CN201223440Y - Three-dimensional dissection type anterior steel plate for acetabulum - Google Patents

Three-dimensional dissection type anterior steel plate for acetabulum Download PDF

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CN201223440Y
CN201223440Y CNU2008201215693U CN200820121569U CN201223440Y CN 201223440 Y CN201223440 Y CN 201223440Y CN U2008201215693 U CNU2008201215693 U CN U2008201215693U CN 200820121569 U CN200820121569 U CN 200820121569U CN 201223440 Y CN201223440 Y CN 201223440Y
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plate
alate
blade
inner
outer
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CNU2008201215693U
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宏 傅
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宏 傅
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Abstract

The utility model relates to a steel plate used for reduction of the fracture, in particular to three-dimensional anatomical acetabulum anterior steel plates suitable for composite acetabular fracture. The steel plate comprises an upper inner alate plate, an upper outer alate plate, a lower alate plate and a baffle, wherein the upper inner alate plate and the lower alate plate is integrally aligned with the lower alate plate, the upper outer alate plate extends outwards, an acute angle is formed between the upper inner alate plate and the upper outer alate plate, the baffles are respectively positioned on one side of the upper inner alate plate and the lower alate plate, and the steel plate integrally presents a Y shape; a plurality of screw holes are formed on the upper inner alate plate, the upper outer alate plate and the lower alate plate, and the radians of the plate bodies of the upper inner alate plate; the upper outer alate plate and the lower alate plate are matched with the anatomical shape of an acetabular pelvic surface. The utility model has the advantages of accordance with the anatomical shape of the anatomical pelvic surface, firm and stable position and small surgical injury.

Description

三维解剖型髋臼前路钢板 Three-dimensional anatomical acetabular anterior plate

技术领域 FIELD

本实用新型涉及一种骨折复位用钢板,尤其是一种适用于复合型髋臼骨折的三维解剖型髋臼前路钢板。 The present invention relates to a steel sheet fractures, particularly suitable for complex three-dimensional anatomical acetabular fractures acetabular anterior plate. 背景技术 Background technique

临床上,髋臼复合型骨折常因部位深在、骨质菲薄、紧邻关节,周围有软组织及临近腹腔脏器等因素,使得复位与固定均十分困难,在手术入路中,有报道经髂腹股沟入路治疗能有效治疗一部分复合型骨折,然而目前由于内固定不当所致的髋臼骨折复位丢失的报道日益增多,因此髋臼骨折的有效内固定是进一步提高骨折治疗的关键。 Clinically, complex acetabular fractures often result in deep parts, bone thin, close to the joints, and soft tissue around near the abdominal viscera and other factors, making the reduction and fixation are very difficult, in surgical approaches, there are reports by the iliac inguinal approach therapy is effective in treating part of a compound fracture, but now due to improper fixed within the acetabular fractures caused by the loss of coverage increasing, so the effective internal fixation of acetabular fractures is the key to further improve the treatment of fractures.

髋臼复合型骨折是强暴力作用于股骨头与髋臼之间的结果,手术时要求尽可能解剖复位,早期功能锻炼,以减少远期并发症的发生。 Acetabular fractures are the result of complex rape force acts between the femoral head and the acetabulum, as required anatomical reduction, early exercise, in order to reduce long-term complications of the surgery. 但对于复杂的髋臼骨折, 尤其是涉及臼顶区、髋臼内壁部的粉碎骨折,由于髋臼周围常因有大量坚强的肌肉及韧带牵拉,因此导致手术复位较困难,而且由于髋臼的臼顶部、内壁较薄, 常用的平行于四方区的螺钉放置较为困难,螺钉易误入关节腔或盆腔,造成手术失败或产生严重的合并症,即使达到解剖复位,远期亦有复位丢失的危险。 However, for complex fracture, in particular, to acetabular roof area, the inner wall portion of the acetabular comminuted fracture, often due to the surrounding acetabular strong due to a large number of muscles and ligaments stretch, thus resulting in a reset operation more difficult, and because of the acetabulum top mortar, thin inner wall, commonly placed parallel to the screw is difficult Sifang, screw or pelvic joint cavity easily diverted, causing operation failure or serious complications, even if the anatomic reduction, also the long-term loss of reduction danger. 并且, 当髋臼粉碎骨折较为严重时,螺钉固定几乎无法完成。 And, when the acetabular comminuted fracture more serious, almost impossible to complete screw fixation. 因此设计符合局部解剖的内固定物极为重要。 Therefore, the design of internal fixture topography is extremely important.

