Closed osteotomy guide for the upper part of the tibia and fibula in ankle arthritis

Abstract

The present invention belongs to the technical field of medical devices, and particularly relates to a closed supra-ankle osteotomy guide for ankle arthritis of the tibia and fibula. It includes a rotation angle adjustment component, a distal tibia and fibula osteotomy component, and a proximal tibia and fibula osteotomy component; the rotation angle adjustment component includes an orbital ring and a height adjustment rod, the orbital ring is provided with scales, the height adjustment rod is slidably connected to the orbital ring, and the height adjustment rod is used to adjust the height; the distal tibia and fibula osteotomy component includes a distal cutting plate, a fixing bolt and a distal osteotomy bracket, and the distal osteotomy bracket includes a nut rod and a distal connecting rod; the proximal tibia and fibula osteotomy component includes a proximal cutting plate, a proximal connecting rod, a sliding sleeve and a cross jacking rod, and one end of the two proximal connecting rods is connected to the proximal cutting plate. The present invention significantly improves the accuracy of supra-ankle closed osteotomy, greatly increases the treatment effect of the operation, avoids the occurrence of medical technical accidents, and is suitable for popularization in clinical medicine.

Description

Technical Field

[0001] The present invention belongs to the technical field of medical devices, and particularly relates to a closed supra-ankle osteotomy guide for tibiofibular ankle in ankle arthritis. Background Art

[0002] Ankle osteoarthritis (OA) is a progressive disease, mainly manifested as degenerative changes of articular cartilage, and often accompanied by varus or valgus deformity of the ankle joint. In the treatment of ankle OA, it is currently a relatively consistent view that end-stage OA requires arthrodesis or arthroplasty. However, for the treatment of mid-stage OA with an affected area less than 1 / 2, supra-ankle osteotomy is an effective method for treating mid-stage ankle OA with malalignment. For varus ankle OA, supra-ankle osteotomy can correct the negative gravity line, reshape joint coordination, relieve the medial pressure of the tibio-talar joint, and delay or even reverse the process of OA.

[0003] Supra-ankle osteotomy has been used to treat ankle osteoarthritis caused by post-traumatic malunion. Corresponding to "high tibial osteotomy" for treating varus knee osteoarthritis, supra-ankle osteotomy for treating varus ankle arthritis is also called "low tibial osteotomy". Different from knee chondrocytes, the chondrocytes of the ankle joint can naturally resist degeneration and are also easy to repair if damaged. Therefore, osteotomy is considered to be very effective if a favorable biomechanical environment for cartilage repair is created within the joint. The mechanism of action of supra-ankle osteotomy in treating deformed arthritis lies in correcting the displacement of the original negative gravity line, transferring the load and dispersing the stress, and avoiding stress concentration on the ankle joint surface.

[0004] The load-bearing area of the ankle is smaller than that of the knee, and the load per unit area is relatively higher. Therefore, once structural abnormalities occur, osteoarthritis is likely to occur. The ankle joint is vulnerable to injury, and post-fracture arthritis accounts for a high proportion of ankle osteoarthritis. It is most commonly caused by ankle fractures or pilon fractures. Another possible cause is the morphological abnormality of the ankle joint caused by varus deformity of the distal tibial articular surface or joint instability, including residual deformities of poliomyelitis and congenital clubfoot, as well as valgus deformity of the ankle joint caused by abnormal fibula.

[0005] There are two options for supra-ankle osteotomy. One is open osteotomy, whose advantages are multi-planar correction, but the disadvantages are that bone grafting is required for the open gap, and there are risks of non-union of osteotomy and nerve and blood vessel traction after surgery. The other is closed osteotomy, which can correct large-angle ankle valgus deformity. Its advantages are multi-planar correction, avoiding nerve and blood vessel traction, and a low risk of non-union of osteotomy.

[0006] In closed supra-ankle osteotomy surgery, fibular osteotomy is a conventional procedure, and the osteotomy planes need to match each other. Therefore, closed wedge osteotomy is technically difficult. Currently, combined spinal-epidural anesthesia or general anesthesia is used for the surgery, and the patient lies in the supine position. An anteromedial ankle incision is made to expose the anteromedial ankle space and the anteromedial bone surface of the distal tibia. An osteotome or a reciprocating saw is used to clean the anterior and medial osteophytes of the ankle joint. The osteotomy line is located 4-5 cm above the tip of the medial malleolus. After intraoperative positioning with a Kirschner wire, a reciprocating saw is used to cut the medial, anterior, and posterior cortices parallel to the distal tibial articular surface from inside to outside, or slightly obliquely from inside-superior to outside-inferior, while preserving the lateral cortex. The osteotomy gap is closed, and intraoperative fluoroscopy is repeatedly performed to determine and adjust until satisfactory orthosis is achieved, and then internal fixation is performed. Therefore, situations such as unsatisfactory osteotomy angles, excessive bone loss, uneven osteotomy surfaces, and poor alignment may even occur. Summary of the Invention

[0007] To solve the problem of inaccurate osteotomy mentioned in the background art, the present invention discloses a supra-ankle closed osteotomy guide for tibiofibular in ankle arthritis.

