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CN111134770A - Novel customized acetabulum guide plate and use method thereof - Google Patents

Novel customized acetabulum guide plate and use method thereof Download PDF

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Publication number
CN111134770A
CN111134770A CN202010132527.5A CN202010132527A CN111134770A CN 111134770 A CN111134770 A CN 111134770A CN 202010132527 A CN202010132527 A CN 202010132527A CN 111134770 A CN111134770 A CN 111134770A
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CN
China
Prior art keywords
plate
ischium
locating
ilium
acetabular
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Pending
Application number
CN202010132527.5A
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Chinese (zh)
Inventor
解凤宝
史春宝
许奎雪
王先泉
王非凡
韩敬梅
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Beijing Chunlizhengda Medical Instruments Co Ltd
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Beijing Chunlizhengda Medical Instruments Co Ltd
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Application filed by Beijing Chunlizhengda Medical Instruments Co Ltd filed Critical Beijing Chunlizhengda Medical Instruments Co Ltd
Priority to CN202010132527.5A priority Critical patent/CN111134770A/en
Publication of CN111134770A publication Critical patent/CN111134770A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/16Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1735Guides or aligning means for drills, mills, pins or wires for rasps or chisels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/16Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1742Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
    • A61B17/1746Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for the acetabulum

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Dentistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention discloses a novel customized acetabulum guide plate, which belongs to the field of medical instruments, and adopts the technical scheme that the novel customized acetabulum guide plate comprises a closed structure for limiting the working position of an acetabulum file, wherein a positioning assembly for positioning the pubis, the ischium and the ilium is fixedly arranged on the closed structure, mounting holes for mounting kirschner wires are formed in the positioning assembly, the number of the mounting holes is not less than two, and the positioning assembly is obliquely arranged towards one direction. The invention achieves the effect of controlling the angle and the depth of the acetabular file.

