CN104188716A - Acetabulum parastyle and posterior column united steel plate - Google Patents
Acetabulum parastyle and posterior column united steel plate Download PDFInfo
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- CN104188716A CN104188716A CN201410329224.7A CN201410329224A CN104188716A CN 104188716 A CN104188716 A CN 104188716A CN 201410329224 A CN201410329224 A CN 201410329224A CN 104188716 A CN104188716 A CN 104188716A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8038—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being inserted in the screw head
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
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- Engineering & Computer Science (AREA)
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Abstract
The invention discloses an acetabulum parastyle and posterior column united steel plate. The united steel plate is composed of a main plate, a parastyle steel plate and a baffle which are connected into a whole. At least two threaded holes are formed in the main plate and are arranged along the bow-shaped edge from the proximately-bow-shaped edge face of the fossa iliaca. The axis of each threaded hole is vertical. One side of the main plate is bent downwards and extends to the square area above the ischial spine to form the baffle. The curved surface formed by the lower surface of the baffle and the lower surface of the main plate is matched with the curved surface formed by the corresponding proximately-bow-shaped edge face of the fossa iliaca, the surface of a bow-shaped edge from the front edge of the sacroiliac joint and the surface of the square area above the ischial spine of the acetabulum bone. A plurality of fixed screw holes are formed in the baffle. The parastyle steel plate extends to the ramus superior ossis pubis from one end of the main plate along the surface of the proximately-bow-shaped edge face of the fossa iliaca. A parastyle fixing screw hole is formed in the parastyle steel plate. The bone fracture plate is easy and convenient to operate, high in safety, small in operation wound, and capable of being used for simultaneously drawing in fractured acetabulums of the parastyle and the posterior column.
Description
Technical field
The present invention relates to a kind of surgical instruments, be specifically related to the fixation steel plate of acetabular bone and peripheral structure, this associating steel plate is applicable to the fracture repair of acetabular anterior column and rear pillar.
Background technology
Acetabular bone and peripheral structure can be divided into front pillar and rear pillar, and front pillar, by oblique front lower place, crista iliaca top, terminates in pubic symphysis through pubic branch, part ilium and pubis, consists of; Rear pillar by greater sciatic notch through acetabular bone center to ischial tuberosity, comprise the vertical component of ischium and the part ilium being connected with ischium; Front and back post is down " Y " shape, as cradle shape, has acetabular bone in arms, at medial surface, meets at squared region, can prevent that hip joint is shifted to the inside.Fracture of acetabulum is divided into 2 large classes: simple and complexity, every large class is divided into again 5 subclass, in these 10 kinds of classification of fracture, although do not define separately squared region fracture, but except part Fracture Simple (simple antetheca, rear wall, part front pillar fracture), other fracture all can involve squared region.
Operative treatment is considered to the first-selected therapeutic scheme of the fracture of acetabulum of displacement, and the principle of operative treatment of acetabular fractures is that the treatment of reset is determining the effect of operative treatment by the anatomical reduction of heavy burden articular surface being realized to the good recovery of function of joint.But there is following first technical problem: because the residing anatomical position of acetabular bone is darker, adjoin anatomy relationship complexity, traditional operation and internal fixation method are too pursued the reset of fracture and fixing stability, then ignored long incision, expose extensively, hemorrhage volume, post-operative complication is more, concrete as, the problems such as iatrogenic injury of sciatic nerve, ectopic ossification, femur head necrosis.
For the fracture of acetabulum that involves front pillar and rear pillar simultaneously, the treatment in past can adopt fixedly rear pillar of double steel plate by single rear K-L approach, but there is following second technical problem: this often occurs postoperative reset loss, causes being shifted again of sclerite, solid failure in final appearance.
Also have through anterior-posterior, front pillar, rear pillar are fixed with reconstruction plate respectively, after the method is fixing, but there is following the 3rd technical problem: forward and backward post is just fixed respectively, before and after between post or lack contact, and because operation wound is large, easily cause the incidence rate that intraoperative hemorrhage is many, increase complication such as infecting probability and heterotopic ossification following surgical, finally still patient's function of joint is caused to great harmful effect.
