Ulna olecranon tension band kirschner wire screw placement guide plate and preparation method and use method thereof

Abstract

The invention discloses an ulna olecranon tension band kirschner wire screw placement guide plate as well as a preparation method and a use method thereof. The screw placement guide plate comprises a pasting plate and a connecting rod, the pasting plate is of a plate-shaped structure designed through anatomical signs of the back side and the U-shaped areas on the two sides of the olecranon of the ulna. The connecting rod extends to the near ulna end from the attaching plate, and a guide hole is formed in one end, located at the near ulna end, of the connecting rod; and the axis of the guide hole is collinear with the proximal ulna needle insertion path. The preparation method comprises the following steps: 1) acquiring ulna CT data of a patient and performing three-dimensional modeling; 2) designing a pasting plate and confirming the position of a guide hole based on the anatomical mark; and 3) 3D printing of the guide plate. The use method comprises the steps that during an operation, the pasting plate is pasted to the olecranon area of the ulna, the guide hole and the needle inlet point of the near end of the ulna are collinear, and a kirschner wire is inserted into the needle inlet point of the ulna along the guide hole. The ulna olecranon tension band kirschner wire screw placement guide plate can be obtained before an operation, assistance is provided for ulna olecranon fracture double-cortex fixed needle insertion, the operation time is shortened, the operation efficiency is improved, and meanwhile the risk is reduced.

Description

Technical Field

[0001] The invention belongs to the technical field of medical devices, and in particular relates to a guide plate for placing a Kirschner wire with a tension band on the olecranon, and a preparation method and a use method thereof. Background Art

[0002] Tension band wire (TBW) fixation is required for olecranon fractures and complex elbow fractures after olecranon osteotomy, and bone compression is required through Kirschner wires (K-wires). In traditional techniques, Kirschner wires are usually placed in the following two ways: Intramedullary placement: The Kirschner wire is inserted into the medullary cavity along the long axis of the ulna, but it is easy to cause low fixation strength, easy loosening and pin removal, protrusion of the needle tail, skin irritation, infection and secondary surgery. Transcortical placement: The Kirschner wire penetrates the anterior cortex of the proximal ulna to enhance stability with bicortical fixation (AO recommendation), but the operation depends on the surgeon's experience, and it is easy to have needle angle deviations, and the Kirschner wire mistakenly penetrates the joint surface, resulting in surgical failure.

[0003] Therefore, the defects of existing technologies mainly include: 1) inaccurate positioning, it is difficult to ensure the parallelism of the Kirschner wire and the consistency of the insertion point during manual operation, which increases the number of intraoperative fluoroscopy and radiation exposure; 2) high incidence of complications, the Kirschner wire mistakenly penetrates the joint surface, and the patient needs a second operation to remove the metal implant; 3) lack of individual adaptation, the universal guide plate cannot match the patient's anatomical variations, such as differences in olecranon morphology and trochlear notch position. Summary of the invention

[0004] The purpose of the present invention is to provide a ulna olecranon tension band Kirschner wire nail placement guide plate and its preparation method and use method. The nail placement guide plate can be obtained before surgery, and provides assistance for the precise bicortical placement of Kirschner wires, thereby reducing the operation time, improving the operation efficiency and also reducing the risk.

[0005] In order to achieve the above-mentioned purpose, the technical solution of the present invention is to design a tension band Kirschner wire placement guide plate for the ulnar olecranon, including a covering plate and a connecting rod; the covering plate is a plate-like structure designed using the anatomical landmarks of the dorsal and bilateral U-shaped regions of the ulnar olecranon; the connecting rod extends from the covering plate to the proximal end of the ulna, and a guide hole is provided at one end of the connecting rod located at the proximal end of the ulna; the axis of the guide hole is collinear with the needle insertion path of the proximal end of the ulna.

[0006] Furthermore, there are two guide holes, which are respectively located at the left and right 1 / 3 below the trochlear notch and parallel to the articular surface.

