CN100450452C - Hybrid interlocking proximal femoral fracture fixation - Google Patents

Abstract

The present invention provides a unique and novel internal fixation for fixing an intracapsular fracture of a femoral neck while using minimal invasive procedure. The fixation comprises a hollowed or full tubular member having a sharp end and a blunt end that is adapted to be implanted while slightly crossing the fracture line. The tubular member is provided with three passages that extend from the sharp end to the blunt end. Three lag screws are adapted to pass through the passages and extend outwardly beyond said sharp end while thread that is provided in the lag screws so as to allow compression of fragments of the bone. The lag screws are provided with screw heads so as to prevent the screws from being fully inserted into the passages and through the trochanteric cortical bone. The internal fixation can be incorporated into an external-interlocking fixation apparatus that comprises the tubular member laterally provided with bores on opposite sides of the tubular member wherein pin screws are adapted to be inserted through the bores so as to interlock the tubular member and additional pin screw that are nailed in a distal femoral fragment. A connecting member is adapted to secure the pin screws together so as to assure stability of the tubular member within the bone and to allow reduction, correction and fixation in the intra and post-operative period.

Description

Hybrid interlocking proximal femoral fracture fixation device

technical field

The present invention relates to fracture fixation devices. More specifically, the present invention relates to a hybrid interlocking proximal femoral fracture fixation device.

Background technique

Internal fixation using nails and plates is a well-known surgical procedure used in orthopedics and traumatology to fix proximal femoral fractures. The procedure is a conventional, direct-view major surgical procedure with several potentials for serious complications. The firmness of the fracture site was considered an advantage in the past, therefore, many existing internal fixation devices are constructed to eliminate all motion (except for proper sliding) at the fracture site. It is now generally accepted that some gentle movement over the fracture site is essential for better fracture healing and even for promoting the formation of healing tissue. However, this view does not apply to intracapsular fractures of the femoral neck.

Internal fixation has many disadvantages, including an extremely expensive and complicated procedure, which can be complicated by severe blood loss and infection. At the same time, it cannot be refixed after surgery, and the morbidity and mortality are high, and because of the surgery, the hospital stay is long, which is related to perioperative complications. The mortality rate of proximal (intracapsular) fractures following internal fixation is alarming: 3% in the hospital, 25% within one year of surgery, and 40% within two years. In terms of postoperative local and systemic complications, 30% of patients experienced avascular necrosis, 43% of patients experienced nonunion and 50% of patients experienced perioperative. The above data were collected from "Clinical Orthopedics and Related Research" (348:22-28, 1998 and 399:119-128, 2002). These papers are incorporated herein by reference, and similar results have been published and published in many other scientific review journals. The consequences of intertrochanteric/peritchanteric (intratrochanteric) fractures are equally astounding: 15% of patients experience fixation failure, 10% die within one year, 20% die within two years, 20% have concurrent infection, and 30% heal bad. Similar results were found for subtrochanteric fractures.

An external fixation device that attaches nails and screws to the femoral head, neck, and shaft of the femur by external devices fixes the fracture. The therapy is performed through a minimally invasive interventional procedure.

Clinical evidence clearly demonstrates that external fixation for peritrochanteric femoral neck fractures significantly reduces mortality compared with traditional internal fixation, reduces the incidence of serious complications, and improves fracture outcomes soon after surgery. External fixation has other advantages, such as shorter hospital stays and medical costs, less postoperative pain at fracture sites, easier patient care, less need for bed rest, and less chance of developing bedsores, pulmonary embolism, and lung infections sex. For trochanteric fractures, external fixation is a safe and reliable therapy to stabilize the bone. In general, external fixation therapy enhances multiple adaptability, and is easy to operate, minimizing operation time, bleeding and tissue damage.

