CN115153795A - Intramedullary nail lag screw drilling guide device - Google Patents
Intramedullary nail lag screw drilling guide device Download PDFInfo
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- CN115153795A CN115153795A CN202210739487.XA CN202210739487A CN115153795A CN 115153795 A CN115153795 A CN 115153795A CN 202210739487 A CN202210739487 A CN 202210739487A CN 115153795 A CN115153795 A CN 115153795A
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
- A61B17/7225—Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
- A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
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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
- A61B17/90—Guides therefor
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Abstract
The invention discloses an intramedullary nail lag screw drilling guide device, which belongs to the technical field of medical instruments and comprises an aiming arm, wherein one end of the aiming arm is used for being detachably connected with the upper end of a main nail of an intramedullary nail, the other end of the aiming arm is provided with a lag screw guide hole, a guide sleeve is coaxially arranged in the lag screw guide hole, a limit button is arranged at the lag screw guide hole of the aiming arm, the limit button has a locking state and an unlocking state, the guide sleeve is locked in the lag screw guide hole in the locking state, and the guide sleeve can be slidably connected in the lag screw guide hole in the unlocking state. The intramedullary nail lag screw drilling guide device has the advantages of small occupied space, simple and convenient operation and easy control of the stress degree, thereby ensuring accurate guiding and positioning of the drilling hole and accurate position of the bottom hole, further ensuring accurate implantation position of the diagonal tension screw and good stability of the intramedullary nail.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an intramedullary nail lag screw drilling guide device.
Background
The intramedullary nail operation of thighbone near-end needs the pre-drilling when beating oblique tension screw to in the nail of planting, the pre-drilling generally includes aims arm location, protective sleeve direction and drill bit and punches etc.. The protective sleeve is used for preventing the side edge from directly contacting with the soft tissue when the drill bit rotates and mincing the soft tissue; the inner end of the protective sleeve is required to be always tightly attached to the outer cortex of the femur in the operation and does not retract when being impacted by the rotating elasticity of the drill bit, so that a certain inward pressure is required to be ensured.
The common pressurizing mode of the protective sleeve is that a pressurizing nut is arranged on the aiming arm, a rod part of the protective sleeve is provided with a corresponding thread, and the pressurizing nut is rotated to enable the end part of the inner side of the protective sleeve to be gradually close to the cortex of the outer side of the femur until the protective sleeve is tightly attached to the cortex of the outer side of the femur. By adopting the pressurizing mode of screwing the pressurizing nut, the distance between the end part of the inner side of the protective sleeve and the cortex of the outer side of the femur can be manually and linearly shortened in the screwing process of the pressurizing nut, so that the pressurizing force is more accurate.
However, the pressurizing method has certain disadvantages, because of the difference of human bodies, the distance between the aiming arm and the outer cortex of the femur is uncertain, the length of the thread of the rod part of the protective sleeve must be long enough, thus when the pressurizing nut is rotated, dozens of turns of rotation cannot be caused to screw the protective sleeve to a proper position, the pressurizing process is too complicated, the pressurizing degree is manually adjusted, different operators cannot control the pressurizing degree, the pressurizing degree is easy to be too small or too large and difficult to be unified, the drilling guide and positioning are inaccurate, the drilling depth is influenced, the bottom hole position is inaccurate, the oblique tension screw implantation position is inaccurate, and the stability of the intramedullary nail is influenced.
Disclosure of Invention
The invention aims to provide the intramedullary nail lag screw drilling guide device which is simple to operate, easy to control the stress degree and accurate in drilling guide and positioning.
In order to solve the technical problems, the invention provides the following technical scheme:
the utility model provides an intramedullary nail lag screw drilling guiding device, includes the arm of aiming, the one end of arm of aiming is used for dismantling the upper end of connecting the intramedullary nail main nail, and the other end is equipped with the lag screw guiding hole, the coaxial guide sleeve that is provided with in the lag screw guiding hole, the arm of aiming is in lag screw guiding hole department is equipped with limit button, limit button has locking state and unblock state under the locking state, guide sleeve is locked in the lag screw guiding hole under the unblock state, but guide sleeve sliding connection be in the lag screw guiding hole.
Furthermore, be equipped with on the limit button and be used for wearing to establish guide sleeve's through-hole, the internal diameter of through-hole is greater than guide sleeve's external diameter, the internal surface of through-hole with one of them is equipped with the location tooth on guide sleeve's the near-end surface, is equipped with on the other and can stretches into to location arch in the location tooth.
