WO2021120265A1 - 截骨手术引导工具及其使用方法 - Google Patents

截骨手术引导工具及其使用方法 Download PDF

Info

Publication number
WO2021120265A1
WO2021120265A1 PCT/CN2019/128489 CN2019128489W WO2021120265A1 WO 2021120265 A1 WO2021120265 A1 WO 2021120265A1 CN 2019128489 W CN2019128489 W CN 2019128489W WO 2021120265 A1 WO2021120265 A1 WO 2021120265A1
Authority
WO
WIPO (PCT)
Prior art keywords
positioning
guide
hole
guide plate
osteotomy
Prior art date
Application number
PCT/CN2019/128489
Other languages
English (en)
French (fr)
Inventor
刘非
Original Assignee
上海昕健医疗技术有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 上海昕健医疗技术有限公司 filed Critical 上海昕健医疗技术有限公司
Publication of WO2021120265A1 publication Critical patent/WO2021120265A1/zh

Links

Images

Classifications

    • 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
    • A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14—Surgical saws ; Accessories therefor
    • A61B17/15—Guides therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14—Surgical saws ; Accessories therefor
    • A61B17/15—Guides therefor
    • A61B17/154—Guides therefor for preparing bone for knee prosthesis
    • A61B17/157—Cutting tibia
    • 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
    • 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
    • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee

