Novel acromioclavicular joint fixing device

Abstract

The invention discloses a novel acromioclavicular joint fixing device, and relates to the technical field of orthopedic medical instruments. At present, an internal fixation instrument for distal clavicle fracture and acromioclavicular joint dislocation usually passes through an acromioclavicular joint and subacromial tissue, tissue damage is caused, and the micro-motion function of the acromioclavicular joint is damaged, but the novel internal fixation instrument crosses the acromioclavicular joint instead of passing through the acromioclavicular joint and the subacromial tissue, and meanwhile, the micro-motion function of the acromioclavicular joint is kept. The acromioclavicular joint fixing device comprises an acromioclavicular plate, a clavicular plate and a connecting cable, the acromioclavicular plate and the clavicular plate are each provided with a cable channel, the cable penetrates through the channels according to a certain sequence and then is fixed in an 8 shape, and by means of channel sliding, cable flexibility and 8-shaped fixing, stable static fixing is achieved, and the micro-motion function of an acromioclavicular joint can also be achieved. The novel acromioclavicular joint fixing device is mainly suitable for distal clavicular fracture, acromioclavicular joint dislocation and the combination of the distal clavicular fracture and the acromioclavicular joint dislocation, and plays a supporting and protecting role before fracture healing and joint dislocation healing.

Description

Technical Field

[0001] The invention relates to the technical field of orthopedic medical devices and is a novel acromioclavicular joint fixation device. Specifically, the device does not damage the acromioclavicular joint and subacromial tissue and can meet the biomechanical requirements of acromioclavicular joint micromotion. Background Art

[0002] Distal clavicle fracture and acromioclavicular joint dislocation are common shoulder injuries in clinical practice. At present, there is no unified standard for the treatment of unstable distal clavicle fracture and acromioclavicular joint dislocation. Various treatments have their advantages and disadvantages. Since Schmittinger proposed the use of clavicle hook plate to treat acromioclavicular joint dislocation and distal clavicle fracture in 1983, many studies have confirmed that clavicle hook plate has few complications and definite efficacy. By utilizing the lever effect formed by the plate fixed at the distal end of the clavicle and the hook passing under the acromion, the clavicle hook plate forms a long-lasting and stable pressure at the distal end of the clavicle to achieve the purpose of anatomical reduction and fixation. Zhu Yiyong et al. studied the use of clavicle hook plate to treat acromioclavicular joint dislocation and distal clavicle fracture. After surgery, 25.5% of patients had varying degrees of shoulder pain. There were six causes of pain, four of which were related to the clavicle hook plate: unhooking, clavicle hook hitting the acromion, poor or incorrect plate position, and too long tail hook of the plate. Zhai Yanbin et al. studied 95 patients with acromioclavicular joint dislocation treated with clavicular hook plates. After surgery, 70 patients with hook plates had various complications such as acromioclavicular joint pain and limited movement, including 45 cases of subacromial osteolysis, 3 cases of internal fixation fracture, 13 cases of acromial impingement, 2 cases of screw loosening, and 5 cases of frozen shoulder. The complication rate was 97.1% (68 / 70). The clavicular hook of the clavicular hook plate works by being placed under the acromion. There are complications after surgery: subacromial osteolysis, acromial impingement, and rotator cuff injury, which are all significantly related to the clavicular hook. Can an internal fixator be designed that can play the role of the clavicular hook plate and avoid the "deficiencies" of the clavicular hook plate? In addition to improving the design of the clavicular hook plate, a new alternative product can also be designed.

[0003] The new acromioclavicular joint fixation device designed in this study does not pass through the acromioclavicular joint or the subacromial space during use, but crosses the acromioclavicular joint and is located above the acromioclavicular joint. It can not only play a stable fixation role, but also meet the micro-motion of the acromioclavicular joint, providing sufficient time for the healing of clavicle fractures and acromioclavicular joint dislocations. So far, no similar acromioclavicular joint fixation device has been found. Summary of the invention

[0004] The purpose of the present invention is to provide a novel acromioclavicular joint fixation device which can not affect the micro-motion of the acromioclavicular joint.

[0005] To achieve the above-mentioned purpose, the technical solution adopted by the present invention is: the novel acromioclavicular joint fixation device is composed of three parts: an acromion plate, a clavicle plate and a connecting cable, all of which are made of titanium alloy. The clavicle plate and the acromion plate are designed according to the anatomical shapes of the clavicle and the acromion. When in use, they are fixed to the acromion and clavicle respectively, and then connected in the middle with a cable. The cable is soft and movable. By adjusting the tightness of the cable, the relative mobility and degree of engagement of the acromion plate and the clavicle plate can be adjusted, that is, the acromion plate and the clavicle plate can achieve stable static fixation after being connected by the cable, and horizontal, longitudinal and rotational micro-movements can occur, which can meet the needs of acromioclavicular joint micro-movements to a certain extent.

