CN217447927U

CN217447927U - Clamping tool for femoral greater trochanter lengthening osteotomy

Info

Publication number: CN217447927U
Application number: CN202220237602.9U
Authority: CN
Inventors: 徐源; 曾小燕; 张利祥; 蔡有军; 周圆圆; 刘娇
Original assignee: Second Affiliated Hospital Army Medical University
Current assignee: Second Affiliated Hospital Army Medical University
Priority date: 2022-01-28
Filing date: 2022-01-28
Publication date: 2022-09-20
Anticipated expiration: 2032-01-28

Abstract

The utility model provides a clamping tool for thighbone greater trochanter extension osteotomy, clamping tool includes the first pincers body, the second pincers body, it is first, the front end of the second pincers body sets up the clamping part, the rear end is the grab handle, the first pincers body, the middle part of the second pincers body is articulated through the round pin axle, the clamping part of first pincers body front end sets up to the grip block that the width is greater than the pincers body, set up the bar guiding hole that extends along width direction on the grip block, the front end symmetry of the second pincers body sets up two centre gripping fingers that extend forward, the spatial separation between two centre gripping fingers is the same with the extension length of bar guiding hole, the centre gripping indicates, it respectively sets up the interlock tooth to divide equally on the opposite face between the grip block, articulated locking screw rod on the grab handle of the first pincers body, locking screw rod's extension end passes the back screw-thread fit locking nut that sets up on the second pincers body. The femur fixing device can be used for osteotomy guiding for a greater trochanter prolonged osteotomy, simplifies the operation process of the operation, shortens the operation time, can fix the femur and prevents the femur from vibrating greatly in the operation process.

Description

Clamping tool for femoral greater trochanter lengthening osteotomy

Technical Field

The utility model relates to the field of medical equipment, in particular to a clamping tool for extension osteotomy of greater trochanter of femur.

Background

Anatomical parameters of greater trochanter region of human femur: the total length of greater trochanter (65.15 + -7.41) mm, the protrusion of greater trochanter (11.61 + -3.12) mm, the depth of pear-shaped fossa (18.79 + -1.74) mm, and the width of greater trochanter (33.36 + -4.25) mm. The included angle of the upward extension line of the greater trochanter and the lateral cortex of the femur (the included angle of the greater trochanter) is 16.38 degrees +/-4.04 degrees; the transverse diameter of the horizontal femoral shaft of the small rotor is (31.05 +/-3.57) mm; the front and rear diameters of the horizontal femoral shaft of the small rotor are (27.63 +/-2.96) mm; the transverse diameter of a femoral shaft 5cm below the small rotor is (26.36 +/-3.22) mm; the anterior-posterior diameter of the femoral shaft 5cm below the small rotor is (25.59 +/-2.75) mm.

Total medullary replacement (THA) is the "gold standard" for the treatment of end-stage medullary joint disease, but the number of medullary revision surgeries has increased due to complications such as postoperative aseptic loosening, periprosthetic infection, periprosthetic fractures, dislocation, etc. The marrow joint revision operation is complex, and has the technical difficulties of exposed operation visual field, complete removal of femoral prosthesis, thorough and clear residual bone cement sheath, accurate treatment of narrow distal medullary cavity of femur, correction of proximal femur deformity, reconstruction of marrow joint function and the like. The adoption of the greater trochanter prolonged osteotomy (ETO) has excellent operative field exposure, can more easily take out residual prosthesis and bone cement, is favorable for correcting proximal femur deformity, and can more directly treat the distal femur medullary cavity. In addition, osteotomies nourish the arteries and the muscles attached thereto, and the greater contact area between the osteotomy and the bone bed, which makes the osteotomy easier to heal, are all advantages not available from other osteotomies, and therefore, greater trochanteric lengthening osteotomies can address the above difficulties to some extent.

At present, the oblique osteotomy of the traditional greater trochanter lengthening osteotomy starts from the upper edge of the greater trochanter of the femur, the length is determined according to the X-ray before operation, generally, the length of the oblique osteotomy is about 9cm from the vertex of the greater trochanter, the oblique osteotomy is inclined downwards to the horizontal osteotomy surface, then the oblique osteotomy is turned for 90 degrees, the horizontal osteotomy is changed from the back to the front, the width of the horizontal osteotomy is about 1/3 of the circumference of the cortical bone of the femoral shaft, and the osteotomy block, the gluteus medius muscle, the gluteus minimus muscle and the vastus lateralis muscle form a 'muscle-bone-muscle' structure together. The specific operation steps are as follows: marking the range of the osteotomy required in the posterior lateral area of the femur; then, a bone drill is used for drilling through the whole cortex at intervals along the marking line; then, connecting the drill holes in sequence by using a bone knife, a swing saw or a trephine by bare hands; finally, the extension osteotomy of the greater trochanter of the hip joint is completed. However, conventional greater trochanter lengthening osteotomies also have a number of problems: 1) when the osteotomy is performed by bare hands, the swinging saw is easy to jump, so that the osteotomy surface is uneven and even deviates from a preset osteotomy line. 2) There is no instrument to hold the proximal femur so that the amplitude of the femur is greater during osteotomy. 3) Before osteotomy, a bone drill is used for drilling and marking along the marking line, so that the operation steps are multiple, and the operation time is longer.

