CN115553907A - Guider and using method - Google Patents

Abstract

The invention belongs to the technical field of medical instruments, and particularly relates to a guider and a using method thereof; the left positioning shaft is connected with a left foot near-end handle in a spherical hinge mode, a first connecting cylinder is arranged at the bottom of the left positioning shaft, the right foot near-end handle and the left foot near-end handle are connected through a shaft, the right foot near-end handle is sleeved in a connecting sleeve, the right positioning shaft is connected to the connecting sleeve through a spherical hinge, and a second connecting cylinder is fixed on the right positioning shaft; the connecting rod is sleeved in the connecting sleeve, and the connecting rod of the handle at the near end of the right foot is fastened in the connecting sleeve through a connecting screw rod; the invention is used as a guide of a guide wire or a guide needle for inserting an implant into a bone to treat a bone defect.

Description

Guider and using method

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to a guider and a using method thereof.

Background

Implants or devices of various shapes and sizes are commonly used in modern medicine to repair bone defects, such as bone fractures; the surgeon typically places the bone to be repaired in the correct location and then fixes it with an implant or device for healing.

The scaphoid is the pivotal joint of the wrist joint and is the main cause of dysfunction of the wrist joint. Scaphoid fracture is common in clinic, accounts for 70% of fracture of carpal bones, and is a fracture (second to fracture of distal radius) with the second highest incidence rate in fracture of upper limbs, which is higher than that of people in the age range of 20-30 years.

Traditional treatment methods for scaphoid fractures often employ plaster braking and open internal fixation procedures. Most of the fracture of the fresh scaphoid without displacement can be healed by adopting a plaster braking method, however, the braking time is as long as 12-16 weeks, so that the joint stiffness can be caused, and the functional rehabilitation of hands and wrists is influenced. Furthermore, prolonged gypsum braking is often unacceptable for those who are unable to wear gypsum to work or for some young patients who prefer sports. The other treatment method is that the ligament of the wrist joint is damaged by incising and internally fixing the operation, the brake is required to be prolonged after the operation, the residual blood vessel is damaged, and the incidence rate of nonunion and ischemic necrosis is increased.

The minimally invasive treatment of scaphoid firstly reports the clinical research of treating scaphoid fracture of Chinese people by adopting a dorsal approach percutaneous compression screw internal fixation method. Early curative effect and patient satisfaction are superior to those of the traditional method, but because the scaphoid is hidden and has complex three-dimensional shape, even a specialist with rich experience often needs to try for many times and perform X-ray fluoroscopy repeatedly to finish the operation, and the scaphoid waist and the near are very narrow, the space for placing the internal fixing screw is small, and the fault-tolerant rate is low. The problem is further exacerbated by the fact that the navicular bone of a chinese individual is smaller than that of the euro, and that it is difficult to ensure the exact orientation and angle of the internal fixture by free-hand operation of the guide pin, which can be assisted by X-rays taken in the anterior-posterior and lateral planes before and after placement of the guide wire. Such an operation requires considerable skill and often involves one or more attempts before proper positioning is achieved. Difficulties often encountered in inserting and positioning guide wires are caused by the slippery environment of the surgical procedure and the tendency of thin guide wires to wobble and bend as they are inserted into position in the bone. The accuracy of the spatial position between these devices in the bone is critical to a successful procedure.

Historically, guides designed to assist in positioning the guidewire have been plagued by the problem of slippage and difficulty in use with X-rays, both of which can prolong the time of the surgical procedure, which is both patient-unfriendly and costly. Errors involving an operator loading the guide wire into the bone in the wrong position or in the wrong orientation relative to other hardware may require the insertion of additional guide wires to correct the error. These errors can damage an already defective bone, leading to fragility of the bone, deepening of the bone damage, and poor healing.

Accordingly, there is a need in the art for a guide that addresses the sliding problem and is capable of ensuring the correct spatial orientation of the hardware or devices used for fracture fixation.

Disclosure of Invention

To overcome the above problems, the present invention provides a guide and a method of using the same as a guide for a guide wire or guide pin for inserting an implant into a bone to treat a bone defect.

