CN111281510A - Combined anatomical intramedullary fixation device for proximal femur fracture - Google Patents

Abstract

The embodiment of the invention relates to a combined anatomical intramedullary fixation device for proximal femoral fracture, which comprises a proximal intramedullary nail, a proximal locking nail and a distal locking nail; the proximal intramedullary nail is of a rod-shaped structure and comprises a first fixing part, a transition part and a second fixing part; the near-end locking nail comprises a cutter head, a connecting part and a sleeve; the shape of the far-end lock pin is matched with that of the second lock pin hole. The shapes and the abduction angles of the first fixing part and the transition part of the proximal femoral intramedullary nail provided by the embodiment of the invention have high matching degree with the proximal femoral medullary cavity, and the proximal femoral intramedullary nail has the model selection of different diameters and lengths.

Description

Combined anatomical intramedullary fixation device for proximal femur fracture

Technical Field

The invention relates to the field of orthopedic medical instruments, in particular to a combined anatomical intramedullary fixing device for proximal femoral fracture.

Background

Proximal femoral fractures including femoral neck fractures, intertrochanteric fractures and subtrochanteric fractures occur at a rate of about 7.3% of total adult fractures, and in elderly patients with fractures the rate of 23.8%. With the progression of aging of the global population, the incidence of proximal femoral fractures increases with age. It is reported that about 450 million new aged proximal femoral fractures occur every year in the world, and the number of patients with proximal femoral fractures in the world is expected to increase to 2100 million in the future 40 years, wherein the incidence rate of asians accounts for about 50% of the global incidence rate. The increasing need for treatment of proximal femoral fractures and the high living quality requirements of patients have become a challenge for orthopedists.

With the further research on the theory and technology of internal fixation instruments, open or closed reduction internal fixation is considered as the gold standard for treating proximal femoral fractures. The internal fixing device is selected from a locking steel plate, an intramedullary nail, a bridge connection combined type internal fixing device and the like.

Currently, the existing intramedullary nail internal fixation system has a plurality of defects. For the main nail, firstly, the shape design does not conform to the anatomical morphology characteristics of the proximal medullary cavity of the femur of Chinese people, so that the matching degree of the main nail and the proximal medullary cavity of the femur is poor, the main nail is difficult to insert, and the iatrogenic burst of the outer side wall is easy to cause; secondly, when the existing intramedullary nail main nail is applied to the internal fixation operation of proximal femoral fracture of Chinese population, the proximal end of the existing intramedullary nail main nail often protrudes out of the vertex of the greater tuberosity to cause irritation to proximal soft tissue, so that long-term pain and discomfort sometimes occur, and the life of a patient and the function recovery of an affected limb are influenced; thirdly, the external deflection angle of the existing main nail of the proximal intramedullary nail of the femur is large, and when the main nail is placed, the stress of the proximal expanded part and the outer side wall is too large, so that the placement of the main nail is difficult, and the local stress concentration is easy to cause; fourthly, when the distal end of the existing intramedullary nail main nail passes through the femoral front arch, the femoral medullary cavity of the front arch and the distal end part of the main nail are easy to generate stress resistance, which not only causes the difficulty of the main nail in the process of placing, but also has the risk of causing stress fracture due to local stress concentration; fifth, the main nail of the existing proximal femoral intramedullary nail lacks a model with a smaller diameter, and does not consider the requirement of internal fixation after proximal femoral fracture of a patient with a part of narrow medullary cavity (such as a patient with abnormal bone metabolism and poliomyelitis). In addition, the variation range of the length of the femur is large, and the length of the existing proximal intramedullary nail main nail is limited according to a plurality of factors such as height, sex and the like. In the existing proximal locking nail, the length of the spiral blade and the locking part is single, the difference between different types of fractures or different types of fractures of the same type is not considered, the optimal resetting and fixing effect is difficult to realize, and the effectiveness of internal fixation cannot be ensured. For example, the distances from the fracture end of the femoral neck base part fracture and the intertrochanteric fracture to the inner edge of the femoral head are different, the required spiral blade lengths are different, and the spiral blade length of the existing proximal locking nail is single, so that the more personalized internal fixation requirement cannot be realized; in the case of a single fracture, there are various types and subtypes according to the number of fracture fragments, the degree of displacement, and the like. For fractures with different displacement degrees, if proximal locking nails with the same locking part length are placed, the final fracture end reduction and pressurization effects are greatly different, and better rehabilitation and prognosis cannot be realized.

Disclosure of Invention

The invention aims to provide a combined anatomical intramedullary fixation device for proximal femur fracture, aiming at overcoming the defects of the prior art and designing an intramedullary nail internal fixation system which accords with the anatomical morphological characteristics of the proximal medullary cavity of the femur of Chinese population. Through the measurement of the large sample Chinese population proximal femur three-dimensional image, a whole set of Chinese population proximal femur three-dimensional morphological parameter system with a plurality of indexes is finally summarized and summarized, and the indexes such as the shape, the length, the diameter of the circular body part, the related opening angle of the proximal femur intramedullary nail main nail, the length and the diameter of the related component of the proximal locking nail, the length of the distal locking nail and the like are designed based on the parameter system. In order to further verify the matching of the designed intramedullary nail and the real femur, the invention adopts an internal fixation matching virtual matching technology which has independent intellectual property rights and is based on a virtual reality technology, matches an intramedullary nail system with the proximal femur of a large sample Chinese population and repeatedly adjusts detailed parameters. By adopting the virtual matching technology, repeated adjustment and repeated verification can be carried out on the internal fixation model and the real bone model with less time consumption and lower cost.

