CN106725792A - A kind of flexible intramedullary nail with pressurization anti-rotation function - Google Patents
A kind of flexible intramedullary nail with pressurization anti-rotation function Download PDFInfo
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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Abstract
一种具有加压抗旋转功能的弹性髓内钉，属于骨科医疗器械技术领域，用于长骨干骺端粉碎性骨折的内固定。其技术方案是：髓内钉头部和髓内钉尾部分别向髓内钉中部的相同一侧弯曲，髓内钉头部和髓内钉尾部的弯曲部分与髓内钉中部在同一平面上，髓内钉头部、髓内钉中部、髓内钉尾部的弯曲弧形两侧的髓内钉钉体上分别有凹槽。本发明是髓内钉的首创，将传统的直体髓内钉改为弯曲的弧形髓内钉，使髓内钉在通过锁定螺钉进行内固定的同时，兼具有弹性加压和防止发生横向旋转的作用，赋予了髓内钉在内固定中新的功能，提高了髓内钉的内固定效果，加快了骨折愈合的时间，减少了患者的痛苦，为骨科长骨骨折的治疗提供了新的有力的器具，值得推广使用。
An elastic intramedullary nail with pressurization and anti-rotation functions belongs to the technical field of orthopedic medical devices and is used for internal fixation of comminuted fractures of the long bone metaphysis. The technical solution is: the head of the intramedullary nail and the tail of the intramedullary nail are respectively bent to the same side of the middle part of the intramedullary nail, and the curved parts of the head of the intramedullary nail and the tail of the intramedullary nail are on the same plane as the middle part of the intramedullary nail. The intramedullary nail head, the middle part of the intramedullary nail, and the curved arc of the intramedullary nail tail are respectively provided with grooves on the nail body of the intramedullary nail. The invention is the first of the intramedullary nails, changing the traditional straight intramedullary nails into curved arc-shaped intramedullary nails, so that the intramedullary nails can be internally fixed by locking screws, and at the same time have elastic pressure and prevent The role of lateral rotation endows the intramedullary nail with new functions in internal fixation, improves the internal fixation effect of the intramedullary nail, speeds up the time of fracture healing, reduces the pain of patients, and provides a new method for the treatment of long bone fractures in orthopedics. It is a powerful tool that is worthy of promotion and use.
Description
技术领域technical field
本发明涉及一种用于长骨干骺端粉碎性骨折的弹性髓内钉，属于骨科医疗器械技术领域。The invention relates to an elastic intramedullary nail for comminuted fractures of the metaphysis of long bones, belonging to the technical field of orthopedic medical devices.
背景技术Background technique
在骨科治疗中，对于股骨远端、胫骨近端以及肱骨近端等长骨干骺端粉碎性骨折，临床医生常常会选择单侧或双侧钢板进行外固定，但此方法需剥离大部分软组织，创伤大，出血量多，因此常常会伴随感染，不愈合以及畸形愈合等并发症的发生。由于钢板固定应力集中，容易松动，甚至容易断裂，继而出现对位，对线不良所致的成角畸形和旋转畸形。除了钢板固定外，髓内钉固定也是临床广泛使用的治疗手段，髓内钉用于下肢骨干骨折的治疗有其独特的优越性，由于人体在直立位的重力作用会对骨折端有加压作用，弥补了髓内钉固定可能存在的骨折端接触不紧密的缺点。因此目前在下肢骨折的治疗中，髓内钉也是临床医生的主要选择之一。用于治疗骨干骨折的髓内钉有多种，如常用的Ender钉、Lottes钉、矩形钉…等。但是传统的髓内钉有以下缺点：首先，传统的髓内钉一般要经过关节内打入，会破坏关节的完整性；其次，传统的髓内钉自身无法实现对骨折端的加压效果，必须借助置入更多的动态螺钉才可以实现弹性加压，而动态螺钉的置入也在一定程度上增加了创伤范围，不利于患者的早起康复；第三，对于长骨干骨折，尤其是合并干骺端粉碎性骨折的患者，传统的髓内钉因干骺端粉碎没有可靠的支撑，仅靠传统的螺钉无法实现坚强固定，因此大大限制其广泛应用。In orthopedic treatment, for comminuted metaphyseal fractures of long bones such as the distal femur, proximal tibia, and proximal humerus, clinicians often choose unilateral or bilateral plate fixation, but this method requires stripping most of the soft tissue. The trauma is large and the amount of bleeding is large, so it is often accompanied by complications such as infection, non-union, and malunion. Due to the concentrated stress of the steel plate, it is easy to loosen and even break, and then there will be angular deformity and