CN106175874A - A kind of DDH osteotomy guide plate and making and use method thereof - Google Patents
A kind of DDH osteotomy guide plate and making and use method thereof Download PDFInfo
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- CN106175874A CN106175874A CN201610497889.8A CN201610497889A CN106175874A CN 106175874 A CN106175874 A CN 106175874A CN 201610497889 A CN201610497889 A CN 201610497889A CN 106175874 A CN106175874 A CN 106175874A
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- 238000000034 method Methods 0.000 title claims abstract description 29
- 230000000399 orthopedic effect Effects 0.000 claims abstract description 58
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 17
- 238000004519 manufacturing process Methods 0.000 claims abstract description 15
- 210000000689 upper leg Anatomy 0.000 claims description 36
- 230000001105 regulatory effect Effects 0.000 claims description 25
- NJPPVKZQTLUDBO-UHFFFAOYSA-N novaluron Chemical compound C1=C(Cl)C(OC(F)(F)C(OC(F)(F)F)F)=CC=C1NC(=O)NC(=O)C1=C(F)C=CC=C1F NJPPVKZQTLUDBO-UHFFFAOYSA-N 0.000 claims description 20
- 229910000831 Steel Inorganic materials 0.000 claims description 18
- 239000010959 steel Substances 0.000 claims description 18
- 238000004904 shortening Methods 0.000 claims description 11
- 241000469816 Varus Species 0.000 claims description 9
- 239000002184 metal Substances 0.000 claims description 8
- 230000001575 pathological effect Effects 0.000 claims description 7
- 241001227561 Valgus Species 0.000 claims description 6
- 238000005516 engineering process Methods 0.000 claims description 5
- 230000000007 visual effect Effects 0.000 claims description 5
- 101100008044 Caenorhabditis elegans cut-1 gene Proteins 0.000 claims description 3
- 238000002591 computed tomography Methods 0.000 claims description 3
- 238000002059 diagnostic imaging Methods 0.000 claims description 3
- 210000002436 femur neck Anatomy 0.000 claims description 3
- 239000007943 implant Substances 0.000 claims description 3
- 238000009434 installation Methods 0.000 claims description 3
- 210000000528 lesser trochanter Anatomy 0.000 claims description 3
- 210000003205 muscle Anatomy 0.000 claims description 3
- 238000004088 simulation Methods 0.000 claims description 3
- 239000007787 solid Substances 0.000 claims description 3
- 238000007639 printing Methods 0.000 claims description 2
- 238000005520 cutting process Methods 0.000 claims 1
- 238000010030 laminating Methods 0.000 claims 1
- 230000007306 turnover Effects 0.000 claims 1
- 238000011017 operating method Methods 0.000 abstract description 3
- 238000011161 development Methods 0.000 description 3
- 238000010146 3D printing Methods 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000011960 computer-aided design Methods 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 238000012546 transfer Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/14—Surgical saws
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/155—Cutting femur
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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Abstract
The invention discloses a kind of DDH osteotomy guide plate, including being fitted in the bone surface of osteotomy region fixing end and round end, fixing end and round end are connected by link block.A kind of DDH osteotomy guide plate, uses this osteotomy guide plate can improve operation precision, simplifies operating procedure, shorten operating time in operation, and doctor, without relying on micro-judgment to correct angle in orthopedic bone-culting operation, improves degree of accuracy, reduces operation risk.Reduce the operation demand threshold to doctors experience simultaneously.The manufacture method of a kind of DDH osteotomy guide plate, uses this manufacture method can accurately, conveniently manufacture osteotomy guide plate.The using method of a kind of DDH osteotomy guide plate, uses the method can shorten operating time.
Description
Technical field
The invention belongs to osteotomy orthomorphia equipment technical field, be specifically related to a kind of DDH osteotomy guide plate, further relate to this section
The manufacture method of bone conduction plate, the using method of this osteotomy guide plate.
Background technology
At biomedical sector, modern medicine trends towards the therapeutic strategy of individuation, strong along with Computing ability
Strength promotes, computer technology and the combination extensively and profoundly of medical science, defines emerging cross discipline-digital medical, greatly
Promote the development of the Clinics of modern clinic individuation.Simultaneously as 3D prints the feature with individuation, just with existing
Diagnosis and treatment theory for medical science is consistent, and therefore, it will be heaven-made match that 3D printing technique is applied to biomedical sector.At present,
People are by computer digital correlation technique, after ambits multiple for medical science carry out image real time transfer, formed and dissect
Modeling and three-dimensional reconstruction, show and position the anatomical structure of skeleton, and, it is simulated operation technique in a computer,
Design optimal operation pathway, and reasonably individualized surgical planning, improve the levels of precision of operation, and, simplify hands
Art operating procedure, shortens the learning curve of junior doctor.At field of orthopaedics, by digitized (CT/MRI) to patient etc.
