CN111904579A - Intramedullary nail for treating femoral fracture - Google Patents
Intramedullary nail for treating femoral fracture Download PDFInfo
- Publication number
- CN111904579A CN111904579A CN202010907960.1A CN202010907960A CN111904579A CN 111904579 A CN111904579 A CN 111904579A CN 202010907960 A CN202010907960 A CN 202010907960A CN 111904579 A CN111904579 A CN 111904579A
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- nail
- hole
- main
- intramedullary
- holes
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Classifications
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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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7241—Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
-
- 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
-
- 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
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
- A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
-
- 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
- A61B2017/564—Methods for bone or joint treatment
Abstract
The invention discloses an intramedullary nail for treating femoral fracture, which comprises a locking sleeve and a main nail with a cavity; the locking sleeve and the main nail are mutually matched and connected through internal and external threads; the main nail is provided with a plurality of rows of through holes along the longitudinal direction, the through holes are evenly distributed on the circumferential surface of the main nail, the junction of each through hole and the circumferential surface of the main nail is in arc connection, and the cavity of the main nail is filled with a high polymer degradable material mixed with medicines. The intramedullary nail has the advantages that the cavity and the small hole are formed in the main nail of the intramedullary nail, so that the intramedullary nail has the functions of medicine loading and continuous medicine release, meanwhile, the small hole and the edge of the main nail are arranged in an arc shape, so that the surface of the intramedullary nail is in microcontinuousness, the femoral lining is prevented from bearing more load, the aim of benefiting the growth of bone tissues is fulfilled, finally, the spiral blade locking nail is arranged to tightly hold the femur and the intramedullary nail, the spiral blade can be prevented from rotating in the femoral head, and sufficient stability is provided.
Description
Technical Field
The invention relates to an intramedullary nail for treating femoral fracture.
Background
The intramedullary pin is a special medical instrument for internal fixation of a tubular bone fracture part in an orthopedic operation, and the fixation of a long tubular bone fracture by the intramedullary pin is considered as a standard treatment method. Compared with other external fixation, the intramedullary nail has the advantages of high strength, small wound and fast healing, and the intramedullary nail has ideal reduction and fixation to the fracture, thereby being a commonly used means for treating the fracture.
The surface structure of the existing intramedullary nail has two problems, namely the surface of the intramedullary nail is too flat and smooth and lacks micro-continuity, which is not beneficial to the growth of bone tissues to the surface of the intramedullary nail, or the edge angle and the surface area of the surface of the intramedullary nail are clear, which leads to the increase of load of endosteum, and is not beneficial to the growth of the bone tissues to the surface of the intramedullary nail, which leads to the failure of the implanted intramedullary nail. In addition, the existing intramedullary nail has no drug loading function or drug loading through a surface coating, the stability of the drug loading of the surface coating is poor, the drug falling in the implantation process is easily caused, and the function of continuously dosing and controlling the drug release speed is not provided. In addition, the intramedullary nail carrying the medicine through the surface coating has weak bonding force with the intramedullary nail, the implantation process needs special care, the release speed of the medicine after implantation is obviously increased and then obviously reduced, and the medicine can not be continuously administered, so that the infection focus caused by the formation of fibrous capsule in the gap between the soft tissue of the endosteum and the surface of the intramedullary nail can not be eliminated in time.
Disclosure of Invention
The purpose of the invention is as follows: the invention aims to provide an intramedullary nail with a surface structure favorable for bone tissue growth and a drug-loading function.
The technical scheme is as follows: the intramedullary nail for treating femoral fracture comprises a locking sleeve and a main nail with a cavity; the locking sleeve and the main nail are mutually matched and connected through internal and external threads; the main nail is provided with a plurality of rows of through holes along the longitudinal direction, the through holes are evenly distributed on the circumferential surface of the main nail, the junction of each through hole and the circumferential surface of the main nail is in arc connection, and the cavity of the main nail is filled with a high polymer degradable material mixed with medicines.
