CN207168541U - A kind of distal femur osteotomy locating guide device - Google Patents

A kind of distal femur osteotomy locating guide device Download PDF

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Publication number
CN207168541U
CN207168541U CN201720053955.2U CN201720053955U CN207168541U CN 207168541 U CN207168541 U CN 207168541U CN 201720053955 U CN201720053955 U CN 201720053955U CN 207168541 U CN207168541 U CN 207168541U
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China
Prior art keywords
plate
osteotomy
locating
guide device
distal femur
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Expired - Fee Related
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CN201720053955.2U
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Chinese (zh)
Inventor
邬培慧
廖威明
傅明
盛璞义
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First Affiliated Hospital of Sun Yat Sen University
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First Affiliated Hospital of Sun Yat Sen University
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Priority to CN201720053955.2U priority Critical patent/CN207168541U/en
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Abstract

It the utility model is related to a kind of distal femur osteotomy locating guide device, include locator and measuring appliance, the locator includes the first location-plate, sieve plate, femur grooving, contiguous block, osteotomy guide pad, fixing glue and locating pin, and the measuring appliance includes the first measurement plate, the second measurement plate and pushnut.The utility model can carry out accurate measurement to osteotomy thickness, if necessary the position of sieve plate can be inserted come the adjustment osteotomy direction of precise quantification and thickness by adjusting locating pin, angle of the osteotomy surface in sagittal plane is adjusted by selecting the locating pin of different angle, reach Design requirement, final to realize personalized accurately TKA osteotomy, the utility model is using location technology outside marrow, avoid to the interference in femoral bone cavitas medullaris, intraoperative hemorrhage is reduced, improves operative effect, reduces operation risk.

Description

A kind of distal femur osteotomy locating guide device
Technical field
It the utility model is related to field of surgical, more particularly to a kind of distal femur osteotomy locating guide device.
Background technology
Total knee replacement has strict demand to recovering lower limb to line.If postoperative lower limb malalignment, can cause vacation Body articular surface stress distribution is abnormal, and then causes local prosthese stress concentration and accelerated wear test, increases the risk of prosthetic loosening.It is false Body Turning matched can then cause patellar tract abnormal extremely, bend and stretch gap imbalance, and increase postoperative ankle bends and stretches dysfunction, ached Pain is uncomfortable and accelerates the risk of prosthesis wear, be accurately positioned osteotomy in art and prosthese installation be rebuild preferable lower limb to line and Recover the key of suitable prosthese Turning matched.
Determine that distal femur osteotomy direction mainly there are 3 kinds of technologies in art:Location technology, computer assisted navigation positioning in marrow Technology and personalized osteotomy guide plate location technology.Location technology is presently the most conventional method in femur marrow, its positioning principle It is to utilize the direction of the walking direction femur machinery line of force of femur im rod instruction distal femur medullary cavity axis, and then determination distal end The direction of osteotomy.Therefore, there are 2 for the operation key point of location technology in marrow:Accurately preoperative analysis femur mechanical axis With the corner dimension between femur distal section medullary cavity axis, and ensure that femur im rod in art accurately indicates distal section dissection axis Direction.When being operated in art, the direction of femur distal section anatomical axis can accurately be indicated by being correctly inserted into femur im rod, and patient needs to recognize Know and simultaneously clearly cause the operation mistaken ideas of im rod position deviation, it is main to include expanding the entry position of marrow, direction, depth and straight Footpath.In addition, inventor find the size of the femur valgus angle of preoperative measurement by the angle of femoral rotation during patient photographs influenceed compared with Greatly, for it is preoperative measurement osteotomy angle can caused by maximum deviation can be more than 3 degree, at different rotary position, to femur The measured value of ectocondyle osteotomy thickness difference does not make significant difference in distal end.Therefore, ectocondyle osteotomy thickness difference can conduct in distal femur The relatively reliable measurement parameter of the previous item of total knee arthroplasty, osteotomy in art is instructed to position.Therefore, with reference to generation described above The factor of error, in conventional femoral marrow the presence of localization method produce the larger potential risk of error.Clinical research is it has also been found that base The risk for occurring deviation in the femoral prosthesis installation site of location technology in femur marrow is higher.In addition, location technology in femur marrow Need to be about locating rod in 30cm marrow toward insertion in femoral bone cavitas medullaris, pulp cavity internal haemorrhage, fat embolism etc. can be caused in operating process Complication, the patient for merging femoral shaft distal end deformity or pulp cavity occlusion, it is difficult to using location technology in conventional femoral marrow.
