CN209422081U - A kind of tibial intramedullary nailing and merging instrument convenient for merging operation - Google Patents

Abstract

A kind of tibial intramedullary nailing and merging instrument convenient for merging operation, belongs to orthopedic medical device technical field.Its technical solution is: the body of rod of tibial intramedullary nailing is divided into proximal segment, interlude and distal ports, angle between proximal segment axis, distal ports axis and interlude axis is respectively 14 °, 2.1 °, the axis of five locking screw holes in proximal segment and the angle of proximal segment axis are respectively 83 ° 28 ', 96 ° 33 ', 93 °, 90 °, 90 °, and the axis of three locking screw holes in distal ports is formed by plane respectively with proximal segment axis and interlude axis respectively and has 90 °, 58 ° 8 ', 121 ° 6 ' of angle.The utility model breaches the structure of traditional tibial intramedullary nailing, so that proximal tibia Anteroposterior aproach is changed into tibial intramedullary nailing merging, operation will not involve articular cavity in art, and knee joint can be at stretching bit manipulation completely, keep fluoroscopy during operation and operation more convenient, enormously simplifies surgical procedure.

Description

A kind of tibial intramedullary nailing and merging instrument convenient for merging operation

Technical field

The utility model relates to a kind of tibial intramedullary nailings treating fracture of tibia and using, and belong to orthopedic medical device technology neck Domain.

Background technique

Fracture of tibia is fracture common in clinic, is more common in the personnel by bang and wound, traffic accident, eminence fall, It is main cause that weight, which wounds contour Energy Damage,.The therapeutic purposes at fracture initial stage are to reset, reconstruction of stability, while saving blood Liquid supply, enables patient and suffering limb early ambulant.It is common means in treatment that intramedullary nail is placed in after fracture of tibia, and intramedullary nail is adopted With Medullary fixation, fixed axis therefore basically will not produce stress shielding close to the central axis of long bone.In the same of Intramedullary nailing When allowable stress along cortical bone be conducted through fracture site downwards, make it have certain stress to stimulate union.From See that the healing of fracture needs certain stress stimulation on biological point.Cross locking marrow nail uses flexible fastening, both can be real Existing static(al) is fixed, and power may be implemented and fix, and it is a small amount of can to guarantee that fracture end has while reaching sufficiently stable in this way Fine motion is in favor of union.The structure of intramedullary nail with lock designs and modus operandi is all using the anatomic form of bone as foundation 's.Shaft of tibia is in triangular prism shaped, and anterior border of tibia top is sharp thin, and gradually blunt circle, inside and outside two sides are separated by leading edge for middle and lower part.In shin bone Outer two sides platform joint is in saddle type, and normotopia sight is slightly concave, and shin bone knuckle is non-articular surface area between interior outside platform, Herein from the front to the back sequence with ligamentum transversum, medial meniscus anterior angle, anterior cruciate ligament, lateral meniscus anterior angle, shin bone spine, Lateral meniscus relief angle, medial meniscus relief angle and posterior cruciate ligament of knee.Lateral view, platform articular surface are slightly in convex, are integrally moved back, The extended axis of the horse of shin bone pulp cavity stenosis area intersects with platform leading edge, which is also the leading edge of ligamentum transversum, this point and shin bone knot Inclined-plane between section is the conventional into nail position of current intramedullary nail, is non-because it has fat filling under kneecap between ligamentum patellae Functional areas, but it is often difficult into nail, because having a certain degree into nail direction with shin bone pulp cavity stenosis area central axes.By a large amount of Clinical discovery, existing tibial intramedullary nailing have the disadvantage that:

Firstly, use two kinds of approaches when existing tibial intramedullary nailing is placed in, one is when knee sprung position, using entering by kneecap Road and incision kneecap tendon approach；When another kind is that knee joint partly stretches, using approach on kneecap.The former knee joint, which is in, extremely bends Qu Wei, pulls to the side kneecap tendon after kneecap tendon lateral incision or kneecap tendon of directly riving, the center merging intramedullary nail above tibial tubercle. After buckling knee joint, lower section needs to pave shank using bracket or assistant holds, so that fluoroscopy during operation is difficult.Knee joint extreme buckling So that knee joint proximal end is generated lopsided stress, is unfavorable for the replacement and fixation of fractured near end.When entering dataway operation on kneecap, although knee joint In position is partly stretched, C-arm is easier to have an X-rayed in art, also avoids the generation of Proximal tibia fracture deformity, but it needs stringer Quadriceps muscle of thigh is separated, patellofemoral joint is passed through, belongs to joint transluminal operation, expanding the clast that the operations such as marrow generate in art may leave In articular cavity, or even kneed articular cartilage can be damaged.

