Anterior approach ulna coracoid process bone fracture plate

Abstract

The utility model discloses an ulna coracoid process bone fracture plate through anterior approach, bone setting of ulna coracoid process is achieved through anterior approach, the bone fracture plate is of a T-shaped structure, the total length of the bone fracture plate is smaller than 2.5 cm, the bone fracture plate comprises an adaptive plate and a fixing plate which are in angle connection, the adaptive plate is located above the fixing plate, the adaptive plate is used for being matched with a far-end lateral column of the ulna coracoid process, and the fixing plate is used for being matched with the far-end lateral column of the ulna coracoid process. The adaptive plate comprises a positioning hole and suture holes formed in the two sides of the positioning hole; the fixing plate is narrower than the adaptive plate, an adjusting hole and a fixing hole are formed in the fixing plate, the adjusting hole is located between the positioning hole and the fixing hole and used for achieving adaptive adjustment of the bone fracture plate and the far-end outer side column, and the total length is the total distance between the top end of the adaptive plate and the bottom end of the fixing plate. According to the bone fracture plate, the matching stability of the bone fracture plate and the front portion of the elbow joint after bone fracture is improved, stimulation to local soft tissue is reduced, the contact area between the bone fracture plate and ulna coracoid processes is increased, the fixing strength between the bone fracture plate and the ulna coracoid processes is improved, the postoperative healing effect is improved, and the stress fracture risk is reduced.

Description

Technical Field

[0001] The utility model belongs to the technical field of medical devices, and particularly relates to an ulnar coronoid process osteosynthesis plate through an anterior approach. Background Art

[0002] The ulnar coronoid process is an important structure to prevent posterior dislocation of the elbow joint and is also one of the main structures to maintain the stability of the humeroulnar joint. The coronoid process and the radial head provide an anterior blocking effect in preventing posterior dislocation and subluxation of the elbow joint. Fractures of the ulnar coronoid process account for 10-15% of elbow joint injuries. When the coronoid process fracture is combined with elbow joint dislocation and radial head fracture, it is called the "terrible triad" of the elbow joint. This complex elbow joint injury is extremely prone to persistent elbow joint instability and early joint stiffness, and the prognosis is extremely poor if not properly treated. Many scholars believe that in the case of elbow joint instability, regardless of the size of the fracture fragment, the vast majority of coronoid process fractures need to be fixed. At present, the fractures of the ulnar coronoid process mainly have the Regan-Morrey classification and the O'Driscoll classification. The latter is the most commonly used and can be used to predict related injuries and elbow joint instability, as well as plan surgical methods and treatments. The position of the ulnar coronoid process is relatively deep and difficult to expose. At present, there are many methods for treating coronoid process fractures, and there is no unified view on the surgical approach and fixation method.

[0003] The surgical approaches for ulnar coronoid process fractures often include: 1. Lateral approach (Kocher approach): It is difficult to expose the ulnar coronoid process through the lateral approach, with a large dissection range. It is generally selected when combined with radial head fractures and is applicable when the radial head needs to be replaced. Only after removing the fracture fragment can the coronoid process be better exposed. It is only applicable to patients with radial head resection. If the radial head does not need to be resected, the lateral approach should not be chosen. 2. Posterior midline approach: It is only applicable when combined with the proximal ulna. The coronoid process can be exposed through the ulnar fracture end. The disadvantage is that sometimes the ulnar nerve needs to be exposed, with relatively large soft tissue trauma and difficulty in reducing and fixing the lateral bone fragment. 3. Medial approach: Due to the obstruction of the pronator and flexor muscle groups, it is difficult to expose the coronoid process. The "over-the-top" approach is required to expose the coronoid process. The medial approach often requires freeing the ulnar nerve, which is prone to nerve symptoms. The dissection range is extensive, and sometimes even medial epicondyle osteotomy is required. Exposure and operation are difficult, and it is also difficult to fix the anterior and posterior vertical fracture lines. 4. Anteromedial approach: It is a modified medial approach. The coronoid process is exposed through the interval between the pronator teres and the flexor carpi radialis via an anteromedial skin incision of the elbow joint. The medial collateral ligament can be explored and repaired simultaneously. The disadvantage is that it is easy to damage the branches of the median nerve innervating the pronator teres, flexor carpi radialis, and palmaris longus. 5. Anterior approach: It is an approach through the space between the nerve (median nerve) and blood vessels (brachial artery and vein), with its unique advantages, including simple anatomical layers, clear exposure, effective avoidance of nerve and blood vessel injuries, easy to master and apply, less tissue dissection required during the operation, avoidance of damaging the normal anatomical structure of the elbow joint, reduction of the risk of heterotopic ossification formation, and wide and clear surgical field. Reduction and operation can be performed directly under vision, vertical compression can be applied to the fracture fragment, the fixation is strong and reliable, early functional exercise can be carried out, and rehabilitation is easy. This approach has a wide range of indications and is applicable not only to simple ulnar coronoid process fractures but also to well-expose the humeral coronoid fossa and trochlea of the humerus. It is especially applicable to medial coronoid shear fractures of the distal humerus and the treatment of terrible triad combined with other approaches.