The end part of the locking sleeve is closed through an end cover screw, and the end cover screw is fixedly connected with the locking sleeve through internal and external threads; the locking sleeve is also provided with a first nail hole and a second nail hole, and a spiral blade locking nail penetrates through the first nail hole; the second nail hole is penetrated with a locking nail.
Wherein, first nail hole is the inclined nail hole, the central axis in inclined nail hole and the central axis of locking sleeve between the contained angle be 100 ~ 120.
The number of the spiral blades of the spiral blade locking nail is 2-4, all the spiral blades rotate anticlockwise by 90 degrees from the head end to the tail end of the spiral blades, and the width of the tail end of each spiral blade is 8-10 mm.
The main nail is provided with a third nail hole and a fourth nail hole, and cortical bone screws penetrate through the third nail hole and the fourth nail hole.
Wherein, adjacent row through-hole is along vertically taking the dislocation set, and the through-hole on the same periphery sets up relatively.
Wherein the through holes in each row of through holes are arranged at equal intervals, and the distance between every two adjacent through holes is 10-20 mm; the diameter of the through hole is 0.5-2 mm.
The structure of the invention is beneficial to the growth of bone tissues according to the principle that: the method is characterized in that a fusion method is adopted to fill degradable high polymer material mixed medicine into a cavity of the intramedullary nail, when tissue fluid and cells enter the cavity through a medicine release small hole, the high polymer material is degraded, so that the medicine is released to a contact part of the intramedullary nail and the femoral intima through the small hole, and the regulation and control of the medicine release speed and the degradation rate of the high polymer material are achieved by controlling the diameter and the number of the small holes and the filling proportion of the medicine, so that the infection between the intramedullary nail and the femoral intima is prevented and treated; the intramedullary nail surface is provided with a considerable amount of drug release small holes which penetrate through the main intramedullary nail and the cavity, the joint part of the small holes and the main intramedullary nail adopts an arc design, so that the surface of the intramedullary nail has more microstructures, and can induce the growth of more bone tissues; the intramedullary nail proximal end locking adopts screw locking with a spiral blade shape, and the spiral blade shape screw has a large specific surface area, so that even a patient with femoral osteoporosis symptoms can tightly hold a femur and the intramedullary nail through the spiral blade screw, and the spiral blade is prevented from rotating in a femoral head, so that enough stability is provided.
Has the advantages that: the intramedullary nail has the advantages that the cavity and the small hole are formed in the main nail of the intramedullary nail, so that the intramedullary nail has the functions of medicine loading and continuous medicine release, meanwhile, the small hole and the edge of the main nail are arranged in an arc shape, so that the surface of the intramedullary nail is in microcontinuousness, the femoral lining is prevented from bearing more load, the aim of facilitating the growth of bone tissues is fulfilled, finally, the femur and the intramedullary nail are tightly held by the spiral blade locking nail, the spiral blade can be prevented from rotating in the femoral head, and sufficient stability is provided.
Drawings
FIG. 1 is a schematic structural diagram of an intramedullary nail for treating femoral fractures in accordance with the present invention;
FIG. 2 is a cross-sectional view taken along line A-A of FIG. 1;
FIG. 3 is a cross-sectional view taken along line B-B of FIG. 1;
FIG. 4 is a cross-sectional view of the locking sleeve;
FIG. 5 is an enlarged view of the proximal end of the primary staple;
fig. 6 is a structural schematic view of a helical blade-shaped screw.
Detailed Description
The technical solution of the present invention is further explained with reference to the accompanying drawings and specific embodiments.
