WO2021054554A1 - Method for setting correct insertion direction of tibiofibular ligament syndesmotic screw - Google Patents

Method for setting correct insertion direction of tibiofibular ligament syndesmotic screw Download PDF

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Publication number
WO2021054554A1
WO2021054554A1 PCT/KR2020/003419 KR2020003419W WO2021054554A1 WO 2021054554 A1 WO2021054554 A1 WO 2021054554A1 KR 2020003419 W KR2020003419 W KR 2020003419W WO 2021054554 A1 WO2021054554 A1 WO 2021054554A1
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WIPO (PCT)
Prior art keywords
fibula
tibia
ligament
radiation
nasolabial
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PCT/KR2020/003419
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French (fr)
Korean (ko)
Inventor
이동오
김주학
송상헌
류한별
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의료법인 명지의료재단
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Publication of WO2021054554A1 publication Critical patent/WO2021054554A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1714—Guides or aligning means for drills, mills, pins or wires for applying tendons or ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1775—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the foot or ankle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90—Guides therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy

Definitions

  • the present invention relates to a method for setting the correct insertion direction of the nasolabial ligament coupling screw, and in particular, the correct insertion of the nasolabial ligament coupling screw that helps to form the perforation hole for the insertion of the nasolabial ligament coupling screw in the correct direction in the fibula and tibia It is about how to set the direction.
  • the leg bones from the bottom of the knee to the ankle of the human body are composed of the tibia and fibula.
  • the tibia is the thick bone on the inside, and the fibula refers to the elongated bone that is arranged parallel to the outside of the tibia.
  • the tibia and fibula may be fractured due to an accidental impact, and in this case, the cut portion must be adhered to the correct position and fixed so as not to move until both bones are joined.
  • a method of attaching a plate to the fibula surface and fastening the nasolabial ligament coupling screw to the fibula and tibia has been widely used.
  • the present invention was conceived to solve the problems of the prior art, and the nasolabial ligament coupling screw is correctly fastened in the correct direction to the proper position of the fibula and tibia. Its purpose is to provide a method of setting the insertion direction.
  • the method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention for solving the above problem includes the steps of irradiating radiation toward the nasal ligament of the patient with a radiation generating unit of a real-time radiographic apparatus; Generating a projection image of the patient's nasal ligament by detecting the irradiated radiation with a camera of a real-time radiographic apparatus; Outputting the generated image through a monitor of a real-time radiographic apparatus; Including, wherein the radiation generating unit is irradiated with radiation while moving around the patient's nasopharyngeal ligament, and the relative position of the tibia and fibula in the image output to the monitor.
  • the movement is stopped, and after the movement of the radiation generating unit is stopped, the end of the support arm of the guider for cruciate ligament reconstruction is embedded and supported on the tibial surface, and the guider for cruciate ligament reconstruction
  • the guide pipe of the fibula is supported in contact with the surface of the fibula, and after the through pin connected to the drill is inserted into the guide pipe, the fibula and the tibia are continuously penetrated to form a passage through which the nasolabial ligament coupling screw passes.
  • a ratio of the distance between the left end of the fibula and the left end of the tibia and the distance between the right end of the fibula and the right end of the tibia is 1:1.
  • the data set in the control unit further includes that the fibula is located in front of the tibia.
  • the monitor screen blinks or a buzzer sound is generated.
  • the step of penetrating the nasal ligament coupling screw installation hole is performed while radiation is irradiated from the radiation generating unit.
  • the method for setting the correct insertion direction of the nasal ligament coupling screw of the present invention configured as described above is to guide the correct point of the fibula and tibia through which the nasolabial ligament coupling screw will pass, so that the fibula and tibia are properly secured by the nasolabial ligament coupling screw.
  • the operator can check the process of forming the perforated hole for fastening the nasolabial joint screw through the monitor. There is an advantage of being able to determine the insertion direction.
  • FIG. 1 is a view showing a real-time radiographic apparatus used in the method for setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention.
  • Figure 2 is a view showing the correct insertion direction of the nasal ligament coupling screw.
  • FIG. 3 and 4 are diagrams showing a guider for cruciate ligament reconstruction used in the method for setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention.
  • FIG. 5 is a view showing a state in which the nasal ligament coupling screw is fastened to the fibula and tibia by the method of setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention.
  • FIG. 6 is a view showing a monitor screen of a real-time radiographic apparatus according to the present invention in which the fibula and tibia are arranged.
  • FIG. 7 is a view showing a monitor screen of a real-time radiographic apparatus according to the present invention in which the fibula and tibia are arranged.
  • the method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention for solving the above object includes the steps of irradiating radiation toward the nasal ligament of the patient with a radiation generating unit of a real-time radiographic apparatus; Generating a projection image of the patient's nasal ligament by detecting the irradiated radiation with a camera of a real-time radiographic apparatus; Outputting the generated image through a monitor of a real-time radiographic apparatus; Including, wherein the radiation generating unit is irradiated with radiation while moving around the patient's nasopharyngeal ligament, and the relative position of the tibia and fibula in the image output to the monitor.
  • the movement is stopped, and after the movement of the radiation generating unit is stopped, the end of the support arm of the guider for cruciate ligament reconstruction is embedded and supported on the tibial surface, and the guider for cruciate ligament reconstruction
  • the guide tube of is in contact with the fibula surface, and a through pin connected to the drill is inserted into the guide tube and then continuously penetrates the fibula and tibia to form a passage through which the nasolabial ligament coupling screw passes.
  • FIG. 1 is a diagram showing a real-time radiographic apparatus used in the method for setting the correct insertion direction of the nasolabial joint screw according to the present invention
  • FIG. 2 is a diagram showing the correct insertion direction of the nasolabial ligament coupling screw.
  • Figure 3 and Figure 4 is a diagram showing a guider for cruciate ligament reconstruction used in the method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention
  • Figure 5 is the correct insertion direction of the nasolabial ligament coupling screw according to the present invention This is a diagram showing how the nasolabial ligament coupling screw is fastened to the fibula and tibia by setting method.
  • the method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention is when the tibia (T) and fibula (F) are connected with the nasolabial ligament coupling screw (S), the nasolabial ligament coupling screw (S) is the fibula (F) and the tibia. It is to provide an optimal passage through which the naso ligament coupling screw (S) passes before the fastening of the nasolabial ligament coupling screw (S) so that it can be connected continuously through the center of (T).
  • the radiation generating unit 12 of the real-time radiographic apparatus 10 starts with a step of irradiating radiation toward the nasal ligament of the patient.
  • the real-time radiographic imaging device 10 is an equipment commonly referred to as a C-arm, and includes a frame 11, a radiation generator 12 installed at one end of the frame 11, and the other end of the frame 11 A camera 13 installed in, a control unit 14 connected to the frame 11 to move or rotate the frame 11, a control unit 15 electrically connected to the control unit 14, It is configured to include a monitor 16 connected to the control unit 15.
