CN216535477U - A dynamic compression device for bone wound repair - Google Patents

Abstract

The application discloses a dynamic pressurizing device for repairing bone wounds, which comprises a bone fracture plate, a screw hole and a pressurizing screw, wherein the inner surface of the bone fracture plate is matched with the shape of the lower part of a femoral greater tuberosity, the screw hole is arranged on the bone fracture plate, and the pressurizing screw is inserted into the screw hole; the screw hole comprises a bowl-shaped lower part and a cylindrical upper part, one end of the lower part close to the inner side of the bone fracture plate is provided with a clamping structure, and the upper part is of a unthreaded hole structure; the lower part of the pressurizing screw is a locking structure matched with the clamping structure, and the upper part of the pressurizing screw is a non-locking structure capable of moving in the screw hole; the lower part of the screw hole on the bone fracture plate is also provided with a locking hole, and the locking hole is used for penetrating a locking nail. The invention can protect the soft tissues such as muscles around the thighbone to a certain extent and can also improve the fixing effect of the thighbone.

Description

A dynamic compression device for bone wound repair

technical field

The invention belongs to the field of orthopedic instruments, and in particular relates to a dynamic compression device used for treating femoral neck fracture repair.

Background technique

The treatment methods for femoral neck fractures are divided into conservative treatment and surgical treatment. For unstable femoral neck fractures, surgical treatment is generally used. For patients under the age of 65, surgical reduction and internal fixation are often used. At present, the internal fixation of femoral neck fractures mostly adopts three cannulated screw fixation techniques. The needle is inserted from the femoral tuberosity, through the femoral tuberosity, the femoral neck to the femoral head, to achieve the effect of fixing the broken end of the fracture. Although this technique can press and fix the fractured end, because the three cannulated screws are not connected to each other, and there is no other support and fixation, the following problems are prone to occur: 1. Poor stability, the anti-rotation force of the three cannulated screws and Poor torsion resistance, prone to displacement of the femoral head, leading to nonunion of the femoral neck or bone malunion; 2. The rate of long-term necrosis of the femoral head is high; 3. During the healing process of the femoral neck, it is easy to shorten the femoral neck , resulting in the withdrawal of the fixed needle and the shortening of the lower limbs, affecting walking; 4. Longer bed rest is required, and early weight-bearing exercise cannot be performed.

In order to solve the above problems, the locking plate for the treatment of femoral neck fractures has appeared one after another. The supporting part of the locking plate is fixed with one or two screws and the bone at the distal end of the fracture, so that the proximal and distal ends of the fracture, the locking plate and the locking screw are integrated. It is a stable fixation, but this kind of fixation does not pressurize the fracture end, and the fracture end is a static fixation, which blocks the transmission of force, which is not conducive to the stimulation of the fracture end force and the growth of callus. Broken ends are prone to bone resorption and nonunion.

For this reason, in order to solve the above-mentioned problems caused by the locking plate for the treatment of femoral neck fractures, there are three-hole locking plates for the treatment of femoral neck fractures. The three compression locking screw holes and compression screws on the locking plate can not only pressurize the fractured end of the femoral neck, but also lock and support it axially. It can adapt to the dynamic compression characteristics of bone growth, and is more conducive to the healing of fracture ends.

But their locking plate and compression screw are fixed together, which will cause the following problems:

1. Since the femoral neck will shorten during the healing process, the compression screw will retreat relative to the femoral neck during the shortening process, so that the locking plate will also retreat relative to the femoral neck. Squeeze the surrounding musculature, causing compression and damage to soft tissues such as the muscles around the femur.

2. During the movement, the compression screw will advance and retreat repeatedly, and the locking plate will also advance and retreat repeatedly with the compression screw, which will eventually lead to the failure of the femoral head fixation.

SUMMARY OF THE INVENTION

The purpose of the present invention is to provide a dynamic compression device for bone wound repair in view of the deficiencies of the prior art, which is used to solve the problem that the compression screw locks the plate when the compression screw moves backward relative to the femoral neck during the dynamic compression process in the prior art. It also retreats relative to the femoral neck at the same time, resulting in technical problems such as compression and injury to the soft tissues such as the muscles around the femur and the failure of the femoral head fixation.

