An extracorporeal guiding frame for a percutaneous internal fixation and enhanced intramedullary nail around the acetabulum

Abstract

The present invention relates to an external guiding frame for a percutaneous internal fixation and strengthening intramedullary nail around the acetabulum, belonging to the field of orthopedic medical devices. It includes a universal guiding frame, which consists of an anterior guiding frame and a posterior guiding frame, respectively applicable to the supine and prone positions of the patient. Each universal guiding frame includes an arc-shaped component, which includes a left arc-shaped guide plate, a middle guide plate, and a right arc-shaped guide plate. The two ends of the middle guide plate are detachably connected to the left arc-shaped guide plate and the right arc-shaped guide plate respectively to form the arc-shaped universal guiding frame; a cross-column nail catheter and an anterior column nail catheter are arranged on the left arc-shaped guide plate or the right arc-shaped guide plate; at least one arc-shaped rod is connected to the middle plate, and a posterior column nail catheter is fixed at the end of the arc-shaped rod; when the universal guiding frame is set on the patient, the cross-column nail catheter, the posterior column nail catheter, and the anterior column nail catheter are respectively opposite to the direction between the anterior superior iliac spine and the anterior inferior iliac spine around the patient's pelvis, the ischial tuberosity of the buttocks, and the pubic upper limb of the acetabular apex.

Description

Technical Field

[0001] The invention relates to the field of orthopedic medical devices, and in particular to an in vitro guide frame for percutaneous internal fixation and strengthening of intramedullary nails around the acetabulum. Background Art

[0002] The pelvis is the second most common site of tumor bone metastasis after the spine. Once the tumor metastasizes to the acetabulum, the patient may experience severe pain, limited movement, inability to walk, decreased quality of life, etc., or even pathological fractures and loss of mobility, which accelerates death. Therefore, patients with metastatic cancer around the acetabulum often need to undergo surgical treatment. Existing treatments for metastatic cancer around the acetabulum often use open surgery, including: tumor resection, curettage, acetabular internal fixation, total hip replacement, combined acetabular reinforcement cup, titanium mesh patch, hemipelvic prosthesis reconstruction, etc.

[0003] However, the current problems with open surgery for periacetabular metastatic cancer include: long surgery and anesthesia time; large amounts of blood loss during open surgery, high incidence of perioperative complications such as surgical site infection, wound non-healing, deep vein thrombosis, and hip prosthesis dislocation. Patients recover slowly after surgery, their hospital stay is prolonged, and systemic treatment of the tumor is significantly delayed, which may lead to systemic tumor progression and endanger their lives. Even if the patient passes the perioperative period smoothly, the mid- and long-term complications of open surgery include loosening, dislocation, fracture, and tumor recurrence of implants.

[0004] At present, it is found in clinical practice that by inserting three internal fixation and strengthening intramedullary nails in the pelvic bone around the diseased acetabulum, which are staggered in space and arranged like a tripod, the patient's pain symptoms can be immediately and significantly relieved and the motor function can be restored. At the same time, the operation is percutaneous, which is minimally traumatic to the patient compared with open surgery, and the surgical bleeding is negligible. The patient can quickly resume systemic tumor treatment. The follow-up observation of clinical patients also found that the complications of this operation are extremely low, which has significant advantages over open surgery. The three internal fixation and strengthening intramedullary nails are as follows: Cross-column nail: Pass through one of the points between the anterior superior iliac spine and the anterior inferior iliac spine of the ilium on the affected side, and use this as the starting point, pass through the top of the acetabulum, and reach the sacroiliac joint along the cancellous bone of the greater sciatic notch but do not pass through the articular surface. Posterior column nail: Pass through the ischial tuberosity of the buttocks, and use the ischial tuberosity of the ischial tuberosity as the starting point, along the inside of the sciatic ramus bone, pass through the posterior wall of the acetabulum, and pass to the proximal end of the greater sciatic notch but do not pass through the cortical bone. Anterior column nail: through the ilium at the apex of the acetabulum, and from this point, through the acetabulum and the anterior wall of the acetabulum to the upper limb of the pubic bone, and the end point is the pubic symphysis on the affected side but does not penetrate the cortical bone. Figure 1 shown.

[0005] Although the intramedullary nail with internal fixation strengthened by tripod-like arrangement can significantly improve the symptoms of patients and improve open surgery, its operation is relatively complex and requires a profound understanding of intraoperative X-ray fluoroscopy imaging and human anatomical structures. Professionals also need to go through a long learning curve to master the key points of its surgical techniques. On the other hand, the fault tolerance rate of this surgical technique is low, and slight deviations in delicate operations may cause the intramedullary nail with internal fixation to penetrate through the cortical bone, resulting in damage to abdominal organs and secondary joint trauma involving the hip joint. Summary of the Invention

[0006] In view of the above problems, the object of the present invention is to provide an external guide frame for percutaneous placement of intramedullary nails with internal fixation around the acetabulum, which is used to solve the problems existing in the current treatment methods for metastatic cancer around the acetabulum, such as long operation time, high incidence of surgical complications and wound complications, slow patient recovery, etc. caused by open surgery, as well as the problems of high surgical technical difficulty, long learning curve, and low complication fault tolerance rate of the hand-held tripod-like internal fixation intramedullary nail surgery, significantly improving the surgical accuracy, reducing the surgical technical difficulty, shortening the operation time, and thus benefiting the patients.

[0007] To achieve the above object, the present invention adopts the following technical solutions:

[0008] The present invention discloses an external guide frame for percutaneous placement of intramedullary nails with internal fixation around the acetabulum, including a general-purpose guide frame. The general-purpose guide frame includes an arc-shaped component. The arc-shaped component includes a left arc-shaped guide plate, a middle guide plate, and a right arc-shaped guide plate. The two ends of the middle plate are respectively detachably connected to the left arc-shaped guide plate and the right arc-shaped guide plate to form the arc-shaped component by splicing; a cross-column nail catheter and a front-column nail catheter are arranged on the left arc-shaped guide plate or the right arc-shaped guide plate, and at least one arc-shaped rod is connected to the middle plate, and a rear-column nail catheter is fixed at the end of the arc-shaped rod;

[0009] When the general-purpose guide frame is set on a patient, the cross-column nail catheter, the rear-column nail catheter, and the front-column nail catheter are respectively opposite to the area between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient's pelvis, the ischial tuberosity of the buttocks, and the direction of the superior pubic ramus of the acetabular apex;

[0010] Among them, the cross-column nail catheter is used to pass through and guide a cross-column nail guide needle, so that the cross-column nail passes through one of the areas between the anterior superior iliac spine and the anterior inferior iliac spine, and starting from this point, it passes through the acetabular roof and reaches the sacroiliac joint along the bone inside the greater sciatic notch but does not penetrate through;

[0011] The rear-column nail catheter is used to pass through and guide a rear-column nail guide needle, so that the rear-column nail passes through the ischial tuberosity of the buttocks, and starting from the ischial tuberosity of the ischium, it passes along the inside of the ischial ramus bone, passes through the posterior wall of the acetabulum, and penetrates to the proximal end of the greater sciatic notch but does not penetrate through the cortical bone;

[0012] The anterior column screw catheter is used to thread and guide the anterior column screw guide pin, so that the anterior column screw passes through the iliac part of the acetabular apex, and starting from this point, passes through the acetabular roof and the anterior acetabular wall to the superior pubic ramus, and the end point reaches the affected side of the pubic symphysis without piercing the cortical bone;

[0013] And the cross-column screw, the posterior column screw and the anterior column screw are spatially staggered with each other to form a percutaneous acetabular tripod for strengthening the periphery of the acetabulum to be reinforced.

