CN113813034A - Conformal nail for treating intertrochanteric fracture - Google Patents
Conformal nail for treating intertrochanteric fracture Download PDFInfo
- Publication number
- CN113813034A CN113813034A CN202110967890.3A CN202110967890A CN113813034A CN 113813034 A CN113813034 A CN 113813034A CN 202110967890 A CN202110967890 A CN 202110967890A CN 113813034 A CN113813034 A CN 113813034A
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- China
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- nail
- hole
- intramedullary
- intramedullary nail
- tension
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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
-
- 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
- A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
Abstract
The invention discloses a conformal nail for treating intertrochanteric fracture, which comprises an intramedullary nail, a pressure nail, a tension nail and an anti-rotation locking nail, wherein the lower end of the intramedullary nail is inserted into a medullary cavity of a femur, the upper end of the intramedullary nail is positioned at the proximal end of the femur and is provided with a positioning handle connecting structure, a nail rod of the intramedullary nail is provided with the tension nail hole, the pressure nail hole and the anti-rotation locking nail hole, the front end of the pressure nail penetrates through the pressure nail hole and is inserted into the femoral head along the direction of a small pressure bone beam, the front end of the tension nail penetrates through the pressure nail hole and is inserted into the femoral head along the direction of the small tension bone beam, the anti-rotation locking nail penetrates through the anti-rotation locking nail hole and a femoral shaft, and one side of the upper end of the intramedullary nail, which is opposite to the femoral head, contracts towards the direction of a central line of the intramedullary nail. The invention can ensure that the fracture line at the lesser trochanter is not spread while the internal fixation strength is not influenced, thereby promoting the recovery of the biomechanics angle of the femoral neck and the femoral shaft and avoiding the bone necrosis caused by the unhealed affected part.
Description
Technical Field
The invention relates to a conformal nail used for internal fixation of a bone when treating intertrochanteric fracture, belonging to the technical field of medical instruments.
Background
The intertrochanteric fracture of femur, also called intertrochanteric fracture, is a common clinical orthopedic disease, the disease is frequently seen in the elderly population, the incidence rate of intertrochanteric fracture of femur also shows a trend of increasing year by year along with the continuous deepening of the aging degree of the population in China and the acceleration of the rhythm of social life, and the proportion of intertrochanteric fracture of femur in hip fracture can reach about 50%. If the patient with the disease is not treated and intervened timely and effectively, various structural dysfunctions can occur, and even the lower limb mobility is lost. Conservative treatment requires long-term bed rest, which can lead to more complications and threaten the life of patients in severe cases. Surgical treatment is therefore the best treatment for intertrochanteric femoral fractures.
The main flow directions for treating the diseases by the operation comprise two types of steel plate internal fixation and intramedullary nail internal fixation, the femoral head is a main stress component of a human body, and the dynamic hip fixation is the steel plate cortical fixation, so when the dynamic hip fixation is applied to femoral end fracture, the revision is often caused by over-force, and the intramedullary nail internal fixation mode is the main flow solution aiming at the diseases at present.
Various types of femoral intramedullary nail fixing systems are widely applied to treatment of unstable femoral intertrochanteric fractures, but in the clinical application process, it is found that fracture lines of many affected parts pass through the top end of the tuberosity, and the area is the most preferable area for intervention of an intramedullary nail (see fig. 1 and 2).
There is therefore a great need for an internal fixation instrument that is suitable for use in the passage of a fracture line through the region of the tuberosity apex.
In addition, when the intramedullary nail needs to be taken out, the top end of the intramedullary nail is connected with the intramedullary nail extractor through threads in the traditional method, and then the intramedullary nail is extracted through the intramedullary nail extractor, so that the operation is more complicated, and the operation efficiency is reduced.
Disclosure of Invention
The invention aims to provide a shape-adaptive nail for treating intertrochanteric fracture aiming at the defects of the prior art, so as to prevent fracture lines at the lesser trochanter from being spread by an intramedullary nail and avoid bone necrosis caused by the fact that the affected part cannot be healed.
In order to achieve the purpose, the invention adopts the following technical scheme:
a conformal nail for treating intertrochanteric fracture comprises an intramedullary nail, a pressure nail, a tension nail and an anti-rotation locking nail, wherein the lower end of the intramedullary nail is inserted into a medullary cavity of a femur from a nail hole at the proximal end of the femur of a patient, the upper end of the intramedullary nail is positioned at the proximal end of the femur and is provided with a positioning handle connecting structure, a tension nail hole, a pressure nail hole and an anti-rotation locking nail hole are sequentially arranged on a nail rod of the intramedullary nail from top to bottom, the front end of the pressure nail penetrates through the pressure nail hole and is inserted into the femoral head along the direction of a pressure bone trabecula, the front end of the tension nail penetrates through the pressure nail hole and is inserted into the femoral head along the direction of the tension bone trabecula, the anti-rotation locking nail penetrates through the anti-rotation locking nail hole and the femoral shaft, and after improvement, one side, opposite to the femoral head, of the intramedullary nail shrinks towards the central line direction of the intramedullary nail.
