An adjustable angle guide reduction device for the subtalar joint

Abstract

The application discloses an angle-adjustable guiding reset device for tibiofibular syndesmosis, which comprises an adjusting mechanism, a first guiding reset mechanism, a second guiding reset mechanism and a positioning mechanism; the two guiding reset mechanisms are symmetrically arranged on the two sides of tibia and fibula and are connected through the adjusting mechanism; the positioning mechanism comprises a positioning plate and a positioning rod, the positioning plate is attached to the posterolateral surface of the fibula, and the positioning plate is connected with the adjusting mechanism through the positioning rod; the adjusting mechanism adjusts the position and axial direction of the two guiding reset mechanisms clamping the tibia and the fibula with the positioning plate as the reference. The posterolateral surface of the fibula is used as the reference datum of the guiding reset device to accurately correspond the axial direction of the guiding reset mechanism in the three-dimensional space to the reset axis planned in the CT image, so that the reset effect of the tibia and the fibula is closer to the ideal reset state. Especially, the reset mode of the two guiding reset mechanisms clamping the two bones in opposite directions can further enhance the stability in the reset process and reduce the risk of bone damage.

Description

Technical Field

[0001] This invention belongs to the field of medical device technology, and in particular relates to an adjustable-angle guide repositioning device for the distal tibiofibular joint. Background Technology

[0002] The tibia and fibula are the main skeletal structures of the human lower leg. The distal articular surface of the fibula and the fibular articular surface of the tibia form the distal tibiofibular joint. When this tibiofibular joint is fractured, the fibula and tibia may separate and shift under the action of muscles or external forces. Therefore, when repairing the distal tibiofibular joint, it is necessary to reposition and fix the tibia and fibula.

[0003] In clinical practice, when reducing and fixing the distal tibiofibular joint, it is necessary to take cross-sectional CT images of the tibia and fibula beforehand. These CT images are used to plan the clamping positions, reduction directions, and the placement and angle of the Kirschner wires. During the surgery, the tibia and fibula are first clamped and tightened according to the clamping positions and reduction directions planned on the CT images, so that the tibia and fibula are in contact. Then, Kirschner wires are inserted into the surfaces of the two bones at the positions indicated on the CT images. Finally, bone screws are inserted using the Kirschner wires as guides to fix the two bones.

[0004] During the reduction of the tibia and fibula, a reduction device is needed to press the two bones together, and a guide device is also required during the insertion of Kirschner wires and screws. Combining these two functions creates a guided reduction device that simultaneously performs tibia-fibula reduction and Kirschner wire guidance. However, due to the irregular cross-sectional shapes of the tibia and fibula, the two-dimensional planar parameters on CT images are prone to errors when converted into three-dimensional spatial parameters for clinical operation. This error can lead to deviations in the reduction of the tibia and fibula, causing the separation tendency of the two bones due to muscle entanglement and traction to generate a large force in a direction deviating from the axis of the bone screw. In severe cases, this can cause dislocation of the distal tibiofibular joint. This not only affects the effectiveness of tibiofibular joint repair but also carries the risk of secondary injury to the tibia or fibula.

[0005] Therefore, there is an urgent need for a guiding and repositioning device that can use a reference surface with minimal error to perform high-precision repositioning and fixation of the tibia and fibula. Summary of the Invention

[0006] The purpose of this invention is to provide an adjustable-angle guide repositioning device for the distal tibiofibular joint, using the posterolateral surface of the fibula as a reference, thereby improving the positioning accuracy of the guide repositioning device and solving the problem of poor repositioning accuracy of the fibula and tibia in existing guide repositioning devices.

[0007] This invention is achieved through the following technical solution:

[0008] An adjustable-angle guide reduction device for the distal tibiofibular joint includes an adjustment mechanism, a first guide reduction mechanism, a second guide reduction mechanism, and a positioning mechanism. The two guide reduction mechanisms are symmetrically arranged on both sides of the tibia and fibula and connected through the adjustment mechanism. The positioning mechanism includes a positioning plate and a positioning rod. The positioning plate is fitted against the posterolateral surface of the fibula, and the positioning plate is connected to the adjustment mechanism through the positioning rod. The adjustment mechanism adjusts the position and axial direction of the tibia and fibula held by the two guide reduction mechanisms with reference to the positioning plate.

