CN214180606U

CN214180606U - Femur osteotomy positioner

Info

Publication number: CN214180606U
Application number: CN202022674218.9U
Authority: CN
Inventors: 王度; 张文明
Original assignee: First Affiliated Hospital of Fujian Medical University
Current assignee: First Affiliated Hospital of Fujian Medical University
Priority date: 2020-11-18
Filing date: 2020-11-18
Publication date: 2021-09-14
Anticipated expiration: 2030-11-18

Abstract

The utility model relates to a thighbone cuts bone locator, including mounting and sliding plate, the mounting includes vertical sliding shaft, sliding shaft lower extreme both sides all link firmly the condyle board of embracing that the level extends, the sliding shaft with embrace condyle board opposite one side of extending direction and sliding plate sliding fit, the constant head tank has been seted up to the sliding plate on with sliding shaft complex glide plane, the constant head tank has been seted up a plurality of and has been run through the sliding plate around all, this thighbone cuts bone locator simple structure, the simple operation can be used to coronal face thighbone distal end location and rotational positioning.

Description

Femur osteotomy positioner

Technical Field

The utility model relates to the field of medical equipment, a thighbone cuts bone locator.

Background

Knee replacement is an effective method of treating end-stage knee disease by implanting an artificial joint prosthesis to restore lost joint function. Accurate implantation of the prosthesis is critical to the success of the surgery. The coronal plane of the femoral prosthesis is required to be perpendicular to the mechanical force line of the femur, and the rotational orientation is parallel to the femoral condyle access line on the axial position. The positioning of the femoral prosthesis is critical to restoring the force lines of the knee joint, maintaining joint balance and good patellar tracking. The current method is mainly based on the anatomical landmarks of the condyles of the femur for localization.

1. Rotational positioning

Landmark landmarks for rotational positioning include the surgical condylar approach (sTEA), the clinical or anatomical condylar approach (aTEA), the posterior condylar line (PCA), and the trochlear anterior-posterior axis (whiteside line). The academia holds that the tea is the anatomical landmark closest to the flexion-extension axis of the knee joint and that the rotational positioning of the femoral prosthesis should be aligned parallel to this. Unfortunately, it is difficult for the physician to accurately mark this axis due to the coverage of the ligament soft tissue and the influence of the intraoperative viewing angle. Whiteside line also shows less accuracy in labeling due to the lack of clear anatomical landmarks. PCA is a connecting line of most prominent points of the medial and lateral posterior condyles, is easy to position, has high mark repeatability, and has an average included angle of 3 degrees between PCA and sTEA according to the measurement of human body specimens, and the currently clinically used method is to determine the rotating position of the femoral prosthesis by the outward rotation of 3 degrees (PCA +3 degrees) of the PCA. However, the data of the 3 ° outward rotation is derived from the white race, and the data of Chinese is 5.1 ± 1.9 °, and in addition, there is individual difference, and about 10% of people are out of this range. Individualized positioning is therefore the best method.

With the development of science, navigation technology (navigation) and 3D printing technology (individual specific guide PSI) have appeared to meet individual requirements, and these technologies have disadvantages of requiring dedicated equipment and requiring high additional cost.

2. Coronal plane orientation

The current positioning method is to measure the femur dissection-force line intersection angle (A-M angle) on the full-length sheet before operation, and the femur intramedullary positioning is adopted in the standard operation. The problem is that the femoral medullary cavity of each patient is not a straight line, and the medullary cavity has a certain volume, and drawing a straight line in the medullary cavity has quite large difference, so that the repeatability is low, and the accuracy is reduced. The approach of the approach to the medullary cavity and the point of opening the medullary cavity in the body during the operation is not always consistent with that planned on the X-ray before the operation, which causes errors in the positioning on the coronal plane.

SUMMERY OF THE UTILITY MODEL

In view of the not enough of prior art, the utility model aims to solve the technical problem that a thighbone cuts bone locator is provided, and not only simple structure is reasonable, and the simple operation can be used to the distal end location of coronal face thighbone and rotational positioning moreover.

In order to solve the technical problem, the technical scheme of the utility model is that: the utility model provides a thighbone cuts bone locator, includes mounting and sliding plate, the mounting includes vertical sliding shaft, sliding shaft lower extreme both sides all link firmly the condyle board of embracing that the level extends, the sliding shaft with embrace condyle board opposite one side of extending direction and sliding plate sliding fit, the sliding plate has seted up the constant head tank on with sliding shaft complex glide plane, the constant head tank has been seted up a plurality ofly and has been run through the sliding plate around just all.

