Steel plate capable of fixing large and small knots and used for shoulder joint half-shoulder replacement

Abstract

The invention relates to a steel plate capable of fixing large and small nodules for shoulder joint half-shoulder replacement, which comprises a head part at the near end and a trunk part at the far end, and the head part and the trunk part are integrally arranged; the inner surfaces of the head part and the trunk part are arc-shaped curved surfaces which are tightly attached to the outer surface of the humerus of a human body; a plurality of combination holes are distributed in the length direction of the stem part, and a plurality of first screw holes which are distributed dispersedly are formed in the head part; an insertion sheet is arranged at the near end of the head part; a shaping plate is further connected to the side edge of the head and extends to the small tubercle of the humerus head, a locking plate is arranged at the end of the shaping plate, the locking plate is of an anatomical structure matched with the physiological appearance of the small tubercle of the humerus head, and a second screw hole is formed in the locking plate. The device is suitable for a shoulder joint half-shoulder replacement operation, is matched with a shoulder joint prosthesis for use, can solve the problem of fixation of large and small tubercle fracture blocks, effectively improves the firmness and stability of connection with a human humerus, and avoids a secondary operation caused by incapability of fixation or internal fixation failure of a pure conventional bone fracture plate, a screw or an intramedullary nail.

Description

Technical Field

[0001] The invention relates to the field of orthopedic consumables, in particular to a steel plate capable of fixing greater and lesser tuberosities and used for hemi-shoulder replacement of shoulder joint. Background Art

[0002] The shoulder joint is one of the joints with the greatest range of motion in the body. Elderly patients with shoulder fractures and osteoporosis are prone to adverse events such as fracture reduction loss, delayed healing, and refracture, which often leave behind varying degrees of functional impairment, making clinical treatment relatively difficult. Proximal humeral fractures are one of the common osteoporotic fractures in the elderly, and their incidence has increased dramatically with the aging of the population.

[0003] In a typical four-part fracture, the relationship between the humeral head, greater tuberosity, lesser tuberosity, and the proximal end of the humerus and the glenoid fossa is completely destroyed. The necrosis rate of the humeral head in this type of fracture is very high, reaching 50%-70%. For severe osteoporosis or extremely comminuted Neer three-part and four-part fractures, head-preserving treatment will cause serious complications. Therefore, hemiarthroplasty has an irreplaceable advantage over internal fixation.

[0004] The anatomical reconstruction and healing of the greater and lesser tuberosities are the main factors affecting the recovery of shoulder joint function after surgery. If the greater and lesser tuberosity fracture fragments can be anatomically healed during surgery, the patient's shoulder joint function can be restored to near normal. However, malunion or nonunion occurs, resulting in the rotator cuff being in a state of functional failure. The impact on shoulder joint function is similar to that of a massive rotator cuff injury, which may be accompanied by instability of the artificial shoulder joint. The existing surgical technology uses high-strength sutures to fix the fracture fragments to the artificial shoulder joint. The mechanical strength of the sutures is difficult to maintain for a long time; coupled with the need for repeated needle threading and sutures during surgery, it brings difficulties to the surgical operation. In addition, due to the sparse bone mass of the proximal humerus, high-strength suture cutting is prone to occur, resulting in fixation failure and secondary displacement. If the sutures are sutured and fixed, due to the large range of motion of the shoulder joint and muscle traction, it is easy to loosen and shift, resulting in the risk of surgery failure.

[0005] CN218651981U discloses a novel proximal humeral sliding pressure hook-shaped steel plate, which enables the plate to grip the greater tubercle of the humerus by adding a pressure hook structure; however, based on current experimental data, the gripping method using a claw structure does not provide a good fixation effect, and sliding still occurs between the steel plate and the greater tubercle, resulting in displacement of the fracture end.

[0006] CN206007351U discloses a proximal humeral tubercle compression locking plate, which achieves auxiliary fixation by adding the side wings of the lesser tubercle. However, as mentioned above, the actual situation is that the relationship between the humeral head, greater tubercle, lesser tubercle, proximal humerus and scapular glenoid is completely destroyed. In other words, in many fracture surgeries, the added side wings of the lesser tubercle alone do not play an auxiliary fixation role for elderly patients with shoulder fractures. Summary of the invention

[0007] The purpose of the present invention is to provide a steel plate for fixing the greater and lesser tuberosities for hemi-shoulder replacement of the shoulder joint, which is suitable for hemi-shoulder replacement surgery of the shoulder joint and can be used in conjunction with a shoulder joint prosthesis to solve the problem of fixing the greater and lesser tuberosity fracture fragments, effectively improve the firmness and stability of the connection with the human humerus, and effectively avoid secondary surgery caused by the inability to fix with a simple conventional bone plate, screw or intramedullary nail or the failure of internal fixation.

