CN213249631U - Sacroiliac screw percutaneous implantation guiding device - Google Patents

Sacroiliac screw percutaneous implantation guiding device Download PDF

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Publication number
CN213249631U
CN213249631U CN202021723548.6U CN202021723548U CN213249631U CN 213249631 U CN213249631 U CN 213249631U CN 202021723548 U CN202021723548 U CN 202021723548U CN 213249631 U CN213249631 U CN 213249631U
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China
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groove
plate
positioning
positioner
screw
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Expired - Fee Related
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CN202021723548.6U
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Chinese (zh)
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独行业
顾家烨
殷小军
姜雪峰
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Jiangyin Peoples Hospital
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Jiangyin Peoples Hospital
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Priority to CN202021723548.6U priority Critical patent/CN213249631U/en
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Abstract

A sacroiliac screw percutaneous insertion guide, comprising: the transverse positioner is connected with the longitudinal positioner, the position of the sacroiliac screw guide pin corresponding to the needle inserting point of the external iliac plate is positioned, and the angle guider is connected with the longitudinal positioner, so that the angle between the sacroiliac screw guide pin and the coronal plane of the body is positioned. The utility model discloses during the use according to the sacroiliac screw position of planning out on pelvis cross section and pelvis three-dimensional perspective image through software in advance, measure the position relation that obtains ilium planking needle feeding point and anterior superior iliac spine and the contained angle isoparametric of the nail feeding direction of sacroiliac screw and coronal plane, horizontal positioner among the accurate adjusting guide device, the cooperation position and the angle relation of vertical positioning ware and angle director, reappear the above-mentioned needle feeding parameter of predetermineeing, can be safe, fast, accurately put into the sacroiliac screw through the skin, thereby shorten ray exposure and operation time, reduce the operation wound.

