WO2018072100A1 - 一种护翼型角钢板以及骨干固定系统 - Google Patents

一种护翼型角钢板以及骨干固定系统 Download PDF

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Publication number
WO2018072100A1
WO2018072100A1 PCT/CN2016/102447 CN2016102447W WO2018072100A1 WO 2018072100 A1 WO2018072100 A1 WO 2018072100A1 CN 2016102447 W CN2016102447 W CN 2016102447W WO 2018072100 A1 WO2018072100 A1 WO 2018072100A1
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WO
WIPO (PCT)
Prior art keywords
locking
backbone
steel plate
angle steel
wing
Prior art date
Application number
PCT/CN2016/102447
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English (en)
French (fr)
Inventor
陈华
唐佩福
Original Assignee
陈华
唐佩福
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 陈华, 唐佩福 filed Critical 陈华
Priority to JP2019520854A priority Critical patent/JP2019533507A/ja
Priority to EP16919528.6A priority patent/EP3530222A4/en
Priority to PCT/CN2016/102447 priority patent/WO2018072100A1/zh
Priority to US16/343,152 priority patent/US11116555B2/en
Publication of WO2018072100A1 publication Critical patent/WO2018072100A1/zh
Priority to JP2021165590A priority patent/JP2022002747A/ja

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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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • 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
    • 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
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8014—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the extension or compression force being caused by interaction of the plate hole and the screws
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • 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
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/8615—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the central region of the screw 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • 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
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526—Methods of manufacturing

Definitions

  • the invention relates to the technical field of medical instruments, in particular to a wing-shaped angle steel plate and a bone fixation system for nonunion or fracture nonunion after a bone fracture.
  • the stability of the fracture end can be basically divided into two categories of stability and instability.
  • stable fractures it is usually repaired by hand, using external fixation such as plaster, splint, brace, traction brake to maintain stable fixation and final healing.
  • external fixation such as plaster, splint, brace, traction brake to maintain stable fixation and final healing.
  • unstable fixation surgical treatment is needed, including internal fixation system and The external fixation system, wherein the internal fixation system is further divided into a nail plate fixation system and an intramedullary nail fixation system.
  • the invention is directed to the problem of instability of the fracture end, non-union of the fracture or delayed healing after the fixation of the bone fracture in the prior art by using the nail plate system, and a wing-shaped angle steel plate structure is proposed, which is connected and matched with each other.
  • the matching flap part and the body fixing part which are closely attached to the backbone can stably fix the fracture end and support the fracture end of the backbone fracture from the inner side, prevent the fracture end from being dislocated, and assist the accurate positioning, reduction and healing of the fracture site.
  • the invention also relates to a backbone fixation system.
  • a wing-shaped angle steel plate comprising: a fitting wing portion and a body fixing portion, the bonding wing portion and the body
  • the body fixing portions are fixedly connected to each other, and the fitting wing portions are configured to support the fracture end and have a structure matching the inner side surface of the backbone
  • the body fixing portion is configured to fix the fitting wing portion and has a front side with the backbone a matching structure
  • the body fixing portion is provided with at least two first locking holes for passing through the first locking screw at a position at the boundary with the fitting wing portion, the angle of the first locking hole Passing the first locking screw to ensure that the body fixing portion and the fitting wing portion are in close contact with the backbone and supporting the inner side of the backbone
  • the body fixing portion is provided with at least two structures on the structure matching the front side of the backbone
  • a second locking hole passing through the second locking screw the second locking hole being angled such that the passing second locking screw achieves the body fixing portion in close contact with the backbone and controls the rotation and axial stability
  • the fitting flap portion has a structure that completely covers the broken end of the fracture.
  • the abutment flap has a structure that exposes the fracture end and supports the fracture end at the distal end and the proximal end of the fracture end, respectively.
  • the fitting wing portion and the body fixing portion are fabricated by an integral molding process.
  • the body fixing portion is further provided with at least two lateral pressing holes for passing through the pressing screw on the structure matching the front side of the backbone, the angle of the lateral pressing hole is such that the pressing screw passes through Pressure is generated between the backbone and the wing-shaped angle plate.
  • the body fixing portion has three second locking holes disposed on the structure matching the front side of the backbone, and the three second locking holes are arranged in a line or in a triangle.
  • the body fixing portion has four or more second locking holes disposed on the structure matching the front side of the backbone, and four or more second locking holes are arranged in a line or in a polygonal shape.
  • a backbone fixing system comprising the above-mentioned wing type angle steel plate, further comprising a first locking screw for fixing the wing angle steel plate through the first locking hole and a second through the second locking hole a locking screw and a backbone outer locking structure for fixing the fracture end, the backbone outer locking structure comprising a locking plate and at least two third locking screws for fixing the locking plate, the locking plate having a matching outer side of the backbone
  • the locking plate is provided with at least two third locking holes for passing through the third locking screw on the structure matching the outer side surface of the backbone, and the third locking screw passes through the locking plate Three locking holes.
  • the first locking screw and the second locking screw for fixing the wing angle steel plate have a diameter ranging from 2.4 to 4.5 mm.
  • the first locking screw and/or the second locking screw and/or the third locking screw are hollow locking screws or solid locking screws.
  • the invention relates to a wing-shaped angle steel plate, comprising a fitting wing part and a body fixing part, wherein the bonding wing part and the body fixing part are fixedly connected to each other and preferably integrally formed integrally, and the fitting wing part is used for supporting
  • the fracture end has a structure matching the inner side of the backbone
  • the body fixing portion is configured to fix the fitting wing portion and has a structure matching the front side of the backbone
  • the fixing portion is provided with at least two first locking holes for passing through the first locking screw at a portion at the boundary with the fitting wing portion and at least two are provided on the structure matching the front side of the backbone
  • the first locking hole and the second locking hole each have respective specific angles to achieve a specific function in cooperation with the first locking screw and the second locking screw, respectively.
  • the wing-type angle steel plate proposed by the invention has the joint wing portion and the body fixing portion connected to each other and cooperated to fix and support the broken end portion of the bone fracture, thereby enhancing the stability of the fracture end and effectively ensuring the stable reduction of the auxiliary fracture site.