It can significantly improve the osteotomy accuracy of knee replacements for emerging Computer navigation surgery, but the skill Art is high to equipment requirement, therefore limits the extensive use of the technology.For 3D printing individuation osteotomy guide plate location technology, with 3D printing technique is opened up in medical industry application, and the application of the technology is more and more extensive at present, has research to think the technology with passing System apparatus location technology is compared to having no significant advantage in osteotomy precision, but relative increase medical treatment cost.Itself main reason is that Relative closure in 3D printing guide plate design at present and the design of related instrument, shortage can be according to actual conditions in art Appropriate regulation and the operation tool for checking verification, so as to have impact on its precision of performing the operation, and controllability.
To solve these above-mentioned clinical problems, it is necessary to invent a kind of distal femur using location technology outside femur marrow and cut Bone device.
Utility model content
In view of this, it is necessary to for it is above-mentioned the problem of, there is provided a kind of distal femur osteotomy locating guide device.
A kind of distal femur osteotomy locating guide device, comprising locator and measuring appliance, it is fixed that the locator includes first Position plate, sieve plate, femur grooving, contiguous block, osteotomy guide pad, fixing glue and locating pin, the measuring appliance include the first measurement plate, Second measurement plate and pushnut;
First location-plate includes the first bottom plate and the first vertical plate provided with vertical first nail, first bottom plate It is vertical with the first vertical plate;The sieve plate includes the second vertical plate, two sieve aperture side plates, and one end of two sieve aperture side plates is vertically set The second vertical plate is put, second vertical plate is detachably connected with the first vertical plate, and sieve aperture side plate is used to insert locating pin;
The locating slot run through and section instruction groove are offered on the femur grooving, locating slot is used to insert locating pin and company Block is connect, section instruction groove is used for the end plate for inserting the first measurement plate;
The both sides of connecting plate are provided with the second nail, and the second nail is used to inserting fixing glue, connecting plate can be inserted into locating slot and In interval between two sieve aperture side plates;
Osteotomy guide pad includes femur kerf, the 3rd nail and skew nailing hole;
First measurement plate includes screw rod and the end plate positioned at screw rod one end, and the screw rod is provided with external screw thread, promotes spiral shell Mother is provided with internal thread, and the second measurement plate is rotatably connected rear enclosure outside the first measurement plate with pushnut.
Preferably, each sieve aperture side plate is provided with 1-4 and arranges parallel hole slot.
Preferably, multiple row hole slot shifts to install.
Preferably, adjacent hole position difference 0.5-1mm in adjacent two row hole slot.
Preferably, second vertical plate is provided with horizontal projection or groove, is set on corresponding first vertical plate There are the groove or projection of matching, groove coordinates with projection makes the second vertical plate to be moved left and right relative to the first vertical plate.
Preferably, second vertical plate is provided with the second magnet, and corresponding first vertical plate is provided with matching First magnet, the second magnet coordinates with the first magnet makes the second vertical plate to be moved left and right relative to the first vertical plate.
Preferably, the locating pin includes rivet nut, end and baffle plate, and the baffle plate is between rivet nut and end.
Preferably, the locating pin also includes limited block, and the limited block tilts located at baffle plate and end junction rivet nut Direction side.
Preferably, the angle of inclination of locating pin is 0-10 °.
Preferably, second nail is arc-shaped through-hole.
