WO2023213127A1 - 一种偏心型骨骺生长平衡装置 - Google Patents

一种偏心型骨骺生长平衡装置 Download PDF

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Publication number
WO2023213127A1
WO2023213127A1 PCT/CN2023/079524 CN2023079524W WO2023213127A1 WO 2023213127 A1 WO2023213127 A1 WO 2023213127A1 CN 2023079524 W CN2023079524 W CN 2023079524W WO 2023213127 A1 WO2023213127 A1 WO 2023213127A1
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Prior art keywords
epiphyseal
screw
metaphyseal
hole
mounting part
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PCT/CN2023/079524
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English (en)
French (fr)
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杜晓杰
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杜晓杰
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Publication of WO2023213127A1 publication Critical patent/WO2023213127A1/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
    • 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

Definitions

  • the utility model relates to the technical field of medical auxiliary devices, and in particular to an eccentric epiphyseal growth balancing device.
  • the enlarged parts at both ends of children's long bones are called epiphyses, and the transition parts are called metaphyses.
  • the cartilage disc between the metaphyses and epiphyses is called epiphyseal plates. Because the cartilage is not visualized, X-rays show the epiphyses.
  • the plate is a line, so it is also called the epiphyseal plate or epiphyseal line.
  • the epiphyseal line has the ability to grow bones longitudinally, and it only grows in one direction (the direction of the center of the long tubular bone). The gradual growth and length of children's long bones are the result of the longitudinal growth of the epiphyseal line.
  • the long-term result is that structural abnormalities directly cause the cartilage of the femur, tibia and patella of the knee joint to wear out more than normal.
  • the degree of arthritis accelerates, causing knee joint pain in the near future and osteoarthritis in middle-aged and elderly people. Therefore, the consensus at home and abroad is that it is a disease that requires treatment.
  • the above two types of diseases are one of coronal plane deformity and the other of axial rotation deformity. Some of these two diseases alone show coronal plane curvature deformity, and some are combined to cause lower limb curvature on one or both sides of the patient.
  • the common clinical manifestation is varus deformity of the femur and tibia, but it is usually combined with severe internal rotation deformity of the tibia. We usually see not only "O-shaped legs” but also "buckets".
  • the current clinical practice is to first correct the knee varum with a figure-8 plate epiphyseal block surgery. The remaining tibial internal rotation can only be corrected through various osteotomy methods.
  • Amir Arami[1] a physician from a children's hospital in Israel, created an animal model of epiphyseal rotation. They used 6-week-old New Zealand rabbits. They first used Kirschner wires to drill into the bones at both ends of the epiphyseal line to mark, and then used a device similar to an 8-shaped steel plate to place the epiphyseal line on the hind legs under the monitoring of a C-arm bedside fluoroscopy machine. On both sides, the steel plate is tilted about 45° from the longitudinal axis.
  • balance locking steel plate (symmetrical type) in the existing technology. Its principle is to prevent recurrence of epiphyseal block surgery. Through normal epiphyseal growth and balanced epiphyseal growth, the epiphyseal growth is balanced and the lines of force of the lower limbs are always balanced when the child matures. . Preventing the recurrence of lower limb force lines until the epiphyseal line is closed, this type of balanced locking plate (symmetrical type) is mainly used to treat lower limb varus and varus to prevent recurrence, but cannot treat rotational deformities.
  • this utility model is to provide an eccentric epiphyseal growth balancing device to solve the problem that the balance locking steel plate (symmetrical type) used in the prior art can only treat varus and varus of the lower limbs, but cannot treat axial rotation deformity of the lower limbs. Untreatable technical problems.
  • the utility model provides an eccentric epiphyseal growth balance device, which includes a steel plate, screws and blocking members that cooperate with the steel plate.
  • the steel plate includes an epiphyseal end mounting part and a metaphyseal end mounting part.
  • a central positioning hole is provided between the epiphyseal end mounting part and the metaphyseal end mounting part.
  • the epiphyseal end mounting part and the metaphyseal end mounting part are arranged asymmetrically with respect to the central positioning hole.
  • the epiphyseal end mounting part The metaphyseal mounting portion is provided with a through hole that cooperates with the screw, and the metaphyseal mounting portion is provided with a through hole that cooperates with the screw and the blocking member.
  • the through hole on the epiphyseal end mounting portion that cooperates with the screw is set as a single hole, and the screw is disposed through the single hole.
  • the through hole of the metaphyseal installation part that cooperates with the screw and the blocking member is set as an oblong hole, and the blocking member and the screw both pass through the oblong hole, and the blocking member
  • the pieces are located on both sides of the screw and are used to squeeze and fix the screw.
  • the through holes at both ends of the oblong hole that cooperate with the blocking member are set as sink holes.
  • the inner wall of the sunken hole is provided with threads at both ends, the blocking member is threadedly connected in the sunken hole, and the top end of the blocking member is flush with the top surface of the steel plate.
  • the angle between the epiphyseal mounting part and the metaphyseal mounting part is 150-180 degrees.
  • the length of the screws installed on the epiphyseal installation part is shorter than the length of the screws installed on the metaphyseal installation part, and all the screws installed on the metaphyseal installation part are The length of the screw is 2/3 of the diameter of the backbone.
  • the screws installed on the epiphyseal end mounting portion and the screws installed on the metaphyseal end mounting portion are both cannulated screws.
  • both ends of the steel plate are further provided with end positioning holes for determining the angle between the steel plate and the femoral shaft.
  • the end positioning hole is used to tilt the locking plate during surgery.
  • this eccentric epiphyseal growth balancing device has the same Yes, they all include a steel plate, screws and blocking parts that match the steel plate.
  • the steel plate of the present utility model includes an asymmetrically arranged epiphyseal end installation part and a metaphyseal end installation part.
  • a central positioning hole is provided between the epiphyseal end installation part and the metaphyseal end installation part.
  • the epiphyseal end installation part is provided with a through hole that cooperates with the screw.
  • the metaphyseal end installation part is provided with a through hole that cooperates with the screw and the blocking member.
  • Figure 1 is a schematic structural diagram of an eccentric epiphyseal growth balancing device according to an embodiment of the present invention
  • Figure 2 is a top view of the eccentric epiphyseal growth balancing device in Figure 1;
  • Figure 3 is a side view of the eccentric epiphyseal growth balancing device in Figure 1;
  • Figure 4 is a schematic structural view of the eccentric epiphyseal growth balancing device in Figure 1 from another angle;
  • Figure 5 is a schematic structural diagram of the steel plate of the eccentric epiphyseal growth balancing device in Figure 1;
  • Figure 6 is a side view of the steel plate in Figure 5.