Description

Sacroiliac screw percutaneous implantation guiding device
Technical Field
The utility model relates to the technical field of minimally invasive surgery in orthopedics department, more specifically the guider is put into to sacroiliac screw percutaneous that says so.
Background
The treatment of the pelvic fracture is carried out through three development stages of conservative treatment, surgical treatment and minimally invasive treatment, and the minimally invasive treatment is developed into a preferred method and a common means for the treatment of the pelvic fracture at present. The minimally invasive fixing technology is an indispensable important link in minimally invasive treatment, wherein the channel screw technology becomes an ideal minimally invasive fixing technology due to the advantages of small surgical trauma, reliable fixing and the like.
The sacroiliac screw percutaneous screw placement technology is an ideal channel screw technology for treating pelvic posterior ring injury, is a scheme with the best stability and strength in pelvic posterior ring fixation, is often applied to sacroiliac joint dislocation, sacral fracture, sacroiliac joint fracture dislocation and the like, but serious complications, neurovascular injury and spinal cord injury can often occur when the screw position is not good enough.
The traditional percutaneous nail placing method is carried out under the monitoring and guiding of a C-shaped arm X-ray machine, a guide needle is firstly inserted percutaneously, a needle feeding point is determined on a standard sacrum lateral image, then the guide needle is adjusted to be pointed on an inlet position and an outlet position of a pelvis to enable the guide needle to be completely positioned in bones (to avoid damaging important peripheral vascular nerves), and finally a sacroiliac screw with proper diameter and length is driven along the guide needle. This process is simplified by a study of zeihormin et al [1], which was simulated and confirmed by digital medical software: after the needle feeding point of the sacroiliac screw guide needle is determined, the direction of the guide needle with good pointing can be obtained only by adjusting the guide needle in the transverse section of the pelvis and adjusting the included angle between the guide needle and the coronal plane of the pelvis, and the research endows the standard sacrum lateral image with the functions of establishing the needle feeding point of the guide needle and adjusting the pointing direction of the guide needle.
Because the needle insertion point is determined on the lateral sacral image often needs to be tried for a plurality of times, and meanwhile, the external iliac plate is smooth and hard, the determined needle insertion point is easy to lose due to the sliding of the guide needle under fluoroscopy; in addition, even if only the angle between the guide pin and the coronal plane is adjusted, repeated attempts are needed, and the thick muscles and soft tissues of the buttocks can obstruct the adjustment of the direction of the guide pin. Even if the direction of the guide pin is adjusted, the position of the guide pin is difficult to maintain in a bare-handed state in the hammering process of the guide pin. This clearly increases the radiation exposure and operation time, and correspondingly increases the chances of surgical trauma and infection.
SUMMERY OF THE UTILITY MODEL
The utility model mainly solves the technical problem of providing a sacroiliac screw percutaneous implantation guiding device.
The purpose of the utility model is realized through the following technical scheme:
the utility model discloses a guider is put into to sacroiliac screw percutaneous, include: the transverse positioner is connected with the longitudinal positioner, the position of the sacroiliac screw guide pin corresponding to the needle inserting point of the external iliac plate is positioned, and the angle guider is connected with the longitudinal positioner, so that the angle between the sacroiliac screw guide pin and the coronal plane of the body is positioned.
The utility model discloses can also adopt following technical measure:
the transverse positioner is of a U-shaped structure and comprises a bottom edge and side edges arranged on two sides of the bottom edge, and a plurality of nail holes are linearly arranged on the bottom edge; the side edge is provided with scales, the scale line of 0 and the corresponding circle center of each nail hole are on the same straight line, the side edge is provided with a sliding chute, and the sliding chute is parallel to the setting direction of the scales.