[0004] There are so many surgical approaches for ulnar coronoid process fractures because the anatomical structures around the ulnar coronoid process are complex, and combined with the diversity of fractures, the fixation methods are even more diverse, including sutures, Kirschner wires, anchor screws, anatomical plates, cannulated screws, metacarpophalangeal plates combined with Kirschner wires, and even loop plates, etc., which vary. At present, no surgical approach and internal fixation material have absolute advantages for ulnar coronoid process fractures. In recent years, minimally invasive and refined treatment has been emphasized in trauma orthopedics. Exploring the surgical approach and improving and innovating surgical instruments are the necessary ways to explore fracture treatment methods. Due to the complexity of the treatment approach for ulnar coronoid process fractures and the lack of specific internal fixation materials for this fracture, it is necessary to provide an ulnar coronoid process bone plate in combination with the approach method. Utility Model Content

[0005] Aiming at the deficiencies of the prior art, the purpose of the present utility model is to provide an ulnar coronoid process bone plate through the anterior approach, which solves the problems in the prior art that after bone connection of the ulnar coronoid process fracture through the anterior approach, the stability in front of the elbow joint is poor, the irritation to local soft tissues is large, the contact and fixation strength with the ulnar coronoid process is low, the postoperative healing effect is poor, and stress fractures are likely to occur.

[0006] The present utility model discloses an ulnar coronoid process bone plate through the anterior approach. The bone plate realizes bone connection of the ulnar coronoid process through the anterior approach. The total length of the bone plate is less than 2.5 cm. The bone plate is of a T-shaped structure. The bone plate includes an adaptation plate and a fixing plate. The adaptation plate is located above the fixing plate. The adaptation plate and the fixing plate are angularly connected. The adaptation plate is used to adapt to the distal lateral column of the ulnar coronoid process. The adaptation plate includes a positioning hole and suture holes arranged on both sides of the positioning hole. The fixing plate is narrower than the width of the adaptation plate. The fixing plate is provided with an adjustment hole and a fixing hole. The adjustment hole is located between the positioning hole and the fixing hole. The adjustment hole is used to realize the adaptation adjustment of the bone plate to the distal lateral column. Wherein, the total length is the total distance between the top end of the adaptation plate and the bottom end of the fixing plate.

[0007] In some embodiments, the suture holes are of an elliptical structure.

[0008] In some embodiments, the angle between the adaptation plate and the fixing plate is 10° - 30°.

[0009] In some embodiments, both sides of the adaptation plate are of an arc structure.

[0010] In some embodiments, the suture holes are symmetrically arranged on both sides of the positioning hole.

[0011] In some embodiments, the aperture of the positioning hole is 2.2 mm - 2.4 mm.

[0012] In some embodiments, the first aperture at one end of the adjustment hole close to the positioning hole is smaller than the second aperture at one end close to the fixing hole.

[0013] In some embodiments, the first aperture is 2.2 mm - 2.4 mm, and the second aperture is 2.4 mm - 2.7 mm.

[0014] In some embodiments, the aperture of the adjustment hole gradually increases according to a target increment from the end close to the positioning hole to the end close to the fixing hole.

[0015] In some embodiments, the aperture of the fixing hole is 2.2 mm - 2.4 mm.

