CN111973256A - Femoral neck fracture fixing device - Google Patents
Femoral neck fracture fixing device Download PDFInfo
- Publication number
- CN111973256A CN111973256A CN202010885481.4A CN202010885481A CN111973256A CN 111973256 A CN111973256 A CN 111973256A CN 202010885481 A CN202010885481 A CN 202010885481A CN 111973256 A CN111973256 A CN 111973256A
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- Prior art keywords
- blade
- femoral neck
- wall
- bone cavity
- core rod
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- 208000020089 femoral neck fracture Diseases 0.000 title claims abstract description 19
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 77
- 210000002436 femur neck Anatomy 0.000 claims abstract description 42
- 206010017076 Fracture Diseases 0.000 description 8
- 208000010392 Bone Fractures Diseases 0.000 description 7
- 230000006835 compression Effects 0.000 description 7
- 238000007906 compression Methods 0.000 description 7
- 230000007547 defect Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 206010020100 Hip fracture Diseases 0.000 description 1
- 210000000588 acetabulum Anatomy 0.000 description 1
- 230000003044 adaptive effect Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 230000000452 restraining effect Effects 0.000 description 1
- 210000000689 upper leg Anatomy 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/74—Devices for the head or neck or trochanter of the femur
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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)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a femoral neck fracture fixing device which comprises a core rod, a plurality of blades and a locking component, wherein the distal end of each blade comprises an outward protruding front flange part, and the front flange part is matched and supported on the inner wall of a bone cavity at a corresponding position. The outer side of the core rod is axially provided with a positioning groove, the core rod is inserted into the center of the bone cavity, the knife back part at the rear side of each blade is matched and embedded in the corresponding axial positioning groove, each blade is supported at the corresponding position of the inner wall of the bone cavity by the core rod, and the rear end of the core rod is fixed at the root of the femoral neck. The invention uses the blade to be jointed with the inner wall of the femoral neck to enter the bone cavity first, and the destructiveness of loose bone parts in multiple bone cavities is reduced to the minimum. The proper blades can be selected to be completely matched and sleeved on the inner end expansion part of the femoral neck, the edge profile of each blade is completely attached to the inner wall of the bone cavity expansion part, and after the back of each blade is supported by the core rod, each blade is radially supported on the inner wall of the femoral neck bone cavity.
Description
Technical Field
The invention belongs to the technical field of reduction fixing devices for femoral neck fracture, and particularly relates to a femoral neck fracture fixing device.
Background
Fractures of the neck and tuberosity of the femur are common frequently encountered diseases of the old. When the femoral neck fracture or intertrochanteric fracture is fixed by a screw and nail plate system, the traditional internal fixation method for the femoral neck fracture is many, and joint replacement is often finally performed due to difficult operation and many complications. The femur neck has special anatomical structure, a shaft angle and an anteversion angle on different planes, and the position is deep and hidden, so that the positioning guide pin is difficult to be correctly placed. When the internal fixation is used for treating the fracture of the femoral neck and the femoral tuberosity, a guide needle is firstly placed for positioning. The main factor of the traditional fixing method for inserting the guide pin is the problem of weak fixation, which is usually performed according to the clinical experience of doctors.
In another aspect, the femoral neck includes an outer hard bone portion and an inner loose bone portion, the loose bone portion filling the entire bone cavity as shown in FIG. 15. The loose bone part of the inner layer has large volume and low density, the intramedullary nail has fixing strength when being fixed on the hard bone part of the outer layer, but the fixing strength when being fixed on the loose bone part of the inner layer is insufficient, and most of the intramedullary nails are actually positioned on the loose bone part of the inner layer. The outer diameters of the root part and the tail end of the femoral neck are larger than that of the neck part, and part of the intramedullary nail is exposed out of the neck part, so that the problem of poor firmness in fixation of the intramedullary nail is caused.