The longitudinal positioner comprises a longitudinal adjusting frame, a sliding block fixing bolt and a longitudinal adjusting screw rod, the longitudinal adjusting frame comprises a horizontal plate and a vertical plate which are perpendicular to each other, the upper end of the horizontal plate is provided with a sliding block, and the sliding block is matched with a sliding groove on the side edge of the transverse positioner; the slide block fixing bolt adjusts and limits the position of the slide block in the sliding groove; the upper end of the horizontal plate is provided with a positioning screw hole, the longitudinal adjusting screw rod is matched with the positioning screw hole and penetrates through the horizontal plate, and the lower end of the longitudinal adjusting screw rod is provided with an annular groove; a guide groove is formed in a vertical plate of the longitudinal adjusting frame, and a plurality of nail holes are distributed in the vertical plate; the vertical plate of the longitudinal adjusting frame is provided with scales, and the scale line of 0 is on the same plane with the bottom edge of the transverse positioner.
The cross section of the sliding groove on the side edge of the transverse positioner is I-shaped, the top surface of the sliding groove is provided with a sliding block positioning groove which penetrates through the side edge, the cross section of the sliding block on the horizontal plate of the longitudinal adjusting frame is I-shaped and is matched with the shape of the sliding groove, the sliding block is provided with a fixing screw hole, a sliding block fixing bolt is matched with the fixing screw hole, and the sliding block fixing bolt penetrates through the sliding block positioning groove to be matched and connected with the sliding block and positions the sliding block.
The angle guider comprises a guide disc, a sliding sleeve, a positioning sleeve, a first fixing bolt and a second fixing bolt; the guide disc comprises a straight plate and an arc plate which are connected with each other, a horizontal groove is formed in the front end of the straight plate, the straight plate is of a tuning fork-shaped structure, the straight plate penetrates through an annular groove in the lower end of the longitudinal adjusting screw rod along the horizontal groove, a transverse positioning groove is formed in a manner of penetrating through the horizontal groove wall, a first fixing bolt penetrates through the transverse positioning groove in the horizontal groove wall to abut against the annular groove in the longitudinal adjusting screw rod, an arc groove is formed in the arc plate, the arrangement direction of the arc groove is consistent with the direction of the arc plate, an angle scale is arranged on the arc plate, and the 0-degree position of the angle scale corresponds to the direction parallel to the; the sliding sleeve is matched with the arc-shaped groove and slides along the arc-shaped groove, the direction of a middle shaft of the sliding sleeve is consistent with the radius direction of the arc plate which slides to the corresponding position, a sliding sleeve positioning groove is formed in the side wall of the arc plate, which penetrates through the arc-shaped groove, a second fixing bolt penetrates through the sliding sleeve positioning groove to be matched and connected with the sliding sleeve and positions the rotating angle of the sliding sleeve relative to the 0-degree position, and a positioning hole is coaxially formed in the sliding sleeve; the positioning sleeve coaxially penetrates out along the positioning hole of the sliding sleeve, when the positioning sleeve is completely inserted into the sliding sleeve, the front end of the positioning sleeve corresponds to the circle center of the arc plate, and the positioning sleeve is coaxially provided with a guide pin hole.
The utility model discloses a guider is put into to sacroiliac screw percutaneous beneficial effect does:
the utility model discloses a guider is put into to sacroiliac screw percutaneous when using, according to the sacroiliac screw position of planning out through software on pelvis cross section and pelvis three-dimensional perspective image in advance, the measurement obtains the position relation of ilium planking needle entering point and anterior superior iliac spine and the contained angle isoparametric of the nail direction of advancing and the coronal plane of sacroiliac screw, horizontal locator in the accurate regulation guider, the cooperation position and the angle relation of longitudinal register and angle director, reappear the above-mentioned needle parameter of predetermineeing, can be safe, fast, accurately put into sacroiliac screw percutaneous, thereby shorten ray exposure and operation time, reduce the operation wound.
Drawings
The present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.
Fig. 1 is a schematic perspective view of a sacroiliac screw percutaneous implantation guide device of the present invention;
FIG. 2 is a schematic structural view of the guide pin of the sacroiliac screw percutaneous insertion guide device of the present invention;
fig. 3 is a schematic structural view of a transverse positioner in the sacroiliac screw percutaneous implantation guide device of the invention;
fig. 4 is a schematic structural view of a longitudinal adjusting bracket in the sacroiliac screw percutaneous implantation guiding device of the invention;
fig. 5 is a schematic structural view of a longitudinal adjusting screw rod in the sacroiliac screw percutaneous insertion guide device of the present invention;
fig. 6 is a schematic structural view of a guide disc in the sacroiliac screw percutaneous implantation guide device of the invention;
