CN210521048U

CN210521048U - Operation tool for femoral head necrosis bone transplantation

Info

Publication number: CN210521048U
Application number: CN201920916445.2U
Authority: CN
Inventors: 阎作勤; 陈增淦; 华秉譞; 袁恒锋; 曹渊武; 姜畅; 王新元
Original assignee: Zhongshan Hospital Fudan University
Current assignee: Shandong Weigao Orthopedic Materials Co Ltd
Priority date: 2019-06-18
Filing date: 2019-06-18
Publication date: 2020-05-15
Anticipated expiration: 2029-06-18

Abstract

The utility model discloses a surgical tool for femoral head necrosis bone transplantation, it includes guide pin, trephine, bush, strikes pole, flat file, sleeve and sleeve handle. The utility model discloses an operation instrument can be used for implementing a series of femoral head avascular necrosis drilling decompression and bone grafting operation that use bone flap transplantation restoration femoral head necrosis operation as the representative between the inboard arterial branch rotor of rotatory thigh, improves the operation quality and plants bone success rate, is favorable to the postoperative to be recovered.

Description

Operation tool for femoral head necrosis bone transplantation

Technical Field

The utility model belongs to the field of medical equipment, a surgical tool for femoral head necrosis bone transplantation is related to, concretely relates to detachable, the operation instrument subassembly of combination formula promptly that uses for femoral head necrosis bone transplantation.

Background

The femoral head hip protection operation treatment is usually used for early femoral head necrosis, particularly for patients with a light age, and mainly comprises simple medullary decompression and bone block transplantation and repair operations with blood supply. The operation of transplanting the bone with the blood vessel is used for treating femoral head necrosis for 40 years, is an important operation mode of hip protection treatment of the femoral head necrosis in early and middle stages, is rich in blood supply of the bone graft block with the blood vessel compared with simple medullary core decompression, is suitable for the femoral head necrosis in early and middle stages, especially large-range femoral head necrosis, and can provide mechanical support, recover the blood supply of the femoral head and remarkably improve the repair speed and quality by implanting vascularization autogenous bone after removing dead bone when the joint surface is not collapsed or collapsed in early stage, so that the time for accepting hip joint replacement is delayed, even the disease is completely cured by stimulating new bone formation, and the simple decompression and pressing of the bone graft have poor treatment effect on the large-range necrosis.

At present, vascularization Bone grafting operation mainly comprises free Bone flap grafting method with blood vessel pedicle Bone flap, muscle pedicle Bone flap and anastomotic blood vessel, etc. Urbaniak in 1979 proposes free fibula grafting (FVFGFF) anastomotic blood vessel (URBANIAK J R, COOGAN P G, GUNNESON E B, et al. J Bone Joint Surg Am,1995,77(5): 681) which has been developed for decades and has stable operation effect, can obviously relieve pain of patients and delay the replacement time, however, FZhao VFG still has many limitations, such as complicated operation of operation, long operation time, large incision of ② operation, ③ needs a certain empirical microsurgical operation technique, has a certain failure rate of anastomotic blood vessel, so that great numbers of femoral head bypass artery bypass graft method (adult ①, Zhao Wei Ju) in ancient medical institution in 1986 have been proposed by great transvaginal femoral head bypass surgery, European Union femoral head bypass, European Union, European leg bypass.

Because most of femoral head necrosis focuses are positioned at the front upper part of the femoral head, ideal positions are difficult to achieve through anterior approach decompression and bone grafting, the focuses are not thoroughly removed, and the repair effect and the mechanical support of the focuses are influenced.

The superior prosthesis etc. has designed the intertrochanteric bone flap that adopts the square pedicle of femur, its deep surface includes the internal artery branch of selection thigh, adopt the rear approach, it is direct to have the bone grafting passageway, clear away the thorough advantage of focus, nevertheless because the internal artery of whirling the thigh is at its deep surface, there is the risk of injury internal artery of whirling the thigh, the collateral muscle of bone grafting piece and too much unfavorable implantation of soft tissue etc. are not enough, simultaneously, because of lacking special instrument, adopt the osteotome, the abrasive drilling etc. there is certain degree of difficulty in the operation, the bone grafting position is with press to join in marriage not ideal, it supports to be difficult to obtain good mechanics, also do not do benefit to furthest's reservation femoral head blood supply.

SUMMERY OF THE UTILITY MODEL

In order to overcome the problem that the existing surgical instruments are difficult to implement the operation of transplanting and repairing Femoral head necrosis by implanting the medial Femoral branch intertrochanteric flap, in particular the operation of treating early and medium ischemic Femoral head necrosis by using the medial Femoral transverse artery branch flap, on the basis of summarizing the advantages and the disadvantages of the method, the subject group designs a Femoral medial Femoral branch intertrochanteric flap accurate implantation and repair technology (FMCVB-PG) and a special surgical tool to repair Femoral head necrosis, and has the characteristics of abundant blood supply of the vascular flap and the vascular free fibular bone graft, and compared with the two types of surgical techniques, the surgical instruments have the following advantages: 1. the operation is simple, the technology is standardized, the operation time is short, the wound is small, the postoperative recovery is fast, the popularization is easy, and the method can be popularized to primary hospitals; 2. a special tool is adopted through the rear approach, the bone grafting channel is more accurate, the necrotic focus is directly and thoroughly removed, and the operation is more convenient and faster; 3. the transverse branch of the medial circumflex artery is constant in dissection, the diameter of a blood vessel can reach 2mm, and blood is fully supplied; 4. the intertrochanteric bone block has small influence on the biomechanics of the proximal end of the femur, and the risk of postoperative fracture is reduced. According to clinical practice experience, the subject group designs a surgical tool or surgical tool assembly for femoral head necrosis bone graft.

