide pin and the second guide pin as oblique edges, calculating the hole position of the third guide pin corresponding to the third regulation hole, and inserting the third guide pin into the femur head.
The invention also provides a using method of the screw guide for the open reduction of the fracture of the femoral neck, which comprises the following steps:
The method comprises the steps of arranging an inner guide part at a position, close to a femoral neck, in a body, clamping and fixing a fixing part on a trochanter line of the femoral neck, arranging a measurer at the femoral neck, adjusting a first caliper and a second caliper to clamp upper and lower poles of the femoral neck, respectively penetrating a first positioning groove and a second positioning groove, inserting the first positioning needle and the second positioning needle into a femoral neck junction for fixing, respectively sleeving an outer guide part on the first positioning needle and the second positioning needle through a first positioning hole and a second positioning hole, and arranging the outer guide part on the outer side of the femoral neck to realize positioning;
the first adjusting hole corresponding to the side edge of the second positioning needle is the hole position corresponding to the first guide needle, the first guide needle passes through the hole position corresponding to the first adjusting hole and is inserted into the femoral head, the hole position corresponding to the first guide needle is symmetrical to the second adjusting hole by the central connecting line of the third adjusting hole and the first positioning hole, the hole position corresponding to the second guide needle is obtained, the second guide needle passes through the hole position corresponding to the second adjusting hole and is inserted into the femoral head, the hole position corresponding to the third guide needle is obtained according to isosceles right triangle arrangement, the third guide needle passes through the hole position corresponding to the third adjusting hole and is inserted into the femoral head, and after the inner guide piece and the outer guide piece are removed, the hollow screw can be screwed in along the first guide needle, the second guide needle and the third guide needle respectively.
The invention has the beneficial effects that:
The screw guider for open reduction of femoral neck fracture provided by the invention has the advantages that the position of the outer guide piece can be determined through the first positioning needle and the second positioning needle on the fixing part of the inner guide piece, the width value of the femoral neck can be measured through the measurer of the inner guide piece, and the corresponding hole position of the first adjusting hole required to be selected by the first guide needle can be calculated according to the thickness of the cortical bone and the radius of the first guide needle; similarly, according to the thickness of the cortical bone and the radius of the second guide pin, the corresponding hole position of the second adjusting hole required to be selected by the second guide pin can be calculated; because the first guide pin, the second guide pin and the third guide pin are arranged on the outer guide piece in an isosceles right triangle, the corresponding hole position of the third adjusting hole required to be selected by the third guide pin can be calculated, and after the inner guide piece and the outer guide piece are removed, the hollow screw can be screwed in along the first guide pin, the second guide pin and the third guide pin respectively. In this way, the anatomical characteristics of the proximal femur (femur neck-femur-trochanter line, etc.) are utilized, the guiding device which is formed by combining an inner guiding piece (in vivo) and an outer guiding piece (in vitro) and is used for determining the position and the direction of the femur neck hollow screw is designed by adopting the osseous mark and the femur distance of the trochanter line, so that the perspective times can be reduced, the hollow screw can be accurately implanted, the requirements of parallelism, welting and inverted triangle can be met, the quality of reduction and fixation can be improved, and the probability of non-union of the femur neck and necrosis of the femur head can be reduced.
The screw guider for open reduction of femoral neck fracture provided by the invention can determine the position of the outer guide piece through the first positioning needle and the second positioning needle on the fixing part of the inner guide piece, the first adjusting hole corresponding to the side edge of the second positioning needle is the hole position corresponding to the first guide needle, and the hole position corresponding to the first guide needle is symmetrically connected to the second adjusting hole by the connecting line of the third adjusting hole and the center of the first positioning hole, so that the hole position corresponding to the second guide needle is obtained. And obtaining the corresponding hole position of the third guide pin in the third adjusting hole according to the isosceles right triangle arrangement. After the inner guide piece and the outer guide piece are removed, the hollow screw can be screwed in along the first guide pin, the second guide pin and the third guide pin respectively. Therefore, the operation is simplified, the anatomical characteristics of the proximal femur (femur neck-femur-trochanter line and the like) are utilized, the guiding device which is formed by combining an inner guiding element (in vivo) and an outer guiding element (in vitro) and is used for determining the position and the direction of a femur neck hollow screw is designed by adopting the osseous mark and the femur distance of the trochanter line, the perspective times can be reduced, the hollow screw can be accurately implanted, and the requirements of parallelism, welting and inverted triangle are met, so that the quality of reduction and fixation is improved, and the probability of non-union of the femur neck and necrosis of the femur head is reduced.