[0008] To achieve the above object, the following technical solutions are provided:

[0009] A supra-ankle closed osteotomy guide for tibiofibular in ankle arthritis includes a rotation angle adjustment component, a distal tibiofibular osteotomy component, and a proximal tibiofibular osteotomy component;

[0010] The rotation angle adjustment component includes an orbital ring, a height adjustment rod, and a scale disk. The orbital ring is provided with scales, and the scale disk is connected to the orbital ring through a vertical rod; a foot tray is arranged on the scale disk, and the foot tray is rotatably connected to the scale disk; the height adjustment rod is slidably connected to the orbital ring, and the height adjustment rod is used to adjust the height;

[0011] The distal tibiofibular osteotomy component includes a distal cutting plate, a fixing bolt, and a distal osteotomy bracket. The distal osteotomy bracket includes a nut support rod, a bolt guide rod, and a distal connecting rod. The nut support rod is parallel to the bolt guide rod. A nut hole is arranged on the nut support rod, and a guide hole is arranged on the bolt guide rod. The nut hole and the guide hole are coaxial; the two distal connecting rods fixedly connect the nut support rod and the bolt guide rod, and one end of the distal connecting rod fixedly connects the distal cutting plate; the distal cutting plate is rotatably connected to one end of the height adjustment rod;

[0012] The proximal tibiofibular osteotomy component includes a proximal cutting plate and a proximal connecting rod. One end of the two proximal connecting rods is connected to the proximal cutting plate, and the other end is rotatably connected to the distal connecting rod, and an angle plate is arranged at the rotatable connection.

[0013] Further, the cross-section of the orbital ring is rectangular, and one end of the height adjustment rod is a rectangular ring, and the rectangular ring is connected to the orbital ring in a matching manner.

[0014] Further, scales are provided on the height adjustment rod to facilitate observing the set height.

[0015] Further, a dial is provided at the bottom of the track ring, and the dial is connected to the track ring through a vertical rod.

[0016] Further, a pointer is provided on the side of the foot tray, and the front of the foot tray is provided with the shape of a sole.

[0017] Advantages of the present invention:

[0018] The tibiofibular syndesmosis closed osteotomy fusion guide device provided by the present invention makes the supra-ankle closed osteotomy feasible. By rotating the angle between the distal tibiofibular osteotomy component and the proximal tibiofibular osteotomy component, the osteotomy surface can be accurately determined, making the osteotomy plane accurate to 1° and flat and anastomosed with each other, thus significantly improving the accuracy of the supra-ankle closed osteotomy, greatly increasing the therapeutic effect of the surgery, avoiding the occurrence of medical technical accidents, and being suitable for popularization in clinical medicine. Description of the Drawings

[0019] Figure 1 Stereogram of the supra-ankle closed osteotomy guide for ankle arthritis Figure 1 ;

[0020] Figure 2 Stereogram of the supra-ankle closed osteotomy guide for ankle arthritis Figure 2 ;

[0021] Figure 3 Partial view of the proximal tibiofibular osteotomy component of the supra-ankle closed osteotomy guide for ankle arthritis;

[0022] Figure 4 Partial view of the sliding sleeve of the supra-ankle closed osteotomy guide for ankle arthritis;

[0023] Figure 5 Exploded view of the cross head rod and fixing bolt of the supra-ankle closed osteotomy guide for ankle arthritis;

[0024] Wherein: 1. Rotation angle adjustment component; 11. Track ring; 12. Height adjustment rod; 121. Rod one; 122. Rod two; 13. Dial; 14. Shape of sole; 2. Distal tibiofibular osteotomy component; 21. Distal cutting board; 211. Distal cutting opening; 22. Fixing bolt; 23. Distal osteotomy bracket; 231. Nut support rod; 2311. Nut hole; 232. Distal connecting rod; 3. Proximal tibiofibular osteotomy component; 31. Proximal cutting board; 311. Proximal cutting board opening; 32. Proximal connecting rod; 321. Pointer; 33. Sliding sleeve; 331. Inner shaft; 332. Outer shaft; 34. Cross head rod; 35. Connecting piece; 4. Angle plate; 41. Pointer groove. Detailed implementation mode

[0025] To make the technical solutions of the present invention clearer and more definite to those skilled in the art, the technical solutions of the present invention will be described in detail below with reference to the accompanying drawings, but the implementation modes of the present invention are not limited thereto.

