Femoral head lesion auxiliary positioning guide and high-precision positioning method

Abstract

The application discloses a femoral head lesion auxiliary positioning guider and a high-precision positioning method, and relates to the technical field of medical treatment, which comprises a femoral head lesion guider, a guider positioner and a needle depth positioner, the guider positioner comprises a fixing set, a holding handle and an iliac bone positioning plate, the fixing set is arranged at one end of the holding handle, the iliac bone positioning plate is arranged at the other end of the holding handle, a precut anterior superior iliac spine clamping groove is arranged on the iliac bone positioning plate, and a channel positioning cavity is arranged in the middle of the fixing set. The femoral head lesion auxiliary positioning guider of the application is customized, the precision and effect of traditional positioning of femoral head lesions can be effectively improved, the bone shape and lesion conditions of different patients can be better adapted to, the success rate of surgery and the postoperative recovery effect of patients are improved, the number of fluoroscopy in surgery is greatly reduced, the surgery time is shortened, the surgery risk is reduced, and the surgery success rate is improved.

Description

TECHNICAL FIELD

[0001] The application belongs to the technical field of medical devices, and particularly relates to a femoral head lesion auxiliary positioning guide and a high-precision positioning method. BACKGROUND

[0002] Core decompression can significantly relieve the hip pain of patients, delay the hip replacement time, and effectively play a role in hip preservation. The treatment method can significantly reduce the hip joint pain of patients by reducing the pressure in the femoral head, improving venous return, promoting blood supply reconstruction and repairing necrotic bone tissue. The femoral head core decompression is suitable for early femoral head necrosis. Firstly, a hole needs to be drilled in the femoral head, and a guide needle needs to be inserted. The position and depth of the guide needle are repeatedly adjusted according to the intraoperative fluoroscopy, so that the guide needle reaches the center of the femoral head lesion, and then the lesion is removed according to the position of the inserted guide needle.

[0003] At present, the femoral head core decompression still has the following problems: 1. The necrotic area of each patient is not the same. The guide needle needs to be inserted into the three-dimensional spherical structure of the femoral head from the lateral cortex of the femur, pass through the femoral neck, and reach the femoral head lesion area. It cannot accurately move the guide needle to the lesion area; 2. Intraoperative C-arm machine needs to be repeatedly fluoroscopy dozens of times or even hundreds of times to achieve the ideal effect of confirming that the guide needle accurately reaches the necrotic area, resulting in a long operation time; if the operation is not properly performed due to lack of experience, it may even cause the guide needle not to reach the necrotic lesion, leading to postoperative failure; 3. Repeated puncture and uncontrollable guide needle depth can easily damage the normal cartilage tissue of the femoral head and the acetabulum side, and cause osteoarthritis in the later period.

[0004] A bone support implant navigation device for femoral head necrosis disclosed in the invention with the announcement number CN111166475A includes a fixed needle guide, a bone support implant guide, and a fitting guide plate that is fitted with the bone surface of the lateral femur. The fixed needle guide and the bone support implant guide are both fixedly connected to the fitting guide plate. The bone support implant guide is provided with a drill bit guide hole, and the center axis of the drill bit guide hole extends from the neck of the femur to the lesion of the femoral head. The fixed needle guide is provided with a fixed needle guide hole. The above technical solution can only control the direction and route of the guide needle after being inserted. Since the lateral femur is flat and has no specific anatomical structure, the insertion position of the guide plate cannot be accurately positioned, so the guide needle cannot be accurately inserted into the necrotic lesion area. In addition, the insertion depth of the guide needle cannot be accurately controlled, so the guide needle cannot be accurately controlled to reach the preoperative predetermined femoral head lesion position. Therefore, multiple repeated fluoroscopy is required to understand the insertion depth and position of the guide needle. Therefore, we propose a femoral head lesion auxiliary positioning guide and a high-precision positioning method. SUMMARY

