Ssacro-1 oblique sacroiliac joint hollow screw fixing sighting device

Abstract

The invention relates to the technical field of medical apparatus and instruments, in particular to a sacro-1 oblique sacroiliac joint hollow screw fixing sighting device which comprises an outer fixing support, a needle entry point hollow sleeve, a far-end sliding positioner and a needle exit point adjusting rod, and the outer fixing support comprises a near-end hollow module, an arc-shaped support and a far-end hollow module. The near-end hollow module and the far-end hollow module are connected to the two ends of the arc-shaped support respectively, a needle inlet point and an ideal needle outlet point are determined through a pelvis CT image according to the principle that a straight line is determined through two points and the characteristics of relatively stable bony tissue, and the needle inlet point and the ideal needle outlet point are adjusted by adjusting a far-end sliding positioner and a needle outlet point adjusting rod. The sacroiliac screw is accurately implanted, so that the device is simple in structure and easier to operate, the operation time is shortened, and the perspective frequency is reduced.

Description

Technical Field

[0001] The invention belongs to the technical field of medical devices, and in particular relates to a sacral 1 oblique sacroiliac joint hollow screw fixing aimer. Background Art

[0002] Pelvic fracture is a common disease in trauma orthopedics, often combined with sacroiliac joint dislocation and sacral fracture. Sacroiliac joint fixation is required to maintain the stability of the posterior pelvic ring. The surgical methods are open reduction plate fixation and sacroiliac joint hollow screw fixation. Because the sacroiliac joint hollow screw is minimally invasive and the most stable in biomechanical testing, it has become the preferred surgical method for sacroiliac joint fixation. The sacroiliac joint hollow screw through S1 can be divided into sacroiliac joint parallel hollow screw and sacroiliac joint oblique hollow screw according to the distance from the front edge of the S1 cone to the front edge of the nerve root canal. The oblique hollow screw of the sacroiliac joint is difficult to implant because of the selection of the needle point and the control of the angle of the implanted hollow screw. Due to the complex anatomical structure around the S1 cone, there are blood vessels, nerves and important organs and tissues, and once the deviation occurs, serious consequences will occur. Computer-assisted navigation technology can provide a reliable technical guarantee for sacroiliac joint hollow screw fixation technology, but the existing instruments are difficult to operate, which makes the implantation of sacroiliac screws take a long time, reducing the efficiency of sacroiliac screw implantation. Summary of the invention

[0003] The purpose of the present invention is to provide a sacral 1 oblique sacroiliac joint hollow screw fixation aiming device. The existing instruments are difficult to operate, so that when the sacroiliac screw is implanted, it takes a long time, which reduces the efficiency of the sacroiliac screw implantation.

[0004] To achieve the above technical purpose, the technical solution adopted by the present invention is as follows: comprising an external fixing bracket, a hollow sleeve for needle entry, a distal sliding positioner, a needle exit adjustment rod and a fixing bolt,

[0005] The external fixation bracket includes a proximal hollow module, an arc-shaped bracket and a distal hollow module, the proximal hollow module and the distal hollow module are respectively connected to the two ends of the arc-shaped bracket, the hollow tube cavity of the proximal hollow module is cylindrical, the needle entry point hollow sleeve is cylindrical, the needle entry point hollow sleeve passes through the proximal hollow module, the hollow tube cavity of the distal hollow module is rectangular, the distal sliding locator is rectangular, the distal sliding locator cooperates with the distal sliding locator, the distal sliding locator passes through the distal hollow module, the proximal hollow tube cavity of the distal sliding locator is cylindrical, the needle exit point adjustment rod is cylindrical, the needle exit point adjustment rod passes through the distal sliding locator, the needle exit point adjustment rod has a tip of the needle exit point adjustment rod, the tip of the needle exit point adjustment rod is pointed, and the needle exit point adjustment rod has a scale line.

[0006] Among them, the long axis of the hollow sleeve at the rear needle entry point, the long axis of the distal sliding locator and the long axis of the needle exit point adjustment rod are in the same plane.

[0007] Wherein, the extension line of the major axis of the rear needle entry point hollow sleeve passes through the tip of the needle exit point adjustment rod of the needle exit point adjustment rod.

