CN210204897U - 3D printing external guide plate for guiding execution of minimally invasive femoral neck fracture surgery - Google Patents
3D printing external guide plate for guiding execution of minimally invasive femoral neck fracture surgery Download PDFInfo
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- CN210204897U CN210204897U CN201920742853.0U CN201920742853U CN210204897U CN 210204897 U CN210204897 U CN 210204897U CN 201920742853 U CN201920742853 U CN 201920742853U CN 210204897 U CN210204897 U CN 210204897U
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Abstract
The utility model relates to a 3D prints external baffle for guiding carry out femoral neck fracture minimal access surgery, include: the base plate comprises an upper surface and a lower surface opposite to the upper surface, and the lower surface of the base plate is used for being attached to the outer surface of a femur; and one or more needle guide tubes, each needle guide tube channel located on and projecting outwardly from the upper surface of the base plate, wherein each needle guide tube comprises a needle guide channel, each needle guide channel communicating with the lower surface of the base plate for guiding a fixation needle therethrough and into a patient to repair a femoral neck bone fracture site. Through the utility model discloses, can utilize bony landmark to fix a position, be different from the skin location, the error rate is minimum because bony landmark is stable reference point, does not rock like skin.
Description
Technical Field
The utility model relates to a fixed field that resets of femoral neck bone fracture, more specifically a 3D prints external baffle for guiding carry out femoral neck bone fracture minimal access surgery.
Background
For fractures between the femoral head down to the base of the femoral neck, a traditional surgical incision is usually taken, which is a less invasive and less traumatic way to achieve an equivalent/better therapeutic outcome. Minimally invasive surgery has an incision of only a few millimeters or no incision (penetration).
Also adopts the internal fixation of the hollow compression screw for the closed reduction of the femoral neck fracture. The fixation is suitable for fresh femur and neck bone with a light age (generally below 65 years old), especially for young fracture patients, a plurality of hollow compression screws are mainly advocated for fixation, and the fixation has the advantages of high strength and torsion resistance, simple and convenient operation, small operation wound and the like. The hollow compression screw internal fixation mainly comprises incision reduction internal fixation and closing reduction internal fixation. The purpose of the operation treatment is to reposition and fix the two ends of the fracture, restore the normal anatomical structure, and enable the twisted and spastic femoral neck blood vessels to recover as early as possible, thereby improving the blood vessel compensation capacity. The affected limb after operation can perform functional exercise in early stage, improve the recovery condition of the patient after injury, improve the life quality and the like.
The closed reduction internal fixation indication is applicable to all types of fractures, including no or displacement. When in operation, the patient lies horizontally after anesthesia, is fixed on an orthopedic traction operating bed, and the affected limb is pulled to the far end to restore the femoral neck, and the restoration is determined to be good by the perspective of a C-shaped movable operating arm type X-ray fluoroscopy machine (hereinafter referred to as C-shaped arm X-ray fluoroscopy machine).
The prior art is fixed by using an electric drill to aim and insert a guide pin according to the perspective of an X-ray machine in operation and guiding and inserting a compression screw. However, because of the manual operation, it is difficult to achieve a satisfactory triangle structure, and the mechanical stability is greatly affected by the level of the manual operation, which is a major factor causing the re-displacement of the fracture and the inversion of the hip. The X-ray machine is used repeatedly to irradiate to determine the penetration state of the guide pin, whether the guide pin is deviated from the predetermined position, and the operator and the patient are exposed to the extra X-ray radiation to cause radiation damage to the body and even cancer. The operation time is unstable: similarly, due to the influence of human operation factors and the fact that the operation is performed by patients with different experience and technical level, the operation process can be as short as 30 minutes and as long as hours, and the operation time length is greatly different; may result in lengthy anesthesia times, increased infection rates in the patient's incisions, additional trauma from repeated intraoperative procedures, etc.
In addition, the C-arm X-ray machine has the following disadvantages due to the operation. At the same time, only a plane projection X-ray image on an azimuth axis can be provided, while the operation part is in a 3D reality, and from the measurement point of view, an X, Y, Z-axis image needs to be established to obtain a local true imaging image. In this case, the operator is caused to satisfy the operation requirement of 1 axis or/and 2 axes among the 3 axes during the operation, but the remaining 1 and/or 2 axes may perform the operation in the wrong orientation. As a result, the C-arm X-ray machine needs to be rotated repeatedly to perform X-ray irradiation, and the needle insertion directions in different axial directions need to be adjusted manually repeatedly, which finally results in excessive radiation dose, local additional injury caused by repeated operation, prolonged operation and anesthesia time, and even failure of the operation.
