CN106344141B - Two-way fixed steel plate and backbone fixing system - Google Patents
Two-way fixed steel plate and backbone fixing system Download PDFInfo
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- CN106344141B CN106344141B CN201610917171.XA CN201610917171A CN106344141B CN 106344141 B CN106344141 B CN 106344141B CN 201610917171 A CN201610917171 A CN 201610917171A CN 106344141 B CN106344141 B CN 106344141B
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- 229910000831 Steel Inorganic materials 0.000 title claims abstract description 151
- 239000010959 steel Substances 0.000 title claims abstract description 151
- 210000003275 diaphysis Anatomy 0.000 claims abstract description 74
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 29
- 230000035876 healing Effects 0.000 claims abstract description 23
- 208000010392 Bone Fractures Diseases 0.000 claims description 75
- 238000000034 method Methods 0.000 claims description 10
- 230000006641 stabilisation Effects 0.000 claims description 10
- 238000011105 stabilization Methods 0.000 claims description 10
- 239000007787 solid Substances 0.000 claims description 3
- 238000000465 moulding Methods 0.000 claims description 2
- 230000000149 penetrating effect Effects 0.000 abstract description 17
- 230000002457 bidirectional effect Effects 0.000 abstract description 9
- 206010017076 Fracture Diseases 0.000 description 71
- 230000000694 effects Effects 0.000 description 9
- 208000006735 Periostitis Diseases 0.000 description 4
- 230000006378 damage Effects 0.000 description 4
- 210000003460 periosteum Anatomy 0.000 description 4
- 206010017088 Fracture nonunion Diseases 0.000 description 3
- 208000005214 Poroma Diseases 0.000 description 3
- 201000001013 eccrine acrospiroma Diseases 0.000 description 3
- 230000001054 cortical effect Effects 0.000 description 2
- 230000003111 delayed effect Effects 0.000 description 2
- 210000003414 extremity Anatomy 0.000 description 2
- 230000003014 reinforcing effect Effects 0.000 description 2
- 230000000087 stabilizing effect Effects 0.000 description 2
- 238000005728 strengthening Methods 0.000 description 2
- 238000007920 subcutaneous administration Methods 0.000 description 2
- 238000011282 treatment Methods 0.000 description 2
- 206010017081 Fracture delayed union Diseases 0.000 description 1
- 206010020649 Hyperkeratosis Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 239000002639 bone cement Substances 0.000 description 1
- 210000001185 bone marrow Anatomy 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000003203 everyday effect Effects 0.000 description 1
- 210000003195 fascia Anatomy 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 210000001105 femoral artery Anatomy 0.000 description 1
- 239000012634 fragment Substances 0.000 description 1
- 229910052602 gypsum Inorganic materials 0.000 description 1
- 239000010440 gypsum Substances 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 238000010030 laminating Methods 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 238000011269 treatment regimen Methods 0.000 description 1
Classifications
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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
- A61B17/8004—Cortical 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
- A61B17/8014—Cortical 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
-
- 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
-
- 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
-
- 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
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention relates to a two-way fixing steel plate and a diaphysis fixing system, the two-way fixing steel plate comprises a steel plate body, the steel plate body is used for being placed in from the diaphysis front side and is provided with a structure matched with the diaphysis front side so as to fix and attach to a broken end of a bone, the steel plate body is provided with at least two pairs of guide holes which are respectively used for penetrating through first locking screws in an arrangement mode on the structure matched with the diaphysis front side, and the angles of the guide holes enable the penetrating first locking screws to clamp an intramedullary nail together so as to control the rotation and axial stability of the intramedullary nail. According to the bidirectional fixing steel plate, the supporting, rotation resistance and axial stability of the fracture end part of the diaphysis fracture can be realized when the bidirectional fixing steel plate is matched with the first locking screw through the specific angle of the guide hole of the steel plate body, so that the fixing reliability after the reduction is further enhanced, and the stable reduction and healing of the fracture part are effectively ensured to be assisted.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a bidirectional fixing steel plate for bone nonunion or nonunion after diaphysis fracture and a diaphysis fixing system.
