Background technology:
Because the development of Modern Traffic, vehicle accident is more and more, and extremity fracture is the most common in vehicle accident.The method of such fractures is varied: have that the traction of manual reduction rear plate or plaster fixation, bone, exterior fixation bracket are fixed, open reduction steel plate internal fixation or an intramedullary pin internal fixation.These methods respectively have pluses and minuses, but total developing direction is: otch is little, wound is few, operation is simple, operating time is short, post-operative recovery is fast, can early ambulant and walking.
In the treatment of fractures means, internal fixation is being played the part of important role all the time.On limb fractures such as treatment femur, adopted comparatively advanced intramedullary pin technology and equipment in recent years, intramedullary pin belongs to fracture internal fixation technology, this technology adopts intramedullary pin to add diagonal or walk crosswise pinning, make it to form an integral body with whole long bone, can control the rotation and the shearing of fracture end to a certain extent, prevent that fracture from rotating displacement, thereby expand to the indication of intramedullary pin comminuted, grow the fracture at oblique and femur two ends etc., increased the stability of fracture fixation, improved the union of fracture rate, reduced infection rate, for treatment of fractures has increased a kind of biological method that more meets.But find still to exist following defective in the practice: 1, intramedullary nail with lock must increase operative incision because locking is positioned at the two ends of long diaphysis, and the complex operation of locking is installed, and secondary damage is big; 2, in the operation, the distance that swings with main locating rod because of intramedullary pin changes, and height gauge can not accurately be located, cause the no longer same plane of locating hole on locking of intramedullary nail and the main locating rod, thereby often cause the boring failure, need both to have prolonged operating time from new CT or X-ray boring down, increase operating difficulty, also can influence surgical effect; 3, intramedullary pin and corresponding pinning nail does not have pressurization to fracture line, still may become flexible even stagger after fracture is fixing, thereby fracture gap is strengthened, and is unfavorable for union of fracture; 4, the fixing back formation of intramedullary pin and corresponding locking firm static is fixed, thereby produces stress concentration in intramedullary pin and corresponding locking, causes with decided at the higher level but not officially announced and/or corresponding locking fracture; 5 and firm static fix, because of the relation of elastic modelling quantity, fracture is produced stress shielding, cause nonunion; 6 from fixed form, mostly is two-dimentional body between internal fixation and the bone, the weak part on mechanics, and this fixed system is difficult to reach the shearing resistance bending and revolves all-round excellent on the ability.The installation of 7 intramedullary pins need destroy bone marrow, influences the blood supply of bone.
In order to address the above problem, there is Chinese patent file 200320107607.7 to disclose the fixedly compound interlocking intramedullary nail of self-locking of a kind of femoral intertrochanteric, this kind intramedullary pin includes neck of femur self-locking intramedullary nail and femoral shaft self-locking intramedullary nail two large divisions and forms.Wherein, the neck of femur self-locking intramedullary nail includes neck of femur self-locking intramedullary nail main body again, neck of femur is followed closely two parts from lock core, adds a dog screw and forms.And its femoral shaft self-locking intramedullary nail, comprise femoral shaft self-locking intramedullary nail main body, expansion lock core and trip bolt composition, it is said: its intramedullary pin apparatus is simple, reliable, cheap, clinical practice is better, can make the mutual intercalation of fracture line, tightly involutory, can implement positioning and fixing to the fracture of femoral intertrochanteric, effectively prevent the rotation displacement phenomenon of any formation, help union of fracture; Operation wound is little, processing ease, and relative cost is lower, helps early exercise.But, though having from lock core nail and femoral shaft expansion lock core, this neck of femur prevents to fracture two sections bifurcateds of rotation mutually, because this nail expansion structure exists processed complex, intensity to be difficult to guarantee, expand and prevent that the spin degree is difficult to assurance; And the more important thing is, the inner chamber axis of bone all is crooked, and intramedullary pin is because the intensity reason can not be too thin, therefore, intramedullary pin is in the bending that all can occur certain degree with intracavity, correspondingly, the stretching screw of intramedullary pin and expansion lock core are all can be to some extent crooked or be subjected to the retardance of intramedullary pin inwall, in implanting the intramedullary pin operation process, be difficult to by the office in addition the screw threads head of head draw the nut formula expansion major part of the other end, also be difficult to advance the expansion lock core bar that its bifurcated is separately magnified, bring difficulty even cause operative failure to implant surgery by other the screw threads head of head of office; It promptly is implantation success, after union of fracture, when needing to take out pinning, expansion major part or expansion lock core may be because the screw application of force and advance and retreat difficulties, rotate and extract difficulty, be difficult to get loose, remove expansion, cause nut formula expansion major part on the control screw distal end, to come off fully in pulp cavity, increase the misery of taking out operating difficulty and patient though perhaps take out.
