CN221205618U - Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture - Google Patents

Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture Download PDF

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Publication number
CN221205618U
CN221205618U CN202322658678.6U CN202322658678U CN221205618U CN 221205618 U CN221205618 U CN 221205618U CN 202322658678 U CN202322658678 U CN 202322658678U CN 221205618 U CN221205618 U CN 221205618U
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China
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positioning
transverse
block
tibia
longitudinal
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CN202322658678.6U
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Chinese (zh)
Inventor
董江涛
郑义
张壮岱
牛映祯
郑丽
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Third Hospital of Hebei Medical University
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Third Hospital of Hebei Medical University
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Abstract

The utility model discloses a tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture, which comprises an arc-shaped positioning frame, a tubular fixing arm, a positioning block, a transverse sliding block, a tubular positioning arm and a guide cylinder, wherein the front end of the fixing arm is fixedly connected with the upper end of the positioning frame; the front end of the guide cylinder is fixedly connected with the lower end of the positioning frame, and the rear end of the guide cylinder points to a wire inlet at the rear end of the fixed arm. The positioning frame can be fixed on the tibia through the positioning arm and the guide pin, after one bone tunnel is prepared, the positioning frame is quickly moved to the position for preparing the other bone tunnel by adjusting the position of the transverse sliding block, so that the operation efficiency can be greatly improved, and the operation effect is ensured.

