CN104586494B - Proximal humerus bone plate - Google Patents
Proximal humerus bone plate Download PDFInfo
- Publication number
- CN104586494B CN104586494B CN201510050631.9A CN201510050631A CN104586494B CN 104586494 B CN104586494 B CN 104586494B CN 201510050631 A CN201510050631 A CN 201510050631A CN 104586494 B CN104586494 B CN 104586494B
- Authority
- CN
- China
- Prior art keywords
- humerus
- bone plate
- proximal humerus
- screw
- head
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
-
- 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
-
- 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
Abstract
The present invention relates to proximal humerus bone plate, multiple screw holes are provided on proximal humerus bone plate, for multiple screw holes to enable the screw for being each passed through multiple screw holes to be placed into the different zones of humerus head, the average value of the back rake angle of the central axes of multiple screw holes is greater than 0 °.The central axes of multiple screw holes in above-mentioned proximal humerus bone plate integrally tilt backwards, the screw helped to realize across multiple screw holes is uniformly distributed in the whole region of humerus head, the front end of humerus head is avoided to be placed into more screw, to reduce the influence that the screw of merging transports the blood of humerus head front end, the necrosis of humerus head front end is avoided；The front end of humerus head can also be avoided to lose too many bone amount, humerus head front end is avoided to collapse.In addition, multiple screws are more evenly distributed in humerus head, holding power provided by multiple screws can also be made bigger, and be more uniformly stressed each region of humerus head, keep the stability of bone plate more preferable, avoid the front end damage of humerus head.
Description
Technical field
The present invention relates to the medical instruments fields for the treatment of fracture, and in particular, to one kind is for treating proximal humeral fracture
Proximal humerus bone plate.
Background technique
When treating fracture, after the bone reduction of fracture, generally require the bone of fracture using bone plate firmly
It is connected and fixed to together.Bone plate can carry out early functional exercise convenient for patient, make to fracture to avoid the displacement of bone
Bone restore function to greatest extent.The fracture for betiding proximal humerus is to be easiest to occur, also most commonly seen fracture class
One of type, quantity account about the 6~7% of all fracture.
Fig. 1 is existing a kind of for treating the schematic diagram of the bone plate of proximal humeral fracture；Fig. 2 is that screw is mounted on figure
Schematic diagram on bone plate shown in 1；Fig. 3 is the schematic top plan view of the bone plate of mounting screw.As shown in FIG. 1 to 3, the synthetism
The shape of plate is consistent with proximal humerus anatomic morphological, thereon region corresponding with proximal humerus, and under proximal humerus
The corresponding region of edge is provided with multiple screw holes 10.Wherein, screw hole 10 corresponding with proximal humerus is used to be built into spiral shell to humerus head
Nail 20, the screw 20 are fixed for multiple bone blocks caused by fracturing；Screw hole 10 corresponding with the lower edge of proximal humerus be used for
Humerus head is built into screw 21, which is used for the inside in humerus head and provides support, to avoid collapsing on the inside of humerus head.
When carrying out fracture reduction operation, firstly, by the bone plate from 0.5~1cm below greater tubercles of humerus vertex along humerus
It is solid fixed；Then, multiple screws 20 are passed through into screw hole 10 corresponding with proximal humerus, and with fixed angle merging humerus with
The region (in humerus head) of bone plate face, and, multiple screws 21 are passed through into screw hole 10, and humerus is placed in fixed angle
With the region of bone plate face (inside for reaching humerus head).In this process, screw 20 and screw 21 are generally required and are crossed
Or the long axis of humerus head is at least reached, so that screw 20 and screw 21 have enough holding powers.
In practical applications, there are following technical problems for above-mentioned bone plate:
Firstly, since humerus head has about 30 degree of a back rake angle, humerus head is only it with the region of bone plate face
Front end, therefore, using the humerus of above-mentioned plate fixation, the front end of humerus head is densely distributed multiple screws 20 relatively
With screw 21, the blood fortune that will lead to humerus head front end in this way is a greater impact, to be easy to cause caput humeri necrosis；With
And more bone amount is lost in humerus head front end, so that humerus head front end be easy to cause to collapse；In addition, screw 20 and screw
21 are distributed only over the front end of humerus head, it is insufficient also to make holding power provided by multiple screws 20, and make humerus head front end
The stress in portion is more concentrated, so that the stability that will lead to bone plate is poor, and is also easy to cause the front end of humerus head
Damage.
Summary of the invention
The present invention is directed at least solve one of the technical problems existing in the prior art, a kind of proximal humerus synthetism is proposed
Plate can reduce the influence to humerus head front end blood fortune and the loss of humerus head front end bone amount；At the same time it can also
The front end of humerus head is avoided to damage, and stability with higher.
