WO2023142423A1 - 一种用于肱骨近端骨折的修复装置 - Google Patents

一种用于肱骨近端骨折的修复装置 Download PDF

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Publication number
WO2023142423A1
WO2023142423A1 PCT/CN2022/110473 CN2022110473W WO2023142423A1 WO 2023142423 A1 WO2023142423 A1 WO 2023142423A1 CN 2022110473 W CN2022110473 W CN 2022110473W WO 2023142423 A1 WO2023142423 A1 WO 2023142423A1
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WIPO (PCT)
Prior art keywords
hole
support
repair device
guide
humeral head
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Application number
PCT/CN2022/110473
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English (en)
French (fr)
Inventor
陈华
唐佩福
Original Assignee
中国人民解放军总医院
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Publication date
Application filed by 中国人民解放军总医院 filed Critical 中国人民解放军总医院
Publication of WO2023142423A1 publication Critical patent/WO2023142423A1/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
    • A61B17/68—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
    • A61B17/744—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 an intramedullary nail

Definitions

  • the invention relates to the technical field of medical equipment for orthopedic surgery, in particular to a repair device for proximal humerus fractures.
  • Proximal humeral fracture is a common fracture in clinical practice, and its incidence rate is on the rise. It is one of the difficulties in trauma orthopedic treatment. For this fracture, a more common surgical method is to place a marrow bone inside the humerus. Inner nails, but their fixation to the humeral head is limited, lack of stable fixation for severe comminuted fractures, and cannot provide effective mechanical support for early functional exercise of the shoulder joint; in addition, the implantation of intramedullary nails requires drilling into the entry point , and the intramedullary nail obviously does not match the internal structure of the medullary cavity, which will affect the intramedullary blood supply.
  • the inventor of the present invention once proposed a fixation device with a larger supporting area to replace the intramedullary nail (see Chinese invention patent with application number 201410342347.4) to achieve a better supporting effect on the humeral head.
  • the support effect of the fixation device is better; but the invention of this device is to provide a specific angle of the support surface, and for the fixed connection between it and the humeral head, that is, through the main nail connected to the humeral head. accomplish.
  • the overall strength of the fixation device is not ideal, so that the fixation effect is not very ideal, which makes the part of the patient's fracture must rest for a period of time after the fixation device is placed in the patient's body.
  • Performing activities at the fracture site is not conducive to the recovery of the relevant joints at the fracture site; in addition, after the fixation device is connected to the humeral head by its main nail, it is difficult to fine-tune the position of the humeral head.
  • the technical problem solved by the present invention is to provide a repair device with stronger strength and better fixation and support effect, so that the repair device can be stably combined at the fracture site.
  • a repair device for proximal humerus fractures comprising:
  • the humeral medullary cavity support part has a proximal end, the proximal end is an end close to the shoulder, and the proximal end includes a humeral head support surface for supporting the humeral head from the inside, The proximal end defines a first through hole passing through the supporting surface of the humeral head;
  • the first plug-in body has a threaded end and a male coupling end respectively arranged at its two ends, the male coupling end is provided with an internal thread or an external thread, and the first plug-in body can be plugged into The first through hole and its threaded end can be screwed into the humeral head;
  • Fitting portion which includes a fitting surface capable of fitting on the lateral wall of the humerus and a lateral surface opposite to the fitting surface, the position of fitting on the lateral wall of the humerus is away from the humeral head and adjacent to the greater tuberosity and the lateral wall of the humerus of the lesser tubercle, the fitting portion opens a second through hole passing through the fitting surface, and when the fitting portion fits on the lateral wall of the humerus, the second through hole coincident with the axis of the first through hole;
  • the second plug-in body, the second plug-in body has a female coupling end and a clamping end respectively arranged at its two ends, and the female coupling end is an external thread or an external thread provided to match the internal thread or external thread of the male coupling end. internal thread, when the second inserting body is inserted into the second through hole, the clamping end clamps the second through hole on the outer surface of the fitting part and the female coupling end is combined
  • the male coupling end enables adjustment of the coupling position of the male coupling end and the female coupling end through the clamping end, thereby adjusting the position of the humeral head.
  • the bonding part is a sheet structure
  • the sheet structure has a top side, a bottom side, a left side and a right side located between the top side and the bottom side and connecting the top side and the bottom side
  • the top side is close to the proximal end and the bottom side is away from the proximal end
  • the left side is close to the greater tuberosity and the right side is close to the
  • the small nodule the direction from the top side to the bottom side is the length direction
  • the length from the top side to the bottom side along the length direction is 3-6cm
  • the left side to the right side The direction is the width direction, and the width from the left side to the right side along the width direction is 2-4cm.
  • a number of rotator cuff suture through-holes passing through the fitting surface and the outer surface are opened on the sheet-like structure near the top side, for the rotator cuff suture to pass through so as to sew the rotator cuff on the surface.
  • a third through hole is opened through the fitting surface and the outer surface on the sheet structure near the bottom side, and the repair device also includes a pair of anti-rotator cuff screws, the anti-rotator cuff screws
  • the rotator cuff screw can pass through the third through hole and its threaded tail can be fixedly connected to the humerus.
  • the end of the anti-rotator cuff screw snaps into the third through hole and is located on the outer surface of the sheet structure. on the side.
  • the humeral head has a lower edge away from the proximal end, the lower edge is connected to the humeral shaft below it, and the axial direction of the third through hole faces the humerus in the range of 1-3.5cm away from the lower edge.
  • the third through hole is a through hole inclined to the left and arranged downward, and the left inclination is that the axis direction of the through hole approaches the left side from the vertical axis direction perpendicular to the bonding surface of the sheet structure.
  • the direction of the side deviates from the direction of the 10-30° angle
  • the downward direction is the direction of the axis of the through hole deviates from the vertical axis direction perpendicular to the lamination surface of the sheet structure to the direction close to the bottom side by 5-40°
  • the direction of the angle is a through hole inclined to the left and arranged downward, and the left inclination is that the axis direction of the through hole approaches the left side from the vertical axis direction perpendicular to the bonding surface of the sheet structure.
  • the direction of the side deviates from the direction of the 10-30° angle
  • the downward direction is the direction of the axis of the through hole deviates from the vertical axis direction perpendicular to the lamination surface of the sheet structure to
  • the position on the sheet-like structure close to the top side is the edge of the sheet-like structure close to the top side and along the width direction, and the position on the sheet-like structure close to the top side and close to An edge along the length direction of the left side and an edge along the length direction of the sheet structure near the top side and near the right side.
  • two large nodular through-holes through the fitting surface and the outer surface are opened along the length direction on the sheet-like structure near the left side, and the sheet-like structure is near the right side.
  • Two small nodule through-holes through the fitting surface and the outer surface are opened along the length direction at the position on the side, and the repair device also includes two large nodule fixing screws and two small nodule fixing screws.
  • the greater tuberosity fixing screw can pass through the greater tuberosity through hole and its threaded tail can be fixedly connected to the greater tuberosity, and the end of the greater tuberosity fixing screw snaps into the greater tuberosity through hole and Located on the outer surface of the sheet structure, the nodule fixing screw can pass through the nodule through hole and its threaded tail can be fixedly connected to the nodule, and the end of the nodule fixing screw The part snaps into the through hole of the small nodules and is located on the outer surface of the sheet structure.
  • the through hole of the greater tubercle is a through hole inclined to the left, and the left inclination is that the axis direction of the through hole is from the vertical axis direction perpendicular to the lamination surface of the sheet structure to the left side.
  • the direction deviates from the direction of an angle of 10-30°
  • the through hole of the small nodule is a through hole that is inclined to the right, and the right inclination is that the axis direction of the through hole is changed from the vertical axis direction perpendicular to the lamination surface of the sheet structure.
  • the opening position of the second through hole is at the middle position along the length direction of the sheet structure and is located in the third through hole, the large nodule through hole, and the small nodule through hole. between.
  • the humerus medullary cavity support part further includes a vertical part connected to the proximal end part and extending from the proximal end part in a direction away from the proximal end, and the humerus medullary cavity support part is combined with the
  • the proximal end is designed to have a width capable of avoiding the fixation screws of the greater tuberosity and the fixation screws of the lesser tuberosity in the width direction
  • the The vertical part is designed to have a width capable of avoiding the anti-rotator cuff screw in the width direction, and at least one horizontal through hole extending along the horizontal direction is opened on the vertical part
  • the repair device also includes a matching There is at least one insertion screw for the number of the horizontal through holes, the insertion screws can be arranged one by one corresponding to the horizontal through holes and the threaded end of the insertion screw can be screwed into the humerus rod.
  • the first plug-in body is hollow so that a guide pin can be passed through to guide the first plug-in body to be plugged into the first through hole through the guide pin, and the first plug-in body Internal threads are provided in the hollow rod body of the male coupling end, and the female coupling end of the second insert body is a rod body provided with external threads, and the external threads can be threadedly connected to the internal threads.
  • the axial direction of the first through hole is perpendicular to the supporting surface of the humeral head.
  • the support surface of the humeral head is a support plane, which is arranged at an angle of 45°-50° to the medullary cavity.
  • the proximal end includes a humeral head support and a greater tuberosity support
  • the humeral head support surface is set on the humeral head support
  • the greater tuberosity support and the humeral head support The part is divided into two parts, the greater tuberosity support has a protrusion facing and capable of supporting the greater tuberosity, and the humeral head support is provided with a first joint at a position facing the greater tuberosity support, the The greater tuberosity support is provided with a second joint part at a position facing the humeral head support, and the first joint part combined with the second joint can make the greater tuberosity support and the humeral head support connect.
  • the repair device also includes:
  • the positioning part includes a first positioning end and a second positioning end respectively arranged at two ends, and a third joint part is provided at a position away from the supporting surface of the humeral head on the proximal end part, and the first joint part is not When combined with the second joint part, the first positioning end of the positioning part can be detachably connected to the third joint part;
  • a guide part the guide part includes an upper end and a lower end, an upper joint part is arranged on the guide part close to the upper end, the second positioning end can be detachably connected to the upper joint part, the A first guide through hole is opened on the guide part for providing guidance for the first plug-in body to be inserted into the first through hole, and at least one second guide through hole is also opened on the guide part , the second guide through hole is used to provide guidance for the insertion screw to be inserted into the horizontal through hole;
  • the direction from the upper end of the guide part to its lower end is parallel to the vertical direction of the vertical part, and the second The axis direction of a guide through hole coincides with the axis direction of the first through hole, and the axis direction of the second guide through hole coincides with the axis direction of the corresponding horizontal through hole.
  • a convex step is provided on both sides of the position of the humeral head support facing the greater tuberosity support to form the first joint portion, and the greater tuberosity support faces the position with the convex step.
  • a matching concave step is provided at the corresponding position to form the second joint part, and the second joint part overlaps the first joint part so that the humeral head support part can support the greater tuberosity support part, forming
  • a depression is provided in the middle of the two convex steps of the first joint part, and two joint insertion blind holes arranged side by side are arranged in the depression, and a threaded blind hole is arranged between the two joint insertion blind holes.
  • the third joint part is formed by combining the blind hole for insertion;
  • the positioning part includes a hollow rod and a positioning rod, two ends of the hollow rod are provided with two insertion protrusions, respectively forming the first positioning end and the second positioning end, and the first positioning end
  • the two insertion protrusions at the end are inserted into the two insertion blind holes of the third joint part, and the two insertion protrusions at the second positioning end are inserted into the guide part.