The clinical data that series provides, is set up the pathological model of skeleton in a computer, and is changed by omnibearing understanding skeleton pathology
Become, simultaneously go out the therapeutic scheme of optimal individuation and surgical guide or prosthese by computer-aided design, and pass through
The reasonability of design is verified and assesses by related software, has expanded range of operation, has been greatly improved the standard of operative treatment
Really property and safety, solid foundation has been established in innovation and development for numeral orthopaedics and tranmstology.Also it is other every subjects simultaneously
The cross development in field and deeply provide reference, also for 3D be printed upon that the application of biomedical sector creates incomparable broad
Space.
In tradition DDH bone-culting operation, doctor's clinical practice experience with two-dimensional medical image and doctor before this determines trouble
The osteotomy angle of person's femoral rotation osteotomy, then only carries out stock by doctor's clinical experience and existing survey tool in operation
Bone rotary osteotomy so that degree of accuracy is the highest, operating time is long in operation, operation wound and other complication risk are big, also have simultaneously
Certain radiological hazard.
Summary of the invention
The first object of the present invention is to provide a kind of DDH osteotomy guide plate, uses this osteotomy guide plate can improve operation precision.
The second object of the present invention is to provide the manufacture method of a kind of DDH osteotomy guide plate, uses this manufacture method energy accurately
Manufacture osteotomy guide plate easily.
The third object of the present invention is to provide the using method of a kind of DDH osteotomy guide plate, uses the method can shorten operation
Time.
First technical scheme of the present invention is, a kind of DDH osteotomy guide plate, including being fitted in osteotomy region skeleton table
Fixing end and round end on face, fixing end and round end are connected by link block；
Being provided with alignment pin a on fixing end, the upper and lower of the front end of fixing end is respectively arranged with V word mouth and steel plate
Gathering sill a, the both sides that the top of fixing end front end is relative are provided with Kirschner wire location hole a, the rear end of fixing end and skeleton table
Fit in face；
Round end includes osteotomy position and the orthopedic position being connected with the rear end of osteotomy position, osteotomy position is provided with alignment pin d,
Alignment pin b and Kirschner wire location hole b, the rear end of osteotomy position is provided with skeleton binding face, orthopedic position is provided with regulating tank a and
Alignment pin c, the bottom of orthopedic position is provided with steel plate gathering sill b.
The feature of the present invention also resides in,
Alignment pin a arranges two, and all with screw hole in two alignment pin a, hole, Kirschner wire location is positioned at two and determines
The side of position bearing pin a, the bottom of alignment pin a is provided with the nut placing trough a for placing hex nut, nut placing trough a
Opening be positioned at the bottom of fixing end；
With screw hole in alignment pin b, the bottom of alignment pin b is provided with the nut for placing hex nut and places
The opening of groove b, nut placing trough b is positioned at the bottom of osteotomy position.
Link block is osteotomy module, and osteotomy module includes osteotomy guider pedestal and osteotomy guider, osteotomy guider
On be provided with boss, be provided with osteotomy gathering sill in boss, in osteotomy gathering sill, be inserted with metal guider, osteotomy guider pedestal
Middle part is provided with osteotomy guider fixing port, and osteotomy guider is provided with several dowel holes a, and osteotomy guider is positioned at and cuts
On bone guider fixing port.
Metal guider includes guide way, and guide way is vertically connected with base station, and base station is provided with gathering sill.
Dowel hole a arranges five, and two dowel hole a and two alignment pin a coordinate, two dowel holes and two
Alignment pin c coordinates, and last alignment pin coordinates with alignment pin b.
Link block is orthopedic template, and orthopedic template includes orthopedic location-plate, and orthopedic location-plate is provided with V-shaped valley, tune
Joint groove b and dowel hole b, the bottom of orthopedic location-plate is provided with rectification platform.
Dowel hole b arranges four, and two dowel hole b and two alignment pin c coordinate, two other dowel hole b
Coordinating with two alignment pin a, regulating tank a overlaps with regulating tank b.
Alignment pin c arranges two, and regulating tank a is between two alignment pin c.