As shown in fig. 1-6, the intramedullary nail for treating femoral fracture of the present invention comprises a locking sleeve 2 and a main nail 5 with a cavity 51; the locking sleeve 2 is a sleeve with internal threads at two ends, one end of the locking sleeve 2 is matched and connected with the upper end of the main nail 5 through the internal threads and the external threads, and the lower end of the main nail 5 is closed; the locking sleeve 2 and the main nail 5 can not relatively rotate around the central line after being screwed tightly by threads, but the rotation angle of the nail hole can be changed by arranging a gasket between the femoral head and the femoral trochanter according to the conditions of the femoral head and the femoral trochanter; the other end of the locking sleeve 2 is closed through an end cover screw 1, the end cover screw 1 is fixedly connected with the locking sleeve 2 through internal and external threads, a round hexagon socket head cap head screw without edges and corners is arranged outside a nail head of the end cover screw 1, the scratch of the head of the screw on tissues can be effectively reduced, the end cover screw is connected with one end of the locking sleeve 2 through the internal and external threads, the size and the diameter of the head of the screw can be just screwed into the locking sleeve 2 to close the locking sleeve 2, the end cover screw 1 can be fastened in the locking sleeve 2 after being screwed to the locking sleeve 2 through the threads, and the loosening condition cannot occur; the main nail 5 is longitudinally provided with two groups of through holes (53, 56), each group of through holes 56/53 are longitudinally and symmetrically arranged on the circumference of the main nail, corresponding through holes in each group of through holes 56/53 are positioned on the same circumference of the main nail 5, and corresponding through holes in the two groups of through holes (53, 56) are arranged in a staggered manner; the through holes 52 are uniformly distributed on the circumferential surface of the main nail 5, the junction of each through hole 52 and the circumferential surface of the main nail 5 is in arc connection, the through holes 52 in each row of through holes are arranged at equal intervals, and the distance a between every two adjacent through holes 52 is 10-20 mm; the diameter of the through hole 52 is 0.5 to 2 mm. The cavity 51 of the main nail 5 is filled with a high molecular degradable material mixed with medicines.
The high molecular degradable material filled in the cavity 51 includes, but is not limited to, one or more blends of polylactic acid (PLA), levorotatory polylactic acid (L-PLA), polyglycolic acid (PGA), Polycaprolactone (PCL), polytrimethylene carbonate (PTMC), polyamino acid derived carbonate (PDTE), or Polyorthoester (POE); the medicine mixed with the degradable high polymer material in the cavity 51 is one or more of gentamycin, streptomycin, kanamycin, neomycin, ribostamycin, micronomicin, doxorubicin, tetracycline, doxycycline, chloramphenicol, thiamphenicol, erythromycin, acetylspiramycin, clindamycin, bacitracin, polymyxin, fosfomycin, capreomycin, cycloserine, griseofulvin, mitomycin or cyclosporine; the degradable polymer material is melted and mixed with the drug and then filled into the cavity 51, and is slowly released through the through-hole (drug release pore) 52.
Wherein, the locking sleeve 2 is also provided with a first nail hole 21 and a second nail hole 22, and the spiral blade locking nail 3 penetrates through the first nail hole 21; the locking nail 4 penetrates through the second nail hole 22; the second nail hole 22 is a horizontal locking nail hole, an internal thread is arranged in the horizontal locking nail hole, the locking nail 4 is connected with the locking sleeve 2 through a thread, and the locking nail 4 is a locking screw with a quincuncial groove and a cylindrical head. The spiral blade locking nail 3 penetrates through the locking sleeve 2 through the first nail hole 21, and the front end part of the spiral blade locking nail is screwed into the femoral neck and the femoral head. The first nail hole 21 is an oblique nail hole, and an included angle b between the central axis of the oblique nail hole 21 and the central axis of the locking sleeve 2 is 100-120 degrees.
Wherein the number of the spiral blades 31 of the spiral blade locking nail 3 is 2-4, all the spiral blades 31 rotate 90 degrees counterclockwise from the head end to the tail end (in the direction from C to D), and the width of the tail end of each spiral blade 31 is 8-10 mm; the end of the head of the spiral blade locking nail 3 is an inner hexagonal cylinder head, the length of the spiral blade locking nail 3 is 60-120 mm, and the spiral blade locking nail is added every 5 mm.