[0008] Among them, the long axis of the hollow sleeve at the needle entry point is parallel to the long axis of the distal sliding locator, and the long axis of the needle exit point adjustment rod is perpendicular to the long axis of the distal sliding locator.

[0009] Among them, the needle entry point hollow sleeve, the distal sliding locator and the needle exit point adjustment rod are respectively connected to the proximal hollow module, the distal hollow module and the distal sliding locator through the fixing bolts.

[0010] The present invention provides a S1 oblique sacroiliac joint hollow screw fixing aimer, through which a needle exit point adjustment rod is inserted into the proximal hollow tube cavity of a distal sliding locator, and the adjustment length of the needle exit point adjustment rod is adjusted according to the distance from the highest point of the contralateral iliac inner plate to the extension line of the ideal channel measured before surgery, and then fixed with a bolt. If the virtual needle exit point just passes through the highest point of the iliac inner plate, the needle exit point adjustment rod is set to 0. If the virtual needle exit point is above the highest point of the iliac inner plate, the adjustment length corresponding to the needle exit point adjustment rod is adjusted downward, that is, positively. Conversely, if the virtual needle exit point is below the highest point of the iliac inner plate, the adjustment length corresponding to the needle exit point adjustment rod is adjusted upward, that is, negatively. The patient lies supine horizontally on the operating table, and the lateral view of the S1 pyramid is taken with fluoroscopy. The posterior edge of the S1 pyramid is also divided into four equal parts. A 2.5 mm Kirschner wire is gently inserted into the affected iliac outer plate perpendicular to the sagittal plane of the body. The fluoroscopy confirms that the relative position of the Kirschner wire insertion point is consistent with the insertion point of the posterior edge of the S1 pyramid reconstructed in the midsagittal plane of the preoperative CT. A straight line is drawn through the insertion point perpendicular to the longitudinal axis of the body to the intersection of the highest point of the inner plate of the healthy iliac crest and exposed surgically. A hollow sleeve is inserted along the Kirschner wire until the affected iliac outer plate, and the external fixator is connected. The hollow sleeve of the insertion point Insert the proximal hollow module and fix it with the fixing bolts, adjust the distal sliding locator, insert the distal hollow module and adjust until the tip of the needle exit point adjustment rod can be placed at the highest point of the surgically exposed iliac inner plate, fix the distal sliding locator with the fixing bolts, adjust the patented instrument to make it perpendicular to the longitudinal axis of the body, continue to implant the Kirschner wire along the direction of the hollow sleeve of the needle entry point, confirm the appropriate length and position through fluoroscopy, and then screw in the hollow screw of appropriate length, so as to make the operation of the device easier, thereby reducing the operation time and improving the efficiency of sacroiliac screw implantation. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The present invention is further illustrated by means of the non-limiting examples given in the accompanying drawings.

[0012] Figure 1FIG. 4 is a three-dimensional diagram of an external fixing bracket according to a first embodiment of the present invention.

[0013] Figure 2 It is a stereoscopic view of the distal sliding positioner according to the first embodiment of the present invention.

[0014] Figure 3 It is a side view of the needle exit point adjustment rod according to the first embodiment of the present invention.

[0015] Figure 4 It is a side view of the sacral 1 oblique sacroiliac joint hollow screw fixation aiming device according to the first embodiment of the present invention.

[0016] In the figure: 101-external fixing bracket, 102-hollow sleeve of needle entry point, 103-distal sliding positioner, 104-needle exit point adjustment rod, 105-fixing bolt, 106-proximal hollow module, 107-arc bracket, 108-distal hollow module, 109-tip of needle exit point adjustment rod, 110-scale line. DETAILED DESCRIPTION

[0017] In order to enable those skilled in the art to better understand the present invention, the technical solution of the present invention is further described below in conjunction with the accompanying drawings and embodiments.

[0018] Embodiment 1:

[0019] like Figure 1-4 As shown, Figure 1 FIG. 4 is a three-dimensional diagram of an external fixing bracket according to a first embodiment of the present invention. Figure 2 It is a stereoscopic view of the distal sliding positioner according to the first embodiment of the present invention. Figure 3 It is a side view of the needle exit point adjustment rod according to the first embodiment of the present invention. Figure 4 It is a side view of the sacral 1 oblique sacroiliac joint hollow screw fixation aiming device according to the first embodiment of the present invention.

