CN1269198A - Femur neck and head fixing screw with interlocking fixation structure - Google Patents

Abstract

A kind of fixation screw for intertrochantor fracture of femur and fracture of neck of fmur is characterized by that the head fixation screw for neck of femur and its head possesses a cross-through hole which is equipped with a fix-locking screw, both screws are formed into a right-angle interlocking form and formed into a rigid structure. The fix-locking screw is inwards and down-obliquely passed trough contralateral cortex of femoral shaft to connect the above-mentioned fixation screw and fix it on the cortex or femoral shaft so as to be able to prevent the head of femur from turning and shifting, and posses excellent fixation and retaining action for collodiaphyseal angle. It features small wound and firm fixation.

Description

An a kind of neck of femur and hold-down screw with interlocking fixed structure

The present invention relates to a kind of medical orthopedic fixation device material.

Femoral intertrochanteric and fracture of femoral neck are comparatively common, and mostly are the old people, and present Therapeutic Method is more.Aspect intertrochanteric fracture, fixation include Maxwell gooseneck boom nail internal fixation, nail-plate internal fixation, slidingtype internal fixation [being mostly the Richard nail], " Y " the type intramedullary pin is fixed, Ender pin internal fixation and exterior fixation bracket are fixing etc.The operative treatment of fracture of femoral neck includes fixationes such as three flanged nail, many nails [pin], forcing screw, also feasible femoral head or total hip joint.

Above-mentioned various operation multipotencys are obtained good effect, but operation technique is complicated relatively and take the operation of length, particularly intertrochanteric fracture, the otch of operation is big, it is hemorrhage many that soft tissue injury reaches more, and exterior fixation bracket is fixing also can to cause the inconvenience that patient lives, and the possibility of pin site infection is also arranged.And the old people often is associated with multiple chronic pathological changes or the organ function sorrow is moved back, the intertrochanteric fracture patient of some body constitution differences gives tolerate surgery and selects traction therapy of bone owing to difficulty, this has just increased the difficulty of nursing aspect, the also normal residual coxa vara deformity that has, more very be easily to cause as decubital ulcer, breathe complication such as the yarn togetherness is dyed, thrombosis, increased patient's mortality rate.

Also have the method treatment of orthopedist on probation many or the fixed this treatment fracture of femoral neck of single screw [pin] slightly fall between fracture, but because the structure that screw [pin] not is not connected and fixed with femoral shaft, moving or swing of screw [pin] appears easily, cause displacement fracture and to femoral neck shaft angle keep and fixing not good enough.

Now adopt the fixation for treatment fracture of femoral neck multipotency of many nails [pin] to obtain good curative effect, the simple advantage of operation is also arranged, but part base of nebk ot femur or the tangible patient of [reaching] osteoporosis also there are postoperative generation displacement fracture to form the possibility of coxa vara.

It is simple to the purpose of this invention is to provide a kind of operation, and femoral neck shaft angle had the good internal fixation screw of fixing and keep effect, only need to do two little otch in its art, the easier rehabilitation of wound minor illness people postoperative, also make patient more acceptant and tolerate surgery treatment, the especially patient of intertrochanteric fracture of old femoral intertrochanteric or fracture of femoral neck.

Its neck of femur of internal fixation screw of the present invention and a hold-down screw part are similar to existing Richard nail, it also is the hold-down screw of a hollow, but one horizontal perforation is arranged at screw head, be installed with another in the perforation and lock screw admittedly, this lock admittedly screw outside the greater trochanter sending down the fishbone by on inwardly down direction pass and be fixed on the offside cortex of femoral shaft, being about to a neck of femur and a hold-down screw is connected and fixed on the femoral shaft, its effect is the same with the steel plate of Richard nail, and two screw shaped become the interlocking shape and between form a rigid structure, prevented the rotation and the sliding transfer of a neck of femur and a hold-down screw, made it have good fixation femoral neck shaft angle.It cooperates special-purpose operation technique apparatus, makes the operation simple and fast.

Below by accompanying drawing the present invention is explained in detail:

Fig. 1 is an axonometric chart of the present invention.

Fig. 2 is longitudinal center's cutaway view of screw among Fig. 1 [10].

Fig. 3 is the schematic perspective view of several main operating apparatuss of the present invention.

Fig. 4 is under the resected femur intertrochanteric fracture state of the present invention and the frontal plane cutaway view of the main operating apparatus that connects.

