CN103169534B - Outside anatomical type locking plate after tibial plateau - Google Patents

Abstract

The present invention is a tibial plateau posterolateral anatomical locking bone plate, which includes a horizontal part, a connecting part and a longitudinal part. Through holes are all arranged on the horizontal part, the connecting part and the longitudinal part. The horizontal part is arc-shaped, and a certain angle is formed between the longitudinal part and the horizontal part and inclines to the inside. The posterolateral anatomical locking bone plate of the tibial plateau of the present invention adopts a shape more fitting to the surface of the bone, and is locked and fixed by screws, which is convenient to use, achieves the maximum support and fixation strength, and ensures the quality of the operation.

Description

Posterolateral Tibial Plateau Anatomical Locking Plate

technical field

The invention belongs to the technical field of medical devices, and relates to a medical anatomical locking bone plate, in particular to a posterolateral anatomical locking bone plate of the tibial plateau.

Background technique

Tibial plateau fractures have always been a difficult point in the treatment of trauma orthopedics, especially the treatment of complex tibial plateau fractures, which has a high rate of complications and disability. Tibial plateau fractures are intra-articular fractures that require anatomical reduction and firm fixation. Especially when the posterior column bone is split or collapsed, the traditional anterior knee approach with open reduction and front-to-back internal fixation often fails to achieve the expected therapeutic effect, and is prone to secondary loss of reduction and fixation failure . In current clinical practice, more and more clinicians support the reduction of posterior column fractures of the tibial plateau through the posterior approach of the knee joint and the method of fixation with the posterior support plate.

Various non-anatomic fixation implants have been widely used in the fixation of posterior column fractures through the posterior approach of the knee joint, and all of them play a role of support. The internal fixation implants used by each doctor are different. Many scholars have used 3.5mm limited contact dynamic compression plate (LC-DCP), reconstruction plate, 3.5mm or 4.5mm-T-shaped and clover-shaped bone plate and other fixation systems. These internal fixation implants are general-purpose internal fixators, which cannot fit perfectly with the anatomical shape of the posterior side of the tibial plateau, so the surgical effects are not the same, and the results cannot be judged uniformly. It is precisely because of the need for treatment that we are increasingly aware that for the special type of fracture of the posterior column of the tibial plateau, there is a lack of exclusive anatomical internal fixation implants both internationally and domestically.

In addition, the locking plate follows the biological principles of external fixation and does not rely on the friction between the plate and the bone. Therefore, the impact on the blood supply of the bone surface and the fracture end is bound to be reduced. Through the anastomotic interlocking of the screw tail thread and the screw hole thread, there is an angular stability between the screw and the bone plate, allowing the locking bone plate to be placed without contacting the bone at all, so it is a biological internal fixation system. For metaphyseal fractures and osteoporotic fractures, the locking system has great biomechanical advantages. In essence, the locking plate can still be regarded as a subcutaneous external fixator, but the distance between it and the bone is shorter to be more stable.

Anatomical plates designed based on the morphological data of the posterolateral tibial plateau can improve the fixation effect of simple posterolateral tibial plateau fractures caused by trauma or complex fractures involving the posterolateral tibial plateau. In the Chinese invention patent CN201010230592.8, an anatomical support locking bone plate for lateral and posterior tibial bending without pre-bending is disclosed. But there are many serious defects in this invention in design. First of all, due to the very important anatomical structure of the fibular head on the posterolateral side of the tibial plateau, the existence of this structure makes it necessary for the general internal fixation implant to be placed obliquely at a certain angle during implantation, and cannot be parallel to the longitudinal axis of the tibia. longitudinal placement. Moreover, the important vascular and nerve structures in the posterolateral aspect of the proximal tibia do not allow the longitudinal placement of internal fixation plates. Secondly, the height of the posterolateral platform of the tibia is limited, and the goal of setting two rows of nail holes on the head of the bone plate described in this invention cannot be achieved. If two rows of bone plates are set, the diameter of the nail holes is very limited, and the implantation of screws is bound to be limited. The diameter is reduced, so the fixation effect will be greatly reduced. . Therefore, this invention (CN201010230592.8) does not fully conform to the actual anatomical characteristics of the posterolateral side of the tibial plateau, and therefore cannot provide effective fixation.

Therefore, those skilled in the art are committed to developing a more stable posterolateral anatomical locking plate of the posterolateral tibial plateau that is more in line with the anatomical characteristics of the posterior proximal tibial segment, fits more closely to the surface morphology of the posterolateral tibial plateau.

