Tibial plateau posterior lateral fixing device

Abstract

A tibial plateau posterior lateral fixing device comprises a fixing steel plate and screws. The fixing steel plate comprises a C-shaped steel plate body, a binding face which is formed on the inner side of the C-shaped steel plate body and used for being attached to sclerotin under a tibial plateau articular surface, one or more fixing screw holes formed in the front end of the C-shaped steel plate body, and positioning holes which are formed in the rear end of the C-shaped steel plate body and are opposite to the one or more fixing screw holes. The screws are matched with the one or more fixing screw holes, and the tail ends of the screws can be clamped in the positioning holes; according to the fixing device limited by the application, the injury risk of nerve, blood vessel and tendon caused by a complicated anatomical structure of a conventional rear side approach is avoided; the C-shaped steel plate body can penetrate through a gap between an outer side collateral ligament and a tibial condyle above a fibula head and wrap the rear outer side of a tibial plateau, so that extrusion supporting of a blind area bone block on the rear outer side is achieved; and the two screws are clamped into the rear positioning holes to form a frame structure, so that the fixing device has good mechanical stability.

Description

TECHNICAL FIELD

[0001] The utility model belongs to the field of fracture fixation apparatus, specifically relates to a tibial plateau posterolateral fixation device. BACKGROUND

[0002] Tibial plateau fracture (TPF) is a common fracture in clinical trauma orthopedics, which is usually caused by high-energy impact factors such as traffic accidents, and posterolateral tibial plateau fracture can cause obvious swelling, local pain and limited activity of the knee joint. When the knee joint is flexed, the posterolateral platform of the tibia is extremely important for stabilizing the posterolateral knee joint, and if the fracture is not well reduced and fixed, the patient will have obvious discomfort and dysfunction. Therefore, the purpose of surgical treatment is to restore the flatness of the articular surface and maximize the flexion function of the knee joint.

[0003] Open reduction and internal fixation of posterolateral tibial plateau fracture has always been a clinical difficulty, the main reason is that the posterolateral tibial plateau is blocked by bone structure and tendons (fibular head and lateral collateral ligament, tendon, etc.) and important blood vessels and nerves (common peroneal nerve, popliteal artery, lateral inferior genicular artery, etc.), making it difficult to expose and place the implant. There are many surgical approaches, including osteotomy approach (Gerdy's tubercle osteotomy approach, lateral femoral condyle osteotomy approach, two-belly muscle osteotomy approach of fibular head, etc.) and non-osteotomy approach (posterior median approach, Calson approach, posteromedial approach, posterolateral approach, etc.). Although the osteotomy approach has better surgical field exposure, it may have poor bone healing at the osteotomy site and affect the stability of the posterolateral structure of the knee joint. At present, there are many surgical approaches and internal fixation methods to treat this type of fracture, but simple, minimally invasive and reliable internal fixation methods are still being explored. Related literature reports that for compression fractures, especially those with posterior cortical ring rupture, internal fixation treatment should emphasize wrapping the posterolateral cortex of the tibia and supporting the fracture block, so that the implant can lift the collapsed articular surface fracture block like a palm. Therefore, we propose a posterolateral wrapping plate for tibial plateau and related instruments, in order to provide a new idea for the surgical treatment of posterolateral tibial plateau fracture. SUMMARY

[0004] The utility model aims at overcoming the shortcomings of prior art, and provides a tibial plateau posterolateral fixation device.

[0005] The utility model adopts the following technical scheme:

[0006] A tibial plateau posterolateral fracture fixation device, comprising a fixation steel plate and a screw,

[0007] A fixing plate, comprising a C-shaped plate body, a fitting surface formed inside the C-shaped plate body and used to fit with the tibial plateau articular surface, one or more fixing screw holes arranged at the front end of the C-shaped plate body, and a positioning hole arranged at the rear end of the C-shaped plate body and opposite to the one or more fixing screw holes;

[0008] A screw, provided with a plurality of screw holes, matched with the one or more fixing screw holes and with a tail end capable of being clamped in the positioning hole; the C-shaped plate body can pass through the gap between the lateral collateral ligament and the tibial malleolus above the fibular head and wrap around the posterior lateral tibial plateau; a frame structure is formed between the screw and the C-shaped plate body, so that a fixing area wrapping around the posterior lateral tibial plateau bone block is formed between the screw and the fitting surface.

[0009] Further, the C-shaped plate body further comprises one or more first Kirschner wire holes arranged between the positioning hole and the fixing screw hole on the C-shaped plate body.

