阅读说明：本技术 截骨手术治具 (Bone-culting operation jig ) 是由 鍾怀谷 于 2018-06-12 设计创作，主要内容包括：本发明的截骨手术治具系根据病患的胫骨量身订做,当截骨手术治具的表面恰可靠抵病患的胫骨的表面轮廓时,代表该截骨手术治具已放置在正确位置上,对手术操作者而言十分便利。此外,本发明的截骨手术治具的连接器还具有可作为切口撑开角度的量规,当连接器的凸部恰可伸入切口中时,代表切口已撑开到预设角度,对于手术操作者而言可以大幅省下评估切口的撑开角度的时间。本发明的截骨手术治具可以节省医生学习HTO手术的时间,让HTO手术更能依照预期的方式施作,同时对于病患而言也大幅降低了HTO手术过程中发生不可预期结果的风险。(Bone-culting operation jig system of the invention represents the bone-culting operation jig and has been placed on correct position according to the shin bone custom-made by size of sufferer when the surface of bone-culting operation jig can just abut against the surface profile of shin bone of sufferer, very convenient for operator.Furthermore, the connector of bone-culting operation jig of the invention also has the gauge that can be used as notch distraction angle, it when the protrusion of connector can just be protruded into notch, represents notch and has strutted predetermined angle, the time of the distraction angle of assessment notch can be substantially saved for operator.Bone-culting operation jig of the invention can save doctor learn HTO operation time, allow HTO operation can more be applied according to expected mode, simultaneously for also significantly reduced for sufferer in HTO surgical procedure occur can not expected results risk.)

1. a kind of bone-culting operation jig, suitable for high tibial osteotomy operation is imposed to a shin bone and be cut into one first notch with One second notch, which is characterized in that the bone-culting operation jig includes:

One first fixing seat includes:

One first abutting part has to one first supporting surface that abuts against the circumferential surface of the tibial plateau of the shin bone, and this first is supported Socket part includes an at least fixation hole；

One extension, one end are connected to the side of first abutting part, and from the side of first abutting part towards far from this first The direction of abutting part extends, which has the extension supporting surface to abut against the femoral surface above first notch； And

One first guidance part includes one first flat part, one first bending part and one first fixed part, first flat part connection In the other end of the extension, which is connected to the side of first flat part and does not put down altogether with first flat part Face, first fixed position is in first flat part；

One second fixing seat includes:

One second abutting part has to one second supporting surface that abuts against the femoral surface of first suitable order, and this second Abutting part includes an at least fixation hole；And

One second guidance part includes one second flat part, one second bending part and one second fixed part, second flat part connection In second abutting part, which is connected to the side of second flat part and not coplanar with second flat part； And

One pedestal, separably attached first fixed part and second fixed part, when the pedestal connect first fixed part with When second fixed part, between first flat part and second flat part define one first guiding road, first bending part with One second guiding road is defined between second bending part.

2. bone-culting operation jig as described in claim 1, which is characterized in that the lower surface of first fixed part has one first The upper surface of groove, second fixed part has one second groove, between the first connecting pin of the interconnecting piece and second connection end It is formed with one first convex block and one second convex block；When the pedestal with its first connecting pin connect first fixed part and with its second When connecting pin connects second fixed part, which is located in first groove, which is located at second groove In.

3. bone-culting operation jig as claimed in claim 2, which is characterized in that multiple spicules are further included, to be each passed through this The fixation hole of the fixation hole of first abutting part and second abutting part, and the first abutting part and second abutting part are fixed on this On shin bone.

4. bone-culting operation jig as claimed in claim 3, which is characterized in that first abutting part includes two fixation holes, should Second abutting part includes two fixation holes.

