A medial malleolus osteotomy guide and method of use

Abstract

The present application relates to the technical field of medical devices, in particular to an inner malleolus osteotomy guide plate and a use method, the inner malleolus osteotomy guide plate comprises a guide plate, a screw rod, a guide rod, a threaded block, a sliding block and a limiting frame; when performing an osteotomy operation, the osteotomy guide plate is fixed to the inner malleolus, then the saw blade of a swing saw is inserted through the through groove and the osteotomy groove, and the saw blade is used to perform osteotomy along the shape of the osteotomy groove; when the osteotomy operation reaches a certain depth, the limiting frame will contact the shell of the swing saw, thereby blocking the saw blade from continuing to penetrate deeply, and avoiding the damage to the cartilage on the surface of the talus due to excessive osteotomy during the osteotomy process. The position of the limiting frame is adjusted according to the intraoperative situation, the threaded block moves along the screw rod by rotating the screw rod, and the limiting frame is driven to move. The position of the limiting frame is dynamically adjusted during the operation, so that the depth of osteotomy is accurately controlled, and iatrogenic talus cartilage damage caused by excessive osteotomy is avoided.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, and in particular to a medial malleolus osteotomy guide plate and its method of use. Background Technology

[0002] For talar parietal osteochondral injuries with significant cystic changes, open surgery is currently the most effective treatment. Surgical methods include autologous osteochondral transplantation, autologous periosteal-bone composite transplantation, and allogeneic osteochondral transplantation. Regardless of the method used, rapid and precise exposure of the lesion is the first step to a successful surgery. Currently, medial malleolar osteotomy is commonly used both domestically and internationally to expose the lesion. During the osteotomy, the surgeon first marks the osteotomy line 2-2.5 cm above the tip of the medial malleolus, then uses a medical oscillating saw at a specific angle to cut the medial malleolus, thereby exposing the lesion on the talar surface. Ideally, the osteotomy should cut the medial malleolus without damaging the cartilage on the talar surface. However, due to the small tibiotalar joint space (approximately 2 mm in physiological conditions), improper technique during the osteotomy can easily lead to excessively deep osteotomy, causing iatrogenic damage to the talar cartilage surface. Summary of the Invention

[0003] The purpose of this invention is to provide a medial malleolus osteotomy guide plate and its usage method, which can avoid iatrogenic damage to the talus cartilage surface caused by excessive osteotomy during medial malleolus osteotomy.

[0004] To achieve the above objectives, in a first aspect, the present invention provides a medial malleolus osteotomy guide plate, comprising a guide plate, a screw, a guide rod, a threaded block, a slider, and a limiting frame;

[0005] The guide plate has an osteotomy groove; the screw is rotatably connected to the guide plate and located on one side of the guide plate; the guide rod is fixedly connected to the guide plate and located on one side of the guide plate; the threaded block is threadedly connected to the screw and is penetrated by the screw; the slider is slidably connected to the guide rod and is penetrated by the guide rod; the limiting frame is fixedly connected to the threaded block and fixedly connected to the slider, and located between the threaded block and the slider, and the limiting frame has a through groove.

[0006] The medial malleolus osteotomy guide plate also includes a knob; the knob is fixedly connected to the screw and is located at the end of the screw away from the guide plate.

[0007] The medial malleolus osteotomy guide plate also includes a limiting block; the limiting block is fixedly connected to the guide rod and is located at the end of the guide rod away from the guide plate.

[0008] The guide rod has scale lines; the scale lines are located on the side of the guide rod.

[0009] The guide plate includes a first positioning plate, a universal ball, a connecting shaft, a guide plate, two snap fasteners, and a second positioning plate. The universal ball is rotatably connected to the first positioning plate and is located inside the first positioning plate. The connecting shaft is fixedly connected to the universal ball and is located on one side of the universal ball. The guide plate is fixedly connected to the connecting shaft and is located at the end of the connecting shaft away from the universal ball. The two snap fasteners are respectively disposed on the side of the guide plate. The second positioning plate is disposed between the two snap fasteners.

