CN115844508A - Anatomical locking steel plate for minimally invasive treatment of humeral fracture - Google Patents

Anatomical locking steel plate for minimally invasive treatment of humeral fracture Download PDF

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CN115844508A
CN115844508A CN202310150314.9A CN202310150314A CN115844508A CN 115844508 A CN115844508 A CN 115844508A CN 202310150314 A CN202310150314 A CN 202310150314A CN 115844508 A CN115844508 A CN 115844508A
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steel plate
hole
universal
minimally invasive
distal end
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CN202310150314.9A
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CN115844508B (en
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陈晓斌
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Beijing Tongren Medical Technology Co ltd
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Beijing Tongren Hospital
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Abstract

The invention discloses an anatomical locking steel plate for minimally invasive treatment of humeral fracture, which comprises a proximal end part and a distal end part which are integrally formed and connected with each other, wherein the distal end part is gradually twisted from a joint with the proximal end part to form an included angle of 3~8 degrees with a plane where the proximal end part is located, a plurality of first threaded holes are formed in the proximal end part, a first screw is screwed in each first threaded hole in a matching manner, a plurality of universal holes are formed in the distal end part, and a second screw is screwed in each universal hole in a matching manner. The safe distance between the steel plate and the radial nerve is increased by the torsion of the steel plate, the risk of injury in the operation is reduced, and the anatomical locking steel plate for minimally invasive treatment of humeral fracture can be matched with an orthopedic operation robot to perform bone reduction operation, so that the reduction accuracy is high.

Description

Anatomical locking steel plate for minimally invasive treatment of humeral fracture
Technical Field
The invention belongs to the technical field of medical instruments, and relates to a single-layer reticulated shell structure. More particularly, the present invention relates to an anatomical locking plate for minimally invasive treatment of humeral fractures.
Background
Humeral shaft fractures are common injuries of upper limbs, and when humeral fracture is treated by incision reduction and internal fixation, the currently adopted common steel plate has some problems: firstly, compared with the back side of the humerus, the front proximal section of the humerus is straight, but the middle and distal ends are very special in anatomical form, the middle and distal ends are triangular, a coronary fossa is arranged in front of the distal end, and a olecranal fossa is arranged behind the distal end, so that the steel plate is not easy to place when being simply inserted from the front; secondly, under the condition that the matching degree of the steel plate shape and the special anatomical shape of the humeral shaft is too large, the loss of fracture reduction after fixation can be caused, and the functional recovery of the upper limb can be influenced by the over stimulation of the steel plate to the soft tissues such as muscles, blood vessels, nerves and the like in front of the humerus; thirdly, in order to solve the matching problem, the current locking steel plate needs to be bent in the operation to enable the locking steel plate to be approximately matched with the special anatomical structure in front of the humerus, but the problem exists that the steel plate of the upper arm is thick, long time and good skill are needed for achieving a good bending effect in the operation, and the operation time and the operation difficulty are increased; fourthly, the locking nail holes of the steel plate deform in the bending and adjusting processes, the strength of the steel plate is obviously reduced, the biomechanical strength of the steel plate is influenced, the fixing stability is influenced, and hidden dangers are left for subsequent rehabilitation function exercises; fifthly, after the far end of the steel plate is bent, the far end is matched with the special anatomical structure of the far end of the humerus, but the bending of the steel plate can enable the walking position of the steel plate to be closer to that of the radial nerve, and the possibility of causing iatrogenic injury of the radial nerve in the steel plate implantation process can be increased; sixth, the conventional straight LCPs used for the spiral fracture of the middle or lower humerus have the defects of large diameter of the fixable holes at the fracture distal end and small number of holes, and are not in good agreement with the anatomical characteristics that the bone of the lateral surface of the distal humerus is relatively thin and the anterior and posterior sides of the bone have a convex crown and a concave olecranon, which easily causes insufficient fixation strength or internal fixation failure caused by iatrogenic fracture and the like.
