KR20160116077A

KR20160116077A - Open wedge plate for opening wedge high tibial osteotomy

Info

Publication number: KR20160116077A
Application number: KR1020150041297A
Authority: KR
Inventors: 김윤기
Original assignee: 김윤기
Priority date: 2015-03-25
Filing date: 2015-03-25
Publication date: 2016-10-07

Abstract

The present invention provides the best stability with minimal fixation (minimum volume, size) to minimize the damage of the soft tissues of the proximal tibia while maintaining the stability of the proximal tibial osteotomy of the tibia, The present invention relates to a metal fixture for an open-tibio-proximal tibial osteotomy.
The present invention provides a metal fixture for insertion into a proximal tibia of a tibia to treat arthritis confined to the inside of a knee joint with varus deformity, wherein the metal fixture (10) comprises a plate-shaped bone fixation part (11) And a bone supporting part 15 formed perpendicularly to a central part of the bone fixing part 11. The bone supporting part 15 forms the bony part 52 after the osteotomy is widened, The distal end portion of the distal end portion of the bone support 50 supports the bone 50. The distal end portion of the bone defect portion 16 forms a groove with a predetermined depth, a support leg 17 that forms both sides of the distal portion 16, And both ends of the support leg 17 are chamfered to form an oblique edge 18, and the bone anchoring portion 18 11) is soft and soft, Tibia is formed to make it easier to close, the amount of side characterized in that the fastening means is inserted into the screw insertion hole (12, 13) so as to form the through.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention [0001] The present invention relates to a metal fixation device for an open-tibial proximal tibial osteotomy,

The present invention relates to a metal fixture for an open-ended torn-tibial proximal osteotomy.

The present invention relates to a metal fixture for an open tibial proximal tibial osteotomy, and more particularly, to a metal fixture for an open tibial proximal tibial osteotomy, in which the stability of the proximal tibial component of the tibia is good, ) To achieve maximal stability and to allow other procedures to be performed in conjunction with the tibial proximal osteotomy, and also to facilitate the operation of the metal fixture for an open tibial proximal osteotomy.

Proximal tibial osteotomy, a method of treating arthritis confined to the medial side of the knee joint with varus deformity (saddle leg), has been developed since its introduction in 1958 by Jackson. Proximal tibial osteotomy is a procedure that corrects an abnormal anatomical axis caused by degenerative changes in articular cartilage and reduces pain by uniformly distributing weight overload in the medial side of the knee due to varus deformity to the entire knee joint. Tibial proximal osteotomy and open tibiofibular proximal osteotomy.

The tibial proximal osteotomy should be done with a metal plate or a special screw for stability after operation, regardless of the procedure.

In the open type, the procedure is relatively simple and there is no complication of the peroneal nerve injury due to the need for tibial incision, and there is an advantage of restoring the tension to the medial ligament. It is widely used because it can maintain the bone quality when the joint is completely damaged.

However, since the open tibial proximal osteotomy is theoretically open to the bone, bone fusion is delayed and bone graft is necessary, resulting in complications (infection, donor neck pain). The technique itself is easy, Also reported.

As shown in FIGS. 6A and 6B, the tomopix (TomoFix, trade name of synthes, trade name, Switzerland) is a typical instrument used for the open-type sagittal proximal tibial osteotomy. So that the metal plate 60 is brought into close contact with the surface of the inner trough and is fixed by using a plurality of screws 62. [

In addition, the metal plate used in the conventional open tibial proximal osteotomy is designed to be relatively large and thick. However, the medial side of the proximal tibia in which the metal plate is located is adjacent to the bone and skin, which may cause irritation due to permanent fixation. In addition, the medial collateral ligament and Pesanserius, which are most important for medial stability of the knee joint, Such soft tissue damage is unavoidable when these metal plates are used.

In addition, there has been an increase in the number of surgeries for patients who need to undergo simultaneous correction of varus deformity and other procedures to treat knee instability (anterior cruciate ligament reconstruction, posterior cruciate ligament reconstruction, and posterior lateral instability) In this case, it is impossible or extremely difficult to perform the osteotomy and another operation together with the conventional metal plate. The increase in the posterior tilt angle of the tibia has been associated with the disruption of the complete extension of the knee, especially in the anterior cruciate ligament.

Korea No. 10-1131253

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems and it is an object of the present invention to provide a surgical instrument and a tibial osteotomy, which are capable of minimizing the stability of the proximal tibia and minimizing the stability It is intended to provide a metal fixture for an open tibial proximal tibial osteotomy, which can perform other procedures together with the tibial proximal osteotomy and make it easier to perform the operation, as well as easily adjust the tilt angle of the tibia.

The present invention provides a metal fixture for insertion into a proximal tibia of a tibia to treat arthritis confined to the inside of a knee joint with varus deformity, wherein the metal fixture (10) comprises a plate-shaped bone fixation part (11) And a bone supporting part 15 formed perpendicularly to a central part of the bone fixing part 11. The bone supporting part 15 forms the bony part 52 after the osteotomy is widened, The distal end portion of the distal end portion of the bone support 50 supports the bone 50. The distal end portion of the bone defect portion 16 forms a groove with a predetermined depth, a support leg 17 that forms both sides of the distal portion 16, And both ends of the support leg 17 are chamfered to form an oblique edge 18, and the bone anchoring portion 18 11) is soft and soft, Tibia is formed to make it easier to close, the amount of side characterized in that the fastening means is inserted into the screw insertion hole (12, 13) so as to form the through.

