CN210056195U - Binding and fixing device based on proximal femoral intramedullary nail system - Google Patents

Abstract

A steel wire bundling and fixing device based on a proximal femoral intramedullary nail system comprises an annular gasket, an inserted U-shaped loop steel plate and the like, wherein the annular gasket is matched with a tail cap and belongs to a part which is added between the tail end of a main nail of the proximal femoral intramedullary nail system and the tail cap, the annular titanium alloy thin plate is an annular titanium alloy thin plate, the inserted U-shaped loop steel plate is matched with a tuberosity part spiral blade or a tension screw of the proximal femoral intramedullary nail system, the inserted U-shaped loop steel plate comprises an inserting rod, a clamping block and a U-shaped thin plate, on the basis that the proximal femoral intramedullary nail system fixes femoral intertrochanteric fracture, the bundling and fixing device bundles and fixes the front and back walls, the outer side wall and a tuberosity fracture tip part by using silk threads, provides a support with more sufficient strength for femoral intertrochanteric fracture, and provides guarantee for early-stage out-of-bed activity and smooth healing of a patient, simultaneously provides a minimally invasive surgery operation device, and has simple and convenient operation and low cost.

Description

A binding and fixing device based on the proximal femoral nail system

technical field

The utility model relates to the technical field of medical devices, in particular to a binding and fixing device based on a proximal femoral intramedullary nail system.

Background technique

Intertrochanteric fractures, including fractures of the anterior and posterior walls of the trochanter, lateral wall, and tip of the greater trochanter, are unstable fractures and have always been a difficult clinical treatment. The goal of treatment is to achieve stable internal fixation after reduction and restore the patient. To pre-injury functional level, no pain or limp. For unstable intertrochanteric fractures, especially when the medial wall is incomplete, the stress on the lateral wall as the tension side increases significantly, and deformities such as coxa varus are prone to occur. Most of the patients with hip fractures are elderly. Even if there is support from the medial tuberosity, it is less likely that the medial can provide effective support. Therefore, for unstable intertrochanteric fractures, especially when the medial wall is incomplete, it should be Actively fix fractures of the anterior and posterior walls of the trochanter, the lateral wall, and the tip of the greater trochanter, especially the lateral wall of the femoral tuberosity, thereby reducing the risk of surgical failure.

In the selection of implants, intramedullary nails have biomechanical and minimally invasive advantages, and the main nail is also equivalent to the metal lateral wall, which reduces the external displacement of fractures to a certain extent. However, when the lateral wall is weak and the greater trochanter is fractured, the insertion of the main nail will easily lead to fracture separation and aggravate the injury, and the intramedullary nail cannot hold the fracture fragments of the lateral wall at the same time, and the anti-varus stability of the intramedullary nail is reduced. A single intramedullary nail for the treatment of femoral intertrochanteric fractures with lateral wall fractures, due to the incomplete lateral wall, loses the fixation fulcrum of the screw blade of the intramedullary nail, and is prone to internal fixation failure after surgery. When intramedullary nailing is used to treat this type of unstable fracture, reconstruction of the lateral wall is recommended.

At present, the internal fixation method for reconstructing the lateral wall has been controversial. The reconstruction methods such as long screws or small metaphyseal plates cannot use the small incision of the minimally invasive intramedullary nail, and the lateral wall needs to be completely incised and exposed before internal fixation can be performed. , thereby destroying the biological environment of fractures.

In order to seek biomechanical and minimally invasive advantages, this utility model patent discloses a strapping and fixing device with a simple structure and convenient operation, which completes the strapping and fixing of fractures including the front and rear walls of the trochanter, the lateral wall and the tip of the greater trochanter.

SUMMARY OF THE INVENTION

The purpose of this utility model is to overcome the above-mentioned deficiencies of the prior art, in the proximal femur intramedullary nail system (PFNA, interten, Gamma-3) treatment associated with fractures including the anterior and posterior walls of the trochanter, the lateral wall, and the tip of the greater trochanter On the basis of the femoral intertrochanteric fracture, a strapping and fixing device is provided for the fracture of the anterior and posterior walls of the trochanter, the lateral wall and the tip of the greater trochanter.