Particularly, the utility model comprises the following technical scheme.

A surgical tool for femoral head necrosis bone graft, comprising:

the guide pin is used for being inserted into a femoral head necrosis furnace (generally, the front, inner and upper part of a femoral head), the guide pin with length scales is preferred, the main body of the guide pin is a cylinder, and the head part of the guide pin is a sharp needle point;

the trephine is used for drilling necrotic focus sclerotin, the trephine is integrally in a circular tube shape, a hollow pipeline in the trephine can contain a guide pin, the hollow pipeline can be penetrated through from front to back to allow the guide pin to pass through, the trephine comprises a head in a circular tube shape, a middle in a circular tube shape and a tail used for being connected with an electric drill joint, a plurality of (for example, more than 10, more than 12, more than 14, more than 16 and more than 18) saw-tooth-shaped drilling teeth are arranged at the tail end of the head of the trephine and used for drilling sclerotin, holes or grooves are hollowed in the head of the trephine, for example, four or two long strip-shaped holes are symmetrically formed in the head of the trephine and used for observing drilling depth and conveniently performing operation of twisting off drilled bone blocks (or necrotic bone cores), the outer diameter of the head of the trephine is larger than the outer diameter of the; the shape and size of the tail part are matched with those of the electric drill joint; the length of the inner cavity of the trephine head is larger than the sum of the length of the lining and the maximum length of the necrotic bone core;

the bushing is a round tubular body with a through front and back, the inner diameter of the bushing is matched with the outer diameter of the guide pin or slightly larger than the outer diameter of the guide pin so as to allow the guide pin to pass through, the outer diameter of the bushing is matched with the inner diameter of the trephine head or slightly smaller than the inner diameter of the trephine head so as to allow the trephine head to be nested, the tail end of the head of the bushing is provided with a plurality of (for example, more than 4, more than 5, more than 6, more than 7 and more than 8) nail teeth so as to nail the head of the bushing into the cortex (namely cortical bone) of the femoral neck, so that the bushing is fixed on the bone surface, a plurality of (e.g., 4, 6, 8, 10, or 12) pin holes are symmetrically disposed in the middle of the bushing perpendicular to the axis and may be staggered at a plurality of angles to facilitate insertion of the outer shank through the trephine opening to twist off the drilled bone pieces and pull the bushing out of the trephine head along with the drilled bone pieces. Because the outer diameter of the bushing is obviously larger than that of the guide pin, compared with the guide pin, the guide pin can more accurately control the drilling direction of the trephine and limit the maximum drilling depth;

the inner diameter of the knocking rod is matched with the outer diameter of the guide pin or slightly larger than the outer diameter of the guide pin so as to accommodate the main body of the guide pin and/or allow the guide pin to pass through, the tail part of the knocking rod is through or closed, the head part is a flat end and abuts against the tail end of the bushing and is used for driving the bushing into a femoral head necrosis stove in a matching mode through striking; such as nailing the liner nail into the femoral head necrosis lesion bone surface by striking the tail end of the striking rod with a striking tool, such as a hammer; the outer diameter of the knocking rod is approximately equal to that of the bushing, and the length of the knocking rod can be larger than that of the guide pin, so that the guide pin cannot be exposed out of the tail of the knocking rod when the multifunctional tapping tool is used;

the flat file is used for filing and flattening the rough bottom of a cavity (or called bone tunnel, bone tunnel cavity and pressure reduction channel) formed after the bone block is removed, and/or extruding and pushing artificial bone filler to tamp the bottom of the cavity. The flat file is wholly cylindric, contains the head that is the cylindric generally, is the middle part of cylinder, is used for connecting the afterbody that the electric drill connects (the shape and the size of afterbody and electric drill connect phase-match), and wherein the external diameter of head is equivalent with the external diameter of trephine head, and the external diameter of head is greater than the external diameter at flat file middle part, and the head is along the axial uniformly concave a plurality of (for example for 3, 4 or 5) helicla flutes that are equipped with.

The guide pin can be a conventional Kirschner wire, preferably a Kirschner wire with length scales, and more preferably a Kirschner wire with an outer diameter phi of 2.5mm with length scales. The overall diameter of the guide pin can be between 2.0 mm and 4mm, such as 2.2 mm to 3.8mm, 2.5mm to 3.5mm or 2.8 mm to 3.2 mm. The length of the guide pin can be between 200 and 280mm, such as 210 and 270mm, 215 and 260mm, 220 and 250mm, or 230 and 240 mm.

The length of the knocking rod can be between 200 and 280mm, such as 210 and 270mm, 215 and 260mm, 220 and 250mm or 230 and 240 mm.