Background
In the prior art, after fracture occurs, the fracture can be basically divided into two categories of stability and instability according to the stability degree of the fractured end of the bone. For stable fracture, external fixation modes such as gypsum, splints, braces, traction brakes and the like are usually used for stabilizing fixation and final healing through manual reduction; for unstable fixation, surgical treatment is required, including internal fixation systems, which are in turn divided into pegboard fixation systems and intramedullary nail fixation systems, and external fixation systems. However, regardless of the treatment regimen described above, follow-up studies with large samples showed that some patients had fracture nonunion or delayed healing and the incidence was up to 10%.
For the patients with fracture nonunion or delayed union caused by the fixation of the intramedullary nail system, the patients are divided into two main types of multi-poroma and less poroma according to the poroma generation of the fracture part except for infection factors; the stability of broken ends of fracture can be classified into stable and unstable. Aiming at patients with stable broken ends and multiple porosities, most of the patients can adopt an observation treatment mode; the broken end of the bone is stable, and the patient with little callus can adopt a bone grafting treatment mode. For unstable fractures, whether multiple porosities or few porosities, because the fracture is locally unstable, it is desirable to enhance stabilization of the fractured ends of the bone in various ways to promote gradual healing of the fracture. However, the clinically selectable internal fixation method still cannot perfectly solve the problems of defect at the fracture end of the fracture part or unstable fracture end of broken fracture, nonunion or internal fixation of nonunion (such as the bone nonunion 10 after the diaphysis 1 fracture shown by a dotted circle in fig. 1) after the fixation of the intramedullary nail system, that is, no stable medical device specially designed for the nonunion and the nonunion at present, so that there is a great need to develop an internal fixation device, system or method for the nonunion and the nonunion.
Disclosure of Invention
Aiming at the problems of unstable fracture broken ends, non-union fracture, delayed union and the like which occur after diaphysis fracture is fixed by adopting an intramedullary nail system in the prior art, the invention provides a two-way fixed steel plate structure, which adopts a steel plate body with a structure matched with the diaphysis front side, and a plurality of guide holes for penetrating locking screws are arranged on the steel plate body, so that the rotation and the axial stability of the intramedullary nail can be further controlled by matching with a first locking screw, the stable fixation of the fracture broken ends can be realized, the dislocation of fracture broken ends can be prevented, and the accurate positioning, the resetting and the union of auxiliary fracture parts can be ensured. The invention also relates to a backbone fixing system.
The technical scheme of the invention is as follows:
the utility model provides a two-way fixed steel sheet, its characterized in that includes the steel sheet body, the steel sheet body is used for leading in from the diaphysis leading side and has with diaphysis leading side assorted structure in order to fix laminating bone broken end, the steel sheet body is on leading side assorted structure with the diaphysis arranging and is setting up two at least pairs of guiding holes that are used for passing first locking screw respectively, the angle of guiding hole makes each first locking screw that passes clip the intramedullary nail jointly and realizes controlling the rotation and the axial stabilization of intramedullary nail.
And the distal end and/or the proximal end of the steel plate body are/is provided with a positioning hole for passing through the second locking screw, and the angle of the positioning hole enables the second locking screw to pass through to realize the position positioning of the steel plate body closely contacted with the backbone.
The steel plate body is manufactured by adopting an integral forming process.
The long shaft of the steel plate body is consistent with the intramedullary nail when the steel plate body is placed, and each pair of guide holes are sequentially formed along the long shaft direction of the steel plate body and are arranged in double rows.
The steel plate body is two pairs of guide holes arranged on the structure matched with the backbone front side surface, each pair of guide holes is arranged along the short axis of the steel plate body, and the steel plate body is divided into two rows along the long axis direction.
The guide holes arranged on the structure matched with the front side face of the backbone of the body fixing part are four pairs, each pair of guide holes is arranged along the short axis of the steel plate body, and the steel plate body is divided into four rows along the long axis direction.
