CN108175494A - A kind of shoulder blade anatomical type locking plate - Google Patents

A kind of shoulder blade anatomical type locking plate Download PDF

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Publication number
CN108175494A
CN108175494A CN201810068150.4A CN201810068150A CN108175494A CN 108175494 A CN108175494 A CN 108175494A CN 201810068150 A CN201810068150 A CN 201810068150A CN 108175494 A CN108175494 A CN 108175494A
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sections
stripe
stripe boards
boards
omoplate
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史会明
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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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061Cortical 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
    • 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
    • A61B2017/564Methods 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)
  • Prostheses (AREA)

Abstract

The invention discloses a kind of shoulder blade anatomical type locking plates, including bone plate ontology, the bone plate ontology includes the CD section stripe boards for being used to fix neck of scapula to match with neck of scapula, the DE section stripe boards for being used to fix the external lateral margin of omoplate to match with the external lateral margin of omoplate, the EF section stripe boards for being used to fix angulus inferior scapulae outside portion to match with angulus inferior scapulae outside portion, the HJ section stripe boards being used for across omoplate body portion weak area to match with omoplate body portion weak area, the JJ2 section stripe boards for being used to fix mesoscapula to match with mesoscapula, the HK section stripe boards being used for across omoplate body portion weak area to match with omoplate body portion weak area, the KK2 section stripe boards for being used to fix mesoscapula to match with mesoscapula.Compared with prior art, the present invention has the characteristics that convenient, practical, minimally invasive, fixation.