  • the real-time radiographic apparatus 10 is called a C-arm.
  • This frame 11 rotates or moves around the treatment area of the patient lying on the bed, that is, the nasolabial ligament.
  • the radiation generating unit 12 irradiates radiation toward the patient's nasal ligament.
  • the camera 13 is installed at the other end of the frame 11 and faces the radiation generating unit 12.
  • the control unit 14 corrects or adjusts the positions of the radiation generating unit 12 and the camera 13 by moving or rotating the radiation generating unit 12 and the frame 11 on which the camera 13 is installed in various directions. do.
  • the control unit 15 is a PC and controls the real-time radiographic apparatus 10 as a whole. In this control unit 15, data that helps to set the optimal path through which the nasolabial joint screw (S) must pass for fastening the fibula (F) and tibia (T) is set.
  • the irradiated radiation is detected with the camera 13 to generate a projection image of the patient's nasopharyngeal ligament. The steps follow.
  • the step of outputting the generated image through the monitor 16 is performed.
  • the radiation generator 12 moves or rotates around the patient's nasal ligament while irradiating radiation, and the relative position of the tibia T and the fibula F in the image output to the monitor 16 is determined by the control unit 15 If it is the same as the data set in, the movement and rotation of the radiation generating unit 12 are stopped, and a stop is made at that position.
  • control unit 15 inputs data on whether the tibia (T) and fibula (F) are arranged in the most appropriate situation to fasten the nasolabial ligament coupling screw (S).
  • the tibia (T) and fibula (F) that are output to the monitor 16 are the same, the movement of the radiation generating unit 12 is stopped.
  • the current arrangement of the fibula (F) and tibia (T) is It is in the proper arrangement state to form the perforated hole through which the ligament coupling screw (S) passes in the fibula (F) and tibia (T).
  • the data input to the control unit 15 includes the distance (L1) between the left end of the fibula (F) and the left end of the tibia (T) and the distance between the right end of the fibula (F) and the right end of the tibia (T) (
  • the fibula (F) and tibia (T) are arranged so that the ratio of L2) is 1:1.
  • the arrangement state in which the fibula (F) is located in front of the tibia (T) may be included in the data.
  • the frame 11 or the bed on which the patient lies may be rotated.
  • the bed on which the patient lies or the radiation generator 12 and the camera 13 are moved through the guide rail in the horizontal direction so that the center line of the monitor screen is aligned with the intended position (the insertion position of the penetration pin 22a, 61). You can move.
  • Fibula so that the ratio of the distance (L1) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L2) between the right end of the fibula (F) and the right end of the tibia (T) is 1:1.
  • the insertion position of the penetrating pin (22a) on the fibula (F) may be displayed on the monitor screen in the form of a target (61).
  • the position where the gong 23a of the guider 20 is stuck on the rear of the tibia T is displayed as a target 62 on the monitor screen.
  • the display of the penetration pin 22a insertion position target 61 and the punching position target 62 of the gong 23a may be selected by setting and manipulation of the user.
  • the target 62 and the gong 23a displayed on the screen are located at the rear of the tibia T, they are indicated by dotted lines in the drawing.
  • the monitor 16 screen flashes or the control unit 15 generates a buzzer sound. By doing so, it is possible to inform the outside that the current state is a proper arrangement state for forming the perforated holes in the fibula (F) and tibia (T).
  • the combination of the fibula (F) and tibia (T) is made stronger. It is possible to additionally fasten the joint screw (S) of the guard ligament so that it can be secured.
  • FIG. 7 is a view showing a monitor screen of a real-time radiographic apparatus according to the present invention in which an arrangement state of the fibula (F) and tibia (T) for additional fastening of the nasolabial ligament coupling screw (S) is displayed.
  • the monitor screen of FIG. 7 shows the ratio of the distance (L3) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L4) between the right end of the fibula (F) and the right end of the tibia (T). It indicates the state in which the fibula (F) and tibia (T) are arranged to be 1: 1.
  • the frame 11 or the bed on which the patient lies may be rotated.
  • the bed on which the patient lies or the radiation generator 12 and the camera 13 are moved through the guide rail in the horizontal direction so that the center line of the monitor screen is aligned with the intended position (the insertion position of the penetration pin 22a, 71). You can move.
  • Fibula so that the ratio of the distance (L3) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L4) between the right end of the fibula (F) and the right end of the tibia (T) is 1:1.
  • the insertion position of the through pin 22a on the fibula (F) may be displayed on the monitor screen in the form of the target 71.
  • the position where the gong 23a of the guider 20 is stuck on the rear of the tibia T is displayed as a target 72 on the monitor screen.
  • the display of the penetration pin 22a insertion position target 71 and the punching position target 72 of the gong 23a may be selected by a user's setting and manipulation.
  • the target 72 and the gong 23a displayed on the screen are located at the rear of the tibia T, they are indicated by a dotted line in the figure.
  • the monitor 16 screen flashes or the control unit 15 generates a buzzer sound. By doing so, it is possible to inform to the outside that the current state is an appropriate arrangement state for additionally forming perforated holes in the fibula (F) and tibia (T).
  • the step of penetrating the nasolabial ligament coupling screw installation hole is performed through the guider 20 for cruciate ligament reconstruction.
  • the guider 20 for cruciate ligament reconstruction is a device used for early stabilization when the anterior cruciate ligament is ruptured, and has a gripping part 21 that is gripped so as not to flow when a perforated hole is formed, and one end of the gripping part 21
  • a hollow guide tube 22 into which a through pin 22a connected to a drill (not shown) is inserted and fixed after being inserted to be movable back and forth, and a pointed gong at the other end of the gripping part 21 It is configured to include a support arm 23 provided with 23a).
  • the step of penetrating the nasolabial ligament coupling screw installation hole through the guider 20 for cruciate ligament reconstruction configured as above is such that the end of the support arm 23 of the guider 20 for cruciate ligament reconstruction is embedded and supported on the surface of the tibia (T), The end of the guide tube 22 is contacted and supported on the surface of the fibula (F), and after the through pin (22a) is inserted into the guide tube (22), it continuously penetrates the fibula (F) and the tibia (T). It is a process of forming a passage through which the coupling screw (S) passes.
  • the step of penetrating the nasal ligament coupling screw installation hole is performed while the radiation is irradiated from the radiation generating unit 12 of the real-time radiographic apparatus 10. That is, the step of penetrating the nasal ligament coupling screw installation hole is performed while irradiation of the radiation generation unit 12 and the image generation and display of the generated image by the camera 13 are performed.
  • the present invention relates to a method for setting the correct insertion direction of the nasal ligament coupling screw, and when the tibia and fibula are fractured due to an accidental impact, when the nasolabial ligament coupling screw is used to fix it so that it does not move until the fractured bone is joined Since the present invention is applied, it can be used in medicine, health care, and related medical equipment industries.