Furthermore, the front end face and the rear end face of the sliding plate are symmetrically provided with sliding grooves matched with the sliding shaft, and the positioning grooves penetrate through the sliding grooves from front to back.

Furthermore, the constant head tank all extends in the slant in the left and right sides direction, and inclination increases progressively 1 along with the constant head tank of bottom to top in proper order.

Further, the inclination that is located the constant head tank of lowermost end is 2, upwards be 3 in proper order, 4, 5, 6, 7 constant head tanks altogether for confirm femoral prosthesis's position, the sliding plate can be followed the sliding shaft and slided, is convenient for remove to ideal position, and current joint replacement apparatus is 2 regulations, the utility model discloses the locator is 1 regulation, and the precision is higher.

Further, two embrace the condyle board and set firmly respectively on the sliding shaft left and right sides, and equal level extends forward, does not influence the sliding plate dorsad and removes along the sliding shaft, embraces the condyle board and sets firmly as an organic whole with the sliding shaft.

Furthermore, the fixing piece assembly is made of medical alloy, so that the strength is high, and the use requirements of all aspects are met. The sliding plate component is made of transparent polymer organic materials, so that observation and positioning in the operation are facilitated.

Compared with the prior art, the utility model discloses following beneficial effect has: the femur osteotomy positioner can meet the special condition of each patient individually, does not need to expend too much cost, saves cost, can make knee joint CT scanning for others before operation because doctors hardly mark sTEA on human bodies accurately, marks external epicondyle protrusion and internal epicondyle depression on a femur condylar axis position tomography image, and a two-point connecting line is sTEA, and when drawing PCA, an included angle of two lines is a rotation angle of a femur prosthesis, the conventional PCA + 3-degree positioner is used for positioning in the operation, and the femur osteotomy positioner is used for checking whether the rotation angle is consistent with a planned value before the operation. If the preoperative CT measurement angle is not equal to 3 degrees, the difference of 1 degree is a clinically acceptable value, and no adjustment is performed; if the angle is more than or equal to 2 degrees, the adjustment is carried out. The method achieves individualized positioning, is equivalent to an individual special guide plate PSI, improves the accuracy of the rotational positioning of the femoral prosthesis and lays a good foundation for better recovering the joint function.

In the coronal plane positioning, the method of the utility model measures the intersection angle (the distal condyle-force line angle, DC-M angle) of the mechanical force line of the femur and the distal connecting line of the femur condyle on the full-length sheet before the operation, and positions the femoral prosthesis by taking the intersection angle as the standard. Because the distal end of the femoral condyle is the most protruded part of the bone and is the same as the femoral posterior condyle (PCA line) for determining the rotating position, the connection line of the inner condyle and the outer condyle is easy to confirm, and the repeatability and the accuracy are higher than those of the femoral anatomy-force line angle; in the operation, firstly, the femoral positioner designed by the project is used for marking the osteotomy angle at the femoral anterior condyle, then the traditional distal osteotomy positioner is connected to be parallel to the marking line, the osteotomy position is positioned (the osteotomy amount is determined), and the osteotomy is completed, so that the aim that the osteotomy surface is vertical to the femoral force line is realized.

The present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.

Drawings

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

fig. 2 is a schematic structural view of a fixing member in an embodiment of the present invention;

fig. 3 is a schematic view of the structure of the sliding plate in the embodiment of the present invention.

In the figure: 1-fixed piece, 2-sliding plate, 3-sliding shaft, 4-condyle plate, 5-positioning groove and 6-sliding groove.

Detailed Description

In order to make the aforementioned and other features and advantages of the present invention comprehensible, embodiments accompanied with figures are described in detail below.

As shown in fig. 1 to 3, a femoral osteotomy positioner comprises a fixing member 1 and a sliding plate 2, wherein the fixing member comprises a vertical sliding shaft 3, both sides of the lower end of the sliding shaft are fixedly connected with horizontally extending condyle holding plates 4, the sliding shaft is in sliding fit with the sliding plate on one side opposite to the extending direction of the condyle holding plates, a positioning groove 5 is formed in a sliding surface of the sliding plate matched with the sliding shaft, and the positioning groove is formed in a plurality of positions and penetrates through the sliding plate front and back.

