JP2023004965A - Plate system for bone fixation - Google Patents

Abstract

To provide a plate system for bone fixation capable of tightly connecting and fixing a separated long bone at a separation place.SOLUTION: The plate system comprises: a first fixation plate 1 which abuts on one side face of a long bone W and couples and fixes the long bone W astride a separation place of the long bone W; a second fixation plate 2 which abuts on the other side face of the long bone W and couples and fixes the long bone W astride the separation place of the long bone W; and a connection part 3 which connects the second fixation plate 2 to the first fixation plate 1.SELECTED DRAWING: Figure 1

Description

TECHNICAL FIELD The present invention relates to a bone fixation plate system for fixing a separated portion of a long bone such as a tibia or a femur.

For example, in proximal tibial osteotomy for osteoarthritis of the knee, a plate is used to correct the knee joint to its normal shape by enlarging the incision made on the medial side of the tibia, and to fix this state. be done.

Conventionally, this type of plate is known to be abutted on the medial side of the tibia across an incision and fixed by screwing screws into the proximal and distal tibia through the incision (for example, See Patent Document 1).

At this time, the two parts of the tibia separated by the cut are supported by the hinge part located on the outer side of the tibia and the plate located on the inner side, and are fixed.

JP 2010-220762 A

By the way, as shown in FIGS. 11A and 11B, in order to perform osteotomy at the distal tibial tuberosity, the tibia W is formed with a hanging tongue-shaped flange Wa.

The medial position incision of the tibia W is fixed by the plate 11 described above. On the other hand, the front side of the tibia W is not fixed by the plate 11 . For this reason, for example, as shown in FIGS. 11A and 11B, the movement of the flange Wa is restricted by screwing a screw 11 into the flange Wa on the front side of the tibia W and tightening it.

However, when screwing the screw 12 through the flange Wa, it depends on the strength of the flange Wa. For this reason, the flange Wa cannot be fixed with sufficient strength, and when a bending stress is applied to the base of the flange Wa or a load is applied to the joint, the bone may fuse in a curved state, or the flange Wa may be deformed. Damage may occur.

SUMMARY OF THE INVENTION It is an object of the present invention to provide a bone fixation plate system capable of firmly connecting and fixing separated long bones at the separation point.

In order to achieve such an object, the present invention provides a bone fixation plate system for fixing a separation point of a long bone, which abuts on one side surface of the long bone to fix the separation point of the long bone. A first fixation plate for straddling and fastening and fixing, and abutting on the other side surface of the long bone facing in a direction different from the contact surface of the first fixing plate to fasten and fix across the separation point of the long bone. and a connecting portion for connecting the second fixing plate to the first fixing plate.

Also, in the present invention, the connecting part is characterized by comprising distance adjusting means for fixing the distance between the first fixing plate and the second fixing plate so as to be changeable.

Also, in the present invention, the connection part is characterized by having angle adjustment means for fixing the angle of the second fixing plate with respect to the first fixing plate so as to be changeable.

Further, the present invention is a bone fixation plate system for fixing a separated portion of a long bone, which abuts on one side surface of the long bone and is fastened and fixed across the separated portion of the long bone. and a second fixing plate for fastening and fixing across the separated part of the long bone by contacting the other side surface of the long bone that faces in a direction different from the surface with which the first fixing plate abuts. , wherein the second fixing plate is formed integrally with the first fixing plate and extends to the side of the first fixing plate.

Also, in the present invention, it is characterized by comprising a third fixation plate fixed to the side surface of the long bone at a different position from the first fixation plate and the second fixation plate.

Further, in the present invention, the first fixing plate is characterized by protruding a restricting piece that abuts on a surface other than the separated portion of the long bone and restricts sliding of the first fixing plate with respect to the long bone. and

In addition, in the present invention, as a specific embodiment, when partially separated long bones are fixed by proximal long bone osteotomy, the first fixing plate is placed on the inner surface or the outer surface of the long bone. and the second fixing plate is used in contact with the anterior surface of the long bone.

According to the present invention, by providing not only the first fixing plate but also the second fixing plate through the connection part, the second fixing plate is fixed to the surface on the side different from the surface to which the first fixing plate is fixed. It is possible to firmly connect and fix separated long bones.

