WO2012025027A1 - 医用灌注式动力髋螺钉 - Google Patents

医用灌注式动力髋螺钉 Download PDF

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Publication number
WO2012025027A1
WO2012025027A1 PCT/CN2011/078531 CN2011078531W WO2012025027A1 WO 2012025027 A1 WO2012025027 A1 WO 2012025027A1 CN 2011078531 W CN2011078531 W CN 2011078531W WO 2012025027 A1 WO2012025027 A1 WO 2012025027A1
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Prior art keywords
screw
rough
edged
dynamic hip
steel plate
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PCT/CN2011/078531
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English (en)
French (fr)
Inventor
顾军
Original Assignee
Gu Jun
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Publication of WO2012025027A1 publication Critical patent/WO2012025027A1/zh

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Classifications

    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/746—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
    • A61B17/7098—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants wherein the implant is permeable or has openings, e.g. fenestrated screw
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated

Definitions

  • the utility model belongs to a medical instrument for bone surgery fixation, in particular to a hollow perfusion type dynamic hip screw. Background technique
  • Intertrochanteric fractures are more common in the elderly. Due to osteoporosis in the elderly, the lower extremity suddenly twists or sharply over-expands or adducts when falling, or the external force directly impacts the large trochanter to cause bone fracture. If left untreated, it can cause complications such as hemorrhoids due to prolonged bed rest. And improper treatment can cause malformation and affect the function of the affected limb, so it should be treated promptly.
  • the utility model provides a medical perfusion type hip screw, which enhances the fixing effect between the broken ends by injecting a fixing agent in the hollow passage of the screw.
  • the medical perfusion type dynamic hip screw comprises a steel plate, a rough-edged screw connecting the femoral neck, and a fixing screw, wherein the rough-edged screw is a hollow screw, and the end has a plurality of through holes.
  • the root of the roughened screw is provided with a section of external thread. It can be consistent with the tension thread of the rough-edged screw, which can properly increase the power pressurization effect, and can be combined with the steel plate.
  • the threaded fit plays a fixed role for both.
  • the central axis of the end of the roughened screw end intersects the central axis of the hollow passage of the screw, and the central axes of the at least two through holes are not parallel.
  • the fixing agent passage is provided without substantially affecting the overall strength of the screw.
  • the number of the through holes of the rough screw end is 2 to 11.
  • the steel plate is provided with a sleeve, and the root of the rough-edged screw projects into the sleeve.
  • the rough-edged screw can slide on the sleeve, which has the dual functions of compression and sliding.
  • the screw can be shortened along the sleeve, avoiding the nail tip penetrating the femoral head and making the fracture end Get power pressurization.
  • This program is suitable for young people or patients with better bone condition. Pushing CaS0 4 or artificial bone powder into the hollow channel through the putter, and then spreading it into the femur through the end through hole, increasing the force area. , achieve a good fixed effect.
  • the rough-edged screw is screwed to the steel plate. It is fixedly connected to the steel plate by a tail cap with a built-in inner thread.
  • This program is more suitable for patients whose bone density does not reach the fixed level, such as elderly patients with more severe bones.
  • the cement or other coagulant is pushed into the hollow channel through the push rod, and then spread through the end through hole in the femur. , forming a dendritic bifurcation, increasing the area of the force, achieving a good fixation effect.
  • the utility model can be made of titanium alloy.
  • the screw can also be provided with a cutting surface at the end, and a retreating groove is arranged along the central axis of the outer circumference of the screw.
  • the implementation process of the utility model is as follows: positioning with a guide pin under X-ray fluoroscopy, then performing sounding, selecting a thick-length screw of a suitable length, and after fixing the broken bone with the steel plate and the fixing screw, in the rough-edged screw
  • the fixing agent is filled in the hollow passage, and the gasket of the push rod is increased or decreased according to requirements, and after the appropriate length is reached, the push rod is pushed and pushed forward, so that the fixing agent is pushed out along the through hole of the end of the screw and the passage opening of the end.
