Distal multiplanar interlocking intramedullary nail

Abstract

This invention discloses a distal multi-planar interlocking intramedullary nail, relating to the field of bone fixation device technology. It includes: a main nail with a first nail hole at its first end and first and second locking nail holes located away from the first end; a head and neck traction nail slidably connected to the main nail through the first nail hole; and a distal locking nail assembly including a first distal locking nail and a second distal locking nail. The first distal locking nail passes through the first locking nail hole and is fixedly connected to the main nail, while the second distal locking nail passes through the second locking nail hole and is fixedly connected to the main nail, with preset angle ranges in the horizontal and coronal planes, forming a three-dimensional spatial structure. This invention solves the technical problems of insufficient matching between the main nail and the medullary cavity, the inability of a single distal locking nail to effectively control the inversion and valgus movement of the main nail, and low reliability and stability of fixation for comminuted osteoporotic fractures in existing technologies. It achieves the technical effects of improving the mechanical stability of the intramedullary nail, the certainty of compression at the fracture ends, and the overall postoperative fixation strength.

Description

Technical Field

[0001] This invention relates to the technical field of bone fixation devices, specifically to a distal multiplanar interlocking intramedullary nail. Background Technology

[0002] Intertrochanteric fractures of the femur are a common type of hip fracture in clinical practice, especially prevalent among elderly individuals with osteoporosis. With the accelerating aging of the population, the incidence of this type of fracture is increasing significantly year by year. After an intertrochanteric fracture, patients not only lose the ability to walk and perform basic daily activities, but also require long-term specialized care, placing a burden on families and society. Currently, the clinically recognized best treatment option is minimally invasive surgical closed reduction combined with intramedullary nailing. Commonly used internal fixation products include PFNA, INTERTAN, APFN, and PFBN, with the common goal of firmly fixing the femoral head and neck fragment to the femoral shaft, restoring the femur's supporting function. Simultaneously, the modern concept of Enhanced Recovery After Surgery (ERAS) advocates for prompt surgery after injury and early postoperative mobilization to achieve rapid recovery and improve prognosis.

[0003] However, existing technologies still face several challenges in treating osteoporotic intertrochanteric fractures of the femur: insufficient matching between the main nail and the medullary canal, resulting in poor system stability. Osteoporotic patients have reduced femoral cortical thickness and a relatively increased medullary canal diameter. The maximum distal diameter of the main nail in existing products is approximately 13mm, while the medullary canal diameter in some osteoporotic patients can reach 15mm or even 17mm, leading to a significant gap between the main nail and the cortical bone. This severely impacts the initial stability and long-term fixation of the intramedullary nail system. Simply increasing the main nail diameter to match the medullary canal would exacerbate damage to the femoral attachment point of the gluteus medius, potentially causing complete separation of the gluteus medius from the femur, severely affecting hip joint function. The distal locking method is simplistic and lacks anti-swing capability. Currently, most products use only one screw with a connecting hole for distal fixation. While this limits axial rotation of the main nail, it cannot effectively control its sway in the varus / valgus direction, reducing overall mechanical stability. The fixation effect on comminuted bone fragments is limited. Some improved products attempt to increase fixation for the greater trochanter, lesser trochanter, and lateral wall bone fragments. However, because anatomical repositioning of comminuted bone fragments is difficult to achieve in minimally invasive surgery, and the proximal femur is mostly composed of cancellous bone with limited screw fixation strength when osteoporosis is present, such improvements do not significantly enhance overall stability. Neglecting muscle biomechanical reconstruction affects early postoperative weight-bearing. Existing technologies and products focus only on the biomechanical restoration of bony structures, neglecting the biomechanical reconstruction of key muscles such as the gluteus medius. Postoperatively, the greater trochanteric fragment remains in a free state, and the biomechanical connection between the gluteus medius and the proximal femur is not restored, making it difficult for patients to achieve early weight-bearing or even walking, severely hindering the achievement of rapid recovery goals. Summary of the Invention

[0004] This application provides a distal multi-plane interlocking intramedullary nail, which solves the technical problems in the prior art, such as insufficient matching degree between the main nail and the medullary cavity, inability of a single distal locking nail to effectively control the inversion and valgus swing of the main nail, and low reliability and stability of fixation for comminuted osteoporotic fractures. It achieves the technical effect of improving the mechanical stability of the intramedullary nail, the certainty of compression at the fracture ends, and the overall fixation strength after surgery.

