CN117481742B - Tibial side guide plate and ankle joint guide plate assembly having the same - Google Patents

Abstract

The application provides a tibia side guide plate and an ankle guide plate assembly with the tibia side guide plate, wherein the tibia side guide plate comprises: the tibia positioning seat is provided with a first side and a second side which are oppositely arranged in the extending direction of a sagittal axis, and the first side of the tibia positioning seat is provided with a tibia matching surface; the tibia cutting guide seat is rotatably arranged at the second side of the tibia positioning seat, extends vertically relative to the rotation axis of the tibia positioning seat and is provided with a tibia cutting guide part and an angle detection part, the tibia cutting guide part extends transversely, and the angle detection part can detect an included angle between the extending direction of the tibia cutting guide part and the coronal plane; the angle adjusting structure is arranged between the tibia locating seat and the osteotomy guiding seat to adjust an included angle between the extending direction of the tibia osteotomy guiding part and the coronal plane. The technical scheme provided by the application can solve the problems of complex operation and long learning period in ankle joint replacement operation in the related technology.

Description

Tibial side guide plate and ankle joint guide plate assembly having the same

Technical Field

The present invention relates to the technical field of medical devices, in particular to a tibial side guide plate and an ankle joint guide plate assembly having the same.

Background technique

The ankle joint (the part connecting the calf and the foot) is one of the important joints of the lower limbs. The ankle joint is composed of the tibia, the distal end of the fibula and the foot. The ankle joint is a trochlear joint. The foot can perform dorsiflexion (toes facing up and the angle between the foot and the calf is less than 90°) or plantar flexion (toes facing down and the angle between the foot and the calf is greater than 90°) relative to the calf along the coronal axis that passes through the talus body. When the foot performs plantar flexion relative to the calf, the foot can perform a certain range of lateral rotation relative to the calf around the extension axis of the calf.

Generally speaking, ankle pain can be caused by trauma or local lesions. For example, external force may cause bone or soft tissue damage to the ankle, resulting in severe pain in the ankle. At this time, a clear history of trauma can assist in diagnosis (CT and MRI of the ankle to determine whether a fracture has occurred. If the fracture is not treated correctly, traumatic arthritis of the ankle may also occur, causing ankle pain). Local lesions of the tibia may also cause ankle pain. When the above conditions occur, conservative treatment can no longer effectively relieve the patient's pain, and the patient may even lose the ability to walk.

In related technologies, ankle fusion surgery can relieve ankle pain, but it will reduce the mobility of the ankle joint and increase the risk of arthritis in other nearby joints. Studies have shown that reconstruction of the joints below the knee is necessary, and ankle replacement surgery removes the end of the damaged bone and replaces it with an ankle prosthesis, which can preserve the mobility of the ankle joint and avoid problems such as increased stress on other joints caused by degenerative changes in the ankle joint.

However, the anatomical structure and movement patterns of the ankle joint are very complex, and ankle replacement has higher requirements than other weight-bearing joint replacements, resulting in a small number of studies on ankle replacement and its lack of universal acceptance. Most orthopedic surgeons do not have the opportunity to come into contact with more patients who need ankle replacements, resulting in a lack of updates in the design concept of ankle prostheses, the complexity of the supporting surgical tools for ankle replacement surgery, and a long learning cycle for ankle replacement surgery.

Summary of the invention

The present invention provides a tibial side guide plate and an ankle joint guide plate assembly having the same, so as to solve the problems of complicated operation and long learning period in ankle joint replacement surgery in the related art.

According to one aspect of the present invention, a tibial side guide plate is provided, which includes: a tibial positioning seat, having a first side and a second side arranged opposite to each other in the extension direction of the sagittal axis, the first side of the tibial positioning seat being provided with a tibial mating surface; an osteotomy guide seat, rotatably arranged on the second side of the tibial positioning seat, the osteotomy guide seat extending vertically relative to the rotation axis of the tibial positioning seat, the osteotomy guide seat having a tibial osteotomy guide portion and an angle detection portion, the tibial osteotomy guide portion extending laterally, and the angle detection portion being able to detect the angle between the extension direction of the tibial osteotomy guide portion and the coronal plane; an angle adjustment structure, arranged between the tibial positioning seat and the osteotomy guide seat, to adjust the angle between the extension direction of the tibial osteotomy guide portion and the coronal plane.

Furthermore, the angle adjustment structure includes: a gear structure, which is arranged on the side of the osteotomy guide seat facing the tibial positioning seat, and the axis of the gear structure is the rotation axis of the osteotomy guide seat relative to the tibial positioning seat; a rack, which is movably arranged on the tibial positioning seat in the transverse direction, and the rack is meshed with the gear structure.

Furthermore, the tibial side guide plate also includes a positioning structure for limiting the rotation of the osteotomy guide seat relative to the tibial positioning seat.

Furthermore, the positioning structure includes: a plurality of positioning grooves arranged along the extension direction of the rack, the plurality of positioning grooves being arranged on one of the rack and the tibial positioning seat; an elastic positioning member being arranged on the other of the rack and the tibial positioning seat, the elastic positioning member being capable of cooperating with one of the plurality of positioning grooves, the elastic positioning member having a positioning state of extending into the positioning groove and an adjustment state of being out of the positioning groove.

Furthermore, a positioning groove is arranged on the tibial positioning seat, and a mounting hole is arranged on the side of the rack facing the positioning groove, and the extension direction of the mounting hole is perpendicular to the extension direction of the rack, the elastic positioning member includes an elastic pressure plate and a spring, the elastic pressure plate cover is arranged at one end of the mounting hole facing the positioning groove, the middle part of the elastic pressure plate is provided with a spherical protrusion protruding away from the rack, the spring is arranged in the mounting hole, and the two ends of the spring are respectively abutted against the rack and the middle part of the elastic pressure plate; and/or, a guide channel extending in the transverse direction is arranged on the tibial positioning seat, the rack is movably arranged in the guide channel, and a contact port is arranged on the side of the tibial positioning seat facing the osteotomy guide seat, the contact port is connected with the guide channel, and the rack is meshed with the gear structure through the contact port.

