CN211409321U

CN211409321U - Irregular surface multi-node staggered-anterograde acetabulum posterior column screw positioning sighting device

Info

Publication number: CN211409321U
Application number: CN201921845847.4U
Authority: CN
Inventors: 邓迎生; 邓喆尹
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-10-30
Filing date: 2019-10-30
Publication date: 2020-09-04
Anticipated expiration: 2029-10-30

Abstract

The utility model discloses an irregular face multinode stagger-antegrade acetabulum back column screw location sight, include: the positioning guide module comprises a positioning support rod and a fixing support rod which are positioned on the same horizontal plane and are vertically connected, and a sliding rod which is vertically perpendicular to the fixing support rod, wherein a plurality of positioning screw holes are formed in the positioning support rod; the sliding seat is provided with a locking mechanism for fixing the sliding rod and the sleeve on the sliding seat; set up the guide pin passageway in the sleeve, the utility model discloses can avoid putting the nail many times and to patient's damage, effectively guarantee the accurate position of guide pin inside the bone.

Description

Irregular surface multi-node staggered-anterograde acetabulum posterior column screw positioning sighting device

Technical Field

The utility model relates to the field of orthopedic medical equipment, relates to the orthopedic surgery equipment of wicresoft's treatment, concretely relates to irregular face multinode stagger-antegrade acetabulum postero-column screw location sight that is used for complicated acetabulum fractures such as front column + postero-column.

Background

In the traditional incision reduction internal fixation operation, for acetabular anterior column fracture, an ilio-inguinal groove needs to be incised from the front approach to expose a fracture end; for fracture of the posterior column of acetabulum, gluteus muscles need to be cut from the back to expose the fracture; therefore, in the case of the fracture of the anterior column and the posterior column of the acetabulum which are combined at the same time, the anterior and the posterior ways are required to be incised at the same time, the operation trauma is extremely large (a large amount of blood transfusion is required), the complications are many, and the joint function and the general condition of the patient are slow to recover.

In order to reduce the surgical trauma, in recent years, with the popularization of minimally invasive surgery concepts and surgical techniques, more and more operators will choose to insert a nail from an inner iliac plate (which can be exposed in anterior acetabular surgery) and drill a hollow nail into an ischial tuberosity direction on the basis of anterior fixation of the fracture of the anterior acetabular column for a patient with combined fracture of the anterior acetabular column and the posterior acetabular column to stabilize the posterior acetabular column, namely, an antegrade posterior acetabular column channel screw. The operation not only avoids the great damage of the posterior incision reduction fixation to muscles, blood vessels and nerves and all the complications brought by the same, but also greatly reduces the medical expense and greatly shortens the recovery time of patients.

However, the current surgical operation of the anterograde acetabular posterior column channel screw is that an operator selects a nail feeding point from an inner iliac plate according to own experience and the assistance of C-arm X-ray machine fluoroscopy, tries to drill a guide needle (not only avoiding the acetabulum from damaging articular cartilage but also avoiding the guide needle from being drilled outside the bone) into the direction of an ischial tuberosity through the center of the posterior column of the acetabulum, judges whether the guide needle is satisfied and makes corresponding adjustment in time through the combination of repeated multi-angle fluoroscopy and the feeling of the operator, and then screws 1 to 2 hollow screws with proper diameter and length into the direction of the satisfied guide needle. However, since the posterior column screw cannot be drilled under direct vision in the operation field of anterior incision, a certain operation blind area exists; in addition, the four directions of the acetabulum are concave irregular surfaces, so that whether the running track of the guide pin is completely positioned in the bone in the operation is difficult to judge accurately in time, the guide pin with a proper direction can be inserted generally by multiple adjustments, but the bone is damaged and the holding force of the screw is reduced by the multiple adjustments; in addition, the technical problems of needle insertion point selection, needle insertion direction selection and the like are still lack of objective standards, and the operation risk is obviously increased; the surrounding anatomical structure of the part is complex and important, the inner side (in the pelvis) of the part is provided with pelvic viscera, dead crown blood vessels and the like, the outer side of the part is provided with acetabulum, sciatic nerve, superior hip blood vessels and the like, once the bone is broken by a screw, not only are complications such as weak fixation, broken screw, re-displacement of fracture and the like caused, but also the operation risk is greatly increased.

The existing implantation technology of the anterograde acetabulum posterior column screw lacks objective standards and related guiding devices in the aspects of determination of a screw feeding point, the walking directions of a coronal plane and a sagittal plane, the length of the screw and the like, is not possible to ensure one-time success, is not capable of accurately guiding the needle and positioning the screw, and is extremely easy to break through iatrogenic injuries of surrounding tissues caused by extraosseous substances.