Description

Novel customized acetabulum guide plate and use method thereof
Technical Field
The invention relates to the field of medical instruments, in particular to a novel customized acetabulum guide plate.
Background
The hip joint is a multiaxial spherical socket joint, consists of two parts, namely a femoral head of a femur and an acetabulum of a hip bone, is an important joint for connecting a trunk and a lower limb, and is also a joint with the highest load and the highest stress of the whole body. Since the hip is the center of a series of body movements, various disorders are prone to occur. For example: femoral neck fracture, femoral head necrosis, osteoarthritis coxitis, rheumatoid arthritis, ankylosing spondylitis, etc. In order to solve the problem of hip joint damage, a hip joint replacement method is generally adopted clinically, the femoral head is cut off, the artificial femoral head is replaced, the hyperplastic osteophyte is removed from the acetabulum side, an artificial acetabular cup is installed, a new hip joint is formed by the artificial femoral head and the acetabular cup, and the hip joint replacement operation can solve most of hip joint diseases and can achieve better clinical curative effect.
In the existing hip joint replacement operation, the adjustment problem of the acetabular cup angle basically depends on two fixed pointers on a cup holding device in a standard hip joint surgical instrument used by a doctor, the angle is positioned by referring to a ground plane, the acetabular cup depth needs to depend on the doctor to use an acetabular file rasp for multiple times, and the final rasp depth is determined by multiple tests. The defects of the mode are that:
1. the angle and the depth of the acetabular file are guided by referring to the ground plane, the influence of human factors is large, and the main and the secondary need to judge whether the angle is in place or not by experience and naked eyes;
2. because the angle specified by the cup holder is based on the ground plane, after the angle of a patient on a sickbed and the like are changed, the obtained abduction angle and anteversion angle are different, and the error is larger;
3. the reference object is not used for guiding the lower filing depth of the acetabular bone file, the acetabular bone file needs to be used for filing for many times in the operation, and then a test mould is used for testing whether the acetabular bone file is in place or not, so that the operation time and the operation difficulty are increased;
4. no reference is provided for guiding the filing depth of the acetabular bone file, the filing depth cannot be measured in advance, and the acetabular bone file may be deeply filed and excessive bone removal is possible.
Therefore, it is imperative to develop instruments that guide the angle of installation of hip joint prostheses.
Disclosure of Invention
Aiming at the defects in the prior art, the invention aims to provide a novel customized acetabulum guide plate, which solves the problem that doctors in the operation need to judge the angle and the depth by experience and naked eyes by guiding the filing angle and the depth in the process of customizing the individualized hip joint prosthesis operation.
In order to achieve the purpose, the invention provides the following technical scheme: the utility model provides a novel customization acetabular bone baffle, is including the closed structure that is used for restricting acetabular bone file operating position, closed structure sets firmly be used for with the locating component of pubic bone, ischium and ilium location, offers the mounting hole that is used for installing the kirschner wire on the locating component, and two are no less than to the mounting hole, and locating component surpasss a direction slope setting.
Through adopting above-mentioned technical scheme, acetabulum baffle position location is accurate, obtains suitable position according to three-dimensional analog data, fixes a position at pubic bone, ischium and ilium direction respectively, and three-point location method is more accurate, and more accurate suitable position of finding can be simultaneously when filing the bone, can pass through the relative position of judging the acetabulum and contused with closed structure and confirm the degree of depth of contusion.
Preferably, the following steps: the enclosed structure includes a central ring for exposing the operative field.
Through adopting above-mentioned technical scheme, the centre ring is cyclic annular, and the acetabular bone file can grind the file through the hole on the centre ring, and cyclic annular simultaneously can also provide effectual direction and location to the acetabular bone file, and the centre ring is cyclic annular also be convenient for process in addition, and the cost is lower.
Preferably, the following steps: the locating component comprises a pubis locating plate used for locating with the pubis, an ilium locating plate used for locating with the ilium and an ischium locating plate used for locating with the ischium, and the pubis locating plate, the ilium locating plate and the ischium locating plate are circumferentially distributed on the side wall of the closed structure.
Preferably, the following steps: mounting holes are formed in the pubis positioning plate, the ilium positioning plate and the ischium positioning plate.
Through adopting above-mentioned technical scheme, the setting of mounting hole can be convenient for the installation of kirschner wire, can be with the stable arrangement on patient's bone of centre ring that has the locating component through kirschner wire to in providing location and direction to the use of acetabular bone file.
Preferably, the following steps: the pubis locating plate, the ilium locating plate and the ischium locating plate are arranged at included angles with the axis of the center ring, and the pubis locating plate, the ilium locating plate and the ischium locating plate are arranged towards the same end face direction of the center ring.
Preferably, the following steps: a plurality of reinforcing plates are fixedly arranged on a center ring between the ilium positioning plate and the ischium positioning plate, and a positioning groove for accommodating protruding bone spines is formed between every two adjacent reinforcing plates.
Through adopting above-mentioned technical scheme, the area of contact with the ilium direction can be increased in the setting of reinforcing plate for the centre ring can be more stable stop on the bone, applys stable effectual direction and spacing effect to the acetabular bone file, makes the centre ring be difficult to produce more and rocks even the displacement, has also improved the job stabilization nature of centre ring.
Preferably, the following steps: and a reinforcing plate which is erected on the ischial tuberosities is fixedly arranged on the ischial positioning plate.
Through adopting above-mentioned technical scheme, the setting of constant head tank can make ischium locating plate more stable be connected with the ischium, reduces the center ring and produces the effect of rocking and displacement, has improved the job stabilization nature of center ring.
Preferably, the following steps: the clavicle positioning plate is fixedly provided with a buckling part which can be buckled on the ischial tuberosity.
Through adopting above-mentioned technical scheme, the setting of buckling parts can make ischium locating plate more stable be connected with the ischium, reduces the center ring and produces the effect of rocking and displacement, has improved the job stabilization nature of center ring.
The use method of the novel customized acetabulum guide plate is characterized in that: including foretell novel customization acetabular bone baffle, still include the following step:
the method comprises the following steps: before hip joint replacement, simulating the final mounting position of the prosthesis according to the CT reverse three-dimensional bone model of the patient;
step two: the final installation position of the prosthesis determines the angle and the depth of a final acetabular cup, and an acetabular guide plate with proper size is customized on a plane according to the end surface of a central ring which is finally close to a positioning assembly and an acetabular opening, wherein the inner diameter of a closed structure is 0.8-1.5mm larger than the outer diameter of an acetabular file in the operation;
