CN105232130B - 一种可定位调节加压的微创接骨板装置 - Google Patents

一种可定位调节加压的微创接骨板装置 Download PDF

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CN105232130B
CN105232130B CN201510760003.XA CN201510760003A CN105232130B CN 105232130 B CN105232130 B CN 105232130B CN 201510760003 A CN201510760003 A CN 201510760003A CN 105232130 B CN105232130 B CN 105232130B
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陈伟
宇文培之
冯琛
付蕾
王娟
张英泽
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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
    • A61B17/683Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8014Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the extension or compression force being caused by interaction of the plate hole and the screws
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • 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
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • 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
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B2017/8655Pins or screws or threaded wires; nuts therefor with special features for locking in the bone

Abstract

一种可定位调节加压的微创接骨板装置,属于骨科医疗器具技术领域,用于快速准确置入接骨板、确定钉孔、固定骨折并防止接骨板术中移动。微创接骨板在两端增加了定位槽,同时在锁定钉的钉帽下表面与定位槽两侧的接骨板的上板面有锁定钉锁紧结构。在皮下置放接骨板微创治疗长骨干骨折时,皮外以相同的接骨板通过两端的定位槽结构和皮下接骨板的两端相连,用于临时定位钉孔位置及置钉方向使用,可以避免手术操作时皮下置放的接骨板滑动或者移动。锁定钉锁紧结构可拉紧两侧定位槽,起到加压固定两侧定位槽的作用。定位槽和锁定钉锁紧结构可依据不同骨折类型等因素进行适当的调整,实现精准定位。效果显著,解决了长期以来微创接骨板定位易出现偏差的问题。