The applicant in first to file, a kind of navigation template (publication number is CN102657553A) of implanting acetabular posterior column screw,
but there is following several technical problem:in clinical, fracture of acetabulum often involves front pillar and rear pillar simultaneously, implant the navigation template of acetabular posterior column screw, be single for safety, implant acetabular posterior column screw exactly, after pedicle screw, navigation template will take out external, can not solve the fixing of front pillar, the fixing barrier functionality that does not possess squared region of simple rear pillar lag screw, does not more have the forward and backward post of acetabular bone and combines fixing effect simultaneously.
In sum, still there is no at present a implantable internal fixation device, can be by single operative approach exactly, safely acetabular anterior column and rear pillar be fixed simultaneously, and keep contacting between front pillar and rear pillar, front pillar, rear pillar is fixing as a whole, have simultaneously and stop squared region, prevent that sclerite is again to the function of pelvic cavity internal shift.
Summary of the invention
The deficiency that the present invention exists in order to overcome above prior art, provides a kind of acetabular bone front and back post associating steel plate, and blade plate of the present invention is easy and simple to handle, safety good, operation wound is little, can be used for involving the fracture of acetabulum of forward and backward post simultaneously.
Object of the present invention realizes by following technical scheme: post associating steel plate before and after this acetabular bone, and associating steel plate consists of the mainboard being connected, Anterior column plate and baffle plate, wherein,
On described mainboard, at least have two screwed holes that connect rear pillar lock screw sleeve, this screwed hole is arranged along arciform edge from the near arciform edge face near iliac fossa, and the axis of each screwed hole is vertical;
The squared region that described baffle plate is bent downwardly and extends to and be more than ischial spine by a side of mainboard forms, and the formed curved surface of lower surface of the two is with the near arciform edge face of corresponding iliac fossa, before sacroiliac joint, the formed curved surface in the surface of one section of arciform edge and surface, the squared region more than ischial spine of acetabular bone of genesis matches; On baffle plate, have some fixing screw holes;
By of mainboard, the surface along the near arciform edge face of iliac fossa extends to superior ramus of pubis to described Anterior column plate; On described Anterior column plate, have some front pillar fixing screw holes of arranging along Anterior column plate length direction.
Between the every adjacent front pillar fixing screw hole of described Anterior column plate, be provided with two semi-circular recesses.
Described front pillar fixing screw hole is 3-8, and diameter is 3.5mm, and is arranged in a row along arciform edge.
Described screwed hole is 2, diameter 5mm.
The diameter of described fixing screw hole is 3.5mm.
Described steel plate thickness is 2mm, and steel plate is that medical stainless steel or titanium alloy are made.
The present invention has advantages of as follows with respect to prior art:
The present invention is a kind ofly applicable to combine fixedly acetabular anterior column and rear pillar, and has the internal fixation device of baffle plate barrier functionality, and in this research, man, female's experimental data there are differences, therefore be designed to man, two kinds of specifications of female; Have left and right two, this steel plate consists of mainboard, Anterior column plate, baffle plate, the screwed hole of mainboard is used for connecting external sleeve, by sleeve, play guide effect, can be used for inserting rear pillar lag screw from anterior lateral cervical approach direct motion, screw can not be placed in hip joint, has safety, feature accurately; Anterior column plate is the reconstruction plate design in 3-8 hole, along arciform edge, places, and can facilitate mouldingly, selects number and the position of the screw implanted according to the position of front pillar fracture line and patient's pelvis size; Baffle plate is attached at squared region, has plain screw hole on baffle plate, is fixed to the rear portion of rear pillar for inserting screw, can stop that whole associating steel plate is to Intrapelvic displacement.
The advantage of this device is through single anterior lateral cervical approach, to reset and to fix complicated fracture of acetabulum, square shaped district has and stops the function that prevents that it is shifted again, and front pillar, rear pillar are combined fixing as a whole, one block plate can be combined fixedly front pillar and rear pillar, and can prevent to Intrapelvic displacement.The present invention is intended to the stability by the least possible interior fixedly acquisition fracture of acetabulum maximum, and its object will reduce operation wound exactly as much as possible, shortens operating time, especially very important for the larger complicated operation of fracture of acetabulum of wound.