Furthermore, the positioning teeth are positioned on the guide sleeve, the positioning protrusions are positioned on the inner surface of the through hole close to the tail end of the limiting button, and a spring is arranged at the tail end of the limiting button;
and/or a long round hole extending along the length direction of the limiting button is formed in the limiting button, a pin hole is formed in the aiming arm corresponding to the long round hole, and a positioning pin penetrates through the pin hole and the long round hole.
Furthermore, the first end surface of the positioning protrusion and the first end surface of the positioning tooth are parallel to the cross section of the guide sleeve, the second end surface of the positioning protrusion and the second end surface of the positioning tooth form an acute angle with the cross section of the guide sleeve, the first end surface of the positioning protrusion is abutted against the first end surface of the positioning tooth, and the second end surface of the positioning protrusion is abutted against the second end surface of the positioning tooth;
or, the bellied first terminal surface in location is on a parallel with the cross section of uide bushing, the first terminal surface of location tooth the bellied second terminal surface in location with the second terminal surface of location tooth all with the acute angle is personally submitted to the uide bushing's cross section, the bellied first terminal surface in location with the first terminal surface butt of location tooth, the bellied second terminal surface in location with the second terminal surface butt of location tooth.
Furthermore, the cross sections of the lag screw guide hole and the guide sleeve are in a segmental shape;
and/or the arc length enclosed by the starting end and the terminating end of the positioning tooth is less than the semi-circumference of the cross section of the guide sleeve;
and/or the radius corresponding to the arc length surrounded by the starting end and the terminating end of the positioning tooth is smaller than the radius of the guide sleeve;
and/or the distal end of the guide sleeve is provided with a tip for contacting with the lateral cortex of the femur.
Furthermore, the near end of the guide sleeve is coaxially provided with a positioning frame outside the aiming arm, the near end of the guide sleeve is provided with a base station, the base station is provided with an axially extending positioning hole, and the positioning frame is provided with a positioning column which penetrates through the positioning hole and is abutted against the aiming arm.
Furthermore, a drill rod is arranged in the guide sleeve, the tail part of the drill rod is provided with scales, and a sliding and lockable depth limiting piece is arranged at the scales at the tail part of the drill rod;
the depth limiting piece is provided with a control button, the control button is provided with a locking state and an unlocking state, the depth limiting piece is locked on the drill rod when the control button is in the locking state, and the depth limiting piece is connected on the drill rod in a sliding mode when the control button is in the unlocking state.
Furthermore, the connecting end of the aiming arm and the main intramedullary nail is provided with an inserting column matched with a threaded hole at the upper end of the main intramedullary nail, and the edge of the inserting column is provided with a vertical positioning bulge matched with a vertical positioning groove at the upper end of the main intramedullary nail.
Furthermore, the connecting end of the aiming arm and the main nail of the intramedullary nail is provided with a mounting hole which extends along the axial direction of the insertion column and penetrates through the insertion column, and a fastening screw which is used for being connected to a threaded hole at the upper end of the main nail of the intramedullary nail so as to fix the aiming arm and the main nail of the intramedullary nail together is arranged in the mounting hole in a penetrating manner.
Furthermore, aim the arm and include the director handle, the one end of director handle is used for dismantling the upper end of connecting the intramedullary nail main nail, and the other end can be dismantled and be connected with the director main part with intramedullary nail main nail parallel arrangement, lag screw guiding hole is located in the director main part.
The invention has the following beneficial effects:
the intramedullary nail tension screw drilling guide device is characterized in that a guide sleeve is coaxially arranged in a tension screw guide hole on a sighting arm, a limiting button is arranged at the tension screw guide hole on the sighting arm, the limiting button has a locking state and an unlocking state, the guide sleeve is locked in the tension screw guide hole in the locking state, the guide sleeve can be slidably connected in the tension screw guide hole in the unlocking state, the guide sleeve is pressed inwards to reach a pressurizing position, and compared with a mode of adopting a pressurizing nut, the intramedullary nail tension screw drilling guide device is small in occupied space, simple and convenient to operate, easy to control the pressurizing degree, accurate in drilling guide and bottom hole position, accurate in oblique tension screw implantation position and good in intramedullary nail stability, only the tension screw guide hole needs to be coaxial with the guide sleeve, positioning is convenient, and positioning difficulty is low.