Contents of the invention

In view of the above problems, the purpose of the present invention is to provide a more stable posterolateral anatomical locking plate of the tibial plateau that is more in line with the anatomical characteristics of the posterior proximal tibial segment, fits the surface shape of the posterolateral bone of the tibial plateau, and is more stable.

A posterolateral tibial plateau anatomical locking bone plate of the present invention comprises a horizontal part, a connecting part and a longitudinal part, the horizontal part, the connecting part and the longitudinal part are connected to each other in turn, and the horizontal part, the connecting part and the longitudinal part The row parts are provided with through holes, the horizontal part is curved in an arc shape, the plane where the longitudinal part is located is perpendicular to the arc-shaped cross section of the horizontal part, and the center line of the longitudinal part is in line with the circle of the horizontal part. The angle between the arc cross sections is 55°~62°.

In a preferred embodiment of the present invention, the arc-shaped cross-section of the horizontal portion has a radius of 18-23 mm and a central angle of 105°-112°.

In another preferred embodiment of the present invention, the plane perpendicular to the arc-shaped cross-section on the horizontal part, the plane where the connecting part is located, and the plane where the wale part is located are Z-shaped, and the horizontal part is connected to the circle. There is a first included angle of 128°-135° between the plane perpendicular to the arc-shaped cross-section and the plane where the connecting portion is located; a second included angle is 135°-142° between the plane where the connecting portion is located and the plane where the longitudinal section is located.

In another preferred embodiment of the present invention, the number of through holes on the horizontal portion is two to four.

In another preferred embodiment of the present invention, the axes of the through-holes on the horizontal portion are arranged on an arc-shaped surface in a radial arrangement.

In another preferred embodiment of the present invention, the through hole on the horizontal portion is a circular threaded locking hole.

In another preferred embodiment of the present invention, the number of through holes on the connecting portion is one, and the direction of the hole axis is inclined relative to the connecting portion.

In another preferred embodiment of the present invention, the number of through holes on the wale portion is two to four, and the through holes on the wale portion are arranged along the extending direction of the wale portion. The hole axis of the through hole is perpendicular to the wale portion.

In another preferred embodiment of the present invention, the through holes on the connecting portion and the wale portion are combined holes, and the combined holes are holes in which unthreaded holes and threaded holes are fused together.

In another preferred embodiment of the present invention, an included angle of 60° is formed between the central line of the wale portion and the arc-shaped cross section of the horizontal portion.

The posterolateral anatomical locking bone plate of the tibial plateau of the present invention is more in line with the anatomical characteristics of the posterior side of the proximal tibia, fits the surface shape of the posterolateral bone of the tibial plateau, and is locked and fixed by screws. It is easy to use and achieves the maximum support and fixation strength. Guaranteed the quality of surgery.

Description of drawings

Fig. 1 is the structural representation of an embodiment of the present invention;

Fig. 2 is a structural schematic view on a horizontal plane of an embodiment of the present invention;

Fig. 3 is a structural schematic view on the sagittal plane of an embodiment of the present invention;

Fig. 4 is a schematic view of the coronal structure of an embodiment of the present invention.

detailed description

The present invention will be described in detail below in conjunction with the accompanying drawings.

The horizontal plane described in the present invention is a section parallel to the ground; the sagittal plane refers to the section in which the osteosynthesis plate of the present invention is longitudinally cut into left and right parts along the front and back direction of the human body in the use state and is parallel to the horizontal plane; the coronal plane is Refers to the section perpendicular to the horizontal and sagittal planes.

It should be noted that the up, down, left, and right in the present invention refer to the directions shown when the bone plate of the present invention is placed according to FIG. 1 .

The present invention is based on the perfect anatomical contour curve of the proximal tibia, including the bone surface shape data on the rear side of the platform articular surface, and proposes a convenient and simple bone plate technical solution that fits the bone surface more closely and follows the anatomical characteristics of the posterolateral aspect of the proximal tibia. . The present invention uses spiral CT scanning, three-dimensional reconstruction images and corresponding image measurement software to collect, measure and calculate specimen data with a relatively large sample size. Through the morphological measurement and research on the bone surface of the posterior proximal tibia of normal healthy Chinese people with a large sample size, it was concluded that: The posterolateral cortical edge of the tibial plateau mainly presents a circular arc structure in the horizontal plane. The radius of the circle where the posterior outer arc is located is about 20mm, and the central angle of the arc is about 108°; In the sagittal plane, the morphology of the posterior proximal tibial cortex is clearly discernible, with two distinct angles, running like a "Z" shape rotated 90°. From top to bottom, the size of the first corner is about 47°; the size of the second corner is about 40°. And proposed the present invention on the basis of this data. The results of the data used in the present invention have been published in comprehensive professional journals (Sun Hui, Luo Congfeng. Morphological Measurement of the Posterior Side of the Normal Chinese Tibia. Shanghai Medical Sciences. 2008, 31(5): 335-338. <Core Journals , Statistical Source Journals>).