5. a kind of bone-culting operation jig, suitable for high tibial osteotomy operation is imposed to a shin bone and be cut into one first notch with One second notch, which is characterized in that the bone-culting operation jig includes:

One first fixing seat includes:

One first abutting part has to one first supporting surface that abuts against the circumferential surface of the tibial plateau of the shin bone, and this first is supported Socket part includes an at least fixation hole；

One extension, one end are connected to the side of first abutting part, and from the side of first abutting part towards far from this first The direction of abutting part extends, which has the extension supporting surface to abut against the femoral surface above first notch； And

One first guidance part includes one first flat part, one first bending part and one first fixed part, first flat part connection In the other end of the extension, which is connected to the side of first flat part and does not put down altogether with first flat part Face, first fixed position is in first flat part；

One second fixing seat includes:

One second abutting part has to one second supporting surface that abuts against the femoral surface of first suitable order, and this second Abutting part includes an at least fixation hole；And

One second guidance part includes one second flat part, one second bending part and one second fixed part, second flat part connection In second abutting part, which is connected to the side of second flat part and not coplanar with second flat part； And

One pedestal, includes an interconnecting piece and a protrusion, and two ends of the interconnecting piece separately include one first connecting pin and connect with one second End is connect, which protrudes the interconnecting piece from first connecting pin；When the pedestal connects first fixed part with its first connecting pin One first is defined and when connecting second fixed part with its second connection end, between first flat part and second flat part to lead It leads the way, one second guiding road is defined between first bending part and second bending part；When the pedestal is with its second connection end company When connecing first fixed part, the protrusion pass through between first flat part and second flat part and protrude second supporting surface with And the extension supporting surface.

6. bone-culting operation jig as claimed in claim 5, which is characterized in that the lower surface of first fixed part has one first The upper surface of groove, second fixed part has one second groove, between the first connecting pin of the interconnecting piece and second connection end It is formed with one first convex block and one second convex block；When the pedestal with its first connecting pin connect first fixed part and with its second When connecting pin connects second fixed part, which is located in first groove, which is located at second groove In.

7. bone-culting operation jig as claimed in claim 6, which is characterized in that multiple spicules are further included, to be each passed through this The fixation hole of the fixation hole of first abutting part and second abutting part, and the first abutting part and second abutting part are fixed on this On shin bone.

8. bone-culting operation jig as claimed in claim 7, which is characterized in that first abutting part includes two fixation holes, should Second abutting part includes two fixation holes.

Technical field

The present invention relates to a kind of bone surgery jig, especially a kind of jig suitable for high tibial osteotomy operation.

Background technique

For because tibial flexion (such as toed-in leg or toed-out leg) cause kneed single lateral cartilages abrasion compared with Fastly, the patient of degenerative arthritis occurs ahead of time, medical circles develop a kind of entitled high tibial osteotomy operation (High Tibial Osteotomy, HTO) it is treated.

The art process of applying of so-called HTO is first to cut one in the specific position of the shin bone of patient (neighbouring top inside the knee) Notch is strutted a special angle then according to the difference of the tibial flexion degree of few patients by road notch.Then distracted Bone cement is injected in notch, and as support, while outside shin bone, application bone plate and bone nail are fixed.The purpose of HTO operation exists In allowing patient, kneed cartilage can be returned to normal condition, that is, fifty-fifty force on tibial plateau after surgery, In addition to solve patient originally because of localized cartilage excessive wear caused by gonalgia other than, while also slowing down kneed cartilage Wear away speed.

However, although HTO operation at present can achieve quite good treatment through the preoperative careful assessment to every sufferer Effect, but be still dependent on very much operator in a way and judge instantly and surgical experience.Operator more insufficient for experience, Error may occur for notch depth or the distraction angle of notch；Furthermore, it is also possible to cause whole because the experience of operator is insufficient The time that body applies art is spun out, and the operation risk of sufferer is increased.

