Series of instruments for exposing lesion in posterior talar trochlea

Abstract

The present invention relates to the technical field of medical instruments, and in particular to a series of instruments for exposing a lesion in a posterior talar trochlea, comprising: a lesion exposure distractor for distracting an ankle joint, wherein the lesion exposure distractor comprises a fixed handle, a supporting strip is fixedly provided on one side of the fixed handle, a movable handle and a locking mechanism are slidably connected to the supporting strip, and the tail ends of the fixed handle and the movable handle each are provided with a fixing pin; retractor hooks for retracting tissue laterally, wherein each retractor hook comprises a retractor hook handle, the tail end of the retractor hook handle is bent and extends downwards, and the bent extending part is a retractor hook blade; and a talus lesion bone harvester for lesion removal and bone harvesting, wherein the talus lesion bone harvester comprises a bone harvesting round rod and a steering rod, the steering rod is detachably connected to the head end of the bone harvesting round rod, a bone cutting end and a bone harvesting section are sequentially provided at the tail end of the bone harvesting round rod, the bone cutting end is a conical annular cutting edge, a bone harvesting groove is formed in the side wall of the bone harvesting section, and the bone harvesting groove is communicated with the bone cutting end, so that a bone block cut by the bone cutting end is taken out of the bone harvesting groove. The present invention increases the exposure of a lesion and the operative field illumination.

Description

A series of instruments for exposing posterior talar trochlea lesions Technical Field

[0001] The present invention relates to the technical field of medical instruments, and in particular to a series of instruments for exposing posterior trochlea lesions of the talus. Background Art

[0002] Osteochondral lesions of the talus (OLT) are common articular cartilage injuries that often occur secondary to ankle trauma. They manifest as talar cartilage exfoliation and involvement of the subchondral bone. They may be accompanied by talar bone cysts, leading to ankle pain, instability, and osteoarthritis, affecting the patient's daily life and even causing disability. Conservative treatment is appropriate for shallow, small, and mildly symptomatic OTL. However, surgical treatment is usually required for OLT that is refractory to conservative treatment. Arthroscopic debridement combined with bone marrow stimulation (BMS) is the most commonly used technique and is suitable for symptomatic OLT with an area <107.4 mm. 2 and / or diameter <10.2mm. For larger lesions, open surgery with autologous or allogeneic talar osteochondral transplantation is required. Because most OLT lesions are located on the posteromedial side of the talar dome and are deep, with bony obstructions on the medial and lateral malleolus, medial malleolar osteotomy is often required to achieve adequate intra-articular lesion exposure. This surgical procedure is demanding, difficult, and slow to recover. It can easily damage cartilage and cause bone loss on the ankle joint surface. Postoperative immobilization and fixation are required, and there are complications associated with osteotomy.

[0003] Currently, the instruments used in open surgery for deep-seated talar soft bone lesions in clinical practice do not have ideal exposure effects, and there is no series of lesion exposure instruments suitable for open surgery for deep-seated talar soft bone lesions on the market. Therefore, research on a series of lesion exposure instruments for the posterior trochlea of ​​the talus can effectively solve the pain points and difficulties encountered during surgery.

[0004] Summary of the Invention

[0005] The purpose of the present invention is to overcome the defects and shortcomings of the existing technology and provide a series of instruments for exposing the posterior trochlea of ​​the talus, which are used in open surgery for soft bone injury lesions of the talus. They can effectively open and maintain the hyperextension position of the ankle joint, increase the exposure range of the posterior trochlea of ​​the talus and increase the lighting and illumination of the surgical field, avoiding the disadvantage of traditional surgery that requires medial malleolus osteotomy to achieve lesion exposure.

[0006] The purpose of the present invention can be achieved through the following technical solutions:

[0007] A series of instruments for exposing posterior talar pulley lesions include: a lesion exposing spreader for spreading the ankle joint, the lesion exposing spreader includes a fixed handle, a support bar is fixed on one side of the fixed handle, a movable handle and a locking mechanism for limiting the relative movement of the movable handle are slidably connected to the support bar, the ends of the fixed handle and the movable handle are both provided with fixing nails, the fixed handle cooperates with the movable handle and the locking mechanism to control the two fixing nails to spread and fix the ankle joint to maintain the hyperextension position of the ankle joint; a retractor for pulling the tissue laterally, the retractor includes a retractor handle, the end of the retractor handle is turned to the side The lower part is bent and extended, and the bent and extended part is a retractor leaf, which is driven by the retractor handle to retract the soft tissue; a talus lesion bone remover for lesion removal and bone removal, the talus lesion bone remover includes a bone removal round rod and a steering rod, the steering rod is detachably connected to the head end of the bone removal round rod, and the end of the bone removal round rod is sequentially provided with a bone cutting end and a bone removal segment, the bone cutting end is a conical annular cutting edge, the bone removal round rod is inserted into the bone block through the conical annular cutting edge and cuts the bone column, a bone removal groove is opened on the outer wall of the bone removal segment, the bone removal groove is connected to the bone cutting end, and the cut bone block is removed from the bone removal groove.

[0008] As a preferred embodiment, the locking mechanism includes an adjusting nut and a fixing nut, both of which have internal threads that can match the outer wall of the support bar. The adjusting nut is arranged on the side of the movable handle close to the fixed handle, and the fixing nut is arranged on the side of the movable handle away from the fixed handle.

[0009] As a preferred embodiment, the fixing nail includes an upper fixing nail and a lower fixing nail, and the ends of the fixed handle and the movable handle are both provided with through holes, the upper fixing nail is inserted into the through hole of the fixed handle, and the lower fixing nail is inserted into the through hole of the movable handle; the fit between the fixing nail and the through hole is a clearance fit.

[0010] As a preferred embodiment, the bone cutting end is a ring-shaped variable-section cutting edge structure whose cross-sectional area gradually decreases toward the end of the bone-removing round rod.

[0011] As a preferred embodiment, a through groove is provided on the bone cutting end, and two through grooves are symmetrically distributed on the side wall of the bone cutting end.

[0012] As a preferred embodiment, it also includes a distal tibial target shaping guide and a bone cutting instrument for removing bony obstructions. The distal tibial target shaping guide includes a guide body and a guide extension fixedly connected to the guide body. The guide body is provided with a guide groove for inserting the bone cutting instrument, and the guide extension is provided with a guide hole for guiding the drilling of the guide fixing nail.

[0013] As a preferred embodiment, the corners of the guide plate body and the guide plate extension are rounded, and the guide plate body and the guide plate extension are an integrally formed teardrop-shaped structure that fits the distal tibia bone.

[0014] As a preferred embodiment, it also includes a light source assembly for increasing the exposure field of the lesion. The light source assembly includes a light guide tube, the end of the light guide tube is bent and extended downward, and its bending angle is adapted to the bending point of the retractor handle. The head end of the light guide tube is connected to a cold light source through a light source line.

[0015] As a preferred embodiment, a groove adapted to the size of the light source line is provided on the hook handle, the head end of the light guide is connected to the light source line along the groove, and a plurality of blocks are fixed on the top of the hook handle.

[0016] As a preferred embodiment, the retractor leaf is further provided with a light guide fixing block, the light guide fixing block is provided with a fixing hole adapted to the outer diameter of the light guide, and the light guide is installed on the light guide fixing block through the fixing hole.

[0017] Compared with the prior art, the present invention has the following advantages and beneficial effects:

[0018] 1. A series of instruments for exposing the posterior talar pulley lesions used in open surgery for soft bone injuries of the talus consists of a lesion exposure spreader, a retractor, a talar lesion bone extractor, a light source assembly, a distal tibial target shaping guide, and a bone cutting instrument. Different instruments are used in different surgical steps. During the entire surgical process, this series of instruments is inseparable. By using the present invention during open surgery, medical staff can expose deep lesions of the ankle joint to the greatest extent, shorten the operation time, increase the success rate of the patient's operation, reduce the possibility of complications in the patient, and facilitate the patient's postoperative recovery.

[0019] 2. By obliquely inserting upper and lower fixation pins at the posterior part of the patient's lower tibia and calcaneal tuberosity, and coordinating the fixed handle and the movable handle to maintain the ankle joint in a hyperextension position, the target tissue can be effectively retracted and exposed, thereby achieving the maximum range of exposure of the posterior pulley of the talus, leaving the surgical field unobstructed and reducing the difficulty of lesion exposure; using two nuts to adjust and fix the sliding step of the movable handle can simplify the surgical operation, eliminate the need for a dedicated person to operate the distractor, and eliminate the need for repeated adjustments, saving labor and reducing surgical intensity.

