WO2022142696A1 - 全膝关节置换手术用股骨导板及其使用方法 - Google Patents

全膝关节置换手术用股骨导板及其使用方法 Download PDF

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Publication number
WO2022142696A1
WO2022142696A1 PCT/CN2021/127786 CN2021127786W WO2022142696A1 WO 2022142696 A1 WO2022142696 A1 WO 2022142696A1 CN 2021127786 W CN2021127786 W CN 2021127786W WO 2022142696 A1 WO2022142696 A1 WO 2022142696A1
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Prior art keywords
femoral
osteotomy
guide plate
condyle
distal
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PCT/CN2021/127786
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English (en)
French (fr)
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张逸凌
刘星宇
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北京长木谷医疗科技有限公司
张逸凌
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Publication of WO2022142696A1 publication Critical patent/WO2022142696A1/zh

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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
    • A61B17/1732—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
    • A61B17/16—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
    • A61B17/171—Guides or aligning means for drills, mills, pins or wires for external fixation
    • 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 invention relates to the technical field of total knee joint replacement surgery, in particular to a femoral guide plate for total knee joint replacement surgery and a method for using the same.
  • TKA total knee arthroplasty
  • preoperative prediction is based on knee X-ray or CT to determine the deviation of lower limb alignment, femoral valgus angle, and femoral external rotation angle. lead to surgical errors.
  • the mechanical axis of the femur is inconsistent with the anatomical axis.
  • most osteotomy positioning is achieved by maintaining the valgus angle of the femur, so when the femur is laterally arched or deformed, it may lead to corresponding errors; conventional surgery intramedullary or intramedullary surgery.
  • the surgical method of external positioning instruments has a single standard and cannot meet the needs of individualization. The accuracy of localization depends on the operator's surgical experience, and intramedullary localization has a large amount of bleeding, which may cause embolism.
  • the invention provides a femoral guide plate for total knee joint replacement surgery and a method of using the same, which are used to solve the defect of poor positioning accuracy of osteotomy in total knee joint replacement surgery in the prior art, realize the accuracy of osteotomy positioning of the femoral guide plate, and improve the accuracy of osteotomy positioning. Success rate of total knee replacement surgery.
  • the invention provides a femoral guide plate for total knee replacement surgery, which comprises a femoral guide plate body, and the first side of the femoral guide plate body is provided with a distal femoral osteotomy groove aligned with the osteotomy surface of the distal femur and a The anterior condyle osteotomy groove aligned with the condyle osteotomy surface, the first sickle blade that can be inserted in the distal osteotomy groove is set to be able to verify the osteotomy volume of the distal femur, and the anterior condyle osteotomy groove is set to be able to be inserted.
  • the second sickle blade for verifying the osteotomy of the anterior femoral condyle the first end of the second side of the femoral guide plate that faces away from its first side is provided with a fitting area for the anterior femoral condyle, and the femoral guide plate body faces away from its first side
  • the second end of the second side is provided with a medial femoral condyle fitting area and a lateral femoral condyle fitting area.
  • the first end of the femoral guide plate body is provided with a positioning hole for the distal femoral osteotomy, and the positioning hole for the distal femoral osteotomy is set to be inserted into the distal femur.
  • the bone instrument is connected to the positioned first positioning pin.
  • a femoral guide plate for total knee replacement surgery there are two locating holes for osteotomy in the distal end of the femur, and the two locating holes for osteotomy in the distal end of the femur are located on the same horizontal line.
  • the second end of the femoral guide plate body is provided with a positioning hole for the posterior femoral condyle osteotomy, and the positioning hole for the posterior femoral condyle osteotomy is set to be inserted into the posterior condyle of the femur.
  • the bone instrument is connected to the positioned second positioning pin.
  • two locating holes for the osteotomy of the posterior condyle of the femur are provided, and the two locating holes for the osteotomy of the posterior condyle of the femur are located on the same horizontal line.
  • the femoral bone guide plate for total knee replacement surgery is an integral molding structure.
  • the femoral bone guide plate for total knee replacement surgery is prepared by a 3D method.
  • the material of the femoral guide plate body is medical resin or medical metal.
  • the present invention also provides a method for using a femoral guide plate for total knee replacement surgery, comprising the following steps:
  • the distal femur and the anterior femoral condyle were separately osteotomized by osteotomy instruments.
  • performing osteotomy on the distal end of the femur and the anterior femoral condyle with an osteotomy instrument respectively includes: after removing the second positioning pin , remove the femoral guide plate; install and register the distal osteotomy instrument with the first positioning pin, perform the osteotomy, and remove the osteotomy instrument and the first positioning pin after the osteotomy is completed; install the second positioning pin Re-insert into the screw channel corresponding to the second positioning pin; after installing and configuring the posterior malleolus osteotomy instrument and the second positioning pin, perform posterior malleolus osteotomy, anterior malleolus osteotomy, oblique anterior osteotomy and oblique posterior osteotomy.
  • the present invention provides a femoral guide plate for total knee replacement surgery and a method of using the same.
