Intramedullary nail aiming system

Abstract

The invention discloses an intramedullary nail aiming system. In the invention, the intramedullary nail aiming system comprises: a handle; a gear lever; an aiming module, the aiming module comprises: a first aiming member, a first guide groove is provided on the first aiming member; the first guide groove has a plurality of first holes arranged along the height direction of the first aiming member; a second aiming member, the first aiming member is located between the gear lever and the second aiming member; a second guide groove is provided on the second aiming member that penetrates along its thickness direction; the second guide groove has a second hole position; when the second aiming member is located at the aiming position, the center of the second hole position is located on the same horizontal line as the center of any first hole position, and the first aiming member and the second aiming member are locked and fixed; a plurality of intramedullary nail locking hole positioning modules, comprising: a drill sleeve; an annular drill; a center guide, the annular drill and the center guide can be rotatably arranged. This reduces the number of intraoperative X-ray fluoroscopy, reduces trauma to the patient, and reduces bone debris residue.

Description

Technical Field

[0001] The invention relates to the technical field of medical instruments, and in particular to an intramedullary nail aiming system. Background Art

[0002] Intramedullary nail treatment is a commonly used internal fixation method for fractures, especially for long bones of the lower limbs such as the femur and tibia. During the installation of the intramedullary nail, the steps of proximal opening, long bone shaft medullary expansion, intramedullary nail implantation, proximal locking nail installation and distal locking nail installation are usually required. The most difficult part of the operation is the installation of the distal locking nail. Due to the difference in the arc shape of the patient's long bones, the distal end of the intramedullary nail will have different degrees of deviation. The most commonly used technique in clinical practice is to use a lateral pressure rod to eliminate the difference in the front and back directions of the intramedullary nail in the medullary cavity to achieve the purpose of aiming. In the existing scheme, the distal aiming arm is all of an integrated design. Once the lateral pressure rod fails to fine-tune the distal end of the intramedullary nail to the predetermined position during the operation, the locking nail installation hole at the distal end of the distal aiming arm and the locking nail hole of the intramedullary nail in the patient's body will not be in a straight line. According to the expected surgical steps, the installation of the distal locking nail will encounter difficulties. At this time, the integrated distal aiming arm used in the existing technology lacks the ability to fine-tune itself, which brings challenges to the surgeon during the operation. In addition, the adjustment mechanism of the lateral support requires an additional lateral hole to be added to the patient's affected limb bone, which is only used to adjust the intramedullary nail in the anterior-posterior position to achieve the aiming function. This lateral hole will cause additional trauma to the patient, and multiple holes in a certain area of ​​the distal femur will increase the risk of secondary fractures in this area. In the existing surgical procedure, after the intramedullary nail aiming arm is installed, the third-level drill sleeve is used as a guide and bluntly inserted into the surgical incision until the bone surface; then the third-level inner core in the center is pulled out, and the drill bit is inserted through the center channel to drill a locking screw. The hole is in a straight line with the intramedullary nail, and finally the locking screw is installed. However, the tool combination during the drilling process is relatively complicated, the operation is inconvenient, and a large amount of bone chips are generated. The bone chips remain in the patient's body, increasing the risk of embolism. Summary of the invention

[0003] The purpose of the present invention is to provide an intramedullary nail aiming system, which can reduce the number of X-ray fluoroscopy during surgery and eliminate the need to add additional positioning holes on the patient's affected limb bones, thereby reducing trauma to the patient; in addition, the surgery is more convenient, bone debris residue can be reduced, and surgical risks can be reduced.

[0004] In order to solve the above technical problems, an embodiment of the present invention provides an intramedullary nail aiming system, comprising:

[0005] handle;

[0006] A gear lever, the gear lever having a distal end and a proximal end; the direction from the distal end to the proximal end of the gear lever is the length direction of the gear lever; the proximal end of the gear lever is connected to the handle;

[0007] A targeting module, the targeting module comprising:

[0008] a first aiming member, wherein the first aiming member is detachably connected to the distal end of the gear lever, and the first aiming member is provided with a first guide groove penetrating along the thickness direction thereof; the first guide groove has a plurality of first holes arranged along the height direction of the first aiming member; the height direction of the first aiming member, the length direction of the gear lever and the thickness direction of the first aiming member are perpendicular to each other; and

[0009] A plurality of second aiming members, wherein the second aiming members are slidably connected to the first aiming member along a height direction of the first aiming member, and the first aiming member is located between the shift lever and the second aiming member; a second guide groove is provided on the second aiming member and penetrates along a thickness direction thereof; and the second guide groove has a second hole position;

[0010] The second aiming member has an initial position and an aiming position; when the second aiming member is at the aiming position, the center of the second hole position is on the same horizontal line as the center of any of the first hole positions, and the first aiming member and the second aiming member are locked and fixed; the heights of the first holes in different aiming modules are different;

[0011] Multiple intramedullary nail lock hole positioning modules, including:

[0012] a drill sleeve having a passage extending therethrough and along its length;

[0013] An annular drill, the annular drill is rotatably connected to the drill sleeve and inserted into the passage, and both ends of the annular drill are located outside the drill sleeve; the annular drill is provided with a through hole, and the through hole extends along the length direction of the annular drill and penetrates the annular drill; the drill sleeve and the annular drill cooperate to form an integral part, and the drill sleeve carries the annular drill for inserting into or removing from the first hole position and / or the second hole position;

[0014] wherein the outer diameters of at least two annular drills in the plurality of intramedullary nail locking hole positioning modules are different;

[0015] A center guide is used to insert into or pull out of the through hole of the annular drill; and after the center guide is inserted into and penetrates the through hole, the annular drill and the center guide can be rotatably arranged.

[0016] Compared with the prior art, the embodiment of the present invention is characterized in that the second aiming member can be adjusted in height due to the setting of the aiming module and the active connection between the second aiming member and the first aiming member. That is to say, after the gear lever and the aiming module are installed, the second aiming member is in the initial position, and a pre-judgment hole is first punched on the bone of the affected limb through the second hole position to form a pre-judgment hole. According to the expected upward or downward direction of the pre-judgment hole and the locking screw hole at the distal end of the intramedullary nail, a suitable first hole position is selected to drill a hole on the bone of the affected limb to form a pre-drilled hole. When the pre-drilled hole is connected to the screw hole on the intramedullary nail, the pre-drilled hole is expanded to form a locking hole, and then the second aiming member is moved to the aiming position, so that the center of the second hole position is on the same horizontal line as the center of the first hole position forming the locking screw hole, thereby realizing the fine adjustment of the distal hole position in the locking of the intramedullary nail, reducing the number of X-ray fluoroscopy during the operation, and no additional positioning holes are added on the bone of the patient's affected limb, reducing trauma to the patient, and reducing the pressure of the doctor's self-adjustment. The annular drill is inserted into the drill sleeve, wherein the annular drill with a small outer diameter cooperates with the drill sleeve to form a pre-drilled hole, and the annular drill with a large outer diameter cooperates with the drill sleeve to expand the hole. The center guide is used to check whether the pre-drilled hole on the bone of the affected limb is on the same axis as the locking hole on the intramedullary nail. The doctor can distinguish it by the touch of the head of the center guide, or by the insertion depth to determine whether the center guide passes through the locking hole on the intramedullary nail. As can be seen from the above, compared with the prior art, the combination of multiple intramedullary nail locking hole positioning modules and center guide drilling requires fewer tool pieces, fewer assembly and use times, and more convenient surgery. In addition, the through hole setting in the annular drill reduces the contact area between the drill bit edge of the annular drill and the bone surface during the drilling process, generates less heat, and reduces burns to soft tissue during the drilling process. In addition, the through hole of the ring drill can accommodate blocky bone fragments and bring them out of the body. The drill bit is now a solid drill. During the hole opening process, the removed bone is broken down into bone fragments and left in the patient's body. The ring drill has fewer bone fragments, which can reduce the risk of embolism during surgery and make the surgery safer.

[0017] In one embodiment, the central axis of the channel of at least one of the drill sleeves in the plurality of intramedullary nail locking hole positioning modules deviates from the central axis of the drill sleeve;

[0018] The central axis of the channel of at least one drill sleeve in the plurality of intramedullary nail locking hole positioning modules is coaxial with the central axis of the drill sleeve.

[0019] In one embodiment, the annular drill is a stainless steel annular drill; the drill sleeve is a plastic drill sleeve; and the center guide is made of nickel-titanium alloy.

[0020] In one embodiment, the distal end of the center guide is a tip portion, and the outermost tip of the tip portion coincides with the side edge of the center guide.

