CN106236237B - Retrograde minimally invasive steel plate screw fixing system for bone fracture - Google Patents
Retrograde minimally invasive steel plate screw fixing system for bone fracture Download PDFInfo
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- CN106236237B CN106236237B CN201610782904.3A CN201610782904A CN106236237B CN 106236237 B CN106236237 B CN 106236237B CN 201610782904 A CN201610782904 A CN 201610782904A CN 106236237 B CN106236237 B CN 106236237B
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- 229910000831 Steel Inorganic materials 0.000 title claims abstract description 77
- 239000010959 steel Substances 0.000 title claims abstract description 77
- 208000010392 Bone Fractures Diseases 0.000 title claims description 20
- 210000000988 bone and bone Anatomy 0.000 claims description 8
- 230000000149 penetrating effect Effects 0.000 claims description 4
- 210000005036 nerve Anatomy 0.000 abstract description 8
- 210000004204 blood vessel Anatomy 0.000 abstract description 6
- 206010017076 Fracture Diseases 0.000 description 13
- 238000002513 implantation Methods 0.000 description 4
- 238000000034 method Methods 0.000 description 3
- 208000006735 Periostitis Diseases 0.000 description 2
- 230000008878 coupling Effects 0.000 description 2
- 238000010168 coupling process Methods 0.000 description 2
- 238000005859 coupling reaction Methods 0.000 description 2
- 210000003460 periosteum Anatomy 0.000 description 2
- 230000008093 supporting effect Effects 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 206010017088 Fracture nonunion Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 230000013011 mating Effects 0.000 description 1
- 238000001356 surgical procedure Methods 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, e.g. tourniquets
- 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, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/683—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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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)
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Abstract
The invention discloses a retrograde minimally invasive steel plate screw fixing system for fracture, which comprises a steel plate body implanted in a patient body, wherein one end of the steel plate body implanted in the patient body is a far end, and the other end of the steel plate body is a near end; the device also comprises an aiming plate which is arranged outside the patient body and is positioned on the opposite side of the steel plate body, and one end of the aiming plate is detachably connected with the near end of the steel plate body through a connecting device; the steel plate body is provided with a plurality of locking holes at intervals along the length direction, the aiming plate is provided with a plurality of aiming holes along the length direction, when the aiming plate is connected with the steel plate body, the positions of the aiming holes correspond to the positions of the locking holes one by one, and the aiming holes are used for the medical care personnel to determine the positions of the internal locking holes by the outside of the body of the patient. The retrograde minimally invasive steel plate screw fixing system for the fracture has good fitting property and can not hurt nerves and blood vessels.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a retrograde minimally invasive steel plate screw fixing system for fracture.
Background
Since the AO tissue was pushed out of the plate screw fixation system, open reduction plate internal fixation became the treatment of choice for most patients with bone fractures. With the wide application of the internal fixation of the incision reduction steel plate, the complication of the fracture nonunion arouses the high attention of the clinician; some doctors believe that the main reason of bone nonunion is due to serious damage to blood circulation at the fracture end caused by open surgery, so in recent years, a minimally invasive fixation system (LISS) appears, and the method for using a steel plate screw is as follows: after minimally invasive insertion of the steel plate for fracture reduction, a matched locking screw is used for implantation from the lateral side to the opposite side of the steel plate; in view of the fact that the main nerve vessels of the human body are mostly distributed on the inner side of the limbs, in order to avoid damaging the nerve vessels, the steel plate is usually placed on the outer side of the limbs; but for partial medial cortical incomplete fractures, placement of the supporting steel plate on the medial side has better biomechanical properties. In addition, the direction of the thread in the hole of the existing steel plate is fixed, thereby limiting the implantation direction of the screw, and when the implantation direction is deviated, the screw is difficult to obtain effective fixation.
Disclosure of Invention
The technical problem to be solved by the invention is to provide a retrograde minimally invasive steel plate screw fixing system for fracture, which has good biomechanical property, prevents nerve and blood vessel damage and has good fitting property, aiming at the defects of the prior art.
In order to solve the technical problems, the invention adopts the technical scheme that the retrograde minimally invasive steel plate screw fixing system for the fracture comprises a steel plate body implanted in the body of a patient, wherein one end of the steel plate body implanted in the deep part of the patient is a far end, and the other end of the steel plate body is a near end; the device also comprises an aiming plate which is arranged outside the patient body and is positioned on the opposite side of the steel plate body, and one end of the aiming plate is detachably connected with the near end of the steel plate body through a connecting device;
the steel plate body is provided with a plurality of locking holes at intervals along the length direction, the aiming plate is provided with a plurality of aiming holes along the length direction, when the aiming plate is connected with the steel plate body, the positions of the aiming holes correspond to the positions of the locking holes one by one, and the aiming holes are used for the medical care personnel to determine the positions of the internal locking holes by the outside of the body of the patient.
