High medial open wedge osteotomy of tibia guide

Abstract

The application discloses a tibia high medial open wedge osteotomy surgical guider and belongs to the technical field of medical devices. The guider comprises a fibula tip positioning frame, a tibia positioning frame is arranged on the right side of the outer side wall of the fibula tip positioning frame, an adjusting groove is formed in the front surface of the tibia positioning frame, and the outer side wall of the fibula tip positioning frame is in sliding connection with the inside of the adjusting groove. The prior art needs to frequently rely on imaging equipment for perspective inspection and needle positioning adjustment, which not only prolongs the operation time but also increases the radiation exposure of patients and medical staff. The two scale lines arranged in the application are used to observe the extension distance of the telescopic sleeve, so as to calculate the total length of the cut tibia, enable the needle to be accurately positioned at one time, greatly reduce the number of repeated adjustment and perspective in the operation, and significantly shorten the operation time, which is helpful to reduce the anesthesia time of the patient and the intraoperative risk.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical devices, in particular to a tibial high medial open wedge osteotomy surgery guide. BACKGROUND

[0002] Tibial high medial open wedge osteotomy (HTO) surgery is an effective method for treating knee varus (knee valgus) and related osteoarthritis. Knee varus usually causes increased medial load of the knee joint due to abnormal tibial axis, which further causes or aggravates osteoarthritis. HTO surgery aims to adjust the force line of the tibia, redistribute the load of the knee joint, thereby reducing the pressure on the medial joint surface, improving joint function, and slowing down the progression of osteoarthritis. In recent years, the introduction of arthroscopic technology has made HTO surgery more minimally invasive. Through arthroscopic technology, doctors can operate under smaller incisions, which not only reduces trauma to patients, but also shortens recovery time after surgery. However, arthroscopic surgery still faces some technical challenges, especially in the accurate positioning of guide pins and the control of osteotomy depth.

[0003] Accurate positioning of guide pins is crucial for the success of HTO surgery. Traditional manual positioning methods are easily influenced by the experience of the operator, which may cause deviations in the position and angle of the guide pin. In addition, due to the difficulty in positioning guide pins and controlling osteotomy depth, traditional HTO surgery often requires a long operation time, which increases the risk to patients and the likelihood of postoperative complications. Although minimally invasive techniques can shorten recovery time, further improving surgical precision and reducing intraoperative adjustment frequency remains a key direction for current technological development. SUMMARY

[0004] The purpose of the present application is to provide a solution to the problem that traditional manual positioning of guide pins is easily influenced by the experience of the operator, which may cause deviations in the position and angle of the guide pin. Another purpose of the present application is to provide a solution to the problem that due to the difficulty in positioning guide pins and controlling osteotomy depth, traditional HTO surgery often requires a long operation time, which increases the risk to patients and the likelihood of postoperative complications.

[0005] Technical solution: The tibial high medial open wedge osteotomy surgery guide comprises a fibular tip positioning frame, a tibial positioning frame is arranged on the right side of the outer side wall of the fibular tip positioning frame, an adjustment groove is opened on the front surface of the tibial positioning frame, and the outer side wall of the fibular tip positioning frame is in sliding connection with the inside of the adjustment groove.

[0006] The bottom end of the tibial positioning frame is fixedly connected with a positioning sleeve one, the lower surface of the positioning sleeve one is fixedly connected with an adjusting box, the lower part of the adjusting box is provided with a positioning sleeve two, the right side of the positioning sleeve one and the positioning sleeve two is respectively provided with a through type screw hole, the inside of the two screw holes is respectively threaded with an expansion sleeve, the left side of the two expansion sleeves is fixedly connected with a tibial positioning head, the right end of the two expansion sleeves is fixedly connected with an adjusting handle one, the left side tip of the fibular tip positioning frame is fixedly connected with a fibular tip positioning head.

[0007] Further, the upper surface of the fibular tip positioning frame is fixedly connected with two supports, the top end of the two supports is commonly fixedly connected with a guide fixator, the inside of the guide fixator is provided with a sliding cavity, the inside of the sliding cavity is slidably connected with a guide needle fixing arm, the right side of the guide needle fixing arm extends to the right side of the fibular tip positioning frame and is fixedly connected with an adjusting sleeve, the lower part of the adjusting sleeve is provided with a guide needle fixing box.

