CN107510500A - Anatomical form pubic symphysis locking steel plate - Google Patents
Anatomical form pubic symphysis locking steel plate Download PDFInfo
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- 210000004061 pubic symphysis Anatomy 0.000 title claims abstract description 58
- 229910000831 Steel Inorganic materials 0.000 title claims abstract description 20
- 239000010959 steel Substances 0.000 title claims abstract description 20
- 238000000034 method Methods 0.000 abstract description 8
- 210000000988 bone and bone Anatomy 0.000 abstract description 6
- 238000012360 testing method Methods 0.000 abstract description 5
- 238000005452 bending Methods 0.000 abstract description 4
- 238000004458 analytical method Methods 0.000 abstract description 3
- 210000003689 pubic bone Anatomy 0.000 abstract description 3
- 239000000463 material Substances 0.000 abstract 1
- 206010017076 Fracture Diseases 0.000 description 5
- 208000010392 Bone Fractures Diseases 0.000 description 4
- 238000013461 design Methods 0.000 description 4
- 238000013459 approach Methods 0.000 description 3
- 238000010586 diagram Methods 0.000 description 3
- 238000000926 separation method Methods 0.000 description 3
- 230000000694 effects Effects 0.000 description 2
- 238000002594 fluoroscopy Methods 0.000 description 2
- 210000004197 pelvis Anatomy 0.000 description 2
- 238000010146 3D printing Methods 0.000 description 1
- 206010053206 Fracture displacement Diseases 0.000 description 1
- 206010027677 Fractures and dislocations Diseases 0.000 description 1
- 206010034246 Pelvic fractures Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000002591 computed tomography Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000010197 meta-analysis Methods 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 210000001139 rectus abdominis Anatomy 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- 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
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
- A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- 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
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- 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
- A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
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Abstract
本发明提供一种解剖型耻骨联合锁定钢板，其为一体结构的板体，板体的横截面呈弯弧状，具有一个内凹面和一个外凸面；所述板体的板面的上侧与下侧各设有四个锁定螺孔，上下相对的锁定螺孔的轴线呈空间交错布置。此解剖型耻骨联合锁定钢板的四枚锁定螺钉按力学角度设计，分别固定于耻骨联合两侧骨质最致密的部位，能提供更好的骨把持力及稳定性，经过力学测试及有限元分析，优于传统的双平面重建钢板固定方式，与传统的双八字普通钢板固定方式相比，具有更高的抗旋转能力。本发明为一块钢材使用数控车床切削加工而成，为解剖型设计，贴附于耻骨联合表面，不需预弯，不影响钢板强度。
The invention provides an anatomical symphysis pubis locking plate, which is a plate body with an integral structure, the cross section of the plate body is curved and has an inner concave surface and an outer convex surface; the upper side and the lower side of the plate surface of the plate body are Each side is provided with four locking screw holes, and the axes of the upper and lower relative locking screw holes are spatially staggered. The four locking screws of this anatomical pubic symphysis locking plate are designed according to the mechanical angle, and are respectively fixed on the densest bone on both sides of the pubic symphysis, which can provide better bone holding force and stability. After mechanical testing and finite element analysis , which is superior to the traditional double plane reconstruction steel plate fixation method, and has higher anti-rotation ability than the traditional double eight-character ordinary steel plate fixation method. The invention is a piece of steel material cut and processed by a numerical control lathe, which is anatomically designed and attached to the surface of the pubic symphysis without pre-bending and does not affect the strength of the steel plate.
Description
技术领域technical field
本发明涉及一种解剖型耻骨联合锁定钢板，用于采用斯托帕(Stoppa)入路，切开复位治疗耻骨联合分离及耻骨联合区域骨折时，安放于耻骨联合内表面及上表面，达到解剖复位、坚强内固定的治疗目的的装置。The invention relates to an anatomical pubic symphysis locking plate, which is used for open reduction to treat pubic symphysis separation and pubic symphysis area fracture through Stoppa approach. A device for therapeutic purposes of reduction and rigid internal fixation.