[0010] The first positioning plate has two first fixing holes, which are located on the top surface of the first positioning plate and penetrate the first positioning plate at an angle of 45° to the first positioning plate.

[0011] The second positioning plate has two second fixing holes located on the top surface of the second positioning plate and penetrating the second positioning plate in a direction perpendicular to the second positioning plate.

[0012] Secondly, the present invention also provides a method of using a medial malleolus osteotomy guide plate, comprising:

[0013] Manually rotate the screw, and the rotation of the screw drives the threaded block to move along the screw, which in turn drives the limit frame to move.

[0014] Depending on the intraoperative situation, the distance between the limiting frame and the guide plate is dynamically reduced, so that the limiting frame limits the saw blade of the oscillating saw at different positions.

[0015] This invention discloses a medial malleolus osteotomy guide plate and its usage method. During osteotomy surgery, a longitudinal incision of approximately 5 cm is first made at the medial malleolus, and the incision is made layer by layer to expose the medial malleolus bone surface. Four custom-made screws are used to fix the medial malleolus osteotomy guide plate to the medial malleolus through the first and second positioning holes. Then, the blade of an oscillating saw is passed through the through groove and the osteotomy groove (the oscillating saw used is a conventional medical oscillating saw, mainly comprising a shell, a drive end, and a saw blade; the drive end is mounted on the shell, and the saw blade is connected to the drive end) to perform osteotomy. The osteotomy groove limits the osteotomy range, and the limiting frame limits the osteotomy depth. Based on preoperative X-ray measurements, an initial distance is set between the limiting frame and the guide plate, so that before the osteotomy depth exceeds the ideal depth (i.e., the oscillating saw blade just cuts the medial malleolus), the limiting frame will contact the shell of the oscillating saw, preventing the saw blade from penetrating further. Then, the distance between the limiting frame and the guide plate is gradually reduced according to the intraoperative situation until the osteotomy depth reaches the ideal depth, thus completing the osteotomy. This avoids damage to the cartilage on the surface of the talus due to excessive depth of the saw blade during the osteotomy. The position of the limiting frame is adjusted according to the intraoperative situation. The adjustment method of the limiting frame is as follows: rotating the screw, since the guide rod restricts the position of the slider, the limiting frame and the threaded block can only slide along the guide rod. When the screw rotates, the threaded block will move along the screw, driving the limiting frame to move. During the operation, the distance between the limiting frame and the guide plate can be dynamically reduced according to the position of the oscillating saw in the medial malleolus. At the same time, the distance of each reduction is controlled by the scale line on the guide rod, realizing the dynamic blocking of the oscillating saw by the limiting frame and the precise control of the osteotomy depth. Attached Figure Description

[0016] To more clearly illustrate the technical solutions in the embodiments of this application or the prior art, the accompanying drawings used in the description of the embodiments or the prior art will be briefly introduced below.

[0017] Figure 1 This is a schematic diagram of the structure of a medial malleolus osteotomy guide plate invented in this invention.

[0018] Figure 2 This is another structural schematic diagram of a medial malleolus osteotomy guide plate invented in this invention.

[0019] Figure 3 This is a frontal sectional view of a medial malleolus osteotomy guide plate according to the present invention.

[0020] Figure 4 This is a side cross-sectional view of a medial malleolus osteotomy guide plate according to the present invention.

[0021] Figure 5 This is a flowchart of a method for using a medial malleolus osteotomy guide plate according to the present invention.