rotational deformity caused by poor alignment. In addition to plate fixation, intramedullary nailing is also widely used in clinical treatment. Intramedullary nailing has its unique advantages in the treatment of shaft fractures of the lower extremities. The gravity of the human body in the upright position will exert pressure on the fracture ends. , to make up for the lack of close contact of the fracture end that may exist in intramedullary nailing. Therefore, in the treatment of lower extremity fractures, intramedullary nailing is also one of the main choices for clinicians. There are many kinds of intramedullary nails used for the treatment of diaphysis fractures, such as commonly used Ender nails, Lottes nails, rectangular nails, etc. However, traditional intramedullary nails have the following disadvantages: First, traditional intramedullary nails generally have to be driven into the joint, which will destroy the integrity of the joint; Elastic compression can only be achieved by placing more dynamic screws, and the placement of dynamic screws also increases the extent of trauma to a certain extent, which is not conducive to the early recovery of patients; For patients with comminuted metaphyseal fractures, traditional intramedullary nails have no reliable support due to metaphyseal comminuted, and traditional screws alone cannot achieve strong fixation, which greatly limits their wide application.
发明内容Contents of the invention
本发明所要解决的技术问题是提供一种具有加压抗旋转功能的弹性髓内钉，这种髓内钉可以在长骨的纵向进行弹性加压，同时可以防止发生横向旋转，使得固定效果更加确切，有利于骨折的尽快愈合。The technical problem to be solved by the present invention is to provide an elastic intramedullary nail with pressurization and anti-rotation function. This intramedullary nail can elastically pressurize the long bone in the longitudinal direction, and can prevent lateral rotation at the same time, so that the fixation effect is more accurate. , is conducive to the healing of fractures as soon as possible.
解决上述技术问题的技术方案是：The technical scheme that solves the above-mentioned technical problem is:
一种具有加压抗旋转功能的弹性髓内钉，它由髓内钉头部、髓内钉中部、髓内钉尾部组成，髓内钉头部和髓内钉尾部分别连接在髓内钉中部的两端形成一体结构，髓内钉头部和髓内钉尾部分别向髓内钉中部的相同一侧弯曲，髓内钉头部和髓内钉尾部的弯曲部分与髓内钉中部在同一平面上，髓内钉头部、髓内钉中部、髓内钉尾部的弯曲弧形两侧的髓内钉钉体上分别有凹槽，位于髓内钉钉体弯曲弧形的弓弦一侧凹槽的宽度大于髓内钉钉体弯曲弧形的弓背一侧凹槽的宽度。An elastic intramedullary nail with pressurized anti-rotation function, which is composed of the head of the intramedullary nail, the middle part of the intramedullary nail, and the tail of the intramedullary nail. The head of the intramedullary nail and the tail of the intramedullary nail are respectively connected to the middle part of the intramedullary nail The two ends of the intramedullary nail form an integrated structure, the head of the intramedullary nail and the tail of the intramedullary nail are respectively bent to the same side of the middle part of the intramedullary nail, and the curved parts of the head of the intramedullary nail and the tail of the intramedullary nail are in the same plane as the middle part of the intramedullary nail Above, the head of the intramedullary nail, the middle part of the intramedullary nail, and the intramedullary nail body on both sides of the curved arc of the intramedullary nail tail have grooves respectively, which are located on the bowstring side of the curved arc of the intramedullary nail body The width is greater than the width of the groove on the dorsal side of the curved arc of the intramedullary nail body.