In the prior art, a structure similar to an expansion wire is adopted, the inner wall of a bone cavity is supported in the femoral neck bone cavity through a distraction expansion part, and actually, the inner wall is supported at a loose bone part and compresses the loose bone part to the hard bone inner wall, and the expansion type bone pressing device has the following problems: (1) the expansion surface is a cambered surface, loose bone parts can not be completely stripped and directly contact the inner wall of the hard bone, so that the firmness after compression is insufficient, (2) after expansion and compression, enough constraint force of the femoral neck in the circumferential direction can not be provided, the femoral neck can be dislocated due to rotation, (3) the destructiveness of the loose bone parts is high, when the inner end of the loose bone parts is expanded, all loose bone parts in the bone cavity of the femoral neck are damaged, (4) the expansion part at the inner end of the loose bone parts can not be completely matched with the inner wall of the bone cavity of the femoral neck, and can not provide enough anti-torsion strength, the fracture reduction of a femoral neck fracture patient needs to be maintained at the internal rotation position of the lower limb, the point is embedded by the acetabulum and is not completely spherical, and the body position rotation can bring large torsion to an internal support part, so that the expansion part. For example, the "expansion fixing femoral head inner support body" provided by CN 202146350U includes a support main body and an inner expansion screw, the support main body is sleeved outside the inner expansion screw, the top of the support main body is arc-shaped, the support main body is provided with radial expansion wings, the expansion wings are composed of a plurality of wing panels, an expansion gap is formed between the wing panels, the inner expansion screw is provided with an expansion section, the expansion section can expand the expansion wings after the inner expansion screw is placed in the support main body, and the support main body is in threaded connection with the inner expansion screw. This patent document has the above problems (1) to (4), and "an adjustable compression fixation expansion bolt for femoral neck fracture" disclosed in publication No. CN2299593Y has the above problems (1) to (4). The above problems (2) and (4) are associated with the "femoral neck expansion type locked compression screw" of publication No. CN2487349Y and the "expansion compression bone bolt" of publication No. CN 2209507Y.
Disclosure of Invention
Aiming at the defects and problems of various fixing modes of the prior femur neck, the invention provides a femur neck fracture fixing device which can effectively fix the fracture part of the femur neck from the inside, provide enough torsion-preventing force and prevent secondary damage in a fixing state by sleeving a blade with a matched profile along the radial direction in a femur neck bone cavity, and utilizing a core rod to press the blade and position the blade.
The invention adopts the technical scheme that the femoral neck fracture fixing device comprises a core rod, a plurality of blades and a locking component.
At least two blades matched with the inner wall are sleeved on the corresponding positions of the inner wall of the bone cavity at the tail end of the femoral neck, the far end of each blade comprises an outward protruding front flange part, and the front flange part is matched and supported on the inner wall of the bone cavity at the corresponding position.
The core rod is inserted into the center of the bone cavity, the back of each blade is embedded in the corresponding axial positioning groove, each blade supports the corresponding position of the inner wall of the bone cavity by the core rod, and the rear end of the core rod is fixed at the root of the femoral neck.
The proximal end of each blade also comprises a rear flange part protruding outwards, the rear flange part is sleeved on the inner wall of the bone cavity at the corresponding position at the rear side of the neck of the femoral neck in a matching mode, and the core rod supports each blade so that the rear flange part supports the corresponding position of the inner wall of the bone cavity.
The flange part of each blade contains latch.
The rear end of the core rod is provided with a radial fixing hole along the radial direction and is fixed at the root of the femoral neck by installing a locking wire.
The rear end of the core rod is also provided with a connecting hole for connecting the fixing frame.
The invention has the beneficial effects that: the invention uses the blade to be jointed with the inner wall of the femoral neck to enter the bone cavity first, and the destructiveness of loose bone parts in multiple bone cavities is reduced to the minimum. The proper blades can be selected to be completely matched and sleeved on the inner end expansion part of the femoral neck, the edge profile of each blade is completely attached to the inner wall of the bone cavity expansion part, and after the back of each blade is supported by the core rod, each blade is radially supported on the inner wall of the femoral neck bone cavity. This way of supporting and fixing has the following advantages: (1) the blade enters the bone cavity and has small destructiveness to loose bone parts in the femoral neck bone cavity, main loose bone parts (mainly the loose bone parts contacted with the hard bone parts) are reserved, the edge part outline of each blade is completely attached to the inner wall of the expanded part of the bone cavity, the defect of point compression of the existing expansion bolt is overcome, firm compression and uniform stress can be realized, and (3) enough constraint force of the femoral neck in the circumferential direction can be effectively provided, and the femoral neck is prevented from being dislocated due to rotation.