  • the fixative is fixed to form a dendritic shape
  • the bifurcation, together with the screw, constitutes a firm end fixing effect, which solves the problem of loosening and breaking of the screw and increases the anti-torsion force.
  • the fixing agent continuously replenishes the void caused by the extrusion until the hollow passage of the entire screw is filled. . Fix the broken bone together with the steel plate and the fixing screw.
  • the fixative is selected according to the patient's specific condition.
  • the elderly patients choose bone cement, and the young and middle-aged patients choose artificial bone powder or other biological materials such as CaS04.
  • DRAWINGS are selected according to the patient's specific condition.
  • the elderly patients choose bone cement, and the young and middle-aged patients choose artificial bone powder or other biological materials such as CaS04.
  • Figure 1 is a schematic view of the structure of the rough-edged screw of the present invention (suitable for the elderly)
  • Figure 2 is a schematic view of the structure of the rough-edged screw of the present invention (suitable for young people)
  • Figure 3 is a schematic view of the structure of the push rod of the present invention
  • Figure 4 is a schematic cross-sectional view of the screw and through hole of the present invention
  • Figure 5 is a schematic view of the structure of the gasket of the present invention.
  • Figure 6 is a schematic view of the state of use of the utility model (sleeve connection type)
  • Figure 7 is a schematic view of the state of use of the utility model (threaded type)
  • the medical perfusion type dynamic hip screw comprises a steel plate 4, a rough-edged screw 1 for connecting the femoral neck, and a fixing screw 5, wherein the rough-edged screw is a hollow screw, and a plurality of through-holes 13 are opened at the end.
  • the central axis of the rough screw end through hole 13 intersects the central axis of the screw hollow passage 10, and the central axes of at least two through holes are not parallel. With this configuration, the fixing agent passage is provided without substantially affecting the overall strength of the screw. Such as the through hole 130 and the through hole 131 shape.
  • the number of the rough screw end through holes 13 is 2 to 11.
  • the push rod 2 is composed of a body 20 and a handle 21, and the body 20 is engraved with a scale 201, and A plurality of spacers 3 are provided, and the number of the spacers 3 can be increased or decreased to control the length of the body 20 to prevent excessive damage to the femur.
  • a plurality of inclined holes 16 can be arranged on the rough-edged screw. The position is adapted to the broken bone.
  • a fixative or a nutrient can be inserted into the passage 10, and the oblique hole 16 is inserted into the broken bone wound, which is beneficial to the healing of the wound.
  • the steel plate 4 is provided with a sleeve 41, and the root portion 14 of the rough-edged screw extends into the sleeve.
  • the rough-edged screw can slide on the sleeve 41, and has the dual functions of pressure and sliding.
  • the screw can be shortened along the sleeve 41, avoiding the nail tip penetrating the femoral head and making the fracture The broken end is powered by pressure.
  • This solution is suitable for young people or patients with better bone condition, and pushes CaS0 4 or artificial bone powder into the hollow channel 10 through the putter 2, and then spreads through the end through hole 13 and the end hole 101 and the like.
  • a dendritic bifurcation is formed, which increases the area of the force and achieves a good fixation effect.
  • the rough-edged screw 1 is screwed to the steel plate 4.
  • the roughened screw 1 root 14 can be provided with a section of external thread 11. It can be screwed with the tension thread 12 of the rough screw 1 to appropriately increase the power pressurization.
  • the end cap 15 with an internal thread is fixedly connected to the steel plate 4, and the fixing screw and the steel plate are also fixedly connected. This program is more suitable for patients whose bone density is not fixed enough, such as elderly patients with more severe bones.
  • the pusher 2 pushes bone cement or other coagulant into the hollow channel, and then spreads through the end through hole to the femur. Inside, a dendritic bifurcation is formed, which increases the area of the force and achieves a good fixing effect.
  • the medical perfusion type dynamic hip screw of the present invention preferably uses the following parameters:
  • the neck dry angle is 135.
  • the thickness of the steel plate is 6mm
  • the width of the steel plate is 190mm
  • the hole pitch is 16mm
  • the diameter of the rough screw screw is 8mm
  • the thread depth is 3mm
  • the thread length is 22mm
  • the through hole diameter is 2.8mm
  • the rough thread screw is 50-110mm.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Description

