CN103860249A - Proximal femoral anti-rotation locking device - Google Patents
Proximal femoral anti-rotation locking device Download PDFInfo
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- CN103860249A CN103860249A CN201410086138.8A CN201410086138A CN103860249A CN 103860249 A CN103860249 A CN 103860249A CN 201410086138 A CN201410086138 A CN 201410086138A CN 103860249 A CN103860249 A CN 103860249A
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- 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 proximal femoral anti-rotation locking device, which comprises a bone setting plate and a locking screw, wherein one end of the bone setting plate is a head part, the other end of the bone setting plate is a rod part, the head part is pasted with the greater trochanter, the rod part is pasted with the outer side of the thighbone, the head part is provided with five head threaded locking holes and two needle guide holes, the five head threaded locking holes respectively allow five locking screws extending into the greater trochanter, the femoral neck and the femoral calcar to be arranged on the head of the bone setting plate in a crossed way, the axial line direction of the five head threaded locking holes respectively forms an included angle with the plane and the vertical surface of the bone setting plate plane, through the axial line space, the inserted screws cannot mutually touch each other, and three lower locking screws in the five are crossed with the two upper locking screws. The proximal femoral anti-rotation locking device has the advantages that the locking screw looseness and the bone fracture setting loss can be effectively avoided, and the coxa vara malformation and the like are prevented; in addition, the application range is wide, and the proximal femoral anti-rotation locking device is applicable to instability, thrypsis, osteoporosis and intertrochanteric fracture in the old; finally, the proximal femoral anti-rotation locking device conforms to the proximal femoral anatomical structures, the pasting effect is good, the direction of the locking screws is relatively fixed, and the operation is convenient.
Description
Technical field
The invention belongs to field of medical devices, relate in particular to the anti-locking device that revolves of a kind of near end of thighbone.
Background technology
Femur upper segment mechanotransduction complex structure, the bone trabecula that separately terminates in neck of femur inner side from femoral head cabin fan shape is compression trabeculae, in femoral head, below 1/4 is tension force bone trabecula to the arcuate structure in greater trochanter distally, the axis of power does not overlap with femur axis, in the time that intertrochanteric fracture of the femur occurs, the normal mechanical structure disequilibrium of near end of thighbone skeleton, especially when there is bulk cortical bone fracture neck of femur inner side, its sclerite can not be born the load while heavy burden, compressive stress can not effectively be transmitted by femur square district, tensile stress obviously increases, easily cause coxa vara deformity, inside when the reduction of the fracture cortical bone be difficult to operation appear, above-mentioned factor has all increased femoral intertrochanteric fracture with operation treatment difficulty, affect fracture fixation because have: 1, bone mass, 2, classification of fracture, 3, reduction of the fracture quality, 4, the design of inside-fixture, 5, the storing position of inside-fixture in skeleton.Wherein first 2 is observation factor, and the 3rd is influence factor in art, and the 4th, 5 is to consider emphasis.
Along with deepening continuously of biological study, the appearance of new material and improvement, and the appropriate design of new apparatus is quoted, its Therapeutic Method constantly increases, and inside-fixture is selected to be followed closely to transition such as DHS, dissection armor plate, PFN, PFNA by early stage simple Kirschner wire, forcing screw and condyle screw steel plate, Gamma.
