A reduction and fixation device and system for posterior column fractures of the acetabulum via an anterior approach

Abstract

A reduction and fixation apparatus and system for posterior column acetabular fracture through anterior approach, the apparatus comprises a iliac wing part, a fulcrum part and a posterior column acetabular part connected in sequence; the iliac wing part is placed in the iliac wing position when in use, the fulcrum part comprises a fulcrum hole; the posterior column acetabular part is used for clamping the lower edge of the posterior column acetabular; a fulcrum screw is fixed to the medial side of the iliac wing through the fulcrum hole; the iliac wing part, the fulcrum part and the posterior column acetabular part form a lever system with the fulcrum screw; the fulcrum screw serves as a rotating support shaft, the iliac wing part above rotates around the fulcrum screw towards the sacrum, and the posterior column acetabular part gives a reduction force to the posterior column acetabular away from the sacrum. The system uses an imaging system to cooperate with the above reduction and fixation apparatus to complete the setting of the reduction and fixation apparatus through the anterior approach, the reduction and fixation of the fracture. The above reduction and fixation apparatus and system realize the reduction of the posterior column acetabular fracture by rotating the iliac wing part, which has small trauma and low risk.

Description

Technical Field

[0001] This invention relates to a reduction and fixation device for pelvic and acetabular fractures, and more particularly to a reduction and fixation device for posterior column fractures of the acetabulum. Specifically, it is a reduction and fixation device and system for posterior column fractures of the acetabulum via an anterior approach. Background Technology

[0002] The posterior column of the acetabulum, also known as the ilioficinal column, is a bony columnar structure formed by the fusion of the posteroinferior part of the ilium and the ischium. It provides bony support for the posterior half of the acetabulum and is one of the two pillars of Letournel's two-column theory of the acetabulum, bearing the weight-bearing and mechanical stability of the posterior side of the acetabulum.

[0003] A major posterior impact is the primary cause of posterior column fractures of the acetabulum. When a posterior column fracture occurs, it shifts towards the sacrum and into the pelvis. Therefore, in clinical practice, posterior column fractures are often treated by exposing the posterior column in the prone position and directly tractioning and reducing it, followed by fixation. However, the posterior approach requires transection of the short external rotator muscles of the hip, extensive splitting of the gluteus maximus muscle fibers, and full exposure of the sciatic nerve, which is quite invasive. If an anterior approach is chosen, it is difficult to directly access the posterior column due to the distance from the approach point. Therefore, the posterior approach is currently the preferred surgical method for posterior column fractures in clinical practice.

[0004] In addition, posterior column fractures of the acetabulum are often accompanied by fractures of other parts of the pelvis in clinical practice. When performing fracture reduction and fixation, a floating position is often required. This involves reducing and fixing the anterior column fracture from the supine position via an anterior approach, and then switching to the prone or lateral position via a posterior approach for reduction and fixation of the posterior column fracture. The entire process is time-consuming and highly invasive. Therefore, there is a need for an instrument that can reduce surgical time and trauma, allowing for the reduction and fixation of the posterior column of the acetabulum or fractures of the posterior column combined with other fractures through a single approach. Summary of the Invention

[0005] In general, pelvic and acetabular fractures rely on exposing the fracture site, reducing it with tools, and then fixing it with a bone plate. The numerous instruments required for this procedure are why it's currently difficult to effectively expose, reduce, and fix posterior column fractures of the acetabulum via an anterior approach. The inventors wondered if using a reduction and fixation plate could increase the feasibility of an anterior approach. They devised a method using leverage, dividing the reduction and fixation plate into a power-driven rotating part located at the iliac wing, a reduction-pushing part located at the posterior column of the acetabulum, and a fulcrum section with a fulcrum hole. In use, the bone plate is inserted anteriorly via imaging, and the reduction-pushing part is then inserted through the iliac wing into the fracture fragment of the posterior column of the acetabulum, away from the sacrum. The reduction-pushing part features a bent anastomosis structure to achieve anastomosis of the posterior column of the acetabulum from the medial to the lateral side of the pelvis. A fulcrum screw is then placed in the fulcrum hole. By rotating the power-driven rotating part at the iliac wing, the reduction-pushing part is moved outward away from the sacrum, thus reducing the posterior column of the acetabulum. After observing reduction of the posterior column of the acetabulum under imaging, the fulcrum screws are first tightened, and then multiple fixation screws are screwed into the fixation holes of the dynamic adjustment unit. This approach allows for fracture reduction of the posterior column of the acetabulum via an anterior approach.