Definitions

  • the present invention relates to the field of medical equipment, in particular to a guide tool for osteotomy surgery and a method of use thereof.
  • High tibial osteotomy is currently used to treat medial compartment osteoarthritis (OA) of the knee joint.
  • HTO can effectively preserve the femur and tibia of the knee joint.
  • HTO is divided into closed wedge-shaped HTO and open wedge-shaped HTO. Since closed wedge-shaped HTO is prone to complications such as atrioventricular syndrome, lateral muscle separation, proximal fibula amputation, limb shortening, and peroneal nerve injury, open wedge-shaped HTO is easier to obtain favorable surgery After the effect, and a large number of clinical studies have proved its efficacy.
  • the doctor In the traditional medial open wedge HTO, the doctor relies on clinical experience and existing measurement tools to perform osteotomy operations, which leads to a high dependence on the doctor’s experience in the accuracy and correction accuracy of the osteotomy. In addition, frequent X-ray fluoroscopy measurements are performed during the operation. , It also increases the radiation hazards of patients and doctors.
  • the purpose of the present invention is to provide an osteotomy surgical guide tool with simple structure, convenient operation and stable maintenance of the expansion angle, and a method of use thereof.
  • the present invention provides a guide tool for osteotomy surgery, which includes a first guide plate and a second guide plate for combination and fixation in a first direction, and a first guide plate and a second guide plate that cooperate with the first guide plate and the second guide plate and are used for angle.
  • the first guide plate includes a first positioning column protruding outward and a first positioning portion at the top of the first positioning column
  • the second guide plate includes the same A second positioning post protruding from the direction and a second positioning part located at the top end of the second positioning post
  • the first positioning part and the second positioning part each include a positioning hole penetrating in the first direction, and before the correction A correction angle is formed between the central axis of the positioning hole of the first positioning part and the second positioning part
  • the first positioning post has a through hole
  • the osteotomy guide tool is also provided with the second
  • a positioning pin continuously passes through the through hole and the alignment hole to form a three-point fixation.
  • the second guide plate further includes an alignment column protruding in the same direction as the second positioning column, and the alignment hole is provided on the side surface of the alignment column and penetrates the alignment column correspondingly.
  • the second guide plate includes a lower guide portion for guiding the cutting path, the alignment post is arranged outside the lower guide portion, and the position of the alignment hole is higher than the lower guide portion.
  • the first guide plate includes a side guide portion for guiding the cutting path and an upper guide portion, the upper guide portion is located above the lower guide portion, and between the upper guide portion and the lower guide portion A guide groove for guiding the path of the cutting tool is formed.
  • the alignment hole includes a first hole penetrating the first guide plate and a second hole penetrating the second guide plate.
  • the central axes of the through hole, the first hole and the second hole are in the same straight line. on.
  • the first guide plate includes a side guide portion for guiding the cutting path and an upper guide portion, and the first hole is located at the upper guide portion and is provided through the thickness direction of the upper guide portion.
  • the first guide plate includes a lower guide part located below the upper guide part and used to guide the cutting path, and a guide groove for guiding the cutting tool path is formed between the upper guide part and the lower guide part, so The second hole is located at the lower guide portion and is formed through the thickness direction of the lower guide portion.
  • the first guide plate further includes a first fixing portion that protrudes in the same direction as the first positioning post and is used to allow the fixing needle to pass through and fix the second guide plate. It protrudes in the same direction and is used to allow the fixing needle to pass through the fixed second fixing part.
  • first fixing portion and the second fixing portion are respectively provided as a pair, and in the corrected state, the connecting line of the through hole and the alignment hole is located in the pair of first fixing portions and the pair of second fixing portions, respectively.
  • the present invention provides a method for using an osteotomy guide tool, which includes the following steps: placing the osteotomy guide tool on the patient's lesion area, and make the first guide plate and the second guide plate of the osteotomy guide tool The inner surface of the bone is attached to the bone surface of the patient’s lesion area, and the osteotomy guide tool is moved and positioned so that it fits the bone surface without moving and is fixed; according to the preoperative plan, the cutting tool is inserted into the osteotomy guide tool and saw Cut off the corresponding part of the cortex of the patient’s lesion area, and gradually open an opening in the patient’s lesion area; pass one end of the positioning rod through the positioning holes of the first positioning part and the second positioning part in turn, when the positioning rod continuously passes through the first positioning part The positioning holes of the positioning part and the second positioning part reach the correcting angle planned before the operation; a positioning needle is passed through the through hole of the first positioning column and the alignment hole located beside the second positioning column in turn.