Disclosure of Invention

The utility model aims at prior art not enough, provide a clamping tool for thighbone greater trochanter extension osteotomy, it can cut the bone direction for greater trochanter extension osteotomy, simplifies operation flow, shortens operation time to can fix the thighbone, prevent that the thighbone from taking place vibration by a wide margin at the operation in-process.

The technical scheme of the utility model is that: a clamping tool for femoral greater trochanter extension osteotomy, which comprises a first clamp body and a second clamp body, the front ends of the first and the second clamp bodies are provided with clamping parts, the rear ends are handles, the middle parts of the first and the second clamp bodies are hinged through a pin shaft, the clamping part at the front end of the first clamp body is provided with a clamping plate with the width larger than that of the clamp body, the clamping plate is provided with a strip-shaped guide hole extending along the width direction, the strip-shaped guide hole is vertical to the axial direction of the first clamp body, the front end of the second clamp body is symmetrically provided with two clamping fingers extending forwards, the space distance between the two clamping fingers is the same as the extension length of the strip-shaped guide hole, the opposite surfaces between the clamping fingers and the clamping plate are respectively provided with an occlusion tooth, the grab handle of the first clamp body is hinged with a locking screw rod, and the extending end of the locking screw rod penetrates through a through hole formed in the second clamp body and then is in threaded fit with a locking nut.

Furthermore, a hinge groove is formed in the first caliper body, and one end of the locking screw rod is inserted into the hinge groove and hinged through a hinge pin.

Furthermore, one side sets up articulated seat in opposite directions with the second pincers body of first pincers body, locking screw passes through the hinge pin and articulates cooperation with articulated seat.

Furthermore, the front end of the first clamp body is transited to the clamping plate from an arc which is bent outwards, and a yielding hole is formed between the clamping plate and the first clamp body.

Furthermore, two arc transition sections are symmetrically arranged at the front end of the second clamp body, the clamping fingers are located at the front ends of the arc transition sections, and the arc transition sections are all outwards bent.

Further, the extension length of bar guiding hole is 100~110mm, and the width of bar guiding hole is 2~3 mm.

Furthermore, the grab handles at the rear ends of the first forceps body and the second forceps body are respectively provided with a hand-holding ring.

Furthermore, the length of the first clamp body and the second clamp body is 140-160 mm, the length of the cross section is 10-12 mm, and the width is 4-6 mm.

Adopt above-mentioned technical scheme: this clamping tool is when using, the splint on the first pincers body and the centre gripping on the second pincers body indicate respectively from both sides centre gripping thighbone, make the bar guiding hole on the splint coincide with the osteotomy line of greater trochanter extension osteotomy, when cutting the bone operation, the pendulum saw can directly accomplish thighbone osteotomy along the bar guiding hole, make the pendulum saw cut the bone in-process at whole osteotomy throughout by the restriction in the bar guiding hole, prevent to take place to beat at the osteotomy in-process because of the pendulum saw, and lead to the osteotomy face unevenness, and avoid the skew preset osteotomy line of pendulum saw. After this centre gripping instrument centre gripping is on the thighbone, the opening angle of the first pincers body of locking nut locking on the accessible locking screw and the second pincers body makes clamping instrument fix at the thighbone near-end through the interlock tooth, plays the effect of fixed thighbone, prevents that the thighbone amplitude is too big when the pendulum saw cuts the bone, improves the success rate of operation, and locking screw articulates on the first pincers body, makes bar guiding hole and locking nut all be located doctor's field of vision within range, the operation of being convenient for. In addition, the clamping tool does not need to be marked by drilling holes with a bone drill before osteotomy, thereby simplifying the operation process and shortening the operation time.

The front end of the first pincers body is transited to the clamping plate by the arc of outside bending, set up the hole of stepping down between clamping plate and the first pincers body, can improve the joint strength of the first pincers body and clamping plate, can reduce the art and wild the sheltering from through the hole of stepping down again.

The front end of the second forceps body is symmetrically provided with two arc transition sections, the clamping fingers are positioned at the front ends of the arc transition sections, the arc transition sections are outwards bent, so that an enough surgical field space is reserved between the two clamping fingers, and the toughness can be increased by the transition from the arc transition sections to the clamping fingers.

The invention is further described with reference to the drawings and the specific embodiments.