[0005] This application provides a distal multiplanar interlocking intramedullary nail, the proximal femoral intramedullary nail comprising: a main nail, the first end of which has a first nail hole, and a first locking screw hole and a second locking screw hole located away from the first end; a head and neck traction screw, the head and neck traction screw being slidably connected to the main nail through the first nail hole; and a distal locking screw assembly, the distal locking screw assembly comprising a first distal locking screw and a second distal locking screw, the first distal locking screw passing through the first locking screw hole and being fixedly connected to the main nail, the second distal locking screw passing through the second locking screw hole and being fixedly connected to the main nail, and the first distal locking screw and the second distal locking screw having a preset angle range in the horizontal plane and the coronal plane, forming a three-dimensional spatial structure.

[0006] In a possible implementation, the first distal locking pin is inserted from the outer rear to the inner front, and the second distal locking pin is inserted from the front outer to the inner rear. The insertion directions of the first distal locking pin and the second distal locking pin are staggered, and both intersect the coronal plane where the head and neck tension pins are located at a preset angle.

[0007] In a possible implementation, the head and neck tension pin and the distal locking pin assembly are each equipped with an independent guide, and the axes of the head and neck tension pin and the distal locking pin assembly are spatially staggered so that the corresponding guides do not interfere with each other. The three guides can be inserted simultaneously, and the screw insertion order can be freely selected.

[0008] In one possible implementation, the first distal locking pin is located at the waist of the main pin and shares a surgical incision with the head and neck traction pin.

[0009] In possible implementations, the preset angle range is 30° to 60°.

[0010] In a possible implementation, both the first and second lock pin holes are circular static locking pin holes, and the diameter of the circular static lock pin hole matches the diameter of the corresponding lock pin.

[0011] In one possible implementation, the first end of the main nail is provided with a U-shaped suture groove, which includes a horizontal suture groove and two vertical suture grooves, and the horizontal suture groove communicates with the two vertical suture grooves for pre-threading and fixing high-strength sutures to suture and fix the gluteus medius muscle.

[0012] This application proposes a distal multi-plane interlocking intramedullary nail, comprising a main nail with a first nail hole at one end and first and second locking nail holes at a position away from the first end; a head and neck traction nail slidably connected to the main nail through the first nail hole; and a distal locking nail assembly including a first distal locking nail and a second distal locking nail. The first distal locking nail passes through the first locking nail hole and is fixedly connected to the main nail, and the second distal locking nail passes through the second locking nail hole and is fixedly connected to the main nail. The first and second distal locking nails have preset angle ranges in the horizontal and coronal planes, forming a three-dimensional spatial structure. This invention solves the technical problems of insufficient matching between the main nail and the medullary cavity, the inability of a single distal locking nail to effectively control the inversion and valgus movement of the main nail, and low reliability and stability of fixation for comminuted osteoporotic fractures in existing technologies. It achieves the technical effect of improving the mechanical stability of the intramedullary nail, the certainty of compression at the fracture ends, and the overall postoperative fixation strength. Attached Figure Description

[0013] To more clearly illustrate the technical solutions of the embodiments of this disclosure, the accompanying drawings of the embodiments of this disclosure will be briefly described below. Flowcharts are used in this application to illustrate the structure of the embodiments according to this application. It should be understood that the preceding or following operations are not necessarily performed precisely in sequence. Instead, various steps can be processed in reverse order or simultaneously as needed. Furthermore, other operations can be added to these processes, or one or more steps can be removed from these processes.

