A 3D printing method for osteotomy guide plate for transverse tibial bone transport surgery

Abstract

The present invention provides a 3D printing method for an osteotomy guide plate for transverse tibial bone transport surgery, which relates to the technical field of medical auxiliary equipment and includes the following steps: S1: CT scanning to obtain continuous tomographic data, perform three-dimensional reconstruction, and measure the diameter of the tibial medullary cavity; S2: reconstruct the overall structure of the instrument, design a transport navigation module, make it a rectangular parallelepiped, and set two bone circular needle guide columns in the middle; S3: divide the bone transport navigation module into two parts in the middle, and design a rectangular array of holes; S4: set a reference plane, use the reference plane to obtain a two-dimensional projection of the tibial plateau articular surface contour, and design a continuous guide groove. The present invention accurately measures the bone block to be cut, and can determine the height during surgery, so that accurate osteotomy can be performed, and the area to be osteotomized can be precisely planned to avoid damaging surrounding tissues. Continuous osteotomy can be performed with high osteotomy efficiency, and can be matched with different instruments and different osteotomy techniques, protecting the skin to the greatest extent and reducing the wound surface.

Description

Technical Field

[0001] This invention relates to the field of medical assistive device technology.

[0002] In particular, the present invention relates to a 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery. Background Technology

[0003] Tibial transverse bone transport is a technique derived from Ilizarov's tensile stress principle for treating ischemic limb diseases caused by diabetes, arteriosclerosis obliterans, and other conditions. Slow, continuous traction stimulates cell proliferation and biosynthesis, enhancing tissue metabolism. By applying appropriate traction stress to the bone, this technique mobilizes the tissue's natural repair potential, enabling the bone and its attached muscles, fascia, blood vessels, and nerves to grow synchronously, thereby achieving the natural reconstruction of microcirculation in damaged tissues.

[0004] In transverse tibial transport surgery, a square bone block needs to be cut on the medial side of the proximal tibia and a transport device needs to be installed. The osteotomy requires completely cutting only a single layer of cortical bone, avoiding splitting the bone block, allowing the transport device to continuously pull the bone block away from the medullary cavity and accurately reimplant it, while also protecting soft tissue as much as possible and avoiding other osteotomy complications. Therefore, osteotomy is a core component of this surgery and requires a high level of technical skill. However, current procedures for this surgery often rely on the surgeon's experience, which cannot achieve efficient and precise osteotomy to meet the aforementioned requirements. Therefore, an auxiliary osteotomy guide plate is crucial for this procedure. For example, Chinese invention patent CN110720965A discloses a tibial transverse bone transport osteotomy device for treating diabetic foot, comprising a first plate, a second plate, a connecting rod, a cutting drill, and a fixing needle. Two of each of the first and second plates are provided. The first plate has a connector, and the second plate has a connector opening, so that the two first plates and two second plates form a rectangle. Both the first and second plates have osteotomy holes through which the drill enters the patient's diabetic foot tibia. The first plate includes two sub-plates, and the angle between the two sub-plates can be adjusted by an angle adjustment mechanism. The connecting rod is connected to both first plates at both ends and has through fixing holes, allowing the fixing needle to enter the patient's diabetic foot tibia through these holes. This invention facilitates the surgeon's cutting of the diabetic foot tibia and reduces harm to the patient.

[0005] However, the above-mentioned device still has the following drawbacks: it lacks accurate measurement of the bone block to be cut, it does not plan the area to be cut in order to achieve a balance between the size of the bone block being too large, which would cause damage to the tibial crest, and too small, which would cause the bone block to split during the bone cutting and installation of the transport device, while avoiding damage to important soft tissues such as the pes anserinus. The bone cutting efficiency is low, it cannot meet the requirements of continuous bone cutting, and it cannot provide sufficient time for the installation of the transport device before bone cutting. There is still a possibility of harm to the patient.

[0006] Therefore, in order to solve the above problems, it is necessary for us to design a reasonable 3D printing method for osteotomy guides used in tibial transverse bone transport surgery. Summary of the Invention

[0007] The purpose of this invention is to provide a 3D printing method for an osteotomy guide plate used in tibial transverse bone transport surgery. This method allows for accurate measurement of the bone block to be cut, precise height setting during surgery via continuous guide grooves, accurate positioning for precise osteotomy, and precise planning of the osteotomy area. This enables continuous osteotomy while avoiding damage to surrounding important soft tissues such as the goosefoot, resulting in high osteotomy efficiency. The plate can be matched with different instruments and osteotomy techniques, maximizing skin protection and minimizing wound size.