A shallow groove which is called a radial nerve groove and is inclined from inside to top and downward to outside is arranged behind the far end in the humerus body, the radial nerve passes along the groove, when the fixation treatment is carried out in a reduction steel plate for cutting humeral fracture, the radial nerve needs to be isolated, and the fixation is carried out by passing through the steel plate below the radial nerve, so that iatrogenic radial nerve injury is easily caused. In addition, the existing straight steel plate must pass under the radial nerve, and the steel plate and the radial nerve are easy to generate friction to cause injury. For example, in patent publication No. CN 215384536U, an arched steel plate for use in crossing the radial nerve of the humerus is disclosed.
In addition, in order to allow the locking screw implanted in the steel plate to have an optimal fixation effect, it is required that the locking screw must be implanted in a bone in a specific direction; due to the differences of broken parts of the fracture and the shape of bones among different individuals, in clinical application, the locking steel plate screw system often has the contradiction that the set implantation direction between the locking screw and the steel plate is inconsistent with the optimal implantation direction, and the operation effect is influenced. For example, patent No. 201310244223.8 discloses a pressing cap sliding slot type universal locking femoral condyle steel plate system, which enables a screw and a steel plate to be locked and fixed within a 60-degree range.
Disclosure of Invention
An object of the present invention is to provide an anatomical locking steel plate for minimally invasive treatment of humerus fracture, which has a simple structure, matches with a special anatomical structure of a distal radius, and the twisted part avoids the radial nerve, thereby reducing the risk of iatrogenic injury of the radial nerve during implantation of the steel plate.
To achieve these objects and other advantages and in accordance with the purpose of the invention, as embodied and broadly described herein, there is provided an anatomical locking plate for minimally invasive treatment of humeral fracture, comprising a proximal portion and a distal portion integrally connected to each other, wherein the distal portion is gradually twisted from a connection point with the proximal portion to an included angle of 3~8 ° with a plane of the proximal portion, the proximal portion has a plurality of first threaded holes, each of the first threaded holes has a first screw screwed therein, the distal portion has a plurality of universal holes, and each of the universal holes has a second screw screwed therein.
Preferably, the inner wall of universal hole is the hemisphere face shape structure, by the surface of distal end portion to bottom surface the aperture of universal hole reduces gradually, one side week edge that the universal hole lies in the distal end portion surface is provided with a perpendicular inside annular protruding edge that extends, the downthehole activity of universal holds a rotating assembly, rotating assembly is the drum-shaped structure, by the surface of distal end portion to bottom surface rotating assembly's external diameter increases earlier the back and reduces, set up the second screw hole that link up each other between the mutually parallel roof of rotating assembly and the diapire, the second screw matching is soon inserted in the second screw hole.
Preferably, the inner wall of universal hole is provided with many spouts along warp, runner assembly's curved surface outer wall is provided with many first beads along warp, in many first bead one-to-one card embedding many spouts.
Preferably, an annular second protruding ridge is arranged on the outer wall of the curved surface of the rotating assembly along the latitude line, and the outer diameter of the second protruding ridge is larger than the inner diameter of the annular protruding edge of the universal hole.
Preferably, still be provided with a external member in the universal hole, the external member is cydariform annular structure, and its cover is established runner assembly's periphery to hold into with runner assembly in the universal hole, the curved surface outer wall of external member is provided with a third bead along weft, the external diameter of third bead is greater than the internal diameter on the protruding edge of the annular of universal hole.
Preferably, the thickness of the proximal portion is greater than the thickness of the distal portion.
Preferably, the aperture of each first threaded hole is larger than the aperture of each second threaded hole.
The invention at least comprises the following beneficial effects:
firstly, the anatomical locking steel plate for minimally invasive treatment of humeral fracture is provided with a torsion structure at the distal end part, and the structure of the steel plate is matched and attached with a special anatomical structure at the distal end of the humerus, so that the firmness of the fractured bone after reduction is improved;
secondly, the torsion position of the distal part avoids the position of radial nerve walking, so that the risk of radial nerve iatrogenic injury caused in the steel plate implantation process is reduced;
thirdly, the position of the steel plate does not conflict with a positioning point when the surgical robot resets the bone, the steel plate can be matched with the bone surgery robot to perform bone resetting operation, and the resetting accuracy is high;
fourthly, a plurality of universal holes are formed in the distal end part, rotating assemblies are arranged in the universal holes, the angle can be freely adjusted, the screwing angle of the second screw can be conveniently adjusted, the anatomical characteristics that the bone of the outer side surface of the distal humerus is relatively thin, and a coronal fossa and an olecranal fossa are arranged in the front and at the back of the bone are adapted, and internal fixation failure caused by insufficient fixation strength or iatrogenic fracture and the like is avoided.