  • the medial condyle of the femur and the lateral condyle of the femur are aligned and fitted to realize the precise positioning and installation of the femoral guide plate; by setting the distal osteotomy slot and the anterior condyle osteotomy slot, and inserting the sickle blade correspondingly, the distal femoral osteotomy and the
  • the accurate verification of the osteotomy volume of the anterior femoral condyle ensures the accurate positioning of the osteotomy in the operation, improves the safety and success rate of the operation, and has a simple structure, convenient operation and accurate positioning.
  • FIG. 1 is a side view of a femoral guide plate for total knee replacement surgery provided by the present invention
  • FIG. 2 is a top view of a femoral guide plate for total knee replacement surgery provided by the present invention
  • FIG. 3 is a rear view of a femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 4 is a side view of the femoral guide plate for total knee replacement surgery provided by the present invention and the effect of assembling the femur;
  • FIG. 5 is a rear view of the femoral guide plate and the femur for total knee replacement surgery provided by the present invention
  • FIG. 6 is a bottom view of the femoral guide plate for total knee replacement surgery provided by the present invention and the effect of assembling the femur;
  • FIG. 7 is a flowchart of a method for using a femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 8 is a schematic diagram of operation 1 in the using method of the femoral guide plate for total knee replacement surgery provided by the present invention
  • FIG. 9 is a schematic diagram of operation 2 in the using method of the femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 10 is a schematic diagram of operation three in the method of using the femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 11 is a schematic diagram of operation 4 in the using method of the femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 12 is a schematic diagram of operation five in the method for using the femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 13 is a schematic diagram of operation six in the method for using the femoral guide plate for total knee replacement surgery provided by the present invention.
  • FIG. 14 is a schematic diagram of operation 7 in the using method of the femoral guide plate for total knee replacement surgery provided by the present invention.
  • 15 is a schematic diagram of the femur after osteotomy is completed using the method of using the femoral guide plate for total knee replacement surgery provided by the present invention.
  • 100 femoral guide plate body; 110, distal femoral osteotomy slot; 120, anterior femoral condyle osteotomy slot; 130, femoral anterior condyle fitting area; 140, femoral medial condyle fitting area; 150, femoral lateral condyle fitting Area; 160, locating hole for distal femur osteotomy; 161, first positioning pin; 170, locating hole for posterior femoral condyle osteotomy; 171, second positioning pin; 180, sickle blade; 200, femur; 300, distal femur Osteotomy instruments; 400, Posterior femoral condyle osteotomy instruments.
  • connection and “connected” should be understood in a broad sense, for example, it may be a fixed connection or a detachable connection, Or integral connection; it can be mechanical connection or electrical connection; it can be directly connected or indirectly connected through an intermediate medium.
  • connection should be understood in a broad sense, for example, it may be a fixed connection or a detachable connection, Or integral connection; it can be mechanical connection or electrical connection; it can be directly connected or indirectly connected through an intermediate medium.
  • the first feature "above” or “under” the second feature may be in direct contact with the first and second features, or the first and second features pass through the middle indirect contact with the media.
  • the first feature being “above”, “over” and “above” the second feature may mean that the first feature is directly above or obliquely above the second feature, or simply means that the first feature is level higher than the second feature.
  • the first feature being “below”, “below” and “below” the second feature may mean that the first feature is directly below or obliquely below the second feature, or simply means that the first feature has a lower level than the second feature.
  • a femoral guide plate for total knee replacement surgery will be described below with reference to FIGS. 1 to 6 , including a femoral guide plate body 100 .
  • the sickle blade, the second sickle blade set to be able to verify the osteotomy amount of the anterior femoral condyle is inserted in the osteotomy slot 120 of the anterior femoral condyle, and the first end of the second side of the femoral guide plate body 100 opposite to the first side is set.
  • There is an anterior femoral condyle fitting area 130 and the second end of the second side of the femoral guide plate 100 opposite to the first side is provided with a medial femoral condyle fitting area 140 and a lateral femoral condyle fitting area 150 .
  • the first side of the femoral guide plate body 100 is provided with a horizontally arranged distal femoral osteotomy slot 110 and a vertically arranged anterior femoral condyle osteotomy slot 120, wherein the distal femoral osteotomy slot 110 is provided.
  • the anterior femoral condyle osteotomy groove 120 is aligned with the anterior femoral condyle osteotomy surface.
  • the first sickle blade and the second sickle blade may be different sickle blades, or the same sickle blade 180 may be used.
  • a sickle blade 180 can be inserted into the osteotomy slot 120 of the anterior condyle of the femur to verify and locate the osteotomy amount of the distal femur.
  • a sickle blade 180 can be inserted into the osteotomy slot 120 of the anterior femoral condyle to verify and locate the osteotomy of the anterior femoral condyle. Improve the accuracy and success rate of the surgical osteotomy process.