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Abstract

The present invention relates to a method for setting a correct insertion direction of a tibiofibular ligament syndesmotic screw. In particular, the method comprises the steps of: radiating radiation toward the tibiofibular ligament of a patient with a radiation generating part of a real-time radiographic apparatus; generating a projection image of the tibiofibular ligament of the patient by detecting the radiated radiation with a camera of the real-time radiographic apparatus; and outputting the generated image through a monitor of the real-time radiographic apparatus, wherein the radiation generating part is configured to radiate radiation while moving around the tibiofibular ligament of the patient and to stop moving when the relative positions of the tibia and fibula in the image outputted through the monitor are the same as data set in a control part of the real-time radiographic apparatus. As such, the present invention allows the tibia and fibula to be correctly fastened by a tibiofibular ligament syndesmotic screw, thereby having an effect of helping a patient to quickly recover.

Description

경비인대 결합나사의 올바른 삽입방향 설정방법How to set the correct insertion direction of the security ligament coupling screw
본 발명은 경비인대 결합나사의 올바른 삽입방향 설정방법에 관한 것으로서, 특히 경비인대 결합나사의 삽입을 위한 천공홀이 비골과 경골에 올바른 방향으로 형성될 수 있도록 도움을 주는 경비인대 결합나사의 올바른 삽입방향 설정방법에 관한 것이다.The present invention relates to a method for setting the correct insertion direction of the nasolabial ligament coupling screw, and in particular, the correct insertion of the nasolabial ligament coupling screw that helps to form the perforation hole for the insertion of the nasolabial ligament coupling screw in the correct direction in the fibula and tibia It is about how to set the direction.
인체의 무릎 밑에서부터 발목까지의 다리뼈는 경골과 비골로 구성되어 있다. 경골은 내측에 있는 굵은 뼈이고, 비골은 경골의 외측에 평행하게 배치되어 있는 가늘고 긴 뼈를 말한다.The leg bones from the bottom of the knee to the ankle of the human body are composed of the tibia and fibula. The tibia is the thick bone on the inside, and the fibula refers to the elongated bone that is arranged parallel to the outside of the tibia.
이러한 경골과 비골은 사고로 인한 충격으로 인해 골절이 발생할 수 있는데, 이때는 절단 부위를 정위치에 접착시켜 양쪽의 뼈가 접합될 때까지 움직이지 않게 고정시켜야 한다. 이를 위하여 플레이트를 비골 표면에 부착하고 경비인대 결합나사를 비골과 경골에 체결하여 고정하는 방법이 널리 사용되어 왔다.The tibia and fibula may be fractured due to an accidental impact, and in this case, the cut portion must be adhered to the correct position and fixed so as not to move until both bones are joined. To this end, a method of attaching a plate to the fibula surface and fastening the nasolabial ligament coupling screw to the fibula and tibia has been widely used.
그러나, 이러한 종래의 방법은 경비인대 결합나사를 비골과 경골의 중심 부분을 관통하여 체결시키지 못하고 비골과 경골에 비스듬히 체결될 수 있는 문제점을 갖고 있다.However, such a conventional method has a problem that the nasolabial ligament coupling screw cannot be fastened through the central portion of the fibula and tibia and may be obliquely fastened to the fibula and tibia.
본 발명은 상기한 종래기술의 문제점을 해결하기 위하여 안출된 것으로서, 경비인대 결합나사가 비골과 경골의 제 위치에 올바른 방향으로 정확하게 체결되도록 하여 환자의 신속한 회복을 도울 수 있는 경비인대 결합나사의 올바른 삽입방향 설정방법을 제공하는데 그 목적이 있다.The present invention was conceived to solve the problems of the prior art, and the nasolabial ligament coupling screw is correctly fastened in the correct direction to the proper position of the fibula and tibia. Its purpose is to provide a method of setting the insertion direction.
상기한 과제를 해결하기 위한 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법은 실시간 방사선 촬영장치의 방사선 발생부로 환자의 경비인대를 향해 방사선을 조사하는 단계와; 조사된 방사선을 실시간 방사선 촬영장치의 카메라로 검출하여 환자의 경비인대에 대한 투영 영상을 생성하는 단계와; 생성된 영상을 실시간 방사선 촬영장치의 모니터를 통해 출력하는 단계;를 포함하되, 상기 방사선 발생부는 환자의 경비인대 주위를 따라 이동하면서 방사선을 조사하다가 상기 모니터에 출력되는 영상에서 경골과 비골의 상대적 위치가 실시간 방사선 촬영장치의 제어부에 설정된 데이터와 동일한 경우 이동이 멈추며, 상기 방사선 발생부의 이동이 멈춘 다음 십자인대 재건술용 가이더의 지지암 끝단이 경골 표면에 박혀 지지되도록 함과 아울러 상기 십자인대 재건술용 가이더의 가이드관이 비골 표면에 접촉 지지되도록 하고, 드릴에 연결된 관통핀이 상기 가이드관에 삽입된 후 상기 비골과 경골을 연속적으로 관통하여 경비인대 결합나사가 지나가는 통로를 형성한다.The method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention for solving the above problem includes the steps of irradiating radiation toward the nasal ligament of the patient with a radiation generating unit of a real-time radiographic apparatus; Generating a projection image of the patient's nasal ligament by detecting the irradiated radiation with a camera of a real-time radiographic apparatus; Outputting the generated image through a monitor of a real-time radiographic apparatus; Including, wherein the radiation generating unit is irradiated with radiation while moving around the patient's nasopharyngeal ligament, and the relative position of the tibia and fibula in the image output to the monitor. When is the same as the data set in the control unit of the real-time radiographic apparatus, the movement is stopped, and after the movement of the radiation generating unit is stopped, the end of the support arm of the guider for cruciate ligament reconstruction is embedded and supported on the tibial surface, and the guider for cruciate ligament reconstruction The guide pipe of the fibula is supported in contact with the surface of the fibula, and after the through pin connected to the drill is inserted into the guide pipe, the fibula and the tibia are continuously penetrated to form a passage through which the nasolabial ligament coupling screw passes.
여기서, 상기 제어부에 설정된 데이터는 상기 비골의 좌측단과 경골의 좌측단 사이의 거리와 상기 비골의 우측단과 경골의 우측단 사이의 거리의 비가 1 : 1 이다.Here, in the data set in the control unit, a ratio of the distance between the left end of the fibula and the left end of the tibia and the distance between the right end of the fibula and the right end of the tibia is 1:1.
그리고, 상기 제어부에 설정된 데이터는 상기 비골이 경골의 전방에 위치되는 것을 더 포함한다.In addition, the data set in the control unit further includes that the fibula is located in front of the tibia.
또한, 경골과 비골의 상대적 위치가 상기 제어부에 설정된 데이터와 동일하여 방사선 발생부의 이동이 멈춘 경우 상기 모니터 화면이 점멸하거나 부저음이 발생된다.In addition, when the relative position of the tibia and fibula is the same as the data set in the control unit and the movement of the radiation generating unit is stopped, the monitor screen blinks or a buzzer sound is generated.
