CN219579008U

CN219579008U - 3D printing honeycomb head guide plate assisting in placing sacroiliac screw

Info

Publication number: CN219579008U
Application number: CN202320690759.1U
Authority: CN
Inventors: 盛斌
Original assignee: Hunan Provincial Peoples Hospital
Current assignee: Hunan Provincial Peoples Hospital
Priority date: 2023-03-31
Filing date: 2023-03-31
Publication date: 2023-08-25
Anticipated expiration: 2033-03-31

Abstract

The utility model relates to the field of auxiliary positioning equipment in medical operation, in particular to a 3D printing honeycomb head guide plate for assisting in the placement of sacroiliac screws. Aims at solving the problems of low perspective definition, wrong nail placement, damage to nerves, blood vessels and high risk of pelvic organs in the prior art. The utility model comprises a guiding part, an operating part and an arc-shaped connecting part, wherein the guiding part is cylindrical, and a through hole is arranged along the main shaft direction of the guiding part for installing a guiding needle; the operating part comprises at least two lotus-shaped positioning bodies, the diameters of the positioning bodies are gradually widened from bottom to top, and a plurality of positioning holes which are outwards dispersed from the positioning bodies are formed in the positioning bodies; one end of the arc-shaped connecting part is fixedly connected with the guiding part, and the other end of the arc-shaped connecting part is fixedly connected with the operating part. The advantages are that: the operation time is shortened, and peripheral vascular nerves and pelvic organs are not damaged in the operation. The post-operative review CT confirms that the sacroiliac screw position is good.

Description

3D printing honeycomb head guide plate assisting in placing sacroiliac screw

Technical Field

The utility model relates to the field of auxiliary positioning equipment in medical operation, in particular to a 3D printing honeycomb head guide plate for assisting in the placement of sacroiliac screws.

Background

The pelvic fracture is a serious wound, frequent combined traumatic hemorrhagic shock and combined injury of pelvic organs of the serious pelvic fracture, and the death rate can reach 10.2 percent. Because of the complex anatomy in the pelvis and the numerous nerve vessels, the treatment of pelvic fracture has always been one of the most troublesome problems for trauma orthopedics practitioners. In the past, non-operative treatment is mostly adopted for pelvic fracture, but the risks of complications such as pulmonary infection, bedsores, deep vein thrombosis of lower limbs, pain, lameness, fracture deformity healing and the like are high. In recent years, more and more students consider that unstable pelvic fractures should be treated by selecting appropriate surgery as early as possible. Wang Qiugen, etc., but the surgical damage is large and the steel plate is expensive. Schildhauer et al can firmly fix the pelvic posterior ring by using a triangle fixation (TOS) technique, but the screw tail presses the skin to cause postoperative pain, infection, skin necrosis, pressure sores and other complications. Matta research shows that the sacroiliac screw can resist vertical shearing force and torsion more effectively, and can avoid the defects of large wound surface, excessive bleeding in operation, severe postoperative pain, influence on early recovery and the like in incision and reduction operation.

Related improvements to the technology at present, such as the chinese utility model patent publication No. CN115553906 a, include: the nail placing guide plate is provided with a plurality of hollow columns for driving in the bolts; the display mechanism is arranged at the outer side of the hollow column, and displays the placement position of the nail-placing guide plate after the nail-placing guide plate is extruded to the bone surface of a patient; the utility model only needs medical staff to place the nail-placing guide plate on the iliac crest of a patient, press the nail-placing guide plate, automatically adjust the formulated guide plate to the correct position through the adjusting mechanism, and then display the adjusting process and the adjusting result through the display mechanism, so that the operation is simpler, and the operation difficulty is reduced. For another example, chinese patent publication No. CN 114983548A discloses a pelvic fixation device, which includes a pubic symphysis fixation plate, a pelvic reconstruction fixation plate, a sacroiliac joint fixation plate, and at least one connecting member, wherein the pubic symphysis fixation plate, the pelvic reconstruction fixation plate, the sacroiliac joint fixation plate, and the at least one connecting member are all 3D printed according to the anatomy of the patient, and the at least one connecting member is connected between the pubic symphysis fixation plate, the pelvic reconstruction fixation plate, and/or the sacroiliac joint fixation plate, and the connecting member is made of an absorbable material; the pelvis fixing device can fix the fracture at the position with the most concentrated stress, ensures the stability among the fixing plates and is easy to perform operation implantation.