Furthermore, the angle detection portion includes at least three first force line holes extending vertically, the tibial side guide plate has an observation surface perpendicular to the extension direction of the tibial osteotomy guide portion, and the projections of the at least three first force line holes on the observation surface are arranged at equal intervals.

Furthermore, the tibial side guide plate also includes an observation plate, which is detachably arranged on the osteotomy guide seat, and is provided with at least two connecting holes. The observation plate is connected to the osteotomy guide seat through the at least two connecting holes, and the observation plate has a second force line hole extending vertically, wherein a first force line hole and a second force line hole are arranged at intervals in the extension direction of the coronal axis.

Furthermore, the tibial osteotomy guide portion includes at least two Kirschner wire holes arranged on the osteotomy guide seat, and the Kirschner wire holes extend in the transverse direction.

Furthermore, the tibial positioning seat includes a seat body, a mounting platform and a mounting column, the tibial matching surface is arranged on the seat body, the mounting platform is arranged on the seat body, the mounting column is arranged on the side of the mounting platform away from the tibial matching surface in the extension direction of the coronal axis, the mounting column extends vertically, and the osteotomy guide seat is rotatably mounted on the mounting column around the extension direction of the mounting column; the tibial side guide plate also includes a force line rod and a Kirschner wire; the lower end of the tibial positioning seat is provided with a tibial connecting hook protruding from the tibial matching surface; the tibial positioning seat is provided with a tibial connecting hole.

According to another aspect of the present invention, an ankle joint guide plate assembly is provided. The ankle joint guide plate assembly includes a talar side guide plate and a tibial side guide plate. The tibial side guide plate is the tibial side guide plate provided above.

Furthermore, the talar side guide plate has a talar matching surface, and a talar osteotomy guide portion is also provided on the talar side guide plate, and the angle between the extension direction of the talar osteotomy guide portion and the long axis of the talus is between 15° and 25°.

According to the technical solution of the present invention, the tibial side guide plate includes a tibial positioning seat, an osteotomy guide seat and an angle adjustment structure. The tibial positioning seat is installed on the tibia that needs osteotomy, so that the tibial matching surface arranged on the first side of the tibial positioning seat fits with the outer surface of the tibia. Since the osteotomy guide seat is arranged on the second side of the tibial positioning seat, the first side and the second side of the tibial positioning seat are arranged relatively in the extension direction of the sagittal axis. The osteotomy guide seat has a tibial osteotomy guide portion extending in the transverse direction, so that in the subsequent tibial osteotomy operation, the tibial osteotomy operation can be performed along the extension direction of the tibial osteotomy guide portion to obtain the osteotomy surface extending in the transverse direction. The osteotomy guide seat is rotatably arranged on the tibial positioning seat. During the operation, the clinician can select the appropriate osteotomy direction of the tibial osteotomy operation according to the intraoperative situation, and use the angle detection part to detect the angle between the extension direction of the tibial osteotomy guide part and the coronal plane, and use the angle adjustment structure to adjust the angle between the extension direction of the tibial osteotomy guide part and the coronal plane, so that the extension direction of the tibial osteotomy guide part conforms to the osteotomy direction selected by the clinician, which is convenient for quickly reproducing the preoperative plan of the tibial osteotomy operation and can adjust the osteotomy direction of the tibial osteotomy operation according to the intraoperative situation, reduce the complexity of the tibial side guide plate, and shorten the learning cycle of clinicians.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings constituting a part of the present application are used to provide a further understanding of the present invention. The exemplary embodiments of the present invention and their descriptions are used to explain the present invention and do not constitute an improper limitation of the present invention. In the drawings:

FIG1 is a schematic structural diagram of a tibial side guide plate provided according to an embodiment of the present invention;

Fig. 2 shows a front view of a tibial side guide plate provided according to an embodiment of the present invention;

FIG3 is a schematic structural diagram of a tibial positioning seat, an osteotomy guide seat and an angle adjustment structure of a tibial side guide plate provided according to an embodiment of the present invention;

FIG4 shows a schematic structural diagram of a tibial positioning seat and an angle adjustment structure of a tibial side guide plate provided according to an embodiment of the present invention;

FIG5 is a schematic structural diagram of an osteotomy guide seat of a tibial side guide plate provided according to an embodiment of the present invention;

FIG6 is a schematic structural diagram showing another perspective of the osteotomy guide seat of the tibial side guide plate provided in an embodiment of the present invention;

FIG7 is a schematic structural diagram of a tibial positioning seat of a tibial side guide plate provided according to an embodiment of the present invention;

FIG8 shows a cross-sectional view of a tibial positioning seat of a tibial side guide plate provided according to an embodiment of the present invention;

FIG9 is a schematic structural diagram of a rack of a tibial side guide plate provided according to an embodiment of the present invention;

FIG10 shows a cross-sectional view of a tibial positioning seat of a tibial side guide plate provided according to an embodiment of the present invention;

FIG11 shows a coronal view of a tibia to which a tibial lateral guide plate needs to be installed according to an embodiment of the present invention;

FIG12 is a schematic diagram showing a structure of a tibial positioning seat of a tibial side guide plate provided according to an embodiment of the present invention being installed on a tibia;

FIG13 is a schematic diagram showing a structure of a tibial side guide plate installed on a tibia according to an embodiment of the present invention;

14 shows a coronal view of a tibial side guide plate provided according to an embodiment of the present invention installed on a tibia;

15 shows a sagittal view of a tibial side guide plate installed on a tibia according to an embodiment of the present invention;

16 shows a coronal view of a tibial positioning seat and an osteotomy guide seat of a tibial side guide provided according to an embodiment of the present invention installed on a tibia;

FIG17 shows a schematic diagram of the structure of the osteotomy module installed on the tibia;

FIG18 is a schematic structural diagram showing a talar side guide plate of an ankle joint guide plate assembly provided in an embodiment of the present invention being installed on the talus;

FIG. 19 shows a schematic structural diagram of the osteotomy module installed on the talus.

