CN110037786B - 一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定 - Google Patents

一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定 Download PDF

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CN110037786B
CN110037786B CN201910412098.4A CN201910412098A CN110037786B CN 110037786 B CN110037786 B CN 110037786B CN 201910412098 A CN201910412098 A CN 201910412098A CN 110037786 B CN110037786 B CN 110037786B
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谢凯
杨家赵
方诗元
朱万博
刘雷
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • A61B17/742Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • A61B17/742Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/746Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head

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Abstract

本发明公开了一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,包括,髓内钉杆、拉力螺钉、交锁钉、螺钉和外侧壁锁定钢板;所述髓内钉杆为远端细近端粗并带有一定弯曲度的长轴杆,在髓内钉杆近端设有斜向的螺钉孔;所述外侧壁锁定钢板整体呈拱形,一端为固定端固定在所述髓内钉杆近端顶部,且能够以髓内钉杆近端顶部为中心旋转;另一端设置有开口槽;所述外侧壁锁定钢板主体上还开有若干孔洞,用于植入螺钉固定;所述拉力螺钉一端为螺旋式钻头,中间直径小于所述螺旋式钻头直径,尾端直径大于所述螺旋式钻头直径;使用时所述拉力螺钉的所述螺旋式钻头依次穿过所述的外侧壁锁定钢板上的所述开口槽,和所述的髓内钉杆上的所述螺钉孔。

Description

一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定
技术领域
本发明属于医疗器械领域。涉及一种骨科内固定器械,具体涉及一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定。
背景技术
文献提出股骨粗隆间骨折合并外侧壁骨折的发生率高达88.4%,包括外伤当时造成,以及部分高龄患者骨质疏松严重,术中操作造成的医源性因素;当合并外侧壁骨折时,内固定术后失败率达到11.1%,明显要高于不合并外侧壁骨折时1.66%的内固定失败率。
治疗合并大粗隆及外侧壁骨折的股骨粗隆间骨折,在临床上,常使用髓内钉固定加辅助钢板或钢丝张力带来固定大粗隆及外侧壁的骨折。术中需要充分暴露骨折端以及骨折远端置入钢板的区域,手术创伤较大;由于股骨髓腔内髓内钉的存在,以及高龄患者的骨质疏松的因素,导致置入钢板时的螺钉长度以及螺钉的把持力非常有限,从而使得骨折稳定性相对欠佳,甚至出现钢板螺钉松动的风险。当处理大粗隆骨折(臀中肌止点)时,普通钢板无专门提供肌肉止点重建的位置、钢板宽度有限,使得操作较为困难,固定的可靠程度有限;
股骨粗隆间骨折目前治疗的金标准是髓内钉固定,现有髓内钉髓内钉设计,不能处理大转子及外侧壁骨折问题,容易出现内固定失效、步态异常等并发症;
对于合并大粗隆及外侧壁骨折的股骨粗隆间骨折的治疗,内固定方式需要髓内钉联合辅助钢板或钢丝张力带,需要附加的切口完成,牵涉到不同材质,可能发生电解反应,不利于骨折的愈合。
发明内容
针对现有技术中的不足之处,本发明以一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,解决了上述的难题。
为了上述目的,本发明技术方案如下:
本发明一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,包括,髓内钉杆、拉力螺钉、交锁钉、螺钉和外侧壁锁定钢板;
所述髓内钉杆为远端细近端粗并带有一定弯曲度的长轴杆,在髓内钉杆近端设有斜向的螺钉孔;
所述外侧壁锁定钢板整体呈拱形,一端为固定端固定在所述髓内钉杆近端顶部,且能够以髓内钉杆近端顶部为中心旋转;另一端设置有开口槽;所述外侧壁锁定钢板主体上还开有若干孔洞,用于植入螺钉固定;
所述拉力螺钉一端为螺旋式钻头,中间直径小于所述螺旋式钻头直径,尾端直径大于所述螺旋式钻头直径;
使用时所述拉力螺钉的所述螺旋式钻头依次穿过所述的外侧壁锁定钢板上的所述开口槽,和所述的髓内钉杆上的所述螺钉孔。
进一步的,所述髓内钉杆远端开有交锁钉孔,并且使用交锁钉穿过所述交锁钉孔,从而使所述髓内钉杆进一步的固定。
进一步的,所述开口槽延伸过所述螺钉孔
进一步的,所述拉力螺钉尾端直径大于所述外侧壁锁定钢板上所述开口槽。
有益效果:本发明一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,将外侧壁钢板和髓内钉结合,且二者最终连接为一整体;
固定方便、可靠,提供外侧的支撑,术后内固定失败率相对较小。患者大粗隆重建固定可靠,患者术后臀部疼痛、步态异常等并发症发生率降低。
附图说明
图1为本发明整体结构示意图;
如图1所示:1-髓内钉杆,2-外侧壁锁定钢板,3-拉力螺钉,4-交锁钉,11-近端顶部,12-螺钉孔,13-交锁钉孔,21-固定端,22-开口槽,23-孔洞,31-螺旋式钻头,32-中间,33-尾端。
具体实施方式
以下参照具体的实施例来说明本发明。本领域技术人员能够理解,这些实施例仅用于说明本发明,其不以任何方式限制本发明的范围。
本发明一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,包括,髓内钉杆1,外侧壁锁定钢板2,拉力螺钉3,交锁钉4,近端顶部11,螺钉孔12,交锁钉孔13,固定端21,开口槽22,孔洞23,螺旋式钻头31,中间32,尾端33。
其中,所述髓内钉杆1为远端细近端粗并带有一定弯曲度的长轴杆,在髓内钉杆1近端设有斜向的螺钉孔12。
其中,所述外侧壁锁定钢板2整体呈拱形,一端为固定端21固定在所述髓内钉杆1近端顶部11,且能够以髓内钉杆1近端顶部11为中心旋转;另一端设置有开口槽22。
其中,所述外侧壁锁定钢板2主体上还开有若干孔洞23,用于植入螺钉固定。
其中,所述拉力螺钉3一端为螺旋式钻头31,中间32直径小于所述螺旋式钻头31直径,尾端33直径大于所述螺旋式钻头31直径。
使用时,所述拉力螺钉3的所述螺旋式钻头31依次穿过所述的外侧壁锁定钢板2上的所述开口槽22,和所述的髓内钉杆上1的所述螺钉孔12。
进一步的,所述髓内钉杆1远端开有交锁钉孔13,并且使用交锁钉4穿过所述交锁钉孔13,从而使所述髓内钉1杆进一步的固定。
进一步的,所述开口槽22延伸过所述螺钉孔12.
进一步的,所述拉力螺钉3尾端33直径大于所述外侧壁锁定钢板2上所述开口槽22。
实施例1
治疗使用时,将髓内钉杆1远端由股骨大转子的内侧梨状窝处植入骨髓。
将大粗隆及外侧壁卡压在外侧壁锁定钢板2下方,并采用螺钉穿过其上的所述孔洞23固定;
然后将所述拉力螺钉3的所述螺旋式钻头31依次穿过所述的外侧壁锁定钢板2上的所述开口槽22,和所述的髓内钉杆上1的所述螺钉孔12,钻入股骨头;
最后将所述交锁钉4穿过所述交锁钉孔13,使所述髓内钉1杆进一步的稳固;
从而实现患者股骨粗隆间骨折合并外侧壁骨折的重建固定。

