Expanding dynamic coxa slip nail-plate
Technical field
This utility model relates to a kind of bone fracture internal fixing device material, is specifically related to a kind of expanding dynamic coxa slip nail-plate that is used for fixing the osteoporotic intertrochanteric fracture.
Background technology
(Schumpelick W, Jantzen PM.A new principle in theoperatuive treatment of trochanteric fractures of the femur.J Bone JointSurg Am 1955 that dynamic coxa slip pegboard systems (DHS) designs for the treatment intertrochanteric fracture specially early than nineteen fifty-five; 37A:693-8.).Its clinical practice in 1964 is seen in bibliographical information (Clawson DK.Trochanteric fractures treated by the sliding screw platefixation method.J Trauma 1964 first; 4:732-52).After this a large amount of research all recommends to adopt DHS treatment intertrochanteric fracture (Doppelt SH.The sliding compressionscrew-today ' s best answer for stabilization of intertrochanteric hipfractures.Orthop Clin North Am 1980; 11 (3): 507-23), DHS has been acknowledged as main internal fixation means (the Moroni A of treatment intertrochanteric fracture at present, Faldini C, Pegreffi F, et al.Dynamic hip screw compared with external fixation fortreatment of osteoporotic intertrochanteric fractures.A prospective, randomized study.J Bone Joint Surg Am 2005; 87:753-9.).Its design principle is that operation is screwed into when the pressurization tail is followed closely and can produces the firm static pressurization in fracture gap, can promote union of fracture by dynamically pressurization between slip generation fracture mutually between the nail-plate when postoperative trouble limb bears a heavy burden.Its structure is as shown in Figure 1: comprising: hip screw 1, dynamic hip screw 2, steel plate screw 3 and pressurization tail nail 4, wherein dynamic hip screw 2: the nail hole of the hip screw 1 of its near-end be designed to steel plate be about 135 degree, six rib hollow pipes in bone, extend a section; Its remote design is restriction contact dynamic compression plate or the locking steel plate that several nail holes are arranged.Hip screw 1: be designed to the thick screw of the about 10mm of diameter that is screwed into along the neck of femur major axis, one section skin of its head end is provided with deep thread or screw wing; Its tail end is hollow outer six prisms, just be 135 and spend the interior six rib hollow pipes that the extend internally socket that is complementary, can slide mutually between the two, but guarantee that it can not rotate relatively with the dynamic hip screw near-end, fracture gap can produce dynamic pressurization during heavy burden, can promote union of fracture.Pressurization tail nail 4: the nail body has fine thread, can be connected mutually with outer six prismatic hollow female threads of dynamic hip screw tail end, in art, tighten pressurization tail nail, can make dynamic hip screw moving to stern skidding in the interior six rib hollow pipes of dynamic hip screw, fracture gap is produced the firm static pressurization.The steel plate screw 3 of far-end: be os integumentale screw or lock screw, by dynamic hip screw far-end bone fixation broken line distal femoral cadre.
But along with it in clinical extensive use, especially the application among the senile osteoporosis intertrochanteric fracture patient, its shortcoming also comes out gradually: under the osteoporosis situation, femoral head and cervical region by the nearly broken ends of fractured bone of the fixing fracture of one piece of hip screw obviously owe firm, because its hold to femoral head and cervical region spongy bone weakens, make fixations such as its resistance to plucking goes out, incompressible and anti-rotation relatively poor (Wang Yicong. B﹠J damages [M]. the 4th edition. Beijing: the People's Health Publisher, 2007.1179-1193); Therefore develop a kind of expanding dynamic coxa slip pegboard systems that can overcome above-mentioned weak point and become an orthopaedics field difficult problem anxious to be solved.
Summary of the invention
The purpose of this utility model be to provide a kind of can support around spongy bone, significantly strengthen the hold of hip screw-bone interface, thereby reach the purpose expanding dynamic coxa slip nail-plate that fixedly secures the osteoporotic intertrochanteric fracture.
For achieving the above object, the technical solution adopted in the utility model is: comprise dynamic hip screw, be provided with six rib hollow pipes in become 135 degree angles with dynamic hip screw in bone, extend a section at the near-end of this dynamic hip screw, the near-end of hip screw is the outer six rib shapes that are complementary with interior six rib hollow pipes, hip screw links to each other by pressurization tail nail with interior six rib hollow pipes, far-end at dynamic hip screw offers the screw hole that adapts with steel plate screw, described hip screw adopts the expanding hip screw, but its far-end offers the screw thread bar of 2-6 elasticity opening and closing.
