Distal tibiofibular screw implantation guider and use method thereof

Abstract

The invention belongs to the technical field of medical instruments in the orthopedics department, and particularly relates to a distal tibiofibular screw implantation guider and a using method thereof.When the distal tibiofibular screw implantation guider is used, firstly, data of a fracture part and distal tibiofibular combination are obtained, a corresponding three-dimensional model is established, and simulation reduction operation is conducted on the three-dimensional model. Then, acquiring a cross section image of a specified distance above the ankle joint of the three-dimensional model after restoration, and calculating the implantation angle alpha of the inferior tibiofibular screw according to the image; and then, the forceps body is fixed on the fibula, the angle of the needle tube is adjusted to be alpha, a cortical bone screw is placed after drilling is completed, and finally, the forceps body is taken down, and an incision is sutured. The operation time can be shortened, and the number of times of perspective in the operation is reduced; meanwhile, the implantation angle alpha of the distal tibiofibular screw can be accurately adjusted, operation errors are reduced, and the probability of sequelae caused by deviation of the implantation angle of the screw of a patient is reduced.

Description

Technical Field

[0001] The present invention belongs to the technical field of orthopedic medical devices, and in particular relates to a distal tibiofibular screw insertion guide and a use method thereof. Background Art

[0002] The ankle joint bears significant loads during activities such as standing, walking, running, and jumping, and the syndesmosis is crucial for maintaining the integrity and stability of the ankle joint. Ankle injuries are often accompanied by syndesmotic separation, and currently, hollow syndesmotic screws and bolts are the primary fixation methods for these injuries.

[0003] Currently, there is no universal tool for screw fixation of the tibiofibular syndesmosis in clinical practice. Conventional practice involves first using a point reduction clamp to stabilize the tibiofibular syndesmosis. The surgeon then relies on experience or, with the assistance of C-arm fluoroscopy, inserts the screws from back to front. This process often requires repeated adjustments of the guide wire's direction during surgery, and multiple fluoroscopy sessions are required to determine the final insertion direction. This not only prolongs the operation but also creates uncertainty about the surgical outcome.

[0004] Therefore, a guide for inserting a distal tibiofibular screw and a method for using the guide are proposed. Summary of the Invention

[0005] The purpose of the present invention is to provide a distal tibiofibular screw insertion guide and a method of using the same to solve the above problems.

[0006] To achieve the above object, the present invention provides the following solutions:

[0007] A guide for inserting a distal tibiofibular screw comprises a caliper body, a clamping and fixing assembly is provided on the caliper body, a mounting base is provided at a rotating shaft of the caliper body, a positioning mechanism is provided on the mounting base, and the positioning mechanism is connected to the mounting base via a lifting and adjusting assembly;

[0008] The positioning mechanism includes a positioning component, an adjusting component is provided on the positioning component, a first fixing component is provided between the adjusting component and the positioning component, a needle tube is provided on the adjusting component, and a second fixing component is provided between the needle tube and the adjusting component.

[0009] Preferably, the positioning assembly includes a scale plate, the scale plate is provided with two guide slots, the two guide slots are arranged concentrically, the scale plate is provided with scale lines, and the scale lines are arranged concentrically with the guide slots.

[0010] Preferably, the lifting adjustment assembly includes a polished rod, the polished rod is coaxially arranged with the rotating shaft of the caliper body, the polished rod is fixed to the mounting base, a spring is sleeved on the outer side of the polished rod, the top end of the spring abuts against the scale plate, and a distance is left between the polished rod and the scale plate;

[0011] A second through hole is formed on opposite sides of the scale plate, and a lifting adjustment bolt is passed through the second through hole. The bottom end of the lifting adjustment bolt is threadedly connected to the mounting base.

[0012] Preferably, the adjustment component includes an angle adjustment block, and two sliders are fixed to the bottom end of the angle adjustment block. The two sliders are respectively slidably connected in the two guide slots, and the sliders do not fall out of the guide slots. The needle tube is arranged on the angle adjustment block.

[0013] Preferably, the first fixing assembly includes a second threaded hole provided on the angle adjustment block, an angle locking bolt is threadedly connected to the second threaded hole, and the bottom end of the angle locking bolt passes through the angle adjustment block and abuts against the top surface of the scale plate.

[0014] Preferably, a first through hole is provided on the angle adjustment block, the first through hole is arranged along the length direction of the pliers body, and the needle tube is passed through the first through hole.