  • the osteotomy guide tool of the present invention adds through holes and alignment hole structures that cooperate with each other.
  • the positioning rod can continuously pass through the first positioning part and the second positioning part. And fixed between the first positioning column and the second positioning column.
  • a positioning pin is continuously passed through the through hole and the alignment hole, and fixed between the first positioning column and the second guide plate, so that the first positioning The column, the second positioning column and the part of the second guide plate provided with the alignment hole form a three-point fixation, which can maintain the expansion angle more stably, avoiding the effect of subsequent surgery, or repeating the complicated adjustment of the expansion angle, simplifying the operation process and saving operation time.
  • the structure accurately locates the height and angle of the tibial distraction after osteotomy, improves the accuracy of the operation, reduces the difficulty of the operation and the dependence on the doctor’s experience, avoids the frequent X-ray fluoroscopy measurement in the traditional operation, and reduces Radiation hazards for patients and doctors.
  • Fig. 1 is a three-dimensional schematic diagram of the guide tool for osteotomy operation of the present invention with the positioning rod removed;
  • Fig. 2 is a perspective schematic view of another perspective view of the guide tool for osteotomy surgery of the present invention with the positioning rod removed;
  • 3 and 4 are schematic diagrams of the osteotomy surgical guide tool removal positioning rod of the present invention placed on the tibia and in a sawing state;
  • Figure 5 is a schematic diagram of the osteotomy guide tool of the present invention placed on the tibia and in the initial state of correction;
  • Fig. 6 is a schematic diagram of the osteotomy surgical guide tool of the present invention placed on the tibia with a fixed needle inserted in a corrected state.
  • the osteotomy guide tool 100 of the present invention is used to guide osteotomy and corrective operations, so as to realize the reconstruction of the lower limb force line and restore normal knee joint motion.
  • the osteotomy guide tool 100 is used in high tibial osteotomy, and it is a three-dimensional model reconstructed according to the medical image data of the patient's tibia reversely designed and manufactured by rapid prototyping technology.
  • a first direction, a second direction, and a third direction that are perpendicular to each other are defined, and the first direction is the extension direction of the tibia.
  • the osteotomy surgical guide tool 100 includes a first guide plate 1 and a second guide plate 2 for combination and fixation in a first direction, and the first guide plate 1 and the second guide plate 2 are matched and used Positioning rod 3 for angle calibration.
  • the first guide plate 1 includes a first positioning post 11 protruding outward and a first positioning portion 12 located at the top end of the first positioning post 11.
  • the second guide plate 2 includes a second positioning pillar 21 protruding in the same direction as the first positioning pillar 11 and a second positioning portion 22 located at the top end of the second positioning pillar 21.
  • the first positioning pillar 11 and the second positioning pillar 21 each include positioning holes 13 and 23 penetrating in a first direction, and the positioning holes 13 of the first positioning pillar 11 and the second positioning pillar 21 are before the correction.
  • a correction angle is formed between the central axes of 23.
  • the first guide plate 1 and the second guide plate 2 are connected to each other by a connecting portion (not shown) to form a whole, and are arranged at a fixed distance apart.
  • the central axes of the positioning holes 13, 23 of the first positioning post 11 and the second positioning post 21 intersect to form an included angle, which is used before making the osteotomy guide tool 100
  • the correction angle calculated through the foregoing planning that is, the correction angle corresponds to the distraction angle of the proximal tibia of the patient, so that when the positioning holes 13, 23 of the first positioning post 11 and the second positioning post 21 are When the central axis reaches the same straight line, the expansion angle reaches the corrective angle planned above.
  • the first positioning post 11 has a through hole 14, and the osteotomy guide tool 100 is also provided with an alignment located beside the second positioning post 21. Hole 4.
  • the central axis of the alignment hole 4 intersects the central axis of the through hole 14.
  • the positioning rod 3 continuously passes through the first positioning portion 12 and the second positioning portion 33, and a positioning pin 300 continuously penetrates The through hole 14 and the alignment hole 4 form a three-point fixation.
  • the positioning rod 3 can continuously pass through the first positioning portion 12 and the second positioning portion 22 and be fixed to the first positioning column 11 and the second positioning post 21.
  • a positioning pin 300 is continuously passed through the through hole 14 and the alignment hole 4, and fixed between the first positioning post 11 and the second guide plate 2, so that the first positioning The post 11, the second positioning post 21, and the part of the second guide plate 2 where the alignment hole 4 is provided form a three-point fixation, which can maintain the expansion angle more stably, avoid affecting the effect of subsequent operations or repeatedly adjusting the expansion angle. Surgical procedures, saving operation time.
  • the structure accurately locates the height and angle of the tibial distraction after osteotomy, improves the accuracy of the operation, reduces the difficulty of the operation and the dependence on the doctor’s experience, avoids the frequent X-ray fluoroscopy measurement in the traditional operation, and reduces Radiation hazards for patients and doctors.