Secondly, location guide is located in front of shin bone when being placed in conventional intramedullary nails art, and when throwing according to shin bone normotopia X-ray, C Arm needs to give certain tilt angle to avoid guide rod.

Further more, the position of tibial intramedullary nailing far-end locking is usually prismatoidal position in shin bone.In traditional shin bone marrow Compression bar is just pressed on the ridge in front of prismatic in front of nail outrigger, is easy sliding, it is more difficult to operate.

In conclusion current tibial intramedullary nailing is more difficult when being placed in operation, operating difficulty is increased, it is possible to right Kneed articular cavity causes to damage, therefore designs and use when a kind of tibial intramedullary nailing that merging can be facilitated to operate and merging Instrument is very necessary.

Utility model content

The technical problem to be solved by the utility model is to provide a kind of tibial intramedullary nailing convenient for merging operation and mergings Instrument, this tibial intramedullary nailing and merging instrument will not involve articular cavity when being placed in tibial intramedullary nailing, and knee joint can be at Bit manipulation is stretched completely, keeps fluoroscopy during operation and operation more convenient, while the operating position for being placed in instrument does not influence in art to shin Bone positive side position is had an X-rayed, and the operation fixation in art is also more easier to implement.

The technical solution for solving above-mentioned technical problem is:

A kind of tibial intramedullary nailing and merging instrument convenient for merging operation, it includes tibial intramedullary nailing, proximal end diopter, remote Diopter is held, the body of rod of tibial intramedullary nailing is divided into proximal segment, interlude and distal ports, and proximal segment and interlude have bending angle, Interlude and distal ports have bending angle, and in proximal segment, there are five the locking screw holes arranged from top to bottom, there are three distal ports The locking screw holes arranged from top to bottom, improvements are that the angle between the axis of proximal segment and the axis of interlude is 14 °, proximal segment axis and interlude axis are formed by the angle immediately ahead of plane and shin bone between the plane that shin bone is formed It is 42 ° 3 ', the axis and proximal segment axis of five locking screw holes arranged from top to bottom in proximal segment have angle, proximal end respectively The angle of section axis and the axis in the first hole of proximal segment is 83 ° 28 ', with the angle of the axis in the second hole of proximal segment be 96 ° 33 ', Angle with the axis in proximal segment third hole is 93 ° 0 ', the angle point with the axis in the 4th hole of proximal segment and the 5th hole of proximal segment Wei not be 90 °, on the horizontal plane perpendicular to tibial intramedullary nailing body of rod interlude, the axis in proximal segment third hole be the horizontal plane with The intersection for the plane that proximal segment axis and interlude axis are formed, the axis in proximal segment third hole and the axis in the second hole of proximal segment Angle be 42 ° 3 ', the angle of the axis of the axis and the first hole of proximal segment in proximal segment third hole is 43 ° 47 ', proximal segment third The angle of the axis in hole and the axis in the 4th hole of proximal segment and the 5th hole of proximal segment is respectively 89 ° 58 ', and three in distal ports are certainly The axis of the locking screw holes of upper and lower arrangement on the horizontal plane perpendicular to tibial intramedullary nailing body of rod interlude respectively with proximal segment Axis and interlude axis, which are formed by plane, angle, and angle is respectively the axis in the first hole of distal ports perpendicular to proximal segment axis The angle that line and interlude axis are formed by the axis of plane, the axis in the second hole of distal ports and the first hole of distal ports is 58 ° 8 ', the angle of the axis in distal ports third hole and the axis in the first hole of distal ports is 180 ° -58 ° 4 '.

Above-mentioned tibial intramedullary nailing and merging instrument convenient for merging operation, the 4th hole of proximal segment of the tibial intramedullary nailing is Ellipse slide lock hole, oval long axis along proximal segment length direction.

