An HTO surgery positioning osteotomy guiding auxiliary device

Abstract

The application discloses an HTO operation positioning osteotomy guiding auxiliary device, and relates to the technical field of medical instruments, which comprises components A, B and C, the components B and C can be assembled on the component A, the component A is connected with the component B, the component B is provided with at least one group of steel needle guiding holes for guiding the placement of a steel needle, a swing saw guiding hole parallel to the section where the steel needle guiding holes are located, and a coronal section osteotomy guiding hole with a 110° angle with the section where the steel needle guiding holes are located, the component A is connected with the component C, the component C comprises a first fixing part and a second fixing part, the first fixing part and the second fixing part are fixed to the tibia through a bone nail, the second fixing part is flipped relative to the first fixing part, and the first fixing part is provided with a protractor for measuring the flip angle of the second fixing part. The device can complete the whole HTO operation, including the placement of a steel needle, osteotomy, distraction and the installation of a steel plate, has low cost and is convenient to use.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical devices, in particular to an HTO surgery positioning osteotomy guiding auxiliary device. BACKGROUND

[0002] The HTO surgery, also known as tibial high osteotomy, is to correct the knee joint from valgus deformity to normal force line.

[0003] During the HTO surgery, the following steps are included:

[0004] As shown in Figure 1 and Figure 2 , first, two steel needles 1 are punched in from the proximal medial side of the tibia to determine the osteotomy plane a, and the osteotomy plane a formed by the two steel needles 1 should be parallel to the articular surface b, but there are difficulties in placing the steel needles, including: first, it is difficult to ensure that the osteotomy plane a formed by the steel needles is parallel to the articular surface b in the sagittal plane by experience operation, and second, it is difficult to accurately keep 1.5 cm between the two steel needles near the tibial plateau;

[0005] As shown in Figure 2 , secondly, a swing saw is used to cut the tibia along the direction of the steel needle, and then a coronal osteotomy is performed at the tibial tuberosity, and the osteotomy plane a cut along the direction of the steel needle and the coronal osteotomy plane c form a 110-degree angle in the sagittal plane, and in this process, the angle between the osteotomy plane a and the coronal osteotomy plane c needs to be visually observed by the main surgeon, which is not accurate enough;

[0006] As shown in Figure 3 and Figure 4 , finally, a distractor 2 is used to distract the cut tibia from the cut along the steel needle to correct it, and after correction, a Tomofix steel plate 3 is used for fixation, and in this process, the osteotomy plane a is only fixed by a distractor 2, and the entire tibia is unstable, which can easily cause the change of the tibial inclination angle, resulting in inaccurate correction, and also cannot accurately grasp the angle of the tibia after distraction. SUMMARY

[0007] The main purpose of the present application is to provide an HTO surgery positioning osteotomy guiding auxiliary device, which aims to solve the above technical problems.

[0008] The technical scheme adopted by the present application is as follows:

[0009] An HTO surgery positioning osteotomy guiding auxiliary device, comprising a component A, a component B and a component C, the component B and the component C can be replaceably assembled to the component A;

[0010] The component A and the component B are connected to form a first clamping area for clamping the tibia, the component B is provided with at least one set of needle guide holes for guiding the needle implantation, a swing saw guide hole parallel to the section where the needle guide holes are located, and a coronal section osteotomy guide hole with a 110° angle with the section where the needle guide holes are located;

[0011] The component A and the component C are connected to form a second clamping area for clamping the tibia, the component C includes a first fixed part and a second fixed part, the first fixed part and the second fixed part are fixed with the tibia through a bone nail, the second fixed part rotates relative to the first fixed part to correct the tibia from the varus deformity to the normal force line, and the first fixed part is provided with a protractor for measuring the turning angle of the second fixed part.

[0012] Optionally, the component A includes:

[0013] A connecting part, two ends of the connecting part are respectively provided with a first connecting port and a second connecting port;

[0014] A component connecting arm, the component connecting arm is slidingly inserted into the first connecting port and is fastened through a first locking bolt;

[0015] A first clamping arm, the first clamping arm is arranged in the second connecting port in a direction perpendicular to the connecting part and is fastened through a second locking bolt.