A kind of proximal humerus bone plate is provided to achieve the purpose of the present invention, is provided on the proximal humerus bone plate
Multiple screw holes, the multiple screw hole is to enable the screw for being each passed through multiple screw holes to be placed into the different zones of humerus head, institute
The average value for stating the back rake angle of the central axes of multiple screw holes is greater than 0 °.
Wherein, the multiple screw hole is arranged to such form, that is, connects when humerus head is fixed on the proximal humerus
When on bone plate, the screw across multiple screw holes is uniformly arranged in each region of humerus head.
Wherein, the direction of the central axes institute direction of at least two screw holes is different.
Wherein, the direction of the central axes institute direction of the multiple screw hole is all different.
Wherein, the average value of the back rake angle of the central axes of the multiple screw hole is equal to the back rake angle of humerus head.
Wherein, projection of the central axes of the multiple screw hole in the plane perpendicular to humeral shaft is with the back rake angle of humerus head
It is symmetrical for symmetry axis.
Wherein, the aperture of the screw hole is less than 3.5mm.
Wherein, the aperture of the screw hole is at least 2.4mm.
Wherein, the range of the quantity of the screw hole be 4~9, and wherein at least one screw hole be arranged on it is close with humerus
The corresponding position of the lower edge at end.
Wherein, the quantity of screw hole corresponding with the lower edge of the proximal humerus is 2.
Wherein, length of the screw hole corresponding with the lower edge of the proximal humerus apart from proximal humerus bone plate top is small
In 40mm.
Wherein, two back rake angles of central axes of screw hole corresponding from the lower edge of the proximal humerus are different, and the two
Back rake angle average value be equal to humerus head back rake angle.
Wherein, along towards the direction of humerus head, the central axes of two screw holes corresponding with the lower edge of the proximal humerus are in
Outer expanding shape, and the top rade of the central axes of described two screw holes is 115 °, the difference between the two back rake angle is 10 °.
The invention has the following advantages:
The average value of proximal humerus bone plate provided by the invention, the back rake angle of the central axes of multiple screw holes is greater than 0 °,
The central axes of i.e. multiple screw holes tilt backwards on the whole, help to realize the screw across multiple screw holes in this way in the complete of humerus head
Portion is uniformly distributed in region, and the front end of humerus head is avoided to be placed into more screw, to reduce the screw of merging to humerus
The influence of the blood fortune of head front end, avoids the necrosis of humerus head front end；The front end of humerus head can also be avoided to lose too much
Bone amount avoids humerus head front end from collapsing.In addition, multiple screws are more evenly distributed in humerus head, multiple screws can also be made
Provided holding power is bigger, and is more uniformly stressed each region of humerus head, to make the stability of bone plate more
It is good, and avoid the front end damage of humerus head.
In a preferred embodiment of the invention, the apertures of multiple screw holes is less than 3.5mm, compared with the prior art in synthetism
Plate, the present invention in screw hole aperture it is smaller, that is to say, that across multiple screw holes merging humerus head in screw diameter more
It is small, the bone mass loss of humerus caused in screw merging humerus can be reduced in this way, to be more suitable for humerus size relatively
Small China and Asian use.
In addition, in another preferred embodiment of the invention, screw hole corresponding with the lower edge of proximal humerus connects with proximal humerus
The distance between bone plate top is less than 40mm, compared with prior art, between above-mentioned screw hole and proximal humerus bone plate top
Distance is smaller, the probability in the long axis of the screw merging humerus head of above-mentioned screw hole can be improved in this way, to be more suitable for the upper arm
The relatively small China of bone size and Asian use.
Detailed description of the invention
The drawings are intended to provide a further understanding of the invention, and constitutes part of specification, with following tool
Body embodiment is used to explain the present invention together, but is not construed as limiting the invention.In the accompanying drawings:
Fig. 1 is existing a kind of for treating the schematic diagram of the bone plate of proximal humeral fracture；
Fig. 2 is that screw installs the schematic diagram on bone plate shown in Fig. 1；
Fig. 3 is the schematic top plan view of the bone plate of mounting screw；
Fig. 4 is the schematic diagram of the embodiment of proximal humerus bone plate provided by the invention；
Fig. 5 is the schematic top plan view of proximal humerus bone plate shown in Fig. 4.
Wherein, appended drawing reference:
1: proximal humerus bone plate；2,20: screw；21: screw, supporting screw；10: screw hole；101: supporting screw hole.