背景技术Background technique
目前，在坎贝尔手术学中，对于治疗耻骨联合分离及耻骨联合区域骨折移位较大的患者时，目前采用两枚普通四孔或五孔重建钢板的装置，其构成(方法)是将两枚重建钢板呈90度角安放于耻骨联合内表面和上表面，不足之处(缺点)是需要术中多次折弯塑型，固定强度差，应力负荷集中，固定不可靠，易出现松动断裂。At present, in Campbell's surgery, for the treatment of patients with pubic symphysis separation and large fracture displacement in the pubic symphysis area, two ordinary four-hole or five-hole reconstruction plates are currently used. The reconstruction plate is placed on the inner and upper surfaces of the pubic symphysis at an angle of 90 degrees. The disadvantages (disadvantages) are that multiple bending and shaping are required during the operation, the fixation strength is poor, the stress load is concentrated, the fixation is unreliable, and it is prone to loosening and fracture.
发明内容Contents of the invention
本发明提供一种解剖型耻骨联合锁定钢板，其目的是克服现有的应用两块重建钢板成角固定技术的上述缺点。The present invention provides an anatomical pubic symphysis locking plate, and its purpose is to overcome the above-mentioned shortcomings of the existing angled fixation technology using two reconstruction plates.
为实现上述目的，本发明采用的技术方案是：In order to achieve the above object, the technical scheme adopted in the present invention is:
一种解剖型耻骨联合锁定钢板，其特征在于：其为一体结构的板体，板体的横截面呈弯弧状，具有一个内凹面和一个外凸面；所述板体的板面的上侧与下侧各设有四个锁定螺孔，上下相对的锁定螺孔的轴线呈空间交错布置。An anatomical pubic symphysis locking steel plate is characterized in that: it is a plate body with an integrated structure, the cross section of the plate body is curved, and has an inner concave surface and an outer convex surface; the upper side of the plate body and the upper side of the plate body Four locking screw holes are respectively arranged on the lower side, and the axes of the upper and lower relative locking screw holes are spatially staggered.
所述的解剖型耻骨联合锁定钢板，其中：所述板面由左板、右板与连接板组成，所述左板与右板呈左右对称，所述连接板的宽度小于左板和右板的宽度，并且连接在左板与右板之间。The anatomical pubic symphysis locking plate, wherein: the plate surface is composed of a left plate, a right plate and a connecting plate, the left plate and the right plate are bilaterally symmetrical, and the width of the connecting plate is smaller than that of the left plate and the right plate width and is connected between the left and right boards.
所述的解剖型耻骨联合锁定钢板，其中：所述连接板的上侧留有凹口，使所述板面呈“C”字形。In the anatomical symphysis pubis locking plate, a notch is left on the upper side of the connecting plate, so that the plate surface is in a "C" shape.
所述的解剖型耻骨联合锁定钢板，其中：所述左板的上侧和下侧以及所述右板的上侧和下侧均设有两个所述锁定螺孔。The anatomical pubic symphysis locking plate, wherein: the upper and lower sides of the left plate and the upper and lower sides of the right plate are provided with two locking screw holes.
所述的解剖型耻骨联合锁定钢板，其中：所述锁定螺孔均由所述外凸面向所述内凹面呈渐缩状。The anatomical pubic symphysis locking plate, wherein: the locking screw holes are tapered from the outer convex surface to the inner concave surface.
所述的解剖型耻骨联合锁定钢板，其中：上下相对的锁定螺孔的轴线呈空间交错垂直布置。In the anatomical pubic symphysis locking plate, the axes of the upper and lower opposite locking screw holes are vertically arranged in a spatially staggered manner.
与现有技术相比较，本发明具有的有益效果是：Compared with prior art, the beneficial effect that the present invention has is:
1.此解剖型耻骨联合锁定钢板的四枚锁定螺钉按力学角度设计，分别固定于耻骨联合两侧骨质最致密的部位，能提供更好的骨把持力及稳定性，经过力学测试及有限元分析，得出的结果是优于传统的双平面重建钢板固定方式。1. The four locking screws of this anatomical pubic symphysis locking plate are designed according to the mechanical point of view, and are respectively fixed on the most dense bone parts on both sides of the pubic symphysis, which can provide better bone holding force and stability. After mechanical tests and limited Meta-analyses, the results obtained are superior to traditional biplane reconstruction with plate fixation.
2.此解剖型耻骨联合锁定钢板采用立体设计，经力学测试，与传统的双八字普通钢板固定方式相比，具有更高的抗旋转能力。2. This anatomical pubic symphysis locking plate adopts a three-dimensional design. After mechanical testing, it has a higher anti-rotation ability than the traditional double-horizontal common plate fixation method.