[0014] Preferably, when internal fixation of the left acetabulum of a patient is required, the cross-column screw catheter and the anterior column screw catheter are respectively arranged at the inner end and the outer end of the left arc-shaped guide plate; when internal fixation of the right acetabulum of a patient is required, the cross-column screw catheter and the anterior column screw catheter are respectively arranged at the inner end and the outer end of the right arc-shaped guide plate; at least one left Kirschner wire guiding and fixing tube, at least one central Kirschner wire guiding and fixing tube and at least one right Kirschner wire guiding and fixing tube are respectively arranged on the left arc-shaped guide plate, the middle plate and the right arc-shaped guide plate for percutaneous puncture on the pelvic bones.

[0015] As a specific embodiment, when the external guiding frame is arranged on the anterior abdomen of the patient, the universal guiding frame is an anterior approach guiding frame, and at least one anterior arc-shaped rod is fixedly connected to the bottom end of the middle plate of the anterior approach guiding plate frame, and the posterior column screw catheter is fixed at the end of the anterior arc-shaped rod; when the anterior approach guiding plate frame is arranged on the lower anterior abdomen of the patient, the left arc-shaped guide plate, the middle plate and the right arc-shaped guide plate of the anterior approach guiding plate frame are respectively attached to the left lower abdomen-iliac external region, the lower abdomen-pubic symphysis region and the right lower abdomen-iliac external region of the patient, and the anterior arc-shaped rod tilts backward and wraps around to the inner rear of the patient's thigh, so that the cross-column screw catheter, the posterior column screw catheter and the anterior column screw catheter are respectively opposite to the direction between the anterior superior iliac spine and the anterior inferior iliac spine around the affected side acetabulum of the patient, the ischial tuberosity of the buttock and the superior pubic ramus of the acetabular apex.

[0016] Preferably, two anterior arc-shaped rods are fixedly connected to the bottom end of the middle plate of the anterior approach guiding plate frame, and the ends of the two anterior arc-shaped rods are both fixed on the outer wall of the posterior column screw catheter.

[0017] Preferably, two left Kirschner wire guiding and fixing tubes, two central Kirschner wire guiding and fixing tubes and two right Kirschner wire guiding and fixing tubes are respectively arranged on the left arc-shaped guide plate, the middle plate and the right arc-shaped guide plate of the anterior approach guiding plate frame for percutaneous puncture on the pelvic bones.

[0018] As another specific embodiment, when the external guiding frame is arranged on the posterior lumbar region of the patient, the universal guiding frame is a posterior approach guiding frame, the posterior approach guiding frame further includes an auxiliary plate, at least one posterior arc-shaped rod is fixedly connected to the auxiliary plate, the posterior column screw catheter is fixed at the end of the posterior arc-shaped rod, and the middle plate of the arc-shaped assembly of the posterior approach guiding frame is detachably connected to the auxiliary plate;

[0019] When the posterior guiding frame is disposed on the posterior lumbar region of a patient, the left arcuate guide plate and the right arcuate guide plate of the posterior guiding frame are respectively clamped at the left iliac crest and the right iliac crest of the patient, the middle plate and the auxiliary plate of the posterior guiding frame are respectively attached to the lumbosacral midline and the gluteal groove-inner thigh of the patient, and the rear arcuate rod tilts forward and bypasses the patient's buttocks, so that the cross-column nail catheter, the posterior-column nail catheter, and the anterior-column nail catheter are respectively opposite to the direction between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient, the ischial tuberosity of the buttocks, and the pubic upper limb of the acetabular apex.

[0020] Preferably, the lower end of the middle plate of the posterior guiding frame is detachably connected to the auxiliary plate through two rods; two rear arcuate rods are fixedly connected to the auxiliary plate, and the ends of the two rear arcuate rods are both fixed on the outer wall of the posterior-column nail catheter.

[0021] Preferably, the middle plate of the posterior guiding frame is an inverted heart-shaped plate, including a middle top end, a left lower end, and a right lower end. The middle top end and the left lower end are connected through a convex arc, the left lower end and the right lower end are connected through a concave arc, and the right lower end and the middle top end are connected through a convex arc. Among them, the left lower end and the right lower end are used to abut against the erector spinae muscles on both sides of the posterior lumbar spine of the patient, and the middle top end inclines inward and is used to abut against the lumbosacral spine of the patient.

[0022] Preferably, the left arcuate guide plate and the right arcuate guide plate of the posterior guiding frame are respectively provided with at least one left Kirschner wire guiding and fixing tube and one right Kirschner wire guiding and fixing tube, and the left middle plate of the posterior guiding frame is provided with five central Kirschner wire guiding and fixing tubes. Among them, one central Kirschner wire guiding and fixing tube is located on the middle top end, two central Kirschner wire guiding and fixing tubes are respectively located on the left lower end and the right lower end, and there are two central Kirschner wire guiding and fixing tubes respectively located on the convex arcs between the middle top end and the left lower end and between the middle top end and the right lower end; the left Kirschner wire guiding and fixing tube, the right Kirschner wire guiding and fixing tube, and the central Kirschner wire guiding and fixing tube of the posterior guiding frame are used for percutaneous puncture on the bones around the acetabulum.

[0023] Preferably, the two ends of the middle plate are respectively detachably connected to the left arcuate guide plate, the right arcuate guide plate, and the middle plate of the arcuate assembly of the posterior guiding frame and the auxiliary plate through rod insertion or pipe fitting threaded connection.

