CN217244758U

CN217244758U - Positioning device for assisting hollow screw insertion

Info

Publication number: CN217244758U
Application number: CN202220710764.XU
Authority: CN
Inventors: 刘峰; 雷青; 蔡立宏; 王康; 阳宏奇; 丁州; 何鹏; 黄大立
Original assignee: Third Hospital Of Changsha
Current assignee: Third Hospital Of Changsha
Priority date: 2022-03-30
Filing date: 2022-03-30
Publication date: 2022-08-23
Anticipated expiration: 2032-03-30

Abstract

The utility model discloses a positioning device for assisting the placement of a hollow screw, which is used for rescuing pelvis fracture of a human body and structurally comprises a guide device, a positioning part and a connecting piece for connecting the guide device and the positioning part together; the connecting piece is long arc, guider is the guide cylinder of cavity pipeline column structure, the guider lateral wall with connecting piece one end fixed connection, the guider axle center is to putting the nail position, positioning element is fixed in puts nail object surface, it keeps away from to put the nail position positioning element covers the position. The utility model discloses according to positioner and guider design connecting rod, it arranges the guide cylinder in external exact through long arc linking arm and puts the nail position to reach the effect of accurate direction.

Description

Positioning device for assisting hollow screw insertion

Technical Field

The utility model belongs to the technical field of medical orthopedics is fixed, especially, relate to a positioner that supplementary hollow screw was put into.

Background

The incidence rate of pelvic fracture is (20-35.2)/(10 ten thousand years), which accounts for 1% -3% of bone joint injury, and the pelvic fracture of a human body needs to be rescued. And this proportion has increased year by year with the development of modern vehicles. Among them, unstable pelvic fracture has a large amount of bleeding, a high mortality rate, and a high incidence of complications such as nerve injury, nonunion, abnormal healing, chronic pain, and the like. Early reduction and fixation can ameliorate these symptoms. The traditional internal fixation has the inevitable defects of large surgical injury, much bleeding and the like. With the development of imaging and surgical techniques, percutaneous cannulated screw fixation of pelvic fractures has become the preferred option. However, the pelvis is an irregular bone, the nail placing channel is narrow and has long stroke, the surrounding anatomical structure is complex, and the slight deviation in the nail placing process can cause the damage of important structures such as blood vessels, nerves and the like, thereby causing serious complications. Therefore, the technology has a long learning curve and can be developed only in a small part of large hospitals. Therefore, it is urgent to develop a new, safer, more effective and simple method for fixing pelvic fracture by hollow screw.

Pelvic fracture is the most fatal disability-causing disease in traumatic orthopedics, and the occurrence of the pelvic fracture represents dangerous, serious and acute symptoms. It is commonly seen in car accidents and high fall. Such diseases are therefore often sent to the nearest primary hospitals. And primary hospitals face the following problems. First, the pelvis fracture operation has a certain difficulty, and the primary hospital cannot perform corresponding treatment in time due to equipment and technical reasons. Second, the critical patient's condition cannot be transported to the higher hospital. The result is a substantial amount of mortality or disability in such patients. At present, a small number of researchers at home and abroad use a 3D printing guide device for fixing a single part of a pelvis fracture posterior ring, however, the existing guide device and a positioning component are positioned at the same position, so that the area of the positioning component is large, and an operation wound is increased during fixing.

SUMMERY OF THE UTILITY MODEL

For solving the problem among the above-mentioned prior art, the utility model provides a positioner and positioning system that supplementary hollow screw put into, this utility model arranges the guide cylinder in external exact through long arc linking arm and puts the nail position to reach the effect of accurate direction. The improvement is both minimally invasive and accurate.

In order to achieve the above object, the utility model discloses a positioner that supplementary cannulated screw was put into's concrete technical scheme as follows:

a positioning device for assisting the insertion of a hollow screw comprises a guide device, a positioning part and a connecting piece for connecting the guide device and the positioning part together;

the connecting piece is long arc, guider is the guide cylinder of cavity pipeline column structure, the guider lateral wall with connecting piece one end fixed connection, the guider axle center is to putting the nail position, positioning element is fixed in puts nail object surface, it keeps away from to put the nail position positioning element covers the position.

Further, the connecting piece is of a cylindrical structure or a plate-shaped structure.

Further, the guide cylinder length of the hollow pipeline-shaped structure is not less than 2 CM.

Further, guider includes first guide cylinder and second guide cylinder, the connecting piece includes first arc linking arm and second arc linking arm, first guide cylinder through first arc linking arm with locating part fixed connection, the second guide cylinder through second arc linking arm with locating part fixed connection.