Furthermore, by providing the third fixation plate, the long bone can be sandwiched between the second fixation plate and the third fixation plate, and the spaced long bones can be connected and fixed more firmly.

In addition, by providing the first fixing plate with the restricting piece, the first fixing plate can be prevented from moving unintentionally, so that the connection state of the long bones can be stably maintained for a long period of time.

FIG. 1A is an explanatory front view of the bone fixation plate system, and FIG. 1B is an explanatory side view of the bone fixation plate system. FIG. 2 is an explanatory plan view of the bone fixation plate system of FIG. 1; FIG. 3A is an explanatory front view showing a modification of the connecting portion, and FIG. 3B is an explanatory side view showing a modification of the connecting portion. Explanatory sectional drawing which shows the slide structure of a plate. FIG. 4 is an explanatory side view showing a modification of long holes in the connecting portion of FIG. 3 ; An explanatory side view showing other modifications of a connecting part. An explanatory side view showing a modification of a 2nd fixed plate and a connecting part. An explanatory side view showing the 3rd fixed plate. FIG. 9A is an explanatory view showing a first fixing plate provided with a restricting piece, and FIGS. 9B and 9C are explanatory views showing a contacting state of the restricting piece with a bone. Explanatory drawing which shows the usage example of the plate system for bone fixation to the distal femur. FIG. 11A is an explanatory front view of a conventional plate, and FIG. 11B is an explanatory side view of the conventional plate.

One embodiment of the present invention will be described based on the drawings. The bone fixing plate system of the present invention can be used for long bones such as tibia and femur, but in this embodiment, the case where it is used for tibia will be described.

The plate system according to this embodiment includes a first fixing plate 1, a second fixing plate 2, and a connecting portion 3, as shown in FIGS. 1A and 1B. A first fixation plate 1 and a second fixation plate 2 are fixed to the high side of the tibia W by screws 4 .

The first fixing plate 1 is an elongated strip-like member fixed to the high medial surface of the tibia W after osteotomy in proximal tibial osteotomy for knee osteoarthritis. It has a subtly curved shape according to a typical surface shape so that it can conform to the curved surface shape of the side of the tibia W at a position where it transitions toward the hip.

That is, the first fixing plate 1 integrally includes an elongated strip-shaped main body portion 1a and a horizontal portion 1b extending in a direction intersecting the longitudinal direction of the main body portion 1a, and is substantially T-shaped as a whole. is formed in Although not shown, the first fixation plate 1 may be configured to be fixed to the high lateral surface of the tibia W after osteotomy.

A plurality of screw insertion holes 5 are formed in the body portion 1a of the first fixing plate 1 at intervals in the longitudinal direction. Further, a plurality of screw insertion holes 5 are formed in the transverse portion 1b at intervals in a direction crossing the longitudinal direction of the main body portion 1a.

The second fixation plate 2 is shorter than the first fixation plate 1 and is fixed to the high anterior surface of the tibia W after osteotomy. A plurality of screw insertion holes 5 are formed in the second fixing plate 2 .

The connecting portion 3 is positioned between the first fixing plate 1 and the second fixing plate 2 and connects the two fixing plates 1 and 2 integrally.

As is well known, there are a plurality of types of screws 4, and they are appropriately selected and used according to the screwing position. In the case of this embodiment, as shown in FIG. 2, it is screwed into a prepared hole (not shown) formed in the tibia W. As shown in FIG.

When the screws 4 are inserted into the screw insertion holes 5 of the first fixing plate 1 and the second fixing plate 2, as shown in FIG. It is adapted to be screwed into the tibia W so as to be fixed.

In addition, one screw 4a has a screw thread formed in the tip half, and a base end half (screw head side) does not have a screw thread and has a smooth peripheral surface. The other screw 4b is called a cortical screw and has a thread formed over its entire length. Further, the screws 4a and 4b are both formed in a tubular shape, and guide pins (not shown) can be inserted therethrough.

As shown in FIG. 2, one screw 4a can firmly bring the second fixing plate 2, the flange Wa, and the tibia W into close contact with each other by deepening the screwing into the tibia W. As shown in FIG. The other screw 4 a is screwed into a thread formed in the screw through hole 5 of the first fixing plate 1 .