  • Two guide plug blind holes one end of the positioning rod is a threaded end, the threaded end passes through the hollow rod and is threadedly connected to the threaded blind hole, the other end of the positioning rod is a clamping end, and the clamping end is Connected to the outer side of the end of the positioning rod close to the guide part.
  • the repair device When the repair device is used on patients with fractures, it forms an extremely stable overall structure formed by the support part of the humerus medullary cavity connected to the humeral head, the first insertion body, the second insertion body and the fitting part , the first inserting body is connected to the humeral head, and at the same time it is also fixedly connected to the second inserting body clamped on the fitting part, and its strength is relatively strong.
  • the repair device After the repair device is placed in the patient's body, the patient's fracture This part can perform a full range of early activities almost after the operation is completed, which is conducive to the recovery of the joints at the fracture repair site.
  • the threaded end of the first inserting body is fixedly connected to the humeral head to realize the fixed connection between the repair device and the humeral head, and then the second inserting body is connected to the first inserting body with an adjustable connection between them, which can be passed through
  • the second inserting body can adjust the position of the humeral head which has been fixedly connected to the first inserting body, so as to achieve accurate positioning of the humeral head at the fracture site during operation, which is beneficial to later recovery.
  • the second plug-in body is clamped through the fitting part. During the adjustment process, when the second plug-in body is rotated, due to the larger area of the fitting part, it can avoid the second plug-in part.
  • the damage to other tissues caused by the clamping end of the inserting body during the rotation process; at the same time, the position fixation of the fitting part is also realized by the combination of the first inserting body and the second inserting body, which reduces the damage to the humerus
  • the operation of drilling holes to fix the fitting part further reduces the trauma to the patient during the operation.
  • the fitting part is a sheet structure, and its length is limited to 3-6cm, and its width is 2-4cm.
  • the fixed long plate in the prior art mainly plays the role of fixing the humeral head. In order to achieve its better fixing effect, it needs to be set to a length of about 10 cm or more, and it is necessary to set up more than 10 cm on the long plate body.
  • a perforation offers a plurality of perforations above it, and through this perforation through a plurality of screws can this fixed long plate be stably connected on the humeral head, and then needs to set up a plurality of below this plate body. The perforation allows the screw to pass through the shaft of the humerus to achieve effective fixation.
  • the fitting part of the present application is a sheet-like structure, which does not play the role of fixing the humeral head, because the humerus medullary cavity support part in the repair device has already played a role of supporting and fixing, and the main function of the sheet-like structure is It is used to provide the second through hole for the insertion of the second socket body, and the effect of the bonding part mentioned above. And the setting of the length and width of the sheet-like structure can be greatly reduced, which can reduce the trauma to the patient caused when the sheet-like structure is placed in the operation process.
  • the sheet-like structure is provided with a rotator cuff suture through hole, which is located near the top side, and a third through hole is opened at a position close to the bottom side of the top side on the opposite side to provide resistance
  • the rotator cuff screw passes through, and the anti-rotator cuff screw setting can resist the force of the sutured rotator cuff on the sheet structure, and prevent the sheet structure from being tilted due to the force of the rotator cuff and causing damage to other tissues.
  • the axial direction of the third through hole is defined to be towards the humeral shaft in the range of 1-3.5 cm from the lower edge, because the humeral shaft is a relatively solid part, and in the case of proximal humeral fracture, its comminuted The possibility of this is extremely small, so that the anti-rotator cuff screw can be stably fixed on the humerus.
  • the third through hole is a through hole inclined to the left and arranged downwards, and the left inclination means that the axis direction of the through hole deviates from the vertical axis direction perpendicular to the bonding surface of the sheet structure to the direction close to the left side
  • the direction at an angle of 10-30° is downwardly the direction in which the axis direction of the through hole deviates from the direction of the vertical axis perpendicular to the bonding surface of the sheet structure to the direction close to the bottom side at an angle of 5-40°.
  • the third through hole provided, after receiving the anti-rotator cuff screw, will make the anti-rotator cuff screw exert a force in this direction on the sheet structure, so that the fitting degree of the sheet structure on the lateral wall of the humerus is greatly improved. Lifting is beneficial to the recovery of the fracture site of the patient to which the sheet-like structure fits.
  • the large nodule through hole and the small nodule through hole are opened on the sheet structure, and the direction of the large nodule through hole and the small nodule through hole is limited so that the in situ recovery effect of the large nodule and the small nodule better recovery in situ.
  • the supporting surface of the humeral head is a supporting plane, and it is set at 45°-50° to the medullary cavity, which has an excellent supporting effect on the humeral head.
  • the greater tuberosity support and the humeral head support are set separately.
  • the size of the protrusion of the greater tuberosity support is adjustable, and the protrusions of various sizes can be produced to suit different needs. Therefore, according to the individual differences of patients, we can provide various sizes of large tubercle supports for matching, and then provide appropriate support for the corresponding patients, so that the postoperative recovery effect can be improved.
  • the applicant found that the one-piece support is difficult to place into the medullary cavity, and the separate setting can first connect the greater tuberosity support with the humerus The head support is separated, and only the humeral medullary cavity support with the humeral head support is easily placed into the medullary cavity.
  • the repair device further includes a positioning part, wherein when the first combining part is not combined with the second combining part, the positioning part can be combined with the third combining part, and the second positioning end of the positioning part
  • the guide part can be connected, and the nail-piercing operation can be performed.
  • the third joint part is used to provide good support for the guide part through the positioning part, which relieves the secondary trauma to fix the guide part or additional operation during the nail-piercing operation
  • the defect that the personnel come to hold the guide part greatly reduces the time and cost.
  • a convex step is provided on both sides of the humeral head support towards the position of the greater tuberosity support to form the first joint part, and a convex step is provided in the middle of the two convex steps forming the first joint part.
  • a depression in which there are two combined blind holes arranged side by side, a threaded blind hole is arranged between the two combined blind holes, and the third combined part is formed by combining the blind holes, which is almost The same position of the end portion, that is, the outer side and inner side of the position form the first joint part and the third joint part, and two different joint parts are provided at the same position to be combined with the greater tuberosity support or the positioning part respectively , it just takes advantage of the staggered placement of the large tuberosity support and the positioning part, that is, the required setting is realized at a limited position, which does not require additional parts to complete the connection, which is obviously a lower-cost setting.
  • the arrangement of the recessed part is equivalent to further reducing the weight of the first supporting part, and also saving materials.
  • the specific setting of the positioning part and the guiding part can be realized through the setting when connecting the various components, and then a stable fixed connection structure between the supporting part of the medullary canal of the humerus and the positioning part and the guiding part can be formed.
  • FIG. 1 is a schematic diagram of an image of a fixed long plate applied in fracture surgery in the prior art
  • Fig. 2 is a structural schematic diagram of the humeral medullary cavity support part and the sheet structure combined to the humerus in an embodiment of the repair device provided by the present invention
  • Fig. 3 is the split diagram in Fig. 2;
  • Fig. 4 is a front view and a side view of the humeral medullary cavity support part and the sheet structure combined to the humerus in an embodiment of the provided repair device;
  • Fig. 5 is a schematic diagram when the sheet-like structure is combined to the humerus
  • Fig. 6 is the front view of sheet structure
  • Fig. 7 is a structural schematic diagram of an embodiment of the repair device provided by the present invention, including the humeral medullary canal support part, positioning part and combining part;
  • Fig. 8 is an influence diagram of the application of the humerus medullary canal support part and sheet-like structure in fracture surgery provided by the present invention.
  • Fig. 9 is a schematic structural view of an embodiment of a hollow rod and a positioning rod provided by the present invention.
  • Fig. 10 is a front view of an embodiment of the humerus medullary cavity support provided by the present invention.
  • Fig. 11 is a front view of the guiding part provided by the present invention.
  • 1 Humeral medullary cavity support part 2 Proximal end, 3 Humeral head, 4 Humeral head supporting surface, 5 First through hole, 6 First insertion body, 7 Threaded end, 8 Male joint end, 9 Fitting surface, 10 Outer side, 11 Large tubercle, 12 Small tubercle, 13 Second through hole, 14 Second plug-in body, 15 Female coupling end, 16 Clamping end, 17 Sheet structure, 18 Top side, 19 Bottom side, 20 left side, 21 right side, 22 rotator cuff suture through hole, 23 third through hole, 24 anti-rotator cuff screw, 25 thread tail, 26 end of anti-rotator cuff screw, 27 lower edge, 28 1-3.5cm Humeral shaft within range, 29 greater tuberosity through hole, 30 lesser tuberosity through hole, 31 greater tuberosity fixation screw, 32 lesser tuberosity fixation screw, 33 vertical part, 34 horizontal through hole, 35 insertion screw, 36 Humeral head support, 37 greater tuberosity support, 38 protrusion, 39 positioning part, 40 first positioning end
  • Figure 1 is a schematic image of a fixed long plate in the prior art applied to fracture surgery
  • Figure 2 is an embodiment of the humerus medullary cavity support part and the repair device provided by the present invention
  • Figure 3 is the disassembled view in Figure 2
  • Figure 4 is the humeral medullary canal support part and the sheet structure combined to the main body of the humerus in an embodiment of the provided repair device View and side view
  • Fig. 5 is a schematic diagram of the sheet structure combined with the humerus
  • Fig. 6 is a front view of the sheet structure
  • FIG. 7 is an embodiment of the repair device provided by the present invention including the support of the medullary canal of the humerus part, positioning part and joint part;
  • Figure 8 is a schematic image of the humerus medullary canal support part and sheet structure provided by the present invention applied in fracture surgery;
  • Figure 9 is a hollow rod and positioning rod provided by the present invention 10 is a front view of an embodiment of the humerus medullary canal support provided by the present invention;
  • FIG. 11 is a front view of the guide provided by the present invention.
  • the repair device includes:
  • the humerus medullary cavity support part 1, the humerus medullary cavity support part 1 has a proximal end part 2, the proximal end part is an end close to the shoulder, and the proximal end part 2 includes a support for supporting the humeral head 3 from the inside The humeral head supporting surface 4, the proximal end 1 opens a first through hole 5 passing through the humeral head supporting surface 4;
  • the first plug-in body 6, the first plug-in body 6 has a threaded end 7 and a male coupling end 8 respectively arranged at its two ends, the male coupling end 8 is provided with an internal thread or an external thread, and the first plug-in body
  • the body 6 can be inserted into the first through hole 5 and its threaded end 7 can be screwed into the humeral head 3;
  • Fitting portion which includes a fitting surface 9 capable of fitting on the lateral wall of the humerus and a lateral surface 10 opposite to the fitting surface 9, the position of fitting on the lateral wall of the humerus is away from the humeral head 3 and Near the lateral wall of the humerus of the greater tuberosity 11 and the lesser tuberosity 12, the fitting portion opens a second through hole 13 passing through the fitting surface 9, and the fitting portion fits on the lateral wall of the humerus , the axis of the second through hole 13 coincides with the axis of the first through hole 5;
  • the second plug-in body 14, the second plug-in body 14 has a female coupling end 15 and a clamping end 16 respectively arranged at its two ends, and the female coupling end 15 is an internal thread or an external thread matching the male coupling end 8
  • the external thread or internal thread provided by the screw thread when the second inserting body 14 is inserted into the second through hole 13, the clamping end 16 clamps the second through hole 13 and is located in the joint and the female coupling end 15 is combined with the male coupling end 8 so that the joint position of the male coupling end 8 and the female coupling end 15 can be adjusted through the snap-in end 16, thereby adjusting the humeral head 3 positions.