[0020] 3. The end of the retractor leaf is tongue-shaped. Its size and shape match the anatomical surface of the side of the talus and the upper part of the calcaneus. It can be stuck on the side of the tissue to facilitate traction, exposure and maintenance of position.

[0021] 4. The light source assembly includes a cold light source. When used in combination with a retractor, the light source assembly can effectively retract the tissue and quickly access the cold light source for lighting, effectively increasing the exposed field of view.

[0022] 5. A groove and a block are provided on the retractor handle, and the light source line is fitted on the retractor through the groove, so that medical staff will not be hindered by the light source line when holding the retractor for surgical operations; the block cooperates with the groove to further limit the relative movement of the light source line; a light guide fixing block is provided on the retractor leaf, and the irradiation direction of the light guide is fixed by the light guide fixing block, thereby increasing the stability of the lighting in the surgical field.

[0023] 6. The bone cutting end of the talar lesion bone harvester is set to a conical annular blade. The conical blade is convenient for penetrating the bone, and the blade is small and the contact surface is small, so it will not cause too large a wound when cutting the bone, reducing the possibility of causing complications; the inner wall of the blade is also provided with a through groove, and the diseased bone engages with the through groove when chiseling the bone, which makes it easy to remove the entire piece of bone lesion and speed up the removal of the talar lesion bone harvester; the bone harvesting rod and the steering rod are set to be detachably connected, and the length of the steering rod can be selected according to the situation. The longer the steering rod is, the smaller the force used to rotate the bone harvesting rod is, which can effectively reduce physical exertion, shorten the operation time, and increase the success rate of the operation.

[0024] 7. Add a guide plate for distal tibial target shaping. By setting a guide groove, the target is shaped with a bone cutting instrument to remove bone obstructions and increase the exposure range of the lesion. The limiting effect of the guide groove can avoid excessive and irregular bone resection. Compared with the oscillating saw cutting used in the existing technology, during the operation, it is less likely to cause deviations in the osteotomy depth and range, affect the stability of the joint surface, or damage the joint surface.

[0025] 8. The fixed handle, movable handle, fixed nail, bone removal rod and steering rod do not adopt a complex structure of fixed connection. The shape is simple, which not only simplifies the structure and manufacturing process, but also makes it easy to disassemble and assemble, easy to store, and when the parts are damaged, they can be replaced separately, reducing the cost of use. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] FIG1 is a schematic structural diagram of a lesion exposing and stretching device according to the present invention;

[0027] FIG2 is a schematic structural diagram of the fixing handle and the support bar of the present invention;

[0028] FIG3 is a schematic structural diagram of the movable handle of the present invention;

[0029] FIG4 is a schematic structural diagram of a retractor of the present invention;

[0030] FIG5 is a schematic structural diagram of the talus lesion bone removal device of the present invention;

[0031] FIG6 is a partially enlarged schematic diagram of the talus lesion bone removal device of the present invention;

[0032] FIG7 is a schematic structural diagram of a distal tibia target shaping guide plate according to the present invention;

[0033] FIG8 is a schematic structural diagram of a light source assembly of the present invention;

[0034] FIG9 is a schematic diagram of the use of the lesion exposure spreader of the present invention;

[0035] FIG10 is a schematic diagram of the use of the lesion-revealing spreader, retractor, and light source assembly of the present invention;

[0036] 11 is a schematic diagram of the use of a retractor and a light source assembly according to the present invention;

[0037] 12 is a schematic diagram of the use of the distal tibial target shaping guide of the present invention;

[0038] Among them: 1: lesion exposure spreader, 11: fixed handle, 12: support bar, 13: movable handle, 14: adjusting nut, 15: fixed nut, 16: upper fixing nail, 17: lower fixing nail, 2: retractor, 21: retractor handle, 22: retractor leaf, 23: stopper, 24: light guide fixing block, 3: talus lesion bone remover, 31: bone removal round rod, 311: bone cutting end, 312: bone removal segment, 313: through groove, 32: steering rod, 4: distal tibial target shaping guide, 41: guide groove, 42: guide hole, 5: light source assembly, 51: light guide, 52: light source line, 53: cold light source, 6: tibia, 7: calcaneus, 8: talus, 9: fibula, 10: light. DETAILED DESCRIPTION

[0039] The present invention will be described in further detail below with reference to the embodiments and drawings, but the embodiments of the present invention are not limited thereto.

