CN101856261B - Rear anatomical supporting and locking plate outside proximal tibial plateau - Google Patents
Rear anatomical supporting and locking plate outside proximal tibial plateau Download PDFInfo
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- CN101856261B CN101856261B CN2010102305928A CN201010230592A CN101856261B CN 101856261 B CN101856261 B CN 101856261B CN 2010102305928 A CN2010102305928 A CN 2010102305928A CN 201010230592 A CN201010230592 A CN 201010230592A CN 101856261 B CN101856261 B CN 101856261B
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Abstract
The invention aims to provide a rear anatomical supporting and locking plate outside the proximal tibial plateau, comprising a roughly quadrangular head with a plurality of penetrated holes and an elongated limb which is connected with the head and is provided with a plurality of penetrated holes. The invention is a novel plate developed based on the traditional plates and the AO internal fixed stent principle. The anatomical locking plate operation dispenses with prebending and massive exposure of the fracture site, minimizes injury to the soft tissues, obviously reduces the failure of implants and remarkably lowers the infection and incidence of nonunion, and bolts can be used for fixing fractures in multiple angles, thus enhancing the stability. The plate conforms to the BO internal fixation principle and has extensive application prospect and incomparable advantages with respect to complicated fracture.
Description
Technical field
The present invention relates to a kind of medical anatomical form and support locking and pressurizing synthetism steel plate, especially a kind of proximal tibial platform outside back dissection type support locking bone fracture plate.The supporting role that its tibial plateau rear pillar that is used for being caused by fracture in operative treatment subsides is played a supporting role by this support locking plate is fixed in bone with lock screw in the operation, makes the tibial plateau rear pillar recover normal configuration state.Belong to technical field of medical.
Background technology
Medical dissection type support locking steel plate is the fracture fixation apparatus that has the locking screw thread hole, can above-mentioned steel plate fixedly be reached the angle Stabilization by screw.The screwed hole of lockplate can be Combination nail hole, both can use lock screw, also can use traditional non-locking screw (being also referred to as the conjunction type steel plate).Locking steel plate just was used to spinal surgery and decorative sursery before 20 years.The late period eighties in last century is up to the mid-90, and the research of various dissimilar bone fracture internal fixing device material has promoted lockplate to be applied to the internal fixation of fracturing.The emphasis of initial research reduces extensively peeling off and damaging of soft tissue when being the held stationary fracture.Some factors of clinicing aspect have also promoted the development of lockplate, mainly comprise: the aged osteoporotic fracture patient in high-energy damage patient's survival rate rising, West Europe and North America constantly increase and patient and doctor dissatisfied to the therapeutic effect of some special fracture around joint.Non-clinical sexual factor comprises industry popular gradually to the development of new technique and new markets and Minimally Invasive Surgery technology.
As long as any traditionally steel plate can use fixed angle/one-tenth angle to stablize screw or bolt can both be used as locking steel plate.Locking steel plate is compared with general steel plate, and topmost biomechanics difference is that the latter must be to the pressurization of the steel plate on the skeleton, and the frictional force that relies between bone-steel plate interface provides stable.Along with the continuous increase of axial load, screw begins to toggle, and frictional force is reduced, and causes steel plate loosening.If this situation takes place early, it is unstable that fracture will take place, and causes graft failure.Therefore, obtain and keep closely screw fixing difficult more (for example, when the metaphysis of bone and osteoporotic bone), keep stable just difficult more.
There is the defective on the biomechanics in general steel plate, because it can influence the blood operation of fracture site to the periosteum pressurization.Utilize general steel plate that fracture is carried out strong fixing (for example, pressurization and lag screw technology between fracture site) following complication easily takes place: infection, internal fixation failure, fracture delayed union and bone does not connect connect.
Comparatively speaking, locking steel plate is followed the biomechanical principle of external fixation, does not rely on the frictional force between steel plate and skeleton.Owing between screw and steel plate, have into the angle stable interface, do not contact skeleton when allowing to place locking steel plate fully, be the inner fixer that meets the biomechanics viewpoint therefore.In essence, locking steel plate still can be counted as subcutaneous external fixator, only because the distance between it and skeleton is shorter just more firm.Present trend is that production firm provides the anatomical plate that has locking device, as the anatomical plate and the calcaneus anatomical plate of anatomical plate, proximal humerus and the far-end of near end of thighbone and far-end.Under many circumstances, the design of locking steel plate allows steel plate to contact with skeleton is less, can protect the blood of periosteum to supply and the skeleton perfusion like this.In addition, the locking steel plate system also has other characteristics, if any the outside support handle, holds tool and passivity edge, these can make things convenient for the doctor by flesh down or Wicresoft's mode such as subcutaneous steel plate is inserted fracture site.