Second technical scheme of the present invention is, the manufacture method of a kind of DDH osteotomy guide plate, specifically according to following step
Rapid enforcement:
Step 1, utilize Medical Imaging Technology, gather the CT scan data that patient femur position is complete, build in a computer
Vertical visual skeleton pathological model；
Step 2, visual skeleton model is imported in 3 d modeling software, calculate the anteversion of femoral neck of patient, neck
Dry angle, then calculates the orthopedic anglec of rotation of osteotomy, interior receipts or valgus angle, the parameter of shortening length；
The angle that the line that top rake is in the axis of neck of femur and femur between ectocondyle midpoint is formed, collodiaphyseal angle is
The angle formed between major axis and the femoral shaft longitudinal axis of neck of femur, by calculating the gap between both angles and normal value,
Determine that the orthopedic number of degrees of needs are how many respectively；Shortening osteotomy is that distal bone cross section is cut 1～2cm, can reduce muscle tight
Zhang Du, in order to reset.
Step 3, according to calculate the orthopedic parameter of osteotomy, make according to osteotomy parameter at skeleton pathological model osteotomy site
Osteotomy curved surface；
Osteotomy is normally at below lesser trochanter at 1～2cm, is perpendicular to femur solution plane direction of principal axis, exists according to this plane
Three-dimensional modeling is simulated osteotomy, after osteotomy completes, by distal part of femur with femur cross section as the center of circle, presses along vertical cross-section direction
Rotate according to the precalculated anglec of rotation, i.e. complete first stage simulation；As patient carried out varus or osteotomy of turning up,
On the basis of the first stage has simulated, then determine the second Osteotomy；As need to carry out shorten osteotomy, then by shorten away from
From precalculating in the first Osteotomy.So, i.e. reach to rotate by twice osteotomy, in turn up, the operation such as shortening
Requirement.Finally, position and the direction of gathering sill in osteotomy oriented module is just can determine that according to two Osteotomies；
Step 4, by three-dimensional engineering software at the osteotomy site of affected part skeleton model, the skeleton extracting osteotomy region is bent
Face, sets up fixing end and the model of round end on this basis, make the skeleton binding face of fixing end and round end by with osteotomy
On the completely reliable skeleton curved surface being fitted in osteotomy region of the bone feature in region, to ensure the accurate and reliable, so of location
Osteotomy guide plate guider base is carried out afterwards according to fixing end and the position of round end and femoral rotation angle, interior receipts or valgus angle
Seat, osteotomy guider, orthopedic template and the modeling of osteotomy module, be then led off the file format required for printing into 3D；
Step 5,3D printer is transferred to print by software processes.
3rd technical scheme of the present invention is, the using method of a kind of DDH osteotomy guide plate, specifically according to following step
Rapid enforcement:
Step 1, fixing end and round end are connected by osteotomy module, and dowel hole coordinates with alignment pin a, dowel hole
Coordinating with alignment pin b, make fixing end be fixed on below osteotomy module with round end, screw is by the fastening in alignment pin a
After hole is connected realization fastening with the nut in nut placing trough a, screw is by the fastener hole in alignment pin b and nut placing trough
After nut in b connects realization fastening, osteotomy guide plate is positioned over patient femur's osteotomy position, and by fixing end and round end
Skeleton binding face osteotomy guide plate is placed on femur, this position is the osteotomy site being pre-designed, and then Kirschner wire leads to
Cross Kirschner wire location hole b and Kirschner wire location hole a osteotomy guide plate is positioned, to guarantee that guide plate and patient femur are reliably fixed
Position；
Step 2, the osteotomy guider in osteotomy module is adjusted correspondingly:
Rotary osteotomy, installs osteotomy guider on osteotomy guider pedestal and carries out the operation of vertical femur axis osteotomy；
Rotate, varus or turn up, shorten osteotomy, install on osteotomy guider pedestal respectively vertical osteotomy guider and
Carry angled osteotomy guider to carry out osteotomy operation successively, to realize wedge osteotomy, first carry out osteotomy, so near femoral head end
After carry out femoral shaft osteotomy；
Step 3, osteotomy back out trip bolt after completing, and change osteotomy module, carry out the installment work of orthopedic module, will be solid
Fixed end and round end are connected by orthopedic template, and two dowel hole b and two alignment pin c coordinate, two other alignment pin
Hole b and two alignment pin a coordinate, and regulating tank a overlaps with regulating tank b, orthopedic module are pacified by adjusting the position of round end
Install into i.e. reach orthopedic purpose include rotating, varus or turn up, shorten；Finally steel plate is inserted in steel plate gathering sill a, respectively
By regulating tank B, V-shaped valley screw, steel plate is fixed with femur, take off whole osteotomy module subsequently, then implant remaining spiral shell successively
Nail, i.e. complete orthopedic after fixed work order.