DHS is that single nail is fixing in neck of femur, blood supply of the femoral head is destroyed large, add that osteoporotic skeleton reduces screw hold, anti-swirl effect is poor, can there is head and neck rotation, it is safe fixedly to owe, the tuberosity part syntripsis that osteoporosis is serious, when fracture line involves DHS entry point, or when contrary intertrochanteric fracture, inapplicable DHS fixes, because slip pressurization cannot stop tuberosity to be shifted laterally, slip between itself and steel plate can make to pulverize greater trochanter and be shifted laterally, cause neck of femur to shorten, shortening deformity of extremity, for fracturing and osteoporotic comminuted unstable fracture (part A2 and A3 type) with the little tuberosity of femur and femur square, because inner side after femoral bone tuberosity lacks strong support, compressive stress is difficult to conduct by femur square, cause inside-fixture stress to increase, in addition screw is at sleeve internal congestion, formation pegboard systems is fixed, make to act on vertical force and screw body and the minimizing of sleeve contact area on DHS, all can make frictional resistance improve, cause screw easily to cut femoral head, steel plate fatiguability, fracture, there is coxa vara malunion, inside-fixture displacement, the complication such as deviate from, in addition, in the time of 1 piece of lag screw resected femur intertrochanteric fracture, neck of femur is rotation when unstable, once lower limb are done flexion and extension, screw occurs loosening in neck of femur, thereby the stressed position of screw is changed, easily cut out, when walking, axial and the torsion acting on screw makes a concerted effort to cause screw displacement, wherein screw rotation is the biomechanics initiating agent that screw cuts out.For contrary intertrochanteric fracture, the direction that displacement occurs fracture near-end is consistent with DHS screw glide direction, causes fracture near-end and is outwards shifted, cannot realize fracture end pressurization, during with osteoporosis, be prone to main nail and exit after dynamic pressurized, in it, fixing mortality reaches 24～56%.Gerontal patient, due to osteoporosis, postoperative apparatus is fixing insecure comparatively common, mainly cause that lag screw is loosening, displacement, in operation, the main nail in neck of femur being pressurizeed to fix repeatedly to cause drive screw to slide, make screw loosening and cannot fix, excessive slip is mainly by due to screw and loose sclerotin interlock defective tightness, under sliding force orders about, excessive slip makes screw outstanding, cause fixing unsuccessfully in early days, patient's pain, later stage can be caused near-end medial displacement, near end of thighbone anatomical structure is changed, adductor atrophy, lower limb cripetura and gait change.Steel plate screw is extracted from femoral shaft cortex, and main because common cortex nail is not tight to fixing of loose sclerotin, after gravity applies, screw is outwards extracted under the use of vertical stress component.
The large complication of the postoperative main generation three of near end of thighbone marrow internal fixation system: 1, femoral head neck in turn over and subside, the consequence directly causing is that screw cuts out, main cause is that screw position is too forward, top, or screw position in femoral head is too dark, and the rotation in loose sclerotin of 1 piece of lag screw is unstable causes loosening and secondary screw cuts out.Postoperative screw has cut out a kind of special circumstances, is called Z effect, and being more common in the main nails such as PFN (PFN) and reconstruction nail is 2 pieces of independently screws.This is mainly that 2 pieces of screws are subject to asymmetric load when bearing a heavy burden, turns over power in excessive and circulating load rearward exits 1 piece of lower screw of position, and in the broken ends of fractured bone, turning over subsequently subsides impels 1 piece of higher screw of position to cut out to enter acetabular bone.2, neck of femur shortened deformity, main cause is that postoperative patient bears a heavy burden and causes the broken ends of fractured bone intercalation of subsiding, screw just can outwards skid off, thereby causes pain, limping, even bone does not connect.3, because power conducts to intramedullary pin pinning far-end, and exist femoral shaft anterior arch to clash into, after heavy burden, occur distal locking nail place fracture of shaft of femur.
PFNA is for westerner's anatomical features and design, and the valgus angle of inside-fixture is larger, for asian patients, there is certain difficulty at expansion marrow and the main nail of insertion, may cause larger damage, using when PFNA, the reset that preoperative needs are good and maintaining, and near end of thighbone deformity, the patient that pulp cavity is narrow is cautious use of, and in addition, PFNA is relative intact based on femur size tuberosity and femur square, just can play effectively fixing, for 1, serious osteoporosis, 2, the syntripsis of greater trochanter own, vertical shape fissure fracture (coronalplane and sagittal plane) between greater trochanter or rotor, separate larger, be difficult to the fracture resetting, because can there is making the separation of fracture site when screw blade is inserted, and after inserting, be difficult to revise, fracture end can not produce satisfied plus-pressure, even screw blade, can not produce enough anchors makes a concerted effort, easily cutting femoral head, neck and de-nail occurs, also cause the advantage of operating time and intraoperative blood loss aspect to disappear, simultaneously, because main nail tail end is thick, for pursuing matching, before plug pin, often need to expand marrow and increase femoral trochanter near-end bone loss, while inserting pulp cavity, increased pressure causes amount of bleeding large, old people's coagulation function is poor, cause the lasting Hidden blood loss of the postoperative existence of entry point and fracture site, a little less than elderly patient body compensatory capacity, automatically hematopoietic potential is poor, easily cause postoperative anemia.
Summary of the invention
The object of the present invention is to provide that a kind of near end of thighbone is anti-revolves locking device, be intended to solve that femur is difficult for that balance is fixed, when postoperative easy coxa vara deformity, the reduction of the fracture inside cortical bone be difficult to the problems such as operation appears.
