CN104490460A - 第一跖楔关节板 - Google Patents
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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
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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
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
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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
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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
- A61B2017/00743—Type of operation; Specification of treatment sites
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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
- A61B2017/564—Methods for bone or joint treatment
Abstract
本发明涉及医疗器械技术领域，尤其是一种第一跖楔关节板,包括：若干个固定孔,用于将第一跖楔关节板固定在第一跖骨和内侧楔骨上，所述第一跖楔关节板上还设有便于第一跖楔关节融合时骨块间加压的滑动孔。本发明提供的一种第一跖楔关节板，作为桥式第一跖楔关节板固定时允许第一跖楔关节面间微动，既保留第一跖楔关节面软骨，又起到限制关节活动作用。作为第一跖楔关节融合第一跖楔关节板固定时，去除关节面软骨后植骨，使用第一跖楔关节板远端滑动孔实现第一跖楔关节面间加压，提高融合率；该第一跖楔关节板为解剖型设计，便于解剖复位，无需在术中再对第一跖楔关节板预弯，避免术中折弯影响第一跖楔关节板强度。
Description
技术领域
本发明涉及医疗器械技术领域，尤其是一种第一跖楔关节板。
背景技术
自1911年Albrecht首次提出第一跖楔关节融合用于矫形足拇外翻、1934年Lapidus研究报道足拇外翻发病机制及第一跖楔关节融合术以来，第一跖楔关节融合术逐步受到关注。Lapidus提出拇外翻的潜在发病机制为第一跖骨内收畸形及第一序列不稳定，第一跖楔关节融合术可在多平面上纠正畸形，稳定第一序列，具有其他拇外翻矫形手术所不具备的优势。随后20年间，Lapidus相继报道应用该手术矫形中重度拇外翻的长期随访结果，并在技术上对该术式进行改良与规范。
Lapidus术式最初包括第一跖楔关节融合及第一、二跖骨基底部融合。在将近1个世纪的发展过程中，许多学者提出手术改良方法，但总体上旨在减少术后第一跖列短缩畸形及加强融合部位固定强度。Giannestras、Butson分别提出，可将切除的第一跖骨头内侧骨赘植入融合关节面，同时第一、二跖骨基底间用克氏针固定。Sangeorzan等报道提出，对存在第一跖列明显短缩患者，可采用自体髂骨植骨以恢复其长度，并用2枚螺钉交叉固定。在之后很长时间内，该固定方法被视为Lapidus术式固定的金标准。但是对于一些需要保留第一跖楔关节面软骨的患者来说，这种经第一跖楔关节螺钉固定方法对第一跖楔关节面软组织进行了破坏，增加了后期骨关节炎的发生率。另外对于行第一跖楔关节融合患者，单纯螺钉内固定的稳定性差，融合率低。
