Fixing device for improving fracture stability of HTO hinge

Abstract

A fixing device for improving fracture stability of an HTO hinge comprises a supporting plate, an attached wing plate, a first locking nail, a second locking nail and a plurality of fixing screws. The wing-attached wing plate is fixed to the supporting plate through a first locking nail, and a second locking nail is driven into the wing-attached wing plate from the rear inner side to the front outer side. The novel fixing device is provided for the outer hinge fracture in the inner side opening wedge-shaped tibia high-position osteotomy, the side wing plate is additionally arranged on the basis of an original supporting plate, the second locking nail which is nailed from the upper portion of the rear inner side to the lower portion of the front outer side is provided for supporting, and therefore the stability of the fracture is improved.

Description

Technical Field

[0001] The utility model belongs to the technical field of tibia surgery related equipment, and particularly relates to a fixing device for increasing the stability of HTO hinge fractures. Background Technique

[0002] Medial knee osteoarthritis is caused by the destruction of articular cartilage in the medial compartment and meniscus wear in the medial compartment, resulting in narrowing of the medial joint space and varus deformity of the knee joint, thereby causing knee pain.

[0003] High tibial osteotomy (HTO) is a lower limb alignment adjustment surgery. By osteotomizing the tibia, the knee joint alignment is adjusted from the worn medial compartment to the relatively normal lateral compartment, thereby slowing down the destruction of the medial compartment to treat medial knee osteoarthritis and extending the service life of the knee joint. Medial open wedge high tibial osteotomy (MOWHTO) has gradually become the mainstream surgical method for treating knee varus deformity due to its advantages such as simple surgical operation, accurate adjustment of the correction angle during the operation, no risk of common peroneal nerve injury, and no need for fibular osteotomy. However, the overall incidence of complications of this surgery is 29.7%, and lateral hinge fractures (LHFs) are the most common complications among them. LHFs are divided into 3 types according to the direction of the fracture line: Type I, the fracture line extends outward to the proximal or medial side of the superior tibiofibular joint; Type II, the fracture line extends to the distal side of the superior tibiofibular joint; Type III, the fracture line extends to the lateral tibial plateau. LHFs can lead to delayed healing, nonunion, malunion of the tibial osteotomy surface, loss of orthopedic angle, and failure of internal fixation. It is very important to avoid the occurrence of lateral hinge fractures and the adverse consequences caused by them after the occurrence of lateral hinge fractures.

[0004] For Type I fractures, there is soft tissue wrapping around the lateral hinge. Even if the bony hinge is broken, as long as the soft tissue hinge remains, it is only necessary to use a lag screw for reduction and fixation and maintain the alignment. After the operation, the patient can recover normally and has a good prognosis. For Type II fractures, there is only the interosseous membrane below the superior tibiofibular joint between the distal and proximal ends of the osteotomy, so Type II fractures are unstable. First, use a lag screw for reduction and adjust the alignment. Then perform structural bone grafting and delayed weight-bearing. For Type III fractures, first remove the distractor at the osteotomy site. At this time, the fracture end will automatically reduce. Insert a lag screw from the outside to the inside to temporarily fix the fracture end of the tibial plateau. Then further deepen the osteotomy line with a saw or osteotome until a 1-cm hinge is retained, and then perform distraction. After adjusting the alignment, perform internal fixation. The patient is also required to perform structural bone grafting and delayed weight-bearing.

[0005] Therefore, for type II and type III fractures of LHFs, the fractures are unstable, and complications such as loss of orthopedic angle, nonunion, and failure of internal fixation are likely to occur on the tibial osteotomy surface of the patient. For such complications, a new type of fixation device is urgently needed to solve this problem. Summary of the Invention

[0006] The purpose of the present utility model is to overcome the shortcomings of the prior art and provide a fixation device that increases the stability of HTO hinge fractures.