fig. 7 is a schematic structural view of a positioning sleeve in the sacroiliac screw percutaneous implantation guide device of the present invention.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings and examples.
As shown in fig. 1 to 7, the sacroiliac screw percutaneous insertion guide device of the present invention comprises: the sacroiliac screw guide needle positioning device comprises a transverse positioner 1, a longitudinal positioner 2 and an angle guider 3, wherein the transverse positioner is connected with the longitudinal positioner, the position of the sacroiliac screw guide needle corresponding to an external iliac plate needle feeding point is positioned, and the angle guider is connected with the longitudinal positioner, so that the angle between the sacroiliac screw guide needle and the coronal plane of a body is positioned.
The transverse positioner is of a U-shaped structure and comprises a bottom edge 1a and side edges 1b arranged on two sides of the bottom edge, wherein a plurality of nail holes 4 are linearly arranged on the bottom edge and can accommodate 2.5mm kirschner wires; the side edge is provided with scales, the scale line of 0 and the corresponding circle center of each nail hole are on the same straight line, the side edge is provided with a sliding chute 5, and the sliding chute is parallel to the setting direction of the scales.
The longitudinal positioner comprises a longitudinal adjusting frame, a sliding block fixing bolt and a longitudinal adjusting screw rod, the longitudinal adjusting frame comprises a horizontal plate 6a and a vertical plate 6b which are perpendicular to each other, a sliding block 7 is arranged at the upper end of the horizontal plate, and the sliding block is matched with a sliding groove on the side edge of the transverse positioner; the slide block fixing bolt 8 adjusts and limits the position of the slide block in the sliding groove; the upper end of the horizontal plate is provided with a positioning screw hole 9, a longitudinal adjusting screw 10 is matched with the positioning screw hole and penetrates through the horizontal plate, and the lower end of the longitudinal adjusting screw is provided with an annular groove 11; the vertical plate of the longitudinal adjusting frame is provided with a guide groove 12, a plurality of nail holes 4 are arranged on the vertical plate, the nail holes can contain nail holes of 2.5mm kirschner wires, and the kirschner wires are driven into the nail holes to fix the longitudinal adjusting frame on the pelvis and ilium. The vertical plate of the longitudinal adjusting frame is provided with scales, and the scale line of 0 is on the same plane with the bottom edge of the transverse positioner.
The cross section of the sliding groove on the side edge 1b of the transverse positioner is I-shaped, the top surface of the sliding groove is provided with a sliding block positioning groove 13 penetrating through the side edge, the cross section of the sliding block on the horizontal plate of the longitudinal adjusting frame is I-shaped and matched with the shape of the sliding groove, the sliding block is provided with a fixing screw hole 14, a sliding block fixing bolt 8 is matched with the fixing screw hole, and the sliding block fixing bolt penetrates through the sliding block positioning groove to be matched and connected with the sliding block and positions the sliding block.
The angle guider comprises a guide disc, a sliding sleeve 16, a positioning sleeve 17, a first fixing bolt 18 and a second fixing bolt 19; the guiding disc comprises a straight plate 15a and an arc plate 15b which are connected with each other, a horizontal groove 20 is arranged at the front end of the straight plate, the straight plate is of a tuning fork structure, the straight plate penetrates through an annular groove 11 at the lower end of the longitudinal adjusting screw rod along the horizontal groove, a transverse positioning groove 21 is arranged by penetrating through the horizontal groove wall, a first fixing bolt 18 penetrates through the transverse positioning groove on the horizontal groove wall to abut against the annular groove on the longitudinal adjusting screw rod, an arc groove 22 is arranged on the arc plate, the arrangement direction of the arc groove is consistent with the direction of the arc plate, an angle scale is arranged on the arc plate, and the 0-degree position of the angle scale corresponds to the direction parallel to the straight plate; the sliding sleeve 16 is matched with the arc-shaped groove 22 and slides along the arc-shaped groove, the direction of the middle shaft of the sliding sleeve is consistent with the radius direction of the arc plate which slides to the corresponding position, a sliding sleeve positioning groove 23 is arranged on the side wall of the arc plate which penetrates through the arc-shaped groove, a second fixing bolt 19 penetrates through the sliding sleeve positioning groove to be matched and connected with the sliding sleeve and positions the rotating angle of the sliding sleeve relative to the 0-degree position, and a positioning hole is coaxially arranged in the sliding sleeve; the positioning sleeve coaxially penetrates out along the positioning hole of the sliding sleeve, when the positioning sleeve is completely inserted into the sliding sleeve, the front end of the positioning sleeve is correspondingly positioned at the circle center of the circular arc plate, the positioning sleeve is coaxially provided with a guide pin hole 25, and a sacroiliac screw guide pin 24, namely a 2.5mm kirschner wire, penetrates through the guide pin hole.
