WO2007031009A1 - Plaque d’ostéosynthèse externe médicale - Google Patents

Plaque d’ostéosynthèse externe médicale Download PDF

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Publication number
WO2007031009A1
WO2007031009A1 PCT/CN2006/002324 CN2006002324W WO2007031009A1 WO 2007031009 A1 WO2007031009 A1 WO 2007031009A1 CN 2006002324 W CN2006002324 W CN 2006002324W WO 2007031009 A1 WO2007031009 A1 WO 2007031009A1
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WIPO (PCT)
Prior art keywords
screw
thread
bone plate
external fixation
length
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Application number
PCT/CN2006/002324
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English (en)
French (fr)
Inventor
Xiangdang Liang
Original Assignee
Xiangdang Liang
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Publication date
Application filed by Xiangdang Liang filed Critical Xiangdang Liang
Publication of WO2007031009A1 publication Critical patent/WO2007031009A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors

Definitions

  • the invention relates to a medical external fixation bone plate, belonging to the technical field of medical equipment. Background technique
  • External fixation technology is one of the basic techniques of orthopedics. It is especially suitable for the initial treatment of fractures with soft tissue problems. It has its unique role, but due to the defects of the traditional external fixation frame, its application range has been obvious. limit.
  • the traditional external fixator is large in size and cumbersome in appearance.
  • the bare steel nail directly penetrates into the skin, which is a malignant stimulation to the patient.
  • the bulky external fixator severely limits the patient's activity, and the patient often cannot wear clothes. Disadvantages make the external fixation often not acceptable to the patient.
  • the traditional external fixing frame is complicated in operation.
  • the nail clamping angle severely limits the direction and angle of the nail insertion; on the other hand, fastening the nail clip and the nut is cumbersome and inconvenient. This greatly affects the surgeon's choice of external fixators.
  • the traditional external fixing frame uses thicker nails.
  • the direction of the nail clamping limits the application of the nail.
  • the thickness of the nail In order to reduce the number of nails, the thickness of the nail must be increased.
  • the body On the other hand, the body is far away from the skin, so the force is greatly reduced.
  • Increasing the thickness of the nail increases the holding force of the external fixator, which leads to complications of the external 'fixed frame: complications such as nail infection, nail fracture, which also limits the application of the external fixator.
  • the object of the present invention is to provide a medical external fixation bone plate, which thoroughly improves the material composition of the frame of the existing external fixation frame, the shape of the nail, and the connection manner of the connecting member, so as to have the advantages of existing internal and external fixation. Moreover, it overcomes the shortcomings of internal and external fixation, and at the same time makes the external fixation operation easier and the trauma is smaller. The doctor's chances of damaging important tissues are greatly reduced, the volume is more compact, the appearance is more beautiful, and the fixed quality is improved, thereby further expanding the external fixation frame. Application range.
  • the medical external fixation bone plate provided by the invention comprises a frame body and a screw.
  • the head end of the screw is relatively fixed to the bone to be connected, and the tail end is relatively fixed to the frame body.
  • the screw length is 2 to 35 cm, and the screw diameter is 1 ⁇ 2 ⁇ ,
  • the width of the groove is 0. 5 ⁇ 2 cm, and the width is 1 ⁇ 2 mm.
  • a plurality of steel wires or elastic fibers can be laterally preset.
  • the frame in the above medical external fixation bone plate can be made of a self-condensing polymer material.
  • the medical external fixation bone plate provided by the invention comprises a frame body and a screw.
  • the head end of the screw is relatively fixed to the bone to be connected, and the tail end is fixed relative to the frame body.
  • the length of the screw is 2 to 35 cm, and the diameter of the screw is 1 to 8 mm.
  • the end of the screw 5 ⁇ 2 ⁇
  • the end is provided with a groove, the groove depth is 0. 5 ⁇ 2 cm, the width is 1 ⁇ 2 mm.
  • the medical external fixation bone plate may be made of a self-condensing polymer material, for example, any one of bone cement, self-setting resin and self-setting plastic.
  • the medical external fixation bone plate proposed by the invention has the advantages of traditional internal and external fixation, and overcomes the shortcomings of the traditional internal and external fixation, so that the operation of the fracture fixation operation is simpler, the volume is more compact, the appearance is more beautiful, and the fixation strength and quality are obvious. Improvements to further extend the range of applications of the external mounts, allowing them to be applied to all areas of fracture like steel sheets.
  • the medical external fixation bone plate of the invention has the following advantages: 1.
