A kind of coronoid process of ulna dissection bone plate
Technical field
The present invention relates to medical instruments field more particularly to a kind of coronoid process of ulna dissection bone plates.
Background technology
Coronoid process of ulna is the important component for constituting proximal ulna semilunar notch, its presence blocks distal humerus
Forward downward and proximal ulna backward upper displacement may, be the primary structure for maintaining stability of joint.Closkey etc. is in corpse
Axial biomechanics experiment is carried out on body sample to show:When coronoid process sclerite is more than 50%, especially when elbow joint buckling is super
When crossing 60 °, elbow joint is obviously unstable.Therefore, restore or rebuild the height and shape of coronoid process, the recovery to elbow joint function
It is most important.
Currently, the special bone plate of coronoid process of ulna only has Acumed coronoid process dissection bone plates, mainly according to America and Europe
Patients design, specifically, steel plate is placed in for fixing bone block in front of coronoid process, which can be divided into two kinds, and one is small size steel
Plate, as shown in Figure 1, due to closely arranging latch-up-free screw, steel plate stability is poor, and bone block can only be fixed by squeezing, after
Phase is susceptible to fatigue fracture, and distal end then needs to be fixed with two pieces of screws;Another kind is large size steel plate, and proximal screw is too
By distal end, it is difficult to fix coronoid process tip sclerite;But the distal screw of above two steel plate is both needed to be fixed on the inside of ulna,
As shown in Fig. 2, the range of exposure of notch can be increased in this way, Iatrogenic injury is increased.In addition to this, in use, have
When also utilize fingers and palms Bone plate substitute coronoid process of ulna dissection bone plate, as shown in figure 3, but since fingers and palms Bone plate has no
Plasticity is dissected, and screw itself anti-rotation performance when reaching contralateral cortex is poor, therefore easily broken nail, vulnerable.
Therefore it provides it is a kind of suitable for it is compatriots, with good dissection plasticity, notch range of exposure can be reduced to drop
The coronoid process of ulna dissection bone plate of low iatrogenic injury will be of great significance to the clinical treatment that coronoid process is fractured.
Invention content
The purpose of the present invention is to provide a kind of coronoid process of ulna dissection bone plates, have good dissection plasticity, can subtract
Few notch range of exposure, to reduce iatrogenic injury.
An aspect of of the present present invention provides a kind of coronoid process of ulna dissection bone plate, includes the steel plate sheet with crooked radian
Body, the crooked radian of the steel plate ontology are 44 ° ± 2.3 °, and the steel plate ontology includes head and shank, the head and handle
Portion's integrally connected, the width on the head is more than the width of the shank and width is from the front end on the head to the shank
Tail end gradually successively decrease, the head be equipped with the first lock hole, between first lock hole and the front end on the head
It is additionally provided with nearly row's steel pinhole, the sliding eye for being of a straight line type arrangement, far-end locking hole and 2-3 a second is provided on the shank
Lock hole, wherein the center vertical line of first lock hole and the triangular angular that plane where its lower surface is formed be 63 ° ±
5.4°。
Optionally, the center vertical line of second lock hole is formed with plane where the lower surface of second lock hole
Triangular angular is 85 ° -90 °.
Preferably, the front end on the head is equipped with nearly row's pawl of multiple decurvations.
In a technical solution, nearly row's steel pinhole is set as a row 4 in the front end close to the head, described close
The triangular angular of the center vertical line and plane formation where its lower surface of arranging steel pinhole is 63 ° ± 5.4 °.Preferably, described first
The two rows of settings of lock hole point are arranged 3, far from the head front end second in the first row close to the head front end respectively
Row's setting 2.
Preferably, the distance of the front end on head described in the central horizontal linear distance of the first lock hole of the first row is
The distance of 5mm, the front end on head described in the central horizontal linear distance of the first lock hole of the second row are 10mm.
Preferably, the cross of the corresponding steel plate ontology both sides of the central horizontal line of the first lock hole of the first row
It is 16 ± 1.4mm, the corresponding steel plate ontology both sides of central horizontal line of the first lock hole of the second row to width
Transverse width be 14.5 ± 1.2mm.
