Fracture treatment fixation device

Abstract

To provide a fracture treatment fixation device for femoral fractures, enabling further reliable treatment of fractures of proximal femur.SOLUTION: A fracture treatment fixation device for treating femoral fractures includes: an intramedullary nail to be inserted into a femoral cavity; a lag screw disposed to penetrate the intramedullary nail diagonally upward and entering a femoral head and a femoral neck; an anterior wall plate to be applied to an anterior wall of a femoral trochanter; and an anterior wall plate fixation pin disposed to penetrate the intramedullary nail and secure the anterior wall plate to the anterior wall of the femoral trochanter.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a fixation device for treating a bone fracture, and more particularly to a fixation device for treating a bone fracture of the proximal femur. [Background technology]

[0002] A treatment method for treating fractures of the proximal femur using an intramedullary nail (intramedullary fixation) has been known for some time. This intramedullary fixation method involves inserting an intramedullary nail into the intramedullary cavity from the proximal end of the femur and fixing the intramedullary nail to the femur with a fixing bolt or the like. As shown in FIG. 16 , the intramedullary nail includes a rod-shaped nail 103 having a proximal portion 101 and a distal portion 102 that is longer than the proximal portion 101, with a bent portion in between; a locking screw 104 provided in the distal portion 102 of the nail 103 as a means for engaging with the bone; a through-hole 105 obliquely drilled through the proximal portion 101 near the bent portion of the nail 103; and a lag screw 107 having a screw 106 at its tip that is screwed into the femoral head 91 and inserted into the through-hole 105.

[0003] To treat a proximal femoral fracture, first, a nail 103 is driven into the inner cavity (medullary cavity) of the femur 90 from the proximal side. Then, a locking screw 104 is passed through the inner cavity of the femur 90 and the distal part 102 of the nail, and the nail 103 is fixed in a predetermined position in the femoral inner cavity. Next, a screw 106 at the tip of a lag screw 107 is threaded into the femoral head 91 through a through-hole 105 of the nail 103 and fixed to the femoral head 91, and the lag screw 106 is pulled toward the proximal side so as to press the femoral head 91 against the fractured part 92. If necessary, an anti-rotation screw 108 is driven into the femoral head 91 separately from the lag screw 106 to prevent the femoral head 91, into which the lag screw 106 has been driven, from rotating relative to the fractured part 92.

[0004] Here, the femoral trochanter is classified and named according to the type of muscle attached, as shown in Figures 17 and 18. The area indicated by A is the area where the anterior gluteus minimus muscle attaches and is called the anterior facet (anterior wall). The area indicated by P is the area where the posterior fibers of the gluteus medius muscle attach and is called the posterior facet (posterior wall). The area indicated by L is the area where the anterior fibers of the gluteus medius muscle attach and is called the lateral facet (outer surface). The area indicated by SP is the area including the top of the trochanter and is the area where the piriformis muscle attaches and is called the superoposterior facet (superior posterior surface). Note that Figure 18 shows the state as viewed from the direction of arrow T in Figure 17.

[0005] The conventional intramedullary fixation method described above is extremely useful in cases where the fracture occurs near the neck between the femoral bone and the trochanter, as shown in Figure 16. However, there is a problem in that, for example, in cases where the posterior wall of the trochanter is also fractured and separated, the trochanteric fracture of the femur cannot be effectively treated.

[0006] To solve this problem, the applicant of the present application developed a bone fracture treatment fixation device that includes a posterior wall plate that can press the posterior wall of the separated trochanteric portion against the femoral trochanteric portion (Patent Document 2). The bone fracture treatment fixation device according to Patent Document 2 can reduce the separated posterior wall to a preferred position relative to the trochanteric portion. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] Japanese Patent Application Laid-Open No. 2004-089259 [Patent Document 2] Japanese Patent Publication No. 2020-92795 Summary of the Invention [Problem to be solved by the invention]

[0008] As described above, the fracture treatment fixation device disclosed in Patent Document 2 can reduce the separated posterior wall to a desirable position relative to the trochanter. However, after surgery, when the patient undergoes rehabilitation such as walking training, weight is applied to the fracture site, causing the tip of the intramedullary nail to move posteriorly, as shown by the arrow in Figure 19. As a result, as shown in Figure 20, the reduced femoral head fragment becomes intramedullary, or the reduced posterior wall becomes re-separated from the trochanter. The term "intramedullary" refers to a condition in which the femoral head fragment falls posteriorly and penetrates the marrow of the diaphyseal fragment, increasing the risk of excessive telescoping (interlocking between bone fragments; excessive interlocking causes excessive shortening of the fracture) or cut out (the lag screw 107 protruding from the femoral head). Furthermore, images A and B in Figure 20 are model images showing the reduced state immediately after surgery, and images C and D are model images showing a state in which the tip of the intramedullary nail has become unstable and moved toward the rear of the body.