The preferred embodiments of the present invention and their advantageous effects will be described in further detail with reference to specific embodiments.
Drawings
The accompanying drawings are included to provide a further understanding of the invention, and are incorporated in and constitute a part of this specification, illustrate the invention and together with the description serve to explain the invention. In the drawings of which there are shown,
FIG. 1 is a view showing a reference of the use state of a screw guide according to a first embodiment of the present invention;
FIG. 2 is a schematic front view of the outer guide of the screw guide of the first embodiment of the present invention;
FIG. 3 is a schematic front view of a measurer for a screw guide according to a first embodiment of the present invention;
FIG. 4 is an isometric view of a femoral neck after placement of a guide pin with a screw guide according to a first embodiment of the present invention;
FIG. 5 is a view showing a reference of the use state of the screw guide according to the second embodiment of the present invention;
FIG. 6 is a schematic front view of an outer guide of a screw guide according to a second embodiment of the present invention;
FIG. 7 is a schematic front view of a measurer for a screw guide according to a first embodiment of the present invention;
fig. 8 is an isometric view of a second embodiment of the present invention after placement of a guide pin with a screw guide in the femoral neck.
Reference numerals illustrate: the guide device comprises an inner guide piece 1, an outer guide piece 2, a first guide needle 3, a second guide needle 4, a first guide needle 5, a second guide needle 6, a third guide needle 7, a fixing part 11, a measurer 12, a connecting part 121, a first caliper 122, a second caliper 123, a first positioning groove 111, a second positioning groove 112, a first positioning hole 21, a second positioning hole 22, a first adjusting hole 23, a second adjusting hole 24, a third adjusting hole 25, a width value a, an oblique line M, a first distance b, a second distance c, a third distance d, a fixing groove 15, a fixing screw 13, an adjusting screw 14, an adjusting gear 124, a rack 125, a fourth guide needle 8, a fourth adjusting hole 26 and a guide sleeve 120.
Detailed Description
The following describes specific embodiments of the present invention in detail with reference to the drawings. It should be understood that the detailed description and specific examples, while indicating and illustrating the invention, are not intended to limit the invention.
First embodiment
Referring to fig. 1 to 4, a screw guide for open reduction of fracture of femoral neck according to a first embodiment includes an inner guide member 1, an outer guide member 2, a first positioning needle 3, a second positioning needle 4, a first guide needle 5, a second guide needle 6, and a third guide needle 7. The inner guide 1 comprises a fixing part 11 and a measurer 12, wherein the fixing part 11 is used for being fixed at the position of a rotor line of a femoral neck, the measurer 12 comprises a connecting part 121, a first caliper 122 and a second caliper 123, one end of the connecting part 121 is connected to the fixing part 11, the first caliper 122 and the second caliper 123 are arranged at the other end of the connecting part 121, the connecting part 121 is arranged at the midpoint positions of the first caliper 122 and the second caliper 123, and the first caliper 122 and the second caliper 123 can be synchronously and telescopically adjusted towards the two ends relative to the midpoint positions so as to clamp the upper pole and the lower pole of the femoral neck, so that the width value a of the femoral neck is measured. The fixing portion 11 is formed with a first positioning groove 111 and a second positioning groove 112 which are arranged in parallel and perpendicular to the line between the rotors, and the first positioning needle 3 and the second positioning needle 4 respectively penetrate through the first positioning groove 111 and the second positioning groove 112 and are inserted into the junction of the head and neck of the femur to be fixed, so as to determine the anteversion angle and the abduction angle from the femoral neck to the first positioning needle 3 and the second positioning needle 4. The outer guide member 2 is provided with a first positioning hole 21 corresponding to the first positioning needle 3 and a second positioning hole 22 corresponding to the second positioning needle 4, and the outer guide member 2 is respectively sleeved on the first positioning needle 3 and the second positioning needle 4 through the first positioning hole 21 and the second positioning hole 22 and is positioned on the outer side of the femoral neck so as to realize positioning. The outer guide member 2 is provided with a first adjusting hole 23, a second adjusting hole 24 and a third adjusting hole 25, the first adjusting hole 23 and the second adjusting hole 24 are located on the same adjusting direction line and extend, the adjusting direction line of the third adjusting hole 25 is perpendicular to the adjusting direction line of the first adjusting hole 23 and the second adjusting hole 24 and located at the midpoint position between the first adjusting hole 23 and the second adjusting hole 24, so that according to the measured femoral neck width value a, the corresponding hole position of the first adjusting hole 23 is selected to be inserted into the first guide pin 5 to the femoral head, the corresponding hole position of the second adjusting hole 24 is selected to be inserted into the second guide pin 6 to the femoral head, the corresponding hole position of the third adjusting hole 25 is selected to be inserted into the third guide pin 7 to the femoral head, and the first guide pin 5, the second guide pin 6 and the third guide pin 7 are arranged in an isosceles right triangle shape on the outer guide member 2.