Further, this connecting device includes the connecting plate, sets up first connecting hole and the coupling nut in the steel sheet body near-end.
Furthermore, the connecting plate is arched, the other end of the connecting plate is connected with a straight plate, a second connecting hole is formed in the straight plate, and the first connecting hole corresponds to the second connecting hole in position and is used for installing a connecting nut.
Further, still including the locking screw and the fixation nut that cooperate and use, fixation nut is the hemisphere, fixation nut sets up in the locking hole, and the inner wall shape in this locking hole is unanimous with fixation nut's shape, and in hemispherical plane place side, the inner wall a week in locking hole forms the recess that is used for the card to hold fixation nut, and hemispherical sphere side is the end of penetrating of locking screw.
Furthermore, the screw tightening device also comprises at least one tightening screw matched with the fixing nut, the middle part of the tightening screw is a smooth screw rod, and the outer wall of the front end of the tightening screw is provided with an external thread.
Furthermore, the inner wall of the locking hole is provided with concave-convex grains.
The invention also discloses a use method of the retrograde minimally invasive steel plate screw fixing system for fracture, which comprises the following steps: inserting a steel plate body from the outside of a periosteum through a minimally invasive incision along the direction of a skeleton of a patient, implanting the far end of the steel plate body into the deep inside the patient, then placing a sighting plate outside the patient and on the opposite side of the steel plate body, placing a straight plate at the near end of the steel plate body, and installing a connecting nut in a first connecting hole and a second connecting hole; at least one tightening screw penetrates through the corresponding aiming hole, the front end of the tightening screw is implanted into the fixing nut, the tightening screw is screwed, the tightening screw is pulled after being screwed, and the steel plate body is pulled to the bone side; and then the locking screw is inserted into the patient body through other aiming holes, the front end of the locking screw is implanted into the corresponding fixing nut, and the locking screw is screwed.
The retrograde minimally invasive steel plate screw fixing system for the fracture has the following advantages: 1. the implantation position and direction of the locking screw are changed, and the dense area of the nerve and blood vessels on the inner side of the limb is avoided, so that the damage of the nerve and blood vessels is avoided. 2. The steel plate body is implanted into the inner side of the limb, so that a good supporting effect is achieved, and a good biomechanical effect of fracture fixation is obtained. 3. The steel plate body is tightly attached to the bone, and the fixation is good. 4. When the steel plate fixing device is fixed, the tightening screw and the locking screw are used, the tightening screw is matched with the locking nut, the steel plate body can be pulled to be fixed, and the fixing performance is better. 5. The operation wound is small, the pain of the patient is relieved, and the fracture healing time is shortened.
Drawings
FIG. 1 is a schematic structural view of a retrograde minimally invasive steel plate screw fixation system for bone fracture according to the present invention;
FIG. 2 is a schematic structural view of a steel plate body according to the present invention;
FIG. 3 is a schematic view of the connection between the collimation plate and the connection plate according to the present invention;
FIG. 4 is a schematic view of the locking screw, retaining nut and mating arrangement of the present invention;
wherein: 1. a steel plate body; 2. a collimation plate; 3. a connecting plate; 4. a locking hole; 5. a sighting hole; 6. a first connection hole; 7. a second connection hole; 8. a connecting nut; 9. straight plate, 10 locking screw; 11 fixing the nut; 12 the screw is tightened.
Detailed Description
The invention discloses a retrograde minimally invasive steel plate screw fixing system for fracture, which comprises a steel plate body 1 implanted in a patient body, wherein one end of the steel plate body 1 implanted in the patient body is a far end, and the other end of the steel plate body is a near end; the device also comprises an aiming plate 2 which is arranged outside the patient body and is positioned on the opposite side of the steel plate body 1, and one end of the aiming plate 2 is detachably connected with the near end of the steel plate body 1 through a connecting device; the steel plate body 1 is provided with a plurality of locking holes 4 at intervals along the length direction, the aiming plate 2 is provided with a plurality of aiming holes 5 along the length direction, when the aiming plate 2 is connected with the steel plate body 1, the positions of the aiming holes 5 correspond to the positions of the locking holes 4 one by one, and the aiming holes 5 are used for medical staff to determine the positions of the locking holes 4 in the body by the outside of the patient body. The structure avoids the dense area of nerve and blood vessels on the inner side of the limb when being implanted into the body of a patient, thereby avoiding the damage of the nerve and blood vessels.