[0010] Further, the fixing screw hole is provided with two fixing screw holes, and the fixing plate further comprises a second Kirschner wire hole arranged between the two fixing screw holes at the front end of the C-shaped plate body, and the first Kirschner wire hole and the second Kirschner wire hole are matched to fix the fractured bone block.

[0011] Further, the C-shaped plate body comprises a first side wing and a second side wing arranged opposite to each other and a connecting plate connected between the first side wing and the second side wing, the fixing screw hole is arranged on the first side wing, and the positioning hole is arranged on the second side wing, and the width of the connecting plate is smaller than that of the first side wing and the second side wing.

[0012] Further, the connecting plate comprises a main body segment connected to the second side wing at one end and a connecting segment connected between the main body segment and the first side wing, the connecting segment is arranged in a curved manner between the main body segment and the first side wing, so that when the fixing device is installed on the posterior lateral tibial plateau, the first side wing is arranged in a sunken manner relative to the main body segment.

[0013] Further, a guide is further included for guiding the tail end of the fixing screw matched with the fixing screw hole to be clamped in the positioning hole, the guide comprises a guide head capable of being embedded in the fixing screw hole, a clearance hole arranged in the guide head and opposite to the fixing screw hole, and an operating handle connected to the guide head and extending outward.

[0014] Further, a connecting part is formed at the upper end of the guide head and connected to the operating handle, the connecting part is formed with a connecting hole extending inward from the side surface thereof for embedding the lower end of the operating handle, and the operating handle comprises a curved segment extending upward at one end and capable of being embedded in the connecting hole and an extension segment extending upward and connected to the curved segment.

[0015] Further, the let-out hole comprises a fixing section opposite to the fixing screw hole and a limiting section extending outwardly connected with the fixing section, and the diameter of the limiting section gradually increases outwardly.

[0016] Further, the distance between the left and right sides of the limiting section gradually increases outwardly.

[0017] Further, the outermost line of the left side edge or the right side edge of the limiting section forms an angle of 20-50° with the axis of the let-out hole.

[0018] From the above description of the utility model, compared with the prior art, the utility model has the advantages that: the fixing device defined in the application is a novel internal fixing device for tibial plateau posterolateral fracture, and has the following advantages compared with other conventional steel plates for tibial plateau fracture: first, the risk of damage to nerves, blood vessels and tendons caused by the complex anatomical structure of the conventional posterior approach is avoided; second, the C-shaped steel plate body can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head and wrap around the posterolateral tibial plateau, thereby realizing extrusion support on the blind area bone block of the posterolateral side; two screws are clamped into the rear positioning hole to form a frame structure, so that the fixing device has good mechanical stability; third, the first Kirschner needle hole and the second Kirschner needle hole can assist in the reduction and fixation of the posterolateral fracture of the tibial plateau, especially the bone close to the articular surface; fourth, the utility model can be used in combination with a conventional proximal tibial lateral plate, and the technology takes into account the needs of supporting the articular surface and the metaphyseal end; fifth, the structure design of the guide makes the outermost line of the left side edge or the right side edge of the limiting section form an angle of 35° with the axis of the let-out hole, and only allows the drill bit to swing left and right, so that the screw cannot pass out of the articular surface upward and cannot be clamped into the positioning groove behind the steel plate; sixth, the curved extension of the connecting section between the main body section and the first side wing makes the first side wing sink relative to the main body section when the fixing device is installed on the posterolateral side of the tibial plateau, so as to avoid the risk that the fixing device is too close to the articular surface and the screw penetrates the joint. BRIEF DESCRIPTION OF DRAWINGS

[0019] Figure 1 Structure diagram of the fixing plate Figure 1 ;

[0020] Figure 2 Structure diagram of the fixing plate Figure 2 ;

[0021] Figure 3 Structure diagram of the fixing plate Figure 3 ;

[0022] Figure 4 Structure diagram of the guide Figure 1 ;

[0023] Figure 2Structure diagram of the guide Figure 6 ;

[0024] Figure 7 Structure sectional view of the guide head

[0025] Figures 1 to 7 Assembly diagram of the fixing steel plate

[0026] In the figure, 1 is the fixing steel plate, 2 is the guide, 3 is the C-shaped steel plate body, 4 is the fitting surface, 5 is the fixing screw hole, 6 is the positioning hole, 7 is the first Kirschner wire hole, 8 is the second Kirschner wire hole, 21 is the guide head, 211 is the connecting part, 212 is the connecting hole, 22 is the clearance hole, 221 is the fixing section, 222 is the limiting section, 23 is the operation handle, 231 is the bending section, 232 is the extending section, 31 is the first side wing, 32 is the second side wing, 33 is the connecting plate, 34 is the main body section, and 35 is the connecting section. DETAILED DESCRIPTION

[0027] The utility model will be further described below through specific embodiments.