  • the fixed needle 6 can be directly used as a bone needle, which is easy to obtain and convenient to use, so that the through hole 14 and the alignment hole 4 are arranged in a small size, which does not affect other structural designs of the first guide plate 1 and the second guide plate In addition, it occupies a small area, is easy to set up its position and is easy to manufacture.
  • the second guide plate 2 further includes an alignment pillar 24 protruding in the same direction as the second positioning pillar 21, and the alignment hole 4 is provided on the side surface of the alignment pillar 24 and corresponds to Pierce through the alignment column 24.
  • the second guide plate 2 also includes a lower guide 25 for guiding the cutting path.
  • the alignment post 24 is arranged outside the lower guide portion 25, and the position of the alignment hole 4 is higher than the lower guide portion 25.
  • the alignment column 24 is disposed against the lower guide portion 25, and the thickness of the upper end is greater than the thickness of the lower end, so that the alignment column 24 faces the inner surface of the first guide plate 1 and the lower guide portion 25.
  • the inner sides facing the first guide plate 1 are flush. Therefore, the part of the alignment post 24 where the alignment hole 4 is located has a sufficient thickness to enhance the firmness of the fixation.
  • the first guide plate 1 further includes an upper guide portion 15 and a side guide portion 16 for guiding the cutting path.
  • the upper guide portion 15 is located above the lower guide portion 25 of the second guide plate 2, and a guide groove 5 for guiding the path of the cutting tool 200 is formed between the upper guide portion 15 and the lower guide portion 25.
  • the side guide 16 and the guide groove 5 jointly guide the cutting tool 200 to complete the sawing and osteotomy.
  • the first guide plate 1 further includes a first fixing portion 17 that protrudes in the same direction as the first positioning post 11 and is used to allow the fixing needle to pass through and fix
  • the second guide plate 2 further includes the same direction as the second positioning post 21 It protrudes and is used to allow the fixing needle to pass through the fixed second fixing portion 26.
  • the first fixing part 17 and the second fixing part 26 are both hollow structures.
  • the first fixing portion 17 and the second fixing portion 26 are respectively provided as a pair.
  • the connecting line of the through hole 14 and the alignment hole 4 are located in a pair, respectively.
  • the pair of first fixing portions 17 and the pair of second fixing portions 26 are arranged along the extending direction of the guide groove 5 and separated by a certain distance, so that the fixing needle will not be fixed when passing through the alignment hole 4 and the pupil 14
  • the fixing pins in the first fixing portion 17 and the second fixing portion 26 are affected or inconvenient to pass between the through hole 14 and the alignment hole 4.
  • the method of using the osteotomy guide tool 100 includes multiple steps.
  • first guide plate 1 and the second guide plate 2 are placed at the preoperative planned position of the patient’s lesion area, so that the inner sides of the first guide plate and the second guide plate are in line with each other.
  • the bone surface of the patient's lesion area is attached, the first guide plate 1 and the second guide plate 2 are moved and positioned so that they are in contact with the bone surface and do not move, and four bone needles are placed in order to fix them.
  • the cutting tool 200 extends into the guide groove 5 to cut and cut off the cortex corresponding to the patient's lesion area, and gradually open an opening in the patient's lesion area. That is, referring to FIGS. 3 and 4, the cutting tool 200 first performs cutting and osteotomy along the guide groove 5, and then performs cutting and osteotomy along the side guide portion 16, thereby completing the sawing and osteotomy.
  • the positioning rod 3 Pass one end of the positioning rod 3 through the positioning holes 13 of the first positioning portion 12 and the second positioning portion 22 in sequence.
  • the positioning rod 3 can continuously pass through the positioning holes 13 of the first positioning portion 12 and the second positioning portion 22, that is Achieve the corrective angle of preoperative planning.
  • the central axes of the positioning holes 13 of the first positioning portion 12 and the second positioning portion 22 are on the same straight line.
  • a bone needle is passed through the through hole 14 of the first positioning column 11 and the alignment hole 4 of the alignment column 24 in sequence.
  • the central axis of the alignment hole 4 and the center of the through hole 14 The axis is on the same straight line and forms a triangular fixation together with the fixation of the positioning rod 3.
  • the alignment hole 4 may also be configured to include a first hole penetrating through the first guide plate 1 and a second hole penetrating through the second guide plate 2.
  • the through hole 14 the first hole It is on the same straight line as the central axis of the second hole.
  • the first hole may be provided in the upper guide portion 15 and penetrated along the thickness direction of the upper guide portion 15.
  • the second hole may be provided in the lower guide part 25 and penetrate through the thickness direction of the lower guide part 25. Therefore, the fixing needle 6 can better maintain the spreading angle through the through hole 14, the first hole and the second hole, and the first hole and the second hole are provided on the upper guide portion 15 and the lower guide portion 25, respectively. It is necessary to add an additional structure for punching, which simplifies the structure design and can achieve the same technical effect.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Dentistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Transplantation (AREA)
  • Surgical Instruments (AREA)