[0008] The present invention is implemented by the following technical scheme: a steel plate for fixing large and small tuberosities for shoulder joint hemi-shoulder replacement, comprising a proximal head and a distal stem, wherein the head and the stem are integrally arranged; The inner surfaces of the head and the shaft are arc-shaped surfaces that fit closely with the outer surface of the human humerus; the head is an anatomical structure that matches the physiological shape of the greater tubercle of the humeral head; the shaft is an anatomical structure that matches the physiological shape of the humeral body at the proximal end of the humerus; A plurality of coupling holes are arranged along the length direction of the trunk, and a plurality of dispersedly arranged first screw holes are provided on the head; The proximal end of the head is provided with an insert extending inwardly; A shaping plate is also connected to the side of the head, the shaping plate is integrally arranged with the head, the shaping plate extends toward the lesser tubercle of the humeral head, and a locking plate is provided at the end of the shaping plate, the locking plate is an anatomical structure adapted to the physiological shape of the lesser tubercle of the humeral head, and a second screw hole is provided on the locking plate; At least one group of suture holes is formed on the head, and the suture holes are close to the proximal edge.

[0009] Compared with the previous technology, the beneficial effects of the present invention are: 1. Two inserts are designed at the proximal end of the head, which can be embedded into the humeral head as a whole; this increases the stability of fixation and prevents the displacement of the fracture end caused by the upward pulling of the rotator cuff muscles.

[0010] 2. In addition, the shaping plate and the locking plate are matched, so that the present invention can be extended to the lesser tuberosity. In the case of a fracture of the lesser tuberosity, the shaping plate and the locking plate extend and fix the fractured fragment of the lesser tuberosity, solving the problem that the bone fragment of the lesser tuberosity cannot be fixed. If the lesser tuberosity is not fractured, it also plays the role of auxiliary fixation.

[0011] 3. The head is designed with suture holes, which can be used to repair and suture the rotator cuff soft tissue.

[0012] 4. The coordinated use of the insert, the shaping plate, the locking plate and the suture hole can improve the integrity between the steel plate of the present invention and the humeral head, and further avoid the displacement of the fracture end.

[0013] 5. Cable holes are designed on the sides of the trunk and the sides at the distal end of the head, which can be used in conjunction with cables to tie and fix the fracture fragments.

[0014] 6. The head is designed with 6 screw holes, which can be used to implant screws at multiple angles to fix the humeral head; the shaft is a combination hole, which can be selected for angle locking or pressure fixation. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Figure 1 It is a schematic diagram of the overall structure of the present invention; Figure 2 for Figure 1 Sectional view at AA in the middle; Figure 3 for Figure 1 A top view of Figure 4 It is a usage state diagram of the present invention; Figure 5 For Figure 4 The effect diagram after the base is fixed by cable binding.

[0016] Explanation of reference numerals: 1 head, 11 first screw hole, 12 suture hole, 2 stem, 21 combining hole, 3 insert, 31 spike, 41 shaping plate, 42 locking plate, 43 second screw hole, 5 cable hole, 9 human humerus, 91 greater tubercle, 92 humeral body, 93 lesser tubercle. DETAILED DESCRIPTION

[0017] The present invention is described in detail below in conjunction with the accompanying drawings: like Figure 1-3 As shown: a steel plate for fixing the greater and lesser tuberosities for hemi-shoulder replacement of the shoulder joint, comprising a proximal head 1 and a distal stem 2, wherein the head 1 and the stem 2 are integrally arranged; The inner surfaces of the head 1 and the shaft 2 are arc-shaped surfaces that fit closely with the outer surface of the human humerus 9; the head 1 is an anatomical structure that matches the physiological shape of the greater tubercle 91 of the humeral head; the shaft 2 is an anatomical structure that matches the physiological shape of the humeral body 92 at the proximal end of the humerus; A plurality of coupling holes 21 are arranged along the length direction of the trunk 2, and a plurality of dispersedly arranged first screw holes 11 are provided on the head 1; The present invention designs multiple screw holes in the head, so that screws can be implanted at multiple angles to fix the humeral head; the stem is a combination hole, which can be locked at an angle or fixed with pressure. Generally speaking, there are six first screw holes 11 here.

[0018] The present invention provides an inwardly extending insert 3 at the proximal end of the head 1; the insert is designed with two inserts at the proximal end of the head, so that the insert can be inserted into the humeral head as a whole, thereby increasing the stability of fixation and preventing the displacement of the fracture end caused by the upward pulling of the rotator cuff muscles.

[0019] A shaping plate 41 is also connected to the side of the head 1, and the shaping plate 41 is integrally arranged with the head 1. The shaping plate 41 extends toward the small tubercle 93 of the humeral head, and a locking plate 42 is provided at the end of the shaping plate 41. The locking plate 42 is an anatomical structure adapted to the physiological shape of the small tubercle 93 of the humeral head, and a second screw hole 43 is provided on the locking plate 42.

