Combined locking bone fracture plate for proximal humerus fracture

Abstract

The invention relates to the technical field of bone fracture plates, in particular to a combined locking bone fracture plate for proximal humerus fracture, which comprises a first part, the first part is in a plate shape capable of being attached to the surface of humerus on one side with a greater tubercle, the first part comprises a proximal humerus locking steel plate and a humerus body locking steel plate which are integrally formed, and a screw hole is further formed in the first part; the proximal humerus locking steel plate further comprises a second part which is arranged on one side of the proximal humerus locking steel plate and used for fixing the side, with the small tubercle, of the humerus. A screw hole is formed in one end, far away from the proximal humerus locking steel plate, of the second part, and the position, corresponding to the internodular sulcus between the greater tubercle and the smaller tubercle, of the second part is in a bent arch shape, so that the second part is prevented from pressing the long-head tendon of the biceps brachii muscle in the internodular sulcus. The first part and the second part are made of the same material, and the side wings extend out of an existing proximal humerus locking steel plate, so that when the humerus head and the greater tuberosity are fixed, the small tuberosity is fixed at the same time.

Description

Technical Field

[0001] The invention relates to the technical field of bone fracture plates, in particular to a combined locking bone fracture plate for proximal humerus fractures. Background Art

[0002] The humerus is located in the upper limbs, one on each side. It is the largest tubular bone in the upper limbs. The upper end is connected to the scapula to form the shoulder joint; the lower end is connected to the ulna and radius to form the elbow joint. The humerus is divided into the humeral body and the upper and lower ends. The upper end has a hemispherical humeral head facing upward and backward, and there are raised large and small tubercles on the outside and front of the humeral head. The upper half of the humeral body is cylindrical, and the lower half is triangular prism-shaped. The lower end is relatively flat, with a hemispherical humeral capitulum in front of the outer part and a trochlear humeral pulley on the inner part.

[0003] Proximal humeral fracture is a common type of fracture in orthopedics. Neer divides proximal humeral fractures into the following four categories according to the degree of fracture displacement between the four anatomical sites of the proximal humerus (humeral head, greater tuberosity, lesser tuberosity and humeral shaft) (with displacement greater than 1 cm or angle greater than 45° as the displacement standard): the first is a one-part fracture, which refers to a proximal humeral fracture. Regardless of the number of fracture lines, there is no displacement or only slight displacement between the four anatomical sites, which does not meet the above displacement standard; the second is a two-part fracture, which refers to a fracture and displacement at only one site of the proximal humerus (such as anatomical neck fracture, greater tuberosity fracture, lesser tuberosity fracture or surgical neck fracture); the third is a three-part fracture, which refers to a fracture at two sites of the proximal humerus accompanied by displacement (such as greater tuberosity combined with surgical neck fracture, lesser tuberosity combined with surgical neck fracture); the fourth is a four-part fracture, which refers to a fracture at all four anatomical sites of the proximal humerus with obvious displacement. Traditional proximal humeral locking plates can meet most fracture fixation requirements, but for three-part and four-part fractures, the greater tuberosity and lesser tuberosity may be injured at the same time, and the greater tuberosity and lesser tuberosity are not located on the same side of the humerus. Therefore, when the existing traditional proximal humeral locking plate is used to fix one side of the greater tuberosity, the lesser tuberosity fracture cannot be taken into account. The existing treatment method is to use suture fixation or single screw fixation. There is a possibility of displacement or absorption of the lesser tuberosity of the humerus in the later stage, which affects the recovery of shoulder joint function after surgery. Based on this problem, it is necessary to design a combined locking plate for proximal humeral fractures to solve the above problems. Summary of the invention

[0004] The present invention provides a combined locking bone plate for proximal humeral fractures, which extends flanks on an existing proximal humeral locking steel plate to achieve fixation of the greater tuberosity and its sides while meeting the fixation requirements for the lesser tuberosity.

[0005] The technical problem solved by the present invention is achieved by adopting the following technical solutions: The present invention provides a combined locking bone plate for proximal humeral fractures, comprising a first part, which is in the shape of a plate that can fit the surface of the humerus on the side with the greater tubercle, and includes an integrally formed proximal humeral locking steel plate and a humeral body locking steel plate, and a screw hole is also provided on the first part; and also includes a second part, which is arranged on one side of the proximal humeral locking steel plate and is used to fix the side of the humerus with the lesser tubercle, and a screw hole is provided on the end of the second part away from the proximal humeral locking steel plate.