[0016] The utility model includes but is not limited to the following beneficial effects: (1) The size of the bone plate in this application is designed such that the length of the entire bone plate is less than 2.5 cm, which is beneficial to avoiding local soft tissue irritation and early postoperative functional exercise; (2) The bone plate in this application adopts a "T-shaped" design with a wider upper part and a narrower lower part, which can fit tightly against the distal lateral column of the ulnar coronoid process, improving the fit between the bone plate and the distal lateral column; the wide end can cover a larger bone area, thereby increasing the contact area and fixation strength between the bone plate and the ulnar coronoid process, improving the stability of the overall component, and the narrow end is convenient for implantation into the narrow medullary cavity to further enhance fixation. Moreover, the design of the bone plate with a wider upper part and a narrower lower part can better disperse stress, avoid excessive stress concentration at specific sites, and reduce the risk of bone plate fracture; (3) The adapter plate is angularly connected to the fixing plate, improving the adaptability of the bone plate to the ulnar coronoid process; (4) The two sides of the adapter plate are designed as arc structures, which can avoid right-angle edges, reduce stress concentration, and lower the risk of stress fracture when the bone plate and the ulnar coronoid process are stressed; (5) Suture holes are provided on the bone plate, which can facilitate suture fixation on the bone cortex or periosteum around the bone plate. This can not only enhance the fixation between the bone plate itself and the bone, but also prevent its displacement, thereby improving the overall fixation stability; in addition, by performing suture fixation around the bone plate, it can drive the surrounding soft tissues to better adhere to the bone, which is beneficial to the jointing and blood supply of the fracture end, thus promoting the fracture healing process; furthermore, during the operation, the suture holes can be used to finely adjust the position and angle of the bone plate to achieve a better correction and fixation effect; moreover, the setting of the suture holes enables the bone plate to perform multi-point fixation with the surrounding bone tissue, improving the anti-breaking force of the overall component and reducing the risk of fracture of the bone plate itself; furthermore, when the bone plate is sutured and fixed through the suture holes, it can drive the repair of surrounding soft tissues such as tendons and ligaments together, which is beneficial to the postoperative functional recovery; (6) Adjustment holes are provided, which allow doctors to adjust the position and angle of the bone plate according to needs during the operation to better adapt to the fracture line and bone quality conditions. In addition, the design of the sliding holes can better disperse the stress distribution around the bone plate, reduce stress concentration, and lower the risk of stress fracture of the bone plate. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] In order to more clearly illustrate the technical solutions in the embodiments of the present utility model or the prior art, the following will briefly introduce the drawings required for use in the description of the embodiments or the prior art.

[0018] Figure 1 It is a schematic structural diagram of the ulnar coronoid process bone plate through the anterior approach described in the present utility model;

[0019] Figure 2 It is a planar schematic diagram of an angle of the ulnar coronoid process bone plate through the anterior approach described in the present utility model;

[0020] Figure 3 It is a schematic plan view of another angle of the ulnar coronoid process bone plate through the anterior approach according to the present utility model;

[0021] In the figure, 1 - bone plate, 2 - adapter plate, 3 - fixing plate, 4 - positioning hole, 5 - suture hole, 6 - adjusting hole, 7 - fixing hole. Specific embodiments

[0022] Next, the technical solutions in the embodiments of the present utility model will be clearly and completely described in conjunction with the accompanying drawings in the embodiments of the present utility model. For the embodiments of the present utility model, all other embodiments obtained by those of ordinary skill in the art without making creative efforts shall fall within the protection scope of the present utility model.

[0023] The present utility model discloses an ulnar coronoid process bone plate through the anterior approach. The bone plate 1 realizes the bone connection of the ulnar coronoid process through the anterior approach. As Figures 1 to 3 shown, the total length of the bone plate 1 is less than 2.5 cm. The bone plate 1 is of a T-shaped structure. The bone plate 1 includes an adapter plate 2 and a fixing plate 3. The adapter plate 2 is located above the fixing plate 3. The adapter plate 2 and the fixing plate 3 are angularly connected. The adapter plate 2 is used to adapt to the distal lateral column of the ulnar coronoid process. The adapter plate 2 includes a positioning hole 4 and suture holes 5 arranged on both sides of the positioning hole 4; the fixing plate 3 is narrower than the width of the adapter plate 2. The fixing plate 3 is provided with an adjusting hole 6 and a fixing hole 7. The adjusting hole 6 is located between the positioning hole 4 and the fixing hole 7. The adjusting hole 6 is used to realize the adaptation adjustment between the bone plate 1 and the distal lateral column. Among them, the total length is the total distance between the top end of the adapter plate 2 and the bottom end of the fixing plate 3. Exemplarily, this total distance is the straight-line distance between the top end of the adapter plate 2 and the bottom end of the fixing plate 3.