[0005] The purpose of the present application is to provide a femoral head lesion auxiliary positioning guide and a high-precision positioning method to solve the problem of being unable to accurately place a guide needle into the femoral head lesion area at one time in the background art; the ideal effect of confirming that the guide needle accurately reaches the necrotic area can be achieved only by relying on a C-arm machine for dozens of times or even hundreds of times of repeated fluoroscopy during the operation, which causes the operation time to be too long; if the operation is not properly performed due to lack of experience, the guide needle may not reach the necrotic lesion, which may lead to failure of the later operation; repeated puncture and the inability to control the depth of the guide needle may easily cause the femoral head to be pierced, which may damage the normal cartilage tissue of the femoral head and the acetabulum side, and may cause osteoarthritis in the later period. To achieve the above purpose, the present application provides the following technical solutions: a femoral head lesion auxiliary positioning guide, comprising a femoral head lesion guide, a guide positioning device and a guide needle depth positioning device, the guide positioning device comprises a fixing set, a holding handle and an iliac bone positioning plate, the fixing set is arranged at one end of the holding handle, the iliac bone positioning plate is arranged at the other end of the holding handle, a pre-iliac spine clamping groove is arranged on the iliac bone positioning plate, and a channel positioning cavity is arranged in the middle of the fixing set.

[0006] Preferably, the femoral head lesion guide comprises a guide base and a guide channel, and the guide channel is arranged on one side of the outer surface of the guide base.

[0007] Preferably, the guide channel is clamped in the channel positioning cavity.

[0008] Preferably, the guide base is in a saddle structure, is connected with the guide channel and is integrally formed, is more reasonable and conforms to the human anatomical structure, can be attached to the bone surface during the operation and can achieve the predetermined effect.

[0009] Preferably, the spatial positions of the fixing set, the iliac bone positioning plate and the pre-iliac spine clamping groove are designed according to the anatomical positions of the femoral neck stem and the pre-iliac spine, so that the iliac bone positioning plate and the pre-iliac spine clamping groove can be quickly positioned with the pre-iliac spine of the patient and the positioning accuracy of the device can be improved.

[0010] The high-precision positioning method of the femoral head lesion auxiliary positioning guide comprises the following specific steps:

[0011] S1, designing a femoral head lesion auxiliary positioning guide;

[0012] S2, 3D printing a femoral head lesion auxiliary positioning guide;

[0013] S3, sterilizing and packaging the femoral head lesion auxiliary positioning guide;

[0014] S4, installing the femoral head lesion auxiliary positioning guide;

[0015] S5, positioning a guide needle to the femoral head lesion.

[0016] Preferably, S1 is specifically, through the analysis of CT data of the patient, the femoral head lesion site, the iliac anterior superior spine position and other human anatomical landmarks are used to computer draw the femoral head lesion auxiliary positioning guide.

[0017] Preferably, S2 is specifically, using 3D printing technology, the above-mentioned femoral head lesion auxiliary positioning guide is printed by using photosensitive resin.

[0018] Preferably, S3 is specifically, the femoral head lesion auxiliary positioning guide is packaged after low-temperature plasma disinfection for use in surgery.

[0019] Preferably, S4 is specifically, after the patient is placed in a supine position and anesthetized and disinfected, the skin, subcutaneous tissue and deep fascia of the affected side of the femur are incised, the vastus lateralis muscle is bluntly separated to expose the lateral cortical bone of the proximal femur, the femoral head lesion guide base is placed on the lateral cortical bone of the proximal femur to make it fit the femoral bone surface, the fixing sleeve in the guide positioning device is sleeved outside the guide direction channel, the iliac anterior superior spine clamping groove is moved to fit the iliac anterior superior spine of the patient, and the guide needle depth positioning device is inserted into the fixing sleeve and connected with the guide direction channel of the coded guide.