[0016] Optionally, the component connecting arm includes a long arm strip and a U-shaped connecting head perpendicular to the long arm strip, the long arm strip is inserted into the first connecting port, and the component B and the component C are both connected to the U-shaped connecting head.

[0017] Optionally, the component B includes a second clamping arm, the second clamping arm is arranged opposite to the first clamping arm, and one end of the second clamping arm is provided with a first insertion block inserted into the U-shaped connecting head, and the first insertion block is fastened through a third locking bolt.

[0018] Optionally, the second clamping arm is provided with the needle guide hole, the swing saw guide hole and the coronal section osteotomy guide hole.

[0019] Optionally, the first clamping arm and the second clamping arm are provided with an arc groove matched with the tibia.

[0020] Optionally, the first fixed part and the second fixed part are both semi-enclosing arc plates, the first fixed part and the second fixed part are provided with bone nail through holes, and the front surface of the first fixed part and the second fixed part is further provided with a Tomofix steel plate mounting avoiding hole.

[0021] Optionally, the side surface of the first fixed part is provided with a cylindrical connecting rod, one end of the cylindrical connecting rod is inserted with the U-shaped connector through a second insertion block, and is fastened through a third locking bolt.

[0022] Optionally, a connecting plate is rotatably arranged on the cylindrical connecting rod, the other end of the connecting plate is fixedly connected with the second fixed part, and the second fixed part rotates around the cylindrical connecting rod through the connecting plate.

[0023] Optionally, a damping angle indicator is further arranged on the cylindrical connecting rod, and the connecting plate is located at the 90° scale line of the angle indicator in the initial state.

[0024] Compared with the prior art, the application has the following beneficial effects:

[0025] Firstly, the HTO surgery positioning and bone cutting guiding auxiliary device provided in the embodiment of the application can ensure that the steel needle is placed in the tibia at a preset angle by clamping the tibia with the component A and the component B and guiding the placement direction of the steel needle through the steel needle guiding hole on the component B, so that the bone cutting plane a along the steel needle direction meets the requirements, and the swing saw is guaranteed to cut the bone along the plane determined by the steel needle, ensuring the accuracy of bone cutting. Meanwhile, the coronal bone cutting guiding hole with a 110° angle with the bone cutting plane a is arranged, thereby ensuring the accuracy of the coronal bone cutting and solving the defect that the 110° angle is not accurate enough observed by the naked eye of the surgeon.

[0026] Secondly, the HTO surgery positioning and bone cutting guiding auxiliary device provided in the embodiment of the application can increase the stability of the tibia when the tibia is distracted by the distractor by clamping the tibia with the component C and the component A, the first fixed part and the second fixed part in the component C are fixed with the tibia, and the first fixed part and the second fixed part have a specific connection relationship. Meanwhile, the overturning angle of the second fixed part compared with the first fixed part can be observed by the arrangement of the angle indicator, thereby accurately correcting the overturning angle of the tibia.

[0027] Thirdly, the HTO surgery positioning and bone cutting guiding auxiliary device provided in the embodiment of the application can meet the use of the whole tibial high osteotomy by connecting the component B and the component C with the component A in turn, thereby reducing the cost and facilitating the use. BRIEF DESCRIPTION OF DRAWINGS

[0028] Figure 1 It is a schematic view of the state of placing the steel needle in the traditional HTO surgery.

[0029] Figure 2 It is a schematic view of the state of bone cutting in the traditional HTO surgery.

[0030] Figure 3 Fig. 1 is a schematic diagram of the state when installing Tomofix steel plate during traditional HTO surgery;

[0031] Figure 4 Fig. 2 is a schematic diagram of the state after correction during traditional HTO surgery;

[0032] Figure 5 Fig. 3 is a schematic diagram of an HTO surgery positioning osteotomy guiding auxiliary device proposed in the embodiment of the present application Figure 1 ;

[0033] Figure 6 Fig. 4 is a schematic diagram of an HTO surgery positioning osteotomy guiding auxiliary device proposed in the embodiment of the present application Figure 2 .

