WO2019184670A1 - 截骨装置及其操作方法 - Google Patents

截骨装置及其操作方法 Download PDF

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Publication number
WO2019184670A1
WO2019184670A1 PCT/CN2019/077193 CN2019077193W WO2019184670A1 WO 2019184670 A1 WO2019184670 A1 WO 2019184670A1 CN 2019077193 W CN2019077193 W CN 2019077193W WO 2019184670 A1 WO2019184670 A1 WO 2019184670A1
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WIPO (PCT)
Prior art keywords
osteotomy
plate
knob
eccentric
groove
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2019/077193
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English (en)
French (fr)
Inventor
孙延东
胡方遒
赵开宇
吴悠
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Suzhou Microport Orthorecon Co Ltd
Original Assignee
Suzhou Microport Orthorecon Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Suzhou Microport Orthorecon Co Ltd filed Critical Suzhou Microport Orthorecon Co Ltd
Priority to JP2020566869A priority Critical patent/JP7145239B2/ja
Priority to US16/970,903 priority patent/US11253270B2/en
Priority to EP19777984.6A priority patent/EP3735917A4/en
Publication of WO2019184670A1 publication Critical patent/WO2019184670A1/zh
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A61B17/154—Guides therefor for preparing bone for knee prosthesis
    • A61B17/155—Cutting femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A61B17/151—Guides therefor for corrective osteotomy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1657—Bone breaking devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1675—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the knee
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment

Definitions

  • the present application relates to the field of medical device technology, and in particular to an osteotomy device and a method of operating the same.
  • femoral osteotomy is an extremely important step because the existing femoral prosthesis has four faces and protrudes inward at the central femur block, so the doctor needs to treat the femur into a false
  • the specific shape corresponding to the body is used to mount the femoral prosthesis, that is, the distal end surface of the femur (the surface connected to the prosthesis) is four-sided osteotomy, and a concave shape is formed at the femoral trochlear. Whether the osteotomy plate is fixed firmly during this process, and whether the repeated disassembly and disassembly of the osteotomy plate is accurate will directly affect the osteotomy effect.
  • osteotomy plates for four-sided osteotomy and femoral truncated osteotomy when performing anterior and posterior femoral iliac crest treatment.
  • This surgical procedure is complicated in operation, and repeated loading and unloading of the osteotomy plate can easily reduce the accuracy of osteotomy and increase the probability of operational errors.
  • the separate use of multiple sets of osteotomy plates not only increases the number of instruments, but also increases the manufacturing cost, and at the same time increases the maintenance cost of sterilization and repeated handling during hospital use.
  • the position of the femoral truncated osteotomy must correspond to the position of the femoral prosthesis trochlear, so the fixed position of the femoral truncated osteotomy plate is more stringent.
  • the osteotomy plate currently used for osteotomy of the femur can not be adjusted left and right, and it is also difficult to determine the positioning of the doctor. Because the femoral block is the orbital movement of the tibia and the femur, if the center of the femoral truncated osteotomy is not accurate, the left and right offset will directly affect the position of the femoral prosthesis, and further affect the humerus after the prosthesis is reset. The deviation of the sliding track may cause problems such as abnormal patella trajectory and pain before sacral.
  • an osteotomy device and method of operation thereof are provided.
  • an osteotomy device comprising a osteotomy plate, a fixation plate and an adjustment structure, the osteotomy plate being mounted on the femur by the fixation plate, the two ends of the adjustment structure respectively
  • the fixation plate is connected to the osteotomy plate, and the osteotomy plate slides to the left and right by the adjustment structure relative to the fixation plate;
  • the osteotomy plate has a femur osteotomy trough capable of four-sided osteotomy and can perform a femoral truncated truncation The femoral trochlear osteotomy groove of the bone.
  • the upper end and the lower end of the fixing plate are respectively provided with latching teeth, and a side of the osteotomy plate facing the fixing plate is provided with a sliding slot, and the latching teeth are slidably engaged with the sliding slot.
  • the latch and the chute can slide relative to each other.
  • the adjustment structure includes a knob and an eccentric, the knob is coupled to the eccentric and rotatably coupled to the osteotomy plate; the eccentric is coupled to the fixation plate Connecting, and when the knob is rotated, the eccentric wheel is eccentrically moved relative to the knob, so that the osteotomy plate slides left and right relative to the fixed plate.
  • the eccentric includes a rotational connection portion and an eccentric portion, the rotational connection portion being coupled to the knob, the eccentric portion being disposed offset from an axis of rotation of the knob.
  • the fixing plate is provided with a groove, and the eccentric portion is embedded in the groove.
  • the eccentric wheel rotates with the knob, the eccentric portion can follow The groove slides up and down.
  • the osteotomy plate is provided with a cavity extending through the osteotomy plate, the groove cavity is connected with the groove to form a communicating cavity, and the knob is disposed in the cavity Inside, when the eccentric rotates, the knob abuts against the side wall of the cavity, and the bone plate is driven to slide left and right.
  • the eccentric and the knob are axially movable relative to each other, and the eccentric is radially limited to the knob, and an elastic compression member is disposed between the eccentric and the knob. The two ends of the elastic compression member are respectively elastically abutted against the eccentric wheel and the knob.
  • the knob has a stepped shape, and one end of the eccentric wheel has a plug portion, and the other end has a latching disc; the rotating connecting portion of the eccentric wheel is open to the plug portion.
  • An adapted slot having a toothed opening at one end of the slot away from the fixed plate, the latch disk being insertable or removable from the toothed opening along an axis of rotation of the knob, and when the latch is The toothed opening limits rotational movement of the knob relative to the osteotomy plate when the disk is embedded in the toothed opening.
  • the bottom of the groove is provided with a perforation through the fixing plate.
  • the end of the slot near the fixing plate has a limiting slot, and the eccentric wheel and the limiting slot are arranged when the eccentric is moved to meet the limit position required for adjusting the stroke of the osteotomy board by the adjusting structure. The ends meet and cannot continue to deflect.
  • the fixing plate is provided with a fixing nail on a side away from the osteotomy plate, and the fixing nail is used to mount the fixing plate on the femur.
  • the osteotomy plate has a femur osteotomy groove capable of four-sided osteotomy and a femoral truncated osteotomy groove for femoral truncated osteotomy, so that the bone plate can be continued without replacing the osteotomy plate after completing the four-sided osteotomy operation.
  • the femoral truncated bone osteotomy operation can effectively reduce the number of instruments, avoid repeated disassembly and assembly, and simplify the operation steps.
  • the osteotomy device can adjust the osteotomy plate to slide left and right relative to the fixed plate by using the adjustment structure, and then the osteotomy plate Adjusted to the femoral trochlear truncated trough to the femoral trochlear, improve the accuracy of femoral truncated osteotomy, avoiding the inaccurate position of the femoral truncated osteotomy and affecting the abnormal sliding track of the tibia after the prosthesis is reset.