In US Patent No. 5,429,641 a percutaneous connection therapy for the fractured upper femur is disclosed. Another example of an outer rotor clamp is disclosed in US Patent No. 5,728,096. European patent application EP 0940124A1 teaches a variable-angle external fixation device for trochanteric fractures. The above mentioned by reference, and other similar devices for external fixation of trochanteric fractures have a number of disadvantages and can lead to complications. Femoral neck screw penetration into the acetabulum due to severe osteoporosis is one such hazard. Other disadvantages include hardware failure, discomfort caused by the device being fixed in a lateral posterior bulging position, and extreme difficulty for the patient in supine or sitting positions.

There has therefore long been a need to provide an external device that eliminates the serious disadvantages of existing devices for external fixation of peritrochanteric fractures, which are fixation devices that can lead to serious complications .

For internal fixation devices, specially designed screws have also been developed, for example a screw element is disclosed in PCT application with publication number WO 00/67653, a intramedullary cavity nail is disclosed in EP 0853923, or US patent application 2002/ A fixator is disclosed in 0143333. Another commercially available fixation device is the Bone Stapler for Unstable Femoral Neck Fractures (Bidirectional Sliding Screw), distributed by the company Fixano S.A., and employs the D.S.S. system.

Contents of the invention

One object of the present invention is to provide a hybrid interlocking fixation device for proximal femur fractures, which can perform minimally invasive fracture fixation. Therefore, the callus of extracapsular fracture can be formed earlier.

Another object of the present invention is to provide an internal fixation device for intracapsular fractures of the femoral neck, which has continuous sliding compression performance.

Another object of the present invention is to provide a hybrid interlocking proximal femoral fracture fixation device, which combines a unique new internal nail with a non-rigid fixator for extracapsular fracture treatment.

Yet another object of the present invention is to provide a fixation technique that is easy to apply and suitable for minor operations with a short time.

Therefore, according to one aspect of the present invention, an internal fixation device for fixing intracapsular fractures of the femoral neck is provided, comprising:

pipe fittings with pointed and blunt ends;

having at least one channel in said tubing, wherein said at least one channel extends from said tip to said blunt end;

at least one screw adapted to pass through said at least one channel and adapted to extend outwardly beyond said tip;

having threads on a portion of said at least one screw adapted to extend beyond said tip;

said at least one screw has a screw head, thereby preventing said at least one screw from being fully inserted into said at least one channel;

Thus, after the tube is implanted into the bone approximately 1 or 2 mm past the fracture line, the at least one screw is inserted into the at least one channel to maintain pressure on the bone fragment for healing.

In addition, according to another preferred embodiment of the present invention, the pipe is a hollow pipe.

Furthermore, according to another preferred embodiment of the present invention, said hollow tube has a contour, such as circular, elliptical, triangular or rectangular.

Furthermore, according to another preferred embodiment of the present invention, the hollow tube has holes.

In addition, according to another preferred embodiment of the present invention, the hollow tube can be filled with a bone graft material that promotes bone healing.

In addition, according to another preferred embodiment of the present invention, the pipe member combined with the at least one screw can perform pressing and sliding motions.

Furthermore, according to another preferred embodiment of the present invention, there are three lag screws corresponding to the three passages on the pipe.

Furthermore, according to another preferred embodiment of the present invention, said tubular member is inserted into the femoral neck at an angle of approximately 95-110 degrees relative to the axis of the femoral shaft, thereby positioning the lower of said three lag screws in the femoral neck. Orient the inferior quadrant of the bone so that the inferior screw touches the firm cortical bone of the femoral calcar on the femoral neck slightly.

In addition, according to another preferred embodiment of the present invention, the three screws are suitable for piercing the lower quadrant of the femoral head, preferably the distal part of the vascular distribution of the round ligament.

Furthermore, according to another preferred embodiment of the present invention, wherein the tubular member is equipped with a bone substitute so that bone is grafted into the tubular member.

In addition, according to another preferred embodiment of the present invention, the fixation device is further interlocked with an external fixator.