The diaphysis fixing system is characterized by comprising the two-way fixing steel plate, an intramedullary nail and a plurality of first locking screws, wherein the intramedullary nail is used for fixing a broken end of a bone and is provided with a structure matched with an inner cavity of diaphysis marrow, and each first locking screw is tightly attached to the side surface of the intramedullary nail after penetrating through a corresponding guide hole respectively and fixedly clamps the intramedullary nail together to control the rotation and axial stability of the intramedullary nail.
The backbone fixing system further comprises a second locking screw passing through the positioning hole for positioning the bi-directional fixing steel plate.
The diameters of the first locking screw and the second locking screw are 2.4-4.5mm.
The first locking screw and/or the second locking screw is a hollow locking screw or a solid locking screw.
The invention has the following technical effects:
the invention relates to a two-way fixing steel plate, which comprises a steel plate body, wherein the steel plate body is used for being placed in from the front side of a diaphysis and is provided with a structure matched with the front side of the diaphysis so as to fix and attach to a broken end of a bone, at least two pairs of guide holes for penetrating a first locking screw are arranged on the steel plate body, and preferably, the steel plate body can be integrally formed, and each pair of guide holes respectively have a specific angle so as to respectively match with the first locking screw to realize a specific function when in application. The two-way fixing steel plate provided by the invention has the advantages that the steel plate body with the structure matched with the diaphysis front side is utilized to put in and fix the diaphysis fracture broken end part from the diaphysis front side, and the steel plate body can also support and protect the diaphysis fracture broken end part so as to enhance the stability of the fracture broken end, and effectively ensure the stable reduction and healing of the auxiliary fracture part; the steel plate body with a specific structure is matched with the guide holes with specific angles in pairs, so that after the first locking screw penetrates into the steel plate body along the direction of the guide holes, the intramedullary nail can be clamped together to realize the control of the rotation and the axial stability of the intramedullary nail, in addition, the guide holes can also be understood as universal locking holes, the steel plate body can be tightly contacted with diaphysis (namely, a two-way fixed steel plate is tightly attached to the diaphysis) and the diaphysis fracture broken end part support and the steel plate body locking are realized, the unique structure of the invention can realize the anti-rotation and the anti-axial instability of the diaphysis fracture broken end part, control the rotation and the reinforced support of the intramedullary nail, and improve the fracture broken end stability; and when in actual use, can put into and the first locking screw's of diaphysis front side wicresoft put into can not receive original fixed interference, two-way fixed steel sheet simple structure, small in size can put into at diaphysis front side incision to the specific angle that sets up through the guiding hole makes it when cooperating with first locking screw can realize propping, anti-rotation and the axial stability to diaphysis fracture broken end position, with the reliability of further reinforcing fixed after the reduction, thereby be favorable to the fracture healing.
According to the bidirectional fixing steel plate, the locating holes for penetrating the second locking screws can be formed in the far end and/or the near end of the steel plate body, so that the position location of the steel plate body closely contacted with the diaphysis can be realized after the second locking screws penetrate in the direction of the locating holes, the accuracy of reduction fixation is further improved, and the fracture healing effect is enhanced.
In addition, the guide holes arranged in pairs can be sequentially arranged along the long axis direction of the steel plate body according to the logarithm of the guide holes, and finally, each guide hole is arranged in multiple rows and double columns, and the specific arrangement structure can be reasonably selected and arranged according to the specific situation of the fracture part, for example, the guide holes are divided into two rows, four rows, six rows, eight rows and the like along the long axis of the steel plate body, so that the fracture end is supported and protected, the fracture end is stabilized, and simultaneously, the fracture end is matched with the fracture end part, so that the optimal anti-rotation and anti-axial instability effects are realized, the fracture healing is accelerated and promoted, and the fracture healing state is better.