The shape of the cross section of the upper end of the intramedullary nail is D-shaped or oblate.
The shape-adaptive nail for treating femoral intertrochanteric fracture comprises a positioning handle connecting structure, a positioning opening and a clamping groove, wherein the positioning handle connecting structure is arranged on the upper end face of an intramedullary nail and matched with a positioning table on a positioning handle, a positioning opening matched with an anti-rotation clamping table on the positioning handle is formed in the hole wall of the positioning hole, and the clamping groove is formed in the inner walls of two sides of the positioning hole.
According to the shape-adaptive nail for treating intertrochanteric fracture, the through hole is formed in the nail rod of the pressure nail, and the tension nail penetrates through the through hole.
According to the shape-adaptive nail for treating intertrochanteric fracture, the front ends of the pressure nail and the tension nail are respectively provided with the pressurizing threads.
According to the shape-adaptive nail for treating femoral intertrochanteric fracture, the tension nail is in threaded fit with the intramedullary nail.
The lower end of the intramedullary nail is tapered.
According to the shape-adaptive nail for treating femoral intertrochanteric fracture, the upper end of the intramedullary nail is provided with the lifting top cover, the lifting top cover comprises a lifting handle, a cover body and two hooks, the cover body is a box body with an opening at the bottom, the lifting handle is installed at the top of the cover body, hook handles of the two hooks are inserted into the cover body from the opening at the bottom of the cover body, hook heads respectively correspond to clamping grooves in inner walls of two sides of a positioning hole in the upper end face of the intramedullary nail, sliding inclined planes corresponding to the inner edges of orifices of the positioning hole are arranged at the lower part of the hook heads, the middle part of each hook handle is rotatably connected with the cover body through a rotating shaft, the upper ends of the hook handles are connected with the side walls of the cover body through springs, and the hook heads of the hooks are clamped into the corresponding clamping grooves through the elasticity of the springs.
Above-mentioned be used for treating bone screw that adapts to between femoral trochanter fracture, the handle is n type structure, and its both sides straight arm inserts in the through-hole on the lid roof and with roof sliding connection, is equipped with the anticreep limiting plate at the lower extreme of straight arm.
According to the shape-fitting nail for treating femoral intertrochanteric fracture, the bottom of the cover body is provided with the boss corresponding to the positioning notch on the wall of the positioning hole on the upper end surface of the intramedullary nail.
The invention improves the shape of the upper end of the intramedullary nail, can avoid the interference between the intramedullary nail and the fracture end without influencing the internal fixation strength, and ensures that the fracture line at the lesser trochanter is not spread, thereby promoting the recovery of the biomechanics angle of the femoral neck and the femoral shaft and avoiding the bone necrosis caused by the unhealed healing of the affected part.
Drawings
The present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.
FIG. 1 is a schematic view of a proximal femur configuration;
FIG. 2 is a schematic view of the internal fixation of intertrochanteric fractures using a conventional intramedullary nail;
FIG. 3 is a schematic structural view of the present invention (except for the lift cap, the cross-sectional shape of the upper end of the intramedullary nail is oblate);
FIG. 4 is a side sectional view of FIG. 3;
FIG. 5 is a tangential cross-sectional view of the intramedullary nail of FIG. 3;
FIG. 6 is a schematic view of the mounting of the lift cap on the intramedullary nail;
FIG. 7 is a cross-sectional view of a lift cap;
fig. 8 is another configuration of the present invention (the cross-sectional shape of the upper end of the intramedullary nail is D-shaped), wherein fig. 8 (a) is an isometric view; fig. 8 (b) is a side view.
The reference numbers in the figures are as follows:
1. intramedullary nail, 2, pressure nail, 3, tension nail, 4, anti-rotation locking nail, 5, lifting top cover, 6, greater trochanter, 7, tuberosity, 8, femoral shaft, 9, lesser trochanter, 10, femoral neck, 11 and femoral head;
1-1 parts of positioning holes, 1-2 parts of positioning notches, 1-3 parts of clamping grooves, 1-4 parts of tension nail holes, 1-5 parts of pressure nail holes, 1-6 parts of anti-rotation locking nail holes;
5-1 parts of handles, 5-2 parts of cover bodies, 5-3 parts of springs, 5-4 parts of hooks, 5-5 parts of sliding inclined planes, 5-6 parts of bosses, 5-7 parts of anti-falling limiting plates, 5-8 parts of rotating shafts.
