CN109805995B - Bundling and fixing device based on proximal femur intramedullary nail system - Google Patents
Bundling and fixing device based on proximal femur intramedullary nail system Download PDFInfo
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- CN109805995B CN109805995B CN201910289288.1A CN201910289288A CN109805995B CN 109805995 B CN109805995 B CN 109805995B CN 201910289288 A CN201910289288 A CN 201910289288A CN 109805995 B CN109805995 B CN 109805995B
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- intramedullary nail
- tuberosity
- annular gasket
- nail system
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- 210000000689 upper leg Anatomy 0.000 title claims abstract description 38
- 229910000831 Steel Inorganic materials 0.000 claims abstract description 21
- 239000010959 steel Substances 0.000 claims abstract description 21
- 229910001069 Ti alloy Inorganic materials 0.000 claims abstract description 4
- UZUFPBIDKMEQEQ-UHFFFAOYSA-N perfluorononanoic acid Chemical compound OC(=O)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)F UZUFPBIDKMEQEQ-UHFFFAOYSA-N 0.000 claims description 11
- 235000013057 Chorispora tenella Nutrition 0.000 claims description 3
- 241001118070 Chorispora tenella Species 0.000 claims description 3
- 210000001694 thigh bone Anatomy 0.000 claims 1
- 206010017076 Fracture Diseases 0.000 description 32
- 208000010392 Bone Fractures Diseases 0.000 description 29
- 206010020100 Hip fracture Diseases 0.000 description 9
- 238000000034 method Methods 0.000 description 8
- 230000000149 penetrating effect Effects 0.000 description 5
- 229910052751 metal Inorganic materials 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 241000469816 Varus Species 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 2
- 238000003825 pressing Methods 0.000 description 2
- 208000002193 Pain Diseases 0.000 description 1
- 208000004550 Postoperative Pain Diseases 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 238000009954 braiding Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000002391 femur head Anatomy 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 208000030175 lameness Diseases 0.000 description 1
- 230000005012 migration Effects 0.000 description 1
- 238000013508 migration Methods 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 230000006641 stabilisation Effects 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
Abstract
The invention discloses a wire strapping and fixing device based on a proximal femur intramedullary nail system, which comprises an annular gasket, an inserted U-shaped loop steel plate and the like, wherein the annular gasket is matched with a tail cap, belongs to a part which is added between the tail end of a main nail of the proximal femur intramedullary nail system and the tail cap, is an annular titanium alloy sheet, is matched with a tuberosity spiral blade or a lag screw of the proximal femur intramedullary nail system, comprises an inserted rod, a clamping block and the U-shaped sheet, and is simple and convenient to operate and low in cost on the basis that the proximal femur intramedullary nail system is used for fixing the intertrochanter fracture of the femur.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a bundling and fixing device based on a proximal femur intramedullary nail system.
Background
Intertrochanteric fractures, which are accompanied by fractures including anterior and posterior walls, lateral walls, and large tuberosity tips of the tuberosity, are unstable fractures, and have been a clinical treatment difficulty with the goal of achieving stable internal fixation after reduction, allowing the patient to recover to a pre-traumatic functional level without pain or lameness. For unstable intertrochanter fracture of femur, especially when the inside wall is incomplete, the stress of the outside wall as tension side is obviously increased, and deformities such as hip varus are easy to appear. Most of hip fracture patients are old people, and even if the inner side is supported by a small tuberosity, the possibility that the inner side can provide effective support is small, so that for unstable intertrochanteric fracture, especially when the inner side wall is incomplete, fracture of the front and rear walls, the outer side wall and the large tuberosity tip of the tuberosity, especially fracture of the outer side wall of the femoral tuberosity, the fracture should be actively fixed, so that the risk of operation failure is reduced.
In the aspect of selecting the endophytes, the intramedullary nail has biomechanics and minimally invasive advantages, and meanwhile, the main nail is also equivalent to the outer side wall of metal, so that the bone fracture migration is reduced to a certain extent. However, when the outer side wall is thin and weak and the large rotor is fractured, the main nail is inserted to easily cause fracture separation and aggravate damage, and the intramedullary nail cannot simultaneously hold the fracture blocks of the outer side wall, so that the anti-varus stability of the intramedullary nail is reduced. Single intramedullary nail treatment of intertrochanter fracture of femur with fracture of lateral wall, because its lateral wall is incomplete, lost the fixed fulcrum of the screw blade of intramedullary nail, the easy shortcoming such as internal fixation failure of postoperative, therefore, when using intramedullary nail to treat this type of unstable fracture, it is recommended to reconstruct the lateral wall.
