CN109965966A - A kind of preceding columnae medialis bone plate being exclusively used in hyperextension i nternal lined type fracture of tibial plateau - Google Patents

A kind of preceding columnae medialis bone plate being exclusively used in hyperextension i nternal lined type fracture of tibial plateau Download PDF

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Publication number
CN109965966A
CN109965966A CN201910303641.7A CN201910303641A CN109965966A CN 109965966 A CN109965966 A CN 109965966A CN 201910303641 A CN201910303641 A CN 201910303641A CN 109965966 A CN109965966 A CN 109965966A
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screw
tibial plateau
fracture
screw hole
tibial
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任广凯
吴丹凯
彭传刚
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/8004Cortical 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
    • A61B17/8014Cortical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/8052Cortical 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
    • A61B17/8057Cortical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/808Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms

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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)
  • Prostheses (AREA)

Abstract

A kind of main force's support bone plate being exclusively used in hyperextension i nternal lined type fracture of tibial plateau, belongs to orthopedic medical device design field.The present invention is based on the anatomical structure designs of entocondyle before tibial plateau, it fractures for inside pressure before tibial plateau, it completes the main force and supports interior fixed function, the bone plate is conducive to fight the varus trend that leans forward of bone block, can preferably maintain before tibial plateau the reduction of the fracture of columnae medialis and reduce that front sclerotin sinks or varus collapses.The present invention provides inner prop dissection type bone fracture plate before a kind of tibial plateau, it realizes to support the main force that inside pressure before tibial plateau is fractured by main element and fix, columnae medialis before the head wrapping fixed tibial proximal end platform of main element, the effect of its inner fixed support and angulation stability provide more stable biomechanical environment, and more existing curved surface plate fixation is stronger, reliable.