[0028] Referring to ​ The tibial plateau posterolateral fixation device shown in the figure comprises a fixing steel plate 1, a screw and a guide 2.

[0029] The fixing steel plate 1 comprises a C-shaped steel plate body 3, a fitting surface 4 formed on the inner side of the C-shaped steel plate body 3 and used for fitting with the tibial plateau articular surface bone, two fixing screw holes 5 arranged at the front end of the C-shaped steel plate body 3, a positioning hole 6 arranged at the rear end of the C-shaped steel plate body 3 opposite to the two fixing screw holes 5, two first Kirschner wire holes 7 arranged on the C-shaped steel plate body 3 between the positioning hole 6 and the fixing screw hole 5 and a second Kirschner wire hole 8 arranged at the front end of the C-shaped steel plate body 3 between the two fixing screw holes 5, wherein the two first Kirschner wire holes 7 and the second Kirschner wire hole 8 are matched to facilitate temporary fixation of the fractured block.

[0030] The steel plate body 3 of the C type can pass through the gap between the lateral collateral ligament and the tibial malleolus above the fibular head and wrap around the posterolateral tibial plateau; it comprises a first side wing 31 and a second side wing 32 arranged opposite to each other and a connecting plate 33 connected between the first side wing 31 and the second side wing 32, and the width of the connecting plate 33 is smaller than that of the first side wing 21 and the second side wing 32; wherein the connecting plate 33 comprises a main body segment 34 connected to the second side wing 32 at one end and a connecting segment 33 connected between the main body segment 34 and the first side wing 31, and the connecting segment 33 is arranged in a curved manner between the main body segment 34 and the first side wing 31, so that when the fixing device is installed on the posterolateral tibial plateau, the first side wing 31 is arranged to be sunken relative to the main body segment 34, avoiding the risk of the screw penetrating the joint due to the fixing device being too close to the articular surface; specifically, the fixing screw hole 5 is arranged on the first side wing 31, the positioning hole 6 is arranged on the second side wing 32, and the two first Kirschner wire holes 7 are arranged on the main body segment 34; further, the steel plate body 3 of the C type is designed with a low notch to minimize soft tissue irritation; by limiting the specific structure of the steel plate body 3 of the C type, the fitting surface 4 arranged on the inner side thereof can be well fitted with the posterolateral tibial plateau subarticular bone, thereby realizing extrusion support on the blind area bone block of the posterolateral side.

[0031] The fixing screw hole 5 is a counterbore arranged on the first side wing 31, and when the screw cooperates with the fixing screw hole 5, the head of the screw is arranged in the fixing screw hole 5, the tail end is clamped in the positioning hole 6, and a frame structure is formed between the steel plate body 3 of the C type, so that a fixing area wrapping around the posterolateral tibial plateau bone block is formed between the screw and the fitting surface 4, so as to better wrap around the posterolateral tibial plateau bone block and improve the stability.

[0032] The screw is provided with two, respectively cooperating with two fixing screw holes 5, and the tail end is clamped in the positioning hole 6.

[0033] The guide 2 is used to guide the tail end of the screw cooperating with the fixing screw hole 5 to be clamped in the positioning hole 6, comprising a guide head 21 which can be embedded in the fixing screw hole 5, a relief hole 22 arranged in the guide head 21 opposite to the fixing screw hole 5 and an operating handle 23 connected to the guide head 21 and extending outward, wherein the upper end of the guide head 21 is formed with a connecting part 211 connected to the operating handle 23, and the connecting part 211 is formed with a connecting hole 212 extending inward from the side surface thereof for embedding the lower end of the operating handle 23; the operating handle 23 comprises a curved segment 231 extending upward with one end embedded in the connecting hole 212 and an extension segment 232 connected to the curved segment 231 and extending upward; the connection between the front end of the curved segment 231 and the connecting hole 212 is formed by laser welding.

[0034] The let go hole 22 includes a fixing section 221 opposite to the fixing screw hole 5 and a limiting section 222 connected to the fixing section 221 and extending outward, wherein the diameter of the limiting section 222 increases outward in sequence; specifically, the distance between the left and right sides of the limiting section 222 increases outward in sequence, so that the cross section of the limiting section 222 is arranged in a non-circular shape, and the outermost line of the left side or the right side of the limiting section 222 forms an angle of 20-50° with the axis of the let go hole 22, so that the drill bit of the locking screw is only allowed to swing at a certain angle in the left and right directions, so as to avoid that the tail end of the screw penetrates through the articular surface upward and cannot be clamped in the positioning hole 6; specifically, the outermost line of the left side or the right side of the limiting section 222 forms an angle of 35° with the axis of the let go hole 22, which is the best.

