CN104013458B - 肱骨大结节锁定钢板 - Google Patents

肱骨大结节锁定钢板 Download PDF

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CN104013458B
CN104013458B CN201410265853.8A CN201410265853A CN104013458B CN 104013458 B CN104013458 B CN 104013458B CN 201410265853 A CN201410265853 A CN 201410265853A CN 104013458 B CN104013458 B CN 104013458B
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薛兆龙
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Xue Zhaolong
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8009Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the plate having a ratchet
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones

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  • Orthopedic Medicine & Surgery (AREA)
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  • Surgical Instruments (AREA)

Abstract

本发明公开了一种肱骨大结节锁定钢板,其包括钢板本体,该钢板本体包括依次相连的固定头部、固定中部和固定尾部,固定头部上对称设有两卡爪,固定中部上设有一凸起,所述固定中部上设有多个锁定螺钉孔和克氏针临时固定孔,所述固定尾部上设有远端调节孔和远端克氏针临时固定孔;本发明结构设计合理,结合了张力带原则,借鉴髌骨固定结构及髌腱原理,巧妙设有卡爪及凸起,并科学布局其位置,能较好地同大结节骨折块锚定贴附,满足了最小程度影响肩袖肌活动,最大限度对骨折坚强固定,固定稳定性好,大大提高了手术的安全性和有效性,而且操作方便、灵活,创伤小、避免给患者带来不必要的痛苦,另外整体结构简单,成本低,易于实现,便于广泛推广应用。

Description

肱骨大结节锁定钢板
技术领域
本发明涉及治疗肱骨大结节骨折固定工具技术领域,具体涉及一种用于治疗肱骨大结节骨折的肱骨大结节锁定钢板。
背景技术
肱骨大结节骨折是肱骨近端骨折的一部分,也可以为肩关节脱位合并大结节骨折,是一种临床常见的创伤,以粉碎性骨折常见。由于其解剖特征,肱骨大结节位置不良造成的影响,除了肩峰下撞击征外,还可能造成肩袖肌功能紊乱,直接关系到患肩术后功能康复。
目前治疗以手术治疗为主,内固定物的选择较多,但总是存在一定的不足,主要表现在:螺钉固定可能导致骨折块的进一步粉碎,并且固定时加用垫圈则加大了肩峰下撞击发生的可能;张力带钢丝固定强度大,可能造成医源性肱骨外科颈骨折;若肱骨大结节骨折为粉碎性,锚钉缝线则可能会进一步降低骨折块间的稳定性,并且Braunstein的生物力学测试表明锚钉缝线固定生物力学稳定性远低于螺钉组和张力带组,统计学差异明显,势必影响患者术后早期功能康复锻炼;肱骨近端锁定钢板太长,手术创作较大,有损伤腋神经可能。因此,迫切需要一种专门用于治疗肱骨大结节骨折的工具。
发明内容
针对上述不足,本发明的目的在于,提供一种结构设计巧妙、合理,适用于肱骨大结节固定,且固定牢靠,使用方便的肱骨大结节锁定钢板。
为实现上述目的,本发明所提供的技术方案是:
一种肱骨大结节锁定钢板,其包括钢板本体,所述钢板本体的一端呈逐渐缩小状形成固定尾部,中部水平延伸形成固定中部,另一端向一侧方向弯折形成固定头部,该固定头部的中部设有一缺口,使其两侧对称各形成一卡爪,所述固定中部与所述固定头部相连接处的中间位置设有一凸起,所述固定中部上设有多个锁定螺钉孔和克氏针临时固定孔,所述固定尾部上设有远端调节孔和远端克氏针临时固定孔。
作为本发明的一种改进,所述卡爪的下端较大,上端向内侧方向弯折,并逐渐缩小形成尖角,其中该卡爪的外侧面呈弧形凸起状,而内侧面呈弧形凹入状。两卡爪整体呈双爪样,使得爪尖能进一步同大结节骨折块锚定贴附,进而减小对肩袖肌活动的影响,以及较好地对骨折进行固定,整体结构符合肱骨近端解剖特点,与骨面贴附紧密。
作为本发明的一种改进,所述凸起的横截面外形轮廓呈三角形,定位固定效果更佳。
作为本发明的一种改进,所述固定中部与所述固定头部之间的夹角为80~100度。
作为本发明的一种改进,所述锁定螺钉孔分布在所述固定中部的两侧,且两侧的锁定螺钉孔交错排列,相邻两锁定螺钉孔之间的间距为10mm,便于更好地稳定固定。
作为本发明的一种改进,所述远端调节孔的外形轮廓为椭圆形,以方便调节固定位置,满足不同形状大小的肱骨大结的锁定和固定。
作为本发明的一种改进,所述锁定螺钉孔的直径为3.2~3.8mm,克氏针临时固定孔的直径为1~1.2mm,所述远端克氏针临时固定孔的直径为1~1.2mm;所述固定头部与凸起之间的间隔为5~6mm;所述钢板本体的厚度为2.3~2.7mm,宽度为15~17mm,长度为50~54mm。结构设计巧妙、合理。
本发明的有益效果为:本发明结构设计合理,结合了张力带原则,借鉴髌骨固定结构及髌腱原理,巧妙设有卡爪及凸起,并科学布局其位置,能较好地同大结节骨折块锚定贴附,满足了最小程度影响肩袖肌活动,最大限度对骨折坚强固定,固定稳定性好,大大提高了手术的安全性和有效性,而且操作方便、灵活,创伤小、避免给患者带来不必要的痛苦,另外整体结构简单,成本低,易于实现,便于广泛推广应用。
下面结合附图与实施例,对本发明进一步说明。
附图说明
图1是本发明的立体结构示意图。
图2是本发明的主视结构示意图。
图3是本发明的侧视结构示意图。
图4是本发明的俯视结构示意图。
具体实施方式
参见图1至图4,本实施例提供的一种肱骨大结节锁定钢板,其包括钢板本体1,所述钢板本体1的一端呈逐渐缩小状形成固定尾部11,中部水平延伸形成固定中部12,另一端向一侧方向弯折形成固定头部13,该固定头部13的中部设有一缺口131,使其两侧对称各形成一卡爪132,所述固定中部12与所述固定头部13相连接处的中间位置设有一凸起121,所述固定中部12上设有多个锁定螺钉孔122和克氏针临时固定孔123,所述固定尾部11上设有远端调节孔111和远端克氏针临时固定孔112。
较佳的,参见图2,所述卡爪132的下端较大,上端向内侧方向弯折,并逐渐缩小形成尖角,其中该卡爪132的外侧面呈弧形凸起121状,而内侧面呈弧形凹入状。两卡爪132整体呈双爪样,使得爪尖能进一步同大结节骨折块锚定贴附,进而减小对肩袖肌活动的影响,以及较好地对骨折进行固定。
参见图2,所述凸起121的横截面外形轮廓呈三角形,其定位固定效果更佳。参见图3,所述固定中部12与所述固定头部13之间的夹角为80~100度。
参见图4,所述锁定螺钉孔122分布在所述固定中部12的两侧,且两侧的锁定螺钉孔122交错排列,相邻两锁定螺钉孔122之间的间距为10mm,便于更好地稳定固定。而所述远端调节孔111的外形轮廓为椭圆形,以方便调节固定位置,满足不同形状大小的肱骨大结的锁定和固定。在实施例中,较佳的,所述锁定螺钉孔122的直径为3.2~3.8mm,优选为3.5mm;克氏针临时固定孔123的直径为1~1.2mm,优选为1mm,所述远端克氏针临时固定孔112的直径为1~1.2mm,优选为1mm;所述固定头部13与凸起121之间的间隔为5~6mm,优选为6mm;所述钢板本体1的厚度为2.3~2.7mm,优选为2.5mm,宽度为15~17mm,优选为16mm,长度为50~54mm,优选为50mm。结构设计巧妙、合理。
使用时,取患肩前内侧切口,由三角肌胸大肌间隙进入,将三角肌向外侧牵开,暴露骨折端,清除血肿及嵌入骨折端的软组织,将骨折块解剖复位,用本发明肱骨大结节锁定钢板进行固定,使两卡爪132和凸起121的同大结节骨折块锚定贴附,伴有肩袖撕裂的同时修复,伴肩关节脱位的患者术中行关节囊修复。同时设有锁定螺钉孔122、克氏针临时固定孔123、远端调节孔111和远端克氏针临时固定孔112,能配合带线锚钉治疗移位的肱骨大结骨折,利用张力带固定的原理加上螺丝钉的固定,有利于骨折端的稳定,允许早期患肢功能锻炼,最大限度地减少患肢肩关节撞击、关节僵硬,疗效效果好,功能恢复良好,疼痛缓解明显,避免给患者带来不必要的痛苦,大大提高了手术的安全性和有效性,而且操作方便、灵活。
根据上述说明书的揭示和教导,本发明所属领域的技术人员还能够对上述实施方式进行变更和修改。因此,本发明并不局限于上述的具体实施方式,凡是本领域技术人员在本发明的基础上所作出的任何显而易见的改进、替换或变型均属于本发明的保护范围。此外,尽管本说明书中使用了一些特定的术语,但这些术语只是为了方便说明,并不对本发明构成任何限制,采用与其相同或相似结构而得到的其它固定部件,均在本发明保护范围内。