  • the repair device When the repair device is used on patients with fractures, it forms the overall stability formed by the humeral medullary cavity support part 1 connected to the humeral head 3, the first inserting body 6, the second inserting body 14 and the fitting part. Extremely strong structure, the first inserting body 6 is not only connected with the humeral head 3, but also fixedly connected with the second inserting body 14 clamped on the fitting part, and its strength is relatively strong. After entering the patient's body, the fractured part of the patient can perform a full range of early activities almost after the patient completes the operation, which is conducive to the recovery of the joint at the fracture repaired part.
  • the threaded end 7 of the first inserting body 6 is fixedly connected to the humeral head 3 to realize the fixed connection between the repair device and the humeral head 3, and then the second inserting body 14 is connected to the first inserting body 6 and there is a space between them.
  • Adjustable connection the position of the humeral head 3 that has been fixedly connected to the first inserting body 6 can be adjusted through the second inserting body 14, so that the accurate humeral head 3 at the fracture site can be realized during the operation. The positioning is conducive to the later recovery.
  • the second inserting body 14 is clamped through the fitting portion.
  • the second inserting body 14 when the second inserting body 14 is rotated, due to the larger area of the fitting portion, it can avoid The damage to other tissues caused by the clamping end 16 of the second inserting body 14 during the rotation; at the same time, the position of the fitting part is fixed by the combination of the first inserting body 6 and the second inserting body 14 In this way, the operation of opening a drill hole on the humerus to fix the fitting part is reduced, and the trauma to the patient during the operation is further reduced.
  • the bonding portion is a sheet-like structure 17, and the sheet-like structure 17 has a top side 18, a bottom side 19, and is located between the top side 18 and the bottom side 19.
  • the width of the right side 21 is 2-4cm.
  • the fitting part is a sheet-like structure 17, and its length is limited to 3-6cm, and its width is 2-4cm, which is completely different from the fixed long plate 57 used for setting on the outside of the humerus in the prior art.
  • the fixed long plate 57 in the technology mainly plays the role of fixing the humeral head 3. In order to achieve its better fixing effect, it needs to be set to a length of about 10 cm or more, and it needs to be set on the plate body with a length of more than 10 cm.
  • a plurality of perforations 58 offer a plurality of perforations 58 above it, and pass through this perforation 58 by a plurality of screws 59 just can this fixing long plate 57 be stably connected on the humeral head 3, and then on this plate
  • the bottom of the body needs to be provided with a plurality of perforations 58 for the screws 59 to pass through the shaft of the humerus, so as to achieve effective fixation. If the setting is too short (such as below 10cm), it will not have the effect of stably connecting and fixing the humeral head.
  • the bonding part of the sheet-like structure 17 which does not play the role of fixing the humeral head, because the humeral medullary cavity support part 1 in the repair device has already played a role of supporting and fixing, and the sheet-like structure 17
  • the main function is to provide the second through hole 13 for the insertion of the second socket body 14 , and the effect of the bonding part mentioned above.
  • the setting of the length and width of the sheet-like structure 17 has been greatly reduced, which can reduce the trauma to the patient caused when the sheet-like structure 17 is placed during the operation.
  • a plurality of rotator cuff suture through holes 22 passing through the fitting surface 9 and the outer surface 10 are opened on the sheet structure 17 close to the top side 18 for the shoulder
  • the sleeve suture thread passes through to sew the rotator cuff on the sheet structure 17, and a third passage is opened on the sheet structure 17 near the bottom side 19 and passes through the fitting surface 9 and the outer surface 10. Hole 23.
  • the repair device also includes a pair of anti-rotator cuff screws 24, the anti-rotator cuff screws 24 can pass through the third through hole 23 and its thread tail 25 can be fixedly connected to the humerus
  • the end 26 of the anti-rotator cuff screw snaps into the third through hole 23 on the outer surface 10 of the sheet structure 17 .
  • the sheet structure 17 is provided with a rotator cuff suture through hole 22, and is located at a position close to the top side 18, and by opening a third through hole 23 at a position close to the bottom side 19 of the top side 18,
  • the setting of the anti-rotator cuff screw 24 can resist the force of suturing the rotator cuff to the sheet structure 17, and avoid the sheet structure 17 from warping due to the force of the rotator cuff. Damage to other tissues.
  • the humeral head 3 has a lower edge 27 away from the proximal end, the lower edge 27 is connected to the humeral shaft below it, and the axial direction of the third through hole 23 is toward the lower edge
  • the humeral shaft 28 within the range of 1-3.5 cm enables the thread tail 25 of the anti-rotator cuff screw 24 to be fixedly connected to the humeral shaft 28 within the range of 1-3.5 cm from the lower edge.
  • the axial direction of the third through hole 23 is limited to the humeral shaft 28 in the range of 1-3.5 cm from the lower edge, because the humeral shaft is a relatively solid part, and in the case of a proximal humeral fracture, its comminuted The possibility is extremely small, so that the anti-rotator cuff screw 24 can be stably fixed on the humerus.
  • the third through hole 23 is a through hole inclined to the left and set downwards.
  • the left inclination is that the axis direction of the through hole is changed from the vertical axis direction perpendicular to the bonding surface 9 of the sheet structure 17
  • the direction that deviates from the direction close to the left side 20 by an angle of 10-30°, the downward direction is the direction of the axis of the through hole from the direction perpendicular to the vertical axis direction of the bonding surface 9 of the sheet structure 17 to the direction close to the bottom
  • the direction of the side 19 deviates from the direction by an angle of 5-40°.
  • the third through hole 23 is a through hole inclined to the left and set downwards.
  • the third through hole 23 set in the specific angle direction will make the anti-rotator cuff screw 24 opposite to the sheet after accommodating the anti-rotator cuff screw 24.
  • the force in this direction is exerted by the structure 17, so that the fitting degree of the sheet-like structure 17 on the lateral wall of the humerus is greatly improved, which is beneficial to the recovery of the patient's fractured part to which the sheet-like structure 17 is fitted.
  • the position on the sheet structure 17 close to the top side 18 is the edge of the sheet structure 17 close to the top side 18 along the width direction.
  • two large nodules are opened along the length direction on the sheet structure 17 near the left side 20 and pass through the fitting surface 9 and the outer surface 10.
  • Holes 29, two small nodule through holes 30 that pass through the fitting surface 9 and the outer surface 10 along the length direction on the sheet structure 17 close to the right side 21, and the repair device also Comprising two greater tuberosity fixing screws 31 and two lesser tuberosity fixing screws 32 the greater tuberosity fixing screw 31 can pass through the greater tuberosity through hole 29 and its thread tail can be fixedly connected to the greater tuberosity node 11, the end of the greater tuberculosis fixing screw 31 snaps into the greater tuberosity through hole 29 and is located on the outer surface 10 of the sheet structure 17, and the lesser tubercle fixing screw 32 can pass through the
  • the small nodule through hole 30 and its threaded tail can be fixedly connected to the small nodule 12, and the end of the small nodule fixing screw 32 snaps into the small nodule through hole 30 and is located at the end
  • the greater tuberosity through hole 29 is a through hole arranged obliquely to the left.
  • the direction of the left side 20 deviates from the direction of an angle of 10-30°
  • the small nodule through hole 30 is a through hole arranged obliquely to the right.
  • the direction of the vertical axis of the fitting surface 9 deviates from the direction close to the right side 21 by an angle of 10-30°.
  • the large nodule through hole 29 and the small nodule through hole 30 are provided on the sheet structure 17, and the direction of the large nodule through hole 29 and the small nodule through hole 30 is limited so that the in situ recovery effect of the large nodule 11 and The in situ recovery effect of the small nodule 12 is better.
  • the opening position of the second through hole 13 is at the middle position along the length direction of the sheet structure 17 and is located at the third through hole 23 and the greater tuberosity through hole 29 , Between the through holes 30 of the small nodules.
  • the humeral medullary cavity support part 1 further includes a vertical part 33 connected to the proximal end part 2 and extending from the proximal end part 2 in a direction away from the proximal end.
  • the proximal end part 2 is designed in the width direction so as to avoid the greater tuberosity
  • the width of the fixing screw 31 and the lesser tubercle fixing screw 32, the vertical portion 33 is designed to have a width capable of avoiding the anti-rotator cuff screw 24 in the width direction, the vertical portion 33
  • a hole 34 is provided and its threaded end can be screwed into the humeral shaft.
  • first plug-in body 6 for the combination of the first plug-in body 6 and the second plug-in body 14, wherein the first plug-in body 6 is hollow so that the guide pin 62 can pass through to be guided by the guide pin 62
  • the first plug-in body 6 is plugged into the first through hole 5, and the hollow rod body of the male coupling end 8 of the first plug-in body 6 is provided with an internal thread
  • the second plug-in body 14 The female coupling end 15 is a rod body provided with an external thread, and the external thread can be threadedly connected with the internal thread.
  • the axial direction of the first through hole 5 is perpendicular to the support surface 4 of the humeral head.
  • the humeral head support surface 4 is a support plane, and it is set at 45°-50° to the medullary cavity, which has an excellent support effect on the humeral head 3 .
  • the proximal end 2 includes a humeral head support 36 and a greater tuberosity support 37, the humeral head support surface 4 is arranged on the humeral head support 36, and the greater tuberosity supports
  • the humeral head support 37 and the humeral head support 36 are set separately, the greater tuberosity support 37 has a protrusion 38 facing and capable of supporting the greater tuberosity 11, and the humeral head support 36 faces the greater tuberosity
  • a first joint part is provided at the position of the support part 37, and a second joint part is provided at the position of the greater tuberosity support part 37 toward the position of the support part 36 of the humeral head, and the first joint part is combined with the second joint part
  • the greater tuberosity support 37 and the humeral head support 36 can be connected.
  • the greater tuberosity supporting part 37 and the humeral head supporting part 36 are arranged separately.
  • the size of the protrusion 38 of the greater tuberosity supporting part 37 is adjustable, and this protrusion 38 of various sizes can be produced to be able to To adapt to the greater tuberosity 11 of different sizes, for this reason, according to the individual differences of patients, a variety of sizes of greater tuberosity support 37 can be provided for matching, and then can provide appropriate support for the corresponding patient, so that the postoperative
  • the supporting part 37 is separated from the humeral head supporting part 36, and only the humeral medullary cavity supporting part 1 with the humeral head supporting part 36 is easy to be inserted into the medullary cavity.
  • the repair device also includes:
  • the positioning part 39 includes a first positioning end 40 and a second positioning end 41 respectively arranged at two ends, and a third joint part is provided at a position away from the humeral head support surface 4 on the proximal end part 2 , the When the first joint part is not combined with the second joint part, the first positioning end 40 of the positioning part 39 can be detachably connected to the third joint part;
  • a guide portion 42 the guide portion 42 includes an upper end 43 and a lower end 44, an upper joint portion is provided on the guide portion 42 near the upper end 43, and the second positioning end 41 can be detachably connected to the
  • the guide part 42 is provided with a first guide through hole 45, which is used to provide guidance for the first inserting body 6 to be inserted into the first through hole 5, and the guide part 42 is also provided with at least one second guide through hole 46, and the second guide through hole 46 is used to provide guidance for the insertion screw 35 to be inserted into the horizontal through hole 34;
  • the first positioning end 40 of the positioning portion 39 is coupled with the third coupling portion of the proximal end portion 2 and the second positioning end 41 of the positioning portion 39 is coupled with the upper coupling portion of the guide portion 42 , a stable structure in which the humerus medullary canal support part 1, the positioning part 39 and the guide part 42 are sequentially connected can be formed.
