CN103860249B - The anti-locking device that revolves of a kind of near end of thighbone - Google Patents
The anti-locking device that revolves of a kind of near end of thighbone Download PDFInfo
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- CN103860249B CN103860249B CN201410086138.8A CN201410086138A CN103860249B CN 103860249 B CN103860249 B CN 103860249B CN 201410086138 A CN201410086138 A CN 201410086138A CN 103860249 B CN103860249 B CN 103860249B
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
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Abstract
The invention provides a kind of near end of thighbone and prevent revolving locking device, comprise bone plate and lock screw; Bone plate one end is made as head, the other end is made as bar portion, wherein, head pastes greater trochanter, lateral side of femur is pasted by bar portion, head is provided with 5 head thread lock holes and 2 guide pinholes, 5 head thread lock holes intersect and are arranged on bone plate head for 5 pieces of lock screw that extend in greater trochanter, neck of femur and femur square respectively, the axis direction in these 5 head thread lock holes becomes respectively an angle of cut with bone plate plane and vertical plane thereof, axis spacing makes to insert screw and does not mutually touch, and in 5 pieces of lock screw, lower 3 intersect with upper 2. The present invention can effectively avoid that lock screw is loosening, the reduction of the fracture is lost, and has prevented coxa vara deformity etc.; In addition, wide accommodation, is applicable to unstable, pulverizing, osteoporosis, PERCUTANEOUS MULTIPLE PINS FOR; Finally, meet near end of thighbone anatomical structure, attach, lock screw direction is relatively fixing, facilitating operation.
Description
Technical Field
The invention belongs to the field of medical devices, and particularly relates to a proximal femur rotation-preventing locking device.
Background
The upper section mechanics conduction structure of thighbone is complicated, the trabecula that ends at the thighbone neck inboard from the fan-shaped separation of thighbone top is the pressure trabecula, the arc structure from below 1/4 in the thighbone head to the greater trochanter far side is the tension trabecula, the axis of power and thighbone axis do not coincide, when fracture takes place between thighbone tuberosity, the normal mechanics structure of thighbone near-end skeleton loses balance, especially when there is big cortical bone fracture in thighbone neck inboard, load when its fracture piece can not bear a burden, compressive stress can not carry out effective transmission through femoral bone matrix district, tensile stress obviously increases, easily cause the hip varus deformity, inboard cortical bone is difficult to expose in the operation when the fracture resets, above-mentioned factor has all increased the fracture operation treatment degree of thighbone tuberosity between, the factor that influences fracture fixation has: 1. bone quality, 2, fracture type, 3, fracture reduction quality, 4, design of internal fixation objects, and 5, placement positions of the internal fixation objects in the bone. The first 2 items are observation factors, the 3 rd item is an influence factor in the operation, and the 4 th and 5 th items are important points.
With the continuous and intensive biological research, the emergence and improvement of new materials and the introduction of reasonable design of new instruments, the treatment methods are continuously increased, and the internal fixture selection has been transited from early simple kirschner wires, compression screws, condyle screw steel plates, Gamma nails to DHS, anatomical steel plates, PFN, PFNA and the like.