Specific embodiment
Below in conjunction with attached drawing, detailed description of the preferred embodiments.It should be understood that this place is retouched
The specific embodiment stated is merely to illustrate and explain the present invention, and is not intended to restrict the invention.
Fig. 4 and Fig. 5 is please referred to, Fig. 4 is the schematic diagram of the embodiment of proximal humerus bone plate provided by the invention；Fig. 5
For the schematic top plan view of proximal humerus bone plate shown in Fig. 4.In the present embodiment, it is provided on proximal humerus bone plate 1 more
A screw hole 10, the multiple screw hole 10 are multiple to make to be each passed through (when humerus head is fixed on proximal humerus bone plate)
The screw 2 of screw hole 10 can be placed into the different zones of humerus head, and the back rake angle of the central axes of the multiple screw hole 10 is averaged
Value is greater than 0 °.
For humerus, generally, using end where humerus head as " upper end " of humerus, end where capitulum of humerus is humerus
" lower end "；When being hung down naturally with the arm of people, humerus is " preceding " towards the direction before human body, and the direction towards the human body back side is
" rear ".Based on above-mentioned, the back rake angle of the central axes of the multiple screw hole 10 refers to its sweptback angle.
In the prior art, as shown in figure 3, multiple screws are only placed in and the region of bone plate face, it may be assumed that a part of screw
Perpendicular to bone plate merging (back rake angle of the part screw be 0 °), another part screw with the screw that is vertically placed in symmetrically towards
(in the part screw, the back rake angle of screw includes negative value and positive value to the inclination of former and later two directions, the back rake angle of multiple screws
Summation and average value are 0 °), dispersion and/or convergence state is presented.It can be seen from the above, the back rake angle of multiple screws of merging humerus head
Average value be 0 °；In the case, due to the region of bone plate face be humerus head front end, the screw to turn forward
Inclination angle is typically small, also, is symmetrical arranged due to leaning forward with the screw of hypsokinesis, makes the inclination angle of the screw to retreat also corresponding in this way
It is smaller, so as to cause the rear end that will not be placed to humerus head the screw to retreat, and before being still located at humerus head
End, that is to say, that multiple screws are fully recessed into the front end of humerus head.
And in the present embodiment, as shown in figure 5, the average value of the back rake angle of the central axes of multiple screw holes 10 is greater than 0 °,
That is, compared with prior art, the central axes hypsokinesis on the whole of multiple screw holes 10 in present embodiment in this way can be with
Keep the angle across the average value of back rake angle of the screw 2 of multiple screw holes 10 and the back rake angle of humerus head smaller, to have
Help realize that multiple screws 2 are uniformly distributed in the whole region of humerus head, i.e., not only the front end of humerus head is placed into screw
2, end is also placed into part screw 2 thereafter.Obviously, more screw 2 is placed into this avoid the front end of humerus head, from
And the influence that the screw 2 that can reduce merging transports the blood of humerus head front end, avoid the necrosis of humerus head front end；It can also keep away
Too many bone amount is lost in the front end for exempting from humerus head, and humerus head front end is avoided to collapse.In addition, multiple screws 2 are in humerus head
Be more evenly distributed, holding power provided by multiple screws 2 can also be made bigger, and make humerus head each region stress more
Uniformly, to keep the stability of bone plate more preferable, and the front end damage of humerus head is avoided.
Preferably, the multiple screw hole is arranged to such form, that is, when humerus head is fixed on the proximal humerus
When on bone plate, the screw across multiple screw holes is uniformly arranged in each region of humerus head.Setting can be utmostly in this way
Ground avoids screw 2 from causing dramatic impact to the blood fortune of the regional area of humerus head, and, farthest avoid the office of humerus head
A large amount of losses of the bone amount in portion region；At the same time it can also farthest improving the stability of bone plate, and, utmostly
Ground avoids the damage of the front end of humerus head.
Specifically, the direction of the central axes institute direction of at least two screw holes 10 is different, that is to say, that at least two screws 2
The direction of institute's direction is different, the direction of holding power provided by least two screws 2 can be made different, in this way so as to improve
The resisting pull out forces of bone plate increase the stability of bone plate.Preferably, the direction of the central axes institute direction of the multiple screw hole 10
It is all different, to increase the resisting pull out forces of bone plate as much as possible.
Specifically, the average value of the back rake angle of the central axes of multiple screw holes 10 is equal to the back rake angle of humerus head；I.e. across more
The angle of hypsokinesis is identical as the angle of humerus head hypsokinesis on the whole for the screw 2 of a screw hole 10, can make multiple screws 2 in the upper arm in this way
The front end and rear end of bone are distributed.Preferably, the central axes of the multiple screw hole 10 are perpendicular to the flat of humeral shaft
Projection in face is symmetrical as symmetry axis using the back rake angle of humerus head.