The invention has the following advantages: through deep research and exploration on anatomical morphological characteristics of proximal femoral medullary cavities of large-sample Chinese population, the appearance design of a first fixing part and a transition part of the intramedullary nail has extremely high matching degree with the proximal femoral medullary cavities, and the higher matching degree reduces the possibility of iatrogenic burst of the outer side wall; secondly, aiming at the length of the proximal part of the intramedullary nail designed for the bones of Chinese people, the proximal end is prevented from protruding out of the vertex of the greater tuberosity, and irritation to the proximal soft tissue of the femur is reduced; adjusting the included angle (abduction angle) between the proximal segment part and the distal segment circular body part, and more conforming to the morphological characteristics of the proximal femoral medullary cavity of Chinese population moving towards the diaphysis; fourthly, the branch structure is designed at the far end, so that the stress resistance with the front arch is reduced when the branch structure passes through the front arch of the femur, and the risk of stress fracture is reduced; the model with different diameters and lengths has high matching degree, can meet wider clinical requirements, realizes more stable fracture alignment and promotes fracture healing; furthermore, through the artificial intelligence-based digital femur proximal end morphology three-dimensional measurement mode and the virtual matching technology based on the virtual reality technology, the femur proximal end locking nail provided by the embodiment of the invention has extremely high matching degree with the femur proximal end bone of Chinese population. The spiral blade has spiral blades with various length specifications, and can be selected individually according to different types of fractures so as to realize more stable fixation; in addition, the proximal femur locking nails with different lengths of central locking structures can be selected according to the fracture separation degree. Through the conversion of the unlocking state of the near-end locking nail to the locking state, the resetting between fracture ends can be realized more individually and more accurately, the stress is proper, and the effectiveness of internal fixation is ensured.

The embodiment of the invention provides a combined anatomical proximal femoral fracture intramedullary fixation device, which comprises a proximal intramedullary nail, a proximal locking nail and a distal locking nail;

the proximal intramedullary nail is of a rod-shaped structure and comprises a first fixing part, a transition part and a second fixing part; the first fixing part is connected with the second fixing part through the transition part, and the first fixing part, the transition part and the second fixing part are integrally formed; a first through hole is axially formed in the first fixing part, a second through hole is axially formed in the second fixing part, and the first through hole is communicated with the second through hole; the first fixing part is provided with a first nail locking hole which is an inclined insertion hole; the second fixing part is provided with a second lock pin hole which is vertical to the second fixing part, and the lower end of the second fixing part is of a forked structure;

the near-end locking nail comprises a cutter head, a connecting part and a sleeve; the cutter head comprises a cutting part and a transmission part, and the outer wall of the transmission part is of a smooth structure; one end of the cutting part is connected with one end of the transmission part; the connecting part is of a hollow structure, and the outer wall of the connecting part is of a threaded structure; one end of the connecting part is connected with the other end of the transmission part; the inner wall of the sleeve is of a smooth structure, and the other end of the transmission part and the connecting part are accommodated in the sleeve; the section shape of the near-end locking nail is matched with that of the first locking nail hole so as to be locked with the first fixing part when the near-end locking nail penetrates through the first locking nail hole;

the shape of the far-end locking nail is matched with that of the second locking nail hole so as to be locked with the second fixing part when the far-end locking nail penetrates through the second locking nail hole.

Preferably, an included angle between the first fixing part and the second fixing part is 3-6 degrees, and the sectional area of any position of the first fixing part is larger than that of any position of the second fixing part;

the included angle between the first nail locking hole and the first fixing part is 130-140 degrees, and the first nail locking hole is spindle-shaped;

the section of the sleeve is spindle-shaped.

Preferably, the length of the transition part is 25 mm-35 mm;

the transition portion is a circular truncated cone structure, the first fixing portion and the second fixing portion are connected respectively at two axial ends of the circular truncated cone structure, the cross-sectional area of one end of the first fixing portion connected with the circular truncated cone structure is larger than the cross-sectional area of one end of the second fixing portion connected with the circular truncated cone structure, the cross-sectional area of the joint of the circular truncated cone structure and the first fixing portion is equal, and the cross-sectional area of the joint of the circular truncated cone structure and the second fixing portion is equal.

Preferably, the length of the first fixing part is 55mm to 65 mm; the cross section of the first fixing part is in a water drop shape which accords with anatomical morphological parameters of a proximal femoral medullary cavity, the length of a long shaft of the water drop shape is 14-22 mm, and the length of a short shaft of the water drop shape is 12-18 mm, so that the proximal femoral intramedullary nail is matched with the proximal femoral medullary cavity in shape;

the second fixing part is of a cylindrical structure, and the diameter range of the cylindrical structure is 7-14 mm.

Preferably, a nail cap hole is formed in the end face of the upper end of the first fixing portion, the nail cap hole is communicated with the first through hole, and the size and the shape of the nail cap hole are matched with those of a nail cap.

Preferably, the bifurcated structure comprises a plurality of independent petals with the same structure, and the length of each petal is 25-55 mm.

Preferably, the transmission part comprises a first component and a second component, and the first component and the second component are integrally connected; the front end of the first component is connected with the cutting part, and the rear end of the first component is connected with the front end of the second component; the rear end of the second part is connected with the connecting part;

the outer diameter of the first part is larger than the inner diameter of the sleeve, and the outer diameter of the second part is smaller than the inner diameter of the sleeve;

the length of the second component is 16 mm-70 mm.

Preferably, the cutter head is of a hollow structure, and the cutting part and the transmission part are of an integrated structure; the cutting part is a spiral blade;

the length of the cutter head is 58 mm-118 mm; the length of the cutting part is 20 mm-50 mm;

when in a locking state, the length of the proximal femur locking nail is 70-130 mm.

Preferably, the proximal femoral locking nail further comprises an anti-rotation nut; one end of the anti-rotation nut is sleeved on the other end of the connecting part and is contained in the sleeve; the other end of the anti-rotation nut is clamped at the other end of the sleeve and arranged outside the sleeve.

Preferably, when in use, the proximal intramedullary nail is placed in a proximal medullary cavity of a femur, the proximal locking nail is placed in the femur through the first locking nail hole, after the cutting part passes through a femoral fracture end, the connecting part is rotated, and the driving part of the cutter head drives the cutting part to move towards the direction close to the sleeve until the proximal locking nail of the femur reaches a locking state; and placing the distal locking nail into the femur through the second locking nail hole, so as to realize the fixation between the assembled anatomical proximal femur fracture intramedullary fixation device and the femur.

