CN104352273A - Device for preventing femoral head necrosis after femoral neck fracture and treating femoral head necrosis - Google Patents

Device for preventing femoral head necrosis after femoral neck fracture and treating femoral head necrosis Download PDF

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Publication number
CN104352273A
CN104352273A CN 201410541109 CN201410541109A CN104352273A CN 104352273 A CN104352273 A CN 104352273A CN 201410541109 CN201410541109 CN 201410541109 CN 201410541109 A CN201410541109 A CN 201410541109A CN 104352273 A CN104352273 A CN 104352273A
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screw
negative pressure
repair
femoral
lumen
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CN 201410541109
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Chinese (zh)
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CN104352273B (en )
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刘振东
周嘉辉
陈腾飞
吴松
张克祥
王魁向
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刘振东
周嘉辉
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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
    • A61B17/74Devices for the head or neck or trochanter of the femur

Abstract

The invention relates to fixation and repair at the positions of femoral neck fractures, in particular to a device for preventing femoral head necrosis after femoral neck fractures and treating the femoral head necrosis. The device comprises a hollow repair screw arranged at a femoral neck fracture; a section of threads screwed in a femoral head is formed in the inner end of the repair screw; a plurality of through holes communicated with the inner cavity of the hollow repair screw are formed in the section of screw threads; a connecting head is arranged at the outer end of the repair screw, and a negative pressure pipe connected with a negative pressure machine is communicated with the inner cavity through the connecting head. According to the device, the negative pressure environment is formed around the inner end of the repair screw by adopting the negative pressure pipe, and thus the mechanical stretching of cells at the fracture is realized, the growth of the cells and granulation tissue is promoted, the expression of cell factors such as TGFs (Transforming Growth Factors) and VEGFs (Vascular Endothelial Growth Factors) is promoted, and the purpose of quick healing is achieved; meanwhile, a reverse threaded column is adopted to be connected with the negative pressure pipe, and when the negative pressure pipe is detached, the repair screw is more fastened, so that the safety of operation is improved.

Description

预防股骨颈骨折后股骨头坏死及治疗股骨头坏死的装置 Prevention of femoral neck fracture and osteonecrosis of the femoral head necrosis treatment device

技术领域 FIELD

[0001] 本发明涉及股骨颈骨折断裂处的固定和修复,具体说是预防股骨颈骨折后股骨头坏死及治疗股骨头坏死的装置。 [0001] The present invention relates to fixation of femoral neck fractures and breaks repair, specifically means osteonecrosis and femoral head necrosis of femoral neck fracture prevention.

背景技术 Background technique

[0002] 股骨颈骨折常发生于老年人。 [0002] Femoral Neck Fractures often occur in the elderly. 随着人的寿命延长,其发病率日渐增高,尤其随着人口老龄化,该病已成为严重的社会问题,其临床治疗中存在骨折不愈合和股骨头缺血坏死两个主要难题。 With people living longer, the incidence rate gradually increased, especially as the population ages, the disease has become a serious social problem, there is a fracture in the clinical treatment of nonunion and avascular necrosis two major problems. 至今,股骨颈骨折的治疗及结果等多方面仍遗留许多未解决的问题。 So far, the treatment of femoral neck fracture and results and other aspects still left many questions unresolved. 由于暴力导致发生于年轻人的股骨颈骨折,也由于股骨颈骨折处的血运差,常常导致后期的股骨头坏死。 Because of the violence occurred in the femoral neck fractures lead to young people, but also because of poor blood supply of femoral neck fracture, often resulting in the latter part of the femoral head necrosis.