[0034] Explanation of reference numerals in the drawings:

[0035] 1-steel needle, 2-distraction device, 3-Tomofix steel plate, 4-connection part, 5-component connecting arm, 501-long arm strip, 502-U-shaped connecting head, 6-first clamping arm, 7-first locking bolt, 8-second locking bolt, 9-second clamping arm, 10-third locking bolt, 11-first insertion block, 12-steel needle guiding hole, 13-saw guiding hole, 14-coronal osteotomy guiding hole, 15-first fixing part, 16-second fixing part, 17-bone nail hole, 18-cylindrical connecting rod, 19-second insertion block, 20-connection plate, 21- protractor, 22-avoidance hole, 23-circular arc groove, 24-fibula clamping area, 25-fixing nail hole, 26-guiding plate, 27-insertion plate, 28-T-shaped nail. DETAILED DESCRIPTION

[0036] The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application. Obviously, the described embodiments are only part of the embodiments of the present application, rather than all the embodiments of the present application. Based on the embodiments in the present application, all other embodiments obtained by those skilled in the art without creative labor fall within the scope of protection of the present application.

[0037] It should be noted that all directional indications (such as up, down, left, right, front, back, etc.) in the embodiments of the present application are only used to explain the relative positional relationship, movement condition, etc. between components in a certain posture (as shown in the drawings), and if the certain posture changes, the directional indications also change accordingly.

[0038] ​In this application, unless otherwise clearly specified and limited, the terms "connection", "fixation" and the like should be understood in a broad sense, for example, "fixation" can be fixed connection, or detachable connection, or integral; can be mechanical connection, or electrical connection; can be direct connection, or indirect connection through intermediate medium; can be internal connection of two elements, or interaction relationship between two elements, unless otherwise clearly limited. For those skilled in the art, the specific meaning of the above terms in this application can be understood according to the specific circumstances.

[0039] In addition, if the description of "first", "second" and the like is involved in the embodiments of the present application, the description of "first", "second" and the like is only for the purpose of description, and cannot be understood as indicating or implying the relative importance of the indicated technical features or implicitly indicating the number of the indicated technical features. Therefore, the features limited by "first", "second" can explicitly or implicitly include at least one of the features. In addition, the meaning of "and / or" appearing throughout the text includes three parallel schemes. For example, "A and / or B" includes A scheme, or B scheme, or A and B scheme. In addition, the technical solutions of each embodiment can be combined with each other, but it must be based on the realization of ordinary skilled in the art, when the combination of technical solutions appears contradictory or unachievable, it should be considered that the combination of technical solutions does not exist, nor within the scope of protection claimed by the present application.

[0040] Referring to the drawings Figure 5 and Figure 6 The embodiments of the present application provide a kind of HTO surgery positioning osteotomy guiding auxiliary device, including component A, component B and component C, component B and component C can be replaced and assembled in component A, component A and component B are used in cooperation, guide steel needle is placed into tibia with correct angle, and it is guaranteed to complete accurate osteotomy, component A is used in cooperation with component C, realize that distractor is stable and opens tibia, and it is guaranteed that tibia correction angle.

[0041] Specifically:

[0042] As Figure 5As shown, component A includes a connecting part 4, a component connecting arm 5 and a first clamping arm 6. The connecting part 4 is like a Z-shaped handle structure. First and second connecting openings are respectively arranged at two ends of the connecting part 4. The first connecting opening is a square hole, and the second connecting opening is a round hole. The component connecting arm 5 includes a long arm strip 501 and a U-shaped connecting head 502 perpendicular to the long arm strip 501. The long arm strip 501 is integrally formed with the U-shaped connecting head 502. The long arm strip 501 is inserted into the first connecting opening and can be adjusted in length of the whole component A along the first connecting opening. A first locking bolt 7 is arranged on the connecting part 4. The first locking bolt 7 tightly fixes the long arm strip 501 on the connecting part 4. One end of the first clamping arm 6 is provided with a short shaft which is inserted into the second connecting opening. The first clamping arm 6 can rotate and is tightly fixed by a second locking bolt 8.

