Reverse tension supporting screw and tibial plateau fracture fixing system

Abstract

The utility model discloses a reverse tension supporting screw and a tibial plateau fracture fixing system, and belongs to the technical field of medical instruments, the reverse tension supporting screw comprises a middle shaft connecting rod, the middle shaft connecting rod comprises a main body rod part, and two ends of the main body rod part are respectively provided with a first thread section and a second thread section; the first threaded section is connected with a pressurizing nut used for fixing the front outer side of the trauma of the tibial plateau, the second threaded section is connected with a pressurizing nut used for fixing the rear outer side of the trauma of the tibial plateau, and a first instrument driving part is arranged on the portion, on the outer side of the first threaded section, of the main body rod part. The reverse tension supporting screw is suitable for tibial plateau posterior lateral fracture, the reverse tension supporting screw is of a split type three-part design, the size of each part is relatively small, and minimally invasive treatment can be better achieved; and the pressurizing nut and the pressurizing nut cap can be effectively fixed on the front side and the rear side of the trauma of the tibial plateau and can be firmly fixed on the trauma of the tibial plateau after being tensioned by reverse tension, and the fixing / supporting effect is good.

Description

Technical Field

[0001] The utility model relates to the technical field of orthopedic implants, in particular to a reverse tension support screw and a tibial plateau fracture fixation system. Background Art

[0002] Tibial plateau fractures often occur in high-energy trauma, such as falls from heights, car accidents, and falls. Since the tibial plateau is an important load-bearing structure of the lower limbs, when it is subjected to severe vertical and valgus and valgus violence, it often causes bone structure damage, often manifested as tibial plateau split fractures, with or without articular surface collapse, and even knee dislocation and metaphysis comminution in severe cases. The soft tissues around the knee joint and the stable structures of the joint (medial and lateral collateral ligaments, meniscus and cruciate ligaments) will also be affected.

[0003] Posterolateral tibial plateau fractures have always been a difficult problem in tibial plateau surgery. The abundant blood vessels, nerves and posterolateral angle on the posterior side have caused great trouble to the surgery. Although the conventional anterolateral surgical approach can expose the posterior side through osteotomy and obtain a flat joint surface, the posterior bone block lacks effective structural support, which still poses great difficulties.

[0004] Utility model patent CN207152642U discloses a combined cancellous bone double-head threaded compression screw, including a screw sleeve and a screw threaded into the screw sleeve. When in use, the screw sleeve is inserted from one side of the tibial plateau, and the screw is inserted from the other side of the tibial plateau and screwed into the threaded sleeve to pressurize the fracture fragment on both sides to promote fracture healing. However, in this solution, the size of the screw sleeve and the screw are both long and need to be implanted on both sides, resulting in a large surgical opening and inability to achieve minimally invasive treatment. Utility Model Content

[0005] The technical problem to be solved by the utility model is to provide a reverse tension support screw and a tibial plateau fracture fixation system which are suitable for posterolateral tibial plateau fractures and can achieve minimally invasive treatment and have good fixation effect.

[0006] In order to solve the above technical problems, the utility model provides the following technical solutions:

[0007] On the one hand, a reverse tension support screw is provided, including a central axis connecting rod, the central axis connecting rod including a main rod portion, the two ends of the main rod portion are respectively provided with a first threaded segment and a second threaded segment, the first threaded segment is connected to a compression nut for fixing the anterior and lateral side of the tibial plateau trauma site, the second threaded segment is connected to a compression nut for fixing the posterior and lateral side of the tibial plateau trauma site, and a first instrument driving portion is provided on the main rod portion on the outside of the first threaded segment.

[0008] Furthermore, an axial through hole for the positioning guide pin to pass through is provided inside the central axis connecting rod.

[0009] Furthermore, a second instrument driving part is provided on the main body rod outside the second threaded section;

[0010] And / or, the outer diameter of the main body rod is greater than the outer diameters of the first thread segment and the second thread segment.

[0011] Furthermore, the pressure nut includes a first main body and a first end cap located at one end of the first main body, the first main body is provided with a first threaded hole matching with the first threaded section, and the first end cap is provided with a first instrument driving hole connected with the first threaded hole.

