CN111658176B - Accurate positioner for double-nail fixing position of Mayfield headstock - Google Patents
Accurate positioner for double-nail fixing position of Mayfield headstock Download PDFInfo
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- CN111658176B CN111658176B CN202010664113.7A CN202010664113A CN111658176B CN 111658176 B CN111658176 B CN 111658176B CN 202010664113 A CN202010664113 A CN 202010664113A CN 111658176 B CN111658176 B CN 111658176B
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- 210000003625 skull Anatomy 0.000 claims abstract description 58
- 230000005489 elastic deformation Effects 0.000 claims description 3
- 239000000463 material Substances 0.000 claims description 3
- 239000003550 marker Substances 0.000 claims 1
- 206010003497 Asphyxia Diseases 0.000 description 4
- 208000020431 spinal cord injury Diseases 0.000 description 4
- 206010033799 Paralysis Diseases 0.000 description 3
- 230000001815 facial effect Effects 0.000 description 3
- 230000000642 iatrogenic effect Effects 0.000 description 3
- 210000003205 muscle Anatomy 0.000 description 3
- 230000000007 visual effect Effects 0.000 description 3
- 208000028979 Skull fracture Diseases 0.000 description 2
- 210000004204 blood vessel Anatomy 0.000 description 2
- 210000005036 nerve Anatomy 0.000 description 2
- 210000001782 transverse sinus Anatomy 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 206010019233 Headaches Diseases 0.000 description 1
- 208000032843 Hemorrhage Diseases 0.000 description 1
- 206010059491 Intracranial haematoma Diseases 0.000 description 1
- 206010057268 Spinal cord paralysis Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000002146 bilateral effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000002950 deficient Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 231100000869 headache Toxicity 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 210000003582 temporal bone Anatomy 0.000 description 1
- 210000000966 temporal muscle Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
- A61B2090/3916—Bone tissue
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Veterinary Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Neurosurgery (AREA)
- Surgical Instruments (AREA)
Abstract
本发明公开一种Mayfield头架双钉固定位置精准定位器，包括定位器本体，定位器本体包括弧面，弧面与Mayfield头架的双钉侧的摇臂的内弧面形状、尺寸相同，弧面设有中心定位杆和两个颅骨钉定位杆，中心定位杆、颅骨钉定位杆的前端均有标记装置，两个颅骨钉定位杆分别位于与摇臂上的两个颅骨钉的相同的位置，颅骨钉定位杆的轴向与颅骨钉的轴向相同，两个颅骨钉定位杆相对于中心定位杆的轴线对称，中心定位杆、颅骨钉定位杆的前端均位于弧面的内侧。本发明可以增加定位的准确性、可靠性和便捷性，将中心定位杆插到耳廓后上方2.5cm皮肤处，将之前的“虚拟点”变为直观定位点，可以直观精准地确定中心点，方便观察中心点是否与单钉侧水平。
The invention discloses a Mayfield head frame double-nail fixed position precise positioner, comprising a positioner body, the positioner body comprising an arc surface, and the arc surface and the inner arc surface of the double-nail side rocker of the Mayfield head frame have the same shape and size. The arc surface is provided with a central positioning rod and two skull nail positioning rods. The front end of the central positioning rod and the skull nail positioning rod are provided with marking devices. The two skull nail positioning rods are respectively located at the same position as the two skull nails on the rocker arm. Position, the axial direction of the skull nail positioning rod is the same as the axial direction of the skull nail, the two skull nail positioning rods are symmetrical with the axis of the central positioning rod, and the front ends of the central positioning rod and the skull nail positioning rod are located on the inner side of the arc surface. The invention can increase the accuracy, reliability and convenience of positioning, insert the center positioning rod into the skin 2.5cm above the back of the auricle, and change the previous "virtual point" into an intuitive positioning point, and the center point can be determined intuitively and accurately , it is convenient to observe whether the center point is level with the single nail side.
Description
Technical Field
The invention relates to a medical instrument, in particular to a Mayfield headstock double-nail fixing position precise positioner.