[0009] The present invention has been made to solve such problems, and aims to provide a fixation device for treating femoral fractures that can more reliably treat fractures in the proximal femur. [Means for solving the problem]

[0010] The above-mentioned objects of the present invention are achieved by a fracture treatment fixation device for treating a femoral fracture, comprising: an intramedullary nail inserted into a femoral cavity; a lag screw disposed to penetrate the intramedullary nail obliquely upward and enter the femoral head and femoral neck; an anterior wall plate applied to the anterior wall of the femoral trochanter; and an anterior wall plate fixation pin disposed to penetrate the intramedullary nail and fix the anterior wall plate to the anterior wall of the femoral trochanter. This fracture treatment fixation device can be suitably used for fractures involving a posterior femoral fragment, in addition to femoral neck fractures.

[0011] In the above-mentioned bone fracture treatment fixation device, it is preferable that the front wall plate fixing pin is configured to be able to be screwed onto the intramedullary nail.

[0012] The anterior wall plate preferably has a claw portion that abuts against the surface of the femoral trochanter.

[0013] Furthermore, it is preferable that the front wall plate has a base portion that is circular in a plan view and a plurality of claw portions that protrude radially outward from the base portion, each of which has a through hole formed in a direction perpendicular to the thickness direction of the base portion, and that the through hole has an opening on one side surface and the other side surface of the claw portion.

[0014] Preferably, a recess is formed on the outer peripheral surface of the base portion, and the recess is connected to the inner peripheral surface of the through hole.

[0015] Moreover, it is preferable that the intramedullary nail has a plurality of first fixing pin insertion holes into which the anterior wall plate fixing pins can be inserted.

[0016] It is also preferable that the implant further comprises a posterior wall plate that is applied to the posterior wall of the femoral trochanter, and a posterior wall plate fixation pin that is arranged to pass through the intramedullary nail and fixes the posterior wall plate to the posterior wall of the femoral trochanter.

[0017] It is also preferable that the anterior wall plate and the posterior wall plate are configured to be able to sandwich the femoral trochanter.

[0018] Furthermore, it is preferable that the posterior wall plate fixing pin is configured to be able to be screwed onto the intramedullary nail.

[0019] The rear wall plate preferably has a claw portion that abuts against the surface of the femoral trochanter.

[0020] It is also preferable that the anterior wall plate fixing pin be positioned closer to the tip of the intramedullary nail than the posterior wall plate fixing pin.

[0021] Furthermore, it is preferable that the inclination angle of the anterior wall plate fixation pin relative to the axis of the lag screw and the inclination angle of the posterior wall plate fixation pin relative to the axis of the lag screw are the same angle, so that the present invention can be used to treat fractures of either the left or right femur.

[0022] Moreover, the intramedullary nail preferably has a plurality of second fixing pin insertion holes into which the posterior wall plate fixing pins are inserted.

[0023] It is also preferable that the intramedullary nail has a plurality of first fixation pin insertion holes into which the anterior wall plate fixation pins can be inserted, and a plurality of second fixation pin insertion holes into which the posterior wall plate fixation pins can be inserted. [Effects of the Invention]

[0024] According to the present invention, it is possible to provide a fixation device for treating a femoral fracture that can more reliably treat a fracture in the proximal femur. [Brief explanation of the drawings]