The screw guider for open reduction of femoral neck fracture provided by the invention can determine the position of the outer guide piece 2 through the first positioning needle 3 and the second positioning needle 4 on the fixing part 11 of the inner guide piece 1, can measure the width value of the femoral neck through the measurer 12 of the inner guide piece 1, and can calculate the corresponding hole position of the first adjusting hole 23 required to be selected by the first guide needle 5 according to the thickness of the cortical bone and the radius of the first guide needle 5; similarly, according to the thickness of the cortical bone and the radius of the second guide pin 6, the corresponding hole position of the second adjusting hole 24 required to be selected by the second guide pin 6 can be calculated; because the first guide pin 5, the second guide pin 6 and the third guide pin 7 are arranged on the outer guide member 2 in an isosceles right triangle, the corresponding hole position of the third adjusting hole 25 required to be selected by the third guide pin 7 can be calculated, and after the inner guide member 1 and the outer guide member 2 are removed, hollow screws can be screwed in along the first guide pin 5, the second guide pin 6 and the third guide pin 7 respectively. In this way, the anatomical characteristics of the proximal femur (femur neck-femur-trochanter line, etc.) are utilized, the guiding device combining the inner guiding piece 1 (in vivo) and the outer guiding piece 2 (in vitro) for determining the position and the direction of the femur neck hollow screw is designed by adopting the ossification mark and the femur distance of the trochanter line directly, the perspective times can be reduced, the hollow screw can be accurately implanted, the requirements of parallelism, welting and inverted triangle are met, the quality of reduction and fixation is improved, and the probability of non-union of the femur neck and necrosis of the femur head is reduced.
The invention also provides a using method of the screw guide for the open reduction of the fracture of the femoral neck, which comprises the following steps: the surgical approach is a direct anterior approach (DAA approach), the hip joint capsule is exposed between the rectus femoris and the lateral vastus, the intertrochanteric line and the femoral neck are exposed after T-incision of the hip joint anterior joint capsule, and the femoral neck is temporarily fixed by a Kirschner wire after reduction of the femoral neck by a series of methods such as poking and traction. Then, the screw guide according to the present invention is started to be used, the inner guide 1 is disposed in the body near the femoral neck, the fixing portion 11 is fastened on the intertrochanteric line of the femoral neck, the measuring instrument 12 is disposed at the femoral neck, and the first caliper 122 and the second caliper 123 are adjusted to fasten the upper and lower poles of the femoral neck, thereby measuring the width value a of the femoral neck. The first positioning needle 3 and the second positioning needle 4 respectively penetrate through the first positioning groove 111 and the second positioning groove 112 and are inserted into the junction of the neck of the femur to be fixed, and the outer guide member 2 is respectively sleeved on the first positioning needle 3 and the second positioning needle 4 through the first positioning hole 21 and the second positioning hole 22 and is positioned at the outer side of the neck of the femur to realize positioning. According to anatomical features and specific parameters of the femoral neck, on the perspective phase of the axial position of the femoral neck, the front side wall of the femoral neck and the line between the rotors form a diagonal line M, after the first positioning needle 3 is placed close to the line between the rotors, the directions (the forward inclination angle and the outward expansion angle) of the first guide needle 5, the second guide needle 6 and the third guide needle 7 to be placed are determined, the width value a of the femoral neck is read through the first caliper 122 and the second caliper 123, the first positioning needle 3 is positioned at the midpoint position of the first caliper 122 and the second caliper 123, the thickness of the upper cortex (refer to relevant literature: applied anatomy of femoral distance in 24-year of the journal 2001) is calculated, the sum of the thickness of the lower cortex (refer to relevant literature) and the radius of the hollow screw to be implanted is calculated as a second distance c, and the boundary lines on the two sides of the width value a of the femoral neck are respectively translated inwards by the first distance b and the first distance c, and the upper and lower distribution positions of the first guide needle 5 and the second guide needle 6 are obtained; calculating the sum of the thickness of the anterior cortex (refer to related literature) and the radius of the hollow screw to be implanted as a third distance d, translating the diagonal line M inwards by the third distance d to obtain the anteroposterior distribution positions (relative to the diagonal line M) of the first guide pin 5 and the second guide pin 6, respectively selecting the hole positions corresponding to the first adjusting hole 23 and the second adjusting hole 24 at two intersection points formed by the boundary line of the width value a of the femoral neck after translation and the diagonal line M after translation, and inserting the first guide pin 5 and the second guide pin 6 into the femoral head after passing through the hole positions corresponding to the first adjusting hole 23 and the second adjusting hole 24 respectively. Because the first guide pin 5, the second guide pin 6 and the third guide pin 7 are arranged in an isosceles right triangle, the connecting line of the first guide pin 5 and the second guide pin 6 is used as a bevel edge, the hole position of the third guide pin 7 corresponding to the selected third adjusting hole 25 is calculated, and the third guide pin 7 passes through the corresponding hole position of the third adjusting hole 25 and is inserted into the femoral head. After the inner guide 1 and the outer guide 2 are removed, the hollow screws are screwed along the first guide pin 5, the second guide pin 6 and the third guide pin 7 respectively.