[0009] Through the above solution, the present invention achieves at least the following technical effects:

[0010] Through long-term research on the anatomical characteristics of the distal fibula, a constant planar structure was discovered on the posterolateral aspect of the fibula. This planar structure projects a corresponding straight line segment onto a cross-sectional CT image. This invention selects the posterolateral surface of the fibula as a reference for the conversion between two-dimensional planar parameters and three-dimensional spatial parameters to reduce errors. When taking a cross-sectional CT image of the tibiofibular joint preoperatively to plan the axis of the guiding reduction mechanism, the straight line segment projected onto the CT image by the posterolateral surface of the fibula is used as a reference. After drawing the reduction axis representing the axis of the guiding reduction mechanism, the angle between the straight line segment and the reduction axis is calculated to obtain a preset angle parameter. The guiding reduction device of this invention uses the posterolateral surface of the fibula as a reference plane for positioning the axis of the guiding reduction mechanism in three-dimensional space. The positioning plate is placed parallel to the posterolateral surface of the fibula, and the angle between the common axis of the two guiding reduction mechanisms and the surface of the positioning plate is adjusted by an adjustment mechanism until the angle equals the preset angle parameter, achieving the effect that the axis of the guiding reduction mechanism corresponds to the reduction axis on the cross-sectional CT image. Under the action of the two guide reduction mechanisms clamping the two bones along the axis, the tibia and fibula are brought closer together and accurately reduced. Then, Kirschner wires are inserted along the axis of the two guide reduction mechanisms to complete the fixation of the two bones.

[0011] Preferably, the adjustment mechanism includes a semi-circular guide rail and a slider; two guide reset mechanisms are respectively disposed at both ends of the semi-circular guide rail, the slider is slidably connected to the semi-circular guide rail, and the positioning rod is threadedly connected to the slider; the slider slides along the semi-circular guide rail, so that the two guide reset mechanisms rotate around the tibia and fibula with the positioning plate as a reference; the surface of the semi-circular guide rail is provided with scale lines of corresponding angles.

[0012] Preferably, the positioning plate includes an integrally formed mounting part and a connecting part, the mounting part being fitted to the posterolateral surface of the fibula, and the connecting part being fixedly connected to a positioning rod arranged radially along the semi-circular guide rail.

[0013] Preferably, the connecting part is a straight plate or an arc-shaped plate.

[0014] Preferably, the positioning plate has a clearance hole, allowing the second guide reset mechanism to pass through the clearance hole and abut against the tibia or fibula.

[0015] Preferably, the first guide reset mechanism includes a pressure sleeve and a rotating rod; the pressure sleeve is hollow inside for inserting Kirschner wires or bone screws; the end of the semi-circular guide rail is provided with an internal thread mounting hole, the outer wall of the pressure sleeve is provided with an external thread, the pressure sleeve is threadedly fed into the internal thread mounting hole, so that the pressure sleeve moves radially along the semi-circular guide rail; the rotating rod is perpendicular to and fixed to the pressure sleeve.

[0016] Preferably, the first guide repositioning mechanism further includes a soft tissue protective sleeve and a soft tissue push rod; the soft tissue protective sleeve is installed at one end of the pressure sleeve for abutting against the tibia or fibula, and the soft tissue push rod passes through the other end of the pressure sleeve and abuts against the soft tissue protective sleeve.

[0017] Preferably, the soft tissue push rod has a cone head at one end and an end cap at the other end; the end of the soft tissue protective sleeve that abuts against the tibia or fibula is frustum-shaped and has a through hole on its end face; the end of the soft tissue push rod with the cone head passes through the pressure sleeve and protrudes from the through hole at the end of the soft tissue protective sleeve.

[0018] Preferably, the second guide reset mechanism includes a fixing sleeve and a positioning nut; the fixing sleeve passes through the end of the semi-circular guide rail and is fixed by the positioning nut.