[0007] The present utility model adopts the following technical solutions:

[0008] A fixation device for increasing the stability of HTO hinge fractures, comprising a support plate, an attached wing plate, a first locking screw, a second locking screw, and a plurality of fixing screws;

[0009] The support plate includes a connecting head arranged in a T shape, a support rod body arranged at the lower end of the connecting head, a plurality of first fixing screw holes arranged at intervals on the connecting head, and a plurality of second fixing screw holes arranged at intervals on the support rod body;

[0010] The attached wing plate is detachably arranged on one side of the upper end of the connecting head, and includes a connecting section that fits on the inner side of the proximal tibial plateau and is connected to the connecting head, a stability increasing section arranged at the lower end of the connecting section, a first locking screw hole arranged on the connecting section opposite to a first fixing screw hole, and a second locking screw hole arranged on the stability increasing section. A positioning groove for the upper end side of the connecting head to be embedded is formed on the relative surface between the connecting section and the connecting head;

[0011] The first locking screw passes through the first locking screw hole and cooperates with the opposite first fixing screw hole to fix the attached wing plate on the connecting head and make the connecting section fit on the inner side of the proximal tibial plateau;

[0012] The second locking screw cooperates with the second locking screw hole. In the sagittal plane, its axis forms an angle of 40 - 45° with the tibial bearing; in the coronal plane, its axis forms an angle of 45 - 50° with the tibial axis;

[0013] A plurality of fixing screws respectively cooperate with a plurality of second fixing screw holes and the remaining first fixing screw holes, so that the connecting head wraps the inner side of the proximal tibial plateau and is fixed, and the support rod body fits on the inner side surface of the tibial shaft and is fixed.

[0014] Furthermore, the first locking screw includes a first locking screw head and a first locking screw rod. The first locking screw head is designed with a flat head, and the thread of the first locking screw rod is adapted to the thread of the first fixing screw hole.

[0015] Furthermore, the connecting head includes a main body section and an extension section that extends downward from the lower end of the main body section and is connected to the support rod body. One side of the main body section is embedded in the relative positioning groove, and the stability increasing section is arranged on one side of the extension section and cooperates with the extension section to fit on the curved surface of the tibial bone surface.

[0016] Further, an arc-shaped limiting portion capable of supporting the lower end of the main body segment is formed in the positioning groove.

[0017] Further, the plurality of first fixing screw holes include three first upper fixing screw holes horizontally arranged on the main body segment and one first lower fixing screw hole arranged on the extension segment. The first locking screw hole is opposite to one of the first upper fixing screw holes, and the first lower fixing screw hole is vertically opposite to the middle first upper fixing screw hole.

[0018] Further, the plurality of second fixing screw holes are vertically arranged on the support rod body.

[0019] Further, the support plate further includes a pressure hole arranged on the support rod body, and the pressure hole is partially overlapped with the first second fixing screw hole.

[0020] Further, an arc surface extending from the outside to the inside is formed on one side of the stability-increasing segment close to the connecting head.

[0021] Further, the second locking nail includes a second locking nail head and a second locking screw rod. The second locking nail head is designed with a flat head, and the thread of the second locking screw rod is adapted to the thread of the second locking screw hole.

[0022] Further, the end of the second locking screw rod is conical.

[0023] As can be seen from the above description of the present invention, compared with the prior art, the beneficial effects of the present invention are as follows: The present invention is a new fixing device proposed for the fracture of the lateral hinge in the medial opening wedge high tibial osteotomy. An additional wing plate is added on the basis of the original support plate, and a second locking nail driven from the posterior medial upper part to the anterior lateral lower part is provided for support, thereby improving the stability of the fracture. It has the following advantages compared with the traditional support plate: (1) In terms of treatment: The additional wing plate and the second locking nail make the stability of the hinge fracture better, thereby reducing the occurrence of complications such as nonunion, malunion, and loss of orthopedic angle; (2) Quality improvement: This device can also be routinely used in the medial opening wedge high tibial osteotomy orthopedics without hinge fracture, increasing the stability of fixation; (3) Simple operation: In the medial opening wedge high tibial osteotomy orthopedics, whether it is used routinely or as a remedy after the occurrence of hinge fracture, the operation is simple, and there is no need to increase too much operation time and the complexity of the operation; (4) Patient feedback: Compared with the traditional treatment methods for hinge fracture, such as bone grafting and delayed weight-bearing, the device of the present invention can shorten the hospitalization time of patients and accelerate the recovery of patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Figure 1 Schematic diagram of the use state of the fixing device;