There is also a positioning technology for pelvis fracture surgery, for example, the existing percutaneous implantation of sacroiliac screw requires repeated fluoroscopy, which can prolong the surgery time, increase the radiation exposure of patients and operators, reduce the perspective definition in surgery due to the problems of intestinal tract qi accumulation and the like, and have the risk of damaging nerves, blood vessels and pelvic organs due to wrong nail placement, and currently, there is no better solution in terms of reducing the number of times of perspective in surgery and reducing the surgery risk.

Disclosure of Invention

The utility model aims to solve the problems of low perspective definition and high risk of damage to nerves, blood vessels and pelvic organs caused by wrong nail placement in the prior art.

The specific scheme of the utility model is as follows:

the 3D printing honeycomb head guide plate for assisting in the placement of sacroiliac screws comprises a guide part, an operation part and an arc-shaped connecting part, wherein the guide part is cylindrical, and a through hole is formed along the main shaft direction of the guide part so as to install a guide needle; the operating part comprises at least two lotus-shaped positioning bodies, the diameters of the positioning bodies are gradually widened from bottom to top, and a plurality of positioning holes which are outwards dispersed from the positioning bodies are formed in the positioning bodies; one end of the arc-shaped connecting part is fixedly connected with the guiding part, and the other end of the arc-shaped connecting part is fixedly connected with the operating part. In this embodiment, the operation unit corresponds to the patient size. And the positioning is convenient.

The arc-shaped connecting part comprises a silica gel coating, a flexible rubber tube and a skeleton support made of nonmetallic materials from outside to inside.

In a specific implementation, the framework support comprises more than two connecting rods with hinged ends.

In specific implementation, the end part of the arc connection is provided with a sleeve, the sleeve is sleeved outside the guide part, and a positioning pin is arranged between the sleeve and the guide part for connection.

In specific implementation, the skeleton support is replaced by a memory alloy with an metamorphosis temperature of 40 ℃.

In the implementation, still include the laminating the locating lever of arc connecting portion installation, the locating lever with the strapping dress is passed through between the arc connecting portion.

In a specific implementation, a side iliac cushion corresponding to the side iliac shape position is arranged below the guide part.

In specific implementation, the method further comprises a pre-operation preset pelvic bone model, wherein the pre-operation preset pelvic bone model is made of 3D printed plastic and is consistent with the pelvic bone size of a patient.

The utility model has the beneficial effects that:

compared with the prior art, the number of perspective times in operation is obviously reduced, the operation time is shortened, and peripheral vascular nerves and pelvic organs are not damaged in operation. The post-operation review CT confirms that the position of the sacroiliac screw is good;

the whole operation vision and the operation space of the instrument are not influenced, the feasibility is higher, and the comfort level of patients is improved on the side;

in a specific embodiment, the introduction of the memory alloy and the hinge connection provides the possibility for the device to adapt to each individual case.

Drawings

FIG. 1 is a schematic structural view of the structure of the present utility model;

FIG. 2 is a front view of another embodiment of the structure of the present utility model;

the names of the components in the figure are as follows: 1. a guide section; 2. an operation unit; 3. an arc-shaped connecting part; 4. positioning holes; 5. a side ilium pad; 6. positioning pinholes in parallel; 7. a sleeve.

Detailed Description

The preferred embodiments of the present utility model will be described below with reference to the accompanying drawings, it being understood that the preferred embodiments described herein are for illustration and explanation of the present utility model only, and are not intended to limit the present utility model.

Examples

The 3D printing honeycomb head guide plate for placing the sacroiliac screw comprises a guide part 1, an operation part 2 and an arc-shaped connecting part 3, wherein the guide part 1 is cylindrical, and a through hole is formed along the main shaft direction of the guide part 1 so as to install a guide needle; the operation part 2 comprises at least two shower-shaped positioning bodies, the diameters of the positioning bodies are gradually widened from bottom to top, and a plurality of positioning holes 4 which are outwards diverged from the positioning bodies are formed in the positioning bodies; one end of the arc-shaped connecting part 3 is fixedly connected with the guiding part 1, and the other end is fixedly connected with the operating part 2. The design of the shower-like positioning body is used for designing the position of the positioning needle, wherein the shower-like design can further determine the nailing angle. On the one hand, the design combines the body shape and the size of the patient into one body at the beginning of the design, on the other hand, the number, the angle and the length can be adjusted in multiple aspects, and meanwhile, the overall shape design does not influence the operation vision of medical staff and the operation space of operation equipment.