Above-mentioned tibial intramedullary nailing and merging instrument convenient for merging operation, the first hole of distal ports of the tibial intramedullary nailing is Ellipse slide lock hole, oval long axis along distal ports length direction.

Above-mentioned tibial intramedullary nailing and merging instrument convenient for merging operation, the front compression bar of the proximal end diopter operate dress It sets and is located on the extended line of proximal segment overbending direction of tibial intramedullary nailing with the compression bar position of distal end diopter, compression bar position It is opposite with front side of shin bone face respectively.

Above-mentioned tibial intramedullary nailing and merging instrument convenient for merging operation, the arc stent of the proximal end diopter is 3/ 4 semicircles.

The beneficial effects of the utility model are:

Firstly, the tibial intramedullary nailing proximal segment of the utility model and the tilt angle of tibial intramedullary nailing interlude are greater than tradition Tilt angle, and tibial intramedullary nailing proximal segment to immediately ahead of shin bone outside rotate, it is such improvement have the advantage that first is that So that be located at the outer upside of tibial tubercle, the bone on the inside of iliotibial tract stop (Gerdy tubercle) naked for improved tibial intramedullary nailing approach At area, this can allow intramedullary nail nail tail to avoid kneecap tendon, postoperative caused by avoiding because of intramedullary nail nail urogomphus abrasion kneecap tendon Pain before knee；Meanwhile the operative approach in outside partially avoids ramus infrapatellaris nervi sapheni, therefore also effectively prevent caused by neurotrosis Knee pain.Two are easy for intramedullary nail merging pulp cavity, be located at before shin bone due to improved intramedullary nail diopter on the outside of, Bu Huiying Ring take the photograph shin bone just, side position X-ray examination, make fluoroscopy during operation and operation it is more convenient.Third is that using improved tibial intramedullary nailing, art In carry out reset operation when, knee joint can be at stretching bit manipulation completely, make in art using lower limb traction instrument substitution assistant lead Draw and is possibly realized.And all operations are respectively positioned on outside knee joint in improved intramedullary nail art, do not involve articular cavity, therefore it is broken to avoid bone Bits enter articular cavity and intra-articular institutional framework iatrogenic injury, can fundamentally reduce the disease incidence of the pain of the knee joint.

Secondly, the proximal end locking screw hole of improved tibial intramedullary nailing is at the both vertically and horizontally angle of proximal segment axis The proximal end locking screw hole of degree and traditional tibial intramedullary nailing all changes, after change proximal tibia locking screw hole angle, proximal end locking Screw can fix outside mesa-shaped in proximal tibia at good support, and lock screw can be made not penetrate tibial plateau joint Face expands the use scope of tibial intramedullary nailing.

Further more, the front compression bar operating device of proximal end diopter and the compression bar position of distal end diopter are located at shin bone Front side makes the compression bar direction of proximal end diopter and distal end diopter after improving be exactly perpendicular to outer side seam face before shin bone, makes art Fixation easier to operate when middle operation.

In addition, improved tibial intramedullary nailing proximal end diopter arc stent is 3/4 semicircle, in suffering limb straight position The normal lower limb in opposite side can be just avoided when entering tibial intramedullary nailing, reduce accidentally touching bring surgical errors.

The utility model is tibial intramedullary nailing and is placed in the pioneering of instrument, breaches the structure of traditional tibial intramedullary nailing, So that proximal tibia Anteroposterior aproach is changed into tibial intramedullary nailing merging, operation will not involve articular cavity in art, and knee joint can In bit manipulation is stretched completely, keep fluoroscopy during operation and operation more convenient.The utility model breaches traditional thinking, with simple Structure change solve the problems, such as not solve for a long time in tibial intramedullary nailing implantation surgery, enormously simplify surgical procedure mistake Journey has good clinical effectiveness, is worthy of popularization.