Description

A kind of preceding columnae medialis bone plate being exclusively used in hyperextension i nternal lined type fracture of tibial plateau
Technical field
The present invention relates to orthopedic medical device design fields, and in particular to it is flat that one kind is exclusively used in hyperextension i nternal lined type shin bone The main force of platform fracture supports bone plate, and anatomical structure design of the bone plate based on entocondyle before tibial plateau, is a kind of solution Cut open type locked pressurized bone plate.
Background technique
Hyperextension damage type fracture of tibial plateau is combined with fracture morphological feature and fracture and injury mechanism and proposes new Type.The damage of knee joint hyperextension type is clinical actually rare, and most distinguishing feature is that ligament injury is serious and incidence is high, leads to knee It is abarticulation, subluxation, unstable, it is easy concurrent Hou Ce popliteal blood vessel and nervus peroneus communis tension injury, the survival of limbs may be jeopardized And functional rehabilitation, it is necessary to be paid much attention to.
Luo Congfeng teaches the three column classifying methods according to fracture of tibial plateau.Fracture is divided according to CT unenhanced result Type is respectively defined as mixed lateral column, columnae medialis and rear side column, will involve cortex rupture and is defined as spinous process of the seventh cervical vertebra folding.
2017, Zhang Binbin, Luo Congfeng et al. proposed " new three columns theory " (uTCC), and damage mechanisms are introduced it by them In, it is detailed to elaborate the relationship of fracture form and damage mechanisms.When injured kneed position (hyperextension/stretch/buckling) and The violence direction (inversion/eversion) for acting on tibial plateau is two key factors for determining damage mechanisms, therefore can be by shin bone Platform Fracture be divided into " hyperextension i nternal lined type ", " hyperextension turn up type ", " stretching i nternal lined type ", " stretching the type that turns up ", " buckling i nternal lined type ", " buckling turn up type " 6 kinds of basic damage mechanisms, and in the form of this releases fracture.By hyperextension damage type fracture of tibial plateau Substantially it is divided into condyle in hyperextension, ectocondyle and bicondylar fracture.
Hyperextension i nternal lined type fracture of tibial plateau is caused by hyperextension varus violence, and the diagonal line for belonging to " preceding interior-rear outer " damages machine System, characterized by inboard compression fracture before tibial plateau and the damage of angulus posteriolateralis ligament soft tissue.Therefore hyperextension i nternal lined type shin bone Platform Fracture is mostly that the splitting collapsed fracture of columnae medialis before platform, ligament injury caused by rear outside stretching violence or head of fibula are torn The tension fracture in inside after de- fracture and (or) platform.
No matter the tension fracture of anterointernal pressure fracture or rear inside, need to select suitable inside-fixture solid It is fixed, to ensure fixed stability, is shifted again after preventing the reduction of the fracture and articular surface collapses again.
Bone of the fracture tension to rear using blocking bone plate, after bone plate pre-bending moulding, after being tightly attached at reset Roll over surface, firm fixation.It fractures for inside pressure before tibial plateau, existing inside platform dissection type bone fracture plate uses The fixed inside fracture of " bamboo raft " technology from inside to outside is lost after being easy to happen reset at this point, front collapses still unstable.
Therefore for preceding inside pressure fracture, it would be highly desirable to which a kind of anatomical form main force of demand supports bone plate;The bone plate The varus trend that leans forward for being conducive to fight bone block can preferably maintain the reduction of the fracture and reduction front sclerotin sinks or varus is collapsed It falls into.
Summary of the invention
For the problems raised in the background art, the present invention provides a kind of anatomical forms of inside condylar fracture before tibial plateau The main force supports bone plate.
To achieve the goals above, the technical scheme adopted by the invention is as follows: before a kind of hyperextension varus damage type tibial plateau The dissection bone plate of inside condylar fracture, wherein include: that the bone plate includes proximal end head, middle interconnecting piece, distally faces directly Portion.
Columnae medialis surface is bent before the surface curvature and proximal tibial platform of the shin bone anteromedial surface of the proximal end head fitting Rate is consistent, and the distal end straight parts is bonded shin bone backbone anteromedial surface and fixation, and the middle interconnecting piece is bonded tibial metaphysis Preceding interior side seam face.
The proximal end head includes the first side and the second side;And proximal end head includes 6 the first lockholes;
First side is equipped with 3 first locking screw holes, and the diameter of lock screw is 2.7mm;
Second side is equipped with 3 first locking screw holes, and the diameter of locking screw hole is 3.5mm;And first on side Locking screw hole axial direction and the second side on lock 90 degree of axial angulation of screw hole;
3, which are each provided with, on first side on the proximal end head and the second side upper end-face edge provides binding for meniscus suture The kirschner pin hole in hole.
The Kirschner wire hole is located above first lock hole, and is arranged between adjacent first lock hole.
The kirschner pin hole of first side and the kirschner pin hole of the second side are connected with wire casing,.
At least two second lock holes are provided on the middle interconnecting piece.
The distal end straight parts is in flat elongated.
It is disposed with multiple third locking compress hole and lock hole along its length in the distal end straight parts.
It is in shuttle-type at the distal end straight parts distalmost end, and the end of distal end takes the form of inclined plane.
Limited contact groove is set on the medial surface that the middle interconnecting piece, distal end straight parts are bonded with shin bone.
The present invention due to using the technology described above, is allowed to compared with prior art, have the following advantages that and actively imitate Fruit:
The dissection type bone fracture plate of entocondyle before tibial plateau provided by the invention is realized by main element to hyperextension i nternal lined type shin The main force that inside pressure is fractured before bone platform, which supports, to be fixed, inside before the head wrapping fixed tibial proximal end platform of main element Column, inner fixed support effect and angulation stability provide more stable biomechanical environment, more existing curved surface bone plate Fixation is stronger, reliable;Its biology " cost performance " is maximum better than the attainable mechanics effect of multiple steel plate use in conjunction institutes The further damage of degree reduction surrounding soft tissue.
Detailed description of the invention
In conjunction with attached drawing, by hereafter state detailed description, can be more clearly understood that above-mentioned and other feature of the invention and Advantage, in which:
Fig. 1 is schematic structural view of the invention --- it sees front;
Fig. 2 is schematic structural view of the invention --- anteromedial surface is seen;
Fig. 3 is schematic structural view of the invention --- it sees above;
Fig. 4 is structure of the invention and shin bone combination schematic diagram --- it sees front;
