Tibial plateau posterior lateral fixing device
By designing the posterior lateral fixation device of C-shaped steel plate and screws, the problem of difficulty in reducing and fixing the posterior lateral fracture of the tibial platform is solved, and stable support and mechanical stability of the posterior lateral bone block is achieved, and neurovascular damage is avoided , taking into account the support needs of the articular surface and metaphyseal ends.
Patent Information
- Application Number
- CN202411416086.6
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2024-10-11
- Publication Date
- 2025-01-03
AI Technical Summary
The incision reduction and internal fixation of the posterior lateral fracture of the tibial platform is difficult, mainly due to the blockage of the anatomy and neurovascular tendons, resulting in many surgical approaches and unstable internal fixation, especially for those with compressive fractures and posterior cortical ring rupture. Fixation treatment requires emphasis on enveloping and supporting the posterior and lateral cortex of the tibia.
A posterior lateral fixation device for the tibial platform including C-shaped steel plates and screws is designed. The C-shaped steel plate can pass through the gap between the lateral collateral ligament and the tibial ankle above the fibula head and wrap around the posterior lateral tibial platform, and the screws and the steel plates form a frame. Structure, combined with guide to avoid neurovascular damage and improve mechanical stability.
Effectively avoid the risk of neurovascular tendon damage, realize the squeeze support of the posterior lateral blind spot bone block, improve the mechanical stability of the fixation device, take into account the strength of the support joint surface and metaphyseal end, and reduce the screw penetration of the joint surface risk.
Smart Images
Figure CN119235435A_ABST
Abstract
Description
Technical Field
[0001] The invention belongs to the technical field of fracture fixation instruments, and in particular relates to a tibial plateau posterolateral fixation device. Background Art
[0002] Tibial plateau fracture (TPF) is a common fracture in clinical trauma orthopedics, usually caused by high-energy impact factors such as traffic accidents, of which the cumulative posterolateral plateau accounts for about 20%. In recent years, with the gradual popularization of low-speed vehicles such as electric vehicles, the incidence of posterolateral tibial plateau fractures has increased year by year. Posterolateral tibial plateau fractures can cause significant swelling of the knee joint, local pain and limited movement. When the knee joint is flexed, the posterolateral tibial plateau is extremely important for stabilizing the posterolateral side of the knee joint. If the fracture is not well reduced and fixed, the patient will experience obvious discomfort and functional impairment. Therefore, the purpose of surgical treatment is to restore the flatness of the joint surface and restore the knee flexion function to the greatest extent.
[0003] Open reduction and internal fixation of posterior lateral tibial plateau fractures has always been a difficult problem in clinical practice. The main reason is that the posterior and lateral tibial plateau is blocked by bony structures and tendons (fibular head and lateral collateral ligament, tendon, etc.) and important blood vessels and nerves (common peroneal nerve, popliteal artery, lateral genicular artery, etc.), which makes it very difficult to expose and place implants. There are many surgical approaches, which are divided into osteotomy approaches (Gerdy tubercle osteotomy approach, lateral femoral condyle osteotomy approach, fibular head digastric muscle osteotomy approach, etc.) and non-osteotomy approaches (posterior median approach, CaIson approach, posteromedial approach, posterolateral approach, etc.). Although the osteotomy approach provides better exposure of the surgical field, it may have shortcomings such as poor bone healing at the osteotomy site and affect the stability of the posterior and lateral structures of the knee joint. At present, there are many surgical approaches and internal fixation methods to treat this type of fracture, but methods with simple surgical approaches, less trauma, and reliable internal fixation are still being explored. Related literature reports that for compression fractures, especially those with posterior cortical ring rupture, internal fixation treatment should emphasize the wrapping of the posterolateral cortex of the tibia and the support of the fracture fragment, so that the implant can hold up the collapsed articular surface fracture fragment like a palm. To this end, we proposed a posterolateral wrapping plate of the tibial plateau and related instruments, hoping to provide a new idea for the surgical treatment of posterolateral tibial plateau fractures. Summary of the invention
[0004] The purpose of the present invention is to overcome the disadvantages of the prior art and provide a tibial plateau posterolateral fixation device.