In addition, according to another aspect of the present invention, a hybrid interlocking fixation device for fixing fractures of the femoral neck or the area around the trochanter is provided, comprising:

pipe fittings with pointed and blunt ends;

having at least one channel in said tubing, wherein said at least one channel extends from said tip to said blunt end;

at least one screw adapted to pass through said at least one channel and adapted to extend outwardly beyond said tip;

at least two boreholes located on the sides of the pipe, wherein the at least two boreholes are located on opposite sides of the pipe;

at least four pins, at least two of which are adapted to interlock between the tube and the at least two pins, and at least two of which are driven into the distal bone fragment to ensure that the tube is fixed in the bone ;

a connecting element for securing fastening with said at least two pins;

Thus, the tube is implanted in the femoral neck, the at least one screw is inserted into and passes through the at least one channel, thereby maintaining the pressure and sliding of the fracture block, and at least one pin is driven into the In the tube, through the at least two drill holes, at least two pins are driven into the distal bone fragment at the same time, wherein the pins are connected to each other through the connecting element, so as to facilitate bone healing, and can be used in The connection of the connecting elements is corrected post-operatively.

Furthermore, according to another preferred embodiment of the present invention, the pipe has three channels.

Furthermore, according to another preferred embodiment of the present invention, there are three screws passing through said three channels.

Furthermore, according to another preferred embodiment of the present invention, the pipe has six boreholes, wherein the six boreholes are arranged in such a way that three of the six boreholes are located in the six boreholes Opposite the other three of the pipes, and three pins are adapted to be inserted into the six bores from one side of the pipe to the other.

In addition, according to another preferred embodiment of the present invention, the connecting element comprises two clamps and a screw rod, wherein one clamp clamps the pin driven into the distal bone fragment, and the second clamp Clamp the pin screwed into the pipe.

Furthermore, according to another preferred embodiment of the present invention, the distance between the one clamper and the second clamper can be changed by rotating the rotating screw, wherein the screw is passed through two ball-headed Bolts are connected to each clamp, wherein the rotary screw is threaded onto the two bolts.

Furthermore, according to another preferred embodiment of the present invention, the misalignment of the hybrid interlocking fixation device can be corrected during the intraoperative and postoperative stages.

In addition, according to another preferred embodiment of the present invention, the pipe has a plurality of small wall holes.

Furthermore, according to another preferred embodiment of the present invention, the device has a radiolucent or other material.

Furthermore, according to another preferred embodiment of the present invention, the device may be disposable.

Furthermore, according to another preferred embodiment of the present invention, the tubular member has a bone substitute, enabling bone to be grafted into the tubular member.

According to still another aspect of the present invention, a kind of method for fixing intracapsular fracture of femoral neck is provided, and described method comprises:

An internal fixator is provided, comprising:

pipe fittings with pointed and blunt ends;

having at least one channel in said tubing, wherein said at least one channel extends from said tip to said blunt end;

at least one screw adapted to pass through said at least one channel and adapted to extend outwardly beyond said tip;

having threads on a portion of said at least one screw adapted to extend beyond said tip;

said at least one screw has a screw head, thereby preventing said at least one screw from being fully inserted into said at least one channel;

Make a 2-3 cm long skin incision in the trochanteric area;

inserting the tube into the femoral neck at an angle of about 95-110 degrees relative to the axis of the femoral shaft such that one of the lower screws of the at least one lag screw can be positioned in the lower quadrant of the femoral head, thereby Bring the lower screw into light contact with the solid cortical bone of the calcar, with the tube about 1 or 2 millimeters beyond the fracture line;

Screw in the at least one lag screw.

In addition, according to another preferred embodiment of the present invention, the method further includes:

providing at least two boreholes on said tubular member, wherein said at least two boreholes are located on opposite sides of said tubular member;

interlocking at least two pins in said at least two bore holes;

driving at least two pins into the distal bone fragment;

A connecting element is provided which is adapted to fasten the pins together.

In addition, according to another preferred embodiment of the present invention, the method further includes correction, reduction and fixation in the intraoperative and postoperative stages.

