Patellar fracture 3d printing personalized surgical guide

Abstract

The utility model discloses a kind of patella fracture 3D printing personalized surgical guide plate, including the first guide plate main part and second guide plate main part made by 3D printing, the first guide plate main part and the second guide plate main part are detachably connected by at least two tension bolts, the inner surface of the first guide plate main part and the second guide plate main part after splicing is matched with the surface topography of patient knee joint, the surface of the first guide plate main part and / or the second guide plate main part is in and is equipped with several positioning channels, positioning channel is movably inserted with positioning guider.The utility model innovatively according to patient knee joint CT personalized custom surgical guide plate, and it is realized low cost fast production by 3D printing technology, can be in patella fracture reduction screw internal fixation operation continuously assist bone block reduction and guide screw accurate implantation, avoid repeated X-ray irradiation radiation exposure, save operation time and the physical strength of surgical personnel, more avoid the bone damage of patient by repeated drilling adjustment.

Description

Technical Field

[0001] This utility model belongs to the field of medical auxiliary equipment technology, specifically a 3D-printed personalized surgical guide for patellar fracture. Background Technology

[0002] Surgical treatment is a crucial approach for patellar fractures. For displaced patellar fractures, and even comminuted fractures, surgery is the primary treatment option. Reduction and fixation are key steps in patellar fracture surgery. Specifically, the surgical procedure involves first restoring the fragmented patellar bone pieces to their original anatomical positions and then fixing them using various fixation devices to provide a stable foundation for subsequent bone growth and healing. Common internal fixation devices for patellar fracture surgery include metal cables, Kirschner wires, tension bands, screws, and patellar claws. Among these, screws are favored by trauma orthopedics specialists due to their simple and quick implantation, high mechanical strength, strong postoperative stability, and minimal surgical trauma.

[0003] Taking a common longitudinal patellar fracture as an example, the traditional procedure for patellar fracture reduction and internal fixation with screws is generally as follows: after disinfection and draping, the two separated patellar fragments are tightly clamped with surgical forceps to bring them together and reduce their position; then, a hole is drilled on one side of the patella and a Kirschner wire is inserted to guide the direction of the screw; finally, the screw is inserted along the direction of the Kirschner wire to fix the two bone fragments; if small incisions were made on the skin during the process for drilling and screw insertion, they must be sutured at the end of the surgery.

[0004] The aforementioned patellar fracture reduction and internal fixation surgery using screws has many advantages, but it still faces several shortcomings in clinical application, mainly in the following aspects:

[0005] 1. The position and angle of screw implantation rely to a large extent on the doctor's experience. In order to achieve the ideal position during the operation, multiple X-rays need to be taken and the screw implantation channel needs to be adjusted repeatedly. This process is not only time-consuming, but also exposes the patient to radiation multiple times. In addition, the process of repeated adjustment and drilling can also cause potential damage to the patient's residual bone.

[0006] 2. During the reduction of patellar fragments, the traditional method usually involves manually holding the fragments with two surgical forceps or similar instruments. This method not only consumes a lot of the operator's physical strength, but also has the potential for insufficient clamping force, loosening of the fragments, and displacement of the fragments during the operation.

[0007] Third, because each of the aforementioned similar curved forceps instruments only relies on two points at the tip to contact the patella, their stability is poor. In many cases, the force at the tip is too great and it can even pierce the skin, causing soft tissue damage.

[0008] Fourth, since the placement and angle of screw implantation rely solely on the surgeon's experience, it is difficult to implant multiple screws in patients with complex fracture lines and unique patellar fractures while ensuring uniform placement and reasonable angles. Surgeons often experience interference between screw tracks and drilling deviations during repeated adjustments. In some cases, although the screws are implanted, their intraosseous travel is insufficient, resulting in ineffective fixation. In severe cases, internal screw fixation surgery may not be possible, forcing the surgeon to switch to other more complex and invasive surgical procedures. Utility Model Content

[0009] To overcome the aforementioned bottlenecks, this utility model patent provides a 3D-printed personalized surgical guide for patellar fractures. The surgical guide is innovatively customized based on the patient's knee CT scan and can be manufactured quickly and at low cost using 3D printing technology. This surgical guide can continuously assist in the reduction of bone fragments and guide the precise implantation of screws during patellar fracture reduction and internal fixation surgery.

