CN113558739B - A novel minimally invasive intramedullary fixation device and fixation method for distal humeral fracture - Google Patents
A novel minimally invasive intramedullary fixation device and fixation method for distal humeral fracture Download PDFInfo
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- 206010020462 Humerus fracture Diseases 0.000 title claims abstract description 25
- 208000007981 Humeral Fractures Diseases 0.000 title claims description 22
- 238000000034 method Methods 0.000 title abstract description 13
- 210000002758 humerus Anatomy 0.000 claims abstract description 47
- 238000003780 insertion Methods 0.000 claims description 4
- 230000037431 insertion Effects 0.000 claims description 4
- 210000000988 bone and bone Anatomy 0.000 claims description 2
- 230000000694 effects Effects 0.000 abstract description 4
- 238000002324 minimally invasive surgery Methods 0.000 abstract description 4
- 238000001356 surgical procedure Methods 0.000 abstract description 3
- 239000007943 implant Substances 0.000 description 7
- 210000001185 bone marrow Anatomy 0.000 description 6
- 230000000149 penetrating effect Effects 0.000 description 3
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- 101001121408 Homo sapiens L-amino-acid oxidase Proteins 0.000 description 1
- 102100026388 L-amino-acid oxidase Human genes 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 206010039580 Scar Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
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- 239000002184 metal Substances 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 230000009466 transformation Effects 0.000 description 1
- 230000000472 traumatic 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
- A61B17/72—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
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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
- A61B17/72—Intramedullary devices, e.g. pins or nails
- A61B17/7283—Intramedullary devices, e.g. pins or nails with special cross-section of the nail
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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Abstract
Description
技术领域Technical Field
本发明涉及手术器械领域，更具体地说，涉及一种新型的肱骨远端骨折微创髓内固定器械及固定方法。The present invention relates to the field of surgical instruments, and more specifically, to a novel minimally invasive intramedullary fixation instrument and a fixation method for distal humeral fractures.
背景技术Background technique
现有肱骨远端骨折内置物为内外侧钢板，手术需要行大切口，并对软组织进行广泛剥离，手术创伤巨大，会给患者留下很长的手术瘢痕，而且术后并发症出现几率较高。The existing implants for distal humeral fractures are medial and lateral steel plates. The surgery requires a large incision and extensive stripping of the soft tissue. The surgery is extremely traumatic, leaving the patient with a long surgical scar, and the chance of postoperative complications is relatively high.
发明内容Summary of the invention
本发明针对现有技术的上述缺陷，提供一种新型的肱骨远端骨折微创髓内固定器械及固定方法。In view of the above-mentioned defects of the prior art, the present invention provides a novel minimally invasive intramedullary fixation device and fixation method for distal humeral fractures.
本发明解决其技术问题所采用的技术方案是：构造一种新型的肱骨远端骨折微创髓内固定器械，该固定器械包括可植入肱骨髓内的第一弧形髓内钉、可植入肱骨髓内并与该第一弧形髓内钉交叉设置的第二弧形髓内钉，该第一弧形髓内钉第一端设有用于锁定第一弧形髓内钉的第一锁定机构，该第二弧形髓内钉第一端设有用于锁定第二弧形髓内钉的第二锁定机构，该第一弧形髓内钉和第二弧形髓内钉交叉位置处设有用于锁定该第一弧形髓内钉和第二弧形髓内钉第二端的第三锁定机构。The technical solution adopted by the present invention to solve its technical problems is: constructing a new type of minimally invasive intramedullary fixation device for distal humeral fractures, the fixation device comprising a first arcuate intramedullary nail implantable in the humeral bone marrow, a second arcuate intramedullary nail implantable in the humeral bone marrow and arranged crosswise with the first arcuate intramedullary nail, a first locking mechanism for locking the first arcuate intramedullary nail is provided at the first end of the first arcuate intramedullary nail, a second locking mechanism for locking the second arcuate intramedullary nail is provided at the first end of the second arcuate intramedullary nail, and a third locking mechanism for locking the second ends of the first arcuate intramedullary nail and the second arcuate intramedullary nail is provided at the intersection of the first arcuate intramedullary nail and the second arcuate intramedullary nail.