DE102016001509A1 - Osteosynthesis plate for fracture supply to the humeral head - Google Patents

Abstract

The invention relates to an osteosynthesis plate for fracture supply to the humeral head with a plurality of holes for receiving fixation means, wherein the plate has an upper side and a lower side and a curvature and at least one of the holes has an internal thread for receiving a bone screw. Furthermore, the plate is formed symmetrically in its longitudinal axis extension and has a greater width relative to its distal region in its proximal region. According to the invention, the curvature of the plate is dome-shaped or cup-shaped both in the longitudinal axis direction and across the width of the plate, and at least one spike-like extension is provided in the distal region, extending from the plate underside.

Description

The invention relates to an osteosynthesis plate for fracture supply to the humeral head with a plurality of holes for receiving fixation means, wherein the plate has a top and a bottom and a buckle and at least one of the holes has an internal thread for receiving a bone screw, further the plate in its longitudinal axis direction is formed symmetrically and in its proximal region has a greater width relative to its distal region, according to the preamble of claim 1.

Fractures of the Tuberkulum Majus Numeri are among the common shoulder injuries. The number of injuries is currently increasing, due to skiing, snowboarding and other fun sports accidents. After osteosynthesis of a fracture of the Tuberkulum Majus Numeri it can lead to the formation of pseudarthroses. In the case of an acute fracture treatment, pseudarthrosis can be most effectively prevented by a precise surgical procedure. In this respect, the mechanical stability of the fracture supply in the area of the tubercle major plays an essential role. High primary stability enables early functional physiotherapeutic exercise and is essential to the ultimate functional outcome.

The most common osteosynthesis methods that are relevant here are the so-called transosseous suture, a cancellous bone osteosynthesis or a tension bandage with an anchor screw for the treatment of the fracture.

From the CN 103876815 A a humeral plate is known, which consists of a metallic body and is suitable for receiving bone screws. The aforementioned plate has a triangular shape and is arcuately curved. In the corners of the triangular shaped plate corresponding holes for receiving bone screws are available. In addition, a variety of holes for receiving Kirschner wires are available.

At the suture anchor plate after EP 2254507 A2 is an asymmetrical plate shape, wherein in a peripheral portion in the edge region, the plate comprises a plurality of holes for receiving surgical threads. Furthermore, holes are available in the disk center to fix the plate by means of screws on the bone.

In addition, a plate for stabilizing bone fractures is known DE 69817405 T2 respectively. EP 1077652 B1 , This known plate is formed strictly symmetrical both along its longitudinal axis and its transverse axis and has in the center and on its longitudinal axis a plurality of holes for receiving bone screws. The plate itself is curved and has strongly rounded side sections.

The generic osteosynthetic plate for fracture restoration DE 29913994 U1 is used to hold wires, nails, pins or screws and has a top and a bottom and at least three, top and bottom of the plate connecting holes whose centers are not on a straight line.

According to the favored solution local there are the central axes of at least two holes not on an axis, but are skewed to each other. The in the DE 29913994 U1 plate described in particular as an internal fixator for osteosynthesis, z. B. be used on the proximal humerus.

By the there provided direct concern of the guide plate on the bone, the free length of inserted wires is reduced to a minimum. This should allow for an early loading of the fracture site and a previous use of the affected limbs and a faster healing may be possible.

Based on the described prior art, the object of the invention is to provide a further developed osteosynthetic plate for fracture supply to the humeral head, which makes significant use of the use of bone screws. The screws are inserted laterally in the medial direction. This is intended to avoid the disadvantage of a supply of sutures, which consists in the fact that in older patients an osteoporosis bone no longer has the necessary stability. In addition, the plate to be created should be minimally invasive and be limited on the dimension side to a pure head plate in order to exclude the risk of injury to the nerve axilar. This is particularly relevant insofar as the aforementioned nerve is located about 5 cm below the humeral head. If this nerve is injured during an operation, the patient loses the function for the arm. When using the plate to be created should be ruled out that the doctor penetrates into the zone in which the nervios axilares is located. Furthermore, the plate to be created to give the opportunity to provide ruptures of the rotator cuff.