The invention has the beneficial effects as follows: a kind of DDH osteotomy guide plate, use this osteotomy guide plate can improve operation precision, at hands
Simplifying operating procedure in art, shorten operating time, doctor corrects angle without relying on micro-judgment in orthopedic bone-culting operation
Degree, improves degree of accuracy, reduces operation risk.Reduce the operation demand threshold to doctors experience simultaneously.A kind of DDH osteotomy
The manufacture method of guide plate, uses this manufacture method can accurately, conveniently manufacture osteotomy guide plate.A kind of user of DDH osteotomy guide plate
Method, uses the method can shorten operating time.
Accompanying drawing explanation
Fig. 1 is that end and the round end knot by osteotomy module connection embodiment one fixed by the present invention a kind of DDH osteotomy guide plate
Structure schematic diagram；
Fig. 2 is that end and the round end knot by osteotomy module connection embodiment two fixed by the present invention a kind of DDH osteotomy guide plate
Structure schematic diagram；
Fig. 3 is the structural representation that the present invention a kind of DDH osteotomy guide plate fixes that end is connected by orthopedic template with round end；
Fig. 4 is the structural representation of osteotomy module in the present invention a kind of DDH osteotomy guide plate；
Fig. 5 is the structural representation of round end in the present invention a kind of DDH osteotomy guide plate；
Fig. 6 is the rearview of round end in the present invention a kind of DDH osteotomy guide plate；
Fig. 7 is the structural representation of fixing end in the present invention a kind of DDH osteotomy guide plate；
Fig. 8 is the rearview of fixing end in the present invention a kind of DDH osteotomy guide plate；
Fig. 9 is the structural representation of osteotomy guider pedestal in the present invention a kind of DDH osteotomy guide plate；
Figure 10 is the rearview of osteotomy guider pedestal in the present invention a kind of DDH osteotomy guide plate；
Figure 11 is the structural representation of osteotomy guider embodiment one in the present invention a kind of DDH osteotomy guide plate；
Figure 12 is the structural representation of osteotomy guider embodiment two in the present invention a kind of DDH osteotomy guide plate；
Figure 13 is the structural representation of metal guider in the present invention a kind of DDH osteotomy guide plate.
In figure, 1. fixing end, 2. round end, 3. alignment pin a, 4. nut placing trough a, 5. steel plate gathering sill a, 6. kirschner
Pin location hole a, 7. osteotomy position, the most orthopedic position, 9. alignment pin b, 10. dowel hole a, 11. nut placing trough b, 12. Kirschner wires
Location hole b, 13. alignment pin c, 14. regulating tank a, 15. steel plate gathering sill b, 16. osteotomy guider pedestals, 17. osteotomy guide
Device, 18. osteotomy modules, 19. osteotomy guider fixing ports, 20. osteotomy gathering sills, 21. boss, 22. metal guiders, 23. lead
Xiang Ti, 24. base stations, 25. gathering sills, 26. orthopedic location-plates, 27. dowel hole b, 28. regulating tank b, 29.V word groove, 30. correct
Platform, 31. orthopedic templates, 32. skeleton binding faces, 33. alignment pin d, 34. steel plates.
Detailed description of the invention
The present invention is described in detail with detailed description of the invention below in conjunction with the accompanying drawings.