  • Figure 1- Figure 6 1. Steel plate; 11. Metaphyseal mounting part; 111. Oblong hole; 12. Epiphyseal mounting part; 121. Single hole; 13. Center positioning hole; 14. End positioning hole; 2. Screws; 3. Blocking parts.
  • a balanced locking steel plate (symmetrical type) is used in the prior art. Its principle is to prevent recurrence during epiphyseal block surgery. Through normal epiphyseal growth and balanced epiphyseal growth, balanced epiphyseal growth is achieved and the patient reaches maturity. The lines of force of the lower limbs are always balanced. Preventing the recurrence of lower limb alignment until the epiphyseal line is closed, this type of balanced locking plate (symmetrical type) is mainly used to treat lower limb varus and varus to prevent recurrence, but cannot treat lower limb axial rotation deformity.
  • the present utility model provides an eccentric epiphyseal growth balancing device.
  • the steel plate of the present utility model includes an asymmetrically arranged epiphyseal installation part and a metaphyseal installation part.
  • the epiphyseal mounting part is provided with a through hole that matches the screw.
  • the metaphyseal mounting part is equipped with a through hole that matches the screw and the stopper.
  • the utility model provides an eccentric epiphyseal growth balancing device, which includes a steel plate 1, a screw 2 and a blocking member 3.
  • the steel plate 1 includes an epiphyseal end mounting part 12 and a metaphyseal end mounting part 11.
  • the included angle between the end mounting part 12 and the metaphyseal mounting part 11 is 150-180 degrees, which is determined according to the actual use status, and is not limited by the present invention.
  • the two ends of the steel plate 1 are also provided with end positioning holes 14 for determining the angle between the steel plate 1 and the femoral shaft.
  • the end positioning holes 14 are inclined.
  • the tilt angle is 20°, and it can also be other angles, which is not limited by the present invention.
  • the epiphyseal mounting part 12 and the metaphyseal mounting part 11 are asymmetrically arranged with a central positioning hole 13. As shown in Figure 2, the epiphyseal mounting part 12 is provided with a through hole that matches the screw 2, and the metaphyseal mounting part 11 is provided with There are through holes that fit the screw 2 and the stopper 3.
  • the through hole on the epiphyseal end mounting portion 12 that matches the screw 2 is set as a single hole 121 , and the screw 2 is disposed through the single hole 121 .
  • the through hole of the metaphyseal installation part 11 that cooperates with the screw 2 and the blocking member 3 is set as an oblong hole 111.
  • the blocking member 3 and the screw 2 both pass through the oblong hole 111.
  • the blocking members 3 are located on both sides of the screw 2. Squeeze the set screw 2.
  • the through holes at both ends of the oblong hole 111 that cooperate with the blocking member 3 are preferably sunken holes.
  • the inner wall of the sunken hole is provided with threads at both ends.
  • the blocking member 3 is threadedly connected in the sunken hole, and the top end of the blocking member 3 is connected to the sunken hole.
  • the top surface of steel plate 1 is flush.
  • the length of the screw 2 installed on the epiphyseal end mounting part 12 is shorter than the length of the screw 2 installed on the metaphyseal end mounting part 11, and the length of the screw 2 installed on the metaphyseal end mounting part 11 is 2/ of the diameter of the diaphysis. 3.
  • screws 2 installed on the epiphyseal end mounting part 12 and the screws 2 installed on the metaphyseal end mounting part 11 are both cannulated screws 2 .
  • the eccentric epiphyseal growth balancing device of the present invention Utilizing the eccentric epiphyseal growth balancing device of the present invention, as the epiphysis grows, it rotates this small angle each time. Repeating this process repeatedly accumulates into a larger de-rotation angle, which the epiphysis can also withstand without causing epiphyseal damage. .
  • the treatment cycle is selected to be a 20° tilt angle (this angle is the angle between the long axis of the device and the longitudinal axis of the backbone)
  • a device will first correct it by 10°, then the epiphysis will grow normally for several months, and then it will be corrected by 10° again, so
  • the steel plate 1 corrects the inclination of the bone from 20° to 0°. This process can be used clinically to understand the progress of the correction through X-ray photography.
  • the eccentric epiphyseal growth balancing device of this utility model can repeat this operation and treatment cycle repeatedly. A few 20° can achieve the required correction and derotation angle, thereby achieving the purpose of correcting the rotation of the bone.
  • the eccentric epiphyseal growth balancing device has epiphyseal growth balance.
  • the correction function can completely correct the rotational deformity of the lower limbs until the epiphysis is closed without causing recurrence.
  • the eccentric epiphyseal growth balancing device provided by the present utility model has the following beneficial effects:
  • Rotational deformity is a relatively common disease during children's development. In the past, the only way to treat it was surgical amputation of the bones. Many family members and children were afraid that this surgical treatment would delay the opportunity for childhood correction, resulting in lower limb injuries. Axial rotational deformity has a lifelong onset. The incidence of bone and joint diseases caused by this reason in adults and the elderly has greatly increased, seriously affecting the patient's life and production activities. At the same time, the treatment of related disabilities also consumes a large amount of the country's health resources.
  • Minimally invasive treatment This is the first method at home and abroad to use the minimally invasive concept to treat rotational deformities of long bones of the lower limbs.
  • the rotational deformities of the limbs can be corrected by regulating their own growth without cutting off the bones.
  • the surgical incision may be large, the operation time is long, and the chance of neurovascular tendon damage is increased.
  • the surgical method of the present invention does not need to cut off the bones, there is less bleeding, the operation is simple, the operation time is short, and complications such as damage to nerves and tendons are less likely to occur. There is little opportunity to reduce the postoperative pain of children without plaster fixation. The key is not to affect the longitudinal growth of the epiphysis.
  • the steel plate When the steel plate is unintentionally placed, it is not parallel to the axis of the femur and has an angle with it. With the longitudinal growth of the femoral or tibial epiphysis, the steel plate 1 rotates. According to our analysis of unpublished data, the angle between the preoperative diaphysis and the axis of the figure-8 plate is The maximum is 22.4°. On the other hand, no cases of epiphyseal injury occurred in this group of patients who were followed up for 6 months to 1 year. In addition, the angle between the figure 8 steel plate and the backbone became smaller to varying degrees after the steel plate 1 was placed in the body for a period of time.
  • Purpose 1 Derotation treatment of the femoral or tibial shaft based on epiphyseal blockade - for lower limbs with coronal plane inversion, valgus deformity and axial rotation deformity, it is assumed that the treatment target is low-phosphate anti-D rickets, an 8-year-old boy.