Similar the problems referred to above, there is Chinese patent file 02207522.4 to disclose a kind of setscrew type self-locking intramedullary nail, comprising main body nail and center double-screw bolt two parts, by main nail body near-end fluting, the displacement of tapered cup nut, main nail body near-end is opened automatically to control the rotation of fracture near-end, and far-end is a locking device, the rotation of control fracture far-end; It is said that it can be used for the internal fixation device of femoral supracondylar fracture, swell fixture type self-locking intramedullary nail, locking nail hole changes 135 °, and intramedullary pin is put upside down, and also can be used for femoral subtrochanteric fracture.Can overcome intramedullary nail with lock pinning positioner complex operation, many operative incisions, supporting apparatus complexity, the fixed shortcoming of firm static, has resiliently mounted effect, operation technique is simple, relative damage is little, do not need special installation, low cost of manufacture, is suitable for extensively and carries out.But, this device has similar above-mentioned shortcoming: exist the control of major part tapered cup nut and center double-screw bolt to locate two ends separately equally, because the pulp cavity complications cause rotating and the advance and retreat difficulty, both be unfavorable for the operation implantation, also be unfavorable for taking out pinning after the recovery from illness, even cause implant surgery failure or major part tapered cup nut to break away from fully from control centre's double-screw bolt dropping in the pulp cavity, increase the misery of taking out operating difficulty and patient.
Similar above-mentioned technology, also have Chinese patent file 01230173.6 to disclose a kind of setscrew type self-locking intramedullary nail, it comprises main body nail and center double-screw bolt two parts, the main body nail is changed a social system with the seamless medical stainless steel pipe of hollow or with existing approved product percussopunctator, by master's nail body far-end fluting, move on the tapered cup nut, main nail body far-end is opened automatically to control the rotation of fracture far-end, the near-end ratchet means, the rotation of control fracture near-end.It is said that intramedullary pin is used for the orthopaedics therapy fracture of shaft of femur, positioner complex operation, many operative incisions, supporting apparatus complexity, the fixed shortcoming of firm static have been overcome, have resiliently mounted effect, operation technique is simple, relative damage is little, do not need special installation, low cost of manufacture, be suitable for extensively and carry out.Similar above-mentioned technology also has Chinese patent file 200410077782.5 to disclose a kind of intramedullary pin that struts; Comprise nail body and center-pole, nail body tube wall far-end has the longitudinal dilatation groove, and the center-pole far-end is provided with expansion-head, by moving on the center-pole, main nail body far-end is opened automatically to control the rotation of fracture far-end, and nail body near-end is offered locking nail hole, and is furnished with pinning and controls near-end by pinning.In fact, the shortcoming of such device and last similar is not being given unnecessary details, might distribute because of the long bone of limbs pulp cavity becomes dumbbell shaped simultaneously, far-end pulp cavity excessive (as the tibia hypomere) or the intramedullary pin of selecting are long partially, and intra medullary nail far-end struts and might not reach fixed effect, has influenced the use of this device.
Summary of the invention:
Goal of the invention of the present invention is to provide a kind of simple in structure, easy to manufacture, operation easily, can reduce or not expand marrow intramedullary pin insertion technology, this intramedullary pin tool has the stability of axially holding bone, but shearing resistance bending such as revolves at multi-faceted displacement and multidigit point 3 D stereo is fixed, there is vertical dynamic physiology value of compressive stress at the key longitudinal axis, but induced osteogenesis; The dilating expansion intramedullary nail of non-stress shielding and stress concentration and deflection stress.