The outer diameter of the trephine head may be about 16mm, 18mm or 20mm based on the size specification of the femoral head necrosis drilling cavity (or bone tunnel, bone tunnel cavity, decompression channel) commonly used in clinic. The length of the trephine head (including the drill teeth) may be between 90-140mm, such as 95-135mm, 100-130mm, 105-125mm or 110-120 mm. The overall length of the trephine may be between 200 and 300mm, such as between 210 and 290mm, 220 and 290mm, 225 and 285mm, 230 and 285mm or 235 and 280 mm.

The outside diameter of the bushing may be about 14mm, 16mm or 18mm and the length of the bushing (including the pins) may be between 35-55mm, such as between 38-52mm, 40-50mm, 40-48mm or 42-45 mm. The diameter of the pin hole in the bushing may be between about 3-5mm, such as 2.5-4.5mm or 3.0-4.0 mm.

The flat file head has an outer diameter of 16mm, 18mm or 20mm corresponding to the outer diameter of the trephine head.

Preferably, the extension direction of the spiral groove of the flat file head is between 40 and 75 degrees, such as between 45 and 75 degrees, between 50 and 70 degrees, between 55 and 65 degrees, and between 55 and 60 degrees, relative to the edge of the flat file end, so that the bottom of the bone grafting channel is leveled, a flat bone grafting bed is formed about 3mm under cartilage, and a good press fit is formed between the bone grafting block. The spiral groove can extend in a left-hand spiral relationship with the axial direction, and the spiral direction can compress the filed cancellous bone to the side wall of the bone tunnel.

The length of the said flat file head may be between 50-100mm, for example 55-95mm, 60-90mm, 65-85mm, or 70-80 mm. The overall length of the plain file can be between 150 and 250mm, such as between 160 and 240mm, 170 and 230mm, 175 and 230mm, 180 and 220mm, or 185 and 210 mm.

In one embodiment, the trephine and/or burr file is used with an electric drill. Correspondingly, the tail of the trephine and/or the tail of the flat file are shaped and sized to mate with the drill bit for connection thereto.

Preferably, the surgical tool further comprises a twister for twisting off the bone core and removing it with the bushing out of the trephine head after the trephine has completed the drilling operation. For example, the inserted rod of the kink device is inserted into two symmetrical pin holes of the bushing through the slots on both sides of the trephine, so that the trephine and the bushing rotate together, and the bone block is broken off from the femoral head to form a bone core. For example, the kink may be rectangular with a partial opening formed in one short side, wherein the short side is represented by two symmetrical rods (bayonet rods).

In a preferred embodiment, the surgical tool further comprises a sleeve, which is sleeved on the trephine to control the rotation direction of the trephine and avoid shaking, and the diameter of the filling bone is measured during the autologous bone size test, so that if the bone blocks can be smoothly inserted into the sleeve, the bone tunnel can be smoothly filled. The sleeve is a tubular body, the inner diameter of the sleeve is matched with the outer diameter of the trephine head, a protruding portion is arranged on the outer side of the sleeve, a screw hole is embedded in the protruding portion so as to form a spiral link with the head end of the handle, and the axial direction of the screw hole and the axial direction of the sleeve form an angle of about 30-60 degrees, such as 45 degrees, so that surgical operation is facilitated.

The inner diameter of the sleeve may be about 14mm, 16mm, 18mm or 20 mm. The length of the sleeve may be between 35-55mm, for example between 38-52mm, 40-50mm, 40-48mm or 42-45 mm. The wall thickness of the sleeve may be about 2-4mm, 2.5-3.5 mm.

Preferably, the surgical tool further comprises a sleeve handle comprising a handle and a cylinder, wherein the front end of the cylinder is provided with a thread for screwing the protrusion on the sleeve so as to connect the sleeve handle with the sleeve, and the sleeve handle is matched with the trephine for use and the autogenous bone trial model.

In one embodiment, the surgical tool further comprises a specially shaped osteotome for cutting a blood-bearing bone block from the intertrochanteric ridge or other suitable bone extraction site to fill the pressure relief channel, the osteotome A and osteotome B comprising a handle and an overall blade having a generally flat bar shape and a chisel blade at the head thereof, wherein the osteotome A has a generally flat "W" shape in vertical cross-section and the osteotome B has a generally straight-skimming "shape in vertical cross-section to conform to the shape of the blood-bearing bone block extraction site, such as the intertrochanteric ridge of the femur, and surrounding tendon vasculature to avoid tissue damage.

Preferably, the material of above-mentioned guide pin, trephine, bush, knocking pole, osteotome blade, flat file, sleeve handle cylinder is metal such as medical stainless steel.

The handle of the osteotome and the handle of the sleeve handle can be made of high-temperature-resistant and disinfection polymer materials or wood.

In one embodiment, the surgical tools are combined in a kit-like form for convenient carrying and mating. The surgical tools with various specifications are positioned and placed in the tool box, and disinfection treatment is realized.