[0008] To achieve the above objectives, the present invention employs the following technical solution:

[0009] A 3D printing method for an osteotomy guide plate used in tibial transverse bone transport surgery includes the following steps:

[0010] S1: Perform spiral CT thin-slice scanning on the patient's lower limbs to obtain continuous tomographic DICOM data, perform three-dimensional reconstruction of bone and soft tissues, make the reconstructed bone tissue model semi-transparent, and measure the diameter of the tibial medullary cavity in the coronal plane.

[0011] S2: Obtain the dimensional parameters of the bone transport surgical instruments and reconstruct the overall structure of the instruments. At the same time, design a standardized bone transport navigation module, so that the main structure of the bone transport navigation module is a cuboid, with two bone round needle guide columns in the center to assist in traction of bone segments.

[0012] S3: Divide the bone transport navigation module in half centrally and design a rectangular array of holes, such that the width of the rectangle is equal to the diameter of the tibial medullary cavity, the center distance of the holes on the long side of the rectangle is equal to the minimum bone transport osteotomy length, and the center distance of the holes on the short side of the rectangle is the minimum guiding length of the Kirschner wire.

[0013] S4: Set a reference plane in the direction perpendicular to the central axis of the bone needle guide post, obtain a two-dimensional projection of the tibial plateau articular surface contour using this reference plane, and design a continuous guide groove based on the contour line obtained by the projection.

[0014] As a preferred embodiment of the present invention, when performing step S1, the patient's lower limbs include the affected lower limb and the unaffected lower limb.

[0015] As a preferred embodiment of the present invention, when performing step S1, the continuous tomographic DICOM data is imported into Mimics Medical software for three-dimensional reconstruction of bone and soft tissues.

[0016] As a preferred embodiment of the present invention, when performing step S2, the center distance between the two bone needle guide posts is set according to the center distance of the handling device clamp.

[0017] As a preferred embodiment of the present invention, when performing step S1, the outer diameter of the tibial cortex and the vertical distance from the cortex to the epidermis of the medial tibial bone plane are measured simultaneously with the diameter of the tibial medullary cavity.

[0018] As a preferred embodiment of the present invention, after performing step S2, extended positioning guide holes are provided on both sides of the bone transport navigation module. The length of the extended positioning guide hole is not less than the vertical distance from the cortex to the epidermis of the medial tibial bone plane, so that the extended positioning guide hole is used to position the medial and lateral cortical bone surfaces of the tibia to accurately guide and position the bone round needle guide post to the center of the tibial anatomical axis.

[0019] As a preferred embodiment of the present invention, after performing step S2, the central axis of the extended positioning guide hole is set to be perpendicular to the central axis of the bone needle guide post, and the diameter of the extended positioning guide hole is 1mm.

[0020] As a preferred embodiment of the present invention, when performing step S3, the central axis of the two bone needle guide posts is located on the interface that divides the bone transport navigation module in two.

[0021] As a preferred embodiment of the present invention, when performing step S2, the aperture of the array of holes is not less than 1.5 mm;

[0022] When performing step S4, the width of the continuous guide groove is 1 mm.

[0023] As a preferred embodiment of the present invention, after performing step S4, the reference panel used to set the continuous guide groove is connected to the bone transport navigation module via a connecting rod.

[0024] The beneficial effects of the 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery of the present invention are as follows: by accurately measuring the bone block to be cut, the height can be fixed during the operation through continuous guide grooves, so that accurate osteotomy can be performed under accurate positioning, and the osteotomy area to be precisely planned can be achieved to avoid damage to important soft tissues such as the pes anserinus. Continuous osteotomy can be performed, the osteotomy efficiency is high, and it can be matched with different instruments and different osteotomy techniques, so as to protect the skin to the greatest extent and reduce the wound area. Attached Figure Description

[0025] Figure 1 This is a flowchart illustrating a 3D printing method for an osteotomy guide plate used in tibial transverse bone transport surgery according to the present invention.

[0026] Figure 2 This is a schematic diagram of the finished osteotomy guide plate in the 3D printing method of the osteotomy guide plate for tibial transverse bone transport surgery according to the present invention. Detailed Implementation

[0027] The following are specific embodiments of the present invention, which further describe the technical solution of the present invention, but the present invention is not limited to these embodiments.

[0028] Various exemplary embodiments of the present invention will now be described in detail with reference to the accompanying drawings. It should be noted that, unless otherwise specifically stated, the relative arrangement and steps of the modules and steps set forth in these embodiments do not limit the scope of the invention.