[0021] In one embodiment, a groove is formed on the outer periphery of the central guide, an insert is disposed in the groove, and the insert protrudes out of the groove;

[0022] The outer diameter of the assembly formed by the insert being arranged behind the center guide is smaller than the inner diameter of the annular drill.

[0023] In one embodiment, the embedding component is elastic and is a C-shaped ring.

[0024] In one embodiment, the first guide groove includes a plurality of circular holes, one circular hole forms one first hole position, and the hole centers of the plurality of circular holes are arranged along the height direction of the first aiming member;

[0025] There are a plurality of second holes, which are arranged along the length direction of the gear lever.

[0026] In one embodiment, the first guide groove is in a vertical "8" shape; the second guide groove includes a plurality of circular holes, one circular hole forming one second hole position; and the second guide groove is in a horizontal "∞" shape.

[0027] In one embodiment, the first aiming member is provided with an aiming mark position and an initial mark position, and one aiming mark position corresponds to the center of one first hole position;

[0028] The second aiming member is provided with a pointing mark, and the pointing mark and the center of the second hole are located on the same horizontal line; the pointing mark is used to point to the initial marking position when the second aiming member is located at the initial position, and is also used to point to the aiming marking position when the second aiming member moves to the aiming position;

[0029] When the second aiming member is at the initial position, the distance between the center of the first hole position and the center of the second hole position in each aiming module along the height direction of the first aiming member is the aiming hole distance;

[0030] One aiming module has at least two aiming hole distances; at least two aiming hole distances of at least one aiming module among the plurality of aiming modules are the same; and at least two adjacent aiming hole distances of at least one aiming module among the plurality of aiming modules are different.

[0031] In one embodiment, the distance between two identical aiming holes ranges from 4.5 mm to 5.5 mm; the distance between two adjacent, different aiming holes ranges from 3 mm to 4 mm and 6 mm to 7 mm, respectively.

[0032] In one embodiment, the first aiming member is provided with a plurality of limiting grooves arranged along the height direction of the first aiming member; one of the first hole positions corresponds to one of the limiting grooves, and the area of ​​the first aiming member corresponding to the initial position of the second aiming member has the limiting groove;

[0033] The second aiming member is provided with a slide groove extending along the height direction thereof;

[0034] The aiming module further comprises: a locking member for locking or releasing the first aiming member and the second aiming member;

[0035] The lock comprises:

[0036] A movable rod, which is slidably disposed in the slide groove and is at least partially located outside the second aiming member; an unlocking groove is provided on the movable rod;

[0037] An elastic member, wherein the elastic member is arranged in the slide groove, and one end of the elastic member abuts against the bottom of the movable rod;

[0038] A limiting member, wherein the limiting member is arranged on the second aiming member; the limiting member is used to be embedded in any one of the limiting grooves; when the movable rod slides to the unlocking position, the limiting member is embedded in the unlocking groove, and the second aiming member is unlocked from the first aiming member; when the movable rod slides to the locking position, the limiting member is embedded in the limiting groove and is located outside the unlocking groove and abuts against the side wall of the movable rod, and the second aiming member is locked and fixed to the first aiming member.

[0039] An embodiment of the present invention further provides a method for using the intramedullary nail aiming system as described in any one of the above, wherein the outer diameter of the annular drill used for expanding the hole among the annular drills of the multiple intramedullary nail locking hole positioning modules is greater than the outer diameter of the annular drill used for drilling;

[0040] The specific method of use includes the following steps:

[0041] Inserting the intramedullary nail locking hole positioning module equipped with the central guide into a second hole position, and controlling the annular drill to drill a hole on the target object to form a predicted hole;

[0042] Extracting the center guide inserted into the second hole;

[0043] Inserting the intramedullary nail locking hole positioning module equipped with the central guide into a first hole position, and controlling the ring drill to drill a hole on the target object to form a pre-drilled hole;

[0044] Pull out the intramedullary nail locking hole positioning module inserted into the first hole, and use the center guide to explore the hole;

[0045] Determine whether to replace the aiming module of another model according to the drilling condition of the center guide;

[0046] If necessary, replace the aiming module with another model;

[0047] Inserting the intramedullary nail locking hole positioning module installed with the central guide into the first hole position and the second hole position of the newly replaced aiming module respectively, wherein the first hole position is the intramedullary nail locking hole positioning module for expanding the hole;

[0048] Controlling the annular drill of the intramedullary nail locking hole positioning module in the first hole position to expand the pre-drilled hole to form a locking hole;

[0049] If it is not necessary, the aiming module is not replaced;

[0050] Replacing the intramedullary nail locking hole positioning module for expanding the hole in the first hole position;

[0051] Control the annular drill of the newly replaced intramedullary nail locking hole positioning module to expand the pre-drilled hole to form a locking hole;

[0052] Pull out the intramedullary nail lock hole positioning module in the second hole position;

[0053] Adjust the second aiming member so that the center line of the second hole is on the same horizontal line as the center of the first hole through which the intramedullary nail locking hole positioning module has been inserted;

[0054] An intramedullary nail locking hole positioning module for hole expansion is inserted into the second hole position, and the predicted hole is expanded.

[0055] In one embodiment, the distal end of the central guide is a tip portion, and the outermost tip of the tip portion coincides with the side edge of the central guide;

[0056] The steps of the center guide hole detection and determining whether it is necessary to replace the aiming module of another model include the following steps:

[0057] Controlling the tip of the central guide to detect toward the target object;

[0058] If the tip of the center guide passes through the locking pin hole of the target object, there is no need to replace the aiming module of other models;

[0059] If the tip of the center guide does not pass through the locking nail hole of the target object;

[0060] After rotating the center guide by a preset angle, the tip of the center guide is controlled to detect the target object again;

[0061] If the tip of the rotated center guide passes through the locking nail hole of the target object, it is not necessary to replace other types of aiming modules, and other types of intramedullary nail locking hole positioning modules are replaced to expand the hole, and the central axis of the channel of the drill sleeve of the intramedullary nail locking hole positioning module deviates from the central axis of the drill sleeve;

[0062] If the tip of the rotated center guide does not pass through the locking pin hole of the target object, replace the aiming module with another model. BRIEF DESCRIPTION OF THE DRAWINGS

[0063] One or more embodiments are exemplarily described by pictures in the corresponding drawings, and these exemplified descriptions do not constitute limitations on the embodiments. Elements with the same reference numerals in the drawings represent similar elements, and unless otherwise stated, the figures in the drawings do not constitute proportional limitations.

[0064] Figure 1 is a schematic structural diagram of an intramedullary nail locking hole positioning module according to an embodiment of the present invention;

[0065] Figure 2 is an exploded view of an intramedullary nail locking hole positioning module according to an embodiment of the present invention;

[0066] Figure 3 is a structural schematic diagram of an intramedullary nail lock hole positioning module in which the central axis of the channel deviates from the central axis of the drill sleeve according to an embodiment of the present invention;

[0067] Figure 4 yes Figure 3 The middle end face shows the structural diagram of the drill bit of the annular drill;

[0068] Figure 5 is a schematic structural diagram of a center guide according to an embodiment of the present invention;

[0069] Figure 6 yes Figure 5 A partial enlarged view of middle A;

[0070] Figure 7 yes Figure 5 A partial enlarged view of B in the middle;

[0071] Figure 8 It is a structural schematic diagram of an intramedullary nail aimer, a bone of an affected limb, and a central guide cooperating with an intramedullary nail locking hole positioning module to insert into a second hole according to an embodiment of the present invention;

[0072] Fig. 9 is a schematic structural diagram of an intramedullary nail aiming arm according to an embodiment of the present invention;

[0073] Fig.10 is a schematic structural diagram of a second aiming member located at an aiming position according to an embodiment of the present invention;

[0074] Fig.11 is a schematic structural diagram of a second aiming member in an initial position according to an embodiment of the present invention;

[0075] Fig.12 is a structural schematic diagram of another aiming module according to an embodiment of the present invention where a second aiming member is in an initial position;

[0076] Fig.13is a cross-sectional view of an aiming module connected to a gear lever according to an embodiment of the present invention;

[0077] Fig.14 is a schematic structural diagram of a central guide being pulled out from a second hole according to an embodiment of the present invention;

[0078] Fig.15 It is a structural schematic diagram of an intramedullary nail aimer, a bone of an affected limb, and a central guide cooperating with an intramedullary nail locking hole positioning module inserted into a first hole according to an embodiment of the present invention;

[0079] Fig.16 is a schematic structural diagram of a central guide being pulled out from a first hole according to an embodiment of the present invention;

