CN113081158B - Tibia tunnel positioner for posterior cruciate ligament reconstruction operation - Google Patents

Abstract

The invention discloses a tibia tunnel locator for posterior cruciate ligament reconstruction surgery in the technical field of medical appliances, which comprises a tibia locator and a locating guide pipe, wherein the tibia locator comprises a fixing section and a clamping section, two locating heads are arranged at intervals on the left end head of the clamping section, locating holes are arranged at intervals between the two locating heads, and the locating guide pipe and the tibia locator are both made of circular hollow pipes; the positioning guide pipe is fixed at the fixed section through the positioning sleeve, the positioning guide pipe is horizontally connected in the positioning sleeve in a penetrating manner, and the axis of the positioning guide pipe and the axis of the positioning hole are on the same horizontal line and in the same vertical plane; compared with the prior art, the tibia tunnel opening device has the advantages that the tibia tunnel opening device is more prepared for posterior cruciate ligament reconstruction surgery, ligament penetration is quicker, surgery efficiency is higher, surgery is safer, the structure is simple, and use is convenient.

Description

Tibial Tunnel Positioner for Posterior Cruciate Ligament Reconstruction Surgery

technical field

The invention relates to the technical field of medical appliances, in particular to a tibial tunnel locator for posterior cruciate ligament reconstruction surgery.

Background technique

Posterior cruciate ligament injuries account for 3% to 20% of knee ligament injuries and are often caused by an anterior impact on the knee or a fall in a flexed position. Injury alone is rare, and is prone to other ligament injuries. The posterior cruciate ligament provides 95% of the blocking force for the tibia's positive and posterior displacement, limiting varus and external rotation, and relieving the pressure between the patellofemoral joint and the medial tibiofemoral joint. Untreated posterior cruciate ligament rupture can lead to patellofemoral arthritis and medial knee osteoarthritis. In order to restore the structure and function of the knee joint, it is necessary to actively use arthroscopic surgery to reconstruct the posterior cruciate ligament when the posterior cruciate ligament is ruptured.

The difficulty of arthroscopic reconstruction of the posterior cruciate ligament is that the inferior insertion point of the posterior cruciate ligament is deep, located on the posterior side of the proximal tibia and under the tibial plateau, and the arthroscopic view of this part is poor. In addition, during the reconstruction of the posterior cruciate ligament, the distance between the inner opening of the tibial canal and the vascular and nerve bundles at the popliteal fossa is relatively short, and the average distance between the inner opening of the tibial canal and the vascular and nerve bundles is about 6 mm in the straight knee position. Possibility of vascular nerve bundles. In order to solve the current preparation of the tibial tunnel in the reconstruction of the posterior cruciate ligament, the medial and posterior approach is currently established during the operation, the tissue at the posterior mediastinum of the knee joint is cleaned, the inferior insertion point of the posterior cruciate ligament is exposed, and the guide pin and the needle are inserted under monitoring. drill. At the same time, 90° knee flexion was used during the operation, the study found. When the knee is flexed to 90°, the vascular and nerve bundles of the popliteal fossa will move posteriorly, and the average distance from the inner opening of the tibial canal can exceed 24 mm. The establishment of an intra- and posterior approach to the knee joint during the operation will increase the operation time. According to literature reports, for the same operator, these operations take an average of about 20 minutes. Although these operations can further reduce the probability of vascular and nerve injury during arthroscopic reconstruction of the posterior cruciate ligament, the current literature reports that vascular and nerve injury is still an important complication of this type of surgery. Once vascular and nerve injury occurs during surgery, intraoperative incision and repair of the vascular and nerve bundles are required, and the knee joint is fixed for a long time after surgery. This not only prolongs the operation time and increases the pain of the patient, but most importantly, the ultrasound will seriously affect the knee joint function of the patient after the operation, and the loss of knee joint mobility is almost inevitable.