[0010] To solve the above-mentioned technical problems, the present invention adopts the following technical solution:

[0011] A 3D-printed personalized surgical guide for patellar fracture includes a first guide body and a second guide body made by 3D printing. The first guide body and the second guide body are detachably connected by at least two tension bolts. The inner surfaces of the first guide body and the second guide body after splicing match the surface morphology of the patient's knee joint. Several positioning channels are formed in the surface of the first guide body and / or the second guide body, and positioning guides are movably inserted in the positioning channels.

[0012] Furthermore, at least two sets of matching mortise and tenon structures are respectively provided on the mating surfaces of the first guide plate main body and the second guide plate main body.

[0013] Furthermore, a patellar consolidation semi-ring is fixedly disposed on the inner surface of the first guide plate main body and the second guide plate main body respectively, and the two patellar consolidation semi-rings cooperate to form an approximately arc-shaped patellar consolidation ring that matches the outline of the patient's patella.

[0014] Furthermore, longitudinal grooves are provided on the side wall of the positioning channel.

[0015] Furthermore, the positioning guide is a cylindrical structure with a "T"-shaped cross-section, and a through hole is provided at its axis.

[0016] Compared with the prior art, the beneficial effects of this utility model are as follows:

[0017] 1. The surgical guide of this utility model is precisely designed based on the patellar fracture fragments and skin structure reconstructed by the patient's CT three-dimensional reconstruction. It is precisely placed by conforming to the shape around the patient's knee joint, and its special guiding device directly guides drilling and screw implantation. It can ensure that the ideal screw implantation position and angle can be obtained in one go, which not only avoids repeated X-ray radiation exposure, but also saves surgical time, and at the same time avoids bone damage to the patient caused by repeated drilling and adjustment.

[0018] 2. The surgical guide is equipped with a personalized patellar-aggregating structure that is highly adapted to the shape of the patient's patella. After positioning and installation, it can aggregate patellar fragments and maintain the reduction effect continuously. This avoids the unreliability of loosening and displacement when manually holding instruments to reduce patellar fragments. It also greatly saves the physical strength of the surgeon, allowing him to perform the surgery more calmly and freely.

[0019] 3. The surgical guide plate has a wide and smooth contact area with the skin around the patella, and is equipped with a special locking structure, which can gather and maintain the position of patellar fragments over a large area and for a long time, while avoiding the defects of traditional instruments that can puncture the skin with sharp tips;

[0020] 4. The surgical guide was precisely designed by the medical engineering team based on the patient's fracture CT three-dimensional reconstruction data. The position and angle of each screw implantation were meticulously planned before the operation to ensure that the screws were evenly positioned and that the screws were implanted in a reasonable direction, so as to make the most of the residual bone to provide the most reliable fixation effect.

[0021] 5. This surgical guide uses 3D printing technology to achieve personalized design and low-cost rapid manufacturing. This precise three-dimensional preoperative planning and surgical guidance scheme combines current advanced manufacturing technology, and the technical effect it achieves is difficult to achieve with traditional surgical methods of drilling and implantation. Attached Figure Description

[0022] Figure 1 This is a schematic diagram of the main structure of the first guide plate component;

[0023] Figure 2 This is a rear view structural diagram of the main body of the first guide plate;

[0024] Figure 3 This is a three-dimensional structural diagram of the main body of the first guide plate;

[0025] Figure 4 This is a structural schematic diagram of the mating surface of the first guide plate main body;

[0026] Figure 5 This is a schematic diagram of the main structure of the second guide plate;

[0027] Figure 6This is a rear view structural diagram of the second guide plate main body;

[0028] Figure 7 This is a three-dimensional structural diagram of the main body of the second guide plate;

[0029] Figure 8 This is a structural schematic diagram of the mating surface of the second guide plate main body;

[0030] Figure 9 This is a schematic diagram illustrating the assembly process of the first guide plate main body and the second guide plate main body.