A guide comprising a left sight 1, a right sight 2, wherein:

the left sighting device 1 comprises a left sighting device proximal handle 105, a left positioning shaft 104 and a first connecting cylinder 101, wherein the left positioning shaft 104 is hollow and is connected to the top of the left sighting device proximal handle 105, the bottom of the left positioning shaft 104 is fixedly provided with the first connecting cylinder 101, and a plurality of peripheral guide holes 102 parallel to the left positioning shaft 104 are formed in the first connecting cylinder 101;

the right sighting device 2 comprises a second connecting cylinder 201, a right positioning shaft 204, a right sighting device proximal handle 207 and a connecting sleeve 208, wherein the bottom of the right sighting device proximal handle 207 and the bottom of the left sighting device proximal handle 105 are connected through a shaft 3, the distal end of the right sighting device proximal handle 207 is sleeved in the connecting sleeve 208 through a link 2072, the sleeve 208 can slide up and down along the connecting rod 2072, the right positioning shaft 204 is hollow, the proximal end of the right sighting device proximal handle is connected to the distal end of the connecting sleeve 208 through a spherical hinge, the bottom of the right positioning shaft 204 is fixedly provided with the second connecting cylinder 201, and a plurality of peripheral guide holes 202 parallel to the right positioning shaft 204 are formed in the second connecting cylinder 201;

a through hole is formed in the connecting sleeve 208, a push plate 210 is arranged on one side of the inner wall of the through hole, the right sighting device near-end handle 207 comprises a handle body 2071, a connecting rod 2072 is fixed on the handle body 2071, a boss 209 is arranged at the top of the connecting rod 2072, the connecting rod 2072 is sleeved in the through hole of the connecting sleeve 208, and when the connecting sleeve 208 slides towards the far end, the boss 209 can be matched with the push plate 210 on the inner wall of the connecting sleeve 208 to achieve limiting; while the connecting rod 2072 of the right sight proximal handle 207 is fastened within the connecting sleeve 208 by the connecting screw 206.

The connecting screw 206 penetrates into the connecting sleeve 208 through a threaded hole formed in the connecting sleeve 208 and contacts with the push plate 210.

The left positioning shaft 104 is hard-wired to a left sight proximal handle 105.

A ball 212 is arranged below the right positioning shaft 204, a ball socket 211 is arranged at the top of the connecting sleeve 208, and the right positioning shaft 204 is connected in the ball socket 211 at the top of the connecting sleeve 208 in a matching way through the ball 212 on the right positioning shaft.

The handle body 2071 of the right sight proximal end handle 207 is an L-shaped rod, and comprises a vertical long rod and a transverse short rod, wherein the transverse short rod is arranged above the vertical long rod, and a connecting rod 2072 is fixed on the transverse short rod.

The top of the left positioning shaft 104 is provided with a left tooth 103 to prevent directional slipping on the bone surface, and the top of the right positioning shaft 204 is provided with a right tooth 203 to prevent directional slipping on the bone surface.

A method of inserting a guide wire or needle into a bone, the method comprising:

step one, aligning a left positioning shaft 104 or a right positioning shaft 204 to a position to be inserted according to the position to be inserted;

secondly, the left tooth 103 or the right tooth 203 is close to the bone surface, a guide wire or a guide pin sequentially passes through a required peripheral guide hole 102 and a required left positioning shaft 104 or sequentially passes through a required peripheral guide drilling hole 202 and a required right positioning shaft 204, and the guide wire or the guide pin is inserted into the bone after passing through the left positioning shaft 104 or the right positioning shaft 204;

step three, referring to the position of the guide pin or the guide wire in the bone, swinging the right sighting device 2 to enable the left sighting device proximal handle 105 and the right sighting device proximal handle 207 to move to the required positions around the shaft 3, then pushing the connecting rod 2072 to the position in the connecting sleeve 208 until the right positioning shaft 204 reaches the required positions, then fixing the connecting rod 2072 in the connecting sleeve 208 by screwing the connecting screw rod 206, and meanwhile fixing the ball head 212;

fixing a second guide wire or guide wire to the fracture part, namely sequentially penetrating the second guide wire or guide wire through another peripheral guide hole 102 and the left positioning shaft 104 or sequentially penetrating through another required peripheral guide drilling hole 202 and the right positioning shaft 204, and inserting the guide wire or guide wire into the bone after penetrating through the left positioning shaft 104 or the right positioning shaft 204;

and step four, repeating the step one to the step three according to the requirement to continue inserting the guide wire or the guide pin, and determining the position of the fracture line at one time along each guide wire or guide pin.