Background
The head frame system is commonly used for orthopedic or neurosurgical operations and is used for maintaining the position of the head and neck during operations and adjusting the central axis and the posture of the operations. The Mayfield headgear is a common headgear fixation system in the clinic. When the head is placed in a prone position, a Mayfield head frame is required to be selected to fix the position of the head, and then the head is stably fixed in the air. How to reliably and stably fix the head of the patient to keep the normal axis of the spine, provide the optimal operation visual field for the operator, and ensure the safe and smooth operation becomes one of the key problems of the posture. The Mayfield head frame has the advantages of conveniently adjusting the position of the cervical vertebra, avoiding the pressure injury of the facial skin, conveniently observing the condition of a patient in the operation, managing anesthesia and the like.
As shown in figures 1 and 2, the current Mayfield headstock consists of a connector 5 connected with an operating table, a base 6, a three-nail headstock and three skull nails 1, wherein the three-nail headstock comprises a rocker arm 7 at the double-nail side, a fixing screw 2, a skull fixing semi-ring groove 3 and a one-way east China restriction nail 4, and the rocker arm 7 comprises an inner cambered surface 8.
As shown in fig. 3 and 4, in addition to the pressure requirement for the three fixed nails on the semi-circular groove when the operator installs the head frame, the positions of the nail holes are selected only according to the standard used by neurosurgeons: the double-nail side fixing nail with the nail arm capable of rotating is firmly placed on the skull of the patient by 2.5cm above the back of the auricle at the two sides, pressure is applied to the single nail arm at the opposite side, and then the semi-ring groove is connected with the base of the Mayfield head frame which is fixed on the operating bed. In order to realize reliable fixation, the central point of the double-nail side and the single-nail side are required to be arranged at the 2.5cm position of the upper edge of the auricle and positioned on the maximum transverse diameter of the skull of a patient as far as possible, so that the fixation failure caused by the sliding of the fixing nail in the operation and the risk of paralysis and even death caused by asphyxia due to the increase of spinal cord injury are avoided. The girdle area in fig. 3 is the area of penetration of the cranial nail.
1. In clinical practice, the nail feeding point on the single nail side is easy to determine, the positioning of the nail feeding points on the double nail side is difficult, the nail feeding points are often selected by the naked eyes and experience of an operator, especially, the experience of a young doctor is insufficient, the double top side nails are often ignored due to the single nail side nails, so that the positions of the double side fixing nails are deviated from the front or the back, the central axis of the double nail side and the single nail side are not on the same equatorial line, the stability of the fixed head and the skull is potentially influenced in the prone position, the risks of head frame collapse and fixing failure are caused in the operation, and the risk of paralysis and even suffocation death caused by iatrogenic spinal cord injury is increased.
2. The reason why the double nail side position is not good is that: (1) the center point of the double-nail side is a virtual point, and the 2.5cm position of the upper edge of the auricle positioned by the virtual point is easy to have deviation.
3. Risk of poor double nail side position: (1) in order to pursue the cervical curvature during the operation, the surgeon selects the position of the bilateral nail to be forward, and the surgeon can puncture the skull on the thin temporal bone at the front lower part of the circumference to increase serious complications such as skull fracture, intracranial hematoma and the like. (2) The distance between the top point of the semi-ring groove and the nose is increased by fixing the double-nail side position on the rear half part of the circumference, the radius of the semi-ring groove is fixed, the risk that the semi-ring groove is in contact with the facial structure and clamped and pressed on the nose exists in the prone position, and a cushion needs to be applied to the nose before the disinfection towel is spread to prevent the facial skin of a patient from being pressed. (3) Poor fixation affects the stability of the head part, risks of head frame collapse and fixation failure exist in the operation, and the risk of paralysis and even death by suffocation caused by iatrogenic spinal cord injury is increased.
Disclosure of Invention
The invention aims to provide a Mayfield headstock double-nail fixing position accurate positioner which can increase the positioning accuracy, reliability and convenience, a central positioning rod is inserted into the skin 2.5cm above the back of an auricle, a former virtual point is changed into a visual positioning point, a central point can be visually and accurately determined, and whether the central point is horizontal to a single nail side or not can be conveniently observed.