  • the second side of the femoral guide plate body 100 is the positive side that fits with the femur
  • the first end is provided with an anterior femoral condyle fitting area 130 that is aligned and fitted with the corresponding anterior femoral condyle
  • the two sides of the second end are provided with
  • the lateral femoral condyle fitting area 140 that is aligned and fitted to the corresponding medial femoral condyle and the lateral femoral condyle fitting area 150 that is aligned and fitted to the corresponding lateral femoral condyle are respectively provided.
  • the setting of the zone realizes the precise positioning and fitting of the femoral guide plate and the femur 200, and ensures the stability of the fitting.
  • the first end of the femoral guide plate body 100 is provided with a distal femoral osteotomy positioning hole 160, and the distal femoral osteotomy positioning hole 160 is set to be inserted into the femur.
  • the distal osteotomy instrument 300 is connected to the positioned first positioning pin 161 .
  • the first end of the femoral guide plate body 100 is provided with a horizontally arranged distal osteotomy positioning hole, and along the height direction of the femoral guide plate body 100, the distal osteotomy positioning hole is located in the fitting area of the anterior femoral condyle. 130's underside.
  • a first positioning pin 161 can be inserted into the positioning hole 160 of the distal femur osteotomy, and the first positioning pin 161 is used for connecting and positioning with the distal femoral osteotomy instrument 300 . It can be understood that, after the femoral guide plate body 100 is aligned and fitted with the femur, the first positioning pin 161 is inserted into the positioning hole 160 of the distal femoral osteotomy and fixedly connected with the femur 200 to achieve positioning connection.
  • two distal femoral osteotomy positioning holes 160 are provided, and the two distal femoral osteotomy positioning holes 160 are located on the same horizontal line. It can be understood that, in order to ensure fixation strength and positioning accuracy, preferably two distal femoral osteotomy positioning holes 160 are provided, which are located on the same horizontal line on the left and right sides below the anterior femoral condyle fitting area 130, and are provided in parallel.
  • two positioning holes 160 for osteotomy of the distal end of the femur are provided, and the first positioning pins 161 can be respectively inserted, which can ensure accurate positioning and reduce the number of top holes for the distal end of the femur.
  • the second end of the femoral guide plate body 100 is provided with a positioning hole 170 for posterior femoral condyle osteotomy, and the positioning hole 170 for posterior femoral condyle osteotomy is set to be inserted into the femur.
  • the posterior condyle osteotomy instrument 400 is connected to the positioned second positioning pin 171 . It can be understood that the second end of the femoral guide plate body 100 is provided with a positioning hole 170 for the posterior femoral condyle osteotomy along the vertical direction to locate the position of the posterior femoral condyle osteotomy instrument.
  • a second positioning pin 171 can be inserted into the positioning hole 170 of the posterior femoral condyle osteotomy, and the second positioning pin 171 is used to connect with the posterior femoral condyle osteotomy instrument 400 for positioning. It can be understood that, after the femoral guide plate body 100 is aligned and fitted with the femur, the second positioning pin 171 is inserted into the positioning hole 170 of the posterior condyle of the femur, and is fixedly connected with the posterior condyle of the femur 200 to realize the positioning connection. .
  • a femoral guide plate for total knee replacement surgery there are two locating holes 170 for posterior femoral condyle osteotomy, and the two locating holes 170 for posterior femoral condyle osteotomy are located on the same horizontal line.
  • two posterior femoral condyle osteotomy locating holes 170 it is preferable to provide two posterior femoral condyle osteotomy locating holes 170, and they are all arranged in the vertical direction, that is, the two posterior femoral condyle osteotomy locating holes 170 are provided.
  • the axes are parallel to each other in the vertical direction and lie on the same horizontal line.
  • one positioning hole 170 of the posterior femoral condyle osteotomy is set in the fitting area 140 of the medial femoral condyle, and the other positioning hole 170 of the posterior femoral condyle osteotomy is set in the fitting area 150 of the lateral femoral condyle, which ensures accurate positioning to the greatest extent. while reducing the number of screw holes in the posterior femoral condyle.
  • the femoral bone guide plate for total knee replacement surgery is an integral molding structure.
  • 3D printing is used to prepare the femoral guide.
  • the femoral guide is prepared by 3D printing, taking into account any slight deformities or osteophytes through preoperative design and rehearsal, and the size, position, and rotation of the femoral guide can be determined in advance, which facilitates adjustment of the lower extremity alignment so that It is close to the neutral line of force, which makes the position of the femoral guide plate more accurate, and completely fits the contour of the femur 200 to achieve individualized and precise design.
  • the material of the femoral guide plate is medical resin or medical metal.
  • both medical resin and medical metal are existing materials.
  • polyethylene, polyetheretherketone, polyacetic acid, etc. can be selected for medical resin
  • titanium, titanium alloy, stainless steel, etc. can be selected for medical metal.
  • the present invention also provides a method for using a femoral guide plate for total knee replacement surgery, comprising the following steps:
  • the distal femur and the anterior femoral condyle were separately osteotomized by osteotomy instruments.
