CN104783883A - Special inner fixing steel plate for lateral tibial plateau hypocondyle fracture reduction - Google Patents

Abstract

The invention provides a special inner fixing steel plate for lateral tibial plateau hypocondyle fracture reduction. The special inner fixing steel plate is characterized by comprising a lateral tibial plateau steel plate body (1) and rearwards extending lug steel plate body (2), wherein the edges of the ends, close to each other, of the lateral tibial plateau steel plate body and the lug steel plate body are provided with small edge holes (3), plateau screw holes (4) are formed in the lateral tibial plateau steel plate body and below the small edge holes, hypocondyle screw holes (5) are formed in the inclined lateral tibial plateau hypocondyle portion and below the plateau screw holes (4), side holes (6) are formed in front of the hypocondyle screw holes, far-end screw holes (7) are formed in the far end of the lateral tibial plateau steel plate body, and a sliding screw hole (8) is formed among the far-end screw holes of the lateral tibial plateau steel plate body.

Description

A kind of Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special

Technical field

The present invention is applied to clinical orthopaedics, a kind of Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special, belongs to medical device.It applies to platform postartis fracture operation reduction fixation equipment special outside human tibia.The application of this equipment, can reach and facies artieularis malleolaris after Lateral tibial plateau is returned to original position, can also improve internal fixtion intensity.

Background technology

Knee joint is one of large weight-bearing joints of lower limb three.Proximal tibia fracture, as dealt with improperly, must affect the life after patient's wound and work.The fracture of proximal tibia comprises intra-articular fracture (fracture of the tibial plateau) and extra-articular fracture (proximal tibia 1/4).Because kneed dissection axis is 7 ° of physiology valgus angle, therefore, Lateral tibial plateau fracture is common compared with other types.Usually affect knee joint function with stable, especially this type of condylar fracture companion fibula fractured near end after Lateral tibial plateau.In order to recover and maintain the knee joint function after tibiofibula fractured near end, some type fracture need operative treatment, and expectant treatment result is often barely satisfactory.And these objects will be realized by the anatomical reduction of tibial condyle articular surface, the maintenance joint line of force, recovery ligament stability and the functional activity degree maintaining knee joint painless.At present, the internal fixation materials such as existing various dissection armor plates are applied to fracture of the tibial plateau, but after Lateral tibial plateau, condylar fracture does not also obtain enough attention.Major part patient Lateral tibial plateau postartis fracture surgery is disabled because of solid failure.In order to facies artieularis malleolaris after Lateral tibial plateau is returned to original position, and improve internal fixtion intensity.We have developed a kind of Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special, to make up the deficiency of existing internal fixation material, are also the permanent expectations of medical circle personage and patient.

Summary of the invention

The object of the invention is the deficiency in order to overcome existing internal fixation device, providing a kind of effective the new short fixation instrument material.Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special, it can reach and facies artieularis malleolaris after Lateral tibial plateau is returned to original position, can also improve internal fixtion intensity.Strengthen convalescent bearing capacity, reduce the generation that disables because of solid failure of fracture surgery, and a kind of new operation method of research design.

To achieve these goals, the present invention adopts following technical scheme:

A kind of Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special, is characterized in that Lateral tibial plateau steel plate (1) and the ear steel plate (2) that extends back; Lateral tibial plateau steel plate and ear steel plate proximal edge are provided with edge aperture (3), it has the platform screw hole (4) of parallel tibial plateau, have the postartis screw hole (5) of oblique Lateral tibial plateau postartis again, postartis screw hole leading edge is provided with lateral orifices (6), Lateral tibial plateau steel plate far-end is provided with distal screw holes (7), is provided with sliding screw hole (8) in the middle of Lateral tibial plateau steel plate distal screw holes.Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special is anatomical plate, distinguish left and right, its steel plate near-end is mutually docile with tuberosity of bitia,external surface of bone, far-end with lateral of tibia surface of bone mutually docile and with surface of bone Limited contact.Upper limb or low 0-0.2 centimetre identical with tibial plateau lateral articular face.Lateral tibial plateau steel plate near-end extends rearward to be ear steel plate.Identical or the low 0-0.2 centimetre in posterior joint face outside the consistent and upper limb of ear steel plate upper limb and Lateral tibial plateau steel plate upper limb and tibial plateau.Ear steel plate is the gradually narrow extension backward of Lateral tibial plateau steel plate near-end, and the upper and lower wide 1-3 centimetre of near-end, the upper and lower wide 0.5-2 centimetre of far-end are mutually docile with surface of bone outside the platform postartis of outside.Lateral tibial plateau steel plate and ear steel plate proximal edge are provided with edge aperture.Edge aperture 2-5, diameter is 0.1 centimetre-0.3 centimetre.Edge aperture is for being circular port, and duct is arc, and its entrance is the centre of Lateral tibial plateau steel plate and ear steel plate upper end steel plate thickness, exports the reverse side into Lateral tibial plateau steel plate and ear steel plate near-end subsides surface of bone.Outlet is apart from steel plate upper limb 0.1 centimetre-0.2 centimetre.What be positioned at edge aperture has the platform screw hole being parallel to tibial plateau, and platform screw hole is positioned at ear steel plate width central authorities.The platform screw hole of Lateral tibial plateau steel plate and the platform screw hole of ear steel plate are positioned at sustained height.Platform screw hole 2-6, diameter is 0.2 centimetre-0.5 centimetre, and platform screw orientation is perpendicular to surface of bone, parallel with Lateral tibial plateau plane.The postartis screw hole having oblique Lateral tibial plateau postartis of Lateral tibial plateau plate platform screw hole.Postartis screw hole 1-4, diameter is 0.2 centimetre-0.5 centimetre, and postartis screw hole direction is Lateral tibial plateau steel plate apertured place steel plate synthetism face vertical line, to ear steel plate direction and the 15-60 degree that is inclined upwardly.Lateral orifices is provided with on front side of postartis screw hole.Lateral orifices 1-3, diameter is 0.1 centimetre-0.3 centimetre, the hole direction of lateral orifices perpendicular to surface of bone, apart from steel plate leading edge 0.1 centimetre-0.3 centimetre.

Lateral tibial plateau steel plate postartis screw hole have distal screw holes.Distal screw holes is positioned at Lateral tibial plateau steel plate distal end width central authorities.Distal screw holes 2-20, diameter 0.3 centimetre-0.8 centimetre, distal screw direction is vertical with surface of bone.Be provided with 1, sliding screw hole in the middle of Lateral tibial plateau steel plate distal screw holes, straight 0.3 centimetre-0.8 centimetre, sliding screw direction is vertical with surface of bone.The platform screw hole of Lateral tibial plateau steel plate and the ear steel plate that extends back is screw hole.Lateral tibial plateau steel plate postartis screw hole is screw hole, and distal screw holes is screw hole and the design of two kinds, plain screw hole.Ear steel plate set by Lateral tibial plateau steel plate near-end side.For the steel plate of left tibia platform, its near-end side ear steel plate is located on the right side of Lateral tibial plateau steel plate, and for the steel plate of right side tibial plateau, its near-end side ear steel plate is located on the left of Lateral tibial plateau steel plate.

Operation principle of the present invention is: anaesthetize successfully, patient gets dorsal position, padded under Ipsilateral buttocks, and pueumatic tourniquet is tied in Ipsilateral thigh root, lower limb povidone iodine routine disinfection drape.Esmarch's bandage drives blood, and pueumatic tourniquet is inflated.Interior rotation suffering limb, gets otch approach outside knee joint, outside knee joint, cut skin in the middle of Gerdy tuberosity and fibular head, and otch to be proximally extended down in knee joint 3 centimetres, and arc is to biceps femoral muscle leading edge on rear side fibular head.Distally under Gerdy tuberosity around 2 centimetres, lateral tubercle of tibia edge, and along tibia ridge outer rim 1 centimetre, extend according to fracture line, cut skin fascia, appear tibialis anterior (through the subcutaneous tibialis anterior that is inserted between tibia).Released part tibialis anterior proximal tibia stop, appears joint capsule, below lateral meniscus, cuts joint capsule, appear lateral tibial plateau, and subperiosteum peels off tibial plateau posterior lateral margin soft tissue, appears outside platform postartis.After giving outside platform, condylar fracture is subsided percutaneous reduction by leverage, and Kirschner wire is temporary fixed.Select corresponding length Lateral tibial plateau dorsal condyle steel plate, check steel plate and tibial plateau postartis whether docile, pre-bending if desired.Sliding eye screw is temporary fixed.Through " C-arm " perspective: fracture reduction is good to line, and internal fixation steel plate position is good.Under determining that steel plate top edge is placed in tibial plateau articular surface, lateral orifices Kirschner wire is temporary fixed, fixing sliding eye screw.Leading postartis screw is fixed, and checks with or without screw projecting platform articular surface or postartis, avoids damage platform cartilage Huo popliteal nest soft tissue.Row platform screw is fixed again, avoids deck hole screw to damage postartis screw.Last stationary remote screw as required.Again through " C-arm " perspective: fracture reduction is good to line, and internal fixation steel plate position is good.Pine pueumatic tourniquet, rinses otch and stops blooding, checking dressing apparatus errorless.Lateral articular capsule cutting edge application absorbable thread is sewed up fixing through edge aperture.Otch inserts drainage tube if desired, successively closes otch and wraps up.Postoperative conventional therapy.