[0006] The specific technical solution is a reduction and fixation device for posterior column fractures of the acetabulum via the anterior approach, which includes an iliac wing portion, a fulcrum portion, and a posterior column portion of the acetabulum that are integrally connected in sequence.

[0007] The iliac wing portion is placed in the iliac wing position during use and includes fixation holes.

[0008] The fulcrum portion includes a fulcrum hole.

[0009] The posterior column of the acetabulum extends to the lower edge of the posterior column of the acetabulum during use.

[0010] The fulcrum screw is fixed to the inner side of the iliac wing through the fulcrum hole.

[0011] Fix the reset plate with fixing screws through fixing holes.

[0012] The iliac wing portion, the fulcrum portion, and the posterior column of the acetabulum, together with the fulcrum screw, form a lever system. The fulcrum screw acts as a rotational support axis, with the upper iliac wing portion rotating around the fulcrum screw toward the sacrum, while the posterior column of the acetabulum provides a reduction force to the posterior column of the acetabulum away from the sacrum.

[0013] Furthermore, the posterior column of the acetabulum includes a curved anastomosis structure that enables the posterior column of the acetabulum to anastomose from the medial side of the pelvis to the lateral side of the pelvis. The posterior column of the acetabulum is then positioned at the lower edge of the posterior column of the acetabulum.

[0014] Furthermore, the fulcrum of the lever system is set at the lower inner edge of the iliac wing pelvis, and the fulcrum screw is set at the lower inner edge of the iliac wing pelvis through the fulcrum hole.

[0015] In use, under image guidance, the posterior column of the acetabulum is aligned with the fractured fragment of the posterior column of the acetabulum away from the sacrum. The iliac wing is aligned with the iliac wing. The fulcrum is positioned at the lower inner edge of the iliac wing of the pelvis, and the fulcrum screw is placed in the fulcrum hole. The iliac wing is rotated toward the sacrum, and the rotation of the iliac wing causes the posterior column of the acetabulum to be reduced away from the sacrum. After the posterior column of the acetabulum is observed to be reduced to the appropriate position under image guidance, the fulcrum screw is locked, and then the fixation screws are screwed into the fixation holes in sequence to complete the fixation after reduction.

[0016] Furthermore, when combined with iliac wing fracture, an iliac wing fracture fixation plate is placed on the iliac wing portion, and the iliac wing portion is placed on the fracture fragment of the iliac wing fracture near the sacrum.

[0017] Furthermore, an operating structure is set up in the iliac wing portion, the operating structure including an operating plate that is perpendicular or approximately perpendicular to the first end of the iliac wing.

[0018] Furthermore, the iliac wing portion, fulcrum portion, and posterior column portion of the acetabulum are a reduction and fixation plate that curves from the iliac wing to the edge of the iliac wing, then to the inner side of the pelvis away from the sacral fracture fragment, and finally to the outer side of the pelvis.

[0019] A reduction and fixation plate for anterior acetabular posterior column fractures includes an iliac wing portion, a fulcrum portion, and an acetabular posterior column portion integrally connected in sequence. The iliac wing portion is positioned at the iliac wing position during use and includes a fixation hole. The fulcrum portion includes a fulcrum hole for a fulcrum screw to pass through. The acetabular posterior column portion extends to the lower edge of the acetabular posterior column during use. The reduction and fixation plate and the fulcrum screw form a lever system. The fulcrum screw acts as a rotational support axis, with the upper iliac wing portion rotating around the fulcrum screw towards the sacrum while the acetabular posterior column portion applies a reduction force away from the sacrum to the acetabular posterior column.

[0020] This invention also discloses a reduction and fixation system for anterior acetabular posterior column fractures via anterior approach, comprising: The preoperative planning and reduction fixation plate preparation unit uses three-dimensional pelvic data obtained from preoperative patient imaging data. It utilizes the shape of the iliac wing, the condition of the posterior column of the acetabulum, and the fracture condition of the posterior column of the acetabulum in the three-dimensional pelvic data to plan a digital three-dimensional model of the instrument. The reduction fixation plate is 3D printed using the digital three-dimensional model, or a long strip plate is made according to the shape of the digital three-dimensional model to create the reduction fixation plate.