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该第一锁定机构包括固设于该第一弧形髓内钉第一端的基座、固设于该基座上的至少一个第一钉孔、以及可穿过该第一钉孔并与肱骨外侧髁骨固定连接的至少一个第一锁钉。In the new minimally invasive intramedullary fixation device for distal humeral fractures described in the present invention, the first locking mechanism includes a base fixed to the first end of the first arc-shaped intramedullary nail, at least one first nail hole fixed on the base, and at least one first locking nail that can pass through the first nail hole and be fixedly connected to the lateral condyle of the humerus.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该基座为椭圆盘状基座，该基座与该第一弧形髓内钉第一端通过连接部固定连接。In the novel minimally invasive intramedullary fixation device for distal humeral fractures described in the present invention, the base is an elliptical disc-shaped base, and the base is fixedly connected to the first end of the first arc-shaped intramedullary nail through a connecting portion.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该基座上设有两个第一钉孔，该第一锁定机构包括两个第一锁钉。In the novel minimally invasive intramedullary fixation instrument for distal humeral fractures described in the present invention, two first nail holes are provided on the base, and the first locking mechanism includes two first locking nails.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该第二锁定机构包括设置于该第二弧形髓内钉第一端并贯穿该第二弧形髓内钉的第二钉孔、以及可穿过该钉孔并与肱骨内侧髁骨固定连接的第二锁钉。In the new minimally invasive intramedullary fixation device for distal humeral fractures described in the present invention, the second locking mechanism includes a second nail hole arranged at the first end of the second arcuate intramedullary nail and passing through the second arcuate intramedullary nail, and a second locking nail that can pass through the nail hole and be fixedly connected to the medial condyle of the humerus.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该第三锁定机构包括设置于该第一弧形髓内钉和第二弧形髓内钉交叉位置处的第三锁钉和第四锁钉，该第三锁钉设置于该交叉位置处的第一侧并分别与第一弧形髓内钉和第二弧形髓内钉抵紧，该第四锁钉设置于该交叉位置处的第二侧并分别与第一弧形髓内钉和第二弧形髓内钉抵紧。In the novel minimally invasive intramedullary fixation device for distal humeral fractures described in the present invention, the third locking mechanism includes a third locking nail and a fourth locking nail arranged at the intersection of the first arcuate intramedullary nail and the second arcuate intramedullary nail, the third locking nail is arranged on the first side of the intersection and is respectively pressed against the first arcuate intramedullary nail and the second arcuate intramedullary nail, and the fourth locking nail is arranged on the second side of the intersection and is respectively pressed against the first arcuate intramedullary nail and the second arcuate intramedullary nail.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该第一锁钉和第二锁钉分别从不同方向锁定该第一弧形髓内钉和第二弧形髓内钉。In the novel minimally invasive intramedullary fixation device for distal humeral fractures described in the present invention, the first locking nail and the second locking nail respectively lock the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail from different directions.
在本发明所述的新型的肱骨远端骨折微创髓内固定器械中，该第一弧形髓内钉和第二弧形髓内钉第二端均设有便于第一弧形髓内钉和第二弧形髓内钉插入髓内的尖端。In the novel minimally invasive intramedullary fixation device for distal humeral fractures described in the present invention, the second ends of the first arcuate intramedullary nail and the second arcuate intramedullary nail are both provided with a tip for facilitating the insertion of the first arcuate intramedullary nail and the second arcuate intramedullary nail into the marrow.