The invention has the advantages that the shape and the related angle design of the intramedullary nail accord with the anatomical morphology characteristics of the proximal medullary cavity of the femur, the intramedullary nail has extremely high matching degree with the proximal medullary cavity of the femur, and the possibility of the iatrogenic burst of the outer side wall is reduced; the combination of the far-end round body parts with different thicknesses and lengths realizes more stable fracture alignment and alignment, and promotes fracture healing; the shortened proximal portion can avoid the protrusion of the proximal end from the apex of the greater tuberosity, and reduce irritation to the proximal soft tissue of the femur; the bifurcation structure designed at the far end reduces the stress barrier with the front arch when the bifurcation structure passes through the front arch of the femur, and reduces the risk of stress fracture; aiming at the difference of the thickness of the femoral medullary cavity, proximal femoral intramedullary nails with various diameters are designed, so that the intramedullary nail is suitable for more people and provides better medullary cavity matching degree; a richer choice of length may provide a more adaptable internal fixation device for a broader patient population; because of the anatomical form, the matching degree is high, the intramedullary nail main nail is more convenient and fast to place, the fluoroscopy and bleeding in the operation are reduced, and the functional prognosis of the patient is improved. The near-end locking nail has extremely high matching degree with the near-end skeleton of the femur of Chinese people; the spiral blade has spiral blades with various length specifications, and can be selected individually according to different types of fractures so as to realize more stable fixation; the proximal femur locking nail with the central locking structure of different lengths can be selected according to the fracture separation degree, the reduction between fracture ends can be realized more individually and accurately through the conversion from the unlocking state to the locking state of the proximal locking nail, the stress is proper, and the effectiveness of internal fixation is ensured.

Drawings

FIG. 1 is a schematic structural diagram of a combined anatomical proximal femoral fracture intramedullary fixation device according to an embodiment of the present invention;

fig. 2 is a schematic structural diagram of a proximal intramedullary nail according to an embodiment of the present invention;

FIG. 3 is a cross-sectional view taken in the direction A-A of the proximal intramedullary nail structure of the femur of FIG. 2;

FIG. 4 is a cross-sectional view in the direction B-B of the proximal intramedullary nail structure of the femur of FIG. 3;

FIG. 5 is a side view of a proximal intramedullary nail of a femur provided in accordance with an embodiment of the present invention;

FIG. 6 is a cross-sectional view of a first fixing portion of a proximal intramedullary nail structure of a femur according to an embodiment of the present invention;

FIG. 7 is a schematic illustration showing the shape of a first locking hole in a proximal intramedullary nail structure of a femur, in accordance with an embodiment of the present invention;

FIG. 8 is a schematic structural view of a proximal femoral intramedullary nail cap according to an embodiment of the present invention;

FIG. 9 is a schematic structural view of a locking state of a proximal femur locking pin according to an embodiment of the present invention;

FIG. 10 is a cross-sectional view of a proximal femoral locking pin according to an embodiment of the present invention in a locked state;

fig. 11 is a schematic cross-sectional view of a proximal femur locking pin according to an embodiment of the present invention in an unlocked state;

FIG. 12 is a schematic cross-sectional view of a tool tip provided in accordance with an embodiment of the invention;

FIG. 13 is a schematic cross-sectional view of a cutting portion according to an embodiment of the present invention;

FIG. 14 is a side view of a tool bit provided in accordance with an embodiment of the invention;

fig. 15 is a schematic structural diagram of a connecting member according to an embodiment of the present invention;

FIG. 16 is a side view of a coupling member provided in accordance with an embodiment of the present invention;

FIG. 17 is a schematic cross-sectional view of a sleeve according to an embodiment of the present invention;

FIG. 18 is a schematic cross-sectional view of a sleeve according to an embodiment of the present invention;

FIG. 19 is a schematic structural view of an anti-rotation nut according to an embodiment of the present invention;

FIG. 20 is a side view of an anti-rotation nut provided in accordance with an embodiment of the present invention;

fig. 21 is a schematic structural view of a distal femur locking pin according to an embodiment of the present invention.

Detailed Description

The technical solution of the present invention is further described in detail by the accompanying drawings and embodiments.

The proximal femur locking nail provided by the embodiment of the invention is applied to the fixation of the fracture part in the proximal femur fracture operation. Fig. 1 is a schematic structural diagram of a combined anatomical proximal femoral fracture intramedullary fixation device provided in an embodiment of the present invention, as shown in fig. 1, the combined anatomical proximal femoral fracture intramedullary fixation device includes a proximalintramedullary nail 1, aproximal locking nail 2, and adistal locking nail 3, the proximalintramedullary nail 1, theproximal locking nail 2, and thedistal locking nail 3 cooperate with each other to fix a fracture site in a proximal femoral fracture operation, and structures and working processes of the proximalintramedullary nail 1, theproximal locking nail 2, and thedistal locking nail 3 are described below.

First, the proximalintramedullary nail 1 will be described with reference to fig. 2 to 8.

As shown in fig. 2, the proximal femoralintramedullary nail 1 provided by the present invention comprises a first fixingportion 11, atransition portion 12 and asecond fixing portion 13, wherein the first fixingportion 11 is connected to the second fixingportion 13 through thetransition portion 12, and the first fixingportion 11, thetransition portion 12 and the second fixingportion 13 are integrally formed, in some embodiments, an included angle between the first fixingportion 11 and the second fixingportion 13 is 3 ° to 6 °.

In some embodiments, the cross-sectional area of any position of the first fixingportion 11 is larger than that of any position of the second fixingportion 13, so that the first fixingportion 11 has an expanded shape compared with the second fixingportion 13.