In order to achieve the purpose, the invention is realized by adopting the following technical scheme:
the invention discloses a Mayfield headstock double-nail fixing position accurate positioner which comprises a positioner body, wherein the positioner body comprises an arc surface, the shape and the size of the arc surface are the same as those of an inner arc surface of a rocker arm at the double-nail side of a Mayfield headstock, the arc surface is provided with a central positioning rod and two skull nail positioning rods, the front ends of the central positioning rod and the skull nail positioning rods are respectively provided with a marking device, the two skull nail positioning rods are respectively positioned at the same positions of two skull nails on the rocker arm, the axial direction of the skull nail positioning rods is the same as that of a skull nail, the two skull nail positioning rods are symmetrical relative to the axis of the central positioning rod, and the front ends of the central positioning rod and the skull nail positioning rods are positioned at the inner side.
Preferably, the length of the skull nail positioning rod on the inner side of the cambered surface is the same as the length of the skull nail on the inner cambered surface side of the rocker arm.
Preferably, the marking device is a marking pen.
Preferably, the skull nail positioning rod comprises an elastic section, and the elastic deformation direction of the elastic section is the axial direction of the skull nail positioning rod.
Preferably, the front end of the central positioning rod does not exceed the connecting line of the front ends of the two skull nail positioning rods.
Further preferably, the elastic section is a spring.
Preferably, the front end of the central positioning rod is needle-point-shaped.
Preferably, the front end of the central positioning rod is made of flexible materials.
Further preferably, the central positioning rod is a positioning pin.
Preferably, the center positioning rod and the skull nail positioning rod penetrate through a through hole in the positioner body.
The use method of the invention comprises the following steps: the center point position of the visual central positioning rod and the position of the unilateral nail are horizontally marked through the central positioning rod, then a circumference is drawn around the mark of the central positioning rod after the locator body is rotated, blood vessels, nerves, thinner and defective skull, temporal muscle, occipital muscle groups, transverse sinuses, sagittal sinuses and other dangerous areas are avoided on the circumference, then the double-side nail fixing points are determined and selected, and finally the positions of the double-side nail implanting are automatically marked in the safety area of the circumference.
The invention has the following beneficial effects:
1. the invention can increase the accuracy, reliability and convenience of positioning, the central positioning rod is inserted into the skin 2.5cm above the back of the auricle, the former virtual point is changed into an intuitive positioning point, the central point can be intuitively and accurately determined, whether the central point is horizontal to the side of a single nail or not can be conveniently observed, the problems of insufficient experience of young doctors, easy fixed inclination of the head frame and unstable head frame fixation are solved, the risks of collapse and fixation failure of the head frame in the operation are reduced, and the risks of iatrogenic spinal cord injury, paralysis and even suffocation death of patients caused by improper fixation are reduced.
2. The invention can reduce the compression risk of the face and the nose during the operation: after the double-nail side positioning points are automatically marked, the semi-ring groove can be placed at the marked position in advance, and then the distance between the peak of the semi-ring groove and the nose is visually measured or actually measured, so that the phenomenon that the face and the nose are pressed after the prone position is effectively avoided.
3. After the central point is determined, a circumference can be drawn by the central point, and dangerous areas such as blood vessels, nerves, thinner skull, defects, temporalis muscle, occipital muscle groups, transverse sinuses, sagittal sinuses, skull fracture and the like can be avoided before the positions of the fixing nails on two sides are selected, so that the positions of the double nails are ensured to be automatically marked after the safety area, and the occurrence of complications of nail hole bleeding after the head nails are implanted, slippage of a nail path in an operation and headache after the operation can be effectively reduced.
4. The invention has simple use, reduces the difficulty of Mayfield headstock fixing operation, reduces the learning curve, and has convenient marking due to the marking pens arranged at the two ends and the central positioning point of the model.
Drawings
FIG. 1 is a schematic diagram of a Mayfield headgear configuration;
FIG. 2 is a schematic view of a Mayfield headgear in use;
FIG. 3 is a schematic view of a normal theoretical staple placement area;
FIG. 4 is a schematic view of a skull nail of the Mayfield headgear;
FIG. 5 is a schematic structural view of the present invention;
FIG. 6 is a schematic view of the positioning of a cranial screw using a retrograde Mayfield headgear of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail below with reference to the accompanying drawings.