[0031] Figure 10 A front view schematic diagram of the surgical guide plate fixed on the knee joint;

[0032] Figure 11 A side view of the surgical guide plate fixed on the knee joint.

[0033] Figure 12 A schematic diagram illustrating the assembly process of the tensioning bolts on the surgical guide.

[0034] Figure 13 A schematic diagram illustrating the process of assembling the positioning guide within the positioning channel;

[0035] Figure 14 This is a schematic diagram illustrating the process of inserting the Kirschner wire into the borehole;

[0036] Figure 15 A schematic diagram illustrating the process of implanting the internal fixation screw into the patella;

[0037] Figure 16 This is a schematic diagram of the removal process of the Kirschner wire and surgical guide.

[0038] In the diagram: 1. First guide plate main body; 101. Insertion post; 102. Insertion hole; 103. Patellar semi-ring; 104. Threaded connection hole; 2. Second guide plate main body; 201. Bolt connection hole; 202. Positioning channel; 203. Longitudinal groove; 3. Tensioning bolt; 4. Positioning guide; 5. Kirschner wire; 6. Internal fixing screw. Detailed Implementation

[0039] The preferred embodiments of the present invention will now be described in detail with reference to the accompanying drawings, so that the advantages and features of the present invention can be more easily understood by those skilled in the art, thereby making a clearer and more definite definition of the scope of protection of the present invention.

[0040] It should be noted that when a component is said to be "installed on" another component, it can be directly on the other component or it may be in a component that is centered on it. When a component is said to be "set on" another component, it can be directly set on the other component or it may also be in a component that is centered on it. When a component is said to be "fixed to" another component, it can be directly fixed to the other component or it may also be in a component that is centered on it.

[0041] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention pertains. The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. The term "or / and" as used herein includes any and all combinations of one or more of the associated listed items.

[0042] See appendix Figures 1 to 8 A 3D-printed personalized surgical guide for patellar fractures includes a first guide body 1 and a second guide body 2, both manufactured using 3D printing. Before patellar fracture reduction and screw fixation surgery, a 3D image of the patella is obtained using CT scanning. This data includes the curved contours of the patellar surface and its lateral soft tissues. By setting parameters such as the surface cut-out range and surface smoothing in 3D modeling software, an inner surface of the surgical guide matching the lateral soft tissue surface of the patella is automatically generated. Then, a solid model of the entire surgical guide is created using modeling methods such as surface thickening and boundary smoothing. Finally, in the 3D modeling software, the entire solid model is divided in two along the vertical plane containing the patellar midline, forming the main body of the first guide body 1 and the second guide body 2.

[0043] At least two sets of matching mortise and tenon structures are respectively provided on the mating surfaces (i.e., the aforementioned dividing positions) of the first guide plate main body 1 and the second guide plate main body 2. In this embodiment, a plug-in post 101 and a plug-in hole 102 are provided on the mating surfaces of the first guide plate main body 1 and the second guide plate main body 2. The diameter of the plug-in post 101 and the plug-in hole 102 is 8mm, and the length / depth is approximately 15-20mm. The end of the plug-in post 101 is rounded. The plug-in post 101 on the first guide plate main body 1 is plugged into the plug-in hole 102 on the second guide plate main body 2, and at the same time, the plug-in hole 102 on the first guide plate main body 1 is plugged into the plug-in post 101 on the second guide plate main body 2, thereby achieving pre-fixation between the first guide plate main body 1 and the second guide plate main body 2, which can assist in the assembly of the two guide plate main bodies before the start of surgery. After the first guide plate main body 1 and the second guide plate main body 2 are properly assembled, a complete surgical guide plate is formed. Its inner surface fits well with the soft tissue surface on the outer side of the patella. That is, the inner surface of the first guide plate main body 1 and the second guide plate main body 2 after splicing matches the surface morphology of the patient's knee joint.