[0003] 股骨颈骨折根据骨断裂的具体位置不同而分为多种类型,其治疗方法也复杂多样,治疗的难度也相对较高,如治疗不当或不成功可能会对局部供血产生影响,甚至可能发生骨折断裂部位闭合不完全而造成股骨头坏死。 [0003] There are several types of femoral neck fractures and bone fracture depending on the specific location, which is also complex and diverse methods of treatment, the treatment is relatively high difficulty, such as unsuccessful or improper treatment might affect local blood supply, and even fracture fracture site may occur caused by incomplete closure of femoral head necrosis. 通常,外科医生会选择两至四颗加压螺纹钉作为内固定钉对骨折断裂处进行固定,从而减少骨折线的错位和股骨头的塌陷。 Typically, the surgeon will choose two to four compression screws as fracture fixation nail breaks fixed, thereby reducing dislocation and femoral head collapse of the fracture line. 目前来说,股骨颈骨折的并发症有:1、股骨颈骨折处不愈合,股骨颈骨折发生不愈合比较常见,文献报道其不愈合率为7%-15%,在四肢骨折中发生率最高。 For now, there are complications in femoral neck fractures: 1, femoral neck fracture nonunion, femoral neck fracture nonunion more common, it is not reported healing rate of 7% to 15%, the highest rate in the fracture extremities . 2、股骨头缺血坏死是股骨颈骨折常见的并发症,近年来随着治疗的进展,骨折愈合率可达90%以上。 2, avascular necrosis of the femoral neck fracture is a common complication in recent years, with the progress of treatment, fracture healing rate of 90%. 但股骨头坏死率迄今仍无明显的下降。 But so far no noticeable femoral head necrosis rate of decline. 目前股骨头坏死的治疗有股骨颈钻孔减压术,带血管蒂骨块转移术,以及髋关节置换术等,均给患者带来不小的创伤和痛苦,以及不满意的效果。 Currently the treatment of osteonecrosis of the femoral neck drilling decompression, vascularized pedicle bone metastasis surgery and hip replacement, are not a small trauma and pain to the patient, and the results are not satisfactory.

发明内容 SUMMARY

[0004] 针对上述技术问题,本发明提供一种可改善股骨颈骨折术后股骨头血运,促进股骨颈骨折愈合,预防股骨头坏死,以及治疗股骨头坏死的装置。 [0004] For the above technical problems, the present invention provides an improved blood supply of the femoral head after femoral neck fracture, femoral neck fracture to promote healing, prevention osteonecrosis and femoral head necrosis treatment apparatus.

[0005] 本发明解决上述技术问题所采用的技术方案为:预防股骨颈骨折后股骨头坏死及治疗股骨头坏死的装置,包括设置于股骨颈骨折断裂处的中空修复螺钉,该修复螺钉内端成型有拧入股骨头的一段螺纹,在该段螺纹上开具有与该中空修复螺钉内腔连通的数个通孔;所述修复螺钉的外端设置有连接头,连接负压机的负压管通过该连接头与所述内腔连通。 [0005] aspect of the present invention to solve the above technical problem is: prevention of femoral neck fractures and osteonecrosis of the femoral head necrosis treatment apparatus, comprising a hollow provided in the repair of femoral neck fracture breaks screw, which fixes the inner end of the screw shaped section with a thread screwed into the femoral head, a threaded section on which a screw opening having a lumen fixes the hollow communicating with a number of through-holes; repair of the outer end of the screw is provided with a connector, connecting the suction pipe negative pressure machine by communicating with the lumen of the connector.

[0006] 作为优选,所述修复螺钉的外端面向外周壁延伸有凸缘,所述连接头包括设置在该凸缘上与所述一段螺纹的旋向相反的螺纹柱,所述负压管与该螺纹柱进行密封螺纹连接,该螺纹柱将负压管与所述内腔连通。 [0006] Advantageously, the outer end surface of the screw fixes the outer peripheral wall extending flange, said connector comprising a flange disposed on the threaded section of the screw threaded post opposite to the negative pressure tube sealing threaded connection with the threaded post, the threaded post to the negative pressure tube communicating with the lumen.

[0007] 作为优选,所述螺纹柱为中空螺纹柱,其空腔连通所述负压管和内腔。 [0007] Advantageously, the threaded post has a hollow threaded post, which is communicating with the cavity and the negative pressure tube lumen.

[0008] 作为优选,所述螺纹柱轴向开具有数个负压孔,所述负压管通过该数个负压孔与所述内腔连通。 [0008] Advantageously, the threaded post issued several negative axial holes, through which the negative pressure tube in communication with the plurality of suction hole lumen.

[0009] 作为优选,所述凸缘外周呈外六角形。 [0009] Advantageously, the outer periphery of the flange outer hexagon shape.

