Percutaneous minimally invasive positioning and guiding device for femoral neck nail insertion point

Abstract

The present invention discloses a percutaneous minimally invasive positioning and guiding device for the femoral neck nail insertion point, which includes a needle inserter and a calibration device. A vertical needle insertion hole and an oblique needle insertion hole are arranged on the same horizontal plane of the needle inserter. A depth adjustment slider in the same direction as the vertical needle insertion hole is arranged on the needle inserter. The calibration device is arranged at the front end of the needle inserter and is movably connected to the depth adjustment slider. A locking component is arranged on the depth adjustment slider. The structure of the present invention is simple and the manufacturing cost is low. Through the cooperation of the needle inserter and the calibration device, the angle, front-back and vertical positions of the nail insertion can be calibrated, and the guide needle can be effectively inserted into the calibrated nail insertion point along the needle inserter, improving the accuracy of the operation, thereby achieving the purpose of improving the success rate of the operation, and having the characteristics of high positioning accuracy and convenient operation.

Description

Technical Field

[0001] The present invention belongs to the technical field of surgical instruments, and relates to a positioning guide, specifically a percutaneous minimally invasive positioning guide for the femoral neck nail insertion point. Background Art

[0002] Femoral neck fracture refers to the interruption of the bone continuity in the femoral neck area. For young and middle-aged people, femoral neck fractures are often caused by severe injuries such as car accidents or falls from heights. Those who gradually develop fractures due to excessive or prolonged weight-bearing labor or walking are called fatigue fractures. For the elderly, there are two basic factors contributing to fractures. Osteoporosis weakens bone strength, and the upper region of the femoral neck is densely covered with nutrient vascular foramina, both of which can weaken the biomechanical structure of the femoral neck and make it fragile. In addition, due to the degeneration of hip muscles in the elderly, the reaction is slow, and they cannot effectively counteract the harmful stress on the hip. Coupled with the relatively large stress on the hip (2 to 6 times the body weight), the local stress is complex and changeable. Therefore, it does not require much force, such as slipping on flat ground, falling from bed, or sudden torsion of the lower limb, and even fractures can occur without obvious trauma.

[0003] At present, in the hip-preserving treatment of femoral neck fractures, cannulated screw fixation remains the preferred option, and the insertion of cannulated screw pins is the core technology and operational difficulty. Whether in the operation of inserting cannulated screws under direct vision through open reduction, or internal fixation with a plate, or minimally invasive percutaneous insertion of cannulated screws, safely, accurately, with a reasonable spatial configuration, avoiding or reducing radiation exposure, and successfully inserting the cannulated screw pins in one go have always been the research hotspots and unremitting pursuits of orthopedic surgeons. The conventional mainstream technique is to first apply the pins to the hip skin surface with adhesive tape, determine and mark the surface projection position of the central axis of the femoral neck on the skin surface through fluoroscopy, and then, through visual inspection and estimation, insert a Steinmann pin percutaneously until the lateral cortical bone of the proximal femur (this guide pin is along the direction of the central axis of the femoral neck and forms an angle of 30 - 50° with the femoral shaft), and drill the guide pin into the femoral neck parallel to the central axis. Then, through repeated fluoroscopy, adjust the position, direction, and length of the guide pin until a satisfactory standard is achieved, and then drill a hole along the guide pin and screw in the cannulated screw. Among them, the accurate positioning of the entry point is the crucial first step and also the most difficult step to control during the operation because the entry direction of the guide pin is not perpendicular to the surface of the proximal femoral bone but forms a certain angle (this angle varies from person to person), and there is soft tissue with a thickness of 2 - 10 cm between the skin and the lateral cortical bone of the proximal femur. Therefore, after determining and marking the horizontal line of the entry point through fluoroscopy, it is still impossible to accurately insert the guide pin obliquely onto the cortical bone surface of this horizontal line (the vertical position cannot be accurately positioned), but the guide pin is inserted percutaneously, and it is difficult to accurately judge its anterior-posterior position in the proximal femur; moreover, the guide pin is not perpendicular to the surface of the proximal femoral bone but forms a certain angle, and the surface of the proximal femur is arc-shaped, and the drilling of the guide pin is extremely easy to slide upward, forward, and backward in all directions, resulting in a large deviation. Therefore, the operation of inserting the cannulated screw into the femoral neck not only requires repeated fluoroscopy and adjustment during the operation but also has obvious blindness and randomness, with poor surgical precision and a high failure rate. Currently, there is still a lack of technology and devices in clinical practice that can accurately locate the entry point and stably drill in the guide pin. Summary of the Invention

[0004] The present invention provides a minimally invasive percutaneous positioning guide for the femoral neck entry point in view of the deficiencies of the prior art. Through the cooperation of the needle inserter and the calibration device, the angle, anterior-posterior, and vertical positions of the needle insertion can be calibrated, and the guide pin can be effectively inserted into the calibrated entry point along the needle inserter, improving the surgical precision, thereby achieving the purpose of increasing the surgical success rate.