Clinical experiment proves, adopt the utility model discloses an operation instrument is implemented and is taken the area and revolve the inboard horizontal branch bone flap of thigh to treat when the operation of early and middle period ischemic femoral head necrosis, under the guide pin location, supplementary trephine bores the decompression passageway of getting and arriving at necrotic kitchen, take out behind the bone piece, use the plain end to grind to bore to handle and plant the bone groove, the chisel is got and is transplanted the bone piece, guarantee in the accurate femoral head of implanting of bone piece through the examination mould, obtain good pressure and join in marriage, and the blood vessel is not influenced, the operation quality has been ensured, the bone grafting success rate has been improved, be favorable to the postoperative rehabilitation, thereby overcome the defect in the conventional operation apparatus use of prior art, therefore possess wide popularization and application prospect.

Drawings

Fig. 1 is a schematic view of a femoral head necrosis oven drilling operation performed by the surgical tool according to the present invention.

Figure 2 is a schematic structural view of an embodiment of a lead in a surgical tool according to the present invention.

Fig. 3 is a schematic structural view of an embodiment of a trephine in a surgical tool according to the present invention.

Fig. 4 is a schematic view of an embodiment of a bushing in a surgical tool according to the present invention.

Fig. 5 is a schematic structural view of an embodiment of a striking rod in a surgical tool according to the present invention.

Fig. 6 is a schematic structural view of an embodiment of a kink device in a surgical tool according to the present invention.

FIG. 7 is a schematic view of a flat file embodiment of the surgical tool according to the present invention.

Fig. 8 is a schematic structural view of an embodiment of a sleeve and sleeve handle in a surgical tool according to the present invention.

Fig. 9 is a schematic structural view of an embodiment of a bone knife in the surgical tool according to the present invention.

Fig. 10 is a schematic view of a bone core drilling process performed by the surgical tool of the present invention.

The femoral head that is the subject of the procedure is depicted in the drawings in dotted lines to indicate that it is not a component of the surgical tool of the present invention, as will be understood by those skilled in the art.

Detailed Description

The technical solution of the present invention will be described below with reference to the accompanying drawings. It is to be understood that the described embodiments are merely a few embodiments and not all embodiments of the present application; and the structures shown in the drawings are merely schematic and do not represent actual objects.

The surgical tool of the utility model is detachable and comprises a plurality of apparatus parts, and each part can be independently used and combined. Therefore, those skilled in the art can understand that the surgical tool of the present invention can not only complete the operation of treating the ischemic femoral head necrosis in early and middle stages with the spiral medial artery transverse branch bone flap, but also be obviously used for other surgical operations related to the femoral head lesion.

For the sake of simplicity of description, the term "surgical tool for femoral head necrosis bone graft" may sometimes be referred to herein simply as "surgical tool", "surgical tool set", "surgical tool assembly", "surgical kit" or "kit", which are intended to have the same meaning and may be used interchangeably.

The guide pin in this context can be a conventional kirschner wire, for example a graduated kirschner wire with an outer diameter of 2.5 mm. The kirschner wire is a commonly used internal fixation material in orthopedics, is used for fixing short fractures or avulsion fractures and other fractures with low stress, and is also used for fixing temporary fracture blocks in orthopedic operations. It is in the utility model discloses well mainly used bores gets guiding orientation.

The utility model discloses a bush has been designed in the operation instrument creatively, can be based on direction ke shi needle, to the drilling direction of trephine, the degree of depth carries out accurate control, cooperates the kink ware to use, can twist off very conveniently and take out the necrotic bone core; the design of flat file can guarantee that the tunnel top is level and smooth, makes the bone grafting piece top closely laminate at the bottom of with the tunnel, greatly improves the bone and fuses the success rate. The bone grafting test model is used as the reference for autologous bone trimming, so that the bone grafting block is more attached to the tunnel wall, the defect caused by the non-adaption of the bone block is avoided, and the healing of the bone block and surrounding bone tissues is promoted.

Herein, the terms "head", "top" or "front" used to refer to a component such as a k-wire generally refer to a positional relationship downstream in a direction from outside the bone to inside the bone, but do not mean that it must be oriented in a certain fixed direction in an actual mounting operation, merely to show the positional relationship or connection relationship between the respective components. Similarly, the terms "tail (end)", "rear", and the like do not constitute an absolute spatial relationship limitation, but rather a concept of relative position, as will be understood by those skilled in the art.

When the femoral head necrosis operation is repaired by transplanting the bone flap between the branch rotors of the medial arteria femoralis, particularly when the necrotic bone core is drilled, the operation tool is operated and used under the monitoring of an X-ray machine, so that the accuracy of the operation is guaranteed.

Referring to fig. 1 to 7, the surgical tool 10 of the present invention may mainly include: guide pin 1, trephine 2, bush 3, knock rod 4, kink device 5, flat file 6, sleeve 7, sleeve handle 8, osteotome 9, which are described below respectively.

Guide pin 1

The guide needle 1 is used for inserting a femoral head necrosis furnace G (generally, the front, inner and upper part of a femoral head), and is preferably the guide needle 1 with length scales 11, the main body of the guide needle 1 is a cylinder, and the head 12 is a sharp needle point. The overall diameter of the guide pin 1 can be 2.0-4mm, and the length can be 200-280 mm.

As an example, the guide wire 1 may be a conventional Kirschner wire, preferably a Kirschner wire 1 with a length scale 11, more preferably a Kirschner wire 1 with an outer diameter φ 2.5mm with a length scale 11.