[0010] 作为另一种优选,所述连接头包括所述修复螺钉的螺帽,在该螺帽上由外向内设置有与所述一段螺纹的旋向相反的内螺纹,所述负压管与该内螺纹进行密封螺纹连接,该负压管与所述内腔连通。 [0010] As another preferred, said connector comprising a cap head screw of the repair, the outside to inside is provided with a threaded section on the threaded nut screwed into the opposite, the negative pressure tube sealing connection with the inner screw thread, which suction tube communicates with the lumen.

[0011] 作为优选,所述一段螺纹的牙底开具有所述数个通孔。 [0011] Advantageously, the threaded section of the teeth having a bottom opening and a plurality of through-holes.

[0012] 作为优选,所述断裂处还设置有至少一枚加压螺钉。 [0012] Advantageously, the breaks provided with at least one further compression screw.

[0013] 从以上技术方案可知,本发明采用负压管使修复螺钉的内端周围形成负压环境,从而引起血细胞的趋向移动,增加骨折断端血运,使骨生长因子在骨折端或负压区聚集,促进成骨细胞和肉芽组织生长,使TGF、VEGF等细胞因子表达提升,从而达到快速愈合的目的;加之,本发明的修复螺钉尾端采用反向螺纹柱与带螺纹负压管连接,可在卸掉负压管时,保证修复螺钉更加紧固,提高了手术的安全性。 [0013] apparent from the above technical solutions, the present invention employs negative pressure tube so that the inner end of the screw around repair a negative pressure environment, causing the blood cells tend to move, the fracture site to increase blood circulation, bone growth factor or fracture negative nip aggregation, promote osteoblast growth of granulation tissue and the cytokines TGF, VEGF, etc. expression of lifting, so as to achieve quick healing; Additionally, the present invention fixes the trailing end of the screw threaded post counter using the negative pressure tube and a threaded connection, can be relieved when the negative pressure tube, guarantee to fix the fastening screw further improve the safety of operation.

附图说明 BRIEF DESCRIPTION

[0014] 图1是本发明的一种优选方式的结构示意图; [0014] FIG. 1 is a schematic structural diagram of a preferred embodiment of the present invention;

图2是本发明修复螺钉的结构示意图; FIG 2 is a structural diagram of the present invention fixes the screw;

图3是本发明异于图2中的连接头的结构示意图; FIG 3 is a schematic view of the connector in FIG. 2 is different from the present invention;

图4是本发明另一种修复螺钉的结构示意图。 FIG 4 is a schematic diagram of another configuration of the present invention fixes the screw.

具体实施方式 detailed description

[0015] 下面结合图1、图2详细介绍本发明的装置包括设置于股骨颈1骨折断裂处的中空修复螺钉2,该修复螺钉内端成型有拧入股骨头的一段螺纹21,在该段螺纹上开具有与该中空修复螺钉内腔22连通的数个通孔23,通孔可开具在牙底,也可开具在牙顶,修复螺钉内端端面可封闭,也可具有开口;所述修复螺钉的尾端设置有连接头3,一连接负压机(图中未示出)的负压管或病房中心负压4通过该连接头与所述内腔连通,负压机或中心负压依次通过负压管、连接头、内腔、通孔为修复螺钉的内端提供负压环境,负压管为高分子塑料所制。 [0015] below with reference to FIG. 1, FIG. 2 apparatus in detail to the present invention includes a hollow neck breaks repair a fracture of the screw 2, the formed end repaired with a screw screwed into the threaded section 21 of the femoral head, the threaded section the repair opening having a hollow screw in communication with the lumen 22 of the plurality of through holes 23, through-holes may be issued at the end of the teeth, may also be issued at the crest, the repair may be enclosed within the screw-end face, may also have an opening; said repair the trailing end of the screw machine is provided with a negative pressure or negative pressure tube unit 4 communicates through the center of the negative pressure to the lumen connector (not shown), vacuum suction machine or a central connector 3, a connecting passes through the negative pressure tube, connector, a lumen, a negative pressure environment to provide vias fix the inner end of the screw, the negative pressure tube is made of a polymer plastics. 在手术时,还可在所述断裂处还设置至少一枚加压螺钉5。 During surgery, may be disposed in at least one further breaks the compression screw 5. 本发明通过上述方案可在内端形成负压环境,使得骨折愈合加快。 By the above-described embodiment of the present invention may be formed in the inner end of the negative pressure environment, so that the accelerated fracture healing. 在股骨颈骨折的股骨头内,修复螺钉的螺纹有加压螺钉的功能,使骨折端充分结合在一起。 In femoral neck fracture, repair screw threaded compression screw has the function of the fracture are fully integrated. 同时,在股骨颈内形成一个负压区,可加快血运向股骨头内流转,加强股骨头内的血运,避免股骨头的缺血坏死,并加速骨折端的血运,促进骨折端愈合。 At the same time, a negative pressure zone is formed in the femoral neck, can speed up the flow into the blood supply of the femoral head, the femoral head strengthening blood circulation, prevent ischemic necrosis of the femoral head, and the blood supply to accelerate the fracture, the fracture to promote healing.