[0008] Further, the right side of the guide needle fixing box is provided with a through type circular hole, the lower surface of the guide needle fixing box is provided with an adjusting handle two, the upper surface center of the adjusting handle two is fixedly connected with a screw rod one, the top end of the screw rod one extends to the inside of the circular hole and is provided with an arc-shaped pressing plate, the outside wall of the screw rod one and the inside of the guide needle fixing box are threaded, the right side of the two adjusting handle one is respectively provided with a through type needle insertion hole.

[0009] Further, the outside wall of the two expansion sleeves is respectively provided with a scale line one.

[0010] Further, the upper part of the adjusting sleeve is provided with an adjusting handle three, the lower surface center of the adjusting handle three is fixedly connected with a screw rod two, the inside of the adjusting sleeve is slidably connected with a moving plate, the lower surface of the moving plate is fixedly connected with an extending rod, the bottom end of the extending rod extends to the lower part of the adjusting sleeve and is fixedly connected with the upper surface of the guide needle fixing box, the bottom end of the screw rod two and the upper surface center of the moving plate are rotatably connected through a rotating shaft.

[0011] Further, the upper inner surface and the lower inner surface of the adjusting box are rotationally connected with a screw rod three through a rotating shaft, the outer side wall of the screw rod three is threadedly connected with a sliding plate, the lower surface of the sliding plate is fixedly connected with a hollow support pipe, the lower surface of the hollow support pipe is fixedly connected with the upper surface of the positioning sleeve two, the upper surface of the front surface of the adjusting box is provided with an adjusting handle four, the rear surface center of the adjusting handle four is fixedly connected with a transmission rod, the rear end of the transmission rod extends into the interior of the adjusting box and is fixedly connected with a bevel gear one, the outer side wall of the upper surface of the screw rod three is fixedly connected with a bevel gear two, and the outer side wall of the bevel gear one is meshingly connected with the outer side wall of the bevel gear two.

[0012] Further, the upper inner surface of the sliding cavity is provided with a through-type horizontal groove, the upper surface of the guide fixator and located at the rear of the horizontal groove is provided with a second scale line, and the upper surface of the guide needle fixing arm and located in the interior of the sliding cavity is fixedly connected with a pointer, and the upper surface of the pointer penetrates through the horizontal groove.

[0013] Further, the inner side wall of the adjusting box and located above the sliding plate is fixedly connected with a limiting plate.

[0014] Further, the left side of the two tibia positioning heads and the right side of the fibula tip positioning head are spike-shaped structures.

[0015] Advantages: the prior art needs to frequently rely on imaging equipment for fluoroscopy and needle positioning adjustment, which not only prolongs the operation time, but also increases the radiation exposure of patients and medical staff, the two first scale lines are arranged to observe the extension distance of the telescopic sleeve, so that the total length of the intercepted tibia is calculated, the guide needle can be accurately positioned at one time, the number of repeated adjustment and fluoroscopy in the operation is greatly reduced, the operation time is significantly shortened, the anesthesia time of the patient and the intraoperative risk are reduced, the probability of postoperative complications is reduced, and the overall operation effect is improved.

[0016] The positioning sleeve one, the positioning sleeve two and the guide needle fixing arm are parallel to each other, so that the parallel insertion of the two guide needles is ensured, the precision machining of the parallel needle hole and the flexibility of the guide needle fixing arm sliding are ensured, the doctor can accurately adjust the needle entry point and angle of the two guide needles, the parallelism between the two guide needles is ensured, the unevenness of the bone cutting surface caused by the non-parallel guide needles is avoided, the postoperative force line adjustment effect is ensured, and the occurrence of postoperative complications is reduced.

[0017] The present application can accurately control the depth of the guide needle during insertion by the cooperation between the movement control pointer of the guide needle fixing arm and the scale line two, so that the doctor can ensure that the depth of the guide needle insertion is consistent with the preoperative plan through the accurate depth reading of the scale line two, thereby avoiding the problem of over-insertion or insufficient insertion of the guide needle, reducing the human error in surgery, improving the accuracy of osteotomy and the safety of surgery, and further reducing the postoperative recovery time and the risk of complications.

