CN113648041B - Internal fixation repair system for intertrochanteric fracture of femur - Google Patents
Internal fixation repair system for intertrochanteric fracture of femur Download PDFInfo
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- CN113648041B CN113648041B CN202110988014.9A CN202110988014A CN113648041B CN 113648041 B CN113648041 B CN 113648041B CN 202110988014 A CN202110988014 A CN 202110988014A CN 113648041 B CN113648041 B CN 113648041B
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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
- A61B17/74—Devices for the head or neck or trochanter of the femur
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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
- A61B17/74—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
- A61B17/746—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 a plate opposite the femoral head
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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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8004—Cortical 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
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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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical 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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- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/885—Tools for expanding or compacting bones or discs or cavities therein
- A61B17/8852—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc
- A61B17/8855—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc inflatable, e.g. kyphoplasty balloons
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Abstract
The patent relates to an internal fixation repair system for intertrochanteric fracture, wherein a head sleeve is fixed between the intertrochanteric, a bone cement screw is installed on a head convex sleeve, a balloon expansion instrument is arranged along a central hole of the bone cement screw to expand a cavity inside femoral head, a bone cement injector is arranged along the central hole of the bone cement screw after the balloon expansion instrument is withdrawn, bone cement is injected into the cavity inside the femoral head, the bone cement screw is locked in the head convex sleeve after a rotating steel plate part is attached to the femoral shaft, a first locking screw is locked in a head thread, and a thread tip is arranged in the bone cement; the cortical bone compression screw and the short locking screw are installed next, the whole steel plate is completely fixed between the tuberosity of the femur at last, the fracture end is prevented from rotating when the fracture is fixed between the tuberosity by the two screws at the head, the axial compression and the stability of the fracture end are increased, the crushed fracture block is effectively fixed, the steel plate is effectively prevented from loosening and the fracture block is prevented from shifting, the structure is simple, and the operation of a doctor is convenient.
Description
Technical Field
This patent belongs to medical instrument technical field, particularly relates to an internal fixation repair system for fracture between thighbone tuberosity.
Background
Femoral intertrochanteric fracture refers to fracture occurring at the junction of a femoral shaft and a femoral neck, and as the fracture is the position with the largest shearing force, most of the fracture is cancellous bone and is a part with good osteoporosis, the fracture is easily caused under the action of stress. In the process of healing the fractures, the adopted method mainly adopts the internal fixation technology to carry out internal fixation of the fractures through operations, thereby achieving the purposes of operation reduction and fracture stabilization. However, the intertrochanteric fracture of femur or intertrochanteric fracture of femur, which is an osteoporosis part, has the problems of insecurity, screw loosening, cutting, withdrawal and the like in the internal fixation process of fracture, and finally causes failure of the internal fixation operation of fracture.
In recent years, doctors adopt bone cement screws for fixation, and the adopted method is to inject a certain amount of bone cement into bones to achieve the purpose of strengthening fixation, but the method of forcibly injecting the bone cement has obvious defects that the amount of the bone cement cannot be accurately controlled, the purpose of strengthening fixation cannot be achieved when the bone cement is injected too little, and the risk of bone cement leakage to joint cavities is caused when the bone cement is injected too much; in addition, the existing fracture repair system only adopts a bone cement screw to fix the bone folding plate, the raised sleeve arranged on the bone folding plate is approximately vertical to the bone folding plate at the joint, and the matching contact surface of the bone cement screw and the bone folding plate is too small, so that the bone cement screw can not play a good fixing role. Moreover, the head of the bone folding plate of the existing fracture repair system is bent towards one side of the femoral head, the screw hole is arranged on the periphery of the protruding sleeve, the screw is inserted into the screw hole to fix the steel plate body on the bone of the human body, at the moment, the steel plate body is stressed easily by applying pressure to the steel plate body through the screw, so that secondary injury is caused, the treatment effect is influenced, and when the screw is inserted into the femoral head of comminuted fracture, the stability is poor, and the secondary injury is easily caused to a patient. In addition, the existing system and the bone cement screw matched with the existing system have too few bone cement diffusion holes, so that the bone cement is difficult to diffuse in the inner cavity of the femoral head, the difficulty of bone cement injection is increased, the bone cement injection is less for patients with severe osteoporosis, the effect of stabilization and enhancement cannot be achieved, and the screw is loosened in the recovery stage after the operation is completed, so that the failure of internal fixation is caused. Therefore, the existing fracture repair system cannot treat patients with comminuted fracture or very severe osteoporosis at the femoral head.