  • a fixing nail is provided on a side of the fixing plate away from the osteotomy plate.
  • the initial fixation of the osteotomy plate is provided by the fixation pins on the fixation plate, thereby increasing the stability of the osteotomy plate during the process of adjusting the centering position of the osteotomy plate by the physician by adjusting the structure.
  • the fixing nail is fully fixed by the matching oblique nail to ensure the stability of the osteotomy and the accuracy of the osteotomy.
  • a method of operating an osteotomy device of the above aspect comprising: securing the osteotomy device to the femur through the fixation plate; adjusting the adjustment structure The bone plate is slid to the right and left position relative to the fixed plate; the four-sided osteotomy is performed along the femoral osteotomy groove; and the femoral trochlear osteotomy is performed along the femoral truncated bone truncated groove.
  • FIG. 1 is a schematic exploded view of a structure of an osteotomy device according to an embodiment
  • FIG. 2 is a schematic view showing the assembly structure of the osteotomy plate and the fixing plate of the osteotomy device shown in FIG. 1;
  • Figure 3 is a cross-sectional structural view of the osteotomy device shown in Figure 2;
  • FIG. 4 is a schematic structural view of an osteotomy device installed in a femur according to an embodiment
  • Figure 5 is a cross-sectional view taken along line A-A of Figure 4.
  • FIG. 6 is a flow chart showing a method of operating a osteotomy device in an embodiment.
  • distal and proximal are conventional terms in the field of medical devices. Specifically, “distal” refers to the end away from the operator during the procedure, and “proximal” refers to the end near the operator during the procedure. Taking FIG. 5 as an example, the right side of FIG. 5 is the distal end, and the left side is the proximal end.
  • connection also includes a detachable connection.
  • inner, outer, outer, left, “right”, and the like, as used herein, are for the purpose of illustration and are not intended to be the only embodiment.
  • the osteotomy device of one embodiment includes a bone plate 10 , a fixation plate 20 , and an adjustment structure 30 .
  • the osteotomy plate 10 is mounted on the femur B by the fixation plate 20 and is slidable relative to the fixation plate 20, that is, the osteotomy device can adjust the left and right positions of the osteotomy plate 10 relative to the femur B to perform osteotomy at a suitable position.
  • the left and right positions are defined as follows: Referring to Figures 1 and 5, the osteotomy device is attached to the distal end surface of the femur B, and the distal end surface of the femur B is parallel to the osteotomy groove 11a.
  • the direction is the left-right direction, that is, the horizontal direction, and the direction perpendicular to the horizontal direction is the up-and-down direction, that is, the vertical direction.
  • the osteotomy plate 10 has a femoral osteotomy groove 11 which is capable of four-sided osteotomy, specifically femoral osteotomy grooves 11a, 11b, 11c, 11d.
  • the osteotomy plate 10 also has a femoral trochlear osteotomy trough 12 that can be used for femoral truncated osteotomy.
  • the adjustment structure 30 is configured to drive the osteotomy plate 10 to slide to the left and right relative to the fixation plate 20 to adjust the relative position of the osteotomy plate 10 and the femur B, so that the osteotomy tool such as the saw blade can be along the femur osteotomy grooves 11a, 11b, 11c, Four-sided osteotomy was performed on the 11th side, and the femoral truncated bone truncation groove 12 was used for osteotomy to perform osteotomy of the femoral trochlear.
  • the adjustment structure 30 can adjust the position of the osteotomy plate 10 relative to the femur B, the osteotomy plate 10 can be adjusted to the femoral truncated truncated groove 12 facing the femoral trochlear to ensure the position of the femur block osteotomy.
  • the position of the femoral truncated osteotomy is prevented from being inaccurate, which affects the abnormal sliding trajectory of the tibia after the prosthesis is reset.
  • the osteotomy and the femoral trochlear osteotomy operation can be completed by using the osteotomy device, the femoral truncated osteotomy operation can be continued without disassembling and replacing the osteotomy plate 10 after the four-sided osteotomy operation is completed.
  • the osteotomy plate 10 is of a symmetrical configuration to accommodate the femur B to perform an osteotomy operation at a corresponding location.
  • the femoral trochlear osteotomy groove 12 is disposed at a central position of the osteotomy plate 10 to adjust the osteotomy plate 10 to the femoral B center, and the femoral trochlear osteotomy groove 12 is opposite the femoral trochlear.
  • the osteotomy plate 10 and the fixation plate 20 are respectively provided with a mating sliding connection structure on the surfaces close to each other (i.e., the proximal end surface of the osteotomy plate 10 and the distal end surface of the fixation plate 10).
  • the upper end and the lower end of the fixing plate 20 are respectively provided with the latching teeth 20a, 20b extending in the horizontal direction, and the side of the osteotomy board 10 facing the fixing plate 20 and the latching teeth 20a, 20b
  • the corresponding position is provided with the sliding grooves 10a and 10b extending in the horizontal direction.
  • the engaging teeth 20a are slidably engaged with the sliding groove 10a, and the engaging teeth 20b are slidably engaged with the sliding groove 10b.
  • the latching teeth 20a, 20b on the fixing plate 20 are engaged with the sliding grooves 10a, 10b on the osteotomy plate 10 by sliding snapping, the sliding of the osteotomy plate 10 relative to the fixed plate 20 is achieved.
  • the fixing plate 20 has a better supporting effect on the osteotomy plate 10 in the up and down direction, so that the osteotomy plate 10 has better stability when sliding relative to the fixed plate 20 to ensure the accuracy of the osteotomy position adjustment.
  • the latching teeth 20a in this embodiment may be one continuous latching tooth or may be composed of two or more intermittent latching teeth (as shown in FIG. 3). In the latter case, the latching teeth 20a may also be two or more.
  • the composition of the pillars may be one continuous latching tooth or may be composed of two or more intermittent latching teeth (as shown in FIG. 3). In the latter case, the latching teeth 20a may also be two or more.
  • the composition of the pillars may be one continuous latching tooth or may be composed of two or more intermittent latching teeth (
  • the upper and lower ends of the fixing plate 20 may be respectively provided with sliding grooves, and the one side of the osteotomy plate 10 facing the fixing plate 20 is provided with engaging teeth corresponding to the sliding grooves.
  • the chute and the latch may also be replaced with other sliding joints as long as a relative horizontal sliding between the fixed plate 20 and the osteotomy plate 10 can be achieved.
  • the joint surface of the fixing plate 20 and the osteotomy plate 10 is respectively provided with a sliding fit slider and a sliding groove, so that when the slider slides along the sliding groove, the osteotomy plate 10 can also slide relative to the fixed plate 20, thereby being fixed.
  • the osteotomy plate 10 is adjusted in a sliding manner to the relative position of the femur B to meet the needs of osteotomy, and will not be further described herein.
  • the fixing plate 20 is provided with a fixing nail 21 on a side away from the osteotomy plate 10, so that the osteotomy device can be pre-fixed by the fixing nail 21.