本发明解决其技术问题所采用的技术方案是：公开一种新型的肱骨远端骨折微创髓内固定方法，基于如上述的固定器械，该固定方法包括：The technical solution adopted by the present invention to solve the technical problem is: to disclose a novel minimally invasive intramedullary fixation method for distal humeral fractures, based on the above-mentioned fixation device, the fixation method comprises:
在肱骨外侧髁骨开窗植入第一弧形髓内钉；A first curved intramedullary nail was implanted by opening a window in the lateral condyle of the humerus;
在肱骨内侧髁骨开窗植入第二弧形髓内钉，使得第一弧形髓内钉第二端和第二弧形髓内钉第二端在肱骨髓内交叉；A second arc-shaped intramedullary nail is implanted in a window at the medial condyle of the humerus, so that the second end of the first arc-shaped intramedullary nail and the second end of the second arc-shaped intramedullary nail cross in the humeral bone marrow;
通过第一锁定机构将第一弧形髓内钉第一端固定于肱骨外侧髁骨；Fixing a first end of the first arc-shaped intramedullary nail to the lateral condyle of the humerus by a first locking mechanism;
通过第二锁定机构将第二弧形髓内钉第一端固定于肱骨内侧髁骨；Fixing the first end of the second arc-shaped intramedullary nail to the medial condyle of the humerus through a second locking mechanism;
通过第三锁定机构将第一弧形髓内钉和第二弧形髓内钉交叉位置处进行锁定。The first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail are locked at the intersection position by the third locking mechanism.
在本发明所述的新型的肱骨远端骨折微创髓内固定方法中，该第一锁定机构包括固设于该第一弧形髓内钉第一端的基座、固设于该基座上的至少一个第一钉孔、以及可穿过该第一钉孔并与肱骨外侧髁骨固定连接的至少一个第一锁钉；In the novel minimally invasive intramedullary fixation method for distal humeral fractures described in the present invention, the first locking mechanism includes a base fixed to the first end of the first arc-shaped intramedullary nail, at least one first nail hole fixed to the base, and at least one first locking nail that can pass through the first nail hole and is fixedly connected to the lateral condyle of the humerus;
该第二锁定机构包括设置于该第二弧形髓内钉第一端并贯穿该第二弧形髓内钉的第二钉孔、以及可穿过该钉孔并与肱骨内侧髁骨固定连接的第二锁钉；The second locking mechanism includes a second nail hole provided at the first end of the second arc-shaped intramedullary nail and penetrating the second arc-shaped intramedullary nail, and a second locking nail which can pass through the nail hole and be fixedly connected to the medial condyle of the humerus;
该第三锁定机构包括设置于该第一弧形髓内钉和第二弧形髓内钉交叉位置处的第三锁钉和第四锁钉；The third locking mechanism includes a third locking nail and a fourth locking nail arranged at the intersection of the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail;
该通过第一锁定机构将第一弧形髓内钉第一端固定于肱骨外侧髁骨的步骤具体为：The step of fixing the first end of the first arc-shaped intramedullary nail to the lateral condyle of the humerus by the first locking mechanism is specifically as follows:
使用第一锁钉穿过第一钉孔并与肱骨外侧髁骨固定连接；Using a first locking screw to pass through the first screw hole and fix it to the lateral condyle of the humerus;
该通过第二锁定机构将第二弧形髓内钉第一端固定于肱骨内侧髁骨的步骤具体为：The step of fixing the first end of the second arc-shaped intramedullary nail to the medial condyle of the humerus by the second locking mechanism is specifically as follows:
使用第二锁钉穿过第二钉孔并与肱骨内侧髁骨固定连接；A second locking nail is passed through the second nail hole and fixedly connected to the medial condyle of the humerus;
该通过第三锁定机构将第一弧形髓内钉和第二弧形髓内钉交叉位置处进行锁定的步骤具体为：The step of locking the intersection of the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail by the third locking mechanism is specifically as follows:
将该第三锁钉置于该交叉位置处的第一侧并分别与第一弧形髓内钉和第二弧形髓内钉抵紧；将该第四锁钉置于该交叉位置处的第二侧并分别与第一弧形髓内钉和第二弧形髓内钉抵紧。The third locking nail is placed on the first side of the intersection and pressed against the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail respectively; the fourth locking nail is placed on the second side of the intersection and pressed against the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail respectively.