  • the osteotomy of the distal end of the femur and the anterior condyle of the femur using an osteotomy instrument respectively includes: after removing the second positioning pin, The femoral guide plate is removed; after the distal osteotomy instrument is installed and registered with the first positioning pin, the osteotomy is performed, and the osteotomy instrument and the first positioning pin are removed after the osteotomy is completed; the second positioning pin is reinserted into the screw channel corresponding to the second positioning pin; after the posterior malleolus osteotomy instrument and the second positioning pin are installed and configured, the posterior malleolus osteotomy, the anterior malleolus osteotomy, the oblique anterior osteotomy and the oblique posterior osteotomy are performed.
  • the position of the guide nail hole can be designed according to the relative positional relationship between the nail hole of the planned osteotomy instrument and the osteotomy surface. Therefore, since the positioning nail can play the role of a positioning mark, when the osteotomy amount is determined, , the position of the positioning pin is also uniquely determined, so that when the osteotomy instrument is installed based on the positioning pin, its osteotomy position (eg, the osteotomy plane) is also determined.
  • the osteotomy position and angle are determined in advance;
  • the distal femoral osteotomy slot 110 and the anterior femoral condyle osteotomy slot 120 are designed on the first side of the femoral guide plate, and the anterior femoral condyle fitting area 130, the medial femoral condyle fitting area 140 and the lateral femoral condyle are designed on the second side of the femoral guide plate 100.
  • the condyle fitting area 150 completes the preparation of the individualized femoral guide plate;
  • the second positioning nail 171 in the nail hole of the posterior femoral condyle, preferably, the first positioning nail 161 and the second positioning nail 171 used in the distal femoral osteotomy and the posterior femoral condyle osteotomy can be the same , can also be different;
  • the present invention provides a femoral guide plate for total knee replacement surgery and a method of using the same.
  • the medial condyle of the femur and the lateral condyle of the femur are aligned and fitted to realize the precise positioning and installation of the femoral guide plate; by setting the distal osteotomy slot and the anterior condyle osteotomy slot, and inserting the sickle blade correspondingly, the distal femoral osteotomy and the