  • the number of fixing nails 21 is not limited. In the present embodiment, two fixing nails 21 are provided, and the two fixing nails 21 are symmetrically disposed on the fixing plate 20.
  • the fixing nail 21 may be a columnar spike to facilitate the nailing into the femur B while having better stability.
  • the nail holes 13 are obliquely disposed on both sides of the osteotomy plate 10, so that after the relative positions of the osteotomy plate 10 and the femur B are adjusted by the adjustment structure 30, the fixing members such as nails passing through the nail holes 13 can be driven in.
  • the femur B positions the osteotomy device to ensure stability during osteotomy and improve the accuracy of osteotomy.
  • the osteotomy plate 10 is adaptively provided with a hollow portion to reduce weight.
  • the shape and number and position of the hollow portion are not limited, and may be provided in plurality without affecting the strength of the osteotomy plate 10 and the osteotomy work. In other embodiments, an even number of hollows may be symmetrically disposed on the osteotomy plate 10. Referring to FIG. 2, in the embodiment, the side of the osteotomy plate 10 away from the fixed plate 20 is provided with a T-shaped groove 15 so that after the osteotomy operation, the tool matched with the T-shaped groove 15 by a hammer or the like will be cut. The bone plate 10 is taken out.
  • the adjustment structure 30 includes a knob 31 and an eccentric 32, wherein the knob 31 is coupled to the eccentric 32 and rotatably coupled to the osteotomy plate 10, and the eccentric 32 is coupled to the fixation plate 20. .
  • the knob 31 is rotated, the eccentric wheel 32 is eccentrically moved relative to the knob 31 to slide the osteotomy plate 10 relative to the fixed plate 20 to the left and right.
  • the eccentric 32 includes a rotational connection portion 321 and an eccentric portion 322.
  • the rotational connection portion 321 is coupled to the knob 31, and the eccentric portion 322 is disposed away from the rotational axis of the knob 31.
  • the fixing plate 20 is provided with a groove 22, and the eccentric portion 322 is embedded in the groove 22.
  • the eccentric portion 322 slides up and down along the groove 22, so that when the eccentric wheel 32 is eccentrically moved, the change in the amount of up and down displacement does not interfere with the fixed plate 20.
  • the groove 22 can be an elongated groove or a waist groove having a tendency to extend up and down.
  • the extending direction of the groove 22 is perpendicular to the sliding direction of the osteotomy plate 10 relative to the fixing plate 20, so that the force between the eccentric portion 322 and the fixing plate 20 when moving along the knob 31 is in the left-right direction, so that the osteotomy plate 10 and the fixing plate are fixed.
  • the plates 20 have a good left and right sliding effect.
  • the osteotomy plate 10 is provided with a cavity 10c penetrating the osteotomy plate 10.
  • the position of the groove 10c corresponds to the position of the groove 22, that is, the cavity. 10c is coupled to the recess 22 to form a communicating cavity for receiving the adjustment structure 30.
  • the knob 31 is disposed in the cavity 10c.
  • the interaction force of the eccentric 32 acting on the knob 31 causes the knob 31 to abut against the side wall of the cavity 10c, so that the osteotomy plate 10 is opposite to the fixed plate. 20 slides left and right along the chutes 10a, 10b.
  • the eccentric 32 and the knob 31 are relatively movable in the axial direction, and the eccentric 32 is radially limited to the knob 31.
  • An elastic compression member 33 is disposed between the eccentric 32 and the knob 31. Both ends of the elastic compression member 33 are elastically abutted against the eccentric 32 and the knob 31, respectively.
  • the axial and radial directions described herein are defined as follows: Referring to Fig. 5, the osteotomy device is attached to the distal end surface (the osteotomy surface) of the femur B in a direction perpendicular to the osteotomy surface (i.e., parallel to the rotational axis of the knob 31). The direction is the axial direction, and the direction perpendicular to the axial direction is the radial direction.
  • the elastic compression member 33 may be a compression spring or an elastic ring having better shrinkage properties.
  • the elastic compression member 33 can be compressed by pressing the eccentric 32 and the end of the knob 31 away from the elastic compression member 33, respectively, and the eccentric 32 is changed.
  • the axial spacing of the knobs 31 prevents the eccentric 32 from interfering with the fixed plate 20 when the fixed plate 20 and the osteotomy plate 10 are assembled.
  • the two ends of the elastic compression member 33 are elastically abutted against the eccentric wheel 32 and the knob 31, respectively, the eccentric wheel 32 is pressed into the groove by the elastic compression member 33. twenty two.
  • the eccentric wheel 32 Since the eccentric wheel 32 is radially limited to the knob 31, when the knob 31 is screwed, the eccentric wheel 32 will rotate with the knob 31 to drive the osteotomy plate 10 and the fixed plate 20 to slide relative to each other in the left-right direction, and adjust the osteotomy plate 10 relative to the femur.
  • the bottom of the recess 22 may be provided with a through hole 22a penetrating the fixing plate 20.
  • the eccentric 32 is pressed by the perforation 22a, so that the eccentric 32 compresses the elastic compression member 33 away from the fixed plate 20, and finally the eccentric portion 322 of the eccentric 32 is moved out of the groove 22.
  • the fixing plate 20 does not have the constraint of the eccentric wheel 32 in the left-right direction, so that the fixing plate 20 and the osteotomy plate 10 can be slid away from each other along the chutes 10a, 10b.
  • the knob 31 may be stepped, having an insertion portion 311 near one end of the eccentric wheel 32 and a latching disk 312 at the other end.
  • the rotary connecting portion 321 of the eccentric 32 is provided with a slot 321a adapted to the plug portion 311. It can be understood that the cross-sectional shape of the slot 321a and the plug portion 311 may be non-circular, such as a rectangle, a rounded rectangle, etc., so that the radial limit between the eccentric 32 and the knob 31 can be ensured and the axial direction can be Relative movement.
  • the end of the cavity 10c away from the fixed plate 20 has a toothed opening 14 that can be inserted or removed from the toothed opening 14 along the axis of rotation of the knob 31.
  • the toothed opening 14 limits the rotational movement of the knob 31 relative to the osteotomy plate 10 to lock the relative position of the osteotomy plate 10 and the fixed plate 20, thereby avoiding operational errors or installing the osteotomy device.
  • a displacement occurs between the osteotomy plate 10 and the fixed plate 20.
  • the latching disk 312 moves out of the toothed opening 14 as the knob 31 moves toward the fixed plate 20, thereby releasing the latching disk 312 and the teeth.
  • the engagement of the opening 14 allows the knob 31 to be rotated relative to the osteotomy plate 10, thereby adjusting the relative position of the osteotomy plate 10 and the fixation plate 20 in the horizontal direction, and the femoral truncated bone osteotomy groove on the osteotomy plate 10. 12 Align the femoral block for osteotomy.