A wire binding and fixing device based on a proximal femoral intramedullary nail system, comprising a main nail of the proximal femoral intramedullary nail system, a trochanter helical blade or a lag screw (ie a head screw), a tail cap and a binding and fixing device;

The binding and fixing device is composed of a ring gasket, an inserted U-shaped loop steel plate and a silk wire. The ring gasket is matched with the tail cap of the main nail of the proximal femoral nail system, and is attached to the tail end of the main nail of the proximal femoral nail system. For the part between the ring gasket and the end cap, there is a circular hole at the center of the annular gasket, which can be passed through by the stud of the end cap, and there are several first round holes around the ring gasket for threading threads;

The plug-in U-shaped loop steel plate is matched with the trochanter helical blade or the lag screw (ie the head nail). The plug-in U-shaped loop steel plate is composed of a plug-in rod, a clamping block and a U-shaped thin plate. Insert the helical blade or the central hole of the lag screw (i.e. head nail) until the plug-in U-shaped loop steel plate tail end clamp is inserted into the tail end of the head nail. According to the type of intramedullary nail, the clamp block matched with PFNA is a hexagonal prism The clamping block matched with intertan is in the shape of a cross, and the clamping block matched with Gamma-3 is in the shape of a flower. The insertion rod is connected to the U-shaped sheet through the clamping block. In the lower part, there are several second round holes on the U-shaped sheet for threading threads.

Furthermore, the annular gasket is an annular titanium alloy sheet.

Furthermore, the wire is a steel wire or a non-absorbable suture.

Furthermore, the diameter of the annular spacer is 2mm.

Furthermore, the length of the plunger is between 60-70mm.

The working principle and use process of the utility model:

Taking PFNA for the treatment of femoral intertrochanteric fractures including the lateral wall of the trochanter as an example, the specific working principle and application process of the present invention are introduced.

First, PFNA is used to complete the closed reduction and intramedullary fixation of femoral intertrochanteric fractures. According to the type of lateral wall fracture, several wires of appropriate type are selected, and each wire is passed through the first round hole on the inserted U-loop plate. , and then fold it into two strands in the middle, cover the bend at the first round hole, and use a long pliers to guide all the double strands of silk thread through the small incision inserted by the spiral blade in the tuberosity or the lag screw (ie the head nail). , through the external lateral incision, that is, the small incision where the main nail of the proximal femur intramedullary nail system is placed, and then on the lateral side of the proximal thigh, that is, the trochanteric spiral blade or lag screw (ie, head nail) is inserted into the incision, Insert the insertion rod of the U-shaped loop plate along the center hole of the trochanter helical blade or the lag screw (i.e. the head nail) until the block is inserted into the end of the trochanteric helical blade or the lag screw (i.e. the head nail).

Tighten the silk thread at the incision where the main nail of the proximal femoral intramedullary nail system is placed, braid the ends of each half-folded silk thread together, take a ring gasket, and pass each silk thread along the first round hole of the ring gasket.

The tail cap of the main nail of the proximal femoral intramedullary nail system is a cylindrical fastener with an external thread, and the tail cap is also a pressure cap of an annular gasket.

The tail cap is inserted through the central hole of the annular spacer, and inserted into the tail end screw hole of the main nail of the proximal femoral intramedullary nail system, and the annular spacer between the intervals is squeezed and fixed through the connection of the bolt mode.

Braid all the silk threads at the top of the tail cap, slowly tighten them, and twist them into ropes. The tightened silk threads are like the parachute ropes of an open parachute, which firmly bind the fracture fragments of the outer wall and fix them.

Cut off the excess silk thread, leaving a 3-5 mm stump, bend the stump, and attach it to the metal surface of the tail cap.

Similarly, the Gamma-3 intramedullary nail system and the intertan intramedullary nail system can also use similar strapping and fixation devices to complete the reduction and internal fixation of the anterior and posterior walls, lateral walls of the trochanter, and the tip of the greater trochanter.

The beneficial effects of the present utility model:

1. For intertrochanteric fractures of the femur accompanied by fractures of the anterior and posterior walls of the trochanter, the lateral wall, and the tip of the greater trochanter, the utility model can be used for one-stage reconstruction and fixation, which not only achieves imaging and biomechanical stability, but also The postoperative pain caused by the fracture of the anterior and posterior wall, lateral wall, and tip of the greater trochanter is avoided.

2. The fractures of the anterior and posterior walls, lateral walls of the trochanter, and the tip of the greater trochanter are firmly fixed by bundling, which can provide effective support for intertrochanteric fractures of the femur, and provide anti-rotation and varus stability.

3. On the basis of the proximal femoral intramedullary nail fixation, the present utility model provides sufficient strength support for the internal fixation of the outer lateral wall, which is beneficial to the stability between the bone fragments, thereby reducing the stress of the screw in the femoral head; Provides bony support over time, thereby reducing the rate of internal fixation failure.