  • the accurate verification of the osteotomy volume of the anterior femoral condyle ensures the accurate positioning of the osteotomy in the operation, improves the safety and success rate of the operation, and has a simple structure, convenient operation and accurate positioning.

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Abstract

本发明提供一种全膝关节置换手术用股骨导板及其使用方法，包括股骨导板板体，股骨导板板体的第一侧设有与股骨远端截骨面对齐的股骨远端截骨槽和与股骨前髁截骨面对齐的前髁截骨槽，远端截骨槽内插设被设置为能够验证股骨远端截骨量的第一镰刀片，前髁截骨槽内插设被设置为能够验证股骨前髁截骨量的第二镰刀片，股骨导板板体与其第一侧相背的第二侧的第一端设有股骨前髁拟合区，股骨导板板体与其第一侧相背的第二侧的第二端设有股骨内侧髁拟合区和股骨外侧髁拟合区。本发明实现股骨导板的精准定位安装，以及对股骨远端截骨量和股骨前髁截骨量的精确验证，保证手术的截骨的准确定位，提高手术的安全性和成功率。

Description

全膝关节置换手术用股骨导板及其使用方法
相关申请的交叉引用
本申请要求于2020年12月31日提交中国专利局，申请号为202011635789.X，发明名称为“全膝关节置换手术用股骨导板及其使用方法”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
本发明涉及全膝关节置换术技术领域，特别是涉及一种全膝关节置换手术用股骨导板及其使用方法。
背景技术
全膝关节置换术(total knee arthroplasty，TKA)的成功与否取决于膝关节的定位、间隙以及软组织平衡，而三者均依赖于安放假体的正确位置。传统TKA手术，术前仅根据膝关节X线或CT判断下肢力线的偏移、股骨外翻角、股骨外旋角等角度进行手术预测，且膝关节的旋转也会影响角度判断，可能会导致手术误差。同时，股骨力学轴线和解剖轴线不一致，传统上大部分截骨定位是通过保持股骨外翻角固定来实现的，所以当股骨侧弓或畸形时可能会导致相应的误差；常规手术髓内或髓外定位器械手术方法标准单一，不能满足个体化的需求。定位的准确性依赖术者的手术经验，且髓内定位出血量大，可能引起栓塞。
发明内容
本发明提供一种全膝关节置换手术用股骨导板及其使用方法，用以解决现有技术中全膝关节置换手术中截骨定位准确性差的缺陷，实现股骨导板截骨定位的精准性，提高全膝关节置换手术的成功率。
本发明提供一种全膝关节置换手术用股骨导板，包括股骨导板板体，股骨导板板体的第一侧设有与股骨远端截骨面对齐的股骨远端截骨槽和与股骨前髁截骨面对齐的前髁截骨槽，远端截骨槽内插设被设置为能够验证股骨远端截骨量的第一镰刀片，前髁截骨槽内插设被设置为能够验证股骨前髁截骨量的第二镰刀片，股骨导板板体与其第一侧相背的第二侧的第一端设有股骨前髁拟合区，股骨导板板体与其第一侧相背的第二侧的第二端设有股骨内侧髁拟合区和股骨外侧髁拟合区。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨导板板体的第一端设有股骨远端 截骨定位孔，股骨远端截骨定位孔被设置为插入与股骨远端截骨器械连接定位的第一定位钉。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨远端截骨定位孔设置有两个，两个股骨远端截骨定位孔位于同一水平线。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨导板板体的第二端设有股骨后髁截骨定位孔，股骨后髁截骨定位孔被设置为插入与股骨后髁截骨器械连接定位的第二定位钉。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨后髁截骨定位孔设置有两个，两个股骨后髁截骨定位孔位于同一水平线。
根据本发明提供的一种全膝关节置换手术用股骨导板，全膝关节置换手术用股骨导板为一体成型结构。
根据本发明提供的一种全膝关节置换手术用股骨导板，全膝关节置换手术用股骨导板采用3D方法制备而成。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨导板板体的材质为医用树脂或医用金属。
本发明还提供一种全膝关节置换手术用股骨导板的使用方法，包括如下步骤：
将股骨前髁拟合区与股骨前髁对位拟合，将股骨内侧髁拟合区与股骨内侧髁对位拟合，将股骨外侧髁拟合区与股骨外侧髁对位拟合；
将第一镰刀片插入远端截骨槽内，验证并确定股骨远端的截骨量；
将第二镰刀片插入前髁截骨槽内，验证并确定股骨前髁的截骨量；
通过截骨器械对股骨远端和股骨前髁分别进行截骨。
根据本发明提供的一种全膝关节置换手术用股骨导板的使用方法,通过截骨器械对所述股骨远端和所述股骨前髁分别进行截骨包括：在将第二定位钉移除后，将股骨导板移除；将远端截骨器械与第一定位钉安装配准后，进行截骨动作，并在截骨完成后移除截骨器械和第一定位钉；将第二定位钉重新插入至第二定位钉对应的钉道中；将后踝截骨器械与第二定位针安装配置后，进行后踝截骨、前踝截骨、斜前截骨和斜后截骨。
