CN1527684A - 用于近中的肱骨骨折固定术的接骨板 - Google Patents

用于近中的肱骨骨折固定术的接骨板 Download PDF

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CN1527684A
CN1527684A CNA018233139A CN01823313A CN1527684A CN 1527684 A CN1527684 A CN 1527684A CN A018233139 A CNA018233139 A CN A018233139A CN 01823313 A CN01823313 A CN 01823313A CN 1527684 A CN1527684 A CN 1527684A
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阿尔弗雷德·尼德伯格
埃里克·阿特勒
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread

Abstract

用于近中的肱骨骨折固定术的接骨板。该接骨板包括一柄状部分(1)和一匙状部分(2)，柄状部分的长度大于其宽度x，匙状部分的宽度y大于柄状部分(1)的宽度x。柄状部分(1)和匙状部分(2)具有一共同的纵向中心轴线(3)并且通过一过渡部分(26)相互连接。在柄状部分(1)和匙状部分(2)中设有至少各2个螺钉孔(9、10、16、17，24)。柄状部分(1)中的至少一个螺钉孔(24)具有至少部分的内螺纹(28)或部分环绕的楔形槽。匙状部分(2)中的至少一个螺钉孔(9、10、16、17)具有一种内螺纹(27)或部分环绕的楔形槽。内螺纹(27、28)或部分环绕的楔形槽的螺距在0.5mm至1.1mm的范围内。