[0080] Fig.17 It is a schematic diagram of a position of a pre-drilled hole and a locking nail hole on an intramedullary nail according to an embodiment of the present invention;

[0081] Fig.18 is a schematic diagram of another position of a pre-drilled hole and a locking nail hole on an intramedullary nail according to an embodiment of the present invention;

[0082] Fig.19 is a schematic diagram of another position of the pre-drilled hole and the locking nail hole on the intramedullary nail according to one embodiment of the present invention;

[0083] Among them, 100, intramedullary nail aiming arm; 1, gear lever; 11, hole position; 2, aiming module; 700, handle; 21, first aiming member; 22, second aiming member; 210, first guide groove; 211, first hole position; 220, second guide groove; 221, second hole position; 212, aiming mark position; 213, initial mark position; 222, pointing mark; 30, locking connector; 3, locking member; 31. movable rod; 310. unlocking slot; 32. elastic member; 33. limiting member; 214. limiting slot; 500. intramedullary nail; 4. aiming module; 411. first hole position; 421. second hole position; 600. intramedullary nail locking hole positioning module; 6. drill sleeve; 60. bearing; 61. channel; 7. annular drill; 71. through hole; 8. center guide; 81. tip; 82. embedded member; 400. affected limb bone; 410. pre-drilled hole; 510. locking nail hole. DETAILED DESCRIPTION

[0084] In order to make the purpose, technical scheme and advantages of the embodiments of the present invention clearer, the following will be described in detail with reference to the accompanying drawings. However, it will be appreciated by those skilled in the art that in the various embodiments of the present invention, many technical details are provided in order to enable the reader to better understand the present application. However, even without these technical details and various changes and modifications based on the following embodiments, the technical scheme claimed in the present application can be implemented.

[0085] In the following description, certain specific details are set forth for the purpose of illustrating various disclosed embodiments to provide a thorough understanding of the various disclosed embodiments. However, those skilled in the relevant art will recognize that the embodiments may be practiced without one or more of these specific details. In other cases, well-known devices, structures, and techniques associated with the present application may not be shown or described in detail to avoid unnecessarily obscuring the description of the embodiments.

[0086] Unless the context requires otherwise, throughout the specification and claims, the word "comprise" and variations such as "include" and "have" should be construed in an open, inclusive sense, ie, should be interpreted as "including, but not limited to."

[0087] The following will be described in detail with reference to the accompanying drawings to provide a clearer understanding of the purpose, features and advantages of the present invention. It should be understood that the embodiments shown in the accompanying drawings are not intended to limit the scope of the present invention, but are only intended to illustrate the essential spirit of the technical solution of the present invention.

[0088] References throughout the specification to "one embodiment" or "an embodiment" indicate that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, the appearances of "in one embodiment" or "in an embodiment" in various places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any manner in one or more embodiments.

[0089] As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. It should be noted that the term "or" is generally employed in its sense including "and / or" unless the context clearly dictates otherwise.

[0090] In the following description, in order to clearly show the structure and working mode of the present invention, many directional words will be used for description, but the words "front", "back", "left", "right", "outside", "inside", "outward", "inward", "up", "down", etc. should be understood as convenient terms and should not be understood as restrictive terms.

[0091] Embodiments of the present invention are described below with reference to the accompanying drawings.

[0092] The first embodiment of the present invention relates to an intramedullary nail aiming system. Figure 8 As shown, the intramedullary nail aiming system comprises a handle 700, a shift lever 1, a plurality of aiming modules, a plurality of intramedullary nail locking hole positioning modules 600 and a central guide 8. The shift lever and the aiming module form an intramedullary nail aiming arm 100.

[0093] like Figure 8 , Fig. 9 and Fig.10 As shown, the gear lever 1 is made of stainless steel or carbon fiber material. The gear lever 1 has a plurality of holes 11 arranged along its length direction, which correspond to the intramedullary nails of different length specifications. The gear lever 1 has a distal end and a proximal end. The proximal end is connected to the handle 700, and the distal end is connected to the aiming module 2. The direction from the distal end to the proximal end of the gear lever 1 is the length direction of the gear lever 1. The aiming module 2 includes: a first aiming member 21 and a second aiming member 22. The first aiming member 21 is connected to the distal end of the gear lever 1, and the first aiming member 21 is provided with a first guide groove 210 that penetrates along its thickness direction. The first guide groove 210 has a plurality of first holes 211 arranged along the height direction of the first aiming member 21. The height direction of the first aiming member 21, the length direction of the gear lever 1, and the thickness direction of the first aiming member 21 are perpendicular to each other. The thickness direction, i.e. Fig. 9 The direction of the arrow Z in the middle is the height direction. Fig. 9 The direction of the arrow Y, length direction Fig. 9The direction of the arrow X in the middle. The second aiming member 22 is slidably connected to the first aiming member 21 along the height direction of the first aiming member 21, and the first aiming member 21 is located between the gear lever 1 and the second aiming member 22. The second aiming member 22 is provided with a second guide groove 220 that penetrates along the thickness direction thereof, and the second guide groove 220 has a second hole position 221. The second aiming member 22 has an initial position and an aiming position. When the second aiming member 22 is located at the aiming position, the center of the second hole position 221 is located on the same horizontal line as the center of any first hole position 211, and the first aiming member 21 and the second aiming member 22 are locked and fixed. Since the aiming module 2 is provided and the second aiming member 22 is movably connected to the first aiming member 21, the height of the second aiming member 22 can be adjusted. That is to say, after the shift lever and the aiming module are installed, the second aiming member 22 is in the initial position, and the intramedullary nail locking hole positioning module is first used to drill a hole in the bone of the affected limb through the second hole position 221 to form a pre-judged hole. According to the expected upward or downward direction of the pre-judged hole and the locking nail hole 510 at the distal end of the intramedullary nail 500, a suitable first hole position 211 is selected to drill a hole in the bone of the affected limb to form a pre-drilled hole. When the pre-drilled hole is connected to the screw hole on the intramedullary nail 500, the pre-drilled hole is expanded to form a locking hole, and then the second aiming member 22 is moved to the aiming position so that the center of the second hole position 221 is on the same horizontal line as the center of the first hole position 211 forming the locking hole, thereby realizing fine-tuning of the distal hole position in the locking of the intramedullary nail 500, reducing the number of X-ray fluoroscopy during surgery, and without adding additional positioning holes on the bone of the patient's affected limb, reducing trauma to the patient, and reducing the pressure on the doctor to make independent fine-tuning.

[0094] like Figure 1 and Figure 2 As shown, the intramedullary nail lock hole positioning module 600 includes: a drill sleeve 6 and an annular drill 7, and the drill sleeve 6 has a channel 61 that runs through it and extends along its length direction. The annular drill 7 is rotatably connected to the drill sleeve 6 and inserted into the channel 61, and the two ends of the annular drill 7 are located outside the drill sleeve 6. The annular drill 7 is provided with a through hole 71, and the through hole 71 extends along the length direction of the annular drill 7 and runs through the annular drill 7. By providing the drill sleeve 6 and the annular drill 7, the annular drill 7 and the drill sleeve 6 are used together, and when the annular drill 7 drills a hole, since the annular drill 7 has the through hole 71, during the drilling process, the drill bit edge of the annular drill 7 has a smaller contact area with the bone surface, generates less heat, and reduces the burns to the soft tissue during the drilling process. In addition, the through hole 71 of the annular drill 7 can accommodate block-shaped bone fragments and take them out of the body, while the drill bit is a solid drill, and during the drilling process, the removed bone mass is destroyed into bone fragments and left in the patient's body. The fewer bone fragments provided by the annular drill 7 can reduce the risk of embolism during surgery, and the surgery is safer. like Figure 5 , Figure 8As shown, the outer diameters of at least two annular drills 7 in the plurality of intramedullary nail locking hole positioning modules 600 are different, that is, the number of intramedullary nail locking hole positioning devices can be greater than 3, wherein two annular drills 7 have the same outer diameter, and two have different outer diameters, and the number is either greater than 3 or 2. The outer diameter size of the annular drill 7 is planned according to the demand, and the center guide 8 is used to insert through or pull out of the through hole 71 of the annular drill 7, and after the center guide 8 is inserted through the through hole 71, the annular drill 7 and the center guide 8 can be rotatably arranged. Each annular drill 7 is matched and inserted into the drill sleeve 6, wherein the annular drill 7 with a small outer diameter cooperates with the drill sleeve 6 to form a pre-drilled hole 410, and the annular drill 7 with a large outer diameter cooperates with the drill sleeve 6 to expand the hole. The center guide 8 is used to check whether the pre-drilled hole 410 on the affected limb bone 400 is on the same axis as the locking hole 510 on the intramedullary nail 500. The doctor can distinguish it by the touch of the head of the center guide 8, or by the insertion depth. There may be a scale ring on the center guide 8, and the insertion depth of the center guide 8 can be compared with the length of the ring drill 7 to determine whether the center guide 8 has passed through the locking hole 510 on the intramedullary nail 500.

