CN110074855B - Percutaneous implantation guide plate for femur neck hollow nail - Google Patents
Percutaneous implantation guide plate for femur neck hollow nail Download PDFInfo
- Publication number
- CN110074855B CN110074855B CN201910489286.7A CN201910489286A CN110074855B CN 110074855 B CN110074855 B CN 110074855B CN 201910489286 A CN201910489286 A CN 201910489286A CN 110074855 B CN110074855 B CN 110074855B
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- guide plate
- guide
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- angle
- inclined guide
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- 210000002436 femur neck Anatomy 0.000 title claims abstract description 22
- 238000002513 implantation Methods 0.000 title claims abstract description 14
- 239000002184 metal Substances 0.000 claims abstract description 40
- 210000000689 upper leg Anatomy 0.000 claims description 9
- 230000000694 effects Effects 0.000 description 5
- 208000020089 femoral neck fracture Diseases 0.000 description 5
- 238000000034 method Methods 0.000 description 4
- 239000007943 implant Substances 0.000 description 2
- 230000009467 reduction Effects 0.000 description 2
- 208000010392 Bone Fractures Diseases 0.000 description 1
- 206010017076 Fracture Diseases 0.000 description 1
- 206010020100 Hip fracture Diseases 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000000249 desinfective effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 210000000501 femur body Anatomy 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 238000004904 shortening Methods 0.000 description 1
- 230000007480 spreading Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 210000001694 thigh bone Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention relates to a femoral neck hollow nail percutaneous implantation guide plate, which comprises a guide plate with an arc-shaped inner side, wherein the upper part of the guide plate is provided with a flange part integrally formed with the guide plate, the outer side surface of the flange part is level with the outer side surface of the guide plate, and the thickness of the flange part is smaller than that of the guide plate; two groups of screws are arranged on the flange part, the ends of the two groups of screws are connected with a metal baffle plate, and the metal baffle plate is positioned above the inner side of the guide plate; the guide plate is provided with a plurality of inclined guide holes, the angle of an obtuse angle formed between the central axis of each inclined guide hole and a vertical line is 115 degrees, the inclined guide holes on the guide plate are provided with forward inclination angles, the angle of the forward inclination angles is the same as that of the forward inclination angles of human femoral necks, and four inclined guide holes are internally provided with metal guide pipes; the oblique guide holes can be assembled into different inverted isosceles triangles to serve as nail placing positions. The invention can be quickly, accurately and effectively implanted into three hollow nails in the femoral neck, reduces perspective times and shortens operation time.
Description
Technical Field
The invention relates to the field of medical auxiliary equipment, in particular to a femoral neck hollow nail percutaneous implantation guide plate.
Background
Femoral neck fractures are the most common type of hip fracture, and as the femoral neck needs to bear the movement and supporting functions of a human body in an upright state, the treatment effect of the femoral neck fracture directly influences the life quality of a patient in future.
The main method of the current treatment of the femoral neck fracture is a hollow nail internal fixation mode, namely 3 hollow nails are utilized to fix the fractured femoral head and the femoral shaft part together according to the original physiological anatomy structure of a patient. The key technology is to accurately identify the physiological structure of the individual patient and accurately implant the hollow nails to ideal fixed positions. The conventional method is to observe the angle and distance of the surgical instrument relative to the path of the surgical object in the normal and lateral X-ray images, and the doctor manually adjusts the surgical instrument to coincide with the ideal surgical path to complete the surgical positioning. This method has the following disadvantages: (1) The implantation of the hollow nails completely depends on the experience and skill of doctors, and the positioning difficulty of surgical instruments is high; (2) Usually, a doctor is relied on to hold the instrument manually, and the surgical instrument can deviate and shake to deviate the implantation position, so that the surgical accuracy is reduced, and the surgical quality is affected; (3) the number of perspective times is large, and the operation time is prolonged.