3，此解剖型耻骨联合锁定钢板为一块钢材使用数控车床切削加工而成，为解剖型设计，贴附于耻骨联合表面，不需预弯，不影响钢板强度，传统的两块互成90度的重建钢板固定方式中需要对钢板折弯，影响固定强度。3. This anatomical pubic symphysis locking plate is a piece of steel cut and processed by a CNC lathe. It is anatomically designed and attached to the surface of the pubic symphysis. It does not require pre-bending and does not affect the strength of the plate. The traditional two pieces are 90 degrees to each other. The steel plate needs to be bent in the rebuilding steel plate fixing method, which affects the fixing strength.
4.此解剖型耻骨联合锁定钢板的锁定螺孔经过计算机辅助设计，确保所有锁定螺钉不会打入到耻骨联合的关节间隙内。4. The locking screw holes of this anatomical pubic symphysis locking plate have been computer-aided to ensure that all locking screws will not be driven into the joint space of the pubic symphysis.
5.此解剖型耻骨联合锁定钢板体积较小，厚度较厚(3mm)，便于安放，又能提供较好的力学强度。5. This anatomical pubic symphysis locking plate is small in size and thick (3mm), which is easy to place and can provide better mechanical strength.
附图说明Description of drawings
图1是本发明提供的解剖型耻骨联合锁定钢板的立体结构示意图；Fig. 1 is the schematic diagram of the three-dimensional structure of the anatomical pubic symphysis locking plate provided by the present invention;
图2是沿图1的A-A线剖开后的断开示意图；Fig. 2 is a broken schematic diagram after being cut along the A-A line of Fig. 1;
图3、图4是本发明提供的解剖型耻骨联合锁定钢板的其他方向的立体结构示意图；Fig. 3 and Fig. 4 are three-dimensional structural schematic diagrams of other directions of the anatomical pubic symphysis locking plate provided by the present invention;
图5是锁定螺孔的局部剖视图。Fig. 5 is a partial sectional view of the locking screw hole.
附图标记说明：左板1；右板2；连接板3；锁定螺孔4；内凹面A；外凸面B。Explanation of reference signs: left plate 1; right plate 2; connecting plate 3; locking screw hole 4; inner concave surface A; outer convex surface B.
具体实施方式detailed description
本发明的技术方案是根据耻骨联合部位的解剖学形态特点，设计了治疗耻骨联合分离及耻骨联合区域骨折的解剖型耻骨联合锁定钢板。The technical solution of the present invention is to design an anatomical symphysis pubis locking steel plate for treating separation of the pubic symphysis and fractures in the pubic symphysis area according to the anatomical shape characteristics of the pubic symphysis.
耻骨联合的骨折脱位多数是由于较大暴力引起的，前环的稳定性被破坏，应用于耻骨联合局部的钢板必须结构稳定，解剖形态良好，外形符合耻骨联合生理结构，同时具有抗扭转能力强，安放操作简单固定可靠等特点。Most fractures and dislocations of the pubic symphysis are caused by greater violence, and the stability of the anterior ring is destroyed. The steel plate applied to the pubic symphysis must have a stable structure, good anatomical shape, conform to the physiological structure of the pubic symphysis, and have strong torsion resistance , Easy to place and operate, fixed and reliable.
本发明提供的解剖型耻骨联合锁定钢板，是应用三维CT扫描，通过测量正常成年人骨盆的dicom数据(一种三维重建CT数据输出的格式)，根据测量的骨盆数据，按3D打印设计，按照骨盆耻骨联合区域的结构和形态设计而成。The anatomical pubic symphysis locking plate provided by the present invention uses three-dimensional CT scanning to measure the dicom data (a format for outputting three-dimensional reconstructed CT data) of normal adult pelvis, and according to the measured pelvic data, design according to 3D printing, according to The structure and morphology of the pubic symphysis area of the pelvis are designed.
