技术领域technical field
本实用新型涉及骨折内固定材料技术领域，特别涉及一种具有下胫腓螺钉导向功能的远端锁定钢板。The utility model relates to the technical field of internal fixation materials for fractures, in particular to a distal locking steel plate with the guiding function of inferior tibiofibular screws.
背景技术Background technique
踝关节损伤在骨科非常常见，依据踝关节损伤机制，下胫腓损伤多伴有外踝损伤，经统计下胫腓损伤在踝关节骨折中的发生率高达13％，而在需要手术治疗的踝关节骨折中发生率可达20％，也有学者报道其发生率达37％。手术治疗外踝骨折多通过拉力螺钉复位加压断端后于外踝侧方放置中和钢板，而治疗下胫腓损伤的“金标准”是放置下胫腓螺钉。Ankle joint injuries are very common in orthopedics. According to the mechanism of ankle joint injuries, lower tibiofibular injuries are often accompanied by lateral malleolus injuries. According to statistics, the incidence of tibiofibular injuries in ankle joint fractures is as high as 13%. The incidence rate of fractures can reach 20%, and some scholars have reported that the incidence rate is as high as 37%. In the surgical treatment of lateral malleolus fractures, a lag screw is used to reset and compress the broken end, and then a neutralization plate is placed on the side of the lateral malleolus, while the "gold standard" for the treatment of inferior tibiofibular injuries is the placement of inferior tibiofibular screws.
下胫腓螺钉的放置方法分为经钢板与不经钢板两种，放置下胫腓螺钉时，基于解剖及影像学的研究表明，踝关节水平间隙上方同一平面内胫骨与腓骨的的矢状位旋转中心的连线的矢量轴为最佳置钉方向，该轴的平均位置位于距腓骨外侧皮质顶点2.5mm以内，且100％经过内踝前半，外踝的平均最佳进钉点位于外踝最高点偏后0.06mm，朝向内踝中点前方4.43mm。临床中使用的外踝钢板上所预留钉孔多，因钢板宽度影响，下胫腓螺钉难以经钢板放置，侧方放置的钢板对不经钢板的下胫腓螺钉的放置造成阻挡，导致手术操作不便。There are two methods of placing the inferior tibiofibular screw: through the plate and without the plate. When placing the inferior tibiofibular screw, based on anatomical and imaging studies, it has been shown that the sagittal position of the tibia and fibula in the same plane above the horizontal gap of the ankle joint The vector axis of the line connecting the center of rotation is the optimal direction of screw placement. The average position of this axis is within 2.5mm from the apex of the lateral cortex of the fibula, and 100% passes through the front half of the medial malleolus. 0.06mm posterior, 4.43mm anterior to the midpoint of the medial malleolus. There are many nail holes reserved on the lateral ankle plate used in clinical practice. Due to the influence of the width of the plate, it is difficult to place the inferior tibiofibular screw through the plate. inconvenient.
故，需要设计一种便于手术操作、且能够改善下胫腓复位效果的外踝钢板。Therefore, it is necessary to design a lateral malleolus plate that is convenient for surgical operation and can improve the reduction effect of the inferior tibia and fibula.
实用新型内容Utility model content
本实用新型的目的是提供一种具有下胫腓螺钉导向功能的远端锁定钢板，具有便于手术操作、改善下胫腓复位效果并节约手术时间的优点。The purpose of the utility model is to provide a distal locking plate with the guiding function of the inferior tibiofibular screw, which has the advantages of being convenient for operation, improving the reduction effect of the inferior tibia and fibula, and saving operation time.