A brief description of the drawings

In order to better understand the invention and appreciate its practical application, the following drawings are provided herein and reference is made to said drawings. The same components are denoted by the same reference numerals.

It should be noted that the given drawings are only examples and preferred embodiments, and do not limit the scope defined in the description and claims.

Accompanying drawing 1 shows an isometric view of a hybrid interlocking proximal femoral fracture fixation device according to one of the preferred embodiments of the present invention, showing that the device is positioned on the femur;

Figures 2a-c show views of a staple cartridge implantation device according to a preferred embodiment of the present invention;

Accompanying drawing 3 has shown the isometric view of the staple cartridge implantation device according to another preferred embodiment of the present invention;

Figure 4 is an isometric view of a connecting element according to one of the preferred embodiments of the present invention, wherein said connecting element is connected to an external fixation device;

Accompanying drawing 5 has shown the parts exploded view of hybrid interlocking type proximal femur fracture fixation device as shown in accompanying drawing 1;

Figure 6 shows an isometric view of a staple cartridge implant secured during internal fixation therapy, in accordance with one of the preferred embodiments of the present invention.

Specific Embodiments of the Invention

The invention provides a unique new fixation device for femur fracture, which comprises an internal fixator and an external fixator. Internal fixators for intracapsular fractures of the femoral neck generally consist of a tube with a sharp end and a blunt end. The tubing can be a hollow element or a solid element. At least one channel is provided in the tubular member extending from the tip to the blunt end, wherein the channel is adapted to receive a lag screw. The screw is adapted to protrude outwardly beyond the tip and to penetrate into the bone so as to maintain a fixation pressure at the fracture to facilitate healing, and therefore, the portion of the screw protruding beyond the tip is threaded. Preferably there are three channels and corresponding lag screws. A tube may also be referred to herein as a staple box. The cartridge and lag screw can be used "alone" as a novel and unique internal fixator for intracapsular femoral neck fractures, or as an alternative to traditional cannulated screws to which bone can be grafted in the box. The nail box and lag screws are mainly used for subcapital femoral fractures of Garden I, II, and III types.

The staple cartridge is inserted into the bone in a minimally invasive procedure. Preferably, the staple cartridge is inserted through a 2-3 cm long skin incision. The outer part of the retainer is adapted to be removed at a subsequent outpatient visit without anesthesia. Preferably, the external parts of the device are made of disposable titanium or other radiolucent material, such as FDA (US Food and Drug Administration) approved aluminum 70.

Referring now to FIG. 1 , there is shown an isometric view of a hybrid interlocking proximal femoral fracture fixation device according to one preferred embodiment of the present invention, showing the device positioned on the femur. A severely injured femur (especially the femoral neck) is difficult to immobilize. In general, the fracture fixation device of the present invention is a combination of internal and external fixation devices with an interlocking system that connects the fractured upper segment to the femoral shaft via a standardized fixator. In case of varus or valgus deformity, rotation and angulation shortening due to offset, compression, rotation, angulation or translation, the present invention can be used for postoperative positioning correction . The cause of dislocation may be related to poor surgical technique and poor bone quality.

The hybrid device 10 includes a staple cartridge 12 adapted to be implanted in a femoral neck 14 . Preferably, staple cartridge 12 is a hollow tubular member having a pointed end 16 and a blunt end 18 . Alternatively, the element may be a non-hollow solid structure. The hollowness in the nail box 12 allows fluid to be conducted through the central hole of the screw, thereby alleviating the high-pressure intracystic hemorrhage caused by fracture bleeding. Catheterization reduces damage to the existing fragile vascular supply, thereby reducing one of the common causes of avascular necrosis of the femoral head. The staple cassette 12 is inserted approximately 1-2 mm past the fracture line so that the bone is implanted in the cassette with autograft, allograft or other bone substitute.