Disclosure of Invention
Aiming at the defects of the prior art, the invention provides the percutaneous implantation guide plate for the hollow nails of the femoral neck, which can be used for quickly, accurately and effectively implanting three hollow nails in the femoral neck, thereby reducing the perspective times and shortening the operation time.
The technical solution of the invention is as follows:
The femoral neck hollow nail percutaneous implantation guide plate comprises a guide plate with an arc-shaped inner side, wherein the upper part of the guide plate is provided with a flange part integrally formed with the guide plate, the outer side surface of the flange part is flush with the outer side surface of the guide plate, and the thickness of the flange part is smaller than that of the guide plate; two groups of screws are arranged on the flange part, the ends of the two groups of screws are connected with a metal baffle plate, and the metal baffle plate is positioned above the inner side of the guide plate; the guide plate is provided with a plurality of inclined guide holes, the angle of an obtuse angle formed between the central axis of each inclined guide hole and a vertical line is 115 degrees, and four inclined guide holes are internally provided with metal guide pipes; the oblique guide holes can be assembled into different inverted isosceles triangles to serve as nail placing positions.
The outer side surface of the guide plate and the lower part of the flange part are provided with a handheld part which is integrally formed with the guide plate.
Preferably, the arc surface on the inner side of the guide plate is matched with the structure on the outer side of the thigh of the human body, and the arc surface is tightly attached to the outer side of the thigh.
Preferably, the oblique guide hole on the guide plate is provided with a 15-degree anteversion angle, and the angle of the anteversion angle is the same as the angle of the anteversion angle of the femoral neck of the person.
Preferably, the screw is adjustable, thereby adjusting the gap between the guide plate and the femoral shaft to adjust the size of the neck stem angle.
Preferably, the metal baffle is of a runway type structure, and the thickness of the metal baffle is 1.5mm.
Preferably, the inclined guide holes are round holes, three inclined guide holes with metal guide pipes in the four inclined guide holes with metal guide pipes are arranged in an inverted triangle structure, and the other inclined guide hole with the metal guide pipe is located right below the inverted triangle structure.
Preferably, at least 9 groups of inclined guide holes are arranged around the four inclined guide holes with metal guide pipes.
The invention has the beneficial effects that:
the invention is mainly used for quickly, accurately and effectively implanting three hollow nails in the femoral neck, reduces perspective times, shortens operation time, ensures that the three hollow nails are distributed more uniformly and reasonably, and ensures that the fixation is more effective.
The upper part of the guide plate is provided with a flange part integrally formed with the guide plate, the outer side surface of the flange part is level with the outer side surface of the guide plate, and the thickness of the flange part is smaller than that of the guide plate; two groups of screws are arranged on the flange part, the end parts of the two groups of screws are connected with a metal baffle plate, the metal baffle plate is positioned above the inner side of the guide plate, and the metal baffle plate and the two groups of screws are arranged, so that one of the purposes is that in the aspect of image projection development, the development can be convenient, the position of the guide plate under perspective can be known, and the distance from the guide plate to the thighbone tuberosity point can be known; the second purpose is to want to adjust the gap between the guide plate and the femoral shaft through the screws, so as to achieve the effect of adjusting the size of the neck shaft angle, the two screws are screwed inwards, the proximal end of the guide plate is far away from the femoral shaft, the guide hole angle is enlarged, otherwise, the guide hole angle is reduced, for example, the neck shaft angle of some people is 130 degrees, the two screws are screwed inwards, the proximal end of the guide plate is far away from the femoral shaft, the angle of the guide plate and the femoral shaft is increased to achieve the effect of increasing the front inclination angle, and the screw position is more standard.
The guide plate is provided with a plurality of inclined guide holes, the angle of an obtuse angle alpha formed between the central axis of each inclined guide hole and a vertical line is 115 degrees, and four inclined guide holes are internally provided with metal guide pipes which are convenient to position and reference.