[0019] Preferably, the slider is further provided with a locking bolt, which is threadedly connected to the slider to lock the slider in position on the semi-circular guide rail.

[0020] The beneficial effects of this invention are as follows:

[0021] By using the smooth posterolateral surface of the fibula as a reference point, the axial direction of the guiding reduction device in three-dimensional space is precisely aligned with the planned reduction axis in the CT image, making the reduction effect of the tibia and fibula closer to the ideal restoration state. In particular, the reduction method of the two guiding reduction mechanisms clamping the two bones in opposite directions can further enhance the stability during the reduction process, reduce the risk of bone damage, and improve the overall treatment effect of the tibiofibular joint. It can also improve the efficiency of screw placement in clinical surgery, reduce the number of adjustments and the time spent on adjustments, and shorten the operation time. Attached Figure Description

[0022] Figure 1 This is a schematic diagram of the overall guide reset device provided in one embodiment of the present invention.

[0023] Figure 2This is a schematic diagram of a CT image of a tibiofibular joint cross section provided in one embodiment of the present invention.

[0024] Figure 3 This is a structurally disassembled schematic diagram of the first guide reset mechanism provided in one embodiment of the present invention.

[0025] Figure 4 This is a front view of the positioning mechanism provided in one embodiment of the present invention.

[0026] Figure 5 This is a side view of a positioning mechanism in one embodiment of the present invention, where the mounting part adopts a flat plate.

[0027] Figure 6 This is a side view of a positioning mechanism in which the mounting part of the present invention uses an arc-shaped plate in one embodiment.

[0028] Figure 7 This is a schematic diagram of a CT image of the tibiofibular joint cross section for a comparative embodiment.

[0029] legend:

[0030] 1. Adjustment mechanism; 2. First guide reduction mechanism; 3. Second guide reduction mechanism; 4. Positioning mechanism; 5. Tibia; 6. Fibula;

[0031] 11. Semi-circular guide rail; 12. Slider; 13. Locking bolt;

[0032] 21. Pressure sleeve; 22. Rotating rod; 23. Soft tissue protective sleeve; 24. Soft tissue push rod;

[0033] 31. Fixing sleeve; 32. Locating nut;

[0034] 41 Positioning plate; 42 Positioning rod;

[0035] 61. Posterolateral surface of the fibula;

[0036] 111 graduation mark;

[0037] 211 external thread;

[0038] 231 through hole;

[0039] 241 Cone tip; 242 End cap;

[0040] 411 Mounting part; 412 Connecting part; 413 Clearance hole. Detailed Implementation

[0041] The present invention will be further described below with reference to the accompanying drawings and embodiments.

[0042] like Figure 1As shown, this embodiment provides an adjustable-angle guide reduction device for the distal tibiofibular joint, including an adjustment mechanism 1, a first guide reduction mechanism 2, a second guide reduction mechanism 3, and a positioning mechanism 4. The two guide reduction mechanisms are connected by the adjustment mechanism 1. The positioning mechanism 4 includes a positioning plate 41 and a positioning rod 42. The positioning plate 41 is attached to the posterolateral surface 61 of the fibula and fixed with screws as a reference surface. The positioning plate 41 is connected to the adjustment mechanism 1 through the positioning rod 42, thus completing the entire device.

[0043] The first guiding reduction mechanism 2 and the second guiding reduction mechanism 3 are symmetrically arranged, with the first guiding reduction mechanism 2 located on the side of the tibia 5 and the second guiding reduction mechanism 3 located on the side of the fibula 6. The two guiding reduction mechanisms are coaxially arranged and serve to clamp the tibia 5 and fibula 6 from both sides, bringing the two bones closer together for reduction and guiding the Kirschner wire. The adjustment mechanism 1 adjusts the position and axis of the two guiding reduction mechanisms clamping the tibia 5 and fibula 6 with the positioning plate 41 as a reference.