  • the direction from the upper end 43 to the lower end 44 of the guide part 42 is parallel to the The vertical direction of the vertical portion 33, the axis direction of the first guide through hole 45 coincides with the axis direction of the first through hole 5, the axis direction of the second guide through hole 46 coincides with the corresponding The axis directions of the horizontal through holes 34 are coincident.
  • the repair device also includes a positioning part 39, wherein when the first combining part is not combined with the second combining part, the positioning part 39 can be combined on the third combining part, and the second positioning end of the positioning part 39 41 can be connected to the guide part 42, and can perform the operation of nailing (the insertion of the first inserting body and the inserting screw).
  • the third joint part is used to provide good support for the guide part 42 through the positioning part 39.
  • a convex step 47 is provided on both sides of the humeral head support member 36 facing the position of the greater tuberosity support member 37 to form the first joint portion.
  • the greater tuberosity support 37 is provided with a matching concave step 48 toward the corresponding position with the convex step 47, forming the second joint portion, and the second joint portion overlaps the first joint portion to enable
  • the humeral head support 36 fixedly supports the greater tuberosity support 37, and a depression 49 is provided in the middle of the two convex steps 47 forming the first joint, and two joint inserts arranged side by side are arranged in the depression 49.
  • Blind holes 50 are connected, and a threaded blind hole 51 is arranged between the two combined and inserted blind holes 50, and the combined and inserted blind holes 50 form the third joint portion;
  • the guide part 42 is provided with two guide insertion blind holes 52 near the upper end 43.
  • the guide insertion blind holes 52 form the upper joint part.
  • the two guide insertion blind holes 52 A through hole 53 is arranged between;
  • the positioning part 39 includes a hollow rod 54 and a positioning rod 56, two ends of the hollow rod 54 are provided with two insertion protrusions 55, respectively forming the first positioning end 40 and the second positioning end 41, the two insertion protrusions 55 of the first positioning end 40 are inserted into the two combined insertion blind holes 50 of the third joint part, and the two insertion protrusions 55 of the second positioning end 41
  • the two insertion protrusions 55 are inserted into the two guide insertion blind holes 52 of the guide part 42, and one end of the positioning rod 56 is a threaded end, and the threaded end passes through the hollow rod 54 and is screwed together.
  • the other end of the positioning rod 56 is a clamping end, which is clamped on the outside of one end of the positioning rod 56 close to the guide portion 42 .
  • a convex step 47 is provided on both sides of the humeral head support part 36 facing the position of the greater tuberosity support part 37, forming the first joint part, and the middle of the two convex steps 47 forming the first joint part
  • a depression 49 is provided, and two joint insertion blind holes 50 arranged side by side are arranged in the depression 49, and a threaded blind hole 51 is arranged between the two joint insertion blind holes 50, and the third joint insertion blind hole 50 is formed.
  • the joint part is almost at the same position of the proximal end part 2, that is, the outside and the inside of the position form the first joint part and the third joint part, and two different joint parts are arranged at the same position for connecting with the large knot respectively.
  • the joint support 37 or the positioning part 39 is combined, just taking advantage of the staggered placement of the large joint support 37 and the positioning part 39, that is, the required setting is realized in a limited position, and no additional parts are required to complete the connection. Obviously the lower cost setup. Specifically, the setting of the recess 49 is equivalent to further reducing the weight of the proximal end part 2 and saving materials at the same time. And, the specific setting of the positioning part 39 and the guide part 42 can be realized through the setting when connecting the various components, and then form a stable fixed connection structure of the humerus medullary canal support part 1 and the positioning part 39 and the guide part 42 .
  • this gap enables the humeral medullary canal support part 1 (at this time, the greater tuberosity support part 37 is not combined on the proximal end part 2, so that the gap can be made as small as possible ) into the medullary cavity of the humerus; and make the support surface 4 of the humeral head toward the inner side of the humeral head 3, and then insert the insertion protrusion 55 at one end of the hollow rod 54 into the corresponding joint of the support part 1 of the humeral cavity Insert into the blind hole 50, insert the insertion protrusion 55 at the other end of the hollow rod 54 into the corresponding guide blind hole 52 of the guide part 42, and then insert the positioning rod 56 into the hollow rod 54 , one end of the positioning rod 56 is a threaded end, the threaded end passes through the hollow rod 54 and is threadedly connected to the threaded blind hole 51, and the other end of the positioning rod 56 is a clamping end, which is clamped on the