医用灌注式动力髋螺钉 技术领域
本实用新型属于用于骨外科固定的医疗器具，具体是一种中空的 灌注式动力髋螺釘。 背景技术
股骨粗隆间骨折多见老年人。 因老年人骨质疏松， 跌倒时下肢突 然扭转或急剧过度外展或内收， 或外力直接沖击大粗隆即可发生骨 折。 若不及时治疗， 因长期卧床， 可引起褥疮等并发症。 且治疗不当 可引起畸形愈合， 影响患肢功能， 所以应及时治疗。
保守治疗股骨粗隆间骨折的死亡率为 36.4% , 而手术治疗死亡率 为 17.5%, 因此尽早手术， 坚强固定， 早期锻炼是治疗股骨粗隆间骨 折的首选方案。
目前普遍采用动力髋螺釘作为内固定物治疗股骨粗隆间骨折。但 是由于现有髋螺釘仅通过拉力螺纹进行加压固定，螺釘与股骨内骨组 织接触面较小， 难以达到良好的固定效果。
发明内容
本实用新型针对现有技术的不足， 提供了一种医用灌注式髋螺 釘， 通过在螺釘的中空通道灌注固定剂， 增强了断端间的固定效果。
本实用新型的具体技术方案是：
医用灌注式动力髋螺釘， 包括钢板、 连接股骨颈的粗纹螺釘和固 定螺釘， 其特征在于所述粗纹螺釘为中空螺釘， 端部开有若干通孔。
优化地， 所述粗纹螺釘根部设有一段外螺纹。 可与粗纹螺釘的拉 力螺纹螺向一致，起到适当地增加动力加压的效果， 同时可与钢板上 的螺纹配合， 起到两者的固定作用。
优化地，所述粗纹螺釘端部通孔的中轴线与螺釘中空通道的中轴 线相交， 至少两个通孔的中轴线不相平行。 通过此结构设置， 在提供 固定剂通道的同时基本不影响螺釘的整体强度。
优化地， 所述粗纹螺釘端部通孔的数量为 2 ~ 11个。
优化地， 所述钢板设有套筒， 粗纹螺釘的根部伸入套筒。 粗纹螺 釘可在套筒上滑动， 兼具加压和滑动的双重作用， 当骨折端有骨质吸 收时， 螺釘可以沿套筒缩短， 避免了釘尖穿出股骨头， 而且使骨折断 端得到动力加压。 此方案适合年轻人或骨质酥松情况较好的病者， 通 过配设的推杆将 CaS04或人工骨粉等推入中空通道，然后通过端部通 孔散布于股骨内， 增加了受力面积， 达到良好的固定效果。
另一个优化方案是所述粗纹螺釘与钢板螺接固定。通过内设内螺 纹的尾帽与钢板固定连接。此方案较为适合骨密度达不到固定所需的 患者如骨质酥松较为严重的老年患者，通过推杆将骨水泥或其他凝固 剂等推入中空通道， 然后通过端部通孔散布于股骨内， 形成树枝状分 叉， 增加了受力面积， 达到良好的固定效果。
本实用新型可采用材质为钛合金。
其中， 螺釘还可在端部设置切削面， 在螺釘外周沿中轴线设置退 料槽。
本实用新型的实施过程为： 在 X光透视下用导针进行定位， 然 后进行测深， 选取合适长度的粗纹螺釘， 在与钢板及固定螺釘配合固 定连接断骨后， 在粗纹螺釘的中空通道内灌注固定剂， 根据要求增减 推进杆的垫片， 达到合适的长度后用推进杆做抽插推进， 使得固定剂 沿着螺釘端部的通孔和端头的通道口压出，填补由于骨质疏松等引起 的骨密度达不到固定所需指标的骨头内部， 固定剂固定后形成树枝状 分叉， 与螺釘一道构成牢固的端部固定效果， 解决了螺釘松动和折断 问题， 增大了抗扭转力， 其中， 固定剂不断地补充由于压出引起的空 隙， 直至填满整个螺釘中空通道。 与钢板和固定螺釘一起固定断骨。
根据患者具体状况选择固定剂， 老年患者选用骨水泥， 中青年患 者选用人工骨粉或其他生物材料如 CaS04。 附图说明
图 1为本实用新型的粗纹螺釘结构示意图 （适合老年人）
图 2为本实用新型的粗纹螺釘结构示意图 （适合年轻人）
图 3为本实用新型推进杆结构示意图
图 4为本实用新型螺釘与通孔的剖面结构示意图
图 5为本实用新型垫片结构示意图
图 6为本实用新型使用状态示意图 （套筒连接型）
图 7为本实用新型使用状态示意图 （螺纹连接型）
其中， 粗纹螺釘 1 , 推杆 2, 垫片 3, 钢板 4, 固定螺釘 5, 固形 剂 6, 固形剂 7, 通道 10, 外螺纹 11 , 拉力螺纹 12, 通孔 13, 螺釘 根部 14, 尾帽 15, 斜孔 16, 本体 20, 把手 21 , 刻度 201 , 通孔 130, 通孔 131 , 端孔 101。
具体实施方式
以下结合附图对本实用新型作进一步的描述。
医用灌注式动力髋螺釘， 包括钢板 4、 连接股骨颈的粗纹螺釘 1 和固定螺釘 5, 所述粗纹螺釘为中空螺釘， 端部开有若干通孔 13。
粗纹螺釘端部通孔 13 的中轴线与螺釘中空通道 10的中轴线相 交， 至少两个通孔的中轴线不相平行。 通过此结构设置， 在提供固定 剂通道的同时基本不影响螺釘的整体强度。如通孔 130和通孔 131状。
粗纹螺釘端部通孔 13的数量为 2 ~ 11个。
推杆 2由本体 20和把手 21组成， 本体 20上刻有刻度 201 , 并 配设有若干垫片 3 , 可增减垫片 3数量对本体 20的长度进行控制， 防止过长损伤股骨。
粗纹螺釘上可设置若干斜孔 16, 其位置与断骨处相适应， 可在 通道 10内打入固定剂或营养剂等， 穿过斜孔 16进入断骨创面， 有利 于创面的愈合。
方案一， 钢板 4设有套筒 41 , 粗纹螺釘的根部 14伸入套筒。 粗 纹螺釘可在套筒 41上滑动， 兼具加压和滑动的双重作用， 当骨折端 有骨质吸收时， 螺釘可以沿套筒 41缩短， 避免了釘尖穿出股骨头， 而且使骨折断端得到动力加压。此方案适合年轻人或骨质酥松情况较 好的病者， 通过配设的推杆 2将 CaS04或人工骨粉等推入中空通道 10, 然后通过端部通孔 13及端孔 101等散布于股骨内， 形成树枝状 分叉， 增加了受力面积， 达到良好的固定效果。
方案二是粗纹螺釘 1与钢板 4螺接固定。 粗纹螺釘 1根部 14可 设有一段外螺纹 11。 可与粗纹螺釘 1的拉力螺纹 12螺向一致， 起到 适当地增加动力加压的效果。 通过内设内螺纹的尾帽 15与钢板 4固 定连接， 同时固定螺釘与钢板也为固定连接。 此方案较为适合骨密度 达不到固定所需的患者如骨质酥松较为严重的老年患者， 通过推杆 2 将骨水泥或其他凝固剂等推入中空通道，然后通过端部通孔散布于股 骨内， 形成树枝状分叉， 增加了受力面积， 达到良好的固定效果。
其中， 本实用新型医用灌注式动力髋螺釘较佳地选用以下参数： 颈干角为 135。 ，钢板厚度为 6mm,钢板宽度 190mm,孔间距 16mm, 粗纹螺釘釘杆直径 8mm, 螺纹深度 3mm, 螺纹长度 22mm, 通孔直 径 2.8mm, 粗纹螺釘规格长度 50-110mm。
应当指出的是， 本实用新型不仅仅局限于上述实施例，任何普通 技术人员作出的筒单变形均应认为落入本实用新型的保护范围。