[0022] 101-Guide plate, 102-Screw, 103-Guide rod, 104-Threaded block, 105-Slider, 106-Limit frame, 107-Osteotomy groove, 108-Through groove, 109-Knob, 110-Limit block, 111-Scale line, 112-First positioning plate, 113-Universal ball, 114-Connecting shaft, 115-Guide plate, 116-Swivel buckle, 117-Second positioning plate, 118-Spring, 119-Moving block, 120-Clamping block, 121-Handle, 122-First fixing hole, 123-Second fixing hole. Detailed Implementation

[0023] Firstly, please refer to Figures 1-4 ,in, Figure 1 This is a schematic diagram of the structure of a medial malleolus osteotomy guide plate according to the present invention. Figure 2 This is another structural schematic diagram of a medial malleolus osteotomy guide plate according to the present invention. Figure 3 This is a frontal sectional view of a medial malleolus osteotomy guide plate according to the present invention. Figure 4 This is a side sectional view of a medial malleolus osteotomy guide plate according to the present invention. The present invention provides a medial malleolus osteotomy guide plate, including a guide plate 101, a screw 102, a guide rod 103, a threaded block 104, a slider 105, a limiting frame 106, a knob 109, a limiting block 110, and a scale line 111; the guide plate 101 has an osteotomy groove 107; the limiting frame 106 has a through groove 108; the guide plate 101 includes a first positioning plate 112, a universal ball 113, a connecting shaft 114, a guide plate 115, two snap fasteners 116, and a second positioning plate 117; the first positioning plate 112 has two first fixing holes 122; the second positioning plate 117 has two second fixing holes 123; the snap fastener 116 includes a spring 118, a moving block 119, a locking block 120, and a handle 121.

[0024] In this specific embodiment, the screw 102 and the guide plate 101 are rotatably connected and located on one side of the guide plate 101; the guide rod 103 and the guide plate 101 are fixedly connected and located on one side of the guide plate 101; the threaded block 104 is threadedly connected to the screw 102 and is penetrated by the screw 102; the slider 105 and the guide rod 103 are slidably connected and are penetrated by the guide rod 103; the limiting frame 106 is fixedly connected to the threaded block 104 and fixedly connected to the slider 105, and located between the threaded block 104 and the slider 105. During osteotomy, a longitudinal incision of approximately 5 cm is first made at the medial malleolus, and the incision is made layer by layer to expose the medial malleolus to the periosteum. Four custom screws are used to fix the osteotomy guide plate to the medial malleolus through the first positioning hole 122 and the second positioning hole 123. Then, the saw blade of the oscillating saw is passed through the through groove 108 and the osteotomy groove 107 (the oscillating saw used is an existing medical oscillating saw, mainly including a shell, a drive end and a saw blade, with the drive end set on the shell and the saw blade connected to the drive end) to perform osteotomy. The osteotomy groove 107 can limit the osteotomy range, and the limiting frame 106 can limit the osteotomy depth. According to the preoperative X-ray measurement results, the initial distance between the limiting frame 106 and the guide plate 115 is set so that before the osteotomy depth exceeds the ideal depth (i.e., the oscillating saw blade just cuts the medial malleolus), the limiting frame 106 will contact the shell of the oscillating saw, thereby preventing the saw blade from penetrating too deeply and avoiding damage to the cartilage on the surface of the talus bone due to the saw blade penetrating too deeply during the osteotomy. The position of the limiting frame 106 is adjusted according to the surgical situation. The adjustment method of the limiting frame 106 is as follows: rotate the screw 102. Since the guide rod 103 restricts the position of the slider 105, the limiting frame 106 and the threaded block 104 can only slide along the guide rod 103. When the screw 102 rotates, the threaded block 104 will move along the screw 102, driving the limiting frame 106 to move. During the operation, by dynamically reducing the distance between the limiting frame 106 and the guide plate 115, the limiting frame 106 can block the saw blade at different positions.

[0025] The knob 109 is fixedly connected to the screw 102 and is located at the end of the screw 102 away from the guide plate 101. The user can easily rotate the screw 102 by holding the knob 109.

[0026] Secondly, the limiting block 110 is fixedly connected to the guide rod 103 and is located at the end of the guide rod 103 away from the guide plate 101. The limiting block 110 can prevent the slider 105 from falling off the guide rod 103.

[0027] Meanwhile, the scale line 111 is located on the side of the guide rod 103; the scale line 111 makes it easy to observe the position of the slider 105, thereby controlling the depth of the blocking saw blade.