Expanding hip screw of the present utility model comprises hollow hip screw and drive-in inner core nail, hollow hip screw is divided into the hollow nail bar portion of the outer hexa-prism that tail end matches with interior six rib hollow pipes and hollow thread portion two parts of head end, the internal diameter of the hollow nail bar portion of tail end is greater than hollow thread portion internal diameter, and hollow nail bar portion offers female thread, on the tube wall of hollow thread portion, vertically equidistantly offer 2-6 groove, but form the screw thread bar of 2-6 elasticity opening and closing, drive-in inner core nail is divided into the nail bar portion of tail end and the circular cone tip of head end, and the tail end of nail bar portion offers the external screw thread that matches with hollow nail bar portion female thread.
Expanding hip screw of the present utility model comprises hollow hip screw and lifts type inner core nail, hollow hip screw is divided into the hollow nail bar portion of the outer hexa-prism that tail end matches with interior six rib hollow pipes and hollow thread portion two parts of head end, the internal diameters of hollow nail bar portion and hollow thread portion etc. are thick, and hollow nail bar portion offers female thread, on the tube wall of hollow thread portion, vertically equidistantly offer 2-6 groove, but form the screw thread bar of 2-6 elasticity opening and closing, lift type inner core nail and be divided into the nail bar portion of tail end and the spindle portion of head end, the tail end of nail bar portion offers the external screw thread that matches with hollow nail bar portion female thread.
Hip screw of the present utility model adopts the expanding hip screw, but its far-end offers the screw thread bar of 2-6 elasticity opening and closing, the screw thread bar expands outwardly during use, spongy bone around the support, significantly strengthen the hold of hip screw-bone interface, thereby reach the purpose that fixedly secures the osteoporotic intertrochanteric fracture.
Description of drawings
Fig. 1 is the structural representation of traditional motive power hip slip nail-plate;
Fig. 2 is an overall structure sketch map of the present utility model;
Fig. 3 is the structural representation of this utility model embodiment 1 expanding hip screw;
Fig. 4 is the structural representation of this utility model embodiment 1 inner core nail;
Fig. 5 is the working state figure of this utility model embodiment 1 expanding hip screw;
Fig. 6 is the structural representation of this utility model embodiment 2 expanding hip screws;
Fig. 7 is the working state figure of this utility model embodiment 2 expanding hip screws.
The specific embodiment
Below in conjunction with accompanying drawing structural principle of the present utility model and operation principle are described in further detail.
Embodiment 1: referring to Fig. 2-5, this utility model comprises dynamic hip screw 2, be provided with six rib hollow pipes 13 in 2 one-tenth 135 degree of dynamic hip screw angle in bone, extend one section at the near-end of this dynamic hip screw 2, the near-end of hip screw 1 is the outer six rib shapes that are complementary with interior six rib hollow pipes 13, hip screw 1 links to each other by pressurization tail nail 4 with interior six rib hollow pipes 13, far-end at dynamic hip screw 2 offers the screw hole that adapts with steel plate screw 3, described expanding hip screw 1 comprises hollow hip screw 5 and drive-in inner core nail 6, hollow hip screw 5 is divided into the hollow nail bar portion 7 of the outer hexa-prism that tail end matches with interior six rib hollow pipes 13 and hollow thread portion 8 two parts of head end, the internal diameter of the hollow nail bar portion 7 of tail end is greater than hollow thread portion 8 internal diameters, and hollow nail bar portion 7 offers female thread, on the tube wall of hollow thread portion 8, vertically equidistantly offer 2-6 groove, but form the screw thread bar of 2-6 elasticity opening and closing, drive-in inner core nail 6 is divided into the nail bar portion 9 of tail end and the circular cone tip 10 of head end, and the tail end of nail bar portion 9 offers the external screw thread that matches with hollow nail bar portion 7 female threads.
In the drive-in inner core is followed closely the tube chamber that 6 ecto-entads insert hollow hip screw 5, the drive-in inner core is followed closely 2-6 screw thread bar will pushing hollow hip screw 5 head end threaded portions 8 in 6 circular cone tips 10 and is expanded outwardly, spongy bone around the support, significantly strengthen the hold of hip screw-bone interface, thereby reach the purpose that fixedly secures the osteoporotic intertrochanteric fracture.