Although the situation can be improved by the updated 'G-shaped' movable operation arm type X-ray fluoroscopy machine and 'O-shaped' arm type X-ray fluoroscopy machine at present, the problems of low popularization rate, expensive equipment, larger radiation dose and the like exist. The prior art has the not enough condition of rigidity when implanting the guide pin, if the guide pin in addition bores into the cortex of bone, has certain contained angle, and the guide pin can slide the skew, leads to a great deal of problem. Ultimately resulting in prolonged surgical time, repeated x-ray exposure, etc.
SUMMERY OF THE UTILITY MODEL
The utility model provides a 3D prints external baffle for guiding carry out femoral neck fracture minimal access surgery to solve above technical problem among the prior art at least.
The main purpose of the utility model is to reduce the operation difficulty, facilitate the operation of the operator, improve the precision, reduce the operation risk, etc. The utility model discloses different with prior art mainly lie in the actual operation possibility of locate mode and reality different, the most skin location, fixed that utilize of patent that exist at present, can't really accomplish the accuracy, the utility model discloses a landmark point common location on skin and the skeleton can accomplish real realization clinical application to develop the popularization work smoothly in clinical work.
As an aspect of the utility model, a 3D prints external baffle for guiding carry out femoral neck fracture minimal access surgery, include: the base plate comprises an upper surface and a lower surface opposite to the upper surface, and the lower surface of the base plate is used for being attached to the outer surface of a femur; and one or more needle guide tubes, each needle guide tube channel located on and projecting outwardly from the upper surface of the base plate, wherein each needle guide tube comprises a needle guide channel, each needle guide channel communicating with the lower surface of the base plate for guiding a fixation needle therethrough and into a patient to repair a femoral neck bone fracture site.
In a refinement of the present invention, the 3D printer outer guide plate further comprises one or more positioning pins, each positioning pin being located on the upper surface of the base plate.
The utility model discloses an in the improvement, every the pilot pin pipe all includes the pilot pin passageway, every the pilot pin passageway all with the lower surface intercommunication of base plate for it passes and gets into the patient internal from it to guide the pilot pin, in order to incite somebody to action the external baffle of 3D printing is fixed to take one's place outside the patient's body surface.
According to a further development of the invention, the diameter of the pilot pin channel is matched to the outer diameter of the pilot pin to be inserted into the patient during the operation.
Preferably, at least two of the positioning needle catheters are provided.
As an improvement of the present invention, an end portion of the positioning needle guide protruding from the upper surface of the base plate is formed as a right-angled end portion with respect to the positioning needle guide.
In a refinement of the present invention, the diameter of the lead channel matches the outer diameter of a lead passed therethrough during surgery.
Preferably, the number of the needle guide tubes is at least three.
In a refinement of the invention, the end of the needle guide tube protruding from the upper surface of the base plate is formed as an oblique angle end with respect to the needle guide tube.
The utility model adopts the above technical scheme, have following advantage:
1. locating with bony landmarks, unlike skin locating, has a minimal error rate. Because the bony landmark is a stable reference point, it does not wobble like the skin.
2. 3 shaft positioning can be completed through the two positioning needles, so that the operation is really easy, and the operation difficulty is reduced.
3. The accuracy is high, various surgical parameters can be preset, for example, the depth of the guide pin can limit the dangerous depth through the guide plate. The angle of the internal fixing screw can be preset, and the position for placing the individualized internal fixing screw can be designed.
4. Simple and easy osseous positioning points. In the normal position, the clear and definite lower edge of the femoral neck and the surface of the femoral neck are used as the positioning of the Z + Y axis: the positioning needle slides in tightly clinging to the surface of the femoral neck to complete Z-axis positioning, and simultaneously, the positioning needle is parallel to the lower edge of the femoral neck to complete Y-axis positioning. In the normal position, the clear horizontal line of the upper edge of the lesser trochanter of the femur is used as the position of the X-axis positioning needle, namely the X-axis positioning is completed.
The foregoing summary is provided for the purpose of description only and is not intended to be limiting in any way. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features of the present invention will be readily apparent by reference to the drawings and following detailed description.