By providing the second fixation plate 2, the separated tibia W can be firmly connected and fixed in the front-rear direction. That is, in the proximal tibia osteotomy, the first fixing plate 1 is brought into contact with the high medial surface of the tibia W so as to straddle the incision after the osteotomy. At this time, the high anterior surface of the tibia W is further brought into contact with the second fixation plate 2 . As a result, the second fixation plate 2 can cover and hold the front flange Wa of the tibia W after osteotomy, and compared to the case where the screws 4 are screwed from the flange Wa to fix the tibia W (see FIG. 11), It can be firmly fixed without increasing the burden on the body.

As shown in FIG. 1A, the connecting portion 3 is integrally formed with the first fixation plate 1 and the second fixation plate 2, so that the number of parts required for the tibia fixation plate system is small and the handling is easy. However, it is not limited to this.

That is, as shown in FIGS. 3A and 3B, the first fixing plate 1 and the second fixing plate 2 are separate members, and the second fixing plate 2 is integrally provided with a connecting portion 31 having a long hole 6. good too. The connecting portion 31 is fastened to the connecting position of the first fixing plate 1 via the fastening member 7 . At this time, the fastening member 7 fastens the connecting portion 31 and the first fixing plate 1 through the long hole 6 of the connecting portion 31 .

Since the connecting portion 31 is connected to the first fixing plate 1 by the fastening member 7, by loosening the tightening of the fastening member 7, the angle of the connecting portion 31 with respect to the first fixing plate 1 is set to a desired angle, and the second fixing is performed. The orientation of the plate 2 can be adjusted, and by tightening the fastening member 7, the second fixing plate 2 can be fixed in that posture.

The configuration in which the connecting portion 31 is connected to the first fixing plate 1 by the fastening member 7 functionally corresponds to the angle adjusting means of the present invention.

Moreover, since the connecting portion 31 is connected to the first fixing plate 1 through the long hole 6, the distance between the first fixing plate 1 and the second fixing plate 2 can be reduced by loosening the tightening of the fastening member 7. can be adjusted.

The configuration consisting of the long hole 6 of the connecting portion 31 and the fastening member 7 functionally corresponds to the distance adjusting means of the present invention.

As a result, the contact angle of the second fixation plate 2 with respect to the tibia W and the distance from the first fixation plate 1 can be easily adjusted, and an ideal contact state can be achieved with reduced burden on the affected part. .

Alternatively, as shown in FIG. 4, the first fixing plate 1 may be provided with a grooved rail portion 41 extending in its longitudinal direction, and the connecting portion 31 may be provided with a sliding portion 42 that slides along the grooved rail 41 . . By doing so, the second fixing plate 2 can be slid to a desired position along the longitudinal direction of the first fixing plate 1 . The grooved rail 41 guides the second fixed plate 2, so that linear movement can be performed with high accuracy.

In addition, as shown in FIGS. 5A and 5B , the connection portion 31 may be provided with a plurality of long holes 6 (two parallel to each other in the drawing). By providing a plurality of elongated holes 6 to guide the second fixing plate 2, linear movement can be performed with high accuracy.

Further, as shown in FIG. 6 as a modification, the connecting portion 31 may be provided with a slit portion 8 having an open end portion 8a instead of the elongated hole. According to this, the slit portion 8 can be engaged with the fastening member 7 after the fastening member 7 has been previously attached to the connection position of the first fixing plate 1, and the assembling work can be facilitated.

Furthermore, as shown in FIG. 7 , the second fixing plate 2 and the connecting portion 32 may be separate bodies, and the connecting portion 32 may be connected to the second fixing plate 2 via the pivot shaft 9 . As a result, the connecting portion 32 can swing freely with respect to the second fixing plate 2 , and the degree of freedom in changing the posture of the second fixing plate 2 with respect to the first fixing plate 1 can be dramatically improved.

Further, as shown in FIG. 8, a third fixation plate 10 may be provided that abuts on the rear side of the tibia W on the opposite side of the second fixation plate 2 . The third fixing plate 10 is connected to the first fixing plate 1 via the connecting portion 33 . At this time, each shape shown in FIGS. 3 to 7 can be selectively adopted for the configuration of the connecting portion 33 .