At present, most of the reconstruction of the posterior cruciate ligament is performed by manually finding a point for tunnel establishment, using arthroscopic observation, and then the doctor estimates the drilling based on his own experience, so the drilling is likely to be caused by the doctor's hand shaking or other reasons. Offset has great instability, which greatly reduces the success rate of the operation, and it is very difficult for the artificial ligament to pass through the tunnel. duration.

In conclusion, the applicant proposes a tibial tunnel locator for posterior cruciate ligament reconstruction surgery.

SUMMARY OF THE INVENTION

Aiming at the problems of inaccurate positioning and difficult ligament penetration in the prior art, a tibial tunnel locator for posterior cruciate ligament reconstruction surgery that solves the above problems is proposed.

For realizing the above-mentioned technical purpose, the technical scheme adopted in the present invention is as follows:

A tibial tunnel locator for posterior cruciate ligament reconstruction surgery, characterized in that it includes a tibial locator and a positioning catheter, the tibial locator includes a fixed segment and a clamping segment, the fixing segment is horizontally arranged, and the clamping segment It is U-shaped, at least two positioning heads are provided at intervals on the left end of the clamping section, and positioning holes are provided at the intervals between the two positioning heads, and the positioning guide tube and the tibia locator are both. It also includes a positioning sleeve, the positioning sleeve is fixed on the fixed section, the positioning guide tube is fixed on the fixed section through the positioning sleeve, and the outer surface of the positioning guide tube is set on the fixed section. There is an external thread, the positioning sleeve is provided with an internal thread that matches the external thread on the positioning catheter, the positioning catheter is also horizontally penetrated into the positioning sleeve, and the axis of the positioning catheter and the axis of the positioning hole are on the same horizontal line and in the same vertical plane.

By setting the axis of the positioning head and the positioning catheter on the same horizontal line and in the same vertical plane, the positioning catheter is threaded into the positioning sleeve. When the tibial tunnel is opened, we first find the need to open the tibial tunnel. The position of the hole and the position where the tunnel passes through, and then the positioning head is placed at the position where the tunnel passes out so that the positioning hole coincides with the position where the tunnel passes out. The positioning head is fixed on the tibia, and then the positioning catheter is aligned with the tunnel on the tibia The position of the opening is so that it is close to the tibia. At this time, the drilling needle is drilled from the positioning catheter. In this way, the tunnel opening for the tibia is very accurate, and there will be no deviation, which will lead to poor surgical results. The effect is very good. It is good, and setting the tibial locator and the tibial locator as an empty tube can make the lead wire pass through the inside of the tibial locator and the tibial locator, tie the tail of the lead wire to the artificial ligament, and directly pull the artificial ligament through the tunnel through the lead wire. Then, the tibial locator and positioning catheter are withdrawn, which greatly improves the efficiency of the operation.

Further limited, the positioning head is a conical shape; by setting the positioning head into a conical shape, the positioning head can be better fixed on the tibia by penetrating into the tibial bone, so that the positioning is more accurate.

Further limited, the positioning sleeve is provided with internal threads matching the external threads on the positioning catheter; the positioning catheter is moved in the positioning sleeve along the axial direction of the positioning catheter through the thread, which is very stable and not easy to be cheap.

It is further limited, including a drill needle, the drill needle is movably sleeved in the positioning catheter, the axis of the drill needle and the axis of the positioning hole are on the same horizontal line and in the same vertical plane, and the inner diameter of the positioning sleeve is the same as that of the positioning sleeve. The outer diameter of the positioning catheter is the same, with clearance fit; the inner diameter of the positioning catheter and the outer diameter of the drill needle are the same, with clearance fit, the positioning hole is a round hole, the diameter of the positioning hole is smaller than the diameter of the drill needle, and the inner diameter of the positioning catheter and The outer diameter of the drill needle is 2.5mm, with clearance fit, the diameter of the positioning hole is 2mm, the diameter of the drill needle is set to 2.5mm, and the diameter of the positioning hole is set to 2mm. It will not continue to drill out and harm other organizations, very safe.