For different human bodies, generally there are certain differences for the back rake angle of humerus head.In practice, due to upper
Individual difference is stated, different detection methods detects the back rake angle of humerus head by different technological means in addition, passes through difference
The back rake angle of detection method humerus head detected is also not quite similar.Specifically, piece method detection shoulder abduction is taken the photograph using half axle position X-ray
When 0 ° of rotation neutral position, using lateral epicondyle line in humerus as reference mark, the range of the back rake angle of humerus head obtained is
31.2±4.67°；It is with reference to mark with lateral epicondyle line in humerus when detecting 0 ° of rotation neutral position of shoulder abduction using CT scan method
Will, the range of the back rake angle of humerus head obtained are 38 ± 6.96 °；The model of the back rake angle of above-mentioned two humerus head detected
Enclose the term of reference that can be used as humerus head back rake angle in present embodiment.
In the prior art, for the shape of bone plate on the basis of the humerus anatomical data of American-European ethnic group, the aperture of screw hole is big
In or be equal to 3.5mm, correspondingly, screw 2 is relatively large in diameter, in this way by screw 2 be placed in humerus when, will lead to humerus loss compared with
More bone amount；For China and Asian, especially women, the problem of humerus is less than normal, bone mass loss, is just especially prominent.
In the present embodiment, the aperture of the preferably described screw hole 10 is less than 3.5mm, when being placed in screw 2 to reduce, bone that humerus is lost
Amount；And the aperture of the further preferably screw hole 10 is at least 2.4mm, to make screw 2 while reducing humerus loss bone amount
With enough intensity.
Specifically, the range of the quantity of the screw hole 10 is 4~9, and wherein at least one screw hole is arranged on and the upper arm
The corresponding position of the lower edge of proximal bone, the screw for being placed in the screw hole can play the role of supporting humerus head, and humerus head is avoided to exist
Inside collapses downwards, therefore the screw hole can be referred to as supporting screw hole 101, and the screw for being placed in the screw hole can be referred to as branch
Support screw 21.Specifically, the quantity in the supporting screw hole 101 is 2.
In the prior art, the shape of bone plate is on the basis of the humerus anatomical data of American-European ethnic group, supporting screw hole with
The distance between bone plate top is larger, so that the screw for providing lower edge support passes through supporting screw hole with predetermined angle
When, it can not be locked into humerus head, so that lower edge support can not be provided effectively.In the present embodiment, it is preferable that with it is described
Length of the corresponding supporting screw hole 101 of the lower edge of proximal humerus apart from 1 top of proximal humerus bone plate is less than
40mm, so that the distance between supporting screw hole 101 and proximal humerus bone plate 1 are not too big, thus by supporting screw 21
When being placed in humerus with predetermined angle, supporting screw 21 can be not only presented in humerus head, can also reach or cross humerus head
Long axis, to give humerus head upward support in inside.
Preferably, the back rake angle of the central axes in described two supporting screw holes 101 is different, and the back rake angle of the two is flat
Mean value is equal to the back rake angle of humerus head；In this way setting can make two supporting screws 21 be respectively distributed to humerus head front end and
Rear end, improves the uniformity of screw distribution, while improving the resisting pull out forces of bone plate.It is further preferred that along towards humerus
The direction of head, the central axes in the supporting screw hole 101 are in outer expanding shape, and the central axes in described two supporting screw holes 101
Top rade is 115 ° (angle of downward ray is 115 ° with direction), and the difference between the two back rake angle is 10 °.
In conclusion the proximal humerus bone plate that embodiment of the present invention provides, the hypsokinesis of the central axes of multiple screw holes
The average value at angle is greater than 0 °, i.e. the screw 2 across multiple screw holes 2 tilts backwards on the whole, helps to realize multiple screws 2 in this way
It is uniformly distributed in the whole region of humerus head, the front end of humerus head is avoided to be placed into more screw 2, to reduce merging
Influence of the screw 2 to the blood of humerus head front end fortune, avoid the necrosis of humerus head front end；It can also avoid the front end of humerus head
Portion loses too many bone amount, and humerus head front end is avoided to collapse.In addition, multiple screws 2 are more evenly distributed in humerus head, may be used also
So that holding power provided by multiple screws 2 is bigger, and it is more uniformly stressed each region of humerus head, to make synthetism
The stability of plate is more preferable, and avoids the front end damage of humerus head.