[0043] As shown in Figure 5 , component B includes a second clamping arm 9. One end of the second clamping arm 9 is provided with a first plug 11 which is inserted into the U-shaped connecting head 502. The first plug 11 is provided with a threaded hole. A third locking bolt 10 is arranged on the U-shaped connecting head 502. The third locking bolt 10 is screwed into the threaded hole of the first plug 11, thereby completing the connection between component B and component A. The second clamping arm 9 is arranged opposite to the first clamping arm 6. The first clamping arm 6, the second clamping arm 9 and the component connecting arm 5 and the connecting part 4 form a semi-closed first clamping area. In use, the first locking bolt 7 is loosened, the component connecting arm 5 is adjusted in length, the first clamping arm 6 and the second clamping arm 9 clamp the tibia, and then the first locking bolt 7 is tightened. Figure 1 As shown in , it can be imagined that, since the osteotomy plane a and the articular surface b determined by the steel needle need to be parallel in the sagittal plane during osteotomy, the steel needle is obliquely inserted into the tibia. Therefore, when components A and B are used together, the straight line where the component connecting arm 5 and the connecting part 4 are located is in an inclined state. If the first clamping arm 6 and the second clamping arm 9 are fixed structures, the side surface of the first clamping arm 6 and the second clamping arm 9 cannot be parallel to the tibia, resulting in that the contact surface of the first clamping arm 6 and the second clamping arm 9 with the tibia is relatively small. In order to ensure that the first clamping arm 6 and the second clamping arm 9 can better clamp the tibia, the first clamping arm 6 and the connecting part 4 are arranged in a rotatable connection. Before clamping the tibia, the placement positions of components A and B at the proximal end and the distal end of the tibia are determined by measuring the distance and marking the body surface. Usually, the distance between the needle insertion point at the proximal end of the tibia and the articular end surface is 3 cm, and the distance between the needle exit point at the distal end of the tibia and the articular end surface is 1.5 cm (as shown in Figure 1 ). After marking, the component connecting arm 5 needs to be kept parallel to the line connecting the two marking points. The second locking bolt 8 is loosened, the first clamping arm 6 is rotated to be parallel to the tibia and then is tightened, the second clamping arm 9 is moved to be in contact with the tibia and then is locked, thereby stably clamping the tibia and ensuring the accuracy of the angle of the steel needle, the osteotomy plane a and the coronal plane c.

[0044] In the above, such as Figure 5 As shown, the first clamping arm 6 and the second clamping arm 9 are provided with arc grooves 23. When clamping the tibia, the design of the arc grooves 23 can form a relatively larger contact surface with the tibia compared to a planar structure, which can increase the clamping effect of the first clamping arm 6 and the second clamping arm 9 on the tibia to a certain extent. At the same time, a fibular clamping area 24 for fixing the fibula is provided on the same side of the first clamping arm 6 and the arc grooves 23. The fibular clamping area 24 is provided with fixing pin holes 25. The fibula is clamped by the fibular clamping area 24, and then bone screws are used to be driven into the fibula through the fixing pin holes 25, fixing the first clamping arm 6 to the fibula and clamping the tibia at the same time, maintaining the stability of the entire frame during use.

[0045] The second clamping arm 9 is equipped with a steel pin guide hole 12, an oscillating saw guide hole 13, and a coronal osteotomy guide hole 14. All three holes face from the proximal to the distal end of the tibia. The steel pin guide hole 12 guides the steel pin into the tibia in the correct direction, thus avoiding the hassle of repeated pin insertion and ensuring the correctness of pin implantation. This significantly improves the success rate of the surgery and reduces surgical risks. At least two steel pin guide holes 12 are provided to form the osteotomy plane a for guiding the osteotomy. The oscillating saw guide hole 14... Located below the steel needle guide hole 12, during osteotomy, the oscillating saw, guided by the oscillating saw guide hole 13, performs osteotomy along the osteotomy plane a determined by the steel needle, ensuring the accuracy of the osteotomy. At the same time, a coronal osteotomy guide hole 14 is provided on one side of the oscillating saw guide hole 13, forming a 110° angle with the cross section where the steel needle guide hole 12 is located. Thus, the oscillating saw performs coronal osteotomy along the direction of the coronal osteotomy guide hole 14, ensuring that the coronal osteotomy plane c and the osteotomy plane a along the direction of the steel needle are always accurately 110°, avoiding the inaccuracy of the surgeon's visual judgment.