[0026] As Figures 1 to 5 shown, an above-ankle closed osteotomy guide for ankle arthritis of the tibia and fibula, a rotation angle adjustment assembly 1, a distal tibia and fibula osteotomy assembly 2, and a proximal tibia and fibula osteotomy assembly 3.

[0027] The rotation angle adjustment assembly 1 includes an orbital ring 11, a height adjustment rod 12, and a dial 13. The orbital ring 11 is provided with scales, and the dial 13 is connected to the orbital ring 11 through a vertical rod; the height adjustment rod 12 is slidably connected to the orbital ring 11, and the height adjustment rod 12 is used to adjust the height.

[0028] The front surface of the dial 13 is provided with a foot shape 14, and the thumb of the foot shape 14 points to the 0 scale.

[0029] The angle plate 4 is fixed on the outer shaft 332 of the sliding sleeve 33. A pointer 321 track is provided on the angle plate 4; the pointer 321 is fixed outside the proximal connecting rod 32 and passes through the pointer groove 41. A fastening nut is provided on the pointer 321, and the fastening nut is used for fixing after adjusting the angle between the distal tibia and fibula osteotomy assembly 2 and the proximal tibia and fibula osteotomy assembly 3.

[0030] The distal tibia and fibula osteotomy assembly 2 includes a distal cutting plate 21, a fixing bolt 22, and a distal osteotomy bracket 23. The distal osteotomy bracket 23 includes a nut support rod 231 and a distal connecting rod 232. A nut hole 2311 is provided on the nut support rod 231; the two distal connecting rods 232 are fixedly connected to the nut support rod 231, and one end of the distal connecting rod 232 is fixedly connected to the distal cutting plate 21; the distal cutting plate 21 is fixedly connected to one end of the height adjustment rod 12.

[0031] During installation, the height adjustment rod 12 needs to be passed through from the upper end face and positioned by screwing a nut at the lower part. There is a rod cap at the end of the height adjustment rod 12, and a sink is provided on the lower end face of the distal cutting plate 21. The rod cap falls into the sink, thereby setting the lower end face of the distal cutting plate 21 to be rotatably connected to one end of the height adjustment rod 12.

[0032] The proximal tibiofibular osteotomy assembly 3 includes a proximal cutting plate 31, a proximal connecting rod 32, a sliding sleeve 33, and a cross-shaped ejector rod 34. One end of each of the two proximal connecting rods 32 is connected to the proximal cutting plate 31, and the other end of the proximal connecting rod 32 is rotatably connected to the inner side of the sliding sleeve 33 through an inner shaft 331. An angle plate 4 is provided at the rotatable connection; the sliding sleeve 33 is arranged on the distal connecting rod 232 and is slidably connected to the distal connecting rod 232; the cross-shaped ejector rod 34 is fixed on the sliding sleeve 33, and the tip of the cross-shaped top plate is on the axis of the inner shaft 331; the fixing bolt 22 cooperates with the nut hole 2311, and one end of the fixing bolt 22 is rotatably connected to the cross-shaped ejector rod 34; annular grooves are provided on the cross-shaped ejector rod 34 and the fixing bolt 22, and a raised ring is provided on the inner wall of the connecting member 35. The raised ring is stuck in the annular groove, and the connecting member 35 is a split structure and is connected by bolts.

[0033] Proximal cutting ports and distal cutting ports 211 are respectively provided on the proximal cutting plate 31 and the distal cutting plate 21 for cutting off the redundant fibula by cutting.

[0034] The cross-section of the track ring 11 is rectangular. One end of the height adjustment rod 12 is a rectangular ring, and the rectangular ring is connected to the track ring 11 in a matching manner. One side of the rectangular ring is open and is snapped onto the track ring 11, and a fastening bolt is provided on the rectangular ring. A scale disk 13 is provided at the bottom of the track ring 11, and the scale disk 13 is fixedly connected to the track ring 11 through a vertical rod.

[0035] Scales are provided on the height adjustment rod 12 for facilitating the observation of the set height. The height adjustment rod 12 includes a rod one 121 and a rod two 122. The rod one 121 and the rod two 122 are connected by threads, and the height is adjusted by adjusting the depth of the rod one 121 screwed into the rod two 122.