[0012] Furthermore, the first main body portion of the pressure nut and the main rod portion of the central axis connecting rod are both cylindrical and have the same outer diameter.

[0013] Furthermore, the pressure nut includes a second main body and a second end cap located at one end of the second main body, the second main body is provided with a second threaded hole matching with the second threaded section, and the second end cap is provided with a second instrument driving hole connected with the second threaded hole.

[0014] Furthermore, the second main body portion of the pressure nut and the main rod portion of the central axis connecting rod are both cylindrical and have the same outer diameter.

[0015] On the other hand, a tibial plateau fracture fixation system is provided, comprising an external fixator and the above-mentioned reverse tension support screw, wherein the external fixator comprises an arc-shaped support arm, and a positioning column matching the second instrument drive hole is provided on the inner side of the lower end of the arc-shaped support arm.

[0016] Furthermore, a bolt connection seat is fixedly provided at the upper end of the arc-shaped support arm, and a positioning pressure bolt is threadedly connected to the bolt connection seat. The positioning pressure bolt includes a threaded rod passing through the bolt connection seat, the front end of the threaded rod is used as a bone compression part, and the rear end of the threaded rod is provided with a driving knob.

[0017] Furthermore, a positioning hole for the positioning guide needle to pass through is provided on the lower end of the arc-shaped support arm and the positioning column, and an axial through hole for the positioning guide needle to pass through is provided on the positioning pressure bolt, and the axial through hole and the positioning hole are in the same straight line.

[0018] The utility model has the following beneficial effects:

[0019] The reverse tension support screw and tibial plateau fracture fixation system of the present invention comprises a central axis connecting rod, the central axis connecting rod comprises a main rod portion, two ends of the main rod portion are respectively provided with a first threaded section and a second threaded section, the first threaded section is connected with a pressure nut for fixing the anterior and lateral side of the tibial plateau trauma site, the second threaded section is connected with a pressure nut for fixing the posterior and lateral side of the tibial plateau trauma site, and the main rod portion is provided with a first instrument driving section on the outer side of the first threaded section. In this way, the present invention is suitable for posterior and lateral tibial plateau fractures, that is, it is suitable for situations where there is only one surgical incision in the anterior and lateral approach surgery, and the reverse tension support screw is a split three-part design, and the size of each part is relatively small, so that a larger surgical opening is not required, and minimally invasive treatment can be better achieved; and the pressure nut and the pressure nut can be effectively fixed on the front and rear sides of the tibial plateau trauma site, and the tibial plateau trauma site can be firmly fixed after the reverse tension is tightened, and the fixing / supporting effect is good. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 This is a schematic diagram of the structure of the reverse tension support screw of the utility model;

[0021] Figure 2 for Figure 1 Schematic diagram of the structure of the middle pressure nut, wherein (a) is a front view, (b) is an AA sectional view of (a), and (c) is a right view of (a);

[0022] Figure 3 for Figure 1 Schematic diagram of the structure of the middle-axle connecting rod, wherein (a) is a front view, (b) is an AA sectional view of (a), and (c) is a right view of (a);

[0023] Figure 4 for Figure 1 Schematic diagram of the structure of the middle pressure nut, wherein (a) is a front view, (b) is an AA sectional view of (a), and (c) is a left view of (a);

[0024] Figure 5 Schematic diagram of the structure of the external fixator in the tibial plateau fracture fixation system of the present invention, wherein (a) is a structural diagram in one direction, and (b) is a structural diagram in another direction;

[0025] FIG. 6A to FIG. 6E For the benefit of Figure 5 The external fixator shown will Figure 1 Schematic diagram of the intraoperative use of a reverse tension support screw fixed to a tibial plateau trauma site. DETAILED DESCRIPTION

[0026] In order to make the technical problems to be solved, technical solutions and advantages of the present invention more clear, a detailed description will be given below in conjunction with the accompanying drawings and specific embodiments.

[0027] In the description of the present invention, it should be understood that the terms "upper", "lower", "front", "back", "left", "right", etc. indicate directions or positional relationships based on the directions or positional relationships shown in the accompanying drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific direction, be constructed and operated in a specific direction, and therefore should not be understood as a limitation on the present invention.