Optionally, the sliding eye is oblong hole, is arranged between first lock hole and second lock hole.
Optionally, the length of the steel plate ontology is 52 ± 4.4mm, is highly 22 ± 1.3mm, thickness 1.5mm.
The coronoid process of ulna dissection that another aspect provides a kind of as described in any of the above-described technical solution connects
Application of the bone plate in the recovery of the coronoid process of ulna of fracture or reconstruction process.
The present invention provides a kind of coronoid process of ulna dissection bone plates, compared with existing dissection bone plate, knot of the present invention
Coronoid process anatomical map measurement result is closed, the bone plate that development and design goes out has crooked radian, and upper width is narrow, with coronoid process of ulna
The anatomic form of preceding columnae medialis matches, and can preferably attach in bone section part, has good dissection plasticity, simple front aobvious
Reveal and can fix, also, according to radiographic measurement, the position of the first lock hole is also located on the dissection bone plate, and makes solid
The screw being scheduled in the first lock hole is fixed with bone plate angle, in this way can be effectively well-bound same in screw and bone plate
When, different degrees of effective fixation takes it according to the difference of the fracture situation of coronoid process fracture patient;Meanwhile passing through sliding
The setting in hole can also be finely adjusted the position of bone plate, to using be fixed on screw in the second lock hole to bone section into
Row stability is fixed, and can not only be increased fixedly flexibility in art, can also further be promoted therapeutic effect, is conducive to postoperative extensive
It is multiple.
Description of the drawings
Fig. 1 be in the prior art using Acumed dissection bone plates when, since proximal end is fixed without screw, steel plate stability
The fatigue that later stage caused by difference occurs is disconnected;
Fig. 2 is in the prior art when using Acumed dissection bone plates, since distal screw is caused by inside is fixed
Notch range of exposure the increased Iatrogenic injury of increase and institute;
Fig. 3 is in the prior art when using common fingers and palms Bone plate, due to resisting when steel plate screw sufficient length
Occurs head of a nail fracture in art caused by rotational energy force difference;
The structural schematic diagram for the dissection bone plate that Fig. 4 is provided by the embodiment of the present invention;
The structural schematic diagram of the other direction for the dissection bone plate that Fig. 5 is provided by the embodiment of the present invention;
Each parameters of operating part schematic diagram for the dissection bone plate that Fig. 6 is provided by the embodiment of the present invention;
The dissection bone plate that Fig. 7 is provided by the embodiment of the present invention in a state of use with the side form of coronoid process of ulna
Matching figure;
The dissection bone plate that Fig. 8 is provided by the embodiment of the present invention is attached with the side of coronoid process of ulna in a state of use
Figure.
Specific implementation mode
The technical scheme in the embodiments of the invention will be clearly and completely described below, it is clear that described reality
It is only a part of the embodiment of the present invention to apply example, instead of all the embodiments.Based on the embodiments of the present invention, this field is general
The every other embodiment that logical technical staff is obtained without making creative work belongs to what the present invention protected
Range.
The one side of the embodiment of the present invention provides a kind of coronoid process of ulna dissection bone plate, includes with crooked radian
The crooked radian of steel plate ontology, the steel plate ontology is 44 ° ± 2.3 °, and the steel plate ontology includes head and shank, the head
Portion and shank integrally connected, the width on the head is more than the width of the shank and width is from the front end on the head to institute
The tail end for stating shank gradually successively decreases, and the head is equipped with the first lock hole, before first lock hole and the head
It is additionally provided with nearly row's steel pinhole between end, the sliding eye for being of a straight line type arrangement, far-end locking hole and 2-3 are provided on the shank
A second lock hole, wherein the center vertical line of first lock hole and the triangular angular of plane formation where its lower surface are
63°±5.4°。
In the present embodiment, the steel plate provided is iatrogenic steel plate or titanium alloy material steel plate.Steel plate ontology includes head
Portion and shank, this two parts is integrated component, whole to have crooked radian, compared to head and shank integrally connected but is formed
Be for there is the ontology of angle, the steel plate with crooked radian can while fixed bone block, with bone section part have compared with
Good stickiness stays gap, as shown in Figs. 7-8 without forming sky.
