CN202604992U - Guiding template for planting screw of acetabulum posterior column - Google Patents
Guiding template for planting screw of acetabulum posterior column Download PDFInfo
- Publication number
- CN202604992U CN202604992U CN 201220197156 CN201220197156U CN202604992U CN 202604992 U CN202604992 U CN 202604992U CN 201220197156 CN201220197156 CN 201220197156 CN 201220197156 U CN201220197156 U CN 201220197156U CN 202604992 U CN202604992 U CN 202604992U
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- bone
- acetabular bone
- guiding
- outside plate
- rear pillar
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Abstract
The utility model relates to a guiding device for planting a fixing screw, in particular to a guiding template for planting a screw of an acetabulum posterior column. The guiding template is formed by an outer plate, an inner plate formed by bending and extending the outer plate downwards and a guiding plate formed by extending the upper surface of the outer plate vertically and upwards. A curve formed by the lower surfaces of the outer plate and the inner plate is matched with a curve formed by a surface of a section of an arcuate edge and a surface of a square area of an acetabulum bone, and the arcuate edge is formed at a front edge of a lug-shaped face of a sacroiliac joint and on the surface of a corresponding fossa iliaca. The upper surface of the outer plate extends vertically and upwards to form the guiding plate, at least two guiding holes extending from the upper end faces of the two guiding plates to a posterior column body downwards and penetrating through the outer plate are arranged in a guiding plate body. The guiding holes are arranged into a row from the arcuate edge close to the acetabulum bone to a fossa bottom of the fossa iliaca. The guiding template is suitable for resetting and fixing the acetabulum posterior column in an anterior approach surgery and has the advantages of being simple in structure and correct in locating.
Description
Technical field
This utility model relates to a kind of surgical instruments, is specifically related to implant the guiding device of hold-down screw, and this device is applicable to guiding implantation acetabular bone rear pillar screw.
Background technology
Fracture of acetabulum is divided into Fracture Simple and compound fracture two big classes; Wherein, Fracture Simple comprises 5 kinds of rear walls, rear pillar, antetheca, front pillar, transverse fracture, and compound fracture comprises that rear pillar and rear wall, horizontal shape and rear wall, T shape, antetheca or front pillar accompany 5 kinds of later half transverse fracture, twin columns fracture.Join the posterior approach bone fixation folding that resets before and after the later half transverse fracture of accompanying transverse fracture in above-mentioned 10 kinds of fracture of acetabulums, twin columns fracture, T type fracture and front pillar often adopts, but operation wound is big, in the art, post-operative complication is many.In order to overcome above-mentioned shortcoming,, adopt the front pillar steel plate to add the fixed form of rear pillar screw clinically often through anterior lateral cervical approach.Because the cross section of os metastyloideum is a triangle, and three faces are arranged, medial surface is that four limit bodies, trailing flank are the rear wall and the ischial tuberosity of mortar; Anterolateral surface is the lateral surface of mortar; Very abundant, can be internal fixation reliable support is provided, so the key of said fixing mode is the implantation of acetabular bone rear pillar screw.But; Existing hip joint also has important tremulous pulse and nerve around the acetabular bone rear pillar; As; Arteriovenous on obturator artery, the buttocks, rectum (in, down) tremulous pulse, women's uterine artery, inferior gluteal artery, internal pudendal artery, inferior gluteal nerve, posterior femoral cutaneous nerve and sciatic nerve careless slightlyly will cause malpractice.
The technological means that addresses the above problem in the prior art is that the whole surgery process is carried out under area of computer aided or X-ray guiding; But, because machinery equipment costs an arm and a leg, complicated, the doctor and patient X line in labelling location its extensive use that exposed effects limit such as too much before the art.
Summary of the invention
This utility model technical problem to be solved provides a kind of navigation template of implanting acetabular bone rear pillar screw, and this navigation template is not only simple in structure, and accurate positioning.