Detailed description of the invention

Fig. 1 is the structural schematic diagram of the utility model；

Fig. 2 is the side view of Fig. 1；

Fig. 3 is the locking screw holes axial angle schematic diagram of tibial intramedullary nailing proximal segment；

Fig. 4 is the locking screw holes horizontal direction angle schematic diagram of Fig. 3；

Fig. 5 is the locking screw holes horizontal direction angle schematic diagram of tibial intramedullary nailing distal ports；

Fig. 6 is the side view of Fig. 5；

Fig. 7 is that proximal end diopter uses schematic diagram；

Fig. 8,9 are that distal end diopter uses schematic diagram.

In figure mark it is as follows: shin bone 1, tibial intramedullary nailing 2, proximal segment 3, interlude 4, distal ports 5, the first hole of proximal segment 6, The second hole of proximal segment 7, proximal segment third hole 8, the 4th hole 9 of proximal segment, the 5th hole 10 of proximal segment, the first hole of distal ports 11, distal end The second hole 12 of section, proximal end diopter 14, arc stent 15, handle 16, distal end diopter 17, is fixed distal ports third hole 13 Handle 18, guide rod 19, lock-screw 20, guide pin 21.

Specific embodiment

The utility model includes tibial intramedullary nailing 2, proximal end diopter 14, distal end diopter 17.

Fig. 1,2 displays, the body of rod of tibial intramedullary nailing 2 are divided into proximal segment 3, interlude 4 and distal ports 5, proximal segment 3 and centre Section 4 has a bending angle, and interlude 4 and distal ports 5 have bending, there are five the locking screw holes arranged from top to bottom in proximal segment 3, There are three the locking screw holes arranged from top to bottom in distal ports 5.

Fig. 1,2 displays, the angle between the axis of proximal segment 3 and the axis of interlude 4 is 14 °, while 3 axis of proximal segment The angle being formed by immediately ahead of plane and shin bone between the plane that shin bone 1 is formed with 4 axis of interlude is 42 ° 3 '.Due to This to improve that outside rotates and tilts forward by tibial intramedullary nailing proximal end, bring remarkable advantage is: first, in traditional shin bone marrow Nail entry point is located above tibial tubercle at slope, and improved 2 approach of tibial intramedullary nailing is located at the outer upside of tibial tubercle, ilium shin At bone apterium on the inside of beam stop (Gerdy tubercle), this makes the nail tail of tibial intramedullary nailing 2 avoid kneecap tendon, avoids because of shin bone Pain before postoperative knee caused by the nail urogomphus abrasion kneecap tendon of intramedullary nail 2；Meanwhile hidden mind is avoided to the operative approach in inclined outside Through infrapatellar branch, therefore also effectively prevent knee pain caused by neurotrosis.Second, this improvement is conducive to tibial intramedullary nailing 2 It is placed in pulp cavity.When being placed in traditional tibial intramedullary nailing through approach under kneecap, need repeatedly stretching and beading knee joint to have an X-rayed reduction of the fracture feelings in art Condition increases the risk that fracture shifts again.And when taking the photograph shin bone normotopia X-ray film usually because tibial intramedullary nailing 2 be placed in handle and Proximal end diopter 14 blocks and is difficult to clearly show that the reset case of fracture, and it is close to avoid to need to adjust " C " shape X-ray machine repeatedly Hold diopter 14.Improve ossa tibiale posterius intramedullary nail 2 proximal end diopter 14 be located at before shin bone 1 on the outside of, do not influence to take the photograph shin bone 1 just, side Position X-ray film keeps fluoroscopy during operation and operation more convenient.Third carries out reset operation in operation using this tibial intramedullary nailing 2 When, knee joint can be at stretching bit manipulation completely, make it possible to draw in art using lower limb traction instrument substitution assistant.And change Into tibial intramedullary nailing 2 art in it is all operation be respectively positioned on outside knee joint, do not involve articular cavity, therefore avoid bone scraps and enter pass Chamber and intra-articular institutional framework iatrogenic injury are saved, the disease incidence of the pain of the knee joint can be fundamentally reduced.

Fig. 3,4 displays, the locking screw holes axial angle of 2 proximal segment 3 of tibial intramedullary nailing are as follows: three in proximal segment 3 from upper And the angle that the angle of the axis of the locking screw holes of lower arrangement and proximal segment axis is respectively the first hole of proximal segment 6 be 83 ° 28 ', The angle in the second hole of proximal segment 7 is 96 ° 33 ', the angle in proximal segment third hole 8 is 93 ° 0 and the 4th hole 9 of proximal segment and proximal segment The angle of the axis in the 5th hole 10 is respectively 90 °.