Fig. 5 is structure of the invention and shin bone combination schematic diagram --- anteromedial surface is seen;
Fig. 6 is structure of the invention and shin bone combination schematic diagram --- it sees above.
Figure label are as follows: the proximal end head of 1- main element;The first side 11-, the first lock hole of the first side 111-, The first side 112- kirschner pin hole, 113, the first side 114- wire casing;The second side 12-, the first locking of the second side 121- Hole, the second side 122- Kirschner wire hole, 123, the second side 124- wire casing;
The middle interconnecting piece of 2- main element, the second lock hole of 21-, 22- Limited contact slot;
The distal end straight parts of 3- main element, 31- third lock hole, 32- third locking compress hole, 33- Limited contact slot, 34- Tail end, the distal end 341- kirschner pin hole.
Specific embodiment
Referring to the attached drawing for showing the embodiment of the present invention, the present invention is described in more detail.However, the present invention can be with Many different forms are realized, and should not be construed as being limited by the embodiment herein proposed.On the contrary, proposing that these embodiments are In order to reach abundant and complete disclosure, and those skilled in the art is made to understand the scope of the present invention completely.These are attached In figure, for clarity, the size and relative size of partial region may be exaggerated.
The present invention provides a kind of main forces for being exclusively used in hyperextension i nternal lined type fracture of tibial plateau to support bone plate, main element Including (3) three proximal end head (1), middle interconnecting piece (2), distal end straight parts components.It is flat that proximal tibia is wrapped up on proximal end head (1) Columnae medialis before platform is equipped with the first locking screw hole, can be placed in the first lock screw, kirschner pin hole and for shearing or assisting suture Wire casing;Middle interconnecting piece (2) is bonded tibial metaphysis anteromedial surface, is equipped with the second locking screw hole, can be placed in the second lock screw; Distal end straight parts (3) is bonded shin bone backbone anteromedial surface and fixation, is equipped with third locking screw hole and locking compress combination screw hole, can It is placed in third lock screw and os integumentale screw.
Moreover, the present invention provides columnae medialis dissection type bone fracture plate before a kind of tibial plateau, realized by main element to shin The main force that inside pressure is fractured before bone platform, which supports, to be fixed, inside before the head wrapping fixed tibial proximal end platform of main element Column, inner fixed support effect and angulation stability provide more stable biomechanical environment, more existing curved surface bone plate Fixation is stronger, reliable.
Specific embodiment is described further below:
Please refer to Fig. 1-6 structural schematic diagram.The proximal end head (1) of the main element, curved surface interconnecting piece (2), distal end straight parts (3).
Columnae medialis surface before the surface curvature and proximal tibial platform of the shin bone anteromedial surface of proximal end head (1) fitting Curvature is consistent, including the first side (11) and the second side (12), fixes to reinforce being bonded between head piece and shin bone.
First side (11) is equipped with 3 screw holes (111), is isodistantly spaced arc distribution, a diameter of The direction of 2.7mm, merging are parallel each other.
Second side (12) is equipped with 3 screw holes (121), is isodistantly spaced arc distribution, a diameter of The direction of 3.5mm, merging are parallel each other.
The screw of screw hole (111) position of first side and merging than the second side screw hole (121) position and set The screw entered is closer to platform articular surface.
First side (11) is greater than the second side (12) with the edge of middle interconnecting piece (2) and connect with centre The edge in portion (2), on the first side on the axial direction and the second side (12) of the screw hole (111) of (11) The axial direction of screw hole (121) is in 90 degree.
First lock screw realizes that the main force to inside articular surface before tibial plateau supports by intersecting nail technology It is fixed.
It is provided on proximal end head (1) upper end-face edge and multiple provides the kirschner pin hole of bundle hole for meniscus suture (112) (122) facilitate suture needle suture, increase indication range.
The kirschner pin hole (112) of first side (11) and the kirschner pin hole (122) of the second side are connected with wire casing (113,114) (123,124), the wire casing (113,123) are connected to the kirschner pin hole, and one end extends to the head upper end Edge, the other end extends to head lower end edge, and the wire casing is located in the one side that the head is bonded with shin bone.
Further, the setting of wire casing (113,114) (123,124), kirschner pin hole (112) (122), is walked convenient for suture Line, and it is able to use the suture needle of more minor radius, expand applicable disease of performing the operation;Suture needle easier can pass through wire casing, reduce hand Art difficulty;Meanwhile avoiding accidentally injuring the bone structure etc. of surrounding, improve operation safety.
Further, according to the fracture of inside articular surface before shin bone, the first locking screw hole (111) of merging is reasonably selected (121) position and quantity suitably wipe out part first when necessary and lock screw hole, and wire casing (113) (123) provides to wipe out work Necessary notch.
It is additionally provided at least two screw hole (21) on the middle interconnecting piece (2), a diameter of is 3.5mm, the lock Determine screw fixed tibial metaphysis, it is the structural support screw of metaphysis that placing direction, which is in preceding down toward rear outside upper,.
The inner wall of the interconnecting piece (2) is equipped with Limited contact slot (22), and equidistantly distributed is in two sides, for concave arc in sector Face.
The distal end straight parts (3) is equipped with multiple thirds locking screw hole (31) and third locking compress screw hole (32), straight Diameter is isodistantly spaced linear branch, the direction of the screw of merging is axially vertical with tibial shaft, passes through to be 3.5mm to each other Third locks screw hole (31) and third locking compress screw hole (32) merging lock screw or os integumentale screw for shin bone cadre's It is fixed.
The inner wall of the distal end straight parts (3) is equipped with Limited contact slot (33), and equidistantly distributed is in two sides, for fan-shaped indent Arc surface.
The tail end (34) of the distal end straight parts (3) is in the triangle with circular arc, and triangle tail end is additionally provided with Kirschner wire Hole (341), for being fixed temporarily for bone plate distal end.
Columnae medialis bone plate supports fixed left as the main force before the tibial plateau, is exclusively used in hyperextension i nternal lined type tibial plateau The splitting collapsed fracture of preceding columnae medialis also needs volume for ligament injury caused by rear outside stretching violence or head of fibula avulsion fracture Outer reparation also needs to combine fulcrum bone plate, joint is fixed for the tension fracture in inside after merging tibial plateau.
The above is only a preferred embodiment of the present invention, it is noted that for the ordinary skill people of the art Member, under the premise of not departing from the method for the present invention, can also make several improvement and supplement, these are improved and supplement also should be regarded as Protection scope of the present invention.