Description

A kind of shoulder blade anatomical type locking plate
Technical field
The present invention relates to the interior fixed network of fracture of scapula, especially fractures of body of scapula to merge neck and/or shoulder Shoulder blade ridge basal part unstable fracture, specifically a kind of shoulder blade anatomical type locking plate.
Background technology
Shoulder fracture of scapula (scapular fracture, SF) accounts for the 3%-5% of shoulder fractures, accounts for whole body fracture 0.5%-1%.Unstability fracture of scapula non-operative treatment leads to malunion, causes shoulder joint function bad and chronic pain The complication such as pain.With the progress of medical technology, fracture of scapula operation case is stepped up, and is brought with reducing non-operative treatment Sequelae.
The scrambling of shoulder blade and the diversity of fracture make unsatisfactory, the omoplate of interior fixed selection of fracture of scapula The existing interior fixation of bone fracture mostly locks or non-locking Reconstruction plate, nail or other position bones plate borrow, common interior Fixture mainly includes LCP, reconstruction plate, T steel plate, calcaneum heterotype steel plate etc..The reports such as Jianming Zhou are using double synthetism sheet frames Posture treats severe comminuted fracture of scapula, proposes shoulder blade " inside and outside two column " concept, emphasizes severe comminuted shoulder blade bone Folding must fix two columns to reach frame stability structure simultaneously, create conditions for early functional exercise, be the pass for obtaining satisfactory effect Key, it is believed that more integrated Y types bone plate, mechanics is stablized not good enough.It Yang Yingguo and wears good fortune and reports T shape locks plate and calcaneum entirely Steel plate treats fracture of scapula, and steel plate thickness is 1.6mm, non-omoplate Bones morphology, and when use needs plasticity to adapt to shoulder blade shape State, because alternating bending is reversed, intensity declines, and stability reduces, and there are the deficiencies of steel plate fatigue fracture.
In the design of omoplate Bone plate, the shoulder blade dissection type bone fracture plate for the designs such as outstanding cutting edge of a knife or a sword of having a surplus, form meets omoplate Bone fixation region needs, and can fix neck of scapula, lateral border and mesoscapula simultaneously, supporting & stablizing, but according to surgical procedure from the point of view of, deposit Deficiency in terms of practicality.The omoplate fractures of neck Y-shaped bone plate of the designs such as Zhang Yanqun, it is possible to provide triangle stablizes support, Omoplate neck is only limitted to fix.For the unstable fracture of omoplate body, neck and mesoscapula, a kind of more practical, convenient, fixation Special bone plate development, it appears it is very necessary.
Invention content
The invention aims to the deficiencies of prior art problem, provide a kind of more practical, convenient, fixation omoplate Bone anatomical type locking plate.
In order to achieve the above objectives, the present invention is implemented according to following technical scheme:
A kind of shoulder blade anatomical type locking plate, including bone plate ontology, the bone plate ontology includes and neck of scapula What the CD sections stripe board for being used to fix neck of scapula to match and the external lateral margin of omoplate matched is used to fix the external lateral margin of omoplate DE sections stripe board, with angulus inferior scapulae outside portion match for fixing the EF section stripe boards and shoulder of angulus inferior scapulae outside portion What shoulder blade body portion weak area matched is used for the HJ sections stripe board across omoplate body portion weak area, is used for admittedly with what mesoscapula matched The JJ2 sections stripe board for determining mesoscapula, the HK section items being used for across omoplate body portion weak area to match with omoplate body portion weak area Shape plate, the KK2 section stripe boards for being used to fix mesoscapula to match with mesoscapula, one end of the EF sections of stripe board and DE sections of items One end of shape plate is connected for arc transition, and one end of CD sections of stripe boards is fixedly connected with the other end of DE sections of stripe boards, HK sections of items One end of shape plate and HJ sections of stripe boards is fixedly connected with DE sections of stripe board a side, one end of JJ2 sections of stripe boards and HJ sections of items The other end of shape plate is connected for arc transition, and one end of KK2 sections of stripe boards and the other end of HK sections of stripe boards are fixed by circular arc Connection, the DE sections of stripe board, HJ sections of stripe boards and HK sections of stripe boards are generally aligned in the same plane, the CD sections of stripe board and DE sections of items Obtuse angle ∠ CDE are formed between shape plate, formation obtuse angle ∠ HJJ2 between JJ2 section stripe boards and HJ section stripe boards, KK2 sections of stripe boards and Obtuse angle ∠ HKK2 are formed between HK sections of stripe boards, the EF sections of stripe board tilts down and form obtuse angle between DE sections of stripe boards ∠ DEF, the CD sections of stripe board, EF sections of stripe boards, DE sections of stripe boards, HJ sections of stripe boards, JJ2 sections of stripe boards, HK sections of stripe boards With offer locking screw thread hole in KK2 sections of stripe boards, and the locking screw thread hole in CD sections of stripe boards is diversity angle screw hole.