  • the specific structure of the fitting wing portion and the body fixing portion cooperate with the first locking hole at a specific angle, so that the body fixing portion and the sticker can be realized after the first locking screw is inserted in the direction of the first locking hole
  • the protective wing is in close contact with the backbone (ie, the wing-shaped angle steel plate closely fits the backbone) and supports the inner support of the backbone; and the second locking hole is provided at a specific angle so that the second locking screw follows the second locking hole
  • the body fixing portion can be in close contact with the backbone and the rotation and axial stability of the body fixing portion can be controlled; and in actual use, the first part can be minimally invasively placed on the front side of the backbone and used to fix the wing-shaped angle steel plate.
  • the insertion of the first and second locking screws can be prevented from being interfered with by the original fixing, in particular, the structure of the fitting wing portion is ingenious, which solves the problem that the prior art cannot be minimally invasive on the inner side of the backbone.
  • the problem is still in the anterior incision of the diaphysis, but the fitted flap portion can extend into the inner side of the backbone to support the fracture end and can be placed at a specific angle through the first locking hole to enable it to cooperate with the first locking screw.
  • the inner support of the backbone is realized to further enhance the reliability of the fixation after the reduction, thereby facilitating fracture healing.
  • the fitting wing portion may preferably adopt a structure having a fitting wing portion that completely covers the fracture end, or may have a shape that exposes the fracture end and is at the fracture end.
  • the end and the proximal end respectively support the structure of the conforming wing portion of the fracture end, and the specific shape structure can be reasonably selected according to the fracture site, so as to achieve support, stabilize the fracture end, or cover the fracture end portion. Or the fracture end portion is exposed, and the fracture end portion is matched to accelerate the fracture healing and make the fracture healing state better.
  • the invention also relates to a backbone fixing system, comprising the above-mentioned wing-shaped angle steel plate, a first locking screw and a second locking screw, and a backbone outer locking structure, the above components are used together, and the wing-shaped angle steel plate realizes effective fracture
  • the end part supports and fixes and close contact with the backbone.
  • the outer locking structure of the backbone uses the locking plate to achieve accurate positioning and fixation of the bone fracture site, further strengthens the effective support and fixation for the bone fracture, and assists the accurate positioning of the fracture site, effectively protecting The stability of the bone fracture after reduction.
  • Figure 1 is a schematic diagram of bone nonunion after a bone fracture.
  • Fig. 2 is a front view showing a first preferred structure of the wing type angle steel plate of the present invention.
  • Figure 3 is a front view of a second preferred structure of the wing-type angle steel plate of the present invention.
  • Fig. 4 is a structural schematic view showing the state of use of the first preferred wing-shaped angle steel plate of the present invention.
  • Fig. 5 is a structural schematic view showing the state of use of a second preferred wing-shaped angle steel plate of the present invention.
  • Fig. 6 is a schematic view showing the structure of a third preferred wing-shaped angle steel plate according to the present invention.
  • Fig. 7 is a schematic view showing the structure of a fourth preferred wing-shaped angle steel plate according to the present invention.
  • Figure 8 is a side view of Figure 6 or Figure 7.
  • Figure 9 is a front elevational view showing the structure of a preferred bone fastening system of the present invention.
  • Fig. 10 is a front elevational view showing the structure of a preferred embodiment of the present invention.
  • the invention relates to a wing-shaped angle steel plate, comprising a bonding wing part and a body fixing part, wherein the bonding wing part and the body fixing part are fixedly connected to each other, and the fitting wing part is used for supporting a bone fracture, that is, a fracture
  • the end portion has a structure matching the inner side surface of the backbone
  • the body fixing portion is configured to fix the fitting wing portion, and has a structure matching the front side of the backbone
  • the body fixing portion is at a boundary with the fitting wing portion
  • At least two first locking holes for passing through the first locking screw are disposed on the portion, the angle of the first locking hole is such that the first locking screw that passes through achieves close contact between the body fixing portion and the fitting wing portion and realizes Supporting the inner side of the backbone
  • the body fixing portion is provided with at least two second locking holes for passing through the second locking screw on the structure matching the front side of the backbone, the angle of the second locking hole is such that the The second locking screw realizes
  • the conforming flap portion may be designed to completely cover the fracture nonunion or the structure of the nonunion portion of the fracture end, and may also be designed to expose the fracture nonunion or the structure of the nonunion portion of the fracture end.
  • the second fixing hole of the body fixing portion disposed on the structure matching the front side of the backbone may be three, and the three second locking holes are arranged in a straight line or in a triangle shape; or the body fixing portion is on the front side with the backbone
  • the second locking holes provided on the matching structure may be four or more, and each of the second locking holes is arranged in a straight line or in a polygonal shape.
  • the wing-shaped angle steel plate of the present invention may be according to the body.
  • the fixing portion is arranged on the structure matching the front side of the backbone
  • the number of locking holes is determined to determine the length of the wing-shaped angle steel plate.
  • the length of the wing-shaped angle steel plate may be four holes, six holes or eight holes.
  • FIG. 2 is a front view of a first preferred structure of the airfoil angle steel plate 2 of the present invention.
  • this embodiment includes a fitting wing portion 20 and a body fixing portion 21, and a flap portion 20 and a body.
  • the fixing portions 21 are fixedly connected to each other, and preferably the fitting wing portions 20 and the body fixing portions 21 can be made by a stainless steel material integrally forming process; the fitting wing portions 20 are used for supporting, stabilizing the bone fractures and having the inner side of the backbone
  • the surface matching structure, and the fitting wing portion 20 has a structure for completely covering the fracture of the fracture, that is, the fracture nonunion or the nonunion portion of the fracture end, to support and stabilize the fracture end and promote fracture healing;
  • the portion 21 is for fixing the fitting flap portion 20 and has a structure matching the front side of the backbone, and the body fixing portion 21 is provided with two for passing through the first portion at the boundary with the fitting flap portion 20.
  • the first locking hole of the locking screw (such as the reference numerals 2203 and 2204, that is, the first locking hole 2203 and the first locking hole 2204) is fixed when the first locking screw is used to fix the fixed wing portion 20 and fix the body
  • the portion 21 and the fitting wing portion 20 are in close contact Drying and achieving inner support for the backbone
  • the body fixing portion 21 is provided with two second locking holes for passing through the second locking screw on the structure matching the front side of the backbone (eg, numerals 2201 and 2202, ie, second
  • the locking hole 2201 and the second locking hole 2202 are fixed when the second locking screw is used to achieve axial support, fixation, anti-rotation and close-fitting with the front side of the backbone
  • the body fixing portion is 21
  • the structure matching the front side of the backbone is further provided with two lateral pressing holes for passing through the pressing screws (such as the numerals 2205 and 2206, that is, the lateral pressing holes 2205 and the lateral pressing holes 2206).