  • Step 1 Cut the skin and subcutaneous tissue fascia at the distal tibia, locate the epiphyseal line under fluoroscopy on the lateral side of the ankle joint at the distal tibia, and place the repeatedly adjustable epiphyseal spiral growth control balanced steel plate 1 outside the periosteum.
  • the needle is positioned in the central positioning hole 13 to position the center of the steel plate 1 at the epiphyseal line, and determine that the epiphyseal end mounting part 12 of the steel plate 1 is located at the epiphyseal end, and the metaphyseal end mounting part 11 is located at the metaphyseal end.
  • the end positioning hole 14 of the femoral shaft angle is called the inclined positioning hole, which is inclined at 20°.
  • the epiphyseal end mounting part 12 is inclined to point in the direction of the internal foot rotation.
  • the Kirschner wire fixes the bone through the end mounting hole.
  • the two blocking members 3 The two ends of the threaded ends of the oblong hole 111 of the metaphyseal mounting part 11 are respectively fixed in advance.
  • the hole between the two blocking members 3 can accommodate a screw 2 position.
  • the gap between the single hole 121 and the oblong hole 111 is parallel to the epiphysis.
  • the wire is drilled into the guide pin. After the fluoroscopy shows that the position is satisfactory, two cannulated screws 2 are drilled in respectively. (The epiphyseal screw 2 is shorter; the metaphyseal screw 2 requires 2/3 of the length of the diaphysis diameter.) The operation is completed.
  • Step 2 It is safe to rotate the epiphysis by 10° according to the existing guidelines (tentative angle). Regularly take anteroposterior and lateral images of the tibia after surgery and observe the changes in the angle between the longitudinal axis of the tibia and steel plate 1. This angle can be predicted will become smaller and smaller. When the angle of inclination is reduced to 10°, we surgically remove the blocking member 3 away from the central positioning hole 13, leaving a space. According to the design principle, the screw 2 will follow the epiphysis. During longitudinal growth, the screw 2 of the metaphyseal mounting part 11 moves distally by a distance of the width of the stopper 3. During this period, the locking plate 1 has no blocking effect on the epiphyseal line or derotation. This time may take three months to During the half-year growth period, perform step three
  • Step 3 Since the epiphysis has been growing longitudinally for a period of time, it is a safe treatment principle to derotate once again by 10°. Continue to derotate. At this time, a part of the ankle varus is corrected according to the degree of epiphyseal block correction, while the epiphysis continues to grow longitudinally. As the epiphysis derotates, regular radiographs can predict that the axis of the tibia and plate 1 will gradually become parallel. At this point, the first treatment cycle is over. The rotation angle is corrected to 20°, and the ankle varus is also partially corrected. Step 4 is performed.
  • Step 4 Now take out the blocking piece 3 close to the central positioning hole 13, unscrew the screw 2 of the oblong hole 111, wait for the steel plate 1 to be fixed again according to the principle of tilting 20° in step 1, and then screw it into the center positioning hole 13.
  • the stopper 3 of the center positioning hole 13 the screw 2 has a distance at the far end of the oblong hole 111 of the width left by the screw 2 just taken out, the stopper 3 away from the center positioning hole 13 is re-screwed into its position, and the second step begins. Period, the time it takes for the screw 2 to grow vertically by one width, the screw 2 slides in the oblong hole 111.
  • the photographic review will predict that the epiphyseal growth balance device and steel plate 1 will gradually become parallel, which means that the second treatment cycle is over. At this point, the derotation has been corrected by 40°, and part of the tibial varus has been corrected. Step 5 is performed.
  • Step 5 Repeat steps 1 to 4. Each time the correction is performed, the steel plate 1 is rotated to be parallel to the tibia, until the rotational correction is completed. If there is residual ankle varus, restore the initial epiphyseal growth balance device, and the position of the blocking member 3 is similar to the principle of the 8-shaped steel plate 1 to block the epiphysis until the ankle varus is completely corrected. If the epiphysis is not closed at this time, in order to prevent the recurrence of the above deformities, refer to the operation of the balanced locking plate (symmetrical type) until the epiphyseal line is closed, perform step 6
  • Step 6 Choose two modes according to the maturity age of the child. By changing the positions of screw 2 and blocker 3, screw 2 can slide by a blocker 3 distance and a blocker 3 plus a screw 2 width distance.
  • the growth time of the former is 3 -June, the latter from April to August (estimated), the two models are introduced separately
  • Mode 1 The blocking member 3 close to the center positioning hole 13 is fixed, and the blocking member 3 far away from the center positioning hole 13 is taken out.
  • the longitudinal growth distance of the screw 2 is the width of the blocking member 3. The time is slightly shorter.
  • screw 2 and steel plate 1 play a blocking role. Observe whether there is recurrence of ankle inversion. If there is recurrence of varying degrees, screw 2 temporarily maintains the block until it returns to normal, and then unscrew screw 2 away from the center. Re-screw the blocking piece 3 away from the center positioning hole 13 into the position of the blocking piece 3 of the positioning hole 13.
  • the gap between the blocking piece 3 close to the center positioning hole 13 and the blocking piece 3 far away from the center positioning hole 13 is to remove the unscrewed screw 2. Screw in again. Repeat this process repeatedly until the epiphyseal line is closed. In this process, the sliding growth distance of screw 2 is only the distance away from the stopper 3 of the central positioning hole 13. The epiphysis Longitudinal growth is maintained and there is no recurrence of varus.
  • Mode 2 Fix the blocking member 3 close to the center positioning hole 13, take out the blocking member 3 away from the center positioning hole 13, and slide the screw 2 in the oblong hole 111 by a width of the blocking member 3 as it grows longitudinally.
  • screw 2 and steel plate 1 play a blocking role.
  • screw 2 and steel plate 1 play a blocking role.
  • screw 2 and steel plate 1 play a blocking role.
  • screw 2 temporarily maintains this blocking effect until it returns to normal.
  • the above part is consistent with Same as Mode 1, then unscrew the blocking piece 3 near the central positioning hole 13, and screw the unscrewed screw 2 into the position of the blocking piece 3 near the central positioning hole 13, so that the screw 2 can grow toward the metaphysis as it grows longitudinally.
  • the sliding distance is the width of the screw 2 between the blocking member 3 close to the central positioning hole 13 and the blocking member 3 far away from the central positioning hole 13 plus the width of the blocking member 3 away from the central positioning hole 13.
  • the growth time is lengthened.