Beneficial effect:

One, safety: before the otch approach of condylar fracture open reduction is positioned at biceps femoral muscle and fibula after newly-designed Lateral tibial plateau, between Gerdy tuberosity, tibial tubercle and tibia ridge, without main neural blood vessel.Major nerve blood vessel injury can not be caused during operation.Secondly, platform screw and postartis screw more tiny, tibial plateau cartilage and PoplitealWo soft tissue structure can not be damaged.

Two, effectiveness: ear steel plate design of the present invention, can reach and facies artieularis malleolaris after Lateral tibial plateau is returned to original position, can also improve internal fixtion intensity.Inserting 1-4 screw at Lateral tibial plateau postartis has pulling force to pressurize and the effect of support rib folded block.2-4 the screw being parallel to platform is inserted, the spitting image of " raft " made by steel nail at outside platform.Research shows, the recompression of this kind of the most applicable resistance sclerite of structure.Reduce the generation of surgical menopause mode complication in the past, such as fracture fixation is not strong stable, and fracture surgery subsides caused complication etc.

The invention has the advantages that:

1, the invention provides the reset of Lateral tibial plateau postartis to pressurize and supporting role, strengthen pressurization and supporting role between fracture by postartis screw, ensure that strong stable fixing of fracturing, and avoid injured nerve blood vessel.

2, the invention provides the ear steel plate screw entry design of tibial plateau postartis reduction fixation, meet human dissection, be conducive to pressurization between fracture, simultaneously at Lateral tibial plateau screw, what effectively prevention knee joint turned up that stress causes subsides again.

3, the stitching that the ear steel plate edge aperture that the invention provides tibial plateau postartis reduction fixation is conducive to knee joint lateral articular capsule is fixed.

Accompanying drawing explanation

Fig. 1 is front view of the present invention.

Fig. 2 is left view of the present invention.

Fig. 3 is AA sectional view of the present invention.

Fig. 4 is the top view of Fig. 1.

In Fig. 1 front view of the present invention, icon 3 and to the first from left row totally 4 apertures are edge apertures, the duct of edge aperture goes out for upwards curved bend, and the another end in its hole has in the diagram and clearly represents.

In Fig. 1 front view of the present invention, icon 6 is parallel to the right, left 4 apertures on the lower side and front view bottom be lateral orifices, the duct of lateral orifices is straight hole.

In Fig. 1 front view of the present invention, icon 5 and parallel two holes are left postartis screw hole, and surface of bone hectare oblique 15-60 degree upwards and is to the right pasted in its duct.

In Fig. 1 front view of the present invention, icon 7 and on nearest 2 holes, under nearest 1 hole under icon 7 and icon 8,2 nearest holes are distal screw holes, and duct is straight hole.

In Fig. 1 front view of the present invention, the two circle of icon 4,5,7,8 hole diagram, its outer ring is the nut slot of screw, and inner ring is hole.

Icon: (1) Lateral tibial plateau steel plate, (2) ear steel plate, (3) edge aperture, (4) platform screw hole, (5) postartis screw hole, (6) lateral orifices, (7) distal screw holes, (8) sliding screw hole.