Accompanying drawing explanation
Fig. 1 is the top view of post associating steel plate before and after acetabular bone of the present invention.
Fig. 2 is the upward view of Fig. 1.
Fig. 3 is the axonometric chart of Fig. 1.
Fig. 4 is the using state figure of Fig. 1.
The specific embodiment
Below in conjunction with drawings and Examples, the invention will be further described.
Post associating steel plate before and after acetabular bone as shown in Figure 1 to 4, associating steel plate consists of the mainboard 1 being connected, Anterior column plate 2 and baffle plate 3, wherein,
On mainboard 1, have two screwed holes 4 that connect rear pillar lock screw sleeve 14, this screwed hole 4 is arranged along arciform edge 12 from the near arciform edge face 9 of iliac fossa, and the axis of each screwed hole 4 is vertical;
Baffle plate 3 is bent downwardly and extends to more than 15 squared region 11 of ischial spine by a side of mainboard 1 and forms, and, the near arciform edge face 9 of the formed curved surface of lower surface of the two and corresponding iliac fossa, from the surface of one section of arciform edge 12 and the more than 15 formed curved surface in squared region 11 of the ischial spine of acetabular bone of sacroiliac joint 10 front genesis, match; On baffle plate 3, have 4 fixing screw holes 6;
By of mainboard 1, the surface along the near arciform edge face 9 of iliac fossa extends to superior ramus of pubis 13 to Anterior column plate 2; On Anterior column plate 2, have 6 front pillar fixing screw holes 5 of arranging along Anterior column plate 2 length directions.
The arciform edge 12 that Anterior column plate 2 sends tailing edge ilium from mainboard 1 walks to walk to superior ramus of pubis 13, after moulding, be fixed to pubis above or inner face.Inserting the screw of front pillar fixing screw hole 5 can select according to different front pillar fracture line position, pelvis structure size; The screwed hole 4 of 2 on mainboard 1, hand of spiral is fixed, and is furnished with special rear pillar lock screw sleeve 14, can insert guide pin 7 through rear pillar lock screw sleeve 14, sees after guide pin 7 positions are well and can pull out guide pin 7, and insert lag screw through perspective; On baffle plate 3, there is fixing screw hole 6, baffle plate 3 can be fixed on to the rear portion of rear pillar after inserting screw.
As shown in Figure 4, in operation, fully expose after the fracture site on acetabular bone 8, for answering the fracture of acetabulum of good position, associating steel plate is placed on the arciform edge 12 of ilium, keep the lower surface of mainboard 1 and baffle plate 3 fully contact with near arciform edge face 9, the squared region 11 of iliac fossa respectively, then to sacroiliac joint 10 directions promotions, until that steel plate pushes away is motionless, now, the medial border of baffle plate 3 is concordant with the medial border of the squared region 11 of acetabular bone 8.
Between the every adjacent front pillar fixing screw hole 5 of Anterior column plate 2, be provided with two semi-circular recesses 7.Front pillar fixing screw hole 5 diameters are 3.5mm, and are arranged in a row along the arciform edge 12 of ilium.Screwed hole 4 diameter 5mm on mainboard 1.The diameter of fixing screw hole 6 is 3.5mm.Steel plate thickness is 2mm, and steel plate is that medical stainless steel or titanium alloy are made, high-temperature sterilization repeatedly.
The external rear pillar lock screw of screwed hole 4 sleeve 14, rear pillar lock screw sleeve 14 plays guide effect, inserts fixedly rear pillar of lag screw; Anterior column plate is placed along arciform edge, has good moulding function, guarantees the good attaching of steel plate, be designed to 6 holes, insert fixedly front pillar of screw, steel plate can be combined the front pillar of acetabular bone and rear pillar fixing as a whole, is applicable to involve the fracture of acetabulum of front pillar and rear pillar simultaneously; Fixing screw hole on baffle plate, is fixed to the rear portion of rear pillar for inserting screw, can also prevent that it is shifted to pelvic cavity again in firm squared region.
In this research, man, female's experimental data there are differences, therefore be designed to man, two kinds of specifications of female; Because human pelvis has symmetrical left acetabular bone and right acetabular bone, therefore before and after acetabular bone of the present invention, post associating steel plate obviously comprises before and after the acetabular bone of left side before and after post associating steel plate and right side acetabular bone two kinds of post associating steel plates, and the structure of the two mirror image each other.