step three: after exposing pubis, ilium and ischium in the art, with the acetabulum baffle laminating on patient's sclerotin, use ke shi needle fixed, then select the acetabulum file perpendicular to acetabulum baffle of suitable specification to begin to grind the file, stop when grinding the file to the upper edge of acetabulum file and the lower limb parallel and level of closed structure.
In summary, compared with the prior art, the invention has the following beneficial effects:
1. the reference surface of the acetabulum guide plate is the bone of the patient, the positioning is accurate, and the obtained angle is the designated angle simulated in the three-dimensional data;
2. the acetabulum guide plate is accurate in depth positioning, an acetabulum file can only file to the designed depth after the acetabulum guide plate is placed, and the guide plate can prompt a user of the depth of filing bones so as to prevent deeper sclerotin from being filed;
3. the acetabulum guide plate is accurate in position location, obtains suitable positions according to three-dimensional simulation data, and is respectively located in the directions of pubis, ischium and ilium, and the three-point location method is more accurate and finds suitable positions more accurately.
Drawings
FIG. 1 is an isometric view of a first embodiment; .
Reference numerals: 1. a closed structure; 11. a center ring; 2. a positioning assembly; 21. an ilium positioning plate; 22. a pubic bone locating plate; 23. a ischium positioning plate; 3. a reinforcing plate; 31. positioning a groove; 4. mounting holes; 5. a reinforcing plate; 6. a card slot; 7. a fastening part; 71. cross plates; 72. a vertical plate; 8. an arc surface portion.
Detailed Description
The first embodiment is as follows: a novel customized acetabular guide, see fig. 1, comprises a ring-shaped closed structure 1, the closed structure 1 in this embodiment being a central ring 11. Fixedly connected with locating component 2 on the arc lateral wall of center ring 11, locating component 2 includes pubis locating plate 22, ilium locating plate 21 and ischium locating plate 23, pubis locating plate 22, ilium locating plate 21 and ischium locating plate 23 distribute along circumference, and pubis locating plate 22, all seted up the axis respectively rather than vertically mounting hole 4 on ilium locating plate 21 and the ischium locating plate 23, mounting hole 4 is used for installing the kirschner wire, fix center ring 11 at the current position of patient's health through the kirschner wire.
Fixedly connected with reinforcing plate 3 on the 11 lateral walls of centre ring on one side of ilium locating plate 21, reinforcing plate 3 has two and forms constant head tank 31 between two reinforcing plate 3, and the length direction of constant head tank 31 is on a parallel with the length direction of reinforcing plate 3. The detents 31 are adapted to receive the bony spines of the patient's ilia to provide additional stops for the central ring 11, reducing the likelihood of rotation of the central ring 11 during use.
Pubis locating plate 22, ilium locating plate 21, ischium locating plate 23 and reinforcing plate 3 all set up for the axis slope of center ring 11, and pubis locating plate 22, ilium locating plate 21, ischium locating plate 23 all are the form setting of diverging to the same terminal surface direction of center ring 11. The pubis positioning plate 22, the ilium positioning plate 21 and the ischium positioning plate 23 are arranged at an included angle.
The ischium locating plate 23 is bent to be the plate shape of cambered surface, and the junction of the ischium locating plate 23 and the side wall of the center ring 11 is fixedly connected with a reinforcing plate 5 in the shape of an arc plate, one end of the reinforcing plate 5 is fixedly connected with the ischium locating plate 23, and the reinforcing plate 5 and the ischium locating plate 23 are in smooth transition and form a long and straight clamping groove 6. The reinforcing plate 5 and the clamping grooves 6 can be matched with the ischial positioning plate 23 for use, so that a user can conveniently erect the central ring 11 on the ischial tuberosities and make a part of the ischial tuberosities arranged inside the clamping grooves 6, the connection between the central ring 11 and the bone of a patient is more stable, and the possibility of rotation or displacement of the central ring 11 is reduced.
The end of the ischial positioning plate 23 opposite to the central ring 11 is fixedly connected with an engaging part 7 with an L-shaped section, and the concave direction of the engaging part 7 is consistent with the concave direction of the clamping groove 6. The buckling part 7 comprises a cross plate 71 fixedly connected with the ischial positioning plate 23 and a vertical plate 72 fixedly connected with the cross plate 71, the vertical plate 72 is perpendicular to the cross plate 71, and one surface of the buckling part 7, which faces away from the reinforcing plate 3, is an arc surface 8 matched with the ischial tuberosity of the patient in shape. When the device is used, the cross plates 71 are erected on the top surfaces of the ischial tuberosities, the vertical plates 72 are attached to the side walls of the ischial tuberosities, so that the central ring 11 can be further stably stopped at the current position, and the influence on the working angle of an acetabular file caused by displacement or rotation of the central ring 11 is reduced.
Example two: the use method of the novel customized acetabulum guide plate comprises the novel customized acetabulum guide plate and further comprises the following steps:
the method comprises the following steps: before hip joint replacement, simulating the final mounting position of the prosthesis according to the CT reverse three-dimensional bone model of the patient;
step two: determining the angle and the depth of a final acetabular cup according to the final installation position of the prosthesis, and customizing an acetabular guide plate with a proper size on a plane according to the end surface of a central ring and an acetabular opening which are finally close to a positioning assembly, wherein the inner diameter of a closed structure is 0.8mm larger than the outer diameter of an acetabular file practical in operation;
step three: after exposing pubis, ilium and ischium in the art, with the acetabulum baffle laminating on patient's sclerotin, use ke shi needle fixed, then select the acetabulum file perpendicular to acetabulum baffle of suitable specification to begin to grind the file, stop when grinding the file to the upper edge of acetabulum file and the lower limb parallel and level of closed structure.
Example three: the use method of the novel customized acetabulum guide plate comprises the novel customized acetabulum guide plate and further comprises the following steps:
the method comprises the following steps: before hip joint replacement, simulating the final mounting position of the prosthesis according to the CT reverse three-dimensional bone model of the patient;
step two: determining the angle and the depth of a final acetabular cup according to the final installation position of the prosthesis, and customizing an acetabular guide plate with a proper size on a plane according to the end surface of a central ring and an acetabular opening which are finally close to a positioning assembly, wherein the inner diameter of a closed structure is 1.5mm larger than the outer diameter of an acetabular file practical in operation;
step three: after exposing pubis, ilium and ischium in the art, with the acetabulum baffle laminating on patient's sclerotin, use ke shi needle fixed, then select the acetabulum file perpendicular to acetabulum baffle of suitable specification to begin to grind the file, stop when grinding the file to the upper edge of acetabulum file and the lower limb parallel and level of closed structure.
The above description is only a preferred embodiment of the present invention, and the protection scope of the present invention is not limited to the above embodiments, and all technical solutions belonging to the idea of the present invention belong to the protection scope of the present invention. It should be noted that modifications and embellishments within the scope of the invention may occur to those skilled in the art without departing from the principle of the invention, and are considered to be within the scope of the invention.

