KR101368536B1 - A guide device for the fixing screw of calcaneus fractures capable of minimally invasive surgery - Google Patents

A guide device for the fixing screw of calcaneus fractures capable of minimally invasive surgery Download PDF

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Publication number
KR101368536B1
KR101368536B1 KR1020120117602A KR20120117602A KR101368536B1 KR 101368536 B1 KR101368536 B1 KR 101368536B1 KR 1020120117602 A KR1020120117602 A KR 1020120117602A KR 20120117602 A KR20120117602 A KR 20120117602A KR 101368536 B1 KR101368536 B1 KR 101368536B1
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KR
South Korea
Prior art keywords
fixing
calcaneus
fixing screw
minimally invasive
side
Prior art date
Application number
KR1020120117602A
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Korean (ko)
Inventor
이연수
이준영
이세환
Original Assignee
조선대학교산학협력단
대구가톨릭대학교산학협력단
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Priority to KR1020120117602A priority Critical patent/KR101368536B1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1775Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the foot or ankle
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B2017/90Guides therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4687Mechanical guides for implantation instruments

Abstract

The present invention relates to an apparatus for guiding a fixing screw used for fixing calcaneus fractures fractured during a calcaneus fracture surgery by minimal invasion. The fixing screw guiding apparatus for fixing calcaneus fractures according to the present invention is an apparatus for guiding a fixing screw for fixing calcaneus fractures fractured through longitudinal articular surfaces of calcaneus and anklebone exposed by minimal invasion surgery and space of a part of side of calcaneus, and is characterized by having a specific thickness so as to be provided with the lower horizontal surface contacting the space of a part of side of calcaneus and the upper horizontal surface corresponding to it. Additionally, one side line of the horizontal surface is formed with a straight line so as to be parallel to the longitudinal articular surface, and a guiding groove penetrating the horizontal surface is formed such that the fixing screw can insert into it. According to the present invention, calcaneus fractured can be easily fixed during surgery using the fixing screw, and thereby, facilitating the surgery, and skin incision is made only on the part to which the fixing screw is inserted, and thereby, allowing minimal invasion surgery.

Description

A guide device for the fixing screw of calcaneus fractures capable of minimally invasive surgery}

The present invention relates to a surgical instrument used for calcaneal fracture surgery, and more particularly, to guide the fixing screw for fixing the fractured calcaneus to the target position to easily fix the fractured calcaneus, and only to the portion where the fixing screw is inserted. The present invention relates to a fixed screw guide mechanism for fixing a calcaneal fracture with a skin incision.

Calcaneus are bones that form the heel, and the upper part is connected to the talus through the subtalar joint. The calcaneus, unlike other bones, is shaped like a rugged form, and fractures occur when the person jumps from a high place or stumbles on a staircase.

A calcaneal fixation device for treating a conventional calcaneal fracture is disclosed in Korean Laid-Open Patent Publication No. 2006-0030091. The calcaneal fixing device is composed of a straight member and a curved member, the base is provided with a wire for correcting the damaged portion through the calcaneus, and the linear member is installed with a height adjusting means having a fixing pin fixed to the tibia Corrected calcaneus.

However, the calcaneal fixation device fixes the fractured calcaneus using a wire and a fixation pin outside the body, and there is a concern of infection of bacteria and the like in the affected area where the wire and fixation pin penetrates, and to prevent this, continuous treatment such as the wound. There is discomfort to do. In addition, even after surgery, the patient has to live with the device mounted on the leg, and the surgery is performed to fix the calcaneus by directly cutting the skin of the fracture site and inserting a fixing screw.

The surgical method of inserting the fixation screw into the body can fix the fractured bones firmly, resulting in a fast recovery time, and in the above-described in vitro fixation, there is no burden such as continuous treatment of the affected part. It is difficult to insert and fix the fixing screw in the correct position by using the insertion mechanism, which increases the operation time or sometimes causes the problem of having to reinsert the wrong screw.

In recent years, minimally invasive surgery is performed to minimize the incision during surgery to prevent unnecessary tissue damage and to shorten the treatment and recovery time. It is more difficult to fix the fixing screw through.

1. Republic of Korea Patent Publication No. 2006-0030091 (Invention name: In vitro fixation device of calcaneus)

The present invention has been devised to solve the above problems, the object of the present invention is to guide the fixing screw for fixing the fractured calcaneus to the target position, easy operation is possible, cut the skin only to the part where the fixing screw is inserted The purpose is to provide a fixed screw guide for fixing the calcaneal fracture is made possible minimally invasive surgery.