[0016] 在本发明中,所述修复螺钉2的外端面向外周壁延伸有凸缘24,所述连接头包括设置在该凸缘上与所述一段螺纹的旋向相反的螺纹柱31,所述负压管与该螺纹柱进行密封螺纹连接,该螺纹柱将负压管与所述内腔连通,密封螺纹连接可提供更好的负压环境。 [0016] In the present invention, the outer end surface of the screw 2 repair outwardly extending flange 24 of the peripheral wall, said connector comprising a flange disposed on the section of the screw thread 31 opposite to the threaded post, the negative pressure tube is connected to the sealing screw threaded post, which will be threaded post lumen in communication with the negative pressure tube, seal threaded connection may provide a better negative pressure environment. 当修复螺钉拧入断裂处以后,首先夹紧凸缘,再将负压管拧在螺纹柱上,以防止在拧负压管时修复螺钉松动。 When the screw is screwed into the repair breaks in clamping collar first, then the negative pressure tube is screwed in a threaded column to prevent loose screws when screwed repair the negative pressure tube. 治疗结束后,可通过逆行的旋转方向,解除管压管与螺纹柱的连接。 After treatment, by retrograde rotation direction to release the threaded pipe connection pipe pressure column.

[0017] 作为优选,所述螺纹柱可为中空螺纹柱,其空腔连通所述负压管和内腔;作为另一种优选,可在螺纹柱轴向开具数个负压孔32,所述负压管通过该数个负压孔与所述内腔连通,如图3 ;无论采用那种方式,应保证内腔与负压管相通的同时,螺纹柱与负压管的连接处密封。 [0017] Advantageously, the threaded post may be hollow threaded post, which is communicating with the cavity and the negative pressure tube lumen; As another preferred, can be issued a number of suction holes 32 in an axial threaded post, of the negative pressure tube lumen communicating at the same time, the threaded post connected to the negative pressure tube sealing manner regardless of the kind, should ensure that; said suction tube through the plurality of suction holes communicating with the lumen 3 . 在本发明中,所述凸缘外周呈外六角形,在夹住凸缘时,可采用常用的六角扳手,提高装置的适应性。 In the present invention, the outer periphery of the flange outer hexagon shape, when the clamping flange, the hex wrench can be used to improve the adaptability of the device.

[0018] 如图4,作为本发明的另一种方式,所述连接,3包括所述修复螺钉的螺帽33,在该螺帽上由外向内设置有与所述一段螺纹的旋向相反的内螺纹34,所述负压管的外螺纹与该内螺纹进行密封螺纹连接,该负压管与所述内腔连通。 [0018] FIG. 4, as another embodiment of the present invention, the connector 3 comprises a nut screw 33 fixes the outside to inside of the nut disposed on an opposite directional rotation of the threaded section internal thread 34, the external thread of the negative pressure tube is sealed with the inner screw threaded connection, the negative pressure tube in communication with the lumen. 螺帽可采用内六角螺帽,螺帽的上开具有内腔连通的通孔,通孔内壁成型所述内螺纹,这种结构形式更加简单,成本较低,只需对现有的螺钉进行少量改进就可实现。 The hex nut, the nut having a through-hole opening a lumen in communication with the nut may be employed, forming the inner wall of the through-hole of the inner thread, this structure is more simple, low cost, only to conventional screws a small amount of improvement can be achieved.

