CN115844508B - Anatomical locking plate for minimally invasive treatment of humerus fractures - Google Patents

Abstract

The invention discloses an anatomical locking steel plate for minimally invasive treatment of humerus fracture, which comprises a proximal part and a distal part which are integrally formed and connected with each other, wherein the distal part is gradually twisted from a joint with the proximal part to an included angle of 3-8 degrees with the plane of the proximal part, the proximal part is provided with a plurality of first threaded holes, each first threaded hole is in matched screwing connection with a first screw, the distal part is provided with a plurality of universal holes, and each universal hole is in matched screwing connection with a second screw. The torsion of the steel plate increases the safety distance between the steel plate and the radial nerve, reduces the risk of injury in operation, and the anatomical locking steel plate for minimally invasive treatment of humerus fracture can be matched with an orthopedic operation robot to perform bone reposition operation, and has high reposition accuracy.

Description

Anatomical locking plate for minimally invasive treatment of humerus fractures

technical field

The invention belongs to the technical field of medical devices and relates to a single-layer reticulated shell structure. More specifically, the present invention relates to an anatomical locking plate for minimally invasive treatment of humerus fractures.

Background technique

Humeral shaft fractures are common injuries of the upper extremity. When performing open reduction and internal fixation for humeral fractures, there are some problems with the common steel plate currently used: First, compared with the posterior humerus, the front proximal part of the humerus is relatively straight , but the mid-to-distal anatomical shape is very special, the mid-to-distal end is triangular, and there is a special shape of a coronal fossa in front of the distal end and an olecranon fossa in the rear. Simply inserting the plate from the front is not conducive to the placement of the plate; the second If the matching degree of the plate shape and the special anatomical shape of the humeral shaft is too large, it will lead to the loss of fracture reduction after fixation, and the plate will over-stimulate the soft tissues such as muscles, blood vessels, and nerves in front of the humerus, which will affect the functional recovery of the upper limbs; Third, in order to solve this matching problem, it is necessary to bend the current locking plate during the operation so that it can roughly match the special anatomical structure of the front of the humerus, but the problem is that the plate of the upper arm is relatively thick , It takes a long time and good skills to achieve a good bending effect during the operation, which increases the operation time and difficulty of the operation; fourth, the locking nail hole of the steel plate will be deformed during the bending and adjustment process, and the There will be a significant decrease in strength, which will affect the biomechanical strength of the steel plate and thus affect the stability of the fixation, leaving hidden dangers for subsequent rehabilitation exercises; fifth, after the distal end of the steel plate is bent, the distal end and the humerus The special anatomical structure of the distal end matches, but the bending of the steel plate will make the position of the steel plate and the radial nerve run closer, which may increase the possibility of iatrogenic injury to the radial nerve during the implantation of the steel plate; sixth, the traditional The straight LCPs used for the spiral fracture of the middle and lower part of the humerus have the defects that the diameter of the fixable hole at the distal end of the fracture is relatively large and the number of holes is too small, which is not suitable for the relatively thin bone on the lateral surface of the distal humerus and the coronoid process at the front and rear. The anatomical characteristics of the olecranon fossa and olecranon fossa easily lead to internal fixation failure due to insufficient fixation strength or iatrogenic fractures.

There is a shallow groove at the back of the middle and distal end of the humerus, which is called the radial nerve groove, and the radial nerve passes closely along this groove. During the treatment of humeral fractures with open reduction and internal fixation, the radial nerve needs to be freed. , passing through the steel plate under the radial nerve for fixation may easily cause iatrogenic radial nerve injury. Moreover, the existing straight steel plate must pass under the radial nerve, and friction between the steel plate and the radial nerve is likely to cause damage. Just disclose a kind of arched steel plate that is used to span the humeral radial nerve in the patent of CN215384536 U as authorized notification number.

In addition, in order to achieve the best fixation effect of the locking screw implanted in the plate, it is required that the locking screw must be implanted in the bone in a specific direction. In clinical application, this locking plate screw system often has a contradiction between the set implantation direction and the optimal implantation direction between the locking screw and the plate, which affects the surgical effect. For example, the patent application No. 201310244223.8 discloses a press-cap chute-type universal locking femoral condyle plate system, which can lock and fix the screw and the plate within a range of 60 degrees.