The invention also relates to a diaphysis fixing system, which comprises the two-way fixing steel plate and the first locking screw, and also comprises an intramedullary nail structure, wherein the parts are matched for use in actual use, the long shaft of the steel plate body of the two-way fixing steel plate is consistent with the intramedullary nail, the intramedullary nail realizes effective fracture broken end part supporting and fixing, the first locking screw penetrating through the two-way fixing steel plate is tightly attached to the intramedullary nail and fixed through the cortex, and accurate positioning and fixing, rotation resistance and axial instability resistance of diaphysis realized, so that the steel plate body realizes the effect of controlling rotation and reinforcing support of the intramedullary nail by the two-way fixing screw (or the two-way locking screw) through the cooperation of the corresponding first locking screws with the guide holes with a specific angle, thereby further strengthening the effective support and stability for diaphysis fractured, assisting the accurate positioning and fixing of the fracture part, and effectively guaranteeing the stability after diaphysis reset.
Drawings
Fig. 1 is a schematic representation of bone nonunion after diaphyseal fracture.
Fig. 2 is a front view showing a preferred structure of the bi-directional fixing steel plate of the present invention.
Fig. 3 is a side view showing a structure of the bi-directional fixing steel plate of fig. 2 in a use state.
Fig. 4 is a structural perspective view of the use state of the bi-directional fixed steel sheet of fig. 2.
Fig. 5 is a top view of fig. 4.
Fig. 6 is a front view of another preferred structure of the bi-directional fixing steel plate of the present invention.
Fig. 7 is a structural side view of a preferred diaphyseal fixation system of the present invention in use.
Fig. 8 is a structural perspective view of a use state of the backbone fixing system of fig. 7.
The reference numerals in the figures are listed below:
1-backbones; 10-bone nonunion; 2-two-way fixed steel plates; 20-a steel plate body; 2101-guide holes; 2102-guide holes; 2103-guide holes; 2104-guide holes; 2105-guide holes; 2106-guide holes; 2107-guide holes; 2108-guide holes; 2201-first locking screw; 2202-first locking screw; 2203-first locking screw; 2204-first locking screw; 2205-first locking screw; 2206-first locking screw; 2207-first locking screw; 2208-first locking screw; 23-positioning holes; 3-intramedullary nail.
Detailed Description
The present invention will be described below with reference to the accompanying drawings.
The invention relates to a two-way fixed steel plate, which comprises a steel plate body, wherein the steel plate body is used for being placed in from the front side of a diaphysis and is provided with a structure matched with the front side of the diaphysis so as to be fixedly attached to a broken end of a bone, the steel plate body is provided with at least two pairs of guide holes which are respectively used for penetrating through first locking screws in an arrangement mode on the structure matched with the front side of the diaphysis, and the angle of each guide hole enables each penetrating first locking screw to jointly clamp an intramedullary nail so as to control the rotation and the axial stability of the intramedullary nail. The specific structural shape of the steel plate body, the specific positions of the pairs of guide holes and the number of the guide holes can be reasonably set according to practical application conditions, and the steel plate is not limited by the invention and comprises but is not limited by the scope. For example, the steel plate body can be designed into a rectangular structure, the inner side surface of the steel plate body can be closely attached to the front side surface of the backbone, and the steel plate body can also be designed into other reasonable structures. In addition, the steel plate body is consistent with the intramedullary nail in the length axis of placement and is sequentially provided with each pair of guide holes along the long axis direction of the steel plate body, and the guide holes are arranged in double rows, namely, finally, the guide holes can be arranged in multiple rows and double rows, for example, the steel plate body is provided with two pairs of guide holes on a structure matched with the front side surface of the backbone, each pair of guide holes is arranged along the short axis direction of the steel plate body, and the steel plate body is divided into two rows along the long axis direction; or, the steel plate body is provided with four pairs of guide holes on the structure matched with the backbone front side surface, each pair of guide holes is arranged along the short axis of the steel plate body, and the steel plate body is divided into four rows along the long axis direction. The specific arrangement structure can be reasonably selected and arranged according to specific conditions of the fracture part, such as two rows, four rows, six rows, eight rows and the like along the long axis of the steel plate body, so that the fracture end is supported and protected and stabilized, and simultaneously, the fracture end part is matched, the optimized anti-rotation and anti-axial instability effects are realized, the fracture healing is accelerated, and the fracture healing state is better. In other words, the bi-directional fixing steel plate of the present invention may have a length determined according to the number of guide holes provided in the steel plate body on the structure matching the front side of the backbone, for example, the bi-directional fixing steel plate may have two, four, six, eight or more rows.