上述实施方式仅供说明本发明之用,而并非是对本发明的限制,有关技术领域的普通技术人员,在不脱离本发明精神和范围的情况下,还可以作出各种变化和变型,因此所有等同的技术方案也应属于本发明的范畴。 The above-described embodiments are merely illustrative of the present invention, and are not restrictive of the invention, the technical field of ordinary skill in the art, without departing from the spirit and scope of the invention, can make various changes and modifications, all equivalent technical solutions should belong to the scope of the invention.

Claims (8)

  1. 1.预防股骨颈骨折后股骨头坏死及治疗股骨头坏死的装置,其特征在于:包括设置于股骨颈骨折断裂处的中空修复螺钉,该修复螺钉内端成型有拧入股骨头的一段螺纹,在该段螺纹上开具有与该中空修复螺钉内腔连通的数个通孔;所述修复螺钉的外端设置有连接头,连接负压机的负压管通过该连接头与所述内腔连通。 1. prevention of femoral neck fractures and osteonecrosis of the femoral head necrosis treatment apparatus, characterized by: a femoral neck fracture disposed in the hollow screw at break repair, the repair section has a threaded end screwed into the femoral head forming screw, in open repair screw having a lumen in communication with the hollow through hole of the plurality of sections of the thread; repair the outer end is provided with screw connectors, suction pipe negative pressure connection unit communicates via the connector with the lumen .
  2. 2.根据权利要求1所述的装置,其特征在于:所述修复螺钉的外端面向外周壁延伸有凸缘,所述连接头包括设置在该凸缘上与所述一段螺纹的旋向相反的螺纹柱,所述负压管与该螺纹柱进行密封螺纹连接,该螺纹柱将负压管与所述内腔连通。 2. The apparatus according to claim 1, wherein: said screw fixes the outer peripheral end surface of the outer wall extending flange, said connector comprising a flange disposed on the threaded section of the screw in the opposite the threaded post, sealing the vacuum pipe is connected to the screw threaded post, of the negative pressure tube to the threaded post in communication with the lumen.
  3. 3.根据权利要求2所述的装置,其特征在于:所述螺纹柱为中空螺纹柱,其空腔连通所述负压管和内腔。 3. The apparatus according to claim 2, wherein: said column is a hollow screw threaded post, which is communicating with the cavity and the negative pressure tube lumen.
  4. 4.根据权利要求2所述的装置,其特征在于:所述螺纹柱轴向开具有数个负压孔,所述负压管通过该数个负压孔与所述内腔连通。 4. The apparatus according to claim 2, wherein: said threaded post issued several negative axial hole, the negative pressure tube in communication with the lumen through the plurality of suction holes.
  5. 5.根据权利要求2所述的修复装置,其特征在于:所述凸缘外周呈外六角形。 The repair device according to claim 2, wherein: the outer periphery of the flange outer hexagon shape.
  6. 6.根据权利要求1所述的装置,其特征在于:所述连接头包括所述修复螺钉的螺帽,在该螺帽上由外向内设置有与所述一段螺纹的旋向相反的内螺纹,所述负压管与该内螺纹进行密封螺纹连接,该负压管与所述内腔连通。 6. The apparatus according to claim 1, wherein: said head comprises a nut connected to said repair screw, the nut on the outside in an internal thread disposed opposite to the threaded section have the handedness the negative pressure tube is sealed with the inner screw thread connection, the negative pressure tube in communication with the lumen.
  7. 7.根据权利要求1-6中任意一项所述的装置,其特征在于:所述一段螺纹的牙底开具有所述数个通孔。 7. The apparatus claimed in any one of the preceding claims, characterized in that: said threaded section of said teeth having a bottom opening and a plurality of through-holes.
  8. 8.根据权利要求1所述的装置,其特征在于:所述断裂处还设置有至少一枚加压螺钉。 8. The apparatus according to claim 1, wherein: said breaks is provided with at least one further compression screw.
CN 201410541109 2014-10-14 2014-10-14 Prevention of femoral neck fracture and osteonecrosis of the femoral head necrosis treatment device CN104352273B (en)

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