上述具有加压抗旋转功能的弹性髓内钉，它分别有股骨远端髓内钉、胫骨近端髓内钉和肱骨近端髓内钉三种，股骨远端髓内钉包括股骨远端外侧髓内钉和股骨远端内侧髓内钉，胫骨近端髓内钉包括胫骨近端外侧髓内钉和胫骨近端内侧髓内钉，肱骨近端髓内钉为肱骨近端外侧髓内钉。The elastic intramedullary nails with pressurization and anti-rotation functions include three types: the distal femoral nail, the proximal tibial nail, and the proximal humerus nail. The distal femoral nail includes the distal femoral outer Intramedullary nail and intramedullary nail of distal femur, intramedullary nail of proximal tibia includes intramedullary nail of proximal lateral tibia and intramedullary nail of proximal tibia, intramedullary nail of proximal humerus refers to intramedullary nail of proximal lateral humerus.
上述具有加压抗旋转功能的弹性髓内钉，所述股骨远端外侧髓内钉的髓内钉头部与髓内钉中部的弯曲角度为51-61度，髓内钉尾部与髓内钉中部的弯曲角度为13-23度，股骨远端内侧髓内钉的髓内钉头部与髓内钉中部的弯曲角度为40-50度，髓内钉尾部与髓内钉中部的弯曲角度为10-20度。For the above-mentioned elastic intramedullary nail with pressurization and anti-rotation function, the bending angle between the head of the intramedullary nail and the middle part of the intramedullary nail of the distal femur is 51-61 degrees, and the tail of the intramedullary nail and the intramedullary nail The bending angle of the middle part is 13-23 degrees, the bending angle between the head of the distal femoral intramedullary nail and the middle part of the intramedullary nail is 40-50 degrees, and the bending angle between the tail of the intramedullary nail and the middle part of the intramedullary nail is 10-20 degrees.
上述具有加压抗旋转功能的弹性髓内钉，所述胫骨近端外侧髓内钉的髓内钉头部与髓内钉中部的弯曲角度为40-50度，髓内钉尾部与髓内钉中部的弯曲角度为13-23度，胫骨近端内侧髓内钉的髓内钉头部与髓内钉中部的弯曲角度为25-35度，髓内钉尾部与髓内钉中部的弯曲角度为11-21度。For the above-mentioned elastic intramedullary nail with pressurization and anti-rotation function, the bending angle between the head of the intramedullary nail and the middle part of the intramedullary nail is 40-50 degrees, and the tail of the intramedullary nail and the intramedullary nail The bending angle of the middle part is 13-23 degrees, the bending angle between the head of the intramedullary nail and the middle part of the intramedullary nail in the proximal medial tibia is 25-35 degrees, and the bending angle between the tail of the intramedullary nail and the middle part of the intramedullary nail is 11-21 degrees.
上述具有加压抗旋转功能的弹性髓内钉，所述肱骨近端外侧髓内钉的髓内钉头部与髓内钉中部的弯曲角度为13-23度，髓内钉尾部与髓内钉中部的弯曲角度为3-13度。For the above-mentioned elastic intramedullary nail with pressurization and anti-rotation function, the bending angle between the head of the intramedullary nail and the middle part of the intramedullary nail of the proximal humerus is 13-23 degrees, and the tail of the intramedullary nail and the intramedullary nail The bending angle in the middle is 3-13 degrees.
上述具有加压抗旋转功能的弹性髓内钉，每种髓内钉的髓内钉中部钉体上有6-12个锁定螺钉孔，锁定螺钉孔沿着髓内钉钉体的长度顺序排列，锁定螺钉孔位于髓内钉钉体的凹槽内。For the above-mentioned elastic intramedullary nail with pressurization and anti-rotation function, there are 6-12 locking screw holes on the middle part of the intramedullary nail of each type of intramedullary nail, and the locking screw holes are arranged sequentially along the length of the intramedullary nail body. The locking screw holes are located in grooves in the nail body.