[0005] The present invention adopts the following technical solution:
[0006] A fixation device for posterolateral fracture of tibial plateau, comprising a fixation steel plate and screws.
[0007] The fixing plate comprises a C-shaped plate body, a fitting surface formed inside the C-shaped plate body and used to fit with the bone under the tibial plateau articular surface, one or more fixing screw holes arranged at the front end of the C-shaped plate body, and a positioning hole arranged at the rear end of the C-shaped plate body and opposite to the one or more fixing screw holes;
[0008] A plurality of screws are provided, which cooperate with one or more fixing screw holes and the tail ends can be snapped into the positioning holes; the C-shaped steel plate body can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head and wrap around the posterior and lateral side of the tibial plateau; a frame structure is formed between the screws and the C-shaped steel plate body, so that a fixing area is formed between the screws and the fitting surface to wrap around the posterior and lateral bone block of the tibial plateau.
[0009] Furthermore, the C-shaped steel plate body also includes one or more first Kirschner wire holes arranged on the C-shaped steel plate body between the positioning hole and the fixing screw hole.
[0010] Furthermore, there are two fixing screw holes, and the fixing steel plate also includes a second Kirschner wire hole arranged at the front end of the C-shaped steel plate body and located between the two fixing screw holes, and the first Kirschner wire hole cooperates with the second Kirschner wire hole to fix the fracture fragment.
[0011] Furthermore, the C-shaped steel plate body includes a first side wing and a second side wing that are relatively arranged and a connecting plate connected between the first side wing and the second side wing, the fixing screw hole is arranged on the first side wing, the positioning hole is arranged on the second side wing, and the width of the connecting plate is smaller than that of the first side wing and the second side wing.
[0012] Furthermore, the connecting plate includes a main body section connected to the second side wing at one end and a connecting section connected between the main body section and the first side wing, and the connecting section is bent and extended between the main body section and the first side wing, so that when the fixing device is installed on the posterior and lateral side of the tibial plateau, the first side wing is sunken relative to the main body section.
[0013] Furthermore, it also includes a guide for guiding the tail end of the fixing screw that cooperates with the fixing screw hole to be snapped into the positioning hole. The guide includes a guide head that can be embedded in the fixing screw hole, a clearance hole arranged in the guide head opposite to the fixing screw hole, and an operating handle connected to the guide head and extending outward.
[0014] Furthermore, a connecting portion connected to an operating handle is formed at the upper end of the guide head, and the connecting portion is formed with a connecting hole extending inward from its side for the lower end of the operating handle to be embedded in, and the operating handle includes a curved section at one end which can be embedded in the connecting hole and the other end extending upward, and an extending section connected to the curved section and extending upward.
[0015] Furthermore, the clearance hole includes a fixing section that can be opposite to the fixing screw hole and a limiting section that is connected to the fixing section and extends outward, and the diameter of the limiting section increases gradually toward the outside.
[0016] Furthermore, the distance between the left and right sides of the limiting section increases outwards in sequence.
[0017] Furthermore, an outermost edge line of the left side or the right side of the limiting section forms an angle of 20-50° with the axis of the clearance hole.