Trephine 2

The trephine 2 is used for drilling a sclerotin of a necrotic focus G, the trephine 2 is integrally in a circular tube shape, a hollow pipeline 24 in the trephine can accommodate the guide pin 1, and the hollow pipeline 24 can be penetrated front and back to allow the guide pin 1 to penetrate through. The trephine 2 comprises a generally tubular head portion 21, a tubular central portion 22, and a tail portion 23 for connection to a drill bit (not shown). The tail end of the head 21 of the trephine 2 is provided with a plurality of (for example, more than 10, more than 12, more than 14, more than 16 and more than 18) saw-toothed drilling teeth 211 for drilling bone, and the head 21 of the trephine 2 is provided with openings 212 in a hollow way, for example, four long strip-shaped openings 212 are symmetrically formed, so that the drilling depth can be observed and the operation of twisting off the drilled bone block (or necrotic bone core) can be conveniently implemented. As shown in fig. 3, the outer diameter of the trephine head 21 is larger than the outer diameter of the trephine middle 22 and the inner diameter of the trephine head 21 is larger than the inner diameter of the trephine middle 22; the tail portion 23 is shaped and sized to mate with a power drill bit (not shown). The length of the inner cavity of the trephine head 21 is greater than the sum of the length of the bushing 3 and the maximum length of the necrotic core, which will be described below, so as to facilitate the drilling operation.

The outer diameter of the trephine head 21 may be approximately 16mm, 18mm or 20mm based on the size specification of the femoral head necrosis drilling cavity (or bone tunnel, decompression channel) commonly used in clinic. The overall length of the trephine 2 may be between 200 and 300mm and the length of the trephine head 21 (including the drill teeth 211) may be between 90 and 140 mm.

Bushing 3

The function of the bushing 3 includes acting as a drill guide, for twisting off and removing the drilled bone pieces (or cores, necrotic cores). The bush 3 is a round tubular body with a through front and back, and the inner diameter 31 is matched with the outer diameter of the guide pin 1 or slightly larger than the outer diameter of the guide pin 1 so as to allow the guide pin to pass through. The outer diameter matches the inner diameter of the trephine head 21 or is slightly smaller than the inner diameter of the trephine head 21 for nesting of the trephine head 21. The tail end of the head of the bush 3 is provided with a plurality of (for example, more than 4, more than 5, more than 6, more than 7 and more than 8) nail teeth 32 so as to nail the head of the bush 3 into the femoral head G, and the tail end of the bush 3 is a flat end. In the middle and rear part of the bushing 3, symmetrically arranged perpendicular to the axis, are several (e.g. 4, 6, 8, 10 or 12) pin holes 33, which holes 33 may be staggered at several angles, in order to facilitate the insertion of an external rod, such as a twister 5 described below, through the trephine opening 212 in order to perform the operations of twisting off the drilled bone pieces and pulling the bushing 3 together with the drilled bone pieces out of the trephine head 21. Since the outer diameter of the bushing 3 is significantly larger than the outer diameter of the guide pin 1, it enables a more accurate control of the drilling direction of the trephine 2 and a definition of the maximum drilling depth with respect to a thinner guide pin 1.

The outer diameter of the bush 3 may be approximately 14mm, 16mm or 18 mm. The length of the bushing 3 (including the spikes 32) may be between 35-55mm and the diameter of the pin bore 33 may be between about 3-5 mm.

Knocking rod 4

The striking rod 4 is used to strike the tail end of the liner 3 to drive the spikes 32 on the head of the liner 3 into the femoral head G. The knocking rod 4 is in a circular tube shape, and the inner diameter 41 thereof matches with the outer diameter of the guide pin 1 or is slightly larger than the outer diameter of the guide pin 1 so as to accommodate the main body of the guide pin 1 and/or allow the guide pin 1 to pass through, and is a through tube body (as shown in fig. 5) or is in a structure with one end closed. After the knocking rod 4 is sleeved on the guide pin 1, one end (namely the front end) of the knocking rod is abutted against the tail end of the bush, the other end (namely the rear end) of the knocking rod 4 is knocked by a knocking tool such as a hammer, and the bush 3 is nailed into the femoral head necrosis furnace G in a matching manner. The tapping rod 4 may have an outer diameter substantially equal to or slightly larger than the outer diameter of the bushing 3 for easy handling. The length of the striking rod may be between 200 and 280 mm.

Kinking device 5

When the trephine 2 finishes drilling the bone of the femoral head necrosis range G, the generated bone core needs to be pulled out, and the bone core is only nailed together with the lining 3 at the moment. In order to facilitate removal of the core and the liner 3, it is preferred that the surgical tool 10 further comprises a twister 5 for twisting off the core and removing it together with the liner 3 out of the trephine head 21. The configuration of the twister 5 is not limited as long as the above function can be achieved, for example, in one embodiment, as shown in fig. 6, the twister 5 has a rectangular shape with a partial opening formed on one short side 51, and the short side 51 is formed by two symmetrical rods. The material of the kink device 5 is suitably elastic, for example, medical stainless steel, and in use, the medical staff holds the two long sides 52, inserts the two rods of the open short side 51 through the trephine holes 212 into the two symmetrical pin holes 33 of the bushing 3, rotates the trephine 2 and the bushing 3 together, may twist off the drilled bone fragments (i.e., bone core), and pulls the bushing 3 out of the trephine head 21 together with the drilled bone fragments.