Claims

权 利 要 求 书 、 医用灌注式动力髋螺釘， 包括钢板、 粗纹螺釘和固定螺釘， 其 特征在于所述粗纹螺釘为中空螺釘， 端部开有若干通孔。
、 根据权利要求 1所述的动力髋螺釘， 其特征在于所述粗纹螺釘 根部设有一段外螺纹。
、 根据权利要求 1所述的动力髋螺釘， 其特征在于粗纹螺釘端部 通孔的中轴线与螺釘中空通道的中轴线相交， 至少两个通孔的 中轴线不相平行。
、 根据权利要求 1所述的动力髋螺釘， 其特征在于粗纹螺釘端部 通孔的数量为 2 ~ 11个。
、 根据权利要求 1所述的动力髋螺釘， 其特征在于所述钢板设有 套筒， 粗纹螺釘的根部伸入套筒。
、 根据权利要求 2所述的动力髋螺釘， 其特征在于所述粗纹螺釘 与钢板螺接固定。
PCT/CN2011/078531 2010-08-25 2011-08-17 医用灌注式动力髋螺钉 WO2012025027A1 (zh)

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CN201020504397.5 2010-08-25

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CN201790888U (zh) * 2010-08-25 2011-04-13 顾军 医用灌注式动力髋螺钉
CN103445851B (zh) * 2012-12-28 2015-09-02 林达生 可撑开植骨的动力髋螺钉
CN105496528A (zh) * 2016-01-16 2016-04-20 北京大学深圳医院 经皮可折断空心拉力螺钉及骨连接用组件
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