[0015] Preferably, the second fixing assembly includes a first threaded hole provided on the angle adjustment block, a needle tube locking bolt is threadedly connected to the first threaded hole, and the needle tube locking bolt penetrates into the first through hole and abuts against the outer wall of the needle tube.

[0016] Preferably, the clamping and fixing assembly includes a threaded rod, one end of the threaded rod is hinged to a handle at the handle end of the pliers body, the threaded rod is slidably connected in a through slot, the through slot is opened on the other handle at the handle end, the through slot is opened along the length direction of the handle, the threaded rod passes through the through slot and is threadedly connected to a nut, and the outer diameter of the nut is greater than the width of the through slot.

[0017] Preferably, both clamping pieces at the clamping end of the clamp body are provided with anti-slip grooves, and the anti-slip grooves on the two clamping pieces are arranged correspondingly.

[0018] A method for using a distal tibia and fibula screw insertion guide is provided, based on the distal tibia and fibula screw insertion guide, and the steps are as follows:

[0019] Obtain data on the fracture site and the distal tibiofibular syndesmosis, establish a three-dimensional model of the fracture site and the distal tibiofibular syndesmosis, perform a simulated reduction operation on the three-dimensional model, obtain a cross-sectional image of the three-dimensional model at a specified distance above the ankle joint after reduction, and calculate the distal tibiofibular screw insertion angle α based on the cross-sectional image. Fix the clamp to the fibula, adjust the angle of the needle tube to α, drill a hole and insert the cortical bone screw, remove the clamp, and suture the incision.

[0020] Compared with the prior art, the present invention has the following advantages and technical effects:

[0021] When using the present invention, data on the fracture site and the tibiofibular syndesmosis are first acquired, a corresponding three-dimensional model is constructed, and a simulated reduction operation is performed on the three-dimensional model. Next, a cross-sectional image of the reduced ankle joint is obtained at a specified distance above the 3D model, and the angle α for the insertion of the tibiofibular screw is calculated based on this image. Subsequently, the forceps are secured to the fibula, the needle angle is adjusted to α, the cortical screw is inserted after drilling is completed, and the forceps are removed and the incision is sutured.

[0022] The present invention can shorten the operation time and reduce the number of intraoperative fluoroscopy times; at the same time, it can accurately adjust the insertion angle α of the tibiofibular screw, reduce surgical errors, and reduce the probability of patients suffering sequelae due to screw insertion angle deviation. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the following briefly introduces the drawings required for use in the embodiments. Obviously, the drawings described below are only some embodiments of the present invention. Those skilled in the art can also derive other drawings based on these drawings without inventive work.

[0024] Figure 1 It is an overall schematic diagram of the present invention;

[0025] Figure 2 It is a structural schematic diagram of the present invention;

[0026] Figure 3 Schematic diagram of the tibiofibular screw insertion angle α;

[0027] Figure 4 This is a schematic structural diagram of Example 2 of the present invention;

[0028] Among them, 1. Clamp body; 2. Threaded rod; 3. Mounting plate; 4. Polish rod; 5. Spring; 6. Needle tube; 7. Positioning mechanism; 8. Nut; 101. Clamping end; 102. Handle end; 701. Scale plate; 702. Scale line; 703. Lift adjustment bolt; 704. Needle tube locking bolt; 705. First threaded hole; 706. First through hole; 707. Second through hole; 708. Guide groove; 709. Sleeve; 710. Second threaded hole; 711. Angle locking bolt; 712. Angle adjustment block. DETAILED DESCRIPTION

[0029] The following will clearly and completely describe the technical solutions in the embodiments of the present invention in conjunction with the accompanying drawings. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without making creative efforts are within the scope of protection of the present invention.

[0030] In order to make the above-mentioned objects, features and advantages of the present invention more obvious and easy to understand, the present invention is further described in detail below with reference to the accompanying drawings and specific embodiments.

[0031] Example 1

[0032] Reference Figures 1 to 2 This embodiment discloses 1. A guide for inserting a distal tibiofibular screw, characterized in that it includes a pliers body 1, a clamping and fixing assembly is provided on the pliers body 1, a mounting base is provided at the rotating shaft of the pliers body 1, a positioning mechanism 7 is provided on the mounting base, and the positioning mechanism 7 is connected to the mounting base via a lifting and adjusting assembly;

[0033] The positioning mechanism 7 includes a positioning component, an adjusting component is provided on the positioning component, a first fixing component is provided between the adjusting component and the positioning component, a needle tube 6 is provided on the adjusting component, and a second fixing component is provided between the needle tube 6 and the adjusting component.