Further, as the improvement to above-mentioned technical proposal, the CD sections of stripe board, DE sections of stripe boards, EF sections of stripe boards, HJ sections of stripe boards, JJ2 sections of stripe boards, HK sections of stripe boards, KK2 sections of stripe boards are structure as a whole to form bone plate ontology.
Further, as the improvement to above-mentioned technical proposal, the HJ sections of stripe board, HK sections of stripe boards and DE sections of stripe boards Top be in the forked distribution of triangle.
Further, as the improvement to above-mentioned technical proposal, the synthetism plate body generally " pawl " shape.
Compared with prior art, beneficial effects of the present invention are:
1st, the bone plate of current Clinical practice is compared, there is convenient, practical, minimally invasive, fixation.
2nd, design is using dissection design, form approximation shoulder blade fixed area, such as neck of scapula, outer rim and angulus inferior scapulae, shoulder Shoulder blade ridge portion considers minimally invasive factor in art, bridges fixed mesoscapula;Anatomical form design, in the past reconstruction plate etc., is omitted and is rolled in art than it The time of curved bone plate reduces the surgical exposure time, reduces risk, facilitates operation.It is even if preoperative using 3D fracture and mirror image mould Type preformed bone plate, then also remove the preoperative pre- moulding bone plate time, provide conveniently.
3rd, it is practical:In posterior approach, which embodies as follows:1. neck of scapula appears relative difficulty, fixed also phase Should be difficult, it designs and is fixed by lower half on rear side of neck of scapula, fixing screws is made to pass through neck of scapula by diversity angle screw hole Portion including top half, makes the unnecessary more neck of scapula that appear of operation that can complete whole fixation, similary neck does not use arc It is also that the position is facilitated to fix that degree, which designs and uses straight trip design,;2. lock screw designs, the irregular of shoulder blade, even if Dissection design is also difficult to make conventional pressurized mounting hole close by plate-bone fitting, and " suspension " fixation for locking design is just no longer pursued Height fitting between plate-bone, similary fixation and conveniently.
4th, minimally invasive concept:Precisely, minimally invasive theory, on the basis of shoulder blade data are accurately measured, to the thin of fixed area Dissection design is caused to improve precisely fixed, reduce operation wound;Omoplate neck or/and mesoscapula basal part are merged to fracture of scapular body Unstable fracture fixes mesoscapula by establishing " tunnel " of subscapular muscle, appears without large area stripping, reduces operation Wound.
5th, securely:Design triangle shape stablizes support, if neck of scapula, body and mesoscapula form integration and stablize fixation;Locking Structure design is more secured compared with plain bore nail design;The plate thickness and nail diameter of appropriateness ensure that rational fastness.
6th, superiority:Merge the processing of omoplate neck or/and mesoscapula basal part unstable fracture based on fracture of scapular body It sets out, approach surgical procedure feature is improved with reference to rear Judet, the fixed warp of distal humerus Y-shaped lockplate is applied in our hospital On the basis of testing, design more meets shoulder blade feature, locking bone fracture plate is dissected in the invention of surgical characteristic.Solves omoplate Bone plate Fixed puzzlement problem or special plate fixation are single, it is impossible to formed stablize support or have stablize support but lack it is practical, Minimally invasive deficiency.
Description of the drawings
Fig. 1 is the structural diagram of the present invention.
Fig. 2 is the broad-mouthed receptacle for holding liquid face sagittal view of shoulder blade.
Fig. 3 is facies posterior scapulae view.
Fig. 4 is the mesoscapula of shoulder blade and the view of omoplate body.
Fig. 5 is the external lateral margin of omoplate of shoulder blade and the view of angulus inferior scapulae.
Specific embodiment
With reference to specific embodiment, the invention will be further described, in the illustrative examples and explanation of the invention For explaining the present invention, but it is not as a limitation of the invention.
As shown in Figure 1, being left side shoulder blade locking bone fracture plate, the shoulder blade anatomical type locking plate of the present embodiment wraps Include bone plate ontology, the bone plate ontology include with neck of scapula match for fix the CD sections stripe board 3 of neck of scapula and What the external lateral margin of omoplate matched is used to fix the DE sections stripe board 2 of the external lateral margin of omoplate, match with angulus inferior scapulae outside portion For fix angulus inferior scapulae outside portion EF sections stripe board 1, with omoplate body portion weak area match for cross over omoplate body The HJ sections stripe board 4 of portion weak area is used to fix the JJ2 sections stripe board 5 of mesoscapula and omoplate body portion with what mesoscapula matched Weak area match be used for across omoplate body portion weak area HK sections stripe board 6, with mesoscapula match be used for fix shoulder The KK2 sections stripe board 7 on shoulder blade ridge, one end of the EF sections of stripe board 1 is fixedly connected with one end of DE sections of stripe boards 2 by circular arc, One end of CD sections of stripe boards is fixedly connected with the other end of DE sections of stripe boards, and one end of HK sections of stripe boards 6 and HJ sections of stripe boards 4 is equal It is fixedly connected with DE sections of 2 a sides of stripe board, such mesoscapula portion fixed design fixes mesoscapula