In this embodiment, a fixing groove 15 adapted to the inter-rotor line is formed on one surface of the fixing portion 11, and the fixing groove 15 is disposed perpendicular to the first positioning groove 111 and the second positioning groove 112. The fixing portion 11 is fastened to the intertrochanteric line of the femoral neck by a fixing groove 15. In this way, the anatomical features of the proximal femur (femur neck-femur-trochanter line, etc.) are fully utilized, facilitating the positioning operation of the fixation portion 11. In order to facilitate the fixation of the fixation portion 11 at the intertrochanteric line of the femoral neck, the inner guide 1 further comprises a fixation screw 13, wherein the fixation portion 11 is provided with a fixation hole, and the fixation screw 13 passes through the fixation hole and is screwed into the bone. In order to facilitate adjusting the forward tilting directions of the first positioning needle 3 and the second positioning needle 4, the inner guide 1 further comprises an adjusting screw 14, a screw hole is formed in one side of the fixing portion 11 opposite to the fixing hole, the adjusting screw 14 is screwed into the screw hole of the fixing portion 11 and abuts against the bone surface, and the forward tilting directions of the first positioning needle 3 and the second positioning needle 4 are finely adjusted by screwing in and screwing out.
In this embodiment, the measurer 12 further includes an adjusting gear 124, the adjusting gear 124 is rotatably connected to the connecting portion 121, one ends of the first caliper 122 and the second caliper 123, which are close to the connecting portion 121, are respectively provided with racks 125, the two racks 125 are engaged with two sides of the adjusting gear 124 in parallel, the first caliper 122 and the second caliper 123 are slidably disposed on the connecting portion 121, and the adjusting gear 124 is screwed to drive the first caliper 122 and the second caliper 123 to adjust the measuring distance, i.e. the distance between the clamping pin on the first caliper 122, which is far away from the end of the connecting portion 121, and the clamping pin on the second caliper 123, which is far away from the end of the connecting portion 121. In order to read the width value a of the femoral neck conveniently, the upper surface of the first caliper 122 positioned at the upper layer is provided with a scale value, and twice the scale value pointed by the pointer positioned at the center of the connecting part 121 is the width value of the femoral neck.
In this embodiment, the screw guide for open reduction of femoral neck fracture provided by the present invention further includes a fourth guide pin 8, a fourth adjusting hole 26 is formed above the first adjusting hole 23, the second adjusting hole 24 and the third adjusting hole 25 on the outer guide member 2, and the fourth adjusting hole 26 includes a plurality of hole sites, so that the fourth guide pin 8 is percutaneously placed in parallel with the first guide pin 5, the second guide pin 6 and the third guide pin 7 in the anteversion angle dimension, and points to the midpoint positions of the first caliper 122 and the second caliper 123 in the abduction angle. The fourth guide pin 8 can be aimed at the midpoint position of the first caliper 122 and the second caliper 123 according to the naked eyes. The fourth guide pin 8 is sleeved into the hollow screw to connect the fracture parts of the femoral neck, so as to further strengthen the reinforcement strength of the fracture parts of the femoral neck.
In this embodiment, the first positioning needle 3 and the second positioning needle 4 are all 3mm diameter schlieren needles, and the first guide needle 5, the second guide needle 6 and the third guide needle 7 are all 2.5mm diameter schlieren needles.