[0020] Since the present invention extends two second screw holes 43 to the lesser tubercle 93, the shaping plate 41 can be bent and shaped to ensure that the locking plate and the shaping plate 41 fit the anatomical morphology of the lesser tubercle 93; the second screw hole 43 can be implanted with a 2.7mm locking screw to fix the lesser tubercle and fix the lesser tubercle fracture fragment when the lesser tubercle is fractured.

[0021] like Figure 5 As shown: the side of the trunk 2 is provided with a plurality of cable holes 5, and the side of the distal end of the head 1 is also provided with cable holes 5, and the cable holes 5 are arranged in sequence from far to near. By designing the cable holes, the fracture fragments can be tied and fixed in combination with cables.

[0022] The head 1 is provided with at least one group of suture holes 12, which are close to the proximal edge and can be used to repair and suture the rotator cuff soft tissue.

[0023] The axes of any two first screw holes 11 are arranged non-parallel, so as to ensure that the operator can quickly and effectively insert the insert 3 into the humeral head.

[0024] The end of the insert 3 is a sharp spike 31 with a sharp edge, so that the operator can quickly and effectively insert the insert 3 into the humeral head.

[0025] The specific use of the present invention is as follows: like Figure 4 As shown: the present invention is placed on the anterior and lateral side of the proximal humerus, with its upper edge about 15 mm away from the distal end of the rotator cuff stop point; it does not affect the range of motion of the shoulder joint. Since the overall shape of the present invention fits the anatomical curvature of the proximal humerus, no bending and shaping is required.

[0026] The head of the present invention is fitted to the greater tubercle of the humeral head; the stem is fitted to the humeral body at the proximal end of the humerus, and screws are implanted through the first screw hole of the head to fix the humeral head. The coupling hole of the stem can be selected to be angled locked or pressurized for fixation.

[0027] Considering the need to lock the lesser tuberosity, the shaping plate can be shaped in advance, and then a screw can be implanted in the first screw hole to fix the lesser tuberosity.

[0028] In actual use, it is considered whether to combine with cables to tie and fix the fracture fragments according to needs. In addition, it is also considered whether the rotator cuff soft tissue can be repaired and sutured through the suture holes.

[0029] Finally, it should be noted that the above is only a preferred embodiment of the present invention and is not intended to limit the present invention. Although the present invention has been described in detail with reference to the aforementioned embodiments, it is still possible for those skilled in the art to modify the technical solutions described in the aforementioned embodiments or to make equivalent substitutions for some of the technical features therein. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and principles of the present invention should be included in the protection scope of the present invention.

Claims

1. A steel plate for fixing large and small tuberosities for shoulder joint hemi-shoulder replacement, comprising a proximal head (1) and a distal stem (2), wherein the head (1) and the stem (2) are integrally arranged; The inner surfaces of the head (1) and the shaft (2) are arc-shaped curved surfaces that fit closely with the outer surface of the human humerus (9); the head (1) is an anatomical structure that matches the physiological shape of the greater tubercle (91) of the humeral head; and the shaft (2) is an anatomical structure that matches the physiological shape of the humeral body (92) at the proximal end of the humerus. A plurality of coupling holes (21) are arranged along the length direction of the trunk (2), and a plurality of dispersedly arranged first screw holes (11) are provided on the head (1); Features: The proximal end of the head (1) is provided with an inwardly extending insert (3); A shaping plate (41) is also connected to the side of the head (1). The shaping plate (41) is integrally arranged with the head (1). The shaping plate (41) extends toward the small tubercle (93) of the humeral head. A locking plate (42) is provided at the end of the shaping plate (41). The locking plate (42) is an anatomical structure adapted to the physiological shape of the small tubercle (93) of the humeral head. A second screw hole (43) is provided on the locking plate (42). At least one group of suture holes (12) is provided on the head (1), and the suture holes (12) are close to the proximal edge.

2. The steel plate for fixing the greater and lesser tuberosities for shoulder joint hemi-shoulder replacement according to claim 1, characterized in that: A plurality of cable holes (5) are provided on the side of the trunk (2), and a cable hole (5) is also provided on the side of the distal end of the head (1), wherein the cable holes (5) are arranged in sequence from far to near.

3. The steel plate for fixing the greater and lesser tuberosities for shoulder joint hemi-shoulder replacement according to claim 1, characterized in that: The axes of any two first screw holes (11) are arranged non-parallel.

4. The steel plate for fixing the greater and lesser tuberosities for shoulder joint hemi-shoulder replacement according to claim 1, characterized in that: There are six first screw holes (11).

5. The steel plate for fixing the greater and lesser tuberosities for shoulder joint hemi-shoulder replacement according to claim 1, characterized in that: The end of the insert (3) is a sharp spike (31) with a sharp edge.

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