The invention has the beneficial effects that:

the invention can determine the position of the fracture line at one time, greatly shortens the operation time, and lightens the economic burden of a patient caused by anesthesia time and the operation risk caused by long time; the fracture fixation of scaphoid, metatarsal and the like which have complex shapes originally is simplified, and doctors with abundant experience are not needed, so that the operation is popularized.

The present invention can meet the need for a correct spatial orientation guide for fracture fixation hardware or devices.

Drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings used in the description of the embodiments of the present invention will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art that other drawings can be obtained according to the contents of the embodiments of the present invention and the drawings without creative efforts.

FIG. 1 is a schematic view of the present invention.

Fig. 2 is a detailed structural diagram of the present invention.

FIG. 3 is a schematic view of the structure of the right foot proximal handle and the connecting sleeve of the present invention.

FIG. 4 is a schematic view of the right positioning shaft according to the present invention.

FIG. 5 is a schematic view of the structure of the right foot of the present invention.

FIG. 6 is a schematic side view of the present invention.

Wherein: the device comprises a left aimer 1, a first connecting cylinder 101, a peripheral guide hole 102, a left tooth 103, a left positioning shaft 104, a left aimer proximal handle 105, a right aimer 2, a second connecting cylinder 201, a peripheral guide drill hole 202, a right tooth 203, a right positioning shaft 204, a hinge 205, a connecting screw 206, a right aimer proximal handle 207, a handle body 2071, a connecting rod 2072, a connecting sleeve 208, a boss 209, a push plate 210, a ball socket 211 and a ball head 212.

Detailed Description

The present invention will be described in further detail with reference to the drawings and examples. It is to be understood that the specific embodiments described herein are merely illustrative of the invention and are not limiting of the invention. It should be further noted that, for the convenience of description, only some of the structures related to the present invention are shown in the drawings, not all of the structures.

In the description of the present invention, unless expressly stated or limited otherwise, the terms "connected," "connected," and "fixed" are to be construed broadly, e.g., as meaning permanently connected, removably connected, or integral to one another; can be mechanically or electrically connected; either directly or indirectly through intervening media, either internally or in any other relationship. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

In the present invention, unless otherwise expressly stated or limited, "above" or "below" a first feature means that the first and second features are in direct contact, or that the first and second features are not in direct contact but are in contact with each other via another feature therebetween. Also, the first feature "on," "above" and "over" the second feature may include the first feature being directly above and obliquely above the second feature, or simply indicating that the first feature is at a higher level than the second feature. "beneath," "under" and "beneath" a first feature includes the first feature being directly beneath and obliquely beneath the second feature, or simply indicating that the first feature is at a lesser elevation than the second feature.

In the description of the present embodiment, the terms "upper", "lower", "left", "right", and the like are used based on the orientations and positional relationships shown in the drawings only for convenience of description and simplification of operation, and do not indicate or imply that the referred device or element must have a specific orientation, be configured and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first" and "second" are used only for descriptive purposes and are not intended to have a special meaning.