[0025] [Figure 1] 1 is a side view showing a schematic configuration of a bone fracture treatment fixation device according to the present invention. [Figure 2] FIG. 2 is a schematic plan view of the configuration of FIG. 1 as seen from above. [Figure 3] 1 is a schematic diagram showing a state in which a bone fracture treatment fixing device 1 according to the present invention is attached to a femur. [Figure 4] 1 is a schematic perspective view showing a state in which a bone fracture treatment fixing device according to the present invention is attached to a femur. [Figure 5] 1 is a schematic diagram of an intramedullary nail included in a bone fracture treatment fixation device according to the present invention. [Figure 6] 1 is a schematic diagram showing a state in which a bone fracture treatment fixing device according to the present invention is attached to a femur. [Figure 7] 10 is an explanatory view of a front wall plate provided in the bone fracture treatment fixation device according to the present invention. FIG. [Figure 8]1 is a schematic cross-sectional view of the bone fracture treatment fixation device according to the present invention, taken along the axis of a front wall plate fixing pin. FIG. [Figure 9] 10 is a plan view of a front wall plate fixing pin provided in the bone fracture treatment fixation device according to the present invention. FIG. [Figure 10] 10 is an explanatory view of a rear wall plate provided in the bone fracture treatment fixation device according to the present invention. FIG. [Figure 11] 1 is a schematic cross-sectional view of the bone fracture treatment fixation device according to the present invention, taken along the axis of a rear wall plate fixing pin. FIG. [Figure 12] 10 is a plan view of a rear wall plate fixing pin provided in the bone fracture treatment fixation device according to the present invention. FIG. [Figure 13] 1 is a schematic cross-sectional view of the bone fracture treatment fixture according to the present invention, taken along the axis of an anterior wall plate fixing pin in a state where the fixture is attached to a femur. FIG. [Figure 14] 1 is a schematic cross-sectional view of the bone fracture treatment fixture according to the present invention, taken along the axis of an anterior wall plate fixing pin in a state where the fixture is attached to a femur. FIG. [Figure 15] 10A and 10B are explanatory views of a modified example of a front wall plate included in the bone fracture treatment fixation device according to the present invention. [Figure 16] FIG. 10 is a schematic cross-sectional view showing a conventional fixation device for treating bone fractures. [Figure 17] FIG. 10 is an explanatory diagram for explaining the femoral trochanter. [Figure 18] 18 is an explanatory diagram seen from the direction of an arrow T in FIG. 17. [Figure 19] FIG. 10 is an explanatory diagram for explaining the movement of the tip of the intramedullary nail toward the rear of the human body. [Figure 20] FIG. 10 is an explanatory diagram for explaining the problem that occurs when the tip of the intramedullary nail moves backward in the human body. DETAILED DESCRIPTION OF THE INVENTION

[0026] The fracture treatment fixation device according to the present invention will be described below with reference to the accompanying drawings. Note that each drawing is partially enlarged or reduced to facilitate understanding of the configuration. Fig. 1 is a schematic side view of the fracture treatment fixation device 1 according to the present invention, and Fig. 2 is a schematic plan view of the configuration as seen from above in Fig. 1. Fig. 3 is a schematic view showing the fracture treatment fixation device 1 according to the present invention attached to a femur 90, and Fig. 4 is a schematic perspective view showing the fracture treatment fixation device 1 attached to the femur 90. Note that Fig. 4 is a perspective view as seen from the anterior wall side of the femoral trochanter 94.

[0027] The fracture treatment fixture 1 according to the present invention is a fixture for treating a fracture of the femur, for example, a fracture that involves a posterior femoral fragment Z in addition to a femoral neck fracture, and as shown in FIGS. 1 to 4 , it at least includes an intramedullary nail 2 that is inserted into the inner cavity (intramedullary cavity) of the femur 90, a lag screw 3, an anterior wall plate 4, a posterior wall plate 5, an anterior wall plate fixation pin 6, and an anterior wall plate fixation pin 7. The fracture treatment fixture 1 further includes an anti-rotation screw 8. The intramedullary nail 2, lag screw 3, anterior wall plate 4, posterior wall plate 5, anterior wall plate fixation pin 6, anterior wall plate fixation pin 7, anti-rotation screw 8, and the like that constitute the fracture treatment fixture 1 are preferably made of a metal material having biocompatibility, such as a titanium alloy or stainless steel.

[0028] As shown in Figs. 1 to 5, the intramedullary nail 2 comprises, in order from the top, a proximal portion 21, a tapered portion 22, and a distal portion 23. Note that Fig. 5 is a schematic structural diagram of the intramedullary nail 2 provided in the bone fracture treatment fixation device 1. The proximal portion 21, the tapered portion 22, and the distal portion 23 are integrally formed. The proximal portion 21 is formed in a cylindrical shape with a substantially constant diameter, and is placed on the femoral head 91 side of the femur 90. A cap hole 2a in which an end cap is placed is formed at the upper end of this proximal portion 21. A female thread is formed on the inner peripheral surface of the cap hole 2a, and is configured so that the end cap can be screwed onto it.