Preferably, three compression screws 20 (lag screws) are adapted to pass through the cartridge 12 (from the blunt end 18 of the cartridge to the pointed end 16 of the cartridge) so that the screws extend proximately through the pointed end, and screwed into the bone. The extension of the screw across the staple box 12 minimizes the metal volume pierced into the femoral head, ie, the subchondral bone tissue can be reached using only three lag screws. The minimization of metal penetration volume prevents or avoids further damage to the vascular supply to the femoral head. Each compression screw 20 has a screw head 22 which prevents the screw from moving fully into the magazine 12 . Compression screws 20 are used to pressurize the fracture to speed up healing. The nail box is combined with the compression screw for sliding and compression. Compression is applied from the blunt end 18 of the nail and the screw head to secure the lateral trochanteric cortex around the blunt end of the cartridge. The extension of the compression screw 20 is threaded 24 to facilitate the compression process. Due to the unique structure of the nail, the nail cartridge 12 and compression screw 20 are able to introduce bone fragments and allow them to graft onto the fracture line. In the case that the nail box is hollow, bone grafting material can be filled inside the nail box 12 to promote rapid healing of the bone.

The staple cartridge 12 is inserted into the femoral neck by a minimally invasive procedure. The optimal angle for cartridge and screw penetration is between 100 and 110 degrees relative to the femoral axis. Thereby, the lower screw of the compression screw 20 can be positioned in such a way that it slightly touches the strong cortical bone of the calcar femori. All three compression screws 20 only penetrate the lower half of the femoral head, preferably distal to the vascularity of the round ligament, which avoids damage to intraosseous reticular blood circulation and further reduces the risk of avascular necrosis. possibility.

The external fixator 100 connects the nail box 12 and the distal bone block 102 . Preferably, the external fixator 100 includes 6 pins, of which three pins 104 are driven into the nail box 12 and the other three pins 106 are driven into the distal bone fragment 102 . All six pins, namely 104 and 106 , are interconnected by a connecting element 108 , wherein said connecting element 108 comprises an upper clamp 110 clamping pin 104 and a lower clamp 112 clamping pin 106 . Preferably, the connecting element 108 further comprises two rotating screws 114 connecting the upper gripper 110 and the lower gripper 112 . The rotary screw 114 is of variable length and can connect the grippers in such a way that the grippers have a certain degree of freedom of positioning relative to each other. This aspect will be described in detail below.

Referring now to Figures 2a-c, there are shown views of a cartridge implantation device according to one of the preferred embodiments of the present invention. The staple cartridge implantation device is suitable for incorporation in the hybrid interlocking fixation device of the present invention. The nail box 12 is a hollow tubular member with a triangular cross-section having a pointed end 16, a blunt end 18 and a hollow hole 55 through which the nail passes. The staple cartridge 12 is adapted to be inserted into the femoral neck, ie the staple cartridge 12 is pushed into the bone by its tip 18 . Preferably, the staple cartridge 12 is made of a material that does not cause repulsion, such as titanium. In the case of bone grafts, the staple cassette can be left in place or removed after the bone has healed. At the same time, the nail box and the compression screws passing through it can also be made of biodegradable materials.

In order to allow access and growth of bone with the grafting material, it is preferred that the walls of the staple case 12 have a plurality of relatively small apertures 54 to allow bone to grow into the staple case 12 . Alternatively, autografted bone or osteoconductive/inductive material is introduced into the staple cartridge 12 (not shown) to promote bone growth.

The staple cartridge 12 has channels, preferably three channels 56 , through the tube wall and extending from the pointed end 16 to the blunt end 18 . Channel 56 has openings at both the pointed and blunt ends through which compression lag screws 20 (shown in FIG. 1 ) can be threaded after staple cartridge 12 has been implanted. The nail case of the present invention has pressurization and sliding properties when used with the three lag screws.

Referring now to FIG. 6, there is shown an isometric view of a staple cartridge implant secured during an internal fixation therapy in accordance with a preferred embodiment of the present invention. The nail box 12 is implanted in the femur while three lag screws 20 are interlocked in the nail box 12 .