  • the screw 2 grows to the position of the stopper 3 away from the central positioning hole 13, also observe whether there is recurrence of the ankle joint. If there is recurrence of varying degrees, the screw 2 will be temporarily maintained for a period of time until it returns to normal. This correction The time required for inversion will also increase. Then unscrew the screw 2 that slides to the position of the blocking member 3 away from the central positioning hole 13 and screw it in again at the position of the blocking member 3 close to the central positioning hole 13. Repeat this process repeatedly, each time.
  • the movement distance of secondary screw 2 is wider than that of Mode 1, so Mode 2 is suitable for younger children who require a longer period of time to close the epiphyseal line.
  • the eccentric epiphyseal growth balancing device of the present invention can treat lower limb bending in the coronal plane combined with rotational deformity of the limb.
  • the balance locking plate 1 (eccentric type) can be used on the same principle as the balance locking plate (symmetrical type). It is used to prevent recurrence of epiphyseal block surgery. Through normal epiphyseal growth and balanced epiphyseal growth, the balanced epiphyseal growth can be achieved to achieve the goal of patient recovery. As children grow and mature, the lines of force of their lower limbs are always balanced. Prevent recurrence of lower extremity alignment until the epiphyseal line is closed. Here's how to do it:
  • Step 1 Position the epiphyseal line on the lateral side of the left distal femur. Make a conventional incision on the skin, subcutaneous tissue, fascia, and periosteum and place a balanced locking plate 1 (eccentric type).
  • the central positioning hole 13 is located at the epiphyseal line and drilled with a Kirschner wire.
  • the epiphyseal mounting part 12 is placed on the epiphyseal side, and the metaphyseal mounting part 11 is placed on the metaphyseal side.
  • the blocking members 3 far away from and close to the central positioning hole 13 are screwed into the original position, parallel to the epiphysis.
  • a guide pin is drilled into the gap between the single hole 121 at the metaphyseal end of the line and the blocking member 3 far away from and close to the central positioning hole 13. After the fluoroscopy position is satisfactory, the screw 2 is inserted, and the wound is sutured layer by layer, and the operation is completed.
  • this structural combination plays a role in blocking the epiphysis (the same principle as the currently used figure 8 steel plate).
  • the epiphyseal line is not closed, perform step 2. If it is closed, remove the screw 2 system of the balance locking plate 1. , because there is no worry about recurrence.
  • Step 2 The epiphyseal line is not closed, and the small incision exposes the two blocking members 3. Unscrew the two blocking members 3, unscrew the screw 2 and screw it in again at the position of the blocking member 3 close to the central positioning hole 13, suture the wound, and perform the steps three.