respectively for bifurcated, can be in art Subscapular muscle is not removed extensively, passes through the fixed mesoscapula of tunnel grasping, one end of JJ2 sections of stripe boards 5 and HJ sections of stripe boards 4 under flesh The other end be arc transition connection, one end of KK2 section stripe boards 7 and the other end of HK sections of stripe boards 6 are that arc transition is connect, The DE sections of stripe board 2, HJ sections of stripe boards 4 and HK sections of stripe boards 6 are generally aligned in the same plane, the CD sections of stripe board 3 and DE sections of items Shape plate 2 is folded upward at forming obtuse angle ∠ CDE, and JJ2 sections of stripe boards 5 are folded upward at forming obtuse angle ∠ HJJ2 with HJ sections of stripe boards 4, KK2 sections of stripe boards 7 are folded upward at forming obtuse angle ∠ HKK2 with HK sections of stripe boards 6, and the EF sections of stripe board 1 tilts down and and DE Obtuse angle ∠ DEF, the CD sections of stripe board 3, EF sections of stripe boards 1, DE sections of stripe boards 2, HJ sections of stripe boards are formed between section stripe board 2 4th, locking screw thread hole 8 is offered, and in CD sections of stripe boards 3 in JJ2 sections of stripe boards 5, HK sections of stripe boards 6 and KK2 sections of stripe boards 7 Locking screw thread hole for diversity angle screw hole, fixing screws is made to pass through omoplate neck by diversity angle screw hole, including upper Half part makes the unnecessary more neck of scapula that appear of operation that can complete whole fixation, similary neck using radian design and It is also that the position is facilitated to fix using straight trip design.
Wherein, the CD sections of stripe board 3, DE sections of stripe boards 2, EF sections of stripe boards 1, HJ sections of stripe boards 4, JJ2 sections of stripe boards 5th, HK sections of stripe boards 6, KK2 sections of stripe boards 7 are structure as a whole to form bone plate ontology, the HJ sections of stripe board 4, HK sections of stripe boards The top of 6 and DE sections of stripe board 2 is in the forked distribution of triangle, the synthetism plate body generally " pawl " shape.
When making the shoulder blade anatomical type locking plate, shoulder blade CT data are extracted first, and skill is rebuild using 3D printing Art rebuilds omoplate bone model, establishes necessary data system, and according to design bone plate form, the corresponding fixed area to shoulder blade Domain measures, and measuring method is as follows:
Measuring method is specific as follows with reference to Fig. 2-5:
1) on glenoid surface, from broad-mouthed receptacle for holding liquid, lateral border swells line AB under processus coracoideus basement high to broad-mouthed receptacle for holding liquid, makees in the straight line Vertical plane a and lower 1/4 vertical plane b;
2) glenoid parallel surface c is parallel to the inside 1.0cm in glenoid dorsal border, plane a, b, c meet at omoplate Bone back side millet cake is C point D points, forms dorsal surface CD line segments.CD sections of i.e. corresponding CD sections of stripe boards 3, for fixing omoplate neck regions Domain;
3) there is slight angulation on the outside of body of scapula lateral border and angulus inferior scapulae, with shifting 1cm in the turning point and perpendicular to outer Lateral margin fixed point is E points, and angulus inferior scapulae vertex is F points, and connection DE line segments, EF line segments are corresponding DE sections of stripe boards 2, EF sections of stripe boards 1;
4) it is G, H, I point to determine that 3cm, 4cm, 5cm locate at 3 points on DE line segments, and three in corresponding DE sections of stripe boards 2 lock Determine screw hole 8, be denoted as G, H, I point respectively.This 3 points are the main fixing threaded hole point of design, and H points is draw fixed mesoscapula synthetism The branch point of plate;
5) mesoscapula vertical plane is made with mesoscapula lateral border inside 1cm, 3cm, meet at omoplate body is with mesoscapula intersection J, K points accordingly form j lines, k lines in mesoscapula downside, using J are that starting point determines 0.5cm, 1.5cm point as J1, J2 point on j lines, K1, K2 point are equally defined on k lines.HJ line segments, HK line segments are connected, forms ∠ HJJ2 and ∠ HKK2.HJ, HK are bone plate through shoulder Shoulder blade body portion, ∠ HJJ2 and ∠ HKK2 are bone plate dog-ear, and K1, K2, J1, J2 are fixing threaded hole point;
6) line segment DE, EF forms ∠ CDE, ∠ DEF, and it (is origin perpendicular to straight using E to decompose the vertical plane that ∠ DEF are determined in DE The d planes of line DE) vertical plane where projected angle ∠ DEF1 and DE (projected angle ∠ DEF2, DE that E is the vertical plane e) in origin d faces, EF is the synthetism plate part of fixed lateral border, and ∠ CDE, ∠ DEF are the dog-ear of bone plate;
7) measurement data:C points, D points are neck of scapula thickness;CD line segment lengths;∠CDE;DE line segments, EF line segment lengths;∠ DEF1 and ∠ DEF2;G points, H points, I points axillary margin of scapula thickness, line segment HK, HJ length;J1 points, J2 points, K1 points, K2 points For mesoscapula thickness;The angle of ∠ HJJ2 and ∠ HKK2;
8) in Fundamentals of Measurement, according to data result, approach Minimally Invasive Surgery operating feature is improved with reference to rear Judet, into One step design shoulder blade anatomical type locking plate form is as shown in Figure 1.
Technical scheme of the present invention is not limited to the limitation of above-mentioned specific embodiment, every to do according to the technique and scheme of the present invention The technology deformation gone out, each falls within protection scope of the present invention.