Additional advantages, objects, and features of the invention will be set forth in part in the description which follows and in part will become apparent to those having ordinary skill in the art upon examination of the following or may be learned from practice of the invention.
Drawings
FIG. 1 is a schematic structural diagram of one embodiment of the present invention;
FIG. 2 is an exploded view of a gimbal hole according to an embodiment of the present invention;
FIG. 3 is an exploded view of a gimbal hole assembly according to another embodiment of the present invention;
fig. 4 is a partial top view of a distal portion in accordance with one embodiment of the present invention.
Detailed Description
The present invention is further described in detail below with reference to the drawings and the detailed description so that those skilled in the art can practice the invention with reference to the description.
It will be understood that terms such as "having," "including," and "comprising," as used herein, do not preclude the presence or addition of one or more other elements or groups thereof.
It is to be noted that the experimental methods described in the following embodiments are all conventional methods unless otherwise specified, and the reagents and materials described therein are commercially available unless otherwise specified; in the description of the present invention, it should be noted that unless otherwise explicitly stated or limited, the terms "mounted," "connected" and "disposed" are to be construed broadly and can be, for example, fixedly connected, disposed, detachably connected, disposed or integrally connected and disposed. The specific meanings of the above terms in the present invention can be understood in a specific case to those of ordinary skill in the art. The terms "lateral," "longitudinal," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are used in the orientation or positional relationship indicated in the drawings for convenience in describing the invention and to simplify the description, and do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus should not be construed as limiting the invention.
As shown in fig. 1 and 4, the invention provides an anatomical locking steel plate for minimally invasive treatment of humeral fracture, which comprises a proximal portion 100 and a distal portion 200 that are integrally formed and connected with each other, wherein the distal portion 200 is gradually twisted from a connection point with the proximal portion to a plane where the proximal portion 100 is located, the plane forms an included angle of 3~8 degrees with the plane, a plurality of first threaded holes 101 are formed in the proximal portion 100, a first screw is screwed into each first threaded hole 101 in a matching manner, a plurality of universal holes 201 are formed in the distal portion 200, and a second screw is screwed into each universal hole 201 in a matching manner.
In the technical scheme, the anatomical locking steel plate for minimally invasive treatment of humeral fracture is provided with a proximal portion 100 and a distal portion 200, the proximal portion 100 is attached to the proximal end of the humerus, the distal portion 200 is gradually twisted to be attached to the middle and distal ends of the humerus in a matching manner, an included angle between the planes of the tail end of the distal portion 200 and the proximal portion 100 is 3~8 degrees, the proximal portion 100 is provided with a plurality of first threaded holes 101, each first threaded hole 101 is connected with a first screw in a matching and screwing manner to fix the proximal portion 100 and the proximal end of the humerus, the distal portion 200 is provided with a plurality of universal holes 201, and a second screw is connected in each universal hole 201 in a matching and screwing manner. Compared with a common steel plate used in the prior art, the humerus fracture fixation device needs to be manually bent in an operation, the proximal end portion 100 and the distal end portion 200 are matched and attached with the special anatomical form of the humerus in the technical scheme, so that the steel plate is convenient to implant, the over stimulation of the steel plate to soft tissues such as muscles, blood vessels and nerves in front of the humerus is reduced, the function recovery of upper limbs is facilitated, the biomechanical strength of the steel plate is high, and the fixation stability of the fracture is good; the bending of the distal end part 200 avoids the radial nerve walking position, so that the risk of radial nerve iatrogenic injury caused in the steel plate implantation process is reduced; the distal end part 200 is twisted and bent in advance and then punched, so that the problems of deformation of a threaded hole, reduction of strength of a steel plate and the like caused in the process of bending and adjusting the steel plate in the operation are solved; the position of the anatomical locking steel plate for minimally invasive treatment of humerus fracture in the technical scheme does not conflict with the positioning point of the surgical robot when the bone is reset, the anatomical locking steel plate can be matched with the bone surgery robot to perform bone resetting operation, and the resetting accuracy is high.
