CN111658115A - Proximal tibia posterior lateral locking plate - Google Patents

Proximal tibia posterior lateral locking plate Download PDF

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Publication number
CN111658115A
CN111658115A CN202010460692.3A CN202010460692A CN111658115A CN 111658115 A CN111658115 A CN 111658115A CN 202010460692 A CN202010460692 A CN 202010460692A CN 111658115 A CN111658115 A CN 111658115A
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China
Prior art keywords
locking plate
posterolateral
head
far away
fibula
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Pending
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CN202010460692.3A
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Chinese (zh)
Inventor
杨蓊勃
蒋纯志
马飞
黄加欣
邱宇晨
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Changzhou Waston Medical Appliance Co Ltd
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Changzhou Waston Medical Appliance Co Ltd
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Priority to CN202010460692.3A priority Critical patent/CN111658115A/en
Publication of CN111658115A publication Critical patent/CN111658115A/en
Pending legal-status Critical Current

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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

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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)
  • Surgical Instruments (AREA)

Abstract

The invention belongs to the technical field of medical instruments, and particularly relates to a tibia near-end and back-outer side locking plate which is L-shaped and comprises a head part fixed with the back outer side of a tibia platform and a dry part fixed with a tibia near-end and back-outer side backbone, wherein a blocking strip protruding towards one side far away from a skeleton along the edge of the locking plate is arranged at the corner where the head part and the dry part are mutually connected. According to the locking plate, the blocking strip protruding towards one side far away from the bone along the edge of the locking plate is arranged at the corner where the head part and the cadre of the locking plate are connected, anatomical sign reference is provided for the embedding of the locking plate through the matching between the blocking strip and the fibula, and the head part of the locking plate can be effectively prevented from being inserted between the tibiofibula and the fibula to damage soft tissues such as the common peroneal nerve, the fibula ligament and the like; the locking plate is suitable for the condition that a posterolateral incision is adopted when the posterolateral fracture of the tibial plateau occurs, and is suitable for the condition that a posterolateral incision and a posteromedial incision are adopted when the posterolateral fracture and the posteromedial fracture occur simultaneously, and the two conditions can help a doctor to quickly position, so that the locking plate can be quickly and accurately placed in.