[0006] Preferably, the diameter of the screw hole of the second part is 2.7 mm.

[0007] Preferably, there are multiple second parts, and the multiple second parts are independent of each other.

[0008] Preferably, the second part is detachably connected to the proximal humeral locking plate.

[0009] Preferably, the position of the second part corresponding to the intertubercular groove between the greater tubercle and the lesser tubercle is in a curved arch shape to prevent the second part from compressing the long head of the biceps brachii tendon inside the intertubercular groove.

[0010] Preferably, the first part includes a connecting portion connected to the proximal humeral locking plate, an extending portion integrally formed with the connecting portion and extending from the position of the greater tuberosity to the proximal end of the lesser tuberosity, and a covering portion integrally formed with the extending portion and used to fix the lesser tuberosity, and the screw hole is arranged on the covering portion.

[0011] Preferably, the widths of the connecting portion and the covering portion are greater than the width of the extending portion.

[0012] Preferably, the first part and the second part are made of the same material, both of which are made of medical stainless steel or titanium alloy.

[0013] The beneficial effect of the present invention is that by adding the second part to the existing proximal humeral locking steel plate, the greater tuberosity and its side surfaces can be fixed while the lesser tuberosity can be fixed.

[0014] By arranging the first part and the second part in a detachable connection, the second part of a suitable size can be selected according to the needs of the operation, which is more flexible. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] In order to more clearly illustrate the implementation scheme of the present invention or the technical scheme in the prior art, the drawings required for use in the implementation scheme or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some implementation schemes of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative labor.

[0016] Figure 1 It is a structural schematic diagram of the prior art of the present invention; Figure 2 It is a schematic structural diagram of the existing humerus and the first part of the present invention; Figure 3 is a front view of the first part of the present invention during use with the humerus; Figure 4 is a side view of the first part of the present invention during use with the humerus; Figure 5 A schematic diagram of fixing the first part using bolts according to the present invention; Figure 6 It is a structural schematic diagram of the present invention; Figure 7 It is a front view of the present invention during use; Figure 8 is a side view of the present invention during use; Fig. 9 It is a schematic diagram of the structure of the first part of the present invention and the second part of the first size being disassembled; Fig.10 It is a schematic diagram of the structure of the first part and the second part of the second size disassembled according to the present invention.

[0017] In the figure, 1. humeral body; 2. humeral head; 3. greater tubercle; 4. lesser tubercle; 5. intertubercular groove; 6. first part; 7. proximal humeral locking plate; 8. humeral body locking plate; 9. screw hole; 10. bolt; 11. second part; 1101. connecting part; 1102. extending part; 1103. covering part; 12. screw hole; 13. fixing hole; 14. slot; 15. mounting hole; 16. mounting screw. DETAILED DESCRIPTION

[0018] In order to make the technical means, creative features, objectives and effects achieved by the present invention easy to understand, the present invention is further described below with reference to specific diagrams.

[0019] In order to enable those skilled in the art to understand the inventive point of the present invention, the prior art related to the present invention is first introduced. Figure 1 The existing humeral locking plate is provided with a screw hole 9. When in use, Figure 3 - Figure 5 As shown, the humerus locking plate is fixed to the humerus with a locking screw to achieve fixation of the fractured humerus. The humerus locking plate is formed by an integrally formed proximal humerus locking plate 7 and a humeral body locking plate 8. When the proximal humerus is fractured, the proximal humerus locking plate 7 is attached to the proximal side of the humerus, and the humeral body locking plate 8 is attached to the humeral body 1, and then fixed with a locking screw, which can meet the needs of most existing proximal humeral fractures.