[0021] The incision construction unit is used to construct the anterior incision. The incision line is constructed on the body surface. The incision line is constructed by constructing multiple surface projection points along the iliac crest towards the back through the surface projection point of the anterior superior iliac spine. The incision is constructed along the incision line.

[0022] The iliac wing exposure unit is used to expose the iliac wing; important blood vessels and nerves are dissected to expose the iliac wing.

[0023] The reduction and fixation plate placement unit, guided by imaging equipment, is inserted through the iliac wing into the posterior column of the acetabulum, allowing the curved anastomotic structure of the posterior column to engage with the medial and lateral pelvic sides. A fulcrum screw is then screwed through the fulcrum hole into the lower medial pelvic edge of the iliac wing, with the screw insertion depth exceeding 90% of its total length. This ensures sufficient rotational support and prevents deformation during rotation. The rotation of the iliac wing pushes the fracture fragments of the posterior column away from the pelvis, reducing the fracture fragments from the sacrum to those from the sacrum. Imaging is monitored throughout this process. Once complete reduction is observed, rotation is stopped and the position is maintained before locking the fulcrum screw. The fixation plate unit is reset, and the fixation pins are fixed into the fixation holes of the iliac wing portion, ensuring the iliac wing portion is tightly fixed against the iliac wing. Guide pin channels for the fixation pins of the posterior column of the acetabulum are created via the body surface under image guidance. The fixation pins are then placed into the fixation holes of the posterior column of the acetabulum through the guide pin channels to complete the fixation of the posterior column of the acetabulum.

[0024] Furthermore, if the fracture type is a fracture of the iliac wing combined with the posterior column of the acetabulum, the iliac wing portion is fixed first, followed by fixation with an iliac wing fracture fixation plate, and then fixation with the posterior column of the acetabulum.

[0025] Furthermore, when only the posterior column of the acetabulum is involved in a fracture, the length of the incision line ranges from 10 to 18 cm.

[0026] Furthermore, when fractures involve both the iliac wing and the posterior column of the acetabulum, the incision construction unit creates a 10-15cm first incision line along multiple surface projection points of the iliac crest towards the back, originating from the surface projection point of the anterior superior iliac spine; a second incision line of 3-5cm is then created along multiple surface projection points of the iliac crest towards the abdomen, originating from the surface projection point of the anterior superior iliac spine. This incision method ensures combined treatment of both fracture sites.

[0027] Technical effects: The above-mentioned scheme enables reduction and fixation of posterior column fractures of the acetabulum via the anterior approach, effectively reducing patient injury and saving a significant amount of surgical time. By selecting the lower medial border of the iliac wing pelvis as the fulcrum of the lever system, the reduction and fixation of posterior column fractures of the acetabulum can be effectively completed through the reduction and fixation plate, making the entire fracture reduction operation simpler and more convenient.

[0028] By setting up a bending anastomosis structure for the posterior column of the acetabulum, the posterior column of the acetabulum can be well secured at the lower edge of the posterior column. Due to the irregular shape of the posterior column of the acetabulum, the bending anastomosis structure can be stably set at the lower edge of the posterior column of the acetabulum without change, thus ensuring that an effective repositioning thrust can be provided during rotational repositioning.

[0029] By setting the fulcrum at the lower inner edge of the iliac wing of the pelvis, the length of the iliac wing can be maximized, thus ensuring less effort during rotation and improving ease of operation.

[0030] By placing an iliac wing fracture fixation plate on the iliac wing portion, it is possible to achieve the combined treatment of iliac wing fracture and posterior column fracture of the acetabulum through only one anterior incision.

[0031] The operation structure fitted onto the iliac wing improves the ease of rotation and allows for removal after rotation without affecting incision closure.