  • the pressing screw When the pressing screw is locked at an angle in the lateral direction, pressure can be generated between the backbone and the wing-shaped angle steel plate to further strengthen the close fit of the fitting wing portion 20 and the inner side surface of the backbone, and at the same time, the body fixing portion 21 and the front side of the backbone
  • the close fitting that is, the close contact/close fit of the wing-shaped angle steel plate 2 and the long bone backbone.
  • the second locking hole 2201, the second locking hole 2202, the lateral pressing hole 2205, and the lateral pressing hole 2206 are arranged in an approximately straight line, and the arrangement shape thereof can be arbitrarily set, and only needs to be effective.
  • the wing-type angle steel plate 2 proposed by the present invention adopts a structure including an integrally formed body fixing portion 21 and a fitting wing portion 20, and the fitting wing portion 20 has a structure matching the inner side surface of the backbone, which can fracture the fracture.
  • the fractures of the end are not healed or the non-connected parts are well stabilized and supported, and the fracture site is accurately positioned and healed, which effectively ensures the stability of the fracture healing;
  • the body fixing portion 21 has a structure matching the front side of the backbone. It can realize the axial positioning and fixation of the long bone fracture area, prevent the dislocation of the fracture site, and play a good role of fitting and fixing, further ensuring the accurate positioning, reduction and healing of the auxiliary fracture site.
  • FIG. 3 is a front view of a second preferred structure of the airfoil angle steel plate 2 of the present invention.
  • the wing angle steel plate 2 also includes a fitting wing portion 20 which is fixedly coupled to each other and each has a specific structure.
  • the body fixing portion 21, in this embodiment except for the fitting of the wing portion 20 and its functions are identical to those of the embodiment shown in Fig. 2, the fitting wing portion 20 is still used Supporting the fracture end of the fracture and having a structure matching the inner side of the backbone, with the embodiment of FIG. 2 The difference is that the fitting flap portion 20 shown in the embodiment of Fig.
  • the proximal end supports the structure of the fracture end to achieve the support and stabilize the fracture end, and expose the fracture end, accelerate the fracture healing and make the fracture healing state better.
  • FIGS. 4 to 8 The structural schematic diagram of the preferred state of use of the wing-shaped angle steel plate 2 proposed by the present invention is as shown in FIGS. 4 to 8.
  • the front side of the backbone 1 is the non-contiguous portion of the bone.
  • the skin, subcutaneous, quadriceps muscle and periosteum are exposed, and the nonunion is revealed.
  • the cortical bone cutting is performed on the nonunion site with a sharp bone knife to fully expose the nonunion.
  • Using a Kirschner wire and a bone knife to make a groove in the nonunion site using a Kirschner wire to re-pass the medullary cavity; using a minimally invasive bone drill to take the bone mud and the structural bone graft; Fill the nonunion site, insert the structural bone graft into the medullary cavity of the nonunion site; backfill with the slotted bone; use the extensibility of the skin and muscle to make the subperiosteal strip; then place it under the periosteum as shown in Figure 2 or The flap-type angled steel plate 2 shown in FIG.
  • FIG. 3 has the body fixing portion 21 placed on the front side of the backbone and at the same time the flap portion 20 is inserted into the inner side of the backbone to protect the fracture end portion, and fits inside the flap portion 20.
  • the side surface is in close contact with the inner side of the backbone to provide a good support and support effect, wherein
  • the embodiment shown in Figures 4 and 6 employs a wing-type angled steel plate 2 having a structure of a conforming wing portion 20 that completely covers the fracture end as shown in Figure 2, as shown in Figures 5 and 7.
  • the embodiment adopts a wing-shaped angle steel plate 2 having a structure of a fitting wing portion 20 having an exposed fracture end and a distal end and a proximal end of the fracture end, respectively, as shown in FIG.
  • the inner side surface of the fixing portion 21 is in close contact with the front side of the backbone to provide a stable anti-rotation fixation function, and the fitting wing portion 20 and the body fixing portion 21 cooperate with each other to perfectly realize effective inner support for the bone fracture. And fixation, assisting the accurate location and healing of the fracture site, effectively ensuring the stability of the fracture healing of the bone fracture.
  • the first locking screw 2303 and the first locking screw 2304 respectively pass through the two first locking holes 2203 provided at the portion of the body fixing portion 21 at the boundary with the fitting wing portion 20.
  • first locking hole 2204 to achieve the fixing of the fitting wing portion 20, the body fixing portion 21 and the fitting wing portion 20 in close contact with the backbone and the inner side support for the backbone; the second locking screw 2301 and the second locking screw
  • the second locking hole 2201 and the second locking hole 2202 are respectively disposed on the structure matching the front side of the backbone body through the body fixing portion 21 to realize axial support, fixation, anti-rotation, and backbone of the body fixing portion 21.
  • the front side is closely fitted, as shown in the embodiment shown in Figures 6 and 7 (Fig. 8 is the side view of Fig. 6 or Fig. 7), four second locking holes and four matching second locking screws are provided.
  • a second locking screw 2307 and a second locking screw 2308 are provided, and the four second locking screws may be arranged in a straight line or in a polygonal shape to further strengthen the body fixing.
  • the close contact/close fit of the wing-shaped angle steel plate 2 and the long bone backbone is achieved.
  • the negative pressure drainage tube was left, and the periosteum, myofascial fascia, deep fascia, subcutaneous and skin were closed by suture; the drainage tube was pulled out 48 hours after the operation.
  • the patients with fractures had daily passive extreme knee mobility exercises, lower limb limb isometric contraction exercises, and weight-bearing activities under pain tolerance (5 kg toes). The x-ray is reviewed monthly, and the weight-bearing process is determined according to the fracture healing condition; until the patient is fully recovered.
  • the invention also relates to a backbone fastening system comprising a wing angle steel plate, at least four locking screws for fixing the wing angle steel plate (at least two first locking screws passing through the first locking hole and at least two a second locking screw passing through the second locking hole) and a trunk outer locking structure for fixing the fracture end, wherein the wing type angle steel plate can adopt the wing type angle steel plate structure as shown in FIG.