[0044] Two patellar converging rings 103 are fixedly disposed on the inner surfaces of the first guide plate main body 1 and the second guide plate main body 2, respectively. These two patellar converging rings 103 cooperate to form an approximately arc-shaped patellar converging ring that matches the contour of the patient's patella. The structure of the patellar converging ring is generated in 3D modeling software based on the acquired patellar surface contour data, along with the overall solid model before segmentation. It protrudes approximately 6mm from the inner surface of the solid model, and is irregularly elliptical in shape with a diameter of approximately 60-80mm. In the 3D modeling software, as the overall model is divided in two, the patellar converging ring is also divided in two, correspondingly forming the two patellar converging rings 103. The two patellar converging rings 103 can extensively encircle and separate displaced patellar fragments, and during the process of the first guide plate main body 1 and the second guide plate main body 2 closing towards the center, push the patellar fragments towards the center, ultimately returning them to the correct anatomical position under the extensive centripetal thrust of the patellar converging rings.

[0045] The aforementioned mortise and tenon structure, as well as the threaded connection hole 104, bolt connection hole 201, positioning channel 202, and longitudinal groove 203, etc., set on the first guide plate main body 1 and the second guide plate main body 2, were all manually modeled and created as features after the overall model was created. After the three-dimensional models of the first guide plate main body 1 and the second guide plate main body 2 were created, they were rapidly manufactured using a 3D printer, which is low-cost and suitable for personalized matching of different patient needs.

[0046] The first guide plate main body 1 and the second guide plate main body 2 are detachably connected by at least two tension bolts 3. Specifically, in this embodiment, the mating surface of the first guide plate main body 1 has two threaded connection holes 104, which are M10 in size. The mating surface of the second guide plate main body 2 has bolt connection holes 201, which are countersunk holes with a major diameter of 15mm and a minor diameter of 10.5mm, respectively paired with the two threaded connection holes 104. The threaded connection holes 104 and bolt connection holes 201 are set in two sets and are respectively located on the upper and lower sides of the first guide plate main body 1 and the second guide plate main body 2. The tension bolts 3 are M10 socket head cap screws with a length of approximately 45mm. During the surgery, the two guide plate main components are properly positioned and placed in the correct positions on both sides of the patella. After they are aligned by the tenon and mortise structure, the tension bolts 3 can be inserted into the bolt connection holes 201 and continuously tightened, so that the two guide plate main components are tightly closed in the middle and then fixed in the patient's knee joint position, so that the patellar ring is wrapped around the outside of the patella.

[0047] Several (usually three) positioning channels 202 are formed within the surface of the first guide plate main body 1 and / or the second guide plate main body 2, and positioning guides 4 are movably inserted into the positioning channels 202. In this embodiment, only three positioning channels 202 are formed on the second guide plate main body 2. The outer diameter of the positioning channel 202 is 12 mm and the inner diameter is 9.5 mm. Its position and orientation are precisely designed based on the three-dimensional reconstruction results of the patient's preoperative CT images and the surgical planning scheme.

[0048] The positioning guide 4 is a cylindrical structure with a "T"-shaped cross-section and a through hole at its axis. In this embodiment, the head diameter of the positioning guide 4 is 9mm, the tail diameter is 17mm, the total length is approximately 40mm, and the internal through hole diameter is 3.5mm, which can just accommodate the drill bit and Kirschner wire 5, thereby ensuring that the hole is drilled at the predetermined position and angle and the Kirschner wire 5 is accurately inserted.

[0049] Preferably, the positioning channel 202 has a longitudinal groove 203 on its side wall, which is 4mm wide. If the surgical guide is properly positioned and installed during the operation, and if it is necessary to make a small skin incision on the skin surface at the site where drilling and nailing are to be performed, the scalpel can be inserted into the positioning channel 202 along the longitudinal groove 203 to cut the local skin.

[0050] The procedure for using this surgical guide is as follows:

[0051] (1) Assembly of the main guide plate components: The first guide plate main component 1 and the second guide plate main component 2 are placed on both sides of the patient's patella. The two guide plate main components are accurately aligned using two sets of tenon and mortise structures on the mating surfaces. During this process, the two converging patellar rings also move closer together, tightly embracing the patient's fractured patella. Figures 9 to 11 As shown.