As shown in FIG. 1 , a posterolateral tibial plateau anatomical locking bone plate according to an embodiment of the present invention includes a horizontal part 1 , a connecting part 2 and a longitudinal part 3 . The horizontal part, the connecting part and the wale part are sequentially connected from top to bottom as shown in FIG. 1 . The horizontal part 1 , the connecting part 2 and the wale part 3 are all provided with through holes. In addition, the horizontal part 1 is curved in an arc shape, the plane of the wale part 3 is perpendicular to the arc-shaped cross section of the horizontal part 1, and the center line of the wale part 3 is 55° from the arc-shaped cross-section of the horizontal part 1 ~62° included angle.

The posterolateral anatomical locking bone plate of the tibial plateau of the present invention is more in line with the anatomical characteristics of the posterior side of the proximal tibial segment and fits more closely with the surface shape of the posterolateral bone of the tibial plateau. Thereby the combination is more stable.

As shown in FIG. 2 and FIG. 3 , the bone plate of the present invention is a locked and fixed bone plate, and its horizontal part 1 , connecting part 2 and longitudinal part 3 are all provided with through holes. As shown in Figure 1, the through holes of the horizontal part 1 are simple circular locking screw holes (shown as 11, 12, 13 and 14 in the figure), while the connecting part 2 and the longitudinal part 3 are joint holes. The bone plate can be fixed with screw locking.

Also as shown in Figure 2, because in the surface morphology of the tibial plateau, the posterolateral cortex edge of the tibial condyle portion mainly presents a circular arc structure in the horizontal plane, therefore, as shown in Figure 2, in the bone plate of the present invention The horizontal part 1 adopts a circular arc shape on the horizontal plane to better fit the posterolateral aspect of the tibial plateau.

In a preferred embodiment of the present invention, the radius of the arc-shaped cross-section of the horizontal part is 18~23mm, the central angle is 105°~112°, the preferred radius is 20mm, and the central angle is 108°, so as to adapt to most The shape of the bones in most patients.

As shown in FIG. 3 , on the sagittal plane, the horizontal part 1 , the connecting part 3 and the longitudinal part 2 of a bone plate according to a preferred embodiment of the present invention have a curved shape that coincides with the posterolateral side of the tibia. During use, as shown in FIG. 3 , an angle of 65° is formed between the horizontal portion 1 and the tibial plateau articular surface α. The horizontal part 1, the connecting part 3 and the longitudinal part 2 are Z-shaped, and the connection between the horizontal part and the connecting part is a first included angle, which is 128°~135°; the connection between the connecting part and the longitudinal part The connection is the second included angle, which is 135°~142°. Preferably, the first included angle is 133°, and the second included angle is 140°. The curved shape between the horizontal part 1 , the connecting part 2 and the longitudinal part 3 can better fit the tibia, thereby making the bone plate more stable.

As shown in Fig. 1 and Fig. 4, on the coronal plane, the angle between the longitudinal part 3 and the horizontal part of the bone plate according to the preferred embodiment of the present invention is 55°~62°. An inclination of 60° is preferred. The reason why the longitudinal part 3 is inclined on the coronal plane is that the proximal tibia is blocked by the head of the fibula and the upper tibiofibular joint on the posterolateral side of the tibia, so the inclined longitudinal part 3 can better fit the posterior tibia Laterally, while avoiding important vascular and neural structures.

Also as shown in FIGS. 1 and 2 , the bone plate of the preferred embodiment of the present invention is provided with through holes ( 11 , 12 , 13 , 14 ) on the horizontal portion 1 . Through holes (11, 12, 13, 14) can allow screws and the like to pass through and fix the bone plate. As shown in FIG. 2 and FIG. 3 , the hole axes of the through holes ( 11 , 12 , 13 , 14 ) in this preferred embodiment are on the same plane, and the direction A is parallel to the articular surface α. And it is preferably arranged in a radial pattern, which can prevent the screws from colliding and cutting each other in the middle of the tibial plateau bone, so that the locking of the bone plate is more stable. The axis of the hole is located at the midpoint of the sagittal plane of the horizontal section. Of course, in other embodiments, arc-shaped through holes arranged on different planes may also be provided, which is not limited in this embodiment.

The larger-diameter subarticular nail-row technology in the present invention can provide greater holding force for screw fixation. Conducive to the stability of the bone plate.