The arc-shaped connecting part 3 comprises a silica gel coating, a flexible rubber tube and a framework support made of nonmetallic materials from outside to inside. In the working process, the deformation can be properly carried out according to the requirements.

The framework support comprises more than two connecting rods with hinged ends. In the working process, the angle can be adjusted by using the hinged connection.

The end part of the arc connection is provided with a sleeve 7, the sleeve 7 is sleeved outside the guide part 1 and is connected with the guide part 1 by a positioning pin. The guide part 1 provides a basic positioning point for the whole product, meanwhile, the design of the guide part 1 is convenient for combining and fixing with various fixing devices, and the flexibility of the product is improved.

In this embodiment, still include the laminating the locating lever of arc connecting portion 3 installation, the locating lever with the tie dress is passed through between the arc connecting portion 3.

A lateral iliac cushion 5 corresponding to the lateral iliac shape is arranged below the guiding part 1. The stable positioning and scanning are further realized, and the smooth advance of the preparation work of the pre-set working step in the earlier stage is also facilitated.

In this embodiment, the method further includes a pre-operation preset pelvic bone model, wherein the pre-operation preset pelvic bone model is made of 3D printed plastic and is consistent with the pelvic bone size of the patient. The model is not shown in the drawings, and in a specific work, the model can be utilized to realize operation previewing first, so that hidden danger in the operation process is further reduced.

During the working process:

(1) The fracture is not displaced, or is not displaced or slightly displaced after traction and closed reduction of lower limbs, and the fracture patient with the nail placement condition and the pelvic posterior ring is satisfied. 2 parallel positioning needles with the diameter of 2.5mm are placed under the preoperative local anesthesia at the position about 1 cm and 2cm above the anterior superior iliac spine of the affected side in an auxiliary way through a parallel guider, and then 0.625mmCT thin-layer scanning is performed.

(2) The proper honeycomb head guide plate and pelvis model are designed according to CT data, and the model is assembled and confirmed without error before operation, and is used in operation after cleaning and sterilization.

(3) The full-anesthesia tracheal cannula of the patient in operation is horizontally positioned on an operating table, and the radiation-proof lead coat protects the perineum, the head, neck, chest, upper abdomen and two lower limbs. After disinfection and laying, a 3D printing guide plate is installed on a parallel positioning needle according to a preoperative plan and is tightly attached to bone cortex, a sacroiliac screw guide needle is driven into ilium along a central nail placing channel of a honeycomb head of the 3D printing guide plate to enter the ilium by about 1-2cm, during the operative perspective, if the needle inserting route of the guide needle is confirmed to be safe and effective, the guide needle is continuously driven into the ilium by about 1-2cm if the needle inserting route of the guide needle is expected to deviate slightly, another guide needle is put into the ilium by about the proper nail placing channel of the honeycomb head again, the needle inserting route of the guide needle is confirmed to be safe and effective again through the perspective, the guide needle is continuously driven into the expected depth, the perspective is carried out again, the guide needle is ensured to be positioned in S1 or S2 vertebral bone, nerve injury is caused by no driving into vertebral canal or vascular injury is caused by driving out of vertebral body, the sacroiliac screw with proper length is selected according to measurement, and the sacroiliac screw is screwed into proper depth after tapping. Whether to fix the pelvis front ring is determined according to the needs of patients.

(4) And after the operation is finished, the positioning needle and the 3D printing honeycomb head guide plate are removed, the wound is covered by the sterile dressing, and the position of the sacroiliac screw is confirmed by rechecking CT after the operation.