[0024] Compared with the prior art, the beneficial effects of the present invention are:

[0025] (1) The present invention provides an external guiding frame for a percutaneous internal fixation and enhanced intramedullary nail around the acetabulum. When set on a patient, the cross-column nail catheter, posterior-column nail catheter, and anterior-column nail catheter thereon are respectively opposite to the area between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient's pelvis, the ischial tuberosity of the buttock, and the direction of the superior pubic ramus of the acetabular apex. The doctor only needs to sequentially insert the cross-column nail, posterior-column nail, and anterior-column nail along the cross-column nail catheter, posterior-column nail catheter, and anterior-column nail catheter in chronological order, and can respectively insert the cross-column nail through one of the areas between the anterior superior iliac spine and the anterior inferior iliac spine, and take this as the starting point, pass through the acetabular roof, reach the sacroiliac joint along the bone inside the greater sciatic notch but not penetrate it; insert the posterior-column nail through the ischial tuberosity of the buttock, and take the ischial tuberosity of the ischial tuberosity as the starting point, along the inside of the ischial ramus bone, pass through the posterior wall of the acetabulum, and penetrate to the proximal end of the greater sciatic notch but not penetrate the cortical bone; insert the anterior-column nail through the iliac part of the acetabular apex, and take this as the starting point, pass through the acetabular roof and the anterior wall of the acetabulum, to the superior pubic ramus, and the end point is the affected pubic symphysis but not penetrate the cortical bone. The cross-column nail, posterior-column nail, and anterior-column nail are staggered with each other in space to form a percutaneous acetabular tripod, so as to reinforce the area around the acetabulum with osteolytic bone destruction caused by tumor metastasis.

[0026] (2) The present invention provides an external guiding frame for a percutaneous internal fixation and enhanced intramedullary nail around the acetabulum. As an auxiliary device for doctors to perform operations, it is simple to operate and easy to master, greatly reducing the difficulty of such open surgeries, and improving the surgical accuracy; significantly shortening the patient's operation time, alleviating the patient's nerve compression, pain, and improving the patient's quality of life, and also reducing the risk of a large amount of blood loss during the operation, avoiding surgical infections and the incidence of other related surgical complications. In short, the external guiding frame for a percutaneous internal fixation and enhanced intramedullary nail around the acetabulum provided by the present invention optimizes the positioning of the three reinforcing needles and improves the surgical effect. The specific manifestations of improving the surgical effect are: significantly shortening the operation time, reducing the incidence of surgical complications, improving the surgical accuracy, and significantly reducing the surgical difficulty. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] Figure 1 is a front view of the right acetabulum to be reinforced in the pelvis provided by the prior art with three reinforcing needles inserted;

[0028] Figure 2 is a schematic structural diagram of a left acetabular necrosis and pelvis prosthesis to be reinforced printed by 3D printing according to Embodiment 1 of the present invention;

[0029] Figure 3 is a front view of a general guiding frame fixed to a human model percutaneously with Kirschner wires according to Embodiment 1 of the present invention;

[0030] Figure 4 is a front view of the front guiding frame according to Embodiment 2 of the present invention;

[0031] Figure 5 is the rear view of the front guide frame provided in Embodiment 2 of the present invention;

[0032] Figure 6 is the front view of the middle plate of the front guide frame provided in Embodiment 2 of the present invention;

[0033] Figure 7 is the rear view of the middle plate of the front guide frame provided in Embodiment 2 of the present invention;

[0034] Figure 8 is the front view of the rear guide frame provided in Embodiment 3 of the present invention;

[0035] Figure 9 is the rear view of the rear guide frame provided in Embodiment 3 of the present invention;

[0036] Figure 10 is the front view of the middle plate of the rear guide frame provided in Embodiment 3 of the present invention;

[0037] Figure 11 is the rear view of the middle plate of the rear guide frame provided in Embodiment 3 of the present invention;

[0038] Figure 12 is the front view of the auxiliary plate of the rear guide frame provided in Embodiment 3 of the present invention;

[0039] Figure 13 is the rear view of the auxiliary plate of the rear guide frame provided in Embodiment 3 of the present invention.

[0040] Explanation of reference numerals: A - cross-stud catheter, B - rear stud catheter, C - front stud catheter;

[0041] 1 - arc assembly, 11 - left arc guide plate, 12 - middle plate, 13 - right arc guide plate, 110 - left Kirschner wire guiding and fixing tube, 120 - central Kirschner wire, 130 - right Kirschner wire guiding and fixing tube; 100 - Kirschner wire;

[0042] 2 - anterior guide plate, 21 - anterior arc rod, 221 - eversion plate, 222 - triangular arc plate;

[0043] 3 - posterior guide plate, 30 - auxiliary plate, 31 - posterior arc rod, 321 - middle top end, 322 - left lower end, 323 - right lower end;

[0044] 41 - left connection joint, 42 - right connection joint, 431 - first lower connection joint, 432 - second lower connection joint, 441 - first upper connection joint, 442 - second upper connection joint. Detailed implementation manners

[0045] Exemplary embodiments of the present invention will be described in more detail below with reference to the accompanying drawings. Although the exemplary embodiments of the present invention are shown in the drawings, it should be understood that the present invention can be implemented in various forms and should not be limited by the embodiments set forth herein. On the contrary, these embodiments are provided so that the present invention can be more thoroughly understood and the scope of the present invention can be fully conveyed to those skilled in the art.

[0046] In order to solve the problems existing in the treatment methods of existing periacetabular metastatic carcinoma, such as long operation time, high incidence of surgical complications and wound complications, and slow recovery of patient symptoms due to open surgery, the present invention designs an external guiding frame for percutaneous internal fixation and strengthened intramedullary nail around the acetabulum. When it is set on a patient, the cross-column nail catheter, posterior-column nail catheter, and anterior-column nail catheter on it are respectively opposite to the directions between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient's pelvis, the ischial tuberosity of the buttock, and the superior pubic ramus of the acetabular apex. By using the external guiding frame for percutaneous internal fixation and strengthened intramedullary nail around the acetabulum disclosed in the present invention to carry out percutaneous nail insertion and internal fixation surgery, the doctor only needs to insert the cross-column nail, posterior-column nail, and anterior-column nail along the cross-column nail catheter, posterior-column nail catheter, and anterior-column nail catheter in sequence according to the time sequence, which significantly shortens the operation time, reduces the incidence of surgical complications, improves the surgical accuracy, and significantly reduces the surgical difficulty.

[0047] Example 1: Universal guiding frame

[0048] Example 1 of the present invention provides an external guiding frame for percutaneous internal fixation and strengthened intramedullary nail around the acetabulum, and its structure will be described in detail below with reference to the accompanying drawings.

[0049] Except for severely obese patients, general Chinese adult patients with periacetabular metastatic carcinoma can all be treated surgically using the universal external guiding frame for percutaneous nail insertion in the pelvis.

[0050] Reference Figure 4 and Figure 5 as well as Figure 8 and Figure 9 and, the universal guiding frame includes an arc-shaped assembly 1. The arc-shaped assembly 1 includes a left arc-shaped guide plate 11, an intermediate plate 12, and a right arc-shaped guide plate 13. The two ends of the intermediate plate 12 are detachably connected to the left arc-shaped guide plate 11 and the right arc-shaped guide plate 13 respectively to form the arc-shaped assembly 1 by splicing.

