CN115317193A - 一种用于韧带重建移植物关节内段长度精准测量的方法 - Google Patents

一种用于韧带重建移植物关节内段长度精准测量的方法 Download PDF

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CN115317193A
CN115317193A CN202210839993.6A CN202210839993A CN115317193A CN 115317193 A CN115317193 A CN 115317193A CN 202210839993 A CN202210839993 A CN 202210839993A CN 115317193 A CN115317193 A CN 115317193A
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bone
tibia
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joint
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刘天择
黄轩
刘忠堂
林荣强
张永进
布子恒
徐卫东
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First Affiliated Hospital of Naval Military Medical University of PLA
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Abstract

本发明提供一种用于韧带重建移植物关节内段长度精准测量的方法,包括以下步骤:S1.胫骨打通骨道;S2.股骨打通骨道;S3.软针进入关节腔;S4.牵引钩定位;S5.读取刻度。本发明结合了带刻度的软针和尾孔导针定位后打通的软钻技术,采用在胫骨、股骨分别打通骨道,通过带有刻度的软针对移植物的关节内段长度进行精确测量,保证了粗骨道的精准建立,减小了蹦极效应,增加了手术成功率,同时可以使病人更早期的进行康复训练,快速康复。

Description

一种用于韧带重建移植物关节内段长度精准测量的方法
技术领域
本发明涉及医疗辅助装置技术领域,具体涉及一种用于韧带重建移植物关节内段长度精准测量的方法。
背景技术
目前,成人前交叉韧带(anteriorcruciateligament,ACL)断裂是常见多发病,伤后如果不积极治疗,往往产生明显关节不稳,影响生活质量,发生膝骨关节炎的风险也将增加。近年来逐渐兴起的全内技术(all-insidetechnique,AIT)重建具有封闭的骨隧道、双悬吊固定、减少去骨量、皮肤切口小、保留股薄肌等特点,在减轻术后疼痛方面效果显著。
在ACL的全内重建中,往往仅取一根半腱肌,在能够满足腱骨愈合的条件下,尽可能更短更粗的编制成移植物,植入关节固定。但是,在这个过程中,存在以下技术缺陷:1)、无法准确的测量膝关节内所需移植物的精确长度,主刀医生往往只能通过经验粗略估计,导致在制作股骨和胫骨的粗骨道时,只能凭借经验尽可能做的长一点,需切取2-3条肌腱进行编织以保证肌腱的长度及直径达到所需的强度要求,以免移植物无法正常植入,这样的手术方式使得胫骨或股骨中存在没有移植物填充的空余粗骨道,既造成了骨量浪费,也增加了移植物的“蹦极效应”,不利于腱骨愈合,甚至有可能造成手术失败;2)、因移植物股骨内段、关节内段、胫骨内段之间均有成角,现有硬质带刻度导针无法完成测量工作。
如何设计一种用于韧带重建移植物关节内段长度精准测量的方法,成为急需解决的问题。
发明内容
针对现有技术存在的问题,本发明提供一种用于韧带重建移植物关节内段长度精准测量的方法,以解决上述至少一种技术问题。
本发明的技术方案是:一种用于韧带重建移植物关节内段长度精准测量的方法,包括带有刻度的软针,软针的一端设置有牵引钩,牵引钩上设置有牵引孔,牵引孔内设置有胫骨侧缝线,包括以下步骤:
S1.胫骨打通骨道,胫骨以尾孔导针定位后打通,过爱惜帮缝线一根,一端置于骨道外,另一端经前膝关节内侧入路拉出再次穿尾孔导针;
S2.股骨打通骨道,
股骨以尾孔导针定位后打通,将缝线一端从股骨骨道拉出;
S3.软针进入关节腔,
胫骨侧缝线穿过牵引孔打结后,将软针拉入关节腔;
S4.牵引钩定位,
反向牵引钩于骨面固定;
S5.读取刻度,
根据软针上的刻度读数,即可知道移植物关节内段精确长度。
本发明结合了带刻度的软针和尾孔导针定位后打通的软钻技术,采用在胫骨、股骨分别打通骨道,通过带有刻度的软针对移植物的关节内段长度进行精确测量,保证了粗骨道的精准建立,减小了蹦极效应,增加了手术成功率,同时可以使病人更早期的进行康复训练,快速康复。
优选,所述软针的直径为4mm。所述尾孔导针的直径为4.5mm。
本发明采用直径为4mm的软针,软针在4.5mm骨道内自由放置,能在股骨内段、关节内段、胫骨内段之间的成角上调整形态,保证了粗骨道的精准建立。
附图说明
图1为本发明的工艺流程图。
图2为本发明的结构示意图。
图3为本发明的安装结构示意图。
图中:1.牵引钩;2.牵引孔;3.软针;4.胫骨侧缝线。
具体实施方式
下面结合附图对本发明做进一步的说明。
参阅图1-3,本说明书所附图式所绘示的结构、比例、大小等,均仅用以配合说明书所揭示的内容,以供熟悉此技术的人士了解与阅读,并非用以限定本发明可实施的限定条件,故不具技术上的实质意义,任何结构的修饰、比例关系的改变或大小的调整,在不影响本发明所能产生的功效及所能达成的目的下,均应仍落在本发明所揭示的技术内容得能涵盖的范围内。同时,本说明书中所引用的如“上”、“下”、“左”、“右”、“中间”及“一”等的用语,亦仅为便于叙述的明了,而非用以限定本发明可实施的范围,其相对关系的改变或调整,在无实质变更技术内容下,当亦视为本发明可实施的范畴。
实施例一、一种用于韧带重建移植物关节内段长度精准测量的方法,参考图2、图3,包括软针3,所述软针3的一端设置有牵引钩1,软针3上设置有刻度,牵引钩1上设置有牵引孔2,牵引孔2内设置有胫骨侧缝线4。本发明采用带有刻度的软针,在前交叉韧带全内重建中,对于移植物的关节内段长度进行精确测量,从而保证了粗骨道的精准建立,减小了蹦极效应,增加了手术成功率,同时可以使病人更早期的进行康复训练,快速康复。
实施例二、在实施例一的基础上,所述牵引钩1的厚度为2mm,牵引钩1为7字型结构,牵引孔2设置于7字型结构的竖杆上。本发明采用7字型结构的牵引钩,7字型结构的夹角能在骨面固定。
实施例三、在实施例二的基础上,所述牵引孔2为腰型孔,腰型孔的长轴与7字型结构的竖杆内侧边平行。本发明采用胫骨侧缝线在牵引孔内打结,通过胫骨侧缝线能带动牵引钩运动。
实施例四、在实施例一的基础上,所述软针3的直径为4mm。本发明采用直径为4mm的软针,软针在4.5mm骨道内自由放置,能在股骨内段、关节内段、胫骨内段之间的成角上调整形态,保证了粗骨道的精准建立。
实施例五、在实施例四的基础上,所述软针3的外圈沿着轴向设置有刻度,刻度为2mm一格。本发明采用在软针的外圈沿着轴向设置刻度,能使移植物在股骨内段、关节内段、胫骨内段之间自由放置,解决了移植物在股骨内段、关节内段、胫骨内段之间均有成角,现有硬质带刻度导针无法完成测量工作的技术缺陷。
实施例六、一种用于韧带重建移植物关节内段长度精准测量的方法,参考图1,包括带有刻度的软针3,软针3的一端设置有牵引钩1,牵引钩1上设置有牵引孔2,牵引孔2内设置有胫骨侧缝线4,包括以下步骤:
S1.胫骨打通骨道,胫骨以4.5mm尾孔导针定位后打通,过爱惜帮缝线一根,一端置于骨道外,另一端经前膝关节内侧入路拉出再次穿尾孔导针;
S2.股骨打通骨道,
股骨以上述4.5mm尾孔导针定位后打通,将缝线一端从股骨骨道拉出;
S3.软针3进入关节腔,
胫骨侧缝线4穿过牵引孔2打结后,将软针3拉入关节腔;
S4.牵引钩1定位,
反向牵引钩1于骨面固定;
S5.读取刻度,
根据软针3上的刻度读数,即可知道移植物关节内段精确长度。
本发明结合了带刻度的软针和尾孔导针定位后打通的软钻技术,采用在胫骨、股骨分别打通骨道,通过带有刻度的软针对移植物的关节内段长度进行精确测量,保证了粗骨道的精准建立,减小了蹦极效应,增加了手术成功率,同时可以使病人更早期的进行康复训练,快速康复。
具体实施时,根据移植物关节内段精确长度切取1条肌腱编织,即可达到重建前交叉韧带所需的直径及强度,不仅可以更多的保留骨量,可以保留患者更多的自体肌腱,更有利于患者术后的恢复以及将来重返运动的需求。
以上仅是本发明的优选实施方式,应当指出,对于本技术领域的普通技术人员来说,在不脱离本发明原理的前提下,还可以做出若干改进和润饰,这些改进和润饰也应视为本发明的保护范围。