[0014] Figure 1 This is a schematic diagram of a distal multiplanar interlocking intramedullary nail structure provided in an embodiment of this application.

[0015] Figure 2 This is a schematic diagram of a special hole structure for the distal locking screw of an intramedullary nail with distal multiplanar interlocking, provided as an embodiment of this application.

[0016] Figure 3 This is a schematic diagram of a distal multiplanar interlocking intramedullary nailing surgical procedure provided in an embodiment of this application.

[0017] Figure 4 This is a schematic diagram of a U-shaped suture groove structure at the tail of the main nail of an intramedullary nail with distal multi-plane interlocking, provided as an embodiment of this application.

[0018] Explanation of reference numerals in the attached diagram: 1. Main nail, 2. Head and neck tension nail, 3. First distal locking nail, 4. Second distal locking nail, 5. Pressure anti-rotation nail, 6. Dedicated hole for first locking nail, 7. Dedicated hole for second locking nail, 8. U-shaped wire channel. Detailed Implementation

[0019] To further illustrate the technical means and effects adopted by the present invention in order to achieve the intended purpose, the following detailed description is provided in conjunction with the accompanying drawings and preferred embodiments, based on the specific implementation methods, structures, features and effects of the present invention.

[0020] This application provides an embodiment of a distal multiplanar interlocking intramedullary nail, such as Figure 1 and 2 As shown, it includes: The main nail 1 has a first nail hole at its first end and a first locking nail hole 6 and a second locking nail hole 7 at a position away from the first end.

[0021] Preferably, the two distally intersecting locking screws, the first locking screw and the second locking screw, both intersect the coronal plane formed by the head and neck screw and the main screw 1 at a 15° angle. The guides of each screw do not interfere with each other, can coexist, and the order of screw insertion can be freely chosen. In simple fracture cases, the main screw 1, head and neck screw, compression anti-rotation screw 5, and one distal locking screw can be inserted sequentially. However, when the fracture is comminuted or the medullary cavity is large and the stability of the main screw 1 in the medulla is poor, after inserting the main screw 1 and the head and neck screw, the two distal locking screws should be inserted first to fix the main screw 1 to the femoral shaft. When the compression screw is then inserted, the compression will be more reliable, avoiding the situation where the fracture ends are not compressed and the proximal end of the main screw 1 swings inward.

[0022] Preferably, the main nail 1 is the main component of the intramedullary nail, a slender, hollow or solid titanium alloy or stainless steel rod inserted into the medullary canal of the proximal femur, serving as the core support structure of the entire internal fixation system, used to connect the head and neck traction nail 2 and the distal locking nail; the first end of the main nail 1 refers to the proximal end of the main nail 1, that is, the end that is first inserted into the medullary canal during surgery, located at the proximal femur (greater trochanter side) after implantation, and needs to support the head and neck traction nail 2 for fixing the femoral head and neck bone fragment; the first nail hole is a through hole set at the first end of the main nail 1 or The slot is used to insert and accommodate the head and neck traction screw 2, so that the head and neck traction screw 2 can form a sliding connection with the main screw 1; the position away from the first end refers to the area on the main screw 1 near the distal end, that is, the other side away from the insertion end, located in the medullary canal of the femoral shaft, which needs to be locked and fixed with the femoral shaft cortex; the first locking screw hole 6 and the second locking screw hole 7 are two independent round holes set at the distal end of the main screw 1, which are used to insert the first distal locking screw 3 and the second distal locking screw 4 respectively, to fix the main screw 1 to the femoral shaft cortex.

[0023] Furthermore, the preset angle range is 30° to 60°.

[0024] Furthermore, both the first locking pin hole 6 and the second locking pin hole 7 are perfectly circular static locking pin holes, and the diameter of the perfectly circular static locking pin hole matches the diameter of the corresponding locking pin.