[0051] The cross-column nail catheter A and the anterior-column nail catheter C are provided on the left arc-shaped guide plate 11 or the right arc-shaped guide plate 13. The intermediate plate 12 is connected with at least one arc-shaped rod, and the end of the arc-shaped rod is fixed with the posterior-column nail catheter B.

[0052] When the universal guide frame is set on the patient, the cross-column nail catheter A, the posterior column nail catheter B, and the anterior column nail catheter C are respectively opposite to the area between the anterior superior iliac spine and the anterior inferior iliac spine around the patient's pelvis, the ischial tuberosity of the buttocks, and the acetabular apex.

[0053] Among them, the cross-column nail catheter A is used to thread and guide the cross-column nail, so that the cross-column nail passes through one of the areas between the anterior superior iliac spine and the anterior inferior iliac spine, and starting from this point, it reaches the sacroiliac joint along the inside of the bone but does not penetrate the bone;

[0054] The posterior column nail catheter B is used to thread and guide the posterior column nail, so that the posterior column nail passes through the ischial tuberosity of the buttocks, and starting from the ischial tuberosity, it penetrates to the greater sciatic notch along the inside of the bone but does not penetrate the bone;

[0055] The anterior column nail catheter C is used to thread and guide the anterior column nail, so that the anterior column nail passes through the acetabular apex, and starting from the acetabular apex, it passes through the outside of the iliac wing and ends at the pubic symphysis but does not penetrate the bone;

[0056] And the cross-column nail, the posterior column nail, and the anterior column nail are staggered with each other in space to form a percutaneous acetabular tripod to reinforce the area around the acetabulum to be reinforced.

[0057] To illustrate the application of the universal guide frame in the treatment of pelvic tumors, in Example 1 of the present invention, a 3D-printed personalized pelvic prosthesis is used as the surgical object, as Figure 2 shown, where the pelvic prosthesis is 3D-printed according to the patient's pelvis at a ratio of 1:1, and it can be considered that the two are equivalent. It can be seen from Figure 2 that the left acetabulum of the patient has necrosis due to tumor lesions.

[0058] In order to fix the universal guide frame on the patient, the left arc guide plate 11, the middle plate 12, and the right arc guide plate 13 are respectively provided with at least one left Kirschner wire guide fixing tube 110, at least one central Kirschner wire guide fixing tube 120, and at least one right Kirschner wire guide fixing tube 130, which are used for percutaneous puncture on the bones of the pelvis to fix the universal guide frame on the patient's body. The left Kirschner wire guide fixing tube 110, the central Kirschner wire guide fixing tube 120, and the right Kirschner wire guide fixing tube 130 respectively thread the Kirschner wire 100, and the Kirschner wire 100 passes through the skin until it penetrates and is fixed on the ilium. As Figure 3 shown, when the universal guide frame is set on the patient's anterior abdomen, the universal guide frame at this time becomes the anterior approach guide plate frame 2 in Example 2 later.

[0059] It should be noted that the "front" and "back" in the drawings of the present invention are defined with the patient himself as the center. Specifically, when the universal guide frame is arranged on the anterior abdomen of the pelvic prosthesis, the anterior guide plate frame 2 of the universal guide frame is formed; when the universal guide frame is arranged on the anterior abdomen and posterior lumbar back of the pelvic prosthesis, the universal guide frame becomes the posterior guide frame 3. The direction in which the patient's eyes look straight ahead is defined as the "front", and conversely, the direction opposite to this direction is the "rear" or "back". Therefore, when the anterior guide plate frame 2 is arranged on the anterior abdomen of the patient, the side where the left Kirschner wire guiding and fixing tube 110, the central Kirschner wire 120, and the right Kirschner wire guiding and fixing tube 130 can be seen is the front side; conversely, since the back side of the anterior guide plate frame 2 is closely attached to the skin of the anterior abdomen, the side where the left Kirschner wire guiding and fixing tube 110, the central Kirschner wire 120, and the right Kirschner wire guiding and fixing tube 130 cannot be seen is the back side of the anterior guide plate frame 2 due to this. When the posterior guide frame 3 is arranged on the posterior lumbar back of the patient, since the side where the left Kirschner wire guiding and fixing tube 110, the central Kirschner wire 120, and the right Kirschner wire guiding and fixing tube 130 can be seen is away from the "front", it becomes the "back side" of the posterior guide frame 3; conversely, the side of the posterior guide frame 3 that is closely attached to the skin of the posterior lumbar back is the "front side".

[0060] The settings of the trans-column nail catheter A and the anterior column nail catheter C are determined according to which side of the patient's acetabulum needs internal fixation. Whether it is the left or right acetabulum that needs internal fixation, the trans-column nail catheter A and the anterior column nail catheter C are respectively arranged at the inner end and the outer end of the left arc guide plate 11 or the right arc guide plate 13.

[0061] Specifically, if the left acetabulum of the patient needs internal fixation, the trans-column nail catheter A and the anterior column nail catheter C are respectively arranged at the inner end and the outer end of the left arc guide plate 11; if the right acetabulum of the patient needs internal fixation, the trans-column nail catheter A and the anterior column nail catheter C are respectively arranged at the inner end and the outer end of the right arc guide plate 13.

[0062] As a specific implementation manner for realizing the detachable connection between the two ends of the intermediate plate 12 and the left arc guide plate 11 and the right arc guide plate 13 respectively, the two ends of the intermediate plate 12 are respectively connected to the left arc guide plate 11 and the right arc guide plate 13 by inserting rods. That is, rods are respectively fixed at one end of the intermediate plate 12 and the left arc guide plate 11. Among the two rods, one is equipped with a female head and the other is equipped with a male head, and the two are inserted together through the female head and the male head. Similarly, the other end of the intermediate plate 12 and the right arc guide plate 13 can also be connected together by inserting rods in the form of a female head and a male head.

[0063] As another specific implementation for detachably connecting both ends of the intermediate plate 12 to the left arc guide plate 11 and the right arc guide plate 13 respectively, both ends of the intermediate plate 12 are detachably connected to the left arc guide plate 11 and the right arc guide plate 13 through pipe fittings by screw threads. That is, pipe fittings are respectively fixed to one end of the intermediate plate 12 and the left arc guide plate 11. Among the two pipe fittings, the inner wall of the outer end of one is provided with internal threads, and the outer wall of the outer end of the other is provided with external threads. The two pipe fittings are connected together by screw threads. Similarly, the other end of the intermediate plate 12 and the right arc guide plate 13 can also be connected together by pipe fittings in the form of pipe fitting screw connection.

[0064] Since both the rod insertion and the pipe fitting screw connection are mature existing technologies, they will not be elaborated here.