[0020] The present invention provides a sacral 1 oblique sacroiliac joint hollow screw fixing aimer, comprising an external fixing bracket 101, a needle entry hollow sleeve 102, a distal sliding positioner 103, a needle exit adjustment rod 104 and a fixing bolt 105, wherein the external fixing bracket 101 comprises a proximal hollow module 106, an arc bracket 107 and a distal hollow module 108, and the needle exit adjustment rod 104 has a needle exit adjustment rod tip 109. The above scheme solves the problem of high difficulty in operating the existing instrument, so that when the sacroiliac screw is implanted, it takes a long time and reduces the efficiency of the sacroiliac screw implantation. It can be understood that the above scheme can be used in the case where it is necessary to reduce the difficulty of operation, make it easier to get started, and improve the efficiency of the sacroiliac screw implantation.

[0021] In this embodiment, the pelvic CT scan + three-dimensional reconstruction image is carefully read before the operation, and the pelvic CT horizontal scan image suitable for implanting the trans-sacral oblique iliac screw is selected, and the intersection of the corresponding positioning line and the posterior edge of the S1 vertebra is marked on the median reconstructed sagittal image, and the posterior edge of the S1 cone is divided into 4 equal parts. The relative position of the intersection in a certain part is the position of the needle entry point during the lateral perspective of the operation (the corresponding median sagittal image of the sacral CT is similar to the lateral perspective image), and the point where the horizontal line of the posterior edge of the S1 vertebra intersects with the outer plate of the iliac bone on the affected side is drawn on the pelvic CT horizontal scan image of this layer (it is also the needle entry point during the lateral perspective of the operation), and an ideal sacroiliac joint oblique implantation channel is made along the S1 pedicle of the S1, and a vertical line is made from the highest point of the inner plate of the contralateral iliac bone to the extension line of the ideal insertion channel. The intersection is the virtual needle exit point and the vertical line distance is measured (the adjustment length of the needle exit point adjustment rod 104 of this patent during the operation).

[0022] Among them, the proximal hollow module 106 and the distal hollow module 108 are respectively connected to the two ends of the arc-shaped bracket 107, the hollow tube cavity of the proximal hollow module 106 is cylindrical, the needle entry point hollow sleeve 102 is cylindrical, the needle entry point hollow sleeve 102 passes through the proximal hollow module 106, the hollow tube cavity of the distal hollow module 108 is rectangular, the distal sliding locator 103 is rectangular, the shape of the distal sliding locator 103 is matched with the shape of the hollow tube cavity of the distal sliding locator 103, the distal sliding locator 103 passes through the distal hollow module 108, the proximal hollow tube cavity of the distal sliding locator 103 is cylindrical, the needle exit point adjustment rod 104 is cylindrical, and the needle exit point adjustment rod 104 passes through the The distal sliding locator 103, the needle exit point adjustment rod 104 has a tip 109 of the needle exit point adjustment rod, the tip 109 of the needle exit point adjustment rod is pointed, and the needle exit point adjustment rod 104 has a scale line 110. The needle exit point adjustment rod 104 is inserted into the proximal hollow tube cavity of the distal sliding locator 103. The adjustment length of the needle exit point adjustment rod 104 is adjusted according to the distance from the highest point of the contralateral iliac inner plate to the extension line of the ideal channel measured before surgery, and the bolt 105 is fixed to fix it. If the virtual needle exit point just passes through the highest point of the iliac inner plate, the needle exit point adjustment rod 104 is set to 0. If the virtual needle exit point is above the highest point of the iliac inner plate, the adjustment length of the needle exit point adjustment rod 104 is adjusted downward, that is, positively. On the contrary, if the virtual needle exit point is below the highest point of the iliac inner plate, the adjustment length of the needle exit point adjustment rod 104 is adjusted upward, that is, negatively. The patient lies supine horizontally on the operating table, and the lateral view of the S1 pyramid is taken with fluoroscopy. The posterior edge of the S1 pyramid is also divided into four equal parts. A 2.5 mm Kirschner wire is gently inserted perpendicular to the sagittal plane of the body into the outer plate of the iliac bone on the affected side. The fluoroscopy confirms that the relative position of the insertion point of the Kirschner wire is consistent with the insertion point of the posterior edge of the S1 pyramid reconstructed in the midsagittal plane of the preoperative CT. A straight line is drawn perpendicular to the longitudinal axis of the body through the insertion point to the intersection of the highest point of the inner plate of the healthy iliac crest and exposed surgically. The hollow sleeve 102 at the insertion point is inserted along the Kirschner wire until the outer plate of the iliac bone on the affected side, and the external fixator 101 is connected. The hollow sleeve 102 at the insertion point is inserted into the proximal hollow Module 106 is fixed with bolt 105, the distal sliding locator 103 is adjusted to penetrate into the distal hollow module 108 and adjusted until the tip 109 of the needle exit point adjustment rod can be placed at the highest point of the surgically exposed iliac inner plate, the distal sliding locator 103 is fixed with bolt 105, the patented instrument is adjusted to be perpendicular to the longitudinal axis of the body, and the Kirschner wire is continued to be implanted along the direction of the hollow sleeve 102 of the needle entry point, and the length and position are confirmed to be appropriate by fluoroscopy, and then the hollow screw of appropriate length is screwed in, so that the structure of the instrument is simple and the operation is easier, thereby reducing the operation time and the number of fluoroscopy times.