Fig. 2 is a front view showing a preferred structure of the bi-directional fixing steel plate 2 according to the present invention, and as shown in fig. 2, the embodiment includes a steel plate body 20, preferably the steel plate body 20 may be manufactured by an integral molding process of stainless steel materials; the steel plate body 20 is used for being placed from the front side of the diaphysis and is provided with a structure matched with the front side of the diaphysis so as to fixedly fit with the fracture end, support and stabilize the fracture end and promote fracture healing; the steel plate body 20 of this embodiment is preferably provided with four pairs of guide holes (such as reference numerals 2101-2108, that is, guide holes 2101 and 2102, guide holes 2103 and 2104, guide holes 2105 and 2106, guide holes 2107 and 2108) for penetrating the first locking screws on a structure matched with the front side of the diaphysis, each guide hole is provided with a specific angle, and when the first locking screws are adopted to penetrate along the angle of the guide holes for locking and fixing, the steel plate body 20 can directly contact the diaphysis, and the penetrating first locking screws can clamp the intramedullary nail together to control the rotation and axial stability of the intramedullary nail, that is, the steel plate body 20 is tightly attached to the front side of the diaphysis, the intramedullary nail is fixed and anti-rotated, and then the axial stability, the fixation support and the anti-rotation of the fracture diaphysis realized at the fracture diaphysis broken end position. In addition, as shown in fig. 2, the guide holes 2101, 2105, 2107 and 2103 are arranged in an approximately straight line, and the guide holes 2102, 2106, 2108 and 2104 are arranged in an approximately straight line, that is, the guide holes are arranged in four rows and two columns, and the arrangement shape of the guide holes can be set at will by other means, so that the guide holes can be effectively fixed, anti-rotation, anti-axial instability and less damage to a patient in actual use can be ensured as much as possible. The bidirectional fixing steel plate 2 provided by the invention adopts a structure comprising the integrally formed steel plate body 20, the steel plate body 20 is placed in from the front side of the diaphysis and has a structure matched with the front side of the diaphysis, so that the effects of good fitting and fixing the broken ends of bones can be realized, meanwhile, the axial positioning and fixing of the fracture areas of the diaphysis of long bones can be realized by matching with the first locking screw, the dislocation of fracture parts can be prevented, the fracture nonunion or the nonunion parts of the broken ends of the bones can be well stabilized and supported, the stability of fracture healing is effectively ensured, the accurate positioning, reduction and healing of auxiliary fracture parts are further ensured, the fracture healing is accelerated, and the fracture healing state is better.
The working principle and the using method of the bidirectional fixed steel plate 2 provided by the invention are specifically described as follows:
in the practical use process, firstly, the fracture part, for example, the front side surface of the diaphysis 1, namely the front side of the bone unconnected part, is cut along the long axis of the limb, skin, subcutaneous, quadriceps and myobelly of the femoral artery are incised, the bone unconnected part is exposed, then a sharp osteotome is used for performing cortical cutting operation on the bone unconnected part, and the bone unconnected part is fully exposed; respectively using a minimally invasive bone drill to prepare bone mud and cortical bone fragments; filling bone cement into the bone non-connecting part, and paving cancellous bone strips under the cut bone cortex; the ductility of skin and muscle is utilized to make subperiosteum stripping; then the two-way fixing steel plate 2 shown in figure 2 is placed under periosteum, the steel plate body 20 is placed at the diaphysis front side part, meanwhile, the inner side surface of the steel plate body 20 is tightly contacted and attached with the diaphysis front side surface, good supporting and anti-rotation fixing effects are achieved, effective supporting and fixing of diaphysis fracture are perfectly achieved, accurate positioning and healing of fracture parts are assisted, and the diaphysis fracture reduction healing stability is effectively guaranteed. As shown in fig. 3 and 4 (wherein fig. 3 is a side view and fig. 4 is a perspective view), the first locking screw 2201 and the first locking screw 2202 respectively pass through two guide holes 2101 and 2102 arranged on the steel plate body 20 at a certain