As shown in fig. 1 and fig. 4, in other technical solutions, an inner wall of the universal hole 201 is a hemispherical structure, a diameter of the universal hole 201 gradually decreases from a surface of the distal end portion 200 to a bottom surface of the universal hole, a circumferential edge of one side of the universal hole 201 on the surface of the distal end portion 200 is provided with an annular convex edge 202 extending vertically inward, a rotating assembly 203 is movably accommodated in the universal hole 201, the rotating assembly 203 is in a drum-shaped structure, an outer diameter of the rotating assembly 203 increases and then decreases from the surface of the distal end portion 200 to the bottom surface, a second threaded hole 204 penetrating through the rotating assembly 203 is formed between a top wall and a bottom wall parallel to each other, and the second screw is matched and screwed into the second threaded hole 204.
In the technical scheme, a rotating assembly 203 is movably arranged in each universal hole 201, a second threaded hole 204 is formed in the rotating assembly 203, and a second screw is screwed into each second threaded hole 204 in a matching manner to fix the distal end portion 200 and the distal end of the humerus. The inner wall of universal hole 201 is the hemisphere face, and its one end that is located distal end portion 200 surface is big aperture end, and the one end that is located distal end portion 200 bottom surface is small aperture end, has big aperture end to small aperture end, and the change law in aperture accords with the change law that spherical structure sphere is little round, runner assembly 203 is the drum-shaped structure, and the diameter of its tangent plane changes according to the law that reduces after increasing earlier, a second screw hole 204 has been seted up along the axis on the runner assembly 203, and the both ends of second screw hole 204 correspond with big aperture end, small aperture end of universal hole 201 respectively, but runner assembly 203 sets up suitably rotates in universal hole 201 to the direction of adjustment second screw hole 204. When the humerus fracture fixation instrument is used, the skin of the humerus fracture position is cut, blood clots are cleared, a fracture block is reset, the proximal end portion 100 of the anatomical locking steel plate for minimally invasive treatment of humerus fracture is placed at the proximal end of the humerus, the distal end portion 200 is attached to the distal end of the humerus in a surrounding mode, a first screw is screwed into the first threaded hole 101 of the proximal end portion 100 for fixation, the distal end of the humerus is seen through, the optimal implantation direction is determined, a preset hole is formed in the distal end of the humerus according to the optimal implantation direction, a second screw is screwed into the second threaded hole 204, after the implantation direction of the screws is adjusted, the screws are continuously screwed in, so that the second screw penetrates out of the small-bore end of the universal hole 201 and is screwed into the corresponding preset hole for fixation. The maximum diameter of the rotating assembly 203 is smaller than the diameter of the large-aperture end of the universal hole 201 and larger than the diameter of the small-aperture end of the universal hole 201, so that the rotating assembly 203 can rotate in the universal hole 201 conveniently, the angle range between the second threaded hole 204 and the humerus is enlarged, the position of the rotating assembly 203 is adjusted, the angle between the second threaded hole 204 and the humerus is adjusted, the anatomical characteristics that the bone on the far-end outer side surface of the humerus is relatively thin and the front side and the rear side of the bone are provided with a coronoid fossa and an olecranal fossa respectively are adapted, the optimal implantation direction can be selected according to the fracture characteristics and shape differences of different individuals in the operation, the flexibility is high, the operation is convenient, the internal fixation failure caused by insufficient fixation strength or iatrogenic fracture and the like is avoided, and the stability of the steel plate and the bone fixation is improved.
As shown in fig. 2, in other embodiments, the inner wall of the universal hole 201 is provided with a plurality of sliding grooves 210 along a meridian line, the outer wall of the curved surface of the rotating assembly 203 is provided with a plurality of first protruding ridges 211 along the meridian line, and the plurality of first protruding ridges 211 are inserted into the plurality of sliding grooves 210 in a one-to-one correspondence manner. In this technical scheme, the inner wall of universal hole 201 and the outer wall of runner assembly 203 set up many spouts 210 and many first beads 211 of one-to-one, make runner assembly 203 can follow arbitrary spout and rotate in universal hole 201, and then the angle of second screw hole 204 on the adjustment runner assembly 203, improve the structure flexibility.