4. The utility model provides a guarantee for patients to get out of bed at an early stage and the fracture heals smoothly. Meanwhile, as a minimally invasive operation, the operation is simple and the cost is low, so it has certain popularization and application value.

Description of drawings

FIG. 1 is a front view of a strapping fixation device based on PFNA for the treatment of intertrochanteric fractures including fractures of the anterior and posterior walls of the trochanter, the lateral wall, and the tip of the greater trochanter.

Figure 2 is a schematic diagram of the structure of the plug-in U-shaped loop steel plate matched with the PFNA helical blade.

Figure 3 is a schematic diagram of the end structure of the PFNA helical blade.

Figure 4 is a schematic view of the structure of the annular gasket.

Figure 5 is a front view of a Gamma-3 strapping fixation device for the treatment of intertrochanteric fractures including fractures of the anterior and posterior trochanteric walls, lateral walls, and tip of the greater trochanter.

Figure 6 is a schematic structural diagram of a plug-in U-shaped loop steel plate matched with a Gamma-3 tuberosity lag screw.

Figure 7 is a schematic diagram of the end structure of the Gamma-3 tuberosity lag screw.

8 is a front view of a strapping fixation device for intertrochanteric fractures associated with intertrochanteric fractures including fractures of the anterior and posterior walls of the trochanter, lateral walls, and tip of the greater trochanter based on intertan treatment.

Figure 9 is a schematic structural diagram of a plug-in U-shaped loop steel plate matched with an intertan trochanter lag screw.

Figure 10 is a schematic diagram of the end structure of the intertan tuberosity lag screw.

Detailed ways

Please refer to Fig. 1 to Fig. 10 , a wire binding and fixation device based on the proximal femoral nail system, including the main nail 1 of the proximal femoral nail system, a trochanteric spiral blade or a lag screw (ie a head nail ) 2. Tail cap 3 and binding fixture 4;

The bundling and fixing device 4 is composed of an annular gasket 40, an inserted U-shaped loop steel plate 42 and a wire 41. The annular gasket 40 is matched with the tail cap 3 of the main nail 1 of the proximal femoral intramedullary nail system, and is attached to the proximal femur. The part between the tail end of the main nail 1 of the inner nail system and the tail cap 3, the annular spacer 40 is provided with a circular hole at the center of the ring, which can be passed through by the stud of the tail cap 3, and the annular spacer 40 is provided with several The first round hole 400 is used for threading the wire 41;

The plug-in U-shaped loop steel plate 42 is matched with the trochanter spiral blade or the lag screw (ie the head nail) 2, and the plug-in U-shaped loop steel plate 42 is composed of a plug-in rod 420, a clamping block 421 and a U-shaped thin plate 422. The plug-in rod The head end of 420 can be inserted along the central hole of the trochanter spiral blade or the lag screw (ie head nail) 2, until the plug-in U-shaped loop steel plate 42 The tail end block 421 is embedded in the tail end of the head nail 2, according to the intramedullary nail. Type, the block 421 matched with PFNA is hexagonal, the block 421 matched with intertan is in the shape of a cross, the block 421 matched with Gamma-3 is in the shape of a flower, and the insert rod 420 is connected to the U through the block 421. The U-shaped thin plate 422 constitutes a jaw that can be encircled at the lower part of the femoral tuberosity. The U-shaped thin plate 422 is provided with several second round holes 423 for threading the wire 41 .

Furthermore, the annular gasket 40 is an annular titanium alloy sheet.

Furthermore, the wire 41 is a steel wire or a non-absorbable suture.

More specifically, the diameter of the annular spacer 40 is 2 mm.

More specifically, the length of the insertion rod 420 is between 60-70 mm.

The working principle and use process of this embodiment:

Referring to FIGS. 1 to 10 , the specific working principle and application process of the present invention are introduced by taking PFNA for the treatment of femoral intertrochanteric fractures including the lateral wall of the trochanter as an example.