The anatomical form that both at home and abroad tibial plateau rear side (rear pillar) surgical treatment of fracture is not also adapted supports the locking and pressurizing steel plate at present.In operation, still need the interim pre-bending of steel plate at other positions, make it to stick use, and intensity and the degree of applying ointment or plaster all descend after the steel plate bending, firmly the also corresponding decline of degree and influence therapeutic effect with the tibia rear side.
Summary of the invention
In view of the above problems, the object of the present invention is to provide a kind of proximal tibial platform outside back dissection type support locking bone fracture plate, it is finished on the basis of the anatomy relationship of having measured a large amount of (about 2600 examples) Chinese's tibial plateau rear sides (rear pillar), be the anatomical plate that can roughly stick, filled up the blank in this field.
A kind of proximal tibial platform of the present invention outside back dissection type support locking bone fracture plate, wherein: head, it is tetragon roughly, is formed through a plurality of holes; With bar portion, it is connected with head, is elongated strip, is formed through a plurality of holes; The whole curved shape that coincide with the tibia outside back that between head and bar portion, is.
The above-mentioned a plurality of holes that are formed at head are arranged as: be two rows in the longitudinal direction; On width, first row is four, and second row is two.
Roughly arrange with the end side almost parallel ground of head in above-mentioned first row and second hole of arranging that is formed at head.
Varying in size of the hole that the above-mentioned size and second that is formed at first row is arranged.
In a plurality of holes of above-mentioned first row who is formed at head any is not arranged in string with any in the vertical direction in second a plurality of holes of arranging.
The above-mentioned cadre's of being formed at hole is a substantially elliptical.
Above-mentioned tibial plateau width is 75 ± 5cm, present two arcuate structures at platform rear side horizontal plane, the inner arc central angle is 120 ° ± 15 ° behind platform, the outer arc central angle is 105 ° ± 20 ° behind platform, it is Z-shaped that sagittal plane is, two corners, the inboard first corner angle is 40 ° ± 8 °; The outside first corner angle is 40 ° ± 7.5 °; The inboard second corner angle is 45 ° ± 5 °; The outside second corner angle is 45 ° ± 6 °.
Above-mentioned blade plate material is steel or titanium.
One of inventive point of the present invention is the Position Design in hole, because in inventor's experimentation for many years, finds the hole of arranging with the inventive method, this locking and pressurizing synthetism steel plate is to dissect pre-moulding design, edge-smoothing reduces soft tissue irritation, need not bending in the art.The blade plate head has six pieces of locking screws, can provide firm support for tibial plateau.The cadre has the locking screw that is tilted to, and forms stable triangular frame structure.Above-mentioned lock hole design that this blade plate cadre has is convenient to can choose at random in the art angle and is fixed or add press fit.Simultaneously can make product of the present invention play in the course of the work effectively and can also make body carry out the exchange of nutrient substance outside the good supporting effect unobstructedly, the recovery effects compared with other congener gripper shoes is well a lot of like this.
Another one inventive point of the present invention is exactly " the inner arc central angle is 120 ° ± 15 ° behind platform, and the outer arc central angle is 105 ° ± 20 ° behind platform ", and " the inboard first corner angle is 40 ° ± 8 °; The outside first corner angle is 40 ° ± 7.5 °; The inboard second corner angle is 45 ° ± 5 °; The outside second corner angle is 45 ° ± 6 ° " these several data are angles of summing up after the experiment of having passed through hundreds of time; this angular range; can expose fracture end so that need not large tracts of land; the injury of soft tissue is reduced to minimum, obviously reduce the inner matter failure, significantly reduce the incidence rate that infects with bone does not connect; screw can the fixing fracture of multi-angle; increase stability, these all meet BO internal fixation principle, especially for complicated fracture wide application prospect and incomparable advantage are arranged.
The present invention is as medical implants in vivo, and in operative treatment the rear pillar that is caused by fracture of the tibial plateau being subsided plays a supportive role, and by this steel plate is fixing by the lock screw nail, can make the tibial plateau rear pillar recover normal configuration state relation in the operation.