[0032] Planning the reduction and fixation device based on the patient's three-dimensional pelvic model data obtained before surgery can ensure high compatibility with each position during use and improve the reduction effect. Attached Figure Description

[0033] Various other advantages and benefits will become apparent to those skilled in the art upon reading the following detailed description of preferred embodiments. The accompanying drawings are for illustrative purposes only and are not intended to limit the scope of this application. Furthermore, the same reference numerals denote the same parts throughout the drawings. In the drawings: Figure 1 This is a schematic diagram of the repositioning and fixation device structure of the present invention; Figure 2 This is a schematic diagram of the repositioning and fixing device with an operating structure according to the present invention; Figure 3 A schematic diagram of the anterior tube structure of the reduction and fixation device of the present invention positioned at the fracture site; Figure 4 A schematic diagram of the posterior tube structure of the reduction and fixation device of the present invention positioned at the fracture site; Figure 5 A schematic diagram of the anterior tube structure of a reduction and fixation device with an iliac wing fracture fixation plate, positioned at the fracture site for combined iliac wing fractures.

[0034] Label Explanation 1. Reduction and fixation plate; 11. Iliac wing portion; 12. Fulcrum portion; 121. Fulcrum hole; 13. Posterior column of acetabulum; 131. Curved anastomosis structure; 14. Fixation hole; 2. Fulcrum screw; 3. Iliac wing fracture fixation plate; 4. Operating structure. Detailed Implementation

[0035] To make the objectives, technical solutions, and advantages of this application clearer, the technical solutions of this application will be clearly and completely described below in conjunction with specific embodiments and corresponding drawings. Obviously, the described embodiments are only a part of the embodiments of this application, and not all of them. Based on the embodiments in this application, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of this application.

[0036] In this document, “illustrative” means “serving as an example, illustration or description”, and any illustration or implementation described herein as “illustrative” should not be construed as a more preferred or advantageous technical solution.

[0037] To keep the drawings concise, only the parts relevant to this application are shown schematically in each drawing, and they do not represent the actual structure of the product. In addition, to make the drawings concise and easy to understand, in some drawings, only one of the components with the same structure or function is shown schematically, or only one of them is labeled.

[0038] In this document, unless otherwise expressly specified and limited, the terms "first" and "second" are used for descriptive purposes only and should not be construed as indicating or implying relative importance; unless otherwise specified or stated, the term "multiple" refers to two or more; the terms "connected," "fixed," etc., should be interpreted broadly. For example, "connected" can be a fixed connection, a detachable connection, an integral connection, or an electrical connection; it can be a direct connection or an indirect connection through an intermediate medium. Those skilled in the art can understand the specific meaning of the above terms in this application according to the specific circumstances.

[0039] Example 1: A reduction and fixation device for posterior column fractures of the acetabulum via the anterior approach refer to Figure 1-5 A reduction and fixation device for posterior column fractures of the acetabulum via an anterior approach, comprising a reduction and fixation plate 1, a fulcrum screw 2, and a fixation screw. The reduction and fixation plate 1 travels in the following direction: from the iliac wing to the edge of the iliac wing, then to the medial side of the pelvis away from the sacral fracture fragment in the posterior column of the acetabulum, and finally to the lateral side of the pelvis, where the reduction and fixation plate 1 curves.

[0040] The reduction and fixation plate 1 comprises an iliac wing portion 11, a fulcrum portion 12, and a posterior column portion 13, which are integrally connected in sequence. The iliac wing portion 11 is positioned at the iliac wing position during use; it includes a fixation hole 14; the fulcrum portion 12 includes a fulcrum hole 121; the posterior column portion 13 extends to the lower edge of the posterior column of the acetabulum during use; a fulcrum screw 2 is fixed to the medial side of the iliac wing through the fulcrum hole 121; a fixation screw secures the reduction and fixation plate 1 through the fixation hole 14; the iliac wing portion 11, the fulcrum portion 12, and the posterior column portion 13, together with the fulcrum screw 2, form a lever system; the fulcrum screw 2 acts as a rotational support axis, allowing the upper iliac wing portion 11 to rotate around the fulcrum screw 2 towards the sacrum, while the posterior column portion 13 provides the posterior column of the acetabulum with a position away from the sacrum. The reduction force is directed to ensure that the fulcrum part 12 serves as the lever fulcrum, the iliac wing part 11 serves as the power rotation part, and the posterior column part 13 of the acetabulum serves as the reduction pushing part. After being set up, an effective lever structure is formed. This lever system forms a reduction and fixation structure that is set to the posterior column of the acetabulum through the anterior approach. The fulcrum hole 121 is set at the lower inner edge of the iliac wing in the pelvis, which is a position that allows the anterior approach surgery to reach the position with the longest possible length of the iliac wing. The longer length of the iliac wing part 11 makes the power arm of the lever system longer, ensuring that the rotation operation is more convenient to apply force. After reduction, the reduction fixation plate 1 is fixed by fixing screws.