It is further limited that the length of the positioning catheter is the length of the positioning sleeve from the positioning hole; the outer surface of the positioning catheter is provided with a scale, and the zero scale point of the scale is at the right end of the positioning catheter; it is convenient to set the scale on the outer surface of the positioning catheter like this We check and estimate the depth of the hole that needs to be drilled, making it safer to drill.

It is further limited that the clamping segment is split, including a left clamping segment and a right clamping segment, the left clamping segment is fixedly provided with mounting lugs, and the right clamping segment is provided with two mounting seats at fixed intervals. The spacing between the mounting seats matches the mounting lugs, the mounting lugs are provided with through holes, the mounting seats are provided with adjustment holes at the positions corresponding to the mounting lugs, and the left clamping section and the right clamping section are passed through by bolts. The adjustment hole and the through hole are fixed; we hinge the left clamping section and the right clamping section through bolts to adjust the relative angle of the left clamping section and the right clamping section. We can loosen the bolts and widen the lower openings of the left clamping section and the right clamping section to facilitate the insertion of the tibia. After the tibia is clamped in, the relative angle of the left clamping section and the right clamping section can be adjusted to one line. Straight line, and then tighten the bolts, so the setting can be more convenient for us to use.

Compared with the prior art, the present invention has the beneficial effects that the tibial tunnel opening for posterior cruciate ligament reconstruction surgery is more prepared, the ligament is connected more quickly, and the operation efficiency is higher and safer, and the structure is simple and easy to use.

Description of drawings

1 is a schematic diagram of a positioning state of the present invention;

FIG. 2 is a schematic diagram of the punching state of the present invention.

The indications in the figure correspond to: 1-fixed section, 2-clamping section, 21-left clamping section, 22-right clamping section, 23-installation lug, 24-installation seat, 3-positioning guide tube, 4-positioning Sleeve, 5-positioning head, 6-positioning hole, 7-drill, 8-scale.

Detailed ways

In order to enable those skilled in the art to better understand the present invention, the technical solutions of the present invention are further described below with reference to the accompanying drawings and embodiments.

Example:

As shown in Figures 1 and 2, a tibial tunnel locator for posterior cruciate ligament reconstruction surgery includes a tibial locator and a positioning catheter 3, the tibial locator includes a fixed segment 1 and a clamping segment 2, and the fixed segment 1 is arranged horizontally, The clamping section 2 is U-shaped, and two positioning heads 5 are arranged at intervals on the left end of the clamping section 2. The positioning heads are in the shape of a cone, and a positioning hole 6 is provided at the interval between the two positioning heads 5. Both the positioning catheter 3 and the tibial locator are made of circular hollow tubes; also include a positioning sleeve 4, the positioning sleeve 4 is fixed on the fixed section 1, the outer surface of the positioning catheter 3 is provided with external threads, and the positioning sleeve The barrel 4 is provided with an internal thread that matches the external thread on the positioning conduit 3, the positioning conduit 3 is fixed to the fixed section 1 through the positioning sleeve 4, and the positioning conduit 3 is also horizontally penetrated into the positioning sleeve 4. The positioning conduit 3 The axis of the locating hole 6 and the axis of the positioning hole 6 are on the same horizontal line and in the same vertical plane; also include a drill pin 7, the diameter of the drill pin 7 is 2.5mm, and the drill pin 7 is located in the positioning catheter 3; positioning The length of the catheter 3 is the length of the positioning sleeve 4 from the positioning hole 6; the outer surface of the positioning catheter 3 is provided with a scale 8, and the zero-scale point of the scale 8 is at the right end of the positioning catheter 3; the inner diameter of the positioning catheter 3 and the drill needle 7 The diameter of the positioning hole 6 is smaller than the diameter of the drill pin 7, the inner diameter of the positioning catheter 3 and the outer diameter of the drill pin 7 are both 2.5mm, clearance fit, the positioning hole 6 is a round hole, the positioning hole The diameter of 6 is 2mm; the clamping section 2 is a split type, including a left clamping section 21 and a right clamping section 22, the left clamping section 21 is fixedly provided with mounting lugs 23, and the right clamping section 22 is fixed at intervals There are two mounting seats 24, the interval between the two mounting seats 24 matches the thickness of the mounting lugs 23, the mounting lugs 23 are provided with through holes, and the positions corresponding to the mounting lugs 23 are opened on the mounting seats 24 There are adjustment holes, and the relative positions of the left clamping section 21 and the right clamping section 22 are connected and fixed by bolts passing through the adjustment holes and the penetrating holes; preferably the tibial locator and the positioning catheter 3 are made of stainless steel, preferably the positioning sleeve 4 is also made of stainless steel, the positioning sleeve 4 is fixed on the fixing section 1 of the tibial positioning device by welding, and preferably the positioning head 5 is also fixed with the left clamping section 21 by welding.