Claims (4)

1. a kind of shoulder blade anatomical type locking plate, including bone plate ontology, it is characterised in that:The bone plate ontology includes What the CD sections stripe board for being used to fix neck of scapula and the external lateral margin of omoplate to match with neck of scapula matched is used to fix omoplate The DE sections stripe board of external lateral margin, the EF section bar shapeds for being used to fix angulus inferior scapulae outside portion to match with angulus inferior scapulae outside portion Plate is used for the HJ sections stripe board across omoplate body portion weak area, matches with mesoscapula with what omoplate body portion weak area matched For fix mesoscapula JJ2 sections stripe board, with omoplate body portion weak area match for cross over omoplate body portion weak area HK section stripe boards, with mesoscapula match for fixing the KK2 section stripe boards of mesoscapula, one end of the EF sections of stripe board It is connect with one end of DE sections of stripe boards for arc transition, the other end of one end of CD sections of stripe boards and DE sections of stripe boards, which is fixed, to be connected It connects, one end of HK sections of stripe boards and HJ sections of stripe boards is fixedly connected with DE sections of stripe board a sides, one end of JJ2 sections of stripe boards It is connect with the other end of HJ sections of stripe boards for arc transition, the other end of one end of KK2 sections of stripe boards and HK sections of stripe boards is circle Arc transition connects, and the DE section stripe board, HJ sections of stripe boards and HK sections of stripe boards are generally aligned in the same plane, the CD sections of stripe board and Obtuse angle ∠ CDE are formed between DE sections of stripe boards, obtuse angle ∠ HJJ2, KK2 sections of items are formed between JJ2 sections of stripe boards and HJ sections of stripe boards Obtuse angle ∠ HKK2 are formed between shape plate and HK sections of stripe boards, the EF sections of stripe board tilts down and the shape between DE sections of stripe boards Into obtuse angle ∠ DEF, the CD sections of stripe board, EF sections of stripe boards, DE sections of stripe boards, HJ sections of stripe boards, JJ2 sections of stripe boards, HK sections Locking screw thread hole is offered in stripe board and KK2 sections of stripe boards, and the locking screw thread hole in CD sections of stripe boards is diversity angle Spend screw hole.
2. shoulder blade anatomical type locking plate according to claim 1, it is characterised in that:The CD sections of stripe board, DE Section stripe board, EF sections of stripe boards, HJ sections of stripe boards, JJ2 sections of stripe boards, HK sections of stripe boards, KK2 sections of stripe boards are structure as a whole shape Into bone plate ontology.
3. shoulder blade anatomical type locking plate according to claim 1, it is characterised in that:The HJ sections of stripe board, HK The top of section stripe board and DE sections of stripe boards is in the forked distribution of triangle.
4. shoulder blade locking bone fracture plate according to claim 3, it is characterised in that:The synthetism plate body generally " pawl " Shape.
CN201810068150.4A 2018-01-24 2018-01-24 A kind of shoulder blade anatomical type locking plate Pending CN108175494A (en)

