CN108210047B - Proximal femoral fracture intramedullary fixation device - Google Patents
Proximal femoral fracture intramedullary fixation device Download PDFInfo
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- CN108210047B CN108210047B CN201810258021.1A CN201810258021A CN108210047B CN 108210047 B CN108210047 B CN 108210047B CN 201810258021 A CN201810258021 A CN 201810258021A CN 108210047 B CN108210047 B CN 108210047B
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- 208000008924 Femoral Fractures Diseases 0.000 title claims abstract 10
- 210000000689 upper leg Anatomy 0.000 claims abstract description 81
- 238000004873 anchoring Methods 0.000 claims abstract description 33
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 24
- 230000001054 cortical effect Effects 0.000 claims abstract description 20
- 230000000149 penetrating effect Effects 0.000 claims 1
- 208000010392 Bone Fractures Diseases 0.000 abstract description 16
- 230000000694 effects Effects 0.000 abstract description 6
- 238000000034 method Methods 0.000 abstract description 4
- 241001391944 Commicarpus scandens Species 0.000 abstract description 2
- 238000000465 moulding Methods 0.000 abstract description 2
- 230000008569 process Effects 0.000 abstract description 2
- 230000008093 supporting effect Effects 0.000 abstract description 2
- 238000001356 surgical procedure Methods 0.000 abstract 1
- 230000002459 sustained effect Effects 0.000 abstract 1
- 206010017076 Fracture Diseases 0.000 description 16
- 206010016454 Femur fracture Diseases 0.000 description 12
- 210000002436 femur neck Anatomy 0.000 description 11
- UZUFPBIDKMEQEQ-UHFFFAOYSA-N perfluorononanoic acid Chemical compound OC(=O)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)C(F)(F)F UZUFPBIDKMEQEQ-UHFFFAOYSA-N 0.000 description 9
- 230000007547 defect Effects 0.000 description 5
- 210000003205 muscle Anatomy 0.000 description 5
- 238000013461 design Methods 0.000 description 4
- 238000010009 beating Methods 0.000 description 3
- 230000008901 benefit Effects 0.000 description 3
- 238000006073 displacement reaction Methods 0.000 description 3
- 230000035882 stress Effects 0.000 description 3
- 208000001132 Osteoporosis Diseases 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 210000003692 ilium Anatomy 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 230000001737 promoting effect Effects 0.000 description 2
- 230000009467 reduction Effects 0.000 description 2
- 238000004904 shortening Methods 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 208000024779 Comminuted Fractures Diseases 0.000 description 1
- 241000196324 Embryophyta Species 0.000 description 1
- 210000000588 acetabulum Anatomy 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 210000001185 bone marrow Anatomy 0.000 description 1
- 238000003776 cleavage reaction Methods 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000018109 developmental process Effects 0.000 description 1
- 238000000605 extraction Methods 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 230000007017 scission Effects 0.000 description 1
- 230000006641 stabilisation Effects 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000001694 thigh bone Anatomy 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
Classifications
-
- 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
- A61B17/72—Intramedullary devices, e.g. pins or nails
- A61B17/7233—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone
- A61B17/725—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone with locking pins or screws of special form
-
- 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
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices 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
- A61B17/744—Devices 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
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
本发明公开了一种股骨近端骨折髓内固定装置，包括股骨近端锚定支撑体、股骨髓内钉和髓内钉近端锁钉，所述股骨近端锚定支撑体和所述股骨髓内钉通过所述髓内钉近端锁钉连接；本申请的股骨近端锚定支撑体可由一体成型工艺制作而成，因此，具有更好的机械强度，不易折断，可显著降低内固定失效发生率。本申请的股骨近端锚定支撑体可与股骨近端四周皮质骨，尤其是与内侧皮质紧密充分的贴附，因此，股骨近端锚定支撑体能充分支撑四周皮质，尤其是对内侧皮质的支撑作用，对骨折术后的持续稳定，至关重要。股骨近端锚定支撑体的体部和股骨髓内钉的接触面积很大，可显著减少应力集中的效应，减少两者接触部位折断的几率。
The present invention discloses a proximal femoral fracture intramedullary fixation device, comprising a proximal femoral anchoring support, a femoral intramedullary nail and a proximal intramedullary nail locking nail, wherein the proximal femoral anchoring support and the femoral intramedullary nail are connected by the proximal intramedullary nail locking nail; the proximal femoral anchoring support of the present application can be made by an integrated molding process, therefore, it has better mechanical strength, is not easy to break, and can significantly reduce the incidence of internal fixation failure. The proximal femoral anchoring support of the present application can be closely and fully attached to the cortical bones around the proximal femur, especially to the medial cortex, therefore, the proximal femoral anchoring support can fully support the surrounding cortex, especially the supporting effect on the medial cortex, which is crucial for the sustained stability after fracture surgery. The contact area between the body of the proximal femoral anchoring support and the femoral intramedullary nail is large, which can significantly reduce the effect of stress concentration and reduce the probability of fracture at the contact part between the two.