  • the fixation near the skin makes the fixation strength increase obviously; the nail plate is integrated, because the screw and the frame body are formed by praying, the strength is much larger than the traditional external fixing frame. Improve, avoid the re-displacement of the fracture, and the overall fixation strength is obviously enhanced. 2.
  • the application of fine nails minimizes bone interference and reduces the likelihood of nonunion and delayed healing.
  • the frame is placed outside the skin, no need for secondary surgery to remove the internal fixation. 4. Since the bone cement can be used to bond the fixing screws at any angle, the operation is simpler and the needle can be threaded in any direction as needed. 5. Due to the adhesive fixing between the nail and the frame, the application of the multi-nail nail is made possible. The fixing of the nails and the multiple nails increases the fixing strength and avoids the stress concentration, which greatly reduces the complications caused by the use of the thick nails. Such as: nail infection, nail fracture, etc.; more nails can also achieve the purpose of adequate drainage, reduce soft tissue edema in the fracture. 6.
  • the frame and the nail are connected by pouring and bonding, which greatly simplifies the fixing operation, and does not need to tighten several nuts one by one. 7. It can be molded according to the shape of the body surface, and it can be attached to the skin to the maximum extent. It is beautiful and light, can be worn, and is easy to care for and functionally forged. 8, the frame (bone cement, etc.) through the X-ray to facilitate intraoperative and postoperative X-ray examination; 9, the fixed bone plate operation does not cut the fracture end, thus minimizing the possibility of infection And the timing of surgery is no longer an important consideration, so the operation time can be as early as possible, resulting in a significant reduction in hospital stay. 11, the price is low, the material can be selected in a wider range, with better economics.
  • FIG. 1 is a schematic structural view of a medical external fixation bone plate proposed by the present invention.
  • FIGS. 2 to 5 are structural schematic views of an embodiment of a screw used in the medical external fixation bone plate of the present invention.
  • 1 is a screw
  • 2 is a wire inside the frame
  • 3 is a frame body
  • 4 is a soft tissue of the human body
  • 5 is a fracture site
  • 6 is a bone to be connected
  • 7 is a screw head thread
  • 8 is a screw middle beam.
  • 9 is a plurality of grooves perpendicular to the longitudinal axis of the screw tail surface
  • 10 is a groove whose screw end is parallel to the longitudinal axis
  • 11 is a screw tail thread
  • 12 is a screw front light rod.
  • the medical external fixation bone plate of the present invention has a structure as shown in FIG. 1 , and includes a frame body 2 and a screw 1 .
  • the head end of the screw 1 is relatively fixed to the bone 6 to be connected, and the tail end is fixed relative to the frame body 2 .
  • 5 ⁇ 2 ⁇ , ⁇ 1 ⁇ 2 ⁇ The screw has a length of 2 to 35 cm, a screw having a diameter of 1 to 8 mm, a screw end having a groove 10, a depth of the groove 10 of 0. 5 to 2 cm, and a width of 1 to 2 mm.
  • a plurality of steel wires or elastic fibers 2 can be laterally preset.
  • the frame in the above medical external fixation bone plate can be made of a self-condensing polymer material.
  • the screw in the medical external fixation bone plate of the present invention is mainly composed of three parts, a head, a middle part and a tail part, a head part is located in the bone; a tail part is a part in the polymer material (in the frame body); a middle part It is located between the head and the tail, mainly in the soft tissue, mostly dry.
  • the surface of the head may be threaded, smooth polished rod, triangular shape, etc., the main purpose is to play the role of the bone, the depth of the thread varies according to cancellous bone and cortical bone.
  • the surface of the tail can be a special structure such as a spiral, a groove, a pattern, etc., and the purpose is to increase the holding force between the screw and the frame.
  • the end has a recess parallel to the longitudinal axis for attaching the handle to screw the screw in.
  • the specific structure of the screw of the present invention can have the following four different structural forms:
  • the first structure is shown in Figure 2.
  • the front part is thread 7, the depth of the thread is 1/12 ⁇ 1/4 of the thread diameter, and the thread length is 1/12 ⁇ 1/2 of the length of the screw; the middle of the screw is The polished rod 8, the rear surface of the screw is a plurality of grooves 9 perpendicular to the longitudinal axis.
  • the second structure is shown in Figure 3.