Claims (5)

1. a kind of preceding columnae medialis steel plate special of fracture of tibial plateau, it is characterised in that: main element include proximal end head (1), (3) three middle interconnecting piece (2), distal end straight parts components;Columnae medialis before proximal tibial platform is wrapped up on proximal end head (1), is equipped with First locking screw hole, can be placed in the first lock screw;Kirschner pin hole and for shear or assist suture wire casing;Middle interconnecting piece (2) it is bonded tibial metaphysis anteromedial surface, the second locking screw hole is equipped with, the second lock screw can be placed in;Distal end straight parts (3) patch Shin bone backbone anteromedial surface and fixation are closed, third locking screw hole and locking compress combination screw hole are equipped with, third locking spiral shell can be placed in Nail and os integumentale screw.
2. the preceding columnae medialis steel plate special of a kind of fracture of tibial plateau according to claim 1, it is characterised in that described The surface curvature of the shin bone anteromedial surface of proximal end head (1) fitting is consistent with columnae medialis surface curvature before proximal tibial platform, packet The first side (11) and the second side (12) are included, is fixed to reinforce being bonded between head piece and shin bone.
3. according to claim 1 with a kind of preceding columnae medialis steel plate special of fracture of tibial plateau described in 2, it is characterised in that institute The first side (11) are stated equipped with 3 screw holes (111), arc is isodistantly spaced and is distributed, a diameter of 2.7mm, merging Direction is parallel each other;Second side (12) is equipped with 3 screw holes (121), is isodistantly spaced arc distribution, diameter Direction for 3.5mm, merging is parallel each other;Spiral shell of the screw of screw hole (111) position of first side and merging than the second side The screw of hole (121) position and merging is closer to platform articular surface;The edge of first side (11) and middle interconnecting piece (2) Greater than the edge of the second side (12) and middle interconnecting piece (2), the screw hole (111) of (11) on the first side Axial direction and the second side (12) on screw hole (121) axial direction be in 90 degree;First lock screw passes through intersection Nail technology is realized that the main force to inside articular surface before tibial plateau supports and is fixed.
4. a kind of preceding columnae medialis steel plate special of fracture of tibial plateau according to claim 1, it is characterised in that in described It is additionally provided on interconnecting piece (2) at least two screw hole (21), a diameter of is 3.5mm, which fixes Tibial metaphysis, placing direction are in preceding down toward rear outside upper, are the structural support screw of metaphysis.
5. a kind of preceding columnae medialis steel plate special of fracture of tibial plateau according to claim 1, it is characterised in that described remote Straight parts (3) are held to be equipped with multiple thirds locking screw hole (31) and third locking compress screw hole (32), a diameter of is 3.5mm, It is isodistantly spaced linear branch to each other, the direction of the screw of merging is axially vertical with tibial shaft, locks screw hole by third (31) and third locking compress screw hole (32) is placed in lock screw or os integumentale screw is used for the fixation of shin bone cadre.
CN201910303641.7A 2019-04-16 2019-04-16 A kind of preceding columnae medialis bone plate being exclusively used in hyperextension i nternal lined type fracture of tibial plateau Pending CN109965966A (en)