[0029] Furthermore, a lag screw insertion hole 24 into which the lag screw 3 is inserted is formed in the proximal portion 21. The lag screw insertion hole 24 penetrates the proximal portion 21 so as to extend obliquely upward. With this configuration, the lag screw insertion hole 24 can guide the lag screw 3 obliquely upward toward the femoral head 91 of the femur 90.

[0030] Furthermore, in the proximal portion 21, above and below (or above or below) the lag screw insertion hole 24, insertion holes having a diameter smaller than that of the lag screw insertion hole 24 are formed. These insertion holes are holes for inserting the antirotation screws 8, and like the lag screw insertion holes 24, the antirotation screw insertion holes also penetrate the proximal portion 21 so as to extend obliquely upward. With this configuration, the antirotation screw 8 can be guided obliquely upward toward the femoral head 91 of the femur 90.

[0031] Here, the lag screw 3 and the anti-rotation screw 8 are preferably configured to be parallel to each other as they enter the femoral head 91 and femoral neck 93. The anti-rotation screw 8 is provided to prevent the femoral head 91, into which the lag screw 3 is driven, from rotating relative to the fractured portion 92, but can be omitted if there is little risk of the femoral head 91 rotating relative to the fractured portion.

[0032] The tapered portion 22 is formed in a substantially cylindrical shape, is integrally connected to the proximal portion 21, and is formed to have a smaller diameter toward the distal portion 23. The axis of the tapered portion 22 is inclined, for example, at an angle of 3° to 6° with respect to the axis of the proximal portion 21, and this structure gives the intramedullary nail 2 a slightly bent shape as a whole.

[0033] The distal portion 23 is connected to the distal side of the tapered portion 22 and is formed in a cylindrical shape with a substantially constant diameter, with the distal tip portion slightly tapered. The distal portion 23 is formed so that its axis is collinear with the axis of the tapered portion 22. Furthermore, a plurality of fixation holes 25 into which the locking screw 2b is inserted are formed vertically near the distal end of the distal portion 23. The fixation holes 25 are formed to penetrate the distal portion 23 so as to be substantially perpendicular to the axis of the distal portion 23. That is, the fixation holes 25 guide the locking screw 2b substantially horizontally. Note that FIG. 5 shows an example in which two fixation holes 25 for inserting the locking screw 2b are formed, but the number of fixation holes 25 is not particularly limited. A single fixation hole 25 may be formed, or three or more fixation holes 25 may be formed.

[0034] The lag screw 3 is a fixing connector for fixing a fractured fragment (femoral head 91 of the femur 90) separated due to a neck fracture to the femur 90 (trochanteric portion 94), and is inserted obliquely upward toward the femoral head 91 of the femur 90, as shown in the schematic configuration diagram of FIG. 6. The lag screw 3 is formed in an elongated, approximately cylindrical shape, as shown in FIGS. 2 and 3, and has a screw 31 formed on the outer peripheral surface of its tip. The lag screw 3 is inserted obliquely upward through the intramedullary nail 2 via the lag screw insertion hole 24 formed in the intramedullary nail 2, and the screw 31 at its tip is threaded into the femoral head 91 and positioned in a state where it has advanced into the femoral head 91 and femoral neck 93. As a result, the separated fractured fragment (femoral head) is engaged with and held by the lag screw 3, and the fractured fragment (femoral head) can be fixed to the trochanteric portion 94 of the femur 90. The diameter of the lag screw 3 is configured to be slightly smaller than the diameter of the above-mentioned lag screw insertion hole 24, so that the lag screw 3 can slide within the lag screw insertion hole 24.