Second embodiment
Referring to fig. 5 to 8, the main difference between the second embodiment and the first embodiment is that: the second positioning pin 4 of the screw guide of the first embodiment is fixed in the second positioning groove 112 of the fixing portion 11, and the second positioning pin 4 of the screw guide of the second embodiment is fixed on the first caliper rule 122, and the distance between the clamping leg of the first caliper rule 122 and the second positioning pin 4 is the thickness of the upper cortex, and the second positioning groove 112 is a strip-shaped adjusting hole for enabling the second positioning pin 4 to have a corresponding movable space when the first caliper rule 122 and the second caliper rule 123 adjust the measuring distance. The first positioning needle 3 is located at the midpoint of the first caliper 122 and the second caliper 123. Therefore, the corresponding hole positions of the first adjusting hole 23, the second adjusting hole 24 and the third adjusting hole 25 do not need to be calculated by reading the width value of the femoral neck, and when the upper pole and the lower pole of the femoral neck are clamped by the first caliper 122 and the second caliper 123, the hole position of the first adjusting hole 23 corresponding to the side edge of the second positioning needle 4 is the hole position which is needed to be selected by the first guide needle 5, so that the operation is further simplified.
The screw guider for open reduction of femoral neck fracture provided by the second embodiment comprises an inner guide piece 1, an outer guide piece 2, a first positioning needle 3, a second positioning needle 4, a first guide needle 5, a second guide needle 6 and a third guide needle 7. The inner guide 1 comprises a fixing part 11 and a measurer 12, wherein the fixing part 11 is used for being fixed at the position of a rotor line of a femoral neck, the measurer 12 comprises a connecting part 121, a first caliper 122 and a second caliper 123, one end of the connecting part 121 is connected to the fixing part 11, the first caliper 122 and the second caliper 123 are arranged at the other end of the connecting part 121, the connecting part 121 is arranged at the midpoint positions of the first caliper 122 and the second caliper 123, and the first caliper 122 and the second caliper 123 can be synchronously and telescopically adjusted towards the two ends relative to the midpoint positions so as to clamp the upper pole and the lower pole of the femoral neck. The fixing portion 11 is formed with a first positioning groove 111, a central line of the first positioning groove 111 vertically bisects a measurement distance between the first caliper 122 and the second caliper 123, and the first positioning needle 3 passes through the first positioning groove 111 and is inserted into a femoral head and neck junction for fixing, so as to determine a pre-tilt angle and an abduction angle from the femoral neck to the first positioning needle 3.
The first caliper 122 is vertically connected with a guide sleeve 120, and a second positioning groove 112 perpendicular to the line between the rotors is formed in the guide sleeve 120 and is used for penetrating into the second positioning needle 4 to be fixed at the junction of the head and neck of the femur, so that the anteversion angle and the abduction angle of the femur neck to the second positioning needle 4 are determined. The distance between the second positioning needle 4 and the clamping foot of the first caliper 122 is equal to the thickness of the upper cortex.
The outer guide member 2 is provided with a first positioning hole 21 corresponding to the first positioning needle 3 and a second positioning hole 22 corresponding to the second positioning needle 4, and the outer guide member 2 is respectively sleeved on the first positioning needle 3 and the second positioning needle 4 through the first positioning hole 21 and the second positioning hole 22 and is positioned on the outer side of the femoral neck so as to realize positioning. The second positioning hole 22 is a strip-shaped adjusting hole for enabling the second positioning needle 4 to have a corresponding movable space when the first caliper 122 and the second caliper 123 adjust the measuring distance. The outer guide member 2 is provided with a first adjusting hole 23, a second adjusting hole 24 and a third adjusting hole 25, the first adjusting hole 23 and the second adjusting hole 24 are located on the same adjusting direction line and extend, the adjusting direction line of the third adjusting hole 25 is perpendicular to the adjusting direction line of the first adjusting hole 23 and the second adjusting hole 24 and located at the midpoint position between the first adjusting hole 23 and the second adjusting hole 24, so that the corresponding hole position of the first adjusting hole 23 is selected to be inserted into the first guide pin 5 to the femoral head according to the position of the second positioning pin 4, the corresponding hole position of the second adjusting hole 24 is selected to be inserted into the second guide pin 6 to the femoral head, the corresponding hole position of the third adjusting hole 25 is selected to be inserted into the third guide pin 7 to the femoral head, and the first guide pin 5, the second guide pin 6 and the third guide pin 7 are arranged in an isosceles right triangle shape on the outer guide member 2.