[0095] Specifically, the central guide 8 is made of metal, preferably nickel-titanium alloy, which has good wear resistance and a diameter of 1.9-2.5 mm, which is slightly smaller than the inner diameter of the annular drill 7 used for hole expansion. When judging whether the pre-drilled hole 410 on the affected limb bone 400 is on the same axis as the locking nail hole 510 on the intramedullary nail 500, the doctor can distinguish it by the touch of the head of the central guide 8. There is a difference in the feeling of metal touching metal and metal touching cortical bone.

[0096] The central axis of the channel 61 of at least one drill sleeve 6 in the multiple intramedullary nail locking hole positioning modules 600 deviates from the central axis of the drill sleeve 6, and the central axis of the channel 61 of at least one drill sleeve 6 in the multiple intramedullary nail locking hole positioning modules 600 is coaxial with the central axis of the drill sleeve 6. When pre-drilling the locking hole, the ring drill can be used to fine-tune the hole position, which has the opportunity to reduce the number of times the aiming frame is used for adjustment, optimize from the details, and improve the surgical efficiency. In the prior art, the fine-tuning operation of the aiming frame is relatively cumbersome, and the eccentric ring drill only needs to be rotated to achieve position fine-tuning.

[0097] Furthermore, the annular drill 7 is a stainless steel annular drill, and the drill sleeve 6 is a plastic drill sleeve.

[0098] Furthermore, if Figure 1 , Figure 2As shown, bearings 60 are embedded at both ends of the drill sleeve 6, and the bearings 60 are sleeved outside the annular drill 7. The annular drill 7 is rotatably connected to the drill sleeve 6 through the bearings 60. One end of the annular drill 7 is outside the drill sleeve 6 for connecting the driving member, and the other end of the annular drill 7 is outside the drill sleeve 6 for drilling or expanding the hole. In orthopedic trauma surgery, most of them are open surgeries, and the surgical power does not include a water circulation system and has no cooling function. The overall structure of the bearing is set between the annular drill and the drill sleeve, which can effectively solve the disadvantage of frictional heating between the annular drill and the drill sleeve.

[0099] In addition, the drill sleeve 6 and the annular drill 7 cooperate to form an integral part. When in use, the matched drill sleeve 6 and the annular drill 7 can be inserted into the surgical incision together according to needs until the bone surface. The intramedullary nail lock hole positioning module is used in conjunction with the intramedullary nail aiming arm, and there is no need to install a multi-stage guide sleeve, which saves the doctor operation steps and thus saves operation time. And in use, according to the hole position that needs to be drilled, different models of intramedullary nail lock hole positioning modules can be directly replaced. By using the intramedullary nail lock hole positioning module to fine-tune the hole position, there is an opportunity to reduce the number of adjustments to the intramedullary nail aiming arm, optimize from the details, and improve the surgical efficiency. The fine-tuning operation of the intramedullary nail aiming arm in existing surgery is relatively cumbersome.

[0100] In addition, the outer diameter of the annular drill 7 ranges from 2 mm to 4.5 mm, and the outer diameter of the drill sleeve 6 ranges from 9 mm to 11 mm. The outer diameter of the annular drill 7 is designed to have multiple specifications, such as a diameter of 2 mm to 2.5 mm, which is used as a specification for the pre-drilled hole 410; a diameter of 3 mm to 3.5 mm, which is used as a bottom hole for a 4.5 mm locking screw; and a diameter of 4 mm to 4.5 mm, which is used as a bottom hole for a 5.0 mm locking screw.

[0101] In addition, if Figure 6As shown, the distal end of the center guide 8 is a tip portion 81, the outermost tip of the tip portion 81 coincides with the side edge of the center guide 8, and the tip portion 81 is not arranged at the center position. The center guide 8 is used as a hole position "probe". Specifically, the pre-drilled hole 410 made on the affected limb bone 400, the pre-drilled hole 410 and the locking nail hole 510 on the intramedullary nail 500 inserted into the medullary cavity are usually not in the ideal position, and there is a certain deviation. The center guide 8 cannot be smoothly inserted into the locking nail hole 510 on the intramedullary nail 500. At this time, you can try to rotate the center guide 8, and use its eccentric tip 81 to design and explore the position of the overlapping area of ​​the two holes. After the tip 81 is inserted, the center guide 8 is inserted to the expected depth. During the insertion process, the friction between the center guide 8 and the locking nail hole wall on the intramedullary nail can be felt; then the currently used annular drill 7 is replaced with an eccentric annular drill 7 and the hole is expanded. According to the rotation direction of the center guide 8, the placement direction of the eccentric annular drill 7 is determined, so that the drilling deviation can be corrected by the center guide 8. Preferably, when the position deviation between the pre-drilled hole 410 and the locking nail hole 510 on the intramedullary nail 500 inserted into the medullary cavity is within 2 mm, the eccentric tip 81 is inserted to play a certain prying role, and with the help of the eccentric ring drill 7, the drilling hole is corrected by 1-1.5 mm.

[0102] Furthermore, if Figure 6 As shown, the angle a of the tip portion 81 ranges from 30° to 45°. Optionally, the angle a of the tip portion 81 is 35°, 40° or 42°. The end of the center guide 8 away from the tip portion 81 has a tip indicator, so that at least the tip portion 81 can be oriented, such as the tail section of the center guide 8 (the end away from the tip portion 81) is "D" shaped.

[0103] In addition, if Figure 7 As shown, the outer periphery of the center guide 8 is provided with a groove, and an insert 82 is arranged in the groove, and the insert 82 protrudes out of the groove. The outer diameter of the assembly formed by the insert 82 after the center guide 8 is arranged is smaller than the inner diameter of the annular drill 7.

[0104] Furthermore, if Figure 5 , Figure 7As shown, the insert 82 is elastic and is a C-shaped ring. Specifically, grooves are designed in the head 1 / 3 area, the middle and the tail 1 / 3 area of ​​the center guide 8, and the insert 82 is installed in the groove. The insert 82 has a certain elasticity, and the outer diameter in the free state is slightly larger than the center guide 8. When squeezed and contracted, it can be basically accommodated in the groove. When the insert 82 is tightened, the outer diameter is slightly smaller than the center hole diameter of the annular drill 7. Its function is to help the center guide 8 and the annular drill 7 to achieve better relative rotation. In particular, when the straightness of the center guide 8 is lost, the annular drill 7 can still rotate around the center guide 8. With the help of the insert 82, the contact area between the center guide 8 and the wall of the through hole 71 of the annular drill 7 is reduced, and the friction resistance during the rotation process is reduced. It can be understood that the grooves can also be set in other areas of the center guide 8, and the number can be one or more.