[0020] Preferably, S5 is specifically, the guide needle is connected to an electric drill, and is sequentially attached to the lateral cortical bone of the femur through the guide needle depth positioning device and the guide direction channel, the electric drill switch is started, the handle is held to reduce the vibration of the bone surface, and when the guide needle tip reaches the center of the femoral head lesion, the end of the guide needle reaches the predetermined position of the guide needle depth positioning device.

[0021] Compared with the prior art, the application has the following beneficial effects:

[0022] (1) The application can effectively improve the accuracy and effect of traditional positioning of femoral head lesions by using a personalized customized femoral head lesion auxiliary positioning guide.

[0023] (2) The application utilizes advanced technologies such as ergonomics, CT three-dimensional modeling and 3D printing technology to accurately and simply place the guide needle, reduce the number of fluoroscopy and radiation dose during surgery, shorten the operation time, improve the accuracy and success rate of surgery, and reduce the risk of surgery.

[0024] (3) The application can better adapt to the bone morphology and lesion conditions of different patients through personalized customization, improve the accuracy, success rate of surgery, and postoperative recovery effect of patients. BRIEF DESCRIPTION OF DRAWINGS

[0025] Figure 1 is a structural schematic diagram of the application;

[0026] Figure 2 is a structural schematic diagram of the application after installation and positioning is completed;

[0027] Figure 3 The application provides a femoral head lesion auxiliary positioning guide second embodiment femoral head lesion guide schematic view;

[0028] Figure 4 A flow chart of the femoral head lesion high-precision positioning method;

[0029] In the figure: 11, femoral head lesion guide; 111, guide base; 112, guide direction channel; 12, guide locator; 121, fixing set; 122, holding handle; 123, iliac bone positioning plate; 124, channel positioning cavity; 125, anterior superior iliac spine clamping groove; 13, guide needle depth locator. DETAILED DESCRIPTION

[0030] The technical solutions in the embodiments of the application will be clearly and completely described below with reference to the drawings in the embodiments of the application. Obviously, the described embodiments are only part of the embodiments of the application, rather than all the embodiments of the application. Based on the embodiments in the application, all other embodiments obtained by a person of ordinary skill in the art without creative work fall within the protection scope of the application.

[0031] Embodiment one, please refer to Figures 1-2 The application provides a technical solution: a femoral head lesion auxiliary positioning guide, which comprises a femoral head lesion guide 11, a guide locator 12 and a guide needle depth locator 13. The guide locator 12 comprises a fixing set 121, a holding handle 122 and an iliac bone positioning plate 123. The fixing set 121 is arranged at one end of the holding handle 122. The iliac bone positioning plate 123 is arranged at the other end of the holding handle 122. The iliac bone positioning plate 123 is provided with an anterior superior iliac spine clamping groove 125. The middle part of the fixing set 121 is provided with a channel positioning cavity 124. The femoral head lesion guide 11 comprises a guide base 111 and a guide direction channel 112. The guide direction channel 112 is arranged on one side of the outer surface of the guide base 111. The guide direction channel 112 is provided with three groups. The guide direction channel 112 is clamped in the three groups of channel positioning cavities 124. Meanwhile, the guide needle depth locator 13 is provided with three groups. The guide needle depth locator 13 is connected with the guide direction channel 112 of the femoral head lesion guide 11 through the fixing set 121.

[0032] The length of the guide needle depth locator 13 = effective length of the guide needle - length of the guide needle penetrating into the femur - length of the guide direction channel 112.

[0033] The guide base 111 is in a saddle structure, which is connected with the guide direction channel 112 and is integrally formed. The structure is more reasonable and conforms to the human anatomical structure. In the operation, the structure can be attached to the bone surface to achieve the predetermined effect.

[0034] The spatial positions of the fixing sleeve 121, the iliac positioning plate 123 and the anterior superior iliac spine clamping groove 125 are designed according to the anatomical positions of the femoral neck and the anterior superior iliac spine, so that the iliac positioning plate 123 and the anterior superior iliac spine clamping groove 125 can be quickly positioned with the anterior superior iliac spine of the patient, and the positioning accuracy of the device is improved.