  • Step 3 With the longitudinal growth of the epiphysis, after about half a year (assuming), the screw 2 slides in the oblong hole 111 with the longitudinal growth of the epiphysis to a position away from the stopper 3 of the central positioning hole 13, and then begins to exert a blocking effect. , take a radiograph to see if there is no recurrence of the femur after half a year, screw out the screw 2 through the position of the blocker 3 away from the central positioning hole 13, and screw it again into the position of the blocker 3 close to the central positioning hole 13. The above steps are repeated until the epiphysis. The line is closed. If there is recurrence, perform step 4.
  • Step 4 Slide the screw 2 to the position of the blocking member 3 close to the central positioning hole 13, temporarily block it for a period of time to correct the recurrence until normal, then take out the screw 2 and screw it into the position of the blocking member 3 close to the central positioning hole 13, and suture the wound.
  • the screw 2 once again grows longitudinally in the oblong hole 111 and after half a year (or so) it will inevitably slide to the position of the stopper 3 away from the central positioning hole 13. When it cannot slide, it will block the epiphysis again. Check again whether the femoral varus has recurred. , if recurrence occurs, repeat the above steps until the epiphyseal line is closed.
  • the balance locking plate (eccentric type) is designed for the coronal plane bending of the lower limbs combined with limb rotation deformity.
  • the end positioning holes 14 at both ends of the locking steel plate 1 are used to control the fixation of the steel plate 1 and the backbone according to the designed angle.
  • the oblong hole 111 has two blocking members 3, and there is a space between them for screwing in the screw 2.
  • the combination of the three can make the screw 2 grow longitudinally and have a blocking effect, so it has the function of balancing the locking steel plate 1 (symmetrical Type) has the function of treating varus and varus of lower limbs and preventing recurrence.

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Abstract

本实用新型提供了一种偏心型骨骺生长平衡装置，涉及医疗辅助装置技术领域，该偏心型骨骺生长平衡装置包括钢板、与钢板配合的螺钉和阻挡件，其特征在于，钢板包括骨骺端安装部和干骺端安装部，骨骺端安装部和干骺端安装部之间设有中心定位孔，骨骺端安装部和干骺端安装部以中心定位孔非对称设置，骨骺端安装部上设有与螺钉配合的通孔，干骺端安装部设有与螺钉和阻挡件配合的通孔。本实用新型通过螺钉和阻挡件之间的配合使用，能够同时实现下肢内外翻和下肢轴向旋转畸形的治疗。

Description

一种偏心型骨骺生长平衡装置 技术领域
本实用新型涉及医疗辅助装置技术领域，尤其是涉及一种偏心型骨骺生长平衡装置。
背景技术
儿童长骨两端膨大的部分称为骨骺，与之移行的部位称为干骺端，干骺端与骨骺之间的软骨盘称之为骺板，由于软骨不显影的原因造成X光平片显示骺板是一条线，故也称骺板为骨骺线。骨骺线具有纵向生长骨骼的能力，而且只向一个方向(长管状骨中心方向)生长，儿童长骨的逐渐长高、长长都是骨骺线纵向生长的结果。
儿童很多疾病可以影响骨骼的纵向生长，临床上表现为膝关节的内、外翻，俗称“O型腿”或“X型腿”。这种下肢的弯曲相对容易的被发现，儿童在幼年生长发育过程出现的这种情况也最先由父母发现，其实下肢的轴向的旋转畸形即股骨内旋与胫骨外旋也很常见，我们俗称“内八字”或“外八字”。股骨与胫骨的旋转畸形不但导致外观的异常，行走步态丑陋，同时经常临床上表现为膝关节前疼痛，远期的结果由于结构的异常直接引起膝关节股骨、胫骨及髌骨软骨比正常人磨损的程度加快，近期导致膝关节疼痛，中老年后引起骨性关节炎，因此国内外的共识是需要治疗的疾病。