[0105] When using the intramedullary nail locking hole positioning device composed of the intramedullary nail locking hole positioning module 600 and the center guide 8, take the first hole position 211 as an example, step 1: pre-drilling 410, preferentially use the intramedullary nail locking hole positioning module 600 (the head diameter of the ring drill 7 is 2.5mm) and the center guide 8 to drill through the first hole position, and select a smaller diameter for the ring drill 7 to avoid the pre-drilling 410 from deviating from the ideal position, so as to reserve enough bone for subsequent position correction. Step 2, exploration; Scenario 1, after pulling out the ring drill 7 used in step 1, use the center guide 8 to explore the hole, which is similar to the role of an orthopedic "probe"; such as Fig.17 , Fig.18 , Fig.19 As shown, the small circle indicates the pre-drilled hole 410 made in the affected limb bone 400 in step 1, and the outer large circle indicates the locking nail hole 510 on the intramedullary nail 500 inserted into the medullary cavity. During the operation, the centers of the two holes are usually not in the ideal position, and there is a certain deviation, such as Fig.17 In the eccentricity case 1, the deviation between the center of the two holes is less than 1-1.25mm, and the center guide 8 can be inserted smoothly. In this case, a standard annular drill 7 with a larger diameter (3-3.5mm or 4-4.5mm) is used to expand the hole, and the locking screw can be installed smoothly. Fig.18 In another scenario 2, step 3 is performed: after pulling out the ring drill 7 used in step 1, the center guide 8 is used to perform exploration, which is similar to the role of an orthopedic "probe"; Fig.18The small circle shown is a pre-drilled hole 410 made in the affected limb bone 400 in step 1, and the outer large circle is a locking nail hole 510 on the intramedullary nail 500 inserted into the medullary cavity. During the operation, the centers of the two holes are usually not in the ideal position and there is a certain deviation. When the eccentric situation 2 shown in the figure occurs, the deviation between the centers of the two holes is greater than 1-1.25mm, and the overlapping area of ​​the two holes is smaller than the diameter of the pre-drilled hole 410 and the outer diameter of the center guide 8. The center guide 8 cannot be used to smoothly penetrate the intramedullary nail. The locking nail hole 510 (large circle) on the intramedullary nail 500 can be rotated. The eccentric tip 81 can be used to detect the position of the overlapping area of ​​the two holes. After the tip 81 is inserted, the center guide 8 is inserted to the expected depth. During the insertion process, the friction between the center guide 8 and the wall of the (large circle) locking nail hole 510 on the intramedullary nail 500 can be felt. However, if the locking nail hole 510 on the intramedullary nail 500 still cannot be penetrated after selecting the tip 81, replace the aiming module and explore the hole again. Step 4: Ream the hole; When encountering situation 2 in step 3, an eccentric annular drill 7 needs to be selected for hole expansion. During operation, the placement direction of the eccentric annular drill 7 needs to be determined according to the rotation direction of the center guide 8. The tail section of the center guide 8 is "D"-shaped, which can help determine the rotation position of the center guide 8; when expanding the hole, the center guide 8 can be selectively pulled out, that is, the center guide 8 is pulled out first, and then the eccentric annular drill 7 is used for hole expansion, or the eccentric annular drill 7 is passed through the center guide 8 to complete the hole expansion. The dimensions in the above steps can be replaced according to actual needs, but are not limited to this. In addition, the extraction or insertion of the annular drill 7 is used together with the drill sleeve 6 matching each annular drill 7.

[0106] Furthermore, the first guide groove 210 includes a plurality of circular holes, one circular hole forms a first hole position 211 , and the hole centers of the plurality of circular holes are arranged along the height direction of the first aiming member 21 .

[0107] Furthermore, the first guide groove 210 is in a vertical "8" shape. Fig.11 In the embodiment, two adjacent circular holes are connected, and in another embodiment, the two circular holes may not be connected.

[0108] In addition, if Fig.11 As shown, the distance between the centers of two adjacent first hole positions 211 ranges from 9 mm to 11 mm, and optionally, the distance between the centers of two adjacent first hole positions 211 can be 10 mm, etc. Therefore, if a first hole position 211 is selected and is not suitable for drilling a hole in the affected limb bone, another suitable first hole position 211 is selected to drill and expand the hole in the affected limb bone, and the hole formed can be expanded to the hole drilled on the affected limb bone for the first time, without causing excessive damage to the affected limb bone.

[0109] Further, the diameter of the circular hole in the first guide groove 210 ranges from 7 mm to 11 mm. Optionally, the distance between the centers of two adjacent first hole positions 211 may be 8 mm or 10 mm.

[0110] In addition, if Fig. 9 and Fig.11 As shown, there are multiple second holes 221 , which are arranged along the length direction of the shift lever 1 .

[0111] Furthermore, if Fig. 9 and Fig.11 As shown, the second guide groove 220 includes a plurality of circular holes, and one circular hole forms a second hole position 221. The second guide groove 220 is in the shape of a horizontal "∞". The second aiming piece is provided with a horizontal "∞" hole to support the requirement of using two holes at the same time, that is, when using the second guide groove 220, the second hole position on one side is used as a reference hole, and the second hole position on the other side can be directly used as a locking screw installation hole when fine-tuning is not required. Finally, the locking screw installation and positioning reference holes are separated to avoid secondary expansion of the reference hole and increase the risk of fracture in the punching area. Specifically, the clinical requirement is that the distal locking screw installation hole of the intramedullary nail is a long slot keyway hole. During the initial surgery, the locking screw is preferentially installed at a position on the remote side of the keyway to prevent delayed bone healing in patients after surgery. The locking screw needs to have a certain sliding gap in the keyway to achieve secondary pressurization and promote bone healing. During surgery, the pre-drilled reference hole is preferentially punched on the other side of the keyway hole, that is, when using Fig.14 The first hole on the right side of the middle horizontal "∞" hole structure is used to fine-tune the aiming module according to the position of the reference hole. After the fine-tuning is completed, the second hole near the outer side (far end) is used to drill the locking nail installation hole through the horizontal "∞" hole structure, that is, Fig.14 The leftmost second hole position is independent of each other. When the patient is standing, the second holes are not on the same horizontal plane, which minimizes the loss of bone strength. However, the existing second hole position generally has only one single hole, and the pre-drilled reference hole position and the final locking screw installation hole are not effectively separated.

[0112] In addition, if Fig. 9 , Fig.10 and Fig.11 As shown, the first aiming member 21 is provided with an aiming mark position 212 and an initial mark position 213, and one aiming mark position 212 corresponds to the center of one first hole position 211. The aiming mark position 212 and the initial mark position 213 can be scale lines, and the second aiming member 22 is provided with a pointing mark 222, and the pointing mark 222 can be "△", and the pointing mark 222 and the center of the second hole position 221 are located on the same horizontal line, and the pointing mark 222 is used to point to the initial mark position 213 when the second aiming member 22 is located at the initial position, and is also used to point to the aiming mark position 212 when the second aiming member 22 moves to the aiming position.

[0113] Specifically, Fig.11 For example, the center line of the horizontal "∞" hole is marked with "△", and the symmetric center of the module where the vertical "8" hole is located and the center line of the two circular holes are provided with corresponding scale lines, that is, three scale lines, wherein the scale line of the symmetric center of the module where the vertical "8" hole is located is the initial marking position 213, and the scale lines corresponding to the center lines of the two circular holes are the aiming marking positions 212. In this embodiment, the symmetric center of the module where the vertical "8" hole is located may be the center of the vertical "8" hole. In another embodiment, the vertical "8" hole is above the center of the module where it is located, and at this time, the symmetric center of the module where the vertical "8" hole is located is not on the same horizontal line as the center of the vertical "8" hole. Of course, the scale line as the initial marking position 213 may also not be at the symmetric center of the module where the vertical "8" hole is located. The positions where "△" is aligned with the three scale lines are three positions that support immediate locking. When "△" is aligned with the scale lines on both sides, the positional relationship between the two groups of holes is: the center line of the horizontal "∞" hole and the center of the vertical "8" hole are on the same straight line. In use, when the gear lever, handle, and aiming module are installed on the patient's affected limb bone 400, the second aiming piece 22 is located in the initial position in the initial state, that is, the pointing mark 222 is aligned with the initial mark position 213. Follow the steps below. The first step is to drill a hole in the horizontal "∞" hole at the end of the second aiming piece 22. This hole is a pre-judgment hole. Take an X-ray along the sagittal position of the affected limb to check whether the locking nail hole 510 at the distal end of the intramedullary nail 500 is in the expected upper or lower direction; the second step is to select a first hole position 211 in the first aiming piece 21, and first use the annular drill 7 with a drill bit of 2.5 mm in the intramedullary nail locking hole positioning module 600 in cooperation with the drill sleeve 6 to pass through the first hole position 211 and drill in the patient's affected limb bone 400. After the pre-drilled hole 410 is formed and the center guide 8 is checked to pass smoothly through the screw hole on the intramedullary nail 500, the annular drill 7 and the drill sleeve 6 forming the pre-drilled hole 410 are removed, and the large-diameter annular drill 7 and the drill sleeve 6 are inserted to expand the hole to the expected diameter of 4-4.5 mm, and the installation of the locking screw in the vertical "8" hole is completed; the third step is to adjust the center line of the horizontal "∞" hole at the distal end of the second aiming member 22 and the center of the first hole position 211 drilled by the drill bit in the second step to be on the same straight line, such as Figure 3 In the state of the telescope, the second locking screw at the far end is installed according to the steps of pre-drilling 410, expanding the hole, and finally installing the locking screw. In this case, there is no need to use multiple aiming modules, and one aiming module meets the use requirements.