  • the outer locking structure includes a locking plate and at least two third locking screws for fixing the locking plate, the locking plate having a structure matching the outer side of the backbone, the locking plate being provided with at least two for the structure matching the outer side of the backbone Through the third locking hole of the third locking screw, each of the third locking screws passes through the third locking hole of the locking plate.
  • the locking screws (first locking screw and second locking screw) for fixing the wing angle steel plate have a diameter ranging from 2.4 to 4.5 mm; and a locking screw for fixing the wing angle steel plate (first locking screw)
  • Both the second locking screw and the locking screw (third locking screw) for fixing the locking plate may be a hollow locking screw or a solid locking screw.
  • FIG. 9 and FIG. 10 are schematic structural views showing a state of use of a preferred bone fastening system, including the above-mentioned wing-type angle steel plate 2 and backbone outer locking structure 3 as shown in FIG. 2 or FIG. 3, wherein FIG. 9 A flap type angled steel plate 2 having a structure of a fitting flap portion 20 completely covering the fracture end as shown in Fig. 2 is used, and Fig. 10 is used to have an exposed fracture end as shown in Fig. 3. And at the distal end and the proximal end of the fracture end, respectively support the wing-shaped angle steel plate 2 of the structure of the flap portion 20, and then adopt a plurality of locking screws as shown in FIG. 4-8.
  • the retaining wing angle steel plate 2 is fixed in the manner described herein;
  • the backbone outer locking structure 3 includes a locking plate 30 and a third locking screw for fixing the locking plate 30.
  • the locking plate 30 is preferably a simple rectangular structure and locked
  • the plate 30 has a structure matching the outer side surface of the backbone, and the locking plate 30 is provided with a plurality of openings (third locking holes) on the structure matching the outer side of the backbone, corresponding to the number of openings in the locking plate 30, corresponding
  • the number of the third locking screws of the fixed locking plate 30 can be set Multiple, and the locking screws can be arranged in parallel with each other or some or all of them are arranged at an angle to each other.
  • the third locking screw can select a hollow locking screw or a solid locking screw, the number of screws, the shape of the screw arrangement, and the screw and the locking plate.
  • the angle between 30 can be set according to actual needs, only need to ensure effective fixation, that is, through reasonable layout, each locking screw bears different stresses respectively, so as to achieve accurate positioning and stable resetting of the auxiliary fracture site, which can maximize the reinforcement. Optimal fixation stability, and to the greatest extent possible to ensure less damage to patients in actual use.