Tibial plateau rear side anatomical form locking and pressurizing blade plate of the present invention is on the basis of traditional blade plate, a kind of novel blade plate of being developed in conjunction with AO inner fixed support principle, need not pre-bending in the anatomical form locking bone fracture plate art, need not large tracts of land and expose fracture end, the injury of soft tissue is reduced to minimum, obviously reduce the inner matter failure, significantly reduce the incidence rate that infects with bone does not connect, screw can multi-angle be fixed fracture, increase stability, these all meet BO internal fixation principle, especially for complicated fracture wide application prospect and incomparable advantage are arranged.
Tibial plateau rear side anatomical form of the present invention supports that the locking and pressurizing plate is based on percutaneous Wicresoft steel plate internal fixation technology and a kind of new steel plate of designing is the combination in power pressurization hole and conical locking screw thread hole, has locking and pressurization dual-use function.It also has the stable and axial stability in angle, can prevent the loss of reposition under the stress.
Main feature of the present invention is as follows, the locking steel plate screw has the structure of inner support, by the broken bone piece of nearly articular surface and cancellous bone fracture end being adopted into angle stable type padlock screw and steel plate padlock mutually, and by the fixing fracture of the self-taped type os integumentale screw other end, so form an integral body, can obtain support and whole stable effect articular surface.Blade plate round end, the design of ramped shaped root face help the application in Minimally Invasive Surgical Technology, the indent of blade plate below can reduce contacting of blade plate and surface of bone, help keeping the blood operation of periosteum more, reduce the pressure effect of steel plate, reduce the incidence rate of nonunion bone interface.Adopt locking steel plate modus operandi of the present invention can take percutaneous blade plate technique for fixing, operation wound is minimized, guarantee the confession of fracture end blood, satisfy fixed principle biology.
(invention effect)
Tibial plateau rear side anatomical form locking and pressurizing synthetism steel plate of the present invention is to dissect pre-moulding design, uses Wicresoft and goes into road technique, can provide firm support for the complicated fracture of tibial plateau.
Main feature and advantage
This locking and pressurizing synthetism steel plate is to dissect pre-moulding design, and edge-smoothing reduces soft tissue irritation, need not bending in the art.The blade plate head has six pieces of locking screws, can provide firm support for tibial plateau.The cadre has the locking screw that is tilted to, and forms stable triangular frame structure.Above-mentioned lock hole design that this blade plate cadre has is convenient to can choose at random in the art angle and is fixed or add press fit.
Indication: proximal tibia intraarticular and extra-articular fracture, proximal tibia metaphysis and epiphysis portion fracture, proximal tibia complicated fracture.
Description of drawings
Fig. 1 supports the front view and the side view of locking and pressurizing synthetism steel plate for expression proximal tibia (platform) outside back anatomical form.
Fig. 2 is the working state figure of product of the present invention.
1 is interior plate first corner; 2 is interior plate second corner; 3 is inner arc central angle behind the platform; 4 is platform rear side horizontal plane; 5 is tibia.
The specific embodiment
The present invention is as medical implants in vivo, in operative treatment the tibial plateau rear pillar that is caused by fracture subsided and plays a supporting role, and by fixed support of the present invention, makes the platform rear pillar recover normal configuration state relation.Below, with reference to accompanying drawing, embodiments of the present invention are described.
The present invention is by measuring the anatomy relationship of a large amount of (about 2600 examples) Chinese's tibial plateau rear sides (rear pillar), obtain following data and on this basis design finish.The tibial plateau width is generally 75 ± 5cm.Present two arcuate structures at platform rear side horizontal plane, the inner arc central angle is 120 ° ± 15 ° behind platform, and the outer arc central angle is 105 ° ± 20 ° behind platform.It is Z-shaped that sagittal plane is, two corners, and the inboard first corner angle is 40 ° ± 8 °; The outside first corner angle is 40 ° ± 7.5 °; The inboard second corner angle is 45 ° ± 5 °; The outside second corner angle is 45 ° ± 6 °.
With reference to Fig. 1～Fig. 2, the structure of embodiments of the present invention is described.
Head is tetragon roughly, is formed through a plurality of holes at this head; With the cadre who is connected with head, be elongated strip, be formed through a plurality of holes this cadre.The a plurality of holes that are formed at head are arranged as: be two rows in the longitudinal direction; On width, first row is four, and second row is two, wherein, roughly arrange with the end side almost parallel ground of head in first row and second row's hole, and any in the vertical direction in a plurality of holes of any in a plurality of holes of first row and second row is not arranged in string.In addition, first row's size and second row's the varying in size of hole, and the hole that first row's boring ratio second is arranged is big.The hole that is formed at the cadre is a substantially elliptical.Head is bending ground with the cadre and is connected.