In other embodiments, as shown in fig. 3, the curved outer wall of the rotating member 203 is provided with a second circular rib 220 along the weft, and the outer diameter of the second circular rib 220 is greater than the inner diameter of the circular flange 202 of the universal hole 201. In this technical scheme, be provided with annular second bead 220 on the runner assembly 203, its external diameter is greater than the universal hole 201 week along the internal diameter of annular protruding edge 202, prevents runner assembly 203 slippage universal hole 201, improves structural stability.
As shown in fig. 3, in other technical solutions, a sleeve 221 is further disposed in the universal hole 201, the sleeve 221 is a drum-shaped annular structure, and is sleeved on the outer periphery of the rotating component 203 and accommodated in the universal hole 201 together with the rotating component 203, an annular third protruding rib 222 is disposed on a curved outer wall of the sleeve 221 along a weft, and an outer diameter of the third protruding rib 222 is greater than an inner diameter of the annular protruding edge 202 of the universal hole 201. In the technical scheme, a sleeve 221 is arranged between the universal hole 201 and the rotating assembly 203, the sleeve 221 can rotate in the universal hole 201, and the rotating assembly 203 can rotate in the sleeve 221, so that the angle adjusting range of the second screw is enlarged; and the outer diameter of the third convex ridge 222 is larger than the inner diameter of the annular convex edge 202, so that the sleeve 221 is prevented from slipping out of the universal hole 201, and the structural stability is improved.
In other embodiments, the proximal portion 100 has a thickness greater than a thickness of the distal portion 200. In the technical scheme, the thickness of the proximal portion 100 is different from that of the distal portion 200, so that the humerus anatomical characteristics are met, and the firmness of the steel plate and the fracture position is improved.
In other embodiments, the diameter of each first threaded hole 101 is greater than the diameter of each second threaded hole 204. In the technical scheme, the diameters of the threaded holes of the proximal part 100 and the distal part 200 are different, so that the anatomical characteristics that the bone on the outer lateral surface of the humerus is relatively thin and the anterior and the posterior parts of the bone are respectively provided with the acromion fossa and the olecranal fossa are met, and the internal fixation failure caused by insufficient fixation strength or iatrogenic fracture and the like is effectively avoided.
While embodiments of the invention have been described above, it is not limited to the applications set forth in the description and the embodiments, which are fully applicable in various fields of endeavor to which the invention pertains, and further modifications may readily be made by those skilled in the art, it being understood that the invention is not limited to the details shown and described herein without departing from the general concept defined by the appended claims and their equivalents.

Claims (7)

1. The anatomical locking steel plate for minimally invasive treatment of humeral fracture is characterized by comprising a proximal end portion and a distal end portion which are integrally formed and connected, wherein the distal end portion is gradually twisted from a joint to a plane where the proximal end portion is located to form an included angle of 3~8 degrees, the proximal end portion is provided with a plurality of first threaded holes, each first threaded hole is internally matched and screwed with a first screw, the distal end portion is provided with a plurality of universal holes, and each universal hole is internally matched and screwed with a second screw.
2. The anatomical locking steel plate for minimally invasive treatment of humeral fracture according to claim 1, wherein an inner wall of the universal hole has a hemispherical structure, the diameter of the universal hole gradually decreases from the surface of the distal end portion to the bottom surface, a vertical and inward extending annular convex edge is disposed on a side circumference of the universal hole on the surface of the distal end portion, a rotating assembly is movably accommodated in the universal hole, the rotating assembly has a drum-shaped structure, the outer diameter of the rotating assembly increases from the surface of the distal end portion to the bottom surface and then decreases, a second threaded hole which is mutually communicated is formed between the top wall and the bottom wall of the rotating assembly, which are parallel to each other, and the second screw is matched and screwed into the second threaded hole.
3. The anatomical locking steel plate for minimally invasive treatment of humeral fracture according to claim 2, wherein the inner wall of the universal hole is provided with a plurality of sliding grooves along a meridian, the curved outer wall of the rotating assembly is provided with a plurality of first ribs along the meridian, and the plurality of first ribs are correspondingly inserted into the plurality of sliding grooves one to one.