Use in the art the utility model discloses a guiding device is put into to sacroiliac screw percutaneous accomplishes the concrete step that the sacroiliac screw percutaneous was put into as follows:
(1) the patient lies on the back, the head faces to the right, the foot faces to the left, the anterior superior iliac spine is touched and marked, firstly, a kirschner wire with the length of 2.5mm vertical to the coronal plane of the body is punched in the anterior superior iliac spine of the patient, then, a nail hole parallel to the 0-degree position on the left half section of the transverse positioner is sleeved outside the kirschner wire, the bottom surface of the transverse positioner is contacted with the skin, then, the direction of the base is adjusted, the U-shaped bottom edge of the transverse positioner is vertical to the longitudinal axis of the body, then, another 2.5mm kirschner wire is punched in the corresponding nail hole on the transverse positioner at the right anterior superior iliac spine of the patient, and if necessary, the kirschner wire can be punched in other nail holes of the transverse positioner for reinforcement, so that the transverse positioner is fixed on the pelvis, and then the kirschner wire is cut short;
(2) inserting an I-shaped sliding block at the top end of the longitudinal adjusting frame into the transverse positioner, fixing the longitudinal adjusting frame on the transverse positioner by using a sliding block fixing bolt after adjustment is finished, and finally punching 1-2 kirschner wires into nail holes on two sides of the longitudinal adjusting frame for reinforcement; and the position of the longitudinal adjusting frame on the transverse adjuster is adjusted according to the distance between the external iliac plate needle-inserting point of the sacroiliac screw and the anterior superior iliac spine (body surface mark) on the coronal plane obtained by digital medical technology measurement;
(3) screwing a longitudinal adjusting screw rod into a positioning screw hole at the top end of the longitudinal adjusting frame, and adjusting the distance of the longitudinal adjusting screw rod according to the distance between the needle feeding point of the external iliac plate of the sacroiliac screw and the anterior superior iliac spine (body surface mark) on the sagittal plane obtained by digital medical technology measurement;
(4) then an angle guide disc of the angle guider is installed, so that the tuning fork-like flat plate passes through the annular groove at the lower end of the longitudinal adjusting screw rod; fixing a sliding sleeve at the position of 0 degree of the arc plate, installing a positioning sleeve through the sliding sleeve, opening the skin, enabling the protruding part at the tail end of the positioning sleeve to be in contact with the sliding sleeve, continuously pushing an angle guide disc at the same time, enabling the tip end of the positioning sleeve to be in contact with the outer iliac plate, fixing the flat plate and the lower end annular groove of the longitudinal adjusting screw rod through a first fixing bolt, and enabling the contact point of the positioning sleeve and the outer iliac plate to be the iliac needle feeding point of the sacroiliac screw and the point to be located at the circle center of the arc plate;
(5) and taking down the positioning sleeve, loosening the second fixing bolt to enable the sliding sleeve to slide along the arc plate to slide to a proper position, namely, a certain included angle is formed between the middle shaft and the crown of the sliding sleeve, the numerical value of the included angle is measured according to digital medical software, the sliding sleeve and the arc plate are fixed by the second fixing bolt, and the positioning of the angle of the sacroiliac screw is completed at the moment. The positioning sleeve is inserted into the sliding sleeve again, after the skin is opened, the positioning sleeve is inserted all the time to enable the tip end of the positioning sleeve to be contacted with the external iliac plate, then a 2.5mm kirschner wire, namely a sacroiliac screw guide pin, is driven into the hollow part in the sleeve, and a 6.5mm or 7.0mm hollow screw, namely a sacroiliac screw, is screwed in the direction of the kirschner wire, so that the aim of percutaneously inserting the sacroiliac screw is achieved.
Of course, the above description is not intended to limit the present invention, and the present invention is not limited to the above examples, and the changes, modifications, additions or replacements made by those skilled in the art within the scope of the present invention also belong to the protection scope of the present invention.