[0040] As shown in Figures 1 to 11, a series of instruments for exposing the posterior trochlea of ​​the talus include: a lesion exposing spreader for spreading the ankle joint, the lesion exposing spreader includes a fixed handle, a support bar is fixed on one side of the fixed handle, a movable handle and a locking mechanism for limiting the relative movement of the movable handle are slidably connected to the support bar, and the ends of the fixed handle and the movable handle are both provided with fixing nails, the fixed handle cooperates with the movable handle and the locking mechanism to control the two fixing nails to spread and fix the ankle joint and maintain the ankle joint in a hyperextension position; a retractor for pulling the tissue laterally, the retractor includes a retractor handle, a retractor handle The end of the handle is bent and extended downward, and the bent and extended part is a retractor leaf, which is driven by the retractor handle to retract the soft tissue; a talus lesion bone remover for lesion removal and bone removal, the talus lesion bone remover includes a bone removal round rod and a steering rod, the steering rod is detachably connected to the head end of the bone removal round rod, the end of the bone removal round rod is sequentially provided with a bone cutting end and a bone removal segment, the bone cutting end is a conical annular cutting edge, the bone removal round rod is inserted into the bone block through the conical annular cutting edge and cuts the bone column, a bone removal groove is opened on the side wall of the bone removal segment, the bone removal groove is connected to the bone cutting end, and the cut bone block is removed from the bone removal groove.

[0041] In this embodiment, as shown in Figures 1 to 3, a sliding hole adapted to the size of the support bar is provided on the movable handle, and the movable handle is sleeved on the support bar through the sliding hole; the locking mechanism includes an adjusting nut and a fixing nut, and the adjusting nut and the fixing nut are nuts with internal threads that can match the outer wall of the support bar, the adjusting nut is arranged on the side of the movable handle close to the fixed handle, and the fixing nut is arranged on the side of the movable handle away from the fixed handle, and the adjusting nut and the fixing nut cooperate to limit the relative movement of the movable handle; the fixing nail includes an upper fixing nail and a lower fixing nail, and the ends of the fixed handle and the movable handle are both provided with through holes, the upper fixing nail is inserted in the through hole of the fixed handle, and the lower fixing nail is inserted in the through hole of the movable handle; the fit between the fixing nail and the through hole is a clearance fit.

[0042] As shown in Figure 5, a connecting hole is provided at the head end of the bone-taking rod, and the steering rod is detachably connected to the bone-taking rod through the connecting hole; the bone-taking rod is integrally formed by a solid rod and a hollow rod, the hollow rod is connected to the end of the solid rod, the bone cutting end and the bone-taking segment are arranged on the hollow rod in sequence, and the bone-taking groove is an opening opened on the upper part of the hollow rod.

[0043] As shown in FIG6 , the bone cutting end is a ring-shaped variable-section cutting edge structure whose cross-sectional area gradually decreases toward the end of the bone-removing round rod.

[0044] In this embodiment, a through groove is provided on the bone cutting end, and two through grooves are symmetrically distributed on the side wall of the bone cutting end; the through grooves are rectangular through grooves.

[0045] As shown in FIG7 , the series of instruments for exposing the posterior trochlea lesions of the talus also include a distal tibial target shaping guide and a bone cutting instrument for removing bony obstructions. The distal tibial target shaping guide includes a guide body and a guide extension fixedly connected to the guide body. The guide body is provided with a guide groove for inserting the bone cutting instrument, and the guide extension is provided with a guide hole for guiding the drilling of the guide fixing nail.

[0046] In this embodiment, the corners of the guide plate body and the guide plate extension are rounded, and the guide plate body and the guide plate extension are an integrally formed teardrop-shaped structure that fits the distal tibia bone.

[0047] As shown in FIG8 , the series of instruments for exposing the posterior trochlea of ​​the talus also includes a light source assembly for increasing the exposure field of the lesion. The light source assembly includes a light guide tube, the end of which is bent and extended downward, and the bending angle thereof is adapted to the bending part of the retractor handle. The head end of the light guide tube is connected to a cold light source through a light source line.

[0048] Both the lesion exposure spreader and retractor can be made of medical stainless steel using 3D printing technology. The talus lesion bone extractor can be made of high-strength stainless steel using CNC (numerical control machine tools). The distal tibial target forming guide can be made of high-toughness, elastic, and plastic stainless steel sheets using CNC (numerical control machine tools) with standard tolerances meeting IT14 standards.