또한, 상기 경비인대 결합나사 설치홀 관통단계는 상기 방사선 발생부에서 방사선이 조사되는 중에 이행된다.In addition, the step of penetrating the nasal ligament coupling screw installation hole is performed while radiation is irradiated from the radiation generating unit.
상기와 같이 구성되는 본 발명의 경비인대 결합나사의 올바른 삽입방향 설정방법은 경비인대 결합나사가 통과할 비골과 경골의 올바른 지점을 안내할 수 있도록 함으로써, 비골과 경골이 경비인대 결합나사에 의해 제대로 체결되도록 하여 환자의 신속한 회복을 도울 수 있는 이점이 있다.The method for setting the correct insertion direction of the nasal ligament coupling screw of the present invention configured as described above is to guide the correct point of the fibula and tibia through which the nasolabial ligament coupling screw will pass, so that the fibula and tibia are properly secured by the nasolabial ligament coupling screw. There is an advantage of being able to help the patient recover quickly by making it fastened.
또한, 모니터에 출력되는 경골과 비골의 상대적 위치가 실시간 방사선 촬영장치의 제어부에 설정된 데이터와 동일할 경우 방사선 발생부의 움직임을 멈춤으로써, 현 상태의 비골과 경골의 배치가 경비인대 결합나사의 삽입을 위한 천공홀 형성에 최적의 배치상태임을 술자(Operator)에게 인지시킬 수 있는 이점이 있다.In addition, when the relative position of the tibia and fibula output on the monitor is the same as the data set in the control unit of the real-time radiographic apparatus, the movement of the radiation generating unit is stopped, so that the current arrangement of the fibula and the tibia prevents the insertion of the nasal ligament coupling screw. There is an advantage of being able to recognize to an operator that it is an optimal arrangement for forming a perforated hole.
또한, 경비인대 결합나사의 설치홀을 관통하는 과정이 방사선이 조사되는 중에 이행되기 때문에, 술자가 경비인대 결합나사의 체결을 위한 천공홀 형성 과정을 모니터를 통해 확인할 수 있어서 정확한 경비인대 결합나사의 삽입방향을 판단할 수 있는 이점이 있다.In addition, since the process of penetrating the installation hole of the nasolabial joint screw is carried out while radiation is being irradiated, the operator can check the process of forming the perforated hole for fastening the nasolabial joint screw through the monitor. There is an advantage of being able to determine the insertion direction.
도 1은 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법에 사용되는 실시간 방사선 촬영장치를 보인 도.1 is a view showing a real-time radiographic apparatus used in the method for setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention.
도 2는 경비인대 결합나사의 올바른 삽입방향을 보인 도.Figure 2 is a view showing the correct insertion direction of the nasal ligament coupling screw.
도 3 및 도 4는 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법에 사용되는 십자인대 재건술용 가이더를 보인 도.3 and 4 are diagrams showing a guider for cruciate ligament reconstruction used in the method for setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention.
도 5는 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법에 의해 경비인대 결합나사가 비골과 경골에 체결된 모습을 보인 도.5 is a view showing a state in which the nasal ligament coupling screw is fastened to the fibula and tibia by the method of setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention.
도 6은 비골과 경골의 배치 상태가 표시된 본 발명에 의한 실시간 방사선 촬영장치의 모니터 화면을 보인 도이다.6 is a view showing a monitor screen of a real-time radiographic apparatus according to the present invention in which the fibula and tibia are arranged.
도 7은 비골과 경골의 배치 상태가 표시된 본 발명에 의한 실시간 방사선 촬영장치의 모니터 화면을 보인 도이다.7 is a view showing a monitor screen of a real-time radiographic apparatus according to the present invention in which the fibula and tibia are arranged.
상기한 목적을 해결하기 위한 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법은 실시간 방사선 촬영장치의 방사선 발생부로 환자의 경비인대를 향해 방사선을 조사하는 단계와; 조사된 방사선을 실시간 방사선 촬영장치의 카메라로 검출하여 환자의 경비인대에 대한 투영 영상을 생성하는 단계와; 생성된 영상을 실시간 방사선 촬영장치의 모니터를 통해 출력하는 단계;를 포함하되, 상기 방사선 발생부는 환자의 경비인대 주위를 따라 이동하면서 방사선을 조사하다가 상기 모니터에 출력되는 영상에서 경골과 비골의 상대적 위치가 실시간 방사선 촬영장치의 제어부에 설정된 데이터와 동일한 경우 이동이 멈추며, 상기 방사선 발생부의 이동이 멈춘 다음 십자인대 재건술용 가이더의 지지암 끝단이 경골 표면에 박혀 지지되도록 함과 아울러 상기 십자인대 재건술용 가이더의 가이드관이 비골 표면에 접촉 지지되도록 하고, 드릴에 연결된 관통핀이 상기 가이드관에 삽입된 후 상기 비골과 경골을 연속적으로 관통하여 경비인대 결합나사가 지나가는 통로를 형성한다.The method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention for solving the above object includes the steps of irradiating radiation toward the nasal ligament of the patient with a radiation generating unit of a real-time radiographic apparatus; Generating a projection image of the patient's nasal ligament by detecting the irradiated radiation with a camera of a real-time radiographic apparatus; Outputting the generated image through a monitor of a real-time radiographic apparatus; Including, wherein the radiation generating unit is irradiated with radiation while moving around the patient's nasopharyngeal ligament, and the relative position of the tibia and fibula in the image output to the monitor. When is the same as the data set in the control unit of the real-time radiographic apparatus, the movement is stopped, and after the movement of the radiation generating unit is stopped, the end of the support arm of the guider for cruciate ligament reconstruction is embedded and supported on the tibial surface, and the guider for cruciate ligament reconstruction The guide tube of is in contact with the fibula surface, and a through pin connected to the drill is inserted into the guide tube and then continuously penetrates the fibula and tibia to form a passage through which the nasolabial ligament coupling screw passes.
이하, 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법의 실시 예를 첨부된 도면을 참조하여 상세히 설명한다.Hereinafter, with reference to the accompanying drawings an embodiment of a method for setting the correct insertion direction of the nasolabial ligament coupling screw according to the present invention will be described in detail.
도 1은 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법에 사용되는 실시간 방사선 촬영장치를 보인 도이고, 도 2는 경비인대 결합나사의 올바른 삽입방향을 보인 도이다.1 is a diagram showing a real-time radiographic apparatus used in the method for setting the correct insertion direction of the nasolabial joint screw according to the present invention, and FIG. 2 is a diagram showing the correct insertion direction of the nasolabial ligament coupling screw.