The object of the invention is achieved with an osteosynthesis plate according to the feature combination according to claim 1, wherein the dependent claims comprise at least expedient refinements and developments.

It is therefore assumed that an osteosynthesis plate for fracture supply to the humeral head, wherein the plate comprises a plurality of holes for receiving fixatives. These agents are primarily bone screws, but also Kirschner wires and surgical threads or wires. The plate has a top and a bottom and has a curvature. At least one of the holes has an internal thread for receiving a bone screw. Furthermore, the plate is formed symmetrically in its longitudinal axis orientation and has in its proximal region a greater width relative to its distal region.

A given symmetry allows the use of one and the same plate on the right and left humeral head. On the other hand, asymmetric plates would have to be provided in a left-handed and a right-hand version in order to achieve optimal surgical results. The plate according to the invention is therefore unilateral.

According to the invention, the curvature of the plate is dome-shaped or cup-like, d. H. a curvature is carried out both in the longitudinal axis direction and across the width of the plate. Furthermore, according to the invention, at least one spike-like extension is provided in the distal region, extending from the underside of the plate.

This spike-like extension on the underside of the plate is used for a very easy and quick positioning of the plate by simply pressing.

The plate according to the invention is preferably fastened by bone screws, in particular 2,4-bone screws. These have a shank diameter of 2.4 mm and a head thread diameter of about 3.7 mm

The expansions of the osteosynthesis plate in the longitudinal direction amount to approx. 35 mm and on the broad side to a maximum of 22 mm. The plate thickness is in the range of 2.2 mm. It can be seen from the above exemplary data that it is a very small, easy-to-use osteosynthesis plate for the corresponding fracture supply.

In a preferred embodiment, at least two spike-like extensions are spaced apart on or at or near the longitudinal axis of the plate.

In a preferred embodiment, a plurality of holes with internal thread is provided. These holes with internal thread can preferably be designed as locking holes for bone screws with external thread in the region of the screw head. To ensure angular variability, it is possible to segment the internal threads of the locking holes, i. H. to form so that the inner peripheral side alternately threaded and thread-free sections are provided. In addition or alternatively, it is also possible to form the holes for receiving the locking screws as so-called combo holes, d. H. to realize that in the direction of the top plate, the locking holes have a spherical shape, so that there is the possibility of optional use of conventional bone screws with spherical head screwless thread in the head area.

Preferably, the locking holes are arranged on the edge of the plate rim and symmetrical to the longitudinal plate axis. Furthermore, the number of locking holes in the proximal region preferably exceeds the number of locking holes in the distal region.

In a further development of the invention, a plurality of bores for receiving Kirschner wires are present in the center of the proximal region and a plurality of bores for receiving surgical threads along the circumference of the plate.

The number of holes for receiving surgical threads in the proximal region exceeds that in the distal region of the plate.

The holes for receiving surgical threads are preferably arranged in the spacer space between the locking holes and plate edge side.

Preferably, starting from the bores for receiving surgical threads on the underside of the plate, a respective groove is provided in the direction of the plate outer edge to the thread guide.

In one development of the invention, the at least one spike-like extension in longitudinal section in the form of an acute-angled triangle and is inclined or arranged symmetrically or perpendicular to the underside of the plate.

In one embodiment of the invention, the extension may also have a rounding at its end.

The cross section of the spike-like projections is at least partially circular, oval or polygonal executed.

In a particularly preferred embodiment of the invention, the inclination of the at least one spike-like extension is at an angle α to the vertical and in the direction of the panel executed proximal portion of the plate. Further ausgestaltend the degree of plate curvature in the proximal region exceeds the bulge in the distal region of the plate, in particular along the longitudinal and transverse axis. The curvature in the longitudinal direction is between 40 mm to 100 mm and in the transverse direction between 15 mm and 40 mm.