Drawings
In the drawings, like reference numerals refer to the same or similar parts or elements throughout the several views unless otherwise specified. The figures are not necessarily to scale. It is appreciated that these drawings depict only some embodiments in accordance with the disclosure and are not to be considered limiting of its scope.
Fig. 1 is a front view of a 3D printed external guide plate for guiding performance of a minimally invasive procedure on a femoral neck fracture according to an embodiment of the present invention;
FIG. 2 is a side view of the 3D printer outer guide shown in FIG. 1;
FIG. 3 is a cross-sectional view taken along the line A-A of FIG. 1;
FIG. 4 is another sectional view taken along the line B-B of FIG. 1;
fig. 5 is a schematic front view of a 3D printed external guide plate according to an embodiment of the present invention secured to the outer surface of a femur while performing minimally invasive surgery on a femoral neck fracture; and
fig. 6 is a schematic side view of the 3D printed external guide plate fixed on the outer surface of the femur when performing minimally invasive surgery on femoral neck fracture according to an embodiment of the present invention.
Detailed Description
In the following, only certain exemplary embodiments are briefly described. As those skilled in the art will recognize, the described embodiments may be modified in various different ways, all without departing from the spirit or scope of the present invention. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not as restrictive.
The following disclosure provides many different embodiments or examples for implementing different features of the invention. In order to simplify the disclosure of the present invention, the components and arrangements of specific examples are described below. Of course, they are merely examples and are not intended to limit the present invention. Furthermore, the present invention may repeat reference numerals and/or reference letters in the various examples, which have been repeated for purposes of simplicity and clarity and do not in themselves dictate a relationship between the various embodiments and/or arrangements discussed. In addition, the present disclosure provides examples of various specific processes and materials, but one of ordinary skill in the art may recognize applications of other processes and/or use of other materials.
The 3D printing external guide plate for guiding the execution of the minimally invasive surgery of femoral neck fracture according to the present invention is described in detail below by the accompanying drawings.
In this context, in a minimally invasive surgery, the surgical incision is directed into the body, the anterior approach is through the front of the body, and the posterior approach is through the back of the body. The external guide plate of 3D printing belongs to a surgical instrument with positioning and aiming properties, and is a novel instrument with the advantages of individual customization, accuracy, reliability, rapidness and the like.
Fig. 1 to 4 show a 3D printing body outer guide plate according to an embodiment of the present invention.
Referring to fig. 1 and 2, fig. 1 illustrates a front view of a 3D printed external guide plate for guiding performance of minimally invasive surgery on a fracture of a cervical bone (41 of fig. 5 and 6) of a femur (40 of fig. 5 and 6) according to an embodiment of the present invention, and fig. 2 illustrates a side view of the 3D printed external guide plate illustrated in fig. 1.
As can be seen from FIG. 1, the 3D printer outer guide plate 1 includes a base plate 10, 3 guide pins 20 protruding from one surface of the base plate 10, and 2 positioning pin guides 31 and 32 protruding from the same surface of the base plate 10 as the guide pins 20.
Referring to fig. 3, a cross-sectional a-a view of the 3D printer outer guide shown in fig. 1 is shown. As can be seen in fig. 3, the base plate 10 comprises an upper surface 12 and a lower surface 11 opposite to the upper surface 12, the lower surface 11 being intended to be applied against the outer surface of the femur. One of the introducer needle cannula 20 is shown schematically in fig. 3, with introducer needle cannula 20 positioned on upper surface 12 and projecting outwardly from upper surface 12. The guide pin includes a guide pin channel 21, the guide pin channel 21 communicating to the lower surface 11 of the base plate 10 for guiding a fixation guide pin (shown in figures 5 and 6) therethrough and into the patient for repairing the femoral neck bone fracture site. Although not shown, it is known to those skilled in the art that the structure of the additional needle guide tube is similar to that shown in fig. 3.
Referring to FIG. 4, a B-B cross-sectional view of the 3D printed outer guide plate shown in FIG. 1 is shown to illustrate the positioning needle catheter of the 3D printed outer guide plate. As can be seen from fig. 4, the guide pin duct 31 is located on the upper surface 12 of the base plate 10, and the guide pin duct 31 includes a guide pin passage 311, and the guide pin passage 311 communicates with the lower surface 11 of the base plate 10 for guiding a guide pin (as shown in fig. 5 and 6) therethrough and into the patient to fix the 3D printer outer guide in place outside the surface of the patient. Although not shown, one skilled in the art will appreciate that the structure of the alternative positioning catheter 32 is similar to that of the positioning catheter 31.