Description

Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture
Technical Field
The utility model relates to a tibia positioner used in arthroscope posterior cruciate ligament avulsion fracture ligation reduction operation, belonging to the technical field of orthopedic medical instruments.
Background
The posterior cruciate ligament begins at the medial condylar lateral surface of the femur and ends posteriorly of the intercondylar process of the tibia, with the primary function of limiting posterior movement of the tibia relative to the femur. Because of the wide range of attachment and strong adhesion of the posterior cruciate ligament to the tibia, traumatic avulsion fractures typically occur at this site. Such injuries can lead to instability of the knee joint, which, if not properly treated, can accelerate knee degeneration in the long term. In order to restore the knee joint structure and stability, the posterior cruciate ligament avulsion fracture block needs to be reset by actively adopting arthroscope ligation.
The difficulty of the avulsion and fracture of the cruciate ligament after the reduction of the avulsion under the arthroscope is that the broken line below the avulsion bone block is positioned at the rear side of the proximal tibia and below the tibial plateau (as shown in fig. 5), the position of the part is deep, the view under the arthroscope is poor, and a double tunnel is usually required to be established, namely, a tibial bone tunnel is respectively established at the inner side and the outer side below the avulsion bone block for 8-shaped ligation fixation so as to achieve better reduction effect (as shown in fig. 6), and the operation difficulty of a clinician is increased. Because no special localizer is provided, most of the current instruments for establishing the tibial bone tunnel by the posterior cruciate ligament avulsion fracture still use the tibial localizer when the posterior cruciate ligament is rebuilt, common manufacturers are schlegel, qisheng, arthrex and the like, all locate the lower part of the posterior cruciate ligament avulsion fracture block by the localizer, and respectively drive guide pins at the inner side and the outer side below the fracture line, and then use tibial bone tunnel drill bits with corresponding thickness to establish the tibial bone tunnel. For posterior cruciate ligament avulsion fracture ligation reduction surgery, accurate bone canal positioning is the most important guarantee of surgery success. At present, the locator is needed to be held by an operator in the locator operation during the reconstruction of the posterior cruciate ligament, the position is maintained unchanged, and meanwhile, the pilot needle is drilled by the hand. This procedure is highly demanding on the stability of the medical personnel's hand, and once the assistant moves while drilling the lead, it may cause a deviation in the lead position, increasing the likelihood of surgical failure. Clinically, for patients with avulsion and fracture of the posterior cruciate ligament, the patients are often young and middle-aged patients, the bone strength is good, the tibial cortex is thick, the drilling difficulty is high, when the drilling is not smooth, operators are often difficult to keep the position for a long time, an assistant is also difficult to keep the angle unchanged all the time, and all the factors can lead to the change of the direction of the guide pin and the emergence point, so that the operation effect is influenced. And the bone broken line below the posterior cruciate ligament avulsion bone piece is deeper than the posterior cruciate ligament dead point position, and the tibia locator when using posterior cruciate ligament to rebuild is because its tubular fixed arm is shorter, can not pinpoint in avulsion bone broken line below, often because of its length is shorter, fixes on the fracture line, is difficult to anatomical reduction when finally leading to the ligature to reset.
In addition, after the tibial bone tunnel on one side is prepared by using the tibial locator reconstructed by the posterior cruciate ligament, the tibial bone tunnel on the other side is also needed to be prepared again, and the preparation processes of the two bone tunnels are completely the same, so that the process is time-consuming and labor-consuming due to the limited space behind the knee joint under the arthroscope, the operation efficiency is reduced, the labor intensity of medical staff and the pain of patients are increased, and the operation effect cannot be ensured. Therefore, the tibia localizer which is accurate in localization and convenient to operate and is suitable for the avulsion and fracture of the cruciate ligament behind the knee joint is very necessary.
Disclosure of utility model
The utility model aims at overcoming the defects of the prior art, and provides a tibia positioner for treating the avulsion fracture of the cruciate ligament behind the knee joint, so as to reduce the operation difficulty, improve the operation efficiency and ensure the operation effect.
In order to achieve the above purpose, the utility model adopts the following technical scheme:
The tibia positioner comprises an arc-shaped positioning frame, a tubular fixing arm, a positioning block, a transverse sliding block, a tubular positioning arm and a guide cylinder, wherein the positioning frame is arranged in front of a knee joint of a patient; the front end of the guide cylinder is fixedly connected with the lower end of the positioning frame, and the rear end of the guide cylinder points to a wire inlet at the rear end of the fixed arm.
Above-mentioned a tibia locator for treating knee joint posterior cruciate ligament avulsion fracture, positioning mechanism includes horizontal locating pin, separation blade, horizontal positioning spring and shrouding, is equipped with the positioning mechanism mounting groove on the locating piece, is equipped with a plurality of horizontal alignment's horizontal locating hole on horizontal slider, horizontal positioning spring is located the positioning mechanism mounting groove, the shrouding shutoff is on the notch of positioning mechanism mounting groove, the one end of horizontal locating pin is equipped with horizontal regulation pull disc, and the other end slides in proper order and inserts in a horizontal locating hole after passing centre bore, horizontal positioning spring and the positioning mechanism mounting groove bottom through-hole of shrouding, the separation blade is fixed at horizontal locating pin middle part, and the separation blade is withstood to horizontal positioning spring's one end, and the shrouding is withstood to the other end.