本实用新型的上述技术目的是通过以下技术方案得以实现的：一种具有下胫腓螺钉导向功能的远端锁定钢板，包括：钢板本体；以及，下胫腓螺钉导向套筒；所述钢板本体为贴合腓骨外侧的解剖形状；所述下胫腓螺钉导向套筒为中空圆筒形结构，用于导向置入下胫腓螺钉；所述钢板本体上开设有供所述下胫腓螺钉导向套筒完成导向置入所述下胫腓螺钉的下胫腓螺钉导向孔；所述钢板本体上开设有腓骨近端两用孔；所述腓骨近端两用孔用于固定所述钢板本体以及复位骨折块，不同长度的所述钢板本体近端设计有不同数量的腓骨近端两用孔以适应于不同身高的患者。The above-mentioned technical purpose of the utility model is achieved through the following technical solutions: a distal locking steel plate with the guiding function of the lower tibiofibular screw, comprising: a steel plate body; and a lower tibiofibular screw guiding sleeve; the steel plate body In order to fit the anatomical shape of the outer side of the fibula; the inferior tibiofibular screw guide sleeve is a hollow cylindrical structure for guiding the placement of the inferior tibiofibular screw; The sleeve is guided into the lower tibiofibular screw guide hole of the lower tibiofibular screw; the plate body is provided with a dual-purpose hole for the proximal end of the fibula; the dual-purpose hole for the proximal end of the fibula is used to fix the plate body and To reduce the fracture block, the proximal end of the steel plate body of different lengths is designed with different numbers of dual-purpose holes at the proximal end of the fibula to adapt to patients of different heights.
本实用新型的进一步设置，所述钢板本体上设有贴合所述腓骨的前外侧平面、贴合所述腓骨的外侧嵴凹痕以及贴合所述腓骨的后外侧平面；In a further setting of the present invention, the steel plate body is provided with an anterolateral plane that fits the fibula, a lateral ridge dent that fits the fibula, and a posterolateral plane that fits the fibula;
本实用新型的进一步设置，所述下胫腓螺钉导向套筒包括：设于所述下胫腓螺钉导向套筒一端的带有螺纹的导向器头端；设于所述下胫腓螺钉导向套筒中部的中空圆柱形的筒身；以及，设于所述下胫腓螺钉导向套筒另一端的、供所述下胫腓螺钉插入的导向孔；所述下胫腓螺钉导向孔位于踝关节水平间隙上方2-3cm；所述下胫腓螺钉导向孔侧壁设有供所述导向器头端连接的螺纹。According to the further setting of the present utility model, the lower tibiofibular screw guide sleeve includes: a threaded guide head end arranged at one end of the lower tibiofibular screw guide sleeve; a hollow cylindrical body in the middle of the barrel; and a guide hole at the other end of the lower tibiofibular screw guide sleeve for the insertion of the lower tibiofibular screw; the lower tibiofibular screw guide hole is located at the ankle joint 2-3cm above the horizontal gap; the side wall of the inferior tibiofibular screw guide hole is provided with threads for connecting the head end of the guider.
本实用新型的进一步设置，所述钢板本体上开设有用于复位时定位及临时固定所述钢板本体的克氏针临时固定孔。According to a further setting of the present invention, the steel plate body is provided with temporary fixing holes for Kirschner wires for positioning and temporarily fixing the steel plate body during reset.
本实用新型的进一步设置，所述钢板本体上开设有腓骨远端锁定孔；所述腓骨远端锁定孔用于固定所述钢板本体以及复位骨折块，具有较强的把持力，适用于骨质较差的患者。In a further setting of the present utility model, a locking hole at the distal end of the fibula is provided on the steel plate body; the locking hole at the distal end of the fibula is used for fixing the steel plate body and resetting the fracture block, and has strong holding force, and is suitable for poorer patients.
本实用新型的进一步设置，所述下胫腓螺钉导向孔和所述腓骨远端锁定孔以及所述腓骨近端两用孔的直径为3.5mm；所述下胫腓螺钉导向套筒的内径为3.5mm。Further setting of the utility model, the diameter of the lower tibiofibular screw guide hole, the locking hole at the distal end of the fibula and the dual-purpose hole at the proximal end of the fibula is 3.5 mm; the inner diameter of the lower tibiofibular screw guide sleeve is 3.5mm.