  • the outer trunk locking structure 3 and the wing-shaped angle steel plate 2 are both The same conventional anterior lateral incision can be placed together, and only one incision can be used to achieve the implantation of the bone fixation system of the present invention, and the damage surface, the degree of damage and the amount of bleeding are usually smaller, postoperative healing and The recovery speed is faster.
  • the working principle and usage of the wing-type angle steel plate 2 shown in Figure 2-8 are the same as described above.
  • the outer trunk locking structure 3 adopts the structure of the locking plate 30, and the locking plate 30 is in close contact with the outer side surface of the backbone.
  • a plurality of third locking screws pass through the opening of the locking plate 30 and then enter from the outer side of the backbone and traverse the backbone. To fix the fracture end.
  • the outer lateral locking structure 3 and the wing-shaped angle steel plate 2 cooperate to further strengthen the effective support and fixation for the bone fracture, and assist the accurate positioning of the fracture site, thereby effectively ensuring the stability of the bone fracture after the reduction.

Abstract

一种护翼型角钢板（2）以及骨干固定系统，护翼型角钢板（2）包括贴合护翼部（20）和本体固定部（21），贴合护翼部（20）和本体固定部（21）相互固定连接，贴合护翼部（20）用于撑护骨折断端且具有与骨干（1）的内侧面相匹配的结构，本体固定部（21）用于固定贴合护翼部（20）且具有与骨干（1）前侧面相匹配的结构，本体固定部（21）在与贴合护翼部（20）相交界处的部位上设置有至少两个用于穿过第一锁定螺钉（2303、2304）的第一锁定孔（2203、2204）且在与骨干（1）的前侧面相匹配的结构上设置有至少两个用于穿过第二锁定螺钉（2301、2302、2307、2308）的第二锁定孔（2201、2202）。护翼型角钢板（2）、贴合护翼部（20）和本体固定部（21）相互连接且相互配合以固定且撑护骨干（1）骨折断端部位，有效地保障辅助骨折部位稳定复位和愈合。

Description

一种护翼型角钢板以及骨干固定系统 技术领域
本发明涉及医疗器械技术领域，尤其是涉及一种用于骨干骨折后的骨不连或骨折不愈合的护翼型角钢板以及骨干固定系统。
背景技术
现有技术中，骨折发生以后，根据骨折断端的稳定程度基本可以分为稳定和不稳定两大类。对于稳定的骨折，通常通过手法整复、采用石膏、夹板、支具、牵引制动等外固定方式以维持稳定固定、最终愈合；而对于不稳定固定，则需要手术治疗，包括内固定系统和外固定系统，其中内固定系统又分为钉板固定系统和髓内钉固定系统。但是无论采取上述何种治疗方式，大样本的随访研究显示部分患者会发生骨折不愈合或延迟愈合，且发生率达到了10％。
对于这部分钉板系统固定发生骨折不愈合或延迟愈合患者，除感染因素外，据骨折部位骨痂生成的多少基本分为多骨痂或少骨痂两大类；据骨折断端稳定程度可以分为稳定或不稳定两大类。针对骨折断端稳定、多骨痂患者，大多可采取观察处理方式；骨折断端稳定、少骨痂患者，则可以采取植骨治疗方式。而对于不稳定的骨折，无论是多骨痂或少骨痂，因为骨折局部不稳定，所以需要采取各种方式加强骨折断端的稳定、以促进骨折逐渐愈合。然而环顾临床上可以选用的内固定方式，依然均无法完美解决钉板系统固定后骨折部位的骨折断端存在缺损或骨折粉碎的骨折断端不稳定、骨折不愈合或骨不连(例如图1中虚线圆框所示的一种骨干1骨折后骨不连10)的内固定等问题，即目前没有专门针对骨不连和骨折不愈合设计的稳固医疗器件，因此亟需研发一种骨不连和骨折不愈合的内固定器件、系统或方法。
发明内容
本发明针对现有技术中骨干骨折采用钉板系统固定后发生的骨折断端不稳定、骨折不愈合或延迟愈合等问题，提出的一种护翼型角钢板结构，其采用相互连接且相互配合、有紧密贴合骨干的贴合护翼部和本体固定部，能够完成骨折断端稳定固定且从内侧支撑骨干骨折断端部位、防止骨折断端错位，并辅助骨折部位准确定位、复位和愈合。本发明还涉及一种骨干固定系统。
本发明的技术方案如下：
一种护翼型角钢板，其特征在于，包括贴合护翼部和本体固定部，所述贴合护翼部和本 体固定部相互固定连接，所述贴合护翼部用于撑护骨折断端且具有与骨干内侧面相匹配的结构，所述本体固定部用于固定贴合护翼部且具有与骨干前侧面相匹配的结构，所述本体固定部在与贴合护翼部相交界处的部位上设置有至少两个用于穿过第一锁定螺钉的第一锁定孔，所述第一锁定孔的角度使得穿过的第一锁定螺钉实现本体固定部和贴合护翼部紧密接触骨干以及实现对骨干的内侧支撑，所述本体固定部在与骨干前侧面相匹配的结构上设置有至少两个用于穿过第二锁定螺钉的第二锁定孔，所述第二锁定孔的角度使得穿过的第二锁定螺钉实现本体固定部紧密接触骨干以及控制本体固定部旋转和轴向稳定。