The locking screw holes horizontal direction angle of 2 proximal segment 3 of tibial intramedullary nailing are as follows: in perpendicular to 2 body of rod of tibial intramedullary nailing Between section 4 horizontal plane on, the axis in the locking screw holes proximal segment third hole 8 in proximal segment 3 is the horizontal plane and proximal segment axis The intersection of the plane formed with interlude axis, the axis in the proximal segment third hole 8 in proximal segment 3 and the second hole of proximal segment 7 The angle of axis is 42 ° 3 ', and the angle of the axis and the axis in the first hole of proximal segment 6 in the proximal segment third hole 8 in proximal segment 3 is 43 ° 47 ', the axis in the axis in the proximal segment third hole 8 in proximal segment 3 and the 4th hole 9 of proximal segment and the 5th hole 10 of proximal segment Angle is respectively 89 ° 58 '.

After the angulation change of the locking screw holes of the proximal segment 3 of tibial intramedullary nailing 2, lock-screw 20 can be prevented to be pierced by shin bone Platform articular surface will not cause to damage to articular cavity.

The 4th hole 9 of proximal segment of tibial intramedullary nailing 2 is the slide lock hole of ellipse, and oval long axis is along proximal segment The dynamic pressurized of shin bone axial direction may be implemented using slide lock hole for 3 length direction, be conducive to the healing of fracture.

Proximal segment 3 remains five locking screw holes, and doctor can be made to select different angles according to patients with fractures's situation Locking screw holes are fixed, and are fixed stronger.

Fig. 5,6 displays, the distal ports 5 of tibial intramedullary nailing 2 and the bending angle of interlude 4 are 2.1 °, tibial intramedullary nailing 2 3 axis of proximal segment and 4 axis of interlude of plane and tibial intramedullary nailing 2 that 5 axis of distal ports and 4 axis of interlude are formed are formed Plane intersection, intersection is 4 axis of interlude, the angle of two planes be 42 ° 3 '.The distal ports 5 of tibial intramedullary nailing 2 to 2.1 ° are tilted immediately ahead of shin bone 1, the inclination angle in oriented 3 ° of the front in conventional intramedullary nails distal end, improved purpose is to make new shin bone Intramedullary nail 2 can be smoothly placed in the pulp cavity of 1 distal end of shin bone.

Fig. 5,6 show that the axis of three locking screw holes arranged from top to bottom in distal ports 5 is in perpendicular to shin bone marrow It follows closely on the horizontal plane of 2 body of rod interludes 4 and to be formed by plane with proximal segment axis and interlude axis respectively and have angle, angle point Not Wei the axis in the first hole of distal ports 11 be formed by plane, the second hole of distal ports perpendicular to proximal segment axis and interlude axis The angle of 12 axis and the axis in the first hole of distal ports 11 is 58 ° 8 ', the axis in distal ports third hole 13 and distal ports first The angle of the axis in hole 11 is 180 ° -58 ° 4 '.

The distal ports 5 of improved tibial intramedullary nailing 2 are two circular static locking holes and an oval sliding Lock hole, the first hole of distal ports 11 in distal ports 5 are the slide lock hole of ellipse, and oval long axis is along distal ports 5 Length direction.And the distal ports of traditional tibial intramedullary nailing are five circular static locking nail hole, wherein farthest two are followed closely One of nail hole merging screw only may be selected in Kong Yi horizontal plane.Improved advantage is: first is that, due in shin bone marrow The distal ports 5 of interior nail 2 increase the slide lock hole of ellipse, and surgical doctor can choose the distal ports 5 in tibial intramedullary nailing 2 It is placed in dynamic lock screw, makes doctor that can select screw fixation method according to patients with fractures's situation.Dynamic lock screw can be real The dynamic pressurized of existing shin bone axial direction, increases the probability of union.Second is that traditional tibial intramedullary nailing distalmost end is in same water Two nail hole of plane are removed, the possibility that inside-fixture stress caused by reducing because of intra medullary nail far-end local weak damages Property.And the tibial intramedullary nailing distal end after improveing remains three nail hole, it is sufficient to meet the operation demand of fixed tibial distal end.Three It is to be improved to the 5 pinning relative angle of distal ports of tibial intramedullary nailing 2, to adapt to the tibial intramedullary nailing distal end after improvement Sighting device, and wherein two lockings is made to increase fixed stabilization to the full extent distally perpendicular to the bone face of distal tibial Property.