[0018] The guider in the present application has a flexible adjustment structure design, which can adapt to the anatomical structure and surgical needs of different patients. The parts of the guider can be quickly adjusted according to the surgical needs, including the adjustment of the direction, angle and depth of the guide needle, so that it is suitable for various surgical scenes, thereby improving the application range of the guider and making it a general-purpose surgical tool suitable for various complex HTO surgical conditions. BRIEF DESCRIPTION OF DRAWINGS

[0019] Figure 1 is the overall front view structure schematic diagram of the present application;

[0020] Figure 2 is the top view structure schematic diagram of the guide fixing device of the present application;

[0021] Figure 3 is the side view structure schematic diagram of the guide needle fixing box of the present application;

[0022] Figure 4 is the side view structure schematic diagram of the adjustment box of the present application;

[0023] Figure 5 is the front view structure schematic diagram of the adjustment sleeve of the present application;

[0024] Figure 6 is the Figure 1 enlarged structure schematic diagram of A in the present application.

[0025] In the figure: 1, the tip of the fibula positioning frame; 2, the tibia positioning frame; 3, the adjusting groove; 4, the positioning sleeve one; 5, the adjusting box; 6, the positioning sleeve two; 7, the threaded hole; 8, the telescopic sleeve; 9, the tibia positioning head; 10, the adjusting handle one; 11, the tip of the fibula positioning head; 12, the support; 13, the guide fixer; 14, the sliding cavity; 15, the guide needle fixing arm; 16, the adjusting sleeve; 17, the guide needle fixing box; 18, the round hole; 19, the adjusting handle two; 20, the screw rod one; 21, the arc-shaped pressing plate; 22, the needle insertion hole; 23, the scale line one; 24, the adjusting handle three; 25, the screw rod two; 26, the moving plate; 27, the extending rod; 28, the screw rod three; 29, the sliding plate; 30, the hollow support pipe; 31, the adjusting handle four; 32, the transmission rod; 33, the bevel gear one; 34, the bevel gear two; 35, the horizontal groove; 36, the scale line two; 37, the pointer; 38, the limiting plate. DETAILED DESCRIPTION

[0026] In order to make the technical scheme of the present application clearer, the present application will be further described in detail below with reference to the drawings and specific embodiments. EMBODIMENT

[0027] As shown in Figure 1 , Figure 4 and Figure 6 , a tibial high medial open wedge osteotomy surgery guide is provided, comprising a tip of fibula positioning frame 1, the outer side wall of the tip of fibula positioning frame 1 is provided with a tibia positioning frame 2, the front surface of the tibia positioning frame 2 is provided with an adjusting groove 3, the outer side wall of the tip of fibula positioning frame 1 is slidably connected with the inside of the adjusting groove 3, the bottom end of the tibia positioning frame 2 is fixedly connected with a positioning sleeve one 4, the lower surface of the positioning sleeve one 4 is fixedly connected with an adjusting box 5, the lower part of the adjusting box 5 is provided with a positioning sleeve two 6, the right side of the positioning sleeve one 4 and the positioning sleeve two 6 are both provided with a through-type threaded hole 7, the inside of the two threaded holes 7 are both threadedly connected with a telescopic sleeve 8, the left side of the two telescopic sleeves 8 are both fixedly connected with a tibia positioning head 9, the right end of the two telescopic sleeves 8 are both fixedly connected with an adjusting handle one 10, the left tip of the tip of fibula positioning frame 1 is fixedly connected with a tip of fibula positioning head 11, the outer side wall of the two telescopic sleeves 8 are both provided with a scale line one 23;

[0028] In the HTO operation, the front end of the fibula tip positioning head 11 of the fibula tip positioning frame 1 is aligned with the patient's fibula tip, and then the position of the tibia positioning frame 2 is adjusted according to the patient's tibia width by adjusting the slot 3, so as to facilitate the operation of different sizes of tibia, and then the two telescopic sleeves 8 are rotated in the two threaded holes 7 by rotating the two adjusting handles 10, that is, the two telescopic sleeves 8 are controlled to extend outward, so as to fix the patient's tibia between the two tibia positioning heads 9, so as to fix the tibia guide device on the patient's tibia. Since the distance between the fibula tip positioning head 11 and the tibia positioning frame 2 is known, when the two telescopic sleeves 8 are extended, the doctor can observe the extension distance of the two telescopic sleeves 8 according to the scale line 23 arranged on the outside, so as to calculate the total length of the tibia, without the aid of other auxiliary tools. Then the doctor can judge whether the bone cutting depth is consistent with the preoperative plan according to the measurement result.