angle, the first locking screw 2205 and the first locking screw 2206 respectively pass through two guide holes 2105 and 2106 arranged on the steel plate body 20 at a certain angle, the first locking screw 2207 and the first locking screw 2208 respectively pass through two guide holes 2107 and 2108 arranged on the steel plate body 20 at a certain angle, the first locking screw 2203 and the first locking screw 2204 respectively pass through two guide holes 2103 and 2104 arranged on the steel plate body 20 at a certain angle so as to realize tight fit between the steel plate body 20 and the front side of the backbone to fix the fractured bone, and simultaneously cooperate with each guide hole so that each first locking screw passing through clamps the intramedullary nail 3 together to realize control the rotation and axial stabilization of the intramedullary nail 3, realize the axial support, fixation and the axial stabilization of the intramedullary nail 3, the first locking screw 2203 and the axial stabilization of each intramedullary nail can not be reasonably and effectively clamped against the first locking screw 3 in a certain angle and can be effectively fixed against any axial injury according to the actual conditions; in addition, as shown in fig. 5 (fig. 5 is a top view of fig. 4, i.e. a view from a proximal end to a distal end of a diaphysis), the four pairs of eight first locking screws are respectively arranged in two approximate straight lines, i.e. in four rows and two columns, and each first locking screw passing through the steel plate body 20 is tightly attached to the intramedullary nail 3 and is fixed through the cortex (i.e. between the cortex and the periosteum), so as to jointly clamp the intramedullary nail 3 to realize the rotation and axial stability of the intramedullary nail 3, and the axial supporting, anti-rotation and stabilizing effects of the intramedullary nail 3 are enhanced. After the bidirectional fixed steel plate 2 is used for supporting and fixing, a negative pressure drainage tube is reserved, and periosteum, myofascial, deep fascia, subcutaneous and skin are sutured and closed; the drainage tube was pulled out 48 hours after the operation. Further, the fracture patient exercises the passive limit knee joint mobility every day and performs isometric contraction movement on the limbs of the lower limb; pain tolerates the weight-bearing activities (5 kg foot point ground). The X-ray is reviewed monthly, and the weight bearing progress is determined according to the fracture healing condition; until the patient is completely recovered.
Fig. 6 is a front view of another preferred structure of the bi-directional fixing steel plate of the present invention. In this embodiment, the positioning holes 23 for passing through the second locking screws are formed on the distal end and the proximal end (that is, the upper end and the lower end of the steel plate body) of the steel plate body 20, and the angle of the positioning holes enables the passing second locking screws to realize the positioning of the position where the steel plate body 20 closely contacts the diaphysis, so that the accurate positioning and fixing of the diaphysis fracture broken end part are further improved, and the fracture healing effect is enhanced.
The invention also relates to a diaphysis fixing system, which comprises a two-way fixing steel plate, an intramedullary nail and a plurality of first locking screws, wherein the two-way fixing steel plate can be of a two-way fixing steel plate structure shown in figures 2-5, the intramedullary nail is used for fixing a broken end of a bone and is provided with a structure matched with an diaphysis bone inner cavity, and each first locking screw respectively passes through a corresponding guide hole and then is tightly attached to the side surface of the intramedullary nail to jointly fix and clamp the intramedullary nail so as to control the rotation and axial stability of the intramedullary nail.
Preferably, the diaphysis fixing system may further include a second locking screw penetrating the positioning hole for positioning the bi-directional fixing steel plate, at this time, the bi-directional fixing steel plate adopts the structure shown in fig. 6, that is, the distal end and/or the proximal end of the steel plate body (that is, the upper end portion and/or the lower end portion of the steel plate body) may further be provided with a positioning hole penetrating the second locking screw, and the angle of the positioning hole makes the penetrating second locking screw realize the positioning of the steel plate body closely contacting the diaphysis, so as to realize the accurate positioning and fixing of the diaphysis fracture broken end portion, and enhance the fracture healing effect.