Summary of the invention

In view of this, the present invention proposes a kind of bone-culting operation jig, suitable for imposing high tibial osteotomy hand to a shin bone Art and be cut into one first notch and one second notch, the bone-culting operation jig include the first fixing seat, the second fixing seat and bottom Seat.First fixing seat includes: one first abutting part, has and abuts against to abut against the one first of the circumferential surface of the tibial plateau of the shin bone Face, and first abutting part includes an at least fixation hole；One extension, one end are connected to the side of first abutting part, and certainly The side of first abutting part extends towards the direction far from first abutting part, which has to abut against first notch The one of the femoral surface of top extends supporting surface；And one first guidance part, comprising one first flat part, one first bending part with One first fixed part, first flat part are connected to the other end of the extension, and it is first flat which is connected to this The side in portion and not coplanar with first flat part, first fixed position is in first flat part.Second fixing seat includes: One second abutting part has one second supporting surface to abut against the femoral surface of first suitable order, and second abutting Portion includes an at least fixation hole；And one second guidance part, include one second flat part, one second bending part and one second fixation Portion, second flat part are connected to second abutting part, second bending part be connected to the side of second flat part and with this Second flat part is not coplanar.Separably attached first fixed part of pedestal and second fixed part, when pedestal connection should One first guiding road is defined when the first fixed part and second fixed part, between first flat part and second flat part, it should One second guiding road is defined between first bending part and second bending part.

The present invention also proposes a kind of bone-culting operation jig, be equally applicable to impose a shin bone high tibial osteotomy operation and It is cut into one first notch and one second notch, which includes the first fixing seat, the second fixing seat and pedestal.The One fixing seat includes: one first abutting part, has one first supporting surface to abut against the circumferential surface of the tibial plateau of the shin bone, and First abutting part includes an at least fixation hole；One extension, one end are connected to the side of first abutting part, and from this first The side of abutting part extends towards the direction far from first abutting part, which has to abut against above first notch The one of femoral surface extends supporting surface；And one first guidance part, it include one first flat part, one first bending part and one first Fixed part, first flat part are connected to the other end of the extension, which is connected to the one of first flat part Side and not coplanar with first flat part, first fixed position is in first flat part.Second fixing seat includes: one second Abutting part has one second supporting surface to abut against the femoral surface of first suitable order, and second abutting part includes An at least fixation hole；And one second guidance part, it include one second flat part, one second bending part and one second fixed part, this Second flat part is connected to second abutting part, which is connected to the side of second flat part and second flat with this Smooth portion is not coplanar.Pedestal includes an interconnecting piece and a protrusion, and two ends of the interconnecting piece separately include one first connecting pin and one The interconnecting piece is protruded from first connecting pin in second connection end, the protrusion；When the pedestal with its first connecting pin connect this first Fixed part and when connecting second fixed part with its second connection end, defines one between first flat part and second flat part First guiding road defines one second guiding road between first bending part and second bending part；When the pedestal is with its second company When connecing end and connecting first fixed part, which, which passes through between first flat part and second flat part and protrude this, second is leaned on To face and the extension supporting surface.

In a concept of the invention, the lower surface of the first fixed part of above-mentioned bone-culting operation jig is recessed with one first The upper surface of slot, second fixed part has one second groove, shape between the first connecting pin of the interconnecting piece and second connection end The first convex block of Cheng Youyi and one second convex block；When the pedestal with its first connecting pin connect first fixed part and with its second connect When connecing end connection second fixed part, which is located in first groove, which is located in second groove.

In a concept of the invention, above-mentioned bone-culting operation jig further includes multiple spicules, to be each passed through this first The fixation hole of the fixation hole of abutting part and second abutting part, and the first abutting part and second abutting part are fixed on the shin bone On.

In a concept of the invention, the first abutting part of above-mentioned bone-culting operation jig includes two fixation holes, this second Abutting part includes two fixation holes.

Detailed description of the invention

Fig. 1 is the schematic diagram of an embodiment of bone-culting operation jig of the invention.

Fig. 2 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (1).

Fig. 3 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (2).

Fig. 4 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (3).

Fig. 5 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (4).

Fig. 6 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (5).

Fig. 7 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (6).

Fig. 8 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (7).

Fig. 9 is the schematic diagram that high tibial osteotomy operation is applied using an embodiment of bone-culting operation jig of the invention (8).