[0028] In addition, the universal ball 113 is rotatably connected to the first positioning plate 112 and is located inside the first positioning plate 112; the connecting shaft 114 is fixedly connected to the universal ball 113 and is located on one side of the universal ball 113; the guide plate 115 is fixedly connected to the connecting shaft 114 and is located at the end of the connecting shaft 114 away from the universal ball 113; the two snap fasteners 116 are respectively disposed on the side of the guide plate 115; the second positioning plate 117 is disposed between the two snap fasteners 116.

[0029] The snap fastener 116 allows for the connection and separation of the second positioning plate 117 and the guide plate 115. During osteotomy, the first positioning plate 112 and the second positioning plate 117 are fixed at the medial malleolus, and the osteotomy groove 107 on the guide plate 115 provides guidance during osteotomy. ， The saw blade performs osteotomy along the shape of the osteotomy groove 107, the shape of which is designed according to actual needs. The osteotomy groove 107 can limit the osteotomy range for guidance. After the osteotomy is completed, the snap fastener 116 is controlled to no longer connect the guide plate 115 and the second positioning plate 117. Then, the guide plate 115 can be rotated by the rotation of the universal ball 113, so that the guide plate 115 is away from the medial malleolus osteotomy part. Then, the doctor flips the guide plate 115 and the first positioning plate 112 together with the distal bone block to expose the top surface of the talus. Then, the lesion on the top surface of the talus is removed to complete the lesion removal operation. Subsequently, the periosteum-bone composite is obtained 1-1.5 cm above the osteotomy line to fill the bone groove at the lesion removal site. After the transplantation, the guide plate 115 is flipped in the opposite direction, the medial malleolus is repositioned, and the snap fastener 116 is fastened to replicate the anatomical correction and reposition the medial malleolus.

[0030] After removing the first custom screw from the first fixation hole 122, a first Kirschner wire is inserted into the hole. Then, after removing the second custom screw from the same hole, a second Kirschner wire is inserted. The Kirschner wire passes through the osteotomy line along the direction of the first fixation hole 122 to temporarily fix the reduced medial malleolus. Subsequently, the remaining two custom screws are removed, the medial malleolus osteotomy guide plate is removed, and two hollow screws are inserted along the direction of the Kirschner wires to fix the reduced medial malleolus, completing the surgery.

[0031] Furthermore, the snap fastener 116 includes a spring 118, a moving block 119, and a locking block 120; the spring 118 is fixedly connected to the guide plate 115 and is located inside the guide plate 115; the moving block 119 is fixedly connected to the spring 118 and slidably connected to the guide plate 115, and is located on the side of the guide plate 115; the locking block 120 is fixedly connected to the moving block 119 and is located on the side of the moving block 119. The second positioning plate 117 is provided with a slot that matches the locking block 120. When the locking block 120 is inserted into the slot on the second positioning plate 117, the spring 118 is in a compressed state. Using the elastic potential energy of the spring 118, the two locking blocks 120 can clamp the second positioning plate 117, completing the connection between the second positioning plate 117 and the guide plate 115. When it is necessary to disconnect the guide plate 115 and the second positioning plate 117, the locking block 120 can be pulled away from the second positioning plate 117. At this time, the locking block 120 drives the moving block 119 to move, causing the spring 118 to be compressed.

[0032] Finally, the handle 121 and the locking block 120 are fixedly connected and located on the side of the locking block 120. The user can easily pull the locking block 120 by holding the handle 121.