实施本发明的肱骨远端骨折微创髓内固定器械及固定方法，具有以下有益效果：使用本发明的肱骨远端骨折微创髓内固定器械时，只需在肱骨外侧髁骨开窗植入第一弧形髓内钉，在肱骨内侧髁骨开窗植入第二弧形髓内钉，使得第一弧形髓内钉第二端和第二弧形髓内钉第二端在肱骨髓内交叉，然后通过第一锁定机构将第一弧形髓内钉第一端固定于肱骨外侧髁骨，通过第二锁定机构将第二弧形髓内钉第一端固定于肱骨内侧髁骨，最后通过第三锁定机构将第一弧形髓内钉和第二弧形髓内钉交叉位置处进行锁定。即可实现对第一弧形髓内钉和第二弧形髓内钉的固定，以及对肱骨的固定。使用本申请的固定器械，只需进行小切口微创手术，就可以达到治疗目的，从而减少手术并发症，获得满意的治疗效果。The implementation of the minimally invasive intramedullary fixation device and fixation method for distal humeral fracture of the present invention has the following beneficial effects: when using the minimally invasive intramedullary fixation device for distal humeral fracture of the present invention, it is only necessary to open a window in the lateral condyle of the humerus and implant the first arc-shaped intramedullary nail, and open a window in the medial condyle of the humerus and implant the second arc-shaped intramedullary nail, so that the second end of the first arc-shaped intramedullary nail and the second end of the second arc-shaped intramedullary nail cross in the humeral marrow, and then fix the first end of the first arc-shaped intramedullary nail to the lateral condyle of the humerus by the first locking mechanism, fix the first end of the second arc-shaped intramedullary nail to the medial condyle of the humerus by the second locking mechanism, and finally lock the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail at the intersection position by the third locking mechanism. The fixation of the first arc-shaped intramedullary nail and the second arc-shaped intramedullary nail, as well as the fixation of the humerus, can be achieved. Using the fixation device of the present application, only a small incision minimally invasive surgery is required to achieve the treatment purpose, thereby reducing surgical complications and obtaining satisfactory treatment effects.
附图说明BRIEF DESCRIPTION OF THE DRAWINGS
下面将结合附图及实施例对本发明作进一步说明，附图中：The present invention will be further described below with reference to the accompanying drawings and embodiments, in which:
图1是本发明固定器械的结构示意图；FIG1 is a schematic diagram of the structure of the fixing device of the present invention;
图2是本发明固定器械植入肱骨内的结构示意图。FIG. 2 is a schematic diagram of the structure of the fixation device of the present invention implanted in the humerus.
具体实施方式Detailed ways
为使本发明的目的、技术方案和优点更加清楚，下面将结合附图对本发明实施方式作进一步地详细描述。To make the objectives, technical solutions and advantages of the present invention more clear, the embodiments of the present invention will be further described in detail below with reference to the accompanying drawings.
如图1所示，在本发明的肱骨远端骨折微创髓内固定器械第一实施例中，该固定器械1包括可植入肱骨髓内的第一弧形髓内钉2、可植入肱骨髓内并与该第一弧形髓内钉2交叉设置的第二弧形髓内钉3，该第一弧形髓内钉2第一端设有用于锁定第一弧形髓内钉2的第一锁定机构11，该第二弧形髓内钉3第一端设有用于锁定第二弧形髓内钉3的第二锁定机构12，该第一弧形髓内钉2和第二弧形髓内钉3交叉位置处设有用于锁定该第一弧形髓内钉2和第二弧形髓内钉3第二端的第三锁定机构13。As shown in Figure 1, in the first embodiment of the minimally invasive intramedullary fixation device for distal humeral fractures of the present invention, the fixation device 1 includes a first arcuate intramedullary nail 2 that can be implanted in the humeral bone marrow, and a second arcuate intramedullary nail 3 that can be implanted in the humeral bone marrow and cross-arranged with the first arcuate intramedullary nail 2. The first end of the first arcuate intramedullary nail 2 is provided with a first locking mechanism 11 for locking the first arcuate intramedullary nail 2, and the first end of the second arcuate intramedullary nail 3 is provided with a second locking mechanism 12 for locking the second arcuate intramedullary nail 3. A third locking mechanism 13 for locking the second ends of the first arcuate intramedullary nail 2 and the second arcuate intramedullary nail 3 is provided at the intersection of the first arcuate intramedullary nail 2 and the second arcuate intramedullary nail 3.