As shown in fig. 4, the present invention is primarily directed to a module designed to locate and determine a center point of a set pin and an accurate and safe area for the set pin.
As shown in fig. 5, the accurate positioner for fixing the positions of the two nails of the Mayfield headstock disclosed by the invention comprises a positioner body 20, wherein the positioner body 20 comprises an arc surface 21, the arc surface has the same shape and size as the inner arc surface of the rocker arm at the double-nail side of the Mayfield headstock, the arc surface 21 is provided with a central positioning rod 22 and two skull nail positioning rods 23, the front ends of the central positioning rod 22 and the skull nail positioning rods 23 are respectively provided with a marking device 24, the marking device 24 in the embodiment adopts a marking pen, the two skull nail positioning rods 23 are respectively positioned at the same positions as the two skull nails on the rocker arm, the axial direction of the skull nail positioning rods 23 is the same as the axial direction of the skull nails, the two skull nail positioning rods 23 are symmetrical relative to the axis of the central positioning rod 22, and the front ends of the central positioning rod 22 and the skull nail positioning rods; the length of the skull nail positioning rod 23 positioned on the inner side of the cambered surface 21 is the same as the length of the skull nail positioned on the inner cambered surface side of the rocker arm.
The skull nail positioning rod 23 comprises an elastic section 25, the elastic deformation direction of the elastic section 25 is the axial direction of the skull nail positioning rod 23, and the elastic section 25 adopts a spring in the embodiment, because the human craniofacial part is not a horizontal plane, the length of the front end of the skull nail positioning rod 23 is variable, and the front end is softer, so that the skin of a patient cannot be damaged; the front end of the central positioning rod 22 does not exceed the connecting line of the front ends of the two skull nail positioning rods 23. The front end of the central positioning rod 22 is in a needle point shape, in the embodiment, the central positioning rod 22 adopts a positioning needle, and the front end of the central positioning rod 22 is made of a flexible material and does not puncture skin; the center positioning rod 22 and the skull nail positioning rod 23 penetrate through the through hole on the positioner body 20.
As shown in fig. 6, the skull nail can be accurately positioned by adopting the invention, the circular area in fig. 6 is the ideal nailing area of the skull nail, and the circle center of the circular area is the ideal nailing position of the single-side nail.
The present invention is capable of other embodiments, and various changes and modifications may be made by one skilled in the art without departing from the spirit and scope of the invention.
Claims (9)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010664113.7A CN111658176B (en) | 2020-07-10 | 2020-07-10 | Accurate positioner for double-nail fixing position of Mayfield headstock |
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| CN202010664113.7A CN111658176B (en) | 2020-07-10 | 2020-07-10 | Accurate positioner for double-nail fixing position of Mayfield headstock |
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| CN111658176A CN111658176A (en) | 2020-09-15 |
| CN111658176B true CN111658176B (en) | 2021-07-09 |
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| CN119700331B (en) * | 2025-02-26 | 2025-05-16 | 广州市文翰科学仪器有限公司 | A neurointervention head and neck support device |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| NO313573B1 (en) * | 2000-01-06 | 2002-10-28 | Medinnova Sf | Tools for use in brain operations, as well as a system for determining the insertion depth of a probe or similar brain operations and the coordinates of the tool and probe brain operations |
| CN2776327Y (en) * | 2005-04-05 | 2006-05-03 | 杨惠林 | Location guiding device for pyramis puncture through skin |
| CN201244083Y (en) * | 2008-09-04 | 2009-05-27 | 孙翔宇 | Localizer |
| CN204049785U (en) * | 2014-08-11 | 2014-12-31 | 中国人民解放军第四军医大学 | A kind of stereotaxis intracranial puncture positioning head frame |
| CN209422669U (en) * | 2018-12-06 | 2019-09-24 | 荆门市第二人民医院 | A kind of puncture point orientation marker pen |
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