[0065] It should be noted that the general - type guide frame may be applicable to patients with normal height and body type. However, since it is an indisputable fact that there are differences in human height and body type, for patients with height and body type differences, it is necessary to conduct personalized design on the applicable guide frame.

[0066] In addition, generally, patients can use the anterior approach guide frame. For patients who cannot tolerate the supine position surgery, the prone position surgery can be adopted and the posterior approach guide frame can be applied. According to individual differences, it is also necessary to make separate designs for the anterior abdomen or posterior back.

[0067] In summary, whether it is the guide frame applicable to the anterior abdomen or the posterior back, or the guide frame adjusted according to individual height and body type differences, they are all applicability changes made on the basis of the general - type guide frame. Since this kind of applicability change and the general - type guide frame have basically the same technical problems to be solved and technical effects to be achieved, only the specific technical solutions need to be adaptively changed in structure according to the specific application site and the height and body type differences of specific patients. Therefore, this kind of applicability change is essentially an extension of the design of the general - type guide frame structure for specific application sites and specific patients, and belongs to the same inventive concept as the general - type guide frame, and both are within the protection scope of the extracorporeal guide frame of the percutaneous internal fixation and strengthening intramedullary nail around the acetabulum disclosed in the present invention.

[0068] Next, the structures and their connection relationships of the guide frame applicable to the anterior abdomen and the guide frame applicable to the posterior back will be further described by using Embodiment 2 and Embodiment 3 respectively.

[0069] Embodiment 2: Anterior approach guide frame

[0070] In order to apply the guide frame to the anterior abdomen, on the basis of Embodiment 1, the present invention's Embodiment 2 proposes an anterior approach guide plate frame 2, which is a guide frame applicable to the anterior abdomen of patients. The following will describe its structure in detail with reference to the drawings.

[0071] When the extracorporeal guide frame for percutaneous internal fixation of the acetabulum and the reinforced intramedullary nail is set in the patient's anterior abdomen, the universal guide frame becomes the anterior guide frame 2 .

[0072] refer to Figure 4 and Figure 5 , the bottom end of the middle plate 12 of the front guide plate frame 2 is fixedly connected with at least one front arc-shaped rod 21, and the end of the front arc-shaped rod 21 is fixed with a rear column nail guide tube B;

[0073] When the anterior guide plate frame 2 is set on the patient's anterior abdomen, that is, when the patient is in the supine position for surgery, the left arc guide plate 11, the middle plate 12 and the right arc guide plate 13 of the anterior guide plate frame 2 are respectively attached to the patient's left lower abdomen-external iliac area, the lower abdomen-pubic symphysis area and the right lower abdomen-external iliac area, and the anterior arc rod 21 is tilted backward and bypasses the patient's crotch, so that the cross-column nail catheter A, the posterior column nail catheter B and the anterior column nail catheter C respectively correspond to the anterior superior iliac spine and the anterior inferior iliac spine around the patient's affected side acetabulum, the ischial tuberosity of the buttocks and the pubic superior limb direction of the acetabulum apex.

[0074] refer to Figure 7 The middle plate 12 of the front guide plate frame 2 is an arc-shaped guide plate, including an outer flap plate 221 and a triangular arc plate 222, and the top of the triangular arc plate 222 is fixedly connected to the outer flap plate 221;

[0075] The front projection of the triangular arc plate 222 is a triangle with a circular arc as the bottom angle, the top of which is large and the bottom of which is small, and the lower part of which becomes rounder and thinner as it moves away from the top. The bottom of the triangular arc plate 222 is transitioned through a circular arc.

[0076] The triangular arc plate 222 is used to be close to the center of the patient's lower abdomen, and the outward-turned plate 221 is folded outward to support the protruding flesh above the navel in the center of the lower abdomen.

[0077] As a specific implementation, two front arc-shaped rods 21 are fixedly connected to the bottom end of the middle plate 12 of the front guide plate frame 2, and the ends of the two front arc-shaped rods 21 are fixed on the outer wall of the rear column nail guide tube B.

[0078] In order to fix the anterior guide plate frame 2 on the patient's anterior abdomen, the left arc guide plate 11, the middle plate 12 and the right arc guide plate 13 of the anterior guide plate frame 2 are respectively provided with two left Kirschner wire guide fixation tubes 110, two central Kirschner wire guide fixation tubes 120 and two right Kirschner wire guide fixation tubes 130, which are used for percutaneous puncture on the bones around the acetabulum to fix the anterior guide plate frame 2 on the patient's body.

[0079] A specific implementation method for realizing that both ends of the middle plate 12 of the front guide plate frame 2 are detachably connected to the left arc guide plate 11 and the right arc guide plate 13, refer to Figure 6, on the middle plate 12 of the anterior guide plate frame 2, a left bending rod and a right bending rod are respectively fixed. One end of the left bending rod and the right bending rod is fixed on the middle plate 12 of the arc-shaped component 1 of the anterior guide plate frame 2, and the other ends are bent left and right respectively. Left connecting joints 41 and right connecting joints 42 are respectively arranged at the outer ends of the left bending rod and the right bending rod.

[0080] A right bending rod is arranged at the right end of the left arc-shaped guide plate 11. A right connecting joint 42 is configured at the outer end of the right bending rod. One of the right connecting joint 42 of the left arc-shaped guide plate 11 and the left connecting joint 41 of the left bending rod on the middle plate 12 of the anterior guide plate frame 2 is used as a male head, and the other is used as a female head, and they are inserted into each other.

[0081] A left bending rod is arranged at the left end of the right arc-shaped guide plate 13. A left connecting joint 41 is configured at the outer end of the left bending rod. One of the left connecting joint 41 of the right arc-shaped guide plate 13 and the right connecting joint 42 of the right bending rod on the middle plate 12 of the anterior guide plate frame 2 is used as a male head, and the other is used as a female head, and they are inserted into each other.

[0082] By using the anterior guide frame 2 disclosed in Embodiment 2 of the present invention to perform internal reinforcement surgery on the pelvis of the patient's left acetabulum, still taking the pelvis prosthesis of the same patient as shown in Figure 2 as the surgical object, for the situation that the left acetabulum of the patient needs reinforcement surgery, the cross-column nail catheter A and the anterior column nail catheter C are respectively arranged at the inner end and the outer end of the left arc-shaped guide plate 11.

[0083] As a specific implementation method for performing reinforcement surgery on the patient with the left acetabulum, the left arc-shaped guide plate 11, the middle plate 12 and the right arc-shaped guide plate 13 of the anterior guide plate frame 2 are all printed by 3D printing technology to obtain an integrally formed product component, specifically including:

[0084] Middle plate component: The middle plate 12 of the anterior guide frame 2, the two central Kirschner wire guiding and fixing tubes 120 thereon, the left bending rod and its left connecting joint 41, the right bending rod and its right connecting joint 42, and the two front arc-shaped rods 21 fixedly connected thereto, and the posterior column nail catheter B fixed at the end of the front arc-shaped rod 21 for guiding the posterior column nail during the doctor's operation are printed by 3D printing technology into an integrally formed product component, as shown in Figure 6 and Figure 7 shown.