[0028] On the one hand, the utility model provides a reverse tension support screw 3, such as Figure 1-4 As shown, it includes a central axis connecting rod 31, which includes a main rod portion 312. The two ends of the main rod portion 312 are respectively provided with a first threaded segment 313 and a second threaded segment 314. The first threaded segment 313 is connected to a pressure nut 32 for fixing the anterior and lateral side of the tibial plateau injury site, and the second threaded segment 314 is connected to a pressure nut 33 for fixing the posterior and lateral side of the tibial plateau injury site. The main rod portion 312 is provided with a first instrument driving portion 315 on the outer side of the first threaded segment 313.

[0029] When in use, in the anterolateral approach surgery, firstly, a screw channel is established at the trauma site of the tibial plateau 6 according to the existing technology, and then the pressure nut 33 is placed on the posterolateral side of the trauma site of the tibial plateau 6 through the instrument, and extends into the screw channel. At the same time, the central axis connecting rod 31 is implanted into the screw channel from the front, and the first instrument driving part 315 on the main rod part 312 of the central axis connecting rod 31 is driven by the surgical instrument, so that the second threaded section 314 of the central axis connecting rod 31 is threadedly connected with the pressure nut 33. After the second threaded section 314 is firmly connected with the pressure nut 33, the pressure nut 32 is placed on the anterolateral side of the trauma site of the tibial plateau 6 and extends into the screw channel. The pressure nut 32 is driven by the surgical instrument, so that the pressure nut 32 is threadedly connected with the first threaded section 313 of the central axis connecting rod 31, and the appropriate force is adjusted to adjust the trauma site of the tibial plateau so that the fracture site reaches the ideal healing degree.

[0030] The reverse tension support screw of the utility model comprises a central axis connecting rod, which comprises a main rod portion, and two ends of the main rod portion are respectively provided with a first threaded section and a second threaded section, the first threaded section is connected with a pressure nut for fixing the anterior and lateral side of the tibial plateau trauma, and the second threaded section is connected with a pressure nut for fixing the posterior and lateral side of the tibial plateau trauma, and the main rod portion is provided with a first instrument driving section on the outer side of the first threaded section. In this way, the utility model is suitable for posterolateral fractures of the tibial plateau, that is, it is suitable for situations where there is only one surgical incision in the anterior and lateral approach surgery, and the reverse tension support screw is a split three-part design, and the size of each part is relatively small, so that a larger surgical opening is not required, and minimally invasive treatment can be better achieved; and the pressure nut and the pressure nut can be effectively fixed on the front and rear sides of the tibial plateau trauma, and the tibial plateau trauma can be firmly fixed after the reverse tension is tightened, and the fixing / supporting effect is good.

[0031] In order to solve the problem of posterolateral tibial plateau fracture, including: the anatomical structure around the tibial plateau is complex, and a good exposure field of view is often unable to be achieved during surgery, which can easily cause damage to important blood vessels, nerves or soft tissues, and even endanger limb life; at the same time, in the prior art, some patients have osteoporosis, which causes the screws to loosen inside the bones and cannot be completely fixed, making the screws unstable or shaking relative to the patient's bones. The utility model provides an internal fixation device for the above-mentioned reverse tension support screw.

[0032] The utility model adopts the reverse tension support screw technology, so that the screw adopts reverse tension to play a positive pushing support role, and can complete the contralateral support surgery in one incision, reducing surgical trauma and difficulty, which is conducive to popularization in grassroots hospitals. The reverse tension support screw changes the shortcomings of the existing buttress support technology by applying reverse tension on the opposite side, reduces the limitations of the technology, expands the use space, and the buttress support force on the fracture site is closer to the ideal state, has biomechanical stability, and is not easy to fail.

[0033] After obtaining a flat joint surface alignment through a conventional anterolateral approach, the utility model provides a stable support structure for the posterior bone and can be used together with the existing lateral bone plate to complete the surgical fixation of the complex tibial plateau, thereby achieving the purpose of stable fixation and obtaining a good recovery effect. It can even be used in conjunction with an arthroscopy to perform minimally invasive treatment of posterolateral tibial plateau fractures and reduce surgical trauma.