Preferably, the diameter of the locking screws (first locking screw and second locking screw) for fixing the bi-directional fixing steel plate ranges from 2.4 to 4.5mm; the locking screws (first locking screw and second locking screw) for fixing the bi-directional fixing steel plate may be either hollow locking screws or solid locking screws.
The preferred diaphysis fixing system shown in fig. 7 and 8 is schematically constructed in a use state, wherein fig. 7 is a side view, fig. 8 is a perspective view, including the above-mentioned bi-directional fixing steel plate 2 and intramedullary nail 3 shown in fig. 3 or 4, and further fixing of the bi-directional fixing steel plate 2 and clamping fixation of the intramedullary nail 3 using a plurality of first locking screws as shown in fig. 3 to 4 is performed in the manner as described above to control rotation and strengthen support; the intramedullary nail 3 has a structure matched with the diaphysis intramedullary cavity, the first locking screws respectively penetrating through each pair of guide holes are closely attached to the side surface of the intramedullary nail and control the rotation and the axial stabilization of the intramedullary nail 3, that is, the first locking screws penetrating through the steel plate body 20 are all tightly attached to the intramedullary nail 3 and fixed through the cortex (between the cortex and periosteum), the intramedullary nail 3 is clamped together to control the rotation and the axial stabilization of the intramedullary nail 3, the integral structure that the first locking screws are all tangential and encircling the intramedullary nail 3 is formed, so that the axial supporting, the anti-rotation and the stabilization effects of the intramedullary nail 3 are further enhanced, and the support, the anti-rotation and the axial stabilization of the diaphysis fracture broken end part are further realized.
The working principle and the using method of the backbone fixing system provided by the invention are specifically described as follows:
as shown in fig. 7 and 8, in the actual use process, the intramedullary nail 3 can be inserted into the diaphyseal bone marrow cavity through the diaphyseal fracture end, and the bidirectional fixing steel plate 2 can be placed through a conventional anterolateral incision, so that the diaphyseal fixing system can be placed through only one incision, the damage surface, the damage degree and the bleeding amount in the operation are generally smaller, and the healing and recovery speed after the operation are higher, as the working principle and the using method of the bidirectional fixing steel plate 2 shown in fig. 2-5 are the same as those described above. The two-way fixing steel plate 2 and the intramedullary nail 3 are mutually matched, the long shaft of the steel plate body 20 of the two-way fixing steel plate 2 is kept consistent with the intramedullary nail 3, the intramedullary nail 3 realizes effective fracture broken end part supporting and fixing, each first locking screw penetrating through the two-way fixing steel plate 2 is tightly clung to the intramedullary nail 3 and penetrates the cortex to be fixed, namely, the steel plate body 20 works by matching each corresponding first locking screw through each guide hole provided with a specific angle to realize the effect of controlling rotation and strengthening supporting of the two-way fixing screw (or the two-way locking screw) on the intramedullary nail 3, thereby realizing accurate positioning and fixing, rotation resistance and axial instability resistance of diaphysis further strengthened, effective supporting and stability of diaphysis fracture are further strengthened, accurate positioning and fixing of auxiliary fracture parts are effectively ensured, and stability after diaphysis reduced.
It should be noted that the above-described embodiments will enable those skilled in the art to more fully understand the invention, but do not limit it in any way. Therefore, although the present invention has been described in detail with reference to the drawings and examples, it will be understood by those skilled in the art that the present invention may be modified or equivalent, and in all cases, all technical solutions and modifications which do not depart from the spirit and scope of the present invention are intended to be included in the scope of the present invention.