Figure 10 is the schematic diagram of another embodiment of bone-culting operation jig of the invention.

Wherein appended drawing reference are as follows:

10 bone-culting operation jigs

11 first fixing seats

111 first abutting parts

The first supporting surface of 111a

112 extensions

112a extends supporting surface

113 first guidance parts

1131 first flat parts

1132 first bending parts

1133 first fixed parts

The first groove of 1133a

12 second fixing seats

121 second abutting parts

The second supporting surface of 121a

123 second guidance parts

1231 second flat parts

1232 second bending parts

1233 second fixed parts

The second groove of 1233a

13 pedestals

131 interconnecting pieces

1311 first connecting pins

The first convex block of 1311a

1312 second connection ends

The second convex block of 1312a

132 protrusions

15 spicules

19 fixation holes

30 bone plates

40 bone screws

90 shin bones

91 tibial plateaus

95 first notch

96 second notch

G1 first guides road

G2 second guides road

Specific embodiment

Fig. 1 is please referred to, a bone-culting operation jig 10 is shown and is set to preparation execution high tibial osteotomy operation (HTO) Shin bone 90 on.When carrying out HTO operation, it is necessary to form two notch, respectively the first notch 95 and second on shin bone 90 Notch 96, as shown in Fig. 3 to Fig. 7.Wherein, 95 system of the first notch position tibial plateau 91 lower section and approximately along radial incision In shin bone, side and connection first notch 95 of second 96, the notch in tibial plateau 91, the effect of the second notch 96 are to allow the A kerf 95 is easier to be softened.Tradition must be dependent on the experience of doctor applying when HTO operation, by doctor according to every sufferer Bone shaped determine the position of the first notch 95 and the second notch 96 and start to cut bone.However cutting bone mistake Cheng Zhong, due to relying on the feel of doctor completely, the size and shape of the first notch 95 and the second notch 96 may be because doctor Raw experience is different and is deviated.And the bone-culting operation jig 10 according to custom-made by size the case where every sufferer is penetrated, it can It is greatly reduced because of surgical outcome variation caused by operator's experience difference.

As shown in Figure 1, bone-culting operation jig 10 includes the first fixing seat 11, the second fixing seat 12 and pedestal 13.First is solid Reservation 11 includes the first abutting part 111, extension 112 and the first guidance part 113.First abutting part 111 has to abut against First supporting surface 111a of the circumferential surface of the tibial plateau 91 of shin bone 90, and the first abutting part 111 includes 19 (this of an at least fixation hole Embodiment is two fixation holes 19, but the present invention is not limited to one, be also possible to one, three it is even more).Extension 112 One end be connected to the side of the first abutting part 111, and from the side of the first abutting part 111 towards far from the first abutting part 111 Direction extends.Extension 112, which has, extends supporting surface 112a to the one of the femoral surface for abutting against 95 top of the first notch.First Guidance part 113 includes the first flat part 1131, the first bending part 1132 and the first fixed part 1133.The connection of first flat part 1131 In the other end of extension 112, the first bending part 1132 be connected to the side of the first flat part 1131 and with the first flat part 1131 do not have position in the same plane.First fixed part 1133 is located at the first flat part 1131.

Second fixing seat 12 includes the second abutting part 121 and the second guidance part 123.Second abutting part 121 have to The second supporting surface 121a of the femoral surface of 95 lower section of the first notch is abutted against, and the second abutting part 121 includes an at least fixation hole 19 (the present embodiment is a fixation hole 19, but the present invention is not limited to one, is also possible to two or more).Second guidance part 123 Comprising the second flat part 1231, the second bending part 1232 and the second fixed part 1233, wherein the second flat part 1231 is connected to Second abutting part 121, the second bending part 1232 are connected to the side of the second flat part 1231 and do not have with the second flat part 1231 Position is in the same plane.