  • An operation portion 312a is provided on an end surface of the sprocket wheel 312 to screw the knob 31 with a tool fitted to the operation portion 312a.
  • the operating portion 312a may be a hexagonal counterbore.
  • the knob 31 can be screwed by a tool such as a wrench or a screwdriver that cooperates with the hexagonal counterbore to drive the osteotomy plate 10 to slide left and right relative to the fixed plate 20 by the eccentric motion of the eccentric 32, thereby aligning the osteotomy plate 10
  • the left and right positions of the femur B are adjusted such that the femoral truncated truncated truncated groove 12 is in a centered position relative to the femur B, so that the osteotomy tool such as the saw blade can accurately perform the osteotomy operation on the femoral trochlear along the femoral truncated truncated truncated groove 12.
  • the slot 10c has a limiting slot 10d near one end of the fixing plate 20.
  • the limit groove 10d is used to limit the rotation amplitude of the eccentric wheel 32 with the knob 31, thereby limiting the relative displacement between the osteotomy plate 10 and the fixed plate 20, so that the stroke of the osteotomy plate 10 to the left and right of the femur B is suitable.
  • the osteotomy plate 10 is prevented from sliding too much left and right to cause the latches 20a, 20b to escape from the chutes 10a, 10b, or the contact faces of the latches 20a, 20b and the chutes 10a, 10b are too small to affect the fixation of the entire instrument.
  • the eccentric 32 when the eccentric 32 is moved to meet the limit position required for the adjustment of the adjustment structure 30 to the stroke of the osteotomy plate 10, the eccentric 32 abuts against the end of the limiting groove 10d and cannot continue to deflect.
  • the limit groove may not be provided, but the limit of the rotation amplitude of the eccentric wheel 32 may be achieved by designing the size of the groove 22 .
  • the recess 22 is disposed such that when the eccentric 32 is moved to meet the limit position required for the adjustment of the adjustment structure 30 to the stroke of the osteotomy plate 10, the eccentric 32 abuts against the end of the recess 22 and cannot continue to deflect. Therefore, the rotation range of the eccentric wheel 32 can also achieve a better limit effect.
  • the stroke in which the eccentric 32 drives the bone plate 10 to slide left and right relative to the fixed plate 20 is also affected by the amount of deviation from the rotational axis of the knob 31 when the eccentric 32 itself is eccentrically moved. Specifically, the deviation of the rotational trajectory of the eccentric portion 322 of the eccentric wheel 32 from the rotation axis of the knob 31 is larger.
  • the eccentric 32 drives the osteotomy plate 10 to slide to the left and right of the fixed plate 20 The larger the displacement.
  • the eccentric 32 can be selected first, and then the eccentric 32 is driven to drive the osteotomy plate 10 to slide relative to the fixed plate 20 to the extreme position of the preset stroke.
  • the design of the groove 22 is completed by setting the end position of the groove 22 to the eccentric portion 322 of the eccentric 32.
  • the width of the left and right sides of the osteotomy plate 10 in the osteotomy device is adapted to the width of the femur B to be osteotomy, so that when the position of the osteotomy plate 10 relative to the femur B is adjusted, the femur B can be used as a basis for judging the adjustment position, thereby The femoral trochlear osteotomy groove 12 on the osteotomy plate 10 is quickly moved to oppose the femoral block of the femur B.
  • the femur B size measuring device is first used to measure the femur B size and determine the external rotation angle. Then select the appropriate type of osteotomy device according to the size of the femur B.
  • One side of the osteotomy device setting plate 20 is attached to the distal end surface of the femur B, and the osteotomy device is initially fixed by the fixing nails 21 on the fixing plate 20.
  • the left and right adjustment amount is determined by the relative positions of the both sides of the osteotomy plate 10 and the inner and outer sides of the femur B.
  • a hex wrench or similar instrument adjustment knob 31 is then used to drive the eccentric 32 to rotate.
  • the osteotomy plate 10 When the eccentric wheel 32 rotates, the osteotomy plate 10 will be driven to the right and left. After the adjustment is completed, the oblique nail is inserted into the femur B through the nail hole 13 on the osteotomy plate 10 to fix the osteotomy plate 10, thereby fixing the osteotomy plate 10 firmly by the joint action of the fixing nail 21 and the oblique nail. To avoid osteotomy errors caused by loosening. Four-sided osteotomy is then performed along the four femoral osteotomy grooves 11a, 11b, 11c, 11d using a saw blade in sequence.
  • the femoral trochlear osteotomy can be performed along the femoral truncated bone truncated groove 12 by a saw blade, or processed by a matching U-shaped osteotome.
  • the osteotomy operation is completed, the oblique nail is removed first, and then the osteotomy plate 10 is taken out through the T-shaped groove 15 on the osteotomy plate 10 by a hammer or the like to perform a subsequent femoral B test mode reset operation.
  • the osteotomy device is the osteotomy device described in any of the above embodiments.
  • the osteotomy device is mounted by this method, and the surgical operation is performed.
  • the method specifically includes the following operational steps.
  • step S200 the osteotomy device is fixed on the femur through the fixing plate.
  • step S400 the adjustment structure is adjusted such that the osteotomy plate slides to the right and left positions relative to the fixed plate.
  • step S600 four-sided osteotomy is performed along the femoral osteotomy groove.
  • step S800 the femoral trochlear osteotomy is performed along the femoral truncated osteotomy trough.
  • steps in the flowchart of FIG. 6 are sequentially displayed as indicated by the arrows, these steps are not necessarily performed in the order indicated by the arrows. Except as explicitly stated herein, the execution of these steps is not strictly limited, and the steps may be performed in other orders. Moreover, at least some of the steps in FIG. 6 may include a plurality of sub-steps or stages, which are not necessarily performed at the same time, but may be executed at different times, and the execution of these sub-steps or stages The order is also not necessarily performed sequentially, but may be performed alternately or alternately with at least a portion of the other steps or sub-steps or stages of the other steps.