综上所述，本实用新型具有以下有益效果：In summary, the utility model has the following beneficial effects:
1、手术中依据解剖贴合，在外踝上放置钢板本体后，通过腓骨近端两用孔将钢板本体复位固定在外踝骨折处的同时，在钢板本体上设计预留的放置下胫腓螺钉的下胫腓螺钉导向孔，于标准体位下，依据骨折情况避开顾着线，选择合适高度，下胫腓螺钉导向套筒用于导向放置下胫腓螺钉，以达到改善下胫腓复位效果、便于手术操作且节约手术时间。1. According to the anatomical fit during the operation, after the plate body is placed on the lateral malleolus, the plate body is reset and fixed at the fracture site of the lateral malleolus through the dual-purpose hole at the proximal end of the fibula, and the tibiofibular screw is reserved on the plate body. The guide hole of the inferior tibiofibular screw, in the standard position, according to the fracture situation avoiding the line, select the appropriate height, the inferior tibiofibular screw guide sleeve is used to guide the placement of the inferior tibiofibular screw, in order to improve the reduction effect of the inferior tibiofibular, It is convenient for operation and saves operation time.
2、钢板本体上设有贴合腓骨的前外侧平面、的外侧嵴凹痕以及的后外侧平面，使得钢板本体能够与腓骨解剖侧完全贴合，而便于钢板本体对腓骨的固定作用，能够对下胫腓达到较好的复位效果，且不同长度的钢板本体近端设置有不同数量的腓骨近端两用孔，以适应于不同身高的患者。2. The plate body is equipped with an anterolateral plane that fits the fibula, a lateral ridge indentation, and a posterolateral plane, so that the plate body can be completely attached to the anatomical side of the fibula, which facilitates the fixation of the plate body to the fibula, and can The lower tibia and fibula achieve a better reduction effect, and the proximal ends of the steel plates with different lengths are provided with different numbers of dual-purpose holes at the proximal end of the fibula to adapt to patients of different heights.
3、通过下胫腓螺钉导向套筒一端的导向器头端螺纹连接于下胫腓螺钉导向孔，进而将下胫腓螺钉导向套筒稳定的连接在钢板本体上，而便于置入下胫腓螺钉，对复位骨折块进行固定。3. The guide head at one end of the guide sleeve of the lower tibiofibular screw is threadedly connected to the guide hole of the lower tibiofibular screw, and then the guide sleeve of the lower tibiofibular screw is stably connected to the steel plate body, so that it is easy to insert into the lower tibiofibular screw Screws are used to fix the reduced fracture fragments.
附图说明Description of drawings
图1是本实用新型实施例中具有下胫腓螺钉导向功能的远端锁定钢板中钢板本体的结构示意图；Fig. 1 is the structure schematic diagram of the steel plate body in the distal locking steel plate with lower tibiofibular screw guiding function in the embodiment of the utility model;
图2是本实用新型实施例中具有下胫腓螺钉导向功能的远端锁定钢板中的下胫腓螺钉导向套筒的结构示意图。Fig. 2 is a structural schematic diagram of the lower tibiofibular screw guiding sleeve in the distal locking steel plate with the function of guiding the lower tibiofibular screw in the embodiment of the present invention.
附图标记说明：1、钢板本体；2、下胫腓螺钉导向套筒；20、导向器头端；21、筒身；22、导向孔；10、下胫腓螺钉导向孔；11、腓骨近端两用孔；12、前外侧平面；13、外侧嵴凹痕；14、后外侧平面；15、克氏针临时固定孔；16、腓骨远端锁定孔。Explanation of reference signs: 1. Steel plate body; 2. Lower tibiofibular screw guide sleeve; 20. Guide head end; 21. Barrel body; 22. Guide hole; 10. Lower tibiofibular screw guide hole; 12, the anterolateral plane; 13, the indentation of the lateral ridge; 14, the posterolateral plane; 15, the temporary fixation hole of the Kirschner wire; 16, the locking hole of the distal end of the fibula.
具体实施方式Detailed ways
以下结合附图对本实用新型作进一步详细说明。Below in conjunction with accompanying drawing, the utility model is described in further detail.