In order to accomplish the above object, the present invention adopts the following technical solutions:

A dynamic compression device for bone trauma repair, comprising a bone plate whose inner surface matches the shape of the lower part of the greater trochanter of the femur, a screw hole arranged on the bone plate, and a compression screw inserted in the screw hole,

The central axis of the screw hole is inclined upward; the screw hole includes a bowl-shaped lower part and a cylindrical upper part, and the end of the lower part close to the inner side of the bone plate is provided with a clamping structure, and the upper part is a light hole structure; the lower part of the compression screw It is a locking structure matched with the clamping structure, and the upper part is a non-locking structure that can move in the screw hole; the bone plate is also provided with a locking hole at the lower part of the screw hole, and the locking hole is used for passing through the screw hole. Locking pegs.

As a further improvement to the present invention, the clamping structure is a threaded structure.

As a further improvement to the present invention, the locking structure of the compression screw is a threaded rod.

As a further improvement to the present invention, the non-locking structure of the compression screw is a smooth polished rod.

As a further improvement to the present invention, the screw holes include a first screw hole, a second screw hole and a third screw hole, and the first screw hole, the second screw hole and the third screw hole are distributed in a triangular shape.

As a further improvement to the present invention, the included angle between the central axis of the first screw hole, the second screw hole and the third screw hole and the central axis of the locking hole is θ=36°-50°.

As a further improvement to the present invention, the mutual distance between the center points of the first screw hole, the second screw hole and the third screw hole is 1.2-3 times the thread diameter of the head of the compression screw.

As a further improvement to the present invention, the lower part of the locking hole is provided with a threaded structure.

As a further improvement of the present invention, the top of the upper part of the compression screw is also connected with a screw head that matches the bowl-shaped structure of the lower part of the screw hole, and the upper end face of the screw head is recessed with a locking opening for use with a screwdriver .

As a further improvement to the present invention, the upper middle section of the screw hole is provided with a screw thread structure for screwing the positioner.

Compared with the prior art, the beneficial effects of the present invention are:

1. Through three screw holes distributed in a triangular shape, the central axes are parallel to each other and inclined upward, the compression screw can effectively fix the femoral neck (fracture end) while compressing and fixing the femoral neck. The force of the femoral neck is dispersed, the overall bearing capacity of the pressurized fixation device is increased, and the high support strength makes the femoral neck less prone to displacement and improves the fixation effect.

2. Through the clamping mechanism at the lower part of the screw hole, the locking structure of the compression screw can pass through the screw hole to fix the femoral neck; at the same time, the non-locking structure of the compression screw can be tightly stuck, so that the The inclination direction of the compression screw is limited, and it is not easy to shake, so that the compression screw has better rotational stability during the process of passing through the bone plate and implanting into the bone, and the axial direction will not occur after screwing in. The displacement of the compression screw can avoid the shaking of the compression screw in the bone, and can retain the dynamic compression function in the radial direction; and it can also make the upper limit of the compression screw stuck, preventing the compression screw from passing through the screw hole and detaching from the screw hole. Bone plate.

3. The bone plate and the femoral neck can be fixed together through the locking hole and the locking screw, and then the non-locking structure of the compression screw can make the compression screw move in the screw hole without being restricted by the screw hole, and between the bone plate and the bone plate. In the separated state, the compression screw can move relative to the bone plate. When the femoral neck is in the process of healing and shortening, the non-locking structure of the compression screw will move backward relative to the femoral neck through the screw hole in the bone plate. , and the bone plate will move forward with the femoral neck under the action of the locking screw, and will always be fixed with the femoral neck, which can prevent the bone plate from retreating with the compression screw, which will cause compression to the muscles and other soft tissues around the femur. It can stabilize dynamic compression and protect soft tissue.

4. Since the compression screw can move on the bone plate, only the compression screw repeatedly advances and retreats during the movement, and the bone plate always fixes the femoral neck, so it can avoid the femoral head following the compression screw. The phenomenon of loosening occurs due to the movement, the fixation effect is better, and the healing time can be effectively shortened.

Description of drawings

Fig. 1 is the top view structure schematic diagram of the bone plate of the present invention;

Fig. 2 is the top view structure schematic diagram of the bone plate of the present invention;

Fig. 3 is the overall structure schematic diagram of the present invention;

Fig. 4 is the structural state diagram when the compression screw of the present invention penetrates into the screw hole;

Fig. 5 is the structural state diagram after the compression screw of the present invention penetrates into the screw hole;

Fig. 6 is the partial enlarged schematic diagram of A place in Fig. 5;

Fig. 7 is the front view structure schematic diagram when the present invention is used;

Fig. 8 is the right side view structure schematic diagram when the present invention is used;

Among them, the reference numerals are:

1. Bone plate; 2. Screw hole; 21. Third screw hole; 22. Second screw hole; 23. First screw hole; 3. Locking hole; 4. Compression screw; 41. Screw head; 5. Locking Nail; 6. Thread structure.