The localization method of above-mentioned distal femur osteotomy locating guide device, is comprised the steps of:
S1, the first location-plate is placed in the preceding surface of distal femur cortex bone, plane is to two where along the first vertical plate One piece of short fixing glue is respectively squeezed into first nail, by two sieve aperture sides of sieve plate towards articular side, makes the second vertical plate and One vertical plate is detachably connected;The pilot pin that each one inclination angle of insertion is α on to two sieve aperture side plates, by femur grooving Rivet nut of the locating slot through two locating pins;
S2, by measuring appliance the first measurement plate end plate insertion section instruction groove in, by adjusting pushnut and second The osteotomy thickness of condyle and femoral lateral condyle in the position measurement femur of measurement plate, and position of the pilot pin on sieve aperture side plate is adjusted, Until the osteotomy thickness difference of ectocondyle and consistency of thickness to be cut in the femur measured;
S3, contiguous block inserted in the interval between locating slot and two sieve aperture side plates, squeezed into the second nail long solid Fixed nail, removes contiguous block, femur grooving and sieve plate;
S4, the exposed parts that the 3rd nail in osteotome guide plate is enclosed on to long fixing glue, reuse measuring appliance measurement The osteotomy thickness of ectocondyle in femur, accurate skew nailing of being squeezed into backward in skew nailing hole fix osteotomy guide pad.
Preferably, the α is 0-10 °.
Compared with prior art, the utility model distal femur osteotomy locating guide device has the advantages that:This Utility model can carry out accurate measurement to osteotomy thickness, can insert the position of sieve plate by adjusting locating pin come precise volume if necessary The adjustment osteotomy direction of change and thickness, angle of the osteotomy surface in sagittal plane is adjusted by selecting the locating pin of different angle, Reach Design requirement, it is final to realize personalized accurately TKA osteotomy, the utility model using location technology outside marrow, Avoid, to the interference in femoral bone cavitas medullaris, reducing intraoperative hemorrhage, improve operative effect, reduce operation risk.
Brief description of the drawings
Fig. 1 is the first positioning plate structure schematic diagram in embodiment 1.
Fig. 2 is sieve-plate structure schematic diagram in embodiment 1.
Fig. 3 is femur grooving structural representation in embodiment 1.
Fig. 4 is connecting block structure schematic diagram in embodiment 1.
Fig. 5 is osteotomy guide block structure schematic diagram in embodiment 1.
Fig. 6 is locating pin structural representation in embodiment 1.
Fig. 7 is the measuring appliance structural representation figure of embodiment 1.
Fig. 8 is localization method diagram one.
Fig. 9 is localization method diagram two.
Figure 10 is localization method diagram three.
Figure 11 is localization method diagram four.
Figure 12 is localization method diagram five.
Figure 13 is localization method diagram six.
Figure 14 is localization method diagram seven.
Reference is:
First location-plate 1, sieve plate 2, femur grooving 3, contiguous block 4, osteotomy guide pad 5, locating pin 7, measuring appliance 8, first Measurement plate 81, the second measurement plate 82, pushnut 83, the first vertical plate 11, the first bottom plate 12, the first nail 13, second is vertical Plate 21, sieve aperture side plate 22, hole slot 23, groove 24, locating slot 31, section instruction groove 32, plate body 41, the second nail 42, flank 43, Femur kerf 51, the 3rd nail 52, skew nailing hole 53, short fixing glue 61, long fixing glue 62, skew nailing 63, rivet nut 71, baffle plate 72, end Portion 73, limited block 74.
Embodiment
In order to better illustrate the utility model, it is described further with reference to the accompanying drawings and detailed description.This reality With parts such as the sieve plate in new, osteotomy guide pads, different models can be fabricated to, is selected as the case may be when in use With.
Embodiment 1
As shown in figs. 1-7, a kind of distal femur osteotomy locating guide device, includes locator and measuring appliance.The positioning Device includes the first location-plate 1, sieve plate 2, femur grooving 3, contiguous block 4, osteotomy guide pad 5, fixing glue 6 and locating pin 7.The survey Measuring device 8 includes the first measurement plate 81, the second measurement plate 82 and pushnut 83.
First location-plate 1 is overall L-shaped, comprising the first vertical plate 11 provided with two vertical first nail 13 and with First vertical plate, 11 the first vertical bottom plate 12.The sieve plate 2 includes 21, two sieve aperture side plates 22 of the second vertical plate, two sieves One end of hole side plate 22 is vertically arranged the second vertical plate 21, and second vertical plate 21 is detachably connected with the first vertical plate 11, Sieve aperture side plate 22 is used to insert locating pin 7, has interval between two sieve aperture side plates 22.Each sieve aperture side plate 22 is provided with three row Hole slot 23, each column hole slot include multiple sieve apertures, adjacent hole slot Heterogeneous Permutation, adjacent sieve aperture difference 0.8mm in adjacent hole slot, can With accurate adjustment osteotomy thickness.11 preceding surface of the first vertical plate is provided with strip projection 14 in the present embodiment, after the second vertical plate 21 Surface is provided with groove 24, and by the cooperation of projection 14 and groove 24, the first vertical plate 11 and the second vertical plate 21 can left and right cunnings Dynamic is detachably connected.