Contents of the invention

One object of the present invention is to provide an anatomical locking plate for minimally invasive treatment of humeral fractures, which has a simple structure, matches the special anatomical structure of the distal end of the radius, and avoids the radial nerve at the torsion, reducing the time required for plate implantation. Risk of iatrogenic injury to the radial nerve.

In order to achieve these objects and other advantages according to the present invention, according to one aspect of the present invention, the present invention provides an anatomical locking plate for minimally invasive treatment of humeral fractures, which includes an integrally formed proximal portion and a distal end connected to each other part, the distal part is gradually twisted from the connection with the proximal part to an angle of 3-8° with the plane where the proximal part is located, and a plurality of first threaded holes are opened on the proximal part, A first screw is matched and screwed in each first threaded hole, a plurality of universal holes are opened on the distal end, and a second screw is matched and screwed in each universal hole.

Preferably, the inner wall of the universal hole is a hemispherical structure, and the diameter of the universal hole gradually decreases from the surface of the distal end to the bottom surface, and the universal hole is located on one side of the surface of the distal end. There is an annular flange extending vertically inward, and a rotating assembly is movably accommodated in the universal hole. The rotating assembly has a drum-shaped structure, and the outer diameter of the rotating assembly increases first from the surface of the distal end to the bottom surface. When it is large and then small, there are second threaded holes interpenetrating between the top wall and the bottom wall of the rotating assembly parallel to each other, and the second screws are mated and screwed into the second threaded holes.

Preferably, the inner wall of the universal hole is provided with a plurality of slide grooves along the meridian, and the curved outer wall of the rotating assembly is provided with a plurality of first ribs along the meridian, and the plurality of first ribs are one-to-one. in the chute.

Preferably, the curved outer wall of the rotating assembly is provided with an annular second rib along the latitudinal line, and the outer diameter of the second rib is larger than the inner diameter of the annular rib of the universal hole.

Preferably, a sleeve is also provided in the universal hole, the sleeve is a drum-shaped ring structure, which is sleeved on the outer circumference of the rotating assembly, and is accommodated in the universal hole together with the rotating assembly. The curved outer wall of the sleeve is provided with a third ridge along the parallel, and the outer diameter of the third ridge is larger than the inner diameter of the annular rim of the universal hole.

Preferably, the thickness of the proximal portion is greater than the thickness of the distal portion.

Preferably, the diameter of each first threaded hole is larger than the diameter of each second threaded hole.

The present invention at least includes the following beneficial effects:

First, the anatomical locking steel plate used for the minimally invasive treatment of humeral fractures according to the present invention has a twisting structure at the distal end, and the structure of the steel plate matches and fits the special anatomical structure of the distal humerus to improve the firmness of the fracture after reduction ;

Second, the twisted position of the distal end in the present invention avoids the position where the radial nerve travels, reducing the risk of iatrogenic injury to the radial nerve during the implantation of the steel plate;

Third, the position of the steel plate in the present invention does not conflict with the positioning point when the surgical robot resets the bone, and it can cooperate with the orthopedic surgical robot to perform bone reset surgery with high reset accuracy;

Fourth, a plurality of universal holes are set on the distal end of the present invention, and a rotating assembly is set in the universal holes, the angle can be adjusted freely, and the rotation angle of the second screw can be adjusted conveniently, so as to adapt to the lateral bone of the distal end of the humerus. The internal fixation is relatively thin and has the anatomical characteristics of the coronoid fossa and the olecranon fossa in the front and back, so as to avoid internal fixation failure caused by insufficient fixation strength or iatrogenic fractures.

Other advantages, objectives and features of the present invention will partly be embodied through the following descriptions, and partly will be understood by those skilled in the art through the research and practice of the present invention.

Description of drawings

Fig. 1 is the structural representation of a kind of technical solution among the present invention;

Fig. 2 is an exploded view of the structure of the universal hole in a technical solution of the present invention;

Fig. 3 is an exploded view of the structure of the universal hole in another technical solution of the present invention;

Fig. 4 is a partial top view of the distal end in a technical solution of the present invention.