Disclosure of Invention
In view of the above analysis, the present invention aims to provide an internal fixation repair system for intertrochanteric fracture of femur, so as to solve one or more problems of the existing internal fixation repair system that the fracture end is at risk of rotation, resulting in loosening of steel plate and displacement of fracture block, and that the fracture block cannot be effectively fixed.
The purpose of the invention is realized as follows:
an internal fixation repair system for an intertrochanteric fracture of a femur, comprising:
the locking sleeve plate comprises a main body and a head which are integrally arranged, and the head is provided with a raised sleeve and a first locking hole;
the bone cement screw is arranged in the protruding sleeve in a threaded mode and comprises a screw body, a central hole penetrates through the screw body along the axial direction, a bone cement diffusion hole is formed in the screw body, and the bone cement diffusion hole is communicated with the central hole;
a balloon dilation instrument forming a cavity inside a femoral head through the central bore;
a bone cement injector that injects bone cement into the cavity through the central bore and the bone cement diffusion bore;
a first locking screw inserted into the cavity through a first locking hole.
In a preferred embodiment of the present invention, the main body is a straight section, and the inner surface of the main body can be attached to the surface of the femoral shaft; the head is a curved section, and the inner surface of the head can be attached to the surfaces of the femoral head and the femoral shaft transition section.
In a preferred embodiment of the invention, the curved section comprises a first section with a first curvature and a second section with a second curvature, the first section being connected to the straight section in a transition manner, the second curvature being greater than the first curvature.
In a preferred embodiment of the present invention, the first locking hole is provided in the first section, and a center line of the first locking hole is parallel to a center line of the boss sleeve.
In a preferred embodiment of the present invention, the protruding sleeve is disposed on an inner side surface of the second section, the protruding sleeve is provided with an internal thread, and a connection hole is disposed on an outer side surface of the second section, and the connection hole is communicated with the protruding sleeve.
In a preferred embodiment of the present invention, the center line of the connection hole coincides with the center line of the boss sleeve, and the aperture of the connection hole is equal to the aperture of the mounting opening of the boss sleeve;
in a preferred embodiment of the present invention, the internal fixation repair system for intertrochanteric fracture of femur further comprises a second locking screw and a third locking screw, the second locking screw is a cortical bone compression screw, the third locking screw is a short locking screw, and the steel plate main body is fixed on the femoral shaft by the short locking screw and the cortical bone compression screw.
In a preferred embodiment of the present invention, the main body is provided with a second locking hole and a third locking hole, the second locking screw is fitted into the second locking hole, the third locking hole is a compression hole, the third locking screw is fitted into the third locking hole, and the steel plate main body is fixed to the femoral shaft using the short locking screw and the cortical bone compression screw.
In a preferred embodiment of the present invention, the second locking hole is located between the connecting hole and the third locking hole, and the number of the third locking holes is 2 to 3.
In a preferred embodiment of the invention, the bone cement screw comprises a screw body, the screw body comprises a polished rod section and a threaded section, and the bone cement diffusion hole is formed in the threaded section; the bone cement diffusion holes are provided with a plurality of rows of holes, the holes are arranged along the axial direction of the thread section, and each row of holes comprises at least four bone cement diffusion holes.
In a preferred embodiment of the present invention, the head of the nail body is provided with a quincunx notch.
In a preferred embodiment of the present invention, the balloon dilation instrument includes a front end and a rear end, the front end is provided with a telescopic rod, the telescopic rod can penetrate through the central hole and extend into cancellous bone, and the rear end controls the telescopic rod to form a cavity in cancellous bone.
In a preferred embodiment of the present invention, the bone cement injector comprises a handle and a bone cement delivery pipe, wherein the bone cement delivery pipe is detachably connected to the handle, the bone cement delivery pipe is used for penetrating into a central hole of the bone cement screw, and the handle is pushed to enable bone cement to pass through the bone cement delivery pipe and enter the cavity through the bone cement diffusion hole.
According to a preferred embodiment of the invention, the cross section of the protruding sleeve is circular, the extending height of the protruding sleeve on the inner surface of the locking sleeve plate is 10-30 mm, the diameter of the outer wall of the protruding sleeve is 9-12 mm, the wall thickness of the protruding sleeve is 1.5-3 mm, and an included angle of 130 degrees is formed between the protruding sleeve and the main body.