At present, the internal fixation method of the reconstructed outer side wall is controversial, and the reconstruction methods such as long screws or metaphyseal small steel plates and the like cannot utilize small incisions of the minimally invasive intramedullary nail, and the outer side wall is required to be completely incised and exposed, so that the internal fixation can be carried out, and the biological environment of fracture is damaged.
In order to seek biomechanics and micro-creation advantages, the invention discloses a bundling and fixing device which has a simple structure and is convenient to operate, and bundling and fixing of the fracture comprising the front wall, the rear wall, the outer side wall and the large tuberosity tip of the tuberosity are completed.
Disclosure of Invention
The invention aims to overcome the defects of the prior art, and provides a bundling and fixing device aiming at the fracture comprising the anterior wall, the posterior wall, the outer side wall and the large tuberosity tip of the tuberosity on the basis of treating the fracture between the tuberosities of the femur, which is accompanied by the fracture comprising the anterior wall, the posterior wall, the outer side wall and the large tuberosity tip of the tuberosity, by using a proximal intramedullary nail system (PFNA, interten, gamma-3) of the femur.
A wire binding fixing device based on a proximal femur intramedullary nail system comprises a main femur proximal femur intramedullary nail system nail, a tuberosity spiral blade or lag screw (i.e. a head nail), a tail cap and a binding fixing device;
the bundling and fixing device consists of an annular gasket, an inserted U-shaped loop steel plate and a silk thread, wherein the annular gasket is matched with a tail cap of a main nail of a proximal intramedullary nail system of a femur, and belongs to a part which is added between the tail end of the main nail of the proximal intramedullary nail system of the femur and the tail cap;
the inserted U-shaped loop steel plate is matched with a tuberosity spiral blade or a lag screw (namely a head nail), the inserted U-shaped loop steel plate consists of an inserted link, a clamping block and a U-shaped thin plate, the head end of the inserted link can be inserted along the center hole of the tuberosity spiral blade or the lag screw (namely the head nail) until the clamping block at the tail end of the inserted U-shaped loop steel plate is embedded into the tail end of the head nail, the clamping block matched with the PFNA is in a hexagonal prism shape according to the type of the intramedullary nail, the clamping block matched with the intecan is in a cross flower shape, the clamping block matched with the Gamma-3 is in a straight flower shape, the inserted link is connected with the U-shaped thin plate through the clamping block, the U-shaped thin plate forms a clamping opening and can be embraced at the lower part of the femur tuberosity, and a plurality of second round holes are formed in the U-shaped thin plate and used for threading wires.
Further, the annular gasket is an annular titanium alloy sheet.
Still further, the thread is a wire or a non-absorbable suture.
Still further, the diameter of the annular gasket is 2mm.
Further, the length of the plug rod is between 60 and 70 mm.
The working principle and the using process of the invention are as follows:
taking PFNA treatment with intertrochanteric fracture including the lateral wall of the tuberosity as an example, the specific principles of operation and process of use of the present invention will be described.
The method comprises the steps of firstly completing closed reduction intramedullary fixation of intertrochanter fracture of femur by adopting PFNA, selecting a plurality of wires with proper types according to the type of lateral wall fracture, respectively penetrating each wire from a first round hole on an inserted U-shaped loop steel plate, then doubling the wires in a folded mode, sleeving the bent position at the first round hole, guiding all the doubled wires to penetrate from small cuts matched with a tuberosity spiral blade or a lag screw (i.e. a head nail) by using a long pliers, penetrating from external cuts, namely small cuts placed in a main nail of a proximal intramedullary nail system of femur, then placing the inserted rod of an inserted U-shaped loop steel plate at the cut, along the center hole of the tuberosity spiral blade or the lag screw (i.e. the head nail), until a clamping block is embedded into the tail end of the tuberosity spiral blade or the lag screw (i.e. the head nail).
And tensioning the silk thread at the position of the main nail imbedding incision of the proximal femur intramedullary nail system, braiding the rope ends of each folded silk thread together, taking the annular gasket, and penetrating each silk thread into the first round hole of the annular gasket.
The tail cap of the main nail of the proximal femur intramedullary nail system is a cylindrical fastener with external threads, and the tail cap is also a pressing cap of an annular gasket.