At this time, the fixing means is formed so as to fix only one cortical bone, and a wrench insertion port 25 is formed on one side of the screw head 21 and a tapered portion 23 is formed on the other end side, The screw body may be a screw 20 having an outer diameter of the thread to be fixed and an outer diameter of the thread to be enlarged from the tapered portion 23 toward the threaded head 21 to widen the ridges of the threaded portion to obtain a firm fixing force, The wedge nails 28 and 29 having the inverted triangles stacked thereon may be inserted into the screw insertion holes 12 and 13 and fixed.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will now be described more fully with reference to the accompanying drawings, in which exemplary embodiments of the invention are shown.

FIGS. 1A to 1D are metal fasteners for an open-type tibia proximal osteotomy according to an embodiment of the present invention, FIGS. 2A to 2D are screws for an open tibiofibrous osteotomy according to an embodiment of the present invention, FIG. 3 is an exploded perspective view illustrating the use of a metal fixture for an open-type tibia proximal osteotomy according to another embodiment of the present invention. FIG. A state of use of a metal fixture for an open tibiofemoral osteotomy according to one embodiment

As described above, according to the present invention, the metal fixture is advantageous in that the volume of the mechanism itself is small and the stimulus of the surrounding soft tissues is small and can be easily contacted to the curved tibia. There are also advantages that can be performed simultaneously with anterior cruciate ligament reconstruction, posterior cruciate ligament reconstruction, posterior lateral ligament reconstruction, and artificial joint replacement. The posterior tilt of the tibia can be easily controlled by using two different metal fixtures with different sizes of the anterior and posterior tibia, and when the anterior or posterior instability is present, the tibial posterior tilt can be controlled to improve the stability of the knee joint.

In other words, the tibial resection using the metal fixture and screw of the present invention is easier, and stable fixation can be obtained without damage to the soft tissue, and a patient who needs simultaneous operation can obtain satisfactory results with a single operation without performing several operations There is an effect.

FIGS. 1A to 1D are views illustrating a metal fixture for an open-ended tear-tibial proximal osteotomy according to an embodiment of the present invention,
FIGS. 2A to 2D illustrate a screw for an open tibiofemoral osteotomy according to an embodiment of the present invention,
FIG. 3A and FIG. 3B are views showing a metal fixture for an open-ended tear-tibial osteotomy according to another embodiment of the present invention,
FIG. 4 is an exploded perspective view illustrating the use of a metal fixture for an open-type tear-tear-bone proximal osteotomy according to the present invention;
FIG. 5 is a view illustrating a state of use of a metal fixture for an open-type tibia proximal osteotomy according to an embodiment of the present invention,
FIG. 6A and FIG. 6B are views showing a state of use of a metal plate for a proximal tibial osteotomy and a screw according to an embodiment of the present invention;

As shown in FIGS. 1A to 5, the metal fixture for the open tibial proximal tibial osteotomy according to the preferred embodiment of the present invention is inserted into the proximal tibia of the tibia to treat arthritis limited to the inside of the knee joint with varus deformity A metal fixture 10, and a screw 20 for fixing the metal fixture 10.

1A to 1D, the metal fixture 10 includes a plate-shaped bone fixing part 11 having a predetermined thickness, a bone supporting part 15 formed perpendicularly to the central part of the bone fixing part 11, .

1A is a perspective view of a metal fixture 10, FIG. 1B is a plan view, FIG. 1C is a cross-sectional view, and FIG. 1D is a side view.

The tibia after the osteotomy is formed by the tibia of the bone supporting part 15 to form the osteolysis part 52. The entire depth of the bone supporting part 15 is about 10 mm to support the tongue 50 by entering between the cracks, And has a defect portion 16 of about 6 mm in the center. This can be used not only as a function of the preliminary space in which new bone is created after surgery, but also as a space for filling various materials capable of promoting bone formation.

In addition, the support legs 17 constituting both side surfaces of the defected portion 16 with a site (about 4 mm) to be brought into contact with the hard cortical bone are in complete contact with each other without a defect site so as to be in direct contact with the hard cortical bone of the tibia, In order to facilitate the insertion of the fixture 10, the tip portion is chamfered to form a tapered edge 18.

A screw hole (19) for inserting the metal fixture (10) into the bone defect part is formed on the inside of the bone support part (15) by inserting a driver (40)

The bone anchoring portion 11 is about 1 mm thick, which is very thin, which is the thickness of a device protruding from the bone. That is, the soft tissues of the soft tissues are soft and flexible, so that they can be easily attached to the curved tibia, and screw holes (12, 13) through which the screw (20) can be inserted are formed on both sides. On the other hand, the inner side surfaces of the screw insertion ports 12 and 13 form inclined surfaces 14 so that the screw head 21 of the screw 20 can be completely received.