Detailed ways

The present invention will be described in further detail below in conjunction with the accompanying drawings and specific embodiments, so that those skilled in the art can implement it with reference to the description.

It should be understood that terms such as "having", "comprising" and "including" used herein do not exclude the presence or addition of one or more other elements or combinations thereof.

It should be noted that the experimental methods described in the following embodiments, unless otherwise specified, are conventional methods, and the reagents and materials, if not otherwise specified, can be obtained from commercial sources; in the description of the present invention, It should be noted that, unless otherwise clearly stipulated and limited, the terms "installation", "connection" and "arrangement" should be interpreted in a broad sense, for example, it can be fixedly connected, arranged, or detachably connected, arranged, or Connect and set in one piece. Those of ordinary skill in the art can understand the specific meanings of the above terms in the present invention in specific situations. The terms "landscape", "portrait", "top", "bottom", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", The orientation or positional relationship indicated by "inner", "outer", etc. is based on the orientation or positional relationship shown in the drawings, which is only for the convenience of describing the present invention and simplifying the description, and does not indicate or imply that the referred device or element must have Certain orientations, constructed and operative in certain orientations, therefore are not to be construed as limitations on the invention.

As shown in Figures 1 and 4, the present invention provides an anatomical locking plate for minimally invasive treatment of humerus fractures, including a proximal part 100 and a distal part 200 that are integrally formed and connected to each other, and the distal part 200 is formed with the The connection of the proximal part is gradually twisted to an angle of 3-8° with the plane where the proximal part 100 is located. The proximal part 100 is provided with a plurality of first threaded holes 101, and each first threaded hole 101 A first screw is matched and screwed inside, and a plurality of universal holes 201 are opened on the distal end portion 200 , and a second screw is matched and screwed in each universal hole 201 .

In this technical solution, the anatomically locked steel plate for minimally invasive treatment of humeral fractures is provided with a proximal portion 100 and a distal portion 200, the proximal portion 100 is fitted to the proximal end of the humerus, and the distal portion 200 is gradually twisted with The middle and distal ends of the humerus are fitted together so that the angle between the tail end of the distal part 200 and the plane where the proximal part 100 is located is 3-8°, and the proximal part 100 is provided with a plurality of first threaded holes 101, each first threaded hole 101 is matched and screwed with a first screw to fix the proximal end 100 and the proximal end of the humerus, the distal end 200 is provided with a plurality of universal holes 201, each universal A second screw is matched and screwed into the hole 201 . Compared with the common steel plate used in the prior art, which needs to be manually bent during the operation, the proximal part 100 and the distal part 200 in this technical solution match and fit the special anatomical shape of the humerus, which facilitates the plate The implantation of the steel plate can reduce the excessive stimulation of the soft tissue such as the muscles, blood vessels and nerves in front of the humerus, which is beneficial to the functional recovery of the upper limbs, and the biomechanical strength of the steel plate is high, and the fixation stability to the fracture is good; the distal part 200 The bending avoids the position where the radial nerve walks, reducing the risk of iatrogenic injury to the radial nerve during the plate implantation process; the distal part 200 is twisted and bent in advance before perforating, avoiding the process of bending and adjusting the plate during the operation The threaded hole will be deformed and the strength of the steel plate will be reduced; the position of the anatomically locked steel plate used in the minimally invasive treatment of humeral fractures described in this technical solution does not conflict with the positioning point of the surgical robot when the bone is reset, and it can be performed with an orthopedic surgical robot. Bone reduction surgery with high precision.

As shown in Figures 1 and 4, in other technical solutions, the inner wall of the universal hole 201 is a hemispherical structure, and the diameter of the universal hole 201 gradually decreases from the surface of the distal end 200 to the bottom surface The universal hole 201 is located on one side of the surface of the distal end 200 and is provided with an annular flange 202 extending vertically inward. A rotating assembly 203 is movably accommodated in the universal hole 201, and the rotating assembly 203 is Drum-shaped structure, the outer diameter of the rotating assembly 203 first increases and then decreases from the surface of the distal end 200 to the bottom surface, and a second through-hole is provided between the top wall and the bottom wall of the rotating assembly 203 parallel to each other. A threaded hole 204 , the second screw is matched and screwed into the second threaded hole 204 .