The scheme that this utility model solves the problems of the technologies described above is:
A kind of navigation template of implanting acetabular bone rear pillar screw; This navigation template is by outside plate, by the outside plate downwarping and extend to form inner panel and vertically go up to extend guide plate by the outside plate upper surface and constitute; Wherein, the formed curved surface of the lower surface of said outside plate and inner panel and the surface of corresponding iliac fossa, the surperficial formed curved surface of the squared region of surface and the acetabular bone bone of one section arciform edge of genesis is complementary before the auricular surface of sacroiliac joint; The upper surface of said outside plate is vertically gone up and is extended a guide plate; At least be provided with two in the body of this guide plate and extend and run through the pilot hole of said outside plate downwards in the back cylinder of acetabular bone bone by the upper surface of guide plate, said pilot hole is arranged in a row at the bottom of the nest of iliac fossa from the arciform genesis near the acetabular bone bone.
In the such scheme, the number of described pilot hole can be provided with 2～4 according to the size of acetabular bone bone and fracture and injury degree and be advisable, and the best is 3.When implanting acetabular bone rear pillar screw number above 2, described pilot hole is arranged in a row along a curved line that arches upward to the ilium direction of acetabular bone bone, implants distance between the acetabular bone rear pillar screw to increase.
Produce displacement and influence positioning accuracy for fear of navigation template in operation process, be provided with two locating holes that insert Kirschner wire near panel edges in said on the outside plate described in this utility model navigation template.Further; The middle part of the inner panel upper surface described in this utility model navigation template also is provided with several location recesses; Facilitate the use other shaft-like apparatus inner panel is squeezed in the surface of the squared region of acetabular bone bone, and then reach reset rear pillar and the effect that further improves reliability of positioning.
The manufacture method of the said navigation template of this utility model can be the described method enforcement of patent application of CN 101390773A or CN101816590A with reference to publication number, and the method that this utility model people is recommended may further comprise the steps:
In a, the three-dimensional reconstruction model importing three-dimensional drawing software (like UG or proe commonly used) with the acetabular bone bone; In the predetermined area of the upper surface of the arciform edge of the squared region of iliac fossa, acetabular bone bone and acetabular bone bone, evenly pick up some spots; Then the point that is picked up is fitted to a curved surface; Thicken again, just obtain the outside plate and the inner panel of virtual navigation template to be made;
B, drafting are used to simulate the centrage that acetabular bone rear pillar screw advances to follow closely passage; Swinging pattern is also adjusted the locus and the angle of said centrage respectively then; Make each centrage all pass through the central region of acetabular bone rear pillar; After suitable, set up one and be stretched to the vertical of outside plate upper surface said centrage is contained within intravital guide plate, is that the center of circle is drawn circle and is stretched to downwards along said centrage and runs through outside plate with the intersection point of said centrage and guide plate point end face then; Obtain the pilot hole that at the bottom of the nest of iliac fossa, is arranged in a row near the arciform genesis of acetabular bone bone, promptly accomplish the making of virtual navigation template;
C, be workpiece, utilize RP technique to produce said navigation template with resulting virtual navigation template.
RP technique described in the manufacture method of above-mentioned navigation template is conventional method, as, in three-dimensional software, directly generate the method that former is cast, the successively solidified photocuring forming method of laser irradiation.
In order to satisfy the industrialization batch production requirement; Before carrying out above-mentioned making; Can gather earlier zones of different, different ethnic groups man, woman and adult and all ages and classes section child the acetabular bone bone CT data or nuclear magnetic resonance data and carry out three-dimensional reconstruction, obtain the anatomical parameters of each sample; Then,, carry out statistical analysis, obtain a cover and meet the acetabular bone bone three-dimensional reconstruction model of drafting specification requirement resulting anatomical parameters; At last, obtain the navigation template of the different size of a cover seriation by the described method of above-mentioned steps b, c and d.
Because human body basin bone has symmetrical left acetabular bone bone and right acetabular bone bone, so the described navigation template of this utility model obviously comprises and is used to implant left acetabular bone bone rear pillar screw and two kinds that implant right acetabular bone bone rear pillar screw, and the structure of the two mirror image each other.