Drawings
The invention is further described with reference to the accompanying drawings:
FIG.1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a cross-sectional view of the present invention;
FIG. 3 is a schematic view of the rake angle of the inclined guide hole of the present invention;
FIG. 4 is a schematic view of a metal baffle plate of the present invention;
FIG. 5 is a schematic view of a 15-group inclined guide hole structure according to the present invention;
In fig. 1 to 5: 1-a guide plate; 101-a hand-held part; 102-an arc surface; 2-a flange portion; 3-a screw; 4-a metal baffle; 5-oblique guide holes; 6-a metal conduit; 7, a guide pin; 8-a nail placing group a; 9-a nail placing group b; 10-a nail placing group c; 11-a nail placing group d; alpha-neck dry angle; beta-rake angle.
Detailed Description
1-5, The femoral neck hollow nail percutaneous implantation guide plate comprises a guide plate 1 with an arc-shaped inner side, wherein the guide plate is in a shallow arc section and is convenient to cling to the outer side of thighs, a flange part 2 integrally formed with the guide plate is arranged at the upper part of the guide plate, the outer side surface of the flange part is level with the outer side surface of the guide plate, and the thickness of the flange part is smaller than that of the guide plate; two groups of screws 3 are arranged on the flange part, the ends of the two groups of screws are connected with a metal baffle 4, the metal baffle is positioned above the inner side of the guide plate, the metal baffle and the two groups of screws are convenient to develop, and the position of the guide plate under perspective is known; the angle of an obtuse angle alpha formed between the central axis of the inclined guide hole and a vertical line is 115 degrees, the angle alpha is the angle of a neck shaft angle, the angle formed between the long axis of a femur neck and the longitudinal axis of the femur shaft is called the neck shaft angle, and because of the different human body structures, the range of the neck shaft angle of the human body is 110-140 degrees.
The outer side surface of the guide plate and the lower part of the flange part are provided with a handheld part 101 which is integrally formed with the guide plate, and the handheld part is convenient for people to hold the guide plate.
The arc-shaped surface 102 on the inner side of the guide plate is matched with the structure on the outer side of the thigh of the human body, and the arc-shaped surface is tightly attached to the outer side of the thigh.
The oblique guide hole on the guide plate is provided with a forward inclination angle beta of 15 degrees, and the angle of the forward inclination angle is the same as that of the forward inclination angle of the femoral neck of the human. Because the femur neck of a normal person has a 15-degree anteversion angle, in order to match the angle when the cannulated screw is implanted, the direction is accurate, and the oblique guide hole on the guide plate is provided with the 15-degree anteversion angle. Because the human body structures of all people are different, the human forward inclination angle is not exactly 15 degrees, and is normally in the range of 10 degrees to 20 degrees, and the forward inclination angle is finely adjusted by contact of hand pressure and skin when the device is clinically used.
The screw is adjustable, so that the gap between the guide plate and the femoral shaft is adjusted to adjust the size of the neck stem angle. The size of the neck in front of the dry angle of each person is different and is generally 110-140 degrees, and the average 127 degrees, the two screws are designed for two purposes: one is in the aspect of image projection development, the position of the display guide plate can be developed, and the distance from the peak of the femur tuberosity is as follows: the gap between the guide plate and the femoral shaft is adjusted by the screws, so that the size of the neck shaft angle is adjusted, the two screws are screwed inwards, the proximal end of the guide plate is far away from the femoral shaft, the guide hole angle is enlarged, otherwise, the guide hole angle is reduced, the original guide hole angle made by people is 115 degrees, but if the neck shaft angle is 130 degrees for some people, the two screws are screwed inwards, the proximal end of the guide plate is far away from the femoral shaft, the angle between the guide plate and the femoral shaft is increased to achieve the effect of increasing the front inclination angle, and the screw position is more standard.
The metal baffle is of a runway type structure, and the thickness of the metal baffle is 1.5mm.
In this embodiment, a plurality of the inclined guide holes can be assembled into different inverted isosceles triangles as the nail placement positions.