  • the hollow guide rod 61 is passed through the first guide through hole 45 of the guide part 42, as shown in FIG. 7 , which Pointing to the first through hole 5 of the humeral medullary cavity support part 1, at this time insert a hole-opening part with one end in the shape of a scissors head in the hollow guide rod 61, and use the hole-opening part to cut or perforate the humerus and its outer tissues , so that the hollow guide rod 61 realizes the butt connection with the first through hole 5, and then a guide pin 62 is sequentially passed through the hollow rod 54 and the first through hole 5, and then the hollow first insert body 6 is passed through the The guide pin 62 is introduced into the first through hole 5, and then a hollow cone is used to screw the first insertion body 6 into the humeral head 3, and this process completes the insertion of the first insertion body 6. As shown in FIG. 7 again, the hollow guide rod 61 is introduced into the first through hole 5, and then a hollow cone is used to screw the first insertion body 6 into the
  • the above operation completes the insertion of the first inserting body 6 and the inserting screw 35, and makes the humeral medullary canal supporting part 1 (the greater tuberosity supporting part 37 is not combined on the proximal end part 2 at this time) fixedly connected to the on the humerus.
  • the guide part 42, the positioning rod 56, and the hollow rod 54 are removed.
  • the greater tuberosity support member 37 is matched with the convex step 47 of the proximal end 2 through its concave step 48, so that it overlaps the proximal end.
  • the sheet structure 17 is pasted, and the second plug-in body 14 is inserted into the second through hole 13, so that the second plug-in body 14 and the first plug-in body 6 are combined .
  • the combination of the greater tuberosity fixation screw 31 and the lesser tubercle fixation screw 32 , and the combination of suturing the rotator cuff and resisting the rotator cuff screw 24 are performed. For this reason, an extremely stable fixing structure between the humeral medullary canal supporting part 1 , the first inserting body 6 , the second inserting body 14 and the sheet structure 17 and the humerus is formed.

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Abstract

一种用于肱骨近端骨折的修复装置，包括由肱骨髓腔支撑部（1）、第一插接体（6）、贴合部和第二插接体（14）连接到肱骨的稳定的结构，其中第一插接体（6）和第二插接体（14）结合、第一插接体（6）连接肱骨头（3）、第二插接体（14）卡接在贴合部上。其强度强，在置入患者体内后，患者骨折的该部位几乎可在患者完成手术后就可以进行全范围的早期活动，有利于该骨折修复部位的关节的恢复。并第一插接体（6）的螺纹端（7）固定连接于肱骨头（3）以实现该修复装置和肱骨头（3）的固定连接，进而第二插接体（14）连接第一插接体（6）且其之间为可调的连接，可通过该第二插接体（14）能够对已固定连接在第一插接体（6）上的肱骨头（3）的位置进行调整，以使得能够在手术中实现精准的骨折处的肱骨头（3）的定位，有利于后期的恢复。

Description

一种用于肱骨近端骨折的修复装置 技术领域
本发明涉及用于骨科手术的医疗器材技术领域，具体涉及一种用于肱骨近端骨折的修复装置。
背景技术
肱骨近端骨折是临床上常见的一种骨折,其发病率呈现不断上升的趋势,是目前创伤骨科治疗的难点之一；对于该骨折，较为常见的一种手术方式是于肱骨内部放置一髓内钉，但其对肱骨头的固定是有限的，对于严重的粉碎性骨折更缺乏稳定的固定，不能提供肩关节早期功能锻炼的有效力学支撑；此外髓内钉的植入需要钻制造入点，且髓内钉与髓腔的内部结构明显不匹配，会对髓内血运造成影响。此基础上，本发明的发明人曾提出一种具有较大支撑面积的固定装置来取代髓内钉(见申请号为201410342347.4的中国发明专利)，以实现对肱骨头较好的支撑效果，相对于髓内钉，该固定装置的支撑效果较好；但该装置，其发明点在于提供特定角度的支撑面，而对于其和肱骨头间的固定连接，即通过连接到肱骨头的主钉来实现。在使用中发现，该固定装置的整体强度不太理想，为此使得固定效果不是很理想，这使得该固定装置在置入患者体内后，患者骨折的该部位必须在静养一段时间后，才可以进行骨折部位的活动，这样的话，不利于该骨折部位的相关关节的恢复；另外，该固定装置在通过其主钉连接到肱骨头后，肱骨头的位置难以再进行微调。
因此，如何提供一种能够避免上述弊端的修复装置便成为了本领域技术人员急需解决的技术问题。
发明内容
本发明解决的技术问题在于提供一种强度更强且固定支撑效果更好的修复装置，使得该修复装置稳定结合在骨折处。采用如下技术方案：
一种用于肱骨近端骨折的修复装置，包括：
肱骨髓腔支撑部，所述肱骨髓腔支撑部具有近端端部，所述近端为靠近肩部的一端，所述近端端部包括用于从内侧支撑肱骨头的肱骨头支撑面，所述近端端部开设一穿过该肱骨头支撑面的第一通孔；
第一插接体，所述第一插接体具有分设于其两端的螺纹端和公结合端，所述公结合端设置有内螺纹或外螺纹，所述第一插接体能够插接于所述第一通孔并其螺纹端能够旋入所述肱骨头；
贴合部，其包括能够贴合在肱骨的外侧壁上的贴合面和相反于该贴合面的外侧面，该贴合在肱骨外侧壁的位置为远离所述肱骨头并临近大结节和小结节的肱骨的外侧壁处，所述贴合部开设一穿过该贴合面的第二通孔，所述贴合部贴合在肱骨的外侧壁时，所述第二通孔与所述第一通孔的轴线重合；
第二插接体，所述第二插接体具有分设于其两端的母结合端和卡接端，所述母结合端为匹配所述公结合端的内螺纹或外螺纹而设置的外螺纹或内螺纹，所述第二插接体插接于所述第二通孔时，所述卡接端卡接所述第二通孔位于所述贴合部的外侧面并所述母结合端结合所述公结合端使得通过所述卡接端能够调整所述公结合端和所述母结合端的结合位置进而能够调整肱骨头位置。
作为优选，所述贴合部呈片状结构，所述片状结构具有顶侧、底侧、位于该顶侧和底侧之间并连接该顶侧和底侧的左侧和右侧，该片状结构贴合于所述肱骨外侧壁时，所述顶侧靠近所述近端并所述底侧远离所述近端、所述左侧靠近所述大结节并所述右侧靠近所述小结节，所述顶侧到所述底侧的方向为长度方向，沿该长度方向的所述顶侧到所述底侧的长度为3-6cm，所述左侧到所述右侧的方向为宽度方向，沿该宽度方向的所述左侧到所述右侧的宽度为2-4cm。
作为优选，所述片状结构上靠近所述顶侧的位置处开设若干贯穿所述贴合面和外侧面的肩袖缝合线通孔，供肩袖缝合线穿过以将肩袖缝合在该片状结构上，所述片状结构上靠近所述底侧的位置处开设一贯穿该贴合面和外侧面的第三通孔，所述修复装置还包括一对抗肩袖螺钉，所述对抗肩袖螺钉能够穿过所述第三通孔并其螺纹尾部能够固定连接于所述肱骨，所述对抗肩袖螺钉的端部卡接所述第三通孔位于该片状结构的所述外侧面上。
作为优选，所述肱骨头具有远离所述近端的下边缘，该下边缘连接位于其下方的肱骨干，所述第三通孔的轴线方向朝向距离该下边缘1-3.5cm范围内的肱骨干，使得所述对抗肩袖螺钉的尾部能够固定连接于距离该下边缘1-3.5cm范围内的肱骨干。
作为优选，所述第三通孔为左倾斜且向下设置的通孔，所述左倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述左侧的方向偏离10-30°角度的方向，所述向下为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述底侧的方向偏离5-40°角度的方向。
作为优选，所述片状结构上靠近所述顶侧的位置处为所述片状结构上靠近所述顶侧且沿宽度方向的边缘处、所述片状结构上靠近所述顶侧并靠近所述左侧的沿长度方向的边缘处和所述片状结构上靠近所述顶侧并靠近所述右侧的沿长度方向的边缘处。
作为优选，所述片状结构上靠近所述左侧的位置处沿长度方向上开设贯穿所述贴合面和外侧面的两个大结节通孔，所述片状结构上靠近所述右侧的位置处沿长度方向上开设贯穿所述贴合面和外侧面的两个小结节通孔，所述修复装置还包括两个大结节固定螺钉和两个小结节固定螺钉，所述大结节固定螺钉能够穿过所述大结节通孔并其螺纹尾部能够固定连接于所述大结节，所述大结节固定螺钉的端部卡接所述大结节通孔并位于该片状结构的外侧面上，所述小结节固定螺钉能够穿过所述小结节通孔并其螺纹尾部能够固定连接于所述小结节，所述小结节固定螺钉的端部卡接所述小结节通孔并位于该片状结构的外侧面上。
作为优选，所述大结节通孔为左倾斜设置的通孔，所述左倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述左侧的方向偏离10-30°角度的方向，所述小结节通孔为右倾斜设置的通孔，所述右倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述右侧的方向偏离10-30°角度的方向。
作为优选，所述第二通孔开设的位置为该片状结构上沿所述长度方向的靠中间位置处且位于所述第三通孔和所述大结节通孔、小结节通孔之间。