The screw guider for open reduction of femoral neck fracture provided by the invention can determine the position of the outer guide piece 2 through the first positioning needle 3 and the second positioning needle 4 on the fixing part 11 of the inner guide piece 1, the first adjusting hole 23 corresponding to the side edge of the second positioning needle 4 is the hole position corresponding to the first guide needle 5, and the hole position corresponding to the first guide needle 5 is symmetrical to the second adjusting hole 24 by the central connecting line of the third adjusting hole 25 and the first positioning hole 21, so that the hole position corresponding to the second guide needle 6 is obtained. According to the isosceles right triangle arrangement, the corresponding hole position of the third guide pin 7 in the third adjusting hole 25 is obtained. After the inner guide member 1 and the outer guide member 2 are removed, the hollow screws can be screwed along the first guide pin 5, the second guide pin 6 and the third guide pin 7, respectively. In this way, the operation is simplified, the anatomical characteristics of the proximal femur (femur neck-femur-trochanter line, etc.) are utilized, the guiding device which is formed by combining the inner guiding element 1 (in vivo) and the outer guiding element 2 (in vitro) and is used for determining the position and the direction of the femur neck hollow screw is designed by adopting the osseous mark and the femur distance of the trochanter line, the perspective times can be reduced, the hollow screw can be implanted accurately, and the requirements of parallelism, welt and inverted triangle are met, so that the quality of reduction and fixation is improved, and the probability of non-union of the femur neck and necrosis of the femur head is reduced.
The invention also provides a using method of the screw guide for the open reduction of the fracture of the femoral neck, which comprises the following steps: the surgical approach is a direct anterior approach (DAA approach), the hip joint capsule is exposed between the rectus femoris and the lateral vastus, the intertrochanteric line and the femoral neck are exposed after T-incision of the hip joint anterior joint capsule, and the femoral neck is temporarily fixed by a Kirschner wire after reduction of the femoral neck by a series of methods such as poking and traction. Then, the screw guide of the present invention is started to be used, the inner guide 1 is disposed in the body near the femoral neck, the fixing portion 11 is fastened on the intertrochanteric line of the femoral neck, the measuring instrument 12 is disposed at the femoral neck, and the first caliper 122 and the second caliper 123 are adjusted to clamp the upper and lower poles of the femoral neck. The first positioning needle 3 and the second positioning needle 4 respectively penetrate through the first positioning groove 111 and the second positioning groove 112 and are inserted into the junction of the neck of the femur to be fixed, and the outer guide member 2 is respectively sleeved on the first positioning needle 3 and the second positioning needle 4 through the first positioning hole 21 and the second positioning hole 22 and is positioned at the outer side of the neck of the femur to realize positioning.
The first adjusting hole 23 corresponding to the side edge of the second positioning needle 4 is the hole position corresponding to the first guide needle 5, and the first guide needle 5 passes through the hole position corresponding to the first adjusting hole 23 and is inserted into the femoral head. And the hole position corresponding to the first guide pin 5 is symmetrically connected to the second adjusting hole 24 by the central connecting line of the third adjusting hole 25 and the first positioning hole 21, so that the hole position corresponding to the second guide pin 6 is obtained, and the second guide pin 6 passes through the hole position corresponding to the second adjusting hole 24 and is inserted into the femoral head. According to the isosceles right triangle arrangement, the corresponding hole position of the third guide pin 7 in the third adjusting hole 25 is obtained. The third guide pin 7 is inserted into the femoral head through the corresponding hole site of the third adjusting hole 25. After the inner guide member 1 and the outer guide member 2 are removed, the hollow screws can be screwed along the first guide pin 5, the second guide pin 6 and the third guide pin 7, respectively.
In this embodiment, a fixing groove 15 adapted to the inter-rotor line is formed on one surface of the fixing portion 11, and the fixing groove 15 is disposed perpendicular to the first positioning groove 111 and the second positioning groove 112. The fixing portion 11 is fastened to the intertrochanteric line of the femoral neck by a fixing groove 15. In this way, the anatomical features of the proximal femur (femur neck-femur-trochanter line, etc.) are fully utilized, facilitating the positioning operation of the fixation portion 11. In order to facilitate the fixation of the fixation portion 11 at the intertrochanteric line of the femoral neck, the inner guide 1 further comprises a fixation screw 13, wherein the fixation portion 11 is provided with a fixation hole, and the fixation screw 13 passes through the fixation hole and is screwed into the bone. In order to facilitate adjusting the forward tilting directions of the first positioning needle 3 and the second positioning needle 4, the inner guide 1 further comprises an adjusting screw 14, a screw hole is formed in one side of the fixing portion 11 opposite to the fixing hole, the adjusting screw 14 is screwed into the screw hole of the fixing portion 11 and abuts against the bone surface, and the forward tilting directions of the first positioning needle 3 and the second positioning needle 4 are finely adjusted by screwing in and screwing out.