Abstract

一种截骨手术引导工具（100）及其使用方法。截骨手术引导工具（100）包括第一导板（1）和第二导板（2）以及定位杆（3）、对位孔（4），第一导板（1）的第一定位部（12）和第二导板（2）的第二定位部（22）均分别包括定位孔（13,23），在矫正前第一定位部（12）和第二定位部（22）的定位孔（13,23）的中轴线之间形成一矫正角度，第一定位柱（11）具有一通孔（14），对位孔（4）的中轴线与通孔（14）的中轴线在同一直线上，在矫正状态下，定位杆（3）连续穿过第一定位部（12）和第二定位部（22），一定位针（300）连续穿过通孔（14）和对位孔（4），从而形成三点固定。

Description

截骨手术引导工具及其使用方法
本申请要求了申请日为2019年12月18日，申请号为201911305341.9，发明名称为“截骨手术引导工具及其使用方法”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本发明涉及医疗器械领域，尤其涉及一种截骨手术引导工具及其使用方法。
背景技术
胫骨高位截骨术(high tibial osteotomy,HTO)目前已应用于治疗膝关节内侧间室骨关节炎(osteoarthritis,OA)，相较于传统全膝关节置换手术，HTO可有效保留膝关节股骨、胫骨以及髌骨等的关节面，因此特别适用于年轻的患者。HTO分为闭合楔形HTO和开放楔形HTO，由于闭合楔形HTO易产生房室综合征、侧肌分离、近端腓骨切断、肢体缩短以及腓神经伤害等并发症，因此开放楔形HTO更易获得有利的术后效果，且大量临床研究均证明了其疗效。传统的内侧开放楔形HTO中，医生凭借临床经验和现有的测量工具进行截骨手术操作，因而导致截骨精度和矫正精度对医生的经验依赖较高，此外，术中频繁的X射线透视测量，也增加了患者和医生的辐射危害。
因此，确有必要提供一种截骨手术引导工具及其使用方法，以克服现有技术中存在的缺陷。
发明内容
本发明的目的在于提供一种结构简单、操作方便并可稳定维持撑开角度的截骨手术引导工具及其使用方法。
为实现上述目的，本发明提供了一种截骨手术引导工具，包括用于在第一方向组合固定的第一导板和第二导板以及与所述第一导板和第二导板配合且用于角度校验的定位杆，所述第一导板包括向外突设的第一定位柱及位于所述第一定位柱顶端的第一定位部，所述第二导板包括与所述第一定位柱同向突设的第二定位柱及位于所述第二定位柱顶端的第二定位部，所述第一定位部和第二定位部均分别包括沿第一方向贯通的定位孔，且在矫正前所述第一定位部和第二定位部的定位孔的中轴线之间形成一矫正角度，所述第一定位柱具有一通孔，所述截骨手术引导工具上还设置有位于所述第二定位柱旁侧的对位孔，所述对位孔的中轴线与 所述通孔的中轴线相交，在矫正状态下，所述定位杆连续穿过所述第一定位部和第二定位部，一定位针连续穿过所述通孔和对位孔，从而形成三点固定。
进一步地，所述第二导板还包括与所述第二定位柱同向突伸的对位柱，所述对位孔设于对位柱侧表面上且对应贯穿所述对位柱。
进一步地，所述第二导板包括用于引导切割路径的一下引导部，所述对位柱设于所述下引导部外侧，且所述对位孔位置高出所述下引导部。
进一步地，所述第一导板包括用于引导切割路径的一侧引导部及一上引导部，所述上引导部位于所述下引导部上方，且所述上引导部与下引导部之间形成用于引导切割工具路径的引导槽。
进一步地，所述对位孔包括贯穿第一导板的第一孔和贯穿第二导板的第二孔，在矫正状态下，所述通孔、第一孔和第二孔的中轴线在同一直线上。
进一步地，所述第一导板包括用于引导切割路径的一侧引导部及一上引导部，所述第一孔位于所述上引导部且沿所述上引导部厚度方向贯通设置。
进一步地，所述第一导板包括位于所述上引导部下方且用于引导切割路径的一下引导部，所述上引导部与下引导部之间形成用于引导切割工具路径的引导槽，所述第二孔位于所述下引导部且沿所述下引导部厚度方向贯通设置。
进一步地，所述第一导板还包括与所述第一定位柱同向突伸且用于令固定针穿过固定的第一固定部，所述第二导板还包括与所述第二定位柱同向突伸且用于令固定针穿过固定的第二固定部。
进一步地，所述第一固定部和第二固定部分别设置为一对，在矫正状态下，所述通孔和对位孔的连线分别位于一对第一固定部和一对第二固定部之间。
为实现上述目的，本发明提供了一种截骨手术引导工具的使用方法，包括以下步骤：将截骨手术引导工具放置于患者病灶区，令截骨手术引导工具的第一导板和第二导板的内侧面与患者病灶区骨面贴合，移动定位截骨手术引导工具使其与骨面贴合不移动，并进行固定；按照术前规划，切割工具伸入截骨手术引导工具内部，锯切截断患者病灶区对应部分皮质，并在在患者病灶区逐渐撑开一开口；将定位杆的一端依次穿过第一定位部和第二定位部的定位孔，当定位杆连续穿过第一定位部和第二定位部的定位孔，即达到术前规划的矫正角度；将一定位针依次穿过第一定位柱的通孔及位于所述第二定位柱旁侧的对位孔，此时，所述对位孔的中轴线与所述通孔的中轴线在同一直线上，并与定位杆的固定一同形成三角固定。
本发明的截骨手术引导工具通过增加相互配合的通孔和对位孔结构，当撑开角度达到述 前规划的矫正角度时，定位杆可连续穿过第一定位部和第二定位部，而固定在第一定位柱和第二定位柱之间，此时，将一定位针连续穿过通孔和对位孔，而固定在第一定位柱和第二导板之间，从而第一定位柱、第二定位柱及第二导板上设置对位孔的部分形成三点固定，更稳定的维持撑开角度，避免影响后续手术效果，或重复调整撑开角度的繁复，简化手术流程，节省手术时间。此外，该结构精确定位胫骨截骨后撑开的高度和角度，提高了手术精度，降低了手术难度和对医生的经验依赖度，避免了传统手术术中的频繁的X射线透视测量，降低了患者和医生的辐射危害。
附图说明
图1为本发明的截骨手术引导工具去除定位杆的立体示意图；
图2为本发明的截骨手术引导工具去除定位杆的另一视角的立体示意图；
图3和图4为本发明的截骨手术引导工具去除定位杆置于胫骨上且在锯切状态的示意图；
图5为本发明的截骨手术引导工具置于胫骨上且在矫正初始状态下的示意图；
图6为本发明的截骨手术引导工具置于胫骨上且在矫正状态下插设有固定针的示意图。
具体实施方式
为使本发明的上述目的、特征和优点能够更为明显易懂，下面结合附图对本发明的具体实施例作详细的说明。