2A to 2D, the screw 20 is formed to fix only one cortical bone. A wrench insertion port 25 is formed in the screw head 21, and an end portion of the screw is connected to a tapered portion 23 self-tapping type) is formed. Further, in order to obtain a firm fixing force, the screw body is formed such that the outer diameter of the thread is constant and the outer diameter of the thread is increased from the tapered portion 23 toward the threaded head 21 so that the ridges of the thread are widened. 2A is a perspective view of the screw 20, FIG. 2B is a front view, FIG. 2C is a left side view, and FIG. 2D is a right side view.

3, the wedge nails 28 and 29 are inserted and fixed to the screw insertion holes 12 and 13 formed on both sides of the bone fixing part 11, And the like. At this time, the wedge nails (28, 29) may be integrally formed with the bone fixing part (11), or may be formed by being joined to each other. In addition, the wedge nails 28 and 29 are formed in a wedge shape having an inverted triangle shape in cross section so that they can not be easily detached while being inserted.

4, the metal fixture 10 for the open tennis tibial proximal osteotomy includes a metal fixture inserter 30 and a metal fixture 10 inserted into the metal fixture inserter 30, And a screwdriver 40 for inserting and securing it into the insertion hole 52. [

The metal fixture inserter 30 includes a cylindrical hollow pipe 32, an inserter handle 36 vertically mounted on one end of the hollow pipe 32, And the driver 40 is constituted by a cylindrical driver body 42 into which the hollow pipe 32 can be inserted, And a threaded portion 44 formed on the other end of the driver body 42 at regular intervals. At this time, the threaded portion 44 is formed to be screwed with the nut hole 19 of the metal fixture 10.

Therefore, the driver 40 is inserted through the driver insertion port 38 formed in the hollow pipe 32 of the metal fixture inserter 30 so that the metal fixture 10 is firmly pressed on the compression plate 34 The threaded portion 44 and the nut hole 19 are screwed into each other and can be easily inserted into the bony portion 52.

Thereafter, the screw 20 is inserted into and fixed to the screw insertion ports 12 and 13 of the bone fixing part 11 as in the above embodiment, or the wedge nails 28 and 29 like the above- And is fixed.

In the present invention, as shown in FIG. 5, in a patient with a knee joint lesion with varus deformity, the open tarso tibial proximal osteotomy using the metal fixture 10 according to the present invention generally comprises two metal fixtures 10 .

The insertion site is as far as possible from the osteotomized tibia as far as possible, and it is obvious that maximum stability can be obtained by doing so. In clinical practice, it is possible to have a solid internal fixation, so the patient does not need to use gypsum fixation or orthoses.

In addition, by using two metal fasteners 10 having different sizes before and after the operation, it is possible to easily adjust the backward inclination of the tibia during the operation and adjust the posterior tilt of the tibia when there is anterior or posterior instability, It does.

10: metal fixture 11:
12, 13: screw insertion port 14: inclined surface
15: bone support part 16: defective part
17: support leg 18: beveled edge
19: Nut hole 20, 62: Screw
21: screw head 22: thread
23: tapered portion 25: wrench insertion hole
28, 29: Wedge nail 30: Metal fastener inserter
32: hollow pipe 34: compression plate
36: inserter handle 38: driver inserter
40: Driver 42: Cylindrical body
44: threaded portion 46: driver handle
50: bone (bone) 52:

Claims

In a metal fixture for insertion into a proximal tibia of a tibia to treat arthritis confined to the medial side of the knee joint with varus deformity,
The metallic fixture 10 is formed of a plate-shaped bone fixing part 11 having a predetermined thickness and a bone supporting part 15 formed perpendicularly to the central part of the bone fixing part 11,
The tibia after the osteotomy extends from the bone supporting part 15 to form the osteolysis part 52. The distal part of the bone supporting part 15 supports the tongue 50 by entering the gap between the tongue parts, A support leg 17 constituting both side surfaces of the defect portion 16 and a nut hole 19 formed in the inner side surface at a predetermined depth vertically from the bone fixation portion 11, Both ends of the support leg 17 are chamfered to form a slant edge 18,
The bone fixation part 11 is formed to have a small irritation of the soft tissue and is flexible and easy to adhere to the curved tibia, and screw insertion holes 12 and 13 are formed to penetrate the both sides of the bone fixation part 11 A metal fixture for an open-ended tibial proximal osteotomy.

The method according to claim 1,
The fixing means is formed to fix only one cortical bone. A wrench insertion port 25 is formed in the screw head 21 at one side, a tapered portion 23 is formed at the other end, Characterized in that the body is a screw (20) formed so that the outer diameter of the thread is constant and the outer diameter of the thread is increased from the tapered part (23) to the threaded head (21) so as to obtain a firm fixing force. Metal fixation for the proximal tibial osteotomy of the lingual.

The method according to claim 1,
Wherein the fixing means comprises wedge nails (28, 29) inserted into and fixed to the screw insertion ports (12, 13) in the shape of an inverted triangular wedge having cross-sectional shapes stacked. .