In this embodiment, the measurer 12 further includes an adjusting gear 124, the adjusting gear 124 is rotatably connected to the connecting portion 121, one ends of the first caliper 122 and the second caliper 123, which are close to the connecting portion 121, are respectively provided with racks 125, the two racks 125 are engaged with two sides of the adjusting gear 124 in parallel, the first caliper 122 and the second caliper 123 are slidably disposed on the connecting portion 121, and the adjusting gear 124 is screwed to drive the first caliper 122 and the second caliper 123 to adjust the measuring distance, i.e. the distance between the clamping pin on the first caliper 122, which is far away from the end of the connecting portion 121, and the clamping pin on the second caliper 123, which is far away from the end of the connecting portion 121.
In this embodiment, the screw guide for open reduction of femoral neck fracture provided by the present invention further includes a fourth guide pin 8, a fourth adjusting hole 26 is formed above the first adjusting hole 23, the second adjusting hole 24 and the third adjusting hole 25 on the outer guide member 2, and the fourth adjusting hole 26 includes a plurality of hole sites, so that the fourth guide pin 8 is percutaneously placed in parallel with the first guide pin 5, the second guide pin 6 and the third guide pin 7 in the anteversion angle dimension, and points to the midpoint positions of the first caliper 122 and the second caliper 123 in the abduction angle. The fourth guide pin 8 can be aimed at the midpoint position of the first caliper 122 and the second caliper 123 according to the naked eyes. The fourth guide pin 8 is sleeved into the hollow screw to connect the fracture parts of the femoral neck, so as to further strengthen the reinforcement strength of the fracture parts of the femoral neck.
In this embodiment, the first positioning needle 3 and the second positioning needle 4 are all 3mm diameter schlieren needles, and the first guide needle 5, the second guide needle 6 and the third guide needle 7 are all 2.5mm diameter schlieren needles.
In this specification, each embodiment is described in a progressive manner, and a plurality of embodiments are mainly described and are different from other embodiments, so that identical and similar parts between the embodiments are all mutually referred.
In the description of the present invention, it should be noted that the azimuth or positional relationship indicated by the terms "upper", "lower", etc. are based on the azimuth or positional relationship shown in the drawings, and are merely for convenience of describing the present invention and simplifying the description, and are not indicative or implying that the apparatus or element in question must have a specific azimuth, be constructed and operated in a specific azimuth, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying importance; the words "bottom" and "top", "inner" and "outer" refer to directions toward or away from, respectively, a particular component geometry.
In the description of the present invention, it should be noted that, unless explicitly specified and limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; the communication may be direct or indirect through an intermediate medium, or may be internal to two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art. Furthermore, in the description of the present invention, unless otherwise indicated, the meaning of "a plurality" is two or more.
The foregoing is only illustrative of the present invention and is not to be construed as limiting thereof, but rather as various modifications, equivalent arrangements, improvements, etc., within the spirit and principles of the present invention.
Claims (7)
1. The screw guider for open reduction of femoral neck fracture is characterized by comprising an inner guide piece (1), an outer guide piece (2), a first positioning needle (3), a second positioning needle (4), a first guide needle (5), a second guide needle (6) and a third guide needle (7), wherein the inner guide piece (1) comprises a fixing part (11) and a measurer (12), the fixing part (11) is used for being fixed at the position of a rotor line of the femoral neck, the measurer (12) comprises a connecting part (121), a first caliper (122) and a second caliper (123), one end of the connecting part (121) is connected to the fixing part (11), the other end of the connecting part (121) is provided with a first caliper (122) and a second caliper (123), the connecting part (121) is arranged at the midpoint position of the first caliper (122) and the second caliper (123), the first caliper (122) and the second caliper (123) can be synchronously adjusted towards the two ends relative to clamp the upper end and the lower end of the femoral neck, a first positioning groove (111) is formed on the fixing part (11), the first positioning groove (111) is perpendicular to the first caliper (122) and the second caliper (123) is inserted into the first two-pole positioning groove (3) at a position perpendicular to the junction point of the first caliper (122) and penetrates through the first two-pole positioning needle (3), to determine the anteversion and abduction angle of the femoral neck to the first positioning needle (3);