The present invention is achieved in that the anti-locking device that revolves of a kind of near end of thighbone, and for fixing after fracture between human femur under loading and greater trochanter, wherein, greater trochanter one side is connected with femoral head, comprises blade plate and lock screw; Described blade plate comprises one end and the described greater trochanter head away from the semi arch spoon shape of the adaptive laminating of femoral head direction one side, and is connected with described semi arch spoon head portion and with the adaptive bar portion fitting of bone side surface of described femur; Wherein,
Described head leans on away from two drift angle places, bar portion direction left and right and is respectively equipped with a guide pinhole, and is located at first, second, third, fourth between two guide pinholes and the 5th head locking screw thread hole; The first and second head locking screw thread holes are positioned at the top in the 3rd to the 5th head locking screw thread hole, the lock screw that insert respectively in described the first and second head locking screw thread holes is all from extending in neck of femur square portion cortical bone through greater trochanter, and the lock screw that insert respectively in described the 3rd, the 4th and the 5th head locking screw thread hole extend in femoral head neck spongy bone through after greater trochanter;
Described bar portion is provided with some bar portion's locking screw threads hole of order spread configuration from top to bottom, and the lock screw that insert in described bar portion's locking screw thread hole passes from bar portion direction one side from femoral far.
Preferably, prolong described bar portion and do elongated surfaces toward cephalad direction, the angle forming after the axial line in described elongated surfaces and the first to the 5th head locking screw thread hole is crossing is respectively 80 °, 85 °, 100 °, 125 °, 135 °; In the axial line joining in described elongated surfaces and the first to the 5th head locking screw thread hole, do the vertical line perpendicular to elongated surfaces, the angle between described vertical line and the axial line in the first to the 5th head locking screw thread hole is 12 °.
Preferably, adjacent described first, second, third, fourth and the 5th minimum spacing 2mm between head locking screw thread hole between two; And described first, second, third, fourth and the aperture in the 5th head locking screw thread hole is 5.0mm, the minimum calibration of screw thread is 0.1mm.
Preferably, the quantity in described bar portion's locking screw thread hole is 4～12, and the spacing between each described bar portion's locking screw thread hole is 14～20mm.
Preferably, described bar portion's locking screw thread hole comprises single lock hole and hybrid locking hole;
Described hybrid locking hole forms a macropore by two apertures arranged side by side, and wherein, an aperture is locking strip screwed hole, and another aperture is smooth hole, is screwed into respectively fixing for lock screw and plain screw.
Preferably, described lock screw length is 4～130mm
Preferably, described blade plate length is that 180～400mm, thickness are that 4mm, width are 25mm.
The present invention overcomes the deficiencies in the prior art, provides a kind of near end of thighbone to prevent revolving locking device, comprises blade plate and lock screw, blade 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 extend into greater trochanter for 5 pieces respectively, lock screw intersection in neck of femur and femur square is arranged on blade plate head, the axis direction in these 5 head thread lock holes becomes respectively an angle of cut with blade plate plane and vertical thereof, axis spacing makes to insert screw and does not mutually touch, in 5 pieces of lock screw, lower 3 intersect with upper 2, three are stretched in femoral head neck spongy bone below, two are stretched in neck of femur square portion cortical bone above, the anti-fixing nearly folding end of locking that revolves.
The present invention has three peacekeeping angles and stablizes fixing feature, anti-torsion, anti-cutting stress are strong, effectively avoid that lock screw is loosening, the reduction of the fracture is lost, prevent coxa vara deformity, reduce the destruction of periosteum injury and femoral head blood vessel, preserved the blood fortune of bone piece, strengthened that resistance to plucking goes out and anti-rotational force, be applicable to the reduction of the fracture after different collodiaphyseal angles require and avoid the poor region of sclerotin.In addition, wide accommodation of the present invention, be applicable to unstable, pulverizing, osteoporosis, PERCUTANEOUS MULTIPLE PINS FOR, be particularly suitable for I, II type fracture, intertrochanteric fracture has rear in coronal shear fractures line or fracture end to have the damaged situation person of bone, in the time of femoral intertrochanteric comminuted fracture, and the anatomical form spoon shape structure of its near-end, there is the effect of holding, more useful for comminuted fracture.Finally, the present invention is applicable to Grass-roots Hospital, meets near end of thighbone anatomical structure, attaches, lock screw direction is relatively fixing, does not need plastotype, is convenient to install, confirm locking nail direction without the perspective of C-arm repeatedly, operation wound is little, lose blood less, operating time is short, few intercurrent disease.