Drawings
FIG. 1 is a schematic view of a prior art intramedullary nail having a triangular support fixation structure for an intramedullary nail fixation system;
FIG. 2 is a schematic view of the overall structure of the intramedullary nail lag screw drill guide device of the present invention;
FIG. 3 is an exploded view of the guide handle and the guide body of the intramedullary nail lag screw drill guide device of the present invention;
fig. 4 is a schematic structural view of a guide sleeve in the intramedullary nail lag screw drill guide device of the present invention, wherein (a) is a perspective view in one direction and (b) is a perspective view in another direction;
FIG. 5 is a schematic structural view of a limit button in the intramedullary nail lag screw drill guide device of the present invention;
FIG. 6 is a schematic cross-sectional structural view of the intramedullary nail lag screw drill guide of the present invention at the position of the limit button, wherein (a) is a structural view of the guide sleeve when locked and (b) is a structural view of the guide sleeve when unlocked;
FIG. 7 is a schematic view showing a fitting structure of a positioning tooth and a positioning boss in embodiment 1 of the present invention;
FIG. 8 is a schematic view showing a fitting structure of a positioning tooth and a positioning projection in embodiment 2 of the present invention;
FIG. 9 is a schematic structural view of a positioning frame in the intramedullary nail lag screw drill guide device of the present invention;
fig. 10 is an enlarged schematic structural view of the positioning frame in the intramedullary nail lag screw drilling guide device of the present invention, wherein (a) is a structural view of the positioning frame before installation, and (b) is a structural view of the positioning frame after installation;
FIG. 11 is a schematic structural view of a drill stem in the intramedullary nail lag screw drill guide apparatus of the present invention;
FIG. 12 is a first schematic view of the intramedullary nail lag screw drill guide device of the present invention;
FIG. 13 is a second structural diagram of the intramedullary nail lag screw drill guide device of the present invention, wherein an enlarged structural diagram of the position limiting button is additionally shown;
fig. 14 is an enlarged structural view of a first fitting portion of a guide handle in the intramedullary nail lag screw drill guiding device of the present invention;
fig. 15 is a schematic structural view of a guide body in the intramedullary nail lag screw drill guide device of the present invention, wherein (a) is a front view and (b) is a perspective view;
fig. 16 is a schematic structural view of a locking member in the intramedullary nail lag screw drill guide device of the present invention.
Detailed Description
In order to make the technical problems, technical solutions and advantages of the present invention more apparent, the following detailed description is given with reference to the accompanying drawings and specific embodiments.
The invention provides an intramedullary nail lag screw drilling guide device, which comprises an aiming arm, wherein one end of the aiming arm is used for being detachably connected with the upper end of a main nail 3 of an intramedullary nail, the other end of the aiming arm is provided with a lag screw guide hole 25 (namely, a lag screw bottom hole guide hole), a guide sleeve 26 is coaxially arranged in the lag screw guide hole 25, the aiming arm is provided with a limit button 27 at the position of the lag screw guide hole 25, the limit button 27 has a locking state and an unlocking state, the guide sleeve 26 is locked in the lag screw guide hole 25 in the locking state, and the guide sleeve 26 can be slidably connected in the lag screw guide hole 25 in the unlocking state.
When the intramedullary nail is used, the aiming arm is firstly held, one end of the aiming arm is connected with the upper end of the main intramedullary nail 3, the limiting button 27 is driven to enable the limiting button 27 to be in an unlocking state, then the guide sleeve 26 is pushed into the lag screw guide hole 25, the guide sleeve 26 is pressed inwards until a pressurizing position is reached (namely the far end of the guide sleeve 26 is contacted with the outer cortex of the femur and has certain pressurizing pressure), the limiting button 27 is driven to enable the limiting button 27 to be in a locking state, so that the guide sleeve 26 is locked in the lag screw guide hole 25, and finally the drill rod 5 is used for drilling a diagonal tension screw bottom hole along the guide sleeve 26.