[0020] In order to enable those skilled in the art to better understand the content of the present invention, the structure of the humerus is described here. Figure 2 The humerus is similar to a cylinder, and the end is similar to a sphere. The proximal end refers to the end similar to the sphere, that is, the end that cooperates with the shoulder joint. The part similar to the cylinder is the humeral body 1, and the proximal end similar to the sphere includes the humeral head 2, the greater tubercle 3, the lesser tubercle 4, and the intertubercular groove 5 between the greater tubercle 3 and the lesser tubercle 4. When a slight fracture occurs in the proximal end of the humerus, the above-mentioned humeral locking plate can be used to fix the humerus. However, when a more serious fracture occurs in the proximal end of the humerus, that is, the proximal end of the humerus is classified according to the Neer classification, and a three-part fracture (referring to the three structures of the proximal end of the humerus, such as the humeral head 2, the greater tubercle 3 and the lesser tubercle 4, two of which are fractured and accompanied by displacement) or a four-part fracture (referring to the four structures of the proximal end of the humerus, the humeral head 2 neck, the greater tubercle 3, the lesser tubercle 4 and the metaphysis, are fractured and obviously displaced), the above-mentioned humeral locking plate cannot simultaneously meet the fixation of the greater tubercle 3 and the lesser tubercle 4. The essential reason is that the existing humeral locking plate is similar to a planar plate structure (it also has a certain curvature to ensure that it fits the surface of the humerus), while the greater tuberosity 3 and the lesser tuberosity 4 of the humerus are in two different planes, so the existing plate-like humeral locking plate cannot simultaneously fix the fractures of the greater tuberosity 3 and the lesser tuberosity 4. The existing treatment method is to use suture fixation or a single screw to fix the lesser tuberosity 4 of the humerus. In the later stage, there is a possibility that the lesser tuberosity 4 of the humerus is displaced or absorbed, which affects the recovery of the shoulder joint function after surgery. Based on this problem, the present invention proposes the following solution to solve it.

[0021] The present invention provides a combined locking bone plate for proximal humeral fractures. Figure 6 , Fig. 9 and Fig.10 As shown, its main structure is the same as that of the existing humeral locking plate, and can meet the humeral fixation requirements for general fractures. The improvement of the prior art is that, in addition to the above-mentioned humeral locking plate as the first part 6, it also has a second part 11. The second part 11 is made of the same material as the first part 6, which is made of medical stainless steel or titanium alloy. The second part 11 is arranged on the side wall of the proximal humeral locking plate 7 of the first part 6, as shown in FIG. Figure 7 and Figure 8As shown, when the first part 6 fixes the surface of the greater tubercle 3 of the humerus, the second part 11 extends around the outer edge of the proximal end of the humerus to the other side of the humerus having the lesser tubercle 4, and a screw hole 12 is also provided at the position where the second part 11 contacts the lesser tubercle 4. By implanting a screw inside the screw hole 12, the second part 11 fixes the lesser tubercle 4. At the same time, due to the stable connection between the second part 11 and the first part 6, the lesser tubercle 4 will not be displaced during the later recovery.

[0022] Furthermore, the second part 11 includes a connecting portion 1101 connected to the proximal humeral locking plate 7, an extending portion 1102 integrally formed with the connecting portion 1101 and extending from the position of the greater tuberosity 3 to the proximal end of the lesser tuberosity 4, and a covering portion 1103 integrally formed with the extending portion 1102 and used to fix the lesser tuberosity 4, and the screw hole 12 is arranged on the covering portion 1103.

[0023] Furthermore, since the size of the lesser tubercle 4 is relatively small, the size of its screw hole 12 should not be too large, and should be controlled between 2mm and 3.5mm. Considering the existing sizes of screws for humeral fixation, the size between 2mm and 3.5mm is 2.7mm, so the preferred screw hole 12 is 2.7mm for the lowest cost.

[0024] Furthermore, the second part 11 mentioned above may be one or more. Figure 6 Multiple (two examples in the figure) second parts 11 should be independent of each other. When multiple second parts 11 are independently arranged, screw holes 12 are also independent of each other, and shaping is facilitated by fine-tuning the screw position and direction of screw holes 12.

[0025] Specifically, the second part 11 may also be one. If the fractured position of the tuberosity 4 is convenient for fixation, fixation can be achieved by using one screw, and the second part 11 may be one.

[0026] Specifically, of course, a plurality of screw holes 12 may also be provided on the second portion 11 to achieve sufficient fixation of the small nodule 4 .

[0027] Furthermore, in order to flexibly control the number and size of the second part 11 according to the situation of the operation, the second part 11 is preferably considered to be detachably connected with the first part 6. The present invention also provides an implementation method of a detachable connection method for the convenience of understanding by those skilled in the art. Fig. 9 and Fig.10A slot 14 is provided on the side wall of the proximal humeral locking plate 7 of the first part 6, a mounting hole 15 is provided on the front side (opposite to the side attached to the humerus) of the proximal humeral locking plate 7, and a fixing hole 13 is provided on the connecting portion 1101 of the second part 11. The connecting portion 1101 of the second part 11 is inserted into the slot 14, and then the mounting screw 16 is screwed into the mounting hole 15 until the mounting screw 16 is inserted into the mounting hole 15, so that the second part 11 can be installed.