The present invention realizes like this, constitute by nail body and center-pole, the nail body is hollow tubular and comprises far-end, trunk and near-end three parts, offer three or three above expansion slots on the trunk of nail body and the tube wall of far-end are vertical, connected by latten between the trunk expansion slot, latten is made corrugated, and the crest of waveform is parallel with expansion slot with trough, this makes nail body trunk obtain preferable ductility and compressibility, thereby makes nail body trunk obtain high deformability; Center-pole comprises nearly head, main body and head far away, main body and head far away are coniform from fine to coarse, on the head far away of center-pole expansion-head is set, the main body of center-pole and the maximum outside diameter of expansion-head are greater than the trunk of nail body and the internal diameter of far-end, the nearly head of center-pole is positioned at the near-end of described nail body, near head end is provided with screw-type axial traction device, and nail body near-end is provided with fixed structure, so that will follow closely on the bone that the body near-end is fixed on the patient.Fixed structure is arranged on the locking nail hole of being furnished with pinning on the nail body near-end.The screw rod that the near-end that screw-type axial traction device is arranged on the nail body by rotation has nut in the hole of platform, be arranged on the nearly head of center-pole constitutes.During use, with the nail body together with the center-pole cross-under in patient's needs are refuted the medullary cavity of the bone that connects, then nut thread is socketed on the screw rod on the near head of center-pole, swivel nut, center-pole is moved toward nail body near-end, because the main body of center-pole and the maximum outside diameter of expansion-head are greater than the trunk of nail body and the internal diameter of far-end, like this, just will follow closely the body far-end struts, be fixed in the medullary cavity thereby will follow closely the body far-end, simultaneously, the trunk of nail body is also strutted by the main body of center-pole, corrugated latten opens, the trunk diameter of nail body is increased, and support is in medullary cavity, thereby the part of the fracture of bone is coupled together, at last, the pinning cross-under by passing bone in locking nail hole with the present invention and bone fixation together.Owing to offer three or three above expansion slots on the trunk of nail body and the tube wall of far-end are vertical, the main body of center-pole and the maximum outside diameter of expansion-head are greater than the trunk of nail body and the internal diameter of far-end, like this, the diameter of the trunk of nail body just can dwindle, under the situation that does not expand marrow, the nail body also can pierce in the medullary cavity, makes the expansion marrow no longer become necessary operation process.Corrugated latten by cross direction profiles between the trunk expansion slot connects, and makes the nail body can reach higher morphotropism and rigidity simultaneously, has guaranteed the firmness of the structure of nail body.At center-pole in nail body near-end moving process, nail body trunk constantly expands and launches gradually, far-end struts, thereby make intramedullary pin closely contact the internal fixation effect that reaches strong with trunk with the medullary cavity inwall along nail body far-end, need not the distal locking pinning, this expansion struts elastic force deformation and produced a balanced bending moment in pulp cavity, impels the transverse shift of fracture and angulation displacement to obtain correcting, mechanics conduction after the fracture fixation is the stress sharing type, and is few to the normal biomechanics interference of limbs; To the stable of fracture end is not absolute strong fixing, and there was fine motion in fracture end when limbs active movement or part were born a heavy burden, and helped callus formation, had impelled fracture heals in early days; Nail body near-end can lock easily by pinning.
Here, corrugated latten is compression folding subsides form.
The present invention compared with the prior art, has simple in structure, easy to manufacture, operation easily, can reduce or not expand marrow intramedullary pin insertion technology, during use, this intramedullary pin tool has the stability of axially holding bone, but shearing resistance bending such as revolves at multi-faceted displacement and multidigit point 3 D stereo is fixed, and has vertical dynamic physiology value of compressive stress at the key longitudinal axis, but induced osteogenesis; The advantage of non-stress shielding and stress concentration and deflection stress.