4. The anatomical locking plate for minimally invasive treatment of a humeral fracture according to claim 2, wherein the curved outer wall of the rotation member is provided with a second annular rib along a latitude line, and an outer diameter of the second rib is larger than an inner diameter of the annular convex edge of the universal hole.
5. The anatomical locking steel plate for minimally invasive treatment of humeral fracture according to claim 4, wherein a sleeve is further disposed in the universal hole, the sleeve is a drum-shaped annular structure, the sleeve is sleeved on the outer periphery of the rotating assembly and is accommodated in the universal hole together with the rotating assembly, an annular third protruding rib is disposed on a curved outer wall of the sleeve along a weft, and an outer diameter of the third protruding rib is larger than an inner diameter of an annular convex edge of the universal hole.
6. The anatomical locking plate for minimally invasive treatment of a humeral fracture according to claim 1, wherein a thickness of the proximal portion is greater than a thickness of the distal portion.
7. The anatomical locking plate for minimally invasive treatment of a humeral fracture according to claim 1, wherein an aperture of each first threaded hole is larger than an aperture of each second threaded hole.
CN202310150314.9A 2023-02-22 2023-02-22 Anatomical locking steel plate for minimally invasive treatment of humeral fracture Active CN115844508B (en)

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CN204814131U (en) * 2015-04-16 2015-12-02 闻泰医疗科技(上海)有限公司 Universal locking system of skeleton internal fixation
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CN207613856U (en) * 2017-05-17 2018-07-17 无锡市闻泰百得医疗器械有限公司 A kind of universal lock mechanism and proximal humerus bone plate
CN207613857U (en) * 2017-05-17 2018-07-17 无锡市闻泰百得医疗器械有限公司 Medial distal tibia Universal locking fracture bone plate
CN209474772U (en) * 2018-09-19 2019-10-11 上海三友医疗器械股份有限公司 Spinal internal fixation system
CN211468343U (en) * 2019-12-30 2020-09-11 合肥一辂汽车科技有限公司 Universal hole plug
CN114869439A (en) * 2022-05-05 2022-08-09 张志忠 Tibia full-section anatomical locking plate type external fixing frame

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102005004841A1 (en) * 2004-12-30 2006-07-13 Königsee Implantate und Instrumente zur Osteosynthese GmbH Osteosynthesis plate, for example, radius or humeral head plate, with a variety of holes for receiving bone screws
US20110224736A1 (en) * 2010-03-09 2011-09-15 Humphrey C Scott Proximal humerus fracture repair plate and system
CN101884564A (en) * 2010-07-21 2010-11-17 青岛大学医学院附属医院 Orthopedic assembly type steel plate screw fixing system
CN203291002U (en) * 2012-09-07 2013-11-20 首都医科大学宣武医院 Atlantoaxial dislocation reduction internal fixation device
CN203483496U (en) * 2013-10-09 2014-03-19 天津正天医疗器械有限公司 Combined type compound hole universal locking bone plate
WO2016006653A1 (en) * 2014-07-09 2016-01-14 国立大学法人名古屋大学 Locking plate system for treatment of fracture of distal radius
CN204814131U (en) * 2015-04-16 2015-12-02 闻泰医疗科技(上海)有限公司 Universal locking system of skeleton internal fixation
CN105030316A (en) * 2015-08-24 2015-11-11 苏州市康力骨科器械有限公司 Multidirectional locking steel plate for proximal humerus
CN105796169A (en) * 2016-05-11 2016-07-27 中国人民解放军第三〇七医院 Humerus trailing edge torsion dissection steel plate
CN207613856U (en) * 2017-05-17 2018-07-17 无锡市闻泰百得医疗器械有限公司 A kind of universal lock mechanism and proximal humerus bone plate
CN207613857U (en) * 2017-05-17 2018-07-17 无锡市闻泰百得医疗器械有限公司 Medial distal tibia Universal locking fracture bone plate
CN209474772U (en) * 2018-09-19 2019-10-11 上海三友医疗器械股份有限公司 Spinal internal fixation system
CN211468343U (en) * 2019-12-30 2020-09-11 合肥一辂汽车科技有限公司 Universal hole plug
CN114869439A (en) * 2022-05-05 2022-08-09 张志忠 Tibia full-section anatomical locking plate type external fixing frame

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