[0018] From the above description of the present invention, it can be seen that compared with the prior art, the beneficial effects of the present invention are as follows: the fixation device defined in the present application is a new type of internal fixation device proposed for posterolateral fractures of the tibial plateau, and compared with other traditional steel plates for tibial plateau fractures, it has the following advantages: first, it avoids the risk of damage to the nerves, blood vessels and tendons caused by the complex anatomical structure of the conventional posterior approach; second, the C-shaped steel plate body can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head, and wrap around the posterolateral side of the tibial plateau, thereby achieving compression support for the blind bone block in the posterolateral area; two screws are inserted into the rear positioning holes to form a frame structure, so that the fixation device has good mechanical stability; third, the setting of the first Kirschner wire hole and the second Kirschner wire hole, It can assist in the reduction and fixation of the posterolateral tibial plateau fracture, especially the bone close to the articular surface; fourth, the present invention can be used in combination with a conventional proximal lateral tibial plate, and this technology takes into account the needs of supporting the articular surface and strong fixation of the epiphysis; fifth, the structural design of the guide makes the outermost edge line of the left or right side of the limiting section form a 35° angle with the axis of the giveway hole, and only allows the drill bit to swing to the left and right, which can prevent the screw from passing through the articular surface upward and being unable to get stuck in the positioning groove behind the plate; sixth, the connecting section is bent and extended between the main section and the first side wing, so that when the fixing device is installed on the posterolateral side of the tibial plateau, the first side wing is set downward relative to the main section, so as to avoid the fixing device being too close to the articular surface, resulting in the risk of the screw penetrating the joint. BRIEF DESCRIPTION OF THE DRAWINGS
[0019] Figure 1 Schematic diagram of the structure for fixing the steel plate Figure 1 ;
[0020] Figure 2 Schematic diagram of the structure for fixing the steel plate Figure 2 ;
[0021] Figure 3 Schematic diagram of the structure for fixing the steel plate Figure 3 ;
[0022] Figure 4 The structure of the guide Figure 1 ;
[0023] Figure 5The structure of the guide Figure 2 ;
[0024] Figure 6 It is a structural cross-sectional view of the guide head;
[0025] Figure 7 The figure is a schematic diagram of the assembly for fixing the steel plate;
[0026] In the figure, 1-fixed steel plate, 2-guide, 3-C-shaped steel plate body, 4-fitting surface, 5-fixed screw hole, 6-positioning hole, 7-first Kirschner wire hole, 8-second Kirschner wire hole, 21-guide head, 211-connecting part, 212-connecting hole, 22-yield hole, 221-fixed section, 222-limiting section, 23-operating handle, 231-bending section, 232-extension section, 31-first side wing, 32-second side wing, 33-connecting plate, 34-main section, 35-connecting section. DETAILED DESCRIPTION
[0027] The present invention is further described below through specific implementation modes.
[0028] Reference Figures 1 to 7 As shown, a posterolateral fixation device of the tibial plateau includes a fixing plate 1, screws and a guide 2.
[0029] The fixation plate 1 comprises a C-shaped plate body 3, a fitting surface 4 formed on the inner side of the C-shaped plate body 3 and used for fitting with the bone under the tibial plateau articular surface, two fixing screw holes 5 arranged at the front end of the C-shaped plate body 3, a positioning hole 6 arranged at the rear end of the C-shaped plate body 3 and opposite to the two fixing screw holes 5, two first Kirschner wire holes 7 arranged on the C-shaped plate body 3 and located between the positioning hole 6 and the fixing screw hole 5, and a second Kirschner wire hole 8 arranged at the front 3 ends of the C-shaped plate body and located between the two fixing screw holes 5, wherein the two first Kirschner wire holes 7 cooperate with the second Kirschner wire hole 8 to facilitate temporary fixation of the fracture fragment.
[0030] The C-shaped steel plate body 3 can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head and wrap around the posterior and lateral side of the tibial plateau; it includes a first side wing 31 and a second side wing 32 that are arranged opposite to each other and a connecting plate 33 connected between the first side wing 31 and the second side wing 32, and the width of the connecting plate 33 is smaller than the first side wing 21 and the second side wing 32; wherein the connecting plate 33 includes a main body section 34 connected to the second side wing 32 at one end and a connecting section 33 connected between the main body section 34 and the first side wing 31, and the connecting section 33 is bent and extended between the main body section 34 and the first side wing 31, so that the fixing device is installed on the tibial plateau. When the tibial plate is positioned posterolaterally, the first wing 31 is sunken relative to the main body 34 to prevent the fixing device from being too close to the joint surface, which may cause the risk of the screw penetrating the joint; specifically, the fixing screw hole 5 is arranged on the first wing 31, the positioning hole 6 is arranged on the second wing 32, and the two first Kirschner wire holes 7 are arranged on the main body 34; further, the C-shaped steel plate body 3 is designed with a low notch to minimize soft tissue irritation; the present application limits the specific structure of the C-shaped steel plate body 3 so that the fitting surface 4 arranged on the inner side thereof can fit well with the bone under the posterolateral joint of the tibial plateau, thereby achieving compression support for the posterolateral blind area bone block.