[0034] like Figure 1 and Figure 3As shown, the interior of the central axis connecting rod 31 may be provided with an axial through hole 311 for the positioning guide pin 2 to pass through. A second instrument driving part 316 (such as an external hexagonal) may be provided on the main body rod 312 on the outside of the second threaded section 314, so that the central axis connecting rod 31 can still be used when it is implanted in the reverse direction; the outer diameter of the main body rod 312 may be larger than the outer diameters of the first threaded section 313 and the second threaded section 314, so as to improve the overall strength of the central axis connecting rod 31.

[0035] like Figure 1 and Figure 2 As shown, the pressure nut 32 may include a first main body portion 321 and a first end cap 322 (specifically, it may be cylindrical) located at one end of the first main body portion 321, the first main body portion 321 is provided with a first threaded hole 323 that matches the first threaded segment 313, and the first end cap 322 is provided with a first instrument driving hole 324 (such as an inner hexagonal hole) that is connected to the first threaded hole 323, so that the pressure nut 32 can be threadedly connected to the first threaded segment 313 by driving the first instrument driving hole 324, and the first instrument driving hole 324 is connected to the first threaded hole 323, and does not affect the passage of the positioning guide needle 2.

[0036] The first main body portion 321 of the pressurizing nut 32 and the main rod portion 312 of the central axis connecting rod 31 may both be cylindrical and have the same outer diameter. The cylindrical shape and the same outer diameter minimize the impact on the patient's bones during threaded connection.

[0037] like Figure 1 and Figure 4 As shown, the pressurizing nut 33 may include a second main body portion 331 and a second end cap 332 (specifically, it may be cylindrical) located at one end of the second main body portion 331, the second main body portion 331 is provided with a second threaded hole 333 that matches the second threaded segment 314, and the second end cap 332 is provided with a second instrument driving hole 334 (such as an inner hexagonal hole) that is connected to the second threaded hole 333, so that the pressurizing nut 33 can be threadedly connected to the second threaded segment 314 by driving the second instrument driving hole 334, and the second instrument driving hole 334 is connected to the second threaded segment 314, and does not affect the passage of the positioning guide needle 2.

[0038] The second main body portion 331 of the pressurizing nut 33 and the main rod portion 312 of the central axis connecting rod 31 can both be cylindrical and have the same outer diameter. The cylindrical shape and the same outer diameter have the least impact on the patient's bones during threaded connection.

[0039] On the other hand, the utility model provides a tibial plateau fracture fixation system, comprising an external fixator 1 and the above-mentioned reverse tension support screw 3, such as Figure 5As shown, the external fixator 1 includes an arc-shaped support arm 11 (although the example in the figure is formed by two parts being hinged, it is preferably an integrated fixed design), and a positioning column 111 is provided on the inner side of the lower end of the arc-shaped support arm 11 to cooperate with the second instrument driving hole 334. Since the structure of the reverse tension support screw 3 is the same as described above, it will not be repeated here.

[0040] When in use, firstly, in the anterolateral approach surgery, a screw channel is first established at the wound site of the tibial plateau 6 according to the prior art, and then the pressure nut 33 is placed on the positioning column 111 of the external fixator 1. At this time, the second instrument driving hole 334 of the pressure nut 33 cooperates with the positioning column 111, and the external fixator 1 is extended into the patient's body from the anterior and lateral side of the tibial plateau 6, so that the inner side of the lower end of the arc-shaped support arm 11 abuts against the posterior and lateral side of the tibial plateau 6. At this time, the pressure nut 33 is inserted into the screw channel of the tibial plateau 6 from the rear side, and then the central axis connecting rod 31 is implanted into the screw channel from the front, and the surgical instrument is used to drive the screw. The first instrument driving part 315 on the main rod part 312 of the central axis connecting rod 31 makes the second threaded section 314 of the central axis connecting rod 31 threadedly connected with the pressure nut 33. After the second threaded section 314 is firmly connected with the pressure nut 33, the pressure nut 32 is placed on the anterior and lateral side of the wound on the tibial plateau 6 and extends into the screw channel. The pressure nut 32 is driven by a surgical instrument to make the pressure nut 32 threadedly connected with the first threaded section 313 of the central axis connecting rod 31. The appropriate force is adjusted to adjust the wound on the tibial plateau so that the fracture reaches the ideal degree of healing. Finally, the external fixator 1 is removed.