In the embodiment, after the guide plate is arranged in the operation, one guide pin of the sacroiliac screw is driven into the central nail placing channel of the honeycomb head, the position of the guide pin is slightly deviated when the C-arm inlet position and the outlet position are seen through, the other guide pin is put into the ilium when the honeycomb head is suitable for nail placing channel, the position of the guide pin is seen through again when the C-arm inlet position and the outlet position are suitable for nail placing channel, the needle feeding route is safe and effective, the guide pin is continuously driven into a proper depth, and the proper full-thread sacroiliac screw is driven into after depth measurement and tapping. Compared with the 3D printing honeycomb head guide plate, the operation for driving the sacroiliac screw is obviously reduced, the operation time is shortened, and peripheral vascular nerves and pelvic organs are not damaged in the operation. The post-operative review CT confirms that the sacroiliac screw position is good.

Examples

2 parallel positioning needles are driven into the device after stable reset before operation, and 0.625mmCT thin-layer scanning is performed. The proper honeycomb head guide plate and pelvis model are designed according to CT data, and the model is assembled and confirmed without error before operation, and is used in operation after cleaning and sterilization. After the guide plate is arranged in the operation, one guide pin of the sacroiliac screw is driven into the central nail placing channel of the honeycomb head, the position of the guide pin is slightly deviated when the C-arm inlet position and the C-arm outlet position are seen through, the other guide pin is put into the ilium through the proper nail placing channel of the honeycomb head, the position of the guide pin is seen through again when the C-arm inlet position and the C-arm outlet position are seen through, the needle feeding route is safe and effective, the guide pin is continuously driven into a proper depth, and the proper full-thread sacroiliac screw is screwed into after depth measurement and tapping. Compared with the 3D printing honeycomb head guide plate, the operation for driving the sacroiliac screw is obviously reduced, the operation time is shortened, and peripheral vascular nerves and pelvic organs are not damaged in the operation. The post-operative review CT confirms that the sacroiliac screw position is good.

Examples

In this embodiment, the skeletal support is replaced with a memory alloy having an metamorphosis temperature of 40 ℃. When the temperature exceeds 40 ℃, a certain amount of correction deformation can be presented, and the operation is convenient.

Examples

In the embodiment, the positioning body is rotationally connected with the arc-shaped connecting part, so that the flexible fixation of the full-thread sacroiliac screw can be further improved.

Finally, it should be noted that: the foregoing description is only a preferred embodiment of the present utility model, and the present utility model is not limited thereto, but it is to be understood that modifications and equivalents of some of the technical features described in the foregoing embodiments may be made by those skilled in the art, although the present utility model has been described in detail with reference to the foregoing embodiments. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present utility model should be included in the protection scope of the present utility model.

Claims

1. Supplementary 3D that sacroiliac screw was put into prints honeycomb head baffle, its characterized in that: the device comprises a guide part (1), an operation part (2) and an arc-shaped connecting part (3), wherein the guide part (1) is cylindrical, and is provided with a through hole along the main shaft direction so as to install a guide needle; the operating part (2) comprises at least two shower-shaped positioning bodies, the diameters of the positioning bodies are gradually widened from bottom to top, and a plurality of positioning holes (4) which are outwards diverged from the positioning bodies are formed in the positioning bodies; one end of the arc-shaped connecting part (3) is fixedly connected with the guiding part (1), and the other end is fixedly connected with the operating part (2).

2. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 1, wherein: the arc-shaped connecting part (3) comprises a silica gel coating, a flexible rubber tube and a framework support made of nonmetallic materials from outside to inside.

3. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 2, wherein: the framework support comprises more than two connecting rods with hinged ends.

4. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 2, wherein: the end part of the arc connection is provided with a sleeve (7), the sleeve (7) is sleeved outside the guide part (1), and a positioning pin is arranged between the sleeve and the guide part (1) for connection.

5. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 4, wherein: the skeleton support is replaced by a memory alloy with an metamorphosis temperature of 40 ℃.

6. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 1, wherein: the utility model also comprises a positioning rod attached to the arc-shaped connecting part (3), and the positioning rod is bound with the arc-shaped connecting part (3) through a binding belt.

7. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 1, wherein: a side ilium pad (5) corresponding to the side ilium shape is arranged below the guide part (1).

8. The 3D printing honeycomb head guide assisting in sacroiliac screw placement as defined in claim 1, wherein: the model also comprises a preoperative preset pelvic bone model, wherein the preoperative preset pelvic bone model is made of 3D printed plastic and is consistent with the pelvic bone size of each patient.