Description

一种可定位调节加压的微创接骨板装置
技术领域
本发明涉及一种骨折手术使用的微创接骨板和锁定钉,属于骨科医疗器具技术领域。用于快速准确置入接骨板、确定钉孔、固定骨折并防止接骨板术中移动。
背景技术
钢板固定是骨科治疗骨折的常用的手法,经过近百年的发展,置入性钢板无论在材质上还是种类上都有了前所未有的进步,目前临床上常用的钢板种类包括重建钢板、解剖钢板、钩钢板等,其中以解剖钢板最为常见,常规解剖钢板存在骨膜剥离较多,预后较差的缺点。随着微创手术的开展,微创接骨板可以很好地解决上述常规解剖钢板存在的问题。但是在实践中发现,微创钢板在克服常规解剖钢板缺点的同时也存在自身的问题,主要是闭合复位不准确、操作难度大、四肢骨折固定特别是股骨的固定极易出现钢板断裂松动等。具体来说,目前广泛使用的微创接骨板为弧形端头的钢板或钛板条,其上排列有多个植入钉固定孔,在将接骨板置入患者皮下隧道后,定位并固定接骨板时常出现偏差,不但手术效果受到影响,还增加了患者的痛苦。因此如何改进现有的微创接骨板是十分迫切的任务。
发明内容
本发明所要解决的技术问题是提供一种可定位调节加压的微创接骨板装置,这种微创接骨板装置可同时实现准确固定定位,并可以进行精准调节,以进一步减少手术创伤,使患者得到更快的恢复。
解决上述技术问题的技术方案是:
一种可定位调节加压的微创接骨板装置,它由接骨板和锁定钉组成,接骨板的板体是钢板或钛板条,接骨板的板体中部有多个锁定钉钉孔,锁定钉钉孔沿着接骨板的板体中心线顺序排列,接骨板的板体两端有定位槽,定位槽沿着接骨板的板体长度方向的中心线,定位槽的前端在接骨板的板体端面开口,定位槽的后端与板体连接处为圆弧形,定位槽的宽度与锁定钉的钉杆直径相匹配,锁定钉的钉帽下表面与定位槽两侧的接骨板的上板面有锁定钉锁紧结构。
上述可定位调节加压的微创接骨板,所述锁定钉的钉帽与接骨板的板面的锁定钉锁紧结构是在定位槽两侧的板面上有板面凹槽,板面凹槽与定位槽平行,板面凹槽的长度与定位槽的长度相同,板面凹槽的宽度为0.5-2mm,在锁定钉的钉帽下表面圆周有多个钉帽凸起,钉帽凸起的直径与板面凹槽的宽度相匹配,钉帽凸起嵌在板面凹槽中。
上述可定位调节加压的微创接骨板,所述锁定钉的钉帽与接骨板的板面的锁定钉锁紧结构是在定位槽两侧的板面上有多个板面凸起,多个板面凸起沿着定位槽的长度方向均匀排列,板面凸起的直径为0.5-2mm,在锁定钉的钉帽下表面有环形的钉帽凹槽,钉帽凹槽的宽度与板面凸起的直径相匹配,板面凸起嵌在钉帽凹槽中。
本发明的有益效果是:
本发明的微创接骨板在两端增加了定位槽,同时在锁定钉的钉帽下表面与定位槽两侧的接骨板的上板面有锁定钉锁紧结构。在皮下置放接骨板微创治疗长骨干骨折时,皮外以相同的接骨板通过两端的定位槽结构和皮下接骨板的两端相连,用于临时定位钉孔位置及置钉方向使用,可以避免手术操作时皮下置放的接骨板滑动或者移动。锁定钉锁紧结构可拉紧两侧定位槽,起到加压固定两侧定位槽的作用。定位槽和锁定钉锁紧结构可依据不同骨折类型、固定部位、强度等因素进行适当的调整,实现了精准定位。本发明虽然简单,但效果显著,解决了长期以来微创接骨板定位易出现偏差的问题,并在此基础可进行加压微调,进一步达到精准复位的目的,值得推广使用。
附图说明
图1是本发明的一种接骨板的结构示意图;
图2是与图1接骨板相配套的锁定钉结构示意图;
图3是本发明的另一种接骨板的结构示意图;
图4是与图3的接骨板相配套的锁定钉结构示意图。
图中标记如下:接骨板1、锁定钉钉孔2、定位槽3、锁定钉4、板面凹槽5、钉帽凸起6、板面凸起7、钉帽凹槽8。
具体实施方式
本发明由接骨板1和锁定钉4组成。
图中显示,接骨板1的板体是钢板或钛板条,接骨板1的板体中部有多个锁定钉钉孔2,锁定钉钉孔2沿着接骨板1的板体中心线顺序排列。
图中显示,接骨板1的板体两端有定位槽3,定位槽3沿着接骨板1的板体长度方向的中心线,定位槽3的前端在接骨板的板体端面开口,定位槽3的后端与板体连接处为圆弧形,定位槽3的宽度与锁定钉4的钉杆直径相匹配,定位槽3的宽度根据锁定钉4可以为5-15mm。定位槽3的作用是在手术过程中将皮下放置的微创接骨板1与皮外以相同的接骨板进行定位操作,以避免手术操作时皮下放置的微创接骨板1滑动或者移动。
本发明的锁定钉4的钉帽下表面与定位槽3两侧的接骨板1的上板面有锁定钉锁紧结构,锁定钉锁紧结构有以下两种结构。
图1、2显示,一种锁定钉锁紧结构是在定位槽3两侧的板面上有板面凹槽5,板面凹槽5与定位槽3平行,板面凹槽5的长度与定位槽3的长度相同,板面凹槽5的宽度为0.5-2mm。与之相配合的是,在锁定钉4的钉帽下表面圆周有多个钉帽凸起6,钉帽凸起6的直径与板面凹槽5的宽度相匹配,钉帽凸起6嵌在板面凹槽5中,将锁定钉4与定位槽3锁紧。
图3、4显示,另一种锁定钉锁紧结构与第一种锁定钉锁紧结构相反,是在定位槽3两侧的板面上有多个板面凸起7,多个板面凸起7沿着定位槽3的长度方向均匀排列,板面凸起7的直径为0.5-2mm,在锁定钉4的钉帽下表面有环形的钉帽凹槽8,钉帽凹槽8的宽度与板面凸起7的直径相匹配,板面凸起7嵌在钉帽凹槽8中,将锁定钉4与定位槽3锁紧。
本发明的使用步骤和方法如下:
以第一种锁定钉锁紧结构为例。
首先确定骨折线的位置,根据此位置确定接骨板1一端的位置,在该位置置入克氏针;
在皮下将接骨板1置入,使其一端定位槽3嵌入克氏针;
在接骨板1的另一端的定位槽内3置入第二枚克氏针;
将与皮下接骨板1完全相同的第二个接骨板放置在皮上相对应的位置,使置入皮下接骨板1的两端的克氏针嵌入到皮上接骨板1的两端的定位槽3中,应用器械夹紧两枚克氏针,使两个接骨板1相对固定;
依次按照皮外接骨板1上的锁定钉钉孔2的位置确定皮下接骨板1的锁定钉孔2位置;
骨折复位满意后,在锁定钉钉孔2、定位槽3内分别旋入锁定钉4,使板面凹槽5与钉帽凸起6相吻合,将锁定钉4与定位槽3锁紧,在满意固定接骨板1的同时拉紧两侧定位槽3。