Description

Proximal tibia posterior lateral locking plate
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a proximal tibia and posterior tibia locking plate.
Background
Tibial plateau fracture is also called proximal tibia intra-articular fracture, proximal tibia joint fracture, tibial condyle fracture and the like, and is common lower limb fracture, in which the contact surface between the proximal tibia and the distal femur is often fractured due to violence. The common tibial plateau fracture treatment mode is internal fixation treatment, wherein the internal fixation mainly comprises the steps of placing a locking plate in an incision of a fracture part, enabling the locking plate to cross the fracture part, fixing the locking plate at two ends of the fracture part by using screws, and realizing effective fixation of the fracture part.
The tibia and the fibula are bones of the shanks of the human body, the tibia is arranged on the inner side, the fibula is arranged on the outer side, the tibia is thick and is a main bearing bone, the weight of the human body is born, the fibula is thin and is mainly used as an attachment point of a muscle ligament, and the weight of the human body is born in an auxiliary mode. There are many soft tissues between the tibia and fibula, such as common peroneal nerve and fibular ligament. The tibial plateau fracture can be generally fractured at the posteromedial side and the posterolateral side simultaneously, and the operation generally needs to perform two incisions at the posterolateral side or the posteromedial side of the knee joint or at the two positions simultaneously according to the specific shapes of the fracture and is respectively used for embedding a posterolateral locking plate and a posteromedial locking plate. In order to reduce surgical incision, relieve pain of patients and shorten operation time and recovery time, a posteromedial approach can be adopted at present aiming at the condition that the posterolateral side and the posteromedial side of a tibial plateau are fractured simultaneously, and a posterolateral locking plate and a posteromedial locking plate are arranged in one incision in the posteromedial direction.
However, because the operation field of vision is narrow when the posterior-lateral incision is adopted, and a larger force is required to be applied to overcome the resistance generated by muscle tissues and the like when the posterior-medial incision is adopted, the existing proximal tibia posterior-lateral locking plate is of a sheet structure, has larger freedom degree when being placed, cannot be accurately placed according to the anatomical form of the posterior-lateral platform of the tibial platform, and can be easily inserted between the tibia and the fibula in the process of placement to cause injuries to soft tissues such as common peroneal nerve, fibula ligament and the like. Accordingly, there is a need for a locking plate with anatomical landmark reference that provides a reference during placement to avoid complications that may arise from inaccurate bone plate placement.
Disclosure of Invention
In order to solve the problem that the locking plate is easily inserted between tibiofibulas under the condition of a posterior median approach incision to damage soft tissues such as the common peroneal nerve, the fibula ligament and the like, the invention discloses a proximal tibia posterior and lateral locking plate.
In order to achieve the purpose, the invention adopts the following technical scheme:
the utility model provides a lateral locking plate behind shin bone near-end, the lockplate is the L type, including with fixed cadre of lateral fixation behind the shin bone platform and with fixed cadre of lateral diaphysis behind the shin bone near-end, the corner of head and cadre interconnect is equipped with along the protruding blend stop of locking plate edge to keeping away from skeleton one side.
Preferably, the barrier strips have a height of 0.5-2mm, a width of 0.5-3mm and a length of 5-30 mm.
Preferably, the barrier strip has a height of 1mm, a width of 1mm and a length of 20-30 mm.
Preferably, the distance from one end of the barrier strip far away from the dry part to one end of the head part far away from the dry part is 2-8 mm.
Preferably, the distance from one end of the barrier strip far away from the dry part to one end of the head part far away from the dry part is 4-6 mm.
Preferably, the length of the part of the barrier strip located at the head part is longer than the length of the part of the barrier strip located at the dry part.
Preferably, the edge of the barrier strip has a smooth rounded chamfer.
Preferably, the head and the trunk are provided with a plurality of fixing holes for fixing the locking plate on the fibula.
Preferably, the fixing hole of the head is a universal hole.
Preferably, the locking plate has a bone-joining surface on a side close to the bone and a surface on a side far from the bone, the bone-joining surface of the head portion has a spatial geometry matching a bone-joining surface shape on a posterior-lateral side of the tibial plateau, and the bone-joining surface of the trunk portion has a spatial geometry matching a bone-joining surface shape on a proximal-posterior-lateral side of the tibia.
