Dual-plane vertical fixed-point misalignment-minimal invasive positioning guide device for anterior column screws of acetabulum

Abstract

The present invention relates to a dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device, comprising a support rod, a slider and a fixed base of an L-shaped structure, a slide groove is arranged on the support rod, the first end of the support rod is movably connected to the slider, two or more positioning components are arranged on the slider, the positioning components include a detachable hollow positioning rod and a threaded guide pin, and the threaded guide pin is installed inside the hollow positioning rod; the end of the support rod is connected to the fixed base; a sleeve and a dual-plane positioning frame are movably arranged on the fixed base, the dual-plane positioning frame is located above the sleeve, and the dual-plane positioning frame includes a bracket, and a mutually perpendicular horizontal panel and a vertical panel are arranged on the bracket, and a directional hole corresponding to the threaded guide pin is arranged on the horizontal panel, and a guide hole serving as a circuit opener movable channel is arranged inside the sleeve. The present invention has a simple structure, is easy to use, safe and reliable, and can be accurately positioned, fully guarantees the safety and accuracy of screw placement, and can successfully place the screw at one time.

Description

Technical Field

[0001] The invention belongs to the field of orthopedic surgical equipment, and relates to a minimally invasive positioning guide device for anterior column screws of an acetabulum, in particular to a dual-plane vertical fixed-point offset-minimal invasive positioning guide device for anterior column screws of an acetabulum. Background Art

[0002] With the continuous development of the economy and the improvement of people's living standards, people have also put forward higher requirements for their own health issues. Among them, fractures are the most common and one of the main threats to our health. Especially in recent years, the number of acetabular fractures caused by traffic accidents and other factors has been on the rise, the complexity and difficulty of surgery have been increasing, and the risk of surgery has also increased significantly.

[0003] The anterior column of the acetabulum is composed of the iliac crest, iliac spine, anterior half of the acetabulum and pubic bone. The fracture line of the anterior column of the acetabulum starts from the iliac crest or anterior superior iliac spine of the hip bone, passes in front of the square area to the pubic branch. Pelvic acetabulum anterior column fracture is very easy to damage the surrounding structures and even endanger life due to its complex anatomy and numerous adjacent important tissues and organs.

[0004] At present, the common treatment for anterior column fracture of acetabulum mainly adopts plate fixation technology; the plate technology is to make an incision in the iliac groin, protect the important structures such as femoral nerve and blood vessels in this area, pass the plate from below these important structures, attach it to the pubic comb, and fix the plate to the anterior column of acetabulum with screws after reducing the anterior column fracture of acetabulum. However, its disadvantages are: the anatomy of iliac fossa and groin is complex, there are many important structures, the operation is very invasive and damaging, the surgical incision is long, the trauma is large, the bleeding is more, the femoral blood vessels, dead coronary blood vessels, anterolateral femoral cutaneous nerve damage, infection and other risks are high.

[0005] In recent years, with the popularization of minimally invasive surgery and hollow screw technology, percutaneous placement of acetabular anterior column screws has gradually replaced plate screw fixation technology and become the first choice for acetabular anterior column fractures. The technology of acetabular anterior column screw fixation is to drill a guide pin into the pubic medullary cavity to open a screw channel for the screw, and the screw is screwed in along the screw channel to reduce and fix the fracture of the acetabular anterior column fracture. However, its disadvantages are: it is operated only by the surgeon's feel and repeated fluoroscopic monitoring of the C-arm X-ray machine. There are no preset positioning points and reliable support points, and there is a lack of accurate positioning and easy-to-operate guide devices to guide the direction of the guide pin. The drilled guide pin or screw is easy to encounter resistance in the screw channel and break. The guide pin or screw is very easy to deviate from the channel, which is easy to damage the pubic medullary cavity blood vessels and nerves, femoral nerve, femoral artery and vein, spermatic cord, obturator artery and vein, and pelvic organs, and may even cause hip joint cartilage damage, and even endanger life.