In this technical solution, a rotating assembly 203 is movable in each universal hole 201, and a second threaded hole 204 is provided on the rotating assembly 203, and a second screw is screwed in each second threaded hole 204, and the The distal portion 200 is fixed to the distal end of the humerus. The inner wall of the universal hole 201 is hemispherical, and one end located on the surface of the distal end 200 is a large aperture end, and one end located on the bottom surface of the distal end 200 is a small aperture end, and there is a large aperture end to a small aperture end. The changing law of the spherical structure conforms to the changing law of the small circle of the spherical structure. The rotating assembly 203 is a drum-shaped structure, and the diameter of its cut surface changes according to the law of first increasing and then decreasing. The rotating assembly 203 is provided with a second Threaded hole 204, the two ends of the second threaded hole 204 correspond to the large aperture end and the small aperture end of the universal hole 201 respectively, and the rotating assembly 203 is arranged in the universal hole 201 and can be rotated appropriately, thereby adjusting the second threaded hole 204 for directions. When in use, the skin at the humerus fracture is cut open, blood clots are cleared, and the fracture block is reset. The proximal part 100 of the anatomical locking plate for minimally invasive treatment of humerus fractures is placed on the proximal end of the humerus, and the distal end The part 200 fits around the distal end of the humerus, and the first screw is screwed into the first threaded hole 101 of the proximal part 100 for fixation. Open a preset hole in the best implantation direction, screw the second screw into the second threaded hole 204, adjust the screw implantation direction, continue to screw in so that the second screw passes through the small aperture end of the universal hole 201, and screw Insert it into the corresponding preset hole for fixing. The maximum diameter of the rotating assembly 203 is smaller than the diameter of the large aperture end of the universal hole 201, and larger than the diameter of the small aperture end of the universal hole 201, so that the rotating assembly 203 can rotate in the universal hole 201, and the second threaded hole 204 and For the angle range between the humerus, the angle between the second threaded hole 204 and the humerus can be adjusted by adjusting the position of the rotating assembly 203, so as to adapt to the relatively thin bone quality on the lateral surface of the distal end of the humerus and the coronoid fossa and the coronoid socket at the front and rear. The anatomical characteristics of the olecranon fossa ensure that the best implantation direction can be selected during the operation according to the fracture characteristics and shape differences of different individuals. It is flexible and easy to operate, and avoids internal injuries caused by insufficient fixation strength or iatrogenic fractures. If the fixation fails, the stability of the steel plate and bone fixation is improved.

As shown in Figure 2, in other technical solutions, the inner wall of the universal hole 201 is provided with a plurality of slide grooves 210 along the meridian, and the curved outer wall of the rotating assembly 203 is provided with a plurality of first ribs 211 along the meridian , the plurality of first ribs 211 are inserted into the plurality of slide grooves 210 in one-to-one correspondence. In this technical solution, the inner wall of the universal hole 201 and the outer wall of the rotating assembly 203 are provided with a plurality of slide grooves 210 and a plurality of first ribs 211 corresponding to each other, so that the rotating assembly 203 can move along any direction in the universal hole 201. The chute rotates, thereby adjusting the angle of the second threaded hole 204 on the rotating assembly 203 to improve structural flexibility.

As shown in Figure 3, in some other technical solutions, the curved outer wall of the rotating assembly 203 is provided with an annular second rib 220 along the latitudinal line, and the outer diameter of the second rib 220 is larger than the universal hole The annular protrusion of 201 is along the inner diameter of 202 . In this technical solution, the rotating assembly 203 is provided with an annular second rib 220 whose outer diameter is larger than the inner diameter of the annular convex edge 202 around the universal hole 201, so as to prevent the rotating assembly 203 from slipping out of the universal hole 201 and improve the structure. stability.