The tail cap penetrates through the central hole of the annular gasket and is placed into the screw hole at the tail end of the main nail of the proximal intramedullary nail system of the femur, and the annular gaskets between the intervals are extruded and fixed through the connection of the bolt modes.
All the wires are braided at the top end of the tail cap and are gradually tightened to be in a rope shape, the tightened wires are similar to the umbrella rope of the opened parachute, the fracture blocks on the outer side wall are firmly bound, and the fracture blocks are reset and fixed.
And cutting off the redundant silk thread, leaving a 3-5 mm stump, bending the stump, and attaching the stump to the metal surface of the tail cap.
Similarly, the Gamma-3 intramedullary nail system and the intra-medullary nail system can also adopt similar bundling and fixing devices to complete the reduction and internal fixation of the anterior wall, the posterior wall, the lateral wall and the large tuberosity tip fracture of the tuberosity.
The invention has the beneficial effects that:
1. the invention can be used for reconstructing and fixing the intertrochanter fracture of femur with fracture comprising the anterior and posterior wall, the outer side wall and the greater tuberosity tip of the tuberosity, thereby not only achieving the stability of imaging and biomechanics, but also avoiding postoperative pain caused by the fact that the anterior and posterior wall, the outer side wall and the greater tuberosity tip of the tuberosity are not fixed.
2. The tightly-tied and fixed fracture comprising the anterior and posterior walls, the lateral walls and the large tuberosity tip of the tuberosity can provide effective support for intertrochanteric fractures and provide anti-rotation and varus stability.
3. On the basis of the fixation of the proximal intramedullary nail of the femur, the invention provides support with enough strength for the internal fixation of the outer side wall, is beneficial to the stabilization between bone blocks, and reduces the stress of the screw in the femur head; providing bony support over time, reducing the rate of internal fixation failure.
4. The invention provides guarantee for early bed leaving activities and smooth healing of fracture of patients, and simultaneously is used as a minimally invasive operation, and has the advantages of simple operation and low cost, thus having certain popularization and application values.
Drawings
Fig. 1 is a front view of a PFNA-based strapping fixture for treating intertrochanteric fractures with fractures including the anterior and posterior walls, lateral walls, and large tuberosity tip of the tuberosity.
Fig. 2 is a schematic structural view of an inserted U-shaped loop steel plate matched with a PFNA spiral blade.
Fig. 3 is a schematic diagram of the end structure of the PFNA spiral blade.
Fig. 4 is a schematic structural view of the annular gasket.
FIG. 5 is a front view of a Gamma-3 strapping fixture for treating intertrochanteric fractures with fractures including anterior and posterior walls, lateral walls, and large tuberosity tips of tuberosities.
FIG. 6 is a schematic view of an inserted U-shaped loop steel plate matched with a Gamma-3 tuberosity lag screw.
FIG. 7 is a schematic view of the end structure of the Gamma-3 lag screw.
Fig. 8 is a front view of a strapping fixture for intertrochanteric fractures based on an intenan treatment with a fracture of the femur including a tuberosity anterior-posterior wall, lateral wall, and large tuberosity tip.
Fig. 9 is a schematic view of the structure of an inserted U-shaped loop steel plate matched with an intronan tuberosity lag screw.
Fig. 10 is a schematic view of the end structure of an intronan lag screw.
Detailed Description
Referring to fig. 1 to 10, a wire strapping fixture based on a proximal femoral intramedullary nail system includes a main nail 1, a tuberosity screw blade or lag screw (i.e., head nail) 2, a tail cap 3, and a strapping fixture 4;
the bundling and fixing device 4 consists of an annular gasket 40, an inserted U-shaped loop steel plate 42 and a silk thread 41, wherein the annular gasket 40 is matched with the tail cap 3 of the main nail 1 of the proximal intramedullary nail system of the femur, and belongs to a part attached between the tail end of the main nail 1 of the proximal intramedullary nail system of the femur and the tail cap 3, a circular hole is formed in the annular gasket 40 at the annular center and can be penetrated by a stud of the tail cap 3, and a plurality of first round holes 400 are formed in the periphery of the annular gasket 40 and used for threading the silk thread 41;
the inserted U-shaped loop steel plate 42 is matched with the tuberosity spiral blade or lag screw (i.e. head nail) 2, the inserted U-shaped loop steel plate 42 consists of an inserted link 420, a clamping block 421 and a U-shaped thin plate 422, the head end of the inserted link 420 can be inserted along the center hole of the tuberosity spiral blade or lag screw (i.e. head nail) 2 until the clamping block 421 at the tail end of the inserted U-shaped loop steel plate 42 is embedded into the tail end of the head nail 2, the clamping block 421 matched with the PFNA is in a hexagonal prism shape according to the intramedullary nail type, the clamping block 421 matched with the INertan is in a cross flower shape, the clamping block 421 matched with the Gamma-3 is in a straight flower shape, the inserted link 420 is connected with the U-shaped thin plate 422 through the clamping block 421, the U-shaped thin plate 422 forms a clamping port and can be embraced at the lower part of the femur tuberosity, and a plurality of second round holes 423 are arranged on the U-shaped thin plate 422 and used for threading the wire 41.