[0005] The technical solution adopted by the present invention:

[0006] A minimally invasive percutaneous positioning guide for the femoral neck entry point, comprising a needle inserter and a calibration device. A vertical needle entry hole and an oblique needle entry hole are provided on the same horizontal plane of the needle inserter to guide the entry direction of the guide needle. A depth adjustment slider in the same direction as the vertical needle entry hole is provided on the needle inserter. The calibration device is arranged at the front end of the needle inserter and is movably connected to the depth adjustment slider. A locking assembly is provided on the depth adjustment slider. After the calibration device calibrates and positions the depth, front-back and vertical positions of the guide needle entry point, the position of the calibration device is fixed through the locking assembly to prevent it from sliding, ensuring the positioning accuracy of the nail entry point;

[0007] The calibration device includes a depth adjustment member, a vertical adjustment member, an adjustment mechanism and a bone hook. A scale is provided on the depth adjustment member to cooperate with the guide needle to measure and calibrate the needle entry depth. A chute matching the depth adjustment slider is provided on the depth adjustment member, and the depth adjustment member is connected to the depth adjustment slider through the chute, so that the depth adjustment member can slide on the needle inserter and its position can be fixed through the locking assembly; the adjustment mechanism is movably connected to the depth adjustment member through the vertical adjustment member provided at the front end of the depth adjustment member, so that the adjustment mechanism can vertically move along the vertical adjustment member. The bone hook is arranged on the adjustment mechanism. After the depth is calibrated through the depth adjustment member, the position of the nail entry point is adjusted through the adjustment mechanism, and finally the bone hook hooks the femur to determine the position of the nail entry point, preventing errors from occurring when the guide needle is inserted and avoiding misalignment of the nail entry point;

[0008] The adjustment mechanism consists of a vertical slider, a horizontal adjustment member and a horizontal slider. A locking assembly is provided on the vertical slider. The vertical slider is connected to the vertical adjustment member provided on the depth adjustment member, that is, the vertical slider is movably connected to the vertical adjustment member through the chute provided on the vertical adjustment member. When the vertical slider moves to the corresponding position, the vertical slider can be locked and positioned on the vertical adjustment member through the locking assembly. The horizontal adjustment member is horizontally arranged on the vertical slider. A chute matching the horizontal slider is provided on the horizontal adjustment member, and the horizontal slider is arranged in the chute of the horizontal adjustment member. A locking assembly is provided on the horizontal slider. By moving the horizontal slider, it can be locked and positioned through the locking assembly. An installation seat is provided on the horizontal slider, and the installation seat can be driven by the horizontal slider to move horizontally in the horizontal adjustment member. The bone hook is detachably arranged on the installation seat. After adjusting the installation seat according to the position of the femur, the bone hook can be hooked on the femur to perform nail entry positioning. Scales are provided on both the vertical slider and the horizontal adjustment member to adjust the height position of the depth adjustment member and the horizontal displacement distance of the installation seat.

[0009] Several oblique needle entry holes are provided on the needle inserter to facilitate positioning of the nail entry point from different angles.

[0010] The angles of the oblique needle entry holes are respectively set to multiple angles to facilitate positioning for patients with different neck-shaft angles.