[0025] Figure 2 Structural schematic of the fixing device Figure 1 ;

[0026] Figure 3 Structural schematic of the fixing device Figure 2 ;

[0027] Figure 4 Structural schematic of the attached wing plate Figure 1 ;

[0028] Figure 5 Structural schematic of the attached wing plate Figure 2 ;

[0029] Figure 6 Structural schematic diagram of the first locking screw;

[0030] In the figure, 1 - support plate, 2 - attached wing plate, 3 - first locking nail, 4 - second locking nail, 5 - fixing screw, 11 - connecting head, 111 - main body section, 112 - extension section, 12 - support rod body, 13 - first fixing screw hole, 131 - first upper fixing screw hole, 132 - first lower fixing screw hole, 14 - second fixing screw hole, 15 - pressure hole, 21 - connecting section, 211 - positioning groove, 212 - arc-shaped limiting part, 22 - stability-increasing section, 221 - arc surface, 23 - first locking screw hole, 24 - second locking screw hole, 31 - first locking nail head, 32 - first locking screw rod, 41 - second locking nail head, 42 - second locking screw rod. Specific embodiments

[0031] The following further describes the present utility model through specific embodiments.

[0032] Referring to Figures 1 to 6 shown, a fixing device for increasing the stability of HTO hinge fractures includes a support plate 1, an attached wing plate 2, a first locking nail 3, a second locking nail 4, and a plurality of fixing screws 5.

[0033] The support plate 1 includes a connecting head 11 arranged in a T shape, a support rod body 12 arranged at the lower end of the connecting head 11, a plurality of first fixing screw holes 13 arranged at intervals on the connecting head 11, a plurality of second fixing screw holes 14 arranged at intervals on the support rod body 12, and a pressure hole 15 arranged on the support rod body 12. Among them, the connecting head 11 wraps the inner side of the proximal tibial plateau, and the support rod body 12 fits against the outer side of the tibial shaft.

[0034] Connector 11, including a main body section 111 and an extension section 112 extending downward from the lower end of the main body section 111 and connected to the support rod body 12. Among them, the extension section 112 fits the curved surface of the tibial bone surface. Specifically, the connector 11 is in a spherical bending shape that fits the inner side of the proximal tibial plateau, so that the connector 11 wraps the inner side of the proximal tibial plateau and is fixed. And after fixation, the surface curvature of the inner side surface of the connector 11 in contact with the tibia is consistent with the surface curvature of the inner column of the proximal tibial plateau, so that the connector 11 can better fit the surface of the inner column of the proximal tibial plateau and enhance the fixation effect.

[0035] Multiple first fixing screw holes 13, including three first upper fixing screw holes 131 arranged horizontally on the main body section 111 and one first lower fixing screw hole 132 arranged on the extension section 112. Specifically, the first lower fixing screw hole 132 is vertically opposite to the middle first upper fixing screw hole.

[0036] Multiple second fixing screw holes 14 are arranged vertically on the support rod body 12. Specifically, the multiple second fixing screw holes 14 are staggered on the support rod body 12.

[0037] The pressure hole 15 is arranged overlapping with the first second fixing screw hole in the first position. By setting the pressure hole 15, the fixing effect of the support rod body 12 on the tibial shaft is improved. Specifically, the number and setting position of the pressure holes 15 are not limited to the specific way defined by itself. The number of the pressure holes 1 can be increased according to actual needs and its cooperation with the multiple second fixing screw holes 14, thereby improving the fixing effect on the tibial shaft.

[0038] The attached wing plate 2 is detachably arranged on one side of the upper end of the connector 11, including a connecting section 21 arranged on one side of the main body section 111 and fitting the inner side of the proximal tibial plateau, a stability increasing section 22 arranged at the lower end of the connecting section 21, a first locking screw hole 23 arranged on the connecting section 21 opposite to the first upper fixing screw hole 131 on the side of the main body section 111, and a second locking screw hole 24 arranged on the stability increasing section 22.