The invention provides a kind of DDH osteotomy guide plate, as shown in Fig. 1-Figure 10, including being fitted in osteotomy region bone surface
Upper fixing end 1 and round end 2, fixing end 1 and round end 2 are connected by link block；
Be provided with alignment pin a3 on fixing end 1, the upper and lower of the front end of fixing end 1 be respectively arranged with V word mouth and
Steel plate gathering sill a5, the both sides that the top of fixing end 1 front end is relative are provided with Kirschner wire location hole a6, the rear end of fixing end 1
Fit with bone surface；
Round end 2 includes osteotomy position 7 and the orthopedic position 8 being connected with the rear end of osteotomy position 7, and osteotomy position 7 is provided with location
Bearing pin d33, alignment pin b9 and Kirschner wire location hole b12, the rear end of osteotomy position 7 is provided with skeleton binding face 32, on orthopedic position 8
Being provided with regulating tank a14 and alignment pin c13, the bottom of orthopedic position 8 is provided with steel plate gathering sill b15；
Alignment pin a3 arranges two, and all with screw hole in two alignment pin a3, hole 6, Kirschner wire location is positioned at two
The side of alignment pin a3, the bottom of alignment pin a3 is provided with the nut placing trough a4 for placing hex nut, and nut is put
The opening putting groove a4 is positioned at the bottom of fixing end 1；
With screw hole in alignment pin b9, the bottom of alignment pin b9 is provided with puts for the nut placing hex nut
The opening putting groove b11, nut placing trough b11 is positioned at the bottom of osteotomy position 7；
As shown in Fig. 1 and Fig. 2, Fig. 5 and Fig. 6, link block is osteotomy module 18, and osteotomy module 18 includes osteotomy guider
Pedestal 16 and osteotomy guider 17, osteotomy guider 17 is provided with boss 21, is provided with osteotomy gathering sill 20 in boss 21, cuts
It is inserted with metal guider 22 in bone gathering sill 20, in the middle part of osteotomy guider pedestal 16, is provided with osteotomy guider fixing port 19, cut
Being provided with several dowel holes a10 on bone guider 17, osteotomy guider 17 is positioned on osteotomy guider fixing port 19；
Dowel hole a10 arranges five, and two dowel hole a10 and two alignment pin a3 coordinate, two dowel holes
10 coordinate with two alignment pin c13, and last alignment pin 10 coordinates with alignment pin b9；
As shown in Figure 3 and Figure 4, link block is orthopedic template 31, and orthopedic template 31 includes orthopedic location-plate 26, orthopedic fixed
Being provided with V-shaped valley 29, regulating tank b28 and dowel hole b27 on the plate 26 of position, the bottom of orthopedic location-plate 26 is provided with rectification platform
30；
Dowel hole b27 arranges four, and two dowel hole b27 and two alignment pin c13 coordinate, two other location
Pin-and-hole b27 and two alignment pin a3 coordinate, and regulating tank a14 overlaps with regulating tank b28；
Alignment pin c13 arranges two, and regulating tank a14 is between two alignment pin c13；
As shown in figure 13, metal guider 22 includes guide way 23, and guide way 23 is vertically connected with base station 24, base station 24
On be provided with gathering sill 25；
As shown in figure 11, boss 21 is positioned in the middle part of osteotomy guider 17；
As shown in figure 12, boss 21 is positioned at osteotomy guider 17 bottom.
The invention provides the manufacture method of a kind of DDH osteotomy guide plate, specifically implement according to following steps:
Step 1, utilize Medical Imaging Technology, gather the CT scan data that patient femur position is complete, build in a computer
Vertical visual skeleton pathological model；
Step 2, visual skeleton model is imported in 3 d modeling software, calculate the anteversion of femoral neck of patient, neck
Dry angle, then calculates the orthopedic anglec of rotation of osteotomy, interior receipts or valgus angle, the parameter of shortening length；
The angle that the line that top rake is in the axis of neck of femur and femur between ectocondyle midpoint is formed, collodiaphyseal angle is
The angle formed between major axis and the femoral shaft longitudinal axis of neck of femur, by calculating the gap between both angles and normal value,
Determine that the orthopedic number of degrees of needs are how many respectively；Shortening osteotomy is that distal bone cross section is cut 1～2cm, can reduce muscle tight
Zhang Du, in order to reset.
Step 3, according to calculate the orthopedic parameter of osteotomy, make according to osteotomy parameter at skeleton pathological model osteotomy site
Osteotomy curved surface；
Osteotomy is normally at below lesser trochanter at 1～2cm, is perpendicular to femur solution plane direction of principal axis, exists according to this plane
Three-dimensional modeling is simulated osteotomy, after osteotomy completes, by distal part of femur with femur cross section as the center of circle, presses along vertical cross-section direction
Rotate according to the precalculated anglec of rotation, i.e. complete first stage simulation；As patient carried out varus or osteotomy of turning up,
On the basis of the first stage has simulated, then determine the second Osteotomy；As need to carry out shorten osteotomy, then by shorten away from
From precalculating in the first Osteotomy.So, i.e. reach to rotate by twice osteotomy, in turn up, the operation such as shortening
Requirement.Finally, position and the direction of gathering sill in osteotomy oriented module is just can determine that according to two Osteotomies；
Step 4, by three-dimensional engineering software at the osteotomy site of affected part skeleton model, the skeleton extracting osteotomy region is bent
Face, sets up fixing end 1 and the model of round end 2 on this basis, make the skeleton binding face of fixing end 1 and round end 2 by with
On the completely reliable skeleton curved surface being fitted in osteotomy region of the bone feature in osteotomy region, with ensure location accurately and can
Lean on, then carry out osteotomy guide plate according to fixing end 1 and the position of round end 2 and femoral rotation angle, interior receipts or valgus angle
Guider pedestal 16, osteotomy guider 17, orthopedic template 31 and the modeling of osteotomy module 18, be then led off as 3D printing required
File format；
Step 5,3D printer is transferred to print by software processes.