[0006] In short, the insertion of this screw lacks objective standards in terms of entry point, direction of insertion, screw length, etc., and it is impossible to succeed in one go, so it is technically extremely difficult and challenging. Summary of the invention

[0007] The purpose of the present invention is to provide a dual-plane vertical fixed-point staggered-acetabular anterior column screw minimally invasive positioning guide device with simple structure, easy use, safety and reliability, and precise positioning in response to the deficiencies in the prior art. The dual-plane fixed point is formed by the horizontal plate and the vertical plate of the dual-plane positioning frame, and the threaded guide pin fixing points of the two positioning components determine a straight line. The opener rotates forward along the axial direction of the guide hole of the sleeve to open a screw channel, fully ensuring the safety and accuracy of screw placement and effectively avoiding damage to surrounding important tissues during the process of opening the screw channel.

[0008] The technical solution adopted by the present invention is:

[0009] A dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device, comprising an L-shaped support rod, a slider and a fixed base, a slide groove is arranged on the support rod, the head end of the support rod is movably connected to the slider, the slide groove serves as a track for the slider to move, so that the slider can reciprocate along the slide groove of the support rod, and the slider is provided with two or more positioning components, the positioning component comprises a detachable hollow positioning rod and a threaded guide needle, the threaded guide needle is installed inside the hollow positioning rod, the threaded open-circuit guide needle is longer than the hollow positioning rod, the threaded open-circuit guide needle penetrates the skin and pierces into the pubic surface to ensure the stability of the entire device, the tip of the hollow positioning rod passes through the directional hole of the horizontal panel and is closely attached to the surface of the bone cortex above the pubic bone, and two positioning components are arranged to use the principle of "two points determine a straight line" to determine the active track of the open-circuit guide needle, thereby effectively improving the accuracy of opening the screw channel; the end of the support rod is connected to the fixed base; a sleeve and a dual-plane positioning The double-plane positioning frame is located above the sleeve, and the double-plane positioning frame includes a bracket, a transverse panel and a longitudinal panel perpendicular to each other are arranged at the front end of the bracket, a directional hole corresponding to the threaded guide pin is arranged on the transverse panel, and a guide hole serving as a movable channel for the circuit opener is arranged inside the sleeve; an incision is made at the pubic tubercle, and the double-plane positioning frame enters from the incision and moves along the upper part of the pubic bone, and the front end of the double-plane positioning frame reaches the iliac pubic tuberosity, and the transverse panel of the double-plane positioning frame is attached to the upper part of the pubic bone, and the longitudinal panel thereof is attached to the back of the pubic bone, and the directional hole on the transverse panel is determined as the positioning point of the threaded circuit opener guide pin by utilizing the cooperation of the transverse panel and the longitudinal panel, so as to achieve the effect of vertical fixing, and the threaded circuit opener guide pin passes through the directional hole and is inserted into the upper part of the pubic bone; the sleeve moves into the incision and reaches the pubic bone, and the circuit opener gradually rotates forward along the axial direction of the guide hole of the sleeve, and the circuit opener rotates forward in the pubic medullary cavity to open a screw channel for the screw, so as to fully ensure the safety and accuracy of the screw placement and achieve precise positioning.

[0010] Furthermore, the fixed base and the slider are both provided with adjusting locking bolts; the fixed base locks the sleeve and the double-plane positioning frame respectively by adjusting the locking bolts, and the slider locks the hollow positioning rod by adjusting the locking bolts, thereby enhancing the stability of the sleeve, the double-plane positioning frame and the hollow positioning rod during use.

[0011] Furthermore, the opener includes an open guide needle, the outer wall of the open guide needle is provided with scale lines, and the end of the open guide needle is provided with a directional hole; the scale lines of the open guide needle are convenient for recording the specific telescopic length, and the directional hole of the open guide needle is used to open a screw channel to open a movable space for screwing in the screw, with a simple structure and easy use.

[0012] Furthermore, the guide hole of the sleeve is set as a center hole or an eccentric hole; the guide hole of the sleeve serves as a guide for the open-circuit guide needle, and directs the correct movable track for the open-circuit guide needle. When using the sleeve with a center hole, if there is hard bone in front of the open-circuit guide needle or the resistance in front is large and it cannot move forward, it is replaced with a sleeve with an eccentric hole, which is convenient for fine adjustment of the position and direction of the guide needle, and helps the open-circuit guide needle to continue to smoothly open a screw channel in other directions.