The invention will be explained below with reference to an embodiment and with the aid of several figures.

Hereby show:

1a a plan view of the plate according to the invention;

1b a section through the plate according to the invention along a transverse axis (line AA);

1c a longitudinal section through the plate according to the invention along the longitudinal axis (line BB);

1d a longitudinal side view of the plate according to the invention;

1e a view of the distal, narrow-side end of the plate according to the invention;

1f a perspective view of the top of the plate with a recognizable curvature;

2a a schematic diagram of the arrangement of the spike-like extensions in a symmetrical embodiment;

2 B a schematic diagram of the arrangement of the spike-like projections inclined towards the proximal plate end;

2c a schematic representation of the execution of a spike-like extension with rounding at the outer end of the extension and

3 Representations with exemplary dimensions of the spike-like projections with also exemplary cross-sectional shapes along the line AA.

The osteosynthesis plate for fracture supply to the humeral head according to the embodiment is based on a curved plate configuration, wherein the plate 1 a top 2 and a bottom 3 having.

The plate 1 serves to receive fixation elements, not shown in the figures.

The plate has a curvature, as can be seen from the synopsis of 1c . 1b and 1f with the view 1e for the expert.

Evident points the plate 1 in the longitudinal axis direction BB has a symmetrical shape and has a proximal region 4 greater width relative to its distal region 5 ,

The curvature of the plate 1 is executed dome-shaped or lunate, ie a curvature is present both in the longitudinal axis direction BB and over the plate width. In the distal area 5 extend in the example shown two spike-like extensions 6 starting from the underside of the plate 3 ,

The spike-like extensions 6 are arranged according to a preferred embodiment on the longitudinal axis BB.

Furthermore, a variety of holes 7 With internal thread present, which are designed as locking holes for bone screws, not shown, with external thread in the region of its screw head.

The locking holes 7 are coronary plate edge side and arranged symmetrically to the plate longitudinal axis BB.

The number of locking holes 7 in the proximal region 4 is larger than the locking holes 7 in the distal area 5 ,

In the embodiment of the 1a to 1f For example, it can be seen that there are two locking holes in the distal region and five locking holes in the proximal region, for example. In the lower part of the plate there are two further locking holes 7 ,

In other words, the density of the locking holes is in the proximal region 4 based on the existing there plate area greater than the density of the locking holes 7 in the distal area 5 ,

Exemplary dimensions and radii as well as information on exemplary dimensions of the holes are the 1a . 1b and 1c Removable, but without limiting the theory of invention thereto.

especially the 1a and 1f show in the center of the proximal area 4 several holes 8th for receiving the Kirschner wire, not shown, and along the circumference of the plate 1 several holes 9 for receiving surgical threads, not shown.

The number of holes 9 for receiving surgical sutures in the proximal region 4 exceeds that in the distal region 5 the plate 1 ,

The holes 9 for receiving surgical threads are preferably in the space between the locking holes 7 and plate edge side arranged, as is apparent from the synopsis of 1a and 1f is clear.

Starting from the holes 9 for receiving surgical threads is on the underside of the plate in each case a groove 10 in the direction of the plate outer edge to the thread guide available.

The at least one spike-like extension 6 can resort to the presentation after the 2a to 2c and 3 have the shape of an acute triangle in longitudinal section. This acute-angled triangle can be realized symmetrically with respect to the vertical plane of the panel, wherein the angle β lies between 10 ° and 60 °, preferably at 20 °.

As shown in 2 B there is a preferred possibility of forming the spike-like extensions 6 in that they perform with an inclination α relative to the vertical pitch in the direction of the proximal region. α can be in the range of -10 ° to + 10 °.

According to 2c the spike-like extension can also have a rounding with a radius of, for example, 0.5 mm to 1.5 mm, preferably 0.5 mm.