Separably attached first fixed part 1133 of pedestal 13 and the second fixed part 1233, when the connection of pedestal 13 first is fixed When portion 1133 and the second fixed part 1233, one first guiding road is defined between the first flat part 1131 and the second flat part 1231 G1 defines one second guiding road G2 between the first bending part 1132 and the second bending part 1232.When bone-culting operation jig 10 is proper When getting well the surface by being butted on shin bone 90, the position for exactly corresponding to the first notch 95 of the first guiding road G1, the second guiding road G2 Then exactly correspond to the position of the second notch 96.In this way, which surgical staff can be easily placed along the first guiding road G1 cutting First notch 95 out, and the second notch 96 is cut into along the second guiding road G2.

Referring again to Fig. 1, in one embodiment, pedestal 13 can also include an interconnecting piece 131 and a protrusion 132, connection Two ends in portion 131 separately include one first connecting pin 1311 and a second connection end 1312, and 132 system of protrusion is from the first connecting pin 1311 protrude interconnecting pieces 131 and constitute L-shaped appearance with interconnecting piece 131.Similarly, when pedestal 13 is with its first connecting pin 1311 The first fixed part 1133 of the first fixing seat 11 is connected, and connects the second of the second fixing seat 12 with its second connection end 1312 and consolidates When determining portion 1233, defined between the first flat part 1131 of the first fixing seat 11 and the second flat part 1231 of the second fixing seat 12 First guiding road G1 out, between the first bending part 1132 of the first fixing seat 11 and the second bending part 1232 of the second fixing seat 12 Define the second guiding road G2.In this way, which surgical staff can be cut into the first notch easily placed along the first guiding road G1 95, and the second notch 96 is cut into along the second guiding road G2.In addition, the pedestal 13 of the present embodiment is in 180 degree of rotation Later, the first fixed part 1133 can be connected with its second connection end 1312.When pedestal 13 is with the connection of its second connection end 1312 When the first fixed part 1133, protrusion 132 can be by between the first flat part 1131 and the second flat part 1231 and protrusion second leans on To face 121a and extend supporting surface 112a.

The above system illustrates the exemplary configuration of bone-culting operation jig 10, its application method further explained below.

Since the bone anatomy of each sufferer is all different, bone-culting operation jig 10 must be according to the shin of each sufferer Bone structure custom-made by size.Firstly, can pass through the 3D shadow of the shin bone of X-ray and tomoscan or other camera styles reconstruction sufferer Then picture is judged the position of the first notch 95 for being suitble to the sufferer and the second notch 96 by doctor according to the 3D image of shin bone, Judge the first notch 95 how many angle should be strutted by the sufferer simultaneously, can allow after surgery the knee cartilage of sufferer can It is averagely forced on tibial plateau 91 when sufferer is stood.Then, the mode through mold either 3 D-printing produces suitable Bone-culting operation jig 10 for the sufferer.

Referring to figure 2., when HTO operation to be carried out, pedestal 13 is connected to the first fixed part of the first fixing seat 11 first 1133 and second second fixed part 1233 of fixing seat 12 assembling of bone-culting operation jig 10 can be completed.Then by osteotomy hand Art jig 10 is on the shin bone 90 for being against sufferer, due to the surface profile of shin bone 90 and asymmetric, when the first fixing seat 11 The first supporting surface 111a and extend the second supporting surface 121a of supporting surface 112 and the second fixing seat 12 just can be by being against When femoral surface, the placement location for representing bone-culting operation jig 10 is correct.At this point, it is fixed that spicule 15 can be squeezed into first In seat 11 and the fixation hole 19 of the second fixing seat 12, the first fixing seat 11 and the second fixing seat 12 are fixed on shin bone 90.

Referring to figure 3., after the first fixing seat 11 and the second fixing seat 12 are fixed on shin bone 90 through spicule 15, Pedestal 13 is removed, makes the first guiding road G1 completely exposed.Then, saw blade can be cut shin along the first guiding road G1 by doctor Bone 90 and formed the first notch 95, and along second guiding road G2 cutting shin bone 90 and formed 96 (the second notch of the second notch 96 position can refer to Fig. 6 and Fig. 7).Specifically, in the process for forming the first notch 95 and the second notch 96 In, saw blade can't cut to any one component of bone-culting operation jig 10, therefore the break flour that will not be generated other than bone is residual It stays in human body, leading to sufferer, there is a phenomenon where allergy or inflammation.