Drawings
FIG. 1 is a schematic view of a configuration of the present invention in use.
Fig. 2 is a schematic structural diagram of the present invention.
Fig. 3 is a view showing the structure of direction a in fig. 2.
FIG. 4 is a schematic view of the assembled state of the core pin and the insert.
Fig. 5 is a perspective view of the core rod.
Fig. 6 is a side view of fig. 5.
Fig. 7 is a sectional view of B-B in fig. 6.
Fig. 8 is a sectional view of the structure of fig. 6 taken along line C-C.
Fig. 9 is a block diagram of a blade.
Fig. 10 is a bottom view of fig. 9.
Fig. 11 is another structural view of the blade.
Fig. 12 is an enlarged view of the portion D in fig. 11.
Fig. 13 is a schematic view of a four-blade assembly configuration.
Fig. 14 is a schematic view of the use state of another structure of the present invention.
Fig. 15 is a schematic view of a prior art femoral neck fixation by intramedullary nail.
FIG. 16 is a schematic view of additional axial restraint structures between the core rod and each blade.
Reference numbers in the figures: the core rod comprises a core rod 1, an axial positioning groove 2, a blade 3, a blade back clamping seat 4, a front flange part 5, a rear flange part 5a, a radial fixing hole 6, a connecting hole 7, a clamping tooth 8, an outer-layer hard bone part 10, an inner-layer loose bone part 11, a cone 12, a push rod 13, an elastic pin 14, a pin control 15, a clamping head 16, a rotating rod 17, a screw rod 18, a thread section 19, a tube cavity 20 and a clamping groove 21.
Detailed Description
The traditional way of fracture of the femoral neck, which involves fixation by implanting an intramedullary nail from its root to its tip, is problematic, as in fig. 15, the femoral neck comprises an outer hard bone part and an inner loose bone part, which fills the entire bone cavity. The loose bone part of the inner layer has large volume and low density, the intramedullary nail has fixing strength when being fixed on the hard bone part of the outer layer, but the fixing strength when being fixed on the loose bone part of the inner layer is insufficient, and most of the intramedullary nails are actually positioned on the loose bone part of the inner layer. In addition, the outer diameters of the root and the tail end of the femoral neck are larger than that of the neck (the neck belongs to a fracture part), and even a part of intramedullary nail is exposed out of the neck. This leads to a problem of poor fixation of the intramedullary nail. To address this problem, the present invention employs a femoral neck fracture fixation device as shown in fig. 2, which is placed within the femoral neck cavity as shown in fig. 1. The invention is further illustrated with reference to the following figures and examples.
Example 1: the femoral neck fracture fixing device comprises a core rod and three blades, and various models are set according to body types of different patients, so that the femoral neck fracture fixing device can be conveniently applied to different patients by selecting adaptive models.
The core rod is shown in fig. 5-8. The core rod 1 is designed in a cylinder or prism, and the outer side of the core rod is provided with positioning grooves along the axial direction, and the embodiment is three axial positioning grooves 2 as shown in figure 8. For convenient application, the distal end part of the core rod 1 is provided with a chamfer, and the port position of each axial positioning groove 2 outside the core rod can also be provided with a chamfer.
As shown in fig. 7, the rear end of the core rod is provided with a radial fixing hole 6 along the radial direction, and the core rod is fixed at the position of the root of the femoral neck through installing a locking wire.
One form of construction of the blades 3 is shown in fig. 9 and 10, the distal end of each blade has an outwardly projecting forward flange portion 5, and each blade forward flange portion 5 can be configured to follow the contour of the inner wall of the bone cavity in which the corresponding blade is located, i.e., each blade forward flange portion 5 has its own unique contour to ensure that each blade forward flange portion 5 has more contact surface with the inner wall of the bone cavity.
