CN104546102A - Lisfrance关节损伤融合板 - Google Patents
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Abstract
本发明涉及医疗器械领域，尤其是一种Lisfrance关节损伤融合板，融合板包括第一跖楔关节板、第二跖楔关节板以及用于连接第一跖楔关节板和第二跖楔关节板的第一过渡板，融合板上设有若干个用于将融合板固定在第一跖骨、内侧楔骨、第二跖骨和中间楔骨上的固定孔。本发明提供的Lisfrance关节损伤融合板，采用解剖型设计，在手术中无需对融合板进行预弯，节约了手术的时间，避免折弯对板强度的影响，第一、第二跖楔关节板近端固定孔对内侧、中间楔骨具有更强的把持力，板和螺钉设计充分考虑到亚洲人体解剖曲率设计，多关节面融合便于术中足弓解剖型重建，为关节融合提供更好的稳定性，进一步增加了融合板的固定效果。
Description
技术领域
本发明涉及医疗器械领域，尤其是一种Lisfrance关节损伤融合板。
背景技术
Lisfrance关节，即跖跗关节，是前中足之间的关节。即第一、第二、第三跖骨基底部与相应楔骨所形成的关节，以及第四、第五跖骨基底部与骰骨所形成的关节。跖跗关节参与组成足内侧纵弓(第一跖骨与内侧楔骨)、外侧纵弓(第5跖骨与骰骨)和中间横弓(内中外楔骨与骰骨)，对于维持足正常形态起重要作用。Lisfranc关节损伤即跖跗关节骨折-脱位，为一种广义的关节内损伤。
目前临床上对于移位明显的Lisfranc损伤，主张切开复位、坚强内固定。内固定材料主要采用螺丝钉，但螺钉固定强度不够且不稳定，随着术后患者负重下功能锻炼，容易出现复位丢失或螺钉断裂，最终导致手术失败。且经典Lisfranc螺钉需跨关节固定，可进一步加重跖楔关节及楔骨间关节面软骨损伤，增加术后创伤后骨关节炎风险。
发明内容
本发明要解决的技术问题是：为了解决第一、第二序列Lisfrance关节损伤固定的稳定性和强度差问题，本发明提供了一种Lisfrance关节损伤融合板，通过采用一体成型的设计，分别将用第一跖楔关节板和第二跖楔关节板固定各部位的骨骼，形成一个整体固定的机构，有效解决了固定的稳定性和强度问题。
本发明解决其技术问题所采用的技术方案是：
一种Lisfrance关节损伤融合板，所述融合板包括第一跖楔关节板、第二跖楔关节板以及用于连接第一跖楔关节板和第二跖楔关节板的第一过渡板，所述融合板上设有若干个用于将融合板固定在第一跖骨、内侧楔骨、第二跖骨和中间楔骨上的固定孔。
具体地，所述第一跖楔关节板与内侧楔骨和第一跖骨接触面的空间几何学形态与内侧楔骨和第一跖骨表面形态相匹配，即第一跖楔关节板近端的接触面与内侧楔骨表面形态相匹配，第一跖楔关节板远端的接触面与第一跖骨基底部表面形态相匹配；所述第一跖楔关节板与内侧楔骨和第一跖骨接触面的空间几何学形态与内侧楔骨和第一跖骨表面形态相匹配，即第二跖楔关节板近端的接触面与中间楔骨表面形态相匹配，第二跖楔关节板远端的接触面与第二跖骨基底部表面形态相匹配。
作为优选，所述第一跖楔关节板和/或第二跖楔关节板上设有用于跖骨和楔骨间加压的滑动孔。
作为优选，所述第一跖楔关节板和第二跖楔关节板之间还连接有第二过渡板。
具体地，所述第一过渡板的两端分别与第一跖楔关节板近端和第二跖楔关节板近端连接，所述第二过渡板的两端分别与第一跖楔关节板和第二跖楔关节板的中部固定连接。
具体地，所述第一跖楔关节板近端至少设有两个用于固定内侧楔骨的固定孔，第一跖楔关节板远端至少设有两个用于固定第一跖骨的固定孔，所述第二跖楔关节板近端至少设有两个用于固定中间楔骨的固定孔，第二跖楔关节板远端至少设有两个用于固定第二跖骨的固定孔。
具体地，所述第一跖楔关节板近端设有两个用于固定内侧楔骨的固定孔，第一跖楔关节板远端设有两个用于固定第一跖骨的固定孔；所述第二跖楔关节板近端设有两个用于固定中间楔骨的固定孔，第二跖楔关节板远端设有两个用于固定第二跖骨的固定孔。
作为优选，所述第一跖楔关节板近端的远离第一跖楔关节板远端的一端处设有一弯折部，所述弯折部为向所述第二跖楔关节板方向弯折后形成，所述弯折部与内侧楔骨侧面的表面形态相匹配，所述弯折部设有固定孔。