Embodiment 2, referring to Fig. 2,6,7, expanding hip screw 1 of the present utility model comprises hollow hip screw 5 and lifts type inner core nail 11, hollow hip screw 5 is divided into the hollow nail bar portion 7 of the outer hexa-prism that tail end matches with interior six rib hollow pipes 13 and hollow thread portion 8 two parts of head end, the internal diameters of hollow nail bar portion 7 and hollow thread portion 8 etc. are thick, and hollow nail bar portion 7 offers female thread, on the tube wall of hollow thread portion 8, vertically equidistantly offer 2-6 groove, but form the screw thread bar of 2-6 elasticity opening and closing, lift type inner core nail 11 and be divided into the nail bar portion 9 of tail end and the spindle portion 12 of head end, the tail end of nail bar portion 9 offers the external screw thread that matches with hollow nail bar portion 7 female threads.Other annexation is with embodiment 1.
Lift from inside to outside when lifting type inner core nail 11 tube chambers by hollow hip screw 5, the type inner core of lifting is followed closely 11 spindle portions 12 and will be pushed 2-6 screw thread bar of hollow hip screw 5 head end threaded portions 8 and expand outwardly, support is spongy bone on every side, significantly strengthens the hold of hip screw-bone interface.Thereby reach the purpose that fixedly secures the osteoporotic intertrochanteric fracture.
Use of the present utility model is as follows:
1) reduction of the fracture: intertrochanteric fracture is carried out closure or open reduction.
2) pierce guide pin: after perspective confirms that the reduction of the fracture is satisfied, pierce guide pin to the femoral head about 0.5cm along the neck of femur direction.
3) bore bone road, depth measurement, tapping, be screwed into expanding hip screw 1 along guide pin: perspective drills through the bone road along guide pin with core drill after confirming that the guide pin position is satisfied; Measure the bone road degree of depth with measuring device; With screw tap the bone road is carried out tapping; Be screwed into the expanding hip screw 1 of appropriate length along the bone road.
4) expansion hip screw (only this step is different with traditional power hip slip pegboard systems):
To drive-in expanding hip screw 1: choose appropriate length drive-in inner core nail 6 and insert in the tube chamber of hollow hip screw 5,2-6 the screw thread bar that hollow hip screw 5 head end threaded portions 8 will be pushed in inner core nail tip 10 expands outwardly.
To lifting type expanding hip screw 1: will lift type inner core nail 11 tube chambers and lift from inside to outside by hollow hip screw 5, the type inner core of lifting is followed closely 11 spindle portions 12 and will be pushed 2-6 screw thread bar of hollow hip screw 5 head end threaded portions 8 and expand outwardly, spongy bone around the support, significantly strengthen the hold of hip screw-bone interface, thereby reach the purpose that fixedly secures the osteoporotic intertrochanteric fracture.
5) put dynamic hip screw and being screwed: the outer hexa-prism hollow nail bar portion 7 that six rib hollow pipes in extend a section of dynamic hip screw 2 near-ends is enclosed within expanding hip screw 1 tail end in bone; Dynamic hip screw 2 sections far away are placed the nearly section of the femoral shaft outside, and dynamic hip screw 2 sections far away are fixed near section of femoral shaft with several pieces of screws.
6) pressurization tail nail is installed: the tail that will pressurize nail 4 is connected mutually by the female thread of the outer hexa-prism hollow nail bar portion 7 of its fine thread of following closely body and expanding hip screw 1 tail end, when tightening pressurization tail nail, can make expanding hip screw 1 moving to stern skidding in the interior six rib hollow pipes of dynamic hip screw 2, fracture gap is produced the firm static pressurization.
Eventually the above, expanding dynamic coxa slip pegboard systems designs a kind of expanding hip screw 1 and replaces former hip screw on the basis of motive power hip pegboard systems.This expanding hip screw comprises hollow hip screw 5 and inner core nail.In the drive-in inner core is followed closely the tube chamber that 6 ecto-entads insert hollow hip screw 5, or lift type inner core nail 11 tube chambers and lift from inside to outside by hollow hip screw 5, the drive-in inner core is followed closely 6 circular cone tips 10 or the type inner core of lifting and is followed closely 11 spindle portions 12 and all will push 2-6 screw thread bar of hollow hip screw 5 head end threaded portions 8 and expand outwardly, spongy bone around the support, significantly strengthen the hold of hip screw-bone interface, thereby reach the purpose that fixedly secures the osteoporotic intertrochanteric fracture.