CN113197647A

CN113197647A - Proximal radius lateral bone fracture plate

Info

Publication number: CN113197647A
Application number: CN202110611944.2A
Authority: CN
Inventors: 刘立峰; 高硕�; 彭青; 武乐; 方楠
Original assignee: Shanghai East Hospital Tongji University Affiliated East Hospital
Current assignee: Shanghai East Hospital Tongji University Affiliated East Hospital
Priority date: 2021-06-01
Filing date: 2021-06-01
Publication date: 2021-08-03

Abstract

The invention discloses a radius near-end outside bone fracture plate which comprises a bone fracture plate, wherein the bone fracture plate is of a T-shaped structure integrally and is divided into a bone fracture plate near end and a bone fracture plate far end, the bone fracture plate near end is in an expanded shape extending towards two sides and is bent inwards, the cross section of the bone fracture plate far end is of a cambered surface structure, a row of near-end locking holes are formed in the bone fracture plate near end, 3 near-end locking holes are formed in the bone fracture plate near end, near-end Kirschner wire holes are formed in the left side of each near-end locking hole, 2 near-end Kirschner wire holes are formed in the bone fracture plate far end and are respectively located between the adjacent near-end locking holes, sliding holes, far-end locking holes and far-end Kirschner wire holes are sequentially formed in the bone fracture plate far end from left to right, a plurality of far-end locking holes are formed in the bone fracture plate far end locking holes. The bone fracture plate is designed according to the anatomical form of the proximal surface of the radius, is an anatomical locking bone fracture plate, can be tightly attached to the surface of the radius without molding in an operation, and can not reduce the strength of the bone fracture plate or prolong the operation time.

Description

Proximal radius lateral bone fracture plate

Technical Field

The invention relates to the technical field of medical instruments, in particular to a proximal and lateral radius bone fracture plate.

Background

In adults, proximal radius fractures account for approximately one-third of fractures of the elbow. Fracture of the radius head and neck is usually caused by indirect violence, when injured, the upper limb is in a straight forward position, external force is conducted upwards along the forearm, and fracture is caused by collision of the radius head and the humeral head.

After the proximal radius fracture, both the forearm function and the life quality of a patient are seriously affected, and for the proximal radius simple fracture, plaster fixation or internal fixation treatment can be generally adopted to obtain satisfactory curative effect, but the treatment of the proximal radius complex fracture is still a great challenge for orthopedics doctors, and if the treatment method of the proximal radius injury is not suitable or the anatomical reduction of the brachial and radial joints cannot be recovered, complications or sequelae such as joint instability, postoperative pain, reduced joint range of motion, post-traumatic arthritis, articular cartilage erosion and the like can occur, so the fracture belongs to one of the fracture types which are the most difficult to treat in the joint fracture. Since the radius head is an important structure for resisting the eversion of the elbow joint, it is currently known in the industry to use internal fixation for such fractures to restore the radius head as much as possible. However, the existing bone fracture plate has the defects that the size of the bone fracture plate is large, and the damage to soft tissues and blood circulation is too much; the bone fracture plate is not attached to the bone surface, so that soft tissues are easy to irritate; the near end and the far end of the bone fracture plate are not provided with the Kirschner wire holes for auxiliary positioning, so that locking screws can easily enter joint cavities; due to the shape and the nail hole design of the bone fracture plate, the fixation strength is insufficient, and the reduction and the loss are easy to cause; the bone fracture plate is lack of independent sliding holes, the fault tolerance rate is low when the position of the bone fracture plate is adjusted and the fracture reduction is carried out, the operation is difficult, the repeatability is low, and the like.

Therefore, a new proximal and lateral radius bone plate is needed to solve the above problems.

Disclosure of Invention

The invention aims to provide a bone fracture plate for the proximal and lateral sides of a radius, which solves the problems in the background art. In order to achieve the purpose, the invention provides the following technical scheme: the proximal radius lateral bone plate comprises a bone plate, the bone plate is of a T-shaped structure integrally and is divided into a proximal bone plate end and a distal bone plate end, the proximal bone plate end extends to two sides and is bent inwards to conform to the anatomical form of the proximal radius, the proximal bone plate end and the distal bone plate end are in smooth transition connection and are of an integral structure, the cross section of the distal bone plate end is of a cambered surface structure, a row of proximal locking holes are formed in the proximal bone plate end, 3 proximal locking holes are formed in the proximal locking holes, proximal Kirschner wire holes are formed in the left side of each proximal locking hole, 2 proximal Kirschner wire holes are respectively formed in the positions between the adjacent locking holes, sliding holes, distal locking holes and distal Kirschner wire holes are sequentially formed in the distal bone plate end from left to right, the distal Kirschner wire holes are formed in the right end portion of the distal bone plate end, and a plurality of distal locking holes are formed in the distal bone plate end, and a kirschner wire hole at the far end is arranged between the adjacent far end locking holes.