本具体实施例仅仅是对本实用新型的解释，其并不是对本实用新型的限制，本领域技术人员在阅读完本说明书后可以根据需要对本实施例做出没有创造性贡献的修改，但只要在本实用新型的权利要求范围内都受到专利法的保护。This specific embodiment is only an explanation of the utility model, and it is not a limitation of the utility model. After reading this description, those skilled in the art can make modifications to the embodiment without creative contribution according to needs, but as long as it is within the utility model All new claims are protected by patent law.
实施例：如图1所示，一种具有下胫腓螺钉导向功能的远端锁定钢板，包括：钢板本体1；以及，下胫腓螺钉导向套筒2；钢板本体1为贴合腓骨外侧的解剖形状；下胫腓螺钉导向套筒2为中空圆筒形结构，用于导向置入下胫腓螺钉；钢板本体1上开设有供下胫腓螺钉导向套筒2完成导向以及置入下胫腓螺钉的下胫腓螺钉导向孔10；钢板本体1上开设有腓骨近端两用孔11；腓骨近端两用孔11用于固定钢板本体1以及复位骨折块，钢板本体1上开设有腓骨远端锁定孔16；腓骨远端锁定孔16用于固定钢板本体1以及复位骨折块，具有较强的把持力，适用于骨质较差的患者。Embodiment: As shown in Figure 1, a distal-end locking plate with the guiding function of the inferior tibiofibular screw includes: a steel plate body 1; and a guiding sleeve 2 for the inferior tibiofibular screw; Anatomical shape; the lower tibiofibular screw guide sleeve 2 is a hollow cylindrical structure, used to guide and place the lower tibiofibular screw; the plate body 1 is provided with the lower tibiofibular screw guide sleeve 2 to guide and place the lower tibiofibular screw The lower tibiofibular screw guide hole 10 of the fibula screw; the plate body 1 is provided with a dual-purpose hole 11 for the proximal end of the fibula; The locking hole 16 at the distal end; the locking hole 16 at the distal end of the fibula is used for fixing the plate body 1 and resetting the fracture fragment, which has strong holding force and is suitable for patients with poor bone quality.
如图1所示，该钢板具有贴合腓骨外侧的解剖形状，为解剖型钢板；钢板具有不同长度，配以近端不同数量的直径为3.5mm的腓骨近端两用孔11，以适应不同身高的患者，钢板本体1中段多个直径为3.5mm的下胫腓螺钉导向孔10，以适应不同身高的患者并避开骨折线，该钢板本体1贴合腓骨外侧解剖形状，将下胫腓螺钉导向孔10设计于腓骨外侧的嵴上，较现有钢板更符合下胫腓的解剖结构及旋转对线；腓骨远端锁定孔16直径为3.5mm，具有较强的把持力，可适用于骨质较差的患者；整个钢板本体1为解剖设计，体积较小，方便置入并可减少对皮肤血运的破坏，减少患者留置钢板期间的异物感，从而提高手术质量，改善手术效果。As shown in Figure 1, the steel plate has an anatomical shape that fits the outer side of the fibula, and is an anatomical steel plate; the steel plates have different lengths, and are equipped with different numbers of dual-purpose holes 11 at the proximal end of the fibula with a diameter of 3.5 mm to adapt to different For patients with different heights, there are multiple guide holes 10 for inferior tibiofibular screws with a diameter of 3.5 mm in the middle section of the plate body 1, so as to adapt to patients of different heights and avoid the fracture line. The screw guide hole 10 is designed on the lateral crest of the fibula, which is more in line with the anatomical structure and rotational alignment of the lower tibia and fibula than the existing steel plate; the diameter of the locking hole 16 at the distal end of the fibula is 3.5 mm, which has a strong holding force and can be applied to For patients with poor bone quality, the entire steel plate body 1 is anatomically designed with a small volume, which is convenient for insertion and can reduce damage to the blood supply of the skin, and reduce the foreign body sensation during the indwelling plate, thereby improving the quality of surgery and improving the effect of surgery.