The invention provides the using method of a kind of DDH osteotomy guide plate, specifically implement according to following steps:
Step 1, fixing end 1 and round end 2 are connected by osteotomy module 18, and dowel hole 10 coordinates with alignment pin a3,
Dowel hole 10 coordinates with alignment pin b9, makes fixing end 1 be fixed on below osteotomy module 18 with round end 2, and screw is by fixed
After fastener hole on the bearing pin a3 of position is connected realization fastening with the nut in nut placing trough a4, screw is by alignment pin b9
After fastener hole is connected realization fastening with the nut in nut placing trough b11, osteotomy guide plate is positioned over patient femur's osteotomy position,
And by the skeleton binding face of fixing end 1 with round end 2, osteotomy guide plate is placed on femur, this position is and is pre-designed
Osteotomy site, then osteotomy guide plate is positioned, with really by Kirschner wire by Kirschner wire location hole b12 and Kirschner wire location hole a6
Protect guide plate reliably to position with patient femur；
Step 2, the osteotomy guider 17 in osteotomy module 18 is adjusted correspondingly:
Rotary osteotomy, installs osteotomy guider 17 on osteotomy guider pedestal 16 and carries out vertical femur axis osteotomy behaviour
Make；
Rotate, varus or turn up, shorten osteotomy, vertical osteotomy guider is installed respectively on osteotomy guider pedestal 16
17 carry out osteotomy operation successively with carrying angled osteotomy guider 17, to realize wedge osteotomy, first carry out near femoral head end
Osteotomy, then carries out femoral shaft osteotomy；
Step 3, osteotomy back out trip bolt after completing, and change osteotomy module 18, carry out the installment work of orthopedic module, will
Fixing end 1 and round end 2 are connected by orthopedic template 31, and two dowel hole b27 and two alignment pin c13 coordinate, additionally
Two dowel hole b27 and two alignment pin a3 coordinate, and regulating tank a14 overlaps with regulating tank b28, by adjusting round end 2
Position the installation of orthopedic module 31 is i.e. reached orthopedic purpose include rotating, varus or turn up, shorten, finally by steel plate 34
Insert in steel plate gathering sill a5, with screw, steel plate is fixed with femur by regulating tank B28, V-shaped valley 29 respectively, take off whole subsequently
Individual osteotomy module, then implant remaining screw successively, i.e. complete orthopedic after fixed work order.
A kind of DDH osteotomy guide plate of the present invention, uses this osteotomy guide plate can improve operation precision, simplifies hands in operation
Art step, shortens operating time, and doctor, without relying on micro-judgment to correct angle in orthopedic bone-culting operation, improves accurately
Degree, reduces operation risk.Reduce the operation demand threshold to doctors experience simultaneously.A kind of making side of DDH osteotomy guide plate
Method, uses this manufacture method can accurately, conveniently manufacture osteotomy guide plate.The using method of a kind of DDH osteotomy guide plate, uses the party
Method can shorten operating time.
Claims (10)
1. a DDH osteotomy guide plate, it is characterised in that: include being fitted in fixing end (1) and rotation in the bone surface of osteotomy region
End (2), fixing end (1) and round end (2) are connected by link block；
Being provided with alignment pin a (3) on fixing end (1), the upper and lower of the front end of fixing end (1) is respectively arranged with V word mouth
With steel plate gathering sill a (5), the both sides that the top of fixing end (1) front end is relative are provided with Kirschner wire location hole a (6), fixing end
(1) fit with bone surface in rear end；
Round end (2) includes the orthopedic position (8) that osteotomy position (7) and the rear end with osteotomy position (7) are connected, and osteotomy position (7) are upper to be arranged
Having alignment pin d (33), alignment pin b (9) and Kirschner wire location hole b (12), the rear end of osteotomy position (7) is provided with skeleton laminating
Face (32), orthopedic position (8) are provided with regulating tank a (14) and alignment pin c (13), and the bottom of orthopedic position (8) is provided with steel plate
Gathering sill b (15).
A kind of DDH osteotomy guide plate the most according to claim 1, it is characterised in that: described alignment pin a (3) arranges two,
Two alignment pin a (3) are upper all with screw hole, and Kirschner wire hole, location (6) is positioned at the side of two alignment pin a (3), location
The bottom of bearing pin a (3) is provided with nut placing trough a (4) for placing hex nut, and the opening of nut placing trough a (4) is positioned at
The bottom of fixing end (1)；
With screw hole in alignment pin b (9), the bottom of alignment pin b (9) is provided with puts for the nut placing hex nut
Putting groove b (11), the opening of nut placing trough b (11) is positioned at the bottom of osteotomy position (7).