所述贴合护翼部具有完全罩住骨折断端的结构。
所述贴合护翼部具有露出骨折断端且在骨折断端的远端和近端分别撑护骨折断端的结构。
所述贴合护翼部和本体固定部采用一体成型工艺制作而成。
所述本体固定部在与骨干前侧面相匹配的结构上还设置有至少两个用于穿过加压螺钉的横向加压孔，所述横向加压孔的角度使得穿过的加压螺钉在骨干与护翼型角钢板之间产生压力。
所述本体固定部在与骨干前侧面相匹配的结构上设置的第二锁定孔为三个，三个第二锁定孔呈直线排列或呈三角形排列。
所述本体固定部在与骨干前侧面相匹配的结构上设置的第二锁定孔为四个以上，四个以上的第二锁定孔呈直线排列或呈多边形排列。
一种骨干固定系统，其特征在于，包括上述的护翼型角钢板，还包括用于固定护翼型角钢板的穿过第一锁定孔的第一锁定螺钉和穿过第二锁定孔的第二锁定螺钉以及用于固定骨折断端的骨干外侧锁定结构，所述骨干外侧锁定结构包括锁定板以及用于固定锁定板的至少两个第三锁定螺钉，所述锁定板具有与骨干外侧面相匹配的结构，所述锁定板在与骨干外侧面相匹配的结构上设置有至少两个用于穿过第三锁定螺钉的第三锁定孔，各所述第三锁定螺钉穿过所述锁定板的第三锁定孔。
所述用于固定护翼型角钢板的第一锁定螺钉和第二锁定螺钉的直径范围均为2.4-4.5mm。
所述第一锁定螺钉和/或第二锁定螺钉和/或第三锁定螺钉为空心锁定螺钉或实心锁定螺钉。
本发明的技术效果如下：
本发明涉及一种护翼型角钢板，包括贴合护翼部和本体固定部，贴合护翼部和本体固定部相互固定连接且优选可以整体一体成型，贴合护翼部用于撑护骨折断端且具有与骨干内侧面相匹配的结构，本体固定部用于固定贴合护翼部且具有与骨干前侧面相匹配的结构，本体 固定部在与贴合护翼部相交界处的部位上设置有至少两个用于穿过第一锁定螺钉的第一锁定孔且在与骨干前侧面相匹配的结构上设置有至少两个用于穿过第二锁定螺钉的第二锁定孔，第一锁定孔和第二锁定孔均具有各自特定的角度，以便在应用时分别配合第一锁定螺钉和第二锁定螺钉实现特定功能。本发明提出的护翼型角钢板，贴合护翼部和本体固定部相互连接且相互配合以固定且撑护骨干骨折断端部位，增强骨折断端稳定性，有效地保障辅助骨折部位稳定复位和愈合；特定结构的贴合护翼部和本体固定部，配合设置特定角度的第一锁定孔，这样在第一锁定螺钉顺着第一锁定孔的方向穿进后能够实现本体固定部和贴合护翼部紧密接触骨干(即护翼型角钢板紧密贴合骨干)以及实现对骨干的内侧支撑；配合设置特定角度的第二锁定孔，这样在第二锁定螺钉顺着第二锁定孔的方向穿进后能够实现本体固定部紧密接触骨干以及控制本体固定部旋转和轴向稳定；并且在实际使用时，能够在骨干前侧微创置入且用于固定该护翼型角钢板的第一和第二锁定螺钉的置入能够不受原始固定干扰，尤其是贴合护翼部结构巧妙，解决了现有技术无法在骨干内侧微创的难题，仍然在骨干前侧切口，但是设置的贴合护翼部能够伸入到骨干内侧撑护骨折断端，并通过第一锁定孔设置的特定角度使其在与第一锁定螺钉配合时能够实现对骨干的内侧支撑，以进一步增强复位后固定的可靠性，从而有利于骨折愈合。
本发明提出的护翼型角钢板，其贴合护翼部优选可以采用具有完全罩住骨折断端的贴合护翼部的结构，也可以采用具有露出骨折断端且在骨折断端的远端和近端分别撑护骨折断端的贴合护翼部的结构，具体形状结构可以根据骨折部位合理选择设置，以实现撑护、稳固骨折断端的同时，或罩住骨折断端部位，或露出骨折断端部位，配合骨折断端部位，以加速促进骨折愈合且使得骨折愈合状态更良好。
本发明还涉及一种骨干固定系统，包括上述护翼型角钢板以及第一锁定螺钉和第二锁定螺钉，还包括骨干外侧锁定结构，上述部件配合使用，护翼型角钢板实现有效的骨折断端部位撑护固定以及与骨干的紧密接触，骨干外侧锁定结构利用锁定板实现骨干骨折部位的准确定位固定，进一步强化了针对骨干骨折的有效撑护和固定，辅助骨折部位准确定位，有效地保障了骨干骨折复位后的稳定性。
附图说明
图1是骨干骨折后骨不连的示意图。
图2是本发明护翼型角钢板的第一种优选结构正视图。
图3是本发明护翼型角钢板的第二种优选结构正视图。
图4是本发明第一种优选的护翼型角钢板的使用状态的结构示意图。
图5是本发明第二种优选的护翼型角钢板的使用状态的结构示意图。
图6是本发明第三种优选的护翼型角钢板的使用状态的结构示意图。
图7是本发明第四种优选的护翼型角钢板的使用状态的结构示意图。
图8是图6或图7的侧视图。
图9是本发明一种优选的骨干固定系统的使用状态的结构正视图。
图10是本发明另一种优选的骨干固定系统的使用状态的结构正视图。
图中各标号列示如下：
1－骨干；10－骨不连；2－护翼型角钢板；20－贴合护翼部；21－本体固定部；2201－第二锁定孔；2202－第二锁定孔；2203－第一锁定孔；2204－第一锁定孔；2205－横向加压孔；2206－横向加压孔；2301－第二锁定螺钉；2302－第二锁定螺钉；2303－第一锁定螺钉；2304－第一锁定螺钉；2305－加压螺钉；2306－加压螺钉；2307－第二锁定螺钉；2308－第二锁定螺钉；3－骨干外侧锁定结构；30－锁定板。
具体实施方式
下面结合附图对本发明进行说明。
本发明涉及一种护翼型角钢板，包括贴合护翼部和本体固定部，贴合护翼部和本体固定部相互固定连接，贴合护翼部用于撑护骨干骨折处即骨折断端部位、且具有与骨干内侧面相匹配的结构，本体固定部用于固定贴合护翼部、且具有与骨干前侧面相匹配的结构，本体固定部在与贴合护翼部相交界处的部位上设置有至少两个用于穿过第一锁定螺钉的第一锁定孔，第一锁定孔的角度使得穿过的第一锁定螺钉实现本体固定部和贴合护翼部紧密接触骨干以及实现对骨干的内侧支撑，且本体固定部在与骨干前侧面相匹配的结构上设置有至少两个用于穿过第二锁定螺钉的第二锁定孔，第二锁定孔的角度使得穿过的第二锁定螺钉实现本体固定部紧密接触骨干以及控制本体固定部旋转和轴向稳定。上述贴合护翼部和本体固定部的具体结构形状，以及各锁定孔的具体位置和锁定孔个数，可以根据实际应用情况合理设置，不受本发明限制且包括但不限于上述范围限制。例如，贴合护翼部可以设计为完全罩住骨折断端的骨折不愈合或骨不连部位的结构，也可以设计为露出骨折断端的骨折不愈合或骨不连部位的结构。再例如，本体固定部在与骨干前侧面相匹配的结构上设置的第二锁定孔可以为三个，三个第二锁定孔呈直线排列或呈三角形排列；或本体固定部在与骨干前侧面相匹配的结构上设置的第二锁定孔可以为四个或更多个，各第二锁定孔呈直线排列或呈多边形排列，换而言之，本发明的护翼型角钢板，可以根据本体固定部在与骨干前侧面相匹配的结构上设 置的锁定孔个数确定护翼型角钢板长度，例如，该护翼型角钢板长度可以为四孔、六孔或八孔。