[0034] When using the present invention, data on the fracture site and the tibiofibular syndesmosis are first acquired, a corresponding three-dimensional model is constructed, and a simulated reduction operation is performed on the three-dimensional model. Next, a cross-sectional image of the reduced ankle joint is obtained at a specified distance above the 3D model, and the angle α for the insertion of the tibiofibular screw is calculated based on this image. Subsequently, the forceps are secured to the fibula, the needle angle is adjusted to α, the cortical screw is inserted after drilling is completed, and the forceps are removed and the incision is sutured.

[0035] The present invention can shorten the operation time and reduce the number of intraoperative fluoroscopy times; at the same time, it can accurately adjust the insertion angle α of the tibiofibular screw, reduce surgical errors, and reduce the probability of patients suffering sequelae due to screw insertion angle deviation.

[0036] The mounting base includes a mounting plate 3 , which is disposed on the pliers body 1 and fixedly connected to one of the handles of the handle end 102 .

[0037] A third threaded hole is respectively formed at both ends of the mounting plate 3 .

[0038] A further optimized solution is that the positioning component includes a scale plate 701, two guide grooves 708 are provided on the scale plate 701, and the two guide grooves 708 are arranged concentrically. A scale line 702 is provided on the scale plate 701, and the scale line 702 is arranged concentrically with the guide groove 708.

[0039] Further optimized, the lifting and adjusting assembly includes a polished rod 4, which is coaxially arranged with the rotating axis of the caliper body 1, and is fixed to the mounting base. A spring 5 is sleeved on the outer side of the polished rod 4, and the top end of the spring 5 abuts against the scale plate 701, leaving a distance between the polished rod 4 and the scale plate 701;

[0040] The scale plate 701 has second through holes 707 on opposite sides. A lifting adjustment bolt 703 is passed through the second through holes 707. The bottom end of the lifting adjustment bolt 703 is threadedly connected to the mounting base. The bottom end of the lifting adjustment bolt 703 is threadedly connected to the third threaded hole.

[0041] By turning the two lifting adjustment bolts 703, the height of the scale plate 701 can be adjusted. The outer side of the lifting adjustment bolt 703 is provided with a sleeve 709 to facilitate the screwing of the lifting adjustment bolt 703;

[0042] The spring 5 provides support force for the scale plate 701 .

[0043] To further optimize the solution, the adjustment component includes an angle adjustment block 712, and two sliders are fixed to the bottom end of the angle adjustment block 712. The two sliders are respectively slidably connected in the two guide grooves 708. The sliders do not fall out of the guide grooves 708, and the needle tube 6 is set on the angle adjustment block 712.

[0044] The slider slides in the guide slot 708 , thereby driving the angle adjustment block 712 to move and adjust the angle of the needle tube 6 .

[0045] To further optimize the solution, the first fixing component includes a second threaded hole 710 opened on the angle adjustment block 712, and the second threaded hole 710 is threadedly connected to an angle locking bolt 711, and the bottom end of the angle locking bolt 711 passes through the angle adjustment block 712 and abuts against the top surface of the scale plate 701.

[0046] By turning the angle locking bolt 711, the bottom end of the angle locking bolt 711 passes through the angle adjustment block 712 and abuts against the top surface of the scale plate 701, thereby fixing the angle adjustment block 712; by twisting the angle locking bolt 711 in the opposite direction, the angle adjustment block 712 can be unlocked.

[0047] As a further optimization solution, a first through hole 706 is provided on the angle adjustment block 712 . The first through hole 706 is arranged along the length direction of the pliers body 1 , and the needle tube 6 is passed through the first through hole 706 .

[0048] To further optimize the solution, the second fixing component includes a first threaded hole 705 opened on the angle adjustment block 712, and the needle tube locking bolt 704 is connected to the inner thread of the first threaded hole 705. The needle tube locking bolt 704 passes through the first through hole 706 and abuts against the outer wall of the needle tube 6.

[0049] The needle tube 6 can be locked or loosened by turning the needle tube locking bolt 704 .

[0050] A further optimized solution is that the clamping and fixing assembly includes a threaded rod 2, one end of the threaded rod 2 is hinged to a handle at the handle end 102 of the pliers body 1, the threaded rod 2 is slidably connected in a through slot, the through slot is opened on the other handle at the handle end 102, the through slot is opened along the length direction of the handle, the threaded rod 2 passes through the through slot and is threadedly connected to a nut 8, the outer diameter of the nut 8 is greater than the width of the through slot.