Brief description of the drawings
Fig. 1 is the anti-using state reference diagram that revolves locking device one embodiment of near end of thighbone of the present invention;
Fig. 2 is the anti-side perspective structure chart that revolves locking device of near end of thighbone in Fig. 1;
Fig. 3 is the structure for amplifying schematic diagram of A part in Fig. 2;
Fig. 4 is the anti-Facad structure schematic diagram that revolves locking device of near end of thighbone in Fig. 1.
Detailed description of the invention
In order to make object of the present invention, technical scheme and advantage clearer, below in conjunction with drawings and Examples, the present invention is further elaborated.Should be appreciated that specific embodiment described herein, only in order to explain the present invention, is not intended to limit the present invention.
As shown in Figures 1 to 4, wherein, Fig. 1 is the anti-using state reference diagram that revolves locking device one embodiment of near end of thighbone of the present invention; Fig. 2 is the anti-side perspective structure chart that revolves locking device of near end of thighbone in Fig. 1; Fig. 3 is the structure for amplifying schematic diagram of A part in Fig. 2; Fig. 4 is the anti-Facad structure schematic diagram that revolves locking device of near end of thighbone in Fig. 1.
Femoral head and cervix and acetabular bone form hip joint jointly, are important connecting device and the load-carrying members of trunk and lower limb.Between the long axis of neck of femur and femoral shaft longitudinal axis, forming collodiaphyseal angle, is 110 °～140 °, average 127 °.In the time that gravity conducts, the line of force is not conducted along neck of femur centrage, but along lesser trochanter of femur, the conduction of neck of femur inner edge, therefore forms cortical bone thickening.If it is large that collodiaphyseal angle becomes, and is coxa valga, diminish as coxa vara.Because collodiaphyseal angle changes, the conduction of exerting all one's strength also changes, and easily causes fracture and articular cartilage degeneration, and traumatic arthritis occurs.Observe from sagittal plane, also not at grade, neck of femur has 12 °～15 ° angles forward, is called top rake for the long axis of neck of femur and the longitudinal axis of femoral shaft, and on proximal femur, outside is greater trochanter, and lower inner side is lesser trochanter.Between greater trochanter, lesser trochanter and rotor, be spongy bone.Intersection in femoral shaft and neck of femur between rotor is the position of bearing scissors stress maximum.Due to the particularity that the line of force distributes, the interior rear connecing in neck of femur, involvement, forms fine and close vertical shape hone lamella, is called femur square.Tabular face is slightly curved, along trochantinian front outside vertical upwards, the upper utmost point and neck of femur posterior bony cortex merge, and after the femoral shaft of the lower utmost point and lesser trochanter below, inner side cortical bone merges, leading edge is connected with inner side cortical bone before proximal femur, and trailing edge is connected in proximal femur outside back.The existence of femur square has determined the stability of intertrochanteric fracture.
The invention provides the anti-locking device that revolves of a kind of near end of thighbone, for fixing after fracture between human femur under loading 11 and greater trochanter 12, wherein, greater trochanter 12 1 sides are connected with femoral head 13, and described near end of thighbone prevents that revolving locking device comprises blade plate 2 and lock screw 3; Described blade plate 2 comprises one end and described greater trochanter 12 head 21 away from the semi arch spoon shape of the adaptive laminating of femoral head 13 direction one side, and be connected with described semi arch spoon head portion 21 and with the bar portion 22 of the adaptive laminating of bone side surface of described femur 11; Wherein, described head 21 leans on away from 22 two drift angle places, directions left and right of bar portion and is respectively equipped with a guide pinhole 211, and is located at the first head locking screw thread hole 212, the second head locking screw thread hole 213, the 3rd head locking screw thread hole 214, four-head portion locking screw thread hole 215 and the 5th head locking screw thread hole 216 between two guide pinholes 211; The first head locking screw thread hole 212 and the second head locking screw thread hole 213 are positioned at the top in the 3rd head locking screw thread hole 214, four-head portion locking screw thread hole 215 and the 5th head locking screw thread hole 216, the lock screw that insert respectively in described the first and second head locking screw thread holes 212,213 is all from extending in neck of femur square portion cortical bone through greater trochanter 12, and the lock screw that insert respectively in described the 3rd, the 4th and the 5th head locking screw thread hole 214,215,216 extend in femoral head 13 neck spongy bone through after greater trochanter 12;
Described bar portion 22 is provided with some bar portion's locking screw threads hole of order spread configuration from top to bottom, and the lock screw that insert in described bar portion's locking screw thread hole passes away from bar portion 22 direction one sides from femur 11.