Tibial plateau rear side anatomical form locking and pressurizing synthetism steel plate of the present invention is on the basis of traditional blade plate, adopts steel, non-corrodibility metal materials such as titanium, a kind of novel blade plate of being developed in conjunction with AO inner fixed support principle.Need not pre-bending in the anatomical form locking bone fracture plate art of the present invention, need not large tracts of land and expose fracture end, adopt less invasive techniques in the operation, the injury of soft tissue is reduced to minimum, obviously reduce the inner matter failure, significantly reduce the incidence rate that infects with bone does not connect, can multi-angle fix fracture by lock screw, column stability behind the increase platform, the use of tibial plateau rear-side anatomical-form bone fracture plate of the present invention meets BO internal fixation principle fully, especially for complicated fracture wide application prospect and incomparable advantage is arranged.
When using tibial plateau rear side anatomical form locking and pressurizing synthetism steel plate of the present invention to treat fracture of the tibial plateau, can there be certain interval between metaphysis portion and surface of bone under the rare occasion, makes steel plate seem docile inadequately.In such cases, it is moulding that the way of general steel plate is to use lever to carry out, but the multi-shaft locking steel plate is because moulding in advance, there is the probability of destroying latch-up structure in bending once more, so should avoid again moulding for the metaphysial section of steel plate, even fixing back is docile inadequately with surface of bone, do not influence the fixed stability in the large of lock screw yet.Secondly, answer conventional row CT three-dimensional reconstruction before the art, so that judge shape, size and the direction of displacement of all sclerites, design the direction of all lock screw in advance, the situation that can effectively avoid lock screw to interfere with each other or pass bony surface in sclerotin takes place.Under the prerequisite that should the bone fixation piece interfere with each other again, should lock screw be placed different angles as far as possible, help increasing the stability of locking steel plate like this.
Compare with the common supporting steel plate that previously uses, this locking steel plate can carry out the internal fixation of high stable, avoids resetting and loses.In addition; locking steel plate is very limited with contacting of periosteal tissue, and is less to the compressing that periosteum causes, thereby avoided the generation of periosteum necrosis; help to protect the blood confession of affected area, this may also be to use one of reason that the nonunion rate descends behind the locking steel plate treatment fracture around joint.After screw was screwed into, locking steel plate and lock screw were had a style of one's own, and became a stable system, and no matter the good para-position that can keep fracturing for normal sclerotin or osteoporotic case, all can provide stronger mechanics to stablize line.
Different with common locking steel plate is, the locking screw design of the multi-shaft locking steel plate that the present invention adopts is special, when screw screws in lock hole, groove interlock mutually in screw thread around the head of screw and the lock hole makes lock hole expand gradually, and lock screw thoroughly is fixed on the selected angle and direction the most at last, and before locking fully, lock hole can rotate freely, and lock screw can be adjusted along 40 ° of taper tracks, to guarantee resetting and the adjustment of lock screw direction of sclerite.Therefore, except the treatment advantage of above-mentioned common locking steel plate, the multi-shaft locking steel plate also can carry out accurately fixing according to the trend of fracture line, and the operation of revising screw orientation in the art is also simple, and needn't reappose and plan the nail road of screw as the single shaft locking steel plate.
The intraarticular comminuted fracture, tibial plateau medial and lateral malleolus fracture and Methods for Distal Femoral Fractures are extremely unsettled fracture.After articular surface carried out anatomical reduction, the ossa articularia folded block must reset with the backbone and be connected, and keeps the suitable lower limb line of force.For making union of fracture, it is very difficult obtaining enough stability.When the outside uses general steel plate fixedly, support fracture at inboard increase steel plate in addition or external fixation.Difference between this locking steel plate and general steel plate on mechanics makes locking steel plate more stable.The acquisition of this locking steel plate stability and keep and do not rely on the interface between steel plate-bone and depend on into the stable steel plate-screw interface in angle.This stable structure of locking internal fixation device makes that the lock screw pull-out strength will be far above the general steel plate screw.Because screw all is locked on the steel plate, so be difficult to occur single nail puller nail or loosening.
It is very helpful that the higher stability that locking steel plate of the present invention provided is treated following fracture for the surgeon: the relatively poor fracture of bone mass, comminuted bicondylar fracture or any very unstable and single steel plate can not provide the fracture of enough stability.Because this locking steel plate must not fit tightly with skeleton in the time of fixedly,, keep partial blood supply and promote union of fracture so need only peel off less soft tissue.