Detailed Description
The invention changes the cross section of the top of the intramedullary nail from round to D-shaped or oblate, increases the moving distance of the fracture end to the femoral shaft, thereby perfectly solving the problem that the fracture line at the lesser trochanter of the femur is spread to influence the healing.
Referring to fig. 3 to 8, the present invention includes an intramedullary nail 1, a pressure nail 2, a tension nail 3, an anti-rotation locking nail 4 and a lifting cap 5. Wherein the lifting top cover 5 comprises a lifting handle 5-1, a cover body 5-2, a spring 5-3, a hook 5-4, a boss 5-6, an anti-falling limiting plate 5-7 and a rotating shaft 5-8. The upper end of the intramedullary nail 1 is provided with a positioning handle connecting structure, and the positioning handle connecting structure comprises a positioning hole 1-1, a positioning notch 1-2, a clamping groove 1-3, a tension nail hole 1-4, a pressure nail hole 1-5 and an anti-rotation locking nail hole 1-6.
Referring to fig. 1 and 2, when the fracture line passes through the tuberosity top (lesser trochanter) of the femur, the fracture end and the diaphysis part are in a free state due to small binding force, and when the nail hole is formed at the proximal end of the femur, the hole-opening tool often cannot effectively cut the fracture end, so that the intramedullary nail 1 interferes with the fracture end after being implanted, the fracture end cannot be attached to the femoral shaft part, and the fracture line at the lesser trochanter is spread. The invention adopts cutting, grinding and other modes to ensure that one side of the upper end of the intramedullary nail 1 opposite to the femoral head is contracted towards the central line direction of the intramedullary nail 1, thereby avoiding the interference with the fracture end, ensuring that the fracture line at the lesser trochanter can not be propped open, and well solving the problem that the healing is influenced because the fracture line is propped open.
After the upper end of the intramedullary nail 1 is cut and ground, the cross section of the intramedullary nail can be D-shaped (as shown in figure 8), namely, only one side corresponding to the femoral head is cut and ground; or oblate (as shown in fig. 3), that is, the side of the intramedullary nail 1 corresponding to the femoral head and the opposite side are cut and ground simultaneously, so that the upper end of the intramedullary nail 1 can be inclined towards one side of the femoral shaft, and the reduction of the fracture end is facilitated.
In fig. 8, the connection structure of the positioning handle at the upper end of the intramedullary nail 1 is conventional and may be embodied as the same as in fig. 3.
The connecting structure of the positioning handle at the upper end of the intramedullary nail 1 is used for connecting with the positioning handle. The screw rod of the pressure screw 2 is provided with a through hole matched with the tension screw 3.
The front ends of the pressure nail 2 and the tension nail 3 are respectively provided with a pressurizing thread, so that the pressure nail 2 and the tension nail 3 can be firmly connected with the fracture broken end, and the tension nail 3 is matched with the intramedullary nail 1 through the threads, so that the connection reliability can be improved.
The lower end of the intramedullary nail 1 is tapered, which can disperse the stress borne by the femoral shaft and prevent the fracture of the femoral shaft due to overlarge local stress.
The upper end of the intramedullary nail 1 is provided with a lifting top cover 5 consisting of a handle 5-1, a cover body 5-2, a spring 5-3, a hook 5-4, an anti-drop limiting plate 5-7 and a rotating shaft 5-8, and the function of the lifting top cover is to improve the removal efficiency of the intramedullary nail 1. When the lifting top cover 5 is covered on the upper end surface of the intramedullary nail 1, the sliding inclined planes 5-5 at the lower parts of the two hooks 5-4 are contacted with the inner opening of the positioning hole 1-1 and rotate towards the positioning hole 1-1 along the hook head of the rear hook 5-4, meanwhile, the spring 5-3 is stretched, the hook head of the hook 5-4 rotates into the positioning hole 1-1 and then slides towards the inner opening along the hole wall, and finally, the hook head is clamped into the clamping grooves 1-3 on the inner walls at the two sides of the positioning hole 1-1 under the elastic force of the spring 5-3, so that the quick connection between the lifting top cover 5 and the intramedullary nail 1 is realized, and then the intramedullary nail 1 can be quickly pulled out by utilizing a rope penetrating through the lifting handle 5-1.
It should be noted that, since the upper end of the intramedullary nail 1 is not cylindrical, the opening of the nail hole needs to be enlarged by using an arc-shaped osteotome before the intramedullary nail 1 is pulled out.
The handle 5-1 can be fixedly connected with the cover body 5-2 and also can be movably connected with the top plate of the cover body 5-2.