First, PFNA is used to complete the closed reduction and intramedullary fixation of femoral intertrochanteric fractures. According to the type of lateral wall fracture, several appropriate types of wires 41 are selected. Thread into 400, then fold it into two strands in the middle, cover the bend at the first round hole 400, use a long pliers to guide all the double strands of wire 41 from the trochanter spiral blade or lag screw (ie head nail) 2 Matching The inserted small incision is pierced through the external lateral incision, that is, the small incision placed in the main nail 1 of the proximal femoral intramedullary nail system, and then out of the proximal lateral thigh, that is, the trochanteric spiral blade or lag screw (i.e. Head nail) 2 is placed in the incision, and the insertion rod 420 of the plug-in U-shaped loop steel plate 42 is inserted along the center hole of the trochanter spiral blade or the lag screw (ie the head stud) 2, until the block 421 is embedded in the trochanter spiral. The end of a blade or lag screw (i.e. head nail) 2.

Tighten the wire 41 where the main nail 1 of the proximal femoral intramedullary nail system is inserted into the incision, braid the ends of each wire 41 in half, take the ring gasket 40, and place each wire 41 along the ring gasket 40 first. The round hole 400 is inserted.

The tail cap 3 of the main nail 1 of the proximal femoral intramedullary nail system is a cylindrical fastener with external threads, and the tail cap 3 is also the pressure cap of the annular gasket 40 .

The tail cap 3 is inserted through the central hole of the annular spacer 40 and inserted into the tail end screw hole of the main nail 1 of the proximal femoral intramedullary nail system, and the annular spacer 40 between the intervals is squeezed through the connection of the bolt pattern. fixed.

Braid all the silk threads 41 at the top of the tail cap 3, slowly tighten them, and twist them into a rope shape. The tightened silk threads 41 are like the parachute rope of an open parachute, and firmly bind the fracture fragments of the outer wall, and fix them. .

Cut off the excess silk thread 41 , leaving a stump of 3 to 5 mm, bend the stump, and attach it to the metal surface of the tail cap 3 .

Similarly, the Gamma-3 intramedullary nail system and the intertan intramedullary nail system can also use similar strapping and fixation devices to complete the reduction and internal fixation of the anterior and posterior walls, lateral walls of the trochanter, and the tip of the greater trochanter.

Claims (6)

1. The utility model provides a fixing device is tied up to steel wire based on thighbone near-end intramedullary nail system which characterized in that: comprises a main nail (1) of a proximal femoral intramedullary nail system, a tuberosity part spiral blade or a lag screw (2), a tail cap (3) and a bundling and fixing device (4);

the bundling and fixing device (4) is composed of an annular gasket (40), an inserted U-shaped loop steel plate (42) and a silk thread (41), the annular gasket (40) is matched with a tail cap (3) of the main nail (1) of the proximal femoral intramedullary nail system and is arranged between the tail end of the main nail (1) of the proximal femoral intramedullary nail system and the tail cap (3), a circular hole is formed in the annular center of the annular gasket (40) and penetrates through the tail cap (3), and a plurality of first round holes (400) are formed in the annular periphery of the annular gasket (40) and used for penetrating through the silk thread (41);

bayonet U type tong "pan" steel sheet (42) is supporting with tuberosity portion helical blade or lag screw (2), and bayonet U type tong "pan" steel sheet (42) comprises inserted bar (420), fixture block (421) and U type sheet metal (422), inserted bar (420) head end can be inserted along the centre bore of tuberosity portion helical blade or lag screw (2), until during bayonet U type tong "pan" steel sheet (42) tail end fixture block (421) embedding head nail 2's tail end, U type sheet metal (422) are connected through fixture block (421) in inserted bar (420), and this U type sheet metal (422) constitute to press from both sides the mouth and can encircle in thighbone tuberosity lower part, is equipped with several second round hole (423) on U type sheet metal (422) for wear silk thread (41).

2. The steel wire binding and fixing device based on the proximal intramedullary nail system of femur of claim 1, wherein: the fixture block (421) matched with the PFNA is hexagonal prism-shaped, the fixture block (421) matched with the interertan is cross-flower-shaped, and the fixture block (421) matched with the Gamma-3 is straight-line flower-shaped.

3. The steel wire binding and fixing device based on the proximal intramedullary nail system of femur of claim 1, wherein: the annular gasket (40) is an annular titanium alloy thin plate.

4. The steel wire binding and fixing device based on the proximal intramedullary nail system of femur of claim 1, wherein: the silk thread (41) is a steel wire thread or a non-absorbable suture thread.

5. The steel wire binding and fixing device based on the proximal intramedullary nail system of femur of claim 1, wherein: the diameter of the annular gasket (40) is 2 mm.

6. The steel wire binding and fixing device based on the proximal intramedullary nail system of femur of claim 1, wherein: the length of the inserted bar (420) is 60-70 mm.

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