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111096779A (en) * 2019-12-23 2020-05-05 首都医科大学附属北京潞河医院 Fixing device for tibial plateau hyperextension fracture
CN111728687A (en) * 2020-07-23 2020-10-02 吉林大学 Tibial tubercle fracture bone plate and using method thereof
CN113491568A (en) * 2021-07-07 2021-10-12 郭雪明 Lateral steel plate of tibial plateau
CN114938990A (en) * 2022-07-06 2022-08-26 西安市红会医院 Internal fixator for posterolateral fracture of tibial plateau

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Publication number Priority date Publication date Assignee Title
CN101856262A (en) * 2010-07-20 2010-10-13 孙海钰 Rear anatomical supporting and locking plate in proximal tibial plateau
CN203885605U (en) * 2014-06-17 2014-10-22 王维山 Distal tibia anteromedial anatomic locking plate
US20150066093A1 (en) * 2013-08-28 2015-03-05 Kuan-Yu Lin Proximal tibial posterior plateau locking compression plate
CN105395242A (en) * 2015-11-16 2016-03-16 上海交通大学医学院附属新华医院 Proximal tibia fracture plate system
CN107928774A (en) * 2017-12-06 2018-04-20 上海凯利泰医疗科技股份有限公司 Lockplate on the outside of a kind of proximal tibia
CN207477546U (en) * 2017-04-20 2018-06-12 西安市红会医院 A kind of coronoid process of ulna dissection bone plate

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101856262A (en) * 2010-07-20 2010-10-13 孙海钰 Rear anatomical supporting and locking plate in proximal tibial plateau
US20150066093A1 (en) * 2013-08-28 2015-03-05 Kuan-Yu Lin Proximal tibial posterior plateau locking compression plate
CN203885605U (en) * 2014-06-17 2014-10-22 王维山 Distal tibia anteromedial anatomic locking plate
CN105395242A (en) * 2015-11-16 2016-03-16 上海交通大学医学院附属新华医院 Proximal tibia fracture plate system
CN207477546U (en) * 2017-04-20 2018-06-12 西安市红会医院 A kind of coronoid process of ulna dissection bone plate
CN107928774A (en) * 2017-12-06 2018-04-20 上海凯利泰医疗科技股份有限公司 Lockplate on the outside of a kind of proximal tibia

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111096779A (en) * 2019-12-23 2020-05-05 首都医科大学附属北京潞河医院 Fixing device for tibial plateau hyperextension fracture
CN111728687A (en) * 2020-07-23 2020-10-02 吉林大学 Tibial tubercle fracture bone plate and using method thereof
CN113491568A (en) * 2021-07-07 2021-10-12 郭雪明 Lateral steel plate of tibial plateau
CN114938990A (en) * 2022-07-06 2022-08-26 西安市红会医院 Internal fixator for posterolateral fracture of tibial plateau

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Application publication date: 20190705