图2是本发明护翼型角钢板2的第一种优选结构正视图，如图2所示，该实施例包括贴合护翼部20和本体固定部21，贴合护翼部20和本体固定部21相互固定连接，优选贴合护翼部20和本体固定部21可以采用不锈钢材料一体成型工艺制作而成；贴合护翼部20用于撑护、稳固骨干骨折处且具有与骨干内侧面相匹配的结构，并且贴合护翼部20具有完全罩住骨干骨折处即骨折断端的骨折不愈合或骨不连部位的结构，以撑护、稳固骨折断端，促进骨折愈合；本体固定部21用于固定贴合护翼部20且具有与骨干前侧面相匹配的结构，本体固定部21在与贴合护翼部20相交界处的部位上设置有两个用于穿过第一锁定螺钉的第一锁定孔(如标号2203和2204，即第一锁定孔2203和第一锁定孔2204)，当采用第一锁定螺钉固定时，以实现贴合护翼部20的固定、本体固定部21和贴合护翼部20紧密接触骨干以及实现对骨干的内侧支撑；本体固定部21在与骨干前侧面相匹配的结构上设置有两个用于穿过第二锁定螺钉的第二锁定孔(如标号2201和2202，即第二锁定孔2201和第二锁定孔2202)，当采用第二锁定螺钉固定时，以实现本体固定部21的轴向支撑、固定、抗旋以及与骨干前侧面的紧密贴合；本体固定部在21与骨干前侧面相匹配的结构上还设置有两个用于穿过加压螺钉的横向加压孔(如标号2205和2206，即横向加压孔2205和横向加压孔2206)，当采用加压螺钉横向以一定角度锁定时，能够在骨干与护翼型角钢板之间产生压力，以进一步加强贴合护翼部20与骨干内侧面的紧密贴合以及同时本体固定部21与骨干前侧面的紧密贴合，即实现护翼型角钢板2与长骨骨干的紧密接触/紧密贴合。此外，如图2所示，第二锁定孔2201、第二锁定孔2202、横向加压孔2205和横向加压孔2206呈近似直线排列，其排列形状可以任意设定只需保证能够起到有效固定作用且尽最大可能保证在实际使用中对患者损伤较小即可。本发明提出的护翼型角钢板2采用包括一体成型的本体固定部21在与贴合护翼部20的结构，贴合护翼部20采用具有与骨干内侧面相匹配的结构，能够对骨折断端的骨折不愈合或骨不连部位进行良好稳固、撑护，辅助骨折部位准确定位和愈合，有效地保障了骨折愈合的稳定性；本体固定部21采用具有与骨干前侧面相匹配的结构，能够实现长骨骨干骨折区域轴向定位固定、防止骨折部位错位，以及起到良好的贴合、固定作用，进一步保障辅助骨折部位准确定位、复位和愈合。
图3是本发明护翼型角钢板2的第二种优选结构正视图，如图3所示，护翼型角钢板2同样包括相互固定连接并均具有特定结构的贴合护翼部20和本体固定部21，该实施例中除了贴合护翼部20之外的其它部件及其功能均与图2中所示实施例中名称相同的部件相一致，贴合护翼部20仍用于撑护骨折断端且具有与骨干内侧面相匹配的结构，与图2所示实施例的 区别是，图3实施例中所示的贴合护翼部20具有露出骨折断端的骨折不愈合或骨不连部位、且在骨折断端的骨折不愈合或骨不连部位的远端和近端分别撑护骨折断端的结构，以实现撑护、稳固骨折断端的同时，露出骨折断端部位，加速促进骨折愈合且使得骨折愈合状态更良好。
本发明提出的护翼型角钢板2的工作原理和使用方法具体说明如下：
本发明提出的优选的护翼型角钢板2的使用状态的结构示意图如图4—图8所示，在实际使用过程中，首先，在骨折部位，例如骨干1前侧面即骨不连部位正前方、沿肢体长轴切开皮肤、皮下、股四头肌肌腹、骨膜，显露骨不连部位，然后用锐性骨刀在骨不连部位做骨皮质切削术，充分暴露骨不连部位；用克氏针和骨刀在骨不连部位做开槽，用克氏针沿髓腔做再通髓腔；用微创取骨钻分别取骨泥和结构性植骨块；将骨泥填入骨不连部位，将结构性植骨嵌入骨不连部位髓腔；用开槽的骨骼回填；利用皮肤、肌肉的延展性，做骨膜下剥离；然后在骨膜下置入如图2或图3所示的护翼型角钢板2，将本体固定部21置于骨干前侧部位且同时贴合护翼部20探入骨干内侧护住骨折断端部位，贴合护翼部20的内侧面与骨干内侧面紧密接触贴合起到良好的支撑托护作用，其中，图4和图6中所示的实施例采用如图2中所示的具有完全罩住骨折断端的贴合护翼部20结构的护翼型角钢板2，图5和图7中所示的实施例采用如图3中所示的具有露出骨折断端且在骨折断端的远端和近端分别撑护骨折断端的贴合护翼部20结构的护翼型角钢板2；本体固定部21的内侧面与骨干前侧面紧密接触贴合，起到稳定的抗旋固定作用，贴合护翼部20和本体固定部21相互配合，完美地实现了针对骨干骨折的有效内侧撑护和固定，辅助骨折部位准确定位和愈合，有效地保障了骨干骨折复位愈合的稳定性。如图4—图7所示，第一锁定螺钉2303和第一锁定螺钉2304分别穿过本体固定部21在与贴合护翼部20相交界处的部位上设置的两个第一锁定孔2203和第一锁定孔2204，以实现贴合护翼部20的固定、本体固定部21和贴合护翼部20紧密接触骨干以及实现对骨干的内侧支撑；第二锁定螺钉2301和第二锁定螺钉2302分别穿过本体固定部21在与骨干前侧面相匹配的结构上设置的第二锁定孔2201和第二锁定孔2202，以实现本体固定部21的轴向支撑、固定、抗旋以及与骨干前侧面的紧密贴合，如图6和图7所示的实施例(图8为图6或图7的侧视图)，设置了四个第二锁定孔以及相配合的四个第二锁定螺钉，即除了第二锁定螺钉2301和第二锁定螺钉2302，还设置了第二锁定螺钉2307和第二锁定螺钉2308，四个第二锁定螺钉可呈直线排列或呈多边形排列，以进一步强化本体固定部21的轴向支撑、固定、抗旋以及贴合效果；此外，加压螺钉2305和加压螺钉2306分别已一定角度穿过本体固定部在21与骨干前侧面相匹配的结构上设置的横向加压孔2205和横向加压孔2206，横向加压孔的角度使得穿过的加压螺钉在骨干与护翼型角钢板之间产生压力，如图4—图7所示， 以进一步加强贴合护翼部20与骨干内侧面的紧密贴合以及同时本体固定部21与骨干前侧面的紧密贴合，即实现护翼型角钢板2与长骨骨干的紧密接触/紧密贴合。采用本发明的护翼型角钢板2固定撑护后，留置负压引流管，缝合关闭骨膜、肌筋膜、深筋膜、皮下和皮肤；术后48小时拔出引流管。进而骨折患者每日被动极限膝关节活动度练习、下肢肢体等长收缩运动；疼痛耐受下(5公斤脚尖点地)负重活动。每月复查x线，根据骨折愈合情况决定负重进程；直至患者完全康复。
本发明还涉及一种骨干固定系统，包括护翼型角钢板、用于固定护翼型角钢板的至少四个锁定螺钉(至少两个穿过第一锁定孔的第一锁定螺钉和至少两个穿过第二锁定孔的第二锁定螺钉)以及用于固定骨折断端的骨干外侧锁定结构，其中，护翼型角钢板可以采用如图2-8所示的护翼型角钢板结构，骨干外侧锁定结构包括锁定板以及用于固定锁定板的至少两个第三锁定螺钉，锁定板具有与骨干外侧面相匹配的结构，锁定板在与骨干外侧面相匹配的结构上设置有至少两个用于穿过第三锁定螺钉的第三锁定孔，各第三锁定螺钉穿过锁定板的第三锁定孔。