The invention is used in a retrograde minimally invasive steel plate screw fixing system of fracture, and the connecting device comprises a connecting plate 3, a first connecting hole 6 and a connecting nut 8, wherein the first connecting hole 6 and the connecting nut are arranged at the near end of a steel plate body 1.
This connecting plate 3 is the arch, and its other end is connected with a straight board 9, has seted up second connecting hole 7 on the straight board 9, and straight board 9 is used for placing on the surface of steel sheet body 1, and the position of first connecting hole 6 and second connecting hole 7 is corresponding for installation coupling nut 8. The locking hole 4 has an irregular polygonal shape. When penetrating locking screw 10 in locking hole 4 and screwing up, the screw thread on locking screw 10 and the screw thread of polygon shape are mutually supported, can adjust the position of steel sheet body 1, also make locking screw 10 can fix firmly simultaneously, have guaranteed angle and fastness fixed with the flesh and bone tissue.
As shown in fig. 2 and 4, the locking device further comprises a locking screw 10 and a fixing nut 11 which are used in cooperation, the fixing nut 11 is hemispherical, the fixing nut 11 is arranged in the locking hole 4, the shape of the inner wall of the locking hole 4 is consistent with the shape of the fixing nut 11, a groove for clamping the fixing nut 11 is formed on the periphery of the inner wall of the locking hole 4 on the side of the hemispherical plane, and the side of the hemispherical spherical surface is the penetrating end of the locking screw 10. When the locking screw 10 and the fixing nut 11 are matched for use, the direction can be slightly changed according to the matching of threads, and good matching and fixing can be guaranteed. The inner wall of the locking hole 4 is provided with raised grains, so that when the locking screw 10 and the fixing nut 11 are matched for use, the fixing nut 11 is prevented from sliding in the locking hole 4. As shown in fig. 4, the tail of the locking screw 10 is hemispherical, and the outer walls of the shank are provided with external threads. The screw tightening device further comprises at least one tightening screw 12 matched with the fixing nut 11, the middle of the tightening screw 12 is a smooth screw rod, and an external thread is arranged on the outer wall of the front end of the tightening screw. When the tightening screw 12 is passed through the flesh tissue and fitted to the fixing nut 11, the tightening screw 12 is pulled to pull the steel plate body 1 toward the bone side, so that the fixation is made tighter. In the operation, the number of screws 12 to be screwed is determined according to the actual situation.
The use method of the retrograde minimally invasive steel plate screw fixing system for the fracture comprises the following steps: inserting the steel plate body 1 from the outside of a periosteum through a minimally invasive incision along the trend of a patient skeleton, implanting the far end of the steel plate body 1 into the deep inside the patient body, then placing the aiming plate 2 outside the patient body and on the opposite side of the steel plate body 1, placing the straight plate 9 at the near end of the steel plate body 1, and installing the connecting nut 8 in the first connecting hole 6 and the second connecting hole 7; at least one tightening screw 12 penetrates through the corresponding aiming hole 2, the front end of the tightening screw 12 is implanted into the fixing nut 11, the tightening screw 12 is screwed, the tightening screw 12 is pulled after screwing, and the steel plate body 1 is pulled to the bone side; the locking screw 10 is then inserted through the other aiming hole 2 and into the patient, the leading end of the locking screw 10 is implanted into the corresponding fixing nut 11, and the locking screw 10 is screwed.