[0025] Preferably, both the first locking screw hole 6 and the second locking screw hole 7 are perfectly circular static locking screw holes, and the diameter of the circular static locking screw hole precisely matches the diameter of the corresponding locking screw hole, eliminating relative movement space. The two holes are at a certain angle in space, intersecting at 30° to 60° in both the horizontal and coronal planes, which is used to restrict the relative movement of the main screw 1 with the femur in all dimensions, namely translation, varus / valgus, anteroposterior tilt, and axial rotational displacement in three axes, which is beneficial to the stability of the intramedullary nail system. Specifically, viewed from bottom to top, the distal first locking screw moves from lateral to anteromedial, and the second locking screw moves from anterolateral to posteromedial. The two locking screws form a 15° angle with the coronal plane formed by the head and neck screw and the main screw 1, respectively; the horizontal plane between the two distal locking screws forms a 30° angle; viewed in the coronal plane, the distal first locking screw remains horizontal, and the second locking screw tilts 30° from lateral to medial.

[0026] The head and neck tension nail 2 is slidably connected to the main nail 1 through the first nail hole.

[0027] Preferably, the head and neck traction screw 2, also known as a head and neck screw or traction screw, is a key component in the intramedullary nail system. It is used to fix the head and neck bone fragment of the femoral head. Specifically, it passes through the first screw hole at the proximal end of the main nail 1 and is inserted into the head and neck of the femoral head. It runs obliquely upward and inward from the lateral side of the greater trochanter of the femoral head, pointing towards the femoral head, connecting the free head and neck bone fragment to the main nail 1, restoring the mechanical continuity between the femoral head and neck and the femoral shaft. It is usually a long screw with a threaded head for anchoring in the head and neck bone fragment, and a smooth shaft that can slide within the hole of the main nail 1. The sliding connection means that the head and neck traction screw 2 and the main nail 1 are allowed to slide relative to each other along the screw axis. The first screw hole is opened at the proximal end of the main nail 1. The part of the shaft of the head and neck traction screw 2 that passes through the hole is a smooth shaft (without threads) that can slide freely within the hole. The head and neck traction screw 2 has threads on its head. After being screwed into the head and neck bone fragment, it is fixed to it as one piece. The sliding direction is along the axial direction of the head and neck traction screw 2, that is, obliquely upward / downward, used to apply dynamic pressure to the fracture ends during the healing process.

[0028] Preferred, such as Figure 3As shown, for comminuted intertrochanteric fractures of the femur, closed reduction is first performed using a traction operating table to obtain satisfactory neck-shaft angle and anteversion angle (the angle between the head and neck bone fragment and the femoral shaft). After opening the proximal femur, the main nail 1 is inserted. The insertion depth of the main nail 1 and the position of the guide pin of the head and neck traction screw 2 are adjusted under fluoroscopy. After drilling, the head and neck traction screw 2 is screwed in to fix it as a whole with the head and neck bone fragment. The head and neck traction screw 2 can slide within the groove of the main nail 1. Specifically, the head and neck traction screw 2 is first inserted to fix the head and neck bone fragment, establishing a connection between the head and neck bone fragment and the main nail 1. Then, the compression anti-rotation screw 5 is screwed in, located below the head and neck traction screw 2, with the root of the compression screw thread contacting the outer side of the main nail 1. The compression screw is rotated further, and through the threaded engagement between the compression screw and the head and neck traction screw 2, the head and neck traction screw 2, together with the head and neck bone fragment, is pulled outward. The head and neck traction screw 2 slides outward within the first screw hole of the main nail 1, reducing the gap between the fracture ends and achieving compression of the fracture ends. The root of the compression screw contacts the outer side of the main screw 1. Ideally, further rotation of the compression screw causes the head and neck bone fragments and the lag screw to slide outward and apply pressure, reducing the fracture gap. When the main screw 1 is unstable, rotating the compression screw will push the main screw 1 inward, weakening the pressure effect on the fracture ends and reducing the stability of the system.