[0013] Furthermore, a detachable anti-deformation baffle is provided on the slide groove of the support rod, and the anti-deformation baffle is provided with a groove. A protrusion is provided in the middle of the groove of the anti-deformation baffle, and the width of the protrusion is slightly smaller than the width of the slide groove of the support rod; the slider moves on the slide groove of the support rod, and when it moves to the desired position, the slider is locked on the support rod by adjusting the locking bolt. The slide groove is easily deformed by external force, which will affect the normal movement of the slider. The protrusion of the anti-deformation baffle is placed in the slide groove to reduce the extrusion of external force.

[0014] Furthermore, the hollow positioning rod is provided with an internal thread, and the threaded guide pin is provided with an external thread matching the internal thread; the hollow positioning rod is threadedly connected to the threaded open-circuit guide pin, so that the threaded open-circuit guide pin can rotate conveniently inside the hollow positioning rod, and the threaded open-circuit guide pin gradually moves downward, passes through the directional hole of the horizontal panel on the double-plane positioning frame, and is inserted into the pubic bone.

[0015] Furthermore, the sleeve, the bracket and the support rod of the dual-plane positioning frame are respectively provided with sleeve scale lines, bracket scale lines and support rod scale lines, and the bracket scale lines correspond to the support rod scale lines; the front end of the sleeve is moved to the skin surface of the pubic tubercle, and the length of the screw to be inserted is calculated according to the sleeve scale lines and the scale lines on the open-circuit guide needle, and the bracket scale lines and the support rod scale lines are kept corresponding to each other, thereby effectively ensuring that the directional hole of the horizontal panel on the dual-plane positioning frame is aligned with the threaded open-circuit guide needle directional hole of the positioning component.

[0016] Furthermore, an open groove is provided on the fixed base, and a sleeve is movably arranged in the open groove; after the open-circuit guide pin is drilled into the fracture end of the anterior column of the acetabulum, the positioning guide device is disassembled, the sleeve is taken out from the fixed base, and the open-circuit guide pin is taken out from the opening of the open groove on the fixed base, thereby effectively ensuring the stability of the open-circuit guide pin, and the screw is put on the open-circuit guide pin and slowly screwed in.

[0017] Furthermore, hollow positioning rod scale lines are provided on the outer wall of the hollow positioning rod, and the tip of the hollow positioning rod is tightly attached to the surface of the cortical bone above the pubic bone after passing through the directional hole of the horizontal panel. The hollow positioning rod scale lines of the hollow positioning rod can clearly record the distance of the hollow positioning rod from the slider to the surface of the cortical bone above the pubic bone.

[0018] Compared with the prior art, the present invention has the following beneficial effects:

[0019] 1. The dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device of the present invention is simple to operate, easy to use, safe and reliable, and can accurately position the screws, and the screws can be successfully inserted in one time.

[0020] 2. During the operation, there is no need to repeatedly use fluoroscopy to observe the patient's injured area and whether the position of the nail is accurate, which shortens the operation time, reduces the radiation damage of radiation equipment to doctors and patients, and helps reduce the patient's pain.

[0021] 3. The fixing points of the threaded guide pins of the two positioning components on the pubic bone make full use of the principle of "two points determine a straight line", which greatly improves the accuracy of the activity direction of the opener. The positioning points have a basis, and the threaded guide pins and the opener inserted into the guide hole of the sleeve are used to form a vertical fixed-point offset. The required path of the opener is determined by adjusting the size and direction of the vertical offset.

[0022] 4. After the locking bolt is adjusted to compress the sleeve, the opener passes through the guide hole of the sleeve, and the opener guide needle rotates forward along the axial direction of the guide hole to open a screw channel, effectively avoiding damage to surrounding important tissues during the process of opening the screw channel, and fully ensuring the safety and accuracy of screw placement.