Claims (10)

1. The utility model provides a novel customization acetabular bone baffle which characterized in that: including closed structure (1) that is used for restricting acetabular bone file work position, set firmly on closed structure (1) and be used for with locating component (2) of pubis, ischium and ilium location, set up mounting hole (4) that are used for installing ke shi needle on locating component (2), mounting hole (4) are no less than two.
2. The novel customized acetabular guide plate of claim 1, wherein: the closed structure (1) comprises a central ring (11) for exposing the operative area.
3. The novel customized acetabular guide plate of claim 1, wherein: the locating component (2) comprises a pubis locating plate (22) used for locating with the pubis, an ilium locating plate (21) used for locating with the ilium and an ischium locating plate (23) used for locating with the ischium, and the pubis locating plate (22), the ilium locating plate (21) and the ischium locating plate (23) are circumferentially distributed on the side wall of the closed structure (1).
4. The novel customized acetabular guide plate of claim 2, wherein: mounting holes (4) are formed in the pubis positioning plate (22), the ilium positioning plate (21) and the ischium positioning plate (23).
5. The novel customized acetabular guide plate of claim 2, wherein: pubis locating plate (22), ilium locating plate (21) and ischium locating plate (23) all are the contained angle setting with the axis of center ring (11), and pubis locating plate (22), ilium locating plate (21) and ischium locating plate (23) all set up towards the same terminal surface direction of center ring (11).
6. The novel customized acetabular guide plate of claim 2, wherein: a plurality of reinforcing plates (3) are fixedly arranged on a central ring (11) between the ilium positioning plate (21) and the ischium positioning plate (23), and a positioning groove (31) for accommodating a protruded bone spine is formed between two adjacent reinforcing plates (3).
7. The novel customized acetabular guide plate of claim 2, wherein: and a reinforcing plate (5) erected on the ischial tuberosities is fixedly arranged on the ischial positioning plate (23).
8. The novel customized acetabular guide plate of claim 7, wherein: and an inwards concave clamping groove (6) is formed at the joint between the reinforcing plate (5) and the ischium positioning plate (23).
9. The novel customized acetabular guide plate of claim 2, wherein: the ischium positioning plate (23) is fixedly provided with a buckling part (7) which can be buckled on the ischium tuberosity.
10. The use method of the novel customized acetabulum guide plate is characterized in that: the new customized acetabular guide comprising the above claims 1-9, further comprising the steps of:
the method comprises the following steps: before hip joint replacement, simulating the final mounting position of the prosthesis according to the CT reverse three-dimensional bone model of the patient;
step two: the final installation position of the prosthesis determines the angle and the depth of a final acetabular cup, and an acetabular guide plate with proper size is customized on a plane according to the end surface of a central ring which is finally close to a positioning assembly and an acetabular opening, wherein the inner diameter of a closed structure is 0.8-1.5mm larger than the outer diameter of an acetabular file in the operation;
step three: after exposing pubis, ilium and ischium in the art, with the acetabulum baffle laminating on patient's sclerotin, use ke shi needle fixed, then select the acetabulum file perpendicular to acetabulum baffle of suitable specification to begin to grind the file, stop when grinding the file to the upper edge of acetabulum file and the lower limb parallel and level of closed structure.
CN202010132527.5A 2020-02-29 2020-02-29 Novel customized acetabulum guide plate and use method thereof Pending CN111134770A (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112754597A (en) * 2020-12-31 2021-05-07 南京市儿童医院 Combined 3D printing limit navigation template for assisting hip joint triple osteotomy
CN116370159A (en) * 2023-06-05 2023-07-04 吉林大学 Acetabular reconstruction prosthesis with pile face fixing structure