[0029] The distal locking pin assembly includes a first distal locking pin 3 and a second distal locking pin 4. The first distal locking pin 3 passes through a first locking pin hole 6 and is fixedly connected to the main pin 1. The second distal locking pin 4 passes through a second locking pin hole 7 and is fixedly connected to the main pin 1. The first distal locking pin 3 and the second distal locking pin 4 are provided with a preset angle range in the horizontal plane and the coronal plane to form a three-dimensional spatial structure.

[0030] Preferably, the distal locking screw assembly refers to a locking system used to fix the distal end (femoral shaft side) of the main nail 1 to the femoral cortex. It consists of two independent screws, a first distal locking screw 3 and a second distal locking screw 4, both located distal to the main nail 1, i.e., in the region away from the first end. They pass through the first locking screw hole 6 and the second locking screw hole 7, respectively, and are fixedly connected to the main nail 1, locking the main nail 1 to the femoral cortex. The first distal locking screw 3 passes through the first locking screw hole 6 and is driven into the femoral cortex on both sides to fix it to the main nail 1. The second distal locking screw 4 passes through the second locking screw hole 7 and is driven into the femoral cortex on both sides to fix it to the main nail 1. The first and second locking screw holes 7 are both perfectly circular static locking screw holes with a diameter that precisely matches the diameter of the corresponding locking screw, leaving no extra room for movement. Even if only one distal locking screw is inserted, it is more stable than the connection holes of existing products. The two distal locking screws are not in the same plane, but form an intersecting angle in three-dimensional space.

[0031] Furthermore, the first distal locking pin 3 is inserted from the outer rear to the inner front, and the second distal locking pin 4 is inserted from the front outer to the inner rear. The insertion directions of the first distal locking pin 3 and the second distal locking pin 4 are staggered, and both intersect the coronal plane where the head and neck tension pin 2 is located at a preset angle.

[0032] Preferably, the two locking screws in the horizontal plane (cross-section) intersect at a 30° angle. From the axial perspective, the two screws cross in the horizontal plane. In the coronal plane (front view), the two locking screws intersect at a 30° angle. From the front view, the second locking screw tilts 30° from the upper outer side to the lower inner side, while the first screw remains horizontal. The first distal locking screw 3 intersects the head and neck traction screw 2 at a 15° angle in the coronal plane, and the second distal locking screw 4 intersects the head and neck traction screw 2 at a 15° angle in the coronal plane. The first distal locking screw 3 is inserted obliquely to the anteromedial side from the lateral side of the femur, and the second distal locking screw 4 is inserted obliquely to the posteromedial side from the lateral side of the femur. That is, the two locking screws form an "X" shaped cross structure in space. This restricts the relative movement of the main screw 1 with the femur in all dimensions, namely translation, inversion and eversion, anteroposterior tilt, and axial rotation displacement in three axes, thereby achieving multi-plane interlocking fixation.

[0033] Furthermore, the head and neck tension nail 2 and the distal locking nail assembly are each equipped with an independent guide. The axes of the head and neck tension nail 2 and the distal locking nail assembly are spatially staggered so that the corresponding guides do not interfere with each other. The three guides can be inserted simultaneously, and the screw insertion order can be freely selected.

[0034] Preferably, the head and neck traction nail 2 and the distal locking nail assembly are each equipped with an independent guide. The guide is an auxiliary tool used in intramedullary nailing surgery to guide the drill or screw to be accurately placed into the bone and the main nail 1 along a preset direction and angle, ensuring that the drill or screw enters along the preset trajectory, avoiding deviation, and avoiding damage to surrounding soft tissues, nerves and blood vessels. The head and neck traction nail 2, the first distal locking nail 3, and the second distal locking nail 4 each have their own dedicated guide. Each guide is a physically separated independent tool, and each guide corresponds to one screw. Currently, most products have one distal locking nail, and a very small number of products have two or more distal locking nails. However, the distal locking nail and the head and neck nail are located in the same coronal plane, and the guides conflict with each other. When inserting the proximal head and neck nail and the distal locking nail, the guides need to be replaced. The two cannot coexist. In this invention, three independent guides coexist and the order can be freely selected.