发明内容
本发明要解决的技术问题是：为了克服现有技术中，一些需要保留第一跖楔关节面软骨患者，经第一跖楔关节螺钉固定方法对第一跖楔关节面软组织破坏，增加后期骨关节炎的发生率；以及行第一跖楔关节融合时，单纯螺钉内固定稳定性差，融合率低的问题。本发明提供了一种第一跖楔关节板，在进行固定时通过关节板固定、融合，避免了传统经第一跖楔关节螺钉固定方法对第一跖楔关节面软骨破坏，降低了创伤后骨关节炎发生率，大大增加了第一跖楔关节融合时内固定的稳定性，提高融合率。
本发明解决其技术问题所采用的技术方案是：
一种第一跖楔关节板，包括：若干个固定孔,用于将第一跖楔关节板固定在第一跖骨和内侧楔骨上，所述第一跖楔关节板上还设有便于第一跖楔关节融合时骨块间加压的滑动孔。
具体地，所述第一跖楔关节板与第一跖骨和内侧楔骨接触面的空间几何学形态与第一跖骨和内侧楔骨表面形态相匹配，即第一跖楔关节板近端与内侧楔骨背侧骨面形态相匹配，第一跖楔关节板远端与第一跖骨基底部背侧骨面形态相匹配。
具体地，所述第一跖楔关节板与第一跖骨和内侧楔骨接触面的空间几何学形态与第一跖骨和内侧楔骨表面形态相匹配，即第一跖楔关节板近端与内侧楔骨内侧骨面形态相匹配，第一跖楔关节板远端与第一跖骨基底部内侧骨面形态相匹配。
作为优选，所述滑动孔的位置与第一跖楔关节板固定在第一跖骨和内侧楔骨上时的第一跖楔关节的位置相对应，所述滑动孔位于第一跖楔关节板远端处。
作为优选，所述第一跖楔关节板近端至少设有两个固定孔，所述第一跖楔关节板远端至少设有一个固定孔。
作为优选，所述第一跖楔关节板近端设有两个固定孔，所述第一跖楔关节板远端设有一个固定孔。
具体地，所述第一跖楔关节板近端设有三个固定孔，所述第一跖楔关节板远端设有一个固定孔。
作为优选，所述三个固定孔呈品字形分布。
具体地，所述第一跖楔关节板为低切迹不锈钢板、低切迹钛板或低切迹碳钢板。
本发明的有益效果是：本发明提供的一种第一跖楔关节板，作为桥式板固定时允许第一跖楔关节面间微动，既保留第一跖楔关节面软骨，又起到限制关节活动作用。作为第一跖楔关节融合板固定时，去除关节面软骨后植骨，使用第一跖楔关节板远端滑动孔实现第一跖楔关节面间加压，提高融合率；该第一跖楔关节板为解剖型设计，便于解剖复位，无需在术中再对第一跖楔关节板预弯，避免术中折弯影响第一跖楔关节板强度；同时第一跖楔关节板设计充分依据亚洲人体解剖曲率设计，板厚1.8mm；采用不锈钢、纯钛或碳钢等高强度材料设计，便于早期被动锻炼；隐蔽边缘设计，同时采用螺钉钉帽低于骨板设计，减少对周围软组织刺激。
附图说明
下面结合附图和实施例对本发明进一步说明。
图1是本发明实施例1的一种第一跖楔关节板；
图2是图1的仰视图；
图3是本发明实施例2的一种第一跖楔关节板；
图4是图3的仰视图。
图中：1.固定孔，2.滑动孔，3.接触面，4.第一跖楔关节板近端，5.第一跖楔关节板远端。
具体实施方式
现在结合附图对本发明作进一步详细的说明。这些附图均为简化的示意图，仅以示意方式说明本发明的基本结构，因此其仅显示与本发明有关的构成。
实施例1
如图1、图2所示，一种第一跖楔关节板，为不锈钢板，其厚度为1.8mm，包括近端4和远端5，近端4设有两个固定孔1，远端5设有一个固定孔1，第一跖楔关节板上还设有便于第一跖楔关节融合时骨块间加压的滑动孔2，滑动孔2的位置与关节板固定在第一跖骨和内侧楔骨上时的第一跖楔关节的位置相对应，滑动孔2位于第一跖楔关节板远端5处；第一跖楔关节板与第一跖骨和内侧楔骨接触面3的空间几何学形态与第一跖骨和内侧楔骨表面形态相匹配，即第一跖楔关节板近端4与内侧楔骨背侧骨面形态相匹配，第一跖楔关节板远端5与第一跖骨基底部背侧骨面形态相匹配。