Fig. 7,8,9 show that position is distinguished at the front strut device of proximal end diopter 14 and the compression bar position of distal end diopter 17 In on the extended line of 3 overbending direction of proximal segment of tibial intramedullary nailing 2.And conventional intramedullary nails outrigger, intramedullary nail strut device and marrow The interior corresponding compression bar position of nail is respectively positioned on immediately ahead of shin bone in surgical procedure, and the position of traditional tibial intramedullary nailing far-end locking is logical Prismatoidal tibia sites are frequently located in, compression bar holds just on the tibial crest in front of prismatic in front of tibial intramedullary nailing outrigger Easily sliding, it is more difficult to precise manipulation.After improvement, the compression bar direction of proximal end diopter 14 and distal end diopter 17 is exactly perpendicular to shin bone Outer side seam face before 1, fixation easier to operate when making to operate in art.

Fig. 7 shows that the arc stent 13 of proximal end diopter 14 is 3/4 semicircle.And traditional tibial intramedullary nailing outrigger is Hemicycle.After improvement, when being placed in tibial intramedullary nailing 2 during surgery, suffering limb is in and stretches position, traditional semi-circular tibial intramedullary nailing Outrigger can make it be easy touching contralateral limbs, and surgical procedure precision is caused to decline, and the proximal end of improved tibial intramedullary nailing The arc stent 13 of diopter 14 is that 3/4 semicircle is constituted, and can just be kept away when suffering limb straight position enters tibial intramedullary nailing 2 The normal lower limb in opposite side are opened, accidentally touching bring surgical errors are reduced.

The utility model use process is as follows:

Patient body position's puts:

Patient lies supine position is placed on the operating bed of transmissive x-ray.Patient's hip, knee joint, which are in, stretches position.By C-arm X Line fluoroscopic machine is placed in suitable position, and the convenient articular surface proximally and distally to shin bone carries out the perspective of normotopia and side position.

Determine the length and diameter of intramedullary nail:

It needs to be determined that the length of tibial intramedullary nailing 2 after fracture of lower limb resets.C-beam X-ray image system, which is placed in, to have an X-rayed The position of 1 distal end normotopia of shin bone and side position uses longer pliers, and the parallel of transmissive x-ray is placed in the side of shank. Adjustment ruler to tip is located at shin bone arched roof position, and the tail end of ruler should be positioned ready for the position of plug pin, marks skin in side On position.Image amplifier is translated to proximal tibia, carries out positioned parallel, note according to the label of ruler proximal end on the skin Record normotopia and the side position of proximal tibia.The reset case for checking fracture site again is marked true by the ruler on X-ray examination Determine the length of tibial intramedullary nailing 2.

Operative incision:

It lays one's hand on and the outside upper quadrate bone of tibial tubercle is dashed forward and located, with this as the starting point, row longitudinal cut is about 4-5cm.

The implantation of tibial intramedullary nailing 2:

It is open at the apophysis of top outside tibial tubercle with opening cone, is expanded with pulp cavity reamer to required diameter.

Intramedullary nail is inserted into the pulp cavity expanded in the first step.

Use clamping screw connection guide 19 and fixed handle 18, it is ensured that guide rod 19 scale of corresponding aperture and selected shin in succession The length of intramedullary pin 2 is consistent.

Distal end diopter 17 is installed, distal end diopter 17 is connected to 19 distal end of guide rod, and lock using clamping screw 20.

Compression bar, fixation are distally carried out to tibial intramedullary nailing 2, measurement far-end locking follows closely length.

It is screwed into the first screw of distal ports again by the drilling of distal end diopter 17, then is screwed into far by the drilling of distal end diopter 17 The second screw of section and distal ports third screw are held, this two pieces of screw installations are without successive point.