The above drawings include the following reference numerals:

10. Tibia positioning seat; 11. Tibia matching surface; 12. Guide channel; 13. Contact port; 14. Seat body; 15. Mounting platform; 16. Mounting column; 17. Tibia connection hole;

20. osteotomy guide seat; 21. tibial osteotomy guide portion; 211. Kirschner wire hole; 22. angle detection portion; 221. first force line hole;

30. Angle adjustment structure; 31. Gear structure; 32. Rack; 321. Mounting hole;

40. Positioning structure; 41. Positioning groove; 42. Elastic positioning member; 421. Elastic pressing piece; 4211. Spherical protrusion; 422. Spring;

50. Observation plate; 51. Guide plate connection hole; 52. Second force line hole;

60. talar side guide plate; 61. talar mating surface; 62. talar osteotomy guide portion;

70. tibia; 71. positioning mark; 72. tibia osteotomy module; 73. talus; 74. talus osteotomy module;

80. Kirschner wire; 90. Force line rod.

Detailed ways

The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, rather than all the embodiments. The following description of at least one exemplary embodiment is actually only illustrative and is by no means intended to limit the present invention and its application or use. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

As shown in Figures 1 to 17, an embodiment of the present invention provides a tibial side guide plate, which includes a tibial positioning seat 10, an osteotomy guide seat 20 and an angle adjustment structure 30. The tibial positioning seat 10 has a first side and a second side that are relatively arranged in the extension direction of the sagittal axis. The first side of the tibial positioning seat 10 is provided with a tibial matching surface 11. The osteotomy guide seat 20 is rotatably arranged on the second side of the tibial positioning seat 10. The osteotomy guide seat 20 extends vertically relative to the rotation axis of the tibial positioning seat 10. The osteotomy guide seat 20 has a tibial osteotomy guide part 21 and an angle detection part 22. The tibial osteotomy guide part 21 extends in the transverse direction. The angle detection part 22 can detect the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane. The angle adjustment structure 30 is arranged between the tibial positioning seat 10 and the osteotomy guide seat 20 to adjust the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane.

By using the tibial side guide plate provided in this embodiment, the tibial positioning seat 10 is installed on the tibia that needs osteotomy, so that the tibial matching surface 11 arranged on the first side of the tibial positioning seat 10 fits with the outer surface of the tibia. Since the osteotomy guide seat 20 is arranged on the second side of the tibial positioning seat 10, the first side and the second side of the tibial positioning seat 10 are arranged relatively in the extension direction of the sagittal axis. The osteotomy guide seat 20 has a tibial osteotomy guide portion 21 extending in the transverse direction, so that in the subsequent tibial osteotomy operation, the tibial osteotomy operation can be performed along the extension direction of the tibial osteotomy guide portion 21 to obtain the osteotomy surface extending in the transverse direction. Since the osteotomy guide seat 20 is rotatable The tibial positioning seat 10 is dynamically arranged on the tibial positioning seat 10. During the operation, the clinician can select a suitable osteotomy direction for the tibial osteotomy operation according to the intraoperative situation, use the angle detection part 22 to detect the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, and use the angle adjustment structure 30 to adjust the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, so that the extension direction of the tibial osteotomy guide part 21 conforms to the osteotomy direction selected by the clinician, which is convenient for quickly reproducing the preoperative planning of the tibial osteotomy operation and can adjust the osteotomy direction of the tibial osteotomy operation according to the intraoperative situation, thereby reducing the complexity of the tibial side guide and shortening the learning cycle of the clinician.

Among them, ankle replacement includes tibial plateau replacement at the distal end of the tibia and talar side replacement at the talar trochlea position. Usually, clinicians will consider three aspects when performing prosthesis replacement: osteotomy amount, prosthesis cross-sectional coverage, and prosthesis installation direction:

(1) The amount of osteotomy is mainly affected by the thickness of the prosthesis design and the tightness of the soft tissue. The thickness of the prosthesis design is already determined, and the tightness of the soft tissue can be determined during the operation and solved by selecting a polyethylene gasket of appropriate thickness.

(2) Prosthesis cross-sectional coverage can be solved by selecting the corresponding type of prosthesis according to the cross-sectional area after osteotomy during surgery;

(3) The direction of prosthesis installation is usually determined by the midline of the tibial condyle angle (i.e., the opening angle of the distal tibial condyle).

All of the above design parameters can be determined in advance through preoperative planning and design. Among them, the thickness of the prosthesis that determines the amount of osteotomy and the prosthesis coverage under a certain amount of osteotomy are fixed values, or in other words, after the preoperative planning and design is completed, the thickness of the prosthesis that determines the amount of osteotomy and the prosthesis coverage under a certain amount of osteotomy are almost the same as the preoperative planning during the operation, but only the installation direction of the tibial plateau prosthesis is difficult to control.

As can be seen from the previous article, the direction of prosthesis installation is usually determined by the midline of the tibial condyle angle, but the boundaries on both sides of the condyle are determined by a general trend of the surface morphology of the condyle bone. That is to say, if the patient's bone boundary is clear and of high quality, the judgment of the midline of the tibial condyle angle is more accurate, otherwise the error is larger. In addition, when the patient's ankle joint deformity is more serious, there is a large error in the judgment of the midline of the tibial condyle angle, and other methods are needed to correct it. Normally, when the human body is walking forward, the lower limbs (femur, tibia and foot) almost all move forward. When the installation direction error of the tibial plateau prosthesis is large, it will affect the ankle angle, causing the foot to be crooked, which is not conducive to the patient's movement. Therefore, it will be corrected by adjusting the osteotomy direction of the tibia. Generally speaking, the midline direction of the condyle and the vertical line connecting the posterior edge of the tibial plateau are externally rotated at an angle of 15°.

Therefore, the accuracy of the osteotomy direction of the ankle joint is particularly important. The tibial side guide needs to have the function of real-time control and adjustment of the osteotomy direction of the tibia during surgery. It is necessary to achieve precise adjustment of the osteotomy direction of the tibia with a smaller unit angle rotation to meet the clinician's control over the installation direction of the tibial plateau prosthesis.