[0039] The connecting section 21 and the opposite surface of the main body section 111 form a positioning groove 211 for one side of the main body section 111 to be embedded. During use, one side of the main body section 111 is embedded in the positioning groove 211, so that the connecting section 21 is stacked on one side of the upper end of the connector 11, reducing the volume of the attached wing plate 2, without the need to expand the surgical incision, and with a low-profile design, reducing soft tissue irritation. Further, an arc-shaped limiting portion 212 that can support the lower end of the main body section 111 is formed in the positioning groove 211. When one side of the main body section 111 is embedded in the positioning groove 211, its lower end is supported on the arc-shaped limiting portion 212, which plays a preliminary positioning role in the installation of the attached wing plate 2 and the connector 11, and minimizes the displacement between the two when the first locking screw 3 works.

[0040] The stability enhancement section 22 is arranged on one side of the extension section 112 and cooperates with the extension section 112 to fit onto the curved surface of the tibial bone surface. An arc surface 221 extending inward from the outer side is formed on the side of the stability enhancement section 22 close to the connecting head 11, so as to avoid scratching human tissues by the attached wing plate 2 and reduce the irritation to tissues.

[0041] The first locking screw 3 passes through the first locking screw hole 23 and cooperates with the first fixing upper screw hole 131 to fix the attached wing plate 2 on the connecting head 11 and make the connecting section 21 fit onto the inner side of the proximal tibial plateau. The first locking screw 3 includes a first locking screw head 31 and a first locking screw rod 32. Among them, the first locking screw head 31 is designed with a flat head and can squeeze the attached wing plate 2 onto the main body section 111; the thread of the first locking screw rod 32 is adapted to the thread of the first fixing upper screw hole 131, providing the stability for the connection between the main body section 111 and the attached wing plate 2.

[0042] The second locking screw 4 cooperates with the second locking screw hole 24. In the sagittal plane, the axis of the second locking screw 4 inserted forms an angle of 40 - 45° with the tibial axis; in the coronal plane, the axis of the second locking screw 4 inserted forms an angle of 45 - 50° with the tibial axis; through the cooperation of the second locking screw 4 and the attached wing plate 2 and restricting its specific insertion position, additional support is provided, thereby improving the stability of the HTO fracture; specifically, the second locking screw 4 includes a second locking screw head 41 and a second locking screw rod 42, the second locking screw head 41 is designed with a flat head; the thread of the second locking screw rod 42 is adapted to the thread of the second locking screw hole 24, and its end is tapered.

[0043] Multiple fixing screws 5 respectively cooperate with multiple second fixing screw holes 14 and the remaining first fixing screw holes 13 to wrap and fix the connecting head 11 on the inner side of the proximal tibial plateau, and the support rod body 12 fits onto and is fixed to the inner side surface of the tibial shaft; during the operation for fixation, the drilling depth can be accurately measured by a detector, so as to select the corresponding screw length specification.

[0044] The present utility model is a novel fixing device proposed for the fracture of the lateral hinge in the medial opening wedge high tibial osteotomy. An attached wing plate 2 is added on the basis of the original support plate 1, and a second locking nail 4 driven from the posterior medial to the anterior lateral is provided for support, thereby improving the stability of the fracture. Compared with the traditional support plate, it has the following advantages: (1) In terms of treatment: The additional attached wing plate 2 and the second locking nail 4 make the stability of the hinge fracture better, thereby reducing the occurrence of complications such as nonunion, malunion, and loss of orthopedic angle; (2) Quality improvement: This device can also be routinely used in the medial open wedge high tibial osteotomy without hinge fracture to increase the stability of fixation; (3) Simple operation: In the medial open wedge high tibial osteotomy, whether it is routinely applied or used as a remedy after the occurrence of hinge fracture, the operation is simple and does not require excessive operation time and complexity; (4) Patient feedback: Compared with the traditional treatment methods for hinge fracture, such as bone grafting and delayed weight-bearing, the device of the present utility model can shorten the hospitalization time of patients and accelerate the recovery of patients.

[0045] In summary, the fixing device defined in the present application, by adding an attached wing plate 2 on the support plate 1 and cooperating with the first locking nail 3 and the second locking nail 4, is re-integrated into a complete fixing device, providing a more stable biomechanical environment for the stability of the HTO hinge fracture, and being more firm and reliable than the existing internal fixation of the support plate.