Description
Technical Field
The invention relates to medical supplies, in particular to an intramedullary fixation device for proximal femur fracture.
Background
1. With the development of the aging society, the patients with proximal femur fracture have many internal fixation treatment methods in China, such as bone fracture plates, DHS, PFN, PFNA and I nterTAN each year.
PFNA is currently common and is representative of intramedullary fixation. The PFNA has the advantages of intramedullary fixation, shortening of the arm of force compared with the intramedullary fixation, better mechanical property, and finishing of anti-rotation and angulation stabilization by one inner plant of the spiral blade.
2. The existing fixing device for the proximal end of the femur mainly comprises a main nail arranged in the marrow of the femoral shaft and an auxiliary nail arranged in the femoral neck. The main nail is required to be provided with a through hole along the axial direction of the femoral neck, the through hole is oblique and is in accordance with the structure of the proximal end of the femur, and the auxiliary nail penetrates through the oblique through hole to complete the installation of the device. Disadvantages of the prior art:
a. is not effective in some cases, such as cases of proximal lateral cortical fractures of the femur or osteoporosis. Because cleavage of the outer cortex of the proximal femur on the coronal plane occurs when placing the intramedullary nail, the nail slips out, i.e., the proximal bone does not contain the proximal end of the nail.
B. Design defects. One of the features of PFNA design is to allow the screw blade to slide outward along the bore of the intramedullary nail, creating a compression effect on the femoral neck and tuberosity, promoting fracture healing, but also causing shortening of the femoral neck, withdrawal of the screw blade, resulting in friction between the screw blade tail and the iliotibial band, producing a ringing and pain.
C. Cutting of the femoral head, including cutting obliquely upward toward the loading zone and "centralising" cuts, cannot be completely avoided. The authors state that "centrality" cut-out is an important cause of PFNA failure. The reason for this is that the secondary nails (screw blades) need to pass through the through holes of the primary nails, which can only be designed in a circular or quasi-circular shape for easy installation, and the diameter cannot be excessively large.
D. the reduction and insertion of the intramedullary nail are difficult in cases of subclavian fracture of the femur using PFNA. The subclavian fracture is defined as a fracture of the femoral shaft with the main fracture line within 5cm of the distal end of the lesser tuberosity of the femur. Because of the special anatomical and biomechanical characteristics of the area, the fracture under the femur tuberosity is difficult to reset, and the risk of internal fixation failure is high. The subtuberosity area is the transition area from the femoral neck to the femoral shaft, structurally is the area where cancellous bone migrates to cortical bone, and the cortex is thinner than other parts of the femoral shaft, is a biomechanical stress concentration point, and the fracture is mostly crushed and often accompanies the medial cortex defect. The subtuberosity area of the femur has many strong muscle groups attached, the proximal femur has abductor, abductor and ilium muscles of the hip joint, and the distal femur has adductor and extensor muscle groups. Once a fracture occurs, the original muscle balance is destroyed, and complex displacement occurs. Proximal abduction, supination, and flexion displacement of the fracture results from abduction, supination, and lumbar ilium traction, while distal contraction and adduction displacement results from strong traction of the extensor group and adductor muscles. Such complex stresses lead to clinical repositioning and fixation difficulties. Distal abduction should be performed during the reduction, but abduction of the lower limb tends to cause difficulty in placement of the PFNA. PFNA has only a certain strength of supporting effect on medial cortical defect cases, and fracture patients under femoral tuberosity still have the condition that internal fixtures are broken. The pressurizing effect brought by the sliding of the spiral blade only has the effect of promoting the accelerated healing between the femoral neck and the femoral tuberosity, so the PFNA treatment effect is poor for the case of the medial cortical defect.