The main nail 5 is provided with a third nail hole 54 and a fourth nail hole 55, cortical bone screws (6, 7) penetrate through the third nail hole 54 and the fourth nail hole 55, internal threads are arranged in the third nail hole 54 and the fourth nail hole 55, and the cortical bone screws (6, 7) are connected with the main nail 5 through threads. The cortical bone screws (6, 7) are inner hexagonal socket head cap screws, the length of the screws is 24-60 mm, length increment is set every 2-5 mm, and the cortical bone screws (6, 7) hold the intramedullary nail main nail 5 and the far end of the femur through threads. The outer diameter of the main nail 5 is 10-15 mm, the length of the main nail is 300-480 mm, and every 20mm is a length increment; the cavity 51 longitudinally extends to the upper part of the third nail hole 54 along the main nail 5, and the inner diameter of the cavity is 4-8 mm.
The end cover screws 1, the locking sleeves 2, the spiral blade locking nails 3, the locking nails 4, the main nails 5 and the cortical bone screws (6 and 7) are all made of titanium alloy or stainless steel.
The process of fixing the intramedullary nail on the femur comprises the following steps: (1) carrying out related preparation work of a marrow cavity tube on a femoral part needing operation; (2) the intramedullary nail main nail 5 is driven into the medullary cavity through a corresponding tool, and the position is adjusted to be satisfied; (3) drilling a hole in the bone for the passage of a cortical bone screw (6, 7); (4) cortical bone screws (6, 7) for fixing the far end of the main nail 5 are inserted into the drilled far end holes, and after the cortical bone screws (6, 7) are screwed down, the far end of the intramedullary nail main nail 5 cannot be deviated left and right, so that the stability of the intramedullary nail is maintained; (5) injecting the prepared mixture of degradable polymer and drug into the cavity 51 of the main nail; (6) the locking sleeve 2 is screwed with the near-end thread of the main nail 5; (7) drilling a hole for the screw blade locking nail 3 and the locking nail 4 to pass through in the bone; (8) a spiral blade locking nail 3 for holding the femoral head penetrates through the locking sleeve 2 through a first nail hole 21, a locking nail 4 penetrates through the locking sleeve 2 through a second nail hole 22, the front end part of the spiral blade locking nail 3 is screwed into the femoral neck and the femoral head for stable interlocking, and the intramedullary nail and the femoral head are held; (9) the end screw 1 is screwed into the locking sleeve 2 by means of a corresponding tool.
Claims (7)
1. An intramedullary nail for treating a femoral fracture, characterized by: comprises a locking sleeve and a main nail with a cavity; the locking sleeve and the main nail are mutually matched and connected through internal and external threads; the main nail is provided with a plurality of rows of through holes along the longitudinal direction, the through holes are evenly distributed on the circumferential surface of the main nail, the junction of each through hole and the circumferential surface of the main nail is in arc connection, and the cavity of the main nail is filled with a high polymer degradable material mixed with medicines.
2. An intramedullary nail for treating a femoral fracture according to claim 1, wherein: the end part of the locking sleeve is closed through an end cover screw, and the end cover screw is fixedly connected with the locking sleeve through internal and external threads; the locking sleeve is also provided with a first nail hole and a second nail hole, and a spiral blade locking nail penetrates through the first nail hole; the second nail hole is penetrated with a locking nail.
3. An intramedullary nail for treating femoral fractures according to claim 2, in which: the first nail hole is the inclined nail hole, the central axis in inclined nail hole and the central axis of locking sleeve between the contained angle be 100 ~ 120.
4. An intramedullary nail for treating femoral fractures according to claim 2, in which: the number of the spiral blades of the spiral blade locking nail is 2-4, all the spiral blades rotate 90 degrees anticlockwise from the head end to the tail end of the spiral blades, and the width of the tail end of each spiral blade is 8-10 mm.
5. An intramedullary nail for treating a femoral fracture according to claim 1, wherein: the main nail is provided with a third nail hole and a fourth nail hole, and cortical bone screws penetrate through the third nail hole and the fourth nail hole.
6. An intramedullary nail for treating a femoral fracture according to claim 1, wherein: the through holes in adjacent rows are staggered along the longitudinal direction, and the through holes on the same circumferential surface are arranged oppositely.