[0044] like Figure 1 As shown, to specifically illustrate the method by which the adjusting device adjusts the two guide reset mechanisms, in one embodiment, the adjusting mechanism 1 includes a semi-circular guide rail 11 and a slider 12. The two guide reset mechanisms are respectively disposed at both ends of the semi-circular guide rail 11. The slider 12 slides along the semi-circular guide rail 11, and the slider 12 is connected to the positioning rod 42. Scale lines 111 corresponding to the angle are provided on the surface of the semi-circular guide rail 11 to enable it to function as a protractor.

[0045] The positioning plate 41 is fixed to the posterolateral surface 61 of the fibula. The positioning mechanism 4, consisting of the positioning plate 41 and the positioning rod 42, becomes the main structure for fixing and positioning the entire guide repositioning device. The connection point between the positioning plate 41 and the posterolateral surface 61 of the fibula is located at the center of the semi-circular guide rail 11. When the semi-circular guide rail 11 is pushed to slide relative to the slider 12, the two guide repositioning mechanisms installed at both ends of the semi-circular guide rail 11 will move in an arc around the center. The change in the angle between the common axis of the two guide repositioning mechanisms and the positioning plate 41 corresponds to the axial change in the clamping of the tibia 5 and fibula 6 by the two guide repositioning mechanisms. The contact positions of the two guide repositioning mechanisms with the tibia 5 and fibula 6 will also change. The angle between the common axis of the two guide repositioning mechanisms and the positioning plate 41 can be read by the corresponding angle of the slider 12 on the semi-circular guide rail 11.

[0046] like Figure 1As shown, it is worth mentioning that the slider 12 is also equipped with a locking bolt 13. The bolt 13 passes through the slider 12 and abuts against the semi-circular guide rail 11, thus locking the slider 12 and the semi-circular guide rail 11. Removing the locking bolt 13 unlocks the slider 12, allowing the slider 12 and the semi-circular guide rail 11 to resume relative sliding. The locking bolt 13 is used to lock the two guide reset mechanisms after the position and angle have been adjusted.

[0047] like Figure 1 , Figure 4 and Figure 5 As shown, due to the positional difference between the posterolateral surface 61 of the fibula and the conventional surgical window, the positioning plate 41 needs to bypass the main body of the fibula 6 to contact the posterolateral surface 61 of the fibula after entering the surgical window. Therefore, the positioning plate 41 needs to be made into a curved shape. In one embodiment, the positioning plate 41 is divided into two sections: a mounting part 411 and a connecting part 412. The mounting part 411 is used to fix the connection to the posterolateral surface 61 of the fibula, and the connecting part 412 is used to bypass the main body of the fibula 6 and connect the mounting part 411 to the positioning rod 42. The mounting part 411 and the connecting part 412 are integrally formed to increase strength and maintain the flatness and smoothness of the surface of the positioning plate 41, so that the positioning plate 41 fits against the posterolateral surface 61 of the fibula and remains parallel.

[0048] like Figure 4 , Figure 5 and Figure 6 As shown, it is worth mentioning that the connecting part 412 of the positioning plate 41 has two structures: a straight plate and an arc-shaped plate. When the connecting part 412 adopts a straight plate structure, the processing technology is simpler, and the installation steps of the positioning plate 41 are simpler and more convenient. When the connecting part 412 adopts an arc-shaped plate structure, the arc-shaped plate has a higher degree of fit with the fibula 6. The curvature of the arc-shaped plate can limit the corner of the bone surface of the fibula 6, increase the connection stability between the positioning plate 41 and the fibula 6, and further enhance the positioning effect.

[0049] like Figure 4 As shown, since the positioning plate 41 is located at the center of the semi-circular guide rail 11, in order to prevent the positioning plate 41 from blocking the contact between the second guide repositioning mechanism 3 and the fibula 6, in one embodiment, the positioning plate 41 is provided with a clearance hole 413 that allows the second guide repositioning mechanism 3 to pass through. This allows the second guide repositioning mechanism 3 to pass through the clearance hole 413 and abut against the surface of the fibula 6 as a support for the repositioning of the tibia 5 and the fibula 6. At the same time, providing a clearance hole 413 on the positioning plate 41 will not affect the positioning function of the positioning plate 41.