[0031] The fixing screw hole 5 is a countersunk hole 31 arranged on the first wing. When the screw cooperates with the fixing screw hole 5, its nail head is arranged in the fixing screw hole 5, and the tail end is clamped in the positioning hole 6, forming a frame structure with the C-shaped steel plate body 3, so that a fixing area surrounding the posterior and lateral bone block of the tibial plateau is formed between the screw and the fitting surface 4, so as to better surround the posterior and lateral bone block of the tibial plateau and improve stability.
[0032] There are two screws, which respectively match the two fixing screw holes 5, and the tail ends are clamped in the positioning holes 6.
[0033] The guide 2 is used to guide the tail end of the screw that cooperates with the fixing screw hole 5 to be snapped into the positioning hole 6, and includes a guide head 21 that can be embedded in the fixing screw hole 5, a clearance hole 22 arranged in the guide head 21 opposite to the fixing screw hole 5, and an operating handle 23 connected to the guide head 21 and extending outward, wherein a connecting portion 211 connected to the operating handle 23 is formed at the upper end of the guide head 21, and the connecting portion 211 is formed with a connecting hole 212 extending inward from its side for the lower end of the operating handle 23 to be embedded; the operating handle 23 includes a bent section 231 with one end that can be embedded in the connecting hole 212 and the other end extending upward, and an extending section 232 connected to the bent section 231 and extending upward; the front end of the bent section 231 is connected to the connecting hole 212 by laser welding.
[0034] The clearance hole 22 includes a fixing section 221 which can be opposite to the fixing screw hole 5 and a limiting section 222 which is connected to the fixing section 221 and extends outward, wherein the diameter of the limiting section 222 increases outward in sequence; specifically, the distance between the left and right sides of the limiting section 222 increases outward in sequence, so that the cross-section of the limiting section 222 is non-circular, and the outermost edge line of the left side or the right side of the limiting section 222 forms an angle of 20-50° with the axis of the clearance hole 22, so that the drill bit of the locking screw is only allowed to swing at a certain angle in the left and right directions to avoid the tail end of the screw passing through the joint surface upward and failing to be clamped in the positioning hole 6; specifically, the outermost edge line of the left side or the right side of the limiting section 222 forms an angle of 35° with the axis of the clearance hole 22 as the best.
[0035] The fixation device defined in the present application is a new type of internal fixation device proposed for posterolateral tibial plateau fractures, and compared with other traditional steel plates for tibial plateau fractures, it has the following advantages: first, it avoids the risk of damage to nerves, blood vessels and tendons caused by the complex anatomical structure of the conventional posterior approach; second, the C-shaped steel plate body 3 can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head, and wrap around the posterolateral side of the tibial plateau, thereby achieving compression support for the blind bone block in the posterolateral area; two screws are inserted into the rear positioning holes 6 to form a frame structure, so that the fixation device has good mechanical stability; third, the setting of the first Kirschner wire hole 7 and the second Kirschner wire hole 8 can assist in the reduction and fixation of the posterolateral fracture of the tibial plateau, especially It is the bone close to the articular surface; fourth, the present invention can be used in combination with a conventional proximal lateral tibial steel plate, and this technology takes into account the needs of supporting the articular surface and strong fixation of the epiphysis; fifth, the structural design of the guide makes the outermost edge line of the left or right side of the limiting section 222 form a 35° angle with the axis of the clearance hole 22, and only allows the drill bit to swing to the left and right, which can prevent the screw from passing through the articular surface upward and being unable to get stuck in the positioning groove behind the steel plate; sixth, the connecting section 33 is bent and extended between the main section 34 and the first side wing 31, so that when the fixing device is installed on the posterolateral side of the tibial platform, the first side wing 31 is sunken relative to the main section 34, avoiding the risk of the fixing device being too close to the articular surface and causing the screw to penetrate the joint.