Description

用于近中的肱骨骨折固定术的接骨板
技术领域
本发明涉及一种按照权利要求1的前序部分所述的用于近中的肱骨骨折固定术的接骨板。
背景技术
这样的接骨板用于在近中的肱骨上的所有骨折类型的固定术，但特别用于在近中的肱骨上的全部三个和四个部分的骨折以及脱位的骨折。
在青少年时期近中的肱骨骨折的频繁的原因是高能创伤。这样的骨折型式甚至随着年龄的增加而增加，因为在近中的肱骨的区域内骨结构大大恶化，以致只在骨的周边区域才存在完整的骨结构。在年长的年龄当坠落在伸出的臂上时，骨则特别在该位置骨折。
由US-A 6096040 ESSER已知一种同类的接骨板。
该装置的缺点在于，板在匙状部分具有一孔位置，利用该孔位置不可能夹住近中的肱骨的周边区域内的众所周知的完好的骨结构。
此外，在ESSER描述的植入片中涉及在各板孔中无固定角度的选择的一种板。在应用该板时借助于各个接骨螺钉使其压紧在骨上。这种方法人们称为压缩骨缝术。其中产生的力通过摩擦力在植入片与骨之间传递，而骨必须承受大部分的载荷。由于为了板在骨上的较稳定的固定，接骨螺钉承受大的轴向压力，在动力条件下导致接骨螺钉从骨中拔出并从而伴随着板-骨结构的稳定性的丧失。
以上关于现有技术的讨论只用于说明本发明的周围环境并不意味着，所引用的现有技术是到本申请时刻或其先前在实际上也已知的出版的或公开的现有技术。
发明内容
这里本发明将消除存在的弊端。本发明的目的在于，提供一种用于近中的肱骨骨折固定术的接骨板，借此可以达到一种角度稳定的接骨术。本发明的基本优点是螺钉孔与具有螺纹头的螺钉相组合的角度稳定性、简单的操作、在骨上的最好的解剖学上的配合和没有近中的肱骨的相关的解剖学上的结构的妨碍。通过具有螺纹头的螺钉的应用形成一固定角度的板-骨结构，其即使在动力条件下也能够保持固定。
本发明利用具有权利要求1的特征的接骨板来达到所提出的目的。
微小的螺纹螺距允许在很短的距离上，通常在1至2mm的范围内将螺钉牢固锚定于板中。因此板的厚度可以确定得很薄，而没有降低板-螺钉结构的稳定性的后果。
一优选的进一步构成在于，内螺纹的螺距或部分环绕的楔形槽在0.7至0.9mm的范围内，这进一步完善上述效果。
在另一优选的实施形式中过渡部分从柄状部分的宽度x优选以指数的方式加宽到匙状部分的宽度y。
借此可以达到在人的未骨折的近中的肱骨上的最好的配合。因此板清洁地放在骨上面而不妨碍相关的解剖学上的结构。
板的厚度适当地在1.7至2.3mm的范围内，优选在1.9至2.1mm之间。相对于传统的接骨板的较小的厚度的优点主要在于，较薄的板不妨碍任何相关的结构并且在举起手臂时不会撞到肩峰上。
优选板的柄状部分朝中心轴线方向看去至少在一部分区域内构成弧形的。
在另一优选的实施形式中，板的柄状部分朝中心轴线(3)的方向看去至少在一部分区域内是以椭圆弧形(21)弯曲的。属于椭圆弧形(21)的椭圆的长轴(22)的长度优选在150与170mm之间的范围内，典型地在157与163mm的范围内。属于椭圆弧形的椭圆的短轴的长度优选在60与80mm之间的范围内，典型地在67与73mm之间的范围内。
柄状部分和匙状部分(2)的自由端优选基本上位于彼此平行的平面内。
全部这些优选的措施的优点是，在人的未骨折的近中的肱骨上的改善的配合是可能的，其中板清洁地放在骨上面而不妨碍相关的解剖学上的结构。
在另一优选的实施形式中，接骨板至少在一部分区域内具有一横向于中心轴线延伸的曲率，优选其曲率半径在18至22mm的范围内。
在另一实施形式中，接骨板沿其全长具有一横向于中心轴线延伸的曲率。由此可达到的优点在于，不发生存在的软组织的刺激。在举起手臂时防止接骨板撞到肩峰上。
在另一优选的实施形式中，匙状部分的自由末端部分具有两个对称于中心轴线设置的、具有平行的孔轴线的孔，其中孔轴线与由匙状部分构成的平面之间形成一92°至98°、优选94°至96°的角度。为了达到固定角度的复位，在按照现有技术的植入片的情况下需要叶片，其由插入固定角度的孔中的螺钉代替。叶片的手术技术还需要较长的时间消耗并且比采用如本发明中具有固定角度的那些螺钉更为复杂。通过约95°的接触角加大了与坚固的骨的接触表面，因为坚固的骨材料只存在于相对空心的肱骨头的周边区域内。
在另一优选的实施形式中，匙状部分邻接过渡部分之部分具有两个不对称于中心轴线的孔并且两孔的孔轴线位于相互平行的、优选正交于中心轴线的平面内。一个孔轴线在包含另一孔轴线的平行平面上的投影与该孔轴线之间包括一40°-60°、优选46°-54°的角度。
该装置的优点在于，插入各交叉孔的螺钉允许拉起小的结节，该结节在近中的肱骨骨折时时常骨折。
另一优选的实施形式在于，至少一个对称于和/或不对称于中心轴线设置的孔具有内螺纹或部分环绕的楔形槽。其中有利地应该没有对称于和/或不对称于中心轴线设置的各孔的孔轴线相交。因此得到的优点是，插入孔内的各螺钉不会相互妨碍。
在另一实施形式中设置在柄状部分的各孔垂直于中心轴线。
内螺纹优选构成为多线的，典型地为双线的。
按照本发明的接骨板既可应用于左边的肱骨又可应用于右边的肱骨并且最好地配合于健康的近中的肱骨。
附图说明
以下借助于一实施例的部分示意图更详细地说明本发明及其进一步构成。其中：
图1 本发明的接骨板的俯视图；
图2 沿图1中线II-II截取的剖面；
图3 本发明的接骨板的透视图；以及
图4 本发明的接骨板的侧视图。
具体实施方式
图1至4中所示的用于近中的肱骨骨折固定术的接骨板包括一柄状部分1，其长度大于其宽度x，和一匙状部分2，其宽度y大于柄状部分1的宽度x。柄状部分1和匙状部分2具有一共同的纵向中心轴线3并且通过一过渡部分26相互连接，该过渡部分从柄状部分1的宽度x成指数地加宽到匙状部分2的宽度y。
在柄状部分1和匙状部分2中设有大量的螺钉孔(9、10、16、17；24)。在接骨板的柄状部分1中设置的全部螺钉孔24具有一内螺纹28(该螺纹也可以由部分环绕的楔形槽代替)。
在接骨板的匙状部分2设置的四个螺钉孔(9、10、16、17)同样具有内螺纹27(这里内螺纹也可以由部分环绕的楔形槽代替)。
该内螺纹27、28(或部分环绕的楔形槽)的螺距为0.8mm。接骨板的厚度为2mm。
如由图4显而易见的那样，朝中心轴线3的方向看去，柄状部分1在一部分区域内构成弧形的而且为椭圆弧形21的形式。属于椭圆弧形21的椭圆的长轴22的长度为160mm而属于椭圆弧形21的椭圆的短轴23的长度为70mm。由于柄状部分1的曲率，柄状部分1的自由端5和匙状部分2的自由端基本上位于相互平行的平面内。
如由图2显而易见的那样，接骨板沿其全长具有横向于中心轴线3延伸的曲率6，其曲率半径为20mm。
如由图1和2显而易见的那样，匙状部分2的自由末端部分8具有两个对称于中心轴线3设置的、具有平行的孔轴线的孔9、10，其中孔轴线11、12与由匙状部分2构成的平面14之间形成一95°的角度13。
匙状部分2邻接过渡部分26的部分15还具有两个不对称于中心轴线3设置的孔16、17。两孔16、17的孔轴线18、19位于相互平行的、正交于中心轴线3的平面内。一个孔轴线18在包含另一孔轴线19的平行平面上的投影与孔轴线19之间包括一50°的角度20。
对称于和不对称于中心轴线3设置的各对孔9、10、16、17具有内螺纹27，其也可以由部分环绕的楔形槽代替。对称于和不对称于中心轴线3设置的各对孔9、10，16、17的孔轴线11、12，18、19均不相交。内螺纹27、28构成为双线的。
设置在柄状部分1中的各孔24的轴线垂直于柄状部分1。