In the embodiment of the utility model, the front and back end faces of the sliding plate are symmetrically provided with sliding grooves 6 matched with the sliding shaft, the sliding grooves vertically penetrate through the sliding plate, the positioning grooves vertically penetrate through the sliding grooves, the sliding grooves are arranged on both sides of the sliding plate, the same sliding plate can be suitable for the left and right sides of the human body by turning back and forth, and the left and right knees are universal; r and L may be indicated on the sliding plate to indicate the left and right osteotomy directions.

The embodiment of the utility model provides an in, the constant head tank all extends in the slant of left and right sides orientation, and inclination increases progressively 1 along with the constant head tank of bottom to top in proper order.

The embodiment of the utility model provides an in, the inclination that is located the constant head tank of lower extreme is 2, and the constant head tank is equipped with 6 altogether, and the constant head tank inclination of upper extreme is 7.

In the embodiment of the present invention, the two condyle holding plates are respectively fixed on the left and right sides of the sliding shaft, and the equal level extends forward.

The utility model discloses theory of operation of embodiment: the intersection angle of the mechanical force line of the femur and the far end connecting line of the femoral condyle (far end condyle-force line angle) is measured on the full-length X-ray before the operation, and the intersection angle is used as a standard for positioning the far end osteotomy position of the femoral prosthesis. And measuring the intersection angle of the femoral posterior condyle and the universal condyle line on a CT or magnetic resonance image, and taking the intersection angle as the rotation positioning angle of the femoral prosthesis. For example, one patient has a distal condyle-force line angle of 3 ° and a posterior condyle-universal condyle line intersection angle of 5 °.

The femur positioner designed by the utility model is used for positioning in the operation. The condyle holding plate is pasted on the distal condyle of the femur (pasted on the same plane of the medial and lateral condyles of the distal femur), the sliding plate is moved to a proper position along the sliding shaft, a marking line (generally marked by a sterile marker pen or a Kirschner wire) is made at the anterior condyle of the femur by a positioning groove with an inclination angle of 3 degrees on the sliding plate, and the marking line forms an angle of 3 degrees with the distal condyle. And removing the positioner, installing the traditional distal osteotomy guide to enable the osteotomy groove of the guide to be parallel to the marking line, positioning the osteotomy position (determining the osteotomy amount), and finishing the osteotomy, so that the aim of enabling the osteotomy surface to be perpendicular to the femoral force line is fulfilled.

After the distal femur is resected, the tibia resection or the femur resection can be completed according to the habit of a doctor;

the locator holding condyle plate is pasted on the femoral posterior condyle, the sliding plate is pasted on the far-end osteotomy surface, a line is marked on the osteotomy surface through a locating slot with an inclination angle of 5 degrees on the sliding plate, and the line is the rotary locating line of the femoral prosthesis. Finally, a traditional four-in-one guider is installed, the osteotomy groove of the guider is parallel to the 5-degree marking line, the osteotomy position (osteotomy amount) is determined by moving forwards and backwards, and the axis of the femoral prosthesis is parallel to the universal condyle line after the osteotomy is completed.

The present invention is not limited to the above preferred embodiments, and any person can derive other various forms of femoral osteotomy locators under the teaching of the present invention. All the equivalent changes and modifications made according to the claims of the present invention shall fall within the scope of the present invention.

Claims

1. Thighbone cuts bone locator, its characterized in that: the fixing piece comprises a fixing piece and a sliding plate, the fixing piece comprises a vertical sliding shaft, the two sides of the lower end of the sliding shaft are fixedly connected with horizontally extending condyle plates vertically, the sliding shaft is in sliding fit with the sliding plate on one side opposite to the extending direction of the condyle plates, the sliding plate is provided with a positioning groove on a sliding surface matched with the sliding shaft, and the positioning groove is provided with a plurality of sliding plates which are all penetrated in the front and at the back.

2. The femoral resection locator of claim 1, wherein: the front end face and the rear end face of the sliding plate are symmetrically provided with sliding grooves matched with the sliding shaft, and the positioning grooves penetrate through the sliding grooves from front to back.

3. The femoral resection locator of claim 1, wherein: the constant head tank all extends in the slant in the left and right sides direction, and inclination increases progressively 1 along with the constant head tank of bottom to top in proper order.

4. The femoral resection locator of claim 3, wherein: the inclination angle of the positioning groove at the lowermost end is 2 deg..

5. The femoral resection locator of claim 1, wherein: two embrace condyle boards and set firmly respectively in the slip axle left and right sides, and the equal level extends forward.