本发明的有益效果是：The beneficial effects of the present invention are:
本发明的髓内钉钉体为弧形，且在髓内钉钉体的弯曲弧形两侧分别设置了凹槽。采用这种结构后，髓内钉的弧形钉体可以在长骨的纵向起到弹性加压的作用，髓内钉钉体的弯曲弧形两侧的凹槽可以防止髓内钉发生横向旋转，使得固定效果更加确切，有利于骨折的尽快愈合。The intramedullary nail body of the present invention is arc-shaped, and grooves are respectively arranged on both sides of the curved arc-shaped body of the intramedullary nail. After adopting this structure, the arc-shaped nail body of the intramedullary nail can play the role of elastic pressure in the longitudinal direction of the long bone, and the grooves on both sides of the curved arc-shaped nail body of the intramedullary nail can prevent the lateral rotation of the intramedullary nail. The fixation effect is more accurate, which is conducive to the early healing of the fracture.
本发明是髓内钉的首创，将传统的直体髓内钉改为弯曲的弧形髓内钉，使髓内钉在通过锁定螺钉进行内固定的同时，兼具有弹性加压和防止发生横向旋转的作用，赋予了髓内钉在内固定中新的功能，提高了髓内钉的内固定效果，加快了骨折愈合的时间，减少了患者的痛苦，为骨科长骨骨折的治疗提供了新的有力的器具，值得推广使用。The invention is the first of the intramedullary nails, changing the traditional straight intramedullary nails into curved arc-shaped intramedullary nails, so that the intramedullary nails can be internally fixed by locking screws, and at the same time have elastic pressure and prevent The role of lateral rotation endows the intramedullary nail with new functions in internal fixation, improves the internal fixation effect of the intramedullary nail, speeds up the time of fracture healing, reduces the pain of patients, and provides a new method for the treatment of long bone fractures in orthopedics. It is a powerful tool that is worthy of promotion and use.
附图说明Description of drawings
图1是本发明的结构示意图；Fig. 1 is a structural representation of the present invention;
图2是股骨远端外侧髓内钉的使用状态示意图；Fig. 2 is a schematic diagram of the use state of the intramedullary nail on the outer side of the distal end of the femur;
图3是股骨远端内侧髓内钉的使用状态示意图；Fig. 3 is a schematic diagram of the use state of the intramedullary nail in the distal end of the femur;
图4是胫骨远端外侧髓内钉的使用状态示意图；Fig. 4 is a schematic diagram of the use state of the intramedullary nail on the outer side of the distal end of the tibia;
图5是胫骨远端内侧髓内钉的使用状态示意图；Fig. 5 is a schematic diagram of the use state of the intramedullary nail on the inner side of the distal end of the tibia;
图6是肱骨近端外侧髓内钉的使用状态示意图。Fig. 6 is a schematic diagram of the use state of the intramedullary nail on the lateral side of the proximal end of the humerus.
图中标记如下：髓内钉头部1、髓内钉中部2、髓内钉尾部3、凹槽4、锁定螺钉孔5、支撑螺钉6、股骨7、胫骨8、肱骨9、股骨远端外侧髓内钉10、股骨远端内侧髓内钉11、胫骨近端外侧髓内钉12、胫骨近端内侧髓内钉13、肱骨近端外侧髓内钉14。The marks in the figure are as follows: head of intramedullary nail 1, middle part of intramedullary nail 2, tail of intramedullary nail 3, groove 4, locking screw hole 5, support screw 6, femur 7, tibia 8, humerus 9, distal femur outside Intramedullary nail 10, distal femoral medial intramedullary nail 11, proximal tibial lateral intramedullary nail 12, proximal tibial medial intramedullary nail 13, proximal humeral lateral intramedullary nail 14.
具体实施方式detailed description
本发明是一种髓内钉，它由髓内钉头部1、髓内钉中部2、髓内钉尾部3组成，髓内钉头部1和髓内钉尾部3分别连接在髓内钉中部2的两端形成一体结构。The present invention is an intramedullary nail, which is composed of an intramedullary nail head 1, an intramedullary nail middle 2, and an intramedullary nail tail 3, and the intramedullary nail head 1 and the intramedullary nail tail 3 are respectively connected to the middle part of the intramedullary nail The two ends of 2 form an integral structure.