Alternatively, when the kink reducer 5 is not used, the guide pin 1 described above can be used to perform the function of breaking the bone core.

Flat file 6

After the bone core is taken out of the femoral head necrosis range G, the bottom of the formed cavity (or called bone tunnel, bone tunnel cavity and decompression channel) is rough and uneven generally, which is not beneficial to implanting new bone blocks with blood supply and influences the quality and success rate of the bone transplantation. In order to file the rough bottom, a flat file 6 is provided, which can be used to push/squeeze the artificial bone filler filled in the cavity, tamping the cavity, in addition to filing the bottom of the cavity. Referring to fig. 7, the rasp 6 is generally cylindrical in shape and includes a generally cylindrical head portion 61, a cylindrical middle portion 62, and a tail portion 63 for connection to a drill bit (not shown), the tail portion 63 being shaped and sized to mate with the drill bit. The outer diameter of the head 61 corresponds to the outer diameter of the trephine head 21 (i.e. the cavity inner diameter) and the outer diameter of the head 61 is larger than the outer diameter of the rasp middle portion 62. The outside diameter of the above-mentioned burr head 61 may be 16mm, 18mm or 20mm in correspondence with the outside diameter of the trephine head 21. The whole length of the file 6 can be between 150 and 250mm, and the length of the file head 61 can be between 50 and 100 mm.

The flat file head 61 is uniformly recessed with a plurality of (e.g., 3, 4, or 5) spiral grooves 611 along the axial direction. The angle of the extending direction of the spiral groove 611 relative to the end edge of the flat file 6 is between 40 degrees and 75 degrees, such as between 45 degrees and 75 degrees, between 50 degrees and 70 degrees, between 55 degrees and 65 degrees, and between 55 degrees and 60 degrees, the head end of the flat file 6 is a plane, and the cutting edge of the file is used for completely filing and flattening the bottom of the femoral head bone grafting channel. The helical groove 611 may extend in a left-handed helical relationship with the axial direction of the flat file 6, and this helical direction also compresses the filed cancellous bone to the side wall of the bone tunnel.

The trephine 2 and/or the file 6 are typically used with an electric drill. Correspondingly, the trephine tail 23 and/or the burr tail 63 are shaped and sized to mate with a power drill bit to facilitate connection to the power drill bit.

Sleeve 7

The surgical tool 10 may further comprise a sleeve 7 for fitting over the trephine 2 to control the direction of rotation of the trephine 2 and avoid shaking and to perform a size-matched detection when taking a self-grafting bone (i.e. a bone-filled bone with blood supply), since the diameter of the bone-filled bone should be substantially equal to or slightly smaller than the inner diameter of the cavity, enabling easier insertion of the sleeve 7 of the corresponding size.

As shown in fig. 8, the sleeve 7 is a tubular body, the inner diameter of which matches the outer diameter of the trephine head 21, the protrusion 71 is arranged on the outer side, a screw hole 711 is embedded on the protrusion 71 so as to form a spiral link with the head end 811 of the handle 8, wherein the axial direction of the screw hole 711 and the axial direction of the sleeve 7 form an angle of about 30-60 degrees, for example, 45 degrees, so as to facilitate the operation.

The internal diameter of the sleeve 7 may be approximately 14mm, 16mm, 18mm or 20 mm; the length of the sleeve 7 may be between 35-55 mm; the wall thickness may be between about 2-4 mm.

Sleeve handle 8

In order to accommodate the use of the sleeve 7, the surgical tool 10 further comprises a sleeve handle 8 comprising a handle 82 and a post 81, the post 81 having a head end 811 provided with a thread for engaging the protrusion 71 of the sleeve 7 to connect the sleeve handle 8 to the sleeve 7, for use with the trephine 2 and for autologous bone trial.

Osteotome 9

The utility model discloses a osteotome 9 has adopted special shape for the autogenous bone of filling the cavity (the filling bone who takes blood supply promptly) is usually taken from operation patient's thighbone intertrochanteric ridge (thighbone neck basilar part), also can be used to other suitable confession bone positions, generally all cuts out autogenous bone with the osteotome 9 of special shape, cooperation supersound osteotome (not shown in the figure) when necessary. The surgical tool 10 may therefore also comprise a osteotome 9, which may be composed of two osteotomes (referred to simply as osteotome 9A and osteotome 9B) for use in cooperation therewith. Referring to fig. 9, osteotome a and osteotome B each include handles 9a1, 9B1 and blades 9a2, 9B2, blades 9a2, 9B2 are flat and have chisels at their heads. Wherein the vertical section of the osteotome 9A is substantially flat "W" and the vertical section of the osteotome 9B is substantially stroked in a horizontal direction to conform to the shape of the bone-harvesting portion with blood supply bone, such as intertrochanteric ridge or other suitable portion of the femoral component, and surrounding tendon vascular tissue to avoid tissue damage.