In the above-described embodiments, according to Radiological measurement as a result, crooked radian possessed by steel plate ontology be decided to be 44 ° ±
2.3°.Under the crooked radian, steel plate ontology and the effect that bone section attaches are more excellent.The bone plate and ruler of designed development
The anatomic form of columnae medialis matches before bone coronoid process, i.e., wide at the top and narrow at the bottom, and from top to bottom width becomes narrow gradually, and form is similar.Root
According to Radiological measurement, in conjunction with common fracture situation, the position in each hole on steel plate ontology is set, the spiral shell in corresponding aperture is passed through
Being screwed into for nail can carry out dissection bone plate effectively to fix, and can not only enhance the fixed effect that is screwed into of screw in this way, can also subtract
The range of exposure of few notch, reduces iatrogenic injury.In order to make screw effectively be combined with steel plate ontology, also for can be right
Bone section plays effective fixation, also specifically sets the position of the first lock hole, and i.e. its center vertical line and its lower surface place
The triangular angular that plane is formed is 63 ° ± 5.4 °.The triangular angular should not be too large or too small, can both provide so enough interior solid
Determine intensity, while screw being avoided to enter joint, nearly locking mechanism of arranging can shorten screw length, avoid anti-rotation from broken nail occur existing
As.On the shank of the bone plate, it is additionally provided with the sliding eye that can be used for being finely adjusted to the position of bone plate, for increasing art
In fixedly flexibility, and fixed second lock hole of stability is carried out to bone section, whole effective fixation can be conducive to
Promote therapeutic effect and post-operative recovery effect.
In order to ensure to carry out bone section preferably fixed, the center vertical line of second lock hole and described second
The triangular angular that plane where the lower surface of lock hole is formed is 85 ° -90 °.Screw can be made steadily to be fixed on bone section in this way
On, realize the maximization of fixed effect.Preferably, it is 90 ° to be formed by triangular angular, can make in the second lock hole in this way
Screw steadily is fixed on bone section.
As a preferred embodiment, the front end on the head is equipped with nearly row's pawl of multiple decurvations.It is arranged
Nearly row's pawl is in point pawls shape, is bent downwardly and extends to form from the front end on head, and flexure plane is perpendicular, the perpendicular with
It is formed by plane on the inside of the tip of pawl point and pawl point and is formed with angle, angle is about 25 °.Nearly row's pawl can be connect using dissection
When bone plate carries out effectively fixed to coronoid process of ulna tip, effectively prevent articular cartilage and the abjection of small bone block.
As a preferred embodiment, nearly row's steel pinhole is set as a row 4, institute in the front end close to the head
The center vertical line for stating nearly row's steel pinhole and the triangular angular that plane where its lower surface is formed are 63 ° ± 5.4 °.Specifically, nearly row
Steel pinhole in art for penetrating draw point to be pre-fixed to fracture bone block, it should be noted that close in present embodiment
It is angled setting to arrange steel pinhole, and the draw point that not only can avoid penetrating in this way penetrates joint, but also can be played effectively solid
Fixed effect, so as to fully suture proximal end bone block and capsular ligament.
In another embodiment, the two rows of settings of first lock hole point, respectively close to the of the head front end
One row is arranged 3, is being arranged 2 far from head front end second row.That designs in this way is intended that fracture patient is being fractured
Afterwards, the size, form of the sclerite of fracture are different, and setting in this way can determine the first locking according to the size of sclerite, form
Best fixed position in hole.Specifically, when sclerite area is smaller, it can be merely with the spiral shell in the first lock hole of first row
It is fixed in nail;And when sclerite area is larger, then it can be used simultaneously two rows of screws and be fixed.Also need to explanation
It is not limit the first lock hole of same row specifically here to use simultaneously, for example, it is also possible to be the first locking of side
Hole uses simultaneously, it will also be appreciated that nearly row's steel pinhole above-mentioned can be cooperated with the first lock hole, be played jointly firm
Effect, but in some cases, such as the sclerite of patient is smaller, and nearly row's steel pinhole also can according to circumstances be used only and be consolidated
It is fixed, without recycling the first lock hole to be fixed.Here it should further be understood that being, dissection that the present embodiment is provided
Bone plate and each hole set thereon can meet existing fracture of ulna coronoid process and apply need on a large scale in art
Ask, doctor can select corresponding lock hole and/or sliding eye use according to the different situations of patient, with avoid it is iatrogenic
Patient is effectively treated under the premise of damage.