Drawings

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

FIG. 2 is an enlarged view of a portion of FIG. 1 at A;

FIG. 3 is a schematic structural view of the first clamp body of the present invention;

fig. 4 is a schematic structural diagram of a second clamp body according to the present invention.

Detailed Description

Referring to fig. 1 to 4, a clamping tool for a femur greater trochanter lengthening osteotomy comprises a first clamp body 1 and a second clamp body 2, wherein clamping parts are arranged at the front ends of the first clamp body and the second clamp body, a grab handle is arranged at the rear end of the first clamp body and the second clamp body, the middle parts of the first clamp body 1 and the second clamp body 2 are hinged through a pin shaft, the opening angles of the front end and the rear end of the first clamp body 1 and the second clamp body 2 are the same, the opening angle of the front end clamping part can be larger than the diameter of a femur, and therefore the clamping parts can clamp the femur. The length of the first clamp body 1 and the second clamp body 2 is 140-160 mm, the length of the cross section of the first clamp body 1 and the second clamp body 2 is 10-12 mm, and the width of the first clamp body is 4-6 mm, so that the cross sections of the first clamp body 1 and the second clamp body 2 are rectangular, the strength is improved, and the situation of breakage in the using process is prevented. The clamping part of the front end of the first forceps body 1 is provided with a clamping plate 3 with a width larger than that of the forceps body, the clamping plate 3 is used for fixing one side of the femur to medical staff, a strip-shaped guide hole 4 extending along the width direction is formed in the clamping plate 3, the strip-shaped guide hole 4 is perpendicular to the axial direction of the first forceps body 1, the strip-shaped guide hole 4 is matched with a bone cutting line of a greater trochanter of the femur, and the guide is performed for the bone cutting of a swing saw. The extension length of bar guiding hole 4 is 100~110mm, because the osteotomy length of thighbone greater trochanter extension osteotomy is more than 90mm from the major trochanter apex usually, consequently, the extension length that this embodiment set up bar guiding hole 4 can satisfy the operation needs, and the width of bar guiding hole 4 is 2~3mm, and this width can hold the pendulum saw, can prevent again that the pendulum saw from rocking too big when cutting the bone. The front end of the second forceps body 2 is symmetrically provided with two clamping fingers 5 extending forwards, the space distance between the two clamping fingers 5 is the same as the extension length of the strip-shaped guide hole, enough abdicating space is reserved for the swing saw to cut bones, and meanwhile, the blocking of an operative field is reduced. The opposite surfaces between the clamping fingers 5 and the clamping plate 3 are respectively provided with the meshing teeth 6, so that the friction force between the clamping fingers 5, the clamping plate 3 and the femur is increased, and the clamping stability is improved. The handle of the first forceps body 1 is hinged with a locking screw rod 7, the extending end of the locking screw rod 7 penetrates through a through hole formed in the second forceps body 2 and then is matched with a locking nut 8 in a threaded mode, the opening angle between the first forceps body 1 and the second forceps body 2 can be kept through adjusting the locking nut 8, the clamping tool is fixed on a femur, and the situation that the operation is influenced due to the fact that the clamping tool drops or shifts in the operation process is avoided. This embodiment sets up anti-skidding line on lock nut 8's excircle desktop, frictional force when increasing medical personnel and twist lock nut 8. The grab handles at the rear ends of the first forceps body 1 and the second forceps body 2 are respectively provided with a hand-holding ring 12, so that the clamping tool is convenient to operate.

The first pliers body 1 is provided with a hinge groove 9, one end of the locking screw 7 is inserted into the hinge groove 9 and is hinged through a hinge pin, and the locking screw 7 can rotate along with the opening of the first pliers body 1. The clamping tool is not limited to the above embodiment, and a hinged seat can be arranged on one side of the first clamp body 1 opposite to the second clamp body 2, the hinged seat can be fixedly connected with the first clamp body 1 in a welding manner, and the locking screw 7 is in hinged fit with the hinged seat through a hinged pin.

The front end of the first forceps body 1 is transited to the clamping plate 3 through the arc which is bent outwards, the abdicating hole 10 is formed between the clamping plate 3 and the first forceps body 1, the connection strength of the first forceps body 1 and the clamping plate 3 can be improved, and the surgical field shielding can be reduced through the abdicating hole 10. The front end of the second forceps body 2 is symmetrically provided with two arc transition sections 11, the clamping fingers 5 are positioned at the front ends of the arc transition sections 11, the arc transition sections 11 are all outwards bent, so that an enough surgical field space is reserved between the two clamping fingers, and the toughness can be increased by transition from the arc transition sections to the clamping fingers.

The use steps of the clamping tool are as follows:

1) the patient is lateral lying, the skin, subcutaneous tissue and fascia are cut layer by layer to expose the hip joint, the joint capsule is cut, and the hip joint is rotated outwards to be dislocated. If the femoral head and femoral stem prosthesis are difficult to take out in the operation and the femoral greater trochanter is needed to be subjected to the lengthening osteotomy, the clamping tool is used for assisting the operation.