[0029] At the same time, it should be understood that, for ease of description, the process shown in the attached diagram is not performed in isolation, but rather involves multiple steps that overlap.

[0030] The following description of at least one exemplary embodiment is merely illustrative and is in no way intended to limit the invention or its application or use.

[0031] Techniques and methods known to those skilled in the art may not be discussed in detail, but where appropriate, they should be considered part of the license specification.

[0032] Example: Figure 1 , 2 As shown, a 3D printing method for an osteotomy guide plate used in tibial transverse bone transport surgery includes the following steps:

[0033] S1: Perform spiral CT thin-slice scanning on the patient's lower limbs to obtain continuous tomographic DICOM data, perform three-dimensional reconstruction of bone and soft tissues, make the reconstructed bone tissue model semi-transparent, and measure the diameter of the tibial medullary cavity in the coronal plane.

[0034] S2: Obtain the dimensional parameters of the bone transport surgical instruments and reconstruct the overall structure of the instruments. At the same time, design a standardized bone transport navigation module, so that the main structure of the bone transport navigation module is a cuboid, with two bone round needle guide columns in the center to assist in traction of bone segments.

[0035] S3: Divide the bone transport navigation module in half centrally and design a rectangular array of holes, such that the width of the rectangle is equal to the diameter of the tibial medullary cavity, the center distance of the holes on the long side of the rectangle is equal to the minimum bone transport osteotomy length, and the center distance of the holes on the short side of the rectangle is the minimum guiding length of the Kirschner wire.

[0036] S4: Set a reference plane in the direction perpendicular to the central axis of the bone needle guide post, obtain a two-dimensional projection of the tibial plateau articular surface contour using this reference plane, and design a continuous guide groove based on the contour line obtained by the projection.

[0037] When performing step S1, the patient's lower limbs include the affected lower limb and the unaffected lower limb.

[0038] When performing step S1, the continuous tomographic DICOM data is imported into the Mimics Medical software for three-dimensional reconstruction of bone and soft tissues.

[0039] When performing step S2, the center distance between the two bone needle guide posts is set according to the center distance of the handling device clamp.

[0040] When performing step S1, while measuring the diameter of the tibial medullary cavity, the outer diameter of the tibial cortex and the vertical distance from the cortex to the epidermis of the medial tibial bone plane are also measured.

[0041] After performing step S2, extended positioning guide holes are provided on both sides of the bone transport navigation module. The length of the extended positioning guide hole is not less than the vertical distance from the cortex to the epidermis of the tibial side bone plane, so that the extended positioning guide hole is used to position the medial and lateral cortical bone surfaces of the tibia to accurately guide and position the bone round needle guide post to the center of the tibial anatomical axis.

[0042] After executing step S2, the central axis of the extended positioning guide hole is set to be perpendicular to the central axis of the bone needle guide post, and the diameter of the extended positioning guide hole is 1mm.

[0043] When step S3 is executed, the central axis of the two bone needle guide posts is located on the interface that divides the bone transport navigation module in two.

[0044] When performing step S2, the diameter of the array holes shall not be less than 1.5 mm;

[0045] When performing step S4, the width of the continuous guide groove is 1 mm.

[0046] After performing step S4, the reference panel used to set the continuous guide groove is connected to the bone transport navigation module via a connecting rod.

[0047] This invention discloses a 3D printing method for an osteotomy guide plate used in tibial transverse bone transport surgery. By accurately measuring the bone block to be cut, the plate can be positioned at a fixed height during surgery using continuous guide grooves. This allows for accurate osteotomy under precise positioning, precise planning of the osteotomy area, and continuous osteotomy with high efficiency while avoiding damage to surrounding important soft tissues such as the pes anserinus. It can be matched with different instruments and osteotomy techniques, maximizing skin protection and minimizing wound size.