使用本发明的肱骨远端骨折微创髓内固定器械1时，只需在肱骨外侧髁骨开窗植入第一弧形髓内钉2，在肱骨内侧髁骨开窗植入第二弧形髓内钉3，使得第一弧形髓内钉2第二端和第二弧形髓内钉3第二端在肱骨髓内交叉，然后通过第一锁定机构11将第一弧形髓内钉2第一端固定于肱骨外侧髁骨，通过第二锁定机构12将第二弧形髓内钉3第一端固定于肱骨内侧髁骨，最后通过第三锁定机构13将第一弧形髓内钉2和第二弧形髓内钉3交叉位置处进行锁定。即可实现对第一弧形髓内钉2和第二弧形髓内钉3的固定，以及对肱骨的固定。使用本申请的固定器械1，只需进行小切口微创手术，就可以达到治疗目的，从而减少手术并发症，获得满意的治疗效果。When using the minimally invasive intramedullary fixation device 1 for distal humeral fracture of the present invention, it is only necessary to open a window in the lateral condyle of the humerus and implant the first arc-shaped intramedullary nail 2, and open a window in the medial condyle of the humerus and implant the second arc-shaped intramedullary nail 3, so that the second end of the first arc-shaped intramedullary nail 2 and the second end of the second arc-shaped intramedullary nail 3 cross in the humeral marrow, and then fix the first end of the first arc-shaped intramedullary nail 2 to the lateral condyle of the humerus by the first locking mechanism 11, fix the first end of the second arc-shaped intramedullary nail 3 to the medial condyle of the humerus by the second locking mechanism 12, and finally lock the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 at the intersection position by the third locking mechanism 13. The fixation of the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3, as well as the fixation of the humerus can be achieved. Using the fixation device 1 of the present application, only a small incision minimally invasive surgery is required to achieve the treatment purpose, thereby reducing surgical complications and obtaining satisfactory treatment effects.
如图1、2所示，在本实施方式中，该第一锁定机构11包括固设于该第一弧形髓内钉2第一端的基座4、固设于该基座4上的至少一个第一钉孔5、以及可穿过该第一钉孔5并与肱骨外侧髁骨固定连接的至少一个第一锁钉6。As shown in Figures 1 and 2, in this embodiment, the first locking mechanism 11 includes a base 4 fixed to the first end of the first arc-shaped intramedullary nail 2, at least one first nail hole 5 fixed on the base 4, and at least one first locking nail 6 that can pass through the first nail hole 5 and is fixedly connected to the lateral condyle of the humerus.
具体的，该基座4为椭圆盘状基座4，该基座4与该第一弧形髓内钉2第一端通过连接部固定连接。Specifically, the base 4 is an elliptical disc-shaped base 4, and the base 4 is fixedly connected to the first end of the first arc-shaped intramedullary nail 2 via a connecting portion.
优选的，该基座4上设有两个第一钉孔5，该第一锁定机构11包括两个第一锁钉6。Preferably, the base 4 is provided with two first nail holes 5 , and the first locking mechanism 11 includes two first locking nails 6 .
在固定第一髓内钉第一端时，可使用第一锁钉6穿过第一钉孔5插入至肱骨内，并通过第一锁钉6将基座4固定于肱骨外侧髁骨上。When fixing the first end of the first intramedullary nail, the first locking nail 6 can be inserted into the humerus through the first nail hole 5, and the base 4 can be fixed to the lateral condyle of the humerus through the first locking nail 6.