[0006] In the novel acromioclavicular joint fixation device described above, as a preferred embodiment, the shapes of the acromion plate and clavicle plate are designed according to the anatomical morphology of the acromion of the scapula and the lateral segment of the clavicle, and the plate body has a physiological curvature to increase the fit with the bone surface.

[0007] In the novel acromioclavicular joint fixation device described above, the screws include locking screws and compression screws. The technologies of locking screws and compression screws are relatively mature. As a preferred scheme, the screws of the acromion plate and clavicle plate of this study are evenly distributed, and the locking screws and compression screws are distributed at intervals. The number of locking screws and compression screws can be adjusted according to the degree of bone porosity or bone density, and the fixation effect of the acromion plate and clavicle plate can be adjusted to achieve effective fixation.

[0008] The advantages of the present invention are: 1. The present invention is inspired by the "8" fixation of titanium cables in the Kirschner wire tension band technology, is simple to operate, and has strong practicality. Each component is designed separately and used after being combined, so that the acromioclavicular joint is fixed with both stability and micro-mobility.

[0009] 2. The number of fixing screw holes of the acromion plate and clavicle plate described in the present invention is sufficient, and the locking screws and compression screws are spaced and evenly distributed, which enhances the stability of the fixation of the acromion plate and the locking plate and can reduce the probability of internal fixation failure.

[0010] 3. The connecting cables of the present invention are respectively passed through the acromion plate channel and the clavicle plate channel, and then cross-fixed in an "8" shape. By adjusting the tightness of the titanium cable, it is ensured that after completing the fixation function, the micro-motion function of the acromioclavicular joint can be achieved to the maximum extent, and the influence on the acromioclavicular joint can be minimized after the internal fixation is removed. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] Attached Figure 1 It is a front structural schematic diagram of the novel acromioclavicular joint fixation device described in the present invention.

[0012] Attached Figure 2 It is a side structural schematic diagram of the novel acromioclavicular joint fixation device described in the present invention.

[0013] Attached Figure 3 The present invention is a schematic diagram of the structure of the acromioclavicular joint of a solid skeleton when the novel acromioclavicular joint fixation device is applied to the acromioclavicular joint.

[0014] Attached Figure 4 The present invention is a schematic diagram of the front view of the acromioclavicular joint of a solid skeleton when the novel acromioclavicular joint fixation device is applied thereto. DETAILED DESCRIPTION

[0015] The present invention will be further described below in conjunction with specific embodiments. It should be understood that these embodiments are only intended to illustrate the present invention and are not intended to limit the scope of the present invention. In addition, it should be understood that after reading the content described in the present invention, professionals and technicians in this area or related fields can make various modifications to the present invention, and these equivalent forms fall within the scope limited by the appended claims of the application equally.

[0016] The reference numerals and components involved in the accompanying drawings are as follows: 1. acromion plate 2. clavicle plate 3. connecting cable 4. cable fixing clip 5. cable channel of acromion plate 6. cable channel of clavicle plate 7. fixing screw; 8. clavicle 9. acromion 10. humerus, 8, 9, 10 are not components of the new acromioclavicular joint fixation device.

[0017] Example 1 A novel acromioclavicular joint fixation device Please see attached Figure 1-4 As stated, attached Figure 1 It is a front structural schematic diagram of the novel acromioclavicular joint fixation device described in the present invention.

[0018] Attached Figure 2 1 is a schematic diagram of the side structure of the novel acromioclavicular joint fixation device of the present invention. Figure 3 1 is a schematic diagram of the structure of the acromioclavicular joint of a solid skeleton when the novel acromioclavicular joint fixation device of the present invention is applied to the acromioclavicular joint. Figure 4 The present invention is a schematic diagram of the front view of the acromioclavicular joint of a solid skeleton when the novel acromioclavicular joint fixation device is applied thereto.

[0019] The present invention aims to provide a device that can effectively fix distal clavicle fractures and acromioclavicular joint dislocations to achieve stability and meet the requirements of acromioclavicular joint micro-motion. The device is specifically a micro-motion fixation device for the acromioclavicular joint, comprising an acromion plate 1, a clavicle plate 2, a connecting cable 3, a cable fixing clip 4, a cable channel 5 of the acromion plate, a cable channel 6 of the clavicle and a fixing screw 7. The acromion plate 1, the clavicle plate 2 and the connecting cable 3 are all made of titanium alloy; a connecting cable channel is provided on the clavicle side of the acromion plate, and a connecting cable channel is provided on the acromion side of the clavicle plate. The diameter of the channel is larger than the diameter of the connecting cable and smaller than the thickness of the acromion plate and the clavicle plate. The cable 3 passes through the holes of the acromion plate and the clavicle plate in a certain order, and is finally fixed in an "8" shape. Effective fixation is achieved by adjusting the tightness of the cable.