Above-mentioned a tibia locator for treating knee joint posterior cruciate ligament avulsion fracture, locating piece slip cap dress is in the middle part of locating rack and is connected with the locating rack through positioner, positioner includes apron, longitudinal positioning spring, longitudinal positioning round pin and fender dish, is equipped with the positioner mounting groove on the locating piece, is equipped with a plurality of longitudinal positioning holes of arranging along the slip direction of locating piece on the locating rack, longitudinal positioning spring is located the positioner mounting groove, the apron closing cap is on the notch of positioner mounting groove, the one end of longitudinal positioning round pin is equipped with vertical regulation pulling plate, and the other end slides in proper order and inserts in a longitudinal positioning hole after passing central hole, longitudinal positioning spring and the positioner mounting groove bottom through-hole of apron, the fender dish is fixed at longitudinal positioning round pin middle part, and the fender dish is propped up to longitudinal positioning spring's one end, and the apron is propped up to the other end.
Above-mentioned tibia locator for treating knee joint posterior cruciate ligament avulsion fracture, be transition fit between locating piece and the horizontal slider, between locating piece and the locating rack.
Above-mentioned a tibia locator for treating knee joint posterior cruciate ligament avulsion fracture, the front end of fixed arm and the upper end of locating rack pass through upper locating seat fixed connection, the front end of guide cylinder and the lower extreme of locating rack pass through lower locating seat fixed connection.
The positioning frame can be fixed on the tibia through the positioning block, the transverse sliding block, the positioning arm and the guide pin, a surgeon does not need to hold the positioning device for a long time, after preparing one bone tunnel, the positioning frame is transversely moved by adjusting the position of the transverse sliding block, the positioning frame and the fixing arm are quickly moved to the position for preparing the other bone tunnel, and compared with the tibia positioning device in the reconstruction of the posterior cruciate ligament, the operation difficulty can be greatly reduced, the operation efficiency is improved, and the operation effect is ensured.
Drawings
The utility model will be described in further detail with reference to the drawings and the detailed description.
FIG. 1 is a schematic diagram of the structure of the present utility model;
FIG. 2 is a schematic diagram of the structure of the adjustable positioner;
FIG. 3 is a left side view of FIG. 2;
FIG. 4 is a view showing two states of the adjustable anchor, wherein FIG. 4 (a) is a state when tunneling the left side of the posterior cruciate ligament and FIG. 4 (b) is a state when tunneling the right side of the posterior cruciate ligament;
FIG. 5 is a schematic view of a posterior cruciate ligament avulsion fracture;
FIG. 6 is a schematic illustration of a 8-word ligation fixture.
The reference numerals in the figures are as follows: 1. femur, 2, posterior cruciate ligament, 3, avulsion bone block, 4, tibia, 5, anterior cruciate ligament, 6, tunnel, 7, string, 8, spacer, 9, positioning block, 10, positioning arm, 11, guide pin, 12, lower positioning seat, 13, guide cylinder, 14, cover plate, 15, longitudinal positioning spring, 16, fixing arm, 17, upper positioning seat, 18, line inlet, 19, transverse slider, 20, transverse positioning pin, 21, baffle, 22, longitudinal positioning hole, 23, transverse positioning spring, 24, transverse adjustment pull disc, 25, sealing plate, 26, longitudinal adjustment pull disc, 27, transverse positioning hole, 28, longitudinal positioning pin, 29, baffle disc, 30, locking screw, 31, positioning mechanism mounting groove, 32, positioning device mounting groove.
Detailed Description
Referring to fig. 1-6, the utility model mainly comprises a positioning frame 8, a positioning block 9, a positioning arm 10, a guide pin 11, a lower positioning seat 12, a guide cylinder 13, a cover plate 14, a longitudinal positioning spring 15, a fixed arm 16, an upper positioning seat 17, a wire inlet 18, a transverse sliding block 19, a transverse positioning pin 20, a baffle plate 21, a longitudinal positioning hole 22, a transverse positioning spring 23, a transverse adjusting pull disc 24, a sealing plate 25, a longitudinal adjusting pull disc 26, a transverse positioning hole 27, a longitudinal positioning pin 28, a baffle disc 29 and a locking screw 30.
The locating rack 8 is arranged in front of the knee joint of a patient, the front end of the fixing arm 16 is fixedly connected with the upper end of the locating rack 8 through an upper locating seat 17, the rear end of the fixing arm passes through a gap between the distal end of the femur 1 and the proximal end of the tibia 4 and then abuts against the tibia 4 below the avulsion bone block 3 of the posterior cruciate ligament of the patient, the locating block 9 is connected to the middle part of the locating rack 8, the transverse sliding block 19 slides through a transverse through hole on the locating block 9 and is fixedly connected with the locating block 9 through a locating mechanism, the rear end of the locating arm 10 abuts against the front part of the tibia of the patient, the front end of the locating arm slides through the through hole on the transverse sliding block 19 and is locked by a locking screw 30, and the locating arm 10 can be fixed on the tibia 4 through a guide pin passing through an inner hole of the locating arm, so that the reliable locating of the locating rack 8 is realized; the front end of the guide cylinder 13 is fixedly connected with the lower end of the positioning frame 8 through the lower positioning seat 12, the rear end points to a wire inlet 18 at the rear end of the fixed arm 16, and a bone tunnel prepared on the tibia 4 by the guide cylinder 13 is butted with the wire inlet 18 at the rear end of the fixed arm 16 to form a wire passing channel.