The intramedullary nail tension screw drilling guide device is characterized in that a guide sleeve is coaxially arranged in a tension screw guide hole on a sighting arm, the sighting arm is provided with a limit button at the tension screw guide hole, the limit button has a locking state and an unlocking state, the guide sleeve is locked in the tension screw guide hole in the locking state, the guide sleeve can be slidably connected in the tension screw guide hole in the unlocking state, the guide sleeve is pressed inwards to reach a pressurizing position, and compared with a mode of adopting a pressurizing nut, the intramedullary nail tension screw drilling guide device is small in occupied space, simple and convenient to operate, and easy to control the pressurizing degree, so that the drilling guide position is accurate, the bottom hole position is accurate, the oblique-pulling force screw implantation position is accurate, the stability of the intramedullary nail is good, and only the tension screw guide hole needs to be coaxial with the guide sleeve (the pressurizing nut, the tension screw guide hole and the protective sleeve need to be coaxial in the prior art), the positioning is convenient, and the positioning difficulty is low.
As shown in fig. 4-6 and 13, in order to lock the guide sleeve 26 in the lag screw guide hole 25, a through hole 271 for passing through the guide sleeve 26 may be provided on the limit button 27, an inner diameter of the through hole 271 is larger than an outer diameter of the guide sleeve 26, one of an inner surface of the through hole 271 and a proximal outer surface of the guide sleeve 26 is provided with a positioning tooth 261, and the other is provided with a positioning protrusion 272 capable of extending into the positioning tooth 261.
Further, the positioning teeth 261 may be disposed on the guiding sleeve 26, the positioning protrusions 272 may be disposed on the inner surface of the through hole 271 near the end of the limit button 27, and the end of the limit button 27 may be provided with a spring 273, so as to facilitate self-locking, and enable the guiding sleeve 26 to pass through/lock during the movement of the limit button 27. When the device is used, the limiting button 27 is pressed, the spring 273 is in a compressed state, the guide sleeve 26 can be unlocked, and the guide sleeve 26 can be smoothly inserted into/pulled out of the device (refer to fig. 6 (b)); when the limit button 27 is released, the limit button 27 rebounds under the elastic force of the spring 273, so that the positioning protrusion 272 extends into the positioning tooth 261 to lock the position of the guide sleeve 26 (refer to fig. 6 (a)), and quick locking and unlocking can be realized, and the operation is simple and convenient. The positioning projection 272 is preferably crescent shaped.
As shown in fig. 5-6 and 13, the stop button 27 may be provided with an elongated hole 274 extending along the length direction thereof, the aiming arm may be provided with a pin hole at a position corresponding to the elongated hole 274, and the pin hole and the elongated hole 274 may be provided with a positioning pin 275 therethrough to limit the moving stroke of the stop button 27 and prevent the stop button 27 from falling off.
Depending on the shape of both the positioning teeth 261 and the positioning protrusions 272, the present invention may have the following embodiments:
example 1
As shown in fig. 7, the first end surface (the right end surface in fig. 7) of the positioning protrusion 272 and the first end surface (the left end surface in fig. 7) of the positioning tooth 261 may be parallel to the cross section of the guide sleeve 26, the second end surface (the left end surface in fig. 7) of the positioning protrusion 272 and the second end surface (the right end surface in fig. 7) of the positioning tooth 261 may be at an acute angle with the cross section of the guide sleeve 26, the first end surface of the positioning protrusion 272 and the first end surface of the positioning tooth 261 abut against each other, and the second end surface of the positioning protrusion 272 and the second end surface of the positioning tooth 261 abut against each other, in which case, one of the positioning tooth 261 and the positioning protrusion 272 may be asymmetrically designed, specifically, as a right trapezoid, and the other is a right trapezoid, so that in the locked state, the guide sleeve 26 can be pressed inward through the limit button 27 under a force and cannot be retracted backward, that in the guide sleeve 26 can be pressed only in one direction, and if the limit button 27 is not unlocked, the guide sleeve 26 cannot be retracted backward. In the embodiment shown, the positioning teeth 261 are asymmetrically trapezoidal in design (i.e., right-angled trapezoidal) on the guide sleeve 26, and the positioning protrusions 272 are also right-angled trapezoidal in design on the limit button 27.