[0023] Secondly, the long axis of the rear needle entry point hollow sleeve 102, the long axis of the distal sliding locator 103 and the long axis of the needle exit point adjusting rod 104 are in the same plane. After the device assembly is completed, the long axis of the rear needle entry point hollow sleeve 102, the long axis of the distal sliding locator 103 and the long axis of the needle exit point adjusting rod 104 are in the same plane.

[0024] At the same time, the extension line of the long axis of the rear needle entry point hollow sleeve 102 passes through the tip 109 of the needle exit point adjustment rod 104. After the device assembly is completed, the extension line of the long axis of the rear needle entry point hollow sleeve 102 will pass through the tip 109 of the needle exit point adjustment rod when the needle exit point adjustment rod 104 is set to 0.

[0025] In addition, the long axis of the needle entry point hollow sleeve 102 is parallel to the long axis of the distal sliding locator 103, and the long axis of the needle exit point adjustment rod 104 is perpendicular to the long axis of the distal sliding locator 103. When the device is fully assembled, when the needle exit point adjustment rod 104 passes through the tip 109 of the needle exit point adjustment rod when the needle exit point adjustment rod 104 is placed at 0, the long axis of the needle exit point adjustment rod 104 is perpendicular to the long axis of the distal sliding locator 103.

[0026] Finally, the needle entry point hollow sleeve 102, the distal sliding locator 103 and the needle exit point adjustment rod 104 are respectively connected to the proximal hollow module 106, the distal hollow module 107 and the distal sliding locator 103 through the fixing bolt 105. After the device is assembled, the needle entry point hollow sleeve 102, the distal sliding locator 103 and the needle exit point adjustment rod 104 can be fixed to the proximal hollow module 106, the distal hollow module 108 and the distal sliding locator 103 respectively through the fixing bolt 105.