请结合图1至图6所示，本发明的截骨手术引导工具100用于引导截骨和矫正操作，以实现下肢力线的重建，恢复正常的膝关节运动。在本发明中，所述截骨手术引导工具100应用在胫骨高位截骨术中，且其是根据患者胫骨的医学图像数据重构的三维模型逆向设计并通过快速成型技术制成的。为了便于描述，界定相互垂直的第一方向、第二方向和第三方向，所述第一方向为胫骨延伸方向。
参照图1和图2所示，所述截骨手术引导工具100包括用于在第一方向组合固定的第一导板1和第二导板2以及与第一导板1和第二导板2配合且用于角度校验的定位杆3。所述第一导板1包括向外突设的第一定位柱11及位于第一定位柱11顶端的第一定位部12。所述第二导板2包括与第一定位柱11同向突设的第二定位柱21及位于第二定位柱21顶端的第二定位部22。
所述第一定位柱11和第二定位柱21均分别包括沿第一方向贯通的定位孔13，23，且在矫正前所述第一定位柱11和第二定位柱21的定位孔13，23的中轴线之间形成一矫正角度。
即，在使用前，所示第一导板1和第二导板2通过连接部(未图示)相互连接而成为一整 体，且保持一固定距离间隔设置，当第一导板1和第二导板2放置于胫骨近端时，所述第一定位柱11和第二定位柱21的定位孔13，23的中轴线相交而形成一夹角，该夹角为制作所述截骨手术引导工具100前通过述前规划计算得出的矫正角度，也就是说该矫正角度对应患者胫骨近端的撑开角度，从而，当所述第一定位柱11和第二定位柱21的定位孔13，23的中轴线达到位于同一直线上时，即撑开角度达到述前规划的矫正角度。
参照图1、图2、图5和图6所示，所述第一定位柱11具有一通孔14，所述截骨手术引导工具100上还设置有位于第二定位柱21旁侧的对位孔4。所述对位孔4的中轴线与通孔14的中轴线相交，在矫正状态下，所述定位杆3连续穿过第一定位部12和第二定位部33，一定位针300连续穿过通孔14和对位孔4，从而形成三点固定。
即，参照图5和图6所示，当撑开角度达到述前规划的矫正角度时，定位杆3可连续穿过第一定位部12和第二定位部22，而固定在第一定位柱11和第二定位柱21之间，此时，将一定位针300连续穿过通孔14和对位孔4，而固定在第一定位柱11和第二导板2之间，从而第一定位柱11、第二定位柱21及第二导板2上设置对位孔4的部分形成三点固定，更稳定的维持撑开角度，避免影响后续手术效果，或重复调整撑开角度的繁复，简化手术流程，节省手术时间。此外，该结构精确定位胫骨截骨后撑开的高度和角度，提高了手术精度，降低了手术难度和对医生的经验依赖度，避免了传统手术术中的频繁的X射线透视测量，降低了患者和医生的辐射危害。
在本发明中，所述固定针6可直接使用骨针，便于获取且使用方便，从而通孔14和对位孔4设置尺寸较小，不影响第一导板1和第二导板的其他结构设计且占用面积小，容易设置其位置，便于制造。
参照图1至图6所示，所述第二导板2还包括与第二定位柱21同向突伸的对位柱24，所述对位孔4设于对位柱24侧表面上且对应贯穿对位柱24。
所述第二导板2还包括用于引导切割路径的一下引导部25。所述对位柱24设于所述下引导部25外侧，且所述对位孔4位置高出所述下引导部25。在本发明优选的实施方式中，所述对位柱24贴靠于下引导部25设置，且上端厚度大于下端厚度，令对位柱24面对第一导板1的内侧面与下引导部25面对第一导板1的内侧面相平齐。从而对位孔4所在的对位柱24部分具有足够的厚度，以增强固定的牢靠度。
所述第一导板1还包括用于引导切割路径的一上引导部15及一侧引导部16。所述上引导部15位于第二导板2的下引导部25上方，且所述上引导部15与下引导部25之间形成用于引导切割工具200路径的引导槽5。所述侧引导部16和引导槽5共同引导切割工具200 完成锯切截骨。
所述第一导板1还包括与第一定位柱11同向突伸且用于令固定针穿过固定的第一固定部17，所述第二导板2还包括与第二定位柱21同向突伸且用于令固定针穿过固定的第二固定部26。所述第一固定部17和第二固定部26均为中空结构，当第一导板1和第二导板2放置于胫骨近端时，将固定针通过第一固定部17和第二固定部26打入胫骨，从而将第一导板1和第二导板2固定在胫骨近端处，避免移动等影响手术的情况。
在本发明优选的实施方式中，所述第一固定部17和第二固定部26分别设置为一对，在矫正状态下，所述通孔14和对位孔4的连线分别位于一对第一固定部17和一对第二固定部26之间。一对第一固定部17和一对第二固定部26均沿着引导槽5的延伸方向排布且间隔一定距离，从而令固定针穿过对位孔4和瞳孔14时，不会被固定在第一固定部17和第二固定部26内的固定针所影响或，不便于穿引于通孔14和对位孔4之间。
所述截骨手术引导工具100的使用方法包括多个步骤。
根据手术要求，切开皮肤、组织等，显露胫骨内侧的骨性结构，放置第一导板1和第二导板2于患者病灶区术前规划位置，令第一导板和第二导板的内侧面与患者病灶区骨面贴合，移动定位第一导板1和第二导板2使其与骨面贴合不移动，并依序打上四根骨针将其固定。
按照术前规划，切割工具200伸入引导槽5的内部，锯切截断患者病灶区对应部分皮质，并在在患者病灶区逐渐撑开一开口。即，参照图3和图4所示，切割工具200先沿着引导槽5进行切割截骨，再沿着侧引导部16进行切割截骨，从而完成锯切截骨。
将定位杆3的一端依次穿过第一定位部12和第二定位部22的定位孔13，当定位杆3能够连续穿过第一定位部12和第二定位部22的定位孔13，即达到术前规划的矫正角度。此时，所述第一定位部12和第二定位部22的定位孔13的中轴线在同一直线上。
将一骨针依次穿过第一定位柱11的通孔14及位于所述对位柱24的对位孔4，此时，所述对位孔4的中轴线与所述通孔14的中轴线在同一直线上，并与定位杆3的固定一同形成三角固定。
在其他实施方式，所述对位孔4亦可设置为包括贯穿第一导板1的第一孔和贯穿第二导板2的第二孔，在矫正状态下，所述通孔14、第一孔和第二孔的中轴线在同一直线上。
在本实施方式中，所述第一孔可设置在上引导部15且沿上引导部15厚度方向贯通设置。所述第二孔可设置在下引导部25且沿下引导部25厚度方向贯通设置。因此，固定针6穿过通孔14、第一孔和第二孔可更好的维持撑开角度，而第一孔和第二孔分别设置在上引导部 15和下引导部25上，不需要增加额外的结构来进行打孔，简化了结构设计，且能实现相同的技术效果。
上文所列出的详细说明仅仅是针对本发明的可行性实施方式的具体说明，它们并非用以限制本发明的保护范围，凡未脱离本发明技艺精神所作的等效实施方式或变更均应包含在本发明的保护范围之内。