Example 2
As shown in fig. 8, the first end face (the right end face in fig. 8) of the positioning protrusion 272 may be parallel to the cross section of the guide sleeve 26, the first end face (the left end face in fig. 8) of the positioning tooth 261, the second end face (the left end face in fig. 8) of the positioning protrusion 272, and the second end face (the right end face in fig. 8) of the positioning tooth 261 are all at an acute angle with the cross section of the guide sleeve 26, the first end face of the positioning protrusion 272 abuts against the first end face of the positioning tooth 261, and the second end face of the positioning protrusion 272 abuts against the second end face of the positioning tooth 261, in particular, one of the positioning tooth 261 and the positioning protrusion 272 may be designed as an asymmetric trapezoid, specifically, as a trapezoid with two sides open, and the other is a right trapezoid, so that in the locked state, the guide sleeve 26 can press the limit button 27 inward under a force, and when the force of inward pressing of the guide sleeve 26 exceeds a preset pressure, the guide sleeve 26 can automatically retract backward (the limit button 27 cannot guide sleeve 26). During the use, when the inside pressor dynamics of guide sleeve 26 exceeded preset pressure, limit button 27 was automatic changed into the unblock state (being limit button 27 automatic resilience) by the locking state, and guide sleeve 26 is automatic to be rolled back, and when the inside pressor dynamics of guide sleeve 26 did not exceed preset pressure, limit button 27 was automatic changed into the locking state by the unblock state to locking guide sleeve 26 position.
The present embodiment can control the inward pressing force of the guiding sleeve 26 within a certain range to prevent the excessive pressing force from breaking the guiding sleeve 26 or the connecting position of the aiming arm and the main nail 3 of the intramedullary nail, and the teeth of the pressing direction of the two-side opened trapezoid are more gentle, so that the guiding sleeve 26 can pass through the limit button 27 more easily when being pressed inward, but can be retracted backward when being applied with enough force in the reverse direction. But pressurization degree automatic control in this embodiment predetermines pressure and can set up according to needs in the art in a flexible way, specifically can be through the elasticity of control spring 273, the angle of trapezoidal both sides etc. to adjust and predetermine pressure.
In the above embodiment, the cross-section of the lag screw guide hole 25 and the guide sleeve 26 may be rounded (specifically, D-shaped), so that when the shaft portion of the guide sleeve 26 is used in cooperation with the lag screw guide hole 25, the guide sleeve 26 can be inserted/extracted only in the axial direction and is not rotatable (the contact end of the guide sleeve 26 with the outer cortex of the femur is pointed, and the guide sleeve 26 is prevented from rotating).
As shown in fig. 13, the guide sleeve 26 may be provided with a concave surface at the outer circumference of the positioning tooth 261 such that the guide sleeve 26 is lower by 0.2-0.3mm (indicated by letter H in the drawing) at the positioning tooth 261 than at the portion of the guide sleeve 26 without the positioning tooth 261, so that when the rod portion of the guide sleeve 26 is used in cooperation with the lag screw guide hole 25, the positioning tooth 261 does not contact the lag screw guide hole 25, preventing wear of the lag screw guide hole 25. The concavity is preferably a few semicircles so that the outer cylindrical portion of the shank of the guide sleeve 26 is available for positioning with the lag screw guide hole 25.
The arc length enclosed by the start end and the termination end of the positioning tooth 261 may be smaller than the half circumference of the cross section of the guide sleeve 26; the radius corresponding to the arc length surrounded by the starting end and the terminating end of the positioning tooth 261 is preferably smaller than the radius of the guide sleeve 26, that is, the positioning tooth 261 is less semicircular, that is, the positioning tooth 261 occupies less semicircular part of the rod part of the guide sleeve 26, and the damage to the rod part of the guide sleeve 26 is small, so that the rod part of the guide sleeve 26 has high strength, and the tooth front end of the positioning tooth 261 is not required to be smaller than the diameter of the tooth bottom (the thread pattern requires that the thread front end must be thinner than the thread bottom to be screwed in). The positioning teeth 261 are preferably located on the opposite side of the plane of the segmental structure.
As shown in fig. 4 and 13, the distal end of the guide sleeve 26 may be provided with a tip for contacting the lateral cortex of the femur to improve the security between the distal end of the guide sleeve 26 and the lateral cortex of the femur, thereby improving the overall stability.
As shown in fig. 2 and fig. 9-10, the proximal end of the guiding sleeve 26 may be coaxially provided with a positioning frame 28 outside the aiming arm, the proximal end of the guiding sleeve 26 may be provided with a base 262, the base 262 is provided with an axially extending positioning hole 263, and the positioning frame 28 is provided with a positioning post 281 that passes through the positioning hole 263 and abuts against the aiming arm, so as to ensure that the relative position of the positioning frame 28 and the aiming arm is unchanged, so that the end face position of the positioning frame 28 is always kept unchanged, thereby providing a positioning reference for drilling the drill rod 5, and providing accurate guiding and positioning of drilling and accurate bottom hole position. In the embodiment shown in the figures, the number of the positioning holes 263 is 3, and the number of the corresponding positioning posts 281 is also 3.