By using the tibial side guide provided in this embodiment, during surgery, the clinician can select a suitable osteotomy direction for the tibial osteotomy operation according to the intraoperative situation, use the angle detection part 22 to detect the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, and use the angle adjustment structure 30 to adjust the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, so that the extension direction of the tibial osteotomy guide part 21 conforms to the osteotomy direction selected by the clinician, which facilitates and quickly reproduces the preoperative planning of the tibial osteotomy operation and can adjust the osteotomy direction of the tibial osteotomy operation according to the intraoperative situation, reduces the complexity of the tibial side guide, more accurately controls the surgical effect, and verifies whether the design and placement of the tibial side guide are accurate before osteotomy, further reduces the errors caused by the preoperative design and intraoperative operation of the tibial side guide, and reduces the learning cycle of clinicians.

In this embodiment, a tibial model of the tibia that requires osteotomy is produced using CT imaging and 3D printing technology. In the preoperative planning of the tibial osteotomy operation, a suitable position on the tibia is selected as the installation position of the tibial side guide, and the tibial mating surface 11 is designed according to the outer surface of the tibial model corresponding to the installation position. When the tibial positioning seat 10 is installed on the tibia that requires osteotomy, the tibial mating surface 11 is fitted with the outer surface of the tibia, so that the tibial positioning seat 10 can be quickly and accurately installed at the installation position, thereby greatly reducing the positioning tools required for installing the tibial side guide, saving operation time, and reducing bleeding.

It should be noted that the angle adjustment structure 30 adjusts the angle between the extension direction of the tibial osteotomy guide portion 21 and the coronal plane, and has the following two implementation structures:

(1) The osteotomy guide seat 20 is an integrated structure. The angle adjustment structure 30 drives the osteotomy guide seat 20 to rotate relative to the tibial positioning seat 10. The tibial osteotomy guide portion 21 rotates together with the osteotomy guide seat 20 to change the angle between the extension direction of the tibial osteotomy guide portion 21 and the coronal plane.

(2) The osteotomy guide seat 20 is a split structure. The tibial osteotomy guide portion 21 is arranged on a part of the osteotomy guide seat 20. The angle adjustment structure 30 drives the part of the osteotomy guide seat 20 provided with the tibial osteotomy guide portion 21 to rotate relative to the tibial positioning seat 10. The tibial osteotomy guide portion 21 rotates together with the part of the osteotomy guide seat 20 to change the angle between the extension direction of the tibial osteotomy guide portion 21 and the coronal plane of the tibial osteotomy guide portion 21.

Moreover, in the present embodiment, the sagittal axis refers to the axial direction perpendicular to the sagittal plane of the human body, the coronal axis refers to the axial direction perpendicular to the coronal plane of the human body, the transverse direction refers to the extension direction of the tibial osteotomy guide 21, and the vertical direction refers to the direction perpendicular to the osteotomy surface obtained by performing an osteotomy operation on the tibia 70 along the extension direction of the Kirschner wire 80 along the tibial osteotomy module 72.

As shown in Fig. 1 to Fig. 3, the angle adjustment structure 30 includes a gear structure 31 and a rack 32. The gear structure 31 is arranged on the side of the osteotomy guide seat 20 facing the tibial positioning seat 10. The axis of the gear structure 31 is the rotation axis of the osteotomy guide seat 20 relative to the tibial positioning seat 10. The rack 32 is movably arranged on the tibial positioning seat 10 in the transverse direction, and the rack 32 is meshed with the gear structure 31. The rack 32 is moved in the transverse direction relative to the tibial positioning seat 10. Since the rack 32 is meshed with the gear structure 31, the axis of the gear structure 31 is the rotation axis of the osteotomy guide seat 20 relative to the tibial positioning seat 10, so that the moving rack 32 drives the osteotomy guide seat 20 to rotate relative to the tibial positioning seat 10 through the gear structure 31, so as to adjust the angle between the extension direction of the tibial osteotomy guide portion 21 arranged on the osteotomy guide seat 20 and the coronal plane.

Among them, the meshing rack 32 and the gear structure 31 are used to change the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, which can improve the adjustment accuracy and reliability of the angle adjustment structure 30 on the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane.

In this embodiment, the rack 32 avoids the tibial osteotomy guide part 21 in the extension direction of the tibial osteotomy guide part 21, so as to prevent the rack 32 from interfering with the tibial osteotomy guide part 21 in guiding the tibial osteotomy operation.

As shown in Fig. 7 and Fig. 9, the tibial side guide plate also includes a positioning structure 40 for limiting the rotation of the osteotomy guide seat 20 relative to the tibial positioning seat 10. After the extension direction of the tibial osteotomy guide portion 21 meets the osteotomy direction selected by the clinician, the positioning structure 40 is used to limit the rotation of the osteotomy guide seat 20 relative to the tibial positioning seat 10, so as to avoid subsequent operations causing the osteotomy guide seat 20 to rotate relative to the tibial positioning seat 10, thereby improving the stability of the extension direction of the tibial osteotomy guide portion 21.

It should be noted that the positioning structure 40 has the following two structures:

(1) The positioning structure 40 is a detachable positioning member. When it is necessary to adjust the extension direction of the tibial osteotomy guide portion 21, the positioning member is removed, and the osteotomy guide seat 20 is rotated relative to the tibial positioning seat 10. After the extension direction of the tibial osteotomy guide portion 21 meets the osteotomy direction selected by the clinician, the positioning member is used to connect the osteotomy guide seat 20 and the tibial positioning seat 10 to limit the rotation of the osteotomy guide seat 20 relative to the tibial positioning seat 10.

(2) The positioning structure 40 includes a positioning protrusion and a positioning groove that can be movably matched. When it is necessary to adjust the extension direction of the tibial osteotomy guide portion 21, the osteotomy guide seat 20 is rotated relative to the tibial positioning seat 10, so that the positioning protrusion switches between states of matching with multiple positioning grooves, or the positioning groove switches between states of matching with multiple positioning protrusions. After the extension direction of the tibial osteotomy guide portion 21 meets the osteotomy direction selected by the clinician, the positioning match between the positioning protrusion and the positioning groove is used to limit the rotation of the osteotomy guide seat 20 relative to the tibial positioning seat 10.