优选地，用于固定护翼型角钢板的锁定螺钉(第一锁定螺钉和第二锁定螺钉)的直径范围为2.4-4.5mm；用于固定护翼型角钢板的锁定螺钉(第一锁定螺钉和第二锁定螺钉)以及用于固定锁定板的锁定螺钉(第三锁定螺钉)均可以为空心锁定螺钉或实心锁定螺钉。
如图9和图10所示的优选的骨干固定系统的使用状态的结构示意图，包括上述的如图2或图3所示的护翼型角钢板2和骨干外侧锁定结构3，其中，图9采用的是如图2中所示的具有完全罩住骨折断端的贴合护翼部20结构的护翼型角钢板2，图10采用的是如图3中所示的具有露出骨折断端且在骨折断端的远端和近端分别撑护骨折断端的贴合护翼部20结构的护翼型角钢板2，进而采用若干个如图4-8中所示的锁定螺钉采用如上文所述方式进行护翼型角钢板2的固定；骨干外侧锁定结构3包括锁定板30以及用于固定锁定板30的第三锁定螺钉，优选地，锁定板30优选为简单的矩形结构且锁定板30具有与骨干外侧面相匹配的结构，锁定板30在与骨干外侧面相匹配的结构上设置有若干个开孔(第三锁定孔)，相对应锁定板30上的开孔个数，相应的固定锁定板30的第三锁定螺钉个数可以设置为多个，且锁定螺钉之间可以相互平行排列或其中部分或全部相互呈一定角度排列，第三锁定螺钉可以选取空心锁定螺钉或实心锁定螺钉，其螺钉个数、螺钉排列形状以及螺钉与锁定板30之间角度可以根据实际需求设定，只需保证能够起到有效固定作用，即通过合理布局使得各锁定螺钉分别承担不同应力，实现辅助骨折部位准确定位和稳定复位固定，能够最大限度地强化最优固定稳定性，且尽最大可能保证在实际使用中对患者损伤较小即可。
本发明提出的骨干固定系统的工作原理和使用方法具体说明如下：
如图9和图10所示，本发明提出的骨干固定系统，在实际使用过程中，可采用常规前外侧切口全部置入，也就是说，骨干外侧锁定结构3与护翼型角钢板2均可以通过同一个常规前外侧切口一并置入，只需要一个切口即可以实现本发明提出的骨干固定系统的置入，术中损伤面、损伤度以及出血量通常会更小，术后愈合和恢复速度较快，如图2-8所示的护翼型角钢板2的工作原理和使用方法同上所述。此外，骨干外侧锁定结构3采用锁定板30结构，将锁定板30与骨干外侧面紧密接触，若干个第三锁定螺钉穿过锁定板30的开孔后再从骨干外侧面进入且横穿骨干部位以固定骨折断端。骨干外侧锁定结构3与护翼型角钢板2相互配合，进一步强化了针对骨干骨折的有效撑护和固定，辅助骨折部位准确定位，有效地保障了骨干骨折复位后的稳定性。
应当指出，以上所述具体实施方式可以使本领域的技术人员更全面地理解本发明创造，但不以任何方式限制本发明创造。因此，尽管本说明书参照附图和实施例对本发明创造已进行了详细的说明，但是，本领域技术人员应当理解，仍然可以对本发明创造进行修改或者等同替换，总之，一切不脱离本发明创造的精神和范围的技术方案及其改进，其均应涵盖在本发明创造专利的保护范围当中。

Claims (10)

  1. 一种护翼型角钢板，其特征在于，包括贴合护翼部和本体固定部，所述贴合护翼部和本体固定部相互固定连接，所述贴合护翼部用于撑护骨折断端且具有与骨干内侧面相匹配的结构，所述本体固定部用于固定贴合护翼部且具有与骨干前侧面相匹配的结构，所述本体固定部在与贴合护翼部相交界处的部位上设置有至少两个用于穿过第一锁定螺钉的第一锁定孔，所述第一锁定孔的角度使得穿过的第一锁定螺钉实现本体固定部和贴合护翼部紧密接触骨干以及实现对骨干的内侧支撑，所述本体固定部在与骨干前侧面相匹配的结构上设置有至少两个用于穿过第二锁定螺钉的第二锁定孔，所述第二锁定孔的角度使得穿过的第二锁定螺钉实现本体固定部紧密接触骨干以及控制本体固定部旋转和轴向稳定。
  2. 根据权利要求1所述的护翼型角钢板，其特征在于，所述贴合护翼部具有完全罩住骨折断端的结构。
  3. 根据权利要求1所述的护翼型角钢板，其特征在于，所述贴合护翼部具有露出骨折断端且在骨折断端的远端和近端分别撑护骨折断端的结构。
  4. 根据权利要求1所述的护翼型角钢板，其特征在于，所述贴合护翼部和本体固定部采用一体成型工艺制作而成。
  5. 根据权利要求1至4之一所述的护翼型角钢板，其特征在于，所述本体固定部在与骨干前侧面相匹配的结构上还设置有至少两个用于穿过加压螺钉的横向加压孔，所述横向加压孔的角度使得穿过的加压螺钉在骨干与护翼型角钢板之间产生压力。
  6. 根据权利要求5所述的护翼型角钢板，其特征在于，所述本体固定部在与骨干前侧面相匹配的结构上设置的第二锁定孔为三个，三个第二锁定孔呈直线排列或呈三角形排列。
  7. 根据权利要求5所述的护翼型角钢板，其特征在于，所述本体固定部在与骨干前侧面相匹配的结构上设置的第二锁定孔为四个以上，四个以上的第二锁定孔呈直线排列或呈多边形排列。
  8. 一种骨干固定系统，其特征在于，包括权利要求1至7之一所述的护翼型角钢板，还包括用于固定护翼型角钢板的穿过第一锁定孔的第一锁定螺钉和穿过第二锁定孔的第二锁定螺钉以及用于固定骨折断端的骨干外侧锁定结构，所述骨干外侧锁定结构包括锁定板以及用于固定锁定板的至少两个第三锁定螺钉，所述锁定板具有与骨干外侧面相匹配的结构，所述锁定板在与骨干外侧面相匹配的结构上设置有至少两个用于穿过第三锁定螺钉的第三锁定孔，各所述第三锁定螺钉穿过所述锁定板的第三锁定孔。
  9. 根据权利要求8所述的骨干固定系统，其特征在于，所述用于固定护翼型角钢板的第一锁定螺钉和第二锁定螺钉的直径范围均为2.4-4.5mm。
  10. 根据权利要求8或9所述的骨干固定系统，其特征在于，所述第一锁定螺钉和/或第 二锁定螺钉和/或第三锁定螺钉为空心锁定螺钉或实心锁定螺钉。
PCT/CN2016/102447 2016-10-18 2016-10-18 一种护翼型角钢板以及骨干固定系统 WO2018072100A1 (zh)

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EP16919528.6A EP3530222A4 (en) 2016-10-18 2016-10-18 ANGLE PLATE FOR WING-TYPE PROTECTION AND ASSOCIATED BONE FASTENING SYSTEM
PCT/CN2016/102447 WO2018072100A1 (zh) 2016-10-18 2016-10-18 一种护翼型角钢板以及骨干固定系统
US16/343,152 US11116555B2 (en) 2016-10-18 2016-10-18 Wing-shaped angle steel plate and a bone shaft fixation system
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