图1显示，髓内钉头部1和髓内钉尾部3分别向髓内钉中部2的相同一侧弯曲，髓内钉头部1和髓内钉尾部3的弯曲部分与髓内钉中部2在同一平面上，形成一个两端向同一侧弯曲的弧形髓内钉。髓内钉打入长骨后，弧形钉体可以在长骨的纵向起到弹性加压的作用。Figure 1 shows that the intramedullary nail head 1 and the intramedullary nail tail 3 bend to the same side of the intramedullary nail middle 2 respectively, and the curved parts of the intramedullary nail head 1 and the intramedullary nail tail 3 are in line with the middle part 2 of the intramedullary nail. On the same plane, form a curved intramedullary nail with both ends bent to the same side. After the intramedullary nail is driven into the long bone, the arc-shaped nail body can play the role of elastic compression in the longitudinal direction of the long bone.
图1显示，髓内钉头部1、髓内钉中部2、髓内钉尾部3的弯曲弧形两侧的髓内钉钉体上分别有凹槽4，位于髓内钉钉体弯曲弧形的弓弦一侧凹槽4的宽度大于髓内钉钉体弯曲弧形的弓背一侧凹槽4的宽度。凹槽4的作用是可以防止髓内钉发生横向旋转，使得固定效果更加确切，有利于骨折的尽快愈合。Figure 1 shows that the intramedullary nail body on both sides of the curved arc of the intramedullary nail head 1, the middle part of the intramedullary nail 2, and the tail of the intramedullary nail 3 has grooves 4 respectively, which are located in the curved arc of the intramedullary nail body. The width of the groove 4 on one side of the bowstring is greater than the width of the groove 4 on the arched side of the curved arc of the intramedullary nail body. The function of the groove 4 is to prevent the lateral rotation of the intramedullary nail, so that the fixation effect is more accurate, and it is beneficial to the healing of the fracture as soon as possible.
图1显示，髓内钉中部2钉体上有6-12个锁定螺钉孔5，锁定螺钉孔5沿着髓内钉钉体的长度顺序排列，锁定螺钉孔5位于髓内钉钉体的凹槽4内。锁定螺钉孔5方便锁定螺钉自外侧打入，克服了以往锁定螺钉置入不便的难题。Figure 1 shows that there are 6-12 locking screw holes 5 on the nail body at the middle part of the intramedullary nail. The locking screw holes 5 are arranged sequentially along the length of the intramedullary nail body. in slot 4. The locking screw hole 5 is convenient for the locking screw to drive in from the outside, which overcomes the difficult problem of inconvenient insertion of the locking screw in the past.
本发明的髓内钉包括股骨远端髓内钉、胫骨近端髓内钉和肱骨近端髓内钉三种。股骨远端髓内钉的长度为120-400mm，直径为7-12mm；胫骨近端髓内钉的长度为100-350mm，直径4-12mm；肱骨近端髓内钉的长度为110-170mm，直径3-8mm。The intramedullary nail of the present invention includes three types: the intramedullary nail at the distal end of the femur, the intramedullary nail at the proximal end of the tibia and the intramedullary nail at the proximal end of the humerus. The length of the distal femur intramedullary nail is 120-400mm, and the diameter is 7-12mm; the length of the proximal tibial intramedullary nail is 100-350mm, and the diameter is 4-12mm; the length of the proximal humerus intramedullary nail is 110-170mm, 3-8mm in diameter.
股骨远端髓内钉包括股骨远端外侧髓内钉10和股骨远端内侧髓内钉11，胫骨近端髓内钉包括胫骨近端外侧髓内钉12和胫骨近端内侧髓内钉13，肱骨近端髓内钉为肱骨近端外侧髓内钉14。它们分别用于从股骨远端外侧、股骨远端内侧、胫骨近端外侧、胫骨近端内侧、肱骨近端外侧进行内固定。The distal femoral intramedullary nail includes a distal femoral lateral intramedullary nail 10 and a distal femoral medial intramedullary nail 11, and the proximal tibial intramedullary nail includes a tibial proximal lateral intramedullary nail 12 and a tibial proximal medial intramedullary nail 13, The proximal humeral intramedullary nail is the lateral proximal humeral intramedullary nail 14 . They are respectively used for internal fixation from the outer side of the distal femur, the inner side of the distal femur, the outer side of the proximal tibia, the inner side of the proximal tibia, and the outer side of the proximal humerus.