그리고, 도 3 및 도 4는 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법에 사용되는 십자인대 재건술용 가이더를 보인 도이며, 도 5는 본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법에 의해 경비인대 결합나사가 비골과 경골에 체결된 모습을 보인 도이다.And, Figure 3 and Figure 4 is a diagram showing a guider for cruciate ligament reconstruction used in the method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention, Figure 5 is the correct insertion direction of the nasolabial ligament coupling screw according to the present invention This is a diagram showing how the nasolabial ligament coupling screw is fastened to the fibula and tibia by setting method.
본 발명에 의한 경비인대 결합나사의 올바른 삽입방향 설정방법은 경골(T)과 비골(F)을 경비인대 결합나사(S)로 체결할 때 경비인대 결합나사(S)가 비골(F)과 경골(T)의 중심부를 연속적으로 관통하여 체결될 수 있도록, 경비인대 결합나사(S)의 체결 전에 경비인대 결합나사(S)가 지나가는 최적의 통로를 제공하기 위한 것이다.The method for setting the correct insertion direction of the nasal ligament coupling screw according to the present invention is when the tibia (T) and fibula (F) are connected with the nasolabial ligament coupling screw (S), the nasolabial ligament coupling screw (S) is the fibula (F) and the tibia. It is to provide an optimal passage through which the naso ligament coupling screw (S) passes before the fastening of the nasolabial ligament coupling screw (S) so that it can be connected continuously through the center of (T).
이러한 본 발명은 몇 단계의 과정을 거쳐 완성되는데, 먼저 실시간 방사선 촬영장치(10)의 방사선 발생부(12)로 환자의 경비인대 부위를 향해 방사선을 조사하는 단계로 시작한다.The present invention is completed through several steps. First, the radiation generating unit 12 of the real-time radiographic apparatus 10 starts with a step of irradiating radiation toward the nasal ligament of the patient.
여기에서, 발명의 이해를 위해 실시간 방사선 촬영장치(10)에 대해 먼저 간단히 설명하도록 한다.Here, for the sake of understanding the invention, the real-time radiographic apparatus 10 will be first briefly described.
상기 실시간 방사선 촬영장치(10)는 보통 C-arm이라고 불리는 장비로서, 프레임(11)과, 상기 프레임(11)의 일측 끝단에 설치된 방사선 발생부(12)와, 상기 프레임(11)의 타측 끝단에 설치된 카메라(13)와, 상기 프레임(11)에 연결되어 프레임(11)을 이동시키거나 회동시키는 컨트롤 유닛(14)과, 상기 컨트롤 유닛(14)과 전기적으로 연결되는 제어부(15)와, 상기 제어부(15)와 연결된 모니터(16)를 포함하여 구성된다.The real-time radiographic imaging device 10 is an equipment commonly referred to as a C-arm, and includes a frame 11, a radiation generator 12 installed at one end of the frame 11, and the other end of the frame 11 A camera 13 installed in, a control unit 14 connected to the frame 11 to move or rotate the frame 11, a control unit 15 electrically connected to the control unit 14, It is configured to include a monitor 16 connected to the control unit 15.
상기 프레임(11)은 알파벳 C자와 같은 형태로 형성되기 때문에 실시간 방사선 촬영장치(10)를 C-arm 이라고 부른다. 이러한 프레임(11)은 베드에 누운 환자의 치료부위, 즉 경비인대의 주위를 회전하거나 이동한다.Since the frame 11 is formed in the same shape as the letter C, the real-time radiographic apparatus 10 is called a C-arm. This frame 11 rotates or moves around the treatment area of the patient lying on the bed, that is, the nasolabial ligament.
상기 방사선 발생부(12)는 환자의 경비인대를 향해 방사선을 조사한다.The radiation generating unit 12 irradiates radiation toward the patient's nasal ligament.
상기 카메라(13)는 프레임(11)의 타측 끝단에 설치되어 방사선 발생부(12)와 서로 마주본다.The camera 13 is installed at the other end of the frame 11 and faces the radiation generating unit 12.
상기 컨트롤 유닛(14)은 방사선 발생부(12)와 카메라(13)가 설치된 프레임(11)을 여러 방향으로 이동시키거나 회전시킴으로써 방사선 발생부(12)와 카메라(13)의 위치를 보정하거나 조정한다.The control unit 14 corrects or adjusts the positions of the radiation generating unit 12 and the camera 13 by moving or rotating the radiation generating unit 12 and the frame 11 on which the camera 13 is installed in various directions. do.
상기 제어부(15)는 PC로서, 실시간 방사선 촬영장치(10)를 전체적으로 제어한다. 이러한 제어부(15)에는 비골(F)과 경골(T)의 체결을 위해 경비인대 결합나사(S)가 지나가야 하는 최적의 통로를 설정하기 위해 도움을 주는 데이터가 설정되어 있다.The control unit 15 is a PC and controls the real-time radiographic apparatus 10 as a whole. In this control unit 15, data that helps to set the optimal path through which the nasolabial joint screw (S) must pass for fastening the fibula (F) and tibia (T) is set.
위와 같이 구성되는 실시간 방사선 촬영장치(10)의 방사선 발생부(12)로 경비인대를 향해 방사선을 조사한 이후에는, 조사된 방사선을 카메라(13)로 검출하여 환자의 경비인대에 대한 투영 영상을 생성하는 단계가 이어진다.After irradiating the radiation toward the nasal ligament with the radiation generating unit 12 of the real-time radiographic apparatus 10 configured as above, the irradiated radiation is detected with the camera 13 to generate a projection image of the patient's nasopharyngeal ligament. The steps follow.
환자의 경비인대에 대한 영상이 생성되면, 이 생성된 영상을 모니터(16)를 통해 출력하는 단계가 수행된다.When an image of the patient's nasopharyngeal ligament is generated, the step of outputting the generated image through the monitor 16 is performed.
한편, 방사선 발생부(12)는 환자의 경비인대 주위를 따라 이동 또는 회전하면서 방사선을 조사하다가 모니터(16)에 출력되는 영상에서 경골(T)과 비골(F)의 상대적 위치가 제어부(15)에 설정되어 있는 데이터와 동일한 경우 방사선 발생부(12)의 이동과 회전을 멈추고 그 위치에서 스톱을 한다.On the other hand, the radiation generator 12 moves or rotates around the patient's nasal ligament while irradiating radiation, and the relative position of the tibia T and the fibula F in the image output to the monitor 16 is determined by the control unit 15 If it is the same as the data set in, the movement and rotation of the radiation generating unit 12 are stopped, and a stop is made at that position.
즉, 제어부(15)에는 경골(T)과 비골(F)이 어느 상태로 배치되어 있을 때가 경비인대 결합나사(S)를 체결하기에 가장 적절한 상황인지에 대한 데이터가 입력되어 있는데, 이 데이터와 모니터(16)에 출력되는 경골(T)과 비골(F)의 배치상황이 동일한 경우에 방사선 발생부(12)의 움직임이 멈추는 것이다. That is, the control unit 15 inputs data on whether the tibia (T) and fibula (F) are arranged in the most appropriate situation to fasten the nasolabial ligament coupling screw (S). When the tibia (T) and fibula (F) that are output to the monitor 16 are the same, the movement of the radiation generating unit 12 is stopped.