Referring to fig. 2 and 4, a positioning mechanism mounting groove 31 is formed in the positioning block 9, a plurality of transverse positioning holes 27 which are transversely arranged are formed in the transverse sliding block 19, the transverse positioning spring 23 is plugged in the positioning mechanism mounting groove 31 by the sealing plate 25, one end of the transverse positioning pin 20, which is positioned outside the positioning mechanism mounting groove 31, is provided with a transverse adjusting pull disc 24, the other end of the transverse positioning pin is sequentially slid through a central hole of the sealing plate 25, the transverse positioning spring 23 and a through hole at the bottom of the positioning mechanism mounting groove 31 and then inserted into one transverse positioning hole 27 in the transverse sliding block 19, the baffle 21 is fixed in the middle of the transverse positioning pin 20, and two ends of the transverse positioning spring 23 respectively prop against the baffle 21 and the sealing plate 25. Under normal conditions, the elastic force of the transverse positioning spring 23 pushes the transverse positioning pin 20 through the baffle piece 21, one end of the transverse positioning pin 20 is inserted into one transverse positioning hole 27 on the transverse sliding block 19, the transverse sliding block 19 cannot slide in the transverse through hole of the positioning block 9, when the positioning frame 8 and the fixed arm 16 need to be transversely moved for a certain distance, the transverse positioning pin 20 is pulled up by holding the transverse adjusting pulling disc 24 by hand, the transverse positioning spring 23 is compressed, the end part of the transverse positioning pin 20 is pulled out of the transverse positioning hole 27, then the positioning block 9 is pushed to transversely move, the positioning block 9 drives the positioning frame 8 and the fixed arm 16 to synchronously move, the transverse adjusting pulling disc 24 is released after the positioning block is moved into place, the transverse positioning spring 23 pushes the transverse positioning pin 20 to move towards the transverse sliding block 19 through the baffle piece 21, and the end part of the transverse positioning pin 20 is inserted into the other transverse positioning hole 27 on the transverse sliding block 19, and repositioning of the positioning frame 8 and the fixed arm 16 is achieved.
The positioning block 9 is provided with an arc-shaped through hole matched with the positioning frame 8, the positioning block 9 is sleeved in the middle of the positioning frame 8 in a sliding manner through the arc-shaped through hole and is fixedly connected with the positioning frame 8 through a positioning device, the positioning device comprises a cover plate 14, a longitudinal positioning spring 15, a longitudinal positioning pin 28 and a baffle disc 29, the positioning block 9 is provided with a positioning device mounting groove 32, the positioning frame 8 is provided with a plurality of longitudinal positioning holes 22 arranged along the sliding direction of the positioning block 9, the cover plate 14 covers the longitudinal positioning spring 15 in the positioning device mounting groove 32, one end of the longitudinal positioning pin 28, which is positioned outside the positioning device mounting groove 32, is provided with a longitudinal adjusting pulling disc 26, the other end of the longitudinal positioning pin 28 sequentially slides through a central hole of the cover plate 14, the longitudinal positioning spring 15 and the through hole at the bottom of the positioning device mounting groove 32 and then is inserted into one longitudinal positioning hole 22 on the positioning frame 8, the baffle disc 29 is fixed in the middle of the longitudinal positioning pin 28, and two ends of the longitudinal positioning spring 15 respectively support the baffle disc 29 and the cover plate 14. Normally, the elastic force of the longitudinal positioning spring 15 pushes the longitudinal positioning pin 28 through the baffle disc 29, so that one end of the longitudinal positioning pin 28 is inserted into one longitudinal positioning hole 22 on the positioning frame 8, and the positioning frame 8 cannot slide in the arc-shaped through hole of the positioning block 9. When the height of the positioning frame 8 relative to the positioning block 9 needs to be adjusted, the longitudinal positioning disc 26 is held by a hand to transversely pull the longitudinal positioning pin 28, so that the longitudinal positioning spring 15 is compressed, the end part of the longitudinal positioning pin 28 is pulled out of the longitudinal positioning hole 22, then the positioning block 9 slides along the positioning frame 8, the longitudinal positioning disc 26 is released after the positioning block is slid in place, the longitudinal positioning spring 15 pushes the longitudinal positioning pin 28 to move towards the positioning frame 8 through the baffle disc 29, and the end part of the longitudinal positioning pin 28 is inserted into the other longitudinal positioning hole 22 on the positioning frame 8.
The transverse locating pin 20 and the longitudinal locating pin 28 are unlocked by pulling out the locating holes, so that the transverse locating pin 20 and the longitudinal locating pin 28 cannot be pulled out when a user grasps the fracture locator, unlocking caused by misoperation can be avoided, and smooth operation can be ensured.
In order to improve the positioning accuracy, the positioning block 9 and the transverse sliding block 19 are in transition fit with each other, and the positioning block 9 and the positioning frame 8 are in transition fit with each other.
When the fixing device is used, the relative position of the locating rack 8 and the locating block 9 is firstly adjusted through the locating device according to the specific condition of a patient, then the relative position between the transverse sliding block 19 and the locating block 9 is adjusted through the locating mechanism, then the rear end of the fixing arm 16 is propped against the position of the tunnel inside the lower part of the avulsion fracture line of the posterior cruciate ligament of the patient, the front end of the locating arm 10 is propped against the tibia and then is locked by the locking screw 30, the guide needle 11 is driven into the locating arm 10, and the locator is fixed with the tibia; and driving the guide needle into the inner tunnel through the guide cylinder 13, withdrawing the guide needle after the inner tunnel is driven, transversely moving the fixing arm 16 and the positioning frame 8 to the position for preparing the outer tunnel below the broken line through the positioning mechanism, and driving the guide needle into the guide cylinder 13 after the positioning is finished, so as to manufacture the outer tunnel.