Compared with the prior art, the invention can realize at least one of the following beneficial effects:
a) The invention provides an internal fixation repair system for intertrochanteric fracture, which comprises bone cement screws, first locking screws and a locking sleeve plate, wherein a head sleeve is fixed between the intertrochanteric fractures by using the bone cement screws and the first locking screws; next, a cortical bone compression screw and a short locking screw are installed, and finally, the whole steel plate is completely fixed between the tuberosity of the femur, so that the fracture end can be prevented from rotating while the fracture between the tuberosity is fixed, the axial compression and stability of the fracture end are increased, the fracture block is effectively fixed and crushed, the problems of steel plate loosening, fracture block displacement and the like are effectively prevented, the internal fixation is reliable, the structure is simple, and the operation of a doctor is convenient.
b) The internal fixation repair system for intertrochanteric fracture of femur provided by the invention adopts the balloon dilatation device, and the balloon dilatation device and the bone cement screw are used together, so that the filling space of bone cement is increased, and the fixation stability of the bone cement screw is improved.
c) According to the internal fixation repair system for intertrochanteric fracture of femur provided by the invention, bone cement is injected in times after balloon expansion, so that on one hand, cancellous bones around a cavity left after balloon expansion are compacted, and a barrier for preventing bone cement leakage is manufactured artificially; on the other hand, the push rod is used for injecting the bone cement in multiple times, so that the pressure of the bone cement during injection is greatly reduced compared with the continuous injection of the traditional pressure pump, and the leakage of the bone cement is greatly reduced.
d) According to the internal fixation repairing system for intertrochanteric fracture of femur, the head of the locking sleeve plate is of the arc-shaped structure, the arc-shaped curvature is matched with the curvature of the intertrochanteric femur and can be better attached to the head of the femur, the straight section of the locking sleeve plate is of the concave structure and is in limited contact, the locking sleeve plate can be better and stably fixed on a femoral shaft, excessive stress concentration is reduced, and the stability of internal fixation is improved.
Drawings
In order to more clearly illustrate the embodiments of the present specification or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments described in the embodiments of the present specification, and other drawings can be obtained by those skilled in the art according to the drawings.
Fig. 1 is a schematic view illustrating a balloon expansion process of the internal fixation repair system for intertrochanteric fracture of femur of the present invention.
Fig. 2 is a schematic view illustrating a bone cement injection process of the internal fixation repair system for intertrochanteric fracture of femur of the present invention.
Fig. 3 is a first structural diagram of the internal fixation repair system for intertrochanteric fracture of femur of the present invention.
Fig. 4 is a schematic structural diagram of the internal fixation repair system for intertrochanteric fracture of femur of the present invention.
Fig. 5 is a third structural view of the internal fixation repair system for intertrochanteric femoral fracture of the present invention.
FIG. 6 is a front view of the locking sleeve plate of the present invention.
FIG. 7 is a side view of the locking sleeve plate of the present invention.
Fig. 8 is a structural view of the bone cement screw according to the present invention.
Reference numerals:
1-femur; 1.1-femoral head; 2-locking sleeve plate; 2.1-head; 2.2-a raised sleeve; 2.3-main body; 2.4-first locking hole; 2.5-connecting hole; 2.6-second locking hole; 2.7-a third locking hole; 3-bone cement screws; 3.1-quincunx sink groove; 3.2-connecting end; 3.3-center hole; 3.4-nail body; 3.5-nail body thread; 3.6-bone cement diffusion holes; 3.7-cutting end; 4-balloon dilation instrument; 5-cortical bone compression screws; 6-short locking screws; 7-a first locking screw; 8-a cavity; 9-bone cement; 10-bone cement injector.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are some embodiments of the present application, but not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.
For the purpose of facilitating understanding of the embodiments of the present application, the following description will be made in terms of specific embodiments with reference to the accompanying drawings, which are not intended to limit the embodiments of the present application.