张春才等(参考文献[l]、 [2])曾设计了用于治疗髋臼骨折的记忆合金三维内固定系统。 Zhang only (Reference [l], [2]) has a three-dimensional design of the shape memory alloy fixation system for treating acetabular fractures. 该系统依据髋臼解剖学特点与镍钦合金的特性研制而成,术后随访优良率达92.68%。 The system is based on the characteristics developed from the acetabular anatomy and nickel-titanium alloy, and excellent postoperative follow-up rate was 92.68%. 但该系统力求适用于所有类型的髋臼骨折,而临床中的许多情况,常需要组合使用,这增加了手术难度,也增加了手术创伤的机会;且该系统采用的镍饮合金材料,虽然在力学性能上具有较多优点,但其形体的可塑性有一定限度且较难掌控;同时该系统缺乏符合手术固定力学要求的生物力学实验证据,对于术后早期功能锻炼,缺乏指导依据。 However, the system seeks to apply to all types of fracture, and clinical many cases, often need to be used in combination, which increases the difficulty of operation, but also increases the chance of surgical trauma; and Ni The system uses drink alloy material, although It has a number of advantages in mechanical properties, but there is a limit plasticity body and is difficult to control; at the same time the system is the lack of experimental evidence consistent with the biomechanical fixed mechanical requirements of surgery for early postoperative functional exercise, lack of guidance basis. 再者,纯镍和镍盐有致癌作用,镍钦合金长时间植入人体对机体的影响如何,还需要进一步研究证实。 Moreover, pure nickel and nickel salts are carcinogenic, nickel-titanium alloy implants for a long time how it affects the body on the body, but also confirmed by further studies.

刘云鹏等(参考文献[3])曾设计出三维解剖钢板并用于临床,该"生物型髋臼三维重建钢板"申请了专利号为00255380.5的实用新型专利,在解剖复位, 出血量,手术时间,X线评定,术后功能等方面效果肯定,但是其结果仅依据对研制的内固定器本身作的力学测试及临床病历的总结和临床经验,尚缺乏骨折内 Yunpeng (Reference [3]) has designed a three-dimensional anatomic plates and used clinically, the "biological acetabular reconstruction plate" filed a patent application No. Utility Model Patent No. 00255380.5 in anatomical reduction, blood loss, operation time, X-ray evaluation, postoperative function and other aspects of the effects are, but the results are only based on clinical experience summary and developed itself as a fixed mechanical testing and clinical medical records, lack of fracture

固定模型的力学实验研究且其术中放置相对较为困难。 Model Testing and Mechanical fixed and which is placed relatively difficult surgery. 且其挡板呈带齿状,术中 Toothed belt and which form baffles, intraoperative

极易损伤闭孔动脉、神经,手术损伤较大。 Easily damage the obturator artery, nerve, a large surgical injury.

综上所述,目前对于复合型髋臼骨折,特别合并臼顶部、内壁骨折,临床上 In summary, the present, for complex acetabular fractures, in particular the merger mortar at the top, the inner wall fractures, clinical

还缺乏牢固、稳定的内固定系统,所用的重建钢板及长螺钉并不能提供涉及前后 Lack of strong, stable fixation system used in reconstruction plates and screws do not provide long longitudinal directed

柱联合处、臼顶部及内壁的粉碎骨折的有效固定。 The joint of the column, the top effective fixing comminuted fracture of the acetabulum and an inner wall.