[0085] Left arc-shaped guide plate component: The left arc-shaped guide plate 11, the two left Kirschner wire guiding and fixing tubes 110 thereon, the right bending rod and its right connecting joint 42, and the cross-column nail catheter A and the anterior column nail catheter C for guiding the cross-column nail and the anterior column nail respectively during the doctor's operation are printed by 3D printing technology into an integrally formed product component.

[0086] Right arc guide plate component: The right arc guide plate 13, two right Kirschner wire guiding and fixing tubes 130 thereon, the left bending rod and its left connecting joint 41 are integrally formed product components printed by 3D printing technology.

[0087] Then splice the middle plate component with the left arc guide plate component and the right arc guide plate component to form the anterior approach guide frame 2.

[0088] Through the clinical application of the anterior approach guide frame 2, the extracorporeal guide frame of the percutaneous internal fixation and strengthened intramedullary nail around the acetabulum disclosed by the present invention has the following advantages:

[0089] First, compared with the traditional tripod internal fixation surgery which takes 2.3 hours, by guiding the three reinforcing needles with the anterior approach guide frame disclosed in Embodiment 2, the operation time is 1 hour, significantly shortening the operation time.

[0090] Secondly, the nail placement was successful in all 13 patients, and all were within the bone, without complications. Moreover, it can even restore and maintain the mobility and stability of the hip joint, prevent or treat pathological fractures, and prolong life, indicating that the extracorporeal guide frame of the percutaneous internal fixation and strengthened intramedullary nail around the acetabulum improves the surgical accuracy.

[0091] Finally, it reduces the risk of a large amount of blood loss during the operation, avoids the incidence of surgical complications such as infection around the acetabulum during the operation period, non - healing of the wound, deep vein thrombosis, hip joint dislocation, etc., as well as complications such as loosening of the implant and tumor recurrence that are likely to occur in the medium and long term.

[0092] In addition, the extracorporeal guide frame of the percutaneous internal fixation and strengthened intramedullary nail around the acetabulum disclosed by the present invention is conducive to promotion. It can be applied by medical institutions at all levels and orthopedic professionals, and can significantly reduce the surgical difficulty.

[0093] Embodiment 3: Posterior approach guide frame

[0094] In order to apply the guide frame to the posterior lumbar region, on the basis of Embodiment 1, Embodiment 3 of the present invention proposes a posterior approach guide frame 3, which is a guide frame applicable to the posterior lumbar region of a patient. Its structure will be described in detail below with reference to the accompanying drawings.

[0095] When the extracorporeal guide frame of the percutaneous internal fixation and strengthened intramedullary nail around the acetabulum is set on the posterior lumbar region of the patient, that is, when the patient is in the prone position, the general - type guide frame becomes the posterior approach guide frame 3.

[0096] Refer to Figure 8 and Figure 9 , the posterior approach guide frame 3 further includes an auxiliary plate 30. At least one posterior arc rod 31 is fixedly connected to the auxiliary plate 30. A posterior column nail catheter B is fixed at the end of the posterior arc rod 31. The middle plate 12 of the arc assembly 1 of the posterior approach guide frame 3 is detachably connected to the auxiliary plate 30.

[0097] When the posterior guiding frame 3 is set on the posterior lumbar region of the patient, the left arc guide plate 11 and the right arc guide plate 13 of the posterior guiding frame 3 are respectively clamped at the left iliac crest and the right iliac crest of the patient, the middle plate 12 and the auxiliary plate 30 of the posterior guiding frame 3 are respectively attached to the midline of the lumbosacral region and the gluteal fold-medial thigh of the patient, and the posterior arc rod 31 tilts forward and bypasses the patient's buttocks, so that the cross-column nail catheter A, the posterior column nail catheter B and the anterior column nail catheter C are respectively opposite to the direction between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient, the ischial tuberosity of the buttocks and the pubic upper limb of the acetabular apex.

[0098] As a specific implementation manner, the lower end of the middle plate 12 of the posterior guiding frame 3 is detachably connected to the auxiliary plate 30 through two rods; two posterior arc rods 31 are fixedly connected to the auxiliary plate 30, and the ends of the two posterior arc rods 31 are both fixed on the outer wall of the posterior column nail catheter B.

[0099] Reference 11 and Figure 11 The middle plate 12 of the posterior guiding frame 3 is an inverted heart-shaped plate, including a middle top end 321, a left lower end 322, and a right lower end 323. The transition between the middle top end 321 and the left lower end 322 is through a convex arc, the transition between the left lower end 322 and the right lower end 323 is through a concave arc, and the transition between the right lower end 323 and the middle top end 321 is through a convex arc.

[0100] Among them, the left lower end 322 and the right lower end 323 are used to abut against the erector spinae muscles on both sides of the posterior lumbar spine of the patient, and the middle top end 321 inclines inward for abutting against the lumbosacral spine of the patient.

[0101] In order to fix the posterior guiding frame 3 on the posterior lumbar region of the patient, the left arc guide plate 11 and the right arc guide plate 13 of the posterior guiding frame 3 are respectively provided with a left Kirschner wire guiding and fixing tube 110 and a right Kirschner wire guiding and fixing tube 130.

[0102] The left middle plate 12 of the posterior guiding frame 3 is provided with five central Kirschner wire guiding and fixing tubes 120. Among them, one central Kirschner wire guiding and fixing tube 120 is located on the middle top end 321, two central Kirschner wire guiding and fixing tubes 120 are respectively located on the left lower end 322 and the right lower end 323, and there are two central Kirschner wire guiding and fixing tubes 120 respectively located on the convex arcs between the middle top end 321 and the left lower end 322 and between the middle top end 321 and the right lower end 323.

[0103] The left Kirschner wire guiding and fixing tube 110, the right Kirschner wire guiding and fixing tube 130 and the central Kirschner wire guiding and fixing tube 120 of the posterior guiding frame 3 are used for percutaneous puncture on the bones around the acetabulum to fix the posterior guiding frame 3 on the posterior lumbar region of the patient.

[0104] Among them, both ends of the middle plate 12 of the posterior guiding frame 3 are detachably connected to the left arc-shaped guiding plate 11 and the right arc-shaped guiding plate 13 respectively. Similar to the anterior guiding frame 2, this will not be elaborated here.

[0105] As a specific implementation manner for detachably connecting the middle plate 12 of the arc-shaped component 1 of the posterior guiding frame 3 and the auxiliary plate 30, the middle plate 12 of the arc-shaped component 1 of the posterior guiding frame 3 and the auxiliary plate 30 are detachably connected by inserting rods or threading pipe fittings.