[0011] During use, first set the longitudinal position of the needle entry point (i.e., the horizontal position of the needle entry point on the distal and proximal ends of the human body. Note: The longitudinal position is adjusted by the horizontal slider, and the vertical position is the front-back position. The vertical is relative to the component, and the front-back is relative to the human body direction) and the front-back position (i.e., the distance from the needle entry point to the front of the proximal femur) according to the patient's preoperative CT data. Vertically insert the bone hook through the lateral incision of the proximal femur, pass through the front of the femur, to the medial side, rotate 90°, so that the tip of the bone hook hooks the medial bone cortex, and the transverse arm of the bone hook is parallel and closely attached to the front cortex of the proximal femur. Slide and adjust the vertical position of the needle entry point through the cooperation of the horizontal adjustment part and the horizontal slider, slide and adjust the front-back position of the needle entry point through the cooperation of the vertical slider and the vertical adjustment part, and adjust the position of the mounting seat and the front-back and vertical positions of the needle inserter through the scales on the vertical slider and the horizontal adjustment part to reach the accurate needle entry point position, and position it through the locking component, so that the vertical needle entry hole is parallel to the bone hook and perpendicular to the femur. Insert a steel needle through the vertical needle entry hole, so that the tip of the needle reaches the cortex at the needle entry point and drill in 2-3 mm. Adjust the inner-outer direction position of the needle inserter through the depth adjustment part and the depth adjustment slider to make it reach the position of the appropriate length of the guide needle, and position it through the locking component. Then select the oblique needle entry hole at the corresponding angle according to the patient's neck-shaft angle, and obliquely insert another guide needle through this hole so that the tips of the two guide needles are butted, and the tip of the oblique guide needle enters the drill hole of the vertical guide needle. Then the needle entry guiding and positioning can be completed.

[0012] The structure of the present invention is simple and the manufacturing cost is low. Through the cooperation of the needle inserter and the calibration device, the angle, position and depth of the needle entry can be calibrated, and the guide needle can be effectively guided along the needle inserter into the calibrated needle entry point, improving the accuracy of the operation, so as to achieve the purpose of improving the success rate of the operation, and has the characteristics of high positioning accuracy and convenient operation. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 It is a schematic structural diagram of the present invention.

[0014] Figure 2 It is a schematic structural diagram of the needle inserter of the present invention.

[0015] Figure 3 It is a schematic structural diagram of the depth calibration adjustment part of the present invention.

[0016] Figure 4 It is a schematic structural diagram of the adjustment mechanism of the present invention.

[0017] In the figure: 1. Needle inserter; 2. Depth adjustment slider; 3. Bolt locking part; 4. Depth adjustment part; 5. Horizontal adjustment part; 6. Vertical adjustment part; 7. Bone hook; 8. Mounting seat; 9. Oblique needle entry hole; 10. Vertical needle entry hole; 11. Vertical slider; 12. Horizontal slider. DETAILED DESCRIPTION OF THE INVENTION

[0018] The present invention will be further described below by way of examples in conjunction with the accompanying drawings, but it is not intended to limit the present invention.

[0019] In Figure 1 、 2 、3, and 4, a percutaneous minimally invasive positioning guide for the femoral neck nail entry point provided by the present invention includes a needle inserter 1 and a calibration device. A vertical needle entry hole 10 and an oblique needle entry hole 9 are provided on the same horizontal plane of the needle inserter 1. A plurality of oblique needle entry holes 9 are provided on the needle inserter 1, and the angles of the oblique needle entry holes 9 are respectively set to multiple angles. A depth adjustment slider 2 in the same direction as the vertical needle entry hole 10 is provided on the needle inserter 1. The calibration device is arranged at the front end of the needle inserter 1 and is movably connected to the depth adjustment slider 2. A locking assembly is provided on the depth adjustment slider 2, and the locking assembly is a bolt locking member 3;

[0020] The calibration device includes a depth adjustment member 4, a vertical adjustment member 6, an adjustment mechanism, and a bone hook 7. A scale is provided on the depth adjustment member 4, and a chute matching the depth adjustment slider 2 is provided on the depth adjustment member 4. The depth adjustment member 4 is connected to the depth adjustment slider 2 through the chute; the adjustment mechanism is movably connected to the depth adjustment member 4 through the vertical adjustment member 6 provided at the front end of the depth adjustment member 4, and the bone hook 7 is arranged on the adjustment mechanism;

[0021] The adjustment mechanism is composed of a vertical slider 11, a horizontal adjustment member 5, and a horizontal slider 12. A bolt locking member 3 is provided on the vertical slider 11. The vertical slider 11 is connected to the vertical adjustment member 6 provided on the depth adjustment member 4, that is, the vertical slider 11 is movably connected to the vertical adjustment member 6 through the chute provided on the vertical adjustment member 6. The horizontal adjustment member 5 is horizontally arranged on the vertical slider 11. A chute matching the horizontal slider 12 is provided on the horizontal adjustment member 5, and the horizontal slider 12 is arranged in the chute of the horizontal adjustment member 5. A bolt locking member 3 is provided on the horizontal slider 12. A mounting seat 8 is provided on the horizontal slider 12, and the bone hook 7 is detachably arranged on the mounting seat 8. Scales are provided on both the vertical slider 11 and the horizontal adjustment member 5.