[0007] Furthermore, the connecting rod is provided with a guide block at one end located at the proximal end of the ulna, and the guide block is provided with a through hole, which is coaxial with the guide hole.

[0008] The manufacturing process of the olecranon tension band Kirschner wire placement guide: 1) Perform an imaging examination (computed tomography, CT) on the patient's ulna, reconstruct the ulna data in three dimensions, accurately include detailed information about the bones and tendons, and thus reconstruct the ulna model; 2) Use anatomical landmarks such as the olecranon, triceps tendon, and ulnar trochlear notch on the reconstructed ulna to design a design drawing of a precisely matched needle entry point guide; 3) Export the drawing file of the design drawing, and manufacture the physical guide through high-precision machine tools to ensure its consistency in structure and design; 4) After the guide is cleaned and sterilized, it can be used in surgery to treat the patient, providing precise needle entry point positioning for the surgery, thereby improving the accuracy and safety of the surgery.

[0009] The guide hole is designed according to the specifications of the Kirschner wire, while taking into account the machine tool processing accuracy and assembly clearance, and appropriate tolerances must be reserved.

[0010] How to use the olecranon tension band Kirschner wire nail placement guide: During surgery, place the covering surface of the covering plate on the dorsal U-shaped area of ​​the olecranon of the ulna. At this time, the guide hole is in line with the needle entry point of the proximal end of the ulna, and the Kirschner wire is inserted into the needle entry point of the ulna along the guide hole.

[0011] The advantages and beneficial effects of the present invention are that the olecranon tension band Kirschner wire pinning guide plate of the present invention can be obtained before surgery, providing precise assistance for bicortical fixation of olecranon fractures, reducing operation time, improving operation efficiency and also reducing risks. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] Figure 1 This is a schematic diagram of the structure of Example 1.

[0013] Figure 2 This is a schematic diagram of the structure of Example 2.

[0014] Figure 3 Diagram of the status of the use of the olecranon tension band Kirschner wire screw guide.

[0015] Figure 4 This is a CT scan of the case.

[0016] Figure 5 This is a coronal diagram of the computer simulation of the surgical plan.

[0017] Figure 6 This is a sagittal diagram of the computer simulation of the surgical plan.

[0018] Figure 7 This is a horizontal plane diagram of the computer simulation of the surgical plan.

[0019] Figure 8 Schematic diagram of the insertion distance of the first Kirschner wire.

[0020] Fig. 9 Schematic diagram of the insertion distance of the second Kirschner wire.

[0021] Fig.10 Schematic diagram for verification of actual needle insertion point and standard needle insertion point.

[0022] Among them, there are a covering plate 1, a connecting rod 2, a guide hole 3, a guide block 4, a Kirschner wire 5, and an ulna B. DETAILED DESCRIPTION

[0023] The specific implementation of the present invention is further described below in conjunction with the accompanying drawings and embodiments. The following embodiments are only used to more clearly illustrate the technical solution of the present invention, and cannot be used to limit the protection scope of the present invention. Example 1

[0024] like Figure 1 As shown, a tension band Kirschner wire placement guide plate for the ulnar olecranon comprises a covering plate 1 and a connecting rod 2; the covering plate 1 is a plate-like structure designed using the anatomical landmarks of the dorsal and lateral U-shaped regions of the ulnar olecranon, and the covering surface of the covering plate 1 matches the U-shaped region of the ulnar olecranon.

[0025] One end of the connecting rod 2 is connected to the covering plate 1, and the other end of the connecting rod 2 extends to the upper part of the proximal end of the ulna. The connecting rod 2 above the proximal end of the ulna is provided with a guide hole 3 which is colinear with the needle insertion point of the proximal end of the ulna. Example 2

[0026] like Figure 2 As shown, a tension band Kirschner wire placement guide plate for the ulnar olecranon comprises a covering plate 1 and a connecting rod 2; the covering plate 1 is a plate-like structure designed using the anatomical landmarks of the dorsal and lateral U-shaped regions of the ulnar olecranon, and the covering surface of the covering plate 1 matches the U-shaped region of the ulnar olecranon.