Example 1

As shown in fig. 1 to 6, a guide comprises a left sight 1, a right sight 2, wherein:

the left sighting device 1 comprises a left sighting device proximal handle 105, a left positioning shaft 104 and a first connecting cylinder 101, wherein the left positioning shaft 104 is hollow and is connected to the top of the left sighting device proximal handle 105, the bottom of the left positioning shaft 104 is fixedly provided with the first connecting cylinder 101, and a plurality of peripheral guide holes 102 parallel to the left positioning shaft 104 are formed in the first connecting cylinder 101;

the right sighting device 2 comprises a second connecting cylinder 201, a right positioning shaft 204, a right sighting device proximal end handle 207 and a connecting sleeve 208, wherein the bottom of the right sighting device proximal end handle 207 is connected with the bottom of the left sighting device proximal end handle 105 through a shaft 3, the far end of the right sighting device proximal end handle 207 is sleeved in the connecting sleeve 208 and can slide up and down in the connecting sleeve 208, the right positioning shaft 204 is hollow, the near end of the right positioning shaft 204 is connected to the far end of the connecting sleeve 208 through a spherical hinge, the bottom of the right positioning shaft 204 is fixedly provided with the second connecting cylinder 201, and a plurality of peripheral guide drill holes 202 parallel to the right positioning shaft 204 are formed in the second connecting cylinder 201;

a through hole is formed in the connecting sleeve 208, a push plate 210 is arranged on one side of the inner wall of the through hole, the handle 207 at the near end of the right sighting device comprises a handle body 2071, a connecting rod 2072 is fixed on the handle body 2071, a boss 209 is arranged at the top of the connecting rod 2072, the connecting rod 2072 is sleeved in the through hole of the connecting sleeve 208, and when the connecting rod 2072 slides towards the far end, the boss 209 can be matched with the push plate 210 on the inner wall of the connecting sleeve 208 to achieve limiting; while the connecting rod 2072 of the right sight proximal handle 207 is secured within the connecting sleeve 208 by the connecting screw 206.

The connecting screw 206 penetrates into the connecting sleeve 208 through a threaded hole formed in the connecting sleeve 208 and contacts with the push plate 210.

Set up the recess that is used for cooperating connection boss 209 on the push pedal 210, when boss 209 is located the recess top on the push pedal 210, screw up connecting screw 206, make connecting screw 206 promote push pedal 210 inward movement, boss 209 can cooperate and realize spacingly in the recess on push pedal 210 this moment, when connecting rod 2072 needs to slide to the near-end, reverse rotation connecting screw 206, make push pedal 210 outwards move, boss 209 roll-off in the recess on push pedal 210 this moment, connecting rod 2072 can continue to slide to the near-end.

The left positioning shaft 104 is hard-wired to the left sight proximal handle 105.

A ball 212 is arranged below the right positioning shaft 204, a ball socket 211 is arranged at the top of the connecting sleeve 208, and the right positioning shaft 204 is connected in the ball socket 211 at the top of the connecting sleeve 208 in a matching way through the ball 212 on the right positioning shaft.

The handle body 2071 of right sight near-end handle 207 is L type pole, including vertical stock and horizontal quarter butt, and wherein horizontal quarter butt sets up in vertical stock top, and connecting rod 2072 is fixed on horizontal quarter butt.

The top of the left positioning shaft 104 is provided with left teeth 103 to prevent slipping when the bone surface is oriented, and the top of the right positioning shaft 204 is provided with right teeth 203 to prevent slipping when the bone surface is oriented.

A method of inserting a guide wire or needle into a bone, the method comprising:

step one, according to the position needing to be inserted, the left positioning shaft 104 or the right positioning shaft 204 is aligned to the position to be inserted;

secondly, the left tooth 103 or the right tooth 203 is close to the bone surface, a guide wire or a guide pin sequentially passes through a required peripheral guide hole 102 and a required left positioning shaft 104 or sequentially passes through a required peripheral guide drilling hole 202 and a required right positioning shaft 204, and the guide wire or the guide pin is inserted into the bone after passing through the left positioning shaft 104 or the right positioning shaft 204;

step three, referring to the position of the guide pin or the guide wire in the bone, swinging the right sighting device 2 to enable the left sighting device proximal handle 105 and the right sighting device proximal handle 207 to move to the required positions around the shaft 3, then pushing the connecting rod 2072 to the position in the connecting sleeve 208 until the right positioning shaft 204 reaches the required positions, then fixing the connecting rod 2072 in the connecting sleeve 208 by screwing the connecting screw rod 206, and meanwhile fixing the ball head 212;