In order to match the proximalintramedullary nail 1 of the femur with the proximal medullary cavity of the femur, the cross-sectional shape of the first fixingpart 11 is a 'water drop' as shown in fig. 6, the length a of the long axis of the 'water drop' is 14 mm-22 mm, the length of the short axis b is 12 mm-18 mm, and the length of the first fixingpart 11 is 55 mm-65 mm, which conforms to the anatomical morphology characteristics of the proximal medullary cavity of the femur.

Thetransition part 12 conforms to the structural characteristics of the transition position of the proximal femoral medullary cavity and the backbone medullary cavity, and can be a circular truncated cone structure with the length range of 25 mm-35 mm, two ends of the circular truncated cone structure in the axial direction are respectively connected with the first fixingpart 11 and the second fixingpart 13, and the sectional area of one end of the circular truncated cone structure, which is connected with the first fixingpart 11, is larger than that of one end of the circular truncated cone structure, which is connected with the second fixingpart 13. In addition, the cross-sectional area of the joint of the circular truncated cone structure and the first fixingpart 11 is equal, and the cross-sectional area of the joint of the circular truncated cone structure and the second fixingpart 13 is equal, so that thetransition part 12 is naturally connected with the first fixingpart 11 and the second fixingpart 13, and the outer surface of the rod-shaped proximal femoral intramedullary nail is smooth and free of any edge surface.

Thesecond fixing portion 13 is a main body inserted into the backbone portion, and has a cylindrical shape. In order to match the proximal intramedullary nail of the femur with the proximal medullary cavity of the femur, the diameter range of the cylinder included in the second fixingportion 13 is 7 mm-14 mm, and in practical application, one diameter specification, such as 7mm specification, 7.5mm specification, 8mm specification, etc., may be set every 0.5 mm. In addition, different length specifications can be selected according to actual requirements and individual differences.

In this embodiment, the proximalintramedullary nail 1 has a hollow structure. Specifically, as shown in fig. 3, a first throughhole 14 is axially formed in the first fixingportion 11, a second throughhole 15 is axially formed in the second fixingportion 13, and the first throughhole 14 communicates with the second throughhole 15. In addition, anut hole 16 is provided on an end surface of an upper end (an end away from the second fixing portion) of the first fixingportion 11, the size and shape of thenut hole 16 are adapted to those of thenut 160, and thenut hole 16 communicates with the first throughhole 14. In operation, after the intramedullary nail is placed in the medullary cavity and fixed by the corresponding locking nail, thenail cap 160 is placed in thenail cap hole 16 to close the intramedullary nail through hole. Wherein thenut 160 may be configured as shown in fig. 8.

In this embodiment, the first fixingportion 11 is provided with a firstlocking nail hole 17 for cooperating with theproximal locking nail 2. During operation, after the intramedullary nail is placed in a medullary cavity, theproximal locking nail 2 is driven into a proper position through the firstlocking nail hole 17 after a hole is formed in the cortex of the outer side of the proximal end of the femur by using a bone drill along the special sleeve, and the proximal locking nail is locked after the perspective position is proper.

Thefirst locking hole 17 may be a slanted insertion hole having a slanted insertion direction forming an angle of 130 ° to 140 ° with the first fixingportion 11, as shown in fig. 3, an angle ∠ 2 between an axis L1 of the first fixingportion 11 and an axis L3 of thefirst locking hole 17 is 134 °.

In order to better achieve the locking between theproximal locking nail 2 and the first fixingportion 11, the shape of the firstlocking nail hole 17 and the shape of theproximal locking nail 2 are both spindle-shaped as shown in fig. 7. Of course, in other embodiments, the shape of the firststaple hole 17 and the shape of theproximal staple 2 may also be designed in other different shapes, such as an oval shape, etc.

In this embodiment, a secondlocking nail hole 18 is provided in the vertical direction of the second fixingportion 13, that is, the axial direction of the secondlocking nail hole 18 is perpendicular to the axial direction of the second fixingportion 13, and is used for being matched and fixed with thedistal locking nail 3. During operation, after the intramedullary nail is embedded and thedistal locking nail 3 is driven and fixed, a hole is formed in the outer cortex of the femoral shaft along the special sleeve by using a bone drill, and thedistal locking nail 3 is driven to a proper position through the secondlocking nail hole 18.

Preferably, the secondlocking nail hole 18 may be a power hole with a shape matched with the distal locking nail, the length of the power hole may be 5mm to 8mm, and the width may be 2.5mm or 3.5mm, so that static or dynamic nail placement may be performed according to actual requirements during surgery.

In this embodiment, the lower end of the second fixingportion 13 is a bifurcated structure, so that the stress is reduced when the patient is in the femoral anterior arch. The bifurcated structure comprises a plurality of independent and same-structure lobes, as shown in fig. 4, the bifurcated structure may comprise three same-structure lobes 19, and the cross section of eachlobe 19 is in the shape of a ring with a central angle of 120 °. Preferably, in the bifurcated structure, the length of each petal is 25mm to 55 mm.

The proximal femoralintramedullary nail 1 provided by the invention is of a rod-shaped structure, and the total length of the nail rod is 140 mm-300 mm. In practical applications, a length specification, such as 140mm specification, 145mm specification, 150mm specification and the like, may be set every 5 mm.

The shape and related angle design of the proximal femoral intramedullary nail provided by the invention meet the anatomical morphology characteristics of the proximal femoral medullary cavity, and the proximal femoral intramedullary nail has extremely high matching degree with the proximal femoral medullary cavity, so that the possibility of iatrogenic burst of the outer side wall is reduced; the combination of the far-end round body parts with different thicknesses and lengths realizes more stable fracture alignment and alignment, and promotes fracture healing; the shortened proximal portion can avoid the protrusion of the proximal end from the apex of the greater tuberosity, and reduce irritation to the proximal soft tissue of the femur; the bifurcation structure designed at the far end reduces the stress barrier with the front arch when the bifurcation structure passes through the front arch of the femur, and reduces the risk of stress fracture; aiming at the difference of the thickness of the femoral medullary cavity, proximal femoral intramedullary nails with various diameters are designed, so that the intramedullary nail is suitable for more people and provides better medullary cavity matching degree; a richer choice of length may provide a more adaptable internal fixation device for a broader patient population; because of the anatomical form, the matching degree is high, the intramedullary nail main nail is more convenient and fast to place, the fluoroscopy and bleeding in the operation are reduced, and the functional prognosis of the patient is improved.