[0029] As shown in Figure 1 and Figure 6 , the left side of the two tibia positioning heads 9 and the right side of the fibula tip positioning head 11 are both thorn-shaped knots;

[0030] The left side of the two tibia positioning heads 9 and the right side of the fibula tip positioning head 11 are both thorn-shaped knots, which can improve the friction between the device and the tibia when fixing the patient's tibia, preventing displacement of the device when inserting the guide needle, so that the two guide needles are not in parallel state, thereby affecting the progress of the operation and reducing the efficiency of the operation.

[0031] As shown in Figures 1-3 , the upper surface of the fibula tip positioning frame 1 is fixedly connected with two supports 12, the top ends of the two supports 12 are commonly fixedly connected with a guide fixator 13, a sliding cavity 14 is formed in the inside of the guide fixator 13, a guide needle fixing arm 15 is slidably connected in the inside of the sliding cavity 14, the right side of the guide needle fixing arm 15 extends to the right side of the fibula tip positioning frame 1 and is fixedly connected with an adjusting sleeve 16, a guide needle fixing box 17 is arranged below the adjusting sleeve 16, a through-type horizontal groove 35 is formed in the inside of the upper surface of the sliding cavity 14, a scale line 36 is arranged on the upper surface of the guide fixator 13 and located behind the horizontal groove 35, a pointer 37 is fixedly connected on the upper surface of the guide needle fixing arm 15 and located in the inside of the sliding cavity 14, the upper surface of the pointer 37 penetrates the horizontal groove 35, a through-type circular hole 18 is formed in the right side of the guide needle fixing box 17, an adjusting handle 19 is arranged on the lower surface of the guide needle fixing box 17, a screw rod 20 is fixedly connected on the upper surface of the adjusting handle 19 and located at the center, the top end of the screw rod 20 extends to the inside of the circular hole 18 and is provided with an arc-shaped pressing plate 21, the outer side wall of the screw rod 20 is threadedly connected with the inside of the guide needle fixing box 17, and the right side of the two adjusting handles 10 is respectively provided with a through-type needle insertion hole 22.

[0032] When the osteotomy depth is determined, the guide needle is inserted into the corresponding height of the needle hole 22 through the upper circular hole 18, until it contacts the tibial end of the patient, and then the screw rod 20 is rotated by rotating the adjusting handle 19, so that the arc-shaped pressing plate 21 moves upward, thereby firmly fixing the guide needle in the circular hole 18 through the inner side of the arc-shaped pressing plate 21. In the initial state, the pointer 37 above the guide needle fixing arm 15 points to the initial position of the second scale line 36, and then the guide needle fixing box 17 is controlled to move horizontally by pushing the guide needle fixing arm 15. The guide needle fixing box 17 moves to insert into the inside of the tibia, and the insertion distance can be judged according to the indication position of the pointer 37, without frequently relying on imaging devices for perspective inspection of the insertion depth of the guide needle, thereby not only reducing the operation time, but also preventing the patient and medical staff from being exposed to radiation hazards; after the first guide needle is inserted, the fixation of the first guide needle above is cancelled, the guide needle fixing arm 15 is pulled back to the original position, and then the vertical distance of the guide needle fixing box 17 is adjusted by adjusting the sleeve 16, and then the second guide needle is fixed with the guide needle fixing box 17. The above operation can be repeated to insert the second guide needle to the same depth as the first guide needle, and the first guide needle and the second guide needle are in parallel state, thereby effectively avoiding uneven osteotomy surface caused by non-parallel guide needles, ensuring the postoperative force line adjustment effect and reducing the occurrence of postoperative complications.