Furthermore, the connecting piece still includes the crossbeam, crossbeam both ends respectively with first arc linking arm, second arc linking arm fixed connection, the crossbeam encloses into triangle stable frame structure with first arc linking arm, second arc linking arm.

Further, one positioning part is fixedly connected with a plurality of connecting pieces.

Furthermore, the positioning component is a plate-shaped structure which is matched with the surface of the nail placing object, and at least two fixing holes are formed in the positioning component.

A positioning system for the positioning device for assisting the hollow screw insertion comprises a computer system; wherein, the computer system models the fracture, simulates the fracture reduction and simulates the direction, size and length of the fixation screw.

The utility model relates to a subassembly that connecting piece, guider and locating component link together cooperates the computer instrument to use, can rescue people's pelvis fracture, does not regard bone of nail-placing position as the positioning mark, but regards bone mark that position such as anterior iliac, posterior superior iliac spine, pubic tubercle are shallow and shape characteristic is obvious as the positioning mark, puts the guide cylinder in external correct nail-placing position through long arc linking arm, thus reach the effect of accurate direction; moreover, the surface area of the bone covered by the positioning component of the utility model is small, and the minimally invasive positioning can be realized during the operation. The improvement not only considers the minimal invasion, but also has accuracy and strong practicability.

Drawings

FIG. 1 is a perspective view of a positioning device for assisting the insertion of a hollow screw according to the present invention;

fig. 2 is a schematic view of the positioning device for assisting the insertion of the hollow screw, which is actually used by a human body.

The symbols in the figure illustrate: the connecting piece 1, the first arc connecting arm 11, the second arc connecting arm 12, the cross beam 13, the guide device 2, the first guide cylinder 21, the second guide cylinder 22, the positioning part 3 and the fixing hole 31.

Detailed Description

In order to better understand the purpose, structure and function of the present invention, the following description is made in detail with reference to the accompanying drawings 1-2 for a positioning device and a positioning system for assisting the insertion of a hollow screw.

At present, the pelvis fracture of a human body is rescued, and the existing pelvis fracture guide devices are divided into two types. One is to use the bone at the nail position as the positioning mark to be attached to the bone for installation and guidance, and the other is to use the local body shape as the positioning skin to be attached to be installed and guided. The former has good accuracy but needs to assist a certain incision, and the latter is slightly invasive through percutaneous nail placement, but has poor accuracy due to the fact that the skin can deform and move.

The utility model designs a positioning device for assisting the hollow screw to be inserted, which not only takes the micro-wound into consideration, but also has the accuracy, and the structure of the positioning device mainly comprises a guiding device 2, a positioning part 3 and a connecting piece 1 for connecting the guiding device 2 and the positioning part 3 together; connecting piece 1 is long arc, guider 2 is the guide cylinder of cavity pipeline column structure, 2 lateral walls of guider with 1 one end fixed connection of connecting piece, 2 axle center alignment of guider are put the nail position, positioning element 3 is fixed in puts nail object surface, it keeps away from to put the nail position positioning element 3 covers the position.

Wherein, the nail placing object is a bone. The guide 2, the positioning member 3 and the connecting member 1 are rigid bodies. The guide device 2 is preferably of a guide cylinder structure, and the connecting piece 1 is used for connecting the positioning component 3 with the guide device 2 and is required to be as short as possible without interfering with the skin around the guide plate in the process of travel so as to improve the accuracy of the guide plate. The connecting piece 1 at least comprises a long arc-shaped connecting arm, and the guide device 2 is placed at the correct nail placing position outside the body through the long arc-shaped connecting arm. Wherein, the connecting piece 1 is of a cylindrical structure or a plate-shaped structure. The connecting piece 1 is a cylinder structure with certain length and radian or a plate-shaped structure with certain length and radian, and the length and the radian of the connecting piece are determined according to the distance between the positioning mark and the nail placing position.

The utility model discloses positioner that supplementary hollow screw put into, do not regard to putting nail department sclerotin as the positioning mark, but with before the ilium, the back eminence of ilium, the obvious bony marking of position shallow table and shape feature such as pubic tubercle or the skin form of characteristic are as the positioning mark, arrange guider 2 in external exact through long arc linking arm and put the nail position, thereby reach the effect of accurate direction, this improvement has both taken into account the wicresoft and has the accuracy, solve present many basic unit hospitals and still can not develop the current situation that this type of wicresoft put the nail at present. More patients with serious fracture can be treated on site in time. In addition, for the demonstration the utility model discloses it is superior to traditional c arm perspective and puts into hollow screw method, study contrast.