Next, theproximal locking pin 2 will be described with reference to fig. 9 to 20.

The proximal femur locking nail provided by the embodiment of the invention is applied to the fixation of the fracture part in the femur fracture operation. Fig. 9 and 10 are a schematic structural view and a schematic sectional view of a proximal femur locking nail according to an embodiment of the present invention in a locked state; fig. 11 is a schematic cross-sectional view of an embodiment of the proximal femur locking nail according to the present invention in an unlocked state, and referring to fig. 9 to 11, the proximal femur locking nail according to the present invention includes a cuttinghead 21, a connectingcomponent 22 and asleeve 23; preferably, the central axis of the cuttinghead 21, the central axis of the connectingpart 22 and the central axis of thesleeve 23 are collinear, i.e. the cuttinghead 21, the connectingpart 22 and thesleeve 23 of the proximal femoral nail are coaxial. The structures of the components of the proximal femur locking nail are described below.

Fig. 12 is a schematic cross-sectional view of atool bit 21 according to an embodiment of the present invention, in which thetool bit 21 includes a cuttingportion 211 and atransmission portion 212, and an outer wall of thetransmission portion 212 has a smooth structure; one end of the cuttingpart 211 is connected with one end of thetransmission part 212; preferably, the cuttinghead 21 has a hollow structure, and the cuttingportion 211 and thetransmission portion 212 have an integrated structure.

In a specific example, the cuttingportion 211 may be a spiral blade, the section of which is specifically shown in fig. 13, and the length L3 of the cuttinghead 21 is 58mm to 118 mm.

Thetransmission part 212 may specifically include afirst part 2121 and asecond part 2122, thefirst part 2121 and thesecond part 2122 being integrally connected; the front end of thefirst member 2121 is connected to the cuttingportion 211, and the rear end of thefirst member 2121 is connected to the front end of thesecond member 2122; thesecond part 2122 may be understood to end up in the locking mechanism, the rear end of thesecond part 2122 being connected to the connectingpart 22; thefirst part 2121 has an outer diameter larger than the inner diameter of thesleeve 23 and thesecond part 2122 has an outer diameter smaller than the inner diameter of thesleeve 23. When the connectingcomponent 22 rotates in the first direction under the action of the first external force, the cuttingpart 211 is driven by thefirst component 2121 and thesecond component 2122 to move towards thesleeve 23, and the proximal femur locking nail reaches the locking state; in the locked state, a distance L2 between the rear end surface of thefirst member 2121 and the front end surface of thesleeve 23 is 0.12mm to 0.35 mm.

It will be appreciated that to meet the needs of different fracture conditions, the present invention provides a plurality of different lengths of the cutting portion 211 (screw blade) and the proximal locking pin of the second member 2122 (locking mechanism) wherein the length of the locking mechanism L5 is 16mm to 70mm, one gauge every 2mm, the length of the cutting portion 211L 4 is 20mm to 50mm, and one unit every 5 mm. When the proximal femurmain nail 1 is used, the proximal femurmain nail 1 is placed into the proximal femur medullary cavity, after the proper depth and angle are adjusted, the proximalfemur locking nail 2 with the proper locking structure and the length of the cuttingpart 211 is selected to be placed according to the difference between different types of fractures or different types of the same type of fractures. In a specific example, for fracture of femoral neck base, the distance from femoral head medial edge to fracture line is shorter, proximal locking nail withshorter cutting part 211 is selected to be inserted, and for fracture of femoral intertrochanteric, the distance from femoral head medial edge to fracture line is longer, proximal locking nail with longer cuttingpart 211 is selected to be inserted; for femoral neck base part fracture or intertrochanteric fracture, when the separation of fracture ends is small, theproximal locking nail 2 with the shorter locking mechanism length is selected for placing, and when the separation of fracture ends is large, the proximal locking nail with the longer locking mechanism length is selected for placing.

Fig. 15 is a schematic structural diagram of a connectingpart 22 according to an embodiment of the present invention, in which the connectingpart 22 has a hollow structure and an outer wall of the connectingpart 22 has a threaded structure; one end of the connectingmember 22 is connected to the other end of thetransmission portion 212 of thecutter head 21.

One end of the connectingmember 22 is connected to the other end of thetransmission part 212, and it should be noted that, there are many ways to connect the other end of thetransmission part 212 to one end of the connectingmember 22, in the preferred embodiment, the other end of thetransmission portion 212 is snapped to one end of the connectingmember 22, fig. 14 is a side view of acutter head 1 according to an embodiment of the present invention, which is shown in combination with fig. 12 and 14, at the other end of thetransmission part 212 of thecutter head 21, there is provided a horseshoe-shaped snap-in part, as shown again in fig. 15, the front end of the connectingpart 22 is provided with a clamping part which is matched with the horseshoe-shaped clamping part arranged at the other end of thetransmission part 212, so that thetransmission part 212 of thecutter head 21 is clamped with the connectingpart 22, in a more preferred embodiment, the horseshoe-shaped clamping portion is uniformly provided with a plurality of saw teeth, so that the stability of clamping thetransmission portion 212 and the connectingmember 22 is ensured.

The connectingmember 22 may be a connecting bolt, and the other end of the connectingmember 22 is inserted into a driver, and the driver is inserted into the other end of the connectingmember 22, and the connectingmember 22 is driven by the driver to rotate and move horizontally in thesleeve 23, thereby driving the movement of the cuttingportion 211 of thetool bit 21. The other end of the connectingpart 22 is a force-receiving end surface having a groove, and those skilled in the art can set the shape of the groove, preferably, as shown in fig. 15 and 16, a hexagonal groove is preferably formed at the other end of the connectingpart 22, so as to facilitate the rotation driving of the driver.