在进行第一跖楔关节融合手术时，第一跖楔关节板近端4设有两个固定孔1，用于固定内侧楔骨，第一跖楔关节板远端5设有一个固定孔1，用于固定第一跖骨基底部，其中滑动孔2用于第一跖楔关节融合时骨块间加压，为第一跖楔关节融合提供更为牵靠的稳定性。为了避免术后第一跖楔关节板或螺钉的切迹过 高，可选用锁定2.7mm和非锁定2.7mm的两种螺钉。
实施例2
一种第一跖楔关节板，为纯钛板，其厚度为1.8mm，包括第一跖楔关节板近端4和第一跖楔关节板远端5，第一跖楔关节板近端4设有三个固定孔1，呈品字形分布，第一跖楔关节板远端5设有一个固定孔1，第一跖楔关节板上还设有便于第一跖楔关节融合时骨块间加压的滑动孔2，滑动孔2的位置与第一跖楔关节板固定在第一跖骨和内侧楔骨上时的第一跖楔关节的位置相对应，滑动孔2位于第一跖楔关节板远端5处；第一跖楔关节板与第一跖骨和内侧楔骨接触面3的空间几何学形态与第一跖骨和内侧楔骨表面形态相匹配，即第一跖楔关节板近端4与内侧楔骨内侧骨面形态相匹配，第一跖楔关节板远端5与第一跖骨基底部内侧骨面形态相匹配。
为解剖型低切迹板，加之第一跖楔关节板放置于第一序列内侧，对足背侧肌腱组织激惹少。在进行第一跖楔关节融合手术时，第一跖楔关节板近端4三个固定孔1呈空间立体型固定，对内侧楔骨具有更强把持力，对于骨质疏松患者同样起到较好固定作用，第一跖楔关节板远端5的两个固定孔1用于固定第一跖骨干，其中滑动孔2用于第一跖楔关节融合时骨块间加压，为第一跖楔关节融合提供更为牵靠的稳定性。为了避免术后第一跖楔关节板或螺钉切迹过高，可选用锁定2.7mm和非锁定2.7mm的两种螺钉。
以上述依据本发明的理想实施例为启示，通过上述的说明内容，相关工作人员完全可以在不偏离本项发明技术思想的范围内，进行多样的变更以及修改。本项发明的技术性范围并不局限于说明书上的内容，必须要根据权利要求范围来确定其技术性范围。
Claims (9)
1.一种第一跖楔关节板，其特征在于包括：若干个固定孔(1),用于将第一跖楔关节板固定在第一跖骨和内侧楔骨上，所述第一跖楔关节板上还设有便于第一跖楔关节融合时骨块间加压的滑动孔(2)。
2.如权利要求1所述的第一跖楔关节板，其特征在于：所述第一跖楔关节板与第一跖骨和内侧楔骨接触面(3)的空间几何学形态与第一跖骨和内侧楔骨表面形态相匹配，即第一跖楔关节板近端(4)与内侧楔骨背侧骨面形态相匹配，第一跖楔关节板远端(5)与第一跖骨基底部背侧骨面形态相匹配。
3.如权利要求1所述的第一跖楔关节板，其特征在于：所述第一跖楔关节板与第一跖骨和内侧楔骨接触面(3)的空间几何学形态与第一跖骨和内侧楔骨表面形态相匹配，即第一跖楔关节板近端(4)与内侧楔骨内侧骨面形态相匹配，第一跖楔关节板远端(5)与第一跖骨基底部内侧骨面形态相匹配。
4.如权利要求1-3任一项所述的第一跖楔关节板，其特征在于：所述滑动孔(2)的位置与第一跖楔关节板固定在第一跖骨和内侧楔骨上时的第一跖楔关节的位置相对应，所述滑动孔(2)位于第一跖楔关节板远端(5)处。
5.如权利要求1-3任一项所述的第一跖楔关节板，其特征在于：所述第一跖楔关节板近端(4)至少设有两个固定孔(1)，所述第一跖楔关节板远端(5)至少设有一个固定孔(1)。
6.如权利要求1-3任一项所述的第一跖楔关节板，其特征在于：所述第一跖楔关节板近端(4)设有两个固定孔(1)，所述第一跖楔关节板远端(5)设有一个固定孔(1)。
7.如权利要求3所述的第一跖楔关节板，其特征在于：所述第一跖楔关节板近端(4)设有三个固定孔(1)，所述第一跖楔关节板远端(5)设有一个固定孔(1)。
8.如权利要求7所述的第一跖楔关节板，其特征在于：所述三个固定孔(1)呈品字形分布。
9.如权利要求1所述的第一跖楔关节板，其特征在于：所述第一跖楔关节板为低切迹不锈钢板、低切迹钛板或低切迹碳钢板。
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