A guide sleeve (120) is vertically connected to the first caliper (122), a second positioning groove (112) perpendicular to a rotor line is formed in the guide sleeve (120) and is used for penetrating into the second positioning needle (4) to be fixed at the junction of the head and neck of the femur, so that the anteversion angle and the abduction angle of the femur neck to the second positioning needle (4) are determined, and the distance between the second positioning needle (4) and the clamping foot of the first caliper (122) is equal to the thickness of the upper cortex;
The outer guide piece (2) is provided with a first positioning hole (21) and a second positioning hole (22), the outer guide piece (2) is sleeved on the first positioning needle (3) and the second positioning needle (4) respectively through the first positioning hole (21) and the second positioning hole (22) and is positioned at the outer side of the femoral neck so as to realize positioning, and the second positioning hole (22) is a strip-shaped adjusting hole for enabling the second positioning needle (4) to have a corresponding movable space when the first caliper (122) and the second caliper (123) adjust the measuring distance;
The outer guide member (2) is provided with a first adjusting hole (23), a second adjusting hole (24) and a third adjusting hole (25), the first adjusting hole (23) and the second adjusting hole (24) are located on the same adjusting direction line, the adjusting direction line of the third adjusting hole (25) is perpendicular to the adjusting direction line of the first adjusting hole (23) and the second adjusting hole (24) and located at the midpoint position between the first adjusting hole (23) and the second adjusting hole (24), so that the corresponding hole position of the first adjusting hole (23) is selected to be inserted into the first guide pin (5) to the femoral head according to the position of the second positioning pin (4), the corresponding hole position of the second adjusting hole (24) is selected to be inserted into the second guide pin (6) to the femoral head, the corresponding hole position of the third adjusting hole (25) is selected to be inserted into the third guide pin (7), and the first guide pin (5), the second guide pin (6) and the third guide pin (7) are arranged in an isosceles right triangle shape on the outer guide member (2).
2. Screw guide for open reduction of femoral neck fracture according to claim 1, characterized in that a surface of the fixing part (11) is formed with a fixing groove (15) adapted to the intertrochanter line, the fixing groove (15) is arranged perpendicular to the first positioning groove (111) and the second positioning groove (112), and the fixing part (11) is clamped on the intertrochanter line of the femoral neck by the fixing groove (15).
3. Screw guide for open reduction of femoral neck fractures according to claim 1, characterized in that the inner guide (1) further comprises a fixation screw (13), the fixation part (11) is provided with fixation holes, and the fixation screw (13) passes through the fixation holes and is screwed into the bone.
4. A screw guide for open reduction of femoral neck fracture according to claim 3, wherein the inner guide member (1) further comprises an adjusting screw (14), a screw hole is formed in a side of the fixing portion (11) opposite to the fixing hole, the adjusting screw (14) is screwed into the screw hole of the fixing portion (11) and abuts against the bone surface, and the forward tilting direction of the first positioning needle (3) and the second positioning needle (4) is finely adjusted by screwing in and screwing out.
5. The screw guide for open reduction of femoral neck fracture according to claim 1, wherein the measurer (12) further comprises an adjusting gear (124), the adjusting gear (124) is rotatably connected to the connecting portion (121), one ends of the first caliper (122) and the second caliper (123) close to the connecting portion (121) are respectively provided with racks (125), the two racks (125) are engaged with two sides of the adjusting gear (124) in parallel, and the first caliper (122) and the second caliper (123) are slidably arranged on the connecting portion (121).
6. The screw guide for open reduction of femoral neck fracture according to claim 1, comprising a fourth guide pin (8), wherein a fourth adjustment hole (26) is provided in the outer guide (2) above the first adjustment hole (23), the second adjustment hole (24) and the third adjustment hole (25), the fourth adjustment hole (26) comprising a plurality of holes for percutaneous placement of the fourth guide pin (8) parallel to the first guide pin (5), the second guide pin (6) and the third guide pin (7) in the anteversion dimension and pointing to the midpoint position of the first caliper (122) and the second caliper (123) in the abduction angle.
7. The screw guide for open reduction of femoral neck fracture according to claim 1, wherein the first positioning needle (3) and the second positioning needle (4) are both schlieren needles, and the first guide needle (5), the second guide needle (6) and the third guide needle (7) are all schlieren needles.
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| CN202210460464.5A CN114869442B (en) | 2022-04-24 | 2022-04-24 | Screw guide for open reduction of femoral neck fracture and method of use thereof |
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| CN202210460464.5A CN114869442B (en) | 2022-04-24 | 2022-04-24 | Screw guide for open reduction of femoral neck fracture and method of use thereof |
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| CN114869442A (en) | 2022-08-09 |
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