[0051] By turning the nut 8 , the clamping end 101 of the caliper body 1 can be clamped or loosened.

[0052] As a further optimization solution, both clamping pieces of the clamping end 101 of the clamp body 1 are provided with anti-slip grooves, and the anti-slip grooves on the two clamping pieces are provided correspondingly.

[0053] A method for using a distal tibia and fibula screw insertion guide is based on the distal tibia and fibula screw insertion guide, and is characterized by the following steps:

[0054] Obtain data on the fracture site and the distal tibiofibular syndesmosis, establish a three-dimensional model of the fracture site and the distal tibiofibular syndesmosis, perform a simulated reduction operation on the three-dimensional model, take a cross-sectional image of the three-dimensional model at a specified distance above the ankle joint after reduction, and calculate the distal tibiofibular screw insertion angle α based on the cross-sectional image, fix the clamp body 1 on the fibula, adjust the angle of the needle tube 6 to α, drill and insert the cortical bone screw, remove the clamp body 1 and suture the incision.

[0055] Specific usage:

[0056] Before surgery:

[0057] Mimics software was used to reconstruct the tibia and fibula 3D model and virtually reduce the fracture ends to the anatomical position. A virtual cross section was generated 2 cm above the ankle joint line. Figure 3 Mark the line connecting the anterior and posterior fibula crests as line HI. Points A and B on the anterior and posterior fibula crests serve as the upper and lower clamping points of forceps 1, and point C is the insertion point for needle tube 6. Draw line FG, the ideal screw axis, through point C. Calculate the angle α between line FG and line HI.

[0058] Intraoperative steps

[0059] Reset and fixation:

[0060] The fracture is reduced according to conventional surgical procedures (e.g., for Maisonneuve fractures, the fibula is first lengthened; for trimalleolar fractures, the posterior malleolus is first stabilized). The distal tibiofibular syndesmosis is temporarily stabilized with a point reduction clamp, and the anterior fibula is palpated to confirm the absence of external rotation deformity.

[0061] Guide installation:

[0062] After confirming the level 2 cm above the ankle point using fluoroscopy, clamp the clamp body 1 at points A and B on the distal fibula's anterior and posterior crests, and tighten the nut 8. Rotate the angle adjustment block 712 until the circumference of the needle tube 6 points at the preset angle α, and simultaneously tighten the two angle locking bolts 711. If a fibula plate is incorporated, rotate the lift adjustment bolt 703 to compress the spring 5 until there is no contact between the plate and the needle tube 6.

[0063] Guide wire and screw placement:

[0064] A 2.8mm guide wire was inserted through needle cannula 6. C-arm fluoroscopy confirmed that the wire was parallel to the joint line and did not penetrate the medial tibial cortex. After measuring the length of the wire, a 3.5mm cortical screw (quadruple cortical fixation) was inserted along the wire.

[0065] Final verification: Fluoroscopic evaluation of tibiofibular reduction and screw position, and suture of the incision after removing the guide.

[0066] Example 2

[0067] Reference Figure 4 The difference from Example 1 is that, in this embodiment, the mounting plate 3 is fixedly connected to the top surface of the housing 903, and the center line of the mounting plate 3 always coincides with the center line of the pliers body 1. A through slot 904 is provided on the housing 903. The two clips of the clamping end 101 and the two handles of the handle end 102 all pass through the slot 904 and extend into the housing 903. The two clips are symmetrically arranged, and the two handles are symmetrically arranged. One end of the handle located in the housing 903 is fixed to the outer edge of the second gear 902, and one end of the clip located in the housing 903 is fixed to the outer edge of the first gear 901, and the first gear 901 is meshed with the second gear 902.

[0068] In the description of the present invention, it should be understood that the terms "longitudinal", "transverse", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside", "outside", etc., indicating the orientation or position relationship, are based on the orientation or position relationship shown in the accompanying drawings, and are only for the convenience of describing the present invention, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on the present invention.

[0069] The embodiments described above are merely descriptions of preferred embodiments of the present invention and are not intended to limit the scope of the present invention. Without departing from the spirit of the present invention, various modifications and improvements made to the technical solutions of the present invention by persons skilled in the art should fall within the scope of protection defined by the claims of the present invention.