The assembly relationship of the core rod 1 and each blade 3 is as shown in fig. 4, the core rod 1 is inserted into the center of the bone cavity, and the back of each blade is embedded into the corresponding axial positioning groove 2.
When the device is used, after the lateral surface of the root of the femoral neck is provided with the hole, the three blades penetrate through the loose bone parts one by one under the perspective condition and are inserted into the corresponding positions of the inner wall of the bone cavity at the tail end of the femoral neck, so that the front flange part 5 of each blade is matched with the inner wall of the corresponding position, and the loose bone parts can keep the positions of the blades relatively stable. Then the core rod 1 is inserted into the center of the bone cavity, and the corresponding positions of the inner walls of the bone cavity supported by the blades are shown in figure 1. Finally, the rear end of the core rod 1 is fixed at the root of the femoral neck. In addition, the rear end of the core rod can be further provided with a connecting hole 7 for connecting the fixing frame.
Example 2: based on embodiment 1, a blade with latch 8 at the front flange part 5 is adopted, as shown in fig. 11 and 12, after the front flange part 5 is matched with the inner wall of the bone cavity, a plurality of latches 8 at the front flange part 5 are supported on the inner wall of the bone cavity at the same time, so as to improve the stability of the supporting part.
Example 3: in addition to the front flange portion 5, each blade of example 1 also has a rear flange portion 5a protruding proximally outward, as shown in fig. 14. A recessed neck portion is provided between the front flange portion 5 and the rear flange portion 5 a. The front flange part 5 is used for matching and supporting the inner wall of the tail end of a bone cavity, and the rear flange part 5a is matched and sleeved on the inner wall of the bone cavity at the corresponding position on the rear side of the neck of the femoral neck. Further, the front flange part 5 can be arranged according to the contour of the inner wall of the bone cavity at the position of the corresponding blade, namely, the front flange part 5 and the rear flange part 5a of each blade respectively have own unique contour so as to ensure that the front flange part 5 and the rear flange part 5a of each blade respectively have more contact surfaces with the inner wall of the bone cavity at the corresponding position. The core rod 1 supports the respective blades such that the front flange portion 5 and the rear flange portion 5a support the corresponding positions of the inner wall of the bone cavity, respectively.
In the case of femoral neck fracture, in the above embodiment 3, the front flange part 5 and the rear flange part 5a of each blade are respectively supported on the inner wall with enlarged root and the inner wall with enlarged tip, so as to prevent the fracture part from twisting or separating, and the core rod 1 in this embodiment only needs to provide the supporting function in the radial direction.
Example 4: for the above embodiments 1-3, a four-blade support structure as shown in fig. 14 may be further provided, wherein the front flange portion 5 and the rear flange portion 5a of each blade are configured with unique contours according to the corresponding positions of the four blades in the bone cavity, so as to be respectively matched, attached and pressed with the contours of the inner wall of the bone cavity.
Example 5: as for the above embodiments 1 and 2, an axial constraint structure may be further added between the core bar and each blade, for example, a convex-concave structure surface is disposed on the inner wall of each axial positioning groove 2 on the core bar, and a convex-concave structure surface engaged with the back holder 4 of each blade is disposed, so as to enhance the axial constraint force after the core bar and each blade are assembled. It is not excluded to provide the bottom surface of the core rod 1 or each axial positioning groove 2 of the core rod with a taper. Based on the axial restraining structure adopted by the embodiment, the core rod can be arranged to be tubular, the elastic pin assembly is sleeved in the tube cavity, and the elastic pin assembly extends out of the corresponding axial positioning groove 2 to restrain the blade. For example, as shown in fig. 16, when the adjusting screw 18 is screwed to move axially, the rotating rod 17 pushes the push rod 13 to move axially forward, so as to push the elastic pin to move forward. The elastic pin is an open structure with two or three or four petals, is supported by the distal cone after moving forwards and is dispersed along the radial direction, and then is led out from the corresponding pin control 15, and the clamping head 16 at the tail end is supported in the clamping groove 21 of the knife back clamping seat.