Referring to fig. 5, the guide plate is provided with 15 groups of inclined guide holes, wherein the positions of the four inclined guide holes with metal guide pipes form an inclined guide hole group a8, and the positions of the rest 11 groups of inclined guide holes are formed by moving the inclined guide hole group a leftwards and downwards to form an inclined guide hole group b9, moving the inclined guide hole group a downwards to form an inclined guide hole group c10, and moving the inclined guide hole group a rightwards and downwards to form an inclined guide hole group d11, wherein the inclined guide hole group a and the inclined guide hole group c share one inclined guide hole with metal guide pipe. The nail placing group a8, the nail placing group b9, the nail placing group c10 and the nail placing group d11 can respectively form two groups of inverted triangle structures, so that 8 groups of inverted triangle structures can be formed as nail placing positions, and patients with different heights and different structures can be satisfied.
The four guide holes are arranged in an inverted triangle, three of the four inclined guide holes with metal guide pipes are arranged in an inverted triangle structure, the other inclined guide hole with metal guide pipe is positioned right below the inverted triangle structure, a group of inclined guide holes with inverted triangle arrangement can be selected as nail placement positions according to different human body structures during use, the four guide holes are arranged in an inverted triangle, the most possible guide pin positions are arranged according to the optimal positions of femoral neck fracture hollow screw nails, the arrangement of the inverted triangle three hollow nails is the currently recognized optimal internal fixation mode, and the three inclined guide holes with metal guide pipes in the four inclined guide pipes are convenient to develop but do not interfere perspective images too much.
In the operation process, firstly, a metal inclined guide hole is selected at a position 5-7 cm below the rotor to be driven into the guide pin, the position of the guide pin is found through the positive side position, and then the positions of 2-3 other guide pins are adjusted, namely three holes are selected to be inverted triangles at will, so that the effect of relatively quick positioning and fixing is achieved.
The application method of the invention comprises the following steps: firstly, conducting closed traction reduction of fracture of neck of femur, fixing on an orthopaedics traction bed, after fixing the upper traction bed, conducting C-arm perspective, disinfecting and spreading towel after fracture reduction is satisfied, then placing a guide plate on the outer side of thigh, fixing by using a disinfection film, selecting an inclined guide hole with a metal guide tube to implant a guide needle 7, knowing the position of the guide plate and the position of the guide needle through C-arm perspective, judging whether the position of the guide plate is front or back or front or back, whether the neck stem angle and the front inclination angle are approximately consistent, then adjusting the neck stem angle through two screws 3, forming an inverted triangle by other optional inclined guide holes on the guide plate, generally selecting three inclined guide holes arranged in an inverted triangle, taking down the guide plate under the condition that the position of the three inclined guide needles of the inverted triangle is good after one guide needle is implanted in each inclined guide hole, measuring the length of the guide needle, and then implanting hollow screws one by one.
The foregoing embodiments are provided for further illustrating the present invention, and are not to be construed as limiting the scope of the present invention, and some insubstantial modifications and adaptations of the invention by those skilled in the art are within the scope of the present invention.
Claims (5)
1. A femoral neck hollow nail percutaneous implantation guide plate, which is characterized in that: the device comprises a guide plate with an arc-shaped inner side, wherein the upper part of the guide plate is provided with a flange part integrally formed with the guide plate, the outer side surface of the flange part is level with the outer side surface of the guide plate, and the thickness of the flange part is smaller than that of the guide plate; two groups of screws are arranged on the flange part, the ends of the two groups of screws are connected with a metal baffle plate, and the metal baffle plate is positioned above the inner side of the guide plate; the guide plate is provided with a plurality of inclined guide holes, the angle of an obtuse angle formed between the central axis of each inclined guide hole and a vertical line is 115 degrees, and four inclined guide holes are internally provided with metal guide pipes; the oblique guide holes can be assembled into different inverted isosceles triangles to serve as nail placing positions;
The screw is adjustable, so that the gap between the guide plate and the femoral shaft is adjusted to adjust the size of the neck stem angle;
the inclined guide holes are round holes, three of the four inclined guide holes with metal guide pipes are arranged in an inverted isosceles triangle structure, and the other inclined guide hole with the metal guide pipe is positioned right below the inverted isosceles triangle structure;
The guide plate is provided with 15 groups of inclined guide holes, wherein the positions of the four inclined guide holes with metal guide pipes form an inclined guide hole group a, the positions of the other 11 groups of inclined guide holes are formed by a nail placing group b formed by moving the nail placing group a leftwards and downwards, a nail placing group c formed by moving the nail placing group a downwards and a nail placing group d formed by moving the nail placing group a rightwards and downwards, and the nail placing group a and the nail placing group c share one inclined guide hole with the metal guide pipe.