以上两类疾病一个是冠状面的畸形一个是轴向旋转畸形，这两种疾病有的单独表现冠状面弯曲畸形，有的合并起来同时在一个病人的一侧或双侧肢体出现下肢弯曲。以膝内翻为例，常规临床表现为股骨与胫骨的内翻畸形，但是通常合并有胫骨严重的内旋畸形，我们通常看到的不但有“O型腿”的表现也有“内八字”。遇到这类疾病现在临床上通过首先用8字钢板骨骺阻滞手术先矫正膝内翻，残留的胫骨内旋只能通过各种方法截骨矫正。
现阶段相较于膝内、外翻的8字钢板骨骺阻滞术治疗，下肢的旋转畸形只能通过截骨手术治疗。现在国内、外治疗这类疾病的方法均停留在截骨去旋转矫正治疗股骨与胫骨的旋转畸形，使用的固定器械包括：克氏针、钢板、外固定支架，这种治疗方法不但手术出血多、手术时间长，血管神经肌腱损伤的可能，手术后通常需要石膏夹板固定、数月的卧床、护理方面困难，影响儿童生活学习，花费高也增加家长的经济负担。
最新的研究显示骨骺是可以旋转生长的，Amir Arami[1]是以色列一家儿童医院的医师们制作出了骨骺旋转生长的动物模型。他们用6周龄新西兰家兔，先在骺线两端用克氏针钻入骨内做标记，再用类似8字钢板的装置在C形臂床旁透视机监控下，放置后腿骨骺线的两侧，钢板与纵轴线倾斜约45°，它的原理是随着骨骺纵向生长，钢板以它的中点为中心类似圆周旋转，也就是纵向生长的生物力转变成旋转力，在这种装置作用下骨骺的远端随着钢板旋转生长，这种状况持续6周也就是家兔12周龄时观察家兔骨骺放射学影象检查及组织学检查得出的结果,测量标记克氏针旋转角度、兔股骨三维CT重建及骨骺组织学变化。平均旋转角度17.7°，而且钢板每旋转1°对应的骨骺旋转0.378°,而且他们还发现实验组股骨较对照组短。组织学显示实验组骨骺细胞呈旋转排列，而对照组是纵向线样排列。
现有技术中已有一种平衡锁定钢板(对称型)，其原理是用于骨骺阻滞术防止复发，经过正常骨骺生长与平衡骨骺生长达到骨骺均衡生长达到患儿生长成熟下肢力线始终保持平衡。防止下肢力线的复发，直到骨骺线闭合，该种平衡锁定钢板(对称型)主要针对治疗下肢内外翻以防止复发，而不能针对旋转畸形的治疗。
实用新型内容
有鉴于此，本实用新型目的在于提供一种偏心型骨骺生长平衡装置，以解决了现有技术中采用的平衡锁定钢板(对称型)的只能治疗下肢内外翻，而对于下肢轴向旋转畸形不能治疗的技术问题。
为了实现上述目的，本实用新型提供了一种偏心型骨骺生长平衡装置，包括钢板、与所述钢板配合的螺钉和阻挡件，所述钢板包括骨骺端安装部和干骺端安装部，所述骨骺端安装部和所述干骺端安装部之间设有中心定位孔，所述骨骺端安装部和所述干骺端安装部以所述中心定位孔非对称设置，所述骨骺端安装部上设有与所述螺钉配合的通孔，所述干骺端安装部设有与所述螺钉和所述阻挡件配合的通孔。
根据一种优选实施方式，所述骨骺端安装部上与所述螺钉配合的通孔设为单孔，所述螺钉贯穿所述单孔设置。
根据一种优选实施方式，所述干骺端安装部与所述螺钉和所述阻挡件配合的通孔设为长圆孔，所述阻挡件和所述螺钉均贯穿所述长圆孔，所述阻挡件位于所述螺钉的两侧，用于挤压固定所述螺钉。
根据一种优选实施方式，所述长圆孔两端与所述阻挡件配合的通孔设为沉窝孔。
根据一种优选实施方式，所述沉窝孔内壁两端设有螺纹，所述阻挡件螺纹连接于所述沉窝孔内，且所述阻挡件顶端与所述钢板顶面平齐。
根据一种优选实施方式，所述骨骺端安装部和所述干骺端安装部之间的夹角为150-180度。
根据一种优选实施方式，安装于所述骨骺端安装部的所述螺钉的长度短于安装于所述干骺端安装部的所述螺钉的长度，安装于所述干骺端安装部的所述螺钉的长度为骨干直径的2/3。
根据一种优选实施方式，安装于所述骨骺端安装部的所述螺钉和安装于所述干骺端安装部的所述螺钉均设置为空心螺钉。
根据一种优选实施方式，所述钢板的两端还设有用于确定所述钢板与股骨干角度的端部定位孔。
根据一种优选实施方式，所述端部定位孔用于术中倾斜放置锁定板。
本实用新型提供的偏心型骨骺生长平衡装置，具有以下技术效果：
该种偏心型骨骺生长平衡装置，同传统的骨骺生长平衡装置相比，相同的 是，都包括钢板、与钢板配合的螺钉和阻挡件，同传统的骨骺生长平衡装置相比，不同的是，本实用新型的钢板包括非对称设置的骨骺端安装部和干骺端安装部，骨骺端安装部和干骺端安装部之间设有中心定位孔，骨骺端安装部上设有与螺钉配合的通孔，干骺端安装部设有与螺钉和阻挡件配合的通孔，通过螺钉和阻挡件之间的配合使用，能够同时实现下肢内外翻和下肢轴向旋转畸形的治疗。
附图说明
为了更清楚地说明本实用新型实施例或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本实用新型的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1是本实用新型一实施例的偏心型骨骺生长平衡装置的结构示意图；
图2是图1中偏心型骨骺生长平衡装置的俯视图；
图3是图1中偏心型骨骺生长平衡装置的侧视图；
图4是图1中偏心型骨骺生长平衡装置的另一角度的结构示意图；
图5是图1中偏心型骨骺生长平衡装置的钢板的结构示意图；
图6是图5中钢板的侧视图。
其中，图1-图6：
1、钢板；11、干骺端安装部；111、长圆孔；12、骨骺端安装部；121、
单孔；13、中心定位孔；14、端部定位孔；
2、螺钉；3、阻挡件。
具体实施方式
为使本实用新型的目的、技术方案和优点更加清楚，下面将对本实用新型的技术方案进行详细的描述。显然，所描述的实施例仅仅是本实用新型一部分实施例，而不是全部的实施例。基于本实用新型中的实施例，本领域普通技术 人员在没有做出创造性劳动的前提下所得到的所有其它实施方式，都属于本实用新型所保护的范围。
正如背景技术所述，现有技术中采用一种平衡锁定钢板(对称型)，其原理是用于骨骺阻滞术防止复发，经过正常骨骺生长与平衡骨骺生长达到骨骺均衡生长达到患儿生长成熟下肢力线始终保持平衡。防止下肢力线的复发，直到骨骺线闭合，该种平衡锁定钢板(对称型)主要针对治疗下肢内外翻以防止复发，而不能针对下肢轴向旋转畸形的治疗。
基于此，本实用新型提供了一种偏心型骨骺生长平衡装置，同传统的骨骺生长平衡装置相比，不同的是，本实用新型的钢板包括非对称设置的骨骺端安装部和干骺端安装部，骨骺端安装部和干骺端安装部之间设有中心定位孔，骨骺端安装部上设有与螺钉配合的通孔，干骺端安装部设有与螺钉和阻挡件配合的通孔，通过螺钉和阻挡件之间的配合使用，能够同时实现下肢内外翻和下肢轴向旋转畸形的治疗。
下面结合具体的实施例对本实用新型的技术方案进行详细的说明。
如图1-4所示，本实用新型提供了一种偏心型骨骺生长平衡装置，包括钢板1、螺钉2和阻挡件3，钢板1包括骨骺端安装部12和干骺端安装部11，骨骺端安装部12和干骺端安装部11之间的夹角为150-180度，具体根据实际使用状态确定，本实用新型对此不作限定。
骨骺端安装部12和干骺端安装部11之间设有中心定位孔13，钢板1的两端还设有用于确定钢板1与股骨干角度的端部定位孔14，端部定位孔14倾斜设置，例如，倾斜角度为20°，还可以为其它角度，本实用新型对此不作限定。
骨骺端安装部12和干骺端安装部11以中心定位孔13非对称设置，如图2所示，骨骺端安装部12上设有与螺钉2配合的通孔，干骺端安装部11设有与螺钉2和阻挡件3配合的通孔。