SUMMERY OF THE UTILITY MODEL

To the above-mentioned prior art, the utility model aims to overcome prior art's weak point, provide one kind and use the big front bone ridge of incisional mark of ischium (being acetabular bone back wall and quadrilateral juncture) for the reference, within 25mm in this bone ridge the place ahead, do figure correction and guide pin direction to anomalous quadrilateral through many pieces of location screw, select the fixed point stagger method of the most depressed place of quadrilateral, confirm that the guide pin walks capable direction and screw length at the feed point of pubic comb's feed point and guide pin, once only successfully put the nail, and effectively avoid the anomalous face multisection stagger-antegrade acetabular bone post screw location sight to surrounding structure damage.

An irregular-surface multi-node offset-antegrade acetabulum posterior column screw positioning sight, comprising:

a positioning guide module; the positioning guide module comprises a positioning support rod and a fixed support rod which are positioned on the same horizontal plane and vertically connected with each other, and a sliding rod which is vertically vertical to the fixed support rod, wherein a plurality of positioning screw holes are formed in the positioning support rod; a plurality of positioning screws penetrate through the positioning screw holes, the needle points of the positioning screws are aligned with the cortex of the bone at the most sunken part of the quadrilateral body, the connecting lines of a plurality of positioning screws on the positioning support rod can be used for guiding the placing direction of the rear column screw guide pin, other screws are adjusted to the surface bone of the application quadrilateral body and are consistent with the longitudinal direction of the expected guide pin walking, the edge of the positioning support rod is tightly attached to the pubic comb, and the longitudinal direction of the positioning support rod is parallel to the inner surface of the quadrilateral body; so as to measure and design the depth of the acetabulum posterior column screw guide pin in the bone.

A sliding guide module; the sliding guide module comprises a sliding seat, a sleeve and a guide pin, wherein the sliding seat is provided with a vertical sliding groove for sleeving a sliding rod, the sliding seat is provided with a guide hole for placing the sleeve, and the vertical sliding groove is vertically designed; the sliding seat is provided with a locking mechanism for fixing the sliding rod and the sleeve on the sliding seat; and a guide pin channel is arranged in the sleeve and used for placing a guide pin.

The further technical scheme is as follows: the sliding rod is provided with digital scales, the scales are arranged to better determine the position of the sliding guide module, and the scales are arranged to more conveniently adjust the distance between the guide pin and the positioning screw, namely the offset distance.

The further technical scheme is as follows: locking mechanism is including setting up a plurality of locking screw on the sliding seat, and the locking screw is used for locking sleeve and slip direction module, prevents to rock and influences operation and location.

The further technical scheme is as follows: the guide hole is designed to be of an arc-shaped structure matched with the sleeve, and the arc-shaped structure is matched with the structure of the sleeve structure and used for better placing the sleeve.

The further technical scheme is as follows: the irregular surface multi-node staggered-antegrade acetabulum posterior column screw positioning sighting device further comprises a limiting and orienting hook, the limiting and orienting hook is vertically arranged at the front end of the positioning support rod, and the limiting and orienting hook is used for hooking the ischial spine or the lower part of the ischial tuberosity.

The further technical scheme is as follows: the limiting and orienting hook is provided with a through hole, the through hole is used for preventing the guide pin from penetrating through the through hole, when the guide pin is positioned, the guide pin is prevented from being inserted too deeply to damage surrounding tissues, and when the guide pin props against the through hole, the guide pin is known to reach the farthest position.

The further technical scheme is as follows: the number of the positioning screw holes is 3-5, three positioning screw holes are enough to be used, one positioning screw hole is used for aligning the bone cortex of the most sunken point of the quadrangular body, as the quadrangular body is irregular, other positioning screws are adjusted to the surface bone of the application quadrangular body and are consistent with the longitudinal direction of the expected guide pin walking, the edge of the positioning support rod is tightly attached to the pubic comb, and the longitudinal direction of the positioning support rod is parallel to the inner surface of the quadrangular body.

The further technical scheme is as follows: the positioning guide module, the sliding guide module and the limiting and positioning hook are all made of medical stainless steel materials, and the medical stainless steel materials are adopted, so that the environment-friendly and sanitary effects are facilitated.