具体地，所述固定孔内设有内螺纹。
具体地，所述融合板为不锈钢融合板、纯钛融合板或碳钢融合板。
本发明的有益效果是：本发明提供的Lisfrance关节损伤融合板，采用解剖型设计，便于解剖复位，在手术中无需对融合板进行预弯，节约了手术的时间，避免折弯对板强度的影响，第一、第二跖楔关节板近端固定孔呈空间立体型固定，对内侧、中间楔骨具有更强的把持力，板和螺钉设计充分考虑到亚洲人体解剖曲率设计，多关节面融合便于术中足弓解剖型重建，滑动孔用于跖楔关节融合时骨块间加压，为关节融合提供更好的稳定性，螺钉钉帽低于骨板的设计和隐蔽边缘设计减少对软组织的刺激，且本设计有利于术后早期的被动锻炼，适用于Lisfrance损伤，也适用于跖跗骨关节炎、高弓足患者，即能保留关节面软骨，又起到限制关节活动的作用，在去除关节面软骨后植骨，采用滑动孔实现跖楔关节面间加压，提高融合率，避免了传统采用跖楔关节螺钉固定方法对跖楔关节面软骨的破坏，降低了创伤后骨关节炎的发生率；第一跖楔关节板近端的远离第一跖楔关节板远端的一端处的弯折部设计，在进行固定时，螺钉打入固定孔后，可以穿过内侧楔骨固定在第二楔骨基底部，进一步增加了融合板的固定效果。
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Lisfrance关节损伤融合板的结构示意图。
图中：1.第一跖楔关节板，2.第二跖楔关节板，3.第一过渡板，4.第二过渡板一，5.固定孔，6.滑动孔，7.第一跖楔关节板近端，8.第一跖楔关节板远端，9.第二跖楔关节板近端，10.第二跖楔关节板远端，11.折弯部，100.接触面。
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。
如图1所示，一种Lisfrance关节损伤融合板，融合板为纯钛融合板,板厚1.8mm，融合板包括第一跖楔关节板1和第二跖楔关节板2以及用于连接第一跖楔关节板近端7和第二跖楔关节板近端9的第一过渡板3，第一跖楔关节板近端7设有二个固定内侧楔骨的固定孔5，第一跖楔关节板远端8设有二个固定第一跖骨的固定孔5，第二跖楔关节板近端9设有二个固定中间楔骨的固定孔5，第二跖楔关节板远端10设有二个固定第二跖骨的固定孔5，第一跖楔关节板1和第二跖楔关节板2上分别设有一个用于跖骨和楔骨间加压的滑动孔6。
此实施例中，融合板充分依据亚洲人体解剖曲率设计，板厚1.8mm，用于固定融合板的固定孔5内设有内螺纹，固定孔5可以与直径为2.7mm的锁定螺钉或者直径为2.7mm的非锁定螺钉或者其二者的结合配合使用，固定孔5配置的固定螺钉的螺钉帽优选低于融合板，减少对软组织的刺激，避免手术后融合板或者固定螺钉的切迹过高，并且采用板式设计及不锈钢、纯钛或碳钢等高强度材料，便于手术后的早期被动锻炼，融合板采用隐蔽边缘设计，减少对软组织的刺激，滑动孔6的设计用于跖骨和楔骨间加压，提高了融合率且为关节融合提供更好的稳定性。
在一种具体实施方式中，第一跖楔关节板1与内侧楔骨和第一跖骨接触面100的空间几何学形态与内侧楔骨和第一跖骨表面形态相匹配，即第一跖楔关节板近端7的接触面100与内侧楔骨表面形态相匹配，第一跖楔关节板远端8的接触面100与第一跖骨基底部表面形态相匹配；第一跖楔关节板1与内侧楔骨和第一跖骨接触面100的空间几何学形态与内侧楔骨和第一跖骨表面形态相匹配，即第二跖楔关节板近端9的接触面100与中间楔骨表面形态相匹配，第二跖楔关节板远端10的接触面100与第二跖骨基底部表面形态相匹配。
此实施例采用融合板的接触面100与各接触的骨骼表面的形状相匹配，无需在术中对钢板进行预弯，大大节约了手术时间，避免折弯对钢板强度的影响。
在一种具体实施方式中，第一跖楔关节板1和第二跖楔关节板2之间还连接有第二过渡板4。
在两个滑动孔6的外侧壁之间增加第二过渡板4，使此融合板整体更加稳定牢固，也增强了第二跖楔关节板2和第一跖楔关节板1的牢固度，缩短了患者手术后的恢复时间，固定孔5配合空心螺钉固定，进一步增强了稳定性。