As shown in Figure 3, in some other technical solutions, a sleeve 221 is also arranged in the universal hole 201, the sleeve 221 is a drum-shaped ring structure, which is sleeved on the outer circumference of the rotating assembly 203, and Together with the rotating assembly 203, it is accommodated in the universal hole 201, and the curved outer wall of the sleeve 221 is provided with an annular third rib 222 along the latitudinal line, and the outer diameter of the third rib 222 is larger than that of the universal hole. The annular protrusion of 201 is along the inner diameter of 202 . In this technical solution, a sleeve 221 is arranged between the universal hole 201 and the rotating assembly 203. The sleeve 221 can rotate in the universal hole 201, and the rotating assembly 203 can rotate in the sleeve 221, thereby improving the angle adjustment of the second screw. range; and the outer diameter of the third rib 222 is larger than the inner diameter of the annular rib 202, preventing the sleeve 221 from slipping out of the universal hole 201 and improving structural stability.

In other technical solutions, the thickness of the proximal portion 100 is greater than the thickness of the distal portion 200 . In this technical solution, the proximal part 100 and the distal part 200 have different thicknesses, conforming to the anatomical characteristics of the humerus, and improving the firmness of the steel plate and the fracture site.

In some other technical solutions, the diameter of each first threaded hole 101 is greater than the diameter of each second threaded hole 204 . In this technical solution, the diameters of the threaded holes of the proximal part 100 and the distal part 200 are different, which conforms to the anatomical characteristics of the relatively thin bone on the lateral surface of the distal humerus and the coronoid fossa and olecranon fossa in the front and back, effectively avoiding the Internal fixation failure caused by insufficient fixation strength or iatrogenic fracture.

Although the embodiment of the present invention has been disclosed as above, it is not limited to the use listed in the specification and implementation, it can be applied to various fields suitable for the present invention, and it can be easily understood by those skilled in the art Therefore, the invention is not limited to the specific details and examples shown and described herein without departing from the general concept defined by the claims and their equivalents.

Claims (3)

1. The anatomical locking steel plate for minimally invasive treatment of humerus fracture is characterized by comprising a proximal end part and a distal end part, wherein one end of the distal end part is connected with the proximal end part, the other end of the distal end part is gradually twisted to an included angle of 3-8 degrees with the plane of the proximal end part, a plurality of first threaded holes are formed in the proximal end part, first screws are screwed in each first threaded hole in a matched manner, a plurality of universal holes are formed in the distal end part, and second screws are screwed in each universal hole in a matched manner;

the inner wall of the universal hole is of a hemispherical structure, the aperture of the universal hole gradually decreases from the surface of the distal end part to the bottom surface, an annular convex edge extending vertically inwards is arranged on the periphery of one side of the surface of the distal end part, a rotating assembly is movably accommodated in the universal hole, the rotating assembly is of a drum-shaped structure, the outer diameter of the rotating assembly from the surface of the distal end part to the bottom surface is increased firstly and then decreased, a second threaded hole which is mutually communicated is formed between the top wall and the bottom wall of the rotating assembly, which are mutually parallel, and the second screw is matched and screwed into the second threaded hole;

the outer wall of the curved surface of the rotating assembly is provided with an annular second convex rib along the weft, and the outer diameter of the second convex rib is larger than the inner diameter of the annular convex edge of the universal hole;

the universal hole is further provided with a sleeve piece, the sleeve piece is of a drum-shaped annular structure, the sleeve piece is sleeved on the periphery of the rotating assembly and is contained in the universal hole together with the rotating assembly, the outer wall of the curved surface of the sleeve piece is provided with an annular third convex rib along the weft, and the outer diameter of the third convex rib is larger than the inner diameter of the annular convex edge of the universal hole.

2. The anatomic lock plate for minimally invasive treatment of humeral fractures as claimed in claim 1, in which the thickness of the proximal portion is greater than the thickness of the distal portion.

3. The anatomic lock plate for minimally invasive treatment of humeral fractures as claimed in claim 1, in which the aperture of each first threaded hole is greater than the aperture of each second threaded hole.

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