发明内容 SUMMARY

本实用新型所要解决的技术问题是提供一种符合髋臼盆面解剖形态、牢固稳定定位、手术损伤小的三维解剖型髋臼前路钢板。 The present invention is to solve the technical problem is to provide a line with acetabular anatomy basin surface, solid and stable positioning, small surgical trauma dimensional anatomical acetabular anterior plate.

本实用新型解决上述问题所采用的技术方案是:该钢板由上内翼板、上外翼板、下翼板和挡板组成,其中上内翼板和下翼板呈一体的一字形,上外翼板外伸, 上内翼板和上外翼板之间呈锐角,挡板位于上内翼板和下翼板的一侧,钢板整体呈Y字形;上内翼板、上外翼板、下翼板上设有若干螺钉孔,且上内翼板、上外翼板、下翼板的板体弧度与髋臼盆面的解剖形态相匹配。 Aspect of the present invention to solve the above problem is that: the inner sheet by the blade, the outer blade, the blade and the baffle, of which the upper blade and a lower blade was shaped integrally on extending outside the outer flaps, at an acute angle between the inner and outer wing flaps, barrier is located on the inner side of the blade and the lower blade, the overall Y-shaped steel; upper inner flaps, the outer flap , lower wing plate has a plurality of screw holes, and the inner flange, outer flange, and the curvature of the anatomy of the plate bowl surfaces in the acetabular blade matches.

本实用新型所述的挡板的外轮廓呈半圆弧状,并与髋臼内壁凸面相匹配,且 The outer contour of the baffle of the present invention according to a semicircular arc shape, and the inner wall of the acetabular match the convex surface, and

带有15.948°〜18.336°的外凸弧度;挡板与上内翼板、下翼板之间呈夹角。 With convex curvature of 15.948 ° ~18.336 °; baffles inside the blade, the angle between the blade shape. 本实用新型所述上内翼板和上外翼板之间的锐角为30。 The present invention on the acute angle between the flaps and the outer flaps 30. 〜55° 。 ~55 °. 本实用新型所述的上内翼板与骨盆弓状线相匹配、下翼板与髂耻弓相匹配, According to the present invention the upper wing of arcuate line matches the pelvis, with the lower blade to match the iliac arch shame,

两者的外凸弧度为55. 948°〜78. 336° ,曲率半径为35. 056誦〜55. 342mm。 Both the convex arc of 55. 948 ° ~78. 336 °, radius of curvature of 35.056 recite ~55. 342mm. 本实用新型所述挡板与上内翼板、下翼板之间的夹角为45.948°〜58.336 The present invention on the baffle plate and the inner blade, the blade is the angle between the 45.948 ° ~58.336

本实用新型与现有技术相比,具有以下有益效果:该钢板由上内翼板、上外外翼板、下翼板和挡板组成,符合髋臼的解剖特点,钢板的外形与髋臼盆面的不规则解剖形态相匹配,克服了普通骨盆重建钢板的单平面固定的弊端;使用时, 上内、外翼板分别固定髋臼复合型骨折的臼顶(部分前壁)、后壁,下翼板固定耻骨及髋臼内壁,挡板(无螺钉固定)起复位和稳定髋臼四方体部作用,其余均有螺钉孔固定,钢板的档板通过翼板的牵拉,可使骨折端产生足够的加压应力, 间接复位,并保持骨折块间的相对稳定;且手术中无需对髋臼盆面做较大剥离, 只要能将挡板安放至盆面即可,故手术损伤小、出血少。 Present invention compared with the prior art, it has the following advantages: the inner sheet by the blade, the outer outer blade, the blade and the baffle composed, in line with the anatomical characteristics of the acetabulum, the steel sheet shape and acetabulum irregular anatomy basin surface matches, ordinary reconstruction plates overcome the drawbacks of a single fixed plane; use, the inner and outer flaps are fixed to the composite acetabular fractures acetabular roof (front wall portion), a rear wall , the fixed blade and the pubic acetabular wall, baffles (without screws) from reposition and stabilize tetragonal unit acetabular effect, the remaining screw holes are fixed, baffle plate by pulling the wing, can fracture end to generate sufficient compressive stress, indirect reduction, and remained relatively stable between the fracture fragments; and surgery without having to make large basin surface acetabular release so long as a baffle mounted to the bowl surface can, therefore less damage surgery , less bleeding. 附图说明 BRIEF DESCRIPTION