Referring to figure 4., then the first notch 95 is strutted, then consolidates the connection of second connection end 1,312 first of pedestal 13 Determine portion 1133, the protrusion 132 of pedestal 13 can be by between the first flat part 1131 and the second flat part 1231 at this time, and protrudes the Two supporting surface 121a and extend supporting surface 112a and protrude into distracted first notch 95.Since the size of protrusion 132 is passed through It is specifically designed, when the just permissible protrusion 132 of distracted first notch 95 is protruded into, represents the first notch 95 distracted angle at this time As preset angle.

It referring to figure 5., can be in the first notch 95 and the second notch 96 when the first notch 95 is strutted to preset angle Middle filling bone cement is as support.

Fig. 6 is please referred to, after bone cement hardening, bone-culting operation jig 10 can be removed, bone plate 30 is then penetrated into bone Needle 15 is placed on shin bone 90.

Please refer to Fig. 7, after bone plate 30 is placed on shin bone 90, then one by one remove spicule 15, and green bone needle 15 in Bone screw 40 is locked in perforation left by shin bone 90, then by the wound suture of sufferer, so far can complete HTO hand at last Art.

In addition, being different from above-mentioned Fig. 6 and Fig. 7 is to be placed on bone plate 30 on shin bone 90 again through bone screw through spicule 15 40 are fixed on shin bone 90, and Fig. 8 and Fig. 9 then show another bone plate fixing means.As shown in Fig. 8 and Fig. 9, when being filled in the After bone cement hardening in a kerf 95 and the second notch 96, operator is the upper limb by bone plate 30 by being butted on across shin bone at this time Bone plate 30, is then fixed on shin bone 90 also with bone screw 40 by two spicules, 15 lower section of 91 lower section of platform.

Figure 10 is please referred to, in another embodiment of the invention, the first fixed part 1133 of above-mentioned first fixing seat 11 Lower surface has the first groove 1133a, and the upper surface of the second fixed part 1233 of the second fixing seat 12 has the second groove 1233a.In addition, being formed between the first connecting pin 1311 of pedestal 13 and second connection end 1312 raised in the opposite direction each other The first convex block 1311a and the second convex block 1312a.When pedestal 13 connects the first fixed part 1133 simultaneously with its first connecting pin 1311 When connecting the second fixed part 1233 with its second connection end 1312, the first convex block 1311a is located exactly in the first groove 1133a, Second convex block 1312a is located exactly in the second groove 1233a.

To sum up, 10 system of bone-culting operation jig of above-described embodiment is according to the shin bone institute custom-made by size of each sufferer, as long as and Bone-culting operation jig 10 is placed on the shin bone of sufferer, when the surface of bone-culting operation jig 10 can just abut against the shin bone of sufferer When surface profile, represents the bone-culting operation jig 10 and have been placed on correct position, it is very convenient for operator. In addition, in one embodiment, connector 13 is also used as the other than connecting the first fixing seat 11 and the second fixing seat 12 The gauge of the distraction angle of a kerf 95 represents first and cuts when the protrusion of connector 13 132 can just be protruded into the first notch 95 Mouth 95 has strutted predetermined angle, and can directly start the step of being filled bone cement, for operator It even more can substantially save the time of the distraction angle of the first notch 95 of assessment.For doctor, the present invention can save doctor The time of raw study HTO operation, HTO operation can more be applied according to mode expected from doctor, for sufferer, the present invention Significantly reduce in HTO surgical procedure occur can not expected results risk, improve the precision and success rate of operation.

Although this case is disclosed as above with embodiment, so it is not limited to this case, has in any technical field Usually intellectual, in the spirit and scope for not departing from this case, when can make some changes and embellishment, therefore the protection model of this case It encloses subject to view appended claims institute defender.