[0049] The ankle joint is composed of the joint at the lower end of the tibia and fibula and the articular surface of the upper part of the talus (talar trochlea). The movement characteristics of the ankle joint are: it occurs along the inner surface, and its axis runs from the midpoint of the tip of the medial malleolus through the accessory sinus to the front edge of the tip of the lateral malleolus, with an angle of 68°-88° to the sagittal axis of the human body and an angle of about 20° to the coronal axis. Flexion and extension are accompanied by slight inversion and eversion and adduction and abduction.

[0050] The use steps of the present invention are as follows:

[0051] S1. Use the lesion exposure spreader to spread and stabilize the ankle joint (the results are shown in Figures 9 and 10).

[0052] This step includes:

[0053] a. Exposure of the posterior talar pulley: The patient is generally placed in the prone position. An incision is made medially to the Achilles tendon. The length of the incision can be adjusted based on the patient's weight; it is generally approximately 5-7 cm long. Dissect along the medial aspect of the adductor pollicis longus tendon to the posterior aspect of the ankle joint, and incise the posterior joint capsule.

[0054] b. Dorsiflex the ankle joint: lift the foot so that the ankle joint angle is less than 90 degrees;

[0055] c. Soft tissue separation: The incision is extended to the back of the ankle joint to expose the posterior joint capsule. A small 0.5 cm incision is then made in the middle of the posterior aspect of the lower tibia (3-6 cm from the articular surface) to separate the small blood vessels.

[0056] d. Insert the fixation screws: Drill the upper fixation screw from the bottom back to the front and up on the posterior side of the lower tibia. Drill the lower fixation screw from the bottom back to the front and up on the calcaneal tuberosity toward the first metatarsophalangeal phalanx.

[0057] e. Assemble the lesion exposure spreader: Attach the end of the fixed handle to the upper fixing pin through the through-hole, attach the end of the movable handle to the lower fixing pin, screw in the adjustment nut at the end of the support bar, then attach the head of the movable handle to the support bar through the sliding hole, adjust the position of the movable handle, and screw in the fixing nut.

[0058] f. Adjust and fix the extension distance: When dorsiflexing the ankle joint, gradually extend the ankle joint. First, adjust the extension degree of the ankle joint by turning the adjusting nut, and finally fix the extension distance of the ankle joint by tightening the fixing nut.

[0059] In this embodiment, the inner diameter of the through hole is 4.5 mm, and the outer diameter of the fixing pin is 3.5 mm; the support bar is a rack or a threaded rod; the length of the fixing handle is 5 cm, the length of the support bar is 12 cm, the fixing handle and the support bar are an integrally formed L-shaped structure, the length of the fixing pin is 10 cm, and the end of the fixing pin is a prismatic tip drill bit.

[0060] S2. Use a retractor to pull the tissue laterally (see Figures 10 and 11 for the results).

[0061] In this step, two retractors are placed on both sides of the incision, one side is a retractor with a light source component installed, and the other side is a retractor without a light source component installed. The end of the retractor leaf is placed in the gap on the inner or outer side of the talus, and the tissue is pulled laterally with the side as the fulcrum.

[0062] In this embodiment, as shown in FIG4 , the retractor handle and the retractor leaf are integrally formed into an L-shaped structure. The distal end of the retractor leaf is bent inward at a certain angle, and the bent and extended portion is a blunt tip with a rounded corner. The retractor handle is bent downward at an angle of 80°, the length of the retractor handle is 13 cm, and the length of the retractor leaf is 5 cm. The retractor, equipped with a light source assembly, has a groove adapted to the size of the light source line on the retractor handle. The head end of the light guide is connected to the light source line along the groove. A plurality of blocks are fixed on the top of the retractor handle, which cooperate with the groove to limit the relative movement of the light source line. The retractor leaf is also provided with a light guide fixing block, which has a fixing hole adapted to the outer diameter of the light guide. The light guide is mounted on the light guide fixing block through the fixing hole. Light is emitted from the cold light source along the light source line and irradiated downward under the guidance of the light guide, thereby increasing the lighting and illumination of the surgical field. The light can also be adjusted in brightness and soft light state by the cold light source.

[0063] S3. Determine the exposure range of the lesion.

