CN108451620B - 一种膝关节炎胫骨截骨加压接骨板 - Google Patents

一种膝关节炎胫骨截骨加压接骨板 Download PDF

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CN108451620B
CN108451620B CN201810247178.4A CN201810247178A CN108451620B CN 108451620 B CN108451620 B CN 108451620B CN 201810247178 A CN201810247178 A CN 201810247178A CN 108451620 B CN108451620 B CN 108451620B
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bone
plate
bone fracture
osteotomy
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CN108451620A (zh
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郑占乐
张英泽
刘欢
于贤
康博洋
邢欣
韩志杰
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Third Hospital of Hebei Medical University
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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
    • 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
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • 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
    • 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
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90—Guides therefor

Abstract

一种膝关节炎胫骨截骨加压接骨板，属于骨科医疗器械技术领域，用于对增加接骨板的加压效果。其技术方案是：接骨板的平面板面的上端和下端边缘分别有多个垂直于板面的固定齿，固定齿与截骨间隙的两侧胫骨骨面分别相对，多个固定齿的上部分别有斜向的加压孔，加压孔的轴向分别从两侧向截骨间隙方向倾斜，加压螺钉通过加压孔分别与截骨间隙两侧的胫骨固定连接。本发明是胫骨截骨接骨板的首创，具有结构合理、使用方便、可以同时兼顾接骨板的连接强度和加压效果的优点，采用这种加压接骨板能够增大截骨区植骨压力，促使骨质生长，使截骨更快地愈合，达到良好的手术效果。

Description

一种膝关节炎胫骨截骨加压接骨板
技术领域
本发明涉及一种用于胫骨截骨使用的接骨板，属于骨科医疗器械技术领域。
背景技术
膝关节骨性关节炎是老年人最常见的一种关节疾病，也是引起老年人下肢残疾的主要原因，严重影响着老年人的日常活动和生活质量。膝关节骨性关节炎是指由于膝关节软骨变性、骨质增生而引起的一种慢性骨关节疾患，在临床上主要表现为膝关节疼痛和不同程度的功能障碍，部分有关节肿胀、积液，X线表现关节间隙变窄、关节边缘骨赘形成,软骨下骨硬化和囊性变。55岁以上人群中X线片有膝关节骨性关节炎表现者约60%，其中35%--50%有临床表现。老年患者膝关节炎膝关节内翻时，应力集中在膝关节的内侧部分，并使发生在膝内侧的退行性改变进展加速，对于这种情况，胫骨上端高位截骨术是常见相应的手术治疗方法。为了术中恢复关节面平整及下肢力线、坚强固定截骨部位、避免出现术后创伤性关节炎，术中需要接骨板固定。经过大量的临床实践发现，目前胫骨高位截骨的存在的明显问题是：过分要求支撑强度，忽视了加压效果，明显的顾此失彼。由于目前的接骨板没有有效的截骨区内加压作用，因此常常会出现截骨区植骨压力不足、生长缓慢，甚至会出现生长不良或难以愈合等问题。为此，十分有必要对现有的接骨板进行改进。
发明内容
本发明所要解决的技术问题是提供一种膝关节炎胫骨截骨加压接骨板，这种接骨板用于固定截骨位置，可以在术中同时兼顾强度和加压效果，能够增大截骨区植骨压力，促使骨质生长，使截骨更快地愈合，达到良好的手术效果。
解决上述技术问题的技术方案是：
一种膝关节炎胫骨截骨加压接骨板，它包括接骨板和加压螺钉，接骨板的平面板面的上端和下端边缘分别有多个垂直于板面的固定齿，固定齿与截骨间隙的两侧胫骨骨面分别相对，多个固定齿的上部分别有斜向的加压孔，加压孔的轴向分别从两侧向截骨间隙方向倾斜，加压螺钉通过加压孔分别与截骨间隙两侧的胫骨固定连接。
上述膝关节炎胫骨截骨加压接骨板，它还有瞄准器，瞄准器为长条形板，瞄准器的长条形板的两端分别有横板，横板上沿着横板长度方向有多个平行的斜向瞄准套管，斜向瞄准套管的轴向与横板的板面呈45-75度夹角，斜向瞄准套管的内径与导针的外径相匹配，斜向瞄准套管的前端与加压孔相对，斜向瞄准套管的数量与接骨板两端固定齿上的加压孔的数量相匹配。
上述膝关节炎胫骨截骨加压接骨板，所述接骨板和瞄准器的板面中部分别各有两个连接螺孔，两个连接螺孔分别沿着接骨板和瞄准器的长度方向，接骨板和瞄准器的连接螺孔相对，连接螺栓通过连接螺孔将接骨板和瞄准器相连接。
本发明的有益效果是：
本发明的接骨板两端的固定齿分别插入到截骨间隙两侧的胫骨骨面内，瞄准器通过连接螺栓与接骨板相连接，导针通过瞄准器的斜向瞄准套管穿过接骨板固定齿的加压孔确定加压的角度，加压螺钉沿着斜向瞄准套管的加压角度对接骨板进行加压固定。
本发明是胫骨截骨接骨板的首创，具有结构合理、使用方便、可以同时兼顾接骨板的连接强度和加压效果的优点，采用这种加压接骨板能够增大截骨区植骨压力，促使骨质生长，使截骨更快地愈合，达到良好的手术效果。
附图说明
图1是本发明的结构示意图；
图2是本发明的使用状态示意图。
图中标记如下：胫骨1、截骨间隙2、接骨板3、固定齿4、加压孔5、加压螺钉6、连接螺孔7、瞄准器8、横板9、斜向瞄准套管10、连接螺栓11。
具体实施方式
本发明的胫骨截骨加压接骨板由接骨板3、加压螺钉6、瞄准器8组成。
图中显示，接骨板3的平面板面的上端和下端边缘分别有多个垂直于板面的固定齿4，固定齿4与截骨间隙2的两侧胫骨1骨面分别相对，固定齿4分别插入到截骨间隙2两侧的胫骨1骨面内进行连接。
图中显示，多个固定齿4的上部6分别有斜向的加压孔5，加压孔5的轴向分别从两侧向截骨间隙2方向倾斜，加压螺钉6通过加压孔5分别与截骨间隙2两侧的胫骨1相连接，加压螺钉6一方面将接骨板3与胫骨1进行连接固定，同时对接骨板3进行加压，提高加压效果。由于加压孔5不能确定加压螺钉6的进钉角度，因此还需要瞄准器8对加压螺钉6的进钉角度进行设定。
图中显示，加压螺钉6拧入胫骨1骨面的角度决定了加压的效果，因此采用瞄准器设定合适的角度。瞄准器8为长条形板，瞄准器8的长条形板的两端分别有横板9，横板9的板面与瞄准器8的长条形板在一个平面上。横板9上沿着横板9长度方向有多个平行的斜向瞄准套管10，斜向瞄准套管10的前端与加压孔5相对，斜向瞄准套管10的数量与接骨板3两端固定齿4上的加压孔5的数量相匹配。斜向瞄准套管10的作用是确定加压螺钉6与胫骨1的连接角度。
图中显示，斜向瞄准套管10的轴向与横板9的板面呈45-75度夹角，斜向瞄准套管10的内径与导针的外径相匹配。在实际临床操作中，有多种配置不同倾斜角度斜向瞄准套管10的接骨板3，手术中可以根据不同的截骨间隙2的需要进行选用。
图中显示，在使用瞄准器8时需要将瞄准器8与接骨板3相连接。接骨板3和瞄准器8的板面中部分别各有两个连接螺孔7，两个连接螺孔7分别沿着接骨板3和瞄准器8的长度方向，接骨板3和瞄准器8的连接螺孔7相对，连接螺栓11通过连接螺孔7将接骨板3和瞄准器8相连接。
本发明的一个实施例如下：
接骨板3两端的固定齿4上的加压孔5分别为三个；横板9两端的斜向瞄准套管10分别为三个；斜向瞄准套管10的轴向与接骨板3的板面夹角为60度。
本发明的使用方法如下：
首先将接骨板3两端的固定齿4分别以小锤敲入到截骨间隙2两侧的胫骨1骨面内进行初步连接；
使用连接螺栓11通过连接螺孔7将接骨板3和瞄准器8进行临时连接；
将导针穿过瞄准器8的斜向瞄准套管10，再穿过接骨板3固定齿4的加压孔5插入胫骨1的骨面上，确定加压的角度；
松开连接螺栓11，将瞄准器8与接骨板3分离，使用加压螺钉6沿着导针的倾斜角度对接骨板3进行加压固定。