Claims (4)
1. The retrograde minimally invasive steel plate screw fixing system for the fracture is characterized by comprising a steel plate body (1) implanted into the inner side of a limb of a patient, wherein one end of the steel plate body (1) implanted into the deep part of the patient is a far end, and the other end of the steel plate body is a near end;
the device is characterized by also comprising an aiming plate (2) which is arranged outside the patient body and is positioned on the opposite side of the steel plate body (1), wherein one end of the aiming plate (2) is detachably connected with the near end of the steel plate body (1) through a connecting device;
a plurality of locking holes (4) are formed in the steel plate body (1) at intervals along the length direction of the steel plate body, a plurality of aiming holes (5) are formed in the aiming plate (2) along the length direction of the steel plate body, when the aiming plate (2) is connected with the steel plate body (1), the positions of the aiming holes (5) correspond to the positions of the locking holes (4) one by one, and the aiming holes (5) are used for medical personnel to determine the positions of the locking holes (4) in the body from the outside of the body of a patient;
the connecting device comprises a connecting plate (3), a first connecting hole (6) and a connecting nut (8), wherein the first connecting hole is formed in the near end of the steel plate body (1);
the locking device is characterized by further comprising a locking screw (10) and a fixing nut (11) which are matched for use, wherein the fixing nut (11) is hemispherical, the fixing nut (11) is arranged in the locking hole (4), the shape of the inner wall of the locking hole (4) is consistent with that of the fixing nut (11), a groove for clamping the fixing nut (11) is formed in the periphery of the inner wall of the locking hole (4) on the side where the hemispherical plane is located, and the side of the hemispherical spherical surface is a penetrating end of the locking screw (10);
the screw is characterized by also comprising at least one tightening screw (12) matched with the fixing nut (11), wherein the middle part of the tightening screw (12) is a smooth screw rod, and the outer wall of the front end of the tightening screw is provided with an external thread;
when the bone plate is used, the front end of the tightening screw (12) is implanted into the fixing nut (11), and after the tightening screw (12) is pulled, the steel plate body (1) is pulled to the bone side.
2. The retrograde minimally invasive steel plate screw fixation system for bone fracture according to claim 1, wherein the connecting plate (3) is arch-shaped, the other end of the connecting plate is connected with a straight plate (9), the straight plate (9) is provided with a second connecting hole (7), and the first connecting hole (6) and the second connecting hole (7) are correspondingly positioned for installing a connecting nut (8).
3. The retrograde minimally invasive steel plate screw fixation system for bone fracture according to claim 2, wherein the tail of the locking screw (10) is hemispherical and the outer wall of the shank is provided with external threads.
4. The retrogradable minimally invasive steel plate screw fixation system for bone fractures according to claim 3, characterized in that the inner wall of the locking hole (4) is provided with a relief.
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CN201610782904.3A CN106236237B (en) | 2016-08-30 | 2016-08-30 | Retrograde minimally invasive steel plate screw fixing system for bone fracture |
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CN201610782904.3A CN106236237B (en) | 2016-08-30 | 2016-08-30 | Retrograde minimally invasive steel plate screw fixing system for bone fracture |
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CN106236237B true CN106236237B (en) | 2021-04-30 |
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CN107260289A (en) * | 2017-07-20 | 2017-10-20 | 无锡市闻泰百得医疗器械有限公司 | A kind of pelvis lockplate system |
CN109998654B (en) * | 2019-04-29 | 2024-08-02 | 广东施泰宝医疗科技有限公司 | Percutaneous minimally invasive double-locking external fixation system |
Family Cites Families (12)
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ATE260607T1 (en) * | 1997-11-21 | 2004-03-15 | Synthes Ag | DEVICE FOR SIMULATING IMPLANTS POSITIONED UNDER THE SKIN |
DE20216857U1 (en) * | 2002-11-02 | 2003-02-20 | stryker Trauma GmbH, 24232 Schönkirchen | Aiming device for a locking nail |
US8100952B2 (en) * | 2005-12-22 | 2012-01-24 | Anthem Orthopaedics Llc | Drug delivering bone plate and method and targeting device for use therewith |
CN2879998Y (en) * | 2006-03-31 | 2007-03-21 | 天津正天医疗器械有限公司 | Nail hole locking structure for bone implanted product |
CN201453358U (en) * | 2009-07-09 | 2010-05-12 | 张英泽 | Self-positioned minimally invasive bone fracture plate |
TW201114401A (en) * | 2009-10-16 | 2011-05-01 | Shi-jie YANG | Omni-directional bone plate |
US8439932B2 (en) * | 2010-05-03 | 2013-05-14 | Biomet Manufacturing Corp. | Submuscular plating system |
JP5921544B2 (en) * | 2010-07-23 | 2016-05-24 | シンセス ゲゼルシャフト ミット ベシュレンクテル ハフツングSynthes Gmbh | Protection sleeve retention mechanism |
CN202723966U (en) * | 2012-08-21 | 2013-02-13 | 王立明 | Small-cut scale type steel plate |
CN203763219U (en) * | 2014-03-18 | 2014-08-13 | 闻泰医疗科技(上海)有限公司 | Straight bone fracture plate device for minimally invasive surgery |
CN105534590B (en) * | 2015-12-07 | 2016-08-17 | 张英泽 | The connection of one seed coat outside fix plate and notch graft hone lamella and clamping and conveying device |
CN206560468U (en) * | 2016-08-30 | 2017-10-17 | 李岩 | Retrograde minimally invasive steel plate screw fixing system for fracture |
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