The locating pin 7 includes rivet nut 71, end 73, baffle plate 72 and limited block 74, and the baffle plate 72 is located at the He of rivet nut 71 Between end 73, the limited block 74 is located at baffle plate 72 and the rivet nut incline direction side of the junction of end 73.When end 73 is inserted When entering sieve aperture, baffle plate 72 is located above sieve aperture, prevents rivet nut 71 from slipping into sieve aperture, and limited block 74 is stuck between two sieve apertures, prevents Non-magnetic shim body rotates.
The locating slot 31 run through and section instruction groove 32 are offered on the femur grooving 3, locating slot 31, which is used to insert, to be determined Position nail 7 and contiguous block 4, section instruction groove 32 are used for the end plate 811 for inserting the first measurement plate 81.Connecting plate 4 includes plate body 41, plate The left and right sides of body 41 is respectively provided with second nail of arc 42, and the second nail 42 is used to insert fixing glue, and connecting plate 4 can be inserted into In interval between locating slot 31 and two sieve aperture side plates 22.Two sides is respectively provided with a flank 43 before and after plate body 41, prevents from connecting Dropped in 4 self-positioning groove of plate.5 approximate isosceles trapezoid of osteotomy guide pad, include 51, two the 3rd nail 52 of femur kerf and one Skew nailing hole 53.
First measurement plate 81 includes screw rod 811 and the end plate 812 positioned at screw rod one end, and the screw rod 811 is provided with outer Screw thread and scale, pushnut 83 are provided with internal thread and scale, and the second measurement plate 82 is rotatably connected rear enclosure with pushnut 83 Outside the first measurement plate 81, by movement of the pushnut 83 on screw rod, drive the second measurement plate 82 to move, can read Measure thickness.
Before using the positioning of the utility model distal femur osteotomy locating guide device, first with the preoperative lower limb of patient Total length X-ray photograph, knee joint CT data, calculate when distal femur Osteotomy perpendicular to stock stock machinery line when femur Inner condyles and Osteotomy thickness needed for femoral lateral condyle is used as thickness to be cut;And calculate the femur machinery line of force and femur frontal cortex table in sagittal plane The angle α that face is in, the α are 0-10 °.The positioning side of the utility model distal femur osteotomy locating guide device is used afterwards Method, comprise the steps of as seen in figures 8-14:
S1, the first location-plate is placed in the preceding surface of distal femur cortex bone, plane is to two where along the first vertical plate One piece short fixing glue 61 is respectively squeezed into first nail, by two sieve aperture sides of sieve plate towards articular side, make the second vertical plate with First vertical plate is detachably connected;The pilot pin 7 that each one inclination angle of insertion is α on to two sieve aperture side plates, by femur grooving In locating slot through two locating pins 7 rivet nut;
S2, by measuring appliance the first measurement plate end plate insertion section instruction groove in, by adjusting pushnut and second The osteotomy thickness of condyle and femoral lateral condyle in the position measurement femur of measurement plate, and position of the pilot pin on sieve aperture side plate is adjusted, Until the osteotomy thickness difference of ectocondyle and consistency of thickness to be cut in the femur measured;
S3, contiguous block inserted in the interval between locating slot and two sieve aperture side plates, squeezed into the second nail long solid Surely 62 are followed closely, removes contiguous block, femur grooving and sieve plate;
S4, the exposed parts that the 3rd nail on osteotomy guide pad is enclosed on to long fixing glue 62, reuse measuring appliance survey The osteotomy thickness of ectocondyle in femur is measured, skew nailing 63 is squeezed into accurate backward skew nailing hole and fixes osteotomy guide pad, femur kerf Corresponding plane A is Osteotomy.