In embodiments of the present invention, more specifically, prolong described bar portion 22 and do elongated surfaces toward head 21 directions, the angle forming after the axial line in described elongated surfaces and the first to the 5th head locking screw thread hole (212～216) is crossing is respectively 80 °, 85 °, 100 °, 125 °, 135 °; In the axial line joining in described elongated surfaces and the first to the 5th head locking screw thread hole (212～216), do the vertical line perpendicular to elongated surfaces, the angle between described vertical line and the axial line in the first to the 5th head locking screw thread hole (212～216) is 12 °.
In embodiments of the present invention, head 21 pastes greater trochanter 12, femur 11 outsides are pasted by bar portion 22, the guide pinhole that when head 21 is provided with 5 head thread lock holes and 2 and is temporarily fixed on outside greater trochanter of femur for steel plate proximal head, guide pin penetrates, 5 head thread lock holes extend into greater trochanter 12 for 5 pieces respectively, lock screw intersection in neck of femur and femur square is arranged on blade plate head 21, the axis direction in these 5 head thread lock holes becomes respectively an angle of cut with blade plate plane and vertical thereof, axis spacing makes to insert screw and does not mutually touch, in 5 pieces of lock screw, lower 3 intersect with upper 2, three are stretched in femoral head 13 neck spongy bone below, two are stretched in neck of femur square portion cortical bone above, the anti-fixing nearly folding end of locking that revolves.
In embodiments of the present invention, more specifically, blade plate 2 can adopt rustless steel (00
cr18N
i14MO
3), titanium alloy (TC
4) or blunt titanium (TA
2) three kinds of serial patterns.Lock screw 3 can adopt rustless steel (00
cr18N
i14MO
3) and titanium alloy (TC
4) two kinds of serial patterns.
According to the build sign that receives operation people, such as child, middle age and old people etc., provide respectively the size adapting, in embodiments of the present invention, more specifically, the quantity in described bar portion's locking screw thread hole is 4～12, and the spacing between each described bar portion's locking screw thread hole is 14～20mm.Described lock screw 3 length are 4mm～130mm, and described blade plate 2 length are that 180～400mm, thickness are that 4mm, width are 25mm.Minimum spacing 2mm between adjacent the first head locking screw thread hole 212, the second head locking screw thread hole 213, the 3rd head locking screw thread hole 214, four-head portion locking screw thread hole 215 and the 5th head locking screw thread hole 216, and the aperture in the first head locking screw thread hole 212, the second head locking screw thread hole 213, the 3rd head locking screw thread hole 214, four-head portion locking screw thread hole 215 and the 5th head locking screw thread hole 216 is between two 5.0mm, the minimum calibration of screw thread is 0.1mm.
In embodiments of the present invention, more specifically, described bar portion's locking screw thread hole comprises single lock hole and hybrid locking hole, hybrid locking hole forms a macropore by two apertures arranged side by side, one aperture is locking strip screwed hole, another aperture is smooth hole, supplies lock screw and plain screw to be screwed into respectively fixing, to avoid steel plate stress undue concentration.In 4～12 bar portion locking screw thread holes, half is set to single lock hole, and half is set to hybrid locking hole.
In actual application of the present invention, first allow patient's dorsal position, do vertical arc operative incision along femur 11 near-ends, appear fracture end, after reduction by traction, under C shape arm perspective, blade plate 2 near-ends are attached to femur 11 greater trochanter region, far-end is attached at the dry center of femur 11, from the first head locking screw thread hole 212, the second head locking screw thread hole 213, the 3rd head locking screw thread hole 214, four-head portion locking screw thread hole 215 and 216 places, the 5th head locking screw thread hole are screwed into appropriate length lock screw successively, position that each lock screw is screwed into and the degree of depth are described above, to reach the anti-locking action that revolves of correct fractures of neck end, again the locking screw thread hole in bar portion 22 is screwed into successively to the screw of determining of lock appropriate length, after C shape arm perspective fracture fixation, position is satisfied, irrigate, place drain, successively close otch.