See Fig. 1 earlier, the present invention locks screw [11] admittedly by the hold-down screw [10] of one piece of femoral head and neck and another piece and forms.The thread segment of screw [10] front end and stage casing and existing Richard nail are same or similar, and visibly different is that a horizontal perforation [13] is arranged on its head [12], is through in this perforation admittedly lock screw [11].The nearly head section diameter of screw [10] slightly increases, its diameter is suitable with 10-13mm, because of one side is that near section born the intensity that maximum stress need be big in the fixing current political situation portion of fracturing, be to allow horizontal perforation [13] have bigger diameter on the other hand, allow the solid lock screw [11] that passes have bigger diameter and intensity.The diameter of horizontal perforation [13] is suitable with 5-8mm, and the longitudinal axis of its longitudinal axis and screw [10] intersects and to be an angle of 90 degrees or near an angle of 90 degrees.Screw [10] is a hollow screw, its hollow hole is a screw [14] at the opening part of its head [12], its edge is an endless tube shape projection [15], projection [15] is inboard other, it also is the nut structure [16] that the near-end of head [12] has another annular projection, its diameter is 13-16mm, there are several [among the figure to be two on it, one of them does not show at offside] breach [17] that is symmetrically distributed, they all are to be used for screw [10] with the accurate involutory of its operating apparatus and be connected, another effect of nut structure [16] is for preventing that head of screw [12] from all entering in the cortical bone, makes screw [10] have the effect of lag screw and is used for pressurization to fracture.Admittedly locking the diameter of screw [11] is 5-8mm, length is 60-90mm, be advisable can pass an offside cortical bone 5mm left side, its head also has the nut [18] of an annular projection, be one to be slightly less than the outer-hexagonal header structure [19] of nut [18] on it, make things convenient for the operation of impact wrench to it, nut [18] has the lag screw effect except making solid lock screw [11], prevented in addition outer-hexagonal structure [19] because of cortical bone under the tuberosity block overslaugh impact wrench be inserted in operation.Reduce loosening between two screws for making to have between solid lock screw [11] and the hold-down screw [10] to be connected closely, horizontal perforation [13] with lock admittedly screw [11] through the difference of hole body section diameter should＜0.3mm.

Fig. 2 has shown that screw [10] has a hollow hole [20], and the usefulness of passing guide pin in the art, also having [13] is horizontal perforation, [14]] be structure such as screw.

Find out that by Fig. 3 operating apparatus of the present invention is a part of similar to the Richard nail, and another is partly similar to self-locking nail in the femur marrow.

[21] reaching [22] is two guide pins, and [23] and [24] are respectively the hollow reamer and the screw tap of suitable screw [10].

[25] be the nail holding device of screw [10], in a tubular form, its front end has the internal diameter with annular projection [15] external diameter coupling, and the projection [26] with two breach [17] coupling is arranged, one hollow screw [27] that can be screwed into screw [14] is arranged in the pipe, and it has the head [showing] of interior hexagonal keyhole in pipe.Its rear end jug [28] is used to turn screw [10], and open rearward end also has and screw [10] rear portion structure mutually, and an annular projection [29] is arranged, two breach [30], and screw [31] is used to connect following localizer.

[32] be the localizer of solid lock screw [11], similar to the localizer of the near-end inter-locking screw of existing femoral interlocking intramedullary nail, its connection tube [33] front end all has and the identical syndeton of nail holding device [25], also has one in the pipe

Hollow screw [34] all is used for and being connected of nail holding device [25] open rearward end.Guide pipe [35] links together by arm pipe [36] and connection tube [33], and guide pipe [35] is 90 degree with the line angle of cut of connection tube [33].

[37] be a perforator, the front end of a point is arranged, be used for soft group of puncture perforate of solid lock screw [11].

[38] be a conduit, be used for the guiding of solid lock screw [11] and drill bit [39] thereof, screw tap [40].

[41] be an impact wrench, be used for being screwed into or back-outing of solid lock screw [11].

Also have some common apparatuses, do not draw as Allen key [attacking awl] etc.

[42] are fracture line among Fig. 4, [43] be skin line, screw [10] front end has entered in the femoral head, the upper shed of the some of head of screw [12] and horizontal perforation [13] is kept somewhere under greater trochanter outside the cortical bone, admittedly lock screw [11] passed horizontal perforation [13] downwards diagonal passed the offside cortical bone, and be fixed in the offside cortical bone, and its head is also stayed outside the cortical bone.Also shown being connected between the screw [10] and nail holding device [25], localizer [32] in the art among the figure.