[0114] Furthermore, if Fig.13As shown, the first aiming member 21 is detachably connected to the gear lever 1. Specifically, a dovetail groove can be provided at the distal end of the gear lever 1, and a dovetail groove protrusion structure is provided on the first aiming member 21, which can be inserted into the groove and locked by a locking connector to facilitate detachable connection. It can be understood that the detachable connection structure is not limited to this, and other structures are also possible. In other embodiments, the first aiming member 21 can also be fixedly connected to the gear lever 1, and the two are an integral part and cannot be detached.

[0115] like Fig.13 As shown, in order to quickly adjust the height of the second aiming member 22 and fix the second aiming member 22 to the first aiming member 21, the aiming module 2 also includes: a lock 3 for locking or releasing the first aiming member 21 and the second aiming member 22. The first aiming member 21 is provided with a plurality of limit grooves 214 arranged along the height direction of the first aiming member 21, one first hole position 211 corresponds to one limit groove 214, and the area of ​​the first aiming member 21 corresponding to the initial position of the second aiming member 22 has a limit groove 214. The second aiming member 22 is provided with a slide groove extending along its height direction. The lock 3 includes: a movable rod 31, an elastic member 32 and a limit member 33. The movable rod 31 is slidably arranged in the slide groove, and at least partially located outside the second aiming member 22. An unlocking groove 310 is provided on the movable rod 31. The elastic member 32 is arranged in the slide groove, and one end of the elastic member 32 is against the bottom of the movable rod 31. The limit member 33 is arranged on the second aiming member 22, and the limit member 33 is used to be embedded in any one of the limit slots 214. When the movable rod 31 is pressed to slide to the unlocking position, the limit member 33 is aligned with the unlocking slot 310, and the second aiming member 22 can be moved at this time, and the second aiming member 22 drives the limit member 33 to move, and the side wall of the first aiming member pushes the limit member 33 to enter more into the unlocking slot, and the second aiming member 22 is unlocked from the first aiming member 21. When the second aiming member 22 drives the limit member to move into place, the limit member 33 is aligned with the appropriate limit slot 214, and the movable rod 31 is released. The movable rod 31 is pushed by the elastic member 32 to slide to the locking position, and the limit member 33 is pushed by the movable rod 31 to be embedded in the limit slot 214 and is located outside the unlocking slot 310 and abuts against the side wall of the movable rod 31, and the second aiming member 22 is locked and fixed with the first aiming member 21. Specifically, in this embodiment, if Fig.13There are three middle limiting grooves 214, which correspond to the centers of the two second hole positions 221 and the symmetric center of the module where the vertical "8" hole is located (the symmetric center of the first aiming member 21). When the second aiming member 22 is located at the initial position and is positioned and fixed with the first aiming member 21, the second aiming member 22 aligns the limiting member 33 with the limiting groove 214 at the symmetric center of the first aiming member 21, and the side wall of the movable rod 31 pushes the limiting member 33 to be inserted into the limiting groove 214. In this state, the second aiming member 22 is located at the initial position and is locked with the first aiming member 21. When unlocking is required, press the movable rod 31 to align the limiting member 33 with the unlocking groove 310, and slightly move the second aiming member 22. The limiting member 33 is pushed into the unlocking groove by the side wall of the first aiming member, so that the first aiming member 21 and the second aiming member 22 can move flexibly, and move the second aiming member 22 to the position to be moved. Release the movable rod 31, and the elastic member 32 can be a spring or a spring sheet to push the movable rod 31 to let the limit member 33 slide out of the unlocking groove 310, and the freedom of the first aiming member 21 and the second aiming member 22 in the sliding direction is limited, so that locking is achieved. In order to facilitate, the limit member 33 is a spherical member as a whole or the surface inserted into the unlocking groove 310 and the limit groove 214 is a rounded surface. Through this structural design, the first aiming member 21 and the second aiming member 22 can be locked, which is convenient for operation. In addition, in order to facilitate the sliding of the second aiming member 22 relative to the first aiming member 21, a notch is set at the far end of the first aiming member 21, and a protruding block is set at the proximal end of the second aiming member 22 embedded in the notch. The matching sliding structure of the first aiming member 21 and the second aiming member 22 can be a dovetail groove structure, which is the same as the matching structure of the first aiming member 21 and the gear lever 1. Through the cooperation of the movable rod and the elastic member, the movable rod is pressed to achieve unlocking, and the movable rod is released to achieve locking. The overall adjustment structure is simple and convenient, and the operation time is reduced.

[0116] The locking connector 30 for locking the first aiming member 21 and the shift lever 1 is substantially the same in structure as the locking member 3 for locking the first aiming member 21 and the second aiming member 22. Unlocking is achieved by pressing, thereby facilitating disassembly and saving surgical time. The locking of the first aiming member 21 and the shift lever 1 has only one shift position, and a limit groove is provided on the shift lever 1. The structures of other movable rods, elastic members and limit members are the same as those described above and will not be elaborated on herein.

[0117] In other embodiments, the instant locking structure between the first aiming member and the second aiming member, and between the first aiming member and the shift lever may be of other types, or the module where the movable lever is located may be different from that in the present embodiment.

[0118] Furthermore, the aiming module has multiple aiming modules, and the heights of the first holes in different aiming modules are different. When multiple aiming modules are set, when the first hole is locked with the distal hole of the intramedullary nail during surgery, if the first hole on one aiming module does not correspond to the distal hole of the intramedullary nail, another type of aiming module can be immediately replaced. It is only necessary to exchange the modules in a certain order, and the learning curve is short, so as to shorten the operation time and reduce the risk of wound infection.

[0119] Further, when the second aiming member 22 is at the initial position, the distance between the center of the first hole position 211 and the center of the second hole position 221 in each aiming module along the height direction of the first aiming member 21 is the aiming hole distance. One aiming module has at least two aiming hole distances, and at least two aiming hole distances of at least one aiming module in the plurality of aiming modules are the same. Two adjacent aiming hole distances of at least one aiming module in the plurality of aiming modules are not the same. Specifically, taking two interchangeable aiming modules as an example, Fig.11 As shown, the aiming hole distances h1 and h2 in an aiming module 2 are the same, both being 4.5 mm; Fig.12 As shown, the aiming hole distances h3 and h4 in another aiming module 4 are different, which are 3 mm and 6 mm respectively. At this time, in the aiming module of the same size, the first guide groove 210 has the same shape and size but the position height in the aiming module is different. In use, the aiming module 2 with an aiming hole distance of 4.5 mm can be used first, and the following steps are followed. In the first step, the aiming module 2 with an aiming hole distance of 4.5 mm is installed on the gear lever 1, and a hole is drilled in the horizontal "∞" hole at the end of the second aiming member 22. This hole is a pre-judgment hole. An X-ray is taken along the sagittal position of the affected limb to check whether the locking hole at the distal end of the intramedullary nail 500 is in the expected upward or downward direction; in the second step, a first hole position 211 is selected in the first aiming member 21, and the ring drill 7 with a drill bit of 2.5 mm and the drill sleeve 6 in the intramedullary nail locking hole positioning module 600 are used. Cooperate with the center guide 8 to pass through the first hole 211 to drill a hole in the patient's affected limb bone 400 to form a pre-drilled hole 410, and check whether the center guide 8 passes through the screw hole on the intramedullary nail 500 smoothly. If it passes through smoothly, there is no need to change another aiming module 4, but follow the aiming module usage steps described above. However, if it does not pass through the screw hole on the intramedullary nail 500, it is necessary to activate another model of aiming module at this time, and use its aiming hole distance to achieve fine adjustment, press the locking connector, unlock the combination of the aiming module and the gear lever 1 with an aiming hole distance of 4.5 mm, and Fig.12Another aiming module 4 is quickly connected to the shift lever 1 in the same way, and the locking connector is released to form a new position relationship. At this time, the use of the first hole position 411 and the second hole position 421 on the aiming module 4 directly jumps to the second step (the first step is to drill a hole in the second hole position 221 of the horizontal "∞" hole. This hole is a pre-judgment hole. Checking whether the intramedullary nail 500 is in the expected upward or downward direction has been completed by the aiming module 2 with an aiming hole distance of 4.5 mm); that is, directly select the appropriate first hole position 411 in the vertical "8" hole of the newly replaced aiming module 4, first use the ring drill 7 with a drill bit of 2.5 mm in the intramedullary nail lock hole positioning module 600 to cooperate with the drill sleeve 6 The center guide 8 passes through the first hole 211 to drill a hole in the patient's affected limb bone 400 to form a pre-drilled hole 410. After checking that the center guide 8 passes through the screw hole on the intramedullary nail 500 smoothly, the annular drill 7 and the drill sleeve 6 that form the pre-drilled hole 410 are removed, and the large-diameter annular drill 7 and the drill sleeve 6 are inserted to expand the hole to the expected diameter of 4mm-4.5mm, and the installation of the locking screw in the vertical "8" hole is completed; the third step is to press the locking piece, adjust the center line of the distal second hole 421 and the center of the first hole 411 of the locking nail installed in the second step to be on the same straight line, and then follow the steps of pre-drilling 410, expanding the hole, and then installing the locking screw to complete the installation of the distal second locking screw. In this embodiment, two models of aiming modules are taken as an example, and the aiming module can also have more models. According to the implementation requirements, the appropriate model can be replaced during the operation. The above-mentioned various size data can also be replaced according to actual needs, and are not limited to this. How to detect whether the center guide 8 passes through the screw hole on the intramedullary nail 500 smoothly in the second step of the above steps is specifically described in step 2 of the method for using the intramedullary nail locking hole positioning module 600 and the center guide 8 above. Multiple aiming modules are set. When the first hole position is locked with the distal hole of the intramedullary nail during surgery, if the first hole position on an aiming module cannot correspond to the distal hole of the intramedullary nail, another type of aiming module can be immediately replaced. It is only necessary to interchange the modules in a certain order to shorten the operation time and reduce the risk of wound infection.