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Abstract

一种截骨装置，包括截骨板(10)、固定板(20)和调节结构(30)，截骨板(10)通过固定板(20)安装在股骨(B)上，调节结构(30)的两端分别与固定板(20)和截骨板(10)相连，截骨板(10)通过调节结构(30)相对固定板(20)左右滑动；截骨板(10)具有可进行四面截骨的股骨截骨槽(11)以及可进行股骨滑车截骨的股骨滑车截骨槽(12)。利用截骨装置，在完成四面截骨操作后无需更换截骨板(10)就能继续进行股骨滑车截骨操作，有效减少器械数量，避免反复拆装；此外，截骨装置利用调节结构(30)可以便捷地调整截骨板(10)相对固定板(20)左右滑动，进而将截骨板(10)调节至股骨滑车截骨槽(12)正对股骨滑车处，提高股骨滑车截骨准确度。

Description

截骨装置及其操作方法
援引加入
本申请要求于2018年03月27日提交中国专利局、申请号为201810257229.1、发明名称为“截骨装置”的中国专利申请的优先权，其全部内容通过引用并入在本申请中。
技术领域
本申请涉及医疗器械技术领域，特别是涉及一种截骨装置及其操作方法。
背景技术
在全膝关节置换术中，股骨截骨是极其重要的步骤，因为现有股骨假体内表面为四个面，并在中部股骨滑车处向内凸起，因此医生需要将股骨处理成与假体相对应的特定形状，用以安装股骨假体，即对股骨的远端面(与假体连接的面)进行四面截骨，并在股骨滑车处形成内凹形状。在此过程中截骨板固定得是否牢靠，重复拆装截骨板是否准确等问题都将直接影响截骨的效果。
目前，医生在进行股骨前后髁处理时，往往需要分开使用不同的截骨板进行四面截骨操作和股骨滑车截骨操作。这种手术过程操作复杂，重复地装卸截骨板也极易降低截骨的准确性，增加操作失误的几率。而且分开使用多套截骨板既增加了器械数量，又增加了制造成本，同时使用时也增加了医院使用时消毒灭菌、反复搬运的维护成本。
此外，与四面截骨不同的是，股骨滑车截骨的位置必须与股骨假体滑车轨迹位置相对应，因此对股骨滑车截骨板的固定位置要求较为严苛。而目前用于股骨滑车截骨的截骨板固定后无法左右调节，也增加对医生判断置中定位的难度。由于股骨滑车是髌骨与股骨相对滑动的轨道，所以如果股骨滑车截骨的置中位置不准，发生左右偏移，会直接影响股骨假体安放的位置，更进一步还会影响假体复位后髌骨的滑动轨迹偏移，有可能造成髌骨轨迹异常、髌前疼痛等问题。
发明内容
根据本申请公开的各种实施例，提供一种截骨装置及其操作方法。
根据本申请的一个方面，提供了一种截骨装置，包括截骨板、固定板和调节结构，所述截骨板通过所述固定板安装在股骨上，所述调节结构的两端分别与所述固定板和截骨板相连，所述截骨板通过所述调节结构相对所述固定板左右滑动；所述截骨板具有可进行四面截骨的股骨截骨槽以及可进行股骨滑车截骨的股骨滑车截骨槽。
在其中一个实施例中，所述固定板的上端和下端分别设有卡齿，所述截骨板朝向所述固定板的一面设有滑槽，所述卡齿滑动卡接于所述滑槽，所述卡齿和滑槽可相对水平滑动。
在其中一个实施例中，所述调节结构包括旋钮和偏心轮，所述旋钮与所述偏心轮相连接，且与所述截骨板可旋转地相连；所述偏心轮与所述固定板相连接，且当所述旋钮转动时，所述偏心轮相对所述旋钮做偏心运动，使所述截骨板相对所述固定板左右滑动。
在其中一个实施例中，所述偏心轮包括转动连接部和偏心部，所述转动连接部与所述旋钮相连，所述偏心部偏离所述旋钮的旋转轴线设置。
在其中一个实施例中，所述固定板上开设有凹槽，所述偏心部嵌设于所述凹槽内，当所述偏心轮随所述旋钮旋转运动时，所述偏心部可沿所述凹槽上下滑动。
在其中一个实施例中，所述截骨板开设有贯穿所述截骨板的槽腔，所述槽腔与所述凹槽相连接形成连通的空腔，所述旋钮设于所述槽腔内，当偏心轮旋转时，旋钮与槽腔的侧壁相抵，带动截骨板左右滑动。
在其中一个实施例中，所述偏心轮和所述旋钮可沿轴向相对运动，且所述偏心轮径向限位于所述旋钮，所述偏心轮与所述旋钮之间设有弹性压缩件，所述弹性压缩件的两端分别弹性抵接于所述偏心轮和所述旋钮。
在其中一个实施例中，所述旋钮呈阶梯状，靠近所述偏心轮的一端具有插接部，另一端具有卡齿盘；所述偏心轮的转动连接部开设有与所述插接部相适 配的插槽，所述槽腔远离所述固定板的一端具有齿状开口，所述卡齿盘可沿所述旋钮的旋转轴线嵌入或移出所述齿状开口，且当所述卡齿盘嵌入所述齿状开口时，所述齿状开口限制所述旋钮相对所述截骨板旋转运动。
在其中一个实施例中，所述凹槽的底部设有贯穿所述固定板的穿孔。
在其中一个实施例中，所述槽腔靠近所述固定板的一端具有限位槽，当偏心轮运动至满足调节结构对截骨板行程调节需要的极限位置时，偏心轮与限位槽的端部相抵而不能继续偏转运动。
在其中一个实施例中，所述固定板远离所述截骨板的一侧设有固定钉，所述固定钉用于将所述固定板安装在所述股骨上。
上述截骨装置中，截骨板具有可进行四面截骨的股骨截骨槽以及可进行股骨滑车截骨的股骨滑车截骨槽，从而在完成四面截骨操作后无需更换截骨板就能继续进行股骨滑车截骨操作，有效减少器械数量，避免反复拆装，简化了操作步骤；此外，该截骨装置，利用调节结构可以便捷地调整截骨板相对固定板左右滑动，进而将截骨板调节至股骨滑车截骨槽正对股骨滑车处，提高股骨滑车截骨准确度，避免了股骨滑车截骨位置不准而影响假体复位后髌骨的滑动轨迹异常。
另一方面，本申请中，固定板远离所述截骨板的一侧设有固定钉。通过固定板上的固定钉可提供给截骨板初始固定，从而在医生通过调节结构左右调节截骨板的置中位置的过程中，增加截骨板的稳定性。在确定置中后，该固定钉通过与打入的斜钉配合，对截骨板进行完全固定，以保证截骨时的稳定以及截骨的准确。
根据本申请的另一个方面，提供了一种操作上述方面的截骨装置的方法，所述方法包括：将所述截骨装置通过所述固定板固定在所述股骨上；调节所述调节结构，使得所述截骨板相对所述固定板左右滑动至合适位置；沿着所述股骨截骨槽进行四面截骨；及沿着所述股骨滑车截骨槽进行股骨滑车截骨。
附图说明
为了更清楚地说明本申请实施例或现有技术中的技术方案，下面将对实施 例或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本申请的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他实施例的附图。