Preferably, the front end on head described in the central horizontal linear distance of the first lock hole of the first row
Distance be 5mm, the distance of the front end on head described in the central horizontal linear distance of the first lock hole of the second row is 10mm.
In the above-described embodiments, illustrate first row, second row the first lock hole central horizontal line respectively apart from institute
The distance of the front end on head is stated, what needs to be explained here is that, the position of the first lock hole of first row, second row in the present embodiment
It sets and not arbitrarily sets, it mainly in this way can be right determined by CT photo observation analysis according to Radiological measurement
Bone block in the case of most bone block jackknifings is fixed well.
Preferably, the corresponding steel plate sheet of the central horizontal line of the first lock hole of the first row
The transverse width of body both sides is 16 ± 1.4mm, the corresponding steel of central horizontal line of the first lock hole of the second row
The transverse width of plate ontology both sides is 14.5 ± 1.2mm.
In the above-described embodiments, also further illustrate first row, second row the first lock hole central horizontal line difference
The transverse width of corresponding steel plate ontology both sides, the shape that steel plate ontology is may make after setting and columnae medialis before coronoid process of ulna
Anatomic form matches, and can preferably attach in bone section part, to have good dissection plasticity.
In an optional embodiment, the sliding eye is oblong hole, and setting is in first lock hole and described the
Between two lock holes.Specifically, being arranged sliding eye between the first lock hole and the second lock hole, can rise to a certain extent
To linking transitional function, sliding shoe can be passed through on the basis of carrying out fixed in advance to sclerite using nearly row's steel pinhole in this way
Fine position, the first lock hole and the second lock hole are fixed on optimum position, to play effective fixation.
In any of the above-described optional embodiment, the length of the steel plate ontology is 52 ± 4.4mm, highly for 22 ±
1.3mm, thickness 1.5mm.In the optional embodiment, the related ginseng for the dissection bone plate for meeting design requirement is given
Number.Wherein, above range is after being screened, evaluating according to Radiological measurement, to related data, flat with the measurement of each parameter
The Optimal Parameters range that mean value ± reasonable value obtains can accord with the bone with the overwhelming majority by the prepared bone plate of above range
The bone block jackknifing situation for rolling over patient, to meet various needs of the doctor in art.
The another aspect of the embodiment of the present invention provides a kind of coronoid process of ulna solution as described in any of the above-described embodiment
Cut open application of the bone plate in the recovery of the coronoid process of ulna of fracture or reconstruction process.The ulna hat provided by the present embodiment
The anatomic form of shape prominent dissection bone plate and columnae medialis before coronoid process of ulna matches, and can preferably attach in bone section part, and
Since with good dissection plasticity, simple front appears and can fix, and can preferably reduce iatrogenic injury;In addition, the solution
Bone section progress stability can be fixed by cuing open bone plate, can not only be increased fixedly flexibility in art, can also further be promoted and be controlled
Therapeutic effect is conducive to post-operative recovery.
It, below will knot in order to become apparent from the coronoid process of ulna dissection bone plate introduced the embodiment of the present invention in detail and provided
Specific embodiment is closed to be described.
Embodiment 1
The radiographic measurement of coronoid process of ulna dissection bone plate
Shandong Qilu Hospital (Qingdao) image center selects normal elbow joint CT to rebuild 44 progress iconography surveys of piece
Amount, measures coronoid process of ulna height, the projection of length distance, curvature, width and coronoid process inclined-plane and olecroanon is cut respectively
Wire clamp angle, is listed in Table 1 below respectively, and average value is calculated.Wherein, used CT machines are that Dutch Philips gives birth to when measurement
Production, CR scanning (CT) model Brilliance64-slice.