The described navigation template of this utility model is applicable to fixedly acetabular bone bone rear pillar of the past road operative reduction, and has following beneficial effect:
(1) need not by as how about the computer navigation system of X line perspective can accomplish the implant surgery of acetabular bone rear pillar screw, avoided the injury of X ray to doctor and patient;
(2) accurate positioning, simple to operate, implant experience person's safety operation but not only lack acetabular bone rear pillar screw, and can significantly shorten the time of free-hand implantation acetabular bone rear pillar screw operation;
(3) simple in structure, with low cost, greatly reduced patient's medical expense, help penetration and promotion.
Description of drawings
Fig. 1～5 are used to implant the structural representation of the embodiment of right acetabular bone bone rear pillar screw for of the said navigation template of this utility model, and wherein Fig. 1 is a front view, and Fig. 2 is a left view, and Fig. 3 is a rearview, and Fig. 4 is a vertical view, and Fig. 5 is a upward view.
Fig. 6 is used to implant the structural representation of the embodiment of left acetabular bone bone rear pillar screw for of the said navigation template of this utility model.
Fig. 7 is the user mode figure of Fig. 1～5 illustrated embodiments.
The specific embodiment
During year April in April, 2009 to 2011, the inventor has collected 100 examples (man, each 50 example of woman) pelvis spiral CT (the GE MediCal systems/lightsDeed 16 types) data that compatriots' normal adult is complete; At 20～77 years old age of said 100 example adults, 46.5 years old mean age, male's height is 1.6～1.8 meters, 1.71 meters of average heights; Women's height is 1.5～1.8 meters, 1.62 meters of average heights.Said 100 adults' pelvis does not all have bone lesion and anatomic abnormalities.Then 100 groups of spiral CT data are imported respectively and carry out three-dimensional reconstruction in the Mimics software; Obtain the three-dimensional reconstruction model of 100 adults' pelvis; Again each three-dimensional reconstruction model is deposited into the stl form and import three-dimensional software UG (Unigraphics SolutionS company; The U.S.) measure the value of the arciform edge span of every three-dimensional reconstruction model in respectively; Promptly, then resulting data are divided into two groups by man, women again from the distance between 2 of leading edge to the iliopubic eminences of sacroiliac joint auricular surface, and respectively by descending.Choose from said descending data at last that data are the top-down the 12nd or the 13rd data between an intermediate value (being the top-down the 25th or the 26th data), intermediate value to the maximum) and intermediate value to minima between data (being the top-down the 37th or the 38th data); Find out the pairing three-dimensional reconstruction model of said three data again, distinguish therefrom intercepting left side acetabular bone bone and right acetabular bone bone as the pairing three-dimensional reconstruction model of big-and-middle small size navigation template.After obtaining the three-dimensional reconstruction model of man, the women respectively acetabular bone bone of three kinds of specifications respectively, can carry out manufacturing and designing of navigation template.Below be example with the right acetabular bone bone three-dimensional reconstruction model of the medium specification of being rebuild, describe the process that manufactures and designs of navigation templates in detail in conjunction with Fig. 1～5 and 7.
(1) the right acetabular bone bone three-dimensional reconstruction model with medium specification imports among the three-dimensional software UG; In the predetermined area of the upper surface of the arciform edge 14 of the squared region 13 of the iliac fossa 11 of acetabular bone bone 10, acetabular bone bone 10 and acetabular bone bone 10, evenly pick up some spots; Then the point that is picked up is intended and changed into a curved surface; Thicken again, just obtain the outside plate 1 and inner panel 2 of the virtual navigation template shown in Fig. 1～5.Visible by Fig. 1～5; Inner panel 2 by outside plate 1 downwarping and extend to form; Wherein, the surface of the iliac fossa 11 of the formed curved surface of lower surface of outside plate 1 and inner panel 2 and acetabular bone bone 10, be complementary from the surperficial formed curved surface of the squared region 13 of the surface of one section arciform edge 14 of the auricular surface leading edge 12 of acetabular bone bone 10 and acetabular bone bone 10.Above-mentioned predetermined area is according to the sized of acetabular bone bone 10 and intend the quantity of implanting acetabular bone rear pillar screw and specification setting; In this example; The quantity of implanting acetabular bone rear pillar screw is 3; The nail shank diameter is 4.5mm, drafts outside plate 1 and is 35mm with inner panel 2 coverings from the bowstring length of one section arciform edge 14 of the auricular surface leading edge 12 of acetabular bone bone 10, confirms that further outside plate 1 and inner panel 2 horizontal direction width are 31mm; Outside plate 1 then can advance to follow closely the entry position of passage and the needs setting of actual location area according to 3 acetabular bone rear pillar screws with inner panel 2, and the length of setting outside plate 1 in this example is 26mm, and the length of inner panel 2 is 40mm.