A kind of DDH osteotomy guide plate the most according to claim 2, it is characterised in that: described link block is osteotomy module
(18), osteotomy module (18) includes osteotomy guider pedestal (16) and osteotomy guider (17), and osteotomy guider (17) is upper to be arranged
There is boss (21), be provided with osteotomy gathering sill (20) in boss (21), in osteotomy gathering sill (20), be inserted with metal guider (22),
Osteotomy guider pedestal (16) middle part is provided with osteotomy guider fixing port (19), and osteotomy guider is provided with several on (17)
Dowel hole a (10), osteotomy guider (17) is positioned on osteotomy guider fixing port (19).
A kind of DDH osteotomy guide plate the most according to claim 3, it is characterised in that: described metal guider (22) includes leading
On body (23), guide way (23), it is vertically connected with base station (24), base station (24) is provided with gathering sill (25).
A kind of DDH osteotomy guide plate the most according to claim 3, it is characterised in that: described dowel hole a (10) arranges five
Individual, two dowel hole a (10) coordinate with two alignment pin a (3), two dowel holes (10) and two alignment pin c
(13) coordinating, last alignment pin (10) coordinates with alignment pin b (9).
A kind of DDH osteotomy guide plate the most according to claim 2, it is characterised in that: described link block is orthopedic template
(31), orthopedic template (31) includes orthopedic location-plate (26), and orthopedic location-plate (26) is provided with V-shaped valley (29), regulating tank b
(28) and dowel hole b (27), the bottom of orthopedic location-plate (26) is provided with rectification platform (30).
A kind of DDH osteotomy guide plate the most according to claim 6, it is characterised in that: described dowel hole b (27) arranges four
Individual, two dowel hole b (27) coordinate with two alignment pin c (13), two other dowel hole b (27) and two alignment pins
Axle a (3) coordinates, and regulating tank a (14) and regulating tank b (28) overlaps.
8. according to a kind of DDH osteotomy guide plate described in claim 5 or 7, it is characterised in that: described alignment pin c (13) is arranged
Two, regulating tank a (14) is positioned between two alignment pin c (13).
9. the manufacture method of the DDH osteotomy guide plate described in a claim 8, it is characterised in that specifically real according to following steps
Execute:
Step 1, utilizing Medical Imaging Technology, gather the CT scan data that patient femur position is complete, setting up in a computer can
Depending on the skeleton pathological model changed；
Step 2, visual skeleton model is imported in 3 d modeling software, calculates the anteversion of femoral neck of patient, collodiaphyseal angle,
Then the orthopedic anglec of rotation of osteotomy, interior receipts or valgus angle, the parameter of shortening length are calculated；
The angle that the line that top rake is in the axis of neck of femur and femur between ectocondyle midpoint is formed, collodiaphyseal angle is femur
The angle formed between major axis and the femoral shaft longitudinal axis of neck, by calculating the gap between both angles and normal value, divides
Do not determine that the orthopedic number of degrees of needs are how many；Shortening osteotomy is that distal bone cross section is cut 1～2cm, can reduce muscle tone,
In order to reset；
Step 3, according to calculate the orthopedic parameter of osteotomy, at skeleton pathological model osteotomy site, make osteotomy according to osteotomy parameter
Curved surface；
Osteotomy is normally at below lesser trochanter at 1～2cm, is perpendicular to femur solution plane direction of principal axis, according to this plane in three-dimensional
Modeling is simulated osteotomy, after osteotomy completes, by distal part of femur with femur cross section as the center of circle, along vertical cross-section direction according in advance
The precalculated anglec of rotation rotates, and i.e. completes first stage simulation；As patient carried out varus or osteotomy of turning up, then exist
First stage determines the second Osteotomy on the basis of having simulated；As carried out shortening osteotomy, then the distance by shortening is pre-
First calculate in the first Osteotomy, so, i.e. reach to rotate by twice osteotomy, in turn up, the operation requirement such as shortening,
Finally, position and the direction of gathering sill in osteotomy oriented module is just can determine that according to two Osteotomies；
Step 4, by three-dimensional engineering software at the osteotomy site of affected part skeleton model, extract the skeleton curved surface in osteotomy region,
Set up fixing end (1) and the model of round end (2) on this basis, make the skeleton binding face of fixing end (1) and round end (2) lead to
Cross with the bone feature in osteotomy region on the completely reliable skeleton curved surface being fitted in osteotomy region, with ensure location accurately and
Reliably, then carry out cutting according to fixing end (1) and the position of round end (2) and femoral rotation angle, interior receipts or valgus angle
Bone conduction plate guider pedestal (16), osteotomy guider (17), orthopedic template (31) and the modeling of osteotomy module (18), be then led off
File format required for printing for 3D；
Step 5,3D printer is transferred to print by software processes.