One embodiment of the present invention, as shown in fig. 1-5, discloses an internal fixation repair system for intertrochanteric femoral fractures, comprising:
the locking sleeve plate 2 comprises a main body 2.3 and a head 2.1 which are integrally arranged, and the head 2.1 is provided with a protruding sleeve 2.2 and a first locking hole 2.4;
the bone cement screw 3 is installed in the boss sleeve 2.2 in a threaded mode, the bone cement screw 3 comprises a screw body 3.4, the screw body 3.4 is provided with a center hole 3.3 in a penetrating mode along the axial direction, an external thread and a bone cement diffusion hole 3.6 are formed in the screw body 3.4, and the bone cement diffusion hole 3.6 is communicated with the center hole 3.3;
a balloon dilatation device 4, the balloon dilatation device 4 forming a cavity 8 inside the femoral head through the central hole 3.3;
a bone cement injector 10, wherein the bone cement injector 10 injects the bone cement 9 into the cavity 8 through the central hole 3.3 and the bone cement diffusion hole 3.6;
a first locking screw 7, said first locking screw 7 being inserted into said cavity 8 through a first locking hole 2.4; the head 2.1 is fixed to the femoral head surface by the first locking screw 7, and the front end of the first locking screw 7 is located in the bone cement 9 in the cavity 8.
In a preferred embodiment of the present embodiment, the locking sleeve plate 2 is a unitary structure, the locking sleeve plate 2 has a protrusion sleeve 2.2, and the head of the locking sleeve plate 2 is an arc-shaped structure, so as to better fit with the head 1.1 of the femur and keep the stability of the cement screw 3.
Specifically, as shown in fig. 6, the main body 2.3 of the locking sleeve plate 2 is a straight section, and the straight section 2.3 of the locking sleeve plate 2 is partially in a concave structure and is arranged in a limited contact type, so that the locking sleeve plate can be better fixed on the femoral shaft and reduce the excessive concentration of stress. The inner surface of the main body 2.3 is arc-shaped, the arc curvature is matched with the femur tuberosity curvature, and the main body can be better attached to the surface of a femoral shaft; the head 2.1 of the locking sleeve plate 2 is a curved section, the inner surface of the head 2.1 can be attached to the surface of the femoral head 1.1 and the femoral shaft transition section, namely, the head 2.1 is a curved section, and the inner surface of the curved section is matched with the curve of the femoral head 1.1 rotor. Specifically, the curved section comprises a first section with a first curvature and a second curvature section with a second curvature, the first section is in transition connection with the straight section, and the second curvature is larger than the first curvature, and the structure arrangement enables the locking sleeve plate 2 to be better attached to the femoral shaft, and particularly enables the head to be attached to the surface of the femoral head 1.1 and the femoral shaft transition section.
In a preferred embodiment of this embodiment, the protruding sleeve 2.2 is disposed on an inner side surface of the second section, the protruding sleeve 2.2 is provided with an internal thread, a connection hole 2.5 is disposed on an outer side surface of the second section, and the connection hole 2.5 is communicated with the protruding sleeve 2.2; the first locking hole 2.4 is arranged at the first section, and the central line of the first locking hole 2.4 is parallel to the central line of the boss sleeve 2.2.
In a preferred embodiment of this embodiment, a central line of the connection hole 2.5 coincides with a central line of the boss sleeve 2.2, an aperture of the connection hole 2.5 is equal to an aperture of the mounting hole of the boss sleeve 2.2, and a central line of the central hole 3.3 coincides with a central axis of the nail body 3.4 of the bone cement screw 3.
In a preferred embodiment of this embodiment, the internal fixation repair system for intertrochanteric femoral fracture further comprises a second locking screw and a third locking screw, the second locking screw being a cortical bone compression screw 5 and the third locking screw being a short locking screw 6; the main body 2.3 is provided with second locking holes 2.6 and third locking holes 2.7, as shown in fig. 7, the second locking holes 2.6 are located between the connecting holes 2.5 and the third locking holes 2.7, the number of the third locking holes 2.7 is 2-3, the second locking screws are installed in the second locking holes 2.6, the third locking holes 2.7 are pressurizing holes, the third locking screws are installed in the third locking holes 2.7, and the main body 2.3 is fixed on the femoral shaft by using the short locking screws 6 and/or cortical bone pressurizing screws 5.