如图1、图2、图3、图4所示，是本发明提供的一种解剖型耻骨联合锁定钢板，其为一体结构的板体，板体的板面大小为20*45mm；As shown in Fig. 1, Fig. 2, Fig. 3 and Fig. 4, it is an anatomical pubic symphysis locking plate provided by the present invention, which is a plate body with an integrated structure, and the plate surface size of the plate body is 20*45mm;
如图1所示，所述板面由左板1、右板2与连接板3组成，所述左板1与右板2呈左右对称，所述连接板3的宽度小于左板1和右板2的宽度，并且连接在左板1与右板2之间；在本实施例中，所述连接板3的上侧留有凹口31，使所述板面呈“C”字形；As shown in Figure 1, the board surface is composed of a left board 1, a right board 2 and a connecting board 3, the left board 1 and the right board 2 are left-right symmetrical, and the width of the connecting board 3 is smaller than the left board 1 and the right board The width of the board 2 is connected between the left board 1 and the right board 2; in this embodiment, a notch 31 is left on the upper side of the connecting board 3, so that the board surface is in a "C" shape;
如图2所示，所述板体的横截面呈弯弧状，具有一个内凹面A和一个外凸面B；As shown in Figure 2, the cross-section of the plate is curved, with an inner concave surface A and an outer convex surface B;
如图1、图2、图3、图4、图5所示，所述左板1的上侧和下侧以及所述右板2的上侧和下侧均设有两个锁定螺孔4，所述锁定螺孔4均由所述外凸面B向所述内凹面A呈渐缩状，以供锁定螺钉固定。而且，上下相对的锁定螺孔4的轴线呈空间交错布置，以免锁定螺钉发生干涉，在较佳的实施例中，上下相对的锁定螺孔4的轴线呈空间交错垂直布置，经力学检测及有限元分析，这样的布置方式具有最佳力学效果。As shown in Fig. 1, Fig. 2, Fig. 3, Fig. 4 and Fig. 5, the upper side and the lower side of the left plate 1 and the upper side and the lower side of the right plate 2 are provided with two locking screw holes 4 , the locking screw holes 4 are tapered from the outer convex surface B to the inner concave surface A for fixing by locking screws. Moreover, the axes of the upper and lower relative locking screw holes 4 are spatially staggered to avoid interference of the locking screws. In a preferred embodiment, the axes of the upper and lower relative locking screw holes 4 are spatially staggered and vertically arranged. According to meta-analysis, such an arrangement has the best mechanical effect.
所述解剖型耻骨联合锁定钢板还按解剖形态，设计有凹陷及突出部，用于安放钢板时确定安放于腹直肌止点处使用，确保钢板放置于耻骨联合关节正中处，确保所有锁定螺钉均打入到耻骨上支骨质最好的部位。The anatomical pubic symphysis locking plate is also designed with depressions and protrusions according to the anatomical shape. When placing the plate, it must be placed at the insertion point of the rectus abdominis muscle to ensure that the plate is placed in the middle of the pubic symphysis joint and that all locking screws Both penetrated into the best part of the suprapubic ramus.
本发明使用的时候，对于耻骨联合骨折脱位的患者，待病人病情平稳后，于受伤后3-5日行骨盆骨折切开复位内固定手术，根据骨折具体部位手术入路，通常选择斯托帕(Stoppa)入路+髂窝入路，先将骨折复位，透视下证实复位良好，使用克氏针临时固定，将锁定钢板的内凹面A贴合安放于耻骨联合表面(内凹面A的上侧贴合于耻骨联合内表面，内凹面A的下侧贴合于耻骨联合上表面)，沿中心孔打入导针临时固定，再次透视确定钢板位置安放无误后，使用电钻沿锁定导向器套筒钻孔，测深，按照测量长度结果选择螺钉，依次打入八枚锁定螺钉。再次透视检查钢板及螺钉安放位置恰当。逐层缝合切口。When the present invention is used, for patients with fracture and dislocation of the pubic symphysis, after the patient's condition is stable, open reduction and internal fixation of pelvic fractures will be performed 3-5 days after the injury. (Stoppa) approach + iliac fossa approach, firstly reduce the fracture, and confirm that the reduction is good under fluoroscopy, temporarily fix it with a Kirschner wire, and place the inner concave surface A of the locking plate on the surface of the pubic symphysis (the upper side of the inner concave surface A Attach to the inner surface of the pubic symphysis, the lower side of the inner concave surface A is attached to the upper surface of the pubic symphysis), drive a guide pin along the center hole for temporary fixation, and then use an electric drill to lock the guide sleeve Drill holes, measure depth, select screws according to the measured length results, and drive eight locking screws in sequence. Check the position of the plate and screw again by fluoroscopy. Suture the incision layer by layer.