[0024] In this embodiment, the size of the bone plate 1 is designed such that the length of the entire bone plate 1 is less than 2.5 cm, which is beneficial to avoiding the irritation of local soft tissues and early postoperative functional exercise; further, the bone plate 1 adopts the "T-shaped" design with a wider upper part and a narrower lower part, which can fit more tightly to the distal lateral column of the ulnar coronoid process, improving the adaptability between the bone plate 1 and the distal lateral column; the wide end can cover a larger bone area, thereby increasing the contact area and fixing strength with the ulnar coronoid process, improving the stability of the overall component. The narrow end is convenient for implantation into the narrow medullary cavity to further enhance fixation. Moreover, the design of the bone plate 1 with a wider upper part and a narrower lower part can better disperse stress, avoid excessive stress concentration at specific sites, and reduce the risk of fracture of the bone plate 1; further, the angular connection between the adapter plate 2 and the fixing plate 3 improves the adaptability of the bone plate 1 to the ulnar coronoid process.

[0025] In some embodiments, the suture hole 5 is an oval structure. The oval suture hole 5 can allow the suture to be adjusted translationally to a certain extent within the hole, enabling the doctor to optimize the arrangement of the suture position according to the actual situation, thereby improving the convenience of surgical operation. It can be understood that the suture hole 5 can also be designed as a circular structure. It can be understood that the suture hole 5 with a circular structure design is simpler and faster to manufacture, which can reduce production costs. Further, the suture hole 5 with a circular structure does not require the directionality of the suture, providing greater flexibility for the doctor's operation during the surgery. It can be understood that the suture hole 5 can also be of other shapes, which can be specifically set according to actual needs and will not be specifically limited here. It can be understood that the suture hole 5 is provided on the bone plate 1, which can facilitate suturing and fixing on the bone cortex or periosteum around the bone plate 1. This can not only enhance the fixation between the bone plate 1 itself and the bone, but also prevent its displacement, thereby improving the overall fixation stability. Additionally, by performing suturing and fixing around the bone plate 1, it can drive the surrounding soft tissues to better adhere to the bone, which is beneficial to the jointing and blood supply of the fracture end, thus promoting the fracture healing process. Moreover, during the surgery, the position and angle of the bone plate 1 can be finely adjusted by using the suture hole 5 to achieve a better correction and fixation effect. Moreover, the setting of the suture hole 5 enables the bone plate 1 to perform multi-point fixation with the surrounding bone tissue, improving the anti-breaking force of the overall component and reducing the risk of fracture of the bone plate 1 itself. Moreover, when the bone plate 1 is sutured and fixed through the suture hole 5, it can drive the repair of surrounding soft tissues such as tendons and ligaments together, which is beneficial to the recovery of function after the surgery.

[0026] In some embodiments, the angle between the adapter plate 2 and the fixing plate 3 is 10° - 30°. The angle design of the bone plate 1 can better fit the anatomical surface of the ulnar coronoid process, reduce the gap between the plate and the bone, improve the fixation stability of the bone plate, and reduce stress concentration. Additionally, the angle design of the bone plate can better transfer the stress evenly to the ulnar coronoid process, reduce stress concentration, and lower the risk of stress fracture during the fracture healing process. Moreover, during the surgery, the doctor does not need to perform large-scale bending and trimming on the bone plate, which can reduce the complexity of the surgical operation. Preferably, in this example, the angle is preferably 15°.

[0027] In some embodiments, both sides of the adapter plate 2 are arc structures.

[0028] In some embodiments, the suture holes 5 are symmetrically arranged on both sides of the positioning holes 4. The arc design can avoid right-angle edges, reduce stress concentration, and lower the risk of stress fracture when the bone plate 1 and the ulnar coronoid process are stressed.

[0029] In some embodiments, the aperture diameter of the positioning hole 4 may be 2.2 mm to 2.4 mm. The first aperture diameter at one end of the adjustment hole 6 close to the positioning hole 4 is smaller than the second aperture diameter at the end close to the fixing hole 7. In some embodiments, the first aperture diameter may be 2.2 mm to 2.4 mm, and the second aperture diameter may be 2.4 mm to 2.7 mm.