作为优选，第一过渡板3的两端分别与第一跖楔关节板近端7和第二跖楔关节板近端9连接，第二过渡板4的两端分别与第一跖楔关节板1和第二跖楔关节板2的中部固定连接。
本设计中，第一跖楔关节板1和第二跖楔关节板2也可以用于第二、第三序列的Lisfrance关节损伤，也可以适用于其他序列的Lisfrance关节损伤。
在一种具体实施方式中，第一跖楔关节板近端7的远离第一跖楔关节板远端8的一端处设有一弯折部11，弯折部11为向第二跖楔关节板2方向弯折后形成，弯折部11与内侧楔骨侧面的表面形态相匹配，弯折部11设有固定孔5。
第一跖楔关节板近端7的远离第一跖楔关节板远端8的一端处的弯折部11设计，在进行固定时，螺钉打入固定孔5后，可以穿过内侧楔骨固定在第二楔骨基底部，进一步增加了融合板的固定效果。
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 (10)
1.一种Lisfrance关节损伤融合板，其特征在于：所述融合板包括第一跖楔关节板(1)、第二跖楔关节板(2)以及用于连接第一跖楔关节板(1)和第二跖楔关节板(2)的第一过渡板(3)，所述融合板上设有若干个用于将融合板固定在第一跖骨、内侧楔骨、第二跖骨和中间楔骨上的固定孔(5)。
2.如权利要求1所述的Lisfrance关节损伤融合板，其特征在于：所述第一跖楔关节板(1)与内侧楔骨和第一跖骨接触面(100)的空间几何学形态与内侧楔骨和第一跖骨表面形态相匹配，即第一跖楔关节板近端(7)的接触面(100)与内侧楔骨表面形态相匹配，第一跖楔关节板远端(8)的接触面(100)与第一跖骨基底部表面形态相匹配；所述第一跖楔关节板(1)与内侧楔骨和第一跖骨接触面(100)的空间几何学形态与内侧楔骨和第一跖骨表面形态相匹配，即第二跖楔关节板近端(9)的接触面(100)与中间楔骨表面形态相匹配，第二跖楔关节板远端(10)的接触面(100)与第二跖骨基底部表面形态相匹配。
3.如权利要求1或2所述的Lisfrance关节损伤融合板，其特征在于：所述第一跖楔关节板(1)和/或第二跖楔关节板(2)上设有用于跖骨和楔骨间加压的滑动孔(6)。
4.如权利要求1或2所述的Lisfrance关节损伤融合板，其特征在于：所述第一跖楔关节板(1)和第二跖楔关节板(2)之间还连接有第二过渡板(4)。
5.如权利要求4所述的Lisfrance关节损伤融合板，其特征在于：所述第一过渡板(3)的两端分别与第一跖楔关节板近端(7)和第二跖楔关节板近端(9)连接，所述第二过渡板(4)的两端分别与第一跖楔关节板(1)和第二跖楔关节板(2)的中部固定连接。
6.如权利要求1或2所述的Lisfrance关节损伤融合板，其特征在于：所述第一跖楔关节板近端(7)至少设有两个用于固定内侧楔骨的固定孔(5)，第一跖楔关节板远端(8)至少设有两个用于固定第一跖骨的固定孔(5)，所述第二跖楔关节板近端(9)至少设有两个用于固定中间楔骨的固定孔(5)，第二跖楔关节板远端(10)至少设有两个用于固定第二跖骨的固定孔(5)。
7.如权利要求6所述的Lisfrance关节损伤融合板，其特征在于：所述第一跖楔关节板近端(7)设有两个用于固定内侧楔骨的固定孔(5)，第一跖楔关节板远端(8)设有两个用于固定第一跖骨的固定孔(5)；所述第二跖楔关节板近端(9)设有两个用于固定中间楔骨的固定孔(5)，第二跖楔关节板远端(10)设有两个用于固定第二跖骨的固定孔(5)。
8.根据权利要求1或2所述的Lisfrance关节损伤融合板，其特征在于：所述第一跖楔关节板近端(7)的远离第一跖楔关节板远端(8)的一端处设有一弯折部(11)，所述弯折部(11)为向所述第二跖楔关节板(2)方向弯折后形成，所述弯折部(11)与内侧楔骨侧面的表面形态相匹配，所述弯折部(11)设有固定孔(5)。
9.如权利要求1所述的Lisfrance关节损伤融合板，其特征在于：所述固定孔(5)内设有内螺纹。
10.如权利要求1所述的Lisfrance关节损伤融合板，其特征在于：所述融合板为不锈钢融合板、纯钛融合板或碳钢融合板。
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