The further technical scheme is as follows: set up horizontal recess on the guiding hole, the guiding hole with horizontal recess intercommunication, horizontal recess highly be less than the guiding hole diameter and be greater than the diameter of guide pin, because pelvis acetabular bone operation operating space is little, insert in the pelvis completely in this device, when needing to assemble or dismantle, because horizontal recess highly be less than the guiding hole diameter, be unlikely to drop when putting into the sleeve, dismantle the sleeve earlier, because horizontal recess highly be greater than the guide pin diameter again, can assemble and dismantle whole positioner very conveniently, guide pin or screw are fixed inside again, conveniently dismantle and assemble sleeve and positioner.

The beneficial effects of the utility model reside in that:

within 25mm in front of the bone crest, the irregular quadrangular body is subjected to graphic correction and pointing of the direction of the guide needle through a plurality of positioning screws, the fixed point offset method of the most sunken part of the quadrangular body is selected, the nail feeding point of the guide needle on the pubic comb, the traveling direction of the guide needle and the length of the screw are determined, 1-3 nails are successfully placed at one time according to the selected nail feeding point, the selected traveling direction of the guide needle and the selected length of the screw, the injury of the patient caused by multiple nail placement is avoided, the damage to the surrounding structure is effectively avoided, and the accurate position of the guide needle in the pelvis is ensured.

Drawings

Fig. 1 is a schematic structural diagram of embodiment 1 of the present invention;

fig. 2 is a schematic structural diagram of embodiment 2 of the present invention;

fig. 3 is a schematic structural diagram of a positioning guide module in embodiment 1 of the present invention;

fig. 4 is a schematic structural view of the sliding guide module of the present invention;

FIG. 5 is a schematic structural view of the sleeve and the guide pin of the present invention;

fig. 6 is a schematic structural diagram of a positioning guide module in embodiment 2 of the present invention;

fig. 7 is a usage state diagram of embodiment 1 of the present invention;

fig. 8 is a usage state diagram of embodiment 2 of the present invention;

fig. 9 is a schematic view of the pelvis structure of the present invention.

In the figure: 1 location branch, 2 fixed branch, 3 guiding holes, 4 sliding seats, 5 locking screws, 6 sliding rods, 7 digital scales, 8 chutes, 9 transverse grooves, 10 sleeves, 11 guide pins, 12 location screws, 13 limiting and orienting hooks, 14 through holes, 15 guide pin channels, 16 pubic spars, 17 tetrapods, 18 ischial tuberosities, 19 ischial spines, 20 ischial macropores and 21 iliac fossa.

Detailed Description

The following description will be further made with reference to the accompanying drawings in order to explain technical contents and structural features of the present invention in detail.

Example 1

Referring to fig. 1, 3, 4, 5, 7 and 9, an irregular-surface multi-node offset-antegrade acetabulum posterior column screw positioning sighting device is characterized in that a positioning guide module is installed firstly, a positioning support rod 1 and a fixing support rod 2 are positioned on the same horizontal plane and are vertically welded together, a sliding rod 6 is vertically and vertically welded on the fixing support rod 2, a digital scale 7 is arranged on the

sliding rod

6, 3 positioning screw holes 12 are arranged in the middle of the

positioning support rod

1, 3 positioning screws penetrate through the positioning screw holes 12, the needle points of the positioning screws are aligned to the bone cortex at the most sunken part of a quadrangular body 17, a limiting and orienting hook 13 is vertically welded at the front end of the positioning support rod 1, and a through hole 14 is formed in the limiting and orienting hook 13; through-hole 14 is less than guide pin 11, prevent that guide pin 11 from penetrating too deeply, install the slip guide module again, the slip guide module includes sliding seat 4, sleeve 10 and guide pin 11, embolia slide bar 6 with vertical spout 8 on the sliding seat 4 on, penetrate locking screw 5 locking sliding seat 4 with the screw, put into guide hole 3 on the sliding seat 4 with sleeve 10 in, set up horizontal recess 9 on guide hole 3, horizontal recess 9 be less than guide hole 3 and be greater than guide pin 11, vertical spout 8 is perpendicular form design, penetrate locking screw 5 locking sleeve 10 with the screw, set up guide pin passageway 15 in sleeve 10, guide pin passageway 15 is used for placing guide pin 11, the location direction module, slip guide module and spacing directional hook 13 all adopt medical stainless steel.