图1为一实施方式中截骨装置结构爆炸示意图；
图2为图1示出的截骨装置的截骨板与固定板的装配结构示意图；
图3为图2示出的截骨装置的剖面结构示意图；
图4为一实施方式中截骨装置安装至股骨时的结构示意图；
图5为沿图4中线A-A的剖视示意图；
图6为一实施方式中操作截骨装置的方法的流程示意图。
具体实施方式
为了便于理解本申请，下面将参照相关附图对本申请进行更全面的描述。附图中给出了本申请的较佳实施方式。但是，本申请可以以许多不同的形式来实现，并不限于本文所描述的实施方式。相反地，提供这些实施方式的目的是使对本申请的公开内容理解的更加透彻全面。
为了更加清楚地描述上述器械的结构，本申请限定术语“远端”和“近端”，上述术语为医疗器械领域的惯用术语。具体而言，“远端”表示手术过程中远离操作者的一端，“近端”表示手术过程中靠近操作者的一端。以图5为例，图5的右侧为远端，左侧为近端。
需要说明的是，当元件被称为“固定于”另一个元件，它可以直接在另一个元件上或者也可以存在居中的元件。当一个元件被认为是“连接”另一个元件，它可以是直接连接到另一个元件或者可能同时存在居中元件，所述“连接”也包括可拆卸的连接。本文所使用的术语“内”、“外”、“左”、“右”以及类似的表述只是为了说明的目的，并不表示是唯一的实施方式。
请参阅图1和图2，一实施方式中的截骨装置包括截骨板10、固定板20和调节结构30。截骨板10通过固定板20安装在股骨B上，且可相对固定板20左右滑动，即该截骨装置可以调整截骨板10相对股骨B的左右位置，以便在合适位置实施截骨。此处所述左右位置的定义如下：参见图1和图5，截骨装置贴 合于股骨B的远端面，所述股骨B的远端面所在的平面上，与截骨槽11a平行的方向为左右方向，即水平方向，与水平方向垂直的方向为上下方向，即垂直方向。
该实施方式中，截骨板10具有可进行四面截骨的股骨截骨槽11，具体为股骨截骨槽11a、11b、11c、11d。截骨板10还具有可进行股骨滑车截骨的股骨滑车截骨槽12。调节结构30被配置为驱动截骨板10相对固定板20左右滑动，以调节截骨板10与股骨B的相对位置，以便锯片等截骨工具分别沿股骨截骨槽11a、11b、11c、11d进行四面截骨，同时股骨滑车截骨槽12可供截骨工具进行股骨滑车截骨。
上述实施方式中，由于调节结构30可以调整截骨板10相对股骨B的位置，因此可以将截骨板10调整至股骨滑车截骨槽12正对股骨滑车处，以确保股骨滑车截骨的位置与股骨B假体滑车的运动轨迹相对应，避免了股骨滑车截骨位置不准而影响假体复位后髌骨的滑动轨迹异常。此外，由于利用该截骨装置可以一并完成四面截骨和股骨滑车截骨操作，即在完成四面截骨操作后，不需要拆装更换截骨板10便能继续进行股骨滑车截骨操作。这样使得操作过程更加准确，减少手术时间，提高手术操作效率，并且避免了传统全膝关节置换术中需要分别利用四面截骨板10和股骨滑车截骨板10进行截骨操作，有效减少器械数量，简化了操作步骤，及降低了手术和维护成本。
需要说明的是，在一些实施方式中，截骨板10为对称结构，以与股骨B相适应，以便在对应的位置实施截骨操作。该实施方式中，股骨滑车截骨槽12设置在截骨板10的中部位置，以便将截骨板10调整至股骨B居中位置时，股骨滑车截骨槽12正对股骨滑车处，这种设置便于快速调整截骨板10相对股骨B的左右移动至股骨滑车截骨槽12处于居中位置，以便对股骨滑车进行截骨操作，提高调节效率，同时避免了股骨滑车截骨的位置不会出现偏差，提高手术效果。
截骨板10和固定板20在彼此靠近的表面上(即截骨板10的近端面和固定板10的远端面)分别设有相配合的滑动连接结构。结合图3所示，在一些实施方式中，固定板20的上端和下端分别设有延水平方向延伸的卡齿20a、20b，并且截骨板10朝向固定板20的一面与卡齿20a、20b对应的位置设有延水平方向 延伸的滑槽10a、10b，其中，卡齿20a滑动卡接于滑槽10a，而卡齿20b滑动卡接于滑槽10b。该实施方式中，由于固定板20上的卡齿20a、20b通过滑动卡接的方式与截骨板10上的滑槽10a、10b相配合，因此在实现截骨板10相对固定板20滑动的同时，固定板20对截骨板10在上下方向具有较好的支撑作用，从而使得截骨板10相对固定板20左右滑动时具有较好的稳定性，以确保截骨位置调整的准确性。本实施方式中的卡齿20a可以是一条连续的卡齿，也可以由2条以上间断的卡齿组成(如图3所示)，后一种情况下，卡齿20a也可以由2个以上的柱状物组成。卡齿20b亦然。在另一些实施方式中，也可以是固定板20的上下端分别设有滑槽，而截骨板10朝向固定板20的一面设有与滑槽相配合的卡齿。滑槽和卡齿也可以替换成其他滑动连接结构，只要能够实现固定板20和截骨板10之间的相对水平滑动即可。例如，固定板20和截骨板10的结合面上分别设有滑动配合的滑块和滑槽，从而滑块沿滑槽滑动时，截骨板10也可以相对固定板20滑动，从而在固定板20将截骨板10安装到股骨B上时，截骨板10以滑动的方式调整与股骨B的相对位置，以满足截骨需要，在此不再一一赘述。
在一些实施方式中，固定板20远离截骨板10的一侧设有固定钉21，从而可以利用该固定钉21对截骨装置进行预固定。
需要说明的是，固定钉21的数量不受限制。在本实施方式中，固定钉21为2根，该2根固定钉21左右对称的设置在固定板20上。固定钉21可以是柱状尖钉，以便于钉入股骨B，同时具有较好的稳定性。此外，截骨板10的两侧倾斜地设有钉孔13，以便在通过调节结构30调整好截骨板10与股骨B的相对位置后，穿过钉孔13的钉子等固定件可以打入股骨B对截骨装置进行定位，从而确保截骨操作时的稳定性，提高截骨的准确性。
截骨板10上适应性开设有镂空部，以减轻重量。镂空部的形状和数量及位置不受限制，可以在不影响截骨板10的强度以及截骨作业的情况下设置多个。在另一些实施例中，可以在截骨板10上对称的设置偶数个镂空部。参见图2，该实施方式中，截骨板10远离固定板20的一侧设有T形槽15，以便在截骨操作后，通过滑锤等与该T形槽15相配合的工具将截骨板10取出。
再如图1所示，调节结构30包括旋钮31和偏心轮32，其中，旋钮31与偏心轮32相连接，且与截骨板10可旋转地相连，而偏心轮32与固定板20相连接。当旋钮31转动时，偏心轮32相对旋钮31做偏心运动，使截骨板10相对固定板20左右滑动。