The diameter of each locator needle channel matches the outer diameter of the locator needle to be placed into the patient during surgery to guide and secure the locator needle.
As shown in fig. 1 and 2, the positioning needle guide is provided in two. However, the present invention is not limited thereto, and more positioning needle catheters may be provided.
As shown in fig. 1, 2 and 4, the end portions of the positioning pins 31 and 32 protruding from the upper surface 12 of the base plate 10 are formed as right-angled end portions with respect to the positioning pins 31 and 31. However, the present invention is not limited thereto as long as the positioning needle guide can be easily separated from the guide needle tube region.
The diameter of lead channel 21 matches the outer diameter of the lead passed therethrough during surgery to guide and secure the lead.
As shown in figures 1 and 2, the number of the guide needles is three. However, the present invention is not limited thereto, and more needle guide tubes may be provided.
As shown in fig. 1, 2 and 3, the end of the needle guide tube 20 protruding from the upper surface 12 of the base plate 10 is formed as an oblique end with respect to the needle guide tube 20. However, the present invention is not limited to this, as long as the guide needle tube can be easily distinguished from the positioning needle tube.
Make the utility model discloses a 3D prints required material of external baffle: PLA material (Polylactic Acid, Polylactic Acid or polylactade) for 3D printing, which is a thermoplastic aliphatic polyester. Lactic acid or Lactide (Lactide) required for producing polylactic acid can be obtained by fermentation, dehydration and purification of renewable resources, the obtained polylactic acid generally has good mechanical and processing properties, and the waste polylactic acid product can be rapidly degraded in various modes.
The utility model discloses a 3D prints preparation flow of external baffle:
1. patient lesion/injury site modeling
DICOM (i.e., digital imaging and communications in medicine) data is acquired by CT scanning of the lesion/wound site of the patient.
2. Preliminary modeling
And reading DICOM data through 3D SLICER, extracting required bone and skin data, and storing the bone and skin data as an STL format file (a universal 3D model file) to complete preliminary modeling.
3. Design 3D prints external baffle
Import the STIL file into Mimics Medical, begin to design the utility model discloses a 3D prints external baffle.
Firstly, x, y and z axes of an affected part model are established through MM software, and the positioning direction of the space is determined.
Then, 3 guide pin channels of the internal fixing hollow screws are designed according to fracture modeling (the design is needed by orthopedics specialists according to the fracture condition of patients), so that the positions of the 3 hollow screws are properly distributed in the femoral neck, and the effects of maximally supporting and fixing the fracture are achieved.
4. Final design
Accomplish preliminary design back, intercepting operation area skin is modelled, required location passageway is modelled, interior set screw guide pin passageway is modelled, and final combination becomes the utility model discloses an external baffle of 3D printing accomplishes final design.
5.3D prints external baffle
And converting the finally designed 3D printing body outer guide plate into a 3D printer final execution file (using UC software), importing the file into a 3D printer, executing printing, and manufacturing a finished product, as shown in FIGS. 1 and 2.
The following describes a usage flow of the 3D printing body outer guide plate of the present invention with reference to fig. 5 and 6.
1. And (3) finishing a sterilization procedure (ethylene oxide sterilization or low-temperature plasma sterilization can be selected) on the guide plate, so that the guide plate meets the medical sterile requirement.
2. The patient lies on the operation traction bed, the base plate 10 of the guide plate is attached to the position of the skin 45 designed before the operation, the position of the positioning needle is determined by the C-shaped arm X-ray machine in the operation, and the positioning needle passes through the positioning needle guide pipes 31 and 32 to penetrate into the positioning needle, so that the position of the positioning needle is in accordance with the position designed before the operation, and the positioning of the guide plate is completed.
Specifically, first, a kirschner wire is transversely placed on the skin 45 on the front side of the affected part by using a skin mark, the C-arm perspective is used, so that the position of the wire is overlapped with the horizontal line of the upper edge 43 of the lesser trochanter, namely the X-axis marking line, the marking line is marked, and the guide plate is attached to the skin (the area designed before the operation) matched with the greater trochanter. Then, a guide pin is drilled into the bone through the X-axis positioning guide needle tube 20, when the guide pin is drilled, the guide pin is overlapped with the X-axis marking line, the C-arm perspective confirms the error, corresponding adjustment is made until the guide pin is overlapped with the horizontal line on the upper edge of the small rotor, the primary positioning is completed, and the X-axis positioning is also completed.