In a preferred embodiment of this embodiment, as shown in fig. 8, the bone cement screw 3 includes a shank 3.4 and a central hole 3.3 axially penetrating the shank 3.4, the shank 3.4 is provided with threads and bone cement diffusion holes 3.6, the bone cement diffusion holes 3.6 are evenly arranged along the shank 3.4 at intervals of 90 degrees, and the through holes are four rows of through holesCommunicating with the central bore 3.3. Specifically, the nail body 3.4 comprises a polished rod section and a threaded section, and the bone cement diffusion hole 3.6 is arranged in the threaded section; the bone cement diffusion holes 3.6 are provided with a plurality of rows of holes, each row of holes comprises at least four bone cement diffusion holes 3.6 along the axial direction of the thread section, and the aperture of each bone cement diffusion hole 3.6 is
The centre bore 3.3 is used for sacculus expansion instrument 4 and bone cement syringe 10 to pass, and bone cement syringe 10 diffuses bone cement 9 in to cavity 8 through centre bore 3.3 and multirow bone cement diffusion hole 3.6, through setting up multirow bone cement diffusion hole 3.6, can make even the filling of bone cement in cavity 9, avoids not filling because of the part and causes the blind area of filling, has improved the steadiness of bone cement screw 3 and first locking screw 7.
In a preferred embodiment of this embodiment, one end of the shank 3.4 of the bone cement screw 3 is a cutting end 3.7, the other end of the shank 3.4 is a connecting end 3.2, the connecting end 3.2 is provided with an external thread, and the thread pattern of the external thread matches with the internal thread of the boss sleeve 2.2. The cutting end is a cutting thread in a thread shape, a thread blade is arranged on the cutting thread, a self-tapping groove is arranged at the front end of the thread blade, and the self-tapping groove has a certain back angle and increases self-tapping performance. The cutting end drives the bone cement screw 3 to be driven into the femoral head rotor, and the other end of the nail body 3.4 is provided with an external thread matched with the inner wall of the bulge sleeve 2.2, so that firm threaded connection can be realized.
In a preferred embodiment of this embodiment, the head of the nail body 3.4 is provided with a quincunx sunken groove 3.1, the quincunx sunken groove 3.1 is a T27 quincunx interface, the bone cement screw 3 screws into under the effect of outer clamping equipment inside the protruding sleeve 2.2, the clamping position of the outer clamping equipment is that the quincunx sunken groove is in order to reach the effect of holding by oneself, the centre gripping auto-lock of being convenient for, avoid the nail body 3.4 to drop.
In a preferred embodiment of this embodiment, the thickness of the straight section ranges from 5.5 mm to 6mm, and the width ranges from 17.5 mm to 18.5 mm; the cross-section of protruding sleeve 2.2 is the ring shape, protruding sleeve 2.2 be in 2 internal surfaces of locking sleeve board extend to 10mm ~ 30mm, the outer wall diameter of protruding sleeve 2.2 is 9 ~ 12mm, the wall thickness of protruding sleeve 2.2 is 1.5mm ~ 3mm, protruding sleeve 2.2 with main part 2.3 is 130 contained angles, and this contained angle is unanimous with thighbone head angle, with the protruding sleeve 2.2 of head screw in of bone cement screw 3, the axis of bone cement screw 3 is parallel state with the axis after the locking of first locking screw 7, can be furthest run through the locking with whole femoral head.
A preferred embodiment of this embodiment, sacculus expansion instrument 4 includes front end and rear end, the front end is equipped with the telescopic link, the telescopic link of 4 front ends of sacculus expansion instrument can follow bone cement screw 3 centre bore 3.3 inserts to the femoral head, and the cutting edge that bone cement screw 3 was worn out to the front end stretches into inside the spongy bone, doctor operation control the rear end of sacculus expansion instrument 4, the front end is in prop open or shrink under the rear end control, the front end is strutted the back and is taken out cavity 8 at the inside inflation of femoral head, and sacculus expansion instrument 4 withdraws from after propping out cavity 8, and bone cement screw 3 further squeezes into inside the cavity under outer clamping device's effect, and the thread fit of the protruding sleeve 2.2 of the connecting end 3.2 of bone cement screw 3 head and locking sleeve board 2.2.