[0033] This invention discloses a medial malleolus osteotomy guide plate. During osteotomy surgery, after exposing the medial malleolus by slicing, the guide plate 101 is fixed at the medial malleolus. Specifically, four custom screws are implanted into the medial side of the tibia through the first fixation hole 122 and the second fixation hole 123, respectively, to fix the positions of the first positioning plate 112 and the second positioning plate 117. Then, the blade of an oscillating saw is passed through the through groove 108 and the osteotomy groove 107 (the oscillating saw used is a conventional medical oscillating saw, mainly including a shell, a drive end, and a saw blade, with the drive end set on the shell and the saw blade connected to the drive end) to perform osteotomy. The osteotomy groove 107 can limit the osteotomy range, and the limiting frame 106 can limit the osteotomy depth. Based on the preoperative X-ray measurement results, the initial distance between the limiting frame 106 and the guide plate 115 is set so that before the osteotomy depth exceeds the ideal depth (i.e., the oscillating saw blade just cuts the medial malleolus), the limiting frame 106 will contact the shell of the oscillating saw, preventing the saw blade from penetrating further. Then, depending on the situation during the operation, the distance between the limiting frame 106 and the guide plate 115 is gradually reduced until the osteotomy reaches the ideal depth, thus completing the osteotomy and avoiding damage to the cartilage on the surface of the talus due to the saw blade going too deep during the osteotomy process.The position of the limiting frame 106 is adjusted according to the intraoperative situation. The adjustment method of the limiting frame 106 is as follows: rotating the screw 102, since the guide rod 103 restricts the position of the slider 105, the limiting frame 106 and the threaded block 104 can only slide along the guide rod 103. When the screw 102 rotates, the threaded block 104 will move along the screw 102, driving the limiting frame 106 to move. During the operation, by dynamically reducing the distance between the limiting frame 106 and the guide plate 115, the limiting frame 106 can block the saw blade at different positions. After the osteotomy is completed, the locking block 120 is pulled away from the second positioning plate 117, so that the guide plate 115 and the second positioning plate 117 are no longer connected. Then, the rotation of the universal ball 113 can drive the guide plate 115 to rotate, so that the guide plate 115... Away from the medial malleolus osteotomy site, the surgeon then flips over the guide plate 115 and the first positioning plate 112 along with the distal bone block to expose the top surface of the talus. The lesion is then removed. After lesion removal, a periosteal-bone composite is harvested 1-1.5 cm above the osteotomy line to fill the bone groove at the lesion removal site. After the transplantation, the guide plate 115 is flipped in the opposite direction to reposition the medial malleolus. Then, the locking block 120 is pulled, causing the moving block 119 to move, compressing the spring 118. The locking block 120 is then moved closer to the second positioning plate 117 and released. Under the force of the spring 118, the locking block 120 inserts into the slot on the second positioning plate 117. The second positioning plate 117 and the guide plate 115 are then reconnected, allowing for anatomical correction and repositioning of the medial malleolus. This method avoids excessive osteotomy and achieves anatomical repositioning of the medial malleolus during osteotomy.

[0034] Secondly, please refer to Figure 5 , Figure 5 This is a flowchart of a method for using a medial malleolus osteotomy guide plate according to the present invention. The present invention also provides a method for using a medial malleolus osteotomy guide plate, including:

[0035] S1 manually rotates the screw 102, the rotation of the screw 102 drives the threaded block 104 to move along the screw 102, and the threaded block 104 drives the limit frame 106 to move.

[0036] During osteotomy, the medial malleolus is first exposed by slicing, and then the guide plate 101 is fixed at the medial malleolus. The blade of the oscillating saw is then passed through the through groove 108 and the osteotomy groove 107 (the oscillating saw used is a conventional medical oscillating saw, mainly consisting of a housing, a drive end, and a saw blade; the drive end is mounted on the housing, and the saw blade is connected to the drive end). The saw blade moves along the osteotomy groove 107 to perform osteotomy. The osteotomy groove 107 limits the osteotomy range, while the limiting frame 106 limits the osteotomy depth. Based on preoperative X-ray measurements, the initial distance between the limiting frame 106 and the guide plate 115 is set so that before the osteotomy depth exceeds the ideal depth (i.e., the oscillating saw blade just cuts the medial malleolus), the limiting frame 106 contacts the housing of the oscillating saw, preventing the saw blade from penetrating further. Then, the distance between the limiting frame 106 and the guide plate 115 is gradually reduced according to the intraoperative situation until the osteotomy reaches the ideal depth, thus completing the osteotomy and avoiding damage to the cartilage on the surface of the talus due to excessive depth of the saw blade during the osteotomy. The position of the limiting frame 106 is dynamically fine-tuned according to the osteotomy. The adjustment method of the limiting frame 106 is as follows: rotate the screw 102. Since the guide rod 103 restricts the position of the slider 105, the limiting frame 106 and the threaded block 104 can only slide along the guide rod 103. When the screw 102 rotates, the threaded block 104 will move along the screw 102, driving the limiting frame 106 to move.