The inclination angle that screw [10] enters is identical with femoral neck shaft angle or close, about about 127 degree, but requires not high relatively.

Screw [11] is a long helicitic texture [not shown], be that it is the flat segments except the part at horizontal perforation [13], following part is helicitic texture entirely, its benefit is that the femur skin side near and offside all has screw thread to adhere to and fixing, but the intensity to screw has certain influence, and the screw tap of its use also makes corresponding changes.

The operating process of operation is as follows: patient lies on the back or lateral position, the traction reduction of the fracture is earlier fixed, the guiding of X line is placed similar to existing single femoral head hold-down screw down, the location is made a skin incision guide pin [21] is pierced neck of femur and head center earlier, in order to prevent that capital rotation displacement in the art from piercing another guide pin [22] at the proximal edge place of neck of femur, getting hollow reamer [23] is inserted in and holes on the guide pin [21] to the appropriate degree of depth of femoral head, be inserted in screw tap [24] tapping again, get and be threaded into the appropriate degree of depth and make its horizontal perforation [13] point to femoral shaft center line or submedial position downwards after nail holding device [25] connects screwing [10] and is inserted in guide pin [21], take out guide pin [21] and [22], refill the localizer [32] of horizontal perforation [13], getting perforator [37] is inserted in guide pipe [35] and thrusts after aligned local skin is made little otch to horizontal perforation [13] and locate, change and be inserted in conduit [38], insert drill bit [39] boring to running through the offside femoral cortex, take out conduit [38] after changing the tapping of insertion screw tap [40], change and lock screw [11] in impact wrench [41] connection admittedly and will lock screw [11] admittedly by guide pipe [35] and pass horizontal perforation [13] and be screwed under inwardly, front end passes the offside cortical bone, sewing up two small incision surgeries finishes, operation in the art is if can use electric drill, and is more convenient quick.

Intensity of the present invention is relevant with the manufactured materials that is adopted, and particularly maximum stress has been born in the junction of two screws [10] and [11].

Horizontal perforation [13] is not 90 degree with the longitudinal axis angle of cut of screw [10] yet, but the angle of guide pipe [35] need be done corresponding adjustment, and screw [10] need turn the direction that each circle horizontal perforation [13] just is fit to guide pipe [35].

Be positioned at and slightly fallen for a short time owing to lock offside femoral shaft cortex that screw [11] passes admittedly, so the present invention is applicable to fracture between slightly falling of exhausted major part.

Claims (12)

1, a kind of inter-locking screw that is used for fixing human femur under loading neck and intertrochanteric fracture is characterized in that entering on the head [12] of hold-down screw [10] of neck of femur and head a horizontal perforation [13] is arranged, and is installed with one and locks screw [11] admittedly on horizontal perforation [13].

2, the described inter-locking screw of root a tree name claim 1, the longitudinal axis angle of cut that it is characterized in that horizontal perforation [13] and screw [10] are 90 degree or near 90 degree.

3, root a tree name claim 1,2 described inter-locking screws, the diameter that it is characterized in that horizontal perforation [13] is 5-8mm.

4, the described inter-locking screw of root a tree name claim 1, the opening part that it is characterized in that screw head [12] are a screw [14].

5, according to claim 1,4 described inter-locking screws, it is levied is that its screw [14] edge is an endless tube shape projection [15].

6, inter-locking screw according to claim 1 is characterized in that head [12] near-end of screw [10] has an annular projection nut structure [16].

7, root a tree name claim 1,6 described inter-locking screws is characterized in that having on the annular projection nut structure [16] breach [17] of two or more symmetrical distributions.

8, the described inter-locking screw of root a tree name claim 1 is characterized in that the head of solid lock screw [11] has the nut structure [18] of an annular projection.

9, according to claim 1, the 8 described screws of locking admittedly, it is characterized in that an outer-hexagonal structure [19] is arranged on the nut structure [18].

10, the described inter-locking screw of root a tree name claim 1, the total length that it is characterized in that solid lock screw [11] is 60-90mm.

11, the described inter-locking screw of root a tree name claim 1 is characterized in that the diameter of horizontal perforation [13] and the poor＜0.3mm through hole section diameter that locks screw [11] admittedly.

12, inter-locking screw according to claim 1 is characterized in that its guide pipe of localizer [30] [33] and the line angle of cut of connection tube [31] are 90 degree.

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