[0046] In a preferred embodiment, since the tibial cross-sectional size varies among different patients, the location of the coronal osteotomy guide hole 14 will differ. To accommodate tibias of different cross-sectional sizes, such as... Figure 5As shown, the second clamping arm 9 away from the side of component A is provided with a sliding guide plate 26, and the guide plate 26 is provided with a coronal bone cutting guide hole 14. Specifically, the second clamping arm 9 away from the side of component A is provided with a insertion hole, and the side of the guide plate 26 facing the second clamping arm 9 is provided with an insertion plate 27 inserted into the insertion hole. The top surface of the second clamping arm 9 is provided with a threaded hole perpendicular to the insertion plate 27, and a T-shaped nail 28 is arranged in the threaded hole. It can be understood that by loosening the T-shaped nail 28, the guide plate 26 can be moved left and right, the position of the coronal bone cutting guide hole 14 is adjusted, and the T-shaped nail 28 is locked. Adapt to different patients. Of course, the surface of the insertion plate 27 and the bottom surface of the T-shaped nail 28 are provided with anti-skid lines to increase the friction between the T-shaped nail 28 and the insertion plate 27, so as to more stably fasten the guide plate 26.

[0047] As shown in Figure 6 Component C includes a first fixed part 15 and a second fixed part 16. Both the first fixed part 15 and the second fixed part 16 are semi-enclosed circular arc plates, and both the first fixed part 15 and the second fixed part 16 are provided with a bone nail hole 17. By fitting the first fixed part 15 and the second fixed part 16 with the tibia, and then using a bone nail to nail into the tibia from the bone nail hole 17, the first fixed part 15 and the second fixed part 16 are fixed on the tibia. The side surface of the first fixed part 15 is provided with a cylindrical connecting rod 18, one end of the cylindrical connecting rod 18 is integrally formed with a second insertion block 19, the second insertion block 19 is inserted into the U-shaped connecting head 502, and the second insertion block 19 is fastened by the third locking bolt 10.

[0048] As shown in Figure 6 The cylindrical connecting rod 18 is rotatably provided with a connecting plate 20, and the other end of the connecting plate 20 is fixedly connected with the second fixed part 16, so that the second fixed part 16 rotates around the cylindrical connecting rod 18 through the connecting plate 20. An angle gauge 21 is also arranged on the cylindrical connecting rod 18. The angle gauge 21 is provided with an axle hole, and a friction rubber gasket is arranged in the axle hole. The angle gauge 21 is sleeved on the cylindrical connecting rod 18 through the axle hole to form a damping rotation, and the connecting plate 20 is kept at the initial state of the 90° scale line of the angle gauge 21.

[0049] Thus, it can be imagined that after connecting component C with component A, the telescopic adjusting component connecting arm 5 makes the first fixing part 15 and the second fixing part 16 cooperate with the first clamping arm 6 to clamp the tibia, and at the same time, the first fixing part 15 and the second fixing part 16 are fixed on the tibia by using the bone nail, and the first fixing part 15 and the second fixing part 16 are rotationally connected through the connecting plate 20, so that the tibia can only complete eversion and cannot form left-right dislocation, thereby increasing the stability of the tibia during distraction and avoiding dislocation of the tibia. At the same time, by using the setting of the protractor 21, the turning angle of the second fixing part 16 compared with the first fixing part 15 can be observed, so that the turning angle during tibia correction can be accurately observed. It is not difficult to understand that different people need to correct different angles of the tibia, so when the first fixing part 15 and the second fixing part 16 are used to be fixed with the tibia of different people by using the bone nail, the initial included angle between the first fixing part 15 and the second fixing part 16 will be different, so the protractor 21 with damping rotation is set, and after the first fixing part 15 and the second fixing part 16 are fixed with the tibia, the protractor 21 is rotated to make the 90° scale line of the protractor 21 coincide with the connecting plate 20, so that the angle of tibial eversion can be accurately measured.

[0050] Of course, it can be understood that in order to facilitate the installation of the Tomofix steel plate after the tibia is distracted, as shown in Figure 6 The front surface of the first fixing part 15 and the second fixing part 16 is also provided with a Tomofix steel plate installation avoiding hole 22.