[0030] In some embodiments, the aperture diameter of the adjustment hole 6 gradually increases according to a target increment from the end close to the positioning hole 4 to the end close to the fixing hole 7. In some embodiments, the aperture diameter of the fixing hole 7 may be 2.2 mm to 2.4 mm.

[0031] By providing the adjustment hole 6, the doctor can adjust the position and angle of the bone plate 1 during the operation according to the needs, better adapting to the fracture line and bone quality conditions. In addition, the design of the sliding hole can better disperse the stress distribution around the bone plate 1, reduce stress concentration, and reduce the risk of stress fracture of the bone plate 1. The adjustment hole 6 can accommodate ordinary cortical screws with a diameter of 2.4 mm to 2.7 mm. This adjustable screw hole design allows the doctor to select a suitable screw specification according to the actual situation to adapt to the bone quality conditions of different patients.

[0032] The above shows and describes the basic principles, main features and advantages of the present invention. Those skilled in the art should understand that the present invention is not limited by the above embodiments. What is described in the above embodiments and the specification only illustrates the principles of the present invention. Without departing from the spirit and scope of the present invention, the present invention will have various changes and improvements, and these changes and improvements all fall within the scope of the present invention claimed.

Claims

1. An ulnar coronoid process osteosynthesis plate via an anterior approach, characterized in that, The bone plate (1) realizes bone connection of the coronoid process of the ulna through an anterior approach. The total length of the bone plate (1) is less than 2.5 cm. The bone plate (1) is of a T-shaped structure. The bone plate (1) includes an adaptation plate (2) and a fixing plate (3). The adaptation plate (2) is located above the fixing plate (3). The adaptation plate (2) is angularly connected to the fixing plate (3). The adaptation plate (2) is used to adapt to the distal lateral column of the coronoid process of the ulna. The adaptation plate (2) includes a positioning hole (4) and suture holes (5) arranged on both sides of the positioning hole (4). The width of the fixing plate (3) is narrower than the width of the adaptation plate (2). The fixing plate (3) is provided with an adjustment hole (6) and a fixing hole (7). The adjustment hole (6) is located between the positioning hole (4) and the fixing hole (7). The adjustment hole (6) is used to realize the adaptation adjustment of the bone plate (1) to the distal lateral column. Wherein, the total length is the total distance between the top end of the adaptation plate (2) and the bottom end of the fixing plate (3).

2. The ulnar coronoid process osteosynthesis plate via the anterior approach according to claim 1, characterized in that The suture hole (5) is of an oval structure.

3. The ulnar coronoid process osteosynthesis plate through the anterior approach according to claim 1, characterized in that, The angle between the adaptation plate (2) and the fixing plate (3) is 10°-30°.

4. The ulnar coronoid process osteosynthesis plate via the anterior approach according to claim 1 or 3, characterized in that, Both sides of the adaptation plate (2) are of an arc structure.

5. The ulnar coronoid process osteosynthesis plate via the anterior approach according to claim 1 or 2, characterized in that, The suture holes (5) are symmetrically arranged on both sides of the positioning hole (4).

6. The ulnar coronoid process osteosynthesis plate via the anterior approach according to claim 5, characterized in that, The aperture of the positioning hole (4) is 2.2 mm - 2.4 mm.

7. The ulnar coronoid process locking plate through the anterior approach according to claim 6, characterized in that, The first aperture at one end of the adjustment hole (6) close to the positioning hole (4) is smaller than the second aperture at the end close to the fixing hole (7).

8. The ulnar coronoid process osteosynthesis plate via the anterior approach according to claim 7, characterized in that, The first aperture is 2.2 mm - 2.4 mm, and the second aperture is 2.4 mm - 2.7 mm.

9. The ulnar coronoid process osteosynthesis plate via the anterior approach according to claim 7, wherein The aperture of the adjustment hole (6) gradually increases according to a target increment from the end close to the positioning hole (4) to the end close to the fixing hole (7).

10. The ulnar coronoid process bone plate via the anterior approach according to claim 7 or 9, characterized in that The aperture of the fixing hole (7) is 2.2 mm - 2.4 mm.

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