Firstly, research content:

1) the experimental pelvic fracture patients were randomly grouped (improved percutaneous 3D printing guide device guided cannulated screw placement method surgical group and traditional C-arm fluoroscopy cannulated screw placement surgical group).

2) The operation time, the intraoperative fluoroscopy times, the intraoperative bleeding volume and the intraoperative postoperative complications of the patient are recorded. And (4) reexamining the patients in Marjeed and June after the operation according to the Majeed scoring standard to evaluate the fixed curative effect.

3) And (4) counting, and comparing and analyzing more than two groups of patients to judge the advantages and disadvantages of the two operation methods.

Second, research content implementation method

Study subjects: unstable pelvic fracture patients, age 18-85 years old

Exclusion criteria: 1. patients with nerve injury 2, malignant tumor 3, pregnancy 4, immune system diseases 5, and immunosuppressant

The number of cases to be collected: 20 to 30 cases

Study protocol

General treatment all patients were treated with conventional preoperative preparation after admission and within 14 days after injury. Including anti-infection, nutritional support, etc. Patients started to do functional exercise of the affected limb without load after 3 days of operation.

The operation mode is as follows: a group of guiding devices of a positioning device for assisting hollow screw implantation through improved percutaneous 3D printing guide hollow screws to fix pelvic fracture; two groups of traditional methods are used for fixing pelvic fracture by inserting hollow screws.

The clinical observation indexes are as follows: the operation time, the intraoperative fluoroscopy times, the intraoperative hemorrhage amount and the intraoperative postoperative complications of the patient are recorded. The patients' postoperative Marjee and June reexamination are based on Majeed about standing, sexual life, sitting, pain and daily life curative effect of the patients.

And (3) standard evaluation: and (3) satisfaction: score >85, good: 70-85 minutes, generally: 55-69 min, difference: <55 points to evaluate fixed efficacy

Statistical method

Data processing was performed using SPSS 19.0 statistical software, counts were expressed as percentages, and comparisons between groups were tested by χ 2. The measured data are expressed by mean + -standard deviation, the comparison among groups adopts t test, and the difference is that P is less than 0.05, which has statistical significance. In practical application, good effect is found to be achieved through shooting examination on the rehabilitation of patients.

The utility model discloses a positioner regards as the positioning mark with bone nodule position shallow table and special-shaped bony nature mark, arranges guider 2 in vitro just need put the nail position through connecting piece 1 to make guider 2 assist the hollow screw direction to put into human interior accurate position. As shown in fig. 2, the cross section of the positioning member 3 is U-shaped, the longitudinal section thereof is a plate-shaped structure, and the positioning member 3 is attached and fixed on the surface of the calibrated bone, at least two fixing holes 31 are provided on the positioning member 3, and the positioning member 3 can be temporarily fixed on the surface of the bone by screws to play a role in positioning the guiding device 2, specifically, the positioning member 3 is a plate-shaped structure printed by using bone marks or characteristic skin forms as templates, which are superficial and have obvious shape characteristics, on the periphery of the nail placing position, and the plate-shaped structure preferably has 2 to 3 fixing holes 31 for fixing the guide plate after the guide plate is installed and the kirschner wire is driven in, thereby preventing the displacement during nail placing.

The guiding device 2 is a guiding cylinder with a hollow pipeline-shaped structure, and a hollow screw guide pin to be implanted can penetrate through the center of the hollow pipeline of the guiding cylinder and then be implanted into a human body. The number of the connection relationship between the positioning component 3 and the guiding device 2 can be one-to-many or one-to-one, and the guiding device 2 comprises a first guiding cylinder 21 and a second guiding cylinder 22, and the number of the guiding cylinders is increased according to the positioning requirement. As shown in fig. 1, the present invention is an embodiment using two guide cylinders, but is not limited to two guide cylinders. The long arc-shaped connecting arm is also exemplified by two arc-shaped connecting arms, but is not limited to two, the long arc-shaped connecting arm comprises a first arc-shaped connecting arm 11 and a second arc-shaped connecting arm 12, one end of the first arc-shaped connecting arm 11 and one end of the second arc-shaped connecting arm 12 are both connected to the positioning part 3, the other end of the first arc-shaped connecting arm 11 is connected to the first guide cylinder 21, and the other end of the second arc-shaped connecting arm 12 is connected to the second guide cylinder 22. The two guide cylinders position a plurality of parts, and the system can connect a plurality of connecting pieces 1 and a plurality of connecting pieces 2 to one positioning part 3 and a plurality of guiding devices 2 so as to realize that one device assists the fixation of a plurality of fractures. Or, the positioning component 3 can also be correspondingly connected with one connecting piece 1, one connecting piece 1 is connected with one or more guiding devices 2, and the detailed part of the specific structure can be finely adjusted according to the actual clinical experiment.