2) Marking a preset femoral greater trochanter osteotomy line by using a line drawing pen.

3) This clamping means helps handheld, opens first pincers body 1, the second pincers body, lets grip block 3, centre gripping finger 5 grasp the thighbone from both sides respectively to with grip block 3 just to medical personnel, make bar guiding hole 4 coincide with thighbone greater trochanter osteotomy line, after adjusting the position, adjust the angle that opens of the fixed first pincers body 1 of lock nut 8, the second pincers body 2, the assistant uses less power can be through the fixed thighbone of clamping means.

4) The bone is cut along the strip-shaped guide hole 4 by using an oscillating saw.

5) And (5) finishing the extension osteotomy of the greater trochanter of the femur, loosening the locking nut 8 and taking down the clamping tool.

The clamping tool is simple in structure, convenient to operate, safe and reliable to use and capable of being widely popularized and applied. Use this clamping tool to cut the bone operation, the pendulum saw can directly accomplish thighbone along bar guiding hole 4 and cut the bone, make the pendulum saw be restricted in bar guiding hole 4 all the time at whole bone cutting in-process, prevent taking place to beat at bone cutting in-process because of the pendulum saw, and lead to the osteotomy face unevenness, and avoid the pendulum saw skew preset bone cutting line, and can lock the angle of opening of first pincers body 1 and second pincers body 2 through lock nut 8, make clamping tool fix the thighbone near-end through the interlock tooth, play the effect of fixed thighbone, prevent that the thighbone amplitude is too big when the pendulum saw cuts the bone, improve the success rate of operation, and lock screw 7, grip block 3 all sets up on first pincers body 1, make bar guiding hole 4 and lock nut 8 all be located medical personnel's field of vision scope, and be convenient for the operation.

Claims

1. The utility model provides a clamping tool for thighbone greater trochanter extension osteotomy, clamping tool include first pincers body (1), the second pincers body (2), the front end of first, the second pincers body sets up the clamping part, and the rear end is the grab handle, and the middle part of the first pincers body (1), the second pincers body (2) is articulated through the round pin axle, its characterized in that: the clamping part of the front end of the first clamp body (1) is arranged to be wider than a clamping plate (3) of the clamp body, a strip-shaped guide hole (4) extending along the width direction is formed in the clamping plate (3), the strip-shaped guide hole (4) is perpendicular to the axial direction of the first clamp body (1), the front end of the second clamp body (2) is symmetrically provided with two clamping fingers (5) extending forwards, the space interval between the two clamping fingers (5) is identical to the extending length of the strip-shaped guide hole, the opposite surfaces between the clamping fingers (5) and the clamping plate (3) are equally divided into two parts and are respectively provided with an occlusion tooth (6), a grab handle of the first clamp body (1) is hinged to form a locking screw rod (7), and the extending end of the locking screw rod (7) penetrates through a through hole rear thread matching locking nut (8) arranged on the second clamp body (2).

2. The clamping tool for a femoral greater trochanter lengthening osteotomy of claim 1, wherein: the first pliers body (1) is provided with a hinge groove (9), and one end of the locking screw rod (7) is inserted into the hinge groove (9) and is hinged through a hinge pin.

3. The clamping tool for a femoral greater trochanteric extension osteotomy of claim 1, wherein: one side that first pincers body (1) and second pincers body (2) are in opposite directions sets up articulated seat, locking screw (7) are through articulated round pin and articulated cooperation of articulated seat.

4. The clamping tool for a femoral greater trochanter lengthening osteotomy of claim 1, wherein: the front end of the first clamp body (1) is transited to the clamping plate (3) through an arc which is bent outwards, and a yielding hole (10) is formed between the clamping plate (3) and the first clamp body (1).

5. The clamping tool for a femoral greater trochanter lengthening osteotomy of claim 1, wherein: the front end of the second clamp body (2) is symmetrically provided with two arc transition sections (11), the clamping finger (5) is located at the front end of the arc transition sections (11), and the arc transition sections (11) are all bent outwards.

6. The clamping tool for a femoral greater trochanter lengthening osteotomy of claim 1, wherein: the extension length of bar guiding hole (4) is 100~110mm, and the width of bar guiding hole (4) is 2~3 mm.

7. The clamping tool for a femoral greater trochanter lengthening osteotomy of claim 1, wherein: and hand holding rings (12) are respectively arranged on the grab handles at the rear ends of the first forceps body (1) and the second forceps body (2).

8. The clamping tool for a femoral greater trochanter lengthening osteotomy of claim 1, wherein: the length of the first clamp body (1) and the second clamp body (2) is 140-160 mm, the length of the cross section is 10-12 mm, and the width is 4-6 mm.