Preferably, a lead groove is formed between the edge of the back surface of the near end of the bone plate and the hole of the near end kirschner wire, and the lead groove is communicated with the hole of the near end kirschner wire.

Preferably, the back of the far end of the bone plate is provided with arc-shaped grooves which are positioned at two sides of the Kirschner wire hole on the far end and two sides between the sliding hole and the adjacent far end locking hole.

Preferably, the number of the distal locking holes is 3, and the distal locking holes are distributed equidistantly.

Preferably, the right end part of the far end of the bone plate is of a bevel structure.

Preferably, the diameter of the proximal kirschner wire hole is 1.0mm, the diameters of the kirschner wire hole and the distal kirschner wire hole on the distal end are 1.5mm, the diameter of the proximal locking hole is 2.0mm, the diameter of the distal locking hole is 2.7mm, and the diameter of the screw corresponding to the sliding hole is 2.7 mm.

Preferably, the bone plate has a thickness of 1.5-2.0mm, a length of 3-10cm and a width of 0.5-2.0 cm.

The invention has the technical effects and advantages that: the bone fracture plate is designed according to the anatomical form of the proximal surface of the radius, is an anatomical locking bone fracture plate, can be tightly attached to the surface of the radius without molding in an operation, and can not reduce the strength of the bone fracture plate or prolong the operation time; the back of the bone fracture plate adopts a spot welding technology and is provided with an arc groove, so that the compression on periosteum can be reduced, and the blood circulation at the fracture end is protected; a lead groove is formed from a near-end Kirschner wire hole on the back of the near end of the bone fracture plate to the edge of the bone fracture plate, so that a suture can conveniently pass through, and small bone blocks, ligaments or joint capsules can be repaired and the like in the process of suturing; the proximal end of the bone fracture plate is provided with 2 proximal Kirschner wire holes for judging whether the position of the bone fracture plate is proper and whether the locking screw can enter the joint cavity so as to reduce postoperative complications; meanwhile, the Kirschner wire is thin, so that the damage to bone substances can be almost ignored, the fault tolerance rate is high, the opportunity of adjusting the position of the bone plate is increased, the operation difficulty is reduced, the uniform and stable operation effect can be achieved, the operation of doctors at all levels of hospitals is facilitated, and the comprehensive popularization of products is facilitated; the proximal end of the bone fracture plate is provided with 3 proximal locking holes with the diameter of 2.0mm, the screw is combined with the threads of the proximal locking holes to have angular stability, multi-angle parallel fixation of multiple layers of cortical bone is realized, a bamboo raft effect is formed, the joint surface of the radius head is firmly supported, the application range is wide (such as proximal comminuted fracture of radius), the compression resistance and the anti-rotation force are strong, and the early function exercise is facilitated; early functional exercise; the far end of the bone fracture plate is provided with a sliding hole, the near end of the bone fracture plate is screwed into a locking screw, and then the bone fracture plate is screwed into the sliding hole at the far end of the bone fracture plate by using a cortical screw for pressurization and fixation; the far end of the bone fracture plate adopts the design that a far end locking hole and a Kirschner wire hole on the far end are arranged at intervals, a locking screw is screwed into the far end locking hole to firmly fix the fracture end, a Kirschner wire is screwed into the Kirschner wire hole on the far end, the special fracture or temporary fixation near the fracture line can be realized, and small bone blocks or the forceps holder of point type reduction forceps can be fixed by stitching the Kirschner wire hole on the far end; the cross sections of the near end and the far end of the bone fracture plate are both in curved surface design and are attached to the bone surface on the outer side of the near end of the radius, so that the bone fracture plate is not easy to slide when placed, the operation difficulty is reduced, and the repeatability is improved.

Drawings

FIG. 1 is a front view of the present invention;

FIG. 2 is a rear view of the present invention;

FIG. 3 is a side view of the present invention;

fig. 4 is a schematic diagram of the operation of the present invention.

In the figure: the bone fracture plate comprises a 1-bone fracture plate body, a 2-bone fracture plate near end, a 3-bone fracture plate far end, a 4-near end locking hole, a 5-near end Kirschner wire hole, a 6-sliding hole, a 7-far end locking hole, a 8-far end Kirschner wire hole, a 9-far end Kirschner wire hole, a 10-lead groove, an 11-arc groove and a 12-inclined plane structure.

Detailed Description

In the description of the present invention, it should be noted that unless otherwise specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly and may be, for example, fixedly connected, detachably connected, integrally connected, mechanically connected, or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements.