本发明提供的解剖型耻骨联合锁定钢板与目前应用的90度垂直安放两块重建钢板板相比具有以下优点：The anatomical pubic symphysis locking plate provided by the present invention has the following advantages compared with the currently applied 90-degree vertical placement of two reconstruction plates:
1.此解剖型耻骨联合锁定钢板的四枚锁定螺钉按力学角度设计，分别固定于耻骨联合两侧骨质最致密的部位，能提供更好的骨把持力及稳定性，经过力学测试及有限元分析，得出的结果是优于传统的双平面重建钢板固定方式。1. The four locking screws of this anatomical pubic symphysis locking plate are designed according to the mechanical point of view, and are respectively fixed on the most dense bone parts on both sides of the pubic symphysis, which can provide better bone holding force and stability. After mechanical tests and limited Meta-analyses, the results obtained are superior to traditional biplane reconstruction with plate fixation.
2.此解剖型耻骨联合锁定钢板采用立体设计，经力学测试，与传统的双八字普通钢板固定方式相比，具有更高的抗旋转能力。2. This anatomical pubic symphysis locking plate adopts a three-dimensional design. After mechanical testing, it has a higher anti-rotation ability than the traditional double-horizontal common plate fixation method.
3，此解剖型耻骨联合锁定钢板为一块钢材使用数控车床切削加工而成，为解剖型设计，贴附于耻骨联合表面，不需预弯，不影响钢板强度，传统的两块互成90度的重建钢板固定方式中需要对钢板折弯，影响固定强度。3. This anatomical pubic symphysis locking plate is a piece of steel cut and processed by a CNC lathe. It is anatomically designed and attached to the surface of the pubic symphysis. It does not require pre-bending and does not affect the strength of the plate. The traditional two pieces are 90 degrees to each other. The steel plate needs to be bent in the rebuilding steel plate fixing method, which affects the fixing strength.
4.此解剖型耻骨联合锁定钢板的锁定螺孔4经过计算机辅助设计，确保所有锁定螺钉不会打入到耻骨联合的关节间隙内。4. The locking screw hole 4 of the anatomical pubic symphysis locking plate has been computer-aided to ensure that all locking screws will not be driven into the joint space of the pubic symphysis.
5.此解剖型耻骨联合锁定钢板体积较小，厚度较厚，便于安放，又能提供较好的力学强度。5. This anatomical pubic symphysis locking plate is small in size and thick in thickness, which is easy to place and can provide better mechanical strength.
6.即使少数病人由于解剖变异，使得钢板不能完全贴附，此解剖型耻骨联合锁定钢板具有角度稳定性，仍可提供足够的强度，普通钢板在解剖变异的病人中不易贴附，易在固定过程中产生在移位，影响治疗效果，此解剖型耻骨联合锁定钢板具有明显的优势。6. Even if a small number of patients cannot fully attach the plate due to anatomical variation, this anatomical pubic symphysis locking plate has angular stability and can still provide sufficient strength. Ordinary plates are not easy to attach in patients with anatomical variation and are easy to fix Displacement occurs during the process, which affects the treatment effect. This anatomical pubic symphysis locking plate has obvious advantages.
Claims (6)
- A kind of 1. anatomical form pubic symphysis locking steel plate, it is characterised in that：Its plate body being structure as a whole, the cross section of plate body are in Curved arc shape, there is an inner concave and an arcuate surface；The upside of the plate face of the plate body is respectively provided with four locking spiral shells with downside Hole, the axis of locking screw opposing upper and lower are arranged in spatial intersecting.
- 2. anatomical form pubic symphysis locking steel plate according to claim 1, it is characterised in that：The plate face is by left plate, the right side Plate forms with connecting plate, and the left plate and right panel are symmetrical, and the width of the connecting plate is less than the width of left plate and right panel, And it is connected between left plate and right panel.
- 3. anatomical form pubic symphysis locking steel plate according to claim 2, it is characterised in that：Stayed on the upside of the connecting plate There is recess, it is in " C " font to make the plate face.
- 4. anatomical form pubic symphysis locking steel plate according to claim 2, it is characterised in that：The upside of the left plate is with Side and the upper side and lower side of the right panel are equipped with two locking screws.
- 5. the anatomical form pubic symphysis locking steel plate according to claim 1 or 4, it is characterised in that：The locking screw is equal By the evagination towards the inner concave be in gradually-reducing shape.
- 6. anatomical form pubic symphysis locking steel plate according to claim 1, it is characterised in that：Locking screw opposing upper and lower Axis be arranged vertically in spatial intersecting.
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Application publication date: 20171226 |