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101711695A (en) * 2008-09-30 2010-05-26 德普伊产品公司 Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US20120041445A1 (en) * 2010-08-12 2012-02-16 Roose Jeffrey R Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
CN104887361A (en) * 2015-05-14 2015-09-09 青岛大学附属医院 Fabrication template system for custom individual artificial total hip replacement operation acetabulum
CN205866800U (en) * 2016-05-23 2017-01-11 上海昕健医疗技术有限公司 Hip joint location guiding piece that patient is matchd
US20170258480A1 (en) * 2016-03-14 2017-09-14 Shanghai Xinjian Medical Co. Ltd Patient-specific Accetabular Guide
US20180125676A1 (en) * 2016-11-09 2018-05-10 Benjamin Soo-il SONG Anatomic acetabular positioning device for hip arthroplasty
CN108742770A (en) * 2018-06-20 2018-11-06 重庆大学 For the rasion guide plate of total hip arthroplasty and its manufacture, application method
CN109106475A (en) * 2018-08-17 2019-01-01 北京威高亚华人工关节开发有限公司 A kind of acetabular cup guide plate and preparation method thereof
CN110478090A (en) * 2019-07-17 2019-11-22 天津市天津医院 CAD pelvic tumor is precisely cut off with personalized prosthese and preparation method thereof

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101711695A (en) * 2008-09-30 2010-05-26 德普伊产品公司 Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US20120041445A1 (en) * 2010-08-12 2012-02-16 Roose Jeffrey R Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
CN104887361A (en) * 2015-05-14 2015-09-09 青岛大学附属医院 Fabrication template system for custom individual artificial total hip replacement operation acetabulum
US20170258480A1 (en) * 2016-03-14 2017-09-14 Shanghai Xinjian Medical Co. Ltd Patient-specific Accetabular Guide
CN205866800U (en) * 2016-05-23 2017-01-11 上海昕健医疗技术有限公司 Hip joint location guiding piece that patient is matchd
US20180125676A1 (en) * 2016-11-09 2018-05-10 Benjamin Soo-il SONG Anatomic acetabular positioning device for hip arthroplasty
CN108742770A (en) * 2018-06-20 2018-11-06 重庆大学 For the rasion guide plate of total hip arthroplasty and its manufacture, application method
CN109106475A (en) * 2018-08-17 2019-01-01 北京威高亚华人工关节开发有限公司 A kind of acetabular cup guide plate and preparation method thereof
CN110478090A (en) * 2019-07-17 2019-11-22 天津市天津医院 CAD pelvic tumor is precisely cut off with personalized prosthese and preparation method thereof

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112754597A (en) * 2020-12-31 2021-05-07 南京市儿童医院 Combined 3D printing limit navigation template for assisting hip joint triple osteotomy
CN116370159A (en) * 2023-06-05 2023-07-04 吉林大学 Acetabular reconstruction prosthesis with pile face fixing structure
CN116370159B (en) * 2023-06-05 2023-08-11 吉林大学 Acetabular reconstruction prosthesis with pile face fixing structure

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