DHS is fixed by a single nail in the femoral neck, the damage to the femoral head blood supply is large, the holding force of osteoporotic bones to the screws is reduced, the anti-rotation effect is poor, head and neck rotation can occur, the fixation is not stable, the tuberosity part comminuted fracture with serious osteoporosis can occur, fracture lines wave to DHS needle insertion points or intersubular fracture is not suitable for DHS fixation, the tuberosity can not be prevented from outwards displacing due to the sliding pressurization effect, the comminuted tuberosity can be outwards displaced due to the sliding between the DHS and a steel plate, the femoral neck is shortened, the limb is shortened and malformed, for comminuted unstable fracture (part A2 and A3) with fracture of femoral lesser tuberosity, femoral moment and osteoporosis, the stress of an internal fixed object is increased due to the lack of powerful support at the rear inner side of the femoral tuberosity, the compressive stress is difficult to be conducted through the femoral moment, and the stress of the internal fixed object is blocked in a sleeve by the screws to form nail-plate system fixation, the vertical force acting on the DHS and the contact area of the screw body and the sleeve are reduced, so that the frictional resistance is improved, the screw is easy to cut the femoral head, the steel plate is easy to fatigue and break, complications such as hip varus deformity healing, internal fixture displacement, falling-out and the like occur, in addition, when 1 lag screw fixes intertrochanteric fracture, the femoral neck is unstable in rotation, once the lower limb moves in flexion and extension, the screw loosens in the femoral neck, so that the stress position of the screw is changed and easy to cut, and when the screw walks, the axial resultant force and the torsional resultant force acting on the screw cause the screw displacement, wherein the screw rotation is a biomechanical initiation factor for cutting the screw. For the retrotrochanter fracture, the displacement direction of the fracture proximal end is consistent with the sliding direction of the DHS screw, so that the fracture proximal end is displaced outwards, the fracture end pressurization cannot be realized, the main screw is easy to withdraw after dynamic pressurization when osteoporosis is accompanied, and the internal fixation failure rate reaches 24-56%. In the elderly patients, due to osteoporosis, the postoperative appliances are not firmly fixed, so that the loosening and displacement of tension screws are mainly caused, the repeated pressurization and fixation of main nails in femoral necks in the operation can cause the sliding of threaded nails, the screws are loosened and cannot be fixed, the excessive sliding is mainly caused by the insufficient tightness of the occlusion of the screws and the loose bone, the excessive sliding causes the protruding of the screws under the driving of sliding force, the early fixation failure and the pain of the patients are caused, the proximal end inner side displacement can be caused in the later stage, the proximal femur anatomical structure is changed, adductor muscle atrophy, the lower limb shortening and the gait change are caused. The steel plate screw is pulled out from the femoral cortex, mainly because the ordinary cortical nail is not tightly fixed to loose bone, and when gravity is applied, the screw is pulled out under the action of vertical component force.
Three major complications mainly occur after the proximal intramedullary fixation system of the femur is operated: 1. the direct consequence of invagination and collapse of the femoral head and neck is screw cutting, mainly because the screw is positioned too far forward and upward, or the screw is positioned too deep in the femoral head, and the rotation instability of 1 lag screw in loose bone leads to loosening and subsequent screw cutting. There is a special case of post-operative screw cutting, called the Z-effect, which is commonly seen in 2 independent screws for main nails such as proximal femoral intramedullary nails (PFNs) and reconstruction nails. The main reason is that when the load is loaded, 2 screws are loaded asymmetrically, the excessive inversion pressure and cyclic load make 1 screw with lower position withdraw backwards, and then the broken end is inverted and collapsed to make 1 screw with higher position cut into acetabulum. 2. The main reason for the femoral neck deformity is that the broken ends of the patient are collapsed and inserted due to the load bearing after the operation, and the screws can slide outwards, so that pain, lameness and even nonunion are caused. 3. Because the force is transmitted to the far end of the locking nail of the intramedullary nail and the impact of the front arch of the femoral shaft exists, the femoral shaft fracture at the far end locking nail position appears after the load bearing.
The PFNA is designed aiming at the anatomical characteristics of Western people, the eversion angle of an internal fixture is large, for Asian patients, the intramedullary augmentation and the insertion of a main nail are difficult, large damage is possibly caused, when the PFNA is used, good reduction and maintenance are needed before operation, and the PFNA is cautious for patients with proximal femur bending deformity and narrow medullary cavity, in addition, the PFNA can be effectively fixed based on the relative integrity of femur size tuberosity and femoral moment, and can be used for 1, severe osteoporosis; 2. fracture is crushed by the greater trochanter itself, fracture (coronal plane and sagittal plane) is split longitudinally between the greater trochanter or trochanter, fracture which is difficult to reduce is separated greatly, because the spiral blade can separate the fracture part when being placed, and the fracture part is difficult to correct after being placed, the fracture end can not generate satisfactory pressure, even the spiral blade can not generate enough anchoring force, the nail is easy to be removed when the femoral head and the neck are cut, the advantages of the operation time and the bleeding amount in the operation are lost, and simultaneously, because the tail end of the main nail is thick, for pursuing matching performance, the marrow expansion is usually needed before inserting the nail to increase the loss of proximal bone mass of the femoral trochanter, the pressure is increased when the main nail is inserted into a medullary cavity to cause large amount of bleeding, the blood coagulation function of old people is poor, continuous recessive blood loss exists after the nail feeding point and the fracture broken end operation, the organism compensation capacity of old patients is weak, the automatic hematopoietic capacity is poor, and postoperative anemia is easy to cause.