When the connectingcomponent 22 rotates under the action of external force, the drivingpart 212 is driven to horizontally slide in thesleeve 23 along the axial direction of thesleeve 23, so that the cuttingpart 211, namely the helical blade, is driven to horizontally move along the axial direction of thesleeve 23; when the external force is applied in the opposite direction, the horizontal movement direction of thetransmission part 212 in thesleeve 23 is also opposite, and the movement direction of the helical blade is also opposite.

Fig. 17 is a schematic cross-sectional view of asleeve 23 according to an embodiment of the present invention, wherein an inner wall of thesleeve 23 is smooth, and it can be understood that the inner wall of thesleeve 23 is matched with an outer wall of thetransmission portion 212 of the cuttinghead 21, so as to achieve horizontal sliding of thetransmission portion 212 in thesleeve 23, and the other end of thetransmission portion 212 of the cuttinghead 21 and the connectingpart 22 are accommodated in thesleeve 23.

The proximal femur locking nail is used in cooperation with the proximal femur main nail, the cross section of the proximal femur main nail is in a water drop shape which accords with anatomical morphological parameters of the proximal femur medullary cavity, and in order to be matched with the use and fixation of the proximal femur main nail, the section of thesleeve 23 is preferably arranged in a spindle shape, so that the anti-rotation effect is achieved, and particularly as shown in fig. 18, the proximal locking nail penetrates through a locking nail hole in the proximal main nail and is driven into a bone.

Fig. 19 is a schematic structural view of ananti-rotation nut 24 according to an embodiment of the present invention, in a preferred embodiment, the proximal femoral locking nail further includes ananti-rotation nut 24, and referring to fig. 10 and 19, one end of theanti-rotation nut 24 is sleeved on the other end of the connectingpart 22 and is accommodated in thesleeve 23, it can be understood that the inner wall of theanti-rotation nut 24 has a thread structure matching with the thread structure of the outer wall of the connectingpart 22; the other end of theanti-rotation nut 24 is clamped to the other end of thesleeve 23 and is arranged outside thesleeve 23.

Further, fig. 20 is a side view of theanti-rotation nut 24 according to the embodiment of the present invention, wherein a plurality of saw teeth are uniformly arranged on an end surface of theanti-rotation nut 24 to ensure the overall stability of the proximal lock pin.

As shown in fig. 11, the proximal locking nail is in an unlocked state, in this state, when the connectingcomponent 22 is rotated in the first direction by the first external force, specifically, the driver is inserted into the hexagonal groove at the tail of the connectingcomponent 22, the driver is rotated to connect the external thread of the driver with the internal thread of theanti-rotation nut 24, and the connectingcomponent 22 is pushed to move horizontally toward the sleeve, so that the drivingpart 212 of thedriver bit 21 drives the cuttingpart 211 to move toward thesleeve 23 until the external thread of the driver is completely separated from the internal thread of theanti-rotation nut 24, at this time, the gap between thedriver bit 21 and the front end of thesleeve 23 is minimum, the proximal femoral locking nail reaches a locked state, and when the locked state, the length L1 of the proximal femoral locking nail is 70mm to 130 mm.

As shown in fig. 10, the proximal locking pin is in a locked state, and in this state, when the connectingcomponent 22 rotates in the second direction under the action of the second external force, specifically, the driver is inserted into the hexagonal groove at the tail of the connectingcomponent 22, and the driver is rotated in the opposite direction, so that the external thread of the driver is connected with the internal thread of theanti-rotation nut 24, and the connectingcomponent 22 is pushed to move horizontally in the direction away from the sleeve, so that the drivingpart 212 of thedriver bit 21 drives the cuttingpart 211 to move in the direction away from thesleeve 23 until the driver cannot rotate, at this time, thedriver bit 21 has the maximum axial displacement relative to thesleeve 23, and the proximal femoral locking pin reaches an unlocked state. It will be appreciated that the first direction and the second direction are opposite here.

The above is an introduction to the components of the proximal femur locking nail and the connection relationship between the components, and the use of the proximal femur locking nail is described in detail below with reference to fig. 10 and 11, where the proximal femur locking nail needs to be used in cooperation with the proximal femur main nail and the distal femur locking nail.

The proximal femur main nail is placed in the proximal femur medullary cavity, and after the proximal femur main nail is adjusted to a proper depth and angle, the proximal femur locking nail with a proper central locking structure length is selected according to the difference between different types of fractures or different types of the same fracture.

The driver is inserted into the tail end of the proximal locking nail, namely the connectingcomponent 22, the spiral blade is unlocked, the proximal locking nail is in an unlocked state, the proximal locking nail is placed through a spindle-shaped locking nail hole of the proximal femur main nail, the bottom of the driver is lightly knocked by a hammer, the driver is rotated in the locking direction until locking is achieved after the proximal locking nail is driven into a proper position under fluoroscopy, at the moment, the proximal locking nail is in a locked state, the proximal locking nail is placed completely, and then the distal locking nail is placed through the distal locking nail hole of the main nail. Locking the implanted proximal locking pin to a locked state, a procedure that resets the detached fracture end. Because the proximal femur locking nail with different length central locking structures can be selected according to the fracture separation degree, the fracture ends can be better reset, and the stress is proper.

The proximal femur locking nail provided by the embodiment of the invention solves the problems that the length of a spiral blade of the proximal locking nail is single, and individual selection cannot be carried out according to different types of fractures so as to realize more stable fixation; the problem of central authorities locking structure length singleness, can not select according to fracture separation degree to realize more individualized and more accurate reduction between the fracture end is solved. By solving the problems, the operation fixation of the proximal femur fracture is more reliable and reasonable, the fracture healing is promoted to the maximum extent, the curative effect of a patient is improved, and the occurrence of complications is reduced.

Finally, thedistal locking pin 3 will be described with reference to fig. 21.