[0037] S2 dynamically reduces the distance between the limiting frame 106 and the guide plate 101 according to the intraoperative situation, so that the limiting frame 106 limits the saw blade of the oscillating saw at different positions.

[0038] The position of the limiting frame 106 can be adjusted according to different needs, so that the limiting frame 106 can block the saw blade at different positions, avoiding damage to the cartilage on the surface of the talus bone due to the saw blade going too deep during the osteotomy.

[0039] The above-disclosed embodiments are merely one or more preferred embodiments of this application and should not be construed as limiting the scope of this application. Those skilled in the art can understand that all or part of the processes for implementing the above embodiments and equivalent changes made in accordance with the claims of this application still fall within the scope of this application.

Claims

1. A medial malleolus osteotomy guide plate, characterized in that, Includes guide plate, screw, guide rod, threaded block, slider and limit frame; The guide plate has an osteotomy groove; the screw is rotatably connected to the guide plate and located on one side of the guide plate; the guide rod is fixedly connected to the guide plate and located on one side of the guide plate; the threaded block is threadedly connected to the screw and is penetrated by the screw; the slider is slidably connected to the guide rod and is penetrated by the guide rod; the limiting frame is fixedly connected to the threaded block and fixedly connected to the slider, and located between the threaded block and the slider, and the limiting frame has a through groove; The guide plate includes a first positioning plate, a universal ball, a connecting shaft, a guide plate, two snap fasteners, and a second positioning plate; the universal ball is rotatably connected to the first positioning plate and is located inside the first positioning plate; the connecting shaft is fixedly connected to the universal ball and is located on one side of the universal ball; the guide plate is fixedly connected to the connecting shaft and is located at the end of the connecting shaft away from the universal ball; the two snap fasteners are respectively disposed on the side of the guide plate; the second positioning plate is disposed between the two snap fasteners.

2. The medial malleolus osteotomy guide plate as described in claim 1, characterized in that, The medial malleolus osteotomy guide plate also includes a knob; the knob is fixedly connected to the screw and is located at the end of the screw away from the guide plate.

3. The medial malleolus osteotomy guide plate as described in claim 2, characterized in that, The medial malleolus osteotomy guide plate also includes a limiting block; the limiting block is fixedly connected to the guide rod and is located at the end of the guide rod away from the guide plate.

4. The medial malleolus osteotomy guide plate as described in claim 3, characterized in that, The guide rod has scale lines; the scale lines are located on the side of the guide rod.

5. The medial malleolus osteotomy guide plate as described in claim 4, characterized in that, The first positioning plate has two first fixing holes, which are located on the top surface of the first positioning plate and penetrate the first positioning plate at an angle of 45° to it.

6. The medial malleolus osteotomy guide plate as described in claim 5, characterized in that, The second positioning plate has two second fixing holes located on the top surface of the second positioning plate and penetrating the second positioning plate in a direction perpendicular to the second positioning plate.

7. A method of using a medial malleolus osteotomy guide plate, applied to the method described in any one of claims 1 to 6, characterized in that, include: Manually rotate the screw, and the rotation of the screw will drive the threaded block to move along the screw, and the threaded block will drive the limit frame to move. Depending on the intraoperative situation, the distance between the limiting frame and the guide plate is dynamically reduced, so that the limiting frame limits the saw blade of the oscillating saw at different positions.

Images