本发明提供的全膝关节置换手术用股骨导板及其使用方法，通过设置股骨前髁拟合区、股骨内侧髁拟合区和股骨外侧髁拟合区，实现分别与相对应的股骨前髁、股骨内侧髁和股骨外侧髁对位拟合，实现股骨导板的精准定位安装；通过设置远端截骨槽和前髁截骨槽，并对应插设镰刀片，实现对股骨远端截骨量和股骨前髁截骨量的精确验证，保证手术的截骨的准确定位，提高手术的 安全性和成功率，结构简单，操作方便，定位准确。
本发明的附加方面和优点将在下面的描述中部分给出，部分将从下面的描述中变得明显，或通过本发明的实践了解到。
附图说明
为了更清楚地说明本发明实施例或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作一简单地介绍，显而易见地，下面描述中的附图是本发明的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1是本发明提供的全膝关节置换手术用股骨导板的侧视图；
图2是本发明提供的全膝关节置换手术用股骨导板的俯视图；
图3是本发明提供的全膝关节置换手术用股骨导板的后视图；
图4是本发明提供的全膝关节置换手术用股骨导板与股骨装配效果侧视图；
图5是本发明提供的全膝关节置换手术用股骨导板与股骨装配效果后视图；
图6是本发明提供的全膝关节置换手术用股骨导板与股骨装配效果仰视图；
图7是本发明提供的全膝关节置换手术用股骨导板的使用方法流程图；
图8是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作一的示意图；
图9是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作二的示意图；
图10是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作三的示意图；
图11是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作四的示意图；
图12是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作五的示意图；
图13是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作六的示意图；
图14是本发明提供的全膝关节置换手术用股骨导板的使用方法中操作七的示意图；
图15是本发明提供的全膝关节置换手术用股骨导板的使用方法完成截骨后的股骨的示意图。
附图标记：
100、股骨导板板体；110、股骨远端截骨槽；120、股骨前髁截骨槽；130、股骨前髁拟合区；140、股骨内侧髁拟合区；150、股骨外侧髁拟合区；160、股骨远端截骨定位孔；161、第一定位钉；170、股骨后髁截骨定位孔；171、第二定位钉；180、镰刀片；200、股骨；300、股骨远端截骨器械；400、股骨后髁截骨器械。
具体实施方式
下面结合附图和实施例对本发明的实施方式作进一步详细描述。以下实施例用于说明本发明，但不能用来限制本发明的范围。
在本发明实施例的描述中，需要说明的是，术语“中心”、“纵向”、“横向”、“上”、“下”、“前”、“后”、“左”、“右”、“竖直”、“水平”、“顶”、“底”、“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系，仅是为了便于描述本发明实施例和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本发明实施例的限制。此外，术语“第一”、“第二”、“第三”仅用于描述目的，而不能理解为指示或暗示相对重要性。
在本发明实施例的描述中，需要说明的是，除非另有明确的规定和限定，术语“相连”、“连接”应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或一体连接；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连。对于本领域的普通技术人员而言，可以具体情况理解上述术语在本发明实施例中的具体含义。
在本发明实施例中，除非另有明确的规定和限定，第一特征在第二特征“上”或“下”可以是第一和第二特征直接接触，或第一和第二特征通过中间媒介间接接触。而且，第一特征在第二特征“之上”、“上方”和“上面”可是第一特征在第二特征正上方或斜上方，或仅仅表示第一特征水平高度高于第二特征。第一特征在第二特征“之下”、“下方”和“下面”可以是第一特征在第二特征正下方或斜下方，或仅仅表示第一特征水平高度小于第二特征。
在本说明书的描述中，参考术语“一个实施例”、“一些实施例”、“示例”、“具体示例”、或“一些示例”等的描述意指结合该实施例或示例描述的具体特征、结构、材料或者特点包含于本发明实施例的至少一个实施例或示例中。在本说明书中，对上述术语的示意性表述不必须针对的是相同的实施例或示例。而且，描述的具体特征、结构、材料或者特点可以在任一个或多个实施例或示例中以合适的方式结合。此外，在不相互矛盾的情况下，本领域的技术人员可以将本说明书中描述的不同实施例或示例以及不同实施例或示例的特征进行结合和组合。
下面结合图1至图6描述本发明的一种全膝关节置换手术用股骨导板，包括股骨导板板体100，股骨导板板体100的第一侧设有与股骨远端截骨面对齐的股骨远端截骨槽110和与股骨前髁截骨面对齐的股骨前髁截骨槽120，股骨远端截骨槽110内插设被设置为能够验证股骨远端截骨量的第一镰刀片，股骨前髁截骨槽120内插设被设置为能够验证股骨前髁截骨量的第二镰刀片，股骨导板板 体100与其第一侧相背的第二侧的第一端设有股骨前髁拟合区130，股骨导板板体100与其第一侧相背的第二侧的第二端设有股骨内侧髁拟合区140和股骨外侧髁拟合区150。可以理解的是，股骨导板板体100的第一侧即背侧设有水平设置的股骨远端截骨槽110和竖直设置的股骨前髁截骨槽120，其中股骨远端截骨槽110与股骨远端截骨面对齐，股骨前髁截骨槽120股骨前髁截骨面对齐。第一镰刀片和第二镰刀片可以为不同的镰刀片，也可用同一个镰刀片180。