As shown in fig. 11-12, in order to facilitate adjustment of the drilling depth, the guide sleeve 26 may be provided with a drill rod 5, the tail (i.e. the proximal end) of the drill rod 5 is provided with a scale 51, and the tail of the drill rod 5 is provided with a slidably lockable depth stop 52 at the scale 51;
the depth limiting piece 52 is provided with a control button 53, the control button 53 has a locking state and an unlocking state, the depth limiting piece 52 is locked on the drill rod 5 when the control button 53 is in the locking state, the depth limiting piece 52 is slidably connected on the drill rod 5 when the control button 53 is in the unlocking state, the specific internal structure of the control button 53 is designed by referring to common knowledge in the field, and details are not described herein. Before use, the depth limiting piece 52 is in an unlocked state by driving the control button 53 to slidably adjust the depth limiting piece 52 to a proper scale 51, and then the depth limiting piece 52 is in a locked state by driving the control button 53 for use.
The detachable connection between the aiming arm and the main nail 3 of the intramedullary nail can adopt various structural forms which are easily thought by a person skilled in the art, for example, the connecting end of the aiming arm and the main nail of the intramedullary nail is in threaded connection with a threaded hole at the upper end of the main nail of the intramedullary nail; however, for convenience of implementation, the present invention preferably takes the following structural form:
as shown in fig. 2-3, the connecting ends of the aiming arm and the intramedullary nail main nail 3 may be provided with insertion posts 15 which mate with threaded holes 31 at the upper end of the intramedullary nail main nail 3. The edge of the insertion post 15 may be provided with a vertical positioning protrusion 16 that mates with a vertical positioning groove 32 at the upper end of the intramedullary nail main nail 3 to prevent the aiming arm from rotating relative to the intramedullary nail main nail 3.
Further, in order to improve the firmness of the connection end of the aiming arm and the main intramedullary nail 3, the connection end of the aiming arm and the main intramedullary nail 3 may be provided with a mounting hole 17 extending along the axial direction of the insertion post 15 and penetrating through the insertion post 15, and a fastening screw 18 for connecting to a threaded hole 31 at the upper end of the main intramedullary nail 3 is arranged in the mounting hole 17 in a penetrating manner so as to fix the aiming arm and the main intramedullary nail 3 together. When in use, the fastening screw 18 is taken and screwed into the threaded hole 31 at the upper end of the main nail 3 of the intramedullary nail through the mounting hole 17.
As shown in fig. 2-3 and 12-13, for facilitating the installation and use in the operation, the aiming arm may include a guide handle 1 (which may be C-shaped in particular) and a guide main body 2, one end of the guide handle 1 is used for detachably connecting the upper end of the intramedullary nail main nail 3, the other end is detachably connected with the guide main body 2 arranged in parallel with the intramedullary nail main nail 3, and a tension screw guide hole 25 is located on the guide main body 2.
With the development of technology, an intramedullary nail with a triangular support fixing structure is present in an intramedullary nail fixing system for treating femoral intertrochanteric fracture, and as shown in fig. 1, the intramedullary nail comprises an intramedullary nail main nail 3, a diagonal tension screw 33 penetrating through the upper part of the intramedullary nail main nail 3, and a transverse tension screw 34 penetrating through the top of the intramedullary nail main nail 3 and the diagonal tension screw 33 so as to form a triangular support with good firmness. The inventor discovers that the guide handle and the guide main body are fixed by the locking bolt in the research process, however, the existence of the locking bolt leads to the fact that the transverse nail bottom hole guide hole is difficult to be formed in the guide main body under the scheme (the positions of the transverse nail bottom hole guide hole and the guide main body are easy to conflict), the guide positioning of the drilling hole is inaccurate, the position of the bottom hole is inaccurate, and then the locking screw is implanted inaccurately to influence the stability of the intramedullary nail. To solve this problem, the present invention preferably adopts the following structural form:
as shown in fig. 2 to 3 and fig. 16, the guide body 2 may be provided with a locker 4 for fixing the guide handle 1 and the guide body 2 together, the locker 4 being provided with a through-hole 41 therethrough, the through-hole 41 serving as a guide hole for the bed hole of the cross pin.