Detailed description of the invention

As shown in Figure 1, Figure 2, Figure 3, Figure 4, a kind of Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special, is characterized in that Lateral tibial plateau steel plate (1) and the ear steel plate (2) that extends back; Lateral tibial plateau steel plate and ear steel plate proximal edge are provided with edge aperture (3), it has the platform screw hole (4) of parallel tibial plateau, have the postartis screw hole (5) of oblique Lateral tibial plateau postartis again, postartis screw hole leading edge is provided with lateral orifices (6), Lateral tibial plateau steel plate far-end is provided with distal screw holes (7), is provided with sliding screw hole (8) in the middle of Lateral tibial plateau steel plate distal screw holes.Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special is anatomical plate, distinguish left and right, its steel plate near-end is mutually docile with tuberosity of bitia,external surface of bone, far-end with lateral of tibia surface of bone mutually docile and with surface of bone Limited contact.Upper limb or low 0-0.2 centimetre identical with tibial plateau lateral articular face.Lateral tibial plateau steel plate near-end extends rearward to be ear steel plate.Identical or the low 0-0.2 centimetre in posterior joint face outside the consistent and upper limb of ear steel plate upper limb and Lateral tibial plateau steel plate upper limb and tibial plateau.Ear steel plate is the gradually narrow extension backward of Lateral tibial plateau steel plate near-end, and the upper and lower wide 1-3 centimetre of near-end, the upper and lower wide 0.5-2 centimetre of far-end are mutually docile with surface of bone outside the platform postartis of outside.Lateral tibial plateau steel plate and ear steel plate proximal edge are provided with edge aperture.Edge aperture 2-5, diameter is 0.1 centimetre-0.3 centimetre.Edge aperture is for being circular port, and duct is arc, and its entrance is the centre of Lateral tibial plateau steel plate and ear steel plate upper end steel plate thickness, exports the non-subsides surface of bone into Lateral tibial plateau steel plate and ear steel plate.Outlet is apart from steel plate upper limb 0.1 centimetre-0.2 centimetre.What be positioned at edge aperture has the platform screw hole being parallel to tibial plateau, and platform screw hole is positioned at ear steel plate width central authorities.The platform screw hole of Lateral tibial plateau steel plate and the platform screw hole of ear steel plate are positioned at sustained height.Platform screw hole 2-6, diameter is 0.2 centimetre-0.5 centimetre, and platform screw orientation is perpendicular to surface of bone, parallel with Lateral tibial plateau plane.The postartis screw hole having oblique Lateral tibial plateau postartis of Lateral tibial plateau plate platform screw hole.Postartis screw hole 1-4, diameter is 0.2 centimetre-0.5 centimetre, and postartis screw hole direction is Lateral tibial plateau steel plate apertured place steel plate synthetism face vertical line, to ear steel plate direction and the 15-60 degree that is inclined upwardly.Lateral orifices is provided with on front side of postartis screw hole.Lateral orifices 1-3, diameter is 0.1 centimetre-0.3 centimetre, the hole direction of lateral orifices perpendicular to surface of bone, apart from steel plate leading edge 0.1 centimetre-0.3 centimetre.Lateral tibial plateau steel plate postartis screw hole have distal screw holes.Distal screw holes is positioned at Lateral tibial plateau steel plate distal end width central authorities.Distal screw holes 2-20, diameter 0.3 centimetre-0.8 centimetre, distal screw direction is vertical with surface of bone.Be provided with 1, sliding screw hole in the middle of Lateral tibial plateau steel plate distal screw holes, diameter 0.3 centimetre-0.8 centimetre, sliding screw direction is vertical with surface of bone.The platform screw hole of Lateral tibial plateau steel plate and the ear steel plate that extends back is screw hole.Lateral tibial plateau steel plate postartis screw hole is screw hole, and distal screw holes is screw hole and the design of two kinds, plain screw hole.Ear steel plate set by Lateral tibial plateau steel plate near-end side.For the steel plate of left tibia platform, its near-end side ear steel plate is located on the right side of Lateral tibial plateau steel plate, and for the steel plate of right side tibial plateau, its near-end side ear steel plate is located on the left of Lateral tibial plateau steel plate.