偏心轮32包括转动连接部321和偏心部322，转动连接部321与旋钮31相连，偏心部322偏离旋钮31的旋转轴线设置。该实施方式中，固定板20上开设有凹槽22，偏心部322嵌设于凹槽22内。当偏心轮32随旋钮31旋转运动时，由于卡齿20a、20b与滑槽10a、10b相互卡接的限制作用，固定板20与截骨板10不会在上下方向上产生相对位移，而是偏心部322沿凹槽22上下滑动，从而偏心轮32做偏心运动时，上下位移量的变化不会与固定板20产生干涉。可以理解的，该凹槽22可以是具有上下延伸趋势的长条形槽或腰型槽。
凹槽22的延伸方向与截骨板10相对固定板20的滑动方向垂直，从而使得偏心部322随旋钮31运动时与固定板20之间的作用力沿左右方向，使得截骨板10与固定板20之间具有较好的左右滑动效果。
如图3所示，截骨板10开设有贯穿截骨板10的槽腔10c，当固定板20与截骨板10相配合时，槽腔10c与凹槽22的位置相对应，即槽腔10c与凹槽22相连接形成一个连通的空腔，用于容纳调节结构30。旋钮31设于槽腔10c内。在旋拧旋钮31时，由于偏心轮32相对旋钮31偏心运动，从而偏心轮32作用到旋钮31的相互作用力会促使旋钮31抵持槽腔10c的侧壁，使截骨板10相对固定板20沿滑槽10a、10b左右滑动。
偏心轮32和旋钮31可沿轴向相对运动，且偏心轮32径向限位于旋钮31。偏心轮32与旋钮31之间设有弹性压缩件33，弹性压缩件33的两端分别弹性抵接于偏心轮32和旋钮31。此处所述轴向和径向如下定义：参见图5，截骨装置贴合于股骨B的远端面(截骨面)，与截骨面垂直的方向(即与旋钮31的旋转轴平行的方向)为轴向，与轴向垂直的方向为径向。此处弹性压缩件33可以是压缩弹簧，也可以是具有较好收缩性能的弹性圈。
该实施方式中，由于偏心轮32和旋钮31可沿轴向相对运动，因此可以分别抵压偏心轮32和旋钮31远离弹性压缩件33的一端对弹性压缩件33进行压 缩，改变偏心轮32与旋钮31的轴向间距，从而避免在装配固定板20与截骨板10时，偏心轮32干涉固定板20。同时，固定板20与截骨板10装配好后，由于弹性压缩件33的两端分别弹性抵接于偏心轮32和旋钮31，因此偏心轮32在弹性压缩件33的作用下抵入凹槽22。由于偏心轮32径向限位于旋钮31，因此旋拧旋钮31时，偏心轮32将随旋钮31转动，以驱使截骨板10和固定板20在左右方向相对滑动，调整截骨板10相对股骨B的左右位置，以便在合适的位置进行截骨操作。
凹槽22的底部可以设有贯穿固定板20的穿孔22a。由此，通过该穿孔22a按压偏心轮32，使偏心轮32压缩弹性压缩件33远离固定板20，最终使得偏心轮32的偏心部322移出凹槽22。此时，固定板20没有偏心轮32在左右方向的约束，从而可以将固定板20和截骨板10沿滑槽10a、10b彼此滑离。
旋钮31可以呈阶梯状，其靠近偏心轮32的一端具有插接部311，另一端具有卡齿盘312。偏心轮32的转动连接部321开设有与插接部311相适配的插槽321a。可以理解的，插槽321a与插接部311的截面形状可以为非圆形，例如为矩形、圆角矩形等等，从而可以确保偏心轮32和旋钮31之间径向限位而轴向可以相对运动。
该实施方式中，槽腔10c远离固定板20的一端具有齿状开口14，卡齿盘312可沿旋钮31的旋转轴线嵌入或移出齿状开口14。当卡齿盘312嵌入齿状开口14时，齿状开口14限制旋钮31相对截骨板10旋转运动，以锁定截骨板10与固定板20的相对位置，从而避免操作失误或安装截骨装置时，截骨板10和固定板20之间出现移位。
需要说明的是，上述实施方式中，抵压旋钮31压缩弹性压缩件33时，卡齿盘312会随着旋钮31向固定板20移动而移出齿状开口14，进而解除卡齿盘312与齿状开口14的配合，使得旋钮31可以相对截骨板10旋转运动，从而调整截骨板10与固定板20的在水平方向上的相对位置，且将截骨板10上的股骨滑车截骨槽12对准股骨滑车进行截骨操作。
卡齿盘312的端面上设有操作部312a，以便利用与该操作部312a配合的工具旋拧旋钮31。操作部312a可以是六角沉孔。相应的，通过与该六角沉孔相配 合的扳手或起子等工具便可以旋拧旋钮31，以通过偏心轮32的偏心运动驱使截骨板10相对固定板20左右滑动，从而对截骨板10相对股骨B的左右位置进行调整，使得股骨滑车截骨槽12相对股骨B处于居中位置，以便锯片等截骨工具沿股骨滑车截骨槽12对股骨滑车进行准确截骨操作。
槽腔10c靠近固定板20的一端具有限位槽10d。利用限位槽10d对偏心轮32随旋钮31的转动幅度进行限位，从而限制截骨板10与固定板20之间的相对位移，使得截骨板10相对股骨B左右调节的行程较为适宜，防止截骨板10左右滑动过多而使得卡齿20a、20b脱出滑槽10a、10b，或者卡齿20a、20b与滑槽10a、10b接触面过小而影响器械整体的固定。具体的，当偏心轮32运动至满足调节结构30对截骨板10行程调节需要的极限位置时，偏心轮32与限位槽10d的端部相抵而不能继续偏转运动。
需要说明的是，在另一些实施方式中，也可以不设置限位槽，而是通过对凹槽22尺寸的设计来实现对偏心轮32转动幅度的限位。具体的，将凹槽22设置成当偏心轮32运动至满足调节结构30对截骨板10行程调节需要时的极限位置时，偏心轮32与凹槽22的端部相抵而不能继续偏转运动，从而对偏心轮32的转动幅度也能达到较好的限位效果。
此外，对于偏心轮32驱使截骨板10相对固定板20左右滑动的行程还受偏心轮32自身偏心运动时偏离旋钮31的旋转轴线的偏移量影响。具体的，偏心轮32的偏心部322的转动轨迹偏离旋钮31的旋转轴线的偏移量越大，在旋拧旋钮31相同角度时，偏心轮32驱使截骨板10相对固定板20左右滑动的位移量越大。由此，可以先选定偏心轮32，再模拟偏心轮32驱动截骨板10相对固定板20滑动至预设行程的极限位置。此时，将凹槽22的端部位置设定在与偏心轮32的偏心部322相抵即可完成凹槽22尺寸的设计。
将截骨装置中的截骨板10左右宽度与待截骨操作的股骨B宽度相适应，以便在调节截骨板10相对股骨B的位置时，可以以股骨B作为判断调节位置的依据，从而快速地将截骨板10上的股骨滑车截骨槽12移至与股骨B的股骨滑车处相对。