(2) draw three and be used to simulate the centrage that acetabular bone rear pillar screw advances to follow closely passage; Swinging pattern is also adjusted the locus of each centrage respectively then; Make each centrage all pass through the central region of acetabular bone rear pillar, and do not injure acetabular bone rear pillar tremulous pulse, nerve and joint on every side after guaranteeing to implant acetabular bone rear pillar screw; After the locus of said centrage is suitable; Just setting up one is stretched to the vertical of outside plate 1 upper surface three centrages is contained within intravital guide plate 3; Be that the center of circle is drawn circle and is stretched to downwards along said centrage and runs through outside plate 1 with the intersection point of three centrages and 3 end faces of guide plate respectively then; Obtain 3 pilot hole 4 being arranged in a row from the curved line of arciform edge 14 at the bottom of the nest of the iliac fossa 11 of acetabular bone bone 10 near acetabular bone bone 10, described curved line arches upward to ilium 16 directions of acetabular bone bone 10.
(3) then, on outside plate 1, establish two locating holes 5 that insert Kirschner wire, establish 4 location recesses 6 at the middle part of inner panel 2 upper surfaces, promptly accomplish the making of virtual navigation template near the edge of said inner panel 2.
(4) being workpiece with the resulting virtual navigation template of step (3), directly in three-dimensional software UG, generating former, is that mould can cast out the navigation template shown in Fig. 1～5 with this former.
Referring to Fig. 6, the navigation template that is used to implant left acetabular bone bone rear pillar screw and the navigation template that is used to implant right acetabular bone bone rear pillar screw be mirror image each other, and the navigation template that its preparation method and being used to shown in above-mentioned Fig. 1～5 are implanted right acetabular bone bone rear pillar screw is identical.
Following with reference to Fig. 7 and combine Fig. 1～5 to briefly introduce the method for using of the said navigation template of this utility model:
After from anterior lateral cervical approach the iliac fossa 11 of squared region and acetabular bone bone 10 being come out; Fracture for the acetabular bone rear pillar that has resetted; Only need to select for use the model of the said navigation template of invention according to the pelvis size; And it is placed in squared region 13, and make the left border of inner panel 2 of navigation template 7 concordant with squared region 13 medial borders 15, squeeze into 2 pieces of Kirschner wires 8 respectively and select for use the shaft-like apparatus (like Medical bottle opener) that is of convenient length to act in the recess 6 of location through locating hole 5 then; Inner panel 2 is squeezed on squared region 13, navigation template 7 is fixed on the back, jail squeezes into three guide pins 9 respectively through pilot hole 4.At last, unload navigation template 7, be screwed into acetabular bone bone rear pillar screw along guide pinhole.Perfectly safe in order to ensure operation, can adopt C arm fluoroscopic examination, guarantee to implant the tremulous pulse, nerve and the joint that do not injure behind the acetabular bone rear pillar screw around the acetabular bone rear pillar.
Claims (4)
1. navigation template of implanting acetabular bone rear pillar screw; This navigation template is by outside plate, by the outside plate downwarping and extend to form inner panel and vertically go up to extend guide plate by the outside plate upper surface and constitute; Wherein, the formed curved surface of the lower surface of said outside plate and inner panel and the surface of corresponding iliac fossa, the surperficial formed curved surface of the squared region of surface and the acetabular bone bone of one section arciform edge of genesis is complementary before the sacroiliac joint auricular surface; The upper surface of said outside plate is vertically gone up and is extended a guide plate; At least be provided with two in the body of this guide plate and extend and run through the pilot hole of said outside plate downwards in the back cylinder of acetabular bone bone by the upper surface of guide plate, said pilot hole is arranged in a row at the bottom of the nest of iliac fossa from the arciform genesis near the acetabular bone bone.