[0041] The tibial plateau fracture fixation system of the utility model comprises an external fixator and a reverse tension support screw, the reverse tension support screw comprises a central axis connecting rod, the central axis connecting rod comprises a main rod portion, two ends of the main rod portion are respectively provided with a first threaded section and a second threaded section, the first threaded section is connected with a pressure nut for fixing the anterior and lateral side of the tibial plateau trauma site, the second threaded section is connected with a pressure nut for fixing the posterior and lateral side of the tibial plateau trauma site, and the main rod portion is provided with a first instrument driving section on the outer side of the first threaded section. In this way, the utility model is suitable for posterior and lateral tibial plateau fractures, that is, it is suitable for situations where there is only one surgical incision in the anterior and lateral approach surgery, and the reverse tension support screw is a split three-part design, and the size of each part is relatively small, so that a larger surgical opening is not required, and minimally invasive treatment can be better achieved; and the pressure nut and the pressure nut can be effectively fixed on the front and rear sides of the tibial plateau trauma site, and the tibial plateau trauma site can be firmly fixed after the reverse tension is tightened, and the fixing / supporting effect is good.

[0042] In order to make the external fixator 1 have the function of fracture compression reduction, preferably, a bolt connection seat 13 is fixedly provided at the upper end of the arc-shaped support arm 11 (although the bolt connection seat 13 is hinged on the arc-shaped support arm 11 in the figure, it is preferably an integrated fixed design), and a positioning pressure bolt 14 is connected to the internal thread of the bolt connection seat 13. The positioning pressure bolt 14 includes a threaded rod 142 passing through the bolt connection seat 13, and the front end of the threaded rod 142 is used as a bone compression part. The rear end of the threaded rod 142 is provided with a driving knob 143 (specifically, it can be a knurled outer cylinder). Adjusting the driving knob 143 can make the bone compression part of the positioning pressure bolt 14 compress the wound of the tibial plateau 6 to reduce the fracture site, and the reduction effect is good.

[0043] A positioning hole 112 for the positioning guide needle 2 to pass through may be provided on the lower end of the arc-shaped support arm 11 and the positioning column 111, and an axial through hole 141 for the positioning guide needle 2 to pass through may be provided on the positioning pressure bolt 14. The axial through hole 141 is in the same straight line as the positioning hole 112, so that it is convenient to penetrate the positioning guide needle 2 and facilitate to guide and install the reverse tension support screw 3.

[0044] In summary, if FIG. 6A to FIG. 6E As shown, the specific surgical process of the tibial plateau fracture fixation system of the present invention can be referred to as follows:

[0045] 1) First, if Fig. 6A As shown, as mentioned above, in the anterolateral approach surgery, the external fixator 1 is extended into the patient's body, so that the inner side of the lower end of the arc-shaped support arm 11 is against the posterior and lateral side of the tibial plateau 6, and the bone compression part of the front end of the threaded rod 142 of the positioning and pressurizing bolt 14 is aligned with the anterolateral side of the tibial plateau 6, and then the positioning and pressurizing bolt 14 is rotated to continuously pressurize the fracture line M of the tibial plateau 6. After the fracture site is reduced, the positioning guide pin 2 is implanted, and the positioning guide pin 2 is sequentially passed through the axial through hole 141 on the positioning and pressurizing bolt 14, and the positioning hole 112 on the lower end of the arc-shaped support arm 11 and the positioning column 111, and the positioning guide pin 2 plays a role in positioning;

[0046] 2) Then, if Figure 6B As shown, after the screw channel is established at the wound site of the tibial plateau 6, the pressure nut 33 of the reverse tension support screw 3 is placed on the positioning column 111 of the external fixator 1, and the pressure nut 33 is placed on the posterior and lateral side of the wound site of the tibial plateau 6 through the external fixator 1 to extend into the screw channel, and at the same time, the central axis connecting rod 31 is implanted into the screw channel from the front, and the first instrument driving part 315 on the main rod part 312 of the central axis connecting rod 31 is driven by a surgical instrument (specifically, an internal hexagonal screwdriver 5), so that the second threaded section 314 of the central axis connecting rod 31 is threadedly connected and locked with the pressure nut 33;