Claims (2)

1.一种膝关节炎胫骨截骨加压接骨板，其特征在于：它包括接骨板（3）和加压螺钉（6），接骨板（3）的平面板面的上端和下端边缘分别有多个垂直于板面的固定齿（4），固定齿（4）与截骨间隙（2）的两侧胫骨（1）骨面分别相对，多个固定齿（4）的上部分别有斜向的加压孔（5），加压孔（5）的轴向分别从两侧向截骨间隙（2）方向倾斜，加压螺钉（6）通过加压孔（5）分别与截骨间隙（2）两侧的胫骨（1）固定连接；它还有瞄准器（8），瞄准器（8）为长条形板，瞄准器（8）的长条形板的两端分别有横板（9），横板（9）上沿着横板（9）长度方向有多个平行的斜向瞄准套管（10），斜向瞄准套管（10）的轴向与横板（9）的板面呈45-75度夹角，斜向瞄准套管（10）的内径与导针的外径相匹配，斜向瞄准套管（10）的前端与加压孔（5）相对，斜向瞄准套管（10）的数量与接骨板（3）两端固定齿（4）上的加压孔（5）的数量相匹配。
2.根据权利要求1所述的膝关节炎胫骨截骨加压接骨板，其特征在于：所述接骨板（3）和瞄准器（8）的板面中部分别各有两个连接螺孔（7），两个连接螺孔（7）分别沿着接骨板（3）和瞄准器（8）的长度方向，接骨板（3）和瞄准器（8）的连接螺孔（7）相对，连接螺栓（11）通过连接螺孔（7）将接骨板（3）和瞄准器（8）相连接。
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