2. A femoral neck cannulated nail percutaneous implantation guide according to claim 1, wherein: the outer side surface of the guide plate and the lower part of the flange part are provided with a handheld part which is integrally formed with the guide plate.
3. A femoral neck cannulated nail percutaneous implantation guide according to claim 1, wherein: the arc surface on the inner side of the guide plate is matched with the structure on the outer side of the thigh of the human body, and the arc surface is tightly attached to the outer side of the thigh.
4. A femoral neck cannulated nail percutaneous implantation guide according to claim 1, wherein: the oblique guide hole on the guide plate is provided with a 15-degree forward inclination angle, and the angle of the forward inclination angle is the same as that of the forward inclination angle of the femoral neck of the person.
5. A femoral neck cannulated nail percutaneous implantation guide according to claim 1, wherein: the metal baffle is of a runway type structure, and the thickness of the metal baffle is 1.5 mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910489286.7A CN110074855B (en) | 2019-06-06 | 2019-06-06 | Percutaneous implantation guide plate for femur neck hollow nail |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910489286.7A CN110074855B (en) | 2019-06-06 | 2019-06-06 | Percutaneous implantation guide plate for femur neck hollow nail |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN110074855A CN110074855A (en) | 2019-08-02 |
| CN110074855B true CN110074855B (en) | 2024-06-28 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201910489286.7A Active CN110074855B (en) | 2019-06-06 | 2019-06-06 | Percutaneous implantation guide plate for femur neck hollow nail |
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| CN (1) | CN110074855B (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110693601B (en) * | 2019-11-27 | 2025-01-14 | 上海市浦东新区公利医院(第二军医大学附属公利医院) | A three-hollow-screw implantation guide device for femoral neck fracture surgery |
| CN111297460B (en) * | 2020-02-25 | 2021-03-09 | 扬州大学附属医院 | Femoral neck fracture percutaneous operation auxiliary device and using method thereof |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN210204898U (en) * | 2019-06-06 | 2020-03-31 | 嘉兴市第二医院 | Guide plate is implanted to thighbone neck hollow nail percutaneous |
Family Cites Families (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4383527A (en) * | 1981-02-20 | 1983-05-17 | Howmedica, Inc. | Device for guiding the insertion of surgical wires into bone tissue |
| CN87211460U (en) * | 1987-08-26 | 1988-08-31 | 邹立民 | Immobilization and guiding instrument for intertuberous femoral neck fracture |
| JP3342472B2 (en) * | 2000-07-21 | 2002-11-11 | 不二夫 川上 | Porous guide for femoral neck fracture osteosynthesis surgery |
| JP2004097447A (en) * | 2002-09-09 | 2004-04-02 | For S Medical:Kk | Angle guide for guide pin insertion |
| CN204484277U (en) * | 2015-03-02 | 2015-07-22 | 刘应忠 | Neck of femur localizer |
| CN107961069B (en) * | 2017-12-19 | 2023-06-06 | 暨南大学 | Guide is put into to hollow screw of femur neck fracture |
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2019
- 2019-06-06 CN CN201910489286.7A patent/CN110074855B/en active Active
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN210204898U (en) * | 2019-06-06 | 2020-03-31 | 嘉兴市第二医院 | Guide plate is implanted to thighbone neck hollow nail percutaneous |
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| CN110074855A (en) | 2019-08-02 |
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