As shown in fig. 21, thedistal locking nail 3 includes a nut, a screw portion, and a nail head. The screw cap is connected with one end of the screw connection part, and the screw connection part is provided with a thread structure; the nail head is connected with the other end of the screwing part and is provided with more than one self-tapping blade. Thedistal locking pin 3 is preferably 26mm to 60mm in length, one gauge every 2mm, it being understood that the present invention provides a plurality of distal locking pins 3 of different lengths.

It should be noted that the shape of thedistal locking nail 3 is matched with the secondlocking nail hole 18, so as to lock with the second fixingportion 13 when thedistal locking nail 3 penetrates the secondlocking nail hole 18, specifically, when in use, thedistal locking nail 3 penetrates the secondlocking nail hole 18 on the proximalintramedullary nail 1, and the self-tapping blade of the nail head is driven by the screw cap to be placed into the bone.

The structure and the working process of the proximalintramedullary nail 1, theproximal locking nail 2 and thedistal locking nail 3 of the assembled anatomical proximal femoral fracture intramedullary fixation device are explained above, and the use of the assembled anatomical proximal femoral fracture intramedullary fixation device is explained in detail below with reference to fig. 1 to 21 on the basis of understanding the structure and the working process of the proximalintramedullary nail 1, theproximal locking nail 2 and thedistal locking nail 3.

When in use, the proximalintramedullary nail 1 is placed in the proximal medullary cavity of the femur, theproximal locking nail 2 is placed in the femur through the firstlocking nail hole 17, after the cuttingpart 211 passes through the femoral fracture end, the connectingpart 22 is rotated, and the drivingpart 212 of thecutter head 21 drives the cuttingpart 211 to move towards the direction close to thesleeve 23 until theproximal locking nail 2 reaches the locking state; thedistal locking nail 3 is placed into the femur through the secondlocking nail hole 18, so that the combined anatomical proximal femur fracture intramedullary fixation device is fixed with the femur.

Specifically, firstly, according to the thickness degree of the medullary cavity of a patient and actual requirements, the proximal femoralintramedullary nail 1 with the proper diameter and length is selected, the proximal femoralintramedullary nail 1 is placed into the proximal femoral medullary cavity by the aid of the connecting frame, and the proximal femoralintramedullary nail 1 is positioned to the proper depth and angle.

Second, after drilling a hole in the lateral proximal cortex of the femur along a special sleeve using a bone drill, a proximal femoral locking pin of the appropriate length of the central locking feature (second part 2122) and cutting feature (cutting portion 211) is selected for the difference between different types of fractures or different types of fractures of the same type. Theproximal locking nail 2 is driven into a proper position through the firstlocking nail hole 17, the proper position is determined through perspective and then theproximal locking nail 2 is locked, specifically, a driver is inserted into the tail end of theproximal locking nail 2, namely the tail end of the connectingcomponent 22, the spiral blade is unlocked, theproximal locking nail 2 is in an unlocked state, theproximal locking nail 2 is driven into a spindle-shaped locking nail hole of the femur proximal internal nail, namely the firstlocking nail hole 17, the bottom of the driver is lightly knocked by a hammer, the driver is rotated in a locking direction until theproximal locking nail 2 is locked after theproximal locking nail 2 is driven into the proper position through perspective, at the moment, theproximal locking nail 2 is in a locked state, and theproximal locking nail 2 is completely arranged. The embedded near-end locking nail 2 is locked to a locking state, the separated fracture ends can be reset in the process, and due to the fact that the spiral blades with different lengths and the femur near-end locking nail 2 with the central locking structure can be selected according to different types of fractures and the separation degree of the fracture ends, the fracture ends can be better reset, and the stress is proper.

Finally, after a hole is formed in the outer cortex of the femoral shaft along the special sleeve by using a bone drill, thedistal locking nail 3 is driven into a proper position through the secondlocking nail hole 18, the proper position is determined by perspective and then locked, static or dynamic nail placement can be carried out according to actual requirements, and then anail cap 160 with a proper type is placed into thenail cap hole 16, so that the fixation of the assembled anatomical proximal femoral fracture intramedullary fixation device and the femur is completed.

The assembled anatomical intramedullary fixation device for proximal femur fracture provided by the embodiment of the invention solves the problem that the iatrogenic burst of the outer side wall is caused by poor matching between the shape and the related angle of the intramedullary nail and the proximal femur medullary cavity; the problems that the sizes of the fracture are small, the size of the fracture is small, the clinical requirement cannot be met, and more stable fracture alignment and alignment cannot be realized are solved; the problem that the proximal part protrudes out of the vertex of the greater tuberosity to cause irritation to the proximal soft tissue of the femur is solved; the problem that stress blocking is generated when the distal part passes through the front arch of the femur, and the risk of stress fracture is increased is solved; the problem that the length of a spiral blade of a near-end locking nail is single, and personalized selection cannot be performed according to different types of fractures so as to realize more stable fixation is solved; the problem of central authorities locking structure length singleness, can not select according to fracture separation degree to realize more individualized and more accurate reduction between the fracture end is solved. By solving the problems, the proximal femur fracture fixation is quicker, more convenient and more reliable, the fluoroscopy and bleeding during the operation are reduced, the fracture healing is promoted to the maximum extent, the curative effect of the patient is improved, and the occurrence of complications is reduced.

In the present invention, the term "plurality" means two or more unless explicitly defined otherwise. The terms "mounted," "connected," "fixed," and the like are to be construed broadly, and for example, "connected" may be a fixed connection, a removable connection, or an integral connection; "coupled" may be direct or indirect through an intermediary. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.

In the description of the present invention, it is to be understood that the terms "upper", "lower", "left", "right", "front", "rear", and the like indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience of description and simplification of description, but do not indicate or imply that the referred device or unit must have a specific direction, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention.