Retaining member 4 in this embodiment is the design of two unifications, can realize the connection locking of director handle 1 and director main part 2, hollow structure can provide horizontal nail bottom outlet drilling direction simultaneously, under the prerequisite of guaranteeing director handle 1 and director main part 2 firmly fixed, easily set up horizontal nail bottom outlet guiding hole, occupation space is little, do not disturb the field of vision, and then make drilling guiding orientation accurate, the bottom outlet position is accurate, thereby make locking screw implant position accurate, intramedullary nail stability is good.
The locking member 4 of the guide body 2 may take various configurations as will be readily apparent to those skilled in the art, however, for convenience of implementation, the present invention preferably takes the following configuration:
as shown in fig. 2 to 3 and 14 to 15, a first attaching portion 11 may be provided at one end of the guider handle 1 close to the guider main body 2, a second attaching portion 21 matched with the first attaching portion 11 is provided at the upper end of the guider main body 2, and the locking member 4 is a locking bolt sequentially passing through the second attaching portion 21 and the first attaching portion 11.
As shown in fig. 14-15, in order to facilitate positioning of the first attaching portion 11 and the second attaching portion 21, one of the opposite end surfaces of the first attaching portion 11 and the second attaching portion 21 may be provided with positioning pins 23, 24, and the other may be provided with positioning pin holes 13, 14 matching with the positioning pins 23, 24. In the embodiment shown in the figures, the first attaching portion 11 is provided with positioning pin holes 13 and 14, and the second attaching portion 21 is provided with positioning pins 23 and 24 matched with the positioning pin holes 13 and 14.
Furthermore, the number of the positioning pins 23 and 24 is preferably two or more and the positioning pins 23 and 24 are respectively arranged on the upper side and the lower side of the through hole 41, at least one positioning pin is in a diamond shape, and the shapes of the positioning pin holes 13 and 14 are adapted to the shapes of the positioning pins 23 and 24, so that the first attaching portion 11 and the second attaching portion 21 are prevented from shaking or shifting, and the first attaching portion 11 and the second attaching portion 21 are better positioned. In the embodiment shown in the figure, two positioning pins 23 and 24 are respectively arranged on the upper side and the lower side of the through hole 41, one positioning pin 23 is cylindrical, the other positioning pin 24 is rhombic, two positioning pin holes 13 and 14 are respectively arranged on the upper side and the lower side of the through hole 41, one positioning pin hole 13 is a circular positioning pin hole matched with the cylindrical shape, and the other positioning pin hole 14 is a rhombic positioning pin hole matched with the rhombic shape.
While the foregoing is directed to the preferred embodiment of the present invention, it will be understood by those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the invention as defined in the appended claims.
Claims (10)
1. The intramedullary nail lag screw drilling guide device is characterized by comprising an aiming arm, wherein one end of the aiming arm is used for detachably connecting the upper end of a main nail of an intramedullary nail, the other end of the aiming arm is provided with a lag screw guide hole, a guide sleeve is coaxially arranged in the lag screw guide hole, the aiming arm is provided with a limit button at the lag screw guide hole, the limit button is provided with a locking state and an unlocking state, the guide sleeve is locked in the lag screw guide hole under the locking state, and the guide sleeve is slidably connected in the lag screw guide hole under the unlocking state.
2. The intramedullary nail lag screw drilling guide device according to claim 1, wherein a through hole for penetrating the guide sleeve is arranged on the limit button, the inner diameter of the through hole is larger than the outer diameter of the guide sleeve, one of the inner surface of the through hole and the outer surface of the near end of the guide sleeve is provided with a positioning tooth, and the other one is provided with a positioning protrusion which can extend into the positioning tooth.
3. The intramedullary nail lag screw drill guide of claim 2, wherein the positioning teeth are located on the guide sleeve, the positioning protrusions are located on an inner surface of the through hole near a distal end of the stop button, and a spring is provided at the distal end of the stop button;
and/or a long round hole extending along the length direction of the limiting button is formed in the limiting button, a pin hole is formed in the aiming arm corresponding to the long round hole, and a positioning pin penetrates through the pin hole and the long round hole.