As shown in Fig. 7 and Fig. 9, the positioning structure 40 includes an elastic positioning member 42 and a plurality of positioning grooves 41, wherein the plurality of positioning grooves 41 are arranged along the extension direction of the rack 32, the plurality of positioning grooves 41 are arranged on one of the rack 32 and the tibial positioning seat 10, the elastic positioning member 42 is arranged on the other of the rack 32 and the tibial positioning seat 10, the elastic positioning member 42 can cooperate with one of the plurality of positioning grooves 41, and the elastic positioning member 42 has a positioning state of extending into the positioning groove 41 and an adjustment state of escaping from the positioning groove 41. By adopting the above positioning structure 40, the elastic positioning member 42 can cooperate with one of the plurality of positioning grooves 41 to achieve a positioning effect, so as to limit the osteotomy guide seat 20 from rotating relative to the tibial positioning seat 10, and the elastic positioning member 42 can switch between the states of cooperating with the plurality of positioning grooves 41 to adjust the extension direction of the tibial osteotomy guide portion 21.

As shown in Figures 7 and 9, the positioning groove 41 is arranged on the tibial positioning seat 10, and a mounting hole 321 is arranged on the side of the rack 32 facing the positioning groove 41, and the extension direction of the mounting hole 321 is perpendicular to the extension direction of the rack 32. The elastic positioning member 42 includes an elastic pressing plate 421 and a spring 422. The elastic pressing plate 421 covers one end of the mounting hole 321 facing the positioning groove 41, and a spherical protrusion 4211 protruding in the direction away from the rack 32 is arranged in the middle of the elastic pressing plate 421. The spring 422 is arranged in the mounting hole 321, and the two ends of the spring 422 are respectively abutted against the rack 32 and the middle of the elastic pressing plate 421. The spherical protrusion 4211 has a positioning state in which it is positioned and matched with the positioning groove 41, and an adjustment state in which it is disengaged from the positioning groove 41. By pulling the rack 32, the spherical protrusion 4211 can be driven to switch between the states in which it is matched with multiple positioning grooves 41. The use of the spherical protrusion 4211 can improve the smoothness of the movement of the rack 32 during adjustment. The elastic pressing piece 421 is covered on the end of the mounting hole 321 facing the positioning groove 41, and the mounting hole 321, the spring 422 and the spherical protrusion 4211 all correspond to the middle part of the elastic pressing piece 421, so that the spring 422 is abutted against the middle part of the elastic pressing piece 421, and the elastic forces of the spring 422 and the elastic pressing piece 421 can be used at the same time to provide a reliable reset force for the spherical protrusion 4211 to reset to the reset state.

As shown in Fig. 7 and Fig. 8, a guide channel 12 extending in the transverse direction is provided on the tibial positioning seat 10, and a rack 32 is movably provided in the guide channel 12. A contact port 13 is provided on the side of the osteotomy guide seat 20 facing the tibial positioning seat 10, and the contact port 13 is connected to the guide channel 12, and the rack 32 is meshed with the gear structure 31 through the contact port 13. The guide channel 12 guides the movement of the rack 32 relative to the tibial positioning seat 10, and the rack 32 can mesh with the gear structure 31 at the contact port 13.

As shown in FIG1 , the angle detection part 22 includes at least three first force line holes 221 extending in the vertical direction, and the tibial side guide plate has an observation surface perpendicular to the extension direction of the tibial osteotomy guide part 21, and the projections of the at least three first force line holes 221 on the observation surface are arranged at equal intervals. By inserting force line rods in the at least three first force line holes 221, observation is performed on the coronal plane as shown in FIG16. If the projections of the at least three first force line holes 221 on the coronal plane are arranged at equal intervals, it can be concluded that the observation plane is parallel to the coronal plane, that is, the extension direction of the tibial osteotomy guide part 21 is perpendicular to the coronal plane, and the extension direction of the tibial osteotomy guide part 21 restores the osteotomy direction designed before the operation (that is, the osteotomy operation is performed in a direction perpendicular to the coronal plane).

As shown in Figures 1, 14 and 15, the tibial side guide plate also includes an observation plate 50, which is detachably arranged on the osteotomy guide seat 20. At least two guide plate connecting holes 51 are arranged on the observation plate 50. The observation plate 50 is connected to the osteotomy guide seat 20 through the at least two guide plate connecting holes 51. The observation plate 50 has a second force line hole 52 extending vertically, wherein a first force line hole 221 and a second force line hole 52 are arranged at intervals in the extension direction of the coronal axis. A first force line hole 221 centered relative to the tibia 70 is selected, a force line rod 90 is passed through the first force line hole 221, and the force line rod 90 is inserted into the second force line hole 52, and observed in the sagittal plane as shown in FIG. 15. If the force line rod 90 in the second force line hole 52 points to the center of the medullary cavity of the tibia 70, and observed in the coronal plane as shown in FIG. 14, if the force line rod 90 in the first force line hole 221 points to the center of the medullary cavity of the tibia 70, it can be concluded that the osteotomy plane determined by the extension direction of the tibial osteotomy guide 21 is perpendicular to the tibial axis, and the extension direction of the tibial osteotomy guide 21 restores the osteotomy surface designed before the operation (that is, the osteotomy surface is perpendicular to the tibial axis).

As shown in Fig. 1 to Fig. 3, the tibial osteotomy guide part 21 includes at least two Kirschner wire holes 211 arranged on the osteotomy guide seat 20, and the Kirschner wire holes 211 extend in the transverse direction. After the extension direction of the tibial osteotomy guide part 21 meets the osteotomy direction selected by the clinician (i.e., the extension direction of the Kirschner wire holes 211 meets the osteotomy direction selected by the clinician), at least two Kirschner wires 80 are inserted into the at least two Kirschner wire holes 211 and driven into the tibia 70 in a one-to-one correspondence, the tibial positioning seat 10, the osteotomy guide seat 20 and the angle adjustment structure 30 are removed, and only the Kirschner wires 80 that pass through the Kirschner wire holes 211 and are driven into the tibia 70 are retained, and the tibial osteotomy module 72 is sleeved on the Kirschner wire 80, and the tibial osteotomy module 72 performs an osteotomy operation on the tibia 70 along the extension direction of the Kirschner wire 80.