Then, a guide pin is drilled into the Y + Z axis positioning pin guide hole, the C arm confirms that the guide pin is parallel to the lower edge 44 of the femoral neck at the right position, the Y axis positioning is completed, the guide pin is parallel to the cortex of the front edge 42 of the femoral neck at the side position, the Z axis positioning is completed, and the tip of the guide pin is drilled into the cortex of the femoral head to play a role of fixing the guide plate. At this point, the full positioning of the X, Y, Z shaft is complete.
3. 3 screw guide pins are drilled in along a built-in screw guide pin channel (namely a guide pin channel) on the guide plate, and the position of the guide pin is confirmed to accord with preoperative design by the perspective of a C-shaped arm X-ray machine in the operation.
4. The guide plate is taken down, and the internal fixing hollow screw is arranged along the guide pin. Thus, the minimally invasive surgery incision is bound up, and the surgery is smoothly finished.
The above description is only for the specific embodiments of the present invention, but the scope of the present invention is not limited thereto, and any person skilled in the art can easily think of various changes or substitutions within the technical scope of the present invention, which should be covered by the scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
Claims (9)
1. A 3D-printed external guide plate for guiding the performance of minimally invasive surgery on femoral neck fractures, comprising:
the base plate comprises an upper surface and a lower surface opposite to the upper surface, and the lower surface of the base plate is used for being attached to the outer surface of a femur; and
one or more needle guide tubes, each said needle guide tube channel located on and projecting outwardly from said upper surface of said base plate,
the femoral neck bone fracture repair device is characterized in that each guide needle tube comprises a guide needle channel, and each guide needle channel is communicated with the lower surface of the base plate and used for guiding a fixed guide needle to penetrate through the guide needle channel and enter the body of a patient so as to repair the femoral neck bone fracture.
2. The 3D printing outer guide plate according to claim 1, wherein the 3D printing outer guide plate further comprises one or more positioning needle guide tubes, each positioning needle guide tube being located on the upper surface of the base plate.
3. The 3D printing external guide plate according to claim 2, wherein each of the positioning needle catheters comprises a positioning needle channel, each of the positioning needle channels communicating with the lower surface of the base plate for guiding a positioning needle therethrough and into the patient to fix the 3D printing external guide plate in position outside the surface of the patient.
4. The 3D printing external guide plate according to claim 3, wherein the diameter of the positioning needle channel matches the outer diameter of the positioning needle to be placed in the patient during surgery.
5. The 3D printer external guide plate according to any one of claims 2 to 4, wherein at least two positioning needle catheters are provided.
6. The 3D printer outer guide plate according to any one of claims 2 to 4, wherein an end of the positioning pin guide protruding from the upper surface of the base plate is formed as a right-angled end with respect to the positioning pin guide.
7. The 3D printer external guide plate of claim 1, wherein a diameter of the guide pin channel matches an outer diameter of a guide pin passed therethrough during surgery.
8. The 3D printer external guide plate of claim 1, wherein the number of the needle guide tubes is at least three.
9. The 3D printer external guide plate according to claim 1, wherein the end of the guide needle tube protruding from the upper surface of the base plate is formed as an oblique angle end with respect to the guide needle tube.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201920742853.0U CN210204897U (en) | 2019-05-22 | 2019-05-22 | 3D printing external guide plate for guiding execution of minimally invasive femoral neck fracture surgery |
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| CN201920742853.0U CN210204897U (en) | 2019-05-22 | 2019-05-22 | 3D printing external guide plate for guiding execution of minimally invasive femoral neck fracture surgery |
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| CN210204897U true CN210204897U (en) | 2020-03-31 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114271920A (en) * | 2022-01-05 | 2022-04-05 | 张家港市第一人民医院 | Preparation method of 3D printing combined guide plate suitable for femoral neck system |
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2019
- 2019-05-22 CN CN201920742853.0U patent/CN210204897U/en active Active
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114271920A (en) * | 2022-01-05 | 2022-04-05 | 张家港市第一人民医院 | Preparation method of 3D printing combined guide plate suitable for femoral neck system |
| CN114271920B (en) * | 2022-01-05 | 2023-09-19 | 张家港市第一人民医院 | Preparation method of 3D printing combined guide plate suitable for femoral neck system |
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