Detailed ways

In order to make those skilled in the art better understand the solutions of the present application, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only a part of the embodiments of the present application. not all examples. Based on the embodiments in the present application, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present application.

The present application provides a dynamic compression device for repairing bone trauma. For ease of understanding, please refer to FIG. 1 , which includes a bone plate 1 whose inner surface matches the shape of the lower part of the greater trochanter of the femur, and screw holes arranged on the bone plate 1 2 and the compression screw 4 inserted in the screw hole 2, the bone plate 1 is a steel plate or a titanium alloy plate, the bone plate 1 is an irregular broom-shaped plate, and the maximum length of the bone plate 1 is L1=40-200mm, According to the actual situation, it can be made into different length models every 5mm to suit patients with different femur sizes. The width of the screw is W1=15-40mm, the width of the lower part is W2=6-12mm, the screw hole 2 is arranged on the upper area, and the screw hole 2 includes a first screw hole 23, a second screw hole 22 and a third screw hole 21 , the three screw holes 2 are respectively staggered, and the second screw holes 22 are respectively staggered with the first screw holes 23 and the third screw holes 21, and are located between the two screw holes 2.

Please refer to FIG. 2 and FIG. 3. Specifically, the second screw hole 22 is arranged on the left side of the line connecting the center point of the first screw hole 23 and the third screw hole 21. The three screw holes 2 are distributed in a triangle shape. The distance from the center point of the hole 22 to the center point of the first screw hole 23 is the same as the distance from the center point of the second screw hole 22 to the center point of the third screw hole 21, and the distance is L2=9-15mm, while the center point of the first screw hole 23 is the same The distance between the point and the third screw hole 21 is L3=9-20mm. Since the diameter of the compression screw 4 affects the diameter of the screw hole, and the diameter of the screw hole affects the distance between the center lines of the screw holes, the three screw holes The mutual distance between the center points is 1.2-3 times the thread diameter of the head of the compression screw.

An isosceles triangle or an equilateral triangle is formed between the three screw holes 2, and the central axes of the three screw holes 2 are parallel to each other and inclined upward, that is, the screw holes 2 are arranged obliquely upward, and the compression screw 4 will pass through the screw in an inclined shape. The hole 2 is implanted in the bone, and the inclined angle is θ=36°-50°, that is, the angle between the central axis of the three screw holes 2 and the central axis of the locking hole 3 is θ=36°-50° .

Please refer to Figure 4, Figure 5 and Figure 6, the screw hole 2 includes a bowl-shaped lower part and a cylindrical upper part, the upper part and the lower part are the structure of the screw hole 2 when the bone plate 1 is in a horizontal state, and the height of the upper part is H1=5-8mm, the height of the lower part is H2=2-4mm, the end of the lower part close to the inner side of the bone plate 1 is provided with a clamping structure, the height of the clamping structure is H3=1-2mm, and the upper part is a light hole structure, that is, a screw hole The inner diameter of the lower part of the screw hole 2 is tapered into a bowl-shaped structure, and a clamping structure is arranged on the inner side of the lower part of the screw hole 2. The lower part of the compression screw 4 is a locking structure that matches the clamping structure. The cooperation can make the locking part of the compression screw 4 implant into the bone through the screw hole 2, and the upper part is a non-locking structure that can move in the screw hole 2. Over-clamping structure, and at the same time, it is not easy to shake.

Specifically, the clamping structure is a threaded structure 6, and the locking structure of the compression screw 4 is a threaded rod. The diameter, pitch and tooth shape of the threaded structure 6 can match the threaded rod at the head of the compression screw 4, so that it can be screwed into Through, the non-locking structure of the compression screw 4 is a smooth polished rod, and the tail of the polished rod is a bowl-shaped structure. In the lower part of 2, the screw hole 2 cannot be passed through, that is, the compression screw 4 is composed of the lower threaded rod and the upper polished rod. The length of the compression screw 4 is L4=70-120mm, and the top of the upper part of the compression screw 4 also The screw head 41 is connected with the bowl-shaped structure at the lower part of the screw hole 2. When the compression screw 4 is implanted into the bone, the screw head 41 is located in the bowl-shaped structure at the lower part of the screw head 41. It is also just caught by the threaded structure 6, and a locking port for use with the screwdriver is recessed in the upper end face of the screw head 41, and the compression screw 4 can be implanted into the bone through the locking port. The middle section of the hole structure is provided with a screw structure, and the diameter between the screw structures is larger than the above-mentioned screw structure 6, which is convenient for screwing into the locator of the femoral head guide pin, so that the locator is not easy to shake during screwing in.