Claims (10)
1. A bi-directional fixation steel plate for bone nonunion or nonunion after diaphysis fracture, comprising a steel plate body for being placed from the diaphysis front side and having a structure matched with the diaphysis front side to fix a fitted bone fracture end, wherein after the steel plate body is placed through diaphysis front side incision, the inner side of the steel plate body is tightly fitted with the diaphysis front side to fix and support the diaphysis fracture end position to enhance bone fracture end stability and assist in stable reduction and healing of fracture position, the steel plate body is arranged on the structure matched with the diaphysis front side to arrange at least two pairs of guide holes for respectively passing through first locking screws, each pair of guide holes respectively have specific angles, each pair of guide holes are spaced from each other along the short axis of the steel plate body and have different angles so as to clamp an intramedullary nail from opposite sides through the first locking screws passing through each pair of guide holes, and the different pairs of guide holes are spaced from each other so as to fix the intramedullary nail at different axial positions through the first locking screws passing through the different pairs of guide holes, and the guide holes enable the first locking screws passing through the steel plate body to pass through the first locking screws to realize both locking and locking of the intramedullary nail.
2. The bi-directional fixation steel plate as claimed in claim 1, wherein a positioning hole for passing through the second locking screw is provided on the distal end and/or the proximal end of the steel plate body, and the positioning hole is angled such that the passing through second locking screw achieves a position location where the steel plate body closely contacts the backbone.
3. The bi-directional fixation steel plate of claim 2, wherein the steel plate body is manufactured using an integral molding process.
4. A bi-directional fixation steel plate as claimed in any one of claims 1 to 3, wherein the steel plate body has a long axis aligned with the intramedullary nail when being inserted and is provided with respective pairs of guide holes in sequence along the long axis direction of the steel plate body, the guide holes being arranged in double rows.
5. The bi-directional fixed steel plate of claim 4, wherein the steel plate body has two pairs of guide holes arranged on a structure matching with the front side of the backbone, each pair of guide holes being arranged along the short axis of the steel plate body, and the steel plate body is divided into two rows along the long axis direction.
6. The bi-directional fixing steel plate as set forth in claim 4, wherein the steel plate body fixing parts are provided with four pairs of guide holes on a structure matching with the front side of the backbone, each pair of guide holes being provided along the short axis of the steel plate body, and the steel plate body being divided into four rows along the long axis direction.
7. A diaphysis fixing system, which is characterized by comprising the two-way fixing steel plate as claimed in any one of claims 1 to 6, an intramedullary nail and a plurality of first locking screws, wherein the intramedullary nail is used for fixing a broken end of a bone and is provided with a structure matched with a diaphysis marrow inner cavity, and each first locking screw is tightly attached to the side surface of the intramedullary nail after passing through a corresponding guide hole respectively and is fixed through a cortex and jointly fixes and clamps the intramedullary nail to realize the control of the rotation and the axial stabilization of the intramedullary nail.
8. The diaphyseal fixation system of claim 7 further comprising a second locking screw through the locating hole for locating the bi-directional fixation plate.
9. The diaphyseal fixation system of claim 8, wherein the first and second locking screws each have a diameter ranging from 2.4-4.5mm.
10. The diaphyseal fixation system of claim 8, wherein the first and/or second locking screw is a cannulated locking screw or a solid locking screw.
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| CN201610917171.XA CN106344141B (en) | 2016-10-20 | 2016-10-20 | Two-way fixed steel plate and backbone fixing system |
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| CN201610917171.XA CN106344141B (en) | 2016-10-20 | 2016-10-20 | Two-way fixed steel plate and backbone fixing system |
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| CN106344141B true CN106344141B (en) | 2024-01-12 |
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| CN107744403A (en) * | 2017-10-27 | 2018-03-02 | 中国人民解放军第七五医院 | A kind of intramedullary nail suitable for fractured near end of thighbone |
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| DE60213800T2 (en) * | 2002-09-03 | 2007-08-16 | Pennig, Dietmar, Dr.med. Priv. Doz. | Nail and screw for surgical fixation system |
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| US10314626B2 (en) * | 2015-01-16 | 2019-06-11 | DePuy Synthes Procucts, Inc. | Washer plate |
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| US5356410A (en) * | 1991-12-13 | 1994-10-18 | Dietmar Pennig | Adjuvant for osteosynthesis in the case of pertrochanteric fracture of the neck of the femur |
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| CN106344141A (en) | 2017-01-25 |
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