[0036] The above description is only a preferred embodiment of the present invention, and therefore cannot be used to limit the scope of implementation of the present invention. That is, equivalent changes and modifications made according to the application scope of the present invention and the contents of the specification should still fall within the scope of the present invention.
Claims
1. A fixation device for posterolateral tibial plateau fracture, characterized in that: Including fixing plates and screws, The fixing plate comprises a C-shaped plate body, a fitting surface formed inside the C-shaped plate body and used to fit with the bone under the tibial plateau articular surface, one or more fixing screw holes arranged at the front end of the C-shaped plate body, and a positioning hole arranged at the rear end of the C-shaped plate body and opposite to the one or more fixing screw holes; A plurality of screws are provided, which cooperate with one or more fixing screw holes and the tail ends can be snapped into the positioning holes; the C-shaped steel plate body can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head and wrap around the posterior and lateral side of the tibial plateau; a frame structure is formed between the screws and the C-shaped steel plate body, so that a fixing area is formed between the screws and the fitting surface to wrap around the posterior and lateral bone block of the tibial plateau.
2. The lateral tibial plateau fracture fixation device according to claim 1, characterized in that: The C-shaped steel plate body also includes one or more first Kirschner wire holes arranged on the C-shaped steel plate body between the positioning hole and the fixing screw hole.
3. The lateral tibial plateau fracture fixation device according to claim 2, characterized in that: There are two fixing screw holes, and the fixing steel plate also includes a second Kirschner wire hole arranged at the front end of the C-shaped steel plate body and located between the two fixing screw holes. The first Kirschner wire hole cooperates with the second Kirschner wire hole to fix the fracture fragment.
4. The lateral tibial plateau fracture fixation device according to claim 1, characterized in that: The C-shaped steel plate body includes a first side wing and a second side wing that are arranged opposite to each other and a connecting plate connected between the first side wing and the second side wing. The fixing screw hole is arranged on the first side wing, the positioning hole is arranged on the second side wing, and the width of the connecting plate is smaller than that of the first side wing and the second side wing.
5. The lateral tibial plateau fracture fixation device according to claim 4, characterized in that: The connecting plate includes a main body section connected to the second side wing at one end and a connecting section connected between the main body section and the first side wing. The connecting section is bent and extended between the main body section and the first side wing, so that when the fixing device is installed on the posterior and lateral side of the tibial plateau, the first side wing is sunken relative to the main body section.
6. The lateral tibial plateau fracture fixation device according to claim 1, characterized in that: It also includes a guide for guiding the tail end of a fixing screw that cooperates with the fixing screw hole to be snapped into the positioning hole. The guide includes a guide head that can be embedded in the fixing screw hole, a clearance hole arranged in the guide head opposite to the fixing screw hole, and an operating handle connected to the guide head and extending outward.
7. The lateral tibial plateau fracture fixation device according to claim 6, characterized in that: The upper end of the guide head is formed with a connecting portion connected to the operating handle, and the connecting portion is formed with a connecting hole extending inward from its side for the lower end of the operating handle to be embedded in. The operating handle includes a curved section at one end which can be embedded in the connecting hole and the other end extending upward, and an extending section connected to the curved section and extending upward.
8. The lateral tibial plateau fracture fixation device according to claim 6, characterized in that: The clearance hole comprises a fixing section which can be opposite to the fixing screw hole and a limiting section which is connected to the fixing section and extends outwards, and the diameter of the limiting section increases outwards in sequence.
9. The lateral tibial plateau fracture fixation device according to claim 8, characterized in that: The distance between the left and right sides of the limiting section increases outwards in sequence.
10. The lateral tibial plateau fracture fixation device according to claim 8, characterized in that: The outermost edge line of the left side or the right side of the limiting section forms an angle of 20-50° with the axis of the clearance hole.