[0023] 5. Minimally invasive treatment of anterior column fractures of the acetabulum has obvious advantages. Percutaneous screw fixation can effectively reduce the surgical incision, reduce intraoperative bleeding, and lower the incidence of incision-related complications. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Figure 1 It is a structural schematic diagram of the present invention;

[0025] Figure 2 is a state diagram of the present invention;

[0026] Figure 3 It is a front view structural schematic diagram of the present invention;

[0027] Figure 4 A schematic diagram of the anti-deformation baffle structure designed for the present invention;

[0028] Figure 5 A schematic diagram of the structure of the double-plane positioning frame designed for the present invention;

[0029] Figure 6 A schematic diagram of the cross-sectional structure of the sleeve designed for the present invention;

[0030] In the figure: 1. support rod; 2. support rod scale line; 3. slide groove; 4. slider; 5. hollow positioning rod; 6. adjustment locking bolt; 7. anti-deformation baffle; 8. threaded guide pin; 9. directional hole; 10. horizontal panel; 11 vertical panel; 12. guide hole; 13. sleeve; 14. fixed base; 15. opening groove; 16. bracket; 17. iliopectine tuberosity; 18. pubis; 19. pubic tubercle; 20. open-circuit guide pin; 21. sleeve scale line; 22. bracket scale line; 23. bump; 24. center hole; 25. eccentric hole. DETAILED DESCRIPTION

[0031] The present invention will be further described below by way of examples in conjunction with the accompanying drawings, but this is not intended to limit the present invention.

[0032] In such Figure 1 , Figure 2 , Figure 3 , Figure 4 , Figure 5 , Figure 6In the structure shown, the dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device provided by the present invention comprises a support rod 1, a slider 4 and a fixed base 14 of an L-shaped structure, the support rod 1 is provided with a slide groove 3 and a support rod scale line 2 as a moving track of the slider 4, the slide groove 3 is provided with a detachable anti-deformation baffle 7, the anti-deformation baffle 7 is provided with a groove, a protrusion 23 is provided in the middle of the groove of the anti-deformation baffle 7, and the width of the protrusion 23 is slightly smaller than the width of the slide groove 3 of the support rod 1; the head end of the support rod 1 is movably connected to the slider 4, and the slider 4 is provided with two or more positioning components, and the positioning component comprises a detachable hollow positioning rod 5 and a threaded guide pin 8, the hollow positioning rod 5 is provided with an internal thread inside, and the outer wall thereof is provided with a hollow positioning rod 5 scale line, the threaded guide pin 8 is provided with an external thread matching the internal thread, and the threaded guide pin 8 is installed inside the hollow positioning rod 5; the end of the support rod 1 is connected to the fixed base 14, and the slider 4 movably arranged on the support rod 1 and the fixed base 14 are provided with an adjusting locking bolt 6; an opening slot 15 is provided on the fixed base 14, a sleeve 13 and a double-plane positioning frame are movably provided on the fixed base 14, the sleeve 13 is installed in the opening slot 15, the double-plane positioning frame is located above the sleeve 13, the double-plane positioning frame includes a bracket 16, a horizontal panel 10 and a vertical panel 11 perpendicular to each other are provided on the front end of the bracket 16, a directional hole 9 corresponding to the threaded guide pin 8 is provided on the horizontal panel 10, and the bracket 16 is provided with a vertical panel 11 and a horizontal panel 10. The outer wall is provided with bracket scale lines 22, and the bracket scale lines 22 of the double-plane positioning frame correspond to the support rod scale lines 2 of the support rod 1; the outer wall of the sleeve 13 is provided with sleeve scale lines 21, and the sleeve 13 is provided with a guide hole 12 serving as a movable channel for the opener, and the guide hole 12 is set as a center hole 24 or an eccentric hole 25; the opener includes an open guide pin 20 for opening a screw channel, the outer wall of the open guide pin 20 is provided with scale lines, and the end of the open guide pin 20 is provided with a directional hole.