作为优选，所述肱骨髓腔支撑部还包括连接所述近端端部且由该近端端部沿远离所述近端方向延伸的竖直部，所述肱骨髓腔支撑部在结合所述片状结构并安装所述的各个螺钉时，所述近端端部在所述宽度方向上设计为具有能够避开所述大结节固定螺钉和所述小结节固定螺钉的宽度，所述竖直部在所述宽度方向上设 计为具有能够避开所述对抗肩袖螺钉的宽度，所述竖直部上开设有沿水平方向延伸的至少一个水平通孔，所述修复装置还包括匹配所述水平通孔数量的至少一个插接螺钉，所述插接螺钉能够一一对应所述水平通孔设置且其螺纹端能够旋入所述肱骨杆。
作为优选，所述第一插接体为中空设置使得能够将导向针穿过以通过该导向针引导该第一插接体插接于所述第一通孔，所述第一插接体的公结合端的中空的杆体内设置有内螺纹，所述第二插接体的母结合端为设置有外螺纹的杆体，该外螺纹能够螺纹连接该内螺纹。
作为优选，所述第一通孔的轴线方向垂直于所述肱骨头支撑面。
作为优选，所述肱骨头支撑面为支撑平面，其与髓腔呈45°～50°设置。
作为优选，所述近端端部包括肱骨头支撑件和大结节支撑件，所述肱骨头支撑面设置于所述肱骨头支撑件上，所述大结节支撑件和所述肱骨头支撑件呈分体设置，所述大结节支撑件具有朝向且能够支撑大结节的凸起，所述肱骨头支撑件朝向所述大结节支撑件的位置处设置第一结合部，所述大结节支撑件朝向所述肱骨头支撑件的位置处设置第二结合部，所述第一结合部结合所述第二结合部能够使所述大结节支撑件和所述肱骨头支撑件连接。
作为优选，所述修复装置还包括：
定位部，其包括分设于两端的第一定位端和第二定位端，所述近端端部上背离所述肱骨头支撑面的位置处开设有第三结合部，所述第一结合部未与所述第二结合部结合时，该定位部的所述第一定位端能够可拆卸地连接于所述第三结合部；
导向部，所述导向部包括上端和下端，所述导向部上靠近所述上端的位置处设置有上结合部，所述第二定位端能够可拆卸地连接于所述上结合部，所述导向部上开设有第一导向通孔，用于为将要插接于所述第一通孔的所述第一插接体提供导向，所述导向部上还开设有至少一个第二导向通孔，所述第二导向通孔用于为将要插接于所述水平通孔的所述插接螺钉提供导向；
所述定位部的第一定位端结合所述近端端部的所述第三结合部且所述定位部的第二定位端结合所述导向部的所述上结合部时，能够形成所述肱骨髓腔支撑部、所述定位部和所述导向部依次连接的稳固结构，此时所述导向部的上端到其下端的方向为平行于所述竖直部的竖直方向、所述第一导向通孔的轴线方向和所述第一通孔的轴线方向重合、所述第二导向通孔的轴线方向和相对应的所述水平通孔的轴线方向重合。
作为优选，所述肱骨头支撑件朝向所述大结节支撑件的位置处的两侧均设置一凸台阶，形成所述第一结合部，所述大结节支撑件朝向具有该凸台阶的相应位置处均设置一匹配的凹台阶，形成所述第二结合部，第二结合部搭接于所述第一结合部能够使所述肱骨头支撑件固定支撑该大结节支撑件，形成所述第一结合部的两凸台阶的中间处设有一凹陷，所述凹陷内设置两个并排布置的结合插接盲孔，该两个结合插接盲孔之间设置一螺纹盲孔，所述结合插接盲孔形成所述第三结合部；
所述导向部上靠近所述上端的位置处开设有两个导向插接盲孔，所述导向插接盲孔形成所述上结合部，该两个导向插接盲孔之间设置一通孔；
所述定位部包括一空心杆和一定位杆，该空心杆的的两端均设置两个插接凸起，分别形成所述第一定位端和所述第二定位端，所述第一定位端的所述两个插接凸起插接于所述第三结合部的两个所述插接盲孔，所述第二定位端的所述两个插接凸起插接于所述导向部的两个导向插接盲孔，所述定位杆的一端为螺纹端，所述螺纹端穿过所述空心杆并螺纹连接所述螺纹盲孔，所述定位杆的另一端为卡接端，卡接于所述定位杆靠近所述导向部的一端的外侧。
本申请具有如下技术效果：
该修复装置在对骨折的患者使用时，形成的是连接到肱骨头的肱骨髓腔支撑部、第一插接体、第二插接体和贴合部所形成的整体稳定性极强的结构，第一插接体即和肱骨头实现连接，同时其也和卡接在贴合部上的第二插接体固定连接，其强度较强，在该修复装置置入患者体内后，患者骨折的该部位几乎可在患者完成手术后就可以进行全范围的早期活动，有利于该骨折修复部位的关节的恢复。并第一插接体的螺纹端固定连接于肱骨头以实现该修复装置和肱骨头的固定连接，进而第二插接体连接第一插接体且其之间为可调的连接，可通过该第二插接体能够对已固定连接在第一插接体上的肱骨头的位置进行调整，以使得能够在手术中实现精准的骨折处的肱骨头的定位，有利于后期的恢复。且该第二插接体是通过该贴合部进行卡接，在调节过程中，在转动该第二插接体时，由于该贴合部的较大面积的设置，其可以避开第二插接体的卡接端在旋转过程中造成的对其他组织的损伤；同时，该贴合部的位置固定也是通过第一插接体和第二插接体的结 合来实现，减少了于肱骨上再开设钻孔来固定该贴合部的操作，进一步减少了手术过程中对于患者的创伤。
作为优选，贴合部为片状结构，并限定了其长度为3-6cm、宽度为2-4cm，其是完全不同于现有技术中的用于在肱骨外侧所设置的固定长板，现有技术中的该固定长板主要是起到固定肱骨头的作用，为实现其较好的固定效果，其需要设置为大概10cm以上的长度，并需要在该10cm以上长的板体上开设多个穿孔，如附图1所示，其上方开设多个穿孔，并通过多个螺钉穿过该穿孔才能将该固定长板稳定连接在肱骨头上，进而在该板体的下方需设置多个穿孔，供螺钉穿过连接肱骨干，进而才能实现有效的固定，倘若设置的过短(如10cm以下)，会不具有稳定连接并固定肱骨头的效果。而本申请的为片状结构的贴合部，其并非起到固定肱骨头的作用，因为该修复装置中的肱骨髓腔支撑部是已经起到支撑固定作用，而片状结构的主要作用是用于提供第二通孔，以用于第二插接体的插接，和如上提到的贴合部的效果。并该片状结构的长度和宽度的设置实现了大幅度缩减，可以减轻手术过程中在置入该片状结构时造成的对患者的创伤。
作为优选，该片状结构上设有肩袖缝合线通孔，且是位于靠顶侧的位置处，并通过在相反该顶侧的靠近底侧的位置处开设第三通孔，以供对抗肩袖螺钉穿过，该对抗肩袖螺钉的设定，能够对抗缝合肩袖对片状结构的力，避免该片状结构会因肩袖的力而翘起造成对其他组织的伤害。
作为优选，限定了第三通孔的轴线方向为朝向距离该下边缘1-3.5cm范围内的肱骨干，是因为该肱骨干是较为结实的部分，且在肱骨近端骨折情形中，其粉碎的可能性极小，为此能够使对抗肩袖螺钉能稳定的固定在肱骨上。
作为优选，第三通孔为左倾斜且向下设置的通孔，左倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述左侧的方向偏离10-30°角度的方向，向下为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述底侧的方向偏离5-40°角度的方向，该方向设置的第三通孔，其在容纳对抗肩袖螺钉后，会使得该对抗肩袖螺钉对该片状结构施加该方向的力，使得片状结构贴合在肱骨外侧壁上的贴合度大大提升，有利于该片状结构所贴合的患者骨折的部位的恢复。
作为优选，片状结构上开设大结节通孔和小结节通孔，且大结节通孔和小结节通孔的方向的限定，使得大结节的原位恢复效果和小结节的原位恢复效果较好。
作为优选，肱骨头支撑面为支撑平面，且其与髓腔呈45°～50°的设置，对肱骨头的支撑效果极好。
作为优选，大结节支撑件和肱骨头支撑件呈分体设置，一方面，大结节支撑件的凸起的尺寸为可调整设置，可生产多种尺寸的该凸起，以能够适应不同尺寸的大结节，为此，针对患者的个体差异，可提供多种尺寸的大结节支撑件来进行相匹配，进而能为相应的患者提供合适的支撑，使其术后的恢复效果得到提升；另一方面，相对于一体设置来说，在手术中，申请人发现该一体设置的支撑是很难置入髓腔内，而该分体设置，可以先将大结节支撑件与肱骨头支撑件分离，此时仅具有肱骨头支撑件的该肱骨髓腔支撑部是易于置入髓腔内。
作为优选，该修复装置还包括定位部，其中在第一结合部未与所述第二结合部结合时，可将定位部结合在该第三结合部上，并该定位部的第二定位端可连接导向部，可进行穿钉操作，此时，是采用第三结合部通过定位部为导向部提供了良好的支撑，为穿钉操作时解除了二次创伤来固定导向部或额外的操作人员来手持导向部的缺陷，大大缩减了时间和成本。
作为优选，肱骨头支撑件朝向所述大结节支撑件的位置处的两侧均设置一凸台阶，形成所述第一结合部，形成所述第一结合部的两凸台阶的中间处设有一凹陷，凹陷内设置两个并排布置的结合插接盲孔，该两个结合插接盲孔之间设置一螺纹盲孔，结合插接盲孔形成所述第三结合部，差不多是在近端端部的同一位置，即该位置的外侧和内侧形成第一结合部和第三结合部，在同一位置处设置两种不同的结合部用于分别与大结节支撑件或者定位部进行结合，正好利用了大结节支撑件和定位部的错开放置，即在有限的位置实现了所需的设置，这无需再额外设置部件来完成连接，显然是更低成本的设置。具体的，凹陷部的设置，是等同于进一步的减轻了第一支撑部的重量，同时也节约了材料。并，定位部和导向部的具体的设置，可在进行各个部件的连接时，通过该设置实现，进而形成稳定的肱骨髓腔支撑部和定位部和导向部的固定连接结构。
附图说明
图1为现有技术中的固定长板应用于骨折手术中的影像示意图；
图2本发明所提供的修复装置中的一种实施方式的肱骨髓腔支撑部和片状结构结合到肱骨的结构示意图；
图3为图2中的拆分图；
图4为所提供的修复装置中的一种实施方式的肱骨髓腔支撑部和片状结构结合到肱骨的主视图和侧视图；
图5为片状结构结合到肱骨时的示意图；
图6为片状结构的主视图；
图7为本发明所提供的修复装置中的一种实施方式的包括肱骨髓腔支撑部、定位部和结合部的结构示意图；
图8为本发明提供的肱骨髓腔支撑部和片状结构应用于骨折手术中的影响图；
图9为本发明提供的空心杆和定位杆的一种实施方式的结构示意图；
图10为本发明提供的肱骨髓腔支撑部的一种实施方式的主视图；
图11为本发明所提供的导向部的主视图。
图1-11中的附图标记如下：
1肱骨髓腔支撑部，2近端端部，3肱骨头，4肱骨头支撑面，5第一通孔，6第一插接体，7螺纹端，8公结合端，9贴合面，10外侧面，11大结节，12小结节，13第二通孔，14第二插接体，15母结合端，16卡接端，17片状结构，18顶侧，19底侧，20左侧，21右侧，22肩袖缝合线通孔，23第三通孔，24对抗肩袖螺钉，25螺纹尾部，26对抗肩袖螺钉的端部，27下边缘，28 1-3.5cm范围内的肱骨干，29大结节通孔，30小结节通孔，31大结节固定螺钉，32小结节固定螺钉，33竖直部，34水平通孔，35插接螺钉，36肱骨头支撑件，37大结节支撑件，38凸起，39定位部，40第一定位端，41第二定位端，42导向部，43上端，44下端，45第一导向通孔，46第二导向通孔，47凸台阶，48凹台阶，49凹陷，50结合插接盲孔，51螺纹盲孔，52导向插接盲孔，53通孔，54空心杆，55插接凸起，56定位杆，57固定长板，58穿孔，59螺钉，60肱骨干，61空心导杆，62导向针。
具体实施方式
下面结合技术方案和附图对本发明的具体实施方式进行详细的介绍，显然，所描述的实施例仅仅是本发明一部分实施例，而不是全部的实施例。基于本发明 中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。
如图1-11所示，图1为现有技术中的固定长板应用于骨折手术中的影像示意图；图2本发明所提供的修复装置中的一种实施方式的肱骨髓腔支撑部和片状结构结合到肱骨的结构示意图；图3为图2中的拆分图；图4为所提供的修复装置中的一种实施方式的肱骨髓腔支撑部和片状结构结合到肱骨的主视图和侧视图；图5为片状结构结合到肱骨时的示意图；图6为片状结构的主视图；图7为本发明所提供的修复装置中的一种实施方式的包括肱骨髓腔支撑部、定位部和结合部的结构示意图；图8为本发明提供的肱骨髓腔支撑部和片状结构应用于骨折手术中的影像示意图；图9为本发明提供的空心杆和定位杆的一种实施方式的结构示意图；图10为本发明提供的肱骨髓腔支撑部的一种实施方式的主视图；图11为本发明所提供的导向部的主视图。
结合图2-11所示，一种具体实施方式中，修复装置，包括：
肱骨髓腔支撑部1，所述肱骨髓腔支撑部1具有近端端部2，所述近端为靠近肩部的一端，所述近端端部2包括用于从内侧支撑肱骨头3的肱骨头支撑面4，所述近端端部1开设一穿过该肱骨头支撑面4的第一通孔5；
第一插接体6，所述第一插接体6具有分设于其两端的螺纹端7和公结合端8，所述公结合端8设置有内螺纹或外螺纹，所述第一插接体6能够插接于所述第一通孔5并其螺纹端7能够旋入所述肱骨头3；
贴合部，其包括能够贴合在肱骨的外侧壁上的贴合面9和相反于该贴合面9的外侧面10，该贴合在肱骨外侧壁的位置为远离所述肱骨头3并临近大结节11和小结节12的肱骨的外侧壁处，所述贴合部开设一穿过该贴合面9的第二通孔13，所述贴合部贴合在肱骨的外侧壁时，所述第二通孔13与所述第一通孔5的轴线重合；