Still further, the annular gasket 40 is an annular titanium alloy sheet.
Still further, the thread 41 may be a wire or a non-absorbable suture.
Still further, the annular gasket 40 has a diameter of 2mm.
Still further, the length of the plunger 420 is between 60 mm and 70 mm.
The working principle and the using process of the embodiment are as follows:
referring to fig. 1 to 10, the specific working principle and the use process of the present invention will be described by taking PFNA treatment with intertrochanteric fracture including the lateral wall of the tuberosity as an example.
The method comprises the steps of firstly completing closed reduction intramedullary fixation of intertrochanter fracture of femur by adopting PFNA, selecting a plurality of wires 41 with proper types according to the type of lateral wall fracture, respectively penetrating each wire 41 from a first round hole 400 on an inserted U-shaped loop steel plate 42, then doubling the wires into strands, sleeving the bent parts at the first round hole 400, guiding all the doubled wires 41 to penetrate from a tuberosity spiral blade or a small incision matched with a lag screw (i.e. a head nail) 2 by using a pair of long pliers, penetrating from an external lateral incision, namely a small incision arranged in a main nail 1 of a proximal intramedullary nail system of femur, then placing a cutting part on the outer lateral side of thigh, namely the tuberosity spiral blade or the lag screw (i.e. the head nail) 2, inserting a inserted rod 420 of the inserted U-shaped loop steel plate 42 into the central hole of the tuberosity spiral blade or the lag screw (i.e. the head nail) 2 until a clamping block 421 is embedded into the tail end of the tuberosity spiral blade or the lag screw (i.e. the head nail) 2.
The main nail 1 of the proximal femur intramedullary nail system is placed in the incision to tighten the wires 41, the rope ends of each pair of the wires 41 are braided together, the annular gasket 40 is taken, and each wire 41 is penetrated along the first round hole 400 of the annular gasket 40.
The tail cap 3 of the main nail 1 of the proximal femur intramedullary nail system is a cylindrical fastener with external threads, and the tail cap 3 is also a pressing cap of an annular gasket 40.
The tail cap 3 is inserted through the central hole of the annular gasket 40 and is placed into the screw hole at the tail end of the main nail 1 of the proximal intramedullary nail system of the femur, and the annular gasket 40 between the intervals is extruded and fixed through the connection of the bolt mode.
All the wires 41 are braided at the top end of the tail cap 3, are gradually tightened to be in a rope shape, and the tightened wires 41 are tightly bound with the fracture blocks on the outer side wall like the parachute ropes of the opened parachute, and are reset and fixed.
The excess wire 41 is cut off, leaving a 3-5 mm stub, the stub is bent and applied to the metal surface of the tail cap 3.
Similarly, the Gamma-3 intramedullary nail system and the intra-medullary nail system can also adopt similar bundling and fixing devices to complete the reduction and internal fixation of the anterior wall, the posterior wall, the lateral wall and the large tuberosity tip fracture of the tuberosity.