具体的，骨骺端安装部12上与螺钉2配合的通孔设为单孔121，螺钉2贯穿单孔121设置。干骺端安装部11与螺钉2和阻挡件3配合的通孔设为长圆孔111，阻挡件3和螺钉2均贯穿长圆孔111，阻挡件3位于螺钉2的两侧，用于 挤压固定螺钉2。
进一步的，长圆孔111两端与阻挡件3配合的通孔，优选为沉窝孔，沉窝孔内壁两端设有螺纹，阻挡件3螺纹连接于沉窝孔内，且阻挡件3顶端与钢板1顶面平齐。
进一步的，安装于骨骺端安装部12的螺钉2的长度短于安装于干骺端安装部11的螺钉2的长度，安装于干骺端安装部11的螺钉2的长度为骨干直径的2/3。
进一步的，安装于骨骺端安装部12的螺钉2和安装于干骺端安装部11的螺钉2均设置为空心螺钉2。
利用本实用新型的偏心型骨骺生长平衡装置，随着骨骺的生长每次旋转这种小角度，反复重复这个过程就积累成较大的去旋转角度，骨骺也可以承受，不至于造成骨骺的损伤。
例如，选择治疗周期是20°倾斜角度(这个角度是装置长轴线与骨干纵轴线的夹角)，通过一个装置先让它矫正10°，然后骨骺正常生长数月，然后再矫正10°，这样一个周期钢板1由20°与骨干倾斜矫正至0°，这个过程通过X光拍片掌握矫正进展程度，临床能够操作。
本实用新型的偏心型骨骺生长平衡装置，可以反复重复这个操作治疗周期，数个20°就达到需要的矫正去旋转角度，就达到矫正骨干旋转的目的，偏心型骨骺生长平衡装置有骨骺生长平衡矫正作用，可以完成下肢旋转畸形完全矫正直到骨骺闭合也不造成复发。
与现有技术相比，本实用新型提供的偏心型骨骺生长平衡装置具有以下有益效果：
(1)减轻国家负担：儿童发育过程中旋转畸形是相对常见的疾病，以往只有手术截断骨骼一种方法治疗，家属与患儿多由于惧怕这种手术治疗延误了儿童期矫正的时机，导致下肢轴向的旋转畸形终身发病，成年与老年由于这种原因导致的骨关节疾患发生率大大增加，严重影响患者本人的生活生产活动，同时相关的残疾的治疗也消耗了国家大量的卫生资源。
(2)微创治疗：这是起止国内外首先采用微创理念治疗下肢长骨旋转畸形的方法，不用截断骨骼靠自己的生长调控就可矫正肢体的旋转畸形。首先截骨出血多，手术切口可能较大，手术时间长，神经血管肌腱损伤机会增加；而本发明这种手术方法不用截断骨骼出血少，手术简单，手术时间短，损伤神经肌腱等并发症的机会少，不用石膏固定减轻患儿术后痛苦，关键是不影响骨骺的纵向生长。
(3)不影响学业：以往需要截骨手术治疗此病，需要卧床一段时间，骨骼重新愈合一般需要3-6个月，正常行走需要更长的时间，因此即使寒暑假接受这种治疗开学前也不能完成治疗，不同程度对患儿及家长均是沉重负担。
动物实验证明动物的骨骺可以旋转生长，人体是否也具备这种能力呢？通过以下证明：研究了用8字钢板治疗过的膝内外翻病人手术前与手术后膝关节正侧位X光片，分别测量股骨的纵轴线和8字钢板的轴线，测量两个线之间的夹角，我们发现手术前的股骨与当时放置8字钢板有不同程度的夹角，经过一到两年膝内外翻矫正生长过程取出的时候角度接近于平行，也就是说明手术时放置8字钢板时无意识的放置不平行与股骨的轴线与其有夹角随着股骨或胫骨骨骺的纵向生长钢板1产生了旋转，按照我们分析没有发表的数据显示，术前骨干与8字钢板轴线的夹角最大22.4°，另一方面随访的这组病人随访6月-1年无骨骺损伤病例的发生，另外钢板1在体内放置一段时间8字钢板与骨干夹角均不同程度变小。至此可以说明，正常人的骨干用倾斜于骨干10°的8字钢板固定对生长过程的骨骺没有造成损伤,而且骨骺在这个过程发生了旋转，因为不旋转无法达到骨干与8字钢板的平衡，只是因为这个角度较小没有察觉到，也没有意识去检查。
具体实施过程如下：
用途一：骨骺阻滞术基础上股骨或胫骨干的去旋转治疗—针对下肢有冠状面内、外翻畸形又有轴向旋转畸形，假设治疗对象为低磷抗D佝偻病，男孩，8岁。
正常下肢膝关节与踝关节内侧髁均接触上没有间距，此患儿膝关节内侧有 间距，显示膝内翻、踝内翻。正常人脚的轴线应该与躯干轴线平行，而这个患儿显示有夹角，称为“内八字”即胫骨内旋，因此此患儿膝内翻、踝内翻合并胫骨的内旋
步骤一：于胫骨远端切开皮肤、皮下组织筋膜，于胫骨远端踝关节外侧，透视下定位骨骺线，反复可调的骨骺螺旋生长控制平衡型钢板1放置在骨膜外，使用克氏针于中心定位孔13定位钢板1中心定位于骨骺线，并确定为钢板1的骨骺端安装部12位于骨骺端，干骺端安装部11位于干骺端，钢板1两端有确定钢板1与股骨干角度的端部定位孔14，称为倾斜定位孔，倾斜20°，骨骺端安装部12倾斜指向足内八字旋转方向，克氏针经端部安装孔固定骨质，两个阻挡件3预先分别固定在干骺端安装部11的长圆孔111的两端螺纹端位置，两个阻挡件3之间孔隙可以容纳一枚螺钉2位置，单孔121与长圆孔111的间隙处分别平行骨骺线钻入导针，透视显示位置满意后分别钻入两枚空心螺钉2，(骨骺端螺钉2较短；干骺端螺钉2需要骨干直径2/3长度)术毕。
步骤二：按照现有的指导原则旋转10°的骨骺是安全的(暂定角度)，手术后定期拍胫骨正侧位像，观察胫骨纵轴线与钢板1的夹角的变化，可以预测这个角度会越来越小，当倾斜的角度减少为10°时候，我们手术取出远离中心定位孔13的远离中心定位孔13的阻挡件3，留出一个空间，按照设计的原理螺钉2会随着骨骺纵向生长，干骺端安装部11的螺钉2向远端移动一个阻挡件3宽度的距离，这个时期锁定钢板1对骨骺线没有阻滞作用也没有去旋转作用，这个时间可能需要三个月到半年生长期，执行步骤三
步骤三：由于骨骺已经生长一段时间纵向生长，再次按照一次10°去旋转是安全的治疗原则，继续去旋转，这时按照骨骺阻滞矫正踝内翻的程度矫正一部分，同时骨骺的继续纵向生长伴随骨骺的去旋转，定期拍片可以预测胫骨与钢板1的轴线逐渐会达到平行。至此第一个治疗周期结束了，矫正旋转角度20°，踝关节内翻也矫正一部分，执行步骤四。
步骤四：这时取出靠近中心定位孔13的阻挡件3，拧出长圆孔111的螺钉2等待钢板1再次按照步骤一倾斜20°的原则固定好钢板1，然后再拧入靠近中 心定位孔13的阻挡件3，螺钉2在长圆孔111远端有一个刚刚取出螺钉2留出的宽度的距离，远离中心定位孔13的阻挡件3重新拧入其位置，至此开始第二个周期，纵向生长一个螺钉2宽度的时间螺钉2在长圆孔111内滑动，估计3-6月，螺钉2会逐渐贴近远离中心定位孔13的阻挡件3又开始发挥阻滞与去旋转的作用，当重新测量钢板1与胫骨夹角由20°减到10°，做小切口取出远离中心定位孔13的阻挡件3，螺钉2重新开始纵向生长，螺钉2会在长圆孔111内滑动到远离中心定位孔13的阻挡件3的位置，当螺钉2再次接触长圆孔111远端边缘即远离中心定位孔13的阻挡件3的位置时，骨骺生长平衡装置又发挥阻滞骨骺生长与去旋转作用，照相复查会预测骨骺生长平衡装置与钢板1逐渐趋于平行，即说明第二治疗周期结束，至此去旋转矫正了40°，矫正一部分胫骨内翻，执行步骤五。
步骤五：重复步骤一到步骤四，每次矫正通过钢板1旋转到与胫骨平行的过程，积累到旋转矫正完成。如果有残余的踝内翻，恢复初始骨骺生长平衡装置，阻挡件3位置类似于8字钢板1的原理发挥对骨骺阻滞作用，直到完全矫正踝内翻。这个时候如果骨骺没有闭合，为了防止以上畸形的复发参照平衡锁定板(对称型)的操作直到骨骺线闭合，执行步骤六