Claims (19)

1.用于近中的肱骨骨折固定术的接骨板，该接骨板包括一柄状部分(1)和一匙状部分(2)，柄状部分的长度大于其宽度x，匙状部分的宽度y大于柄状部分(1)的宽度x，其中柄状部分(1)和匙状部分(2)具有一共同的纵向中心轴线(3)并且在通过一过渡部分(26)相互连接，并且在柄状部分(1)和匙状部分(2)中设有至少各2个螺钉孔(9、10、16、17，24)；其特征在于：
A)柄状部分(1)中的至少一个螺钉孔(24)具有一至少部分的内螺纹(28)或部分环绕的楔形槽；
B)匙状部分(2)中的至少一个螺钉孔(9、10、16、17)具有一种内螺纹(27)或部分环绕的楔形槽；以及
C)内螺纹(27、28)或部分环绕的楔形槽的螺距在0.5mm至1.1mm的范围内。
2.按照权利要求1所述的接骨板，其特征在于，内螺纹(27、28)或部分环绕的楔形槽的螺距在0.7至0.9mm的范围内。
3.按照权利要求1或2所述的接骨板，其特征在于，过渡部分(26)的宽度从柄状部分(1)的宽度x优选以指数方式加宽到匙状部分(2)的宽度y。
4.按照权利要求1至3之一项所述的接骨板，其特征在于，其厚度在1.7至2.3mm之间、优选在1.9至2.1mm之间的范围内。
5.按照权利要求1至4之一项所述的接骨板，其特征在于，朝中心轴线(3)的方向看去，柄状部分(1)至少在一部分区域内构成弧形的。
6.按照权利要求1至5之一项所述的接骨板，其特征在于，朝中心轴线(3)的方向看去，柄状部分(1)至少在一部分区域内是以椭圆弧形(21)形状弯曲的。
7.按照权利要求6所述的接骨板，其特征在于，属于椭圆弧形(21)的椭圆的长轴(22)的长度在150与170mm之间，优选在157与163mm之间的范围内。
8.按照权利要求6或7所述的接骨板，其特征在于，属于椭圆弧形(21)的椭圆的短轴(23)的长度在60与80mm之间，优选在67与73mm之间的范围内。
9.按照权利要求1至8之一项所述的接骨板，其特征在于，柄状部分的自由端(5)和匙状部分(2)的自由端基本上位于彼此平行的平面内。
10.按照权利要求1至9之一项所述的接骨板，其特征在于，接骨板至少在一部分区域内具有横向于中心轴线(3)延伸的曲率(6)，优选其曲率半径在18至22mm的范围内。
11.按照权利要求10所述的接骨板，其特征在于，接骨板沿其全部长度具有横向于中心轴线(3)延伸的曲率(6)。
12.按照权利要求1至11之一项所述的接骨板，其特征在于，匙状部分(2)的自由末端部分(8)具有两个对称于中心轴线(3)设置的带有平行的孔轴线的孔(9、10)，其中孔轴线(11、12)与由匙状部分(2)构成的平面(14)之间形成一92°至98°、优选94°至96°的角度(13)。
13.按照权利要求1至12之一项所述的接骨板，其特征在于，匙状部分(2)邻接过渡部分(26)的部分(15)具有两个不对称于中心轴线(3)设置的孔(16、17)。
14.按照权利要求13所述的接骨板，其特征在于，两个孔(16、17)的孔轴线(18、19)位于相互平行的、优选正交于中心轴线(3)的平面内。
15.按照权利要求14所述的接骨板，其特征在于，一个孔轴线(18)在包含另一孔轴线(19)的平行平面上的投影与孔轴线(19)相互间包括一40°至60°、优选46°至54°的角度(20)。
16.按照权利要求12至15之一项所述的接骨板，其特征在于，至少一个对称于和/或不对称于中心轴线(3)设置的孔(9、10、16、17)具有一种内螺纹(27)或部分环绕的楔形槽。
17.按照权利要求12至16之一项所述的接骨板，其特征在于，对称于和/或不对称于中心轴线(3)设置的孔(9、10、16、17)的孔轴线(11、12，18、19)均不相交。
18.按照权利要求1至17之一项所述的接骨板，其特征在于，设置在柄状部分(1)中的各孔(24)的轴线垂直于柄状部分(1)。
19.按照权利要求1至18之一项所述的接骨板，其特征在于，内螺纹(27、28)构成为多线的、优选为双线的。
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CN102018560A (zh) * 2010-12-17 2011-04-20 任绍东 数字化接骨板及其制备方法
CN102018560B (zh) * 2010-12-17 2013-06-12 任绍东 数字化接骨板及其制备方法
CN102835998A (zh) * 2012-08-17 2012-12-26 苏州瑞华医院有限公司 一种治疗肱骨外科颈骨折的新型内固定锁定接骨板
CN105030316A (zh) * 2015-08-24 2015-11-11 苏州市康力骨科器械有限公司 一种肱骨近端多方向锁定钢板

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US8460344B2 (en) 2013-06-11
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