在其他实施方式中，该第一锁定机构11还可以是设置于第一弧形髓内钉2第一端上的锁孔和锁钉。In other embodiments, the first locking mechanism 11 may also be a locking hole and a locking nail provided on the first end of the first arc-shaped intramedullary nail 2 .
在本实施方式中，该第二锁定机构12包括设置于该第二弧形髓内钉3第一端并贯穿该第二弧形髓内钉3的第二钉孔7、以及可穿过该钉孔并与肱骨内侧髁骨固定连接的第二锁钉8。In this embodiment, the second locking mechanism 12 includes a second nail hole 7 provided at the first end of the second arc-shaped intramedullary nail 3 and penetrating the second arc-shaped intramedullary nail 3, and a second locking nail 8 that can pass through the nail hole and be fixedly connected to the medial condyle of the humerus.
在固定第二弧形髓内钉3第二端时，可使用第二锁钉8穿过第二钉孔7插入至肱骨内，实现对第二弧形髓内钉3第二端的固定。When fixing the second end of the second arc-shaped intramedullary nail 3 , the second locking nail 8 may be inserted into the humerus through the second nail hole 7 to fix the second end of the second arc-shaped intramedullary nail 3 .
在其他实施方式中，第二锁定机构12也可以是基座4和锁钉结构。In other embodiments, the second locking mechanism 12 may also be a base 4 and a locking pin structure.
进一步的，该第三锁定机构13包括设置于该第一弧形髓内钉2和第二弧形髓内钉3交叉位置处的第三锁钉9和第四锁钉10，该第三锁钉9设置于该交叉位置处的第一侧并分别与第一弧形髓内钉2和第二弧形髓内钉3抵紧，该第四锁钉10设置于该交叉位置处的第二侧并分别与第一弧形髓内钉2和第二弧形髓内钉3抵紧。Furthermore, the third locking mechanism 13 includes a third locking nail 9 and a fourth locking nail 10 which are arranged at the intersection of the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3, the third locking nail 9 is arranged on the first side of the intersection and is respectively pressed against the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3, and the fourth locking nail 10 is arranged on the second side of the intersection and is respectively pressed against the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3.
优选的，该第一锁钉6和第二锁钉8分别从不同方向锁定该第一弧形髓内钉2和第二弧形髓内钉3。Preferably, the first locking nail 6 and the second locking nail 8 lock the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 from different directions respectively.
通过设置第三锁钉9和第四锁钉10，可起到阻挡第一弧形髓内钉2和第二弧形髓内钉3在髓内上下移动的作用，同时还可以防止第一弧形髓内钉2和第二弧形髓内钉3在髓内旋转。进一步的，第三锁钉9和第四锁钉10还可以挤涨第一弧形髓内钉2和第二弧形髓内钉3向骨髓腔内壁侧，从而增加两者之间摩擦力。By providing the third locking nail 9 and the fourth locking nail 10, the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 can be blocked from moving up and down in the marrow, and the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 can be prevented from rotating in the marrow. Furthermore, the third locking nail 9 and the fourth locking nail 10 can also push the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 toward the inner wall of the marrow cavity, thereby increasing the friction between the two.
为便于第一弧形髓内钉2和第二弧形髓内钉3从肱骨开窗处插入至骨髓腔内，该第一弧形髓内钉2和第二弧形髓内钉3第二端均设有便于第一弧形髓内钉2和第二弧形髓内钉3插入髓内的尖端。To facilitate the insertion of the first arcuate intramedullary nail 2 and the second arcuate intramedullary nail 3 into the medullary cavity from the humeral window, the second ends of the first arcuate intramedullary nail 2 and the second arcuate intramedullary nail 3 are both provided with a tip for facilitating the insertion of the first arcuate intramedullary nail 2 and the second arcuate intramedullary nail 3 into the medullary cavity.