Claims (1)

1.一种肱骨大结节锁定钢板,其包括钢板本体,其特征在于,所述钢板本体的一端呈逐渐缩小状形成固定尾部,中部水平延伸形成固定中部,另一端向一侧方向弯折形成固定头部,该固定头部的中部设有一缺口,使其两侧对称各形成一卡爪,所述固定中部与所述固定头部相连接处的中间位置设有一凸起,所述固定中部上设有多个锁定螺钉孔和克氏针临时固定孔,所述固定尾部上设有远端调节孔和远端克氏针临时固定孔;
所述卡爪的下端较大,上端向内侧方向弯折,并逐渐缩小形成尖角,其中该卡爪的外侧面呈弧形凸起状,而内侧面呈弧形凹入状;
所述固定中部与所述固定头部之间的夹角为80~100度;
所述锁定螺钉孔分布在所述固定中部的两侧,且两侧的锁定螺钉孔交错排列;
所述凸起的横截面外形轮廓呈三角形;
相邻两锁定螺钉孔之间的间距为10mm;
所述远端调节孔的外形轮廓为椭圆形;
所述锁定螺钉孔的直径为3.2~3.8mm,克氏针临时固定孔的直径为1~1.2mm,所述远端克氏针临时固定孔的直径为1~1.2mm;
所述固定头部与凸起之间的间隔为5~6mm;
所述钢板本体的厚度为2.3~2.7mm,宽度为15~17mm,长度为50~54mm。
CN201410265853.8A 2014-06-16 2014-06-16 肱骨大结节锁定钢板 Expired - Fee Related CN104013458B (zh)

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CN106073881A (zh) * 2016-07-08 2016-11-09 丽水市人民医院 一种带钩肱骨近端锁定接骨板
CN106109000A (zh) * 2016-08-23 2016-11-16 浙江科惠医疗器械股份有限公司 一种肱骨近端组合式内固定系统
CN106943188A (zh) * 2017-05-05 2017-07-14 邳州东大医院 肱骨大结节骨折复位固定器械

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