[0035] The fixing device defined in the application is a new type of internal fixation device for tibial plateau posterolateral fracture, which has the following advantages compared with other conventional steel plates for tibial plateau fracture: first, the risk of damage to nerves, blood vessels and tendons caused by the complex anatomical structure of the conventional posterior approach is avoided; second, the C-shaped steel plate body 3 can pass through the gap between the lateral collateral ligament and the tibial condyle above the fibular head, and wrap around the posterolateral tibial plateau, so as to realize the extrusion support of the blind area bone block of the posterolateral side; two screws are clamped into the rear positioning hole 6 to form a frame structure, so that the fixing device has good mechanical stability; third, the first Kirschner wire hole 7 and the second Kirschner wire hole 8 can assist in the reduction and fixation of the posterolateral fracture of the tibial plateau, especially the bone close to the articular surface; fourth, the utility model can be used in combination with a conventional proximal tibial lateral plate, which takes into account the needs of supporting the articular surface and strong fixation of the metaphyseal end; fifth, the structure design of the guide makes the outermost line of the left side or the right side of the limiting section 222 form an angle of 35° with the axis of the let go hole 22, and only allows the drill bit to swing in the left and right directions, so as to avoid that the screw penetrates out of the articular surface upward and cannot be clamped in the positioning slot behind the steel plate; sixth, the connecting section 33 is curvedly and extendingly arranged between the main body section 34 and the first side wing 31, so that when the fixing device is installed on the posterolateral side of the tibial plateau, the first side wing 31 is arranged to be sunken relative to the main body section 34, avoiding that the fixing device is too close to the articular surface, which leads to the risk that the screw penetrates through the joint.

[0036] The above is only a preferred embodiment of the utility model, and therefore cannot limit the range of the utility model implementation, that is, equivalent changes and modifications made according to the scope of the utility model application and the content of the specification should still be within the scope covered by the utility model application.

Claims

1. A tibial platform posterolateral fixation device, characterized by: The fixing steel plate comprises a steel plate body and a screw, The fixing steel plate comprises a steel plate body and a screw, The C-shaped steel plate body can pass through the gap between the lateral collateral ligament and the tibial malleolus above the fibular head and wrap around the posterior lateral tibial plateau.

2. The tibial tray posterolateral fixation device of claim 1, wherein: The C-shaped steel plate body further comprises one or more first Kirschner wire holes arranged between the positioning hole and the fixing screw hole on the C-shaped steel plate body.

3. The tibial tray posterolateral fixation device of claim 2, wherein: The fixing screw hole is provided with two fixing screw holes, and the fixing steel plate further comprises a second Kirschner wire hole arranged between the two fixing screw holes on the front end of the C-shaped steel plate body.

4. The tibial tray posterolateral fixation device of claim 1, wherein: The C-shaped steel plate body comprises a first side wing and a second side wing arranged oppositely and a connecting plate connected between the first side wing and the second side wing.

5. The tibial tray posterolateral fixation device of claim 4, wherein: The connecting plate comprises a main body segment connected to the second side wing and a connecting segment connected between the main body segment and the first side wing.

6. The tibial tray posterolateral fixation device of claim 1, wherein: The connecting segment is curvedly arranged between the main body segment and the first side wing, so that the first side wing is arranged to be sunken relative to the main body segment when the fixing device is installed on the posterior lateral tibial plateau.

7. The tibial tray posterolateral fixation device of claim 6, wherein: The guide further comprises a guide head that can be embedded in the fixing screw hole, a clearance hole arranged in the guide head opposite to the fixing screw hole, and an operating handle connected to the guide head and extending outward.

8. The tibial tray posterolateral fixation device of claim 6, wherein: The guide head is provided with a connecting portion at the upper end connected to the operating handle, and the connecting portion is provided with a connecting hole extending inward from the side surface for embedding the lower end of the operating handle.

9. The tibial tray posterolateral fixation device of Claim 8, wherein: The operating handle comprises a curved segment with one end embedded in the connecting hole and the other end extending upward, and an extension segment connected to the curved segment and extending upward.

10. The tibial tray posterolateral fixation device of claim 8, wherein: The clearance hole comprises a fixing segment opposite to the fixing screw hole and a limiting segment connected to the fixing segment and extending outward. The limiting segment is provided with a left side and a right side, and the distance between the left side and the right side gradually increases outward. The outermost line of the left side or the right side of the limiting segment forms an angle of 20-50° with the axis of the clearance hole.

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