Example 1

The proximal and lateral radius bone plate shown in fig. 1-3 comprises a bone plate 1, wherein the bone plate 1 has a thickness of 1.5-2.0mm, a length of 3-10cm and a width of 0.5-2.0cm, the bone plate 1 is integrally T-shaped, the bone plate 1 is divided into a proximal bone plate end 2 and a distal bone plate end 3, the proximal bone plate end 2 is expanded to both sides and is bent inward to conform to the anatomical shape of the proximal radius, the proximal bone plate end 2 and the distal bone plate end 3 are smoothly and transitionally connected and are integrally structured, the distal bone plate end 3 has a cambered surface structure in cross section, a row of proximal locking holes 4 are formed in the proximal

bone plate end

2, 3 proximal locking holes 4 are formed in the proximal locking holes 4, proximal kirschner wire holes 5 are formed in the left side of the

proximal locking holes

4, 2 proximal kirschner wire holes 5 are formed in the proximal locking holes 4, the bone fracture plate is characterized in that a sliding hole 6, a far-end locking hole 7 and a far-end Kirschner wire hole 8 are sequentially formed in the far end 3 of the bone fracture plate from left to right, the far-end Kirschner wire hole 8 is located in the right end portion of the far end 3 of the bone fracture plate, a plurality of far-end locking holes 7 are formed, and Kirschner wire holes 9 in the far end are formed between every two adjacent far-end locking holes 7.

Example 2

The proximal radius lateral bone plate shown in fig. 1-3 comprises a bone plate 1, wherein the bone plate 1 has a thickness of 1.5-2.0mm, a length of 3-10cm and a width of 0.5-2.0cm, the bone plate 1 is integrally in a T-shaped structure, the bone plate 1 is divided into a proximal bone plate 2 and a distal bone plate 3, the proximal bone plate 2 is expanded towards two sides and is bent inwards to conform to the anatomical shape of the proximal radius, the proximal bone plate 2 and the distal bone plate 3 are connected in a smooth transition manner and are of an integral structure, the distal bone plate 3 has a cambered surface structure in cross section, a row of proximal locking holes 4 with a diameter of 2.0mm are formed in the

proximal bone plate

2, 3 proximal locking holes 4 are provided, proximal kirschner wire holes 5 with a diameter of 1.0mm are formed in the left side of the

proximal locking holes

4, 2 proximal kirschner wire holes 5 are provided, the bone fracture plate is respectively positioned between the adjacent locking holes 4 and can be used for temporarily fixing the bone fracture plate 1 and helping to judge whether a locking screw enters a joint cavity, and the forceps of a fracture end are reset, a small bone block is sutured, a ligament and a joint capsule are repaired, a wire guiding groove 10 is arranged between the edge of the back surface of the near end 2 of the bone fracture plate and the near end Kirschner wire hole 5, the wire guiding groove 10 is communicated with the near end Kirschner wire hole 5 so as to facilitate the passing of a suture, the small bone block is sutured and the ligament or the joint capsule is repaired in the operation, a sliding hole 6, a far end locking hole 7 and a far end Kirschner wire hole 8 are sequentially arranged at the far end 3 of the bone fracture plate from left to right, the diameter of the screw corresponding to the sliding hole 6 is 2.7mm, the far end Kirschner wire hole 8 is positioned at the right end part of the far end 3 of the bone fracture plate and has the diameter of 1.5mm, the right end of the far end 3 of the bone fracture plate is of a bevel structure 12 so as to facilitate the insertion of the bone fracture plate 1 and the operation of an operator, reduce the soft tissue irritation, distal end locking hole 7 is equipped with 3, and the diameter is 2.7mm, and the equidistance distributes, opens between the adjacent distal end locking hole 7 and has the diameter to be 1.5mm Kirschner wire hole 9 on the distal end, Kirschner wire hole 9 can insert the Kirschner wire according to the operation demand on distal end Kirschner wire hole 8 and the distal end and be used for temporary fixation, fracture end forceps holder to reset, sew up the ossicle piece, repair ligament and joint capsule etc., 3 backs of coaptation board distal end are opened there is arc recess 11, arc recess 11 is located on the distal end Kirschner wire hole 9 both sides, sliding hole 6 and the adjacent both sides between the distal end locking hole 7, reducible oppression to the periosteum, protection fracture end blood transportation.