The operation steps of this example 1 are as follows:

step 1, before starting the operation, firstly, the pelvis is cut open, so that an iliac fossa and a quadrilateral 16 (the quadrilateral 16 is also called a square area and is the name of a dissection specialty and expresses a certain part of the pelvis) and bones below an ischial spine 19 or the inner side wall of the ischial tuberosity 18 are exposed, tissues below the ischial spine 19 or the ischial tuberosity 18 are loosened by using medical equipment (a nerve dissecting hook), a positioning guide module is installed, a positioning support rod 1 and a fixing support rod 2 are positioned on the same horizontal plane and vertically connected, a sliding rod 6 vertically vertical to the fixing support rod 2 is arranged, a numerical scale 7 is arranged on the sliding rod 6 and used for reading numerical values, a limiting and orienting hook 13 is installed, the limiting and orienting hook 13 is vertically arranged at the front end of the positioning support rod 1, a through hole 14 is arranged on the limiting and orienting hook 13 is used for hooking the ischial spine 19, set up a plurality of location screw 12 on location branch 1, location screw 12 designs at the middle part, the quantity of location screw 12 sets up to 3, pass the set screw on the location screw 12, the cortex of the most sunken department of tetragonal body 17 is aimed at to the needle point of set screw, other set screws are adjusted to applying ointment or plaster tetragonal body 17 surface sclerotin, and unanimous with the longitudinal direction of expecting the guide pin walking, the plane of location branch 1 is hugged closely the inner face (the pubic comb 16 edge, the boundary edge that is pubic comb 16 and tetragonal body 17) of tetragonal body 17 and location branch is vertical to be parallel with tetragonal body 17 inner surface.

Step 2, setting the offset: when the needle point of the positioning screw on the positioning screw hole 12 is tightly attached to the cortex of the bone at the most sunken part of the quadrangular body 17, the center offset of the guide pin 11 is set to be 4mm-6mm away from the needle point (namely the distance from the central axis of the guide pin 11 to the needle point of the positioning screw); when the basal surface of the limit orientation hook 13 is tightly attached to cortical bone (the junction of the ischial spine 19 and the quadrilateral body 16) inside the quadrilateral body 17, the center offset distance of the guide pin 11 should be set to be 9-10mm away from the basal surface (i.e. the distance from the guide pin 11 to the basal surface of the limit orientation hook 13).

And 3, installing a sliding guide module, aligning a vertical sliding groove 8 of the sliding seat 4 with a sliding rod 6 to be inserted, penetrating a screw into a locking screw hole 5 to lock the sliding seat 4, placing a sleeve 10 into the guide hole 3 of the sliding seat 4, placing a guide pin 11 in a guide pin 11 channel of the sleeve 10, entering from the selected nail feeding point, and drilling into the sliding seat along the direction determined by the positioning support rod 1 and the fixing support rod 2 by proper length.

And 4, replacing the guide pin 11 with a screw channel opener, slowly rotating and pushing the screw channel opener until the opposite cortex of the bone is reached, wherein the screw channel opener belongs to the prior art and reads the length of the screw.

And 5, screwing a hollow screw with a proper length along the direction.

Example 2

The difference between the embodiment 2 and the embodiment 1 is that referring to fig. 2, 4 to 6 and 8, an irregular multi-node offset-antegrade acetabulum posterior column screw positioning sighting device is firstly provided with a positioning guide module, a positioning support rod 1 and a fixing support rod 2 are positioned on the same horizontal plane and vertically welded together, a sliding rod 6 is vertically welded on the fixing support rod 2, a digital scale 7 is arranged on the sliding

rod

6, 3 positioning screw holes 12 are arranged at the front end of the

positioning support rod

1, 3 positioning screws penetrate through the positioning screw holes 12, and the needle point of each positioning screw is aligned with the bone cortex at the most concave position of a quadrangular body 17. Installing a sliding guide module, wherein the sliding guide module comprises a sliding seat 4, a sleeve 10 and a guide pin 11, sleeving a vertical sliding groove 8 on the sliding seat 4 on a sliding rod 6, penetrating a screw into a locking screw hole 5 for locking, placing the sleeve 10 into a transverse groove 9 on the sliding seat 4, penetrating the screw into the locking screw hole 5 for locking, and arranging a guide hole 3 for placing the sleeve 10 on the sliding seat 4; set up guide pin passageway 15 in the sleeve 10 for place guide pin 11, location direction module and slip direction module all adopt medical stainless steel.

The operation steps of this example 2 are as follows:

step 1, the pelvis is firstly cut open, so that the iliac fossa 21 and the upper part (about 3cm deep) of the quadrilateral body 17 are exposed, and the deep part of the quadrilateral body 17, the ischial spine 19 and the ischial tuberosity 18 do not need to be exposed.