이렇게 방사선 발생부(12)가 멈추는 상황, 즉 실시간 방사선 촬영장치(10)의 프레임(11)이 더 이상 움직이지 않는 상황이 되면, 현재의 비골(F)과 경골(T)의 배치상태가 경비인대 결합나사(S)가 통과되는 천공홀을 비골(F)과 경골(T)에 형성시키기에 적절한 배치상태이다.In this way, when the radiation generating unit 12 stops, that is, the frame 11 of the real-time radiographic apparatus 10 does not move anymore, the current arrangement of the fibula (F) and tibia (T) is It is in the proper arrangement state to form the perforated hole through which the ligament coupling screw (S) passes in the fibula (F) and tibia (T).
제어부(15)에 입력되어 있는 데이터는 비골(F)의 좌측단과 경골(T)의 좌측단 사이의 거리(L1)와 상기 비골(F)의 우측단과 경골(T)의 우측단 사이의 거리(L2)의 비가 1 : 1이 되도록 비골(F)과 경골(T)이 배치되는 것이다. 더불어 모니터(16) 상에서 출력되는 화면이 비골(F)과 경골(T)이 앞뒤로 겹쳐서 디스플레이 때 비골(F)이 경골(T)의 전방에 위치되는 배치상태가 데이터에 포함될 수 있다.The data input to the control unit 15 includes the distance (L1) between the left end of the fibula (F) and the left end of the tibia (T) and the distance between the right end of the fibula (F) and the right end of the tibia (T) ( The fibula (F) and tibia (T) are arranged so that the ratio of L2) is 1:1. In addition, when the screen output on the monitor 16 is displayed by overlapping the fibula (F) and the tibia (T) back and forth, the arrangement state in which the fibula (F) is located in front of the tibia (T) may be included in the data.
도 6은 비골(F)의 좌측단과 경골(T)의 좌측단 사이의 거리(L1)와 상기 비골(F)의 우측단과 경골(T)의 우측단 사이의 거리(L2)의 비가 1 : 1이 되도록 비골(F)과 경골(T)이 배치되는 상태가 표시된 본 발명에 의한 실시간 방사선 촬영장치의 모니터 화면을 보인 도이다. 6 is a ratio of the distance (L1) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L2) between the right end of the fibula (F) and the right end of the tibia (T) 1: 1 This is a diagram showing a monitor screen of a real-time radiographic apparatus according to the present invention, in which the fibula (F) and tibia (T) are arranged to be displayed.
비골(F)과 경골(T)의 배치 상태가 도 6과 같이 표시되도록 하기 위해, 프레임(11)이나 환자가 누운 침대가 회전할 수 있다. 또한, 모니터 화면 중심선이 천공을 의도하는 위치(관통핀(22a) 삽입 위치, 61)에 맞추어지도록, 환자가 누운 침대 또는 방사선 발생부(12) 및 카메라(13)가 수평 방향으로 가이드 레일을 통해 이동할 수 있다. In order to display the arrangement of the fibula (F) and tibia (T) as shown in FIG. 6, the frame 11 or the bed on which the patient lies may be rotated. In addition, the bed on which the patient lies or the radiation generator 12 and the camera 13 are moved through the guide rail in the horizontal direction so that the center line of the monitor screen is aligned with the intended position (the insertion position of the penetration pin 22a, 61). You can move.
비골(F)의 좌측단과 경골(T)의 좌측단 사이의 거리(L1)와 상기 비골(F)의 우측단과 경골(T)의 우측단 사이의 거리(L2)의 비가 1 : 1이 되도록 비골(F)과 경골(T)이 배치되면, 비골(F) 상의 관통핀(22a) 삽입 위치가 타겟(61) 형태로 모니터 화면 상에 표시될 수 있다. Fibula so that the ratio of the distance (L1) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L2) between the right end of the fibula (F) and the right end of the tibia (T) is 1:1. When the (F) and tibia (T) are disposed, the insertion position of the penetrating pin (22a) on the fibula (F) may be displayed on the monitor screen in the form of a target (61).
관통핀(22a) 삽입 위치가 결정되면 가이더(20)의 징(23a)이 경골(T) 후면에 박히는 위치가 모니터 화면 상에 타겟(62)으로 표시된다. 관통핀(22a) 삽입 위치 타겟(61)과 징(23a)의 박힘 위치 타겟(62) 표시는 사용자의 설정 및 조작에 의해 선택될 수 있다. 이 때, 화면 상에 표시되는 타겟(62)과 징(23a)은 경골(T)의 후면에 위치하므로 도면에서 점선으로 표시하였다.When the insertion position of the through pin 22a is determined, the position where the gong 23a of the guider 20 is stuck on the rear of the tibia T is displayed as a target 62 on the monitor screen. The display of the penetration pin 22a insertion position target 61 and the punching position target 62 of the gong 23a may be selected by setting and manipulation of the user. At this time, since the target 62 and the gong 23a displayed on the screen are located at the rear of the tibia T, they are indicated by dotted lines in the drawing.
비골(F)과 경골(T)의 상대적 위치가 위와 같은 데이터와 동일하여 방사선 발생부(12)의 이동과 회전이 멈춘 경우에는 모니터(16) 화면이 점멸하거나 제어부(15)에서 부저음이 발생되도록 함으로써 현재의 상태가 비골(F)과 경골(T)에 천공홀을 형성시키기에 적절한 배치상태라는 것을 외부에 알릴 수 있다.When the relative position of the fibula (F) and tibia (T) is the same as the above data and the movement and rotation of the radiation generating unit 12 is stopped, the monitor 16 screen flashes or the control unit 15 generates a buzzer sound. By doing so, it is possible to inform the outside that the current state is a proper arrangement state for forming the perforated holes in the fibula (F) and tibia (T).
경비인대 결합나사(S)가 관통핀(22a) 삽입 위치(61)와 징(23a) 박힘 위치(62)를 관통하여 체결된 후, 비골(F)과 경골(T)의 결합이 보다 강하게 이루어지도록 경비인대 결합나사(S)를 추가 체결할 수 있다. After the nasolabial ligament coupling screw (S) is fastened through the through pin (22a) insertion position (61) and the gong (23a) insertion position (62), the combination of the fibula (F) and tibia (T) is made stronger. It is possible to additionally fasten the joint screw (S) of the guard ligament so that it can be secured.
도 7은 경비인대 결합나사(S)를 추가 체결하기 위한 비골(F)과 경골(T)의 배치 상태가 표시된 본 발명에 의한 실시간 방사선 촬영장치의 모니터 화면을 보인 도이다. 7 is a view showing a monitor screen of a real-time radiographic apparatus according to the present invention in which an arrangement state of the fibula (F) and tibia (T) for additional fastening of the nasolabial ligament coupling screw (S) is displayed.