Yu general steel plate Xiang ratio, tibial plateau rear side anatomical form locking and pressurizing bone-fracture fixation steel plate Zai biomethanics of the present invention and the point of You biologically were so that Zhe Xie Xin Xing implant Zai had obtained extensive use in recent years.
Claims (8)
1. proximal tibial platform outside back dissection type support locking bone fracture plate, it comprises: head, it is tetragon roughly, is formed through a plurality of holes; With bar portion, it is connected with head, is elongated strip, is formed through a plurality of holes; The whole curved shape that coincide with the tibia outside back that is between head and bar portion is characterized in that:
The tibial plateau width is 75 ± 5cm, presents two arcuate structures at platform rear side horizontal plane, and the inner arc central angle is 120 ° ± 15 ° behind platform, the outer arc central angle is 105 ° ± 20 ° behind platform, it is Z-shaped that sagittal plane is, two corners, and the inboard first corner angle is 40 ° ± 8 °; The outside first corner angle is 40 ° ± 7.5 °; The inboard second corner angle is 45 ° ± 5 °; The outside second corner angle is 45 ° ± 6 °, and the described hole that is formed at bar portion is a substantially elliptical.
2. proximal tibial platform as claimed in claim 1 outside back dissection type support locking bone fracture plate is characterized in that:
The described a plurality of holes that are formed at head are arranged as: be two rows in the longitudinal direction; On width, first row is four, and second row is two.
3. the proximal tibial platform outside back dissection type support locking bone fracture plate described in claim 2 is characterized in that:
Roughly arrange with the end side almost parallel ground of head in described first row and second hole of arranging that is formed at head.
4. as claim 2 or 3 described proximal tibial platform outside back dissection type support locking bone fracture plates, it is characterized in that:
Varying in size of the hole that the described size and second that is formed at first row is arranged.
5. as claim 2 or 3 described proximal tibial platform outside back dissection type support locking bone fracture plates, it is characterized in that:
In a plurality of holes of described first row who is formed at head any is not arranged in string with any in the vertical direction in second a plurality of holes of arranging.
6. as any described proximal tibial platform outside back dissection type support locking bone fracture plate among the claim 1-3, it is characterized in that: described blade plate material is steel or titanium.
7. the proximal tibial platform outside back dissection type support locking bone fracture plate described in claim 4, it is characterized in that: described blade plate material is steel or titanium.
8. the proximal tibial platform outside back dissection type support locking bone fracture plate described in claim 5, it is characterized in that: described blade plate material is steel or titanium.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010102305928A CN101856261B (en) | 2010-07-20 | 2010-07-20 | Rear anatomical supporting and locking plate outside proximal tibial plateau |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010102305928A CN101856261B (en) | 2010-07-20 | 2010-07-20 | Rear anatomical supporting and locking plate outside proximal tibial plateau |
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| Publication Number | Publication Date |
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| CN101856261A CN101856261A (en) | 2010-10-13 |
| CN101856261B true CN101856261B (en) | 2011-06-29 |
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| CN2010102305928A Expired - Fee Related CN101856261B (en) | 2010-07-20 | 2010-07-20 | Rear anatomical supporting and locking plate outside proximal tibial plateau |
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Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102525631B (en) * | 2010-12-28 | 2014-02-19 | 北京国人骨科医疗器械有限公司 | Tibial plateau posterolateral bone fracture plate for fracture at attachment of posterior cruciate ligament |
| WO2013095191A1 (en) * | 2011-12-19 | 2013-06-27 | Общество С Ограниченной Ответственностью "Азбука Технологий" | Fixation device for the osteosynthesis of fractures of the proximal portion of the tibia |
| CN103169534B (en) * | 2011-12-20 | 2016-03-30 | 上海市第六人民医院 | Outside anatomical type locking plate after tibial plateau |
| CN103584908A (en) * | 2013-11-26 | 2014-02-19 | 无锡市第三人民医院 | Steel plate placed behind shin bone and used for fixing shin bone far-end bone fracture |
| CN118121301B (en) * | 2024-05-07 | 2024-09-03 | 北京理贝尔生物工程研究所有限公司 | Anatomical steel plate design method for treating fracture of back side of tibial plateau and anatomical steel plate |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8382807B2 (en) * | 2005-07-25 | 2013-02-26 | Smith & Nephew, Inc. | Systems and methods for using polyaxial plates |
| CN201042458Y (en) * | 2007-04-16 | 2008-04-02 | 洪加源 | Rear and internal side tibia far-end dissection type titanium plate |
| US8257405B2 (en) * | 2008-07-31 | 2012-09-04 | Biomet C.V. | Periarticular bone plate with biplanar offset head member |
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