Disclosure of Invention
The invention aims to provide a proximal femur rotation-prevention locking device, and aims to solve the problems that a femur is not easy to be balanced and fixed, hip varus deformity is easy to occur after operation, and inner cortical bone is difficult to be exposed during fracture reduction.
The invention is realized in such a way that the proximal femur anti-rotation locking device is used for fixing the fracture between the human femur and the greater trochanter, wherein one side of the greater trochanter is connected with the femoral head, and the proximal femur anti-rotation locking device comprises a bone fracture plate and a locking screw; the bone fracture plate comprises a semi-circular spoon-shaped head part and a rod part, wherein one end of the semi-circular spoon-shaped head part is matched and attached to one side of the tuberosity far away from the femoral head direction, and the rod part is connected with the semi-circular spoon-shaped head part and is matched and attached to the bone side surface of the femur; wherein,
the head part is provided with a guide pin hole at the left vertex angle and the right vertex angle in the direction away from the rod part, and a first head part locking threaded hole, a second head part locking threaded hole, a third head part locking threaded hole, a fourth head part locking threaded hole and a fifth head part locking threaded hole are arranged between the two guide pin holes; the first head locking threaded hole and the second head locking threaded hole are positioned above the third head locking threaded hole, the locking screws respectively inserted into the first head locking threaded hole and the second head locking threaded hole extend into femoral neck rectangular cortical bone after penetrating through the greater tuberosity, and the locking screws respectively inserted into the third head locking threaded hole, the fourth head locking threaded hole and the fifth head locking threaded hole extend into femoral neck cancellous bone after penetrating through the greater tuberosity;
the rod part is provided with a plurality of rod part locking threaded holes which are sequentially arranged from top to bottom, and the locking screws inserted into the rod part locking threaded holes penetrate out from one side of the femur far away from the direction of the rod part.
Preferably, an extension surface is formed along the rod part towards the head part, and included angles formed after the extension surface is intersected with the axial leads of the first to fifth head locking threaded holes are respectively 80 degrees, 85 degrees, 100 degrees, 125 degrees and 135 degrees; and making a vertical line perpendicular to the extension surface at the intersection point of the extension surface and the shaft axes of the first head locking threaded hole to the fifth head locking threaded hole, wherein the included angles between the vertical line and the shaft axes of the first head locking threaded hole to the fifth head locking threaded hole are all 12 degrees.
Preferably, the minimum distance between every two adjacent first, second, third, fourth and fifth head locking threaded holes is 2 mm; and the first, second, third, fourth and fifth head locking threaded holes are all 5.0mm in aperture and 0.1mm in minimum thread division.
Preferably, the number of the rod part locking threaded holes is 4-12, and the distance between every two rod part locking threaded holes is 14-20 mm.
Preferably, the shank locking threaded bore comprises a single locking bore and a hybrid locking bore;
the mixed locking hole is a big hole formed by two small parallel holes, wherein one small hole is a locking threaded hole, and the other small hole is a smooth hole for respectively screwing and fixing a locking screw and a common screw.
Preferably, the length of the locking screw is 4-130 mm
Preferably, the length of the bone fracture plate is 180-400 mm, the thickness of the bone fracture plate is 4mm, and the width of the bone fracture plate is 25 mm.
The invention overcomes the defects of the prior art and provides a proximal femur rotation-preventing locking device which comprises a bone fracture plate and a locking screw; bone plate one end is established to the head, the other end is established to the pole portion, wherein, the head pastes big tuberosity, the thighbone outside is pasted to the pole portion, the head is equipped with 5 head screw thread locking holes and 2 guide pin holes, 5 head screw thread locking holes supply 5 pieces respectively to stretch into big tuberosity, locking screw cross mounting in thighbone neck and thighbone square is at the bone plate head, the axis direction and the bone plate plane and the perpendicular face of these 5 head screw thread locking holes become an angle of intersection respectively, the axis interval makes the plug-in screw not touch each other, 3 lower and last 2 are criss-cross in 5 pieces of locking screw, three stretch into in the spongy bone of thighbone neck below, two stretch into in thighbone neck square cortex bone above, prevent the fixed near-break end of locking soon.