[0050] like Figure 1As shown, after the common axis of the two guide repositioning mechanisms is adjusted and positioned, the second guide repositioning mechanism 3 abuts against the fibula 6 as support, and the first guide repositioning mechanism 2 pushes the tibia 5 to achieve the repositioning operation of the two bones approaching each other. To specifically illustrate the structure and working principle of the first guide repositioning mechanism 2, in one embodiment, the first guide repositioning mechanism 2 includes a pressure sleeve 21 and a rotating rod 22. The rotating rod 22 is vertically installed at one end of the pressure sleeve 21, and the other end of the pressure sleeve 21 passes through a threaded mounting hole provided on the semi-circular guide rail 11 near the end of the tibia 5. The pressure sleeve 21 forms a threaded feed fit with the threaded mounting hole through the external thread 211 provided on its outer wall. The pressure sleeve 21 can be rotated with the rotating rod 22 as the lever arm. During the rotation of the pressure sleeve 21, the threaded fit will drive the pressure sleeve 21 to move radially along the semi-circular guide rail 11, thereby achieving the pushing effect of the pressure sleeve 21 on the tibia 5.

[0051] The threaded feed mechanism of the pressure sleeve 21 and the semi-circular guide rail 11 ensures stable and smooth pushing of the tibia 5, preventing slippage and misalignment. Furthermore, the feed speed is precisely adjustable, avoiding over-correction or misalignment of the tibia 5 during reduction. Notably, the pressure sleeve 21 is a hollow cylindrical structure with open ends. It serves both as a clamping and reduction structure for pushing the tibia 5 to achieve reduction of the tibia and fibula 6, and as a guide structure for inserting Kirschner wires or bone screws into the tibia 5.

[0052] like Figure 1 and Figure 3 As shown, during the feeding process of the pressure sleeve 21 toward the tibia 5, soft tissue near the tibia 5 may be squeezed between the pressure sleeve 21 and the tibia 5. To avoid the pressure sleeve 21 squeezing the soft tissue and causing soft tissue damage when pushing against the tibia 5, in one embodiment, the first guide reset mechanism 2 further includes a soft tissue protective sleeve 23 and a soft tissue push rod 24. The soft tissue protective sleeve 23 is sleeved on the end of the pressure sleeve 21 facing the tibia 5, and the soft tissue push rod 24 passes through the pressure sleeve 21 from the end away from the tibia 5 and abuts against the soft tissue protective sleeve 23. The soft tissue protective sleeve 23 is frustoconical at its end facing the tibia 5, which can guide the soft tissue blocked in the feeding path of the pressure sleeve 21 to the surrounding areas. By pressing or pushing the soft tissue push rod 24, the end of the soft tissue push rod 24 is pressed against the inner end face of the soft tissue protective sleeve 23, and the soft tissue protective sleeve 24 is driven to move toward the tibia 5. During the movement, the soft tissue protective sleeve 24 pushes the soft tissue to the surroundings to open a channel for the pressure sleeve 21.

[0053] like Figure 3As shown, to further enhance the guiding effect of the soft tissue pusher 24, a conical tip 241 is provided at the end of the soft tissue pusher 24 that abuts against the soft tissue protective sleeve 23; the soft tissue protective sleeve 23 also has a through hole 231 on its end face facing the tibia 5, and the diameter of the through hole 231 is smaller than the diameter of the soft tissue pusher 24, so that the tip of the cone 241 of the soft tissue pusher 24 can protrude from the through hole 231 but the rod body of the soft tissue pusher 24 will not be allowed to pass through. The cone 241 protruding from the through hole 231 is used to guide the small soft tissue that is still blocked between the pressure sleeve 21 and the tibia 5 to the surrounding area, opening the forward passage of the pressure sleeve 21. An end cap 242 is provided at the other end of the soft tissue pusher 24. The end cap 242 facilitates pressing and pushing the soft tissue push rod 24, giving it stronger power to push the soft tissue protective sleeve 23 open the soft tissue, creating space for the spiral feed of the pressure sleeve 21. The cone head 241 is more conducive to clearing soft tissue obstructions between the pressure sleeve 21 and the tibia 5. It is worth mentioning that after the reduction of the tibia 5 and fibula 6 is completed, the through hole 231 can also be used as a channel for Kirschner wires or cobalt ingots to pass through.