Disclosure of Invention
The invention aims to provide an intramedullary fixation device for proximal femur fracture, which solves the technical problems in the prior art.
The invention provides a proximal femur fracture intramedullary fixing device, which comprises a proximal femur anchoring support body, a proximal femur intramedullary nail and a proximal intramedullary nail locking nail, wherein the proximal femur anchoring support body is connected with the proximal femur intramedullary nail through the proximal intramedullary nail locking nail;
The proximal femur anchoring support body comprises a head and a body, wherein the head extends out of a neck part used for being connected with the body, an I-shaped blade is arranged on the head, and the body is a conical body with wide upper part and narrow lower part;
the head, the neck and the body are provided with a Kirschner wire guide hole which penetrates through the head, the neck and the body, and threads are arranged in the Kirschner wire guide hole of the body;
The body is provided with a longitudinally-opened mounting hole, an oval section is arranged in the mounting hole, the femoral intramedullary nail is arranged in the body through the mounting hole, the femoral intramedullary nail is provided with a boss matched with the oval section, and two ends of the femoral intramedullary nail extend to the outer side of the body respectively;
the proximal end lock pin of the intramedullary nail is in threaded connection with the Kirschner wire guide hole in the body part and penetrates through the proximal end lock hole on the intramedullary nail of the femur;
the distal locking hole is arranged on the femur intramedullary nail, and the intramedullary nail distal locking nail is arranged in the distal locking hole.
Further, a plurality of cross-disposed proximal femoral cortical locking screws are mounted to the body.
Further, the body is provided with a plurality of through holes which are arranged in a crossing way, and a plurality of thighbone near-end cortex locking screws are in threaded connection with the through holes.
Further, a cross-shaped slot is formed in the bottom of the body, and the section of the slot is V-shaped.
Further, the top of the femoral intramedullary nail is provided with threads for connecting a sliding hammer.
Further, a thread section for connecting the sliding hammer is arranged on the oval section of the mounting hole.
Further, the head portion is at an angle of 130 degrees to the body portion, and the proximal locking hole is at an angle of 130 degrees to the axis of the femoral intramedullary nail.
Further, the proximal locking hole is a circular hole, and the distal locking hole is a square slot.
Further, the medial curve of the proximal femoral anchor support conforms to the curve of the medial cortex of the proximal femur.
Further, the proximal locking nail of the intramedullary nail comprises a rod body section and a thread section arranged at the end part of the rod body section, and an inner hexagonal groove is formed in the end face of the thread section.
The intramedullary fixing device for proximal femur fracture provided by the invention has the following advantages:
1. The proximal femur anchoring support body can be manufactured by an integral molding process, so that the proximal femur anchoring support body has better mechanical strength, is not easy to break, and can remarkably reduce the incidence rate of internal fixation failure.
2. The proximal femur anchoring support body can be tightly and fully attached to the peripheral cortical bone of the proximal femur, particularly to the inner cortex, so that the proximal femur anchoring support body can fully support the peripheral cortex, particularly to the inner cortex, and is of great importance to the continuous stability after fracture operation.
3. The inner side curve of the proximal femur anchoring support body is consistent with the curve of the proximal femur inner side cortex, the proximal femur inner side cortex can be fully attached to the proximal femur inner side cortex, and the proximal femur inner side cortex is tightly attached, so that the I-shaped blade cannot move to the acetabulum direction along the axis of the femoral neck any more, and then the femoral head is cut, and the centrality cutting out can be reduced to the minimum.
4. The contact area between the body of the proximal femur anchoring support body and the femoral intramedullary nail is large, so that the effect of stress concentration can be obviously reduced, and the probability of fracture at the contact position of the body and the femoral intramedullary nail is reduced.
5. The design concept and the use mode of the patent determine the width of the I-shaped blade without being limited by other aspects, and the width is determined only by the diameter of the femoral neck of a patient. The width of the I-shaped blade is large, so that the I-shaped blade is closer to cortical bone, and because the cortical bone is harder than cancellous bone, the anti-rotation and anti-pulling mechanical advantage of the I-shaped blade is better.