第二插接体14，所述第二插接体14具有分设于其两端的母结合端15和卡接端16，所述母结合端15为匹配所述公结合端8的内螺纹或外螺纹而设置的外螺纹或内螺纹，所述第二插接体14插接于所述第二通孔13时，所述卡接端16卡接所述第二通孔13位于所述贴合部的外侧面10并所述母结合端15结合所述公结合端8使得通过所述卡接端16能够调整所述公结合端8和所述母结合端15的结合位置进而能够调整肱骨头3位置。
该修复装置在对骨折的患者使用时，形成的是连接到肱骨头3的肱骨髓腔支撑部1、第一插接体6、第二插接体14和贴合部所形成的整体稳定性极强的结构，第一插接体6既和肱骨头3实现连接，同时其也和卡接在贴合部上的第二插接体14固定连接，其强度较强，在该修复装置置入患者体内后，患者骨折的该部位几乎可在患者完成手术后就可以进行全范围的早期活动，有利于该骨折修复部位的关节的恢复。并第一插接体6的螺纹端7固定连接于肱骨头3以实现该修复装置和肱骨头3的固定连接，进而第二插接体14连接第一插接体6且其之间为可调的连接，可通过该第二插接体14能够对已固定连接在第一插接体6上的肱骨头3的位置进行调整，以使得能够在手术中实现精准的骨折处的肱骨头3的定位，有利于后期的恢复。且该第二插接体14是通过该贴合部进行卡接，在调节过程中，在转动该第二插接体14时，由于该贴合部的较大面积的设置，其可以避开第二插接体14的卡接端16在旋转过程中造成的对其他组织的损伤；同时，该贴合部的位置固定也是通过第一插接体6和第二插接体14的结合来实现，减少了于肱骨上再开设钻孔来固定该贴合部的操作，进一步减少了手术过程中对于患者的创伤。
一种具体实施方式中，结合图2-11，该贴合部呈片状结构17，所述片状结构17具有顶侧18、底侧19、位于该顶侧18和底侧19之间并连接该顶侧18和底侧19的左侧20和右侧21，该片状结构17贴合于所述肱骨外侧壁时，所述顶侧18靠近所述近端并所述底侧19远离所述近端、所述左侧20靠近所述大结节11并所述右侧21靠近所述小结节12，所述顶侧18到所述底侧19的方向为长度方向，沿该长度方向的所述顶侧18到所述底侧19的长度为3-6cm，所述左侧20到所述右侧21的方向为宽度方向，沿该宽度方向的所述左侧20到所述右侧21的宽度为2-4cm。
贴合部为片状结构17，并限定了其长度为3-6cm、宽度为2-4cm，其是完全不同于现有技术中的用于在肱骨外侧所设置的固定长板57，现有技术中的该固定长板57主要是起到固定肱骨头3的作用，为实现其较好的固定效果，其需要设置为大概10cm以上的长度，并需要在该10cm以上长的板体上开设多个穿孔58，如附图1所示，其上方开设多个穿孔58，并通过多个螺钉59穿过该穿孔58才能将该固定长板57稳定连接在肱骨头3上，进而在该板体的下方需设置多个穿孔58，供螺钉59穿过连接肱骨干，进而才能实现有效的固定，倘若设置的过短(如10cm以下)，会不具有稳定连接并固定肱骨头的效果。而本申请的为片状结构17的贴合部，其并非起到固定肱骨头的作用，因为该修复装置中的肱骨髓腔支撑部1是 已经起到支撑固定作用，而片状结构17的主要作用是用于提供第二通孔13，以用于第二插接体14的插接，和如上提到的贴合部的效果。并该片状结构17的长度和宽度的设置实现了大幅度缩减，可以减轻手术过程中在置入该片状结构17时造成的对患者的创伤。
该具体实施方式中，如图6所示，片状结构17上靠近所述顶侧18的位置处开设若干贯穿所述贴合面9和外侧面10的肩袖缝合线通孔22，供肩袖缝合线穿过以将肩袖缝合在该片状结构17上，所述片状结构17上靠近所述底侧19的位置处开设一贯穿该贴合面9和外侧面10的第三通孔23。并如图2和图4所示，修复装置还包括一对抗肩袖螺钉24，所述对抗肩袖螺钉24能够穿过所述第三通孔23并其螺纹尾部25能够固定连接于所述肱骨，所述对抗肩袖螺钉的端部26卡接所述第三通孔23位于该片状结构17的所述外侧面10上。
该片状结构17上设有肩袖缝合线通孔22，且是位于靠顶侧18的位置处，并通过在相反该顶侧18的靠近底侧19的位置处开设第三通孔23，以供对抗肩袖螺钉24穿过，该对抗肩袖螺钉24的设定，能够对抗缝合肩袖对片状结构17的力，避免该片状结构17会因肩袖的力而翘起造成对其他组织的伤害。
具体的，如图2所示，肱骨头3具有远离所述近端的下边缘27，该下边缘27连接位于其下方的肱骨干，所述第三通孔23的轴线方向朝向距离该下边缘1-3.5cm范围内的肱骨干28，使得所述对抗肩袖螺钉24的螺纹尾部25能够固定连接于距离该下边缘1-3.5cm范围内的肱骨干28。
限定了第三通孔23的轴线方向为朝向距离该下边缘1-3.5cm范围内的肱骨干28，是因为该肱骨干是较为结实的部分，且在肱骨近端骨折情形中，其粉碎的可能性极小，为此能够使对抗肩袖螺钉24能稳定的固定在肱骨上。
一种具体实施方式中，第三通孔23为左倾斜且向下设置的通孔，所述左倾斜为该通孔的轴线方向由垂直于该片状结构17贴合面9的垂直轴线方向向靠近所述左侧20的方向偏离10-30°角度的方向，所述向下为该通孔的轴线方向由垂直于该片状结构17贴合面9的垂直轴线方向向靠近所述底侧19的方向偏离5-40°角度的方向。
第三通孔23为左倾斜且向下设置的通孔，该特定角度方向设置的第三通孔23，其在容纳对抗肩袖螺钉24后，会使得该对抗肩袖螺钉24对该片状结构17施加该方向的力，使得片状结构17贴合在肱骨外侧壁上的贴合度大大提升，有利于该片状结构17所贴合的患者骨折的部位的恢复。
一种具体实施方式中，如图6所示，片状结构17上靠近所述顶侧18的位置处为所述片状结构17上靠近所述顶侧18且沿宽度方向的边缘处、所述片状结构17上靠近所述顶侧18并靠近所述左侧20的沿长度方向的边缘处和所述片状结构17上靠近所述顶侧18并靠近所述右侧21的沿长度方向的边缘处。
结合图2-11，一种具体实施方式中，片状结构17上靠近所述左侧20的位置处沿长度方向上开设贯穿所述贴合面9和外侧面10的两个大结节通孔29，所述片状结构17上靠近所述右侧21的位置处沿长度方向上开设贯穿所述贴合面9和外侧面10的两个小结节通孔30，所述修复装置还包括两个大结节固定螺钉31和两个小结节固定螺钉32，所述大结节固定螺钉31能够穿过所述大结节通孔29并其螺纹尾部能够固定连接于所述大结节11，所述大结节固定螺钉31的端部卡接所述大结节通孔29并位于该片状结构17的外侧面10上，所述小结节固定螺钉32能够穿过所述小结节通孔30并其螺纹尾部能够固定连接于所述小结节12，所述小结节固定螺钉32的端部卡接所述小结节通孔30并位于该片状结构17的外侧面10上。
该具体实施方式中，大结节通孔29为左倾斜设置的通孔，所述左倾斜为该通孔的轴线方向由垂直于该片状结构17贴合面9的垂直轴线方向向靠近所述左侧20的方向偏离10-30°角度的方向，所述小结节通孔30为右倾斜设置的通孔，所述右倾斜为该通孔的轴线方向由垂直于该片状结构17贴合面9的垂直轴线方向向靠近所述右侧21的方向偏离10-30°角度的方向。
片状结构17上开设大结节通孔29和小结节通孔30，且大结节通孔29和小结节通孔30的方向的限定，使得大结节11的原位恢复效果和小结节12的原位恢复效果较好。
且如图6所示，第二通孔13开设的位置为该片状结构17上沿所述长度方向的靠中间位置处且位于所述第三通孔23和所述大结节通孔29、小结节通孔30之间。
一种具体实施方式中，结合图2-11，肱骨髓腔支撑部1还包括连接所述近端端部2且由该近端端部2沿远离所述近端方向延伸的竖直部33，所述肱骨髓腔支撑部1在结合所述片状结构17并安装所述的各个螺钉时，所述近端端部2在所述宽度方向上设计为具有能够避开所述大结节固定螺钉31和所述小结节固定螺钉32的宽度，所述竖直部33在所述宽度方向上设计为具有能够避开所述对抗肩袖螺钉24的宽度，所述竖直部33上开设有沿水平方向延伸的至少一个水平通孔34，所 述修复装置还包括匹配所述水平通孔34数量的至少一个插接螺钉35，所述插接螺钉35能够一一对应所述水平通孔34设置且其螺纹端能够旋入所述肱骨干。
一种具体实施方式中，对于第一插接体6和第二插接体14的结合，其中，第一插接体6为中空设置使得能够将导向针62穿过以通过该导向针62引导该第一插接体6插接于所述第一通孔5，所述第一插接体6的公结合端8的中空的杆体内设置有内螺纹，所述第二插接体14的母结合端15为设置有外螺纹的杆体，该外螺纹能够螺纹连接该内螺纹。
并如图2和图3所示，第一通孔5的轴线方向垂直于所述肱骨头支撑面4。
进一步的，肱骨头支撑面4为支撑平面，且其与髓腔呈45°～50°的设置，对肱骨头3的支撑效果极好。
一种具体实施方式中，近端端部2包括肱骨头支撑件36和大结节支撑件37，所述肱骨头支撑面4设置于所述肱骨头支撑件36上，所述大结节支撑件37和所述肱骨头支撑件36呈分体设置，所述大结节支撑件37具有朝向且能够支撑大结节11的凸起38，所述肱骨头支撑件36朝向所述大结节支撑件37的位置处设置第一结合部，所述大结节支撑件37朝向所述肱骨头支撑件36的位置处设置第二结合部，所述第一结合部结合所述第二结合部能够使所述大结节支撑件37和所述肱骨头支撑件36连接。
大结节支撑件37和肱骨头支撑件36呈分体设置，一方面，大结节支撑件37的凸起38的尺寸为可调整设置，可生产多种尺寸的该凸起38，以能够适应不同尺寸的大结节11，为此，针对患者的个体差异，可提供多种尺寸的大结节支撑件37来进行相匹配，进而能为相应的患者提供合适的支撑，使其术后的恢复效果得到提升；另一方面，相对于一体设置来说，在手术中，申请人发现该一体设置的支撑是很难置入髓腔内，而该分体设置，可以先将大结节支撑件37与肱骨头支撑件36分离，此时仅具有肱骨头支撑件36的该肱骨髓腔支撑部1是易于置入髓腔内。
进一步的，结合图2-11，修复装置还包括：
定位部39，其包括分设于两端的第一定位端40和第二定位端41，所述近端端部2上背离所述肱骨头支撑面4的位置处开设有第三结合部，所述第一结合部未与所述第二结合部结合时，该定位部39的所述第一定位端40能够可拆卸地连接于所述第三结合部；
导向部42，所述导向部42包括上端43和下端44，所述导向部42上靠近所述上端43的位置处设置有上结合部，所述第二定位端41能够可拆卸地连接于所 述上结合部，所述导向部42上开设有第一导向通孔45，用于为将要插接于所述第一通孔5的所述第一插接体6提供导向，所述导向部42上还开设有至少一个第二导向通孔46，所述第二导向通孔46用于为将要插接于所述水平通孔34的所述插接螺钉35提供导向；
所述定位部39的第一定位端40结合所述近端端部2的所述第三结合部且所述定位部39的第二定位端41结合所述导向部42的所述上结合部时，能够形成所述肱骨髓腔支撑部1、所述定位部39和所述导向部42依次连接的稳固结构，此时所述导向部42的上端43到其下端44的方向为平行于所述竖直部33的竖直方向、所述第一导向通孔45的轴线方向和所述第一通孔5的轴线方向重合、所述第二导向通孔46的轴线方向和相对应的所述水平通孔34的轴线方向重合。
该修复装置还包括定位部39，其中在第一结合部未与所述第二结合部结合时，可将定位部39结合在该第三结合部上，并该定位部39的第二定位端41可连接导向部42，可进行穿钉(第一插接体和插接螺钉的插接)操作，此时，是采用第三结合部通过定位部39为导向部42提供了良好的支撑，为穿钉操作时解除了二次创伤来固定导向部或额外的操作人员来手持导向部的缺陷，大大缩减了时间和成本。
一种具体实施方式中，结合图2-11所示，肱骨头支撑件36朝向所述大结节支撑件37的位置处的两侧均设置一凸台阶47，形成所述第一结合部，所述大结节支撑件37朝向具有该凸台阶47的相应位置处均设置一匹配的凹台阶48，形成所述第二结合部，第二结合部搭接于所述第一结合部能够使所述肱骨头支撑件36固定支撑该大结节支撑件37，形成所述第一结合部的两凸台阶47的中间处设有一凹陷49，所述凹陷49内设置两个并排布置的结合插接盲孔50，该两个结合插接盲孔50之间设置一螺纹盲孔51，所述结合插接盲孔50形成所述第三结合部；
所述导向部42上靠近所述上端43的位置处开设有两个导向插接盲孔52，所述导向插接盲孔52形成所述上结合部，该两个导向插接盲孔52之间设置一通孔53；
所述定位部39包括一空心杆54和一定位杆56，该空心杆54的的两端均设置两个插接凸起55，分别形成所述第一定位端40和所述第二定位端41，所述第一定位端40的所述两个插接凸起55插接于所述第三结合部的两个所述结合插接盲孔50，所述第二定位端41的所述两个插接凸起55插接于所述导向部42的两个导向插接盲孔52，所述定位杆56的一端为螺纹端，所述螺纹端穿过所述空心杆 54并螺纹连接所述螺纹盲孔51，所述定位杆56的另一端为卡接端，卡接于所述定位杆56靠近所述导向部42的一端的外侧。