[0041] More specifically, see reference Figure 1-2 The posterior column portion 13 of the acetabulum includes a curved anastomosis structure 131, which enables the posterior column of the acetabulum to be anastomosed from the inner side of the pelvis to the outer side of the pelvis. It can effectively hold the posterior column portion 13 of the acetabulum at the lower edge of the posterior column of the acetabulum. Due to the irregular shape of the posterior column of the acetabulum, the curved anastomosis structure 131 can be stably set at the lower edge of the posterior column of the acetabulum without change, thus ensuring that an effective reduction thrust can be provided during rotational reduction. This setting also ensures the stability of the reduction position and avoids slippage during reduction.

[0042] More specifically, the fulcrum of the lever system is set at the lower inner edge of the iliac wing pelvis, and the fulcrum screw 2 is set at the lower inner edge of the iliac wing pelvis through the fulcrum hole 121. This setting can ensure that, under the same iliac wing conditions, the length of the iliac wing portion 11 is maximized by setting the fulcrum at the lower inner edge of the iliac wing pelvis, thereby ensuring that the rotation operation is labor-saving and provides convenient operation.

[0043] More specifically, see reference Figure 5When combined with iliac wing fracture, an iliac wing fracture fixation plate 3 is set on the iliac wing portion 11 to control the iliac wing portion 11 to be set on the fracture fragment of the iliac wing fracture near the sacrum. This setting can realize the combined treatment of iliac wing fracture and posterior column fracture of acetabulum. Compared with the previous two positions and two incisions for reduction and fixation, this device can complete the reduction and fixation of two sites through only the anterior incision in the supine position, so that the overall trauma of the device is small and the fixation and reduction effect is not affected.

[0044] More specifically, see reference Figure 2 An operating structure 4 is set on the iliac wing portion 11. The operating structure 4 includes an operating plate that is perpendicular or approximately perpendicular to the first end of the iliac wing. The setting of the operating structure 4 can ensure the convenience of rotating the iliac wing portion 11 before repositioning, and can be removed from the iliac wing portion 11 after use.

[0045] More specifically, the iliac wing portion 11 is intersected with the iliac wing fracture fixation plate 3, and the first end of the iliac wing portion 11 retains the fitting part of the operating structure 4, which facilitates the overall control of the entire reduction and fixation plate 1.

[0046] More specifically, based on the three-dimensional pelvic model data obtained from the patient's preoperative imaging data, and utilizing the shape of the iliac wing, the condition of the posterior column of the acetabulum, and the fracture status of the posterior column from the pelvic three-dimensional data, a digital three-dimensional model of the instrument is planned. The plate-shaped structure is then 3D printed using this digital three-dimensional model, or a long strip plate is fabricated following the path of the digital three-dimensional model. This method ensures a better fit between the prepared reduction and fixation instrument and the corresponding position on the patient.

[0047] More specifically, 2-4 fixation holes 14 are provided on the iliac wing portion 11 to ensure effective fixation of the iliac wing portion 11, and the fixation of the posterior column of the acetabulum is completed by fixing the iliac wing portion 11. The fixation screws corresponding to the fixation holes 14 of the iliac wing portion 11 are directly inserted through the anterior incision and driven into the fixation holes 14 to complete the fixation of the iliac wing portion 11 and the iliac wing.

[0048] More specifically, the posterior column of the acetabulum 13 is provided with 2-4 fixation holes 14. When installing the fixation pins, multiple percutaneous guide channels for the fixation pins are first constructed. The fixation pins are installed through these guide channels, and the installation of these guide channels relies on imaging equipment. This method ensures the reduction and fixation of the posterior column of the acetabulum 13. The limited size and number of percutaneous guide channels still cause less trauma to the patient, and ultimately, the installation of the guide channels will not cause greater damage to the patient than the unilateral approach opening, making the overall trauma controllable.

[0049] More specifically, in order to ensure the structural stability of the repositioning fixation plate 1 during operation and the stability of the direction of the thrust provided, the width of the repositioning fixation plate 1 is in the range of 1-2cm and the thickness is in the range of 1-2mm. This size setting can ensure the deformation adaptation and fixation strength during specific surgeries.