Claims (10)

  1. 一种截骨手术引导工具，包括用于在第一方向组合固定的第一导板和第二导板以及与所述第一导板和第二导板配合且用于角度校验的定位杆，其特征在于：所述第一导板包括向外突设的第一定位柱及位于所述第一定位柱顶端的第一定位部，所述第二导板包括与所述第一定位柱同向突设的第二定位柱及位于所述第二定位柱顶端的第二定位部，所述第一定位部和第二定位部均分别包括沿第一方向贯通的定位孔，且在矫正前所述第一定位部和第二定位部的定位孔的中轴线之间形成一矫正角度，所述第一定位柱具有一通孔，所述截骨手术引导工具上还设置有位于所述第二定位柱旁侧的对位孔，所述对位孔的中轴线与所述通孔的中轴线相交，在矫正状态下，所述定位杆连续穿过所述第一定位部和第二定位部，一定位针连续穿过所述通孔和对位孔，从而形成三点固定。
  2. 如权利要求1所述的截骨手术引导工具，其特征在于：所述第二导板还包括与所述第二定位柱同向突伸的对位柱，所述对位孔设于对位柱侧表面上且对应贯穿所述对位柱。
  3. 如权利要求2所述的截骨手术引导工具，其特征在于：所述第二导板包括用于引导切割路径的一下引导部，所述对位柱设于所述下引导部外侧，且所述对位孔位置高出所述下引导部。
  4. 如权利要求3所述的截骨手术引导工具，其特征在于：所述第一导板包括用于引导切割路径的一侧引导部及一上引导部，所述上引导部位于所述下引导部上方，且所述上引导部与下引导部之间形成用于引导切割工具路径的引导槽。
  5. 如权利要求1所述的截骨手术引导工具，其特征在于：所述对位孔包括贯穿第一导板的第一孔和贯穿第二导板的第二孔，在矫正状态下，所述通孔、第一孔和第二孔的中轴线在同一直线上。
  6. 如权利要求5所述的截骨手术引导工具，其特征在于：所述第一导板包括用于引导切割路径的一侧引导部及一上引导部，所述第一孔位于所述上引导部且沿所述上引导部厚度方向贯通设置。
  7. 如权利要求6所述的截骨手术引导工具，其特征在于：所述第一导板包括位于所述上引导部下方且用于引导切割路径的一下引导部，所述上引导部与下引导部之间形成用于引导切割工具路径的引导槽，所述第二孔位于所述下引导部且沿所述下引导部厚度方向贯通设置。
  8. 如权利要求1所述的截骨手术引导工具，其特征在于：所述第一导板还包括与所述第一定位柱同向突伸且用于令固定针穿过固定的第一固定部，所述第二导板还包括与所述第二定位柱同向突伸且用于令固定针穿过固定的第二固定部。
  9. 如权利要求8所述的截骨手术引导工具，其特征在于：所述第一固定部和第二固定部分别设置为一对，在矫正状态下，所述通孔和对位孔的连线分别位于一对第一固定部和一对第二固定部之间。
  10. 一种截骨手术引导工具的使用方法，其特征在于：包括以下步骤：
    将截骨手术引导工具放置于患者病灶区，令截骨手术引导工具的第一导板和第二导板的内侧面与患者病灶区骨面贴合，移动定位截骨手术引导工具使其与骨面贴合不移动，并进行固定；
    按照术前规划，切割工具伸入截骨手术引导工具内部，锯切截断患者病灶区对应部分皮质，并在在患者病灶区逐渐撑开一开口；
    将定位杆的一端依次穿过第一定位部和第二定位部的定位孔，当定位杆连续穿过第一定位部和第二定位部的定位孔，即达到术前规划的矫正角度；
    将一定位针依次穿过第一定位柱的通孔及位于所述第二定位柱旁侧的对位孔，此时，所述对位孔的中轴线与所述通孔的中轴线在同一直线上，并与定位杆的固定一同形成三角固定。
PCT/CN2019/128489 2019-12-18 2019-12-26 截骨手术引导工具及其使用方法 WO2021120265A1 (zh)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201911305341.9 2019-12-18
CN201911305341.9A CN112971911A (zh) 2019-12-18 2019-12-18 截骨手术引导工具及其使用方法

Publications (1)

Publication Number Publication Date
WO2021120265A1 true WO2021120265A1 (zh) 2021-06-24

Family

ID=76343642

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2019/128489 WO2021120265A1 (zh) 2019-12-18 2019-12-26 截骨手术引导工具及其使用方法

Country Status (2)