6. The I-shaped blade has the unique shape design, has good function of preventing the proximal end of femur from rotating, can furthest reduce the cutting of the femoral head in the oblique upward direction, has small cross-sectional area, has little damage to the bone and the blood circulation of the bone when being injected, is not easy to cause femoral head necrosis, and can squeeze cancellous bone to the surrounding cortex, so that the bone is more compact.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic structural view of an intramedullary fixation device for proximal femur fracture according to an embodiment of the present invention;
FIG. 2 is a schematic view of a first perspective structure of a proximal femoral anchor support according to an embodiment of the present invention;
FIG. 3 is a schematic view of a second perspective view of a proximal femoral anchor support according to an embodiment of the present invention;
FIG. 4 is a schematic view of a third perspective view of a proximal femoral anchor support according to an embodiment of the present invention;
FIG. 5 is a schematic view of a proximal femoral anchor support according to a fourth embodiment of the present invention;
FIG. 6 is a schematic view of a proximal femoral anchor support and proximal femoral cortical locking screw according to an embodiment of the present invention from a first perspective;
FIG. 7 is a schematic view of a proximal femur anchoring support and a proximal femur cortex locking screw according to a second embodiment of the present invention;
FIG. 8 is a schematic view showing the structure of a femoral intramedullary nail according to a first embodiment of the present invention;
FIG. 9 is a schematic view of a proximal end locking pin of an intramedullary nail according to a first embodiment of the present invention;
Fig. 10 is a schematic structural view of an i-shaped blade according to an embodiment of the present invention.
Reference numerals 1-proximal femur anchor support, 2-femoral intramedullary nail, 3-proximal intramedullary nail lock nail, 11-head, 12-body, 13-neck, 4-I-shaped blade, 5-Kirschner wire guide hole, 6-mounting hole, 21-boss, 7-distal intramedullary nail lock nail, 8-proximal femur cortex lock screw, 121-through hole, 9-slot, 31-rod section, 32-thread section.
Detailed Description
The following description of the embodiments of the present invention will be made apparent and fully in view of the accompanying drawings, in which some, but not all embodiments of the invention are shown. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In the description of the present invention, it should be noted that the directions or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. are based on the directions or positional relationships shown in the drawings, are merely for convenience of describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, unless explicitly stated or limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, mechanically connected, electrically connected, directly connected, indirectly connected via an intervening medium, or in communication between two elements. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances.
Embodiment one:
Fig. 1 is a schematic structural view of an intramedullary fixation device for proximal femur fracture according to an embodiment of the present invention; fig. 2 is a schematic view of a first perspective structure of a proximal femur anchor support provided by an embodiment of the present invention, fig. 3 is a schematic view of a second perspective structure of a proximal femur anchor support provided by an embodiment of the present invention, fig. 4 is a schematic view of a third perspective structure of a proximal femur anchor support provided by an embodiment of the present invention, fig. 5 is a schematic view of a fourth perspective structure of a proximal femur anchor support provided by an embodiment of the present invention, fig. 6 is a schematic view of a first perspective structure of a proximal femur anchor support and a proximal femur cortical locking screw provided by an embodiment of the present invention, fig. 7 is a schematic view of a second perspective structure of a proximal femur anchor support and a proximal femur cortical locking screw provided by an embodiment of the present invention, fig. 8 is a schematic view of an intramedullary nail provided by an embodiment of the present invention, fig. 9 is a schematic view of a proximal intramedullary nail provided by an embodiment of the present invention, fig. 10 is a schematic view of an i-blade provided by an embodiment of the present invention, fig. 1-10 is a schematic view of a proximal femur anchor support provided by an embodiment of the present invention, fig. 6 is a proximal femur anchor support and a proximal femur bone marrow nail is provided by an intramedullary nail, and a proximal femur anchor device is connected to a proximal femur anchor device 1 and a proximal femur bone nail 2 is provided by a proximal femur bone nail 2;
the proximal femur anchoring support body 1 comprises a head 11 and a body 12, wherein the head 11 extends out of a neck 13 used for being connected with the body 12, an I-shaped blade 4 is arranged on the head 11, and the body 12 is a cone with wide upper part and narrow lower part;
The head 11, the neck 13 and the body 12 are provided with a Kirschner wire guide hole 5 which penetrates through the head, threads are arranged in the Kirschner wire guide hole 5 of the body 12, the threads have three functions, ① are connected with a hollow handle and used for holding, the proximal end of a femur is hit to anchor a support body so that the proximal end of the femur is placed into the femur along the Kirschner wire, ② is connected with a sight which is used for placing a distal locking nail of an intramedullary nail, ③ is used for locking the proximal locking nail of the intramedullary nail, the threads are matched with the threads of the proximal locking nail of the intramedullary nail and can be mutually locked, and the proximal locking nail of the femur is used for statically locking the intramedullary nail of the femur.