图1为本实用新型的主视图。 Figure 1 is a front view of the novel utility.

图2为图1的俯视图。 Figure 2 is a plan view of FIG. 1.

图3为图1的A—A剖视图。 FIG 3 is a cross-sectional view A-A of FIG. 1.

图4为图1的左视图。 FIG 4 is a left side view of FIG. 1.

图5为图1的B — B剖视图。 5 is FIG. 1 B - B cross-sectional view.

具体实施方式 Detailed ways

参见图1〜图5,本实施例由上内翼板1、上外翼板2、下翼板3和挡板4 组成,其中上内翼板1和下翼板3呈连接为一体的一字形,上外翼板2外伸,上内翼板1和上外翼板2之间呈30。 Referring to FIG. 1 ~ 5, the present embodiment 1 from the inside on the blade, the outer blade 2, blade 3 and the shutter 4, of which the upper blade and the lower blade 3 has an integrally connected to a shape, extending outside the outer blade 2, as a 2 between the inner blade 30 and outer blade 1. 〜55°的锐角,挡板4位于上内翼板1和下翼板3的一侧。 ~55 ° acute angle, the shutter 4 is located on the inner side of the blade 1 and the lower blade 3. 挡板4的外轮廓呈半圆弧状,并与髋臼内壁凸面相匹配,且带有15.948°〜18.336°的外凸弧度,挡板4与上内翼板1、下翼板3之间呈夹角为45.948°〜58.336° 。 The outer contour of the shutter 4 semicircular arc shape, and the inner wall of the acetabular match the convex surface, and the convex arc with the 15.948 ° ~18.336 °, the shutter 4 and the upper wing 1, was sandwiched between the lower blade 3 angle of 45.948 ° ~58.336 °. 钢板整体呈Y字形。 Y-shaped plate integrally. 上内翼板1、上外翼板2、下翼板3 上设有若干螺钉孔5。 The upper wing 1, the outer blade 2, the blade 5 is provided with a plurality of screw holes 3. 上内翼板l、上外翼板2、下翼板3的板体弧度与髋臼盆面的解剖形态相匹配,具体为上内翼板与骨盆弓状线相匹配、下翼板与髂耻弓相匹配,两者的外凸弧度为55.948°〜78.336° ,曲率半径为35.056rnm〜 55. 342咖。 L the upper blade, the outer blade 2, the lower blade plate and the curvature of the anatomy of the acetabular basin surface 3 matches, in particular on the inner flange and the arcuate line matches the pelvis, the iliac blade shame bow match, both the convex arc of 55.948 ° ~78.336 °, radius of curvature 35.056rnm~ 55. 342 coffee. 钢板的材质为钛合金。 Steel plate is made of titanium.

本实用新型临床应用于复合型髋臼骨折,特别是合并、四方体、臼顶部、内壁骨折,并且需采用髂腹股沟入路的骨折时,经髂腹股沟入路显露髋臼骨折区域后,清除骨折块间的淤血块、反转嵌压的筋膜及肌肉组织,根据骨折的范围或骨折线的长度通过裁剪来选择上内翼板l、上外翼板2、下翼板3的孔数,以满足骨折固定的要求。 When the present invention is applied to clinical complex fracture, in particular combined, tetragonal, the top of the acetabulum, an inner wall of the fracture, and requires the use of fractures ilioinguinal, dried ilioinguinal exposed region acetabular fractures, fractures clear congestion block between blocks, inverted entrapment fascia and muscle tissue, is selected by the inner cutting blade according to the length l or fracture of the fracture line, 2, the number of the blade holes of the outer blade 3, to meet the requirements of fracture fixation. 将移位骨块的内缘即盆面,用骨膜剥离子做轻微的剥离后,将钢板的档板4安放入内,使髋臼复位的球形顶锥尖端顶住档板4,用力向外推压 The inner edge of the bone that is shifted basin surface, do minor periosteal stripping After peeling, the inner baffle plate 4 into the safety, so that the spherical top of the cone tip acetabular reset withstand the baffle 4, the force pressing an outer