The process flow and the working principle of the invention are as follows: a specific fixing mode of a bone fracture plate on the outer side of the near end of a radius is shown in figure 4, firstly, the fracture end is preliminarily reset, the bone fracture plate 1 is placed on the bone surface on the outer side of the near end of the radius according to anatomical morphology (in the range of a safety area of the near end of the radius, the situation that the position where the bone fracture plate 1 is placed influences the movement of an ulnar joint is prevented), then a Kirschner wire is driven into a Kirschner wire hole 5 at the near end, single-layer cortical bone is penetrated, perspective is conducted, the bone fracture plate 1 is adjusted to be in a proper position, meanwhile, the Kirschner wire inside the Kirschner wire hole 5 is ensured not to enter a joint cavity, after the position of the near end 2 of the bone fracture plate is determined, a cortical bone screw is screwed into a near-end locking hole 4 at the middle position, the single-layer cortical bone is penetrated, pressurization and fixation is carried out, the near end 2 of the bone fracture plate is attached to the bone surface, and then the Kirschner wire in the Kirschner wire hole 5 at the near end is pulled out. And (3) a kirschner wire is driven into the hole 8 of the distal kirschner wire to penetrate through the cortex of a single layer of bone, perspective is conducted, and the distal end 3 of the bone fracture plate is adjusted to be positioned in the middle of the radius. After the bone plate 1 is located at the middle position of the radius, a cortical bone screw is screwed in the sliding hole 6 to penetrate through the double-layer cortex, the Kirschner wire in the Kirschner wire hole 8 at the far end is pulled out before the cortical bone screw in the sliding hole 6 is not screwed, and the cortical bone screw in the sliding hole 6 is screwed while correcting the displacement of the fracture end, so that the fracture of the near end of the radius is anatomically reduced. And (3) after the position of the bone fracture plate 1 is determined, perspective is conducted, and anatomical reduction of fracture of the proximal radius is confirmed. Then, according to the fracture condition, locking screws are screwed into the locking holes at two ends of the fracture line, and it needs to be explained that the holes which are preferentially locked are proximal locking holes 4 at the upper side and the lower side (so that the proximal end 2 of the bone fracture plate is attached to the bone surface, and meanwhile, the locking holes are close to the brachial radius joint, so that the joint surface of the radius head is firmly supported, and a bamboo raft effect is formed); a distal locking hole 7 adjacent to the sliding hole 6 (to allow the bone surface to engage the bone plate 1); the distal locking hole 7 at the rightmost end (to make the distal end 3 of the bone plate fit to the bone surface and prevent the distal end 3 of the bone plate from tilting or displacing to irritate soft tissues, etc.). The final fixation is maintained at both ends of the fracture line using a suitable number of locking screws. Finally, the cortical bone screw in the proximal locking hole 4 at the middle position is replaced by a locking screw, the cortical bone screw in the sliding hole 6 is screwed out, and the operation is finished.

Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that modifications may be made to the embodiments or portions thereof without departing from the spirit and scope of the invention.

Claims

1. The utility model provides a radius near-end outside coaptation board, includes the coaptation board, its characterized in that: the bone fracture plate is integrally in a T-shaped structure and is divided into a bone fracture plate near end and a bone fracture plate far end, the bone fracture plate near end is in an expanded shape extending towards two sides, and is bent inwards to conform to the anatomical morphology of the proximal end of the radius, the proximal end of the bone fracture plate and the distal end of the bone fracture plate are connected in a smooth transition way, and is of an integral structure, the section of the far end of the bone fracture plate is of a cambered surface structure, a row of near-end locking holes are arranged on the near end of the bone fracture plate, the number of the near-end locking holes is 3, the left side of the near-end locking hole is provided with a near-end Kirschner wire hole, the number of the near-end Kirschner wire holes is 2, the near-end Kirschner wire holes are respectively positioned between the adjacent end locking holes, the far end of the bone fracture plate is provided with a sliding hole, a far end locking hole and a far end Kirschner wire hole in sequence from left to right, the distal Kirschner wire holes are formed in the right end portion of the distal end of the bone fracture plate, a plurality of distal end locking holes are formed, and Kirschner wire holes in the distal end are formed between every two adjacent distal end locking holes.

2. A proximal and lateral radius bone plate according to claim 1, wherein: a wire leading groove is formed between the edge of the back face of the near end of the bone fracture plate and the Kirschner wire hole, and the wire leading groove is communicated with the Kirschner wire hole.

3. A proximal and lateral radius bone plate according to claim 1, wherein: the back of the far end of the bone fracture plate is provided with arc-shaped grooves which are positioned on two sides of the Kirschner wire hole on the far end and two sides between the sliding hole and the adjacent far end locking hole.

4. A proximal and lateral radius bone plate according to claim 1, wherein: the distal end locking hole is equipped with 3, and the equidistance distributes.

5. A proximal and lateral radius bone plate according to claim 1, wherein: the right end part of the far end of the bone fracture plate is of an inclined plane structure.

6. A proximal and lateral radius bone plate according to claim 1, wherein: the diameter in near-end ke shi needle hole is 1.0mm, the diameter in ke shi needle hole and distal end ke shi needle hole on the distal end is 1.5mm, the diameter in near-end locking hole is 2.0mm, the diameter in distal end locking hole is 2.7mm, the diameter of the screw that the slip hole corresponds is 2.7 mm.

7. A proximal and lateral radius bone plate according to claim 1, wherein: the thickness of the bone plate is 1.5-2.0mm, the length is 3-10cm, and the width is 0.5-2.0 cm.