The body 12 is provided with a longitudinally-opened mounting hole 6, an elliptical section is arranged in the mounting hole 6, the femoral intramedullary nail 2 is arranged in the body 12 through the mounting hole 6, the femoral intramedullary nail 2 is provided with a boss 21 matched with the elliptical section, and two ends of the femoral intramedullary nail 2 respectively extend to the outer side of the body 12;
the proximal locking hole is formed in the femoral intramedullary nail 2, the proximal locking nail 3 of the intramedullary nail is in threaded connection with the Kirschner wire guide hole 5 in the body 12 and penetrates through the proximal locking hole in the femoral intramedullary nail 2, and the proximal locking nail 3 of the intramedullary nail is used for preventing the femoral intramedullary nail 2 from sliding up and down in the mounting hole 6.
The femoral intramedullary nail 2 is provided with a distal lock hole, and an intramedullary nail distal lock nail 7 is arranged in the distal lock hole.
Specifically, the body 12 has mounted thereon a plurality of intersecting proximal femoral cortical locking screws 8.
Specifically, the body 12 is provided with a plurality of through holes 121 which are arranged in a crossing way, and a plurality of proximal femur cortex locking screws 8 are in threaded connection with the through holes 121.
The proximal femur cortex locking screw 8 is used for fixing the proximal femur anterior and posterior cortical bone and the body 12 of the proximal femur anchoring support body 1, the proximal femur is more stable and the proximal femur anchoring support body 1 is fixed into a whole through the proximal femur cortex locking screw 8, and the proximal femur cortex locking screws 8 are mutually intersected and arranged, so that movement of the proximal femur anchoring support body 1 in all directions can be limited. Thus, the proximal cortical locking screw 8 prevents the I-blade 4 from cutting or backing out of the femoral head and neck.
Specifically, a cross-shaped slot 9 is formed in the bottom of the body 12, and the section of the slot 9 is V-shaped.
The cross section of the slot 9 is V-shaped, which is beneficial to the placement of the femoral intramedullary nail 2, and the outer slot is deeper, so as to observe the condition of the femoral intramedullary nail 2 in the proximal femur anchoring support body 1 and make treatment.
In particular, the top of said femoral intramedullary nail 2 is provided with a thread for connection to a sliding hammer for use in extraction.
Specifically, the oval section of the mounting hole 6 is provided with a thread for connecting a sliding hammer, and when the sliding hammer is used for femoral head replacement, the sliding hammer is taken out from the proximal end of the femur along the longitudinal axis direction after the femoral neck is cut off.
Specifically, the head 11 forms an angle of 130 degrees with the body 12, which is slightly larger than 127 degrees of the average value of the femoral neck shaft angle, and the proximal lock hole forms an angle of 130 degrees with the axis of the femoral intramedullary nail 2.
Specifically, the proximal lock hole is a circular hole, and the distal lock hole is a square slot.
Specifically, the medial curve of the proximal femoral anchor support 1 coincides with the curve of the medial cortex of the proximal femur.
Specifically, the proximal locking nail 3 of the intramedullary nail comprises a rod body section 31 and a thread section 32 arranged at the end part of the rod body section 31, and an inner hexagonal groove is formed in the end face of the thread section 32, so that the proximal locking nail 3 of the intramedullary nail can be conveniently taken out for use.
The using method of the intramedullary fixing device for proximal femur fracture is as follows:
case selection includes proximal femur fractures including fractures within 5cm of the femoral neck, intertrochanter, microtuberosity and subtuberosity.
The application is suitable for treating the unstable proximal femur fracture. Such as comminuted fractures of the medial or lateral cortex of the proximal femur, subclavian fractures, and cases of unstable proximal femur fracture where other fixation systems are considered to be poorly effective.