The present invention is a mechanism for guiding the fixing screw for fixing the fractured calcaneus through the side portion space of the calcaneus exposed by minimally invasive surgery, the lower horizontal plane in contact with a side portion of the calcaneus and the upper horizontal plane facing the And one side surface connecting the upper and lower horizontal surfaces is formed in a straight line so as to be disposed substantially parallel to the longitudinal joint surfaces of the calcaneus and the talus, and a guide hole penetrates the horizontal surface to insert the fixing screw. Provides a fixed screw guide mechanism for fixing the calcaneal fracture to be minimally invasive.

In addition, there is provided a fixing screw guide mechanism for the minimally invasive calcaneal fracture is formed so as to face the one side is formed so that the length of the other side connecting the upper and lower horizontal plane is smaller than the one side.

In addition, the length of the one side provides a fixed screw guide mechanism for fixing the calf bone fracture is minimally invasive, characterized in that 20 ~ 25mm.

In addition, the fixed screw guide for the minimally invasive calcaneal fracture fixing screw guide characterized in that it comprises a fixing screw guide portion extending in the horizontal direction from the one side to form a guide hole and a k-wire guide portion formed extending in the horizontal direction therefrom. Provide an appliance.

In addition, the guide hole provides a fixed screw guide for fixing the calcaneus fracture is minimally invasive, characterized in that formed through the inclined toward the lower horizontal plane from the upper horizontal plane of the fixing screw guide.

In addition, the guide hole provides a fixing screw guide mechanism for fixing the calf bone fracture is minimally invasive, characterized in that the inclined 10 ° to 15 ° based on the horizontal surface on one side.

In addition, the upper and lower surfaces of the fixing screw guide portion provides a fixed screw guide mechanism for fixing the calcaneus fractures is minimally invasive, characterized in that the indentation is formed.

In addition, the k-wire guide is provided with a k-wire hole is provided in the fixed screw guide mechanism for fixing the minimally invasive calcaneal fracture.

In addition, the fixed screw guide provides a minimum screw invasion fixed screw guide mechanism for the minimally invasive, characterized in that the thickness of the k-wire guide portion.

According to the present invention, it is possible to easily fix the fractured calcaneus using a fixing screw during surgery, and the skin is made only to a part into which the fixing screw is inserted, thereby enabling minimally invasive surgery.

In addition, according to the present invention, the insertion position of the fixing screw can be accurately identified and safe and rapid surgery can be performed without damaging many ligaments and nerves distributed around the calcaneus.

1 is a perspective view of the fixing screw guide mechanism for calcaneal fracture fixing according to an embodiment of the present invention.
2 is a cross-sectional view taken along line AA ′ of FIG. 1.
3 shows a three-dimensional computer model of a normal calcaneus obtained from an image information database.
Figure 4 shows the guide mechanism according to the invention seated on the side of the calcaneus.
Figure 5 is a plan view of the calcaneus showing the angle (θ) measured in the horizontal direction at the center of the joint to measure the safe screw insertion (Safe Screw Insertion) is secured.
6 is a left side view of the calcaneus showing the angle φ measured in the vertical direction at the center of the joint to measure a safe screw insertion in which the fixing screw is safely inserted.
7 is a view showing a fixing screw fixing the calcaneus by the guide mechanism according to the present invention.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. Prior to this, terms or words used in the specification and claims should not be construed as having a conventional or dictionary meaning, and the inventors should properly explain the concept of terms in order to best explain their invention in the best way possible. Based on the principle that can be defined, it should be interpreted as meaning and concept corresponding to the technical idea of the present invention. Therefore, the embodiments described in this specification and the configurations shown in the drawings are merely the most preferred embodiments of the present invention and do not represent all the technical ideas of the present invention. Therefore, It is to be understood that equivalents and modifications are possible.

Fixing screw guide mechanism according to the present invention is a device used in the fracture of the calcaneus, support and guide the drill tap or fixing screw to form a hole to be inserted into the screw through the partial space of the calcaneus exposed by minimally invasive surgery It is used for the purpose.

1 is a perspective view of a fixing screw guide mechanism for fixing a calcaneus fracture in accordance with an embodiment of the present invention, Figure 2 is a cross-sectional view taken along the line AA 'of FIG. As shown in the figure, the fixing screw guide mechanism according to the present invention is a plate-shaped body of a predetermined thickness, consisting of a lower horizontal surface 10 in contact with a side portion of the calcaneus and an upper horizontal surface 11 opposite thereto. One side surface 12 connecting the upper and lower horizontal surfaces 10 and 11 is formed in a straight surface so as to be disposed substantially parallel to the longitudinal joint surfaces of the calcaneus and the talus, and extends from the one side surface 12 to guide holes ( 21 is provided with a set screw guide portion 20 and a k-wire guide portion 30 extending in a horizontal direction therefrom.

The lower horizontal surface 10 is a surface which is in contact with the protruding surface of the exposed calcaneus in a minimal incision through minimally invasive surgery, and firmly supports the fixing screw to be seated on a small area of the side of the calcaneal. ) Is formed to be relatively long and is formed such that the length of the other side 13 opposite to the one side 12 is smaller than the one side 12.