By setting the axis of the positioning head 5 and the positioning catheter 3 on the same horizontal line and in the same vertical plane, the positioning catheter 3 is threaded into the positioning sleeve 4, when the tibial tunnel is opened, we can use the medical instrument First find the location where the tunnel needs to be drilled on the tibia and the location where the tunnel is pierced, and then place the positioning head 5 at the position where the tunnel is pierced so that the positioning hole 6 coincides with the position where the tunnel is pierced, and the positioning head 5 is caught on the tibia. Fix, then align the positioning catheter 3 with the position of the tunnel opening on the tibia to make it close to the tibia, and then drill the needle 7 from the positioning catheter 3 to make a hole, so that the tibia is very accurate for tunnel opening. There will be no deviation to cause poor surgical results, and the effect is very good, and setting the tibial locator and the positioning catheter 3 as an empty tube can allow the lead to pass through the positioning catheter 3 and the tibial locator, and the tail of the lead can be passed through. The artificial ligament is tied, and the artificial ligament can be directly pulled out through the tunnel through the lead wire, and then the tibial locator and the positioning catheter 3 can be withdrawn, which greatly improves the efficiency of the operation; Penetrating into the tibial bone can better fix the positioning head 5 on the tibia, so that the positioning is more accurate; the positioning catheter 3 can be moved along the axial direction of the positioning catheter 3 in the positioning sleeve 4 through the thread, which is very stable. It is not easy to be offset; set the diameter of the drill pin 7 to 2.5mm, and the diameter of the positioning hole 6 to 2mm, so that the drill pin 7 will not continue to drill and damage other tissues after drilling out of the tunnel. Safety; we hinge the left clamping section 21 and the right clamping section 22 through bolts to adjust the relative angle of the left clamping section 21 and the right clamping section 22. When we are positioning, we can loosen the bolts , open the lower openings of the left clamping section 21 and the right clamping section 22 to facilitate the insertion of the tibia. After the tibia is inserted, adjust the relative angle of the left clamping section 21 and the right clamping section 22 to a straight line, and then Tighten the bolts, so the setting can be more convenient for us to use; in this way, setting a scale on the outer surface of the positioning guide tube 3 can facilitate us to check and estimate the depth of the required drilling, and it is safer to drill.

When in use, set the positioning head 5 at the tunnel outlet, that is, the attachment of the posterior cruciate ligament to the tibia, insert the positioning head 5 into the attachment of the posterior cruciate ligament for fixation, and then align the positioning catheter 3 with the location where we need to drill the tunnel. After finding the position, drill holes in the positioning catheter 3 through the drill pin 7 on the cortex of the anterior tibia at the corresponding position, until the drill pin 7 drills the bone at the attachment of the cruciate ligament to the tibia and reaches the positioning hole 6. , then take out the drill needle 7, use a thinner steel wire as the lead wire, fix the artificial ligament at the end of the steel wire, insert the lead wire through the positioning catheter 3, pass the positioning hole 6, and first pass through the clamping section 2 from the tibia locator and then fix it through Section 1 is pulled out, the lead wire is pulled out until the artificial ligament comes out, the tibial locator and the positioning catheter 3 can be removed, and the artificial ligament can be reconstructed.