[0106] Specifically, the middle plate 12 of the arc-shaped component 1 of the posterior guiding frame 3 is provided with a first lower bent rod and a second lower bent rod on the side close to the side where the patient needs percutaneous nail insertion. One end of the first lower bent rod and the second lower bent rod is fixed on the middle plate 12 of the arc-shaped component 1 of the posterior guiding frame 3, and the other end is bent downward. The outer ends of the first lower bent rod and the second lower bent rod are respectively provided with a first lower connecting joint 431 and a second lower connecting joint 432.

[0107] Reference Figure 12 and Figure 13 , the auxiliary plate 30 is provided with a first upper bent rod and a second upper bent rod. One end of the first upper bent rod and the second upper bent rod is fixed on the auxiliary plate 30, and the other end is bent upward. The outer ends of the first upper bent rod and the second upper bent rod are respectively provided with a first upper connecting joint 441 and a second upper connecting joint 442.

[0108] One of the first lower connecting joint 431 and the first upper connecting joint 441 is used as a male head, and the other is used as a female head, and they are inserted into each other; one of the second lower connecting joint 432 and the second upper connecting joint 442 is used as a male head, and the other is used as a female head, and they are inserted into each other.

[0109] Performing an internal reinforcement surgery on the patient's pelvis using the posterior guiding frame 3 disclosed in Embodiment 3 of the present invention is similar to the anterior guiding frame 2 disclosed in Embodiment 2. Still taking the internal reinforcement surgery on the pelvis of the patient's left acetabulum as an example, the cross-column nail catheter A and the anterior column nail catheter C are still respectively arranged at the inner end and the outer end of the left arc-shaped guiding plate 11. Since the posterior guiding frame 3 is arranged on the patient's posterior back instead of the anterior abdomen, compared with the anterior guiding frame 2, the posterior guiding frame 3 further includes an auxiliary plate 30. When using 3D printing technology to print product components, the differences between the two are as follows:

[0110] Middle plate component: The middle plate 12 of the posterior guiding frame 3, on which the number of central Kirschner wire guiding and fixing tubes 120 is five. The first lower bent rod and its first lower connecting joint 431 and the second lower bent rod and its second lower connecting joint 432 respectively replace the two front arc-shaped rods 21 of the middle plate 12 of the anterior guiding frame 2;

[0111] Left arc guide plate component: The left arc guide plate 11 of the posterior guiding frame 3, and the number of left Kirschner wire guiding and fixing tubes 110 thereon is one;

[0112] Right arc guide plate component: The right arc guide plate 13 of the posterior guiding frame 3, and the number of right Kirschner wire guiding and fixing tubes 130 thereon is one;

[0113] Auxiliary plate component: The auxiliary plate 30, the first upper bent rod and the first upper connecting joint 441 thereon, the second upper bent rod and the second upper connecting joint 442 thereon, as well as the two rear arc rods 31 fixedly connected thereto, and the rear stud catheter B at the ends of the two rear arc rods 31, are product components printed integrally by 3D printing technology.

[0114] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention and are not intended to limit them; although the present invention has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that they can still modify the technical solutions recorded in the foregoing embodiments, or perform equivalent replacements for some of the technical features; and these modifications or replacements do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the various embodiments of the present invention.

Claims

1. An extracorporeal guiding frame for a percutaneous internal fixation and strengthened intramedullary nail around the acetabulum, characterized in that, It includes a general-purpose guide frame. The general-purpose guide frame includes an arc-shaped component. The arc-shaped component includes a left arc-shaped guide plate, a middle plate, and a right arc-shaped guide plate. The two ends of the middle plate are respectively detachably connected to the left arc-shaped guide plate and the right arc-shaped guide plate to form the arc-shaped component by splicing. A cross-column nail catheter and a front-column nail catheter are provided on either the left arc-shaped guide plate or the right arc-shaped guide plate. The general-purpose guide frame is an anterior approach guide frame and is arranged on the anterior abdomen of the patient. At least one anterior arc-shaped rod is fixedly connected to the bottom end of the middle plate of the anterior approach guide frame, and a posterior-column nail catheter is fixed at the end of the anterior arc-shaped rod. When the anterior approach guide frame is arranged on the patient, the cross-column nail catheter, the posterior-column nail catheter, and the front-column nail catheter are respectively opposite to the area between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient's pelvis, the ischial tuberosity of the buttock, and the pubic upper limb direction of the acetabular apex. Among them, the cross-column nail catheter is used to pass through and guide a cross-column nail guide needle, so that the cross-column nail passes through one of the areas between the anterior superior iliac spine and the anterior inferior iliac spine, and starting from this point, it passes through the acetabular roof, reaches the sacroiliac joint along the bone inside the greater sciatic notch but does not penetrate it. The posterior-column nail catheter is used to pass through and guide a posterior-column nail guide needle, so that the posterior-column nail passes through the ischial tuberosity of the buttock, and starting from the ischial tuberosity of the ischium, it passes along the inside of the ischial ramus bone, passes through the posterior wall of the acetabulum, and reaches the proximal end of the greater sciatic notch but does not penetrate the cortical bone. The front-column nail catheter is used to pass through and guide a front-column nail guide needle, so that the front-column nail passes through the iliac part of the acetabular apex, and starting from this point, it passes through the acetabular roof and the anterior wall of the acetabulum to the pubic upper limb, and the end point reaches the affected pubic symphysis but does not penetrate the cortical bone. And the cross-column nail, the posterior-column nail, and the front-column nail are staggered with each other in space to form a percutaneous acetabular tripod to reinforce the area around the acetabulum to be strengthened.

2. The guide frame for the percutaneous internal fixation and enhanced intramedullary nail around the acetabulum according to claim 1, characterized in that, The left arc-shaped guide plate, the middle plate, and the right arc-shaped guide plate of the anterior approach guide frame are respectively attached to the left lower abdomen - external iliac region, the lower abdomen - pubic symphysis region, and the right lower abdomen - external iliac region of the patient. The anterior arc-shaped rod tilts backward and wraps around to the inner rear of the patient's thigh, so that the cross-column nail catheter, the posterior-column nail catheter, and the front-column nail catheter are respectively opposite to the area between the anterior superior iliac spine and the anterior inferior iliac spine around the affected acetabulum of the patient, the ischial tuberosity of the buttock, and the pubic upper limb direction of the acetabular apex.

3. The extracorporeal guiding frame of the intramedullary nail with percutaneous internal fixation reinforcement around the acetabulum according to claim 2, characterized in that, Two anterior arc-shaped rods are fixedly connected to the bottom end of the middle plate of the anterior approach guide frame, and the ends of the two anterior arc-shaped rods are both fixed on the outer wall of the posterior-column nail catheter.