骨块使其复位,此时钢板的各翼板经弯折后与髂骨、耻骨骨面相吻合,然后逐孔拧入螺钉固定。 Bone reset it, then the steel sheet after each tab is bent and iliac, pubic bone surface coincide, and by a fixing screw screwed into the hole. 对于复合型髋臼骨折,尤其是四方体部骨折,需将该钢板成对使用。 For complex acetabular fractures, especially fractures tetragonal, the steel sheet needs to be used in pairs.

参考文献: references:

[l]张春才,许硕贵,王家林等.髓臼骨折记忆合金三维内固定系统的设计与临床应用.中华骨科杂志,2002, 22 (12) :709-713。 [L] Zhang before, many large expensive, design and application of other Wang Jialin acetabular fracture fixation system of the three-dimensional memory alloy Spine, 2002, 22 (12): 709-713. [2]张春才,许硕贵,禹宝庆,等.应用髋臼三维记忆内固定系(ATMFS)治疗复杂性髋臼骨折及其临床意义.中华创伤杂志,2004, 6(4) :364-368。 [2] Zhang Cai, Xu Shuo expensive, Yu Baoqing, and other applications within the acetabular hip three-dimensional memory fixation system (ATMFS) treatment of complex acetabular fractures and clinical significance of Chinese Journal of Trauma, 2004, 6 (4): 364-368.

[3]刘云鹏,姜俊杰,孙瑞敏等.解剖型髓臼三维重建钢板的研制与临床应用. 中华创伤杂志,2003, 19(9) :559-561。 [3] Liu Yunpeng, Jiang Junjie, Sun Ruimin and other research and clinical application of Chinese Journal of Trauma anatomic acetabular reconstruction steel, 2003, 19 (9): 559-561.

Claims (5)

1、一种三维解剖型髋臼前路钢板,其特征在于:由上内翼板、上外翼板、下翼板和挡板组成,其中上内翼板和下翼板呈一体的一字形,上外翼板外伸,上内翼板和上外翼板之间呈锐角,挡板位于上内翼板和下翼板的一侧,钢板整体呈Y字形;上内翼板、上外翼板、下翼板上设有若干螺钉孔,且上内翼板、上外翼板、下翼板的板体弧度与髋臼盆面的解剖形态相匹配。 1, a three-dimensional anatomical acetabular anterior plate, characterized in that: the inner flap, the outer blade, the blade and the baffle, of which the upper blade and lower blade of the form of a shaped integral , overhanging on the outer flaps, at an acute angle between the inner and outer wing flaps, barrier is located on the inner side of the blade and the lower blade, the overall Y-shaped steel; blade on the inner, outer wing, lower wing plate has a plurality of screw holes, and the inner flange, outer flange, and the curvature of the anatomy of the plate bowl surfaces in the acetabular blade matches.
2、 根据权利要求1所述的三维解剖型髋臼前路钢板,其特征在于:所述的挡板的外轮廓呈半圆弧状,并与髋臼内壁凸面相匹配,且带有15.948°〜18.336 °的外凸弧度;挡板与上内翼板、下翼板之间呈夹角。 2, according to claim dimensional anatomical acetabular anterior plate of claim 1, wherein: the outer contour of the baffle semicircular arc shape, and the inner wall of the acetabular match the convex surface, and with a 15.948 ° ~18.336 ° a convex arc; baffles inside the blade, the angle between the blade shape.
3、 根据权利要求1所述的三维解剖型髋臼前路钢板,其特征在于:所述上内翼板和上外翼板之间的锐角为30。 3, according to claim dimensional anatomical acetabular anterior plate of claim 1, wherein: said inner flaps and outer flaps on the acute angle is between 30. 〜55° 。 ~55 °.
4、 根据权利要求1所述的三维解剖型髋臼前路钢板,其特征在于:所述的上内翼板与骨盆弓状线相匹配、下翼板与髂耻弓相匹配,两者的外凸弧度为55. 948。 4, the three-dimensional anatomical acetabular anterior plate according to claim 1, wherein: said upper wing inner arcuate line matches the pelvis, the iliac blade and bow shame matches both convex arc is 55.948. 〜78. 336° ,曲率半径为35. 056薩〜55. 342mm。 ~78. 336 °, radius of curvature of 35.056 Sa ~55. 342mm.
5、 根据权利要求2所述的三维解剖型髋臼前路钢板,其特征在于:所述挡板与上内翼板、下翼板之间的夹角为45.948。 5, according to claim dimensional anatomical acetabular anterior plate of claim 2, wherein: the angle between the baffle and the upper blade, lower blade is 45.948. 〜58.336° 。 ~58.336 °.
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Cited By (10)