Compared with the prior art, the present invention has the beneficial effects that the tibial tunnel opening for posterior cruciate ligament reconstruction surgery is more prepared, the ligament is connected more quickly, and the operation efficiency is higher and safer, and the structure is simple and easy to use.

The tibial tunnel locator for posterior cruciate ligament reconstruction surgery provided by the present invention has been described in detail above. The description of the specific embodiment is only used to help understand the method and the core idea of the present invention. It should be pointed out that for those skilled in the art, without departing from the principle of the present invention, several improvements and modifications can also be made to the present invention, and these improvements and modifications also fall within the protection scope of the claims of the present invention.

Claims (7)

1. a tibial tunnel locator for posterior cruciate ligament reconstruction surgery is characterized in that: comprise tibial locator and positioning guide tube, described tibial locator comprises fixed section and clamping section, and described fixed section is arranged horizontally, and described clamping The holding section is U-shaped, the left end of the holding section is provided with at least two positioning heads at intervals, and a positioning hole is provided at the interval between the two positioning heads, the positioning catheter and the tibial locator All are made of circular hollow tubes; It also includes a positioning sleeve, the positioning sleeve is fixed on the fixed section, the positioning guide tube is fixed on the fixed section through the positioning sleeve, the outer surface of the positioning guide tube is provided with an external thread, the The positioning sleeve is provided with an internal thread that matches the external thread on the positioning conduit, the positioning conduit is also horizontally penetrated into the positioning sleeve, and the axis of the positioning conduit and the positioning hole are separated. The axes are on the same horizontal line and in the same vertical plane; The clamping segment is split, including a left clamping segment and a right clamping segment, the left clamping segment is fixedly provided with mounting lugs, and the right clamping segment is provided with two mounting seats at fixed intervals , the interval between the two mounting seats matches the mounting lugs, the mounting lugs are provided with through holes, and the mounting seats are provided with adjustment holes at the positions corresponding to the mounting lugs, so The left clamping section and the right clamping section are fixed by bolts passing through the adjustment hole and the penetration hole. 2 . The tibial tunnel locator for posterior cruciate ligament reconstruction surgery according to claim 1 , wherein the locating head is in the shape of a cone. 3 . 3. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery according to claim 1, further comprising a drill needle, the drill needle is movably sleeved in the positioning catheter, and the drill needle The axis of the positioning hole and the axis of the positioning hole are on the same horizontal line and in the same vertical plane. 4 . The tibial tunnel positioner for posterior cruciate ligament reconstruction surgery according to claim 1 , wherein the length of the positioning guide tube is the length of the positioning sleeve from the positioning hole. 5 . 5 . The tibial tunnel locator for posterior cruciate ligament reconstruction surgery according to claim 3 , wherein the inner diameter of the positioning sleeve is the same as the outer diameter of the positioning catheter, and the positioning catheter has a clearance fit; The inner diameter is the same as the outer diameter of the drill pin, and the positioning hole is a circular hole, and the diameter of the positioning hole is smaller than the diameter of the drill pin. 6. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery according to claim 5, wherein the inner diameter of the positioning catheter and the outer diameter of the drill pin are both 2.5mm, and the positioning The diameter of the hole is 2mm. 7. The tibial tunnel locator for posterior cruciate ligament reconstruction surgery according to claim 4, wherein the outer surface of the positioning catheter is provided with a scale, and the zero-scale point of the scale is at the right end of the positioning catheter .

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