The invention has the following beneficial effects:
(1) the proximal tibia and rear outer side locking plate is L-shaped, the corner where the head part and the cadre are connected is provided with the barrier strip which protrudes to one side far away from the bone along the edge of the locking plate, so that the contact area between the rear outer side locking plate and the calves of the fibula can be increased, anatomical sign reference is provided for the implantation of the rear outer side locking plate through the matching between the barrier strip and the calves of the fibula, and the head part of the locking plate can be effectively prevented from being inserted between the tibiofibulas and damaging soft tissues such as common peroneal nerve, fibula ligament and;
(2) the rear outer side locking plate is not only suitable for the condition that a rear outer side incision is adopted when the rear outer side of the tibial plateau is fractured, but also suitable for the condition that a rear median approach incision is adopted when the rear outer side and the rear inner side of the tibial plateau are fractured simultaneously, and under any incision condition, the arrangement of the barrier strips can provide effective anatomical sign reference and can help doctors to perform quick positioning, so that the locking plate is quickly and accurately placed, the operation time is favorably shortened, and the accuracy of placing the locking plate is improved;
(3) the distance from one end of the barrier strip far away from the dry part to one end of the head part far away from the dry part is 2-8mm, preferably 4-6mm, namely, the length of the part of the head part far away from the dry part, which is not provided with the barrier strip, is smaller, namely, the degree of freedom of the head part of the locking plate in the process of inserting is smaller, and the head part can enter along the small head of the fibula more smoothly while the resistance of inserting the head part is reduced;
(4) the fixing hole of the head is set as a universal hole, so that nails can be fed at multiple angles, and fixation is facilitated.
Drawings
The invention is further illustrated with reference to the following figures and examples.
FIG. 1 is a schematic view of the proximal and posterior lateral tibial locking plate of the present invention;
FIG. 2 is a schematic illustration of the position of the rear outboard lock plate and the rear inboard lock plate of the present invention;
FIG. 3 is a left side view of FIG. 1;
FIG. 4 is a right side view of FIG. 1;
in the figure: 1. a head portion; 2. a dry portion; 3. blocking strips; 4. a fixing hole; 5. bone-knitting surface; 6. a surface; 91. a tibia; 92. fibula capitulum; 93. and a rear inner side locking plate.
Detailed Description
The present invention will now be described in further detail with reference to examples.
A tibia near-end back-outer side locking plate is shown in figure 1, the locking plate is L-shaped and comprises a head portion 1 fixed with the back outer side of a tibia platform and a trunk portion 2 fixed with a tibia near-end back-outer side backbone, and a blocking strip 3 protruding towards one side far away from a bone along the edge of the locking plate is arranged at the corner where the head portion 1 and the trunk portion 2 are connected with each other. Outer side lockplate is the L type behind shin bone near-end, and its head 1 is equipped with along locking plate edge to keeping away from the bellied blend stop 3 in skeleton one side with the corner of cadre 2 interconnect, provides anatomy sign reference for putting into of back outside lockplate through the cooperation between blend stop 3 and the fibula microcephaly, can effectively avoid damaging soft tissues such as peroneal nerve, fibula ligament between the head of lockplate inserts the shin fibula.
In a specific embodiment, the barrier strips 3 have a height of 0.5 to 2mm, a width of 0.5 to 3mm and a length of 5 to 30 mm. Wherein the height of the bar 3 refers to the distance that the bar 3 protrudes upwards along the surface 6 of the rear outer locking plate.
The height of the barrier strip 3 is set to be 0.5-2mm, so that the bulge is not too high on the premise of playing an effective blocking role, and serious friction between the bulge and muscle tissues is avoided; the blocking effect can be realized by setting the length to be 5-30 mm.
In a specific embodiment, the barrier strips 3 have a height of 1mm, a width of 1mm and a length of 20-30 mm.
In a particular embodiment, the distance from the end of the barrier 3 remote from the stem 2 to the end of the head 1 remote from the stem 2 is 2-8 mm. The length of the part of the head part 1, which is far away from the end of the cadre part 2 and is not provided with the barrier strip 3, is smaller, namely the degree of freedom of the head part 1 of the back outer side locking plate in the process of insertion is smaller, and the head part 1 can enter along the fibula capitula more smoothly while the resistance of the head part 1 in the process of insertion is reduced.
In a particular embodiment, the distance from the end of the barrier 3 remote from the stem 2 to the end of the head 1 remote from the stem 2 is 4-6 mm.