Claims (8)

1. a Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special, is characterized in that Lateral tibial plateau steel plate (1) and the ear steel plate (2) that extends back; Lateral tibial plateau steel plate and ear steel plate proximal edge are provided with edge aperture (3), it has the platform screw hole (4) of parallel tibial plateau, have the postartis screw hole (5) of oblique Lateral tibial plateau postartis again, postartis screw hole leading edge is provided with lateral orifices (6), Lateral tibial plateau steel plate far-end is provided with distal screw holes (7), is provided with sliding screw hole (8) in the middle of Lateral tibial plateau steel plate distal screw holes.

2. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, it is characterized in that: Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special is anatomical plate, distinguish left and right, its steel plate near-end is mutually docile with tuberosity of bitia,external surface of bone, far-end with lateral of tibia surface of bone mutually docile and with surface of bone Limited contact; Upper limb or low 0-0.2 centimetre identical with tibial plateau lateral articular face.

3. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, is characterized in that: Lateral tibial plateau steel plate near-end extends rearward to be ear steel plate; Identical or the low 0-0.2 centimetre in posterior joint face outside the consistent and upper limb of ear steel plate upper limb and Lateral tibial plateau steel plate upper limb and tibial plateau.Ear steel plate is the gradually narrow extension backward of Lateral tibial plateau steel plate near-end, and the upper and lower wide 1-3 centimetre of near-end, the upper and lower wide 0.5-2 centimetre of near-end are mutually docile with surface of bone outside the platform postartis of outside.

4. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, is characterized in that: Lateral tibial plateau steel plate and ear steel plate proximal edge are provided with edge aperture, and edge aperture 2-5, diameter is 0.1 centimetre-0.3 centimetre; Edge aperture is for being circular port, duct is arc, its entrance is the centre of Lateral tibial plateau steel plate and ear steel plate upper end steel plate thickness, outlet is the reverse side that Lateral tibial plateau steel plate and ear steel plate near-end paste surface of bone, outlet is apart from steel plate upper limb 0.1 centimetre-0.2 centimetre, what be positioned at edge aperture has the platform screw hole being parallel to tibial plateau, and platform screw hole is positioned at ear steel plate width central authorities; The platform screw hole of Lateral tibial plateau steel plate and the platform screw hole of ear steel plate are positioned at sustained height, and platform screw hole 2-6, diameter is 0.2 centimetre-0.5 centimetre, and platform screw orientation is perpendicular to surface of bone, parallel with Lateral tibial plateau plane.

5. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, it is characterized in that: the postartis screw hole having oblique Lateral tibial plateau postartis of Lateral tibial plateau plate platform screw hole, postartis screw hole 1-4, diameter is 0.2 centimetre-0.5 centimetre, and postartis screw hole direction is Lateral tibial plateau steel plate apertured place steel plate synthetism face vertical line, to ear steel plate direction and the 15-60 degree that is inclined upwardly; Be provided with lateral orifices on front side of postartis screw hole, lateral orifices 1-3, diameter is 0.1 centimetre-0.3 centimetre, the hole direction of lateral orifices perpendicular to surface of bone, apart from steel plate leading edge 0.1 centimetre-0.3 centimetre.

6. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, it is characterized in that: Lateral tibial plateau steel plate postartis screw hole have distal screw holes, distal screw holes is positioned at Lateral tibial plateau steel plate distal end width central authorities, distal screw holes 2-20, diameter 0.3 centimetre-0.8 centimetre, distal screw direction is vertical with surface of bone.Be provided with 1, sliding screw hole in the middle of Lateral tibial plateau steel plate distal screw holes, straight 0.3 centimetre-0.8 centimetre, sliding screw direction is vertical with surface of bone.

7. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, it is characterized in that: the platform screw hole of Lateral tibial plateau steel plate and the ear steel plate that extends back is screw hole, Lateral tibial plateau steel plate postartis screw hole is screw hole, and distal screw holes is screw hole and the design of two kinds, plain screw hole.

8. Lateral tibial plateau postartis reduction of the fracture internal fixtion steel plate special according to claim 1, it is characterized in that: the ear steel plate set by Lateral tibial plateau steel plate near-end side, for the steel plate of left tibia platform, its near-end side ear steel plate is located on the right side of Lateral tibial plateau steel plate, for the steel plate of right side tibial plateau, its near-end side ear steel plate is located on the left of Lateral tibial plateau steel plate.