The soft tissue on the outer side of the proximal thigh of the affected side is cut, a guide Kirschner wire is placed after the outer cortex of the tuberosity of the femur is exposed, the guide Kirschner wire enters according to the front dip angle and the neck stem angle of a patient, and the guide Kirschner wire is in an optimal position through perspective, namely, the righting piece is positioned on the center and is positioned on the lower side, and the lateral piece is positioned on the center. The outer cortex is windowed with a special fenestration bone knife along the guide Kirschner wire, and the femoral intramedullary nail 2 is embedded into the distal intramedullary canal after windowing. The proximal femur cancellous bone condition is assessed, and if cancellous bone is dense, the bone mass is removed as appropriate to facilitate placement of the proximal femur anchoring support 1. The proximal femur anchoring support 1 is placed along the guide Kirschner wire and is connected with a hollow screwdriver for holding and beating, the proximal femur anchoring support 1 is placed in the proximal femur bone by beating, the user needs to pay attention not to beat too deeply, and beating is performed when needed, so that the anchoring function of the proximal femur anchoring support is reduced due to the fact that the user needs to quit too deeply. The extracted cancellous bone is planted at the medial cortical defect or other fracture. If osteoporosis is considered, proximal femoral cortical locking screws 8 may be used if necessary to secure the proximal anterior and posterior cortical bone of the femur and to lock to the proximal femoral anchor support 1.
When the body 12 of the proximal femur anchoring support 1 and the femoral medullary cavity are parallel, if necessary, the femoral intramedullary nail 2 is slid proximally, placed in the mounting hole 6 of the proximal femur anchoring support 1, and after reaching a predetermined position, the aiming device is connected, and the intramedullary nail distal locking nail 7 is placed. The sight is removed and the intramedullary proximal locking nail 3 is placed. And (3) the bone pieces taken down during windowing are planted back at the outer cortex windowing position. The soft tissue is sutured and the operation is ended.
It should be noted that the above embodiments are merely for illustrating the technical solution of the present invention and not for limiting the same, and although the present invention has been described in detail with reference to the above embodiments, it should be understood by those skilled in the art that the technical solution described in the above embodiments may be modified or some or all of the technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solution deviate from the scope of the technical solution of the embodiments of the present invention.
Claims (8)
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| Application Number | Priority Date | Filing Date | Title |
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| CN201810258021.1A CN108210047B (en) | 2018-03-27 | 2018-03-27 | Proximal femoral fracture intramedullary fixation device |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201810258021.1A CN108210047B (en) | 2018-03-27 | 2018-03-27 | Proximal femoral fracture intramedullary fixation device |
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| CN108210047A CN108210047A (en) | 2018-06-29 |
| CN108210047B true CN108210047B (en) | 2025-02-18 |
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|---|---|---|---|---|
| CN1694650A (en) * | 2002-10-29 | 2005-11-09 | 马斯医药技术股份公司 | Device for the treatment of fractures of the femur |
| CN203829095U (en) * | 2014-05-23 | 2014-09-17 | 北京威高亚华人工关节开发有限公司 | Proximal femur prosthesis |
| CN208640865U (en) * | 2018-03-27 | 2019-03-26 | 孙立山 | Fractured near end of thighbone Medullary fixation device |
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| CA2648490C (en) * | 2006-04-06 | 2014-09-09 | Halifax Biomedical Inc. | Intramedullary rod with vent |
| JP5662094B2 (en) * | 2010-09-29 | 2015-01-28 | 京セラメディカル株式会社 | Femoral fracture treatment device |
| EP2665432B1 (en) * | 2011-01-21 | 2016-04-13 | Synthes GmbH | Trochanteric femoral nail augmentable |
| TWI589263B (en) * | 2015-06-04 | 2017-07-01 | 愛派司生技股份有限公司 | A fixation system for hip fracture use thereof |
| CN105640629A (en) * | 2016-03-17 | 2016-06-08 | 欧阳晓 | Perfusion biological intramedullary fixation device for osteoporotic proximal femoral fracture |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1694650A (en) * | 2002-10-29 | 2005-11-09 | 马斯医药技术股份公司 | Device for the treatment of fractures of the femur |
| CN203829095U (en) * | 2014-05-23 | 2014-09-17 | 北京威高亚华人工关节开发有限公司 | Proximal femur prosthesis |
| CN208640865U (en) * | 2018-03-27 | 2019-03-26 | 孙立山 | Fractured near end of thighbone Medullary fixation device |
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