Please continue to refer to Fig. 2, the bone plate 1 is also provided with a locking hole 3 at the lower part of the screw hole 2, and a locking nail 5 is detachably connected in the locking hole 3, and the number of the locking holes 3 is 1-5, equally spaced Setting, the distance between the centers of two adjacent locking holes 3 is L5=6-12mm, the diameter of the locking holes 3 is tapered from top to bottom, the lower part is provided with a threaded structure, and the locking nail 5 is also provided with threads Structure, through the action of the locking hole 3 and the locking nail 5, the bone plate 1 can be fixed to the femoral neck and connected with the femoral neck, and further, between and adjacent to the first screw hole 23 and the third screw hole 21 Two positioning holes are respectively provided between the two locking holes 3 , which is convenient for fixing the bone plate 1 , so that the compression screw 4 can be accurately penetrated into the femur.

Please refer to Fig. 7 and Fig. 8. Since the non-locking part of the compression screw 4 can freely pass through the screw hole 2 of the bone plate 1, the bone plate 1 and the compression screw 4 are separated. When the femoral neck is healing When shortening occurs during the process, the bone plate 1 will always be fixed with the femoral neck and move forward together with the femoral neck, so that the femoral neck is always fixed and is not easy to be offset, and the compression screw 4 is implanted in the femoral neck. The part of the femoral neck will be reduced, and the compression screw 4 will be backward relative to the femoral neck, that is, when the femoral neck and the bone plate 1 move forward together, the compression screw 4 will pass through the screw hole 2 on the bone plate 1 and be backward relative to the femoral neck. move.

It should be noted that when the compression screw 4 is completely implanted into the bone, the compression screw 4 is located in the lower part of the screw hole 2, and the compression screw 4 only moves in the upper part of the screw hole 2 when it moves relative to the screw hole 2, It is always located in the screw hole 2, that is, when the femoral neck and the bone plate 1 move forward together, the compression screw 4 will move from the lower part of the screw hole 2 to the upper part, and the range of its movement is the upper part of the screw hole 2. The height, that is, the moving distance is S1=5-8mm.

The working principle of the invention is as follows: according to the size of the patient's femur, select a suitable product model, after the selection, place the patient in a supine position, traction the affected limb, and let the affected limb adduct, internally rotate 12-15°, and reset the femoral neck. A Kirschner wire with a diameter of 3 mm is placed on the skin surface in front of the femoral neck. Under the anteroposterior fluoroscopy of the C-arm machine, it is 6-8 mm away from the upper edge of the femoral neck and parallel to the axial direction of the femoral neck. The angle of the neck shaft of the guide wire is About 130°, fix the bone plate 1 in a suitable position, use the common femoral head guide pin locator for positioning, then drill three guide pins with a diameter of 3.0 into the femur, calculate the implant length, and the distance between the tip of the guide pin and the femur The bone is 3mm below the cartilage, and the 3 guide pins are parallel. Remove the bone plate 1, the locator and the Kirschner wire. Use a suitable drill to pass through the 3 guide pins in turn, and drill according to the direction of the guide pins. Calculate the drilling depth, drill bit The tip should be 5-7mm away from the tip of the guide needle, and at the end of the drilling, take out the drill bit. Re-fit the bone plate 1 to the femur, make the three guide pins pass through the three screw holes 2 of the bone plate 1, fix the position, and then use a hexagonal torx screwdriver to insert the three metal bone screws through the guide pins into the femur in turn , remove 3 guide pins, and finally fix 2 locking pins 5 through the two locking holes 3 at the lower end of the bone plate 1 into the femur.

To sum up, the present invention has the following advantages:

1. Through three screw holes distributed in a triangular shape, the central axes are parallel to each other and inclined upward, the compression screw can effectively fix the femoral neck (fracture end) while compressing and fixing the femoral neck. The force of the femoral neck is dispersed, the overall bearing capacity of the pressurized fixation device is increased, and the high support strength makes the femoral neck less prone to displacement and improves the fixation effect.