[0047] 3) Afterwards, if Figure 6C-6DAs shown, after the second threaded section 314 of the central axis connecting rod 31 is firmly connected with the pressure nut 33, a surgical instrument (specifically, an external hexagonal screwdriver 4) is used to place the pressure nut 32 of the reverse tension support screw 3 on the front and outside of the wound of the tibial plateau 6 and extend it into the screw channel, and the pressure nut 32 is driven to make the pressure nut 32 and the first threaded section 313 of the central axis connecting rod 31 threadedly connected, and the appropriate force is adjusted to adjust the wound of the tibial plateau so that the fracture reaches an ideal degree of healing;

[0048] 4) Finally, the external fixator 1 is removed and the reverse tension support screw 3 is installed at the tibial plateau 6 trauma site. Fig. 6E shown.

[0049] The above is a preferred embodiment of the present invention. It should be pointed out that, for ordinary technicians in this technical field, several improvements and modifications can be made without departing from the principles of the present invention. These improvements and modifications should also be regarded as the protection scope of the present invention.

Claims

1. A reverse tension support screw, characterized in that: It includes a central axis connecting rod, which includes a main rod portion, and two ends of the main rod portion are respectively provided with a first threaded section and a second threaded section, the first threaded section is connected to a pressure nut for fixing the anterior and lateral side of the tibial plateau injury, and the second threaded section is connected to a pressure nut for fixing the posterior and lateral side of the tibial plateau injury, and a first instrument driving part is provided on the main rod portion on the outside of the first threaded section.

2. The reverse tension support screw according to claim 1, characterized in that: An axial through hole for the positioning guide pin to pass through is arranged inside the central axis connecting rod.

3. The reverse tension support screw according to claim 2, characterized in that: A second instrument driving part is provided on the main body rod outside the second threaded section; And / or, the outer diameter of the main body rod is greater than the outer diameters of the first thread segment and the second thread segment.

4. The reverse tension support screw according to claim 2, characterized in that: The pressure nut includes a first main body and a first end cap located at one end of the first main body, the first main body is provided with a first threaded hole matching with the first threaded section, and the first end cap is provided with a first instrument driving hole connected with the first threaded hole.

5. The reverse tension support screw according to claim 4, characterized in that: The first main body portion of the pressure nut and the main rod portion of the central axis connecting rod are both cylindrical and have the same outer diameter.

6. The reverse tension support screw according to any one of claims 2 to 5, characterized in that: The pressurizing nut includes a second main body and a second end cap located at one end of the second main body, the second main body is provided with a second threaded hole matching with the second threaded section, and the second end cap is provided with a second instrument driving hole connected with the second threaded hole.

7. The reverse tension support screw according to claim 6, characterized in that: The second main body portion of the pressure nut and the main rod portion of the central axis connecting rod are both cylindrical and have the same outer diameter.

8. A tibial plateau fracture fixation system, characterized in that: It comprises an external fixator and the reverse tension support screw according to claim 6 or 7, wherein the external fixator comprises an arc-shaped support arm, and a positioning column matching with the second instrument driving hole is provided on the inner side of the lower end of the arc-shaped support arm.

9. The tibial plateau fracture fixation system according to claim 8, characterized in that: A bolt connection seat is fixedly provided at the upper end of the arc-shaped support arm, and a positioning pressure bolt is threadedly connected to the inner thread of the bolt connection seat. The positioning pressure bolt includes a threaded rod passing through the bolt connection seat, the front end of the threaded rod is used as a bone compression part, and the rear end of the threaded rod is provided with a driving knob.

10. The tibial plateau fracture fixation system according to claim 9, characterized in that: A positioning hole for the positioning guide needle to pass through is provided on the lower end of the arc-shaped support arm and the positioning column, and an axial through hole for the positioning guide needle to pass through is provided on the positioning pressure bolt, and the axial through hole and the positioning hole are in the same straight line.

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