[0035] Preferably, each screw has its central axis, that is, the geometric center line of the screw along its length direction. The guide is used to ensure that the drill bit and the screw advance along this axis. The axes of the three screws are in different directions and angles in three-dimensional space, not parallel to each other and not coplanar. The long barrel-shaped structure is the guide required for inserting the screw and is a separate structure. The head-neck screw guide and the first distal guide are separated in space, not in contact and not overlapping. The head-neck screw guide and the second distal guide are separated in space, not in contact and not overlapping. The three guides exist simultaneously (front view), and they are distributed in a "pin" shape or radially, without blocking each other. During the operation, the three guides can be all installed on the guide arm at one time and kept in place, without disassembling another guide for inserting a certain screw. Inserting one guide will not affect the insertion of another guide. According to clinical factors such as fracture type, medullary cavity width, intraoperative fluoroscopy, etc., the insertion sequence of the three screws can be independently determined. For example, when dealing with comminuted fractures, the two distal locking screws are inserted first and then the compression screw to avoid the inward movement of the main nail 1.

[0036] Further, the first distal locking screw 3 is arranged at the waist of the main nail 1 and shares the surgical incision with the head-neck tension screw 2.

[0037] Preferably, the waist of the main nail 1 refers to the middle area between the proximal end (the first end) and the distal end (the terminal end) of the main nail 1. The first distal locking screw is located at the waist level of the main nail 1, which can maximize the distance between the two distal locking screws as much as possible, increase the force arm between the two locking screws, reduce the acting stress of the screw on the bone, and avoid iatrogenic fractures. It can share a surgical incision with the head-neck screw (the two guides are close to each other at the skin position), avoiding the two incisions being too close, which may affect the healing of the incision or even cause skin necrosis. And the first locking screw is from the outer back to the front inner, avoiding the small trochanter bone mass located at the inner back side, so that both the inner and outer sides of the locking screw are located on the femoral shaft, making the fixation more stable. In minimally invasive intramedullary nail surgery, the doctor needs to make a small incision on the skin, insert the guide and the screw through the incision. The first distal locking screw 3 and the head-neck tension screw 2 share the same skin incision. Among them, the entry point positions of the guide of the head-neck tension screw 2 and the guide of the first distal locking screw 3 on the skin surface are very close. The guides can be inserted simultaneously or successively without interfering with each other, thus reducing the number of incisions and avoiding the risk of skin necrosis caused by the incisions being too close.

[0038] Further, a U-shaped wire groove 8 is arranged at the end of the first end of the main nail 1. The U-shaped wire groove 8 includes a horizontal wire groove and two vertical wire grooves, and the horizontal wire groove is communicated with the two vertical wire grooves, which is used for pre-piercing and fixing high-strength suture to suture and fix the gluteus medius muscle.