[0035] The working principle and use process of the present application are as follows: after anesthesia and disinfection of the patient in supine position, the skin, subcutaneous tissue and deep fascia of the affected side of the femur are incised, the vastus lateralis muscle is bluntly separated to expose the lateral cortical bone of the proximal femur, the guide base 111 is placed on the lateral cortical bone of the proximal femur to fit the femoral bone surface, the fixing sleeve 121 in the guide positioning device 12 is sleeved outside the three sets of guide direction channels 112, the iliac positioning plate 123 is moved by holding the handle 122, and the anterior superior iliac spine clamping groove 125 is fitted with the anterior superior iliac spine of the affected side, the three sets of guide needle depth positioners 13 are inserted into the fixing sleeve 121 in turn and connected with the same coded guide direction channels 112; the guide needle is connected with the electric drill, and is attached to the lateral cortical bone of the femur through the guide needle depth positioner 13 and the guide direction channel 112 in turn, the electric drill switch is started, the handle 122 is held to reduce the vibration of the bone surface, and when the guide needle tip reaches the center of the femoral head lesion, the end of the guide needle cannot enter the guide needle depth positioner 13.

[0036] Embodiment two, please refer to Figure 3 The femoral head lesion guide 11 includes a guide base 111 and a guide direction channel 112, and the guide direction channel 112 is provided with two sets.

[0037] In this embodiment, after anesthesia and disinfection of the patient in supine position, the skin, subcutaneous tissue and deep fascia of the affected side of the femur are incised, the vastus lateralis muscle is bluntly separated to expose the lateral cortical bone of the proximal femur, the guide base 111 is placed on the lateral cortical bone of the proximal femur to fit the femoral bone surface, the fixing sleeve 121 in the guide positioning device 12 is sleeved outside the two sets of guide direction channels 112, the iliac positioning plate 123 is moved by holding the handle 122, and the anterior superior iliac spine clamping groove 125 is fitted with the anterior superior iliac spine of the patient, the two sets of guide needle depth positioners 13 are inserted into the fixing sleeve 121 in turn and connected with the same coded guide direction channels 112; the guide needle is connected with the electric drill, and is attached to the lateral cortical bone of the femur through the guide needle depth positioner 13 and the guide direction channel 112 in turn, the electric drill switch is started, the handle 122 is held to reduce the vibration of the bone surface, and when the guide needle tip reaches the center of the femoral head lesion, the end of the guide needle cannot enter the guide needle depth positioner 13.

[0038] Please refer to Figure 4 The high-precision positioning method of the femoral head lesion auxiliary positioning guide is as follows:

[0039] S1, design femoral head lesion auxiliary positioning guide, analyze the CT data of the patient, and draw the femoral head lesion auxiliary positioning guide based on the anatomical landmarks such as the position of the femoral head lesion and the anterior superior iliac spine;

[0040] S2, 3D print the femoral head lesion auxiliary positioning guide, use 3D printing technology, and print the femoral head lesion auxiliary positioning guide using photosensitive resin;

[0041] S3, sterilize and package the femoral head lesion auxiliary positioning guide, and the femoral head lesion auxiliary positioning guide is sterilized and packaged by low-temperature plasma for use in surgery;

[0042] S4, install the femoral head lesion auxiliary positioning guide, after the patient is anesthetized and sterilized in a supine position, the skin, subcutaneous tissue, and deep fascia of the affected side of the femoral neck are incised, the vastus lateralis muscle is bluntly separated to expose the lateral bone cortex of the proximal femur, the base of the femoral head lesion guide 11 is placed on the lateral bone cortex of the proximal femur to fit the femoral bone surface, the fixing sleeve 121 in the guide positioning device 12 is sleeved on the guide direction channel 112, the anterior superior iliac spine clamping groove 125 is moved to fit the anterior superior iliac spine of the patient, and the guide needle depth positioning device 13 is inserted into the fixing sleeve 121 and connected with the coded guide direction channel 112;

[0043] S5, position the guide needle to the femoral head lesion, connect the guide needle to the electric drill, and sequentially pass through the guide needle depth positioning device 13 and the guide direction channel 112 to fit the lateral cortex of the femur, start the electric drill switch, hold the handle 122 to reduce bone surface vibration, and when the guide needle tip cannot enter the guide needle depth positioning device 13, it indicates that the guide needle tip has reached the center of the femoral head lesion.