[0035] As shown in FIGS. 1 to 4 , the anterior wall plate 4 is attached to the anterior wall of the trochanter 94 of the femur 90 and functions to press against the anterior wall of the trochanter 94 via an anterior wall plate fixing pin 6, which will be described later. Here, the anterior wall refers to the anterior facet of the trochanter 94 of the femur 90 where the anterior gluteus minimus muscle attaches. As shown in the plan view shown in FIG. 7( a), the side view (FIG. 7( b)) seen from direction A in FIG. 7( a), and the side view (FIG. 7( c)) seen from direction B in FIG. 7( a), the anterior wall plate 4 includes a base portion 41 and a plurality of claw portions 42. In this embodiment, the anterior wall plate 4 is configured to include three claw portions 42. The base 41 is a plate-like member having a predetermined thickness, and each claw 42 includes a claw arm 42a extending from the base 41 and a claw tip 42b provided at the tip of the claw arm 42a. The claw tip 42b is a portion that abuts against the anterior wall of the femoral trochanter 94 and is formed to protrude at a 90-degree bend relative to the claw arm 42a. Each claw tip 42b is formed so that it protrudes in the same direction. Each claw arm 42a is configured to extend generally along the in-plane direction of the plate-like base 41. Preferably, some of the three claw tip portions 42b are configured to be positioned near the base of the gluteus minimus muscle, which is connected to the trochanter 94.

[0036] In this embodiment, the tip portions (claw tip portions 42b) of the three claw portions 42 are configured to be located at the vertices of a substantially isosceles triangle in a plan view. In other words, the position of each claw tip portion 42b is set so that the figure formed by the imaginary lines connecting the tip portions (claw tip portions 42b) of the three claw portions 42 is an isosceles triangle. In the isosceles triangle formed by the imaginary lines connecting the tip portions of each claw portion 42, the apex angle is preferably set in the range of 15° to 50°, and more preferably set in the range of 25° to 40°. Note that if the tip portions (claw tip portions 42b) of each claw portion 42 are sharp points, the imaginary lines connecting the dotted points may form an isosceles triangle, and the angle range of the apex angle may be set. Furthermore, when the tip of the claw portion 42 (claw tip portion 42b) is tapered but has a predetermined width, as shown in Figure 7(c), an isosceles triangle is formed with the center position of the width as the vertex, and the angle range of the apex angle is set.

[0037] Furthermore, a plate through hole 43 into which the front wall plate fixing pin 6 is inserted is formed in the base portion 41 of the front wall plate 4. The inner peripheral surface of the plate through hole 43 is preferably formed into a bowl-like surface shape that decreases in diameter toward the insertion direction of the front wall plate fixing pin 6. The minimum opening diameter of the plate through hole 43 is formed to be slightly larger than the maximum diameter of a shaft portion 61 of the front wall plate fixing pin 6, which will be described later. Furthermore, the plate through hole 43 is preferably formed so that its center does not coincide with the center position (circumcenter position) of the circumscribed circle of a triangular figure formed by imaginary lines connecting the tip ends of the claw portions 42 (each claw tip portion 42b).

[0038] As shown in FIGS. 1 to 4 , the anterior wall plate fixing pin 6 is inserted into the femur so as to penetrate the intramedullary nail 2, and is a fixing device for fixing the above-mentioned anterior wall plate 4 to the surface (anterior wall) of the femoral trochanteric portion 94. As shown in the schematic cross-sectional view of FIG. 8 , the intramedullary nail 2 is formed with a first fixing pin insertion hole 26 for inserting the anterior wall plate fixing pin 6, and a female thread portion is formed on the inner surface of the first fixing pin insertion hole 26. Here, in FIG. 8 , the posterior wall plate 5 and the posterior wall plate fixing pin 7 are omitted from the illustration. The first fixing pin insertion hole 26 is formed above the above-mentioned lag screw insertion hole 24. The anterior wall plate fixing pin 6 is also positioned closer to the distal end of the intramedullary nail 2 than the posterior wall plate fixing pin 7, which will be described later. In this embodiment, as shown in Figure 8, the front wall plate fixing pin 6 is arranged at a predetermined angle inclined toward the entrance of the lag screw insertion hole 24 with respect to the axis of the above-mentioned lag screw insertion hole 24, but it is preferable to configure it at an inclination angle in the range of 40° to 90° with respect to the axis of the lag screw insertion hole 24, and it is more preferable to set it in the range of 50° to 70° with respect to the axis of the lag screw insertion hole 24.