Near end of thighbone of the present invention prevents that revolving locking device meets biomechanical principle, blade plate 2 near-ends are flat enlarged portion, can cover greater trochanter lateral part, lock screw 3 has different openings direction separately, lock screw 3 forms firmly entirety with blade plate 2, have three peacekeeping angles and stablize fixing feature, anti-torsion, anti-cutting stress are strong, effectively avoid the loosening and reduction of the fracture of lock screw 3 to lose.As an inner fixed stand, pressure is distributed to each lock screw 3, prevent coxa vara deformity, avoid lock screw 3 to become flexible, extract.Wherein, arc cortex inside neck of femur on boring in femur square after the lock screw depth measurement that the first head locking screw thread hole 212, the second head locking screw thread hole 213 are screwed into, reach the anti-locking action that revolves of correct fractures of neck end, avoid femur 11 near-end inside structures to destroy when serious, lacking blade plate 2 pressure that medial support causes increases, stress concentration, fatigue fracture, fracture delayed union, the cutting of ailhead sclerotin, the problems such as neck of femur cripetura, malunion.It is stable that the stable power friction power not relying between blade plate 2 and sclerotin in angle of blade plate 2 and lock screw 3 provides, blade plate 2 and cortical bone are without close contact, reduce periosteum injury, preserve the blood fortune of bone piece, the frictional force bone fixation cortex of avoiding general steel plate to rely on screw compression steel plate to produce affects blood fortune, causes spongy bone distortion in order to avoid reduce cortical bone intensity.Flexible fastening is under effectively axial load exists, bone interblock has 2mm fine motion, this stimulation is the effective pressure transmission of fracture end, maintain fracture end stable time, avoid stress-shielding effect, can ensure the joint early functional exercise under postoperative non-heavy burden condition, many pieces of lock screw 3 different directions and angle are fixed, coronalplane and sagittal plane have certain adjustable extent, effectively large motility, fixing satisfied to the reset of comminuted fracture, reduce the destruction of femoral head blood vessel, after being applicable to the reduction of the fracture, different collodiaphyseal angles requires and avoids the poor region of sclerotin.Lock screw 3 can reach fracture end by pulling force hole, sclerite is played to the effect of pressurization, ensures the requirement resetting.Three pieces of lock screw directions that are screwed into from the 3rd head locking screw thread hole 214, four-head portion locking screw thread hole 215 and the 5th head locking screw thread hole 216 can form certain angle, distributed in three dimensions in neck of femur, strengthen that resistance to plucking goes out and anti-rotational force, the angle stability of lock screw will bear pressure and effectively be scattered in each assembly, be firmly secured to femoral head neck.
In addition, the anti-locking device wide accommodation that revolves of near end of thighbone of the present invention, be applicable to unstable, pulverizing, osteoporosis, PERCUTANEOUS MULTIPLE PINS FOR, be particularly suitable for I, II type fracture, intertrochanteric fracture has rear in coronal shear fractures line or fracture end to have the damaged situation person of bone, in the time of femoral intertrochanteric comminuted fracture, and the anatomical form spoon shape structure of its near-end, there is the effect of holding, more useful for comminuted fracture.
In addition, the anti-locking device that revolves of near end of thighbone of the present invention is applicable to Grass-roots Hospital, meet near end of thighbone anatomical structure, attach, lock screw 3 directions are relatively fixing, do not need plastotype, be convenient to install, confirm locking nail direction without the perspective of C-arm repeatedly, operation wound is little, lose blood less, operating time is short, few intercurrent disease.
Compare and the shortcoming and defect of prior art, the present invention has following beneficial effect:
(1) near end of thighbone of the present invention is anti-revolves locking device design and meets biomechanical principle, there are three peacekeeping angles and stablize fixing feature, anti-torsion, anti-cutting stress are strong, effectively avoid that lock screw is loosening, the reduction of the fracture is lost, prevent coxa vara deformity, reduced the destruction of periosteum injury and femoral head blood vessel, preserved the blood fortune of bone piece, strengthened that resistance to plucking goes out and anti-rotational force, be applicable to the reduction of the fracture after different collodiaphyseal angles require and avoid the poor region of sclerotin.
(2) the anti-locking device wide accommodation that revolves of near end of thighbone of the present invention, be applicable to unstable, pulverizing, osteoporosis, PERCUTANEOUS MULTIPLE PINS FOR, be particularly suitable for I, II type fracture, intertrochanteric fracture has rear in coronal shear fractures line or fracture end to have the damaged situation person of bone, in the time of femoral intertrochanteric comminuted fracture, the anatomical form spoon shape structure of its near-end, has the effect of holding, more useful for comminuted fracture.