2. Through the clamping mechanism at the lower part of the screw hole, the locking structure of the compression screw can pass through the screw hole to fix the femoral neck; at the same time, the non-locking structure of the compression screw can be tightly stuck, so that the The inclination direction of the compression screw is limited, and it is not easy to shake, so that the compression screw has better rotational stability during the process of passing through the bone plate and implanting into the bone, and the axial direction will not occur after screwing in. The displacement of the compression screw can avoid the shaking of the compression screw in the bone, and can retain the dynamic compression function in the radial direction; and it can also make the upper limit of the compression screw stuck, preventing the compression screw from passing through the screw hole and detaching from the screw hole. Bone plate.

3. The bone plate and the femoral neck can be fixed together through the locking hole and the locking screw, and then the non-locking structure of the compression screw can make the compression screw move in the screw hole without being restricted by the screw hole, and between the bone plate and the bone plate. In the separated state, the compression screw can move relative to the bone plate. When the femoral neck is in the process of healing and shortening, the non-locking structure of the compression screw will move backward relative to the femoral neck through the screw hole in the bone plate. , and the bone plate will move forward with the femoral neck under the action of the locking screw, and will always be fixed with the femoral neck, which can prevent the bone plate from retreating with the compression screw, which will cause compression to the muscles and other soft tissues around the femur. It can stabilize dynamic compression and protect soft tissue.

4. Since the compression screw can move on the bone plate, only the compression screw repeatedly advances and retreats during the movement, and the bone plate always fixes the femoral neck, so it can avoid the femoral head following the compression screw. The phenomenon of loosening occurs due to the movement, the fixation effect is better, and the healing time can be effectively shortened.

Although the present invention has been described by using the above-mentioned preferred embodiments, it is not intended to limit the protection scope of the present invention. Any person skilled in the art can make various changes relative to the above-mentioned embodiments without departing from the spirit and scope of the present invention. and modifications still belong to the scope of protection of the present invention.

Claims (10)

1. A dynamic pressure device for repairing bone wound comprises a bone fracture plate with an inner surface matched with the shape of the lower part of a femoral greater tuberosity, a screw hole arranged on the bone fracture plate and a pressure screw inserted on the screw hole,

the central axis of the screw hole is inclined upwards;

the screw hole comprises a bowl-shaped lower part and a cylindrical upper part, one end of the lower part close to the inner side of the bone fracture plate is provided with a clamping structure, and the upper part is of a unthreaded hole structure;

the lower part of the pressurizing screw is a locking structure matched with the clamping structure, and the upper part of the pressurizing screw is a non-locking structure capable of moving in the screw hole;

the lower part of the screw hole on the bone fracture plate is also provided with a locking hole, and the locking hole is used for penetrating a locking nail.

2. The dynamic compression device of bone wound repair of claim 1, wherein the gripping structure is a threaded structure.

3. The dynamic compression device of bone wound repair of claim 2, wherein the locking structure of the compression screw is a threaded shaft.

4. The dynamic compression device of bone wound repair of claim 3, wherein the non-locking structure of the compression screw is a smooth shaped polished rod.

5. The dynamic compression device of bone wound repair of claim 1, wherein the screw holes include a first screw hole, a second screw hole, and a third screw hole, the first screw hole, the second screw hole, and the third screw hole being triangularly shaped.

6. The dynamic compression device for bone wound repair of claim 5, wherein the angle between the central axis of the first, second and third screw holes and the central axis of the locking hole is θ =36 ° -50 °.

7. The dynamic compression device for bone wound repair of claim 6, wherein the mutual distance between the center points of the first, second and third screw holes is 1.2-3 times the diameter of the screw thread of the compression screw head.

8. The dynamic compression device for bone wound repair of claim 1, wherein a lower portion of the locking hole is provided with a thread structure.

9. The dynamic pressure device for bone wound repair according to claim 1, wherein a screw head matched with the bowl structure at the lower part of the screw hole is further connected to the top end of the upper part of the pressure screw, and a locking port matched with a screwdriver is concavely arranged on the upper end surface of the screw head.

10. The dynamic compression device for bone wound repair of claim 1, wherein the upper mid-section of the screw hole is provided with a thread structure for screwing in a locator.

Images