  • the front part is thread 7, the depth of the thread is 1/12 ⁇ 1/4 of the thread diameter, and the thread length is 1/12 ⁇ 1/2 of the length of the screw; the middle of the screw is The polished rod 8, the rear portion of the screw is a thread 11, the depth of the thread is 1/12 to 1/4 of the thread diameter, and the thread length is 1/12 to 1/2 of the length of the screw.
  • the third structure is shown in Fig. 4.
  • the front part is a polished rod 12, and the rear surface of the screw is a plurality of grooves 9 perpendicular to the longitudinal axis.
  • the fourth structure is shown in Fig. 5.
  • the front part is the polished rod 12
  • the rear surface of the screw is the thread 11
  • the depth of the thread is 1/12 ⁇ 1/4 of the thread diameter
  • the thread length is 1/12 of the length of the screw ⁇ 1/2.
  • the operation process of the medical external fixation bone plate proposed by the invention is as follows -
  • the nail is threaded on the thin side of the soft tissue, that is, the screw is screwed into the bone through the groove of the tail of the screw.
  • the number of screws is greater than or equal to 2 at each end according to the specific situation. .
  • the self-condensing polymer material is adhered to the skin to cast and fix the tails of the screws, and the bones and screws and the self-geling molecular materials are formed into one body. After the self-condensing polymer material is solidified, the temporary fixing frame is removed, and the operation is completed.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
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Description

一种医用外固定接骨板 技术领域
本发明涉及一种医用外固定接骨板， 属于医用设备技术领域。 背景技术
外固定技术是骨科的基本技术之一， 特别适用于伴有软组织问题的骨折的初步治 疗， 有其独到的作用， 但是由于传统的外固定架本身存在的缺陷， 使得其应用范围受 到了明显的限制。
传统外固定架体积较大， 外型笨重， 裸露的钢钉直接刺入皮肤， 是对患者的恶性 刺激， 笨重的外固定架， 严重的限制了患者的活动， 同时患者常常不能穿着衣服； 上 述缺点使得外固定架往往不能被患者所接受。
传统外固定架操作复杂， 一方面由于穿钉技术要求较高， 钉夹角度严重限制了进 钉的方向和角度； 另一方面紧固钉夹和螺帽较为繁琐不便。 这大大影响了外科医生对 外固定架的选择。
传统外固定架固定强度有限， 常常发生固定失效， 既骨折再移位， 影响骨折的愈 合， 这使得外固定架常常被作为一种临时的固定器械， 而不是最终的固定形式。