步骤六：根据距离患儿成熟年限选择两种模式，通过更改螺钉2与阻挡件3位置，螺钉2可以滑动一个阻挡件3距离和一个阻挡件3加上一个螺钉2宽度距离，前者生长时间3-6月，后者4-8月(估计)，两个模式分别介绍
模式一：靠近中心定位孔13的阻挡件3固定，取出远离中心定位孔13的阻挡件3，螺钉2纵向生长距离就是一个阻挡件3宽度，时间略短，当螺钉2到远离中心定位孔13的阻挡件3的位置，螺钉2与钢板1发挥阻滞作用，观测有无踝内翻复发，如果有不同程度的复发，螺钉2暂时维持阻滞直到恢复正常，然后拧出螺钉2在远离中心定位孔13的阻挡件3位置重新拧入远离中心定位孔13的阻挡件3，靠近中心定位孔13的阻挡件3与远离中心定位孔13的阻挡件3之间的间隙把拧出的螺钉2再次拧入。反复重复这个过程直到骨骺线闭合，这个过程螺钉2滑动生长距离只是远离中心定位孔13的阻挡件3的距离，骨骺 保持纵向生长也保持没有内翻的复发。
模式二：固定靠近中心定位孔13的阻挡件3，取出远离中心定位孔13的阻挡件3，螺钉2在长圆孔111随着纵向生长滑动一个阻挡件3宽度，当螺钉2到远离中心定位孔13的阻挡件3的位置，螺钉2与钢板1发挥阻滞作用，同样观察有无踝内翻复发，如果有不同程度的复发，螺钉2暂时维持这种阻滞作用直到恢复正常，以上部分与模式一相同，然后拧出靠近中心定位孔13的阻挡件3，拧出的螺钉2在靠近中心定位孔13的阻挡件3的位置拧入，这样螺钉2随着纵向生长可以向干骺端方向滑动的距离是靠近中心定位孔13的阻挡件3和远离中心定位孔13的阻挡件3之间螺钉2宽度加上远离中心定位孔13的阻挡件3的宽度，距离增宽了，生长时间加长了，当螺钉2生长到远离中心定位孔13的阻挡件3的位置，同样观察有无踝关节的复发，如果有不同程度的复发，螺钉2暂时维持一段阻滞一段时间直到恢复正常，这个矫正内翻需要的时间也会增加，然后拧出滑到远离中心定位孔13的阻挡件3位置处的螺钉2在靠近中心定位孔13的阻挡件3的位置再次拧入，反复重复这个过程，每次螺钉2的移动距离较模式一的距离增宽，因此模式二适用于需要较长时间骨骺线才能闭合的年龄较小的患儿。
综上所述：本实用新型的偏心型骨骺生长平衡装置可以治疗冠状面的下肢弯曲合并肢体的旋转畸形的治疗。
用途二：平衡锁定钢板1(偏心型)的用途可以与平衡锁定板(对称型)原理相同，用于骨骺阻滞术防止复发的作用，经过正常骨骺生长与平衡骨骺生长达到骨骺均衡生长达到患儿生长成熟下肢力线始终保持平衡。防止下肢力线的复发，直到骨骺线闭合。操作如下：
以膝内翻左侧股骨远端为例
步骤一：左股骨远端外侧定位骨骺线位置，常规切口皮肤，皮下组织，筋膜，骨膜层外放置平衡锁定钢板1(偏心型)，中心定位孔13位于骨骺线，用克氏针钻入骨质定位，骨骺端安装部12放置于骨骺一侧，干骺端安装部11放置干骺端一侧，远离和靠近中心定位孔13的阻挡件3分别拧入原位，平行骨骺 线干骺端单孔121和远离和靠近中心定位孔13的阻挡件3间隙钻入导针，经透视位置满意，转入螺钉2，逐层缝合伤口，术毕。
这个时候此结构组合起到阻滞骨骺作用(与当前使用的8字钢板原理一样)，当股骨内翻完全矫正但是骨骺线没有闭合执行步骤二，如果闭合了取出平衡锁定钢板1的螺钉2系统，因为不担心复发问题。
步骤二：骨骺线没有闭合，小切口暴露两个阻挡件3，拧出两枚阻挡件3，拧出螺钉2在接近中心定位孔13的阻挡件3的位置再次拧入，缝合伤口，执行步骤三。
步骤三：随着骨骺的纵向生长经过半年左右(假定)时间，螺钉2随着骨骺纵向生长在长圆孔111内滑动到远离中心定位孔13的阻挡件3的位置，这时开始发挥阻滞作用，拍片查看如果股骨经过这个半年时间没有复发，螺钉2经远离中心定位孔13的阻挡件3的位置拧出，再次拧入靠近中心定位孔13的阻挡件3的位置，以上步骤循环，直到骨骺线闭合。如果有复发执行步骤四操作。
步骤四：螺钉2滑动到靠近中心定位孔13的阻挡件3的位置，暂时阻滞一段时间矫正复发直到正常，然后取出螺钉2拧入靠近中心定位孔13的阻挡件3的位置，缝合伤口。螺钉2再次纵向生长在长圆孔111内经过半年(左右)必然向远离中心定位孔13的阻挡件3的位置滑动，当不能滑动时再次出现对骨骺的阻滞作用，再次复查股骨内翻是否复发，如果复发重复以上的步骤，直到骨骺线闭合。
综上所述：平衡锁定板(偏心型)是针对下肢冠状面弯曲同时合并肢体旋转畸形设计的，锁定钢板1两端的端部定位孔14是控制钢板1与骨干按照设计的角度固定使用的，长圆孔111有两个阻挡件3，之间有一个空间拧入螺钉2位置，通过三者的组合可以使螺钉2即可以纵向生长，又有阻滞作用，因此兼有平衡锁定钢板1(对称型)治疗下肢内外翻防止复发的功能。
以上所述，仅为本实用新型的具体实施方式，但本实用新型的保护范围并不局限于此，任何熟悉本技术领域的技术人员在本实用新型揭露的技术范围内，可轻易想到变化或替换，都应涵盖在本实用新型的保护范围之内。因此，本实 用新型的保护范围应以所述权利要求的保护范围为准。

Claims (10)

  1. 一种偏心型骨骺生长平衡装置，包括钢板、与所述钢板配合的螺钉和阻挡件，其特征在于，所述钢板包括骨骺端安装部和干骺端安装部，所述骨骺端安装部和所述干骺端安装部之间设有中心定位孔，所述骨骺端安装部和所述干骺端安装部以所述中心定位孔非对称设置，所述骨骺端安装部上设有与所述螺钉配合的通孔，所述干骺端安装部设有与所述螺钉和所述阻挡件配合的通孔。
  2. 根据权利要求1所述的偏心型骨骺生长平衡装置，其特征在于，所述骨骺端安装部上与所述螺钉配合的通孔设为单孔，所述螺钉贯穿所述单孔设置。
  3. 根据权利要求1所述的偏心型骨骺生长平衡装置，其特征在于，所述干骺端安装部与所述螺钉和所述阻挡件配合的通孔设为长圆孔，所述阻挡件和所述螺钉均贯穿所述长圆孔，所述阻挡件位于所述螺钉的两侧，用于挤压固定所述螺钉。
  4. 根据权利要求3所述的偏心型骨骺生长平衡装置，其特征在于，所述长圆孔两端与所述阻挡件配合的通孔设为沉窝孔。
  5. 根据权利要求4所述的偏心型骨骺生长平衡装置，其特征在于，所述沉窝孔内壁两端设有螺纹，所述阻挡件螺纹连接于所述沉窝孔内，且所述阻挡件顶端与所述钢板顶面平齐。
  6. 根据权利要求1所述的偏心型骨骺生长平衡装置，其特征在于，所述骨骺端安装部和所述干骺端安装部之间的夹角为150-180度。
  7. 根据权利要求1所述的偏心型骨骺生长平衡装置，其特征在于，安装于所述骨骺端安装部的所述螺钉的长度短于安装于所述干骺端安装部的所述螺钉的长度，安装于所述干骺端安装部的所述螺钉的长度为骨干直径的2/3。
  8. 根据权利要求7所述的偏心型骨骺生长平衡装置，其特征在于，安装于所述骨骺端安装部的所述螺钉和安装于所述干骺端安装部的所述螺钉均设置为空心螺钉。
  9. 根据权利要求1-8任一所述的偏心型骨骺生长平衡装置，其特征在于，所述钢板的两端还设有用于确定所述钢板与股骨干角度的端部定位孔。
  10. 根据权利要求9所述的偏心型骨骺生长平衡装置，其特征在于，所述端部定位孔用于术中倾斜放置锁定板。
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