[0048] Example 2, still as Figure 1 ,2 The illustration shown is merely one embodiment of the present invention. Based on Embodiment 1, in the 3D printing method of the osteotomy guide plate for tibial transverse bone transport surgery of the present invention, the 3D printed osteotomy guide plate is used during surgery as follows (the bone transport navigation module is referred to as the guide plate):

[0049] 1. Test the guide plate before assembly; 2. First, insert a 1mm Kirschner wire along the continuous guide groove, close to the medial gap of the knee joint, to fix the height of the guide plate. Then, attach the individualized transverse bone transport guide plate to the tibial skin on the affected or healthy side, so that the guide plate conforms to the bony landmarks and the skin of the lower leg; 3. Insert two 1.0mm Kirschner wires into the extended positioning guide holes on both sides of the guide plate, respectively. Insert the Kirschner wires from the bone-soft tissue gap, close to the bone surface, to fix the relative position of the guide plate and the medial surface of the tibia; 4. Taking advantage of the guide plate's detachable design for easy skin incision, open the guide plate along the disassembly and assembly parts, and then place it along the central axis of the guide plate on the medial side of the tibia. 1. Make a longitudinal incision on the surface, separate the subcutaneous tissue to the periosteum, cut the periosteum and lift it to both sides, and place the guide plate into the incision. The incision should have a length-to-width ratio of less than 1. Alternatively, make eight incisions along the skin below the drainage holes from the center of the guide plate to perform minimally invasive osteotomy. 2. Insert two 5.0mm bone needles through the bone needle guide post. 3. Drill drainage holes along the center distance of the drainage holes using 1.5mm Kirschner wires. 4. Then use a thin-bladed osteotome to cut the bone fragment, so that the cut bone fragment is in a completely free state. During the osteotomy, take care to protect the periosteum and avoid damaging the surrounding important nerves and blood vessels. 5. Install the tibial bone transport frame and suture it in full thickness.

[0050] This invention is not limited to the specific embodiments described above, and various modifications and variations are possible. Any modifications, equivalent substitutions, or improvements made to the above embodiments based on the technical essence of this invention should be included within the scope of protection of this invention.

Claims

1. A 3D printing method for an osteotomy guide plate used in tibial transverse bone transport surgery, characterized in that, Includes the following steps: S1: Perform spiral CT thin-slice scanning on the patient's lower limbs to obtain continuous tomographic DICOM data, perform three-dimensional reconstruction of bone and soft tissues, make the reconstructed bone tissue model semi-transparent, and measure the diameter of the tibial medullary cavity in the coronal plane. When performing step S1, while measuring the diameter of the tibial medullary cavity, the outer diameter of the tibial cortex and the vertical distance from the cortex to the epidermis of the medial tibial bone plane are also measured. S2: Obtain the dimensional parameters of the bone transport surgical instruments and reconstruct the overall structure of the instruments. At the same time, design a standardized bone transport navigation module, so that the main structure of the bone transport navigation module is a cuboid, with two bone round needle guide columns in the center to assist in traction of bone segments. After executing step S2, extended positioning guide holes are set on both sides of the bone transport navigation module. The length of the extended positioning guide hole is not less than the vertical distance from the cortex to the epidermis of the medial tibial bone plane, so that the extended positioning guide hole is used to position the medial and lateral tibial cortex bone surfaces to accurately guide and position the bone round needle guide column to the center of the tibial anatomical axis. S3: Divide the bone transport navigation module in half centrally and design a rectangular array of holes, such that the width of the rectangle is equal to the diameter of the tibial medullary cavity, the center distance of the holes on the long side of the rectangle is equal to the minimum bone transport osteotomy length, and the center distance of the holes on the short side of the rectangle is the minimum guiding length of the Kirschner wire. S4: Set a reference plane in the direction perpendicular to the central axis of the bone needle guide post, obtain a two-dimensional projection of the tibial plateau articular surface contour using this reference plane, and design a continuous guide groove based on the contour line obtained by the projection.

2. The 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: When performing step S1, the patient's lower limbs include the affected lower limb and the unaffected lower limb.

3. The 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: When performing step S1, the continuous tomographic DICOM data is imported into the Mimics Medical software for three-dimensional reconstruction of bone and soft tissues.

4. A 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: When performing step S2, the center distance between the two bone needle guide posts is set according to the center distance of the handling device clamp.

5. A 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: After performing step S2, the central axis of the extended positioning guide hole is perpendicular to the central axis of the bone needle guide post, and the diameter of the extended positioning guide hole is 1mm.

6. A 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: When step S3 is executed, the central axis of the two bone needle guide posts is located on the interface that divides the bone transport navigation module in two.

7. A 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: When performing step S2, the diameter of the perforation holes shall not be less than 1.5 mm; When performing step S4, the width of the continuous guide groove is 1 mm.

8. A 3D printing method for an osteotomy guide plate for tibial transverse bone transport surgery according to claim 1, characterized in that: After performing step S4, the reference panel used to set the continuous guide groove is connected to the bone transport navigation module via a connecting rod.

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