传统外固定架使用的钉子较粗， 钉夹的方向限制了钉子的应用， 为了减少用钉的 数量， 必须增加钉子的粗度， 另一方面架体远离皮肤使得作用力大大减少， 也必须通 过增加钉子的粗度来增加外固定架的把持力量， 这样导致了外 '固定架的并发症： 钉道 感染， 钉道骨折等并发症， 这也限制了外固定架的应用。
所以上述缺陷严重的影响到了外固定架的应用范围， 使得外固定架目前只是应用 于特殊骨折的一种临时外固定器械。 发明内容
本发明的目的是提出一种医用外固定接骨板， 对已有外固定架的架体的材料构成、 钉子的形状、 连接件的连接方式等进行彻底改进， 使其具备已有内外固定的优点， 又 克服内外固定的缺点， 同时使外固定操作更加简便， 创伤更加小， 医生操作损伤重要 组织的几率大大减少， 体积更加小型化， 外观更加美观， 提高固定质量， 从而进一步 扩展外固定架的应用范围。
本发明提出的医用外固定接骨板， 包括架体和螺钉， 所述的螺钉的头端与待接骨 骼相对固定， 尾端与架体相对固定， 螺钉长度为 2〜35厘米， 螺钉直径为 1〜8毫米， 螺钉末端设有凹槽， 凹槽深为 0. 5〜2厘米， 宽为 1〜2毫米。
上述医用外固定接骨板的架体中可以横向预置多道钢丝或弹力纤维。
上述医用外固定接骨板中的架体可以由自凝高分子材料制成。
本发明提出的医用外固定接骨板， 包括架体和螺钉， 螺钉的头端与待接骨骼相对 固定， 尾端与架体相对固定， 螺钉长度为 2〜35厘米， 螺钉直径为 1〜8毫米， 螺钉末 端设有凹槽， 凹槽深为 0. 5〜2厘米， 宽为 1〜2毫米。
上述医用外固定接骨板， 其中的架体可以由自凝高分子材料制成， 例如可以为骨 水泥、 自凝树脂及自凝塑料中的任何一种。
本发明提出的医用外固定接骨板， 同时具备了传统内外固定的优点， 又克服了传 统内外固定的缺点， 使得骨折固定手术操作更加简便， 体积更加小型化， 外观更加美 观， 固定强度和质量明显提高， 从而进一步扩展外固定架的应用范围， 使其可以象钢 板一样应用到骨折所有领域。 本发明的医用外固定接骨板， 具有以下优点： 1、 靠近皮 肤固定使得固定强度明显增大； 钉板一体化， 由于的螺钉和架体之间采用浇祷成型， 强度比传统外固定架大大提高， 避免了骨折的再移位， 整体固定强度明显增强。 2、 细 钉的应用使得骨干扰最小化， 降低了骨折不愈合和延迟愈合的可能性。 3、 架体置于皮 外， 不需要二次手术取出内固定。 4、 由于骨水泥可以任意角度粘合固定螺钉， 使得操 作更简便， 可以根据需要任意方向穿针。 5、 由于钉子和架体之间采取粘合固定， 使得 多钉细钉的应用成为可能， 细钉多钉固定使得固定强度增加， 避免应力集中， 使得由 于使用粗钉带来的并发症大大降低， 如： 钉道感染、 钉道骨折等等； 多钉穿钉还可以 达到充分引流的目的， 减轻骨折局部的软组织水肿。 6、 架体和钉子间通过浇筑粘合方 式连接， 大大简化了固定操作， 不用再逐个拧紧数个螺母。 7、 顺着体表形态可以任意 塑型， 最大限度的紧贴皮肤固定， 美观轻便， 可以穿着衣物， 而且便于护理和功能锻 炼。 8、 架体 （骨水泥等）透过 X线便于术中和术后的 X线检査； 9、 固定接骨板的操 作过程中不切开骨折断端， 因此最大限度降低了感染的可能性， 而且手术时机不再是 必须重要考虑的问题， 因而手术时间可以尽可能的提前， 使得住院时间显著缩短。 11、 价格低廉， 材料可选择的范围较为广泛， 具有较好的经济性。 附图说明
图 1是本发明提出的医用外固定接骨板的结构示意图。
图 2〜图 5是本发明医用外固定接骨板中所用螺钉的实施例结构示意图。
图 1〜图 5中， 1是螺钉， 2是架体内钢丝， 3是架体， 4是人体软组织， 5是骨折 处， 6是待接骨骼， 7是螺钉头部螺紋， 8是螺钉中部光杆， 9是螺钉尾部表面垂直于 纵轴的多条凹槽， 10是螺钉末端平行于纵轴的凹槽， 11是螺钉尾部螺紋， 12是螺钉前 部光杆。 具体实施方式
本发明提出的医用外固定接骨板， 其结构如图 1所示， 包括架体 2和螺钉 1， 所述 的螺钉 1的头端与待接骨骼 6相对固定， 尾端与架体 2相对固定， 螺钉长度为 2〜35 厘米， 螺钉直径为 1〜8毫米， 螺钉末端设有凹槽 10， 凹槽 10的深为 0. 5〜2厘米， 宽 为 1〜2毫米。
上述医用外固定接骨板的架体中可以横向预置多道钢丝或弹力纤维 2。
上述医用外固定接骨板中的架体可以由自凝高分子材料制成。 本发明的医用外固定接骨板中的螺钉， 主要由三部分组成， 头部、 中部和尾部， 头部是位于骨骼内的部分； 尾部为位于高分子材料内的部分（架体内）； 中间部分为位 于头尾之间的部分， 主要位于软组织内， 多为干状。 头部的表面可以是螺紋状、 光滑 的光杆、 三棱状等等， 主要目的是起到把持骨骼的作用， 螺紋的深浅根据松质骨和皮 质骨而有所不同。 尾部的表面可以是螺旋、 凹槽、 花紋等特殊结构， 目的是用来增加 螺钉与架体间的把持力。 末端有平行于纵轴的一个凹槽， 用于连接把手将螺钉拧入。