[0044] In summary, by using the personalized femoral head lesion auxiliary positioning guide, the accuracy and surgical effect of traditional positioning of the femoral head lesion can be effectively improved. The manufacture and application of the device utilize advanced technologies such as ergonomics, CT three-dimensional modeling, and 3D printing technology, which can accurately and simply position the guide needle, reduce the number of fluoroscopy and radiation dose during surgery, shorten the operation time, improve the accuracy and success rate of surgery, and reduce the risk of surgery. In addition, the personalized customization of the device can better adapt to the bone morphology and lesion conditions of different patients, improve the accuracy, success rate of surgery, and postoperative recovery effect of patients.

[0045] Although embodiments of the present application have been shown and described, it will be understood by those skilled in the art that various changes, modifications, substitutions and alterations can be made therein without departing from the principles and spirit of the application, the scope of which is defined by the appended claims and their equivalents.

Claims

1. A femoral head lesion auxiliary positioning guide, characterized in that: The device includes a femoral head lesion guide (11), a guide locator (12), and a guide needle depth locator (13). The guide locator (12) includes a fixation kit (121), a handle (122), and an iliac bone positioning plate (123). The fixation kit (121) is located at one end of the handle (122), and the iliac bone positioning plate (123) is located at the other end of the handle (122). The iliac bone positioning plate (123) is provided with an anterior superior iliac spine groove (125), and the fixation kit (121) is provided with a channel positioning cavity (124) in the middle. The femoral head lesion guide (11) includes a guide base (111) and a guide direction channel (112), wherein the guide direction channel (112) is disposed on one side of the outer surface of the guide base (111); The guide direction channel (112) is engaged within the channel positioning cavity (124); The guide base (111) has a saddle-shaped structure and is connected to the guide orientation channel (112) and integrally formed; After the patient is anesthetized and disinfected in a supine position, the skin, subcutaneous tissue and deep fascia of the lateral femur on the affected side are cut open. The vastus lateralis muscle is bluntly dissected to expose the lateral cortical bone of the proximal femur. The base of the femoral head lesion guide (11) is placed on the lateral cortical bone of the proximal femur to fit the femoral bone surface. The fixation kit (121) in the guide locator (12) is fitted outside the guide directional channel (112). The anterior superior iliac spine slot (125) is moved to fit the anterior superior iliac spine of the patient. The guide needle depth locator (13) is inserted to connect with the fixation kit (121) and the directional channel (112) of the same code guide.

2. The femoral head lesion auxiliary positioning guide according to claim 1, characterized in that: The spatial positions of the fixation kit (121), iliac bone positioning plate (123) and anterior superior iliac spine slot (125) are designed based on the anatomical positions of the femoral neck and anterior superior iliac spine.

3. The femoral head lesion auxiliary positioning guide according to claim 1, characterized in that: By analyzing patient CT data, a computer-aided localization guide for femoral head lesions is created using anatomical landmarks such as the location of the femoral head lesion and the anterior superior iliac spine.

4. The femoral head lesion auxiliary positioning guide according to claim 1, characterized in that: Using 3D printing technology, the above-mentioned femoral head lesion auxiliary positioning guide was printed using photosensitive resin.

5. The femoral head lesion auxiliary positioning guide according to claim 1, characterized in that: The femoral head lesion auxiliary positioning guide is sterilized and packaged with low-temperature plasma for use in surgery.

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