[0046] The above is only a preferred embodiment of the present utility model, and thus cannot limit the scope of implementation of the present utility model. That is, equivalent changes and modifications made according to the scope of the present utility model application and the content of the specification should still fall within the scope covered by the present utility model application.

Claims

1. A fixing device for increasing the stability of HTO hinge fractures, characterized in that: It includes a support plate, an attached wing plate, a first locking screw, a second locking screw and a plurality of fixing screws; The support plate includes a connecting head arranged in a T shape, a support rod body arranged at the lower end of the connecting head, a plurality of first fixing screw holes arranged at intervals on the connecting head, and a plurality of second fixing screw holes arranged at intervals on the support rod body; The attached wing plate is detachably arranged on one side of the upper end of the connecting head. It includes a connecting section attached to the inner side of the proximal tibial plateau and connected to the connecting head, a stability-enhancing section arranged at the lower end of the connecting section, a first locking screw hole arranged on the connecting section opposite to a first fixing screw hole, and a second locking screw hole arranged on the stability-enhancing section. A positioning groove for the upper end side of the connecting head to be embedded is formed on the opposite surface between the connecting section and the connecting head; The first locking screw passes through the first locking screw hole and cooperates with the opposite first fixing screw hole to fix the attached wing plate on the connecting head and make the connecting section fit against the inner side of the proximal tibial plateau; The second locking screw cooperates with the second locking screw hole. In the sagittal plane, its axis forms an angle of 40-45° with the tibial bearing; in the coronal plane, its axis forms an angle of 45-50° with the tibial axis; A plurality of fixing screws respectively cooperate with a plurality of second fixing screw holes and the remaining first fixing screw holes, so that the connecting head wraps and fixes the inner side of the proximal tibial plateau, and the support rod body fits against and is fixed to the inner side surface of the tibial shaft.

2. The fixing device for increasing the stability of HTO hinge fractures according to claim 1, wherein: The first locking screw includes a first locking screw head and a first locking screw rod. The first locking screw head is designed with a flat head, and the thread of the first locking screw rod is adapted to the thread of the first fixing screw hole.

3. The fixing device for increasing the stability of HTO hinge fractures according to claim 1, characterized in that: The connecting head includes a main body section and an extension section extending downward from the lower end of the main body section and connected to the support rod body. One side of the main body section is embedded in the opposite positioning groove, and the stability-enhancing section is arranged on one side of the extension section and cooperates with the extension section to fit against the curved surface of the tibial bone surface.

4. A fixing device for increasing the stability of HTO hinge fractures according to claim 3, characterized in that: An arc-shaped limiting part that can support the lower end of the main body section is formed in the positioning groove.

5. The fixing device for increasing the stability of HTO hinge fractures according to claim 3, characterized in that: The plurality of first fixing screw holes include three first upper fixing screw holes arranged horizontally on the main body section and one first lower fixing screw hole arranged on the extension section. The first locking screw hole is opposite to a first upper fixing screw hole, and the first lower fixing screw hole is arranged vertically opposite to the middle first upper fixing screw hole.

6. The fixing device for increasing the stability of HTO hinge fractures according to claim 1, characterized in that: The plurality of second fixing screw holes are arranged vertically on the support rod body.

7. A fixing device for increasing the stability of HTO hinge fractures according to claim 6, characterized in that: The support plate further includes a pressurizing hole arranged on the support rod body, and the pressurizing hole is partially overlapped with the first second fixing screw hole in the first position.

8. A fixing device for increasing the stability of HTO hinge fractures according to claim 1, characterized in that: An arc surface extending from the outside to the inside is formed on the side of the stability-enhancing section close to the connecting head.

9. A fixing device for increasing the stability of HTO hinge fractures according to claim 1, characterized in that: The second locking screw includes a second locking screw head and a second locking screw rod. The second locking screw head is designed with a flat head, and the thread of the second locking screw rod is adapted to the thread of the second locking screw hole.

10. A fixing device for increasing the stability of HTO hinge fractures according to claim 9, characterized in that: The end of the second locking screw rod is conical.

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