The manufacture method of this associating steel plate, the method comprises the following steps:
A, the Three-dimension Reconstruction Model of acetabular bone is imported in three-dimensional drawing software, in the predetermined area of the upper surface of the squared region of iliac fossa, acetabular bone and the arciform edge of acetabular bone, evenly pick up several points, then picked up point is fitted to a curved surface, thicken again, just the mainboard and the squared region baffle plate that obtain post associating steel plate in front and back to be produced, extend the Anterior column plate of walking to walk to superior ramus of pubis along the near arciform edge face of iliac fossa from mainboard;
B, drafting are for simulating the centrage that acetabular posterior column screw enters to follow closely passage, then swinging pattern is also adjusted respectively locus and the angle of described centrage, make each centrage all pass through the central region of acetabular posterior column, after suitable, in two screw holes of mainboard, set up the helix vertical with centrage, design a supporting sleeve, after sleeve is inserted in screw hole, make parallel the passing through in sleeve of centrage, complete the making of virtual front and back post associating steel plate;
C, the resulting virtual front and back post associating steel plate of take are workpiece, and lathe is produced, and steel plate is that medical stainless steel or titanium alloy are made.
Above content description ultimate principle of the present invention, principal character, using skill and advantage of the present invention.Should be understood that; the present invention is not restricted to the described embodiments; that in above-described embodiment and description, describes just illustrates principle of the present invention; do not departing under the prerequisite of the principle of the invention and scope; the present invention also has multiple changes and improvements; such as: any guider with aiming function that straddles " L " type in this anatomical structure of placing along true pelvis edge, any for combining the fixedly internal fixation device of acetabular anterior column, rear pillar, all should belong in protection scope of the present invention.
Claims (6)
1. a post associating steel plate before and after acetabular bone, is characterized in that: associating steel plate consists of the mainboard being connected, Anterior column plate and baffle plate, wherein,
On described mainboard, at least have two screwed holes that connect rear pillar lock screw sleeve, this screwed hole is arranged along arciform edge from the near arciform edge face of iliac fossa, and the axis of each screwed hole is vertical;
The squared region that described baffle plate is bent downwardly and extends to and be more than ischial spine by a side of mainboard forms, and the formed curved surface of lower surface of the two is with the near arciform edge face of corresponding iliac fossa, before sacroiliac joint, the formed curved surface in the surface of one section of arciform edge and surface, the squared region more than ischial spine of acetabular bone of genesis matches; On baffle plate, have some fixing screw holes;
By of mainboard, the surface along the near arciform edge face of iliac fossa extends to superior ramus of pubis to described Anterior column plate; On described Anterior column plate, have some front pillar fixing screw holes of arranging along Anterior column plate length direction.
2. post associating steel plate before and after a kind of acetabular bone according to claim 1, is characterized in that: between the every adjacent front pillar fixing screw hole of described Anterior column plate, be provided with two semi-circular recesses.
3. post associating steel plate before and after a kind of acetabular bone according to claim 1, is characterized in that: described front pillar fixing screw hole is 3-8, and diameter is 3.5mm, and is arranged in a row along arciform edge.
4. post associating steel plate before and after a kind of acetabular bone according to claim 1, is characterized in that: described screwed hole is 2, diameter 5mm.
5. post associating steel plate before and after a kind of acetabular bone according to claim 1, is characterized in that: the diameter of described fixing screw hole is 3.5mm.