Claims

1. A guide for inserting a distal tibiofibular screw, characterized in that: The invention comprises a clamp body (1), wherein the clamp body (1) is provided with a clamping and fixing assembly, a mounting base is provided at the rotating shaft of the clamp body (1), a positioning mechanism (7) is provided on the mounting base, and the positioning mechanism (7) is connected to the mounting base via a lifting and adjusting assembly; The positioning mechanism (7) comprises a positioning assembly, an adjusting assembly is provided on the positioning assembly, a first fixing assembly is provided between the adjusting assembly and the positioning assembly, a needle tube (6) is provided on the adjusting assembly, and a second fixing assembly is provided between the needle tube (6) and the adjusting assembly.

2. A guide for inserting a distal tibiofibular screw according to claim 1, characterized in that: The positioning assembly includes a scale plate (701), two guide slots (708) are provided on the scale plate (701), and the two guide slots (708) are arranged concentrically. A scale line (702) is provided on the scale plate (701), and the scale line (702) is arranged concentrically with the guide slots (708).

3. A guide for inserting a distal tibiofibular screw according to claim 2, characterized in that: The lifting and adjusting assembly comprises a polished rod (4), the polished rod (4) is coaxially arranged with the rotating shaft of the clamp body (1), the polished rod (4) is fixedly connected to the mounting base, a spring (5) is sleeved on the outer side of the polished rod (4), the top end of the spring (5) is in contact with the scale plate (701), and a distance is left between the polished rod (4) and the scale plate (701); The scale plate (701) is provided with second through holes (707) on opposite sides. A lifting adjustment bolt (703) is passed through the second through hole (707). The bottom end of the lifting adjustment bolt (703) is threadedly connected to the mounting base.

4. The guide for inserting a distal tibiofibular screw according to claim 2, wherein: The adjustment assembly includes an angle adjustment block (712), the bottom end of which is fixedly connected to two sliders, the two sliders being slidably connected in the two guide slots (708) respectively, the sliders not being able to escape from the guide slots (708), and the needle tube (6) being arranged on the angle adjustment block (712).

5. The guide for inserting a distal tibiofibular screw according to claim 4, characterized in that: The first fixing assembly includes a second threaded hole (710) provided on the angle adjustment block (712); an angle locking bolt (711) is threadedly connected to the second threaded hole (710); the bottom end of the angle locking bolt (711) passes through the angle adjustment block (712) and abuts against the top surface of the scale plate (701).

6. The guide for inserting a distal tibiofibular screw according to claim 4, characterized in that: A first through hole (706) is provided on the angle adjustment block (712), the first through hole (706) is arranged along the length direction of the clamp body (1), and the needle tube (6) is passed through the first through hole (706).

7. The guide for inserting a distal tibiofibular screw according to claim 6, characterized in that: The second fixing assembly includes a first threaded hole (705) provided on the angle adjustment block (712), the first threaded hole (705) being internally threadedly connected to a needle tube locking bolt (704), the needle tube locking bolt (704) being inserted into the first through hole (706) and abutting against the outer side wall of the needle tube (6).

8. The guide for inserting a distal tibiofibular screw according to claim 1, wherein: The clamping and fixing assembly comprises a threaded rod (2), one end of the threaded rod (2) is hinged on a handle at the handle end (102) of the pliers body (1), the threaded rod (2) is slidably connected in a through slot, the through slot is provided on the other handle at the handle end (102), the through slot is provided along the length direction of the handle, the threaded rod (2) passes through the through slot and is threadedly connected to a nut (8), the outer diameter of the nut (8) being greater than the width of the through slot.

9. The guide for inserting a distal tibiofibular screw according to claim 1, wherein: Anti-skid grooves are provided on both clamping pieces of the clamping end (101) of the clamp body (1), and the anti-skid grooves on the two clamping pieces are arranged correspondingly.

10. A method for using a distal tibia and fibrous screw insertion guide, based on the distal tibia and fibrous screw insertion guide according to any one of claims 1 to 9, characterized in that: Here are the steps: The data of the fracture site and the tibiofibular syndesmosis are obtained, a three-dimensional model of the fracture site and the tibiofibular syndesmosis is established, a simulated reduction operation is performed on the three-dimensional model, a cross-sectional image of a specified distance above the ankle joint of the three-dimensional model after reduction is obtained, and the insertion angle α of the tibiofibular screw is calculated based on the cross-sectional image, the clamp body (1) is fixed on the fibula, the angle of the needle tube (6) is adjusted to α, a hole is drilled and a cortical bone screw is inserted, the clamp body (1) is removed and the incision is sutured.

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