[0054] The specific steps of the first guiding reduction mechanism 2 in pushing the tibia 5 are as follows: First, the soft tissue push rod 24 drives the soft tissue protective sleeve 23 towards the tibia 5, forming a gap between the end face of the soft tissue protective sleeve 23 and the end face of the pressure sleeve 21 inside the soft tissue protective sleeve 23. Then, the rotating rod 22 is twisted to drive the pressure sleeve 21 to rotate, and the pressure sleeve 21 is spirally fed. The end of the pressure sleeve 21 abuts against the end face of the soft tissue protective sleeve 23 inside the soft tissue protective sleeve 23 again. This operation is repeated. Each time, the soft tissue is first squeezed apart by the soft tissue push rod 24 and the soft tissue protective sleeve 23 to open a feeding channel inside the soft tissue protective sleeve 23 for the pressure sleeve 21, and then the pressure sleeve 21 is driven to feed. This can avoid soft tissue damage near the tibia 5.

[0055] like Figure 1 As shown, although the main function of the second guiding and repositioning mechanism 3 is to support the fibula 6, when inserting the Kirschner wire, the Kirschner wire will enter from the first guiding and repositioning mechanism 2, pass through the tibia 5 and the fibula 6, and then exit from the second guiding and repositioning mechanism 3. Therefore, the second guiding and repositioning mechanism 3 also needs to have a guiding function for the Kirschner wire. Therefore, in one embodiment, the second guiding and repositioning mechanism 3 includes a fixing sleeve 31 and a positioning nut 32. Both ends of the semi-circular guide rail 11 are provided with threaded mounting holes. The threaded mounting hole on the side closer to the tibia 5 is threaded into the pressure sleeve 21, and the other threaded mounting hole is used to insert the fixing sleeve 31 and cooperate with the positioning nut 32 to install and fix the fixing sleeve 31.

[0056] like Figure 1 and Figure 2 As shown, based on the above embodiments, the present invention provides a method for using a guide reset device, comprising the following steps:

[0057] Step 1: Preoperatively, take cross-sectional CT images of the patient's bilateral distal tibiofibular joints (e.g., Figure 2 ).

[0058] Step 2: Using the straight line segment projected onto the cross-sectional CT image of the posterolateral surface 61 of the healthy fibula as a reference baseline, draw the reduction axis of the tibia 5 and fibula 6. This reduction axis is both the movement path of the two bones and the Kirschner wire insertion path.

[0059] Step 3: Measure the angle between the reset axis and the reference baseline on the cross-sectional CT image and set it as the preset angle.

[0060] Step 4: During the operation, slide the semi-circular guide rail 11 according to the preset angle until the angle between the common axis of the two guide reset mechanisms and the mounting part 411 of the positioning plate 41 is equal to the preset angle, and lock the slider 12 and the semi-circular guide rail 11.

[0061] Step 5: Fix the positioning plate 41 to the posterolateral surface 61 of the fibula. By the correspondence between the posterolateral surface 61 of the fibula and the projection of the posterolateral surface 61 of the fibula on the CT image, the correspondence between the two-dimensional planar reference and the three-dimensional spatial reference is realized.

[0062] Step 6: With the second guide reduction mechanism 3 supporting the fibula 6, the first guide reduction mechanism 2 rotates and applies pressure to push the tibia 5, bringing the two bones together to achieve reduction.

[0063] The angle between the common axis of the two guide reset mechanisms and the mounting part 411 of the positioning plate 41 is calculated by measuring the angle between the mounting part 411 and the axis of the positioning rod 42, and reading the angle between the first guide reset mechanism 2 and the positioning rod 42 on the semi-circular guide rail 11. The angle between the common axis of the two guide reset mechanisms and the mounting part 411 is equal to the difference between the two angles.