Claims (3)

1.一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,其特征在于:包括,髓内钉杆、拉力螺钉、交锁钉、螺钉和外侧壁锁定钢板;
所述髓内钉杆为远端细近端粗并带有一定弯曲度的长轴杆,在髓内钉杆近端设有斜向的螺钉孔;
所述外侧壁锁定钢板整体呈拱形,一端为固定端固定在所述髓内钉杆近端顶部,且能够以髓内钉杆近端顶部为中心旋转;另一端设置有开口槽;所述外侧壁锁定钢板主体上还开有若干孔洞,用于植入螺钉固定;
所述拉力螺钉一端为螺旋式钻头,中间直径小于所述螺旋式钻头直径,尾端直径大于所述螺旋式钻头直径,所述拉力螺钉尾端直径大于所述外侧壁锁定钢板上所述开口槽;
所述拉力螺钉的所述螺旋式钻头依次穿过所述的外侧壁锁定钢板上的所述开口槽,和所述的髓内钉杆上的所述螺钉孔。
2.如权利要求1所述的一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,其特征在于,所述髓内钉杆远端开有交锁钉孔,并且使用交锁钉穿过所述交锁钉孔,从而使所述髓内钉杆进一步的固定。
3.如权利要求1所述的一种治疗股骨粗隆间骨折合并外侧壁骨折的内固定,其特征在于,所述开口槽延伸过所述螺钉孔。
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US8267972B1 (en) * 2006-12-01 2012-09-18 Gehlert Rick J Bone plate
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CN208838131U (zh) * 2018-06-05 2019-05-10 常州市南翔医疗器械有限公司 股骨内固定***

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