The invention has the characteristics of stable fixation of three-dimensional and angle, strong torsion resistance and cutting stress resistance, effectively avoids the locking screw loosening and fracture reduction loss, prevents hip varus deformity, reduces periosteum injury and femoral head blood vessel damage, preserves the blood circulation of bone blocks, enhances the pullout resistance and the anti-rotation force, and is suitable for different requirements of cervical shaft angles after fracture reduction and avoids areas with poor bone quality. In addition, the invention has wide application range, is suitable for unstable fracture, crush fracture, osteoporosis and intertrochanteric fracture of old people, is particularly suitable for I, II type fracture, has coronary fracture line or bone defect condition in the internal back of fracture end in intertrochanteric fracture, has accommodation function in proximal anatomical spoon-shaped structure in intertrochanteric comminuted fracture of femur, and is more useful for comminuted fracture. Finally, the invention is suitable for primary hospitals, accords with the anatomical structure of the proximal femur, has good attachment, relatively fixes the direction of the locking screw, does not need to be molded, is convenient to install, does not need to confirm the direction of the locking screw through multiple C-arm perspectives, and has the advantages of small operative trauma, less blood loss, short operative time and less complications.
Drawings
FIG. 1 is a reference view of the proximal femoral anti-rotation locking device of one embodiment of the present invention in use;
FIG. 2 is a side perspective block diagram of the proximal femoral anti-rotation locking device of FIG. 1;
FIG. 3 is an enlarged schematic view of portion A of FIG. 2;
fig. 4 is a schematic front view of the proximal femur anti-rotation locking device of fig. 1.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
Fig. 1 to 4 show a reference view of a proximal femur anti-rotation locking device according to an embodiment of the present invention in a use state; FIG. 2 is a side perspective block diagram of the proximal femoral anti-rotation locking device of FIG. 1; FIG. 3 is an enlarged schematic view of portion A of FIG. 2; fig. 4 is a schematic front view of the proximal femur anti-rotation locking device of fig. 1.
The femoral head, neck and acetabulum together form a hip joint, which is an important connecting device and a bearing structure of the trunk and the lower limbs. The long axis of the femoral neck and the longitudinal axis of the femoral shaft form a neck angle of 110-140 degrees, and the average angle is 127 degrees. When gravity is transmitted, the force line is not transmitted along the central line of the femoral neck, but is transmitted along the femoral lesser trochanter and the inner edge of the femoral neck, so that cortical thickening parts are formed. If the cervical angle is increased, the hip turns outward and becomes smaller, the hip turns inward. The change of the cervical shaft angle changes the force transmission, which is easy to cause fracture and articular cartilage degeneration, and traumatic arthritis occurs. The long axis of the femoral neck and the longitudinal axis of the femoral shaft are not on the same plane in sagittal view, the femoral neck has a forward angle of 12-15 degrees, namely a forward rake angle, the upper outer side of the upper end of the femur is a greater trochanter, and the lower inner side of the upper end of the femur is a lesser trochanter. Cancellous bone is formed among the greater trochanter, the lesser trochanter and the trochanter. The rotor is positioned at the junction of the femoral shaft and the femoral neck and is the position which bears the maximum shear stress. Due to the particularity of the distribution of the force lines, a compact longitudinal bone plate, called femoral moment, is formed inside and behind the femoral neck and stem junction. The plate-shaped surface is slightly arc-shaped, vertically upwards extends along the front outer side of the lesser trochanter, the upper pole is fused with the cortex of the femoral neck rear side, the lower pole is fused with the cortex of the femoral shaft rear inner side below the lesser trochanter, the front edge is connected with the cortex of the femoral upper front inner side, and the rear edge is connected with the femoral upper outer rear side. The presence of the femoral moment determines the stability of the intertrochanteric fracture.