Also as shown in FIG. 4 , in a preferred embodiment of the present invention, a through hole 21 is provided on the connecting part 2 , and through holes 31 , 32 , 33 , 34 are provided on the longitudinal part 3 . The through hole 21 enables the screw to be fixed on the metaphyseal transition part of the tibia to stabilize the bone plate. Also as shown in FIG. 3 , the hole axis direction B of the connecting portion through hole 21 is the line connecting the midpoint of the sagittal plane of the connecting portion and the front edge of the tibial plateau, and the position of the through hole is located at the midpoint of the sagittal plane of the connecting portion. As shown in FIG. 3 , intersections may be formed with the through holes 11 , 12 , 13 , 14 on the horizontal portion 1 . Such a design makes the screws passing through the through hole 21 cooperate with the screws passing through the through holes 11 , 12 , 13 , 14 to more stably fix the bone plate. Of course, in other embodiments, other directions can also be used, as long as the bone plate can be fixed, which is not limited in this embodiment.

In addition, as shown in FIG. 4 , the wale portion 3 of the preferred embodiment of the present invention is provided with through holes 31 , 32 , 33 , 34 , which are located below the second included angle and arranged longitudinally with the wale portion. And as shown in FIG. 3 , the direction C of the hole axes of the through holes 31 , 32 , 33 , 34 is perpendicular to the bone plate. Through holes 31 , 32 , 33 , 34 allow screws to pass through the upper part of the tibial shaft, and cooperate with through holes 11 , 12 , 13 , 14 and through hole 21 to lock and fix the bone plate.

In the bone plate of the embodiment of the present invention, the material of the bone plate can be titanium alloy, so as to provide sufficient strength.

The specific embodiments of the present invention have been described in detail above, but they are only examples, and the present invention is not limited to the specific embodiments described above. For those skilled in the art, any equivalent modifications and substitutions to the present invention are also within the scope of the present invention. Therefore, equivalent changes and modifications made without departing from the spirit and scope of the present invention shall fall within the scope of the present invention.

Claims (9)

1. outside anatomical type locking plate after a tibial plateau, it is characterized in that, comprise horizontal part, connecting portion and stringer portion, described horizontal part, connecting portion and stringer portion are interconnected successively, described horizontal part, connecting portion and stringer portion are equipped with through hole, described horizontal part is bending in circular arc, described stringer portion place plane is vertical with horizontal part radiused cross-section, in the angle of 55 ° ~ 62 ° between the centrage in described stringer portion and described horizontal part radiused cross-section, plane vertical with radiused cross-section on described horizontal part, in zigzag between connecting portion place plane and stringer portion place plane, in 133 ° of first angle between plane vertical with radiused cross-section on described horizontal part and connecting portion place plane, in 140 ° of second angle between described connecting portion place plane and stringer portion place plane, in use, between horizontal part and tibial plateau articular surface α in the angle of 65 °.

2. outside anatomical type locking plate after tibial plateau as claimed in claim 1, it is characterized in that, the radius of described horizontal part radiused cross-section is 18 ~ 23mm, and central angle is 105 ° ~ 112 °.

3. outside anatomical type locking plate after tibial plateau as claimed in claim 1, it is characterized in that, on described horizontal part, the quantity of through hole is two to four.

4. outside anatomical type locking plate after tibial plateau as claimed in claim 3, it is characterized in that, the hole axle of the through hole on described horizontal part is arranged on an arc-shaped surface, radially arranges.

5. outside anatomical type locking plate after the tibial plateau as described in claim 1,3 or 4, it is characterized in that, on described horizontal part, through hole is circular strip threaded locked holes.

6. outside anatomical type locking plate after tibial plateau as claimed in claim 1, it is characterized in that, on described connecting portion, the quantity of through hole is 1, and hole direction of principal axis tilts relative to connecting portion.

7. outside anatomical type locking plate after tibial plateau as claimed in claim 1, it is characterized in that, in described stringer portion, the quantity of through hole is two to four, and in described stringer portion, through hole is along the arrangement of stringer portion bearing of trend, and in described stringer portion, the hole axle of through hole is vertical with stringer portion.

8. after the tibial plateau as described in claim 1,6 or 7, outside anatomical type locking plate, is characterized in that, in described connecting portion and stringer portion, through hole is combined hole, described combined hole be unthreaded hole warm with screwed hole together with hole.

9. outside anatomical type locking plate after tibial plateau as claimed in claim 1, is characterized in that, in the angle of 60 ° between described stringer portion centrage and horizontal part radiused cross-section.