In order to further improve whole positioner's structural stability, connecting piece 1 still includes crossbeam 13, and crossbeam 13 and first arc linking arm 11, second arc linking arm 12 enclose into triangle stable frame structure, utilize geometry triangle stable characteristic to further consolidate this structure, reduce the offset in the operation, improve the degree of accuracy.

Referring to fig. 2, a positioning system for rescuing and repairing pelvic fracture of human body is proposed, which comprises a computer system and the positioning device for assisting the hollow screw implantation; the positioning system adopts the method that the computer models the fracture, simulates the fracture reduction and the direction, the size and the length of the fixation screw, and simulates the guiding implantation experiment by the computer. The guiding device 2 is designed according to the nail placing direction and the shape of the skin soft tissue. And selecting a corresponding special-shaped superficial bony positioning mark according to the position of the guide device 2. The positioning component 3 is designed by using bony marks as templates. And finally, designing a connecting piece 1 according to the positioning part 3 and the guide device 2, and placing the cylinder body of the guide device 2 at the correct nail placing position outside the body through the long arc-shaped connecting arm, thereby achieving the effect of accurate guide.

Wherein the computer simulates the longitudinal insertion positioning of a cannulated screw guide pin along the guide 2. The inner core of the guide device 2 is completely matched and inserted with the computer simulation guide pin, and in a simulation hollow screw experiment, a hollow 3D printing pipeline with the axis in the screw placing direction simulated by a computer can be used. Wherein, the length of the guide cylinder of the hollow pipeline-shaped structure is not less than 2CM, and the height of the guide cylinder is higher than the skin of the body surface. So as to improve the accuracy of the guide plate. The utility model discloses compare with traditional C arm perspective and put into hollow screw fixed pelvis fracture method, percutaneous 3D prints guider guide hollow screw and puts into and to improve and put the nail security, and the accuracy reduces and puts the nail degree of difficulty, provides better curative effect.

It is to be understood that the present invention has been described with reference to certain embodiments, and that various changes or equivalents may be substituted for elements thereof by those skilled in the art without departing from the spirit and scope of the invention. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof. Therefore, the present invention is not limited to the specific embodiments disclosed herein, and all embodiments falling within the scope of the claims of the present invention belong to the protection scope of the present invention.

Claims

1. A positioning device for assisting hollow screw insertion is characterized by comprising a guide device (2), a positioning part (3) and a connecting piece (1) for connecting the guide device (2) and the positioning part (3) together; connecting piece (1) is long arc, guider (2) are the guide cylinder of cavity pipeline column structure, guider (2) lateral wall with connecting piece (1) one end fixed connection, guider (2) axle center is aimed at and is put the nail position, positioning element (3) are fixed in and are put nail object surface, it keeps away from to put the nail position positioning element (3) cover position.

2. The positioning device for assisting the insertion of cannulated screws according to claim 1, wherein the connector (1) is of cylindrical or plate-like construction.

3. The device as claimed in claim 1, wherein the guide cylinder of the hollow conduit-like structure has a length of not less than 2 CM.

4. The positioning device for assisting cannulated screw insertion according to claim 1, wherein the guiding device (2) comprises a first guiding cylinder (21) and a second guiding cylinder (22), the connecting member (1) comprises a first arc-shaped connecting arm (11) and a second arc-shaped connecting arm (12), the first guiding cylinder (21) is fixedly connected with the positioning member (3) through the first arc-shaped connecting arm (11), and the second guiding cylinder (22) is fixedly connected with the positioning member (3) through the second arc-shaped connecting arm (12).

5. The positioning device for putting in the auxiliary cannulated screw according to claim 4, wherein the connecting piece (1) further comprises a cross beam (13), two ends of the cross beam (13) are respectively fixedly connected with the first arc-shaped connecting arm (11) and the second arc-shaped connecting arm (12), and the cross beam (13), the first arc-shaped connecting arm (11) and the second arc-shaped connecting arm (12) enclose a stable triangular frame structure.

6. The positioning device for assisting the insertion of cannulated screws according to claim 1, wherein one positioning part (3) is fixedly connected with a plurality of connecting pieces (1).

7. The positioning device for assisting the placement of cannulated screws according to claim 1, wherein the positioning member (3) is a plate-like structure adapted to the surface of the object to be placed with screws, and at least two fixing holes (31) are provided on the positioning member (3).