[0052] (2) Fastening the guide plate main body: Insert the two tensioning bolts 3 into the two bolt connection holes 201 respectively, so that their heads pass through the bolt connection holes 201 and are threaded into the threaded connection holes 104. Continue to tighten, so that the two guide plate main bodies are tightly closed in the middle, until the two mating surfaces are tightly pressed together, so that the two guide plate main bodies are close to each other and fixed. Figure 12 As shown.

[0053] (3) Drilling on the patellar surface: After the surgical guide plate is positioned and installed, the head end of the positioning guide 4 can be inserted into the positioning channel 202 corresponding to the desired drilling position, and the drill bit can be further inserted into the through hole of the positioning guide 4 to drill a hole at a predetermined position on the surface of the patella, such as... Figure 13 As shown. In this step, if it is necessary to cut the skin at the site to be pierced, the positioning guide 4 can be temporarily removed, and the scalpel can be inserted deep inside the positioning channel 202 along the longitudinal groove 203 to complete the cutting operation of the skin at the site to be pierced.

[0054] (4) Inserting the Kirschner wire: After drilling is completed, insert the Kirschner wire 5 into the through hole of the positioning guide 4, and fix the head end of the Kirschner wire 5 in the drilled hole, such as... Figure 14 As shown.

[0055] (5) Implantation of internal fixation screws: After all three Kirschner wires 5 are fixed, the positioning guide 4 is removed, and the internal fixation screws 6 are implanted into the patella along the Kirschner wires 5 in the positioning channel 202. Figure 15 As shown. In this embodiment, the internal fixation screw 6 is a common hollow screw with an outer diameter of 6.5 mm. It can be movably sleeved on the outside of the Kirschner wire 5 and smoothly rotated into the patellar fragment through the positioning channel 202, and crosses the fracture line, thereby fixing the two bone fragments to each other.

[0056] (6) Removal of the surgical guide plate: After all internal fixation screws 6 have been implanted, remove the Kirschner wires 5, loosen the two tension bolts 3, disassemble the two main guide plate components, and suture the small incision at the implantation site of the internal fixation screws 6 (if necessary). This completes the patellar fracture reduction and internal fixation surgery. Figure 16 As shown.

[0057] The technical features of the above embodiments can be combined in any way. For the sake of brevity, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

[0058] The above description is merely an embodiment of this utility model and does not limit the patent scope of this utility model. Any equivalent structural or procedural transformations made based on the description and drawings of this utility model, or direct or indirect applications in other related technical fields, are similarly included within the patent protection scope of this utility model.

Claims

1. A 3D printed personalized surgical guide for patella fracture, characterized in that: It includes a first guide plate main body and a second guide plate main body made by 3D printing. The first guide plate main body and the second guide plate main body are detachably connected by at least two tension bolts. The inner surface of the first guide plate main body and the second guide plate main body after splicing matches the surface morphology of the patient's knee joint. Several positioning channels are opened in the surface of the first guide plate main body and / or the second guide plate main body, and positioning guides are movably inserted in the positioning channels.

2. The 3D-printed personalized surgical guide for patella fracture according to claim 1, characterized in that: At least two sets of matching mortise and tenon structures are respectively provided on the mating surfaces of the first guide plate main body and the second guide plate main body.

3. The 3D-printed personalized surgical guide for patella fracture according to claim 1 or 2, characterized in that: The inner surfaces of the first guide plate main body and the second guide plate main body are respectively fixedly provided with patellar consolidation semi-rings, and the two patellar consolidation semi-rings cooperate to form an approximately arc-shaped patellar consolidation ring that matches the outline of the patient's patella.

4. The 3D-printed personalized surgical guide for patella fracture of claim 1, wherein: The positioning channel has longitudinal slots on its side wall.

5. The 3D-printed personalized surgical guide for patella fracture of claim 1, wherein: The positioning guide is a cylindrical structure with a "T" shaped cross-section and a through hole at its axis.

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