[0027] One end of the connecting rod 2 is connected to the covering plate 1, and the other end of the connecting rod 2 extends to the upper part of the proximal end of the ulna. A guide block 4 is provided on the connecting rod 2 above the proximal end of the ulna; the guide block 4 is provided with a guide hole 3 which is colinear with the needle insertion point of the proximal end of the ulna.

[0028] like Figure 3 As shown, a method for using a tension band Kirschner wire guide plate for the olecranon of the ulna is shown. During surgery, the covering surface of the covering plate 1 is applied to the olecranon area of ​​the ulna. At this time, the guide hole 3 is in line with the needle entry point at the proximal end of the ulna, and the Kirschner wire 5 is inserted along the guide hole 3 into the needle entry point of the ulna.

[0029] Case Study: like Figure 4 As shown, the patient was examined by CT and MRI before surgery. The examination conditions were as follows: CT required that each layer should be no larger than 1.5 mm, and the data format should be dicom; MRI required that each layer should be no larger than 5 mm, and the data format should be dicom.

[0030] like Figure 5 , Figure 6 , Figure 7 As shown, the patient's surgical plan is simulated by computer, and schematic diagrams of the coronal, sagittal and horizontal planes are obtained respectively.

[0031] like Figure 8 , Fig. 9 As shown, the lengths of the two Kirschner wires in the bone are 37.015 mm and 34.479 mm respectively.

[0032] like Fig.10 As shown in the figure, due to the slight deformation of the guide plate material during disinfection, the thickness of the bone surface periosteum of the covering plate 1 and the U-shaped area of ​​the olecranon may cause slight errors in actual surgery. Therefore, a CT scan of the olecranon was performed after surgery, and the standard needle insertion conditions confirmed by simulating the preoperative data were combined to obtain the deviation data of the actual needle insertion point and the standard needle insertion point.

[0033] The data are as follows: close to the radial side: the distance between the center point of the standard needle insertion point and the actual needle insertion point is 1.757mm; away from the radial side: the distance between the center point of the standard needle insertion point and the actual needle insertion point is 1.642mm.

[0034] The above is only a preferred embodiment of the present invention. It should be pointed out that for ordinary technicians in this technical field, several improvements and modifications can be made without departing from the technical principles of the present invention. These improvements and modifications should also be regarded as the scope of protection of the present invention.

Claims

1. A guide plate for placing a Kirschner wire with a tension band on the ulna olecranon, characterized in that: It includes a covering plate and a connecting rod; the covering plate is a plate-like structure designed using the anatomical landmarks of the dorsal side and the U-shaped areas on both sides of the olecranon of the ulna; the connecting rod extends from the covering plate to the proximal end of the ulna, and a guide hole is provided at one end of the connecting rod located at the proximal end of the ulna; the axis of the guide hole is colinear with the needle insertion path of the proximal end of the ulna.

2. The olecranon tension band Kirschner wire placement guide according to claim 1, characterized in that: There are two guide holes, which are respectively located at the left and right 1 / 3 below the trochlear notch and parallel to the articular surface.

3. The olecranon tension band Kirschner wire placement guide according to claim 1, characterized in that: The connecting rod is provided with a guide block at one end located at the proximal end of the ulna, and a through hole is provided on the guide block, and the through hole is coaxial with the guide hole.

4. The method for preparing a guide plate for placing a Kirschner wire with a tension band on the ulna olecranon according to claim 1, characterized in that: Step 1: Obtain the patient's ulna CT data and create a 3D model; Step 2: Design the covering plate based on anatomical landmarks and confirm the location of the guide hole; Step 3: 3D print the molded guide plate made of medical-grade materials.

5. The method for using the olecranon tension band Kirschner wire guide plate according to any one of claims 1 to 3, characterized in that: During the operation, the covering surface of the covering plate is applied to the olecranon area of ​​the ulna. At this time, the guide hole and the needle entry point of the proximal end of the ulna are in line, and the Kirschner wire is inserted into the needle entry point of the ulna along the guide hole.

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