[0050] In use, an anterior incision is first constructed along the iliac crest towards the back along the anterior superior iliac spine. After dissecting the muscles, blood vessels, and nerves, the iliac wing is exposed. The posterior column portion 13 of the reduction and fixation plate 1 is first inserted through the iliac wing and then, under image guidance, into the posterior column of the acetabulum. Then, the curved anastomosis structure 131 is inserted into the bottom of the posterior column of the acetabulum, so that the curved anastomosis structure 131 achieves anastomosis from the medial side of the pelvis to the lateral side of the pelvis at the bottom of the posterior column of the acetabulum. Finally, the posterior column portion 13 of the acetabulum is attached to the acetabulum away from the sacrum under image guidance. The fracture fragments of the posterior column are located with the iliac wing portion 11 attached to the iliac wing position. The fulcrum portion 12 is positioned at the lower inner edge of the iliac wing in the pelvis, and the fulcrum screw 2 is placed in the fulcrum hole 121. The iliac wing portion 11 is rotated toward the sacrum, and the rotation of the iliac wing portion 11 drives the posterior column portion 13 of the acetabulum to be reduced away from the sacrum. After the posterior column of the acetabulum is observed to be reduced to the appropriate position under imaging, the fulcrum screw 2 is locked, and then the fixation pin is placed in the fixation hole 14 to complete the fixation after reduction.

[0051] Example 2: A reduction and fixation system for posterior column fractures of the acetabulum via an anterior approach A reduction and fixation system for posterior column fractures of the acetabulum via the anterior approach involves preoperative planning and preparation of a reduction and fixation plate 1, followed by incision construction, exposure of the iliac wing, placement of the reduction and fixation plate 1, and fixation of the reduction and fixation plate 1, which are completed sequentially through corresponding units.

[0052] The preoperative planning and reduction fixation plate preparation unit uses the three-dimensional pelvic data obtained from the patient's preoperative imaging data, the shape of the iliac wing, the condition of the posterior column of the acetabulum, and the fracture condition of the posterior column of the acetabulum in the three-dimensional pelvic data to plan the digital three-dimensional model of the instrument, and uses the digital three-dimensional model to 3D print the reduction fixation plate 1, or to make a long strip plate according to the shape of the digital three-dimensional model as the reduction fixation plate 1.

[0053] The incision construction unit is used to construct the anterior incision. The incision line is constructed on the body surface by constructing the incision line through the surface projection point of the anterior superior iliac spine and multiple surface projection points along the iliac crest toward the back. The incision is constructed along the incision line.

[0054] The iliac wing exposure unit is used to expose the iliac wing, dissect important blood vessels and nerves, and further expose the iliac wing.

[0055] The reduction and fixation plate placement unit guides the reduction and fixation plate 1 through the iliac wing to the posterior column of the acetabulum under the guidance of the imaging equipment. This allows the curved anastomosis structure 131 of the posterior column portion 13 to be engaged with the medial and lateral pelvic positions of the posterior column of the acetabulum. Next, the fulcrum screw 2 is screwed through the fulcrum hole 121 and screwed into the lower medial pelvic position of the iliac wing. The screw 2 is screwed in to a depth exceeding 90% of its total length to ensure sufficient rotational support force and prevent deformation during rotation. The rotation of the iliac wing portion 11 drives the posterior column portion 13 of the acetabulum to push the fracture fragments of the posterior column of the acetabulum away from the pelvis, thereby reducing the fracture fragments of the posterior column of the acetabulum away from the sacrum and the fracture fragments of the posterior column of the acetabulum closer to the sacrum. During this process, the imaging equipment is observed. Once complete reduction is observed, rotation is stopped and the position is maintained. Then, the fulcrum screw 2 is locked.

[0056] The fixation plate is reset and the fixation unit is fixed into the fixation hole 14 of the iliac wing portion 11, so that the iliac wing portion 11 is fixed tightly against the iliac wing; a guide screw channel for the fixation screw of the posterior column portion 13 of the acetabulum is opened on the body surface under the guidance of imaging; the fixation screw is placed into the fixation hole 14 of the posterior column portion 13 of the acetabulum through the guide screw channel to complete the fixation of the posterior column portion 13 of the acetabulum.