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Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2757744Y (en) * 2004-09-28 2006-02-15 陈立军 Scapula anatomize type steel plate
CN103610491A (en) * 2013-11-06 2014-03-05 广州军区广州总医院 Auxiliary steel plate assembly for treatment of scapular fracture
CN104306055A (en) * 2014-11-21 2015-01-28 陆晓生 Fixator combining mesoscapula part, acromion part and distal clavicle part
US20150223941A1 (en) * 2012-08-27 2015-08-13 Conformis, Inc. Methods, Devices and Techniques for Improved Placement and Fixation of Shoulder Implant Components
CN205697980U (en) * 2016-04-11 2016-11-23 中国人民解放军第四军医大学 A kind of anatomical plate for complicated fracture of scapula body
CN106667568A (en) * 2016-12-31 2017-05-17 苏州市康力骨科器械有限公司 Dissection type shoulder blade locking steel plate
CN206390982U (en) * 2016-07-28 2017-08-11 胡建斌 A kind of special-shaped bone plate of shoulder blade
CN107049461A (en) * 2017-05-27 2017-08-18 上海市浦东医院 A kind of fracture of scapula dissection locking internal fixation system
CN107280751A (en) * 2017-06-14 2017-10-24 上海交通大学医学院附属第九人民医院 Axillary margin of scapula for fracture of scapula dissects lockplate and application thereof
CN206745430U (en) * 2016-12-16 2017-12-15 四川维思达医疗器械有限公司 A kind of anatomical form omoplate internal fixation device
CN208492286U (en) * 2018-01-24 2019-02-15 史会明 A kind of shoulder blade anatomical type locking plate

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2757744Y (en) * 2004-09-28 2006-02-15 陈立军 Scapula anatomize type steel plate
US20150223941A1 (en) * 2012-08-27 2015-08-13 Conformis, Inc. Methods, Devices and Techniques for Improved Placement and Fixation of Shoulder Implant Components
CN103610491A (en) * 2013-11-06 2014-03-05 广州军区广州总医院 Auxiliary steel plate assembly for treatment of scapular fracture
CN104306055A (en) * 2014-11-21 2015-01-28 陆晓生 Fixator combining mesoscapula part, acromion part and distal clavicle part
CN205697980U (en) * 2016-04-11 2016-11-23 中国人民解放军第四军医大学 A kind of anatomical plate for complicated fracture of scapula body
CN206390982U (en) * 2016-07-28 2017-08-11 胡建斌 A kind of special-shaped bone plate of shoulder blade
CN206745430U (en) * 2016-12-16 2017-12-15 四川维思达医疗器械有限公司 A kind of anatomical form omoplate internal fixation device
CN106667568A (en) * 2016-12-31 2017-05-17 苏州市康力骨科器械有限公司 Dissection type shoulder blade locking steel plate
CN107049461A (en) * 2017-05-27 2017-08-18 上海市浦东医院 A kind of fracture of scapula dissection locking internal fixation system
CN107280751A (en) * 2017-06-14 2017-10-24 上海交通大学医学院附属第九人民医院 Axillary margin of scapula for fracture of scapula dissects lockplate and application thereof
CN208492286U (en) * 2018-01-24 2019-02-15 史会明 A kind of shoulder blade anatomical type locking plate

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