图2显示，在从股骨远端外侧进行内固定时，股骨远端外侧髓内钉10的髓内钉头部1与髓内钉中部2的弯曲角度为51-61度，髓内钉尾部3与髓内钉中部2的弯曲角度为13-23度。Figure 2 shows that when internal fixation is performed from the outside of the distal femur, the bending angle between the head 1 of the intramedullary nail 10 on the outside of the distal femur and the middle part 2 of the intramedullary nail is 51-61 degrees, and the tail of the intramedullary nail 3 The bending angle with the middle part 2 of the intramedullary nail is 13-23 degrees.
图3显示，在从股骨远端内侧进行内固定时，股骨远端内侧髓内钉11的髓内钉头部1与髓内钉中部2的弯曲角度为40-50度，髓内钉尾部3与髓内钉中部2的弯曲角度为10-20度。Fig. 3 shows, when carrying out internal fixation from the inner side of the distal femur, the bending angle of the intramedullary nail head 1 and the middle part 2 of the intramedullary nail 11 of the inner distal femur is 40-50 degrees, and the intramedullary nail tail 3 The bending angle with the middle part 2 of the intramedullary nail is 10-20 degrees.
图4显示，在从胫骨近端外侧进行内固定时，胫骨近端外侧髓内钉12的髓内钉头部1与髓内钉中部2的弯曲角度为40-50度，髓内钉尾部3与髓内钉中部2的弯曲角度为13-23度。Figure 4 shows that when internal fixation is performed from the outside of the proximal tibia, the bending angle between the head 1 of the intramedullary nail 12 on the outside of the proximal tibia and the middle part 2 of the intramedullary nail is 40-50 degrees, and the tail of the intramedullary nail 3 The bending angle with the middle part 2 of the intramedullary nail is 13-23 degrees.
图5显示，在从胫骨近端内侧进行内固定时，胫骨近端内侧髓内钉13的髓内钉头部1与髓内钉中部2的弯曲角度为25-35度，髓内钉尾部3与髓内钉中部2的弯曲角度为11-21度。Figure 5 shows that when internal fixation is performed from the inside of the proximal tibia, the bending angle between the head 1 of the intramedullary nail 13 on the inside of the proximal tibia and the middle part 2 of the intramedullary nail is 25-35 degrees, and the tail of the intramedullary nail 3 The bending angle with the middle part 2 of the intramedullary nail is 11-21 degrees.
图6显示，在从肱骨近端外侧进行内固定时，肱骨近端外侧髓内钉14的髓内钉头部1与髓内钉中部2的弯曲角度为13-23度，髓内钉尾部3与髓内钉中部2的弯曲角度为3-13度。Figure 6 shows that when internal fixation is carried out from the outside of the proximal humerus, the bending angle between the head 1 of the intramedullary nail 14 on the outside of the proximal humerus and the middle part 2 of the intramedullary nail is 13-23 degrees, and the tail of the intramedullary nail 3 The bending angle with the middle part 2 of the intramedullary nail is 3-13 degrees.
图2、3、5显示，在股骨远端外侧髓内钉10、股骨远端内侧髓内钉11、胫骨远端内侧髓内钉13使用时还增加一枚支撑螺钉6，形成三角形结构，使固定更加稳定。Figures 2, 3, and 5 show that when the distal femoral lateral intramedullary nail 10, the distal femoral medial intramedullary nail 11, and the tibial distal medial intramedullary nail 13 are used, a supporting screw 6 is added to form a triangular structure, so that Fixed more stable.
Claims (6)
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| CN107280748A (en) * | 2017-07-27 | 2017-10-24 | 焦作市新港医疗设备有限公司 | A kind of femoral interlocking nail and the femur using the femoral interlocking nail |
| CN107961067A (en) * | 2018-01-12 | 2018-04-27 | 四川大学华西医院 | Lateral inlet tibiobone marrow internal needle |
| CN108720913A (en) * | 2018-06-29 | 2018-11-02 | 宁波市第六医院 | A kind of pelvis front pillar marrow interior locating device |
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