step four, fixing a second guide wire or guide pin to the fracture part, namely sequentially penetrating the second guide wire or guide pin through another peripheral guide hole 102 and the left positioning shaft 104 or through another required peripheral guide drilling hole 202 and a right positioning shaft 204, and inserting the guide wire or guide pin into the bone after penetrating through the left positioning shaft 104 or the right positioning shaft 204;

and step four, repeating the steps one to three according to the requirement to continue the insertion of the guide wire or the guide pin, and determining the position of the fracture line along each guide wire or guide pin at one time.

Example 2

In practice, often the first guide pin or guide wire is inserted blindly by the doctor according to experience, referring to the guide pin or guide wire position of the peripheral guide hole 102 or peripheral guide drilling hole 202, swinging the right sight 2, moving the left sight proximal handle 105 and the right sight proximal handle 207 to the desired position around the shaft 3, finding the best position at the hinge joint 205, pushing the connecting rod 2072 to the desired position in the connecting sleeve 208 until the right positioning shaft 204 reaches the desired position, fixing the connecting rod 2072 in the connecting sleeve 208 by screwing the connecting screw 206, fixing the second guide pin or guide wire to the bone, and inserting the second guide pin or guide wire into the bone after passing through the another peripheral guide hole 102 and left positioning shaft 104 in sequence or through another peripheral guide drilling hole 202 and right positioning shaft 204 in sequence, and then passing through the left positioning shaft 104 or right positioning shaft 204 in sequence.

Third and fourth fixed positions can be found if desired. The position of the fracture line can be determined at one time, the operation time is greatly shortened, and the economic burden of a patient caused by anesthesia time and the operation risk caused by a long time are reduced. The fracture fixation of scaphoid, metatarsal and the like which have complex shapes originally is simplified, and doctors with abundant experience are not needed, so that the operation is popularized.

Further comprising removing the guide and drilling a hole through the guide wire using the hollow drill. In certain embodiments, one or more bone screws are inserted into the bone along a guide wire. In a particular embodiment, the bone screw is cannulated. In a further embodiment, a flowable medium is introduced into the bone screw. In other embodiments, the method includes removing the guidewire and introducing a flowable medium into bone that is not inserted with bone screws. In certain particular embodiments, the flowable medium is a bone void filler, a bone cement, or a pharmaceutical formulation.

In certain embodiments, the bone defect comprises a defect of the radius, ulna, fibula, clavicle, humerus, pelvis, femur, patella, tibia, talus, calcaneus, navicular, cuneiform, metatarsals, metacarpal, phalanges, scapula, ankle, mandible, or vertebra. In a particular embodiment, the bone defect is a fracture.

Although the preferred embodiments of the present invention have been described in detail with reference to the accompanying drawings, the scope of the present invention is not limited to the specific details of the above embodiments, and any person skilled in the art can substitute or change the technical solution of the present invention and its inventive concept within the technical scope of the present invention, and these simple modifications belong to the scope of the present invention.

It should be noted that, in the above embodiments, the various features described in the above embodiments may be combined in any suitable manner, and in order to avoid unnecessary repetition, the present invention does not separately describe various possible combinations.

In addition, any combination of the various embodiments of the present invention is also possible, and the same should be considered as the disclosure of the present invention as long as it does not depart from the spirit of the present invention.

Claims (7)

1. A guide, characterized by comprising a left sight (1), a right sight (2) and an articulated shaft (3) wherein:

the left sighting device (1) comprises a left sighting device near-end handle (105), a left positioning shaft (104) and a first connecting cylinder (101), wherein the left positioning shaft (104) is hollow and is connected to the top of the left sighting device near-end handle (105), the first connecting cylinder (101) is fixed at the bottom of the left positioning shaft (104), and a plurality of peripheral guide holes (102) are formed in the first connecting cylinder (101);