[0033] As shown in Figure 5 The upper part of the adjusting sleeve 16 is provided with an adjusting handle 24, the lower surface center of the adjusting handle 24 is fixedly connected with a screw rod 25, the inside of the adjusting sleeve 16 is slidably connected with a moving plate 26, the lower surface of the moving plate 26 is fixedly connected with an extension rod 27, the bottom end of the extension rod 27 extends to the lower part of the adjusting sleeve 16, and is fixedly connected with the upper surface of the guide needle fixing box 17, and the bottom end of the screw rod 25 is rotatably connected with the center of the upper surface of the moving plate 26 through a rotating shaft;

[0034] When the first guide needle is inserted, the screw rod 25 is rotated by rotating the adjusting handle 24, so that the moving plate 26 is controlled to slide downward through the movement of the screw rod 25, and the extension rod 27 is controlled to move downward when the moving plate 26 slides, so that the guide needle fixing box 17 is vertically controlled to move through the extension rod 27, thereby ensuring the parallelism between the two guide needles.

[0035] As shown in Figure 4As shown, the upper and lower inner surfaces of the adjusting box 5 are jointly connected with a screw rod three 28 through a rotating shaft, the outer side wall of the screw rod three 28 is threadedly connected with a sliding plate 29, the lower surface of the sliding plate 29 is fixedly connected with a hollow support pipe 30, the lower surface of the hollow support pipe 30 is fixedly connected with the upper surface of the positioning sleeve two 6, the upper front surface of the adjusting box 5 is provided with an adjusting handle four 31, the rear surface center of the adjusting handle four 31 is fixedly connected with a transmission rod 32, the rear end of the transmission rod 32 extends into the interior of the adjusting box 5 and is fixedly connected with a bevel gear one 33, the upper outer side wall of the screw rod three 28 is fixedly connected with a bevel gear two 34, and the outer side wall of the bevel gear one 33 is meshingly connected with the outer side wall of the bevel gear two 34.

[0036] The adjusting handle four 31 is rotated to control the rotation of the transmission rod 32, the transmission rod 32 controls the rotation of the bevel gear two 34 through the bevel gear one 33, the screw rod three 28 is rotated through the bevel gear two 34, the screw rod three 28 is rotated to control the downward sliding of the sliding plate 29, the sliding plate 29 moves the positioning sleeve two 6 downward through the hollow support pipe 30, and thus the relative distance between the positioning sleeve two 6 and the positioning sleeve one 4 can be adjusted according to actual use, the size of bone cutting can be adjusted, the flexibility of the device is improved, the device is suitable for various surgical scenes, the flexibility improves the application range of the guide device, the device becomes a general-purpose surgical tool suitable for various complex HTO surgical conditions.

[0037] As shown in the figure, Figure 4 The inner side wall of the adjusting box 5 and above the sliding plate 29 is fixedly connected with a limiting plate 38;

[0038] The limiting plate 38 can ensure the sliding range of the sliding plate 29 and ensure the safety of the transmission device in the adjusting box 5, thereby improving the service life of the device.

[0039] The above-described embodiments only express several embodiments of the present application, the description is more specific and detailed, but it cannot be understood as a limitation on the scope of the patent of the present application. It should be noted that for ordinary skilled in the art, without departing from the concept of the present application, a number of modifications and improvements can be made, which belong to the protection scope of the present application. Therefore, the protection scope of the patent of the present application should be subject to the appended claims.