7. An intramedullary nail for treating a femoral fracture according to claim 6, wherein: the through holes in each row of through holes are arranged at equal intervals, and the distance between every two adjacent through holes is 10-20 mm; the diameter of the through hole is 0.5-2 mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010907960.1A CN111904579B (en) | 2020-09-01 | 2020-09-01 | Intramedullary nail for treating femoral fracture |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010907960.1A CN111904579B (en) | 2020-09-01 | 2020-09-01 | Intramedullary nail for treating femoral fracture |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN111904579A true CN111904579A (en) | 2020-11-10 |
| CN111904579B CN111904579B (en) | 2022-12-06 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010907960.1A Active CN111904579B (en) | 2020-09-01 | 2020-09-01 | Intramedullary nail for treating femoral fracture |
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| CN (1) | CN111904579B (en) |
Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5433718A (en) * | 1992-08-20 | 1995-07-18 | Brinker; Mark | Antibiotic eluding intramedullary nail apparatus |
| US6273722B1 (en) * | 1999-11-29 | 2001-08-14 | Swiss Implants, Inc. | Hybrid press fit-threaded dental implant |
| CN101273913A (en) * | 2008-04-11 | 2008-10-01 | 徐谦 | Intramedullary nail device and medication thereof |
| US20090326534A1 (en) * | 2008-06-30 | 2009-12-31 | Depuy Products, Inc. | Fracture Fixation Apparatus |
| US20110093020A1 (en) * | 2009-09-14 | 2011-04-21 | Yangguan Wu | Poly-porous hollow screw for target delivery of growth factors and stem cells:the design and potential clinical application |
| US20120041395A1 (en) * | 2003-07-15 | 2012-02-16 | Spinal Generations, Llc | Method and device for delivering medicine to bone |
| US20160361102A1 (en) * | 2015-02-09 | 2016-12-15 | Yingze Zhang | Porous bionic internal fixation device for promoting healing of fractured bone |
| CN107320168A (en) * | 2017-08-03 | 2017-11-07 | 大博医疗科技股份有限公司 | Femur fixing device |
| CN110051416A (en) * | 2019-05-23 | 2019-07-26 | 昆明市中医医院 | Caput radii comminuted fracture pile foundation inner fixing device and its fixing means |
| US20190343565A1 (en) * | 2018-05-09 | 2019-11-14 | Warsaw Orthopedic, Inc. | Bone screw and method of manufacture |
-
2020
- 2020-09-01 CN CN202010907960.1A patent/CN111904579B/en active Active
Patent Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5433718A (en) * | 1992-08-20 | 1995-07-18 | Brinker; Mark | Antibiotic eluding intramedullary nail apparatus |
| US6273722B1 (en) * | 1999-11-29 | 2001-08-14 | Swiss Implants, Inc. | Hybrid press fit-threaded dental implant |
| US20120041395A1 (en) * | 2003-07-15 | 2012-02-16 | Spinal Generations, Llc | Method and device for delivering medicine to bone |
| CN101273913A (en) * | 2008-04-11 | 2008-10-01 | 徐谦 | Intramedullary nail device and medication thereof |
| US20090326534A1 (en) * | 2008-06-30 | 2009-12-31 | Depuy Products, Inc. | Fracture Fixation Apparatus |
| US20110093020A1 (en) * | 2009-09-14 | 2011-04-21 | Yangguan Wu | Poly-porous hollow screw for target delivery of growth factors and stem cells:the design and potential clinical application |
| US20160361102A1 (en) * | 2015-02-09 | 2016-12-15 | Yingze Zhang | Porous bionic internal fixation device for promoting healing of fractured bone |
| CN107320168A (en) * | 2017-08-03 | 2017-11-07 | 大博医疗科技股份有限公司 | Femur fixing device |
| US20190343565A1 (en) * | 2018-05-09 | 2019-11-14 | Warsaw Orthopedic, Inc. | Bone screw and method of manufacture |
| CN110051416A (en) * | 2019-05-23 | 2019-07-26 | 昆明市中医医院 | Caput radii comminuted fracture pile foundation inner fixing device and its fixing means |
Also Published As
| Publication number | Publication date |
|---|---|
| CN111904579B (en) | 2022-12-06 |
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