The 3 shows exemplary dimensions of the spike-like extensions 6 , The width or the diameter B1 at the underside of the plate 3 the plate 1 is in the range between 1 mm and 4 mm, preferably 2 mm. The width B2 in particular in rounded embodiment of the spike-like extension 6 is in the range between 0 mm and 4 mm, preferably 1 mm. The length L of the spike-like extensions 6 is in the range between 1 mm and 6 mm, preferably 2 mm.

The cross sections of the spike-like extensions 6 can be configured differently. By way of example, a cross-sectional shape according to the illustrations according to FIG 3 realizable. That is, it may be a circular cross-section, a triangular, square, hexagonal or oval cross-section at least in the designated area after 3 be realized along the line AA.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• CN 103876815 A [0004]
• EP 2254507A2 [0005]
• DE 69817405 T2 [0006]
• EP 1077652 B1 [0006]
• DE 29913994 U1 [0007, 0008]

Claims (12)

Osteosynthesis plate ( 1 ) for fracture supply to the humeral head with a plurality of holes ( 7 ; 8th ; 9 ) for receiving fixatives, wherein the plate ( 1 ) an upper side ( 2 ) and a bottom ( 3 ) and a curvature and at least one of the holes ( 7 ) has an internal thread for receiving a bone screw, the plate ( 1 ) in its longitudinal axis extent (BB) is symmetrical and in its proximal region (BB) 4 ) has a greater width relative to its distal region ( 5 ), characterized in that the curvature of the plate ( 1 ) in the manner of a dome or lobe, both in the longitudinal axis direction and across the width, and in the distal region (FIG. 5 ), extending from the underside of the plate, at least one spikeartiger extension ( 6 ) is provided. Osteosynthesis plate according to claim 1, characterized in that at least two spike-like extensions ( 6 ) spaced on or at the longitudinal axis (BB) are arranged. Osteosynthesis plate according to claim 1 or 2, characterized in that a plurality of holes ( 7 ) are provided with internal thread and are designed as locking holes for external bone screws in the region of its screw head, wherein the locking holes ( 7 ) are arranged like a coronary plate edge and symmetrically to the plate longitudinal axis and the number of locking holes ( 7 ) in the proximal region ( 4 ) the number of locking holes ( 7 ) in the distal region ( 5 ) exceeds. Osteosynthesis plate according to one of the preceding claims, characterized in that in the center of the proximal region ( 4 ) several holes ( 8th ) for receiving a Kirschner wire and along the circumference of the plate ( 1 ) several holes ( 9 ) are designed for receiving surgical threads. Osteosynthesis plate according to claim 4, characterized in that the number of holes ( 9 ) for receiving surgical threads in the proximal region ( 4 ) that in the distal region ( 5 ) of the plate ( 1 ) exceeds. Osteosynthesis plate according to claim 4 or 5, characterized in that the bores ( 9 ) for receiving surgical threads preferably in the space between the locking holes ( 7 ) and plate edge side are arranged. Osteosynthesis plate according to one of claims 4 to 6, characterized in that starting from the bores ( 9 ) for receiving surgical threads on the underside of the plate ( 3 ) each have a groove ( 10 ) is provided in the direction of the plate outer edge to the thread guide. Osteosynthesis plate according to one of the preceding claims, characterized in that the at least one spike-like extension ( 6 ) has the shape of an acute-angled triangle in longitudinal section and inclined or symmetrical or perpendicular to the underside of the plate ( 3 ) is arranged. Osteosynthesis plate according to claim 8, characterized in that the spike-like extension ( 6 ) has at its end a rounding (R). Osteosynthesis plate according to claim 8 or 9, characterized in that the cross section of the spike-like extension is executed at least partially circular, oval or polygonal. Osteosynthesis plate according to one of claims 8 to 10, characterized in that the inclination of the at least one spike-like extension ( 6 ) at an angle (α) to the vertical axis of the plate and in the direction of the proximal region (α). 4 ) of the plate ( 1 ) is executed. Osteosynthesis plate according to one of the preceding claims, characterized in that the degree of plate curvature in the proximal region ( 4 ) the curvature of the plate ( 1 ) in the distal region ( 5 ) exceeds.

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