2. a kind of navigation template of implanting acetabular bone rear pillar screw according to claim 1 is characterized in that described pilot hole is 3, and is arranged in a row along a curved line that arches upward to the ilium direction.
3. a kind of navigation template of implanting acetabular bone rear pillar screw according to claim 1 and 2 is characterized in that, is being provided with two locating holes that insert Kirschner wire near panel edges in said on the described outside plate.
4. a kind of navigation template of implanting acetabular bone rear pillar screw according to claim 3 is characterized in that, the middle part of described inner panel upper surface is provided with several location recesses.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201220197156 CN202604992U (en) | 2012-05-02 | 2012-05-02 | Guiding template for planting screw of acetabulum posterior column |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201220197156 CN202604992U (en) | 2012-05-02 | 2012-05-02 | Guiding template for planting screw of acetabulum posterior column |
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| CN202604992U true CN202604992U (en) | 2012-12-19 |
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| CN 201220197156 Expired - Lifetime CN202604992U (en) | 2012-05-02 | 2012-05-02 | Guiding template for planting screw of acetabulum posterior column |
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Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102657553A (en) * | 2012-05-02 | 2012-09-12 | 王钢 | Navigation template for implanting acetabulum posterior column screw |
| CN103263289A (en) * | 2013-05-28 | 2013-08-28 | 河北医科大学第三医院 | Screw-implanting sighting device used for minimally invasive surgery |
| CN104983458A (en) * | 2015-07-20 | 2015-10-21 | 南方医科大学 | Manufacturing method for posterior column lag screw 3D navigation module used for acetabulum fracture |
| CN106388978A (en) * | 2016-09-13 | 2017-02-15 | 中南大学湘雅医院 | Preparation method of acetabulum side model and guide plate based on three-dimensional reconstruction technology |
| CN106420030A (en) * | 2016-10-14 | 2017-02-22 | 重庆医科大学附属第医院 | Design method and device of internal fixation system for fracture of quadrilateral body of acetabulum |
| CN109645975A (en) * | 2017-10-10 | 2019-04-19 | 深圳市理邦精密仪器股份有限公司 | The processing method and processing device of fetal heart rate curve data |
-
2012
- 2012-05-02 CN CN 201220197156 patent/CN202604992U/en not_active Expired - Lifetime
Cited By (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102657553A (en) * | 2012-05-02 | 2012-09-12 | 王钢 | Navigation template for implanting acetabulum posterior column screw |
| CN103263289A (en) * | 2013-05-28 | 2013-08-28 | 河北医科大学第三医院 | Screw-implanting sighting device used for minimally invasive surgery |
| WO2014190607A1 (en) * | 2013-05-28 | 2014-12-04 | 河北医科大学第三医院 | Screw implantation sighting device used for minimally invasive surgery |
| CN103263289B (en) * | 2013-05-28 | 2015-03-25 | 河北医科大学第三医院 | Screw-implanting sighting device used for minimally invasive surgery |
| CN104983458A (en) * | 2015-07-20 | 2015-10-21 | 南方医科大学 | Manufacturing method for posterior column lag screw 3D navigation module used for acetabulum fracture |
| CN106388978A (en) * | 2016-09-13 | 2017-02-15 | 中南大学湘雅医院 | Preparation method of acetabulum side model and guide plate based on three-dimensional reconstruction technology |
| CN106420030A (en) * | 2016-10-14 | 2017-02-22 | 重庆医科大学附属第医院 | Design method and device of internal fixation system for fracture of quadrilateral body of acetabulum |
| CN106420030B (en) * | 2016-10-14 | 2023-05-16 | 重庆医科大学附属第一医院 | Design method and device for internal fixation system of acetabular quadrilateral fracture |
| CN109645975A (en) * | 2017-10-10 | 2019-04-19 | 深圳市理邦精密仪器股份有限公司 | The processing method and processing device of fetal heart rate curve data |
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Legal Events
| Date | Code | Title | Description |
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| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| AV01 | Patent right actively abandoned |
Granted publication date: 20121219 Effective date of abandoning: 20140702 |
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| RGAV | Abandon patent right to avoid regrant |