[0020] In this embodiment, the shape of the acromion plate 1 and the clavicle plate 2 is preferably an arc-shaped plate, and the shapes of the acromion plate 1 and the clavicle plate 2 are optimized and improved according to the anatomical morphology of the acromion of the scapula and the lateral segment of the clavicle in order to achieve the best match.

[0021] In this embodiment, the acromion plate is preferably provided with 6 nail holes and the clavicle plate is preferably provided with 8 nail holes. The nail holes are designed accordingly according to the locking screws and the compression screws. The number of nail holes and the ratio of the locking nail holes and the compression screw holes can be optimized during specific implementation. The general optimization principle is that, on the one hand, the positions of the screws are evenly distributed on the acromion plate and the clavicle plate, and on the other hand, the locking nail holes and the compression nail holes are spaced and evenly distributed, so that the fixing force is evenly dispersed to prevent screw loosening or fracture caused by stress concentration.

[0022] In this embodiment, the thin end of the connecting cable 3 preferably first passes through the channel of the clip 4, passes through the channel 5 of the acromion plate from left to right in the front view (passes through the channel 5 of the acromion plate from front to back in the side view), and then passes through the channel 6 of the clavicle plate from left to right in the front view (passes through the channel 6 of the clavicle plate from front to back in the side view), and finally passes through the channel of the clip 4 again in the opposite direction to the beginning, tightens and fixes, and cuts off excess cable. The cable is made of titanium alloy to ensure sufficient strength and flexibility. The cable is finally fixed in an "8" shape, and horizontal and vertical micro-movements are achieved with the help of the cable channels of the acromion plate and the clavicle plate, and rotational micro-movements can be achieved with the help of the "8" fixation of the cable.

[0023] The method of use of the present invention: The present invention is applicable to acromioclavicular joint dislocation, distal clavicle fracture, and distal clavicle fracture combined with acromioclavicular joint dislocation. After the surgeon determines that the patient's condition is applicable to the present invention, the acromioclavicular joint or distal clavicle fracture is first exposed by incision, and the damaged coracoclavicular ligament is first repaired or the damaged coracoclavicular ligament is reconstructed, and then the distal clavicle fracture or acromioclavicular joint is reset, and the Kirschner wire is temporarily fixed, and then the distal clavicle fixation plate and the acromion plate are respectively installed, and the cables are passed through the acromion plate and the clavicle plate channel in sequence, and the "8" cross is crossed, and then tightened but not fixed, and the C-arm fluoroscopy is used to check the fracture reduction or acromioclavicular joint reduction, and whether the length of the nail is appropriate. After ensuring that there is no problem, the temporarily fixed Kirschner wire is removed, the tightness of the cable is adjusted, and the assistant moves the shoulder joint to check the stability and micro-motion performance of the fixing device. After ensuring that the tightness is appropriate, it is finally fixed and the excess cable is cut off. After the acromioclavicular joint fixing device is implanted, the wound is repeatedly rinsed, sutured layer by layer, the wound is closed, and sterile dressing is applied to end the operation.

[0024] It should be noted that: the present invention is inspired by work experience summary, simple to operate and use, and the combination of various components has the advantages of stability and micro-motion; the clavicle plate, cable and fixing clip in the present invention are all public in the prior art, and there are many types and they are all sold, but the acromion plate is not widely used in clinical practice, and requires independent research and development design; the acromion plate and clavicle plate in the present invention are designed with enough nail holes, and the distribution, number and type of screw holes can be optimized as needed, and the ultimate goal is to achieve effective fixation and avoid internal fixation failure. The present invention plays a role through the split design of the acromion plate and clavicle plate, the sliding property of the cable channel of the acromion plate and clavicle plate, the flexibility of the cable and the superposition effect of the "8" connection method, while providing a sufficiently long protective support for the repair of the acromioclavicular joint capsule, ligaments and fracture healing, it maintains the micro-motion function of the acromioclavicular joint to the greatest extent and reduces postoperative complications.

[0025] The above is only a preferred embodiment of the present invention. Relevant technicians in this technical field can make appropriate modifications and improvements without departing from the principles of the present invention. These modifications and improvements should also be considered as the scope of protection of the present invention.