[0039] Preferably, as Figure 4As shown, the first end of the main nail 1 is provided with a U-shaped suture groove 8, which is a U-shaped groove structure formed by one transverse groove and two longitudinal grooves. It is used to pre-thread high-strength sutures so that the gluteus medius muscle can be sutured and fixed to the intramedullary nail system after the bony fixation is completed. The transverse groove is a horizontal groove at the end of the main nail 1, which is used to pass through the high-strength suture and serves as a transverse channel for the suture groove. The longitudinal grooves are two grooves located at both ends of the transverse groove and extending along the axial direction (longitudinal direction) of the main nail 1. They are used to accommodate the two ends of the suture respectively, and the guide suture extends distally. The transverse groove and the two longitudinal grooves are connected at the junction, and the suture can pass through the transverse groove and the longitudinal groove continuously. A complete suture path is formed. Specifically, before surgery, high-strength sutures are first passed through the transverse grooves, and then the two ends of the sutures are passed through the two longitudinal grooves respectively, so that the sutures are firmly fixed to the main nail 1. After the bony fixation is completed, the gluteus medius muscle is sutured to the head of the main nail 1 using pre-embedded sutures. The middle section of the suture is located in the transverse groove, and the two ends of the sutures are passed out from the two longitudinal grooves respectively, extending distally along the axis of the main nail 1. The high-strength sutures are made of ultra-high molecular weight polyethylene, polyester fiber, etc., to withstand the large tensile force (about 3 times body weight) generated by the gluteus medius muscle, thereby restoring the mechanical connection between the gluteus medius muscle and the proximal femur, enabling the patient to bear weight and even walk early after surgery, and achieve rapid recovery.

[0040] The above description is merely a preferred embodiment of the present invention and is not intended to limit the present invention in any way. Although the present invention has been disclosed above with reference to preferred embodiments, it is not intended to limit the present invention. Any person skilled in the art can make some modifications or alterations to the above-disclosed technical content to create equivalent embodiments without departing from the scope of the present invention. Any modifications, equivalent changes, and alterations made to the above embodiments based on the technical essence of the present invention without departing from the scope of the present invention shall still fall within the scope of the present invention.

Claims

1. A distal multiplanar interlocking intramedullary nail, characterized in that, The proximal femoral intramedullary nail comprises: The main nail has a first nail hole at its first end and a first locking nail hole and a second locking nail hole at a position away from the first end. A head and neck tension pin, wherein the head and neck tension pin is slidably connected to the main pin through a first pin hole; The distal locking pin assembly includes a first distal locking pin and a second distal locking pin. The first distal locking pin passes through a first locking pin hole and is fixedly connected to the main pin. The second distal locking pin passes through a second locking pin hole and is fixedly connected to the main pin. The first distal locking pin and the second distal locking pin are provided with a preset angle range in the horizontal plane and the coronal plane to form a three-dimensional spatial structure.

2. The distal multiplanar interlocking intramedullary nail as described in claim 1, characterized in that, The first distal locking pin is inserted from the outside to the inside and the front, and the second distal locking pin is inserted from the front to the inside and the back. The insertion directions of the first distal locking pin and the second distal locking pin are staggered, and both intersect the coronal plane where the head and neck tension pin is located at a preset angle.

3. The distal multiplanar interlocking intramedullary nail as described in claim 1, characterized in that, The head and neck tension screw and the distal locking screw assembly are each equipped with an independent guide. The axes of the head and neck tension screw and the distal locking screw assembly are spatially staggered so that the corresponding guides do not interfere with each other. The three guides can be inserted simultaneously, and the screw insertion order can be freely selected.

4. The distal multiplanar interlocking intramedullary nail as described in claim 1, characterized in that, The first distal locking pin is located at the waist of the main pin and shares a surgical incision with the head and neck traction pin.

5. The distal multiplanar interlocking intramedullary nail as described in claim 1, characterized in that, The preset angle range is 30° to 60°.

6. The distal multiplanar interlocking intramedullary nail as described in claim 1, characterized in that, Both the first and second lock pin holes are circular static locking pin holes, and the diameter of the circular static lock pin hole matches the diameter of the corresponding lock pin.

7. The distal multiplanar interlocking intramedullary nail as described in claim 1, characterized in that, The first end of the main nail is provided with a U-shaped suture groove, which includes a horizontal suture groove and two vertical suture grooves. The horizontal suture groove communicates with the two vertical suture grooves and is used to pre-thread and fix high-strength sutures to suture and fix the gluteus medius muscle.

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