10. the using method of a DDH osteotomy guide plate as claimed in claim 8, it is characterised in that specifically according to following steps
Implement:
Step 1, fixing end (1) and round end (2) are connected by osteotomy module (18), dowel hole (10) and alignment pin a (3)
Coordinating, dowel hole (10) coordinates with alignment pin b (9), makes fixing end (1) be fixed on osteotomy module (18) with round end (2)
Lower section, after screw is connected realization fastening by the fastener hole in alignment pin a (3) with the nut in nut placing trough a (4), spiral shell
Follow closely after being connected realization fastening by the fastener hole in alignment pin b (9) with the nut in nut placing trough b (11), osteotomy is led
Plate is positioned over patient femur's osteotomy position, and is placed by osteotomy guide plate by the skeleton binding face of fixing end (1) with round end (2)
On femur, this position is the osteotomy site being pre-designed, and then Kirschner wire is by Kirschner wire location hole b (12) and Kirschner wire
Osteotomy guide plate is positioned, to guarantee that guide plate reliably positions with patient femur by location hole a (6)；
Step 2, the osteotomy guider (17) in osteotomy module (18) is adjusted correspondingly:
Rotary osteotomy, installs osteotomy guider (17) on osteotomy guider pedestal (16) and carries out vertical femur axis osteotomy behaviour
Make；
Rotate, varus or turn up, shorten osteotomy, respectively at the osteotomy guider that the upper installation of osteotomy guider pedestal (16) is vertical
(17) osteotomy operation is carried out successively with carrying angled osteotomy guider (17), to realize wedge osteotomy, first near femoral head end
Carry out osteotomy, then carry out femoral shaft osteotomy；
Step 3, osteotomy back out trip bolt after completing, and change osteotomy module (18), carry out the installment work of orthopedic module, will be solid
Fixed end (1) and round end (2) are connected by orthopedic template (31), and two dowel hole b (27) are joined with two alignment pin c (13)
Closing, two other dowel hole b (27) coordinates with two alignment pin a (3), and regulating tank a (14) and regulating tank b (28) overlaps,
By the position of adjustment round end (2), orthopedic module (31) installation is i.e. reached orthopedic purpose and include rotation, varus or outer
Turn over, shorten；Finally steel plate (34) is inserted in steel plate gathering sill a (5), use spiral shell by regulating tank B (28), V-shaped valley (29) respectively
Nail steel plate is fixed with femur, take off whole osteotomy module subsequently, then implant remaining screw successively, i.e. complete orthopedic after fix
Operation.
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| CN107361815A (en) * | 2017-08-02 | 2017-11-21 | 张永飞 | A kind of orthopedic guide plate of osteotomy and its manufacture method |
| CN108938042A (en) * | 2018-09-07 | 2018-12-07 | 上海黑焰医疗科技有限公司 | Personalized knee osteotomy guide plate component and its design method |
| CN110141299A (en) * | 2019-06-17 | 2019-08-20 | 中山市中医院 | A hip-preserving surgical device for femoral neck osteotomy |
| CN111067586A (en) * | 2019-12-20 | 2020-04-28 | 哈尔滨医科大学 | Child DDH acetabular osteotomy orthopedic guide plate and using method thereof |
| CN111658066A (en) * | 2020-05-29 | 2020-09-15 | 辛欣 | 3D prints assembled, modularization backbone and cuts bone conduction board device |
| CN112568993A (en) * | 2020-12-28 | 2021-03-30 | 上海市第六人民医院 | Fracture is with mechanical experiment anchor clamps |
| CN114681003A (en) * | 2022-03-25 | 2022-07-01 | 湖南铠锶增材制造有限公司 | Elbow-varus-outer-side closed wedge-shaped osteotomy guide plate and manufacturing method thereof |
| CN114848083A (en) * | 2022-05-10 | 2022-08-05 | 北京市春立正达医疗器械股份有限公司 | An osteotomy guide |
| WO2022182312A1 (en) * | 2021-02-26 | 2022-09-01 | Yaldiz Oezguer Sinan | Personalized 3d printing osteotomy guide creation system with software support |
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