Furthermore, when fixing to the tibia W, both the third fixing plate 10 and the second fixing plate 2 can be used, but only one of them can be used.

Further, as shown in FIG. 9A, a restricting piece 35 may protrude from one side edge of the lower end portion of the first fixing plate 1 . As a result, as shown in FIGS. 9B and 9C, the restricting piece 35 is brought into contact with the lateral surface of the tibia W, thereby preventing positional deviation due to sliding of the first fixation plate 1 .

Further, the number of screws and screwing positions in the present invention are not limited to those shown in this embodiment, and although not shown, it goes without saying that an appropriate number of screws are screwed into appropriate positions. .

In addition, in the present embodiment, an example in which the plate system of the present invention is used for the tibia has been described, but the plate system is not limited to the tibia. It can also be applied to bones, and similar effects can be obtained.

An example of use for the distal femur W is shown in FIGS. 10A and 10B. According to this, in osteotomy of the distal femur W, the flange Wa is formed to maintain stability in the same manner as the tibia. At this time, the first fixing plate 1 is brought into contact with the lateral side of the femur W and fixed, and the flange Wa is pressed by the second fixing plate 2 to be fixed. This is advantageous because it is possible to prevent the flange Wa from coming off the femur W when the knee is bent and stretched, for example, and the rehabilitation period can be expected to be shortened.

Note that FIG. 10A shows a type in which four screw insertion holes 5 are provided in the second fixing plate 2 and four screws 4 are used to fix them, and FIG. 2 shows a type in which four screws 4 are provided and two screws 4 are used. The number of screw insertion holes 5 formed in the second fixing plate 2 is not limited to the illustrated one, and it is preferable to provide about 2 to 6 holes.

Needless to say, the shapes of the first fixation plate 1, the second fixation plate 2, and the third fixation plate 10 are formed so as to match the shapes of the long bones such as the tibia and femur to be used. stomach.

W... tibia (long bone), 1... first fixation plate, 2... second fixation plate, 3, 31, 32, 33... connecting part, 6... long hole (distance adjusting means), 7... fastening member (angle adjustment means), 8... slit portion (distance adjustment means), 9... pivot (angle adjustment means), 10... third fixing plate, 35... regulation piece.

Claims (7)

A bone fixation plate system for fixing a separation point of a long bone, comprising:
a first fixation plate for fastening and fixing across a separated portion of the long bone by contacting one side surface of the long bone;
a second fixation plate for contacting the other side surface of the long bone facing in a direction different from the contact surface of the first fixation plate and fastening and fixing across the separation point of the long bone;
A plate system for bone fixation, comprising: a connection part for connecting the second fixation plate to the first fixation plate. 2. The bone fixation plate system according to claim 1, wherein said connecting portion comprises distance adjusting means for variably fixing the distance between said first fixation plate and said second fixation plate. 3. The plate system for bone fixation according to claim 1 or 2, wherein said connecting part comprises angle adjusting means for fixing the angle of said second fixation plate with respect to said first fixation plate so as to be changeable. . A bone fixation plate system for fixing a separation point of a long bone, comprising:
a first fixation plate for fastening and fixing across a separated portion of the long bone by contacting one side surface of the long bone;
a second fixation plate for abutting the other side surface of the long bone facing in a direction different from the contact surface of the first fixation plate and fastening and fixing across the separation point of the long bone;
The bone fixation plate system, wherein the second fixation plate is integrally formed with the first fixation plate and extends laterally of the first fixation plate. 5. The bone fixation plate system according to claim 1, further comprising a third fixation plate fixed to the side surface of the long bone at a position different from that of the first fixation plate and the second fixation plate. 2. The first fixing plate is provided with a protruding restricting piece that abuts on a surface other than the separated portion of the long bone and restricts the sliding of the first fixing plate with respect to the long bone. 5. The plate system for bone fixation according to 4. When partially spaced long bones are fixed by a proximal long bone osteotomy, the first fixation plate abuts the medial or lateral surface of the long bones, and the second fixation plate is a long bone. 5. The bone fixation plate system according to claim 1, wherein the plate system is used in contact with the anterior surface of a bone.

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