Fixing screw guide 20 is disposed substantially parallel to the longitudinal joint surface of the calcaneus and the talus, extending in a horizontal direction from one side surface 12 is formed relatively long. The length of one side 12 is preferably 20 to 25 mm in consideration of the calcaneus or articular surface size. Guide holes 21 penetrating the upper and lower horizontal surfaces 10 and 11 are inserted thereinto. The guide hole 21 is formed to be inclined at a predetermined angle from the upper horizontal plane 11 of the fixing screw guide portion 20 to the lower horizontal plane 10 to guide the fixing screw safely without damaging the ligaments and nerves around the calcaneus. As shown in FIG. 2, the guide hole 21 is formed substantially in the center of the upper horizontal plane 11 of the fixing screw guide 20 and is inclined at a predetermined angle θ toward the lower horizontal plane 10 to the left. It is formed through, it is preferably formed to be inclined 10 ° to 15 ° to the left on the basis of the horizontal surface on one side (12). The safe insertion position of the fixing screw will be described later. Fixing screw guide 20 should be a relatively rigid structure to accurately form a hole in which the fixing screw is inserted in the calcaneus. That is, even when a considerable torque is applied to the surgical drill tap inserted into the guide hole 21 to form the fixing screw hole inside the rigid calcaneus, the drill tap is supported on the inner wall of the guide hole 21 so that the drill tap is subjected to impact. It is possible to form the fixing screw hole exactly at the target position without flowing. Therefore, while the guide mechanism according to the present invention is formed in a small size for minimally invasive, it is preferable that the thickness of the k-wire guide portion 20 is larger because the fixing screw guide portion 20 must be a rigid structure.

Upper and lower surfaces of the fixing screw guide portion 20 are formed with an indentation portion 14 curved inwardly, so that a surgeon can grip the guide mechanism using the indentation portion 14, so that a small area of the side of the exposed calcaneus is exposed. In addition to being able to align in the correct position, a surgical drill can be easily used with the guide mechanism.

The k-wire guide part 30 extends in the horizontal direction from the fixing screw guide part 20, and the k-wire hole 31 is formed through the upper and lower horizontal surfaces 10 and 11. The k-wire hole 31 is for accommodating the k-wire for temporary fixing of the guide mechanism of the present invention before insertion of the fixing screw, and the k-wire is mounted in the surgical drill and the calcaneus through the hole 11. Is installed across. The k-wire holes 11 are preferably formed in plural as shown in the figure.

The fixed screw guide mechanism for fixing the calcaneus fracture according to the present invention configured as described above can easily fix the fractured calcaneus using the fixing screw during the calcaneal fracture surgery, and thus the surgery is easy, The operation can be safely performed without damage to ligaments, etc. The following experiment was performed to measure the safe insertion position of the fixing screw inserted by the guide mechanism according to the present invention.

As shown in FIG. 3, 10 normal calcaneuss were selected from a CT image database and reconstructed into a 3D computer model. In the three-dimensional computer model of the reconstructed calcaneus as shown in FIG. 4, after marking the area where the guide mechanism according to the present invention is to be installed on the calcaneal surface, the fixing screw is safely removed without damaging nerves or ligaments around the calcaneal. The safety screw insertion was identified. For accurate positioning of the safety screw (Safe Screw Insertion), as shown in FIG. 5, the angle (θ) measured in the horizontal direction in the plane crossing the calcaneus in the vertical direction at the center of the joint surface, and shown in FIG. As described above, angles Φ measured in the vertical direction were set at the planes crossing the calcaneus in the horizontal direction at the center of the joint surface. Then, the angles (θ, Φ) at the safe screw insertion were measured from the ten normal three-dimensional computer models obtained in FIG. 3. The results are shown in Table 1 below.

Item θ Φ Sample 1 12 ° 0 ° Sample 2 11 ° 0 ° Sample 3 15 ° 0 ° Sample 4 11 ° 0 ° Sample 5 10 ° 0 ° Sample 6 13 ° 0 ° Sample 7 14 ° 0 ° Sample 8 11 ° 0 ° Sample 9 10 ° 0 ° Sample 10 13 ° 0 ° Safe area 10 ° ~ 15 ° 0 °

As shown in the table above, the ideal insertion screw insertion position for the calcaneal fracture was found to be 10 ° to 15 ° in the horizontal direction and 0 ° in the vertical direction at the center of the joint surface between the calcaneus and the talus. As shown in the above experimental results, the guide mechanism 21 according to the present invention was formed by tilting the guide hole 21 to the left by 13 ° based on the horizontal plane (X). Ten ankle specimens were taken from five dead bodies, and a calcaneal fracture was performed using a guide. As a result, in the X-ray evaluation of ten ankle specimens tested in the carcass, it was found that the screws were all performed in a safe position as shown in FIG. 7.