Claims (5)

1. A sacroiliac screw percutaneous insertion guide, comprising: the transverse positioner is connected with the longitudinal positioner, the position of the sacroiliac screw guide pin corresponding to the needle inserting point of the external iliac plate is positioned, and the angle guider is connected with the longitudinal positioner, so that the angle between the sacroiliac screw guide pin and the coronal plane of the body is positioned.
2. The sacroiliac screw percutaneous placement guide device as defined in claim 1, in which the lateral positioner is a "U" shaped structure comprising a bottom edge and side edges disposed on both sides of the bottom edge, the bottom edge being provided with a plurality of nail holes arranged in a straight line; the side edge is provided with scales, the scale line of 0 and the corresponding circle center of each nail hole are on the same straight line, the side edge is provided with a sliding chute, and the sliding chute is parallel to the setting direction of the scales.
3. The sacroiliac screw percutaneous placement guide device as defined in claim 2, in which the longitudinal positioner comprises a longitudinal adjustment frame, a slider fixing bolt and a longitudinal adjustment screw, the longitudinal adjustment frame comprises a horizontal plate and a vertical plate which are perpendicular to each other, the upper end of the horizontal plate is provided with a slider which is matched with a slide groove on the lateral side of the transverse positioner; the slide block fixing bolt adjusts and limits the position of the slide block in the sliding groove; the upper end of the horizontal plate is provided with a positioning screw hole, the longitudinal adjusting screw rod is matched with the positioning screw hole and penetrates through the horizontal plate, and the lower end of the longitudinal adjusting screw rod is provided with an annular groove; a guide groove is formed in a vertical plate of the longitudinal adjusting frame, and a plurality of nail holes are distributed in the vertical plate; the vertical plate of the longitudinal adjusting frame is provided with scales, and the scale line of 0 is on the same plane with the bottom edge of the transverse positioner.
4. The sacroiliac screw percutaneous insertion guide device as defined in claim 3, in which the cross-section of the lateral locator is "i" shaped, the top surface of the lateral locator is provided with a slide block positioning slot that passes through the lateral edge, the cross-section of the longitudinal adjustment frame horizontal plate is "i" shaped and matches the shape of the lateral locator, the slide block is provided with a fixing screw hole, a slide block fixing bolt matches the fixing screw hole, and a slide block fixing bolt passes through the slide block positioning slot to be connected with the slide block in a matching manner and positions the slide block.
5. The sacroiliac screw percutaneous placement guide device of claim 4, wherein the angle guide comprises a guide disk, a sliding sleeve, a positioning sleeve, a first fixation bolt, and a second fixation bolt; the guide disc comprises a straight plate and an arc plate which are connected with each other, a horizontal groove is formed in the front end of the straight plate, the straight plate is of a tuning fork-shaped structure, the straight plate penetrates through an annular groove in the lower end of the longitudinal adjusting screw rod along the horizontal groove, a transverse positioning groove is formed in a manner of penetrating through the horizontal groove wall, a first fixing bolt penetrates through the transverse positioning groove in the horizontal groove wall to abut against the annular groove in the longitudinal adjusting screw rod, an arc groove is formed in the arc plate, the arrangement direction of the arc groove is consistent with the direction of the arc plate, an angle scale is arranged on the arc plate, and the 0-degree position of the angle scale corresponds to the direction parallel to the; the sliding sleeve is matched with the arc-shaped groove and slides along the arc-shaped groove, the direction of a middle shaft of the sliding sleeve is consistent with the radius direction of the arc plate which slides to the corresponding position, a sliding sleeve positioning groove is formed in the side wall of the arc plate, which penetrates through the arc-shaped groove, a second fixing bolt penetrates through the sliding sleeve positioning groove to be matched and connected with the sliding sleeve and positions the rotating angle of the sliding sleeve relative to the 0-degree position, and a positioning hole is coaxially formed in the sliding sleeve; the positioning sleeve coaxially penetrates out along the positioning hole of the sliding sleeve, when the positioning sleeve is completely inserted into the sliding sleeve, the front end of the positioning sleeve corresponds to the circle center of the arc plate, and the positioning sleeve is coaxially provided with a guide pin hole.
CN202021723548.6U 2020-08-18 2020-08-18 Sacroiliac screw percutaneous implantation guiding device Expired - Fee Related CN213249631U (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202021723548.6U CN213249631U (en) 2020-08-18 2020-08-18 Sacroiliac screw percutaneous implantation guiding device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202021723548.6U CN213249631U (en) 2020-08-18 2020-08-18 Sacroiliac screw percutaneous implantation guiding device

Publications (1)

Publication Number Publication Date
CN213249631U true CN213249631U (en) 2021-05-25

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ID=75972598

Family Applications (1)

Application Number Title Priority Date Filing Date
CN202021723548.6U Expired - Fee Related CN213249631U (en) 2020-08-18 2020-08-18 Sacroiliac screw percutaneous implantation guiding device

Country Status (1)

Country Link
CN (1) CN213249631U (en)

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Granted publication date: 20210525