[0064] When the range of the lesion revealed by the above steps is not sufficient to reveal the lesion, but more than half of the area has been revealed, the talus lesion bone harvester can be used to remove the lesion and harvest bone;

[0065] When the range of the lesion revealed by the above steps cannot fully reveal the lesion and is less than half of the area, bone removal or bone grafting cannot be performed directly. The periosteum can be stripped and exposed at the posterior edge of the tibial articular surface corresponding to the lesion above the lesion. Then, according to the size of the lesion, a distal tibial target shaping guide of corresponding size can be selected to remove the bone obstruction and increase the exposure range of the lesion. Finally, a talar lesion bone harvester can be used to clear the lesion and harvest bone.

[0066] S4. Use the distal tibial target shaping guide to remove bony obstruction (the effect is shown in Figure 12).

[0067] This step includes:

[0068] a. Distal tibial target shaping guide: Select a distal tibial target shaping guide of appropriate size and shape it according to the bone characteristics and anatomical features of the distal tibial joint of a large sample;

[0069] b. Adjust the distal tibial target shaping guide: Fit the shaped distal tibial target shaping guide to the normal anterior and posterior edges of the distal tibia. If there is a deviation in the fit, pre-bend it with needle holders or needle-nosed pliers to ensure that the distal tibial target shaping guide fits the distal tibia.

[0070] c. Fix the distal tibial target shaping guide: Drill the guide plate fixing screws into the guide holes of the distal tibial target shaping guide;

[0071] d. Bone grinding: At the guide groove of the distal tibial target shaping guide, use the corresponding curved bone knife, shaping bone chisel to chisel the bone or the grinding drill ball head to grind the bone to form a target exposure and operation channel with a semicircular bottom and an oblique upper part.

[0072] In this embodiment, the guide groove is an oblong through hole provided on the guide plate body, and the guide groove can be set as an oblong through hole with three specifications: inner diameter 7mm×long axis 12mm, inner diameter 8mm×long axis 13mm, and inner diameter 9mm×long axis 14mm; the guide hole is a circular through hole provided on the guide plate extension, and at least two guide holes are provided on the guide plate extension, and the inner diameter of the guide hole is 2mm; the guide plate body is stamped from a stainless steel sheet with a thickness of 0.5mm, and the distance between the outer diameter of the guide plate body and the inner diameter of the guide groove is 2mm. The guide plate body can be stamped into three sheets of corresponding specifications according to the size of the guide groove, and can be easily bent or shaped by pliers according to the shape of the distal tibia, so that the distal tibia target forming guide fits the anterior and posterior edges of the tibia; the bone cutting instrument can be a bone knife, a bone chisel or a grinding drill.

[0073] S5. Use the talus lesion bone harvester to remove the lesion and harvest bone.

[0074] In this step, select a bone harvester of appropriate size and caliber for the talus lesion, hold the head end of the bone harvesting rod with your hand, insert the bone cutting end vertically downward into the bone toward the posterior lip of the distal tibia, then insert the steering rod into the head end of the bone harvesting rod, and then gently rotate the bone harvesting rod through the steering rod to cut the bone column. After the cutting is completed, lightly tap and pull the bone harvesting rod to bring the bone block out of the body and remove it.

[0075] In this embodiment, the length of the bone cutting end is 6 mm, the length of the bone segment is 30 mm, the bone cutting end can be set to an annular conical cutting edge with three specifications of outer diameters of 7 mm, 8 mm, and 9 mm, and the wall thickness of the bone cutting end is 0.75 mm.

[0076] In general, the size settings of the lesion exposure spreader, retractor, talar lesion bone extractor and distal tibial target forming guide of the present invention are suitable for practical clinical applications, and are consistent with the characteristics of ankle joint anatomy, joint movement and biomechanics. There is no need to use overall osteotomy to expose the depth of the lesion, and it is not easy to cause bone defects and cartilage damage on the ankle joint surface, which is beneficial to the patient's postoperative recovery and does not cause osteotomy-related complications.

[0077] The above-described embodiments merely illustrate several implementations of the present invention, and while their descriptions are relatively specific and detailed, they should not be construed as limiting the scope of the present invention. It should be noted that a person skilled in the art would be able to make numerous variations and improvements without departing from the spirit of the present invention, all of which fall within the scope of protection of the present invention. Therefore, the scope of protection of the present invention shall be determined by the appended claims.