The radiographic measurement data of 1 coronoid process of ulna dissection bone plate of table
In data given by table 1, average value is meter after the maximum value and minimum value eliminated under each data item
It obtains, error can be reduced in this way, keep data be calculated more accurate, in conjunction with above-mentioned Optimal Parameters, development and design
The dissection bone plate that above-described embodiment is provided.
Embodiment 2
The use of coronoid process of ulna dissection bone plate
As Figure 4-Figure 6, coronoid process of ulna dissection bone plate includes the steel plate ontology 1 for having crooked radian, steel plate ontology 1
Crooked radian be 44 °, steel plate ontology 1 includes head and shank, head and shank integrally connected, the length of 52mm, height
For 22mm, thickness 1.5mm, the width on head be more than the width of shank and tail end of the width from the front end on head to shank by
Gradually successively decrease, is matched with the anatomic form with columnae medialis before coronoid process of ulna.Head is equipped with the first lock hole 2, in the first lock
Determine to be additionally provided with nearly row's steel pinhole 6 between hole 2 and the front end on head, wherein head includes being used for by what front end was set gradually
Nearly row's steel pinhole 6 for pre-fixed to bone block and fixed first lock hole 2 of stability is carried out to bone block, is provided on shank in straight
The sliding eye 3 of linear array, 2-3 the second lock holes 4 and far-end locking hole 5, this some holes being arranged on shank be then in order to
After each hole that can be arranged on using head carries out location determination to bone block, the position of steel plate ontology can be carried out micro-
It adjusts, it is made to be more stably mounted on ulna.Wherein, in order to play effective fixation to bone section, in the first lock hole 2
Heart vertical line is 63 ° with the triangular angular that plane where its lower surface is formed.
When in use, draw point is first passed through into nearly row's draw point eye, it is close to arrange to realize that steel plate ontology 1 pre-fixes sclerite
Draw point eye 6 is due to angled setting, about 63 °, and therefore, the draw point passed through will not penetrate joint, to be conducive to subsequently nearly
End bone block and capsular ligament fully suture.After draw point passes through nearly row's draw point eye 6 to realize to the pre-fixing of bone block, sliding eye 3 is utilized
The fixed position of steel plate ontology 1 is adjusted to being screwed into from the first lock hole 2 most beneficial for screw bone block is fixed
Then optimum position is fixed steel plate ontology 1;Then, doctor can ranked first lock hole 2 according to the fracture situation of patient two
The middle suitable hole position of selection carries out stability to sclerite and fixes, and waits that inserting screws into corresponding first lock hole 2 is fixed
Afterwards, corresponding screw is screwed into the second lock hole 4 and far-end locking hole 5 and is fixed with carrying out stability, wait for entire steel plate sheet
When body 1 is firmly secured on coronoid process of ulna, it is tight that nearly row's pawl 7 set by the head front end of steel plate ontology 1 can stretch into tissue
Articular cartilage and small bone block are tightly clasped, at this point, steel plate ontology 1 to be firmly secured to ruler to be repaired according to patient's condition
On bone coronoid process.
Above-described embodiment only lists a kind of steel plate of model, when specifically used, can be selected according to the concrete type of fracture
It is suitble to the steel plate of model, also, after the reduction of the fracture, according to the fracture situation of patient, different suitable hole sites can be selected
Sclerite is fixed, for example, when sclerite is smaller, can be fixed merely with nearly row's draw point eye;Or fracture situation is heavier,
It is fixed using nearly row's draw point eye and the first lock hole cooperation of whole/part.
It is understood that the above is only a specific embodiment of the present invention, it is not intended to restrict the invention, it is all
Within the spirit and principles in the present invention, any modification, equivalent substitution, improvement and etc. done should be included in the guarantor of the present invention
Within the scope of shield.