[0036] The operation method is as follows: Pass the foot through the distal tibiofibular osteotomy assembly 2 and the proximal tibiofibular osteotomy assembly 3 and place it on the scale disk 13; after the foot is normally placed on the scale disk 13, the line connecting the 0-degree and 180-degree of the scale is perpendicular to the front and back of the person, and record the deflection angle of the foot; rotate the position of the height adjustment rod 12 on the track ring 11 to adjust the height of the height adjustment rod so that the distal cutting plate 21 is located at the osteotomy line, and adjust the angle of the proximal cutting plate 31; the adjustment of the height and angle is determined according to the recorded deflection angle and the surgical position; rotate the fixing bolt 22, and the fixing bolt 22 advances forward to push the cross-shaped ejector rod 34, and the cross-shaped ejector rod 34 abuts against one side of the intersection of the osteotomy surfaces. The osteotomy knife cuts in through the proximal cutting plate opening 311 and the distal cutting port 211 to remove the excessive bone mass. Then close the section and fix it with steel nails.

[0037] As described above, it is only the best embodiment of the present invention and does not limit the present invention in any form. Any person skilled in the art can make many possible changes and modifications to the present invention by using the methods and content disclosed above without departing from the scope of the technical solution of the present invention, and all of them fall within the scope protected by the claims.

Claims

1. Ankle arthritis supra-ankle closed osteotomy guide for tibia and fibula, Characterized in that: A rotation angle adjustment component (1), a distal tibia and fibula osteotomy component (2) and a proximal tibia and fibula osteotomy component (3); The rotation angle adjustment component (1) includes an orbital ring (11), a height adjustment rod (12) and a dial (13). The orbital ring (11) is provided with scales, and the dial (13) is connected to the orbital ring (11) through a vertical rod; The height adjustment rod (12) is slidably connected to the orbital ring (11), and the height adjustment rod (12) is used to adjust the height; The distal tibia and fibula osteotomy component (2) includes a distal cutting plate (21), a fixing bolt (22) and a distal osteotomy bracket (23). The distal osteotomy bracket (23) includes a nut rod (231) and a distal connecting rod (232). A nut hole (2311) is provided on the nut rod (231); The two distal connecting rods (232) are fixedly connected to the nut rod (231), and one end of the distal connecting rod (232) is fixedly connected to the distal cutting plate (21); The distal cutting plate (21) is fixedly connected to one end of the height adjustment rod (12); The proximal tibia and fibula osteotomy component (3) includes a proximal cutting plate (31), a proximal connecting rod (32), a sliding sleeve (33) and a cross jacking rod (34). One end of the two proximal connecting rods (32) is connected to the proximal cutting plate (31), and the other end of the proximal connecting rod (32) is rotatably connected to the inner side of the sliding sleeve (33) through an inner shaft (331). An angle plate (4) is provided at the rotatable connection; The sliding sleeve (33) is arranged on the distal connecting rod (232) and is slidably connected to the distal connecting rod (232); The cross jacking rod (34) is fixed on the sliding sleeve (33), and the tip of the cross top plate is on the axis of the inner shaft (331); The fixing bolt (22) cooperates with the nut hole (2311), and one end of the fixing bolt (22) is rotatably connected to the cross jacking rod (34).

2. The supra-ankle closed osteotomy guide for tibia and fibula of arthritis according to claim 1, Characterized in that: The cross section of the orbital ring (11) is rectangular, one end of the height adjustment rod (12) is a rectangular ring with one side open, the rectangular ring is connected to the orbital ring (11) in a matching manner, and a fastening bolt is provided on the rectangular ring.

3. The supra-ankle closed osteotomy guide for tibia and fibula of arthritis according to claim 2, Characterized in that: Scales are provided on the height adjustment rod (12) for easy observation of the set height.

4. The supra-ankle closed osteotomy guide for tibia and fibula of arthritis according to claim 1, Characterized in that: The front of the dial (13) is provided with a foot shape (14), and the thumb of the foot shape (14) points to the 0 scale.

5. The supra-ankle closed osteotomy guide for tibia and fibula of arthritis according to claim 1, Characterized in that: The angle plate (4) is fixed on the outer shaft (332) of the sliding sleeve (33), and a pointer (321) track is provided on the angle plate (4). The pointer (321) is fixed outside the proximal connecting rod (32) and passes through the pointer slot (41). A fastening nut is provided on the pointer (321), and the fastening nut is used for fixing after adjusting the angle between the distal tibiofibular osteotomy assembly (2) and the proximal tibiofibular osteotomy assembly (3).

6. The arthrotic supra-ankle closed tibiofibular osteotomy guide according to claim 1, characterized in that: Annular grooves are provided on the cross head rod (34) and the fixing bolt (22), and a raised ring is provided on the inner wall of the connecting member (35). The raised ring is stuck in the annular groove, and the connecting member (35) is of a split structure and is connected by bolts.

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