优选的，在本实施方式中，该第一锁钉6和第二锁钉8均为直径2.7mm的固定螺钉，第三锁钉9和第四锁钉10均为直径3.5mm的骨皮质螺钉，第一锁钉6、第二锁钉8、第三锁钉9和第四锁钉10的长度可根据人体骨骼形态进行设置。Preferably, in this embodiment, the first locking nail 6 and the second locking nail 8 are both fixing screws with a diameter of 2.7 mm, the third locking nail 9 and the fourth locking nail 10 are both cortical bone screws with a diameter of 3.5 mm, and the lengths of the first locking nail 6, the second locking nail 8, the third locking nail 9 and the fourth locking nail 10 can be set according to the morphology of the human skeleton.
进一步的，该第一弧形髓内钉2和第二弧形髓内钉3均为弧形实心金属圆柱体，其直径、曲率半径、长度可依据人体参数进行设计。Furthermore, the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 are both arc-shaped solid metal cylinders, and their diameters, curvature radii, and lengths can be designed according to human body parameters.
如图2所示，本发明还公开一种新型的肱骨远端骨折微创髓内固定方法，基于如上述的固定器械1，该固定方法包括：As shown in FIG. 2 , the present invention further discloses a novel minimally invasive intramedullary fixation method for distal humeral fractures. Based on the above-mentioned fixation device 1, the fixation method comprises:
步骤S101，在肱骨外侧髁骨开窗植入第一弧形髓内钉2；Step S101, making a window in the lateral condyle of the humerus and implanting a first arc-shaped intramedullary nail 2;
步骤S102，在肱骨内侧髁骨开窗植入第二弧形髓内钉3，使得第一弧形髓内钉2第二端和第二弧形髓内钉3第二端在肱骨髓内交叉；Step S102, implanting the second arc-shaped intramedullary nail 3 in the medial condyle of the humerus through a window, so that the second end of the first arc-shaped intramedullary nail 2 and the second end of the second arc-shaped intramedullary nail 3 cross in the humeral bone marrow;
步骤S103，通过第一锁定机构11将第一弧形髓内钉2第一端固定于肱骨外侧髁骨；Step S103, fixing the first end of the first arc-shaped intramedullary nail 2 to the lateral condyle of the humerus by the first locking mechanism 11;
步骤S104，通过第二锁定机构12将第二弧形髓内钉3第一端固定于肱骨内侧髁骨；Step S104, fixing the first end of the second arc-shaped intramedullary nail 3 to the medial condyle of the humerus by the second locking mechanism 12;
步骤S105，通过第三锁定机构13将第一弧形髓内钉2和第二弧形髓内钉3交叉位置处进行锁定。Step S105 : locking the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 at their intersections by means of the third locking mechanism 13 .
具体的，步骤S103和步骤S104可以先后进行，也可以同时进行，也可以是后先进行。Specifically, step S103 and step S104 may be performed sequentially, simultaneously, or one after the other.
实施本发明的肱骨远端骨折微创髓内固定方法时，只需在肱骨外侧髁骨开窗植入第一弧形髓内钉2，在肱骨内侧髁骨开窗植入第二弧形髓内钉3，使得第一弧形髓内钉2第二端和第二弧形髓内钉3第二端在肱骨髓内交叉，然后通过第一锁定机构11将第一弧形髓内钉2第一端固定于肱骨外侧髁骨，通过第二锁定机构12将第二弧形髓内钉3第一端固定于肱骨内侧髁骨，最后通过第三锁定机构13将第一弧形髓内钉2和第二弧形髓内钉3交叉位置处进行锁定。即可实现对第一弧形髓内钉2和第二弧形髓内钉3的固定，以及对肱骨的固定。使用本申请的固定器械1，只需进行小切口微创手术，就可以达到治疗目的，从而减少手术并发症，获得满意的治疗效果。When implementing the minimally invasive intramedullary fixation method for distal humeral fracture of the present invention, it is only necessary to open a window in the lateral condyle of the humerus and implant the first arc-shaped intramedullary nail 2, and open a window in the medial condyle of the humerus and implant the second arc-shaped intramedullary nail 3, so that the second end of the first arc-shaped intramedullary nail 2 and the second end of the second arc-shaped intramedullary nail 3 cross in the humeral marrow, and then fix the first end of the first arc-shaped intramedullary nail 2 to the lateral condyle of the humerus by the first locking mechanism 11, and fix the first end of the second arc-shaped intramedullary nail 3 to the medial condyle of the humerus by the second locking mechanism 12, and finally lock the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 at the intersection position by the third locking mechanism 13. The fixation of the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3, as well as the fixation of the humerus can be achieved. Using the fixing device 1 of the present application, only a small incision minimally invasive surgery is required to achieve the treatment purpose, thereby reducing surgical complications and obtaining satisfactory treatment effects.