[0064] like Figure 7 As shown, to compare the differences between the present invention and existing guiding and repositioning devices, an embodiment of an existing guiding and repositioning device is provided. The existing guiding and repositioning device includes an arc-shaped guide rail, a slider, a positioning rod, and a guiding and repositioning mechanism. One end of the positioning rod is fixed to the tibia, which has a larger diameter than the fibula, by a screw. The other end of the positioning rod is connected to the slider, which slides in conjunction with the arc-shaped guide rail. The guiding and repositioning mechanism is located at the end of the arc-shaped guide rail. This existing guiding and repositioning device uses the connection point between the positioning rod and the tibia as a support point, and the guiding and repositioning mechanism pushes the fibula radially along the arc-shaped guide rail to achieve the effect of bringing the tibia and fibula closer together and repositioning.

[0065] By combining existing guide repositioning devices with clinical applications, the following usage method is obtained:

[0066] Step 1: Preoperatively, take cross-sectional CT images of the patient's bilateral distal tibiofibular joints (e.g., Figure 7 ).

[0067] Step 2: On the CT image of this section, take the distinctive point at the edge of the tibial projection as the reference point, and draw the reduction axis of the tibia and fibula. This reduction axis is both the movement path of the two bones and the path of the Kirschner wire.

[0068] Step 3: Draw the positioning rod axis on the cross-sectional CT image with the reference point as the starting point, and measure the angle between the reset axis and the positioning rod axis, and set it as the preset angle.

[0069] Step 4: During the operation, fix the positioning rod 42 at the reference point on the corresponding section of the CT image of the tibia.

[0070] Step 5: Slide the arc-shaped guide rail to make the guide reset mechanism rotate around the connection point between the positioning rod and the tibia until the angle between the axis of the guide reset mechanism and the positioning rod is equal to the preset angle, and lock the slider and the arc-shaped guide rail.

[0071] Step Six: Using the connection between the positioning rod and the tibia as support, the guide reduction mechanism applies pressure and pushes the fibula to bring the two bones together and achieve reduction.

[0072] Based on the comparison of the two embodiments above, from the perspective of the positioning effect of the guide repositioning device in three-dimensional space, the guide repositioning device of the present invention establishes a reference plane in three-dimensional space by fitting the positioning plate 41 against the posterolateral surface 61 of the fibula. As long as the positioning rod 42 is fixedly connected to the positioning plate 41, the precise positioning of the guide repositioning device can be achieved without deviation. In contrast, existing guide repositioning devices still use a single point as a reference in three-dimensional space, which cannot handle the axial deviation error of the positioning rod. If the positioning rod is deviated, it will inevitably cause the guide repositioning mechanism to deviate from the predetermined position and angle, resulting in unsatisfactory repositioning effect of the tibia and fibula, and the problem of misaligned bone screw implantation position. The guide repositioning device of the present invention has significant technical progress in positioning effect in three-dimensional space compared to existing guide repositioning devices.

[0073] Based on the comparison of the two embodiments above, in terms of the accuracy of converting two-dimensional planar parameters to three-dimensional spatial parameters, the guiding and repositioning device of the present invention uses the posterolateral surface 61 of the fibula as a reference in three-dimensional space. Its projection on the cross-sectional CT image is a straight line segment, and the axial direction of the guiding and repositioning mechanism can be directly located by the angle between this straight line segment and the repositioning axis. When converting from two-dimensional planar parameters to three-dimensional spatial parameters, the angular relationship between the repositioning axis and the straight line segment is transformed into the angular relationship between the axial direction of the guiding and repositioning mechanism and the posterolateral surface 61 of the fibula. The conversion of the reference reference between the projected line segment and the planar entity is more stable. In contrast, existing guiding and repositioning devices require drawing the axis of the positioning rod on the cross-sectional CT image, and the positioning rod only has a single point as a reference in three-dimensional space, which cannot guarantee the accuracy of the positioning rod's axial direction. This leads to unstable reference conversion when converting the two-dimensional planar parameters of the existing guiding and repositioning devices to three-dimensional spatial parameters, which affects the setting position and axial direction of the guiding and repositioning device, ultimately resulting in unsatisfactory repositioning effect. Therefore, the guiding and repositioning device of the present invention has a significant technical improvement over existing guiding and repositioning devices in terms of the accuracy of converting two-dimensional planar parameters to three-dimensional spatial parameters.