10: lower horizontal plane 11: upper horizontal plane 12: one side
13: other side 14: inlet 20: fixing screw guide
21: guide hole 30: k-wire guide portion 31: k-wire hole
40: fixed screw 50: longitudinal 51: talus
52: longitudinal joint surface 53: transverse joint surface

Claims (9)

  1. As a device for guiding the fixing screw to fix the fractured calcaneus through the side space of the calcaneus exposed by minimally invasive surgery,
    It has a predetermined thickness and has a lower horizontal plane in contact with a side portion of the calcaneus and an upper horizontal plane opposite thereto, and one side surface connecting the upper and lower horizontal planes is straight so as to be disposed substantially parallel to the longitudinal joint surfaces of the calcaneus and the talus. It is made of a surface, fixing screw guide mechanism for the minimally invasive calcaneus fracture fixing, characterized in that the guide hole penetrates the horizontal plane so that the fixing screw is inserted.
  2. The method of claim 1,
    The fixed screw guide mechanism for the minimally invasive calcaneal fracture, characterized in that the length of the other side is formed to face the one side and connects the upper and lower horizontal plane is smaller than the one side.
  3. 3. The method of claim 2,
    The length of the one side of the fixed screw guide mechanism for fixing the calf bone fracture is minimally invasive, characterized in that 20 ~ 25㎜.
  4. The method of claim 1,
    Fixing screw guide mechanism for fixing the minimally invasive calcaneal fracture, characterized in that it has a fixed screw guide portion extending in the horizontal direction from the one side to form a guide hole and a k-wire guide portion formed extending in the horizontal direction therefrom. .
  5. 5. The method of claim 4,
    The guide hole is a fixed screw guide mechanism for fixing the bone fractures possible minimally invasive, characterized in that formed through the inclined toward the lower horizontal plane from the upper horizontal plane of the fixing screw guide.
  6. The method of claim 5,
    The guide hole is a fixed screw guide mechanism for fixing the calf bone fracture is minimally invasive, characterized in that the inclined 10 ° to 15 ° relative to the horizontal surface formed on one side.
  7. The method of claim 5,
    The upper and lower surfaces of the fixing screw guide portion, the inlet portion curved inwardly is formed, the fixed screw guide mechanism for fixing the calcaneus fractures can be minimally invasive.
  8. The method of claim 7, wherein
    Fixing screw guide for fixing the calf bone fracture is minimally invasive, characterized in that the k-wire hole is formed through the horizontal plane of the k-wire guide.
  9. The method of claim 7, wherein
    The fixed screw guide mechanism for fixing the subcutaneous fracture is minimally invasive, characterized in that the thickness of the fixed screw guide is larger than the thickness of the k-wire guide.
KR1020120117602A 2012-10-23 2012-10-23 A guide device for the fixing screw of calcaneus fractures capable of minimally invasive surgery KR101368536B1 (en)

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KR1020120117602A KR101368536B1 (en) 2012-10-23 2012-10-23 A guide device for the fixing screw of calcaneus fractures capable of minimally invasive surgery

Applications Claiming Priority (1)

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KR1020120117602A KR101368536B1 (en) 2012-10-23 2012-10-23 A guide device for the fixing screw of calcaneus fractures capable of minimally invasive surgery

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108309429A (en) * 2018-02-06 2018-07-24 中国人民解放军陆军军医大学第附属医院 Individualized subtalar joint fusion guiding plate and manufacturing method thereof

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006280950A (en) 2005-03-31 2006-10-19 Depuy Products Inc Plate for lengthening the lateral column of the foot
KR20060116434A (en) * 2005-05-10 2006-11-15 이명철 Rigid stepped plate
US20080015587A1 (en) 2006-05-24 2008-01-17 Munoz Felipe L Locking nail system for arthrodesis reconstruction in calcaneus fractures

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006280950A (en) 2005-03-31 2006-10-19 Depuy Products Inc Plate for lengthening the lateral column of the foot
EP1707138B1 (en) * 2005-03-31 2009-05-06 DePuy Products, Inc. Plate for lengthening the lateral column of the foot
KR20060116434A (en) * 2005-05-10 2006-11-15 이명철 Rigid stepped plate
US20080015587A1 (en) 2006-05-24 2008-01-17 Munoz Felipe L Locking nail system for arthrodesis reconstruction in calcaneus fractures

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108309429A (en) * 2018-02-06 2018-07-24 中国人民解放军陆军军医大学第附属医院 Individualized subtalar joint fusion guiding plate and manufacturing method thereof
CN108309429B (en) * 2018-02-06 2019-09-10 中国人民解放军陆军军医大学第一附属医院 A kind of individuation fusion of subtalar joint guide plate and its manufacturing method

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