As shown in FIG4 , the tibial positioning seat 10 includes a seat body 14, a mounting platform 15 and a mounting column 16, wherein the tibial mating surface 11 is arranged on the seat body 14, the mounting platform 15 is arranged on the seat body 14, the mounting column 16 is arranged on the side of the mounting platform 15 away from the tibial mating surface 11 in the extension direction of the coronal axis, the mounting column 16 extends vertically, and the osteotomy guide seat 20 is rotatably sleeved on the mounting column 16 around the extension direction of the mounting column 16. By sleeve-arranging the osteotomy guide seat 20 on the mounting column 16, the osteotomy guide seat 20 can be quickly installed, and the mounting column 16 can be used to provide a definite rotation axis for the osteotomy guide seat 20.

In this embodiment, the tibial side guide plate further includes a force line rod 90 and a Kirschner wire 80 .

In this embodiment, the lower end of the tibial positioning seat 10 is provided with a tibial connection hook protruding from the tibial matching surface 11. The tibial connection hook is used to hook the lower end of the tibia, so that the tibial positioning seat 10 and the tibia that needs osteotomy can be stably matched, avoiding the shaking of the tibial positioning seat 10 relative to the tibia caused by subsequent operations.

As shown in Fig. 7 and Fig. 8, the tibial positioning seat 10 is provided with a tibial connection hole 17. As shown in Fig. 8, at least one tibial connection hole 17 is gradually inclined upward relative to the transverse direction in a direction away from the tibia, and the tibial positioning seat 10 can be installed on the tibia by inserting the Kirschner wire 80 into the tibial connection hole 17.

The tibial side guide plate provided in this embodiment is used with the following operating steps:

(1) Before surgery, engineers first determine the axis, direction, and amount of osteotomy of the tibia, simulate the position and direction of tibial plateau prosthesis implantation, and determine whether its force and coverage are appropriate;

(2) During the operation, the outer edge of the tibial positioning seat 10 is aligned with the positioning mark 71 on the tibia 70 (as shown in FIG. 11 ), and the tibial matching surface 11 is fitted with the outer surface of the tibia, so that the tibial positioning seat 10 is quickly and accurately installed to the installation position designed before the operation, and the hook-shaped structure arranged at the lower end of the tibial positioning seat 10 is used to limit the movement of the tibial positioning seat 10 relative to the tibia, thereby increasing the accuracy of the attachment of the tibial positioning seat 10 to the tibia, and then the tibial positioning seat 10 can be fixed to the tibia by inserting the Kirschner wire 80 into the tibial connection hole 17 (as shown in FIG. 12 );

(3) Verify whether the design and placement of the tibial positioning seat 10 are accurate (i.e., whether the osteotomy surface meets the preoperative design requirement that the osteotomy surface is perpendicular to the tibial axis, and whether the osteotomy direction meets the preoperative design requirement that the osteotomy direction is perpendicular to the tibial coronal plane);

(4) To verify that the osteotomy surface is perpendicular to the tibial axis, a first force line hole 221 centered relative to the tibia 70 is selected, a force line rod 90 is inserted into the first force line hole 221, and the force line rod 90 is inserted into the second force line hole 52. The sagittal plane is observed as shown in FIG. 15. If the force line rod 90 in the second force line hole 52 points to the center of the medullary cavity of the tibia 70, and if the force line rod 90 in the first force line hole 221 points to the center of the medullary cavity of the tibia 70 when observed in the coronal plane as shown in FIG. 14, it can be concluded that the osteotomy plane determined by the extension direction of the tibial osteotomy guide 21 is perpendicular to the tibial axis, and the extension direction of the tibial osteotomy guide 21 restores the osteotomy surface designed before surgery (i.e., the osteotomy surface is perpendicular to the tibial axis);

(5) Verification of the osteotomy direction being perpendicular to the coronal plane of the tibia is performed by inserting force line rods into at least three first force line holes 221 and observing the coronal plane as shown in FIG. 16 . If the projections of at least three first force line holes 221 on the coronal plane are arranged at equal intervals, it can be concluded that the observation plane is parallel to the coronal plane, that is, the extension direction of the tibial osteotomy guide portion 21 is perpendicular to the coronal plane, and the extension direction of the tibial osteotomy guide portion 21 restores the osteotomy direction designed before the operation (that is, the osteotomy operation is performed in a direction perpendicular to the coronal plane).

(6) After the extension direction of the tibial osteotomy guide 21 conforms to the osteotomy direction selected by the clinician (i.e., the extension direction of the K-wire hole 211 conforms to the osteotomy direction selected by the clinician), and the extension direction of the tibial osteotomy guide 21 restores the osteotomy surface designed before the operation (i.e., the osteotomy surface is perpendicular to the tibial axis), at least two K-wires 80 are inserted into the at least two K-wire holes 211 one by one and driven into the tibia 70, the tibial positioning seat 10, the osteotomy guide seat 20 and the angle adjustment structure 30 are removed, and only the K-wire 80 that passes through the K-wire hole 211 and is driven into the tibia 70 is retained, and the tibial osteotomy module 72 is mounted on the K-wire 80, and the tibial osteotomy module 72 performs an osteotomy operation on the tibia 70 along the extension direction of the K-wire 80.