The invention provides a proximal femur rotation-prevention locking device which is used for fixing a fracture between a human femur 11 and a greater tuberosity 12, wherein one side of the greater tuberosity 12 is connected with a femoral head 13, and the proximal femur rotation-prevention locking device comprises a bone fracture plate 2 and a locking screw 3; the bone fracture plate 2 comprises a semi-circular spoon-shaped head part 21 and a rod part 22, wherein one end of the semi-circular spoon-shaped head part 21 is matched and attached to one side of the tuberosity 12 far away from the femoral head 13, and the rod part 22 is connected with the semi-circular spoon-shaped head part 21 and matched and attached to the bone side surface of the femur 11; wherein, the head 21 is provided with a guide pin hole 211 near two top angles on the left and right in the direction away from the rod 22, and a first head locking threaded hole 212, a second head locking threaded hole 213, a third head locking threaded hole 214, a fourth head locking threaded hole 215 and a fifth head locking threaded hole 216 which are arranged between the two guide pin holes 211; the first head locking threaded hole 212 and the second head locking threaded hole 213 are positioned above the third head locking threaded hole 214, the fourth head locking threaded hole 215 and the fifth head locking threaded hole 216, the locking screws respectively inserted into the first head locking threaded hole 212 and the second head locking threaded hole 213 extend into the femoral neck rectangular cortical bone after penetrating through the greater tuberosity 12, and the locking screws respectively inserted into the third head locking threaded hole 214, the fourth head locking threaded hole 215 and the fifth head locking threaded hole 216 extend into the femoral head 13 neck cancellous bone after penetrating through the greater tuberosity 12;
be equipped with a plurality of pole portion locking screw holes that from top to bottom arrange the setting in proper order on pole portion 22, the locking screw that pole portion locking screw hole was inserted is worn out from thighbone 11 and is kept away from pole portion 22 direction one side.
In the embodiment of the invention, more specifically, the rod part 22 is extended towards the head part 21, and the included angles formed after the extended surface is intersected with the axial leads of the first to fifth head locking threaded holes (212-216) are respectively 80 degrees, 85 degrees, 100 degrees, 125 degrees and 135 degrees; perpendicular lines perpendicular to the extension surfaces are made at the intersection points of the extension surfaces and the axial leads of the first to fifth head locking threaded holes (212 to 216), and included angles between the perpendicular lines and the axial leads of the first to fifth head locking threaded holes (212 to 216) are all 12 degrees.
In the embodiment of the invention, the head 21 is attached to the greater tuberosity 12, the rod part 22 is attached to the outer side of the femur 11, the head 21 is provided with 5 head thread locking holes and 2 guide pin holes for the guide pin to penetrate when the proximal head of the steel plate is temporarily fixed to the outer side of the greater trochanter of the femur, the 5 head thread locking holes are respectively used for 5 locking screws extending into the greater tuberosity 12, the femoral neck and the femoral bone matrix to be crossly arranged on the head 21 of the bone fracture plate, the axial directions of the 5 head thread locking holes and the plane and the vertical plane of the bone fracture plate respectively form a crossed angle, the axial distances ensure that the inserting screws are not mutually contacted, the lower 3 of the 5 locking screws are crossed with the upper 2, the lower three of the 5 locking screws extend into the neck bone of the femoral head 13, the upper two of the 5 head thread locking holes extend into the cortical.
In an embodiment of the invention, more specifically, the bone plate 2 may be made of stainless steel (00)cr18Ni14MO3) Titanium alloy (TC)4) Or Titanium (TA)2) Three series of patterns. The locking screw 3 can be made of stainless steel (00)cr18Ni14MO3) And titanium alloy (TC)4) Two series of patterns.