[0074] The various technical features in the above embodiments can be combined arbitrarily, as long as there is no conflict or contradiction between the combinations of features. However, due to space limitations, they are not described one by one.

[0075] This invention is not limited to the above-described embodiments. If any modifications or variations to this invention do not depart from the spirit and scope of this invention, and if such modifications and variations fall within the scope of the claims and equivalent technologies of this invention, then this invention also intends to include such modifications and variations.

Claims

1. An adjustable-angle guide repositioning device for the distal tibiofibular joint, characterized in that: The device includes an adjustment mechanism, a first guide repositioning mechanism, a second guide repositioning mechanism, and a positioning mechanism. The adjustment mechanism includes a semi-circular guide rail and a slider. The surface of the semi-circular guide rail is provided with scale lines corresponding to the angles, and the slider is slidably connected to the semi-circular guide rail. The positioning mechanism includes a positioning rod and a positioning plate. The proximal end of the positioning rod is threadedly connected to the slider. The positioning plate includes an integrally formed mounting part and a connecting part. The mounting part fits against the posterolateral surface of the fibula, and the connecting part is fixedly connected to the positioning rod. The first and second guide repositioning mechanisms are respectively disposed at both ends of the semi-circular guide rail. The position and axial direction of the tibia and fibula held by the two guide repositioning mechanisms are adjusted by the adjustment mechanism with the positioning plate as a reference.

2. The adjustable-angle guide and reset device for the distal tibiofibular joint according to claim 1, characterized in that: The positioning plate connection part is a flat plate or an arc plate.

3. The adjustable-angle guide repositioning device for the distal tibiofibular joint according to claim 1, characterized in that: The positioning plate has a clearance hole, through which the second guide reset mechanism passes and abuts against the tibia or fibula.

4. The adjustable-angle guide repositioning device for the distal tibiofibular joint according to claim 1, characterized in that: The first guide reset mechanism includes a pressure sleeve and a rotating rod; the pressure sleeve is hollow inside for inserting Kirschner wires or bone screws; the end of the semi-circular guide rail is provided with an internal thread mounting hole, the outer wall of the pressure sleeve is provided with an external thread, and the pressure sleeve is threadedly fed into the internal thread mounting hole, so that the pressure sleeve moves radially along the semi-circular guide rail; the rotating rod is perpendicular to and fixed to the pressure sleeve.

5. The adjustable-angle guide repositioning device for the distal tibiofibular joint according to claim 4, characterized in that: The first guiding and repositioning mechanism further includes a soft tissue protective sleeve and a soft tissue push rod; the soft tissue protective sleeve is installed on one end of the pressure sleeve for abutting against the tibia or fibula, and the soft tissue push rod passes through the other end of the pressure sleeve and abuts against the soft tissue protective sleeve.

6. The adjustable-angle guide repositioning device for the distal tibiofibular joint according to claim 5, characterized in that: The soft tissue push rod has a cone head at one end and an end cap at the other end; the end of the soft tissue protective sleeve that abuts against the tibia or fibula is frustum-shaped and has a through hole on its end face; the end of the soft tissue push rod with the cone head passes through the pressure sleeve and protrudes from the through hole at the end of the soft tissue protective sleeve.

7. The adjustable-angle guide repositioning device for the distal tibiofibular joint according to claim 1, characterized in that: The second guide reset mechanism includes a fixing sleeve and a positioning nut; the fixing sleeve passes through the end of the semi-circular guide rail and is fixed by the positioning nut.

8. The adjustable-angle guide repositioning device for the distal tibiofibular joint according to claim 1, characterized in that: The slider is also provided with a locking bolt, which is threadedly connected to the slider to lock the slider in position on the semi-circular guide rail.

Images