In a particular embodiment, as shown in fig. 1-2, the length of the portion of the barrier 3 located at the head portion 1 is greater than the length of the portion of the barrier 3 located at the stem portion 2. In one embodiment, the barrier 3 on the stem 2 does not need to be too long to fit the small head of the fibula and prevent the stem from being inserted between the tibiofibulas.
In a particular embodiment, the edge of the bar 3 has a smooth rounded chamfer.
In a particular embodiment, as shown in figures 1-4, the head 1 and stem 2 are each provided with a plurality of fixing holes 4 for fixing the locking plate to the fibula.
In one particular embodiment, as shown in fig. 1-4, the fixation holes 4 of the head 1 are gimbaled holes.
In a specific embodiment, as shown in fig. 3-4, the side of the locking plate close to the bone is a bone-knitting surface 5, the side far away from the bone is a surface 6, the spatial geometry of the bone-knitting surface 5 of the head 1 matches with the bone-knitting surface form of the tibia plateau posterolateral side, and the spatial geometry of the bone-knitting surface 5 of the stem 2 matches with the bone-knitting surface form of the tibia proximal posterolateral side.
As shown in fig. 2, when the tibial plateau is fractured both medially and posterolaterally, the medial posterior locking plate 93 and the lateral posterior locking plate are inserted simultaneously, and if the incision is made both posterolaterally and posteromedially, the patient is required to suffer additional pain, a longer operation time and a longer recovery time. If the posterior lateral incision is only made, the insertion of the posterior lateral locking plate through the posterior lateral incision can avoid the situation that the soft tissue is damaged when the locking plate is inserted between the tibiofibula, but in this case, the operation of inserting the posterior medial locking plate 93 is difficult, and the insertion situation is unstable. If the back inner side incision is used only, the back outer side fracture part cannot be exposed fully, and the traditional back outer side locking plate cannot be placed accurately. However, with the posterior midline incision, the placement of the lateral and medial locking plates 93 and 93 has only limited visual field, and in the lateral and posterior locking plate, there are popliteal artery and its branches, common peroneal nerve, fibular ligament and other soft tissues between the tibiofibular and the fibular bone due to the fibula. The sheet back outside lockplate of traditional board can't accomplish the matching with fibula anatomical morphology, and the condition of damage soft tissues such as popliteal artery and branch, peroneal nerve, fibula ligament easily appears because of the improper of steel sheet placement position carelessly in the operation.
The utility model provides a back outside lockplate is equipped with along locking plate edge to keeping away from bellied blend stop 3 in skeleton one side in head 1 and cadre 2 interconnect's corner, as shown in fig. 2, assume under the circumstances of the incision of going into the way in the centre in the back, can follow the incision of going into the way in the centre in the back and push back outside lockplate to the left side, in the pushing-in process, head 1 keeps away from the one end of cadre and can play the guide effect, and because the tip does not set up blend stop 3, can effectively reduce the push resistance, and the setting up of rear side (the one side that is close to cadre 2) blend stop 3 has effectively increased the area of contact of lockplate with fibula microcephaly 92, can make the head more smoothly enter along fibula microcephaly 92, avoid inserting between shin 91 and the fibula to damage total nerve. Moreover, after the locking plate is pushed into the proper position, the blocking strip 3 is partially arranged on the dry part 2, after the locking plate is pushed into the proper position, the blocking strip 3 is matched with the fibula small head 92 to prevent a doctor from further pushing the locking plate, and at the moment, the back and outer side locking plate is put into place and can be fixed through screws. Then, the rear inner side locking plate 93 is pushed to the right side along the rear median entrance incision, and is fixed in place by screws. In the embodiment, the insertion order of the rear inner lock plate 93 and the rear outer lock plate may be determined according to the circumstances. Due to the fact that the stop strips 3 are matched with the fibula in shape, when the back and outside locking plate is placed through the back and inside cut or the back and outside cut, although the visual field is limited, the proper placing position can be achieved by taking the fibula position as a reference.
In light of the foregoing description of the preferred embodiment of the present invention, many modifications and variations will be apparent to those skilled in the art without departing from the spirit and scope of the invention. The technical scope of the present invention is not limited to the content of the specification, and must be determined according to the scope of the claims.