And 2, mounting the positioning guide module, enabling the front end of the positioning support rod 1 to be parallel to the ischial major incisal mark (the front part of the positioning support rod 1 in the positioning guide module enters about 30mm below the plane of the pubic comb 16 without being too deep), and to be 10mm away from the ischial major incisal mark edge, and enabling the rear part of the positioning support rod 1 to be tightly attached to the inner surface of the quadrangular body 16 (the edge of the pubic comb 16, namely the intersection edge of the pubic comb 16 and the quadrangular body 17).

And 3, designing a positioning screw hole 12 at the front part of the positioning support rod 1, arranging 3 positioning screw holes 12, screwing 2-3 positioning screws into the 3 positioning screw holes 12 of the positioning support rod 1, arranging a positioning guide module on the inner surface of the quadrilateral body 16, enabling the positioning screws on the positioning screw holes 12 to be perpendicular to the quadrilateral body 17, enabling the tips of 1 positioning screw to be propped against the most sunken point of the bone surface of the quadrilateral body 17, and enabling the positioning support rod 1 of the positioning guide module to be parallel to the big incisure of the ischium and to be 10-20mm away from the ischium and to be applied to the bone crest of the quadrilateral body 17 and the pubic comb 16 by the aid of other positioning screws in the direction of selecting the guide pin 11.

And 4, setting the center offset distance of the guide pin 11 to be 4-6mm away from the tip of the positioning screw (the most concave point of the quadrangular body 17).

And 5, installing a sliding guide module, aligning the sliding groove 8 of the sliding seat 4 with the sliding rod 6 for insertion, penetrating a screw into the locking screw hole 5 for locking the sliding seat 4, fixing the sliding seat 4 on the sliding rod 6, inserting the sleeve 10 into the guide hole 3 of the sliding seat 4, penetrating the screw into the locking screw hole 5 for locking, ensuring that the sleeve 10 is fixed, avoiding influencing the guide pin 11, inserting the guide pin 11 into the guide pin 11 channel of the sleeve 10, and drilling from the selected screw feeding point and along the direction determined by the positioning guide module to a proper length.

And 6, replacing the guide pin 11 with a screw channel opener, slowly rotating and pushing the screw channel opener until the opposite cortex of the bone is reached, wherein the screw channel opener belongs to the prior art and reads the length of the screw.

And 7, screwing a hollow screw with a proper length along the direction.

The above disclosure is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the scope of the invention, therefore, the present invention is not limited by the appended claims.

Claims

1. An irregular surface multinode stagger-antegrade acetabulum posterior column screw positioning sight, comprising:

a positioning guide module; the positioning guide module comprises a positioning support rod and a fixed support rod which are positioned on the same horizontal plane and vertically connected with each other, and a sliding rod which is vertically vertical to the fixed support rod, wherein a plurality of positioning screw holes are formed in the positioning support rod;

a sliding guide module; the sliding guide module comprises a sliding seat, a sleeve and a guide pin, wherein the sliding seat is provided with a vertical sliding groove for sleeving a sliding rod, the sliding seat is provided with a guide hole for placing the sleeve, and the vertical sliding groove is vertically designed; the sliding seat is provided with a locking mechanism for fixing the sliding rod and the sleeve on the sliding seat; a guide pin channel is arranged in the sleeve.

2. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1, wherein: the sliding rod is provided with digital scales.

3. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1, wherein: the locking mechanism comprises a plurality of locking screw holes arranged on the sliding seat.

4. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1, wherein: the guide hole is designed to be of an arc-shaped structure matched with the sleeve.

5. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1, wherein: the irregular surface multi-node staggered-antegrade acetabulum posterior column screw positioning sighting device further comprises a limiting and orienting hook, and the limiting and orienting hook is vertically arranged at the front end of the positioning support rod.

6. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 5, wherein: the limiting and orienting hook is provided with a through hole, and the through hole is used for preventing a guide pin from penetrating through the through hole.

7. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1, wherein: the number of the positioning screw holes is 3-5.

8. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1 or 6, wherein: the positioning guide module, the sliding guide module and the limiting and positioning hook are all made of medical stainless steel materials.

9. The irregular surface multi-node offset-antegrade acetabulum posterior column screw positioning sight of claim 1, wherein: the guide pin guide structure is characterized in that a transverse groove is formed in the side wall of the guide hole, the guide hole is communicated with the transverse groove, and the height of the transverse groove is smaller than the diameter of the guide hole and larger than the diameter of the guide pin.