Claims (6)

1.一种用于韧带重建移植物关节内段长度精准测量的方法,包括带有刻度的软针(3),软针(3)的一端设置有牵引钩(1),牵引钩(1)上设置有牵引孔(2),牵引孔(2)内设置有胫骨侧缝线(4),其特征在于,包括以下步骤:
S1.胫骨打通骨道,
胫骨以尾孔导针定位后打通,过爱惜帮缝线一根,一端置于骨道外,另一端经前膝关节内侧入路拉出再次穿尾孔导针;
S2.股骨打通骨道,
股骨以尾孔导针定位后打通,将缝线一端从股骨骨道拉出;
S3.软针(3)进入关节腔,
胫骨侧缝线(4)穿过牵引孔(2)打结后,将软针(3)拉入关节腔;
S4.牵引钩(1)定位,
反向牵引钩(1)于骨面固定;
S5.读取刻度,
根据软针(3)上的刻度读数,即可知道移植物关节内段精确长度。
2.根据权利要求1所述的一种用于韧带重建移植物关节内段长度精准测量的方法,其特征在于:所述步骤S1和S2中,尾孔导针的直径为4.5mm。
3.根据权利要求1所述的一种用于韧带重建移植物关节内段长度精准测量的方法,其特征在于:所述步骤S3中,软针(3)的直径为4mm。
4.根据权利要求3所述的一种用于韧带重建移植物关节内段长度精准测量的方法,其特征在于:所述步骤S3中,软针(3)的外圈沿着轴向设置有刻度,刻度为2mm一格。
5.根据权利要求4所述的一种用于韧带重建移植物关节内段长度精准测量的方法,其特征在于:所述步骤S4中,牵引钩(1)的厚度为2mm,牵引钩(1)为7字型结构,牵引孔(2)设置于7字型结构的竖杆上。
6.根据权利要求5所述的一种用于韧带重建移植物关节内段长度精准测量的方法,其特征在于:所述7字型结构的夹角能在骨面固定。
CN202210839993.6A 2022-07-18 2022-07-18 一种用于韧带重建移植物关节内段长度精准测量的方法 Pending CN115317193A (zh)

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