In a preferred embodiment of this embodiment, the bone cement injector 10 includes a handle and a bone cement delivery pipe, the bone cement delivery pipe is detachably connected to the handle, the bone cement delivery pipe is used for penetrating into the central hole 3.3 of the bone cement screw 3, the depth of the cancellous bone material input along the central hole 3.3 at the front end of the bone cement delivery pipe is the same as the depth of the bone cement diffusion hole 3.6, and the handle is pushed to make the bone cement 9 enter the cavity 8 through the bone cement delivery pipe via the bone cement diffusion hole 3.6, so as to inject the bone cement in different times. Namely, the interior of the femoral head is expanded by the telescopic rod of the balloon structure and then is injected with bone cement in times, on one hand, cancellous bones around a cavity left after the balloon expansion are compacted, and a barrier for preventing the bone cement from leaking is manufactured artificially; on the other hand, the bone cement is injected by the push rod of the bone cement injector 10 in multiple times, so that the pressure of the bone cement during injection is greatly reduced compared with the continuous injection of the traditional pressure pump, and the leakage of the bone cement is greatly reduced.
In practical application, a doctor needs to match the size of the opening of the femoral head 1.1 with the shape of the outer wall of the protrusion sleeve 2.2, install the protrusion sleeve 2.2 in the interior of the femoral head 1.1, make the cutting end 3.7 of the nail body 3.4 of the bone cement screw 3 contact with the part of the femoral head 1.1 needing to be fixed, screw into the femoral head 1.1 under the action of a surgical instrument, at this time, the connecting end 3.2 at the other end of the bone cement screw 3 is not screwed into the thread in the protrusion sleeve 2.2, then pass the balloon expansion instrument 4 through the central hole 3.3 of the bone cement screw 3 to reach the interior of the femoral head 1.1, and expand to form a cavity 8 in the interior of the femoral head. Withdrawing the balloon dilatation device 4, screwing the connecting end 3.2 of the nail body 3.4 of the bone cement screw 3 into the connecting thread of the convex sleeve 2.2, and locking by using a torque wrench. The bone cement injector 10 is inserted into the cavity 8 expanded by the balloon expansion device 4 along the central hole 3.3 of the bone cement screw 3, the bone cement 9 is injected, the bone cement 9 can be diffused in the expanded femoral head cavity 8 through the central hole 3.3 and the four rows of bone cement diffusion holes 3.6, the bone cement injector 10 is withdrawn after a certain amount of bone cement 9 is injected, and finally the bone cement 9 is solidified to play a role in strengthening and fixing. The surgeon then drills a small hole in the area of the fracture of the femoral head 1.1, the size of the small hole corresponding to the base diameter of the screw to be installed, then matches the steel plate head 2.1 of the locking sleeve plate 2 with the curved line of the trochanter of the femoral head 1.1 and fixes it with a long locking screw 7. A short locking screw 6 is mounted on the second locking hole 2.6 of the steel plate main body 2.3 by using a surgical instrument, a cortical bone compression screw 5 is mounted on the third locking hole 2.7 of the steel plate main body 2.3 by using a surgical instrument, and finally, a short locking screw 6 is mounted on the tail locking hole position of the steel plate main body 2.3 by using the surgical instrument. To this end, an internal fixation repair system for intertrochanteric fractures is installed.
Compared with the prior art, the internal fixation repair system for femoral intertrochanteric fracture provided by the embodiment comprises the bone cement screw and the balloon dilatation device, and the balloon dilatation device and the bone cement screw are used together, so that the filling space of bone cement is increased, and the stability of fixation of the bone cement screw is improved. The locking sleeve plate is fixed between the femoral tuberosities through a plurality of locking screws and cortical bone compression screws in a fixing mode, and the fixing steps are as follows: fixing the head sleeve between the femoral tuberosity, locking a bone cement screw on the head protruding sleeve after the main body of the rotating steel plate is well jointed with the femoral shaft, locking a first locking screw in the head thread, and placing the tip of the thread into the bone cement; the fracture fixation device is characterized in that a cortical bone compression screw and a short locking screw are installed next, and finally the whole steel plate is completely fixed between the tuberosity of the femur, so that the fracture end can be prevented from rotating while the fracture between the tuberosity is fixed, the axial compression and stability of the fracture end are increased, the fracture block is effectively fixed and crushed, the problems of steel plate loosening, fracture block displacement and the like are effectively prevented, the internal fixation is reliable, the structure is simple, and the operation of a doctor is convenient. In addition, the traditional repair system adopts a lag screw, the purpose of the lag screw is to provide pressure between bone blocks, and at the moment, the lag screw can stably fix a steel plate on a fracture block, so that stable fixation is achieved, but blood circulation of periosteum is influenced, and later recovery is influenced; the first screw 7 is a locking screw, so that the angle stability can be provided, a steel plate does not need to be pressed onto the bone surface, the contact area between the steel plate and the bone is reduced, the interference on periosteum blood circulation is reduced while the stability is improved, and the periosteum and the blood circulation are protected.