其中，股骨前髁截骨槽120内可以插设镰刀片180，用以验证并定位股骨远端截骨量。股骨前髁截骨槽120内可以插设镰刀片180，用以验证并定位股骨前髁截骨量。提高手术截骨过程的准确性和成功率。
可选地，股骨导板板体100的第二侧即与股骨贴合的正侧，第一端设置与相对应的股骨前髁对位拟合的股骨前髁拟合区130，第二端的两侧分别设有与相对应的股骨内侧髁对位拟合的股骨内侧髁拟合区140和与相对应的股骨外侧髁对位拟合的股骨外侧髁拟合区150，通过这三处拟合区的设置实现股骨导板与股骨200的精准定位拟合，保证拟合的稳定性。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨导板板体100的第一端设有股骨远端截骨定位孔160，股骨远端截骨定位孔160被设置为插入与股骨远端截骨器械300连接定位的第一定位钉161。可以理解的是，股骨导板板体100的第一端设有水平设置的远端截骨定位孔，且沿股骨导板板体100的高度方向，远端截骨定位孔位于股骨前髁拟合区130的下侧。股骨远端截骨定位孔160内可以插入第一定位钉161，该第一定位钉161用以与股骨远端截骨器械300连接定位。可以理解的是，当股骨导板板体100与股骨对位拟合后，将第一定位钉161穿入股骨远端截骨定位孔160内，并与股骨200固定连接，实现定位连接。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨远端截骨定位孔160设置有两个，两个股骨远端截骨定位孔160位于同一水平线。可以理解的是，为了保证固定强度和定位精准度，优选股骨远端截骨定位孔160设置两个，且位于股骨前髁拟合区130下方的左右两侧的同一水平线上，并平行设置。也就是说，设置两个股骨远端截骨定位孔160，可以分别插入第一定位钉161，即可以保证精准定位，同时减少对股骨远端的顶孔个数。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨导板板体100的第二端设有股骨后髁截骨定位孔170，股骨后髁截骨定位孔170被设置为插入与股骨后髁截骨器械400连接定位的第二定位钉171。可以理解的是，股骨导板板体100的第二端设有沿竖直方向设置股骨后髁截骨定位孔170，用以定位股骨后髁截骨器械位置。股骨后髁截骨定位孔170内可以插入第二定位钉171，该第二定 位钉171用以与股骨后髁截骨器械400连接定位。可以理解的是，当股骨导板板体100与股骨对位拟合后，将第二定位钉171穿入股骨后髁截骨定位孔170内，并与股骨200的后髁固定连接，实现定位连接。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨后髁截骨定位孔170设置有两个，两个股骨后髁截骨定位孔170位于同一水平线。可以理解的是，为了保证固定强度和定位精准度，优选股骨后髁截骨定位孔170设置两个，且均沿竖直方向设置，也就是说，两个股骨后髁截骨定位孔170的轴线沿竖直方向相互平行，且位于同一水平线上。具体的，其中一个股骨后髁截骨定位孔170设于股骨内侧髁拟合区140，另一个股骨后髁截骨定位孔170设于股骨外侧髁拟合区150，最大程度上保证了定位精准度，同时减少股骨后髁钉孔的加工个数。
根据本发明提供的一种全膝关节置换手术用股骨导板，全膝关节置换手术用股骨导板为一体成型结构。在一些更优选的实施方式中，采用3D打印制备股骨导板。可以理解的是，股骨导板采用3D打印制备，通过术前设计和演练考虑到任何轻微的畸形或骨赘，并可事先确定股骨导板大小、位置和旋转，从而有利于调整下肢力线，使其接近于中立位力线，又使股骨导板位置安放更加精准，与股骨200的轮廓完全贴合，实现个体化的精准设计。
根据本发明提供的一种全膝关节置换手术用股骨导板，股骨导板的材质为医用树脂或医用金属。优选地，医用树脂和医用金属均为现有材料，如医用树脂可以选用聚乙烯、聚醚醚酮，聚乙酸等，医用金属可以选用金属钛、钛合金、不锈钢等。
下面对本发明提供的一种全膝关节置换手术用股骨导板的使用方法进行描述，下文描述的全膝关节置换手术用股骨导板的使用方法与上文描述的全膝关节置换手术用股骨导板可相互对应参照。
如图7至图15所示，本发明还提供一种全膝关节置换手术用股骨导板的使用方法，包括如下步骤：
将股骨前髁拟合区130与股骨前髁对位拟合，将股骨内侧髁拟合区140与股骨内侧髁对位拟合，将股骨外侧髁拟合区150与股骨外侧髁对位拟合；
将镰刀片180插入股骨远端截骨槽110内，验证并确定股骨远端的截骨量；
将镰刀片180插入股骨前髁截骨槽120内，验证并确定股骨前髁的截骨量；
通过截骨器械对股骨远端和股骨前髁分别进行截骨。
根据本发明提供的全膝关节置换手术用股骨导板的使用方法，通过截骨器械对所述股骨远端 和所述股骨前髁分别进行截骨包括：在将第二定位钉移除后，将股骨导板移除；将远端截骨器械与第一定位钉安装配准后，进行截骨动作，并在截骨完成后移除截骨器械和第一定位钉；将第二定位钉重新插入至第二定位钉对应的钉道中；将后踝截骨器械与第二定位针安装配置后，进行后踝截骨、前踝截骨、斜前截骨和斜后截骨。
可以理解的是，可以根据计划的截骨器械的钉孔与截骨面之间的相对位置关系设计导板钉孔的位置，因此由于定位钉能够起到定位标识的作用，当截骨量确定后，定位钉的位置也唯一确定，从而当基于定位钉安装截骨器械时，其截骨位置(例如截骨平面)也是确定的。