本发明的螺钉的具体结构， 可以有以下四种不同,的结构形式：
第一种结构如图 2所示， 其前部为螺紋 7， 螺紋的深度为螺纹直径的 1/12〜1/4， 螺紋长度为螺钉长度的 1/12〜1/2； 螺钉的中部为光杆 8， 螺钉的后部表面为多条垂直 于纵轴的凹槽 9。
第二种结构如图 3所示， 其前部为螺紋 7， 螺紋的深度为螺紋直径的 1/12〜1/4， 螺纹长度为螺钉长度的 1/12〜1/2； 螺钉的中部为光杆 8， 螺钉的后部为螺紋 11， 螺紋 的深度为螺紋直径的 1/12〜1/4， 螺紋长度为螺钉长度的 1/12〜1/2。
第三种结构如图 4所示， 其前部为光杆 12， 螺钉的后部表面为多条垂直于纵轴的 凹槽 9。
第四种结构如图 5所示， 前部为光杆 12， 螺钉的后部表面为螺紋 11， 螺纹的深度 为螺纹直径的 1/12〜1/4， 螺紋长度为螺钉长度的 1/12〜1/2。
本发明提出的医用外固定接骨板的操作过程如下-
1、 电视透视下对受伤部位闭合牵引复位 （撬拨复位、 有限切开复位）， 达到功能 复位标准。
2、 在骨折两端距骨折线 2厘米以远， 于软组织较薄侧进行穿钉， 即通过螺钉尾部 的凹槽将螺钉拧入骨骼， 螺钉数量根据具体情况， 每端大于或等于 ·2个。
3、 电视透视下对 折进行精细复位， 并用临时复位固定器临时固定。
4、 用自凝高分子材料紧贴皮肤对各螺钉尾部进行浇铸粘合固定， 将骨骼和螺钉以 及自凝髙分子材料形成一个整体。 自凝高分子材料凝固后拆除临时固定架， 操作结束。

Claims

权利要求
1、 一种医用外固定接骨板， 其特征在于该接骨板包括架体和螺钉， 所述的螺钉的 头端与待接骨骼相对固定， 尾端与架体相对固定， 螺钉长度为 2〜35厘米， 螺钉直径 为 1〜8毫米， 螺钉末端设有凹槽， 凹槽深为 0. 5〜2厘米， 宽为 1〜2毫米。
2、 如权利要求 1所述的医用外固定接骨板， 其特征在于其中所述的架体中横向预 置多道钢丝或弹力纤维。
3、 如权利要求 1所述的医用外固定接骨板， 其特征在于^ 1述的架体由自凝高分子 材料制成。
4、 如权利要求 3所述的医用外固定接骨板， 其特征在于所述的自凝高分子材料为 骨水泥、 自凝树脂及自凝塑料中的任何一种。
5、 如权利要求 1所述的医用外固定接骨板， 其特征在于其中所述的螺钉其前部为 螺紋， 螺纹的深度为螺紋直径的 1/12〜1/4， 螺紋长度为螺钉长度的 1/12〜1/2； 螺钉 的中部为光杆， 螺钉的后部表面为多条垂直于纵轴的凹槽。
6、如权利要求 1所述的医用外固定接骨板， 其特征在于其中所述的螺钉其前部为 螺纹， 螺紋的深度为螺纹直径的 1/12〜1/4， 螺纹长度为螺钉长度的 1/12〜1/2； 螺钉 的中部为光杆， 螺钉的后部为螺紋， 螺纹的深度为螺紋直径的 1/12〜1/4， 螺纹长度为 螺钉长度的 1/12〜1/2。
7、 如权利要求 1所述的医用外固定接骨板， 其特征在于其中所述的螺钉其前部为 光杆， 螺钉的后部表面为多条垂直于纵轴的凹槽。
8、 如权利要求 1所述的医用外固定接骨板， 其特征在于其中所述的螺钉前部为光 杆， 螺钉的后部表面为螺纹， 螺紋的深度为螺紋直径的 1/12〜1/4， 螺纹长度为螺钉长 度的 1/12〜1/2。
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CN1739462A (zh) * 2005-09-16 2006-03-01 梁向党 一种医用外固定接骨板
CN103654931B (zh) * 2013-12-05 2016-05-18 山东航维骨科医疗器械股份有限公司 一种皮质骨和松质骨通用的锁定金属接骨板装置
CN105935310A (zh) * 2016-04-01 2016-09-14 北京良之介医疗科技有限公司 一种用于胫骨骨折治疗的锁定外固定装置
CN108814700B (zh) * 2018-07-05 2024-05-24 徐斌 骨折内外双固定系统
CN109199562A (zh) * 2018-08-30 2019-01-15 瀛ｄ寒 一种骨水泥骨折固定装置及其使用方法

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CN2223081Y (zh) * 1995-06-07 1996-03-27 鞍山钢铁公司 碳纤维加强环氧树脂接骨板
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