4. The extracorporeal guiding frame of the intramedullary nail with percutaneous internal fixation reinforcement around the acetabulum according to claim 2, characterized in that, Two left Kirschner wire guide fixing tubes, two central Kirschner wire guide fixing tubes, and two right Kirschner wire guide fixing tubes are respectively arranged on the left arc-shaped guide plate, the middle plate, and the right arc-shaped guide plate of the anterior approach guide frame for percutaneous puncture on the pelvic bones.

5. An extracorporeal guiding frame for a percutaneous internal fixation reinforced intramedullary nail around the acetabulum, characterized in that, It includes a general-purpose guide frame. The general-purpose guide frame includes an arc-shaped component. The arc-shaped component includes a left arc-shaped guide plate, a middle plate, and a right arc-shaped guide plate. The two ends of the middle plate are respectively detachably connected to the left arc-shaped guide plate and the right arc-shaped guide plate to form the arc-shaped component by splicing. A cross-column nail catheter and an anterior column nail catheter are provided on the left arc-shaped guide plate or the right arc-shaped guide plate. The universal guide frame is a posterior approach guide frame and is arranged on the posterior lumbar region of the patient. The posterior approach guide frame further includes an auxiliary plate, and at least one posterior arc-shaped rod is fixedly connected to the auxiliary plate. A posterior column nail catheter is fixed at the end of the posterior arc-shaped rod. The middle plate of the arc-shaped component of the posterior approach guide frame is detachably connected to the auxiliary plate. When the posterior approach guide frame is arranged on the patient, the cross-column nail catheter, the posterior column nail catheter, and the anterior column nail catheter are respectively opposite to the region between the anterior superior iliac spine and the anterior inferior iliac spine, the ischial tuberosity of the buttock, and the pubic upper limb of the acetabular apex around the affected side of the patient's pelvis. Among them, the cross-column nail catheter is used to thread a cross-column nail guide pin and guide it, so that the cross-column nail passes through one of the regions between the anterior superior iliac spine and the anterior inferior iliac spine, and starting from this point, passes through the acetabular roof, reaches the sacroiliac joint along the bone inside the greater sciatic notch but does not penetrate it. The posterior column nail catheter is used to thread a posterior column nail guide pin and guide it, so that the posterior column nail passes through the ischial tuberosity of the buttock, and starting from the ischial tuberosity of the ischium, along the inside of the ischial ramus bone, passes through the posterior wall of the acetabulum, and penetrates to the proximal end of the greater sciatic notch but does not penetrate the cortical bone. The anterior column nail catheter is used to thread an anterior column nail guide pin and guide it, so that the anterior column nail passes through the iliac part of the acetabular apex, and starting from this point, passes through the acetabular roof and the anterior wall of the acetabulum, to the pubic upper limb, and the end point reaches the affected side of the pubic symphysis but does not penetrate the cortical bone. Moreover, the cross-column nail, the posterior column nail, and the anterior column nail are staggered with each other in space to form a percutaneous acetabular tripod to reinforce the area around the acetabulum to be strengthened.

6. The extracorporeal guiding frame of the intramedullary nail with percutaneous internal fixation reinforcement around the acetabulum according to claim 5, characterized in that, The left arc-shaped guide plate and the right arc-shaped guide plate of the posterior approach guide frame are respectively clamped at the left iliac crest and the right iliac crest of the patient. The middle plate and the auxiliary plate of the posterior approach guide frame are respectively attached to the lumbosacral midline and the gluteal groove-medial thigh of the patient. The posterior arc-shaped rod tilts forward and bypasses the patient's buttocks, so that the cross-column nail catheter, the posterior column nail catheter, and the anterior column nail catheter are respectively opposite to the region between the anterior superior iliac spine and the anterior inferior iliac spine, the ischial tuberosity of the buttock, and the pubic upper limb of the acetabular apex around the affected side of the patient.

7. The extracorporeal guiding frame of the intramedullary nail with percutaneous internal fixation reinforcement around the acetabulum according to claim 6, characterized in that, The lower end of the middle plate of the posterior approach guide frame is detachably connected to the auxiliary plate through two rods. Two posterior arc-shaped rods are fixedly connected to the auxiliary plate, and the ends of the two posterior arc-shaped rods are both fixed on the outer wall of the posterior column nail catheter.

8. The extracorporeal guiding frame of the percutaneous internal fixation and strengthened intramedullary nail around the acetabulum according to claim 6, characterized in that The middle plate of the posterior approach guide frame is an inverted heart-shaped plate, including a middle top end, a left lower end, and a right lower end. The middle top end and the left lower end are connected by an outward convex arc, the left lower end and the right lower end are connected by an inward concave arc, and the right lower end and the middle top end are connected by an outward convex arc. Among them, the left lower end and the right lower end are used to abut against the erector spinae muscles on both sides of the posterior lumbar spinous processes of the patient, and the middle top end inclines inward and is used to abut against the lumbosacral spinous processes of the patient.

9. The extracorporeal guiding frame of the intramedullary nail with percutaneous internal fixation reinforcement around the acetabulum according to claim 8, characterized in that, The left arc-shaped guide plate and the right arc-shaped guide plate of the posterior approach guide frame are respectively provided with at least one left Kirschner wire guiding and fixing tube and one right Kirschner wire guiding and fixing tube. The left middle plate of the posterior approach guide frame is provided with five central Kirschner wire guiding and fixing tubes. Among them, one central Kirschner wire guiding and fixing tube is located at the middle top end, two central Kirschner wire guiding and fixing tubes are respectively located at the left lower end and the right lower end, and the other two central Kirschner wire guiding and fixing tubes are respectively located on the convex arcs between the middle top end and the left lower end and between the middle top end and the right lower end; The left Kirschner wire guiding and fixing tube, the right Kirschner wire guiding and fixing tube and the central Kirschner wire guiding and fixing tube of the posterior approach guide frame are used for percutaneous puncture on the bones around the acetabulum.

10. The extracorporeal guiding frame of the intramedullary nail with percutaneous internal fixation and reinforcement around the acetabulum according to claim 1 or 5, characterized in that, When internal fixation is required for the left acetabulum of the patient, the trans-column nail catheter and the anterior column nail catheter are respectively arranged at the inner end and the outer end of the left arc guide plate. When internal fixation is required for the right acetabulum of the patient, the trans-column nail catheter and the anterior column nail catheter are respectively arranged at the inner end and the outer end of the right arc guide plate; The left arc guide plate, the middle plate and the right arc guide plate are respectively provided with at least one left Kirschner wire guiding and fixing tube, at least one central Kirschner wire guiding and fixing tube and at least one right Kirschner wire guiding and fixing tube, which are used for percutaneous puncture on the pelvic bones.

Images