In the description herein, the description of the terms "a particular embodiment," "some embodiments," "an embodiment," etc., means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

The above-mentioned embodiments are intended to illustrate the objects, technical solutions and advantages of the present invention in further detail, and it should be understood that the above-mentioned embodiments are merely exemplary embodiments of the present invention, and are not intended to limit the scope of the present invention, and any modifications, equivalent substitutions, improvements and the like made within the spirit and principle of the present invention should be included in the scope of the present invention.

Claims (10)

1. The assembled anatomical proximal femoral fracture intramedullary fixation device is characterized by comprising a proximal intramedullary nail, a proximal locking nail and a distal locking nail;

the proximal intramedullary nail is of a rod-shaped structure and comprises a first fixing part, a transition part and a second fixing part; the first fixing part is connected with the second fixing part through the transition part, and the first fixing part, the transition part and the second fixing part are integrally formed; a first through hole is axially formed in the first fixing part, a second through hole is axially formed in the second fixing part, and the first through hole is communicated with the second through hole; the first fixing part is provided with a first nail locking hole which is an inclined insertion hole; the second fixing part is provided with a second lock pin hole which is vertical to the second fixing part, and the lower end of the second fixing part is of a forked structure;

the near-end locking nail comprises a cutter head, a connecting part and a sleeve; the cutter head comprises a cutting part and a transmission part, and the outer wall of the transmission part is of a smooth structure; one end of the cutting part is connected with one end of the transmission part; the connecting part is of a hollow structure, and the outer wall of the connecting part is of a threaded structure; one end of the connecting part is connected with the other end of the transmission part; the inner wall of the sleeve is of a smooth structure, and the other end of the transmission part and the connecting part are accommodated in the sleeve; the section shape of the near-end locking nail is matched with that of the first locking nail hole so as to be locked with the first fixing part when the near-end locking nail penetrates through the first locking nail hole;

the shape of the far-end locking nail is matched with that of the second locking nail hole so as to be locked with the second fixing part when the far-end locking nail penetrates through the second locking nail hole.

2. The assembly type anatomical proximal femoral fracture intramedullary fixation device of claim 1, wherein an included angle between the first fixation portion and the second fixation portion is 3 ° to 6 °, and a cross-sectional area of any position of the first fixation portion is larger than a cross-sectional area of any position of the second fixation portion;

the included angle between the first nail locking hole and the first fixing part is 130-140 degrees, and the first nail locking hole is spindle-shaped;

the section of the sleeve is spindle-shaped.

3. The assembly type anatomical proximal femoral fracture intramedullary fixation device of claim 1, wherein the length of the transition portion is 25mm to 35 mm;

the transition portion is a circular truncated cone structure, the first fixing portion and the second fixing portion are connected respectively at two axial ends of the circular truncated cone structure, the cross-sectional area of one end of the first fixing portion connected with the circular truncated cone structure is larger than the cross-sectional area of one end of the second fixing portion connected with the circular truncated cone structure, the cross-sectional area of the joint of the circular truncated cone structure and the first fixing portion is equal, and the cross-sectional area of the joint of the circular truncated cone structure and the second fixing portion is equal.

4. The assembled anatomic proximal femoral fracture intramedullary fixation device of claim 1, wherein the first fixation portion has a length ranging from 55mm to 65 mm; the cross section of the first fixing part is in a water drop shape which accords with anatomical morphological parameters of a proximal femoral medullary cavity, the length of a long shaft of the water drop shape is 14-22 mm, and the length of a short shaft of the water drop shape is 12-18 mm, so that the proximal femoral intramedullary nail is matched with the proximal femoral medullary cavity in shape;

the second fixing part is of a cylindrical structure, and the diameter range of the cylindrical structure is 7-14 mm.

5. The assembly type anatomical proximal femoral fracture intramedullary fixation device of claim 1, wherein a nail cap hole is disposed on an end surface of an upper end of the first fixation portion, the nail cap hole is communicated with the first through hole, and a size and a shape of the nail cap hole are matched with a size and a shape of the nail cap.

6. The assembly anatomical proximal femoral fracture intramedullary fixation device of claim 1, wherein the bifurcated structure comprises a plurality of independent and structurally identical petals each having a length of 25mm to 55 mm.

7. The assembly anatomic femoral proximal fracture intramedullary fixation device of claim 1, wherein the transmission portion comprises a first component and a second component integrally connected; the front end of the first component is connected with the cutting part, and the rear end of the first component is connected with the front end of the second component; the rear end of the second part is connected with the connecting part;

the outer diameter of the first part is larger than the inner diameter of the sleeve, and the outer diameter of the second part is smaller than the inner diameter of the sleeve;

the length of the second component is 16 mm-70 mm.

8. The assembly type anatomical proximal femoral fracture intramedullary fixation device of claim 1, wherein the cutting head is a hollow structure and the cutting portion and the transmission portion are a unitary structure; the cutting part is a spiral blade;

the length of the cutter head is 58 mm-118 mm; the length of the cutting part is 20 mm-50 mm;

when in a locking state, the length of the proximal femur locking nail is 70-130 mm.

9. The modular anatomic proximal femoral fracture intramedullary fixation device of claim 1, wherein the proximal femoral locking nail further comprises an anti-rotation nut; one end of the anti-rotation nut is sleeved on the other end of the connecting part and is contained in the sleeve; the other end of the anti-rotation nut is clamped at the other end of the sleeve and arranged outside the sleeve.

10. The assembled anatomic proximal femoral fracture intramedullary fixation device of claim 1,

when the proximal intramedullary nail is used, the proximal intramedullary nail is placed in a proximal medullary cavity of a femur, the proximal locking nail is placed in the femur through the first locking nail hole, after the cutting part passes through the femoral fracture end, the connecting part is rotated, and the cutting part is driven by the transmission part of the cutter head to move towards the direction close to the sleeve until the proximal locking nail of the femur reaches a locking state; and placing the distal locking nail into the femur through the second locking nail hole, so as to realize the fixation between the assembled anatomical proximal femur fracture intramedullary fixation device and the femur.

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