[0039] As shown in the plan view of FIG. 9 , the anterior wall plate fixation pin 6 has a structure including a cylindrical shank 61 and a head 62 provided at one end of the shank 61, and a male thread portion 61a is formed on the outer surface of the central portion of the shank 61. The anterior wall plate fixation pin 6 is fixed to the intramedullary nail 2 by threading the first fixation pin insertion hole 26 in the intramedullary nail 2 into the male thread portion 61a formed on the shank 61 of the anterior wall plate fixation pin 6. The diameter of the anterior wall plate fixation pin 6 is formed smaller overall, excluding the head 62, than the minimum diameter of the plate through hole 43 formed in the anterior wall plate 4, so that it can be inserted into the plate through hole 43. On the other hand, the diameter of the head 62 is formed larger than the minimum diameter of the plate through hole 43. As a result, when the anterior wall plate fixing pin 6 is screwed into the intramedullary nail 2, the head 62 of the anterior wall plate fixing pin 6 presses the anterior wall plate 6 against the anterior wall of the femur 90, so that the anterior wall plate 4 can be fixed to the anterior wall of the trochanteric portion 94 of the femur 90. Note that the head 62 has an engagement hole formed therein that engages with the tip of a rotary tool such as a screwdriver or hex wrench, and by rotating such a rotary tool, the anterior wall plate fixing pin 6 advances into the first fixation pin insertion hole 26 in the intramedullary nail 2.

[0040] 9, the head 62 of the front wall plate fixing pin 6 is preferably configured to have a bowl-shaped contact surface 62a that contacts along the inner circumferential surface (inner circumferential surface having a bowl-shaped surface shape) of the through hole of the above-mentioned front wall plate 4. This bowl-shaped contact surface 62a is formed mainly on the head surface side facing the shaft portion 61. Due to such a structure of the head 62 of the front wall plate fixing pin 6 and the inner circumferential surface of the through hole 43 of the front wall plate 4, the front wall plate 4 is configured so that the front wall plate 4 can rotate with respect to the front wall plate fixing pin 6 with the head 62 of the front wall plate fixing pin 6 in contact with the inner circumferential surface of the plate through hole 43.

[0041] Furthermore, it is preferable that the length of the shaft portion 61 of the anterior wall plate fixing pin 6 is configured so that the tip does not protrude from the intramedullary nail 2 or protrudes slightly.

[0042] As shown in FIGS. 1 to 3 , the posterior wall plate 5 is attached to the posterior wall of the trochanteric portion 94 of the femur 90 and functions to press a bone fragment Z of the posterior wall portion separated from the trochanteric portion 94 against the trochanteric portion 94 via a posterior wall plate fixing pin 7 (described later). Here, the posterior wall refers to the portion of the trochanteric portion 94 of the femur 90 where the posterior fibers of the gluteus medius muscle are attached. As shown in the plan view shown in FIG. 10( a), the side view (FIG. 10( b)) seen from direction A in FIG. 8( a), and the side view (FIG. 10( c)) seen from direction B in FIG. 10( a), the posterior wall plate 5 includes a base portion 51 and a plurality of claw portions 52. In this embodiment, the posterior wall plate 5 is configured to include three claw portions 52.

[0043] Furthermore, in this embodiment, similarly to the front wall plate 4 described above, the tip portions (claw tip portions 52b) of the three claw portions 52 are configured to be located at the vertices of a substantially isosceles triangle in a plan view. That is, the position of each claw tip portion 52b is set so that the figure formed by the imaginary lines connecting the tip portions (claw tip portions 52b) of the three claw portions 52 is an isosceles triangle. In the isosceles triangle formed by the imaginary lines connecting the tip portions of each claw portion 52, the apex angle is preferably set in the range of 15° to 50°, and more preferably set in the range of 25° to 40°. Note that, if the tip portions (claw tip portions 52b) of each claw portion 52 are sharp points, the imaginary lines connecting the dotted tips may form an isosceles triangle, and the angle range of the apex angle may be set. Furthermore, when the tip of the claw portion 52 (claw tip portion 52b) is tapered but has a predetermined width as shown in FIG. 10(c), an isosceles triangle may be formed with its vertex at the center of the width, and the angle range of the apex angle may be set. It is preferable that some of the three claw tip portions 52b are configured to be positioned near the bases of the gluteus medius and gluteus minimus muscles, which are connected to the posterior wall of the trochanter 94. Furthermore, a plate through-hole 53 into which the posterior wall plate fixing pin 7 is inserted is formed in the base portion 51 of the posterior wall plate 5. The inner peripheral surface of the plate through-hole 53 is preferably formed into a bowl-shaped surface shape whose diameter decreases in the direction of insertion of the posterior wall plate fixing pin 7, as shown in FIG. 11. The minimum opening diameter of the plate through-hole 53 is formed to be slightly larger than the maximum diameter of the shank 51 of the posterior wall plate fixing pin 7, which will be described later. Furthermore, it is preferable that the plate through hole 53 is formed so that the center of the through hole 53 does not coincide with the center position (circumcenter position) of the circumscribed circle of the triangular figure formed by the imaginary lines connecting each tip end (each claw tip end 52b) of each claw portion 52.