[0022] During installation, first insert the needle inserter 1 into the depth adjustment member 4 along the chute through the depth adjustment slider 2, so that the needle inserter 1 is movably connected to the depth adjustment member 4 and is positioned by the bolt locking member 3; then insert the vertical slider 11 into the vertical adjustment member 6 provided on the depth adjustment member 4 through the chute, so that the vertical slider 11 is movably connected to the depth adjustment member 4 and is positioned by the bolt locking member 3; finally, insert the horizontal slider 12 provided with the mounting seat 8 into the horizontal adjustment member 5 provided on the vertical slider 11, so that the mounting seat 8 is movably connected to the horizontal adjustment member 5, and install the bone hook 7 on the mounting seat 8 to complete the installation.

[0023] During use, first adjust the positions of the mounting base and the needle inserter according to the patient's condition through the cooperation of the horizontal adjusting member and the horizontal slider, as well as the cooperation of the vertical slider and the vertical adjusting member, and adjust their positions through the scales. Then, position them through the locking assembly to make the vertical needle insertion hole parallel to the bone hook. Next, hook the bone hook onto the inner cortex of the patient's femur, and then understand the depth situation according to the scale of the bone hook. Adjust the position of the needle inserter through the depth adjusting member and the depth adjusting slider to make it correspond to the guide needle length, and position it through the locking assembly. Finally, insert the guide needle into the vertical needle insertion hole, enter the patient's leg along the direction of the bone hook, and abut against the outer cortex of the femur. If the insertion depth of the guide needle in the vertical needle insertion hole is large, another guide needle can be inserted through the oblique needle insertion hole at the corresponding angle (large angle) so that the needles of the two guide needles are butted. On the contrary, if the insertion depth of the guide needle in the vertical needle insertion hole is shallow, another guide needle can be inserted through the oblique needle insertion hole at the corresponding angle (small angle) so that the needles of the two guide needles are butted, and thus the nail insertion guiding and positioning can be completed.

[0024] The above are only the preferred embodiments of the present invention. It should be noted that for those of ordinary skill in the art in this technical field, without departing from the technical principle of the present invention, several improvements and refinements can still be made, and these improvements and refinements should also be regarded as the protection scope of the present invention.

Claims

1. A percutaneous minimally invasive positioning and guiding device for the femoral neck entry point, characterized in that: It includes a needle inserter and a calibration device. A vertical needle insertion hole and several oblique needle insertion holes are provided on the same horizontal plane of the needle inserter. A depth adjustment slider in the same direction as the vertical needle insertion hole is provided on the needle inserter. The calibration device is arranged at the front end of the needle inserter and is movably connected to the depth adjustment slider. A locking component is provided on the depth adjustment slider; the angles of the oblique needle insertion holes are respectively set to multiple angles; The calibration device includes a depth adjustment member, a vertical adjustment member, an adjustment mechanism and a bone hook. A scale is provided on the depth adjustment member. A chute matching the depth adjustment slider is provided on the depth adjustment member. The depth adjustment member is connected to the depth adjustment slider through the chute; the adjustment mechanism is movably connected to the depth adjustment member through the vertical adjustment member arranged at the front end of the depth adjustment member, and the bone hook is arranged on the adjustment mechanism; The adjustment mechanism is composed of a vertical slider, a horizontal adjustment member and a horizontal slider. A locking component is provided on the vertical slider. The vertical slider is connected to the vertical adjustment member arranged on the depth adjustment member, that is, the vertical slider is movably connected to the vertical adjustment member through the chute arranged on the vertical adjustment member. The horizontal adjustment member is horizontally arranged on the vertical slider. A chute matching the horizontal slider is provided on the horizontal adjustment member, and the horizontal slider is arranged in the chute of the horizontal adjustment member. A locking component is provided on the horizontal slider. A mounting seat is provided on the horizontal slider. The bone hook is detachably arranged on the mounting seat. Scales are provided on both the vertical slider and the horizontal adjustment member.

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