[0028] Furthermore, since there is an intertubercular groove 5 between the greater tuberosity 3 and the lesser tuberosity 4 of the humerus, the intertubercular groove 5 is used to accommodate the long head of the biceps brachii tendon of the human body. In order to avoid the second part 11 from causing compression on the long head of the biceps brachii tendon, the position of the second part 11 corresponding to the intertubercular groove 5 between the greater tuberosity 3 and the lesser tuberosity 4 is curved and arched.

[0029] Furthermore, when only one second portion 11 is used, in order to ensure the connection stability of the connecting portion 1101, the width of the connecting portion 1101 should be as wide as possible, and in order to ensure that the covering portion 1103 has sufficient coverage area for the small tubercle 4, the covering portion 1103 should be as large as possible. In order to reduce the possibility of the extension portion 1102 causing compression on the long head of the biceps brachii tendon of the human body, the extension portion 1102 should be as narrow as possible (the intertubercular groove 5 is a curved shape, the narrower it is, the less likely it is to be compressed). Therefore, under the premise of ensuring that the second connecting portion 1101 has sufficient rigidity, the width of the connecting portion 1101 and the covering portion 1103 should be greater than the width of the extending portion 1102, that is, Fig.10 shown.

[0030] The above shows and describes the basic principles and main features of the present invention and the advantages of the present invention. It should be understood by those skilled in the art that the present invention is not limited to the above embodiments, and the above embodiments and descriptions are only for explaining the principles of the present invention. Without departing from the spirit and scope of the present invention, the present invention may have various changes and improvements, and these changes and improvements fall within the scope of the present invention to be protected. The scope of protection of the present invention is defined by the attached claims and their equivalents.

Claims

1. A combined locking bone plate for proximal humeral fracture, comprising: A first part (6), the first part (6) being in the shape of a plate capable of fitting onto the surface of the humerus having the greater tuberosity (3) on one side, and comprising an integrally formed proximal humerus locking steel plate (7) and a humeral body locking steel plate (8), and the first part (6) is also provided with a screw hole (9); It is characterized by further comprising: The second part (11) is arranged on one side of the proximal humeral locking plate (7) and is used to fix the side of the humerus having the tubercle (4). A screw hole (12) is arranged at one end of the second part (11) away from the proximal humeral locking plate (7).

2. A combined locking bone plate for proximal humeral fracture according to claim 1, characterized in that: The screw hole (12) of the second part (11) has a diameter of 2.7 mm.

3. A combined locking bone plate for proximal humeral fracture according to claim 1, characterized in that: There are multiple second parts (11), and the multiple second parts (11) are independent of each other.

4. A combined locking bone plate for proximal humeral fracture according to claim 1, characterized in that: The second part (11) is detachably connected to the proximal humeral locking plate (7).

5. The combined locking bone plate for proximal humeral fracture according to claim 1, characterized in that: The position of the second part (11) corresponding to the intertubercular groove (5) between the greater tubercle (3) and the lesser tubercle (4) is in a curved arch shape, so as to prevent the second part (11) from compressing the long head of the biceps brachii tendon inside the intertubercular groove (5).

6. A combined locking bone plate for proximal humeral fracture according to claim 1, characterized in that: The first part (6) comprises a connecting portion (1101) connected to the proximal humeral locking plate (7), an extending portion (1102) integrally formed with the connecting portion (1101) and extending from the position of the greater tuberosity (3) to the proximal end of the lesser tuberosity (4), and a covering portion (1103) integrally formed with the extending portion (1102) and used for fixing the lesser tuberosity (4), wherein the screw hole (12) is provided on the covering portion (1103).

7. A combined locking bone plate for proximal humeral fracture according to claim 6, characterized in that: The widths of the connecting portion (1101) and the covering portion (1103) are greater than the width of the extending portion (1102).

8. The combined locking bone plate for proximal humeral fracture according to claim 1, characterized in that: The first part (6) and the second part (11) are made of the same material, both of which are made of medical stainless steel or titanium alloy.

Images