[0051] In summary, the HTO surgery positioning osteotomy guiding auxiliary device provided by the embodiment of the present application has the following use method:

[0052] First, connect component B with component A, clamp the first clamping arm 6 and the second clamping arm 9 to the body position mark point according to the preoperative measurement of the distance between the proximal end and the distal end of the tibia and the body surface mark, and ensure that the steel needle guide hole 12, the swing saw guide hole 13 and the coronal osteotomy guide hole 14 are in the correct direction;

[0053] Then, place the steel needle into the tibia along the steel needle guide hole 12, and after the steel needle is placed, use the swing saw to perform osteotomy on the tibia from the swing saw guide hole 13 and the coronal osteotomy guide hole 14 in turn; after the osteotomy is completed, remove component B from component A, and connect component C with component A;

[0054] Then, clamp the first clamping arm 6, the first fixing part 15 and the second fixing part 16 to the tibia, and fix the first fixing part 15 and the second fixing part 16 with the tibia by using the bone nail, rotate the protractor 21 to make the 90° scale line of the protractor 21 coincide with the connecting plate 20, and then use the distractor to distract the tibia from the proximal end of the tibia, and observe the distraction angle to the design value through the protractor 21;

[0055] Finally, the tibia is fixed by a steel needle through the avoiding hole 22 of the first fixing part 15 and the second fixing part 16, and the tibia correction is completed.

[0056] The above description is merely preferred embodiments of the present application, and not intended to limit the present application. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application shall be included in the protection scope of the present application.

Claims

1. An HTO surgical positioning osteotomy guide assisting device, characterized in that, The component A, the component B and the component C, the component B and the component C are replaceably assembled to the component A; The component A and the component B are connected to form a first clamping area for clamping the tibia, the component B is provided with at least one group of steel needle guide holes for guiding the insertion of the steel needle, a swing saw guide hole parallel to the section where the steel needle guide hole is located, and a coronal position osteotomy guide hole with a 110° angle with the section where the steel needle guide hole is located; The component A and the component C are connected to form a second clamping area for clamping the tibia, the component C includes a first fixed part and a second fixed part, the first fixed part and the second fixed part are fixed with the tibia through a bone nail, the second fixed part is everted relative to the first fixed part, and the first fixed part is provided with a protractor for measuring the turning angle of the second fixed part; The component A includes: A connecting part, two ends of the connecting part are respectively provided with a first connecting port and a second connecting port; A component connecting arm, the component connecting arm is slidingly inserted into the first connecting port and is fastened by a first locking bolt; A first clamping arm, the first clamping arm is rotatably arranged in the second connecting port in a direction perpendicular to the connecting part and is fastened by a second locking bolt; The component connecting arm includes a long arm strip and a U-shaped connector perpendicular to the long arm strip, the long arm strip is inserted into the first connecting port, and the component B and the component C are connected to the U-shaped connector; The first fixed part and the second fixed part are both semi-enclosed circular arc plates, the first fixed part and the second fixed part are provided with bone nail through holes, and the front surface of the first fixed part and the second fixed part is further provided with a Tomofix steel plate mounting avoidance hole; The side surface of the first fixed part is provided with a cylindrical connecting rod, one end of the connecting rod is inserted into the U-shaped connector through a second insertion block and is fastened by a third locking bolt; A connecting plate is rotatably arranged on the cylindrical connecting rod, the other end of the connecting plate is fixedly connected to the second fixed part, and the second fixed part rotates around the cylindrical connecting rod through the connecting plate; A protractor for damping rotation is further arranged on the cylindrical connecting rod, and the connecting plate is located at the 90° scale line coincidence of the protractor in the initial state.

2. The HTO surgery positioning osteotomy guide assistive device of claim 1, wherein, The component B includes a second clamping arm, the second clamping arm is oppositely arranged with the first clamping arm, and one end of the second clamping arm is provided with a first insertion block inserted into the U-shaped connector, and the first insertion block is fastened by a third locking bolt.

3. The HTO surgery positioning osteotomy guide assistive device of claim 2, wherein, The second clamping arm is provided with the steel needle guide hole, the swing saw guide hole and the coronal position osteotomy guide hole.

4. The HTO surgery positioning osteotomy guide assistive device of claim 2, wherein, The first clamping arm and the second clamping arm are provided with a circular arc groove matched with the tibia.

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