Preferably, the guide pin 1, the trephine 2, the bushing 3, the knocking rod 4, the kink device 5, the flat file 6, the sleeve 7, the sleeve handle column 81 and the osteotome 9, the scalpel body 9a2 and the scalpel body 9B2 are made of metal such as medical stainless steel.

Correspondingly, the handles 9A1, 9B1 of the

scalpels

9A, 9B and the handle 82 of the sleeve handle 8 may be made of a high temperature sterilization resistant polymer material, preferably a medical polymer material or wood.

In one embodiment, the surgical tools 10 are assembled together in a kit form for ease of carrying, sterilization, and kit assembly. The tool box positions and places the surgical tools with various specifications (such as trephines 2 with head external diameters phi 16mm, phi 18mm and phi 20mm, bushings 3 with external diameters phi 14mm, phi 16mm and phi 18mm, and plain end files 6 with head external diameters phi 16mm, phi 18mm and phi 20 mm) and realizes disinfection treatment.

Fig. 10 illustrates the use of a partial component combination in a surgical tool 10 to drill a bone core from a femoral head necrosis G, forming a bone tunnel. The first step is as follows: a guide pin 1 with scales is driven into the designed needle feeding point, and a bush 3 is pushed to the femoral head G along the guide pin 1 (see a in figure 10); the second step is that: sleeving the knocking rod 4 on the guide pin 1 and abutting against the tail end of the bushing 3, and striking the tail end of the knocking rod 4 so as to nail the head 32 of the bushing into the femoral head G (see b in fig. 10); the third step: removing the knocking rod 4, and sleeving the trephine 2 on the guide pin 1 and the bush 3 (see c in fig. 10); the fourth step: sleeving the sleeve 7 on the trephine 2, connecting a sleeve handle 8, connecting an electric drill joint, and performing bone core drilling operation (see d in fig. 10); the fifth step: extracting the guide pin 1, twisting off the bone core with the twister 5, withdrawing the trephine 2 from the femoral head necrosis (G) and pulling the liner 3 out of the trephine head 21 together with the bone core (see e in fig. 10); and a sixth step: the flat file 6 is inserted into the cavity, connected to the electric drill head, and the bottom is filed flat (see f in fig. 10), and the desired cavity is finally obtained (see g in fig. 10).

Use examples

The utility model discloses a use that surgical tool 10 is used for revolving the operation of femoral medial artery branch intertrochanteric bone flap transplantation restoration femoral head necrosis includes following specific operating procedure.

1. And (3) surgical planning: before operation, the operation patient is subjected to hip X-ray positive side position and frog position examination, hip three-dimensional CT and MRI examination to judge the femoral head necrosis range. And reconstructing a necrotic focus by using three-dimensional CT data, and accurately designing the entrance angle of the guide pin 1 so that the trephine head end 21 can reach the center of the necrotic focus along the guide pin.

2. Surgical approach: through improving the posterior hip incision, the skin is incised from the upper edge of the greater trochanter to the lower edge of the greater trochanter to the deep fascia, the gluteus maximus fiber is separated bluntly, and the superior geminal muscle, the inferior geminal muscle and the quadratus femoris are searched as anatomical marks. The medial circumflex femoral artery main trunk is carefully searched between the inferior twin and the quadratus femoris, and the medial circumflex femoral artery main trunk is tracked along the radial direction of the superior circumflex femoral artery main trunk to search the greater trochanter bone blocks distributed on the ascending branch, the transverse branch and the transverse branch.

3. Inserting the guide pin 1: the lower part of the joint capsule is incised, the femoral head is exposed, and a kirschner wire 1 with scales is driven into a proper position of a cartilage transition area behind the femoral head from a designed needle inserting point under the guidance of a C arm.

4. The bushing 3 is positioned: the bushing 3 is pushed to the femoral head G along the guide pin 1, the knocking rod 4 is sleeved on the guide pin 1 and abuts against the tail end of the bushing 3, and the tail end of the knocking rod 4 is hit by a hammer, so that the head of the bushing 3 is nailed into the femoral head G.

5. The knocking rod 4 is taken down, the head 21 of the trephine 2 is sleeved on the bushing 3, the bushing 3 and the guide pin 1 are combined to position the trephine 2, the sleeve 7 is sleeved on the trephine 2, the sleeve handle 8 is connected to be connected with an electric drill joint, and the bone is drilled to reach a proper depth.

6. Pulling out the guide pin 1, inserting the two rod bodies of the short side 51 of the opening of the kink device 5 into the pin hole 33 of the bushing 3 through the trephine opening 212, twisting off the bone core, and taking out the trephine 2, the bushing 3 and the bone core from the femoral head; the liner 3 is then pulled out of the trephine head 21 together with the bone core.

7. The rough bottom of the cavity (namely, a pressure reducing channel) formed after the bone block is removed is filed by a flat file 6, the bottom is filed smoothly, and the distance between the bottom and the subchondral bone is 2-3mm under electric penetration.

8. Searching the ascending branch and the transverse branch of the medial circumflex artery again, ligating the ascending branch, reserving the transverse branch and cutting the greater trochanter bone block which is about 4cm by 1.5cm and is dominated by the transverse branch; the profile of the filled bone is measured and polished with the sleeve 7 until the cavity size is met. The upper part, the lower part and the outer side of the bone grafting block can be cut by an ultrasonic osteotome. The joint of the bottom of the bone grafting block and the femoral neck is cut off by a bone knife 9.