6. post associating steel plate before and after a kind of acetabular bone according to claim 1, is characterized in that: described steel plate thickness is 2mm, and steel plate is that medical stainless steel or titanium alloy are made.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410329224.7A CN104188716B (en) | 2014-07-10 | 2014-07-10 | Post associating steel plate before and after a kind of acetabular bone |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
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| CN201410329224.7A CN104188716B (en) | 2014-07-10 | 2014-07-10 | Post associating steel plate before and after a kind of acetabular bone |
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| CN104188716A true CN104188716A (en) | 2014-12-10 |
| CN104188716B CN104188716B (en) | 2016-08-24 |
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| CN201410329224.7A Expired - Fee Related CN104188716B (en) | 2014-07-10 | 2014-07-10 | Post associating steel plate before and after a kind of acetabular bone |
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Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104644255A (en) * | 2015-02-05 | 2015-05-27 | 郭晓东 | Fixing device for fractures of anterior column, posterior column and square area of acetabulum and method |
| CN105266879A (en) * | 2015-09-01 | 2016-01-27 | 郭晓东 | Device and method for fixing acetabular front pillar and front wall fracture |
| CN105342681A (en) * | 2015-11-24 | 2016-02-24 | 李明 | Universal anatomical locking bone fracture plate for inner side of acetabulum and matched apparatuses of universal anatomical locking bone fracture plate |
| CN105496538A (en) * | 2016-02-05 | 2016-04-20 | 侯志勇 | Acetabulum square area bone fracture plate |
| CN105662567A (en) * | 2016-03-16 | 2016-06-15 | 苏州瑞华医院有限公司 | Bone plate provided with grooves |
| CN105769319A (en) * | 2016-03-19 | 2016-07-20 | 王钢 | Posterior fixing steel plate for fracture of acetabular anterior and posterior columns |
| WO2016124132A1 (en) * | 2015-02-05 | 2016-08-11 | 郭晓东 | Device and method for fixing acetabular anterior and posterior column and tetragonal region fractures |
| CN106420030A (en) * | 2016-10-14 | 2017-02-22 | 重庆医科大学附属第医院 | Design method and device of internal fixation system for fracture of quadrilateral body of acetabulum |
| CN107510500A (en) * | 2017-09-11 | 2017-12-26 | 哈尔滨医科大学 | Anatomical form pubic symphysis locking steel plate |
| CN113440240A (en) * | 2021-04-27 | 2021-09-28 | 华中科技大学同济医学院附属协和医院 | Acetabulum posterior column screw guide device and use method thereof |
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Cited By (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2016124132A1 (en) * | 2015-02-05 | 2016-08-11 | 郭晓东 | Device and method for fixing acetabular anterior and posterior column and tetragonal region fractures |
| CN104644255A (en) * | 2015-02-05 | 2015-05-27 | 郭晓东 | Fixing device for fractures of anterior column, posterior column and square area of acetabulum and method |
| CN105266879A (en) * | 2015-09-01 | 2016-01-27 | 郭晓东 | Device and method for fixing acetabular front pillar and front wall fracture |
| CN105342681A (en) * | 2015-11-24 | 2016-02-24 | 李明 | Universal anatomical locking bone fracture plate for inner side of acetabulum and matched apparatuses of universal anatomical locking bone fracture plate |
| CN105496538A (en) * | 2016-02-05 | 2016-04-20 | 侯志勇 | Acetabulum square area bone fracture plate |
| CN105496538B (en) * | 2016-02-05 | 2018-01-23 | 侯志勇 | A kind of acetabular bone squared region bone plate |
| CN105662567A (en) * | 2016-03-16 | 2016-06-15 | 苏州瑞华医院有限公司 | Bone plate provided with grooves |
| CN105769319A (en) * | 2016-03-19 | 2016-07-20 | 王钢 | Posterior fixing steel plate for fracture of acetabular anterior and posterior columns |
| CN105769319B (en) * | 2016-03-19 | 2018-01-12 | 王钢 | A kind of Posterior fixation steel plate rolled over for the spinous process of the seventh cervical vertebra before and after acetabular bone |
| CN106420030A (en) * | 2016-10-14 | 2017-02-22 | 重庆医科大学附属第医院 | Design method and device of internal fixation system for fracture of quadrilateral body of acetabulum |
| CN107510500A (en) * | 2017-09-11 | 2017-12-26 | 哈尔滨医科大学 | Anatomical form pubic symphysis locking steel plate |
| CN113440240A (en) * | 2021-04-27 | 2021-09-28 | 华中科技大学同济医学院附属协和医院 | Acetabulum posterior column screw guide device and use method thereof |
| CN113440240B (en) * | 2021-04-27 | 2023-02-28 | 华中科技大学同济医学院附属协和医院 | Acetabulum posterior column screw guide device and use method thereof |
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| CN104188716B (en) | 2016-08-24 |
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