Proximal end diopter 14 is installed, determines that hanging bolt, handle 16 and tibial intramedullary nailing 2 connect with ballhead die nut Securely.Proximal end diopter 14 is installed on handle 16.

Three combinations are inserted by the hole ML on proximal end diopter 14, protective case, drill bushing, trochar, puncture incision simultaneously will Trochar is inserted to bone.Remove trochar.

By proximal end diopter 14 drilling again by proximal end diopter 14 be screwed into the first screw of proximal end, the second screw of proximal end, Proximal end third screw, three pieces of screws are screwed into without successive point.

Claims (5)

1. a kind of tibial intramedullary nailing and merging instrument convenient for merging operation, it includes tibial intramedullary nailing (2), proximal end diopter (14), distal end diopter (17), the body of rod of tibial intramedullary nailing (2) are divided into proximal segment (3), interlude (4) and distal ports (5), closely There are bending angle in end section (3) and interlude (4), and there are bending angle in interlude (4) and distal ports (5), there are five proximal segment (3) The locking screw holes arranged from top to bottom, in distal ports (5), there are three the locking screw holes arranged from top to bottom, it is characterised in that: close Holding the angle between the axis of section and the axis of interlude is 14 °, proximal segment axis and interlude axis be formed by plane with Angle immediately ahead of shin bone between the plane of shin bone (1) formation is 42 ° 3 ', and five in proximal segment (3) arrange from top to bottom Locking screw holes axis and proximal segment axis have angle respectively, the folder of the axis in proximal segment axis and the first hole of proximal segment (6) Angle is the folder for the axis that the angle of the axis in 83 ° 28 ' and the second hole of proximal segment (7) is 96 ° 33 ' and proximal segment third hole (8) Angle is 93 ° 0 ', and the angle with the axis in the 4th hole (9) of proximal segment and the 5th hole (10) of proximal segment is respectively 90 °, perpendicular to shin On the horizontal plane of intramedullary pin (2) body of rod interlude (4), the axis in proximal segment third hole (8) is the horizontal plane and proximal segment axis The intersection for the plane that line and interlude axis are formed, the axis of the axis and the second hole of proximal segment (7) in proximal segment third hole (8) Angle is 42 ° 3 ', and the angle of the axis of the axis and the first hole of proximal segment (6) in proximal segment third hole (8) is 43 ° 47 ', proximal segment The angle of the axis in third hole (8) and the axis in the 4th hole (9) of proximal segment and the 5th hole (10) of proximal segment is respectively 89 ° 58 ', far Hold the axis of three locking screw holes arranged from top to bottom on section (5) perpendicular to tibial intramedullary nailing (2) body of rod interlude (4) Horizontal plane on be formed by plane with proximal segment axis and interlude axis respectively and have angle, angle is respectively distal ports first The axis in hole (11) perpendicular to proximal segment axis and interlude axis be formed by plane, the second hole of distal ports (12) axis with The angle of the axis in the first hole of distal ports (11) is 58 ° 8 ', the axis in distal ports third hole (13) and the first hole of distal ports (11) The angle of axis be 180 ° -58 ° 4 '.

2. the tibial intramedullary nailing and merging instrument according to claim 1 convenient for merging operation, it is characterised in that: the shin The 4th hole (9) of proximal segment of intramedullary pin (2) is the slide lock hole of ellipse, and oval long axis is along proximal segment (3) Length direction.

3. the tibial intramedullary nailing and merging instrument according to claim 1 convenient for merging operation, it is characterised in that: the shin The first hole of distal ports (11) of intramedullary pin (2) is the slide lock hole of ellipse, and oval long axis is along distal ports (5) Length direction.

4. the tibial intramedullary nailing and merging instrument according to claim 1 convenient for merging operation, it is characterised in that: described close The compression bar position of the front compression bar operating device and distal end diopter (17) of holding diopter (14) is located at tibial intramedullary nailing (2) Proximal segment (3) overbending direction extended line on, compression bar position is opposite with shin bone (1) leading flank respectively.

5. the tibial intramedullary nailing and merging instrument according to claim 4 convenient for merging operation, it is characterised in that: described close The arc stent (15) for holding diopter (14) is 3/4 semicircle.