9. The position of the bone grafting block is satisfied by the electric transmission observation, the distance between the near end and the cartilage surface is about 3mm, and the bone grafting block is tightly jointed with the bone tunnel. A cannulated screw (not shown) is placed at approximately 45 ° to the long axis of the bone graft and pointing in the lesser trochanter direction to further secure the bone graft. The surrounding soft tissues can stop bleeding sufficiently, and the operation incision can be closed layer by layer after the gauze instrument is checked to be correct.

The surgical tool 10 provided by the present application is described in detail above, and the principle and the embodiment of the present application are explained by applying a specific example, which proves that the surgical kit 10 can be used for performing a series of drilling decompression and bone grafting operations for ischemic necrosis of femoral head represented by a femoral head necrosis operation repaired by intertrochanteric femoral valve grafting of a branch of medial femoral artery. The foregoing description of the embodiments is provided merely as an aid to understanding the methods and concepts of the invention; meanwhile, for a person skilled in the art, according to the idea of the present application, there may be variations in the specific embodiments and the application scope, and in summary, the content of the present specification should not be construed as a limitation to the present application.

Claims

1. A surgical tool for femoral head necrosis bone graft, comprising:

the guide needle is used for being inserted into a femoral head necrosis stove, the main body of the guide needle is a cylinder, and the head of the guide needle is a sharp needle point;

the trephine is used for drilling necrotic cooker sclerotin, the trephine is integrally in a circular tube shape, a hollow pipeline in the trephine can accommodate a guide pin and comprises a head in a circular tube shape, a middle in a circular tube shape and a tail connected with an electric drill joint, sawtooth-shaped drilling teeth are arranged at the tail end of the head of the trephine, an opening is formed in the head of the trephine in an axially hollowed mode, the outer diameter of the head of the trephine is larger than that of the middle of the trephine, and the inner diameter of the head of the trephine is larger than that of;

the bushing is a round tubular body with a through front and back, the inner diameter of the bushing is matched with the outer diameter of the guide pin or is larger than the outer diameter of the guide pin so that the guide pin can penetrate through the bushing, the outer diameter of the bushing is matched with the inner diameter of the trephine head or is smaller than the inner diameter of the trephine head so that the trephine head can be nested, a plurality of nail teeth are arranged at the tail end of the head of the bushing, and a plurality of pin holes are arranged in the middle of the bushing and;

the inner diameter of the round tubular knocking rod is matched with the outer diameter of the guide pin or is larger than the outer diameter of the guide pin so as to accommodate the main body of the guide pin, and the knocking rod is used for nailing the bush into the cortex of the femoral head and neck part in a matched mode through striking so as to fix the bush on the bone surface;

the flat file is used for filing and removing the rough bottom of a cavity formed after a bone block, the whole flat file is cylindrical, comprises a head which is substantially cylindrical, a middle part which is a cylinder and a tail part which is used for connecting an electric drill joint, the outer diameter of the head is basically equivalent to that of the head of a trephine, the outer diameter of the head is larger than that of the middle part of the flat file, and the head is uniformly provided with a spiral groove along the axial direction in a concave mode.

2. The surgical tool for femoral head necrosis bone graft of claim 1, wherein the guide pin is a k-wire.

3. A surgical tool for femoral head necrosis bone graft as in claim 1, further comprising a twister for twisting off the bone core and removing it with the bushing out of the trephine head after the trephine has completed the drilling operation.

4. The surgical tool for femoral head necrosis bone graft according to claim 1, further comprising a sleeve for fitting over the trephine to control a rotation direction of the trephine and to prevent shaking, and measuring a diameter of the filling bone when trying a model of the size of the autogenous bone, wherein the sleeve is a tubular body having an inner diameter matching an outer diameter of the trephine bit, and a protrusion is provided at an outer side thereof, and a screw hole is embedded in the protrusion.

5. The surgical tool for femoral head necrosis bone graft of claim 4, further comprising a sleeve handle including a grip and a post, the post having a thread at a front end thereof for engaging the protrusion on the sleeve to couple the sleeve handle to the sleeve.

6. A surgical tool for osteonecrosis of the femoral head as in claim 1, further comprising a osteotome for cutting a bone block with blood supply from the bone removal site to fill the cavity, wherein the osteotome comprises two cooperating blades each comprising a handle and a blade, the blade being generally flat and the head of the blade being a chisel.

7. A surgical tool for femoral head necrosis bone graft as claimed in claim 1, wherein the trephine head has an outer diameter of 16mm, 18mm or 20 mm; the outer diameter of the bushing is 14mm, 16mm or 18 mm; the external diameter of the flat file head is 16mm, 18mm or 20 mm.

8. A surgical tool for femoral head necrosis bone graft as in claim 1, wherein the trephine and/or burr file is adapted for use with an electric drill.

9. The surgical tool for femoral head necrosis bone graft of claim 1, wherein the guide pin, trephine, bushing, knock rod, flat file, sleeve handle cylinder are made of metal.

10. A surgical tool for femoral head necrosis bone graft as in claim 1, wherein the surgical tool is assembled together in the form of a tool box.