Claims (2)

1.一种可定位调节加压的微创接骨板装置,其特征在于:它由接骨板(1)和锁定钉(4)组成,接骨板(1)的板体是钢板或钛板条,接骨板(1)的板体中部有多个锁定钉钉孔(2),锁定钉钉孔(2)沿着接骨板(1)的板体中心线顺序排列,接骨板(1)的板体两端有定位槽(3),定位槽(3)沿着接骨板(1)的板体长度方向的中心线,定位槽(3)的前端在接骨板(1)的板体端面开口,定位槽(3)的后端与板体连接处为圆弧形,定位槽(3)的宽度与锁定钉(4)的钉杆直径相匹配,锁定钉(4)的钉帽下表面与定位槽(3)两侧的接骨板(1)的上板面有锁定钉锁紧结构;
所述锁定钉(4)的钉帽与接骨板(1)的板面的锁定钉锁紧结构是在定位槽(3)两侧的板面上有板面凹槽(5),板面凹槽(5)与定位槽(3)平行,板面凹槽(5)的长度与定位槽(3)的长度相同,板面凹槽(5)的宽度为0.5-2mm,在锁定钉(4)的钉帽下表面圆周有多个钉帽凸起(6),钉帽凸起(6)的直径与板面凹槽(5)的宽度相匹配,钉帽凸起(6)嵌在板面凹槽(5)中。
2.一种可定位调节加压的微创接骨板装置,其特征在于:它由接骨板(1)和锁定钉(4)组成,接骨板(1)的板体是钢板或钛板条,接骨板(1)的板体中部有多个锁定钉钉孔(2),锁定钉钉孔(2)沿着接骨板(1)的板体中心线顺序排列,接骨板(1)的板体两端有定位槽(3),定位槽(3)沿着接骨板(1)的板体长度方向的中心线,定位槽(3)的前端在接骨板(1)的板体端面开口,定位槽(3)的后端与板体连接处为圆弧形,定位槽(3)的宽度与锁定钉(4)的钉杆直径相匹配,锁定钉(4)的钉帽下表面与定位槽(3)两侧的接骨板(1)的上板面有锁定钉锁紧结构;
所述锁定钉(4)的钉帽与接骨板(1)的板面的锁定钉锁紧结构是在定位槽(3)两侧的板面上有多个板面凸起(7),多个板面凸起(7)沿着定位槽(3)的长度方向均匀排列,板面凸起(7)的直径为0.5-2mm,在锁定钉(4)的钉帽下表面有环形的钉帽凹槽(8),钉帽凹槽(8)的宽度与板面凸起(7)的直径相匹配,板面凸起(7)嵌在钉帽凹槽(8)中。
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