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CN102204841A (en) * 2010-03-30 2011-10-05 李云峰 Special shape locking bone fixing plate of acetabular posterior column or wall fracture
CN102499751A (en) * 2011-10-27 2012-06-20 上海交通大学 Pelvis ala ossis ilii dissection type bone plate
CN102551867A (en) * 2012-01-09 2012-07-11 上海交通大学 Pelvis arcuate line lower edge anatomic bone fracture plate
CN102579123A (en) * 2012-01-09 2012-07-18 上海交通大学 Pelvis arcuate line superior border anatomical bone plate
CN102724927A (en) * 2009-12-11 2012-10-10 斯恩蒂斯有限公司 Mandibular fixation plate
CN103054640A (en) * 2013-01-29 2013-04-24 孙俊英 Combined internal fixation device for reduction of acetabular fractures
CN103385751A (en) * 2012-05-11 2013-11-13 宋文生 Special-shaped bone fracture plate for iliopectineal arch of anterior acetabular column
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US9066767B2 (en) 2009-12-11 2015-06-30 DePuy Synthes Products, Inc. Mandibular fixation plate
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CN102724927A (en) * 2009-12-11 2012-10-10 斯恩蒂斯有限公司 Mandibular fixation plate
US9743967B2 (en) 2009-12-11 2017-08-29 DePuy Synthes Products, Inc. Mandibular fixation plate
CN102204841A (en) * 2010-03-30 2011-10-05 李云峰 Special shape locking bone fixing plate of acetabular posterior column or wall fracture
CN102499751A (en) * 2011-10-27 2012-06-20 上海交通大学 Pelvis ala ossis ilii dissection type bone plate
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CN102551867A (en) * 2012-01-09 2012-07-11 上海交通大学 Pelvis arcuate line lower edge anatomic bone fracture plate
CN103385750A (en) * 2012-05-11 2013-11-13 宋文生 Special-shaped bone fracture plate for iliopectine of anterior acetabular column
CN103385751A (en) * 2012-05-11 2013-11-13 宋文生 Special-shaped bone fracture plate for iliopectineal arch of anterior acetabular column
CN103054640A (en) * 2013-01-29 2013-04-24 孙俊英 Combined internal fixation device for reduction of acetabular fractures
CN104188716A (en) * 2014-07-10 2014-12-10 王钢 Acetabulum parastyle and posterior column united steel plate
EP3023068A3 (en) * 2014-11-19 2016-08-31 Paragon 28, Inc. Bone plates, plate alignment systems, and methods of use
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