Claims (5)

1. The tibia positioner for treating the knee joint posterior cruciate ligament avulsion fracture is characterized by comprising an arc-shaped positioning frame (8), a tubular fixing arm (16), a positioning block (9), a transverse sliding block (19), a tubular positioning arm (10) and a guide cylinder (13), wherein the positioning frame (8) is arranged in front of the knee joint of a patient, the front end of the fixing arm (16) is fixedly connected with the upper end of the positioning frame (8), the rear end of the fixing arm is propped against the tibia below the patient posterior cruciate ligament avulsion bone block, the positioning block (9) is connected to the middle part of the positioning frame (8), the transverse sliding block (19) slides through a transverse through hole on the positioning block (9), a positioning mechanism corresponding to the transverse sliding block (19) is arranged on the positioning block (9), the rear end of the positioning arm (10) is propped against the front part of the tibia of the patient, and the front end of the positioning arm (10) slides through the through hole on the transverse sliding block (19) and is locked by a locking screw (30); the front end of the guide cylinder (13) is fixedly connected with the lower end of the positioning frame (8), and the rear end of the guide cylinder is directed to a wire inlet (18) at the rear end of the fixed arm (16).
2. The tibia positioner for treating the avulsion fracture of the cruciate ligament of the knee joint according to claim 1, wherein the positioning mechanism comprises a transverse positioning pin (20), a baffle plate (21), a transverse positioning spring (23) and a sealing plate (25), a positioning mechanism mounting groove (31) is formed in the positioning block (9), a plurality of transverse positioning holes (27) which are transversely arranged are formed in the transverse sliding block (19), the transverse positioning spring (23) is positioned in the positioning mechanism mounting groove (31), the sealing plate (25) is blocked on a notch of the positioning mechanism mounting groove (31), one end of the transverse positioning pin (20) is provided with a transverse adjusting pulling disc (24), the other end of the transverse positioning pin sequentially slides through a central hole of the sealing plate (25), the transverse positioning spring (23) and a through hole at the bottom of the positioning mechanism mounting groove (31) and then is inserted into one transverse positioning hole (27), the baffle plate (21) is fixed in the middle of the transverse positioning pin (20), and one end of the transverse positioning spring (23) is propped against the sealing plate (25).
3. The tibia positioner for treating the avulsion fracture of the cruciate ligament of the knee joint according to claim 2, wherein the positioning block (9) is slidably sleeved at the middle part of the positioning frame (8) and is connected with the positioning frame (8) through a positioning device, the positioning device comprises a cover plate (14), a longitudinal positioning spring (15), a longitudinal positioning pin (28) and a baffle disc (29), a positioning device mounting groove (32) is formed in the positioning block (9), a plurality of longitudinal positioning holes (22) which are arranged along the sliding direction of the positioning block (9) are formed in the positioning frame (8), the longitudinal positioning spring (15) is positioned in the positioning device mounting groove (32), the cover plate (14) is covered on a notch of the positioning device mounting groove (32), one end of the longitudinal positioning pin (28) is provided with a longitudinal adjusting pull disc (26), the other end sequentially slides through a central hole of the cover plate (14), the longitudinal positioning spring (15) and a through hole at the bottom of the positioning device mounting groove (32) and then is inserted into one longitudinal positioning hole (22), and the baffle disc (29) is fixed at one end of the other end of the longitudinal positioning pin (28) against the cover plate (14).
4. A tibial locator for use in treating a posterior cruciate ligament avulsion fracture of a knee joint according to claim 3, wherein the locating block (9) is in transition fit with the transverse slider (19) and the locating block (9) is in transition fit with the locating frame (8).
5. The tibia positioner for treating the avulsion fracture of the cruciate ligament of the knee joint according to claim 4, wherein the front end of the fixing arm (16) is fixedly connected with the upper end of the positioning frame (8) through an upper positioning seat (17), and the front end of the guide cylinder (13) is fixedly connected with the lower end of the positioning frame (8) through a lower positioning seat (12).
CN202322658678.6U 2023-09-29 2023-09-29 Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture Active CN221205618U (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202322658678.6U CN221205618U (en) 2023-09-29 2023-09-29 Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202322658678.6U CN221205618U (en) 2023-09-29 2023-09-29 Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture

Publications (1)

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CN221205618U true CN221205618U (en) 2024-06-25

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CN202322658678.6U Active CN221205618U (en) 2023-09-29 2023-09-29 Tibia positioner for treating knee joint posterior cruciate ligament avulsion fracture

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