Embodiment 2
Distal femur osteotomy locating guide device, includes locator and measuring appliance in the present embodiment.The locator includes First location-plate 1, sieve plate 2, femur grooving 3, contiguous block 4, osteotomy guide pad 5, fixing glue 6 and locating pin 7.The measuring appliance 8 Include the first measurement plate 81, the second measurement plate 82 and pushnut 83.
First location-plate 1 is overall L-shaped, comprising the first vertical plate 11 provided with vertical first nail 13 and with the One vertical plate, 11 the first vertical bottom plate 12.The sieve plate 2 includes 21, two sieve aperture side plates 22 of the second vertical plate, two sieve apertures One end of side plate 22 is vertically arranged the second vertical plate 21, and second vertical plate 21 is detachably connected with the first vertical plate 11, sieve Hole side plate 22 is used to insert locating pin 7, has interval between two sieve aperture side plates 22.Each sieve aperture side plate 22 is provided with three row holes Groove 23, each column hole slot include multiple sieve apertures, adjacent hole slot Heterogeneous Permutation, adjacent sieve aperture difference 0.8mm in adjacent hole slot, can be with Accurate adjustment osteotomy thickness.11 preceding surface of the first vertical plate is provided with the first magnet in the present embodiment, surface after the second vertical plate 21 Provided with the second magnet, by the cooperation of the first magnet and the second magnet, the first vertical plate 11 and the second vertical plate 21 can left and right That slides is detachably connected.
The locating pin 7 includes rivet nut 71, end 73 and baffle plate 72, the baffle plate 72 be located at rivet nut 71 and end 73 it Between.When sieve aperture is inserted in end 73, baffle plate 72 is located above sieve aperture, prevents rivet nut 71 from slipping into sieve aperture.
The locating slot 31 run through and section instruction groove 32 are offered on the femur grooving 3, locating slot 31, which is used to insert, to be determined Position nail 7 and contiguous block 4, section instruction groove 32 are used for the end plate 811 for inserting the first measurement plate 81.Connecting plate 4 includes plate body 41, plate The left and right sides of body 41 is respectively provided with second nail 42, and the second nail 42 is used to insert fixing glue, and connecting plate 4 can be inserted into fixed In interval between position groove 31 and two sieve aperture side plates 22.Two sides is respectively provided with a flank 43 before and after plate body 41, prevents connecting plate 4 Dropped in self-positioning groove.5 approximate isosceles trapezoid of osteotomy guide pad, it is oblique comprising 51, two the 3rd nail 52 of femur kerf and one Nail 53.
First measurement plate 81 includes screw rod 811 and the end plate 812 positioned at screw rod one end, and the screw rod 811 is provided with outer Screw thread and scale, pushnut 83 are provided with internal thread and scale, and the second measurement plate 82 is rotatably connected rear enclosure with pushnut 83 Outside the first measurement plate 81, by movement of the pushnut 83 on screw rod, drive the second measurement plate 82 to move, can read Measure thickness.
Before using the positioning of the utility model distal femur osteotomy locating guide device, first with the preoperative lower limb of patient Total length X-ray photograph, knee joint CT data, calculate when distal femur Osteotomy perpendicular to stock stock machinery line when femur Inner condyles and Osteotomy thickness needed for femoral lateral condyle is used as thickness to be cut;And calculate the femur machinery line of force and femur frontal cortex table in sagittal plane The angle α that face is in.The localization method of the utility model distal femur osteotomy locating guide device is used afterwards, includes following step Suddenly:
S1, the first location-plate is placed in the preceding surface of distal femur cortex bone, plane is to two where along the first vertical plate One piece of short fixing glue is respectively squeezed into first nail, by two sieve aperture sides of sieve plate towards articular side, makes the second vertical plate and One vertical plate is detachably connected;The pilot pin that each one inclination angle of insertion is α on to two sieve aperture side plates, by femur grooving Rivet nut of the locating slot through two locating pins;
S2, by measuring appliance the first measurement plate end plate insertion section instruction groove in, by adjusting pushnut and second The osteotomy thickness of condyle and femoral lateral condyle in the position measurement femur of measurement plate, and position of the pilot pin on sieve aperture side plate is adjusted, Until the osteotomy thickness difference of ectocondyle and consistency of thickness to be cut in the femur measured;
S3, contiguous block inserted in the interval between locating slot and two sieve aperture side plates, squeezed into the second nail long solid Fixed nail, removes contiguous block, femur grooving and sieve plate;
S4, the exposed parts that the 3rd nail on osteotomy guide pad is enclosed on to long fixing glue, reuse measuring appliance measurement The osteotomy thickness of ectocondyle in femur, accurate skew nailing of being squeezed into backward in skew nailing hole fix osteotomy guide pad.