According to the body physical signs of the operator, such as children, middle-aged people, old people and the like, the sizes of the rod locking threaded holes are respectively provided, in the embodiment of the invention, more specifically, the number of the rod locking threaded holes is 4-12, and the distance between every two rod locking threaded holes is 14-20 mm. The length of the locking screw 3 is 4 mm-130 mm, and the length of the bone fracture plate 2 is 180-400 mm, the thickness is 4mm, and the width is 25 mm. The minimum distance between every two adjacent first head locking threaded holes 212, second head locking threaded holes 213, third head locking threaded holes 214, fourth head locking threaded holes 215 and fifth head locking threaded holes 216 is 2mm, the diameters of the first head locking threaded holes 212, the second head locking threaded holes 213, the third head locking threaded holes 214, the fourth head locking threaded holes 215 and the fifth head locking threaded holes 216 are all 5.0mm, and the minimum pitch of the threads is 0.1 mm.
In an embodiment of the invention, more specifically, the threaded hole for locking the rod part comprises a single locking hole and a mixed locking hole, the mixed locking hole is a large hole formed by two parallel small holes, one small hole is a threaded hole for locking, and the other small hole is a smooth hole for respectively screwing and fixing a locking screw and a common screw, so as to avoid excessive stress concentration of the steel plate. In 4 ~ 12 pole portion locking screw holes, half sets up to single locking hole, and half sets up to mix the locking hole.
In the practical application process of the invention, firstly, a patient is in a supine position, a longitudinal arc-shaped operation incision is made along the near end of the femur 11, the fracture end is exposed, after traction reduction, the near end of the bone fracture plate 2 is attached to the greater trochanter region of the femur 11 under the perspective of the C-shaped arm, the far end is attached to the center of the femur 11, locking screws with proper lengths are sequentially screwed in from the first head locking threaded hole 212, the second head locking threaded hole 213, the third head locking threaded hole 214, the fourth head locking threaded hole 215 and the fifth head locking threaded hole 216, the screwed-in positions and depths of the locking screws are as described above, so as to achieve the anti-rotation locking effect on the fracture end of the head and neck, then the locking threaded holes on the rod part 22 are sequentially screwed in the locking screws with proper lengths, the position of the C-shaped arm is satisfied after the perspective fracture fixation, the wound is washed.
The proximal femur anti-rotation locking device disclosed by the invention accords with the biomechanics principle, the proximal end of the bone fracture plate 2 is a flat expansion part and can cover the outer side part of a greater trochanter, the locking screws 3 have different opening directions, and the locking screws 3 and the bone fracture plate 2 form a firm whole, so that the proximal femur anti-rotation locking device has the characteristics of three-dimensional and angle-stable fixation, is torsion-resistant and strong in cutting stress resistance, and effectively avoids the locking screws 3 from loosening and fracture reduction loss. As an internal fixing frame, the pressure is dispersed to each locking screw 3, thereby preventing the hip varus deformity and avoiding the locking screws 3 from loosening and being pulled out. Wherein, the locking screw that first head locking screw hole 212, second head locking screw hole 213 twisted drills through the inboard arc cortex of upper femur neck in the femoral bone square after sounding, reaches the locking action of preventing soon to head and neck fracture end, avoids thighbone 11 near-end inboard structure when destruction is serious, lacks the bone plate 2 pressure increase that inboard support leads to, stress concentration, fatigue fracture, the delayed union of fracture, pin fin sclerotin cutting, the shortening of thighbone neck, deformity healing scheduling problem. The angle of coaptation board 2 and locking screw 3 is stable does not rely on the stability that powerful frictional force between coaptation board 2 and the sclerotin provided, and coaptation board 2 and bone cortex need not in close contact with, have reduced the periosteum damage, have preserved the blood circulation of bone piece, avoid ordinary steel sheet to rely on the fixed bone cortex influence blood circulation of frictional force that screw pressurization steel sheet produced to reduce bone cortex intensity and lead to cancellous bone to warp. The elastic fixation is under the existence of effective axial load, 2mm micromotion exists between bone blocks, the stimulation is effective pressure transmission of the fracture end, the stability of the fracture end is maintained, the stress shielding effect is avoided, the early function exercise of the joint under the condition of non-load after operation can be ensured, the plurality of locking screws 3 are fixed in different directions and angles, the coronal plane and the sagittal plane have a certain adjustable range, the flexibility is high, the reduction and fixation of comminuted fracture are satisfactory, the damage to femoral head vessels is reduced, and the fracture reduction device is suitable for different requirements of the cervical shaft angle after fracture reduction and avoiding of areas with poor bone quality. The locking screw 3 can reach the fracture end through the tension hole, plays the pressurized effect to the fracture piece, guarantees the requirement that resets. Three locking screws screwed in from the third head locking threaded hole 214, the fourth head locking threaded hole 215 and the fifth head locking threaded hole 216 form a certain angle in the direction, are distributed in the femoral neck in a three-dimensional manner, so that the pullout resistance and the anti-rotation force are enhanced, and the angular stability of the locking screws can effectively disperse the bearing pressure in each component and firmly fix the components on the femoral head and neck.