示例性地，参考图7，通过术前设计和演练考虑到患者任何轻微的畸形或骨赘，事先确定截骨位置和角度；对股骨导板板体100进行3D打印制作，在股骨导板板体100的第一侧设计股骨远端截骨槽110和股骨前髁截骨槽120，在股骨导板板体100的第二侧设计股骨前髁拟合区130、股骨内侧髁拟合区140和股骨外侧髁拟合区150，完成个体化股骨导板的制备；
S101、去除股骨远端拟合位置处的软骨；
S102、将股骨导板与股骨对位拟合，其中包括股骨前髁拟合区130与股骨前髁的对位拟合，股骨内侧髁拟合区140与股骨内侧髁的对位拟合，股骨外侧髁拟合区150与股骨外侧髁的对位拟合；
S103、将两个第一定位钉161分别一一对应穿设于两个股骨远端截骨定位孔160内，并与股骨远端固定连接，将两个第二定位钉171分别一一对应穿设于两个股骨后髁截骨定位孔170内，并与股骨后髁固定连接；
S104、将镰刀片180插入股骨远端截骨槽110内，验证并确定股骨远端的截骨量，将镰刀片180插入股骨前髁截骨槽120内，验证并确定股骨前髁的截骨量；
S105、将第二定位钉171移除；
S106、取下导板；
S107、将股骨远端截骨器械300对应装配在两个第一定位钉161上，进行股骨远端截骨手术；
S108、完成股骨远端截骨后，将第一定位钉161和股骨远端截骨器械300移除；
S109、将第二定位钉171安装于股骨后髁的钉孔内，优选地，股骨远端截骨和股骨后髁截骨过程中所使用的第一定位钉161和第二定位钉171可以相同，也可以不同；
S110、再将股骨后髁截骨器械400对应装配在两个第二定位钉171上；
S111、进行股骨后髁截骨手术，包括股骨后髁、股骨前髁、股骨斜前、股骨斜后四合一截骨；
S112、移除股骨后髁截骨器械400和第二定位钉171。
本发明提供的全膝关节置换手术用股骨导板及其使用方法，通过设置股骨前髁拟合区、股骨内侧髁拟合区和股骨外侧髁拟合区，实现分别与相对应的股骨前髁、股骨内侧髁和股骨外侧髁对位拟合，实现股骨导板的精准定位安装；通过设置远端截骨槽和前髁截骨槽，并对应插设镰刀片，实现对股骨远端截骨量和股骨前髁截骨量的精确验证，保证手术的截骨的准确定位，提高手术的安全性和成功率，结构简单，操作方便，定位准确。
最后应说明的是：以上实施例仅用以说明本发明的技术方案，而非对其限制；尽管参照前述实施例对本发明进行了详细的说明，本领域的普通技术人员应当理解：其依然可以对前述各实施例所记载的技术方案进行修改，或者对其中部分技术特征进行等同替换；而这些修改或者替换，并不使相应技术方案的本质脱离本发明各实施例技术方案的精神和范围。
以上实施方式仅用于说明本发明，而非对本发明的限制。尽管参照实施例对本发明进行了详细说明，本领域的普通技术人员应当理解，对本发明的技术方案进行各种组合、修改或者等同替换，都不脱离本发明技术方案的精神和范围，均应涵盖在本发明的权利要求范围中。

Claims (11)

  1. 一种全膝关节置换手术用股骨导板，包括股骨导板板体，所述股骨导板板体的第一侧设有与股骨远端截骨面对齐的股骨远端截骨槽和与股骨前髁截骨面对齐的前髁截骨槽，所述远端截骨槽内插设被设置为能够验证股骨远端截骨量的第一镰刀片，所述前髁截骨槽内插设被设置为能够验证股骨前髁截骨量的第二镰刀片，所述股骨导板板体与其第一侧相背的第二侧的第一端设有股骨前髁拟合区，所述股骨导板板体与其第一侧相背的第二侧的第二端设有股骨内侧髁拟合区和股骨外侧髁拟合区。
  2. 根据权利要求1所述的全膝关节置换手术用股骨导板，其中，所述股骨导板板体的第一端设有股骨远端截骨定位孔，所述股骨远端截骨定位孔被设置为插入与股骨远端截骨器械连接定位的第一定位钉。
  3. 根据权利要求2所述的全膝关节置换手术用股骨导板，其中，所述股骨远端截骨定位孔设置有两个，两个所述股骨远端截骨定位孔位于同一水平线。
  4. 根据权利要求1所述的全膝关节置换手术用股骨导板，其中，所述股骨导板板体的第二端设有股骨后髁截骨定位孔，所述股骨后髁截骨定位孔被设置为插入与股骨后髁截骨器械连接定位的第二定位钉。
  5. 根据权利要求4所述的全膝关节置换手术用股骨导板，其中，所述股骨后髁截骨定位孔设置有两个，两个所述股骨后髁截骨定位孔位于同一水平线。
  6. 根据权利要求1所述的全膝关节置换手术用股骨导板，其中，所述全膝关节置换手术用股骨导板为一体成型结构。
  7. 根据权利要求6所述的全膝关节置换手术用股骨导板，其中，所述全膝关节置换手术用股骨导板采用3D方法制备而成。
  8. 根据权利要求1至7任一项所述的全膝关节置换手术用股骨导板，其中，所述股骨导板板体的材质为医用树脂。
  9. 根据权利要求1至7任一项所述的全膝关节置换手术用股骨导板，其中，所述股骨导板板体的材质为医用金属。
  10. 一种权利要求1至9任一项所述的全膝关节置换手术用股骨导板的使用方法，其中，包括如下步骤：
    将所述股骨前髁拟合区与股骨前髁对位拟合，将所述股骨内侧髁拟合区与股骨内侧髁对位拟合，将所述股骨外侧髁拟合区与股骨外侧髁对位拟合；
    将所述第一镰刀片插入所述远端截骨槽内，验证并确定股骨远端的截骨量；
    将所述第二镰刀片插入所述前髁截骨槽内，验证并确定股骨前髁的截骨量；
    通过截骨器械对所述股骨远端和所述股骨前髁分别进行截骨。
  11. 根据权利要求10所述的全膝关节置换手术用股骨导板的使用方法，其中，通过截骨器械对所述股骨远端和所述股骨前髁分别进行截骨包括：
    在将第二定位钉移除后，将股骨导板移除；
    将远端截骨器械与第一定位钉安装配准后，进行截骨动作，并在截骨完成后移除截骨器械和第一定位钉；
    将第二定位钉重新插入至第二定位钉对应的钉道中；
    将后踝截骨器械与第二定位针安装配置后，进行后踝截骨、前踝截骨、斜前截骨和斜后截骨。
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