As shown in Fig. 1 to Fig. 19, another embodiment of the present invention provides an ankle joint guide assembly, which includes a talar side guide plate 60 and a tibial side guide plate, wherein the tibial side guide plate is the tibial side guide plate provided above. The ankle joint guide assembly provided by this embodiment can also be used to install the tibial positioning seat 10 on the tibia that needs osteotomy, so that the tibial matching surface 11 arranged on the first side of the tibial positioning seat 10 fits with the outer surface of the tibia. Since the osteotomy guide seat 20 is arranged on the second side of the tibial positioning seat 10, the first side and the second side of the tibial positioning seat 10 are arranged relative to each other in the extension direction of the sagittal axis. The osteotomy guide seat 20 has a tibial osteotomy guide portion 21 extending in the transverse direction, so that in the subsequent tibial osteotomy operation, the tibial osteotomy operation can be performed along the extension direction of the tibial osteotomy guide portion 21 to obtain the osteotomy surface extending in the transverse direction. 0 is rotatably arranged on the tibial positioning seat 10. During the operation, the clinician can select a suitable osteotomy direction of the tibial osteotomy operation according to the intraoperative situation, and use the angle detection part 22 to detect the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, and use the angle adjustment structure 30 to adjust the angle between the extension direction of the tibial osteotomy guide part 21 and the coronal plane, so that the extension direction of the tibial osteotomy guide part 21 conforms to the osteotomy direction selected by the clinician, which is convenient for quickly reproducing the preoperative planning of the tibial osteotomy operation and can adjust the osteotomy direction of the tibial osteotomy operation according to the intraoperative situation, thereby reducing the complexity of the tibial side guide plate and shortening the learning cycle of the clinician.

As shown in FIG18 , the talar side guide plate 60 has a talar matching surface 61, and a talar osteotomy guide portion 62 is also provided on the talar side guide plate 60. The angle between the extension direction of the talar osteotomy guide portion 62 and the long axis of the talus is between 15° and 25°, which meets the requirement that the talar osteotomy angle and the long axis of the talus have an angle of 20°±5°.

The talar side guide plate 60 provided in this embodiment is applied by adopting the following operation steps:

(1) Design the amount of osteotomy on the trochlear side of the talus, the osteotomy angle, the general direction of implantation, and the coverage area of the prosthesis;

(2) The first is the general direction of prosthesis implantation. Here, the direction of the talar side prosthesis is designed to be toward the middle of the toes. Due to the limitation that the patient is in a prone position when taking CT image data, the sole of the foot is in a relaxed state, so the direction of each person's toes is almost different, and it is impossible to form a unified specific feature reference. In addition, the clinician will also make fine adjustments to the direction of prosthesis implantation during the operation;

(3) Then, the amount of osteotomy and the angle of osteotomy on one side of the talar trochlea are controlled. The amount of osteotomy is usually based on the thickness of the implanted prosthesis, that is, the amount of osteotomy is supplemented as much as the amount of osteotomy is removed. For example, for patients with severe bone wear at the talar trochlea, the amount of osteotomy can be reduced according to the actual situation. The design and use of the talar positioning guide plate is simpler than that of the tibial positioning guide plate. The talar positioning guide plate only needs to be attached to the designated position on the surface of the talus 73 using the talar mating surface 61, and fixed by driving two Kirschner wires into the reserved nail holes above the guide plate. Subsequently, two Kirschner wires are driven into the nail holes of the talar osteotomy guide portion 62.

(4) Then, pull out the Kirschner wire used for fixation on the talar positioning guide plate, remove the talar positioning guide plate, retain the two Kirschner wires inserted into the nail holes of the talar osteotomy guide part 62, and replace it with the talar osteotomy module 74 to perform the osteotomy operation.

Among them, considering the complex anatomical structure of the ankle joint and the very limited operating space exposed during surgery, compared with common hip joint surgical guides and knee joint surgical guides, the ankle joint guide assembly provided in this embodiment is small in size (the maximum size of the tibial side guide is only 40 mm, and the maximum size of the talar side guide is even only about 30 mm), so that the ankle joint guide assembly can meet the needs of small incisions or even minimally invasive ankle joint surgery.

It should be noted that the terms used herein are only for describing specific embodiments and are not intended to limit the exemplary embodiments according to the present application. As used herein, unless the context clearly indicates otherwise, the singular form is also intended to include the plural form. In addition, it should be understood that when the terms "comprise" and/or "include" are used in this specification, it indicates the presence of features, steps, operations, devices, components and/or combinations thereof.

Unless otherwise specifically stated, the relative arrangement, numerical expressions and numerical values of the parts and steps set forth in these embodiments do not limit the scope of the present invention. Meanwhile, it should be understood that, for ease of description, the sizes of the various parts shown in the accompanying drawings are not drawn according to actual proportional relationships. The technology, methods and equipment known to those of ordinary skill in the relevant art may not be discussed in detail, but in appropriate cases, the technology, methods and equipment should be considered as a part of the specification. In all examples shown and discussed here, any specific value should be interpreted as being merely exemplary, rather than as a limitation. Therefore, other examples of exemplary embodiments may have different values. It should be noted that similar reference numerals and letters represent similar items in the following drawings, and therefore, once a certain item is defined in an accompanying drawing, it does not need to be further discussed in subsequent drawings.

In the description of the present invention, it is necessary to understand that the directions or positional relationships indicated by directional words such as "front, back, up, down, left, right", "lateral, vertical, perpendicular, horizontal" and "top, bottom" are usually based on the directions or positional relationships shown in the drawings. They are only for the convenience of describing the present invention and simplifying the description. Unless otherwise specified, these directional words do not indicate or imply that the devices or elements referred to must have a specific direction or be constructed and operated in a specific direction. Therefore, they cannot be understood as limiting the scope of protection of the present invention. The directional words "inside and outside" refer to the inside and outside relative to the contours of each component itself.

For ease of description, spatially relative terms such as "above", "above", "on the upper surface of", "above", etc. may be used here to describe the spatial positional relationship between a device or feature and other devices or features as shown in the figure. It should be understood that spatially relative terms are intended to include different orientations of the device in use or operation in addition to the orientation described in the figure. For example, if the device in the accompanying drawings is inverted, the device described as "above other devices or structures" or "above other devices or structures" will be positioned as "below other devices or structures" or "below other devices or structures". Thus, the exemplary term "above" can include both "above" and "below". The device can also be positioned in other different ways (rotated 90 degrees or in other orientations), and the spatially relative descriptions used here are interpreted accordingly.

In addition, it should be noted that the use of terms such as "first" and "second" to limit components is only for the convenience of distinguishing the corresponding components. Unless otherwise stated, the above terms have no special meaning and therefore cannot be understood as limiting the scope of protection of the present invention.