Claims

1. A series of instruments for exposing posterior trochlear lesions of the talus, characterized in that: include: A lesion exposure spreader for spreading an ankle joint, the lesion exposure spreader comprising a fixed handle, a support bar fixedly arranged on one side of the fixed handle, a movable handle and a locking mechanism for limiting the relative movement of the movable handle slidably connected to the support bar, a fixing nail being arranged at the ends of the fixed handle and the movable handle, the fixed handle cooperates with the movable handle and the locking mechanism to control the two fixing nails to spread and fix the ankle joint, and maintain the hyperextension position of the ankle joint; The fixing nails include an upper fixing nail and a lower fixing nail. The ends of the fixed handle and the movable handle are both provided with through holes. The upper fixing nail is inserted into the through hole of the fixed handle, and the lower fixing nail is inserted into the through hole of the movable handle. The matching between the fixing nail and the through hole is a clearance match. A retractor for pulling the tissue laterally, the retractor comprising a retractor handle, the end of which is bent and extended downward, the bent and extended part being a retractor leaf, and the retractor handle drives the retractor leaf to pull the soft tissue apart; A talus lesion bone extractor for lesion removal and bone extraction, comprising a bone extraction round rod and a steering rod, the steering rod being detachably connected to the head end of the bone extraction round rod, the end of the bone extraction round rod being sequentially provided with a bone cutting end and a bone extraction segment, the bone cutting end being a conical annular cutting edge, the bone extraction round rod being inserted into a bone block through the conical annular cutting edge and cutting a bone column, a bone extraction groove being provided on the side wall of the bone extraction segment, the bone extraction groove being connected to the bone cutting end, and the cut bone block being extracted from the bone extraction groove; Also included is a distal tibial target shaping guide plate and a bone cutting instrument for removing bone obstruction, wherein the distal tibial target shaping guide plate comprises a guide plate body and a guide plate extension portion fixedly connected to the guide plate body, the guide plate body is provided with a guide groove for inserting the bone cutting instrument, and the guide plate extension portion is provided with a guide hole for guiding the guide plate fixing nail to drill into; It also includes a light source assembly for increasing the exposure field of the lesion, the light source assembly includes a light guide tube, the end of the light guide tube is bent and extended downward, the bending angle of the light guide tube is adapted to the bending part of the retractor handle, and the head end of the light guide tube is connected to a cold light source through a light source line; The steps of using the series of instruments for exposing the posterior talar trochlear lesion include: S1. Use a lesion exposure spreader to spread and fix the ankle joint; S2. Use a retractor to pull the tissue laterally; S3. Determination of the exposure range of the lesion; S4. Remove bony obstruction using distal tibial targeting guide; S5. Use the talus lesion bone harvester to remove the lesion and harvest bone.

2. A series of instruments for exposing posterior talar trochlea lesions according to claim 1, characterized in that: The locking mechanism includes an adjusting nut and a fixing nut. Both the adjusting nut and the fixing nut have inner threads that can match the outer wall of the support bar. The adjusting nut is arranged on the side of the movable handle close to the fixed handle, and the fixing nut is arranged on the side of the movable handle away from the fixed handle.

3. A series of instruments for exposing posterior talar trochlea lesions according to claim 1, characterized in that: The bone cutting end is a ring-shaped variable-section cutting edge structure whose cross-sectional area gradually decreases toward the end of the bone-taking round rod.

4. A series of instruments for exposing posterior trochlear lesions of the talus according to claim 1, characterized in that: A through groove is provided on the bone cutting end, and two through grooves are symmetrically distributed on the side wall of the bone cutting end.

5. A series of instruments for exposing posterior trochlear lesions of the talus according to claim 1, characterized in that: The corners of the guide plate body and the guide plate extension are rounded, and the guide plate body and the guide plate extension are an integrally formed teardrop-shaped structure that fits the distal tibia bone.

6. A series of instruments for exposing posterior trochlear lesions of the talus according to claim 1, characterized in that: A groove adapted to the size of the light source line is provided on the hook handle, the head end of the light guide tube is connected with the light source line along the groove, and a plurality of stoppers are fixed on the top of the hook handle.

7. A series of instruments for exposing posterior trochlear lesions of the talus according to claim 1, characterized in that: A light guide tube fixing block is also provided on the hook leaf. A fixing hole adapted to the outer diameter of the light guide tube is opened on the light guide tube fixing block. The light guide tube passes through the fixing hole and is installed on the light guide tube fixing block.

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