Looking back at accompanying drawing 2, further, nail box 12 has boreholes, preferably six boreholes, wherein three boreholes 58 are positioned in a row on one side of the tube, and the other three boreholes (viewed in the figure Less than) then be located on the row opposite with three boreholes 58. The two opposing rows of boreholes are offset from each other, for example one row is closer to the blunt end 18 and three boreholes 58 are closer to the tip 16 . All drilled holes have external threads to allow suitable screws to be screwed into them. The bore is adapted to accommodate three pins 104 of an external fixation device (as shown in Figure 1 ), which are screwed into the bore from side to side while maintaining the staple cartridge and the predetermined angle between the pins.

Referring now to Figure 3, there is shown an isometric view of a cartridge implantation device in accordance with another preferred embodiment of the present invention. The nail box 200 is a hollow tube with a circular cross section. Similar to the staple cartridge previously shown herein, staple cartridge 200 has a pointed end 16 and a blunt end 18 adapted to be pushed into bone. Preferably, three channels 56 are adapted to receive lag screws (not shown in the figures of said screws).

Referring now to Figure 1, it is clearly shown that the three compression screws 20 are inserted into the channels 56 and the three pins 104 are inserted into the six side bores. As described above, pin 104 is interconnected with pin 106 , wherein pin 106 is driven into distal bone fragment 102 . The connection angle of the pin 104 to the staple case 12 is such that the external fixation device can be directed anteriorly. As a result, the external fixation device protrudes to the anterior distal portion of the patient's thigh without interfering with the patient's hip flexion or supine position.

A key point to note is that the cartridge can also be implanted using compression lag screws without the use of external fixation devices for fracture fixation in the femoral neck as shown in Figure 6 .

Referring now to Fig. 4, there is shown an isometric view of a connecting element according to one of the preferred embodiments of the present invention, wherein the connecting element is connected to an external fixation device. The connecting element is part of the external fixation device of the present invention. Connecting element 108 is adapted to externally secure and support a staple cartridge implanted in the femoral neck. Connecting element 108 is designed to allow for intra-operative correction as well as post-operative correction. The connection element 108 thus comprises an upper clamp 110 clamping the pin 104 and a lower clamp 112 clamping the pin 106 (the pin is not shown in FIG. 4 ). Preferably, the connecting element 108 further comprises two rotating screws 114 connecting the upper gripper 110 and the lower gripper 112 .

The upper clamp 110 has three bores 150 adapted to pass the pins 104 therethrough. The pin 104 is secured in the bore 150 by three Allen screws 152 (the pin is not shown in FIG. 4 ). In a similar manner, a part of the lower clamp 112 also has three drill holes 154, the pins 106 (not shown) can be inserted into the three drill holes 154, and three Allen screws can be passed 156 fixes the pin 106 in place.

Preferably, the rotating screw 114 connecting the upper gripper 110 and the lower gripper 112 is a tube with an internal thread and preferably also has a hexagonal auxiliary piece 158, wherein the hexagonal auxiliary piece 158 facilitates the rotation of the screw 114 Rotation, thereby facilitating adjustment of the distance and angle between the upper clamp 110 and the lower clamp 112. The rotary screw 114 has a bolt 160 which is screwed into the tube, penetrating all four openings of the tube. Each bolt 160 has a ball head 162, wherein said ball head 162 is securely clamped in a corresponding clamp. When the bolt head is clamped in the clamp, the rotating screw 114 can rotate around its longitudinal axis to change the distance between the two clamps, so that the orientation of the external fixation device can be changed after surgery . Each bolt head 162 is clamped in a recess of the clamp, wherein said recess is adapted to be pressed tightly onto said bolt head by an Allen screw 164 . When wanting to change the angle of the rotating screw rod 114 relative to the clamp, the doctor can loosen the Allen screw 164 to rotate the spherical head in the clamp recess. When turning to a suitable position, the doctor tightens the Allen screw 164 again. It is critical to note that the device of the present invention uses very few parts, thereby facilitating its manipulation by the surgeon.