不同长度的钢板本体1近端设计有不同数量的腓骨近端两用孔11，以适应于不同身高的患者，钢板本体1上还开设有用于复位时定位及临时固定钢板本体1的克氏针临时固定孔15。The proximal end of the steel plate body 1 of different lengths is designed with different numbers of dual-purpose holes 11 at the proximal end of the fibula to adapt to patients of different heights. The steel plate body 1 is also provided with Kirschner wires for positioning and temporarily fixing the steel plate body 1 during repositioning. Temporary fixing holes 15.
钢板本体1上设有贴合腓骨的前外侧平面12、的外侧嵴凹痕13以及的后外侧平面14，使得钢板本体1能够与腓骨解剖侧完全贴合，而便于钢板本体1对腓骨的固定作用，能够对下胫腓达到较好的复位效果。The steel plate body 1 is provided with an anterolateral plane 12, a lateral crest indentation 13, and a posterolateral plane 14 that fit the fibula, so that the steel plate body 1 can fully fit the anatomical side of the fibula, and facilitate the fixation of the fibula by the steel plate body 1 It can achieve a better reduction effect on the lower tibia and fibula.
下胫腓螺钉导向套筒2为中空圆筒形结构，包括：设于下胫腓螺钉导向套筒2一端的带有螺纹的导向器头端20；设于下胫腓螺钉导向套筒2中部的中空圆柱形的筒身21；以及，设于下胫腓螺钉导向套筒2另一端的导向孔22，导向孔22供下胫腓螺钉插入，在本实施例中，下胫腓螺钉导向孔10为三联直径为3.5mm的皮质骨螺钉置钉孔，位于踝关节水平间隙上方2-3cm，下胫腓螺钉导向孔10侧壁上设有供导向器头端20连接的螺纹，使用时将导向器头端20置于下胫腓螺钉导向孔10内，将踝关节外翻20°，与水平面呈30°角以3.5mm钻头钻孔后，置入下胫腓螺钉，下胫腓螺钉经过3层骨皮质。The lower tibiofibular screw guide sleeve 2 is a hollow cylindrical structure, including: a threaded guide head 20 arranged at one end of the lower tibiofibular screw guide sleeve 2; The hollow cylindrical barrel body 21 of; And, the guide hole 22 that is located at the other end of the lower tibiofibular screw guide sleeve 2, the guide hole 22 is inserted for the lower tibiofibular screw, in this embodiment, the lower tibiofibular screw guide hole 10 is a cortical bone screw screw hole with a triple diameter of 3.5 mm, which is located 2-3 cm above the horizontal gap of the ankle joint. The side wall of the lower tibiofibular screw guide hole 10 is provided with threads for connecting the head end 20 of the guider. The head end 20 of the guide is placed in the guide hole 10 of the inferior tibiofibular screw, the ankle joint is turned 20°, and the hole is drilled with a 3.5 mm drill bit at an angle of 30° to the horizontal plane, and the inferior tibiofibular screw is inserted through the hole. 3 layers of cortical bone.
该实施例还包括基于上述新型腓骨远端锁定钢板的手术操作方法：This embodiment also includes the surgical operation method based on the above-mentioned novel fibula distal locking plate:
1.麻醉成功后，患者取平卧位，患肢上止血带，常规消毒铺巾；1. After successful anesthesia, the patient should be placed in a supine position, with a tourniquet on the affected limb, and routine disinfection and draping;
2.在患侧外踝作前外侧切口，分离并显露骨折端，清除骨折端血肿，将骨折牵引复位后，垂直于骨折线拧入一枚下胫腓螺钉固定，透视外踝复位满意后，将钢板本体1置于外踝外侧嵴后用螺钉固定；2. Make an anterolateral incision on the lateral malleolus of the affected side, separate and expose the fracture end, remove the hematoma at the fracture end, and after the fracture is reduced by traction, screw in a lower tibiofibular screw perpendicular to the fracture line for fixation. Body 1 is placed on the lateral crest of the lateral malleolus and fixed with screws;
3.术中作下胫腓应力试验，如存在下胫腓分离，则需置入下胫腓螺钉，将踝关节外翻20°，将导向器头端20置于下胫腓螺钉导向孔10内，与水平面呈30°角以3.5mm钻头钻孔后，置入下胫腓螺钉，螺钉经过3层骨皮质；3. During the operation, the lower tibiofibular stress test is performed. If there is a separation of the lower tibiofibular screw, the lower tibiofibular screw needs to be placed, the ankle joint is everted by 20°, and the head end of the guider 20 is placed in the guide hole 10 of the lower tibiofibular screw. Inside, after drilling with a 3.5mm drill bit at an angle of 30° to the horizontal plane, insert the inferior tibiofibular screw, and the screw passes through the 3 layers of cortical bone;
4.检查骨折固定牢固，经透视复位满意后，逐层缝合各处切口，术毕。4. Check that the fracture is firmly fixed, and after satisfactory reduction by fluoroscopy, the incisions are sutured layer by layer, and the operation is completed.