[0033] The use process of the dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device of the present invention is as follows:

[0034] During the operation, the surgeon makes a transverse incision at the patient's pubic tubercle 19, slightly peels the periostium above and behind the pubic bone 18, and the double-plane positioning frame enters from the incision. The front end of the double-plane positioning frame slowly advances forward along the upper surface of the pubic bone 18 until its front end advances to the iliopectine 17, and the transverse panel 10 of the double-plane positioning frame is attached to the pubic bone 18, and the longitudinal panel 11 is attached to the back of the pubic bone 18. The double-plane positioning frame is locked on the fixed base 14 by adjusting the locking bolt 6; the sleeve 13 is located below the double-plane positioning frame, and the sleeve 13 moves to the surface of the pubic tubercle 19; according to the support rod scale line 2 of the support rod 1 corresponding to the bracket scale line 22, the slider 4 on the support rod 1 is moved along the slide groove 3 to the corresponding position, and the threaded guide pin 8 on the slider 4 corresponds to the directional hole 9 of the transverse panel 10 on the double-plane positioning frame, and the threaded guide pin 8 moves downward and passes through the directional hole 9. The directional hole of the threaded guide pin 8 penetrates the skin and is inserted The open-circuit guide pin 20 of the opener passes through the guide hole 12 of the sleeve 13, and the open-circuit guide pin 20 opens a screw channel in the pubic medullary cavity along the axial direction of the guide hole 12. After the open-circuit guide pin 20 is drilled into the fracture of the anterior column of the acetabulum and the narrow part of the posterior upper part of the acetabulum, the positioning guide device is removed, the sleeve 13 is removed from the fixed base 14, and the open-circuit guide pin 20 is removed from the opening of the open groove 15 on the fixed base 14, effectively ensuring the stability of the open-circuit guide pin 20. The screw adopts a hollow nail, and the hollow nail is sleeved on the open-circuit guide pin 20, and it is slowly screwed in along the axial direction of the open-circuit guide pin 20 to complete the nail placement work, ensuring that the nail placement is successful at one time, fully ensuring the safety and accuracy of the nail placement, and effectively avoiding damage to the surrounding important tissues during the process of opening the screw channel.

[0035] The above is only a preferred embodiment of the present invention. It should be pointed out that for ordinary technicians in this technical field, several improvements and modifications can be made without departing from the technical principles of the present invention. These improvements and modifications should also be regarded as the scope of protection of the present invention.

Claims

1. A dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device, characterized by: It includes an L-shaped support rod, a slider and a fixed base, the support rod is provided with a slide groove as a moving track of the slider, the head end of the support rod is movably connected to the slider, and the slider is provided with two or more positioning components, the positioning components include a detachable hollow positioning rod and a threaded guide pin, and the threaded guide pin is installed inside the hollow positioning rod; the end of the support rod is connected to the fixed base; a sleeve and a double-plane positioning frame are movably provided on the fixed base, the double-plane positioning frame is located above the sleeve, and the double-plane positioning frame includes a bracket, and a mutually perpendicular horizontal panel and a vertical panel are provided on the bracket, and a directional hole corresponding to the threaded guide pin is provided on the horizontal panel, and a guide hole serving as a movable channel of the circuit opener is provided inside the sleeve; A detachable anti-deformation baffle is provided on the slide groove of the support rod, the anti-deformation baffle is provided with a groove, a convex block is provided in the middle of the groove of the anti-deformation baffle, and the width of the convex block is slightly smaller than the width of the slide groove of the support rod; The sleeve, the bracket of the double-plane positioning frame and the support rod are respectively provided with sleeve scale lines, bracket scale lines and support rod scale lines, and the bracket scale lines correspond to the support rod scale lines; The circuit opener comprises a circuit opening guide needle, the outer wall of which is provided with scale lines, and the end of which is provided with a directional hole for opening a screw channel.

2. The dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device according to claim 1, characterized in that: The fixed base and the sliding block are both provided with adjusting locking bolts.

3. The dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device according to claim 1, characterized in that: The guide hole of the sleeve is configured as a central hole or an eccentric hole.

4. The dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device according to claim 1, characterized in that: The hollow positioning rod is provided with an internal thread, and the threaded guide pin is provided with an external thread matching the internal thread.

5. The dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device according to claim 1, characterized in that: The fixed base is provided with an open groove, and the sleeve is movably arranged in the open groove.

6. The dual-plane vertical fixed-point misalignment-acetabular anterior column screw minimally invasive positioning guide device according to claim 1, characterized in that: Hollow positioning rod scale lines are arranged on the outer wall of the hollow positioning rod.

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