The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications and variations. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention shall be included in the protection scope of the present invention.

Claims (11)

1. A tibial side guide, the tibial side guide comprising:

a tibial locating seat (10) having a first side and a second side oppositely disposed in the direction of extension of the sagittal axis, the first side of the tibial locating seat (10) being provided with a tibial mating surface (11);

the osteotomy guide seat (20) is rotatably arranged on the second side of the tibia positioning seat (10), the osteotomy guide seat (20) extends vertically relative to the rotation axis of the tibia positioning seat (10), the osteotomy guide seat (20) is provided with a tibia osteotomy guide part (21) and an angle detection part (22), the tibia osteotomy guide part (21) extends transversely, and the angle detection part (22) can detect an included angle between the extending direction of the tibia osteotomy guide part (21) and a coronal plane;

The angle adjusting structure (30) is arranged between the tibia positioning seat (10) and the osteotomy guide seat (20) to adjust an included angle between the extension direction of the tibia osteotomy guide part (21) and the coronal plane;

The angle detection part (22) comprises at least three first force line holes (221) extending vertically, the tibia side guide plate is provided with an observation surface perpendicular to the extending direction of the tibia osteotomy guiding part (21), the tibia side guide plate further comprises an observation plate (50), the observation plate (50) is detachably arranged on the osteotomy guiding seat (20), the observation plate (50) is provided with second force line holes (52) extending vertically, one of the first force line holes (221) and the second force line holes (52) are distributed at intervals in the extending direction of a coronal axis, the observation is performed in a sagittal plane, if the second force line holes (52) point to the central position of a medullary cavity of the tibia (70), and the observation is performed in a coronal plane, and if the first force line holes (221) point to the central position of the medullary cavity of the tibia (70), the osteotomy plane determined by the extending direction of the tibia osteotomy guiding part (21) can be obtained and the axis is perpendicular.

2. The tibial side guide of claim 1, wherein said angle adjustment structure (30) comprises:

The gear structure (31) is arranged on one side of the osteotomy guide seat (20) facing the tibia positioning seat (10), and the axis of the gear structure (31) is the rotation axis of the osteotomy guide seat (20) relative to the tibia positioning seat (10);

and a rack (32) is arranged on the tibia positioning seat (10) in a movable way along the transverse direction, and the rack (32) is meshed with the gear structure (31).

3. The tibial side guide of claim 2 further comprising a locating feature (40) that limits rotation of the osteotomy guide seat (20) relative to the tibial locating seat (10).

4. A tibial side guide plate according to claim 3, wherein said positioning structure (40) comprises:

A plurality of positioning grooves (41) arranged along the extending direction of the rack (32), wherein the positioning grooves (41) are arranged on one of the rack (32) and the tibia positioning seat (10);

the elastic locating piece (42) is arranged on the other of the rack (32) and the tibia locating seat (10), the elastic locating piece (42) can be matched with one locating groove (41) of a plurality of locating grooves (41), and the elastic locating piece (42) is provided with a locating state extending into the locating groove (41) and an adjusting state falling out of the locating groove (41).

5. The tibial side guide of claim 4 wherein,

The tibia positioning seat comprises a tibia positioning seat body (10), a positioning groove (41) is formed in the tibia positioning seat body, one side, facing the positioning groove (41), of a rack (32) is provided with a mounting hole (321), the extending direction of the mounting hole (321) is perpendicular to the extending direction of the rack (32), an elastic positioning piece (42) comprises an elastic pressing piece (421) and a spring (422), the elastic pressing piece (421) is covered on one end, facing the positioning groove (41), of the mounting hole (321), a spherical protrusion (4211) protruding towards a direction away from the rack (32) is arranged in the middle of the elastic pressing piece (421), the spring (422) is arranged in the mounting hole (321), and two ends of the spring (422) are respectively abutted to the rack (32) and the middle of the elastic pressing piece (421); and/or the number of the groups of groups,

Be provided with on the tibia positioning seat (10) along transversely extending's guide way (12), rack (32) movably wear to locate guide way (12), the orientation of tibia positioning seat (10) one side of osteotomy guide seat (20) is provided with contact opening (13), contact opening (13) with guide way (12) are linked together, rack (32) are through contact opening (13) with gear structure (31) are meshed.

6. The tibial side guide of claim 1, wherein the projections of at least three of said first force line holes (221) on said viewing surface are equally spaced.

7. The tibial side guide of claim 6, wherein said viewing plate (50) has at least two guide plate attachment holes (51) disposed thereon, said viewing plate (50) being attached to said osteotomy guide base (20) by at least two of said guide plate attachment holes (51).

8. The tibial side guide of claim 1, wherein said tibial resection guide (21) includes at least two k-wire holes (211) disposed on said resection guide (20), said k-wire holes (211) extending in a lateral direction.

9. The tibial side guide of any of claims 1 to 8 wherein,

The tibia positioning seat (10) comprises a seat body (14), a mounting platform (15) and a mounting column (16), wherein the tibia matching surface (11) is arranged on the seat body (14), the mounting platform (15) is arranged on the seat body (14), the mounting column (16) is arranged on one side, away from the tibia matching surface (11), of the mounting platform (15) in the extending direction of a crown shaft, the mounting column (16) extends vertically, and the osteotomy guide seat (20) is rotatably sleeved on the mounting column (16) around the extending direction of the mounting column (16);

The tibia side guide plate also comprises a force line rod and a Kirschner wire;

The lower end of the tibia positioning seat (10) is provided with a tibia connecting hook protruding out of the tibia matching surface (11);

And a tibia connecting hole (17) is formed in the tibia positioning seat (10).

10. An ankle fence assembly, characterized in that it comprises a talus side fence (60) and a tibia side fence, the tibia side fence being the tibia side fence of any one of claims 1 to 9.

11. The ankle guide assembly according to claim 10, wherein the talar side guide (60) has a talar mating surface (61), and wherein a talar osteotomy guide (62) is further provided on the talar side guide (60), the talar osteotomy guide (62) extending at an angle between 15 ° and 25 ° to the long axis of the talar.