[0120] Furthermore, if Fig.11 The distances h1 and h2 between the two identical aiming holes in the aiming module 2 range from 4.5 mm to 5.5 mm. Figure 5The ranges of the distances h3 and h4 between the two adjacent different aiming holes in the aiming module 4 are 3mm-4mm and 6mm-7mm respectively. Optionally, the distances h3 and h4 between the two different aiming holes can be a combination of 3mm and 6mm, or a combination of 4mm and 5mm respectively. Thus, if the first hole position 211 in one aiming module is not suitable for drilling a hole in the affected limb bone 400, the hole formed after drilling and expanding the hole in the affected limb bone 400 in another suitable aiming module can be expanded to the hole drilled on the affected limb bone 400 for the first time, and no excessive damage will be caused to the affected limb bone 400.

[0121] When an aiming module has at least two aiming hole distances, the aiming module supports flipping 180° for use. The flipping process is the operation of switching the eccentric distance. For example, in the vertical "8" hole, the offset distances between the two holes and the center are different. For example, the offset distances between the upper and lower holes and the center are 6mm and 4mm respectively. After flipping 180°, the offset distances between the upper and lower holes and the center are converted to 4mm and 6mm, which can quickly achieve aiming adjustment and have better clinical value.

[0122] The intramedullary nail aiming arm in this embodiment has a simple structure and a reduced number of components, and the installation steps of the lateral bracket in the existing equipment are omitted, which saves the doctor's operation time. In addition, there is no need to drill the lateral pressure rod hole on the patient's femur during the operation, which reduces the trauma to the affected limb bone and reduces the risk of secondary fracture in the distal femoral locking nail installation area. The second aiming piece is designed with a specific offset distance, and the offset adjustment of the aiming hole can be quickly realized during the operation, which saves the operation of active fine-tuning during the operation and effectively reduces the number of X-rays for doctors and patients.

[0123] Another embodiment of the present invention also relates to a method for using an intramedullary nail aiming system, wherein the intramedullary nail aiming system is the intramedullary nail aiming system in the above-mentioned implementation, and the outer diameter of the annular drill 7 used for expanding the hole in the plurality of intramedullary nail locking hole positioning modules 600 is greater than the outer diameter of the annular drill 7 used for drilling. Specifically, the method for using comprises the following steps:

[0124] Step 100, such as Figure 8 As shown, the intramedullary nail locking hole positioning module 600 equipped with the center guide 8 is inserted into a second hole position 221, and the ring drill 7 is controlled to drill a hole on the target object to form a predicted hole;

[0125] Step 200, such as Fig.14 As shown, the center guide 8 inserted into the second hole 221 is pulled out;

[0126] Step 300, such as Fig.15 As shown, the intramedullary nail locking hole positioning module 600 equipped with the center guide 8 is inserted into the appropriate first hole position 211, and the ring drill 7 is controlled to drill a hole on the target object to form a pre-drilled hole 410;

[0127] Step 400, such as Fig.16 As shown, the intramedullary nail locking hole positioning module 600 inserted into the first hole position 211 is pulled out, and the hole is explored using the center guide 8;

[0128] Step 500, judging whether to replace another type of aiming module according to the hole detection condition of the center guide 8;

[0129] If necessary, in step 600, another type of aiming module 4 is replaced;

[0130] Step 700, inserting the intramedullary nail locking hole positioning module 600 equipped with the center guide 8 into the first hole position 411 and the second hole position 421 of the newly replaced aiming module 4, wherein the first hole position 411 is the intramedullary nail locking hole positioning module 600 for expanding the hole;

[0131] Step 800, controlling the annular drill 7 of the intramedullary nail locking hole positioning module 600 in the first hole position 411 to expand the pre-drilled hole 410 to form a locking hole;

[0132] If it is not necessary, the aiming module is not replaced;

[0133] Step 900, replacing the intramedullary nail locking hole positioning module 600 with a ring drill 7 of another size in the first hole position 211;

[0134] Step 1100 , controlling the annular drill 7 of the newly replaced intramedullary nail locking hole positioning module 600 to expand the pre-drilled hole 410 to form a locking hole.

[0135] Step 1200, adjust the second aiming member in use so that the center line of the second hole is on the same horizontal line as the center of the first hole into which the intramedullary nail locking hole positioning module 600 has been inserted; specifically, when adjusting the second aiming module, the intramedullary nail locking hole positioning module 600 in the second hole is pulled out from the second hole to facilitate moving the second aiming module; the specific method of moving the second aiming module has been described above and will not be described in detail here.

[0136] Step 1300, insert the intramedullary nail locking hole positioning module 600 for expanding the hole into the second hole position, and expand the predicted hole. The specific insertion process of the intramedullary nail locking hole positioning module 600 can be the same as above, and will not be described in detail here.

[0137] In addition, the distal end of the center guide 8 is a tip portion 81, and the outermost tip of the tip portion 81 coincides with the side edge of the center guide 8. The steps of probing the center guide 8 and determining whether to replace the aiming module of another model have the following steps:

[0138] Control the tip portion 81 of the central guide 8 to detect toward the target object;

[0139] If the tip portion 81 of the center guide 8 passes through the locking nail hole 510 of the target object, there is no need to replace the aiming module with another model;

[0140] If the tip portion 81 of the center guide 8 does not pass through the locking nail hole 510 of the target object;

[0141] After rotating the center guide 8 by a preset angle, the tip 81 of the center guide 8 is controlled again to detect toward the target object;

[0142] If the tip 81 of the rotated center guide 8 passes through the locking nail hole 510 of the target object, it is not necessary to replace the aiming module of another type, and replace the other type of intramedullary nail locking hole positioning module 600 to expand the hole, and the central axis of the channel 61 of the drill sleeve 6 of the intramedullary nail locking hole positioning module 600 deviates from the central axis of the drill sleeve 6;

[0143] If the tip 81 of the rotated center guide 8 does not pass through the locking nail hole 510 of the target object, replace the aiming module with another model. The specific replacement method and replacement model are as shown in the above embodiment and will not be described in detail here.