Claims (10)

1. A proximal tibial posterolateral locking plate, comprising: the locking plate is L-shaped and comprises a head (1) fixed to the rear outer side of the tibial platform and a dry part (2) fixed to the rear outer side of the proximal tibia backbone, and a blocking strip (3) protruding to one side far away from the skeleton along the edge of the locking plate is arranged at the corner where the head (1) and the dry part (2) are connected with each other.
2. The proximal tibial posterolateral locking plate of claim 1, wherein: the height of the barrier strip (3) is 0.5-2mm, the width is 0.5-3mm, and the length is 5-30 mm.
3. The proximal tibial posterolateral locking plate of claim 2, wherein: the height of the barrier strip (3) is 1mm, the width is 1mm, and the length is 20-30 mm.
4. The proximal tibial posterolateral locking plate of claim 1, wherein: the distance from one end of the barrier strip (3) far away from the cadre part (2) to one end of the head part (1) far away from the cadre part (2) is 2-8 mm.
5. The proximal tibial posterolateral locking plate of claim 4, wherein: the distance from one end of the barrier strip (3) far away from the cadre part (2) to one end of the head part (1) far away from the cadre part (2) is 4-6 mm.
6. The proximal tibial posterolateral locking plate of claim 4, wherein: the length of the part of the barrier strip (3) positioned on the head part (1) is larger than that of the part of the barrier strip (3) positioned on the dry part (2).
7. The proximal tibial posterolateral locking plate of claim 1, wherein: the edge of the barrier strip (3) is provided with a smooth arc chamfer.
8. The proximal tibial posterolateral locking plate of claim 1, wherein: the head part (1) and the cadre part (2) are provided with a plurality of fixing holes (4) for fixing the locking plate on the fibula.
9. The proximal tibial posterolateral locking plate of claim 8, wherein: the fixing hole (4) of the head part (1) is a universal hole.
10. The proximal tibial posterolateral locking plate of claim 1, wherein: the bone fracture fixation device is characterized in that one surface, close to bones, of the locking plate is a bone fracture surface (5), one surface, far away from the bones, of the locking plate is a surface (6), the spatial geometric form of the bone fracture surface (5) of the head (1) is matched with the form of the bone surface on the rear outer side of the tibial plateau, and the spatial geometric form of the bone fracture surface (5) of the dry part (2) is matched with the form of the bone surface on the rear outer side of the proximal end of the.
CN202010460692.3A 2020-05-27 2020-05-27 Proximal tibia posterior lateral locking plate Pending CN111658115A (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114557757A (en) * 2022-01-21 2022-05-31 承德医学院附属医院 Novel structure titanium plate of tibial plateau posterior column fracture

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100057133A1 (en) * 2008-08-26 2010-03-04 Simon William H Tibia-talus-calcaneus (T-T-C) locking plate
CN202568419U (en) * 2012-03-06 2012-12-05 常州市康辉医疗器械有限公司 Proximal tibia outer side anatomical locking plate
CN108309424A (en) * 2018-01-18 2018-07-24 江苏百易得医疗科技有限公司 A kind of distal radial palmar lockplate
CN109480993A (en) * 2018-12-25 2019-03-19 吉林大学第医院 Outside dissection armor plate after combined type tibial plateau
CN208822938U (en) * 2017-12-05 2019-05-07 大博医疗科技股份有限公司 A kind of fixation device of olecroanon
CN110522500A (en) * 2019-09-23 2019-12-03 昆明医科大学第二附属医院 A kind of combined type Inferior tibiofibular joint fixed plate
CN210582613U (en) * 2019-04-09 2020-05-22 翁伟 Tibial plateau fixing device
CN212490109U (en) * 2020-05-27 2021-02-09 常州华森医疗器械有限公司 Proximal tibia posterior lateral locking plate

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100057133A1 (en) * 2008-08-26 2010-03-04 Simon William H Tibia-talus-calcaneus (T-T-C) locking plate
CN202568419U (en) * 2012-03-06 2012-12-05 常州市康辉医疗器械有限公司 Proximal tibia outer side anatomical locking plate
CN208822938U (en) * 2017-12-05 2019-05-07 大博医疗科技股份有限公司 A kind of fixation device of olecroanon
CN108309424A (en) * 2018-01-18 2018-07-24 江苏百易得医疗科技有限公司 A kind of distal radial palmar lockplate
CN109480993A (en) * 2018-12-25 2019-03-19 吉林大学第医院 Outside dissection armor plate after combined type tibial plateau
CN210582613U (en) * 2019-04-09 2020-05-22 翁伟 Tibial plateau fixing device
CN110522500A (en) * 2019-09-23 2019-12-03 昆明医科大学第二附属医院 A kind of combined type Inferior tibiofibular joint fixed plate
CN212490109U (en) * 2020-05-27 2021-02-09 常州华森医疗器械有限公司 Proximal tibia posterior lateral locking plate

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114557757A (en) * 2022-01-21 2022-05-31 承德医学院附属医院 Novel structure titanium plate of tibial plateau posterior column fracture

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