In addition, the proximal femur rotation-preventing locking device has wide application range, is suitable for unstable, comminuted, osteoporosis and intertrochanteric fracture of the elderly, and is particularly suitable for I, II-type fracture, intertrochanteric fracture with coronal fracture lines or fracture end internal and back bone defect.
In addition, the proximal femur rotation-preventing locking device is suitable for being developed in primary hospitals, accords with the proximal femur anatomical structure, is good in attachment, relatively fixes the direction of the locking screw 3, does not need to be molded, is convenient to install, does not need to confirm the direction of the locking screw through multiple C-arm perspectives, and is small in operation trauma, less in blood loss, short in operation time and few in complications.
Compared with the defects and shortcomings of the prior art, the invention has the following beneficial effects:
(1) the proximal femur rotation-prevention locking device disclosed by the invention is designed to accord with a biomechanics principle, has the characteristics of three-dimensional and angle stable fixation, is strong in torsion resistance and cutting stress resistance, effectively avoids locking screw loosening and fracture reduction loss, prevents hip varus deformity, reduces periosteum injury and femoral head blood vessel damage, preserves blood circulation of bone blocks, enhances pullout resistance and anti-rotation force, and is suitable for different requirements of jugular angle after fracture reduction and avoids areas with poor bone quality.
(2) The proximal femur anti-rotation locking device has wide application range, is suitable for unstable, comminuted, osteoporosis and intertrochanteric fracture of the old, and is particularly suitable for I, II type fracture, patients with intertrochanteric fracture having coronal fracture lines or bone defect in the rear of fracture ends, and when comminuted fracture occurs between the trochanters of the femur, the proximal anatomical spoon-shaped structure has accommodation function and is more useful for comminuted fracture.
(3) The proximal femur rotation-preventing locking device is suitable for being developed in primary hospitals, accords with the proximal femur anatomical structure, is good in attachment, relatively fixed in locking screw direction, free of molding, convenient to install, free of multiple C-arm perspective for confirming the locking screw direction, small in operation trauma, less in blood loss, short in operation time and few in complications.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.
Claims (1)
1. A proximal femur anti-rotation locking device is used for fixing a fractured femur and a great trochanter of a human body, wherein one side of the great trochanter is connected with a femoral head, and is characterized by comprising a bone fracture plate and a locking screw; the bone fracture plate comprises a semi-circular spoon-shaped head part and a rod part, wherein one end of the semi-circular spoon-shaped head part is matched and attached to one side of the tuberosity far away from the femoral head direction, and the rod part is connected with the semi-circular spoon-shaped head part and is matched and attached to the bone side surface of the femur; wherein,
the head part is provided with a guide pin hole at the left vertex angle and the right vertex angle in the direction away from the rod part, and a first head part locking threaded hole, a second head part locking threaded hole, a third head part locking threaded hole, a fourth head part locking threaded hole and a fifth head part locking threaded hole are arranged between the two guide pin holes; the first head locking threaded hole and the second head locking threaded hole are positioned above the third head locking threaded hole, the locking screws respectively inserted into the first head locking threaded hole and the second head locking threaded hole extend into femoral neck and rectangular cortical bone after penetrating through the tuberosity, and the locking screws respectively inserted into the third head locking threaded hole, the fourth head locking threaded hole and the fifth head locking threaded hole extend into cancellous bone of femoral neck after penetrating through the tuberosity;