Claims

1. A novel acromioclavicular joint fixation device, characterized in that: It includes an acromion plate 1 for fixing the acromion and a clavicle plate 2 for fixing the distal end of the clavicle. The clavicle side of the acromion plate 1 is designed with a titanium cable channel, and the acromion side of the clavicle plate 2 is also designed with a titanium cable channel. The acromion plate 1 and the clavicle plate 2 are connected by a connecting cable 3; the connecting cable 3 passes through the channel of the acromion plate 1 and the channel of the clavicle plate 2 in a certain order, and then passes through a clip 4 to finally be fixed and connected.

2. A novel acromioclavicular joint fixation device according to claim 1, characterized in that: The acromion plate 1, clavicle plate 2, connecting cable 3 and clip 4 are all made of titanium alloy.

3. A novel acromioclavicular joint fixation device according to claim 1, characterized in that: The micro-motion connection structure includes a connecting cable 3 that passes through a horizontal channel 5 on the clavicle side of the acromion plate 1 and a horizontal channel 6 on the acromion side of the clavicle plate 2, and then crosses to form an "8" shape. After adjusting the tightness to a suitable degree, it is finally connected and fixed by a clip 4, and the horizontal, up and down and rotational micro-motion of the acromioclavicular joint is achieved by relying on the sliding of the channel and the flexibility of the titanium cable.

4. A novel acromioclavicular joint fixation device according to claim 3, characterized in that: The acromion plate 1, clavicle plate 2, connecting cable 3 and clip 4 are of separate design and can be assembled. The diameters of the acromion plate 1, clavicle plate 2 and the clip channel are slightly larger than the diameter of the titanium cable, so that the titanium cable can slide or rotate in the channel conveniently.

5. A novel acromioclavicular joint fixation device according to claim 3, characterized in that: The titanium cable channel of the acromion plate 1 is located close to the clavicle side, and the screw holes for fixing screws are evenly distributed on the acromion plate 1 .

6. A novel acromioclavicular joint fixation device according to claim 3, characterized in that: The titanium cable channel of the clavicle plate 2 is located near the acromion side, and the screw holes of the fixing screws are evenly distributed on the clavicle plate 2 .

7. A novel acromioclavicular joint fixation device according to claims 1 and 3, characterized in that: One end of the connecting cable 3 is designed with an expanded titanium alloy, and its diameter is larger than the channels of the acromion plate 1, the clavicle plate 2 and the clip 4; the body of the connecting cable 3 is composed of several titanium wires of uniform thickness evenly wound together; the diameter of the other end of the connecting cable 3 is the same as or slightly smaller than that of the titanium cable body, so as to facilitate passing through the channels of the acromion plate 1, the clavicle plate 2 and the clip 4.

8. A novel acromioclavicular joint fixation device according to claims 3 and 5, characterized in that: The acromion plate 1 is designed according to the anatomical shape of the acromion, and the screw holes of the acromion plate 1 are self-locking screw holes and common screw holes each accounting for half, that is, 4 self-locking screw holes and 4 common screw holes, and the self-locking screw holes and the common screw holes are distributed at intervals; the wider part of the acromion plate 1 is designed with 4 screw holes; the narrower part of the acromion plate 1 is designed with 2 screw holes.

9. A novel acromioclavicular joint fixation device according to claims 3 and 6, characterized in that: The clavicle plate 2 is designed according to the anatomical shape of the lateral segment of the clavicle. The screw holes of the clavicle plate 2 are self-locking screw holes and ordinary screw holes each accounting for half, that is, 4 self-locking screw holes and 4 ordinary screw holes, and the self-locking screw holes and the ordinary screw holes are distributed at intervals; 4 screw holes are designed in 2 rows close to the acromion side, and 4 screw holes are designed in a single row away from the acromion side.

10. A novel acromioclavicular joint fixation device according to claims 1, 3 and 7, characterized in that: When assembling and using, the first step is to fix the acromion plate 1 and the clavicle plate 2; the second step is to pass the thin end of the connecting cable 3 through a channel of the clip 4, and the enlarged side is blocked; the third step is to pass the thin end of the connecting cable 3 from the front to the back through the channel of the acromion plate 1, and then pass it through the channel of the clavicle plate 2 from the front to the back; the fourth step is to pass the thinner end of the connecting cable 3 through the channel of the clip 4 in the opposite direction to the beginning; the fifth step is to use a special titanium cable tool to gradually tighten until the acromioclavicular joint matches properly, keep micro-movement, and then use a special tool to squeeze the body of the clip 4 to deform and narrow the channel of the clip 4 to complete the final fixation.

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