[0144] That is to say, taking the outer diameter of the ring drill 7 for drilling as 2.5mm and the outer diameter of the ring drill 7 for expanding the hole as 4.5mm as an example, the first step is to insert the 2.5mm ring drill 7 (the ring drill 7 and the drill sleeve 6 are matched together) equipped with the center guide 8 into the horizontal "∞" hole to form a protection for the ring drill tooth area, so that the ring drill 7 is not easy to scratch or damage the soft tissue when passing through the surgical incision; the second step is to pull out the center guide 8, connect the surgical power to the tail of the 2.5mm ring drill 7, drill a 2.5mm pre-drilled hole 410 in the cortical bone of the femur of the affected limb, take an X-ray film, and estimate the distance between the distal hole of the intramedullary nail and the ring drill 7. The third step is to select a suitable aiming module with a vertical "8" hole according to the estimated distance. The aiming module with a 4.5mm hole position is selected by default. According to the method in the first step, a 2.5mm annular drill 7 with a center guide 8 is installed in the appropriate first hole position 211 to complete the pre-drilling 410. The fourth step is to pull out the annular drill 7 and the drill sleeve 6, and use the 2.5mm center guide 8 to "probe the hole" to determine the positional relationship between the pre-drilled hole 410 on the cortical bone of the affected limb bone 400 and the locking nail hole 510 on the intramedullary nail. According to the "probing hole" results, there are three situations: a. Case 1 (such as Fig.17 ), the tip 81 of the central guide 8 passes smoothly through the intramedullary nail locking hole 510, and the next step is to use the ring drill 7 to expand the hole smoothly; b. Case 2 (such as Fig.18 ), the center guide 8 touches the metal, and after rotating a certain angle, its eccentric tip 81 can be inserted to a certain depth, and the next step is to switch the eccentric annular drill 7 to expand the hole for fine adjustment; c. Case 3 (such as Fig.19), the center guide 8 touches the metal, and after rotating a certain angle (180°), it still touches the metal. In the next step, it is necessary to switch to another specification of the aiming module 4 for hole expansion; the fifth step, under the guidance of the center guide 8, a ring drill 7 of appropriate specifications is installed in the first hole 411 (the ring drill 7 and the drill sleeve 6 are matched together) to complete the hole expansion, and the ring drill 7 can be selectively pulled out during the hole expansion; after the hole expansion is completed, the first locking screw at the distal end of the intramedullary nail is installed with a special tool; the sixth step: pull out the ring drill 7 and the drill sleeve 6 in the second hole position 421, unlock the locking piece 3, adjust the center of the horizontal "∞" hole on the second aiming piece and the center of the vertical "8" hole on the first aiming piece to be on the same straight line, align the arrow with a certain scale line, install a ring drill 7 of appropriate specifications in the horizontal "∞" hole to complete the hole expansion, and after the hole expansion is completed, use a special tool to install the second locking screw at the distal end.

[0145] When the intramedullary nail locking hole positioning module is inserted into the first hole position or the second hole position in this embodiment, it cooperates with the central guide, and can also be set according to needs in actual use.

[0146] It is not difficult to find that the relevant technical details mentioned in the first embodiment are still valid in this embodiment, and in order to reduce repetition, they are not repeated here. Accordingly, the relevant technical details mentioned in this embodiment can also be applied in the first embodiment.

[0147] Preferred embodiments of the present invention have been described above in detail, but it should be understood that aspects of the embodiments can be modified, if necessary, to employ aspects, features and concepts of the various patents, applications and publications to provide further embodiments.

[0148] These and other changes can be made to the embodiments in light of the above detailed description.In general, in the claims, the terms used should not be considered limited to the specific embodiments disclosed in the specification and the claims, but should be construed to include all possible embodiments along with the full scope of equivalents to which these claims are entitled.

[0149] Those skilled in the art will appreciate that the above embodiments are specific embodiments for implementing the present invention, and that in actual applications, various changes may be made in form and detail without departing from the spirit and scope of the present invention.

Claims

1. An intramedullary nail aiming system, characterized in that: include: handle; A gear lever, the gear lever having a distal end and a proximal end; the direction from the distal end to the proximal end of the gear lever is the length direction of the gear lever; The proximal end of the gear lever is connected to the handle; A plurality of aiming modules, wherein the aiming modules include: a first aiming member, wherein the first aiming member is detachably connected to the distal end of the gear lever, and the first aiming member is provided with a first guide groove penetrating along the thickness direction thereof; the first guide groove has a plurality of first holes arranged along the height direction of the first aiming member; the height direction of the first aiming member, the length direction of the gear lever and the thickness direction of the first aiming member are perpendicular to each other; and a second aiming member, wherein the second aiming member is slidably connected to the first aiming member along a height direction of the first aiming member, and the first aiming member is located between the gear lever and the second aiming member; a second guide groove is formed on the second aiming member and penetrates along a thickness direction thereof; and the second guide groove has a second hole position; The second aiming member has an initial position and an aiming position; when the second aiming member is at the aiming position, the center of the second hole position is on the same horizontal line as the center of any of the first hole positions, and the first aiming member and the second aiming member are locked and fixed; the heights of the first holes in different aiming modules are different; Multiple intramedullary nail keyhole positioning modules, including: a drill sleeve having a passage extending therethrough and along its length; An annular drill, the annular drill is rotatably connected to the drill sleeve and inserted into the passage, and both ends of the annular drill are located outside the drill sleeve; the annular drill is provided with a through hole, and the through hole extends along the length direction of the annular drill and penetrates the annular drill; the drill sleeve and the annular drill cooperate to form an integral part, and the drill sleeve carries the annular drill for inserting into or removing from the first hole position and / or the second hole position; wherein the outer diameters of at least two annular drills in the plurality of intramedullary nail locking hole positioning modules are different; A center guide is used to insert into or pull out of the through hole of the annular drill; and after the center guide is inserted into and penetrates the through hole, the annular drill and the center guide can be rotatably arranged.

2. The intramedullary nail aiming system according to claim 1, characterized in that: The central axis of the channel of at least one of the drill sleeves in the plurality of intramedullary nail locking hole positioning modules deviates from the central axis of the drill sleeve; The central axis of the channel of at least one drill sleeve in the plurality of intramedullary nail locking hole positioning modules is coaxial with the central axis of the drill sleeve.

3. The intramedullary nail aiming system according to claim 1, characterized in that: The annular drill is a stainless steel annular drill; the drill sleeve is a plastic drill sleeve; and the center guide is made of nickel-titanium alloy.

4. The intramedullary nail aiming system according to claim 1, characterized in that: The distal end of the central guide is a tip portion, and the outermost tip of the tip portion coincides with the side edge of the central guide.

5. The intramedullary nail aiming system according to claim 1, characterized in that: A groove is formed on the outer periphery of the central guide, an embedded part is arranged in the groove, and the embedded part protrudes out of the groove; The outer diameter of the assembly formed by the insert being arranged behind the center guide is smaller than the inner diameter of the annular drill.

6. The intramedullary nail aiming system according to claim 5, characterized in that: The embedding piece is elastic and is a C-shaped ring.

7. The intramedullary nail aiming system according to claim 1, characterized in that: The first guide groove includes a plurality of circular holes, one circular hole forms one first hole position, and the hole centers of the plurality of circular holes are arranged along the height direction of the first aiming member; There are a plurality of second holes, which are arranged along the length direction of the gear lever.

8. The intramedullary nail aiming system according to claim 7, characterized in that: The first guide groove is in a vertical "8" shape; the second guide groove includes a plurality of circular holes, one circular hole forming one second hole position; the second guide groove is in a horizontal "∞" shape.

9. The intramedullary nail aiming system according to claim 1, characterized in that: The first aiming member is provided with an aiming mark position and an initial mark position, and one aiming mark position corresponds to the center of one first hole position; The second aiming member is provided with a pointing mark, and the pointing mark and the center of the second hole are located on the same horizontal line; the pointing mark is used to point to the initial marking position when the second aiming member is located at the initial position, and is also used to point to the aiming marking position when the second aiming member moves to the aiming position; When the second aiming member is at the initial position, the distance between the center of the first hole position and the center of the second hole position in each aiming module along the height direction of the first aiming member is the aiming hole distance; One aiming module has at least two aiming hole distances; at least two aiming hole distances of at least one aiming module among the plurality of aiming modules are the same; and at least two adjacent aiming hole distances of at least one aiming module among the plurality of aiming modules are different.

10. The intramedullary nail aiming system according to claim 9, characterized in that: The range of the distance between two identical aiming holes is 4.5 mm -5.5 mm; the range of the distance between two adjacent different aiming holes is 3 mm -4 mm and 6 mm -7 mm respectively.

11. The intramedullary nail aiming system according to claim 1, characterized in that: The first aiming member is provided with a plurality of limiting grooves arranged along the height direction of the first aiming member; one of the first hole positions corresponds to one of the limiting grooves, and the area of ​​the first aiming member corresponding to the initial position of the second aiming member has the limiting groove; The second aiming member is provided with a slide groove extending along the height direction thereof; The aiming module further comprises: a locking member for locking or releasing the first aiming member and the second aiming member; The lock comprises: A movable rod, which is slidably disposed in the slide groove and is at least partially located outside the second aiming member; an unlocking groove is provided on the movable rod; An elastic member, wherein the elastic member is arranged in the slide groove, and one end of the elastic member abuts against the bottom of the movable rod; A limiting member, wherein the limiting member is arranged on the second aiming member; the limiting member is used to be embedded in any one of the limiting grooves; when the movable rod slides to the unlocking position, the limiting member is embedded in the unlocking groove, and the second aiming member is unlocked from the first aiming member; when the movable rod slides to the locking position, the limiting member is embedded in the limiting groove and is located outside the unlocking groove and abuts against the side wall of the movable rod, and the second aiming member is locked and fixed to the first aiming member.

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