4. The intramedullary nail lag screw drill guide of claim 2, wherein the first end surface of the positioning protrusion and the first end surface of the positioning tooth are parallel to the cross section of the guide sleeve, the second end surface of the positioning protrusion and the second end surface of the positioning tooth are at an acute angle to the cross section of the guide sleeve, the first end surface of the positioning protrusion and the first end surface of the positioning tooth abut, and the second end surface of the positioning protrusion and the second end surface of the positioning tooth abut;
or, the bellied first terminal surface in location is on a parallel with the cross section of uide bushing, the first terminal surface of location tooth the bellied second terminal surface in location with the second terminal surface of location tooth all with the acute angle is personally submitted to the uide bushing's cross section, the bellied first terminal surface in location with the first terminal surface butt of location tooth, the bellied second terminal surface in location with the second terminal surface butt of location tooth.
5. The intramedullary nail lag screw drill guide of claim 2, wherein the cross-section of the lag screw guide bore and the guide sleeve is segmental;
and/or the arc length enclosed by the starting end and the terminating end of the positioning tooth is less than the semi-circumference of the cross section of the guide sleeve;
and/or the radius corresponding to the arc length surrounded by the starting end and the terminating end of the positioning tooth is smaller than the radius of the guide sleeve;
and/or the distal end of the guide sleeve is provided with a tip for contacting with the lateral cortex of the femur.
6. The intramedullary nail lag screw drill guide of claim 1, wherein the proximal end of the guide sleeve is coaxially provided with a positioning bracket outside the aiming arm, the proximal end of the guide sleeve is provided with an abutment, the abutment is provided with an axially extending positioning hole, and the positioning bracket is provided with a positioning post which passes through the positioning hole and abuts against the aiming arm.
7. The intramedullary nail lag screw drill guide of claim 1, wherein a drill rod is arranged in the guide sleeve, a scale is arranged at the tail part of the drill rod, and a slidably lockable depth stop is arranged at the scale at the tail part of the drill rod;
the depth limiting piece is provided with a control button, the control button is provided with a locking state and an unlocking state, the depth limiting piece is locked on the drill rod when the control button is in the locking state, and the depth limiting piece is connected on the drill rod in a sliding mode when the control button is in the unlocking state.
8. The intramedullary nail lag screw drilling guide device according to any one of claims 1 to 7, wherein the connecting end of the aiming arm and the intramedullary nail main nail is provided with an insertion post which is matched with a threaded hole at the upper end of the intramedullary nail main nail, and the edge of the insertion post is provided with a vertical positioning projection which is matched with a vertical positioning groove at the upper end of the intramedullary nail main nail.
9. The intramedullary nail lag screw drilling guide device of claim 8, wherein the connecting end of the aiming arm and the main intramedullary nail is provided with a mounting hole extending along the axial direction of the insertion post and penetrating through the insertion post, and a fastening screw for connecting to a threaded hole at the upper end of the main intramedullary nail is arranged in the mounting hole to fix the aiming arm and the main intramedullary nail together.
10. The intramedullary nail lag screw drill guide of claim 8, wherein the aiming arm includes a guide handle having one end for removably coupling to an upper end of the main intramedullary nail and another end for removably coupling to a guide body disposed parallel to the main intramedullary nail, the lag screw guide hole being disposed in the guide body.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210739487.XA CN115153795A (en) | 2022-06-28 | 2022-06-28 | Intramedullary nail lag screw drilling guide device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210739487.XA CN115153795A (en) | 2022-06-28 | 2022-06-28 | Intramedullary nail lag screw drilling guide device |
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| Publication Number | Publication Date |
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| CN115153795A true CN115153795A (en) | 2022-10-11 |
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| CN202210739487.XA Pending CN115153795A (en) | 2022-06-28 | 2022-06-28 | Intramedullary nail lag screw drilling guide device |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN115844482A (en) * | 2022-12-17 | 2023-03-28 | 尤尼泰科(重庆)医疗科技有限公司 | Length-adjustable quick-change orthopedic guide |
-
2022
- 2022-06-28 CN CN202210739487.XA patent/CN115153795A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN115844482A (en) * | 2022-12-17 | 2023-03-28 | 尤尼泰科(重庆)医疗科技有限公司 | Length-adjustable quick-change orthopedic guide |
| CN115844482B (en) * | 2022-12-17 | 2023-08-29 | 尤尼泰科(重庆)医疗科技有限公司 | Length-adjustable quick-change orthopedic guide |
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