The above-mentioned embodiments, objects, technical solutions and advantages of the present application are further described in detail, it should be understood that the above-mentioned embodiments are only examples of the present application, and are not intended to limit the scope of the present application, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present application should be included in the scope of the present application.
Claims (8)
1. An internal fixation repair system for intertrochanteric fractures, comprising:
the locking sleeve plate (2) comprises a main body (2.3) and a head (2.1) which are integrally arranged, and the head (2.1) is provided with a protruding sleeve (2.2) and a first locking hole (2.4);
the bone cement screw (3) is installed in the protruding sleeve (2.2) in a threaded mode, the bone cement screw (3) comprises a screw body (3.4), a center hole (3.3) penetrates through the screw body (3.4) along the axial direction, a bone cement diffusion hole (3.6) is formed in the screw body (3.4), and the bone cement diffusion hole (3.6) is communicated with the center hole (3.3);
a balloon dilatation device (4) forming a cavity (8) inside the femoral head through the central hole (3.3) of the balloon dilatation device (4);
a bone cement injector (10), said bone cement injector (10) injecting bone cement (9) into said cavity (8) through said central bore (3.3) and said bone cement diffusion bore (3.6);
a first locking screw (7), said first locking screw (7) being inserted into said cavity (8) through a first locking hole (2.4);
the head (2.1) is fixed at the transition section of the femoral head (1.1) and the femoral shaft through the first locking screw (7), and the front end of the first locking screw (7) is positioned in the bone cement (9) in the cavity (8);
the main body (2.3) is a straight section, and the inner surface of the main body (2.3) can be attached to the surface of the femoral shaft;
the head (2.1) is a curved section, and the inner surface of the head (2.1) can be attached to the surfaces of the femoral head (1.1) and the femoral shaft transition section; the curved section is composed of a first section with a first curvature and a second section with a second curvature, the first section is in transition connection with the straight section, and the second curvature is larger than the first curvature;
the first locking hole (2.4) is arranged at the first section; the protruding sleeve (2.2) is arranged on the inner side face of the second section.
2. Internal fixation repair system for femoral intertrochanteric fractures according to claim 1, characterized in that the boss sleeve (2.2) is provided with an internal thread and the lateral surface of the second section is provided with a connection hole (2.5), the connection hole (2.5) communicating with the boss sleeve (2.2).
3. The internal fixation repair system for femoral intertrochanteric fractures according to claim 2, characterized in that the center line of the connection hole (2.5) coincides with the center line of the boss sleeve (2.2), and the hole diameter of the connection hole (2.5) is equal to the hole diameter of the mounting opening of the boss sleeve (2.2).
4. An internal fixation repair system for femoral intertrochanteric fractures according to claim 3, further comprising a second locking screw being a cortical bone compression screw (5) and a third locking screw being a short locking screw (6), the body (2.3) being fixed to the femoral shaft by the short locking screw (6) and the cortical bone compression screw (5).
5. An internal fixation repair system for femoral intertrochanteric fractures according to claim 4, characterized in that the body (2.3) is provided with a second locking hole (2.6) and a third locking hole (2.7), the second locking screw being fitted into the second locking hole (2.6), the third locking hole (2.7) being a compression hole and the third locking screw being fitted into the third locking hole (2.7).
6. The internal fixation repair system for femoral intertrochanteric fractures according to claim 5, characterized in that the second locking hole (2.6) is located between the connection hole (2.5) and the third locking hole (2.7), the number of the third locking hole (2.7) being 2-3.
7. The system according to claim 1, wherein the balloon dilation instrument (4) comprises a front end and a rear end, the front end is provided with a telescopic rod, the telescopic rod can penetrate through the central hole (3.3) and extend into cancellous bone, and the rear end controls the telescopic rod to form a cavity (8) in the cancellous bone.
8. The system of claim 1, wherein the cement injector (10) comprises a handle and a cement delivery tube detachably connected to the handle.
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| CN202110988014.9A Active CN113648041B (en) | 2021-02-02 | 2021-08-26 | Internal fixation repair system for intertrochanteric fracture of femur |
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| CN215937619U (en) | 2022-03-04 |
| CN113648041A (en) | 2021-11-16 |
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