[0027] When using a sacral 1 oblique sacroiliac joint hollow screw fixation aiming device implemented in the present invention, the needle exit point adjustment rod 104 is inserted into the proximal hollow tube cavity of the distal sliding locator 103, and the adjustment length of the needle exit point adjustment rod 104 is adjusted according to the distance from the highest point of the contralateral iliac inner plate to the extension line of the ideal channel measured before surgery, and the bolt 105 is fixed to fix it. If the virtual needle exit point just passes through the highest point of the iliac inner plate, the needle exit point adjustment rod 104 is set to 0. If the virtual needle exit point is above the highest point of the iliac inner plate, the adjustment length of the needle exit point adjustment rod 104 is adjusted downward, that is, positively adjusted. Conversely, if the virtual needle exit point is below the highest point of the iliac inner plate, the adjustment length of the needle exit point adjustment rod 104 is adjusted upward, that is, negatively adjusted. The patient lies supine horizontally on the operating table, and the lateral view of the S1 pyramid is taken with fluoroscopy. The posterior edge of the S1 pyramid is also divided into four equal parts. A 2.5 mm Kirschner wire is gently inserted perpendicular to the sagittal plane of the body into the outer plate of the iliac bone on the affected side. The fluoroscopy confirms that the relative position of the insertion point of the Kirschner wire is consistent with the insertion point of the posterior edge of the S1 pyramid reconstructed in the midsagittal plane of the preoperative CT. A straight line is drawn perpendicular to the longitudinal axis of the body through the insertion point to the intersection of the highest point of the inner plate of the healthy iliac crest and exposed surgically. The hollow sleeve 102 at the insertion point is inserted along the Kirschner wire until the outer plate of the iliac bone on the affected side, and the external fixator 101 is connected. The hollow sleeve 102 at the insertion point is inserted into the proximal hollow Module 106 is fixed with bolt 105, the distal sliding locator 103 is adjusted to penetrate into the distal hollow module 108 and adjusted until the tip 109 of the needle exit point adjustment rod can be placed at the highest point of the surgically exposed iliac inner plate, the distal sliding locator 103 is fixed with bolt 105, the patented instrument is adjusted to be perpendicular to the longitudinal axis of the body, and the Kirschner wire is continued to be implanted along the direction of the hollow sleeve 102 of the needle entry point, and the length and position are confirmed to be appropriate by fluoroscopy, and then the hollow screw of appropriate length is screwed in, so that the structure of the instrument is simple and the operation is easier, thereby reducing the operation time and the number of fluoroscopy times.

[0028] The above embodiments are merely illustrative of the principles and effects of the present invention, and are not intended to limit the present invention. Anyone familiar with the technology may modify or change the above embodiments without violating the spirit and scope of the present invention. Therefore, all equivalent modifications or changes made by those with ordinary knowledge in the technical field without departing from the spirit and technical ideas disclosed by the present invention should still be covered by the claims of the present invention.

Claims

1. A hollow screw fixation aimer for the sacral 1 oblique sacroiliac joint, comprising an external fixation bracket, a hollow sleeve for the needle entry point, a distal sliding positioner, a needle exit point adjustment rod and a fixing bolt, characterized in that: The external fixation bracket includes a proximal hollow module, an arc-shaped bracket and a distal hollow module, the proximal hollow module and the distal hollow module are respectively connected to the two ends of the arc-shaped bracket, the hollow tube cavity of the proximal hollow module is cylindrical, the needle entry point hollow sleeve is cylindrical, the needle entry point hollow sleeve passes through the proximal hollow module, the hollow tube cavity of the distal hollow module is rectangular, the distal sliding locator is rectangular, the shape of the distal sliding locator is matched with the shape of the hollow tube cavity of the distal sliding locator, the distal sliding locator passes through the distal hollow module, the proximal hollow tube cavity of the distal sliding locator is cylindrical, the needle exit point adjustment rod is cylindrical, the needle exit point adjustment rod passes through the distal sliding locator, the needle exit point adjustment rod has a tip of the needle exit point adjustment rod, the tip of the needle exit point adjustment rod is pointed, and the needle exit point adjustment rod has a scale line.

2. The sacral 1 oblique sacroiliac joint hollow screw fixation aimer according to claim 1, characterized in that: The long axis of the rear needle entry point hollow sleeve, the long axis of the distal end sliding positioner and the long axis of the needle exit point adjustment rod are located in the same plane.

3. The sacral 1 oblique sacroiliac joint hollow screw fixation aimer according to claim 1, characterized in that: The extension line of the major axis of the rear needle entry point hollow sleeve passes through the tip of the needle exit point adjustment rod of the needle exit point adjustment rod.

4. The sacral 1 oblique sacroiliac joint hollow screw fixation sight according to claim 1, characterized in that: The long axis of the needle entry point hollow sleeve is parallel to the long axis of the distal sliding locator, and the long axis of the needle exit point adjustment rod is perpendicular to the long axis of the distal sliding locator.

5. The Sacral 1 oblique sacroiliac joint hollow screw fixation aiming device according to claim 1, characterized in that: The needle entry point hollow sleeve, the distal end sliding positioner and the needle exit point adjustment rod are respectively connected to the proximal end hollow module, the distal end hollow module and the distal end sliding positioner through the fixing bolts.

Images