Claims (4)
1. A wire-binding fixation device based on a proximal femoral intramedullary nail system, characterized in that: comprises a main nail (1) of a proximal intramedullary nail system of femur, a tuberosity spiral blade or lag screw (2), a tail cap (3) and a bundling and fixing device (4);
the bundling and fixing device (4) consists of an annular gasket (40), an inserted U-shaped loop steel plate (42) and a silk thread (41), wherein the annular gasket (40) is matched with a tail cap (3) of a main nail (1) of a proximal intramedullary nail system of a femur, the annular gasket is arranged between the tail end of the main nail (1) of the proximal intramedullary nail system of the femur and the tail cap (3), a circular hole is formed in the annular center of the annular gasket (40), the annular gasket is penetrated by the tail cap (3), and a plurality of first circular holes (400) are formed in the periphery of the annular gasket (40) and are used for threading the silk thread (41);
the inserted U-shaped loop steel plate (42) is matched with the tuberosity spiral blade or the lag screw (2), the inserted U-shaped loop steel plate (42) consists of an inserted link (420), a clamping block (421) and a U-shaped thin plate (422), the head end of the inserted link (420) can be inserted along the center hole of the tuberosity spiral blade or the lag screw (2) until the clamping block (421) at the tail end of the inserted U-shaped loop steel plate (42) is embedded into the tail end of the lag screw (2), the inserted link (420) is connected with the U-shaped thin plate (422) through the clamping block (421), the U-shaped thin plate (422) forms a clamping opening and can be embraced at the lower part of the thighbone tuberosity, and a plurality of second round holes (423) are formed in the U-shaped thin plate (422) and are used for threading wires (41); the clamping block (421) matched with the PFNA is in a hexagonal prism shape, the clamping block (421) matched with the intertan is in a cross flower shape, and the clamping block (421) matched with the Gamma-3 is in a straight flower shape;
the annular gasket (40) is an annular titanium alloy sheet.
2. A lashing fixture based on a proximal femoral intramedullary nail system according to claim 1, wherein: the thread (41) is a wire thread or a non-absorbable suture.
3. A lashing fixture based on a proximal femoral intramedullary nail system according to claim 1, wherein: the diameter of the annular gasket (40) is 2mm.
4. A lashing fixture based on a proximal femoral intramedullary nail system according to claim 1, wherein: the length of the inserted link (420) is between 60 and 70 mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910289288.1A CN109805995B (en) | 2019-04-11 | 2019-04-11 | Bundling and fixing device based on proximal femur intramedullary nail system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910289288.1A CN109805995B (en) | 2019-04-11 | 2019-04-11 | Bundling and fixing device based on proximal femur intramedullary nail system |
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| Publication Number | Publication Date |
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| CN109805995A CN109805995A (en) | 2019-05-28 |
| CN109805995B true CN109805995B (en) | 2024-01-26 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201910289288.1A Active CN109805995B (en) | 2019-04-11 | 2019-04-11 | Bundling and fixing device based on proximal femur intramedullary nail system |
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| Country | Link |
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| CN (1) | CN109805995B (en) |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4697585A (en) * | 1985-01-11 | 1987-10-06 | Williams Michael O | Appliance for fixing fractures of the femur |
| CN101574280A (en) * | 2009-06-05 | 2009-11-11 | 刘涛 | Fixing system in locking plate at proximal end of thighbone |
| DE202007019576U1 (en) * | 2007-12-20 | 2014-01-14 | Königsee Implantate GmbH | Femoral head implant |
| CN104414724A (en) * | 2013-08-31 | 2015-03-18 | 郭晓山 | Internal fixing system for femoral trochanter nail plate |
| CN210056195U (en) * | 2019-04-11 | 2020-02-14 | 吴丹凯 | Binding and fixing device based on proximal femoral intramedullary nail system |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8734448B2 (en) * | 2004-04-12 | 2014-05-27 | Navin N Thakkar | Implant assembly for proximal femoral fracture |
| US8932301B2 (en) * | 2009-08-26 | 2015-01-13 | Biomet C.V. | Targeting jig for hip fracture nail system |
| US10751096B2 (en) * | 2016-09-22 | 2020-08-25 | Bala Sundararajan | Systems and methods for intramedullary nail implantation |
-
2019
- 2019-04-11 CN CN201910289288.1A patent/CN109805995B/en active Active
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4697585A (en) * | 1985-01-11 | 1987-10-06 | Williams Michael O | Appliance for fixing fractures of the femur |
| DE202007019576U1 (en) * | 2007-12-20 | 2014-01-14 | Königsee Implantate GmbH | Femoral head implant |
| CN101574280A (en) * | 2009-06-05 | 2009-11-11 | 刘涛 | Fixing system in locking plate at proximal end of thighbone |
| CN104414724A (en) * | 2013-08-31 | 2015-03-18 | 郭晓山 | Internal fixing system for femoral trochanter nail plate |
| CN210056195U (en) * | 2019-04-11 | 2020-02-14 | 吴丹凯 | Binding and fixing device based on proximal femoral intramedullary nail system |
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| Publication number | Publication date |
|---|---|
| CN109805995A (en) | 2019-05-28 |
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