肱骨头支撑件36朝向所述大结节支撑件37的位置处的两侧均设置一凸台阶47，形成所述第一结合部，形成所述第一结合部的两凸台阶47的中间处设有一凹陷49，凹陷49内设置两个并排布置的结合插接盲孔50，该两个结合插接盲孔50之间设置一螺纹盲孔51，结合插接盲孔50形成所述第三结合部，差不多是在近端端部2的同一位置，即该位置的外侧和内侧形成第一结合部和第三结合部，在同一位置处设置两种不同的结合部用于分别与大结节支撑件37或者定位部39进行结合，正好利用了大结节支撑件37和定位部39的错开放置，即在有限的位置实现了所需的设置，这无需再额外设置部件来完成连接，显然是更低成本的设置。具体的，凹陷49的设置，是等同于进一步的减轻了近端端部2的重量，同时也节约了材料。并，定位部39和导向部42的具体的设置，可在进行各个部件的连接时，通过该设置实现，进而形成稳定的肱骨髓腔支撑部1和定位部39和导向部42的固定连接结构。
该修复装置在使用时，大致过程如下：
将骨折部位处撑开一间隙，该间隙使得能够将肱骨髓腔支撑部1(此时大结节支撑件37并未结合到近端端部2上，如此操作，能使得该间隙尽可能小)置入肱骨的髓腔内部；并使得肱骨头支撑面4朝向肱骨头3的内侧，之后，将空心杆54的一端的插接凸起55插接于肱骨髓腔支撑部1的对应的结合插接盲孔50中，同时将空心杆54的另一端的插接凸起55插接于导向部42的对应的导向插接盲孔52中，再将定位杆56插接于空心杆54内，定位杆56的一端为螺纹端，螺纹端穿过所述空心杆54并螺纹连接所述螺纹盲孔51，所述定位杆56的另一端为卡接端，卡接于所述定位杆56靠近所述导向部42的一端的外侧。进而形成肱骨髓腔支撑部1、所述定位部39和所述导向部42依次连接的稳固结构。
之后，通过该稳固结构进行第一插接体6和插接螺钉35的插接，具体的，将空心导杆61穿过导向部42的第一导向通孔45，如图7所示，其指向肱骨髓腔支撑部1的第一通孔5，此时在该空心导杆61内插入一端为剪刀头形状的开孔部件，使用该开孔部件对肱骨及其外的组织切开或打眼，使得该空心导杆61实现与第一通孔5的对接连通，进而将一导向针62依次穿过空心杆54和第一通孔5，之后将中空设置的第一插接体6通过该导向针62导入到第一通孔5内，再采用一空心锥将该第一插接体6旋入肱骨头3，该过程完成了第一插接体6的插接。再如图7所 示，将空心导杆61置入导向部42的第二导向通孔46内，采用类似的操作将插接螺钉35插接于水平通孔34内。
上述操作完成了第一插接体6和插接螺钉35的插接，并使得肱骨髓腔支撑部1(此时大结节支撑件37并未结合在近端端部2上)固定连接在肱骨上。之后，将导向部42和定位杆56、空心杆54拆除，在拆除后，将大结节支撑件37通过其凹台阶48和近端端部2的凸台阶47配合，使得其搭接在近端端部2上，此时，将片状结构17进行贴合，并将第二插接体14插接于第二通孔13，使得第二插接体14和第一插接体6结合。之后，再进行大结节固定螺钉31和小结节固定螺钉32的结合、缝合肩袖和对抗肩袖螺钉24的结合。为此，即形成了肱骨髓腔支撑部1、第一插接体6、第二插接体14和片状结构17和肱骨之间的极其稳定的固定结构。
以上实施方式仅为本发明的示例性实施方式，不用于限制本发明，本发明的保护范围由权利要求书限定。本领域技术人员在本发明的实质和保护范围内，对本发明做出的各种修改或等同替换也落在本发明的保护范围内。

Claims (16)

  1. 一种用于肱骨近端骨折的修复装置，其特征在于，包括：
    肱骨髓腔支撑部，所述肱骨髓腔支撑部具有近端端部，所述近端为靠近肩部的一端，所述近端端部包括用于从内侧支撑肱骨头的肱骨头支撑面，所述近端端部开设一穿过该肱骨头支撑面的第一通孔；
    第一插接体，所述第一插接体具有分设于其两端的螺纹端和公结合端，所述公结合端设置有内螺纹或外螺纹，所述第一插接体能够插接于所述第一通孔并其螺纹端能够旋入所述肱骨头；
    贴合部，其包括能够贴合在肱骨的外侧壁上的贴合面和相反于该贴合面的外侧面，该贴合在肱骨外侧壁的位置为远离所述肱骨头并临近大结节和小结节的肱骨的外侧壁处，所述贴合部开设一穿过该贴合面和外侧面的第二通孔，所述贴合部贴合在肱骨的外侧壁时，所述第二通孔与所述第一通孔的轴线重合；
    第二插接体，所述第二插接体具有分设于其两端的母结合端和卡接端，所述母结合端为匹配所述公结合端的内螺纹或外螺纹而设置的外螺纹或内螺纹，所述第二插接体插接于所述第二通孔时，所述卡接端卡接所述第二通孔位于所述贴合部的外侧面并所述母结合端结合所述公结合端使得通过所述卡接端能够调整所述公结合端和所述母结合端的结合位置进而能够调整肱骨头位置。
  2. 根据权利要求1所述的用于肱骨近端骨折的修复装置，其特征在于，所述贴合部呈片状结构，所述片状结构具有顶侧、底侧、位于该顶侧和底侧之间并连接该顶侧和底侧的左侧和右侧，该片状结构贴合于所述肱骨外侧壁时，所述顶侧靠近所述近端并所述底侧远离所述近端、所述左侧靠近所述大结节并所述右侧靠近所述小结节，所述顶侧到所述底侧的方向为长度方向，沿该长度方向的所述顶侧到所述底侧的长度为3-6cm，所述左侧到所述右侧的方向为宽度方向，沿该宽度方向的所述左侧到所述右侧的宽度为2-4cm。
  3. 根据权利要求2所述的用于肱骨近端骨折的修复装置，其特征在于，所述片状结构上靠近所述顶侧的位置处开设若干贯穿所述贴合面和外侧面的肩袖缝合线通孔，供肩袖缝合线穿过以将肩袖缝合在该片状结构上，所述片状结构上靠近所述底侧的位置处开设一贯穿该贴合面和外侧面的第三通孔，所述修复装置还包括一对抗肩袖螺钉，所述对抗肩袖螺钉能够穿过所述第三通孔并其螺纹尾部能够固定连接于所述肱骨，所述对抗肩袖螺钉的端部卡接所述第三通孔位于该片状结构的所述外侧面上。
  4. 根据权利要求3所述的用于肱骨近端骨折的修复装置，其特征在于，所述肱骨头具有远离所述近端的下边缘，该下边缘连接位于其下方的肱骨干，所述第三通孔的轴线方向朝向距离该下边缘1-3.5cm范围内的肱骨干，使得所述对抗肩袖螺钉的螺纹尾部能够固定连接于距离该下边缘1-3.5cm范围内的肱骨干。
  5. 根据权利要求4所述的用于肱骨近端骨折的修复装置，其特征在于，所述第三通孔为左倾斜且向下设置的通孔，所述左倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述左侧的方向偏离10-30°角度的方向，所述向下为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述底侧的方向偏离5-40°角度的方向。
  6. 根据权利要求4所述的用于肱骨近端骨折的修复装置，其特征在于，所述片状结构上靠近所述顶侧的位置处为所述片状结构上靠近所述顶侧且沿宽度方向的边缘处、所述片状结构上靠近所述顶侧并靠近所述左侧的沿长度方向的边缘处和所述片状结构上靠近所述顶侧并靠近所述右侧的沿长度方向的边缘处。
  7. 根据权利要求4所述的用于肱骨近端骨折的修复装置，其特征在于，所述片状结构上靠近所述左侧的位置处沿长度方向上开设贯穿所述贴合面和外侧面的两个大结节通孔，所述片状结构上靠近所述右侧的位置处沿长度方向上开设贯穿所述贴合面和外侧面的两个小结节通孔，所述修复装置还包括两个大结节固定螺钉和两个小结节固定螺钉，所述大结节固定螺钉能够穿过所述大结节通孔并其螺纹尾部能够固定连接于所述大结节，所述大结节固定螺钉的端部卡接所述大结节通孔并位于该片状结构的外侧面上，所述小结节固定螺钉能够穿过所述小结节通孔并其螺纹尾部能够固定连接于所述小结节，所述小结节固定螺钉的端部卡接所述小结节通孔并位于该片状结构的外侧面上。
  8. 根据权利要求7所述的用于肱骨近端骨折的修复装置，其特征在于，所述大结节通孔为左倾斜设置的通孔，所述左倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述左侧的方向偏离10-30°角度的方向，所述小结节通孔为右倾斜设置的通孔，所述右倾斜为该通孔的轴线方向由垂直于该片状结构贴合面的垂直轴线方向向靠近所述右侧的方向偏离10-30°角度的方向。
  9. 根据权利要求7所述的用于肱骨近端骨折的修复装置，其特征在于，所述第二通孔开设的位置为该片状结构上沿所述长度方向的靠中间位置处且位于所述第三通孔和所述大结节通孔、小结节通孔之间。
  10. 根据权利要求8所述的用于肱骨近端骨折的修复装置，其特征在于，所述肱骨髓腔支撑部还包括连接所述近端端部且由该近端端部沿远离所述近端方向延伸的竖直部，所述肱骨髓腔支撑部在结合所述片状结构并安装所述的各个螺钉时，所述近端端部在所述宽度方向上设计为具有能够避开所述大结节固定螺钉和所述小结节固定螺钉的宽度，所述竖直部在所述宽度方向上设计为具有能够避开所述对抗肩袖螺钉的宽度，所述竖直部上开设有沿水平方向延伸的至少一个水平通孔，所述修复装置还包括匹配所述水平通孔数量的至少一个插接螺钉，所述插接螺钉能够一一对应所述水平通孔设置且其螺纹端能够旋入所述肱骨杆。
  11. 根据权利要求1所述的用于肱骨近端骨折的修复装置，其特征在于，所述第一插接体为中空设置使得能够将导向针穿过以通过该导向针引导该第一插接体插接于所述第一通孔，所述第一插接体的公结合端的中空的杆体内设置有内螺纹，所述第二插接体的母结合端为设置有外螺纹的杆体，该外螺纹能够螺纹连接该内螺纹。
  12. 根据权利要求10所述的用于肱骨近端骨折的修复装置，其特征在于，所述第一通孔的轴线方向垂直于所述肱骨头支撑面。
  13. 根据权利要求12所述的用于肱骨近端骨折的修复装置，其特征在于，所述肱骨头支撑面为支撑平面，其与髓腔呈45°～50°设置。
  14. 根据权利要求13所述的用于肱骨近端骨折的修复装置，其特征在于，所述近端端部包括肱骨头支撑件和大结节支撑件，所述肱骨头支撑面设置于所述肱骨头支撑件上，所述大结节支撑件和所述肱骨头支撑件呈分体设置，所述大结节支撑件具有朝向且能够支撑大结节的凸起，所述肱骨头支撑件朝向所述大结节支撑件的位置处设置第一结合部，所述大结节支撑件朝向所述肱骨头支撑件的位置处设置第二结合部，所述第一结合部结合所述第二结合部能够使所述大结节支撑件和所述肱骨头支撑件连接。
  15. 根据权利要求14所述的用于肱骨近端骨折的修复装置，其特征在于，所述修复装置还包括：
    定位部，其包括分设于两端的第一定位端和第二定位端，所述近端端部上背离所述肱骨头支撑面的位置处开设有第三结合部，所述第一结合部未与所述第二结合部结合时，该定位部的所述第一定位端能够可拆卸地连接于所述第三结合部；
    导向部，所述导向部包括上端和下端，所述导向部上靠近所述上端的位置处设置有上结合部，所述第二定位端能够可拆卸地连接于所述上结合部，所述导向 部上开设有第一导向通孔，用于为将要插接于所述第一通孔的所述第一插接体提供导向，所述导向部上还开设有至少一个第二导向通孔，所述第二导向通孔用于为将要插接于所述水平通孔的所述插接螺钉提供导向；
    所述定位部的第一定位端结合所述近端端部的所述第三结合部且所述定位部的第二定位端结合所述导向部的所述上结合部时，能够形成所述肱骨髓腔支撑部、所述定位部和所述导向部依次连接的稳固结构，此时所述导向部的上端到其下端的方向为平行于所述竖直部的竖直方向、所述第一导向通孔的轴线方向和所述第一通孔的轴线方向重合、所述第二导向通孔的轴线方向和相对应的所述水平通孔的轴线方向重合。
  16. 根据权利要求15所述的用于肱骨近端骨折的修复装置，其特征在于，所述肱骨头支撑件朝向所述大结节支撑件的位置处的两侧均设置一凸台阶，形成所述第一结合部，所述大结节支撑件朝向具有该凸台阶的相应位置处均设置一匹配的凹台阶，形成所述第二结合部，第二结合部搭接于所述第一结合部能够使所述肱骨头支撑件固定支撑该大结节支撑件，形成所述第一结合部的两凸台阶的中间处设有一凹陷，所述凹陷内设置两个并排布置的结合插接盲孔，该两个结合插接盲孔之间设置一螺纹盲孔，所述结合插接盲孔形成所述第三结合部；
    所述导向部上靠近所述上端的位置处开设有两个导向插接盲孔，所述导向插接盲孔形成所述上结合部，该两个导向插接盲孔之间设置一通孔；
    所述定位部包括一空心杆和一定位杆，该空心杆的的两端均设置两个插接凸起，分别形成所述第一定位端和所述第二定位端，所述第一定位端的所述两个插接凸起插接于所述第三结合部的两个所述插接盲孔，所述第二定位端的所述两个插接凸起插接于所述导向部的两个导向插接盲孔，所述定位杆的一端为螺纹端，所述螺纹端穿过所述空心杆并螺纹连接所述螺纹盲孔，所述定位杆的另一端为卡接端，卡接于所述定位杆靠近所述导向部的一端的外侧。
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