Claims

1. A surgical guide for open wedge osteotomy of the high medial aspect of the tibia, including a fibular tip positioning frame (1), characterized in that: The fibular tip positioning frame (1) has a tibia positioning frame (2) on the right side of its outer side wall. The front surface of the tibia positioning frame (2) has an adjustment groove (3). The outer side wall of the fibular tip positioning frame (1) is slidably connected to the inside of the adjustment groove (3). The bottom end of the tibial positioning frame (2) is fixedly connected to a positioning sleeve one (4), the lower surface of the positioning sleeve one (4) is fixedly connected to an adjustment box (5), the lower part of the adjustment box (5) is provided with a positioning sleeve two (6), the right side of the positioning sleeve one (4) and the positioning sleeve two (6) are provided with through threaded holes (7), the inside of the two threaded holes (7) is threaded with telescopic sleeves (8), the left side of the two telescopic sleeves (8) is fixedly connected to a tibial positioning head (9), the right end of the two telescopic sleeves (8) is fixedly connected to an adjustment handle one (10), and the left tip of the fibular tip positioning frame (1) is fixedly connected to a fibular tip positioning head (11). Two supports (12) are fixedly connected to the upper surface of the fibular tip positioning frame (1). The top ends of the two supports (12) are fixedly connected to a guide fixator (13). A sliding cavity (14) is opened inside the guide fixator (13). A guide pin fixing arm (15) is slidably connected inside the sliding cavity (14). The right side of the guide pin fixing arm (15) extends to the right side of the fibular tip positioning frame (1) and is fixedly connected to an adjusting sleeve (16). A guide pin fixing box (17) is provided below the adjusting sleeve (16). The guide needle fixing box (17) has a through-hole (18) on its right side. The lower surface of the guide needle fixing box (17) is provided with an adjustment handle (19). The center of the upper surface of the adjustment handle (19) is fixedly connected with a screw (20). The top end of the screw (20) extends into the interior of the hole (18) and is provided with an arc-shaped pressure plate (21). The outer wall of the screw (20) and the interior of the guide needle fixing box (17) are threaded together. The right side of the two adjustment handles (10) and the left side of the two tibial positioning heads (9) are respectively provided with through-hole needle insertion holes (22).

2. The tibial high medial open wedge osteotomy surgical guide according to claim 1, characterized in that: Both of the telescopic sleeves (8) have scale lines (23) on their outer side walls.

3. The tibial high medial open wedge osteotomy surgical guide according to claim 1, characterized in that: An adjustment handle three (24) is provided above the adjustment sleeve (16). A screw two (25) is fixedly connected to the center of the lower surface of the adjustment handle three (24). A moving plate (26) is slidably connected inside the adjustment sleeve (16). An extension rod (27) is fixedly connected to the lower surface of the moving plate (26). The bottom end of the extension rod (27) extends to the bottom of the adjustment sleeve (16) and is fixedly connected to the upper surface of the guide pin fixing box (17). The bottom end of the screw two (25) is rotatably connected to the center of the upper surface of the moving plate (26) through a rotating shaft.

4. The tibial high medial open wedge osteotomy surgical guide according to claim 1, characterized in that: The upper and lower surfaces of the inner surface of the adjusting box (5) are connected to a screw three (28) via a rotating shaft. The outer side wall of the screw three (28) is threaded with a sliding plate (29). The lower surface of the sliding plate (29) is fixedly connected with a hollow support tube (30). The lower surface of the hollow support tube (30) is fixedly connected with the upper surface of the positioning sleeve two (6). An adjusting handle four (31) is provided above the front surface of the adjusting box (5). A transmission rod (32) is fixedly connected at the center of the rear surface of the adjusting handle four (31). The rear end of the transmission rod (32) extends into the interior of the adjusting box (5) and is fixedly connected with a bevel gear one (33). A bevel gear two (34) is fixedly connected above the outer side wall of the screw three (28). The outer side wall of the bevel gear one (33) meshes with the outer side wall of the bevel gear two (34).

5. The tibial high medial open wedge osteotomy surgical guide according to claim 1, characterized in that: The upper surface of the sliding cavity (14) is provided with a through-type transverse groove (35). The upper surface of the guide fixer (13) and behind the transverse groove (35) is provided with a scale line (36). The upper surface of the guide needle fixing arm (15) and inside the sliding cavity (14) is fixedly connected to a pointer (37). The upper surface of the pointer (37) passes through the transverse groove (35).

6. The tibial high medial open wedge osteotomy surgical guide according to claim 4, characterized in that: A limiting plate (38) is fixedly connected to the inner wall of the regulating box (5) and above the sliding plate (29).

7. The tibial high medial open wedge osteotomy surgical guide according to claim 1, characterized in that: The left side of both tibial positioning heads (9) and the right side of the fibular tip positioning head (11) are both spiky structures.

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