[0057] More specifically, the repositioning and fixing plate placement unit includes an operating structure 4 sleeved on the iliac wing portion 11. The operating structure 4 includes an operating plate that is perpendicular or approximately perpendicular to the first end of the iliac wing. The sleeved operating structure 4 ensures the convenience of rotating the iliac wing portion 11 before repositioning, and can be removed from the iliac wing portion 11 after use.

[0058] Of course, anterior approach surgery can also treat fractures of the iliac wing combined with the posterior column of the acetabulum. After the iliac wing portion 11 is fixed, the iliac wing fracture fixation plate 3 is fixed, and then the posterior column portion 13 of the acetabulum is fixed.

[0059] When only the posterior column of the acetabulum is involved, the length of the incision marking ranges from 10 to 18 cm. When both the iliac wing and the posterior column of the acetabulum are involved, the incision construction unit is used to construct a 10-15 cm first incision marking along multiple surface projection points of the iliac crest towards the back, originating from the surface projection point of the anterior superior iliac spine; a second incision marking of 3-5 cm is constructed along multiple surface projection points of the iliac crest towards the abdomen, originating from the surface projection point of the anterior superior iliac spine. This incision method ensures combined treatment of both fracture sites.

[0060] The above description is merely a specific embodiment of this application. Under the guidance of the above teachings, those skilled in the art can make other improvements or modifications based on the above embodiments. Those skilled in the art should understand that the above specific description is only to better explain the purpose of this application, and the scope of protection of this application should be determined by the scope of the claims.

Claims

1. A reduction and fixation device for posterior column fractures of the acetabulum via an anterior approach, comprising: The iliac wing portion, the fulcrum portion, and the posterior column portion of the acetabulum are connected in sequence to form a reduction and fixation plate. The iliac wing portion is placed in the iliac wing position during use, and the iliac wing portion includes fixing holes; The fulcrum portion includes a fulcrum hole; The posterior column of the acetabulum extends to the lower edge of the posterior column of the acetabulum during use; A fulcrum screw is fixed to the medial side of the iliac wing through a fulcrum hole; Use fixing screws to secure the reset plate through the fixing holes; The iliac wing portion, the fulcrum portion, and the posterior column of the acetabulum, together with the fulcrum screw, form a lever system. The fulcrum screw acts as a rotational support axis, with the upper iliac wing portion rotating around the fulcrum screw toward the sacrum, while the posterior column of the acetabulum provides a reduction force to the posterior column of the acetabulum away from the sacrum.

2. The device according to claim 1, characterized in that, The posterior column of the acetabulum includes a curved anastomosis structure, which enables the posterior column of the acetabulum to be anastomosed from the inner side of the pelvis to the outer side of the pelvis, thus securing the posterior column of the acetabulum to the lower edge of the posterior column of the acetabulum.

3. The device according to claim 1, characterized in that, The fulcrum of the lever system is set at the lower edge of the inner side of the iliac wing pelvis, and the fulcrum screw is set at the lower edge of the inner side of the iliac wing pelvis through the fulcrum hole.

4. The device according to claim 1, characterized in that, When there is a combined iliac wing fracture, an iliac wing fracture fixation plate is placed on the iliac wing portion to control the iliac wing portion to be placed on the fracture fragment of the iliac wing fracture near the sacrum.

5. The device according to claim 4, characterized in that, An operating structure is set up in the iliac wing section, the operating structure including an operating plate that is perpendicular or approximately perpendicular to the first end of the iliac wing. Preferably, the iliac wing portion is intersected with the iliac wing fracture fixation plate, and the insertion portion of the operating structure is retained at the first end of the iliac wing portion.

6. The device according to claim 4, characterized in that, The iliac wing portion, the fulcrum portion, and the posterior column portion of the acetabulum are all part of a reduction and fixation plate that curves from the iliac wing to the edge of the iliac wing, then to the posterior column of the acetabulum away from the sacral fracture fragment, and finally to the lateral aspect of the pelvis.