Embodiment described above only expresses several embodiments of the present utility model, and its description is more specific and detailed, But therefore it can not be interpreted as the limitation to the utility model patent scope.It should be pointed out that for the common of this area For technical staff, without departing from the concept of the premise utility, various modifications and improvements can be made, these all belong to In the scope of protection of the utility model.Therefore, the protection domain of the utility model patent should be determined by the appended claims.

Claims (9)

  1. A kind of 1. distal femur osteotomy locating guide device, it is characterised in that comprising locator and measuring appliance, the locator bag Containing the first location-plate, sieve plate, femur grooving, contiguous block, osteotomy guide pad, fixing glue and locating pin, the measuring appliance includes the One measurement plate, the second measurement plate and pushnut;
    First location-plate includes the first bottom plate and the first vertical plate provided with vertical first nail, first bottom plate and One vertical plate is vertical;The sieve plate includes the second vertical plate, two sieve aperture side plates, and one end of two sieve aperture side plates is vertically arranged the Two vertical plates, second vertical plate are detachably connected with the first vertical plate, and sieve aperture side plate is used to insert locating pin;
    The locating slot run through and section instruction groove are offered on the femur grooving, locating slot is used to insert locating pin and connection Block, section instruction groove are used for the end plate for inserting the first measurement plate;The both sides of connecting plate are provided with the second nail, and the second nail is used to insert Enter fixing glue, connecting plate can be inserted into the interval between locating slot and two sieve aperture side plates;Osteotomy guide pad include femur kerf, 3rd nail and skew nailing hole;
    First measurement plate includes screw rod and the end plate positioned at screw rod one end, and the screw rod is provided with external screw thread, and pushnut is set There is internal thread, the second measurement plate is rotatably connected rear enclosure outside the first measurement plate with pushnut.
  2. 2. distal femur osteotomy locating guide device according to claim 1, it is characterised in that set on each sieve aperture side plate There is 1-4 to arrange parallel hole slot.
  3. 3. distal femur osteotomy locating guide device according to claim 2, it is characterised in that the dislocation of multiple row hole slot is set Put.
  4. 4. distal femur osteotomy locating guide device according to claim 3, it is characterised in that adjacent holes in adjacent hole slot Position difference 0.5-1mm.
  5. 5. distal femur osteotomy locating guide device according to claim 1, it is characterised in that on second vertical plate Projection or groove provided with transverse direction, corresponding first vertical plate are provided with the groove or projection of matching.
  6. 6. distal femur osteotomy locating guide device according to claim 1, it is characterised in that on second vertical plate Provided with the second magnet, corresponding first vertical plate is provided with the first magnet of matching.
  7. 7. distal femur osteotomy locating guide device according to claim 1, it is characterised in that the locating pin includes nail Body, end and baffle plate, the baffle plate is between rivet nut and end.
  8. 8. distal femur osteotomy locating guide device according to claim 7, it is characterised in that the locating pin also includes Limited block, the limited block is located at baffle plate and end junction rivet nut incline direction side.
  9. 9. distal femur osteotomy locating guide device according to claim 1, it is characterised in that the angle of inclination of locating pin For 0-10 °.
CN201720053955.2U 2017-01-14 2017-01-14 A kind of distal femur osteotomy locating guide device Expired - Fee Related CN207168541U (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107049415A (en) * 2017-01-14 2017-08-18 中山大学附属第医院 A kind of distal femur osteotomy locating guide device and its localization method

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107049415A (en) * 2017-01-14 2017-08-18 中山大学附属第医院 A kind of distal femur osteotomy locating guide device and its localization method
CN107049415B (en) * 2017-01-14 2023-10-03 中山大学附属第一医院 Femur distal osteotomy positioning guide device and positioning method thereof

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