It is understood that the principle that embodiment of above is intended to be merely illustrative of the present and the exemplary implementation that uses
Mode, however the present invention is not limited thereto.For those skilled in the art, essence of the invention is not being departed from
In the case where mind and essence, various changes and modifications can be made therein, these variations and modifications are also considered as protection scope of the present invention.
Claims (12)
1. a kind of proximal humerus bone plate, is provided with multiple screw holes, the multiple screw hole is each passed through multiple spiral shells to make
The screw in hole can be placed into the different zones of humerus head, which is characterized in that the back rake angle of the central axes of the multiple screw hole is put down
Mean value is greater than 0 °, so that the central axes hypsokinesis on the whole of multiple screw holes；The back rake angle of the central axes of the multiple screw hole
Average value be equal to humerus head back rake angle.
2. proximal humerus bone plate according to claim 1, which is characterized in that the multiple screw hole is arranged to such
Form, that is, when humerus head is fixed on the proximal humerus bone plate, the screw across multiple screw holes is in each of humerus head
It is uniformly arranged in region.
3. proximal humerus bone plate according to claim 2, which is characterized in that the central axes institute direction of at least two screw holes
Direction it is different.
4. proximal humerus bone plate according to claim 3, which is characterized in that the central axes institute direction of the multiple screw hole
Direction be all different.
5. proximal humerus bone plate according to claim 1, which is characterized in that the central axes of the multiple screw hole are vertical
It is symmetrical as symmetry axis using the back rake angle of humerus head in the projection in the plane of humeral shaft.
6. proximal humerus bone plate according to claim 1, which is characterized in that the aperture of the screw hole is less than 3.5mm.
7. proximal humerus bone plate according to claim 6, which is characterized in that the aperture of the screw hole is at least 2.4mm.
8. according to claim 1, proximal humerus bone plate described in any one of 6,7, which is characterized in that the number of the screw hole
The range of amount is 4~9, and wherein at least one screw hole is arranged on position corresponding with the lower edge of proximal humerus.
9. proximal humerus bone plate according to claim 8, which is characterized in that corresponding with the lower edge of the proximal humerus
The quantity of screw hole is 2.
10. proximal humerus bone plate according to claim 8, which is characterized in that corresponding with the lower edge of the proximal humerus
Length of the screw hole apart from proximal humerus bone plate top be less than 40mm.
11. proximal humerus bone plate according to claim 9, which is characterized in that corresponding with the lower edge of the proximal humerus
Two screw holes central axes back rake angle it is different, and the average value of the back rake angle of the two is equal to the back rake angle of humerus head.
12. the proximal humerus bone plate according to claim 9 or 11, which is characterized in that along towards the direction of humerus head, with
The central axes of corresponding two screw holes of the lower edge of the proximal humerus are in outer expanding shape, and the updip of the central axes of described two screw holes
Angle is 115 °, and the difference between the two back rake angle is 10 °.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510050631.9A CN104586494B (en) | 2015-01-30 | 2015-01-30 | Proximal humerus bone plate |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510050631.9A CN104586494B (en) | 2015-01-30 | 2015-01-30 | Proximal humerus bone plate |
Publications (2)
| Publication Number | Publication Date |
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| CN104586494A CN104586494A (en) | 2015-05-06 |
| CN104586494B true CN104586494B (en) | 2019-01-22 |
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| CN201510050631.9A Expired - Fee Related CN104586494B (en) | 2015-01-30 | 2015-01-30 | Proximal humerus bone plate |
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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108904030A (en) * | 2018-07-17 | 2018-11-30 | 苏州欣荣博尔特医疗器械有限公司 | Outside locking bone fracture plate after proximal tibia |
| CN113786233B (en) * | 2021-09-22 | 2022-06-03 | 吉林大学 | Coupling bionic humerus bone fracture plate capable of effectively reducing stress shielding |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8267972B1 (en) * | 2006-12-01 | 2012-09-18 | Gehlert Rick J | Bone plate |
| EP2389884B1 (en) * | 2010-05-25 | 2013-07-31 | Stryker Trauma SA | Implant for bone fixation |
| BR112013032140A2 (en) * | 2011-06-15 | 2016-12-13 | Smith & Nephew Inc | variable angle locking implant |
| CN202637083U (en) * | 2012-05-11 | 2013-01-02 | 常州市康辉医疗器械有限公司 | Multi-angle humerus near end locking bone fracture plate |
| CN204655082U (en) * | 2015-01-30 | 2015-09-23 | 北京市麦迪戴克医疗技术有限公司 | Proximal humerus blade plate |
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| CN104586494A (en) | 2015-05-06 |
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