进一步的，该第一锁定机构11包括固设于该第一弧形髓内钉2第一端的基座4、固设于该基座4上的至少一个第一钉孔5、以及可穿过该第一钉孔5并与肱骨外侧髁骨固定连接的至少一个第一锁钉6。Furthermore, the first locking mechanism 11 includes a base 4 fixed to the first end of the first arc-shaped intramedullary nail 2, at least one first nail hole 5 fixed on the base 4, and at least one first locking nail 6 that can pass through the first nail hole 5 and be fixedly connected to the lateral condyle of the humerus.
该第二锁定机构12包括设置于该第二弧形髓内钉3第一端并贯穿该第二弧形髓内钉3的第二钉孔7、以及可穿过该钉孔并与肱骨内侧髁骨固定连接的第二锁钉8。The second locking mechanism 12 includes a second nail hole 7 disposed at the first end of the second arc-shaped intramedullary nail 3 and penetrating the second arc-shaped intramedullary nail 3 , and a second locking nail 8 that can pass through the nail hole and be fixedly connected to the medial condyle of the humerus.
该第三锁定机构13包括设置于该第一弧形髓内钉2和第二弧形髓内钉3交叉位置处的第三锁钉9和第四锁钉10。The third locking mechanism 13 includes a third locking nail 9 and a fourth locking nail 10 which are arranged at the intersection of the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 .
该步骤S103具体为：The step S103 is specifically as follows:
使用第一锁钉6穿过第一钉孔5并与肱骨外侧髁骨固定连接；A first locking nail 6 is passed through the first nail hole 5 and fixedly connected to the lateral condyle of the humerus;
该步骤S104具体为：The step S104 is specifically as follows:
使用第二锁钉8穿过第二钉孔7并与肱骨内侧髁骨固定连接；A second locking nail 8 is passed through the second nail hole 7 and fixedly connected to the medial condyle of the humerus;
该步骤S105具体为：The step S105 is specifically as follows:
将该第三锁钉9置于该交叉位置处的第一侧并分别与第一弧形髓内钉2和第二弧形髓内钉3抵紧；将该第四锁钉10置于该交叉位置处的第二侧并分别与第一弧形髓内钉2和第二弧形髓内钉3抵紧。The third locking nail 9 is placed on the first side of the intersection and pressed against the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 respectively; the fourth locking nail 10 is placed on the second side of the intersection and pressed against the first arc-shaped intramedullary nail 2 and the second arc-shaped intramedullary nail 3 respectively.
以上所述仅为本发明的实施例，并非因此限制本发明的专利范围，凡是利用本发明说明书及附图内容所作的等效结构或等效流程变换，或直接或间接运用在其他相关的技术领域，均同理包括在本发明的专利保护范围内。The above descriptions are merely embodiments of the present invention and are not intended to limit the patent scope of the present invention. Any equivalent structure or equivalent process transformation made using the contents of the present invention specification and drawings, or directly or indirectly applied in other related technical fields, are also included in the patent protection scope of the present invention.
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