结合图4和图5所示，利用该截骨装置进行手术操作时，先使用股骨B尺 寸测量器测量股骨B大小并确定外旋角。随后根据股骨B大小选取合适型号的截骨装置。将截骨装置设置固定板20的一面贴住股骨B远端面，并且利用固定板20上的固定钉21对截骨装置进行初步固定。通过截骨板10两侧与股骨B内外侧的相对位置来进行判断左右调节量。随后使用六角扳手或类似器械调节旋钮31带动偏心轮32转动。偏心轮32转动时将带动截骨板10左右偏移至合适位置。调节完成后，穿过截骨板10上的钉孔13将斜钉钉入股骨B，以对截骨板10进行固定，从而通过固定钉21和斜钉的共同作用将截骨板10固定牢靠，避免松动引起的截骨失误。随后使用锯片依次沿着四条股骨截骨槽11a、11b、11c、11d进行四面截骨。完成四面截骨后，可通过锯片沿股骨滑车截骨槽12进行股骨滑车截骨，或者通过匹配的U形骨凿进行处理。完成截骨操作后，先取出斜钉，随后通过滑锤等取出工具经截骨板10上的T形槽15将截骨板10取出，以便进行后续的股骨B试模复位操作。
如图6所示，示出了一种操作截骨装置的方法的实施例。在该实施例中，该截骨装置为上述任意一实施例中所述的截骨装置。通过该方法将截骨装置进行安装，进而进行手术操作。该方法具体包括以下操作步骤。
步骤S200，将所述截骨装置通过所述固定板固定在所述股骨上。
步骤S400，调节所述调节结构，使得所述截骨板相对所述固定板左右滑动至合适位置。
步骤S600，沿着所述股骨截骨槽进行四面截骨。
步骤S800，沿着所述股骨滑车截骨槽进行股骨滑车截骨。
上述步骤在上面的描述中已经做了具体地阐述，这里不再一一赘述。
需要注意的是，应该理解的是，虽然图6中的流程图中的各个步骤按照箭头的指示依次显示，但是这些步骤并不是必然按照箭头指示的顺序依次执行。除非本文中有明确的说明，这些步骤的执行并没有严格的顺序限制，这些步骤可以以其它的顺序执行。而且，图6中的至少一部分步骤可以包括多个子步骤或者多个阶段，这些子步骤或者阶段并不必然是在同一时刻执行完成，而是可以在不同的时刻执行，这些子步骤或者阶段的执行顺序也不必是依次进行，而 是可以与其它步骤或者其它步骤的子步骤或者阶段的至少一部分轮流或者交替地执行。
以上所述实施例的各技术特征可以进行任意的组合，为使描述简洁，未对上述实施例中的各个技术特征所有可能的组合都进行描述，然而，只要这些技术特征的组合不存在矛盾，都应当认为是本说明书记载的范围。
以上所述实施例仅表达了本申请的几种实施方式，其描述较为具体和详细，但并不能因此而理解为对发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本申请构思的前提下，还可以做出若干变形和改进，这些都属于本申请的保护范围。因此，本申请专利的保护范围应以所附权利要求为准。

Claims (12)

  1. 一种截骨装置，包括：
    固定板；
    截骨板，配置为通过所述固定板安装在股骨上；及
    调节结构，所述调节结构的两端分别被配置为与所述固定板和截骨板相连，所述截骨板通过所述调节结构能够相对所述固定板左右滑动；
    其中，所述截骨板具有可进行四面截骨的股骨截骨槽以及可进行股骨滑车截骨的股骨滑车截骨槽。
  2. 根据权利要求1所述的截骨装置，其中，所述固定板的上端和下端分别设有卡齿，所述截骨板朝向所述固定板的一面设有滑槽，所述卡齿滑动卡接于所述滑槽，所述卡齿和滑槽可相对水平滑动。
  3. 根据权利要求1或2所述的截骨装置，其中，所述调节结构包括：
    偏心轮，所述偏心轮与所述固定板相连接；及
    旋钮，所述旋钮与所述偏心轮相连接，且与所述截骨板可旋转地相连；
    其中，当所述旋钮转动时，所述偏心轮相对所述旋钮做偏心运动，使所述截骨板相对所述固定板左右滑动。
  4. 根据权利要求3所述的截骨装置，其中，所述偏心轮包括：
    转动连接部，所述转动连接部与所述旋钮相连；及
    偏心部，所述偏心部偏离所述旋钮的旋转轴线设置。
  5. 根据权利要求4所述的截骨装置，其中，所述固定板上开设有凹槽，所述偏心部嵌设于所述凹槽内；
    其中，当所述偏心轮随所述旋钮旋转运动时，所述偏心部可沿所述凹槽上下滑动。
  6. 根据权利要求5所述的截骨装置，其中，所述截骨板开设有贯穿所述截骨板的槽腔，所述槽腔与所述凹槽相连接形成连通的空腔，所述旋钮设于所述槽腔内；
    其中，当偏心轮旋转时，旋钮与槽腔的侧壁相抵，带动截骨板左右滑动。
  7. 根据权利要求3所述的截骨装置，其中，所述偏心轮和所述旋钮可沿轴向相对运动，且所述偏心轮径向限位于所述旋钮；所述偏心轮与所述旋钮之间设有弹性压缩件，所述弹性压缩件的两端分别弹性抵接于所述偏心轮和所述旋钮。
  8. 根据权利要求6所述的截骨装置，其中，所述旋钮呈阶梯状，靠近所述偏心轮的一端具有插接部，另一端具有卡齿盘；所述偏心轮的转动连接部开设有与所述插接部相适配的插槽，所述槽腔远离所述固定板的一端具有齿状开口，所述卡齿盘可沿所述旋钮的旋转轴线嵌入或移出所述齿状开口，且当所述卡齿盘嵌入所述齿状开口时，所述齿状开口限制所述旋钮相对所述截骨板旋转运动。
  9. 根据权利要求5所述的截骨装置，其中，所述凹槽的底部设有贯穿所述固定板的穿孔。
  10. 根据权利要求6所述的截骨装置，其中，所述槽腔靠近所述固定板的一端具有限位槽，当偏心轮运动至满足调节结构对截骨板行程调节需要的极限位置时，偏心轮与限位槽的端部相抵而不能继续偏转运动。
  11. 根据权利要求1所述的截骨装置，其中，所述固定板远离所述截骨板的一侧设有固定钉，所述固定钉用于将所述固定板安装在所述股骨上。
  12. 一种操作截骨装置的方法，所述截骨装置包括固定板、配置为通过所述固定板安装在股骨上的截骨板、以及调节结构，所述调节结构的两端分别被配置为与所述固定板和截骨板相连，所述截骨板通过所述调节结构能够相对所述固定板左右滑动，所述截骨板具有可进行四面截骨的股骨截骨槽以及可进行股骨滑车截骨的股骨滑车截骨槽，所述方法包括：
    将所述截骨装置通过所述固定板固定在所述股骨上；
    调节所述调节结构，使得所述截骨板相对所述固定板左右滑动至合适位置；
    沿着所述股骨截骨槽进行四面截骨；及
    沿着所述股骨滑车截骨槽进行股骨滑车截骨。
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