(3) the anti-locking device that revolves of near end of thighbone of the present invention is applicable to Grass-roots Hospital, meet near end of thighbone anatomical structure, attach, lock screw direction is relatively fixing, do not need plastotype, be convenient to install, confirm locking nail direction without the perspective of C-arm repeatedly, operation wound is little, lose blood less, operating time is short, few intercurrent disease.
The foregoing is only preferred embodiment of the present invention, not in order to limit the present invention, all any amendments of doing within the spirit and principles in the present invention, be equal to and replace and improvement etc., within all should being included in protection scope of the present invention.
Claims (7)
1. the anti-locking device that revolves of near end of thighbone, for fixing after fracture between human femur under loading and greater trochanter, wherein, greater trochanter one side is connected with femoral head, it is characterized in that, comprises blade plate and lock screw; Described blade plate comprises one end and the described greater trochanter head away from the semi arch spoon shape of the adaptive laminating of femoral head direction one side, and is connected with described semi arch spoon head portion and with the adaptive bar portion fitting of bone side surface of described femur; Wherein,
Described head leans on away from two drift angle places, bar portion direction left and right and is respectively equipped with a guide pinhole, and is located at first, second, third, fourth between two guide pinholes and the 5th head locking screw thread hole; The first and second head locking screw thread holes are positioned at the top in the 3rd to the 5th head locking screw thread hole, the lock screw that insert respectively in described the first and second head locking screw thread holes is all from extending in neck of femur, square portion cortical bone through greater trochanter, and the lock screw that insert respectively in described the 3rd, the 4th and the 5th head locking screw thread hole extend in femoral head neck spongy bone through after greater trochanter;
Described bar portion is provided with some bar portion's locking screw threads hole of order spread configuration from top to bottom, and the lock screw that insert in described bar portion's locking screw thread hole passes from bar portion direction one side from femoral far.
2. the anti-locking device that revolves of near end of thighbone as claimed in claim 1, it is characterized in that, prolong described bar portion and do elongated surfaces toward cephalad direction, the angle forming after the axial line in described elongated surfaces and the first to the 5th head locking screw thread hole is crossing is respectively 80 °, 85 °, 100 °, 125 °, 135 °;
In the axial line joining in described elongated surfaces and the first to the 5th head locking screw thread hole, do the vertical line perpendicular to elongated surfaces, the angle between described vertical line and the axial line in the first to the 5th head locking screw thread hole is 12 °.
3. near end of thighbone as claimed in claim 2 is anti-revolves locking device, it is characterized in that, between two adjacent described first, second, third, fourth and the 5th minimum spacing 2mm between head locking screw thread hole; And described first, second, third, fourth and the aperture in the 5th head locking screw thread hole is 5.0mm, the minimum calibration of screw thread is 0.1mm.
4. near end of thighbone as claimed in claim 3 is anti-revolves locking device, it is characterized in that, the quantity in described bar portion's locking screw thread hole is 4～12, and the spacing between each described bar portion's locking screw thread hole is 14～20mm.
5. near end of thighbone as claimed in claim 4 is anti-revolves locking device, it is characterized in that, described bar portion's locking screw thread hole comprises single lock hole and hybrid locking hole;
Described hybrid locking hole forms a macropore by two apertures arranged side by side, and wherein, an aperture is locking strip screwed hole, and another aperture is smooth hole, is screwed into respectively fixing for lock screw and plain screw.
6. near end of thighbone as claimed in claim 5 is anti-revolves locking device, it is characterized in that, described lock screw length is 4～130mm.
7. near end of thighbone as claimed in claim 6 is anti-revolves locking device, it is characterized in that, described blade plate length is that 180～400mm, thickness are that 4mm, width are 25mm.
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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 true CN103860249A (en) | 2014-06-18 |
| CN103860249B 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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| CN108852493B (en) * | 2018-07-13 | 2023-07-14 | 湖州学院 | Novel femur neck locking and pressurizing bone fracture plate |
| CN109864810A (en) * | 2019-04-04 | 2019-06-11 | 苏州市康力骨科器械有限公司 | Bone fracture plate for proximal femoral fracture |
| 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 |
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| 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 |
| 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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