Referring now to FIG. 5 , there is shown an exploded view of the hybrid interlocking proximal femoral fracture fixation device shown in FIG. 1 . The figure clearly shows the minimal but effective number of components that make up the device of the invention. Cassette 12 is adapted to be implanted in the femoral neck, and to accommodate compression screws 20 . In some cases, internal fixation is sufficient and external fixation is no longer required. Where external fixation is required, pins 104 are inserted into staple cartridge 12, while pins 106 are driven into the distal bone fragment. The pins are connected to each other by connecting elements comprising grippers 110 and 112 and a rotating screw 114 . One of the important features of the connecting element of the invention is that it is rotatable only by means of the Allen screw and that the length of its rotating screw can be changed.

The device of the invention is used for intracapsular and extracapsular femoral fractures (including subtrochanteric fractures).

One of the important features of the hybrid interlocking fixation device of the present invention is that the therapy of the present invention is the application of minimally invasive surgical instruments, which mainly perform repeated tissue punctures through pins. This fact facilitates the use of robotics so that surgical procedures can be performed in a fast, accurate and controlled manner.

The outer parts of the hybrid interlocking fixation device are adapted to be removed without anesthesia in a subsequent outpatient visit. The nail box and screws inside stay in place. Nail boxes and screws can be made of bioabsorbable material, which absorbs over time.

Components of the anchor in the insert can be made of radiolucent material to facilitate subsequent x-rays during bone healing.

Alternatively, the device of the present invention may be assembled with disposable components to reduce costs.

It should be clearly understood that the descriptions of the embodiments and the accompanying drawings in the specification are only for helping to better understand the present invention, rather than limiting the scope covered in the claims.

It should also be clearly understood that those skilled in the art may make adjustments and changes covered in the claims to the above-mentioned drawings and embodiments after thoroughly reading the description of the present invention.

Claims (10)

1. inner fixing device in order to resected femur neck intracapsular fracture comprises:

Pipe fitting with most advanced and sophisticated and blunt end;

Described pipe fitting is hollow pipe fitting and has at least one passage that on the sidewall of described pipe fitting wherein, described at least one passage extends to described blunt end from described tip;

At least one screw, it is suitable for passing described at least one passage, and is suitable for crossing described tip and stretches out;

On the part of described at least one screw that is suitable for extending across described tip, be threaded;

Described at least one screw has head of screw, thereby prevents that described at least one screw all is inserted in described at least one passage;

Thus, be transplanted in the neck of femur at described pipe fitting, cross after 1 millimeter of the fracture line, described at least one screw is inserted in described at least one passage, thereby keeps the pressure of bone piece, is beneficial to healing.

2. according to the inner fixing device described in the claim 1, wherein, described hollow pipe fitting can have a circle, ellipse, triangle or orthogonal profile.

3. according to the inner fixing device described in the claim 1, wherein, described pipe fitting has hole.

4. according to the inner fixing device described in the claim 1, wherein, described hollow pipe fitting is filled with the bone grafting material that promotes knitting.

5. according to the inner fixing device described in the claim 1, wherein, the described pipe fitting that lumps together with described at least one set screws can pressurize and gliding motility.

6. according to the inner fixing device described in the claim 1, wherein, have three square head screws, with corresponding to three passages on the sidewall of described pipe fitting.

7. according to the inner fixing device described in the claim 6, wherein, described pipe fitting is with the angle with respect to femoral shaft axis 95-110 degree, be inserted in the neck of femur, thereby make the following screw in the described screw be positioned capital lower quadrant direction, so that described screw down touches the hard matter cortical bone of bigelow's septum on the neck of femur.

8. according to the inner fixing device described in the claim 1, wherein, described screw be suitable for puncturing capital lower quadrant, the i.e. distant place of round ligament vascularity.

9. according to the inner fixing device described in the claim 1, wherein, described hollow pipe fitting is equipped with bone substitute, so that bone is transplanted in the described pipe fitting.

10. according to the inner fixing device described in the claim 1, wherein, described inner fixing device is further interlocked with external fixator.

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