the right sighting device (2) comprises a second connecting cylinder (201), a right positioning shaft (204), a right sighting device near-end handle (207) and a connecting sleeve (208), wherein the bottom of the right sighting device near-end handle (207) is connected with the bottom of the left sighting device near-end handle (105) through a shaft (3), the far end of the right sighting device handle (207) is sleeved in the connecting sleeve (208) through a chain connecting rod (2072), the connecting sleeve (208) can slide up and down along the connecting rod (2072), the right positioning shaft (204) is hollow, the near end of the right sighting device handle is connected to the far end of the connecting sleeve (208) through a spherical hinge, the bottom of the right positioning shaft (204) is fixedly provided with the second connecting cylinder (201), and a plurality of peripheral guide holes (202) are formed in the second connecting cylinder (201);

a through hole is formed in the connecting sleeve (208), a push plate (210) is arranged on one side of the inner wall of the through hole, the right sighting device near-end handle (207) comprises a handle body (2071), a connecting rod (2072) is fixed on the handle body (2071), a boss (209) is arranged at the top of the connecting rod (2072), the connecting rod (2072) is sleeved in the through hole of the connecting sleeve (208), and when the connecting sleeve (208) slides to the far end, the boss (209) can be matched with the push plate (210) on the inner wall of the connecting sleeve (208) to achieve limiting; meanwhile, the connecting rod (2072) is fastened in the connecting sleeve (208) through the connecting screw rod (206).

2. A guide as claimed in claim 1, wherein the connecting screw (206) is threaded into the connecting sleeve (208) through a threaded bore provided in the connecting sleeve (208) to contact the push plate (210).

3. A guide as claimed in claim 1, wherein the left positioning shaft (104) is rigidly connected to a left sight proximal handle (105).

4. The guider according to claim 1, characterized in that a ball head (212) is arranged below the right positioning shaft (204), a ball socket (211) is arranged at the top of the connecting sleeve (208), and the positioning shaft (204) is connected in the ball socket (211) at the top of the connecting sleeve (208) in a matching way through the ball head (212) on the positioning shaft.

5. A guide device according to claim 1, wherein the handle body (2071) of the right sight proximal handle (207) is an L-shaped bar comprising a long vertical bar and a short transverse bar, wherein the short transverse bar is disposed above the long vertical bar and the connecting bar (2072) is fixed to the short transverse bar.

6. A guide device according to claim 1, wherein the left positioning shaft (104) is provided with left teeth (103) at the top and the right positioning shaft (204) is provided with right teeth (203) at the top.

7. A method of inserting a guide wire or needle into a bone using the guide of any one of claims 1 to 6, characterised in that the method comprises:

step one, according to the position needing to be inserted, a left positioning shaft (104) or a right positioning shaft (204) is aligned to the position to be inserted;

secondly, the left tooth (103) or the right tooth (203) is close to the bone surface, a guide wire or a guide pin sequentially passes through a required peripheral guide hole (102) and a left positioning shaft (104) or a required peripheral guide drilling hole (202) and a right positioning shaft (204), and the guide wire or the guide pin is inserted into the bone after passing through the left positioning shaft (104) or the right positioning shaft (204);

step three, referring to the position of the guide pin or the guide wire in the bone, swinging the right sighting device (2), enabling a left sighting device near-end handle (105) and a right sighting device near-end handle (207) to move to required positions around a shaft (3), then pushing the position of a connecting rod (2072) in a connecting sleeve (208) until a right positioning shaft (204) reaches the required positions, then fixing the connecting rod (2072) in the connecting sleeve (208) by screwing a connecting screw rod (206), and meanwhile fixing a ball head (212);

step four, fixing a second guide wire or guide wire to the fracture part, namely sequentially penetrating the second guide wire or guide wire through another peripheral guide hole (102) and the left positioning shaft (104) or another required peripheral guide drilling hole (202) and the right positioning shaft (204), and inserting the guide wire or guide wire into the bone after penetrating through the left positioning shaft (104) or the right positioning shaft (204);

and step four, repeating the steps one to three according to the requirement to continue the insertion of the guide wire or the guide pin, and determining the position of the fracture line along each guide wire or guide pin at one time.

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