도 7의 모니터 화면은 비골(F)의 좌측단과 경골(T)의 좌측단 사이의 거리(L3)와 상기 비골(F)의 우측단과 경골(T)의 우측단 사이의 거리(L4)의 비가 1 : 1이 되도록 비골(F)과 경골(T)이 배치되는 상태를 표시한다. The monitor screen of FIG. 7 shows the ratio of the distance (L3) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L4) between the right end of the fibula (F) and the right end of the tibia (T). It indicates the state in which the fibula (F) and tibia (T) are arranged to be 1: 1.
비골(F)과 경골(T)의 배치 상태가 도 7과 같이 표시되도록 하기 위해, 프레임(11)이나 환자가 누운 침대가 회전할 수 있다. 또한, 모니터 화면 중심선이 천공을 의도하는 위치(관통핀(22a) 삽입 위치, 71)에 맞추어지도록, 환자가 누운 침대 또는 방사선 발생부(12) 및 카메라(13)가 수평 방향으로 가이드 레일을 통해 이동할 수 있다. In order to display the arrangement of the fibula (F) and tibia (T) as shown in FIG. 7, the frame 11 or the bed on which the patient lies may be rotated. In addition, the bed on which the patient lies or the radiation generator 12 and the camera 13 are moved through the guide rail in the horizontal direction so that the center line of the monitor screen is aligned with the intended position (the insertion position of the penetration pin 22a, 71). You can move.
비골(F)의 좌측단과 경골(T)의 좌측단 사이의 거리(L3)와 상기 비골(F)의 우측단과 경골(T)의 우측단 사이의 거리(L4)의 비가 1 : 1이 되도록 비골(F)과 경골(T)이 배치되면, 비골(F) 상의 관통핀(22a) 삽입 위치가 타겟(71) 형태로 모니터 화면 상에 표시될 수 있다. Fibula so that the ratio of the distance (L3) between the left end of the fibula (F) and the left end of the tibia (T) and the distance (L4) between the right end of the fibula (F) and the right end of the tibia (T) is 1:1. When (F) and tibia (T) are disposed, the insertion position of the through pin 22a on the fibula (F) may be displayed on the monitor screen in the form of the target 71.
관통핀(22a) 삽입 위치가 결정되면 가이더(20)의 징(23a)이 경골(T) 후면에 박히는 위치가 모니터 화면 상에 타겟(72)으로 표시된다. 관통핀(22a) 삽입 위치 타겟(71)과 징(23a)의 박힘 위치 타겟(72) 표시는 사용자의 설정 및 조작에 의해 선택될 수 있다. 이 때, 화면 상에 표시되는 타겟(72)과 징(23a)은 경골(T)의 후면에 위치하므로 도에서 점선으로 표시하였다.When the insertion position of the through pin 22a is determined, the position where the gong 23a of the guider 20 is stuck on the rear of the tibia T is displayed as a target 72 on the monitor screen. The display of the penetration pin 22a insertion position target 71 and the punching position target 72 of the gong 23a may be selected by a user's setting and manipulation. At this time, since the target 72 and the gong 23a displayed on the screen are located at the rear of the tibia T, they are indicated by a dotted line in the figure.
비골(F)과 경골(T)의 상대적 위치가 위와 같은 데이터와 동일하여 방사선 발생부(12)의 이동과 회전이 멈춘 경우에는 모니터(16) 화면이 점멸하거나 제어부(15)에서 부저음이 발생되도록 함으로써 현재의 상태가 비골(F)과 경골(T)에 천공홀을 추가로 형성시키기에 적절한 배치상태라는 것을 외부에 알릴 수 있다.When the relative position of the fibula (F) and tibia (T) is the same as the above data and the movement and rotation of the radiation generating unit 12 is stopped, the monitor 16 screen flashes or the control unit 15 generates a buzzer sound. By doing so, it is possible to inform to the outside that the current state is an appropriate arrangement state for additionally forming perforated holes in the fibula (F) and tibia (T).
위와 같은 과정으로 방사선 발생부(12)의 이동이 멈춘 다음에는 십자인대 재건술용 가이더(20)를 통해 경비인대 결합나사 설치홀 관통단계가 수행된다.After the movement of the radiation generating unit 12 is stopped by the above process, the step of penetrating the nasolabial ligament coupling screw installation hole is performed through the guider 20 for cruciate ligament reconstruction.
여기에서, 발명의 이해를 위해 십자인대 재건술용 가이더(20)에 대해 먼저 간단히 설명하도록 한다.Here, the guider 20 for cruciate ligament reconstruction will be briefly described first for understanding the invention.
십자인대 재건술용 가이더(20)는 전방 십자인대가 파열되었을 때 조기에 안정화시키기 위해 사용되는 기구로서, 천공홀 형성시 유동되지 않도록 파지되는 파지부(21)와, 상기 파지부(21)의 일단에 전후이동 가능하게 끼워진 후 고정되고 드릴(미도시)에 연결된 관통핀(22a)이 삽입되는 중공의 가이드관(22)과, 상기 파지부(21)의 타단에 구비되고 끝부분에 뾰족한 징(23a)이 구비된 지지암(23)을 포함하여 구성된다.The guider 20 for cruciate ligament reconstruction is a device used for early stabilization when the anterior cruciate ligament is ruptured, and has a gripping part 21 that is gripped so as not to flow when a perforated hole is formed, and one end of the gripping part 21 A hollow guide tube 22 into which a through pin 22a connected to a drill (not shown) is inserted and fixed after being inserted to be movable back and forth, and a pointed gong at the other end of the gripping part 21 ( It is configured to include a support arm 23 provided with 23a).
위와 같이 구성되는 십자인대 재건술용 가이더(20)를 통해 경비인대 결합나사 설치홀 관통단계는 십자인대 재건술용 가이더(20)의 지지암(23) 끝단이 경골(T) 표면에 박혀 지지되도록 하면서, 가이드관(22)의 끝단이 비골(F) 표면에 접촉 지지되도록 하고, 관통핀(22a)이 가이드관(22)에 삽입된 후 비골(F)과 경골(T)을 연속적으로 관통하여 경비인대 결합나사(S)가 지나가는 통로를 형성하는 과정이다.The step of penetrating the nasolabial ligament coupling screw installation hole through the guider 20 for cruciate ligament reconstruction configured as above is such that the end of the support arm 23 of the guider 20 for cruciate ligament reconstruction is embedded and supported on the surface of the tibia (T), The end of the guide tube 22 is contacted and supported on the surface of the fibula (F), and after the through pin (22a) is inserted into the guide tube (22), it continuously penetrates the fibula (F) and the tibia (T). It is a process of forming a passage through which the coupling screw (S) passes.