Country Link
CN (1) CN112971911A (zh)
WO (1) WO2021120265A1 (zh)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113693673A (zh) * 2021-08-27 2021-11-26 周君琳 一种基于骨科手术的跖骨截骨导板

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0570187A1 (en) * 1992-05-03 1993-11-18 Technology Finance Corporation (Proprietary) Limited Surgical instruments
US8123753B2 (en) * 2008-04-28 2012-02-28 Depuy (Ireland) Ltd. Cutting guide assembly
CN205697912U (zh) * 2016-06-15 2016-11-23 中南大学湘雅医院 一种基于胫骨和股骨的截骨导板组件
CN108635016A (zh) * 2018-05-31 2018-10-12 武汉嘉三维技术应用有限公司 一种胫骨高位双平面截骨导航导板
WO2019038240A1 (fr) * 2017-08-22 2019-02-28 Newclip International Dispositif chirurgical de guidage, pour assister une technique d'osteotomie d'ouverture
CN109770995A (zh) * 2019-03-07 2019-05-21 苏州欣荣博尔特医疗器械有限公司 用于胫骨近端高位截骨手术的导向块
CN209153864U (zh) * 2018-05-31 2019-07-26 武汉嘉一三维技术应用有限公司 一种胫骨高位双平面截骨导航导板
EP3520720A1 (en) * 2018-02-06 2019-08-07 Istituto Ortopedico Rizzoli Instruments for implanting bone inserts

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0570187A1 (en) * 1992-05-03 1993-11-18 Technology Finance Corporation (Proprietary) Limited Surgical instruments
US8123753B2 (en) * 2008-04-28 2012-02-28 Depuy (Ireland) Ltd. Cutting guide assembly
CN205697912U (zh) * 2016-06-15 2016-11-23 中南大学湘雅医院 一种基于胫骨和股骨的截骨导板组件
WO2019038240A1 (fr) * 2017-08-22 2019-02-28 Newclip International Dispositif chirurgical de guidage, pour assister une technique d'osteotomie d'ouverture
EP3520720A1 (en) * 2018-02-06 2019-08-07 Istituto Ortopedico Rizzoli Instruments for implanting bone inserts
CN108635016A (zh) * 2018-05-31 2018-10-12 武汉嘉三维技术应用有限公司 一种胫骨高位双平面截骨导航导板
CN209153864U (zh) * 2018-05-31 2019-07-26 武汉嘉一三维技术应用有限公司 一种胫骨高位双平面截骨导航导板
CN109770995A (zh) * 2019-03-07 2019-05-21 苏州欣荣博尔特医疗器械有限公司 用于胫骨近端高位截骨手术的导向块

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113693673A (zh) * 2021-08-27 2021-11-26 周君琳 一种基于骨科手术的跖骨截骨导板
CN113693673B (zh) * 2021-08-27 2023-09-22 周君琳 一种基于骨科手术的跖骨截骨导板

Also Published As

Publication number Publication date
CN112971911A (zh) 2021-06-18

Similar Documents

Publication Publication Date Title
US20230200855A1 (en) Compressor-distractor for angularly realigning bone portions
US10299800B2 (en) Surgical instrumentation and methods of use for implanting a prosthesis
JP3921635B2 (ja) ひざの関節丘を切削するための切削案内具
US8192441B2 (en) High tibial osteotomy instrumentation
JP4923041B2 (ja) 楔開き高位脛骨骨切り術を行うための方法及び装置
US20140364857A1 (en) Joint Arthroplasty Devices, Systems, and Methods
CN205697912U (zh) 一种基于胫骨和股骨的截骨导板组件
JPS6329546B2 (zh)
JP2016501644A (ja) 外科的穿孔ガイド
KR102156066B1 (ko) 절골술용 기구
KR102140052B1 (ko) 체외 정렬 컴포넌트를 구비한 골절술 디바이스
CN109512484B (zh) 胫骨矫形截骨引导装置
TWI638634B (zh) 截骨手術器械
CN105615979A (zh) 一种髓内钉内固定手术中的辅助装置
WO2021120265A1 (zh) 截骨手术引导工具及其使用方法
KR20210013549A (ko) 앵커 배치용 시스템
US11607255B2 (en) Method and apparatus for treating cranial cruciate ligament disease in canines
CN216167688U (zh) 个性化截骨定位装置
CN109044501A (zh) 一种椎间孔镜微创通道精确定位装置及方法
CN113243967B (zh) 融合膝行全膝关节置换的导航装置
CN211749866U (zh) 个性化截骨手术引导工具
US20220183857A1 (en) Positioning device of a surgical instrument for hip arthroplasty surgery
KR102004365B1 (ko) 골절 부위 연장용 골절 고정 플레이트 세트
JP7257016B2 (ja) 患者適合型ガイド設置用器具
CN111658066A (zh) 一种3d打印组配式、模块化脊柱截骨导板装置

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 19956373

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 19956373

Country of ref document: EP

Kind code of ref document: A1