具体工作过程以及原理：手术中依据解剖贴合，在外踝上放置钢板本体1后，通过腓骨近端两用孔11将钢板本体1复位固定在外踝骨折处的同时，在钢板本体1上设计预留的放置下胫腓螺钉的下胫腓螺钉导向孔10，于标准体位下，依据骨折情况避开顾着线，选择合适高度，下胫腓螺钉导向套筒2用于导向放置下胫腓螺钉，以达到手术操作方便，改善下胫腓复位效果，同时能够减少手术中透视次数，节约了手术时间的目的。The specific working process and principle: According to the anatomical fit during the operation, after the steel plate body 1 is placed on the lateral malleolus, the steel plate body 1 is reset and fixed at the fracture site of the lateral malleolus through the dual-purpose hole 11 at the proximal end of the fibula. Reserve the inferior tibiofibular screw guide hole 10 for placing the inferior tibiofibular screw. Under the standard body position, avoid the line of sight according to the fracture situation and select an appropriate height. The inferior tibiofibular screw guide sleeve 2 is used to guide the placement of the inferior tibiofibular screw. , in order to achieve the convenience of operation, improve the effect of lower tibiofibular reduction, reduce the number of times of fluoroscopy during the operation, and save the operation time.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201821261971.1UCN209301280U (en) | 2018-08-04 | 2018-08-04 | A Distal Locking Plate with Inferior Tibiofibular Screw Guiding Function |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201821261971.1UCN209301280U (en) | 2018-08-04 | 2018-08-04 | A Distal Locking Plate with Inferior Tibiofibular Screw Guiding Function |
| Publication Number | Publication Date |
|---|---|
| CN209301280Utrue CN209301280U (en) | 2019-08-27 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201821261971.1UExpired - Fee RelatedCN209301280U (en) | 2018-08-04 | 2018-08-04 | A Distal Locking Plate with Inferior Tibiofibular Screw Guiding Function |
| Country | Link |
|---|---|
| CN (1) | CN209301280U (en) |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111281515A (en)* | 2020-02-25 | 2020-06-16 | 自贡市第四人民医院(自贡市急救中心) | An auxiliary tool for fracture fixation |
| CN112168321A (en)* | 2020-09-21 | 2021-01-05 | 南京市六合区人民医院 | New locking plate with low profile on the posterior side of the lateral malleolus |
| CN112890941A (en)* | 2021-04-01 | 2021-06-04 | 王嘉颐 | Quick-resetting internal fixing system for proximal humerus fracture |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111281515A (en)* | 2020-02-25 | 2020-06-16 | 自贡市第四人民医院(自贡市急救中心) | An auxiliary tool for fracture fixation |
| CN112168321A (en)* | 2020-09-21 | 2021-01-05 | 南京市六合区人民医院 | New locking plate with low profile on the posterior side of the lateral malleolus |
| CN112890941A (en)* | 2021-04-01 | 2021-06-04 | 王嘉颐 | Quick-resetting internal fixing system for proximal humerus fracture |
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| Date | Code | Title | Description |
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| GR01 | Patent grant | ||
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| CF01 | Termination of patent right due to non-payment of annual fee | Granted publication date:20190827 Termination date:20200804 |