이러한 경비인대 결합나사 설치홀 관통단계는 실시간 방사선 촬영장치(10)의 방사선 발생부(12)에서 방사선이 조사되는 중에 이행된다. 즉 방사선 발생부(12)의 방사선 조사와 카메라(13)의 영상 생성 및 생성된 영상의 디스플레이가 수행되면서 경비인대 결합나사 설치홀 관통단계가 이행된다.The step of penetrating the nasal ligament coupling screw installation hole is performed while the radiation is irradiated from the radiation generating unit 12 of the real-time radiographic apparatus 10. That is, the step of penetrating the nasal ligament coupling screw installation hole is performed while irradiation of the radiation generation unit 12 and the image generation and display of the generated image by the camera 13 are performed.
따라서, 경비인대 결합나사 설치홀 관통단계에서 수행되는 다수의 공정이 실시간 방사선 촬영장치의 모니터(16)를 통해 외부로 디스플레이된다.Accordingly, a number of processes performed in the step of penetrating the nasal ligament coupling screw installation hole are displayed to the outside through the monitor 16 of the real-time radiographic apparatus.
본 발명은 경비인대 결합나사의 올바른 삽입방향 설정방법에 관한 것으로서, 사고에 의한 충격으로 경골과 비골이 골절되었을 때 이 골절된 뼈가 접합될 때까지 움직이지 않게 고정되도록 경비인대 결합나사를 사용할 때 본 발명이 적용되므로, 의료, 보건 및 이와 관련된 의료장비 산업 등에 이용될 수 있다.The present invention relates to a method for setting the correct insertion direction of the nasal ligament coupling screw, and when the tibia and fibula are fractured due to an accidental impact, when the nasolabial ligament coupling screw is used to fix it so that it does not move until the fractured bone is joined Since the present invention is applied, it can be used in medicine, health care, and related medical equipment industries.

Claims (5)

  1. 실시간 방사선 촬영장치(10)의 방사선 발생부(12)로 환자의 경비인대를 향해 방사선을 조사하는 단계와; 조사된 방사선을 실시간 방사선 촬영장치(10)의 카메라(13)로 검출하여 환자의 경비인대에 대한 투영 영상을 생성하는 단계와; 생성된 영상을 실시간 방사선 촬영장치(10)의 모니터(16)를 통해 출력하는 단계;를 포함하되,Irradiating radiation toward the patient's nasal ligament with the radiation generating unit 12 of the real-time radiographic apparatus 10; Generating a projection image of the patient's nasal ligament by detecting the irradiated radiation with the camera 13 of the real-time radiographic apparatus 10; Including; outputting the generated image through the monitor 16 of the real-time radiographic apparatus 10;
    상기 방사선 발생부(12)는 환자의 경비인대 주위를 따라 이동하면서 방사선을 조사하다가 상기 모니터(16)에 출력되는 영상에서 경골(T)과 비골(F)의 상대적 위치가 실시간 방사선 촬영장치(10)의 제어부(15)에 설정된 데이터와 동일한 경우 이동이 멈추며,The radiation generating unit 12 radiates radiation while moving around the patient's nasal ligament, and the relative position of the tibia T and the fibula F in the image output to the monitor 16 is a real-time radiographic apparatus 10 ), if the data is the same as the data set in the control unit 15, the movement is stopped,
    상기 방사선 발생부(12)의 이동이 멈춘 다음 십자인대 재건술용 가이더(20)의 지지암(23) 끝단이 경골(T) 표면에 박혀 지지되도록 함과 아울러 상기 십자인대 재건술용 가이더(20)의 가이드관(22)이 비골(F) 표면에 접촉 지지되도록 하고, 드릴에 연결된 관통핀(22a)이 상기 가이드관(22)에 삽입된 후 상기 비골(F)과 경골(T)을 연속적으로 관통하여 경비인대 결합나사(S)가 지나가는 통로를 형성하는 경비인대 결합나사 설치홀 관통단계를 포함하는 것을 특징으로 하는 경비인대 결합나사의 올바른 삽입방향 설정방법.After the movement of the radiation generating unit 12 stops, the end of the support arm 23 of the guider 20 for cruciate ligament reconstruction is supported by being embedded on the surface of the tibia (T), and the guider 20 for reconstruction of the cruciate ligament The guide pipe 22 is in contact with the surface of the fibula (F), and a through pin (22a) connected to the drill is inserted into the guide pipe (22) and then continuously penetrates the fibula (F) and tibia (T). The method for setting the correct insertion direction of the nasolabial ligament coupling screw, characterized in that it comprises a step of penetrating the nasolabial ligament coupling screw installation hole forming a passage through which the nasolabial ligament coupling screw (S) passes.
  2. 청구항 1에 있어서,The method according to claim 1,
    상기 제어부(15)에 설정된 데이터는 상기 비골(F)의 좌측단과 경골(T)의 좌측단 사이의 거리(L1)와 상기 비골(F)의 우측단과 경골(T)의 우측단 사이의 거리(L2)의 비가 1 : 1 인 것을 특징으로 하는 경비인대 결합나사의 올바른 삽입방향 설정방법.The data set in the control unit 15 is the distance L1 between the left end of the fibula F and the left end of the tibia T and the distance between the right end of the fibula F and the right end of the tibia T ( How to set the correct insertion direction of the nasolabial ligament coupling screw, characterized in that the ratio of L2) is 1: 1.
  3. 청구항 2에 있어서,The method according to claim 2,
    상기 제어부(15)에 설정된 데이터는 상기 비골(F)이 경골(T)의 전방에 위치되는 것을 더 포함하는 것을 특징으로 하는 경비인대 결합나사의 올바른 삽입방향 설정방법.The data set in the control unit 15 is the method of setting the correct insertion direction of the nasolabial ligament coupling screw, characterized in that the fibula (F) is located in front of the tibia (T).
  4. 청구항 1에 있어서,The method according to claim 1,
    경골(T)과 비골(F)의 상대적 위치가 상기 제어부(15)에 설정된 데이터와 동일하여 방사선 발생부(12)의 이동이 멈춘 경우 상기 모니터(16) 화면이 점멸하거나 부저음이 발생되는 것을 특징으로 하는 경비인대 결합나사의 올바른 삽입방향 설정방법.When the movement of the radiation generating unit 12 is stopped because the relative position of the tibia (T) and the fibula (F) is the same as the data set in the control unit 15, the screen of the monitor 16 flashes or a buzzer sound is generated. How to set the correct insertion direction of the nasolabial joint screw.
  5. 청구항 1에 있어서,The method according to claim 1,
    상기 경비인대 결합나사 설치홀 관통단계는 상기 방사선 발생부(12)에서 방사선이 조사되는 중에 이행되는 것을 특징으로 하는 경비인대 결합나사의 올바른 삽입방향 설정방법.The step of penetrating the nasal ligament coupling screw installation hole is performed while the radiation generating unit 12 is irradiated with radiation.
PCT/KR2020/003419 2019-09-20 2020-03-12 Method for setting correct insertion direction of tibiofibular ligament syndesmotic screw WO2021054554A1 (en)

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