the rod part is provided with a plurality of rod part locking threaded holes which are sequentially arranged from top to bottom, and locking screws inserted into the rod part locking threaded holes penetrate out of one side of the femur far away from the rod part;
the rod part is provided with an extension surface towards the head part, and the included angles formed after the extension surface is intersected with the axial leads of the first to fifth head locking threaded holes are respectively 80 degrees, 85 degrees, 100 degrees, 125 degrees and 135 degrees;
making a vertical line perpendicular to the extension surface at the intersection point of the extension surface and the shaft axes of the first to fifth head locking threaded holes, wherein included angles between the vertical line and the shaft axes of the first to fifth head locking threaded holes are 12 degrees;
the minimum distance between every two adjacent first, second, third, fourth and fifth head locking threaded holes is 2 mm; the first, second, third, fourth and fifth head locking threaded holes are all 5.0mm in aperture and 0.1mm in minimum index of threads;
the number of the rod part locking threaded holes is 4-12, and the distance between every two rod part locking threaded holes is 14-20 mm;
the shank locking threaded bore comprises a single locking bore and a hybrid locking bore;
the mixed locking hole is a big hole consisting of two small parallel holes, wherein one small hole is a locking threaded hole, and the other small hole is a smooth hole for respectively screwing and fixing a locking screw and a common screw;
the length of the locking screw is 4-130 mm;
the bone fracture plate is 180-400 mm in length, 4mm in thickness and 25mm in width.
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| CN201410086138.8A CN103860249B (en) | 2014-03-11 | 2014-03-11 | The anti-locking device that revolves of a kind of near end of thighbone |
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| CN201410086138.8A CN103860249B (en) | 2014-03-11 | 2014-03-11 | The anti-locking device that revolves of a kind of near end of thighbone |
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| CN103860249A CN103860249A (en) | 2014-06-18 |
| CN103860249B true CN103860249B (en) | 2016-05-11 |
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| CN201410086138.8A Expired - Fee Related CN103860249B (en) | 2014-03-11 | 2014-03-11 | The anti-locking device that revolves of a kind of near end of thighbone |
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| US10058363B2 (en) * | 2015-09-07 | 2018-08-28 | Karl Leibinger Medizintechnik Gmbh & Co Kg | Rib fixation system |
| EP3389521B1 (en) * | 2015-12-15 | 2023-07-12 | TechMah Medical LLC | Femoral base plate tha |
| US11000320B2 (en) | 2016-02-04 | 2021-05-11 | Tianjin Zhengtian Medical Instrument Co., Ltd | Medial buttress construct and a fracture fixation device for femoral neck |
| CN106880395A (en) * | 2017-04-28 | 2017-06-23 | 宁波大学医学院附属医院 | Fixation dissection armor plate in a kind of fracture of neck of femur |
| CN107411809B (en) * | 2017-05-18 | 2023-08-18 | 长春圣博玛生物材料有限公司 | Cross moment supports two nail devices |
| CN108852493B (en) * | 2018-07-13 | 2023-07-14 | 湖州学院 | Novel femur neck locking and pressurizing bone fracture plate |
| CN109864810B (en) * | 2019-04-04 | 2024-02-09 | 苏州市康力骨科器械有限公司 | Bone fracture plate for proximal femur fracture |
| CN110507400A (en) * | 2019-06-29 | 2019-11-29 | 孙立山 | The fixed device of distributing anti-rotation in a kind of femur marrow |
| CN110897700A (en) * | 2019-12-26 | 2020-03-24 | 天津市威曼生物材料有限公司 | Thighbone near-end dysmorphism piece |
| CN111281516A (en) * | 2020-02-27 | 2020-06-16 | 天津市威曼生物材料有限公司 | Anatomical external fixation steel plate and fixation system for femoral neck fracture |
| CN111248989A (en) * | 2020-04-01 | 2020-06-09 | 福州市第二医院（福建省福州中西医结合医院、福州市职业病医院） | Femoral neck fracture fixing device |
| CN112168316B (en) * | 2020-10-16 | 2024-11-05 | 加莎热特·杰力勒 | Three fork type internal fixing device for treating femur neck fracture |
| CN113648041B (en) * | 2021-02-02 | 2023-03-10 | 浙江德康医疗器械有限公司 | Internal fixation repair system for intertrochanteric fracture of femur |
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