Claims (10)
1. A conformal nail for treating intertrochanteric fracture comprises an intramedullary nail (1), a pressure nail (2), a tension nail (3) and an anti-rotation locking nail (4), wherein the lower end of the intramedullary nail (1) is inserted into a medullary cavity of a femur through a nail hole at the proximal end of the femur of a patient, the upper end of the intramedullary nail is positioned at the proximal end of the femur and is provided with a positioning handle connecting structure, a nail rod of the intramedullary nail (1) is provided with the tension nail hole (1-4), the pressure nail hole (1-5) and the anti-rotation locking nail hole (1-6) which are sequentially arranged from top to bottom, the front end of the pressure nail (2) penetrates through the pressure nail hole (1-5) and is inserted into a femoral head (11) along the direction of a small tension bone beam, the front end of the tension nail (3) penetrates through the pressure nail hole (1-5) and is inserted into the femoral head (11) along the direction of the small tension bone beam, the anti-rotation locking nail (4) penetrates through the anti-rotation locking nail hole (1-6) and a femoral shaft, is characterized in that one side of the upper end of the intramedullary nail (1) opposite to the femoral head (11) shrinks towards the central line direction of the intramedullary nail (1).
2. The conformable nail for the treatment of intertrochanteric fractures according to claim 1, characterized in that the cross-sectional shape of the upper end of the intramedullary nail (1) is D-shaped or oblate.
3. The conformable nail for treating intertrochanteric fracture according to claim 1 or 2, characterized in that the positioning handle connecting structure at the upper end of the intramedullary nail (1) comprises a positioning hole (1-1) which is arranged on the upper end face of the intramedullary nail (1) and is matched with a positioning table on the positioning handle, a positioning notch (1-2) which is matched with an anti-rotation clamping table on the positioning handle is arranged on the hole wall of the positioning hole (1-1), and clamping grooves (1-3) are arranged on the inner walls of the two sides of the positioning hole (1-1).
4. The conformable nail for treating intertrochanteric fracture according to claim 3, characterized in that the shank of the pressure nail (2) is provided with a through hole through which the tension nail (3) passes.
5. The conformable nail for treating intertrochanteric fractures according to claim 4, wherein the pressure nail (2) and the tension nail (3) are provided with compression threads at their front ends.
6. The conformable nail for the treatment of intertrochanteric fractures according to claim 5, characterized in that the tension nail (3) is in threaded engagement with the intramedullary nail (1).
7. The conformable nail for the treatment of intertrochanteric fractures according to claim 6, characterized in that the lower end of the intramedullary nail (1) is tapered.
8. The conformable nail for treating intertrochanteric fracture according to any one of claims 4-7, characterized in that the intramedullary nail (1) is provided at its upper end with a lifting top cap (5), the lifting top cap (5) comprises a lifting handle (5-1), a cover body (5-2) and two hooks (5-4), the cover body (5-2) is a box body with an open bottom, the lifting handle (5-1) is mounted on the top of the cover body (5-2), the hook handles of the two hooks (5-4) are inserted into the cover body (5-2) from the bottom opening of the cover body (5-2), the hooks respectively correspond to the slots (1-3) on the inner walls of the two sides of the positioning hole (1-1) on the upper end surface of the intramedullary nail (1), the lower portion of the hook is provided with a sliding slope (5-5) corresponding to the inner edge of the opening of the positioning hole (1-1), the middle part of each hook handle is rotatably connected with the cover body (5-2) through a rotating shaft (5-8), and the upper end of each hook handle is connected with the side wall of the cover body (5-2) through a spring (5-3), so that the hook head of each hook (5-4) is clamped into the corresponding clamping groove (1-3) through the elasticity of the spring (5-3).
9. The conformable nail for treating intertrochanteric fracture according to claim 8, characterized in that the handle (5-1) is of an n-shaped structure, two straight arms at two sides are inserted into the through hole on the top plate of the cover body (5-2) and are slidably connected with the top plate, and the lower ends of the straight arms are provided with anti-dropping limit plates (5-7).
10. The shape-adaptive nail for treating intertrochanteric fracture according to claim 8 or 9, characterized in that the bottom of the cover body (5-2) is provided with a boss (5-6) corresponding to a positioning notch (1-2) on the wall of a positioning hole (1-1) on the upper end surface of the intramedullary nail (1).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110967890.3A CN113813034A (en) | 2021-08-23 | 2021-08-23 | Conformal nail for treating intertrochanteric fracture |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110967890.3A CN113813034A (en) | 2021-08-23 | 2021-08-23 | Conformal nail for treating intertrochanteric fracture |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN113813034A true CN113813034A (en) | 2021-12-21 |
Family
ID=78923202
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202110967890.3A Withdrawn CN113813034A (en) | 2021-08-23 | 2021-08-23 | Conformal nail for treating intertrochanteric fracture |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN113813034A (en) |
-
2021
- 2021-08-23 CN CN202110967890.3A patent/CN113813034A/en not_active Withdrawn
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Application publication date: 20211221 |