7. The device according to claim 6, characterized in that, Based on the three-dimensional pelvic model data obtained from the patient's preoperative imaging data, the shape of the iliac wing, the condition of the posterior column of the acetabulum, and the fracture status of the posterior column of the acetabulum in the three-dimensional pelvic data are used to plan the digital three-dimensional model of the instrument. The plate-shaped structure is 3D printed using the digital three-dimensional model, or a long strip plate is made according to the shape of the digital three-dimensional model. Preferably, 2-4 fixation holes are provided on the iliac wing portion and 2-4 fixation holes are provided on the posterior column portion of the acetabulum. The width of the reduction fixation plate ranges from 1 to 2 cm, and the thickness ranges from 1 to 2 mm.

8. A reduction and fixation system for anterior acetabular posterior column fractures via an anterior approach, comprising: The preoperative planning and reduction and fixation plate preparation unit uses three-dimensional pelvic data obtained from the patient's preoperative imaging data, and utilizes the shape of the iliac wing, the condition of the posterior column of the acetabulum, and the fracture condition of the posterior column of the acetabulum in the three-dimensional pelvic data to plan a digital three-dimensional model of the instrument. The reduction and fixation plate is 3D printed using the digital three-dimensional model, or a long strip plate is made into a reduction and fixation plate according to the shape of the digital three-dimensional model. The incision construction unit is used to construct the anterior incision. The incision line is constructed on the body surface. The incision line is constructed by constructing multiple surface projection points along the iliac crest towards the back through the surface projection point of the anterior superior iliac spine. The incision is constructed along the incision line. The iliac wing exposure unit is used to expose the iliac wing, dissect important blood vessels and nerves, and expose the iliac wing. The reduction and fixation plate placement unit, guided by the imaging equipment, is inserted through the iliac wing into the posterior column of the acetabulum, so that the curved anastomosis structure of the posterior column of the acetabulum is engaged with the medial and lateral pelvic positions of the posterior column of the acetabulum. Then, the fulcrum screw is screwed through the fulcrum hole into the lower medial pelvic position of the iliac wing, with the fulcrum screw being screwed in to a depth of more than 90% of the entire fulcrum screw. The rotation of the iliac wing causes the posterior column of the acetabulum to push the fracture fragments of the posterior column of the acetabulum away from the pelvis, so that the fracture fragments of the posterior column of the acetabulum away from the sacrum and the fracture fragments of the posterior column of the acetabulum closer to the sacrum are reduced. During this process, the imaging equipment is observed. Once complete reduction is observed, the rotation is stopped and the position is maintained, and then the fulcrum screw is locked. The fixation plate is reset and the fixation unit is fixed into the fixation hole of the iliac wing portion, so that the iliac wing portion is tightly fixed to the iliac wing. Guide pin channels for the fixation pins of the posterior column of the acetabulum are opened on the body surface under image guidance. The fixation pins are placed into the fixation hole of the posterior column of the acetabulum through the guide pin channels to complete the fixation of the posterior column of the acetabulum. Preferably, the fracture type is a fracture of the iliac wing combined with the posterior column of the acetabulum. After the iliac wing portion is fixed, the iliac wing fracture fixation plate is fixed, and then the posterior column of the acetabulum is fixed.

9. The system according to claim 8, characterized in that, When only the posterior column of the acetabulum is involved, the length of the incision marking is 10–18 cm. When both the iliac wing and the posterior column of the acetabulum are involved, the incision construction unit constructs a first part of the incision marking of 10–15 cm along multiple surface projection points of the iliac crest towards the back through the surface projection point of the anterior superior iliac spine. A second part of the incision marking of 3–5 cm is constructed along multiple surface projection points of the iliac crest towards the abdomen through the surface projection point of the anterior superior iliac spine.

10. A reduction and fixation plate for anterior acetabular posterior column fractures, characterized in that, It includes the iliac wing portion, the fulcrum portion, and the posterior column portion of the acetabulum, which are connected in sequence. The iliac wing portion is placed in the iliac wing position during use, and the iliac wing portion includes fixing holes; The fulcrum portion includes a fulcrum hole for the fulcrum screw to pass through; The posterior column of the acetabulum extends to the lower edge of the posterior column of the acetabulum during use; The reduction fixation plate and the fulcrum screw form a lever system; the fulcrum screw acts as a rotation support axis, and the upper iliac wing portion rotates around the fulcrum screw toward the sacrum, while the posterior column of the acetabulum provides a reduction force to the posterior column of the acetabulum away from the sacrum.

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