Claims (5)
1. The utility model provides a femoral neck fracture fixing device, characterized in that, in the terminal bone cavity inner wall relevant position suit of femoral neck match in two at least blades of inner wall, the distal end of every blade contains outside outstanding preceding flange position (5), preceding flange position (5) match support in relevant position bone cavity inner wall, there is a core bar (1), there is the constant head tank outside core bar (1) along the axial, insert core bar (1) bone cavity center and make the back of a knife portion of each blade rear side match inlay the dress in corresponding axial constant head tank (2), utilize core bar (1) to support each blade and support bone cavity inner wall relevant position, core bar (1) rear end is fixed at femoral neck root.
2. A femoral neck fracture fixation device according to claim 1, wherein the proximal end of each blade also includes an outwardly projecting posterior flange portion (5a), the posterior flange portion (5a) being adapted to fit around the inner wall of the bone cavity at a corresponding location on the posterior side of the neck of the femoral neck, the core (1) supporting each blade such that the posterior flange portion (5a) supports the corresponding location of the inner wall of the bone cavity.
3. A femoral neck fracture fixation device as in claim 1, wherein the flange portion of each blade comprises a latch (8).
4. A femoral neck fracture fixation device according to claim 1, wherein the rear end of the core rod is provided with radial fixation holes (6) in the radial direction, and is fixed at the position of the root of the femoral neck by installing lock wires.
5. A femoral neck fracture fixation device according to claim 1, wherein the rear end of the core rod is further provided with a connection hole (7) for connection of a fixation frame.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202010885481.4A CN111973256A (en) | 2020-08-28 | 2020-08-28 | Femoral neck fracture fixing device |
PCT/CN2021/073201 WO2022041643A1 (en) | 2020-08-28 | 2021-01-22 | Femoral neck fracture fixation device |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202010885481.4A CN111973256A (en) | 2020-08-28 | 2020-08-28 | Femoral neck fracture fixing device |
Publications (1)
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CN111973256A true CN111973256A (en) | 2020-11-24 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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CN202010885481.4A Pending CN111973256A (en) | 2020-08-28 | 2020-08-28 | Femoral neck fracture fixing device |
Country Status (2)
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CN (1) | CN111973256A (en) |
WO (1) | WO2022041643A1 (en) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN112716586A (en) * | 2021-01-25 | 2021-04-30 | 李晖 | Intramedullary fixation device for femoral fracture |
WO2022041643A1 (en) * | 2020-08-28 | 2022-03-03 | 陈聚伍 | Femoral neck fracture fixation device |
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CN111973256A (en) * | 2020-08-28 | 2020-11-24 | 陈聚伍 | Femoral neck fracture fixing device |
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2020
- 2020-08-28 CN CN202010885481.4A patent/CN111973256A/en active Pending
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2021
- 2021-01-22 WO PCT/CN2021/073201 patent/WO2022041643A1/en active Application Filing
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US20020143335A1 (en) * | 2001-03-30 | 2002-10-03 | Von Hoffmann Gerard | Distal bone anchors for bone fixation with secondary compression |
CN2659365Y (en) * | 2003-12-10 | 2004-12-01 | 侯庆忠 | Fixing/self locking and composite interlock internal pulp nail between tuberosity of thigh-bone |
WO2006007553A2 (en) * | 2004-07-01 | 2006-01-19 | Smith & Nephew, Inc. | Fixation elements |
WO2010091242A1 (en) * | 2009-02-05 | 2010-08-12 | Novalign Orthopaedics, Inc. | Proximal femur fixation apparatus, systems and methods with angled elongate elements |
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CN112716586A (en) * | 2021-01-25 | 2021-04-30 | 李晖 | Intramedullary fixation device for femoral fracture |
CN112716586B (en) * | 2021-01-25 | 2023-11-03 | 李晖 | Intramedullary fixing device for femur fracture |
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