[0044] As shown in FIGS. 1 to 3 , the posterior wall plate fixation pin 7 is inserted into the femur so as to penetrate the intramedullary nail 2, and is a fixture for fixing the above-mentioned posterior wall plate 5 to the posterior wall of the femoral trochanteric portion 94. As shown in the schematic cross-sectional view of FIG. 11 , the intramedullary nail 2 is formed with a second fixation pin insertion hole 27 for inserting the posterior wall plate fixation pin 7, and a female thread portion is formed on the inner surface of the second fixation pin insertion hole 27. The second fixation pin insertion hole 27 is formed above the first fixation pin insertion hole 26 for inserting the above-mentioned anterior wall plate fixation pin 6. In this embodiment, as shown in FIG. 11 , the posterior wall plate fixation pin 7 is arranged at a predetermined angle toward the entrance of the lag screw insertion hole 24 with respect to the axis of the lag screw insertion hole 24. This angle of inclination is preferably set within a range of 40° to 90° with respect to the axis of the lag screw insertion hole 24, and more preferably within a range of 50° to 70° with respect to the axis of the lag screw insertion hole 24.

[0045] As shown in the plan view of FIG. 12 , the posterior wall plate fixation pin 7 has a structure including a cylindrical shank 71 and a head 72 provided at one end of the shank 71, with a male thread portion 71a formed on the outer surface of the central portion of the shank 71. The posterior wall plate fixation pin 7 is fixed to the intramedullary nail 2 by threading the second fixation pin insertion hole 27 in the intramedullary nail 2 into the male thread portion 71a formed on the shank 71 of the posterior wall plate fixation pin 7. The diameter of the posterior wall plate fixation pin 7 is formed smaller overall, excluding the head 72, than the minimum diameter of the plate through hole 53 formed in the posterior wall plate 5, so that it can be inserted into the plate through hole 53. On the other hand, the diameter of the head 72 is formed larger than the minimum diameter of the plate through hole 53. As a result, when the posterior wall plate fixing pin 7 is screwed into the intramedullary nail 2, the head 72 of the posterior wall plate fixing pin 7 presses the posterior wall plate 5 against the posterior wall of the femur 90, so that the posterior wall plate 5 can be fixed to the posterior wall of the trochanteric portion 94 of the femur 90. The head 72 has an engagement hole formed therein that engages with the tip of a rotary tool such as a screwdriver or hex wrench, and by rotating such a rotary tool, the posterior wall plate fixing pin 7 advances into the first fixation pin insertion hole 26 in the intramedullary nail 2.

[0046] 12, the head 52 of the rear wall plate fixing pin 7 is preferably configured to have a bowl-shaped contact surface 72a that contacts along the inner circumferential surface (inner circumferential surface having a bowl-shaped surface shape) of the through hole of the above-mentioned rear wall plate 5. This bowl-shaped contact surface 72a is formed mainly on the head surface side facing the shaft portion 71. Due to such a structure of the head 72 of the rear wall plate fixing pin 7 and the inner circumferential surface of the through hole 53 of the rear wall plate 5, the rear wall plate 5 is configured to be rotatable with respect to the rear wall plate fixing pin 7 with the head 72 of the rear wall plate fixing pin 7 in contact with the inner circumferential surface of the plate through hole 53.

[0047] The length of the shank 71 of the posterior wall plate fixation pin 7 is set so that its tip reaches a position near the femoral neck. By setting this length, the tip side of the posterior wall plate fixation pin 7 engages with the vicinity of the femoral neck via the intramedullary nail 2, making it possible to further prevent the femoral head 91, into which the lag screw 3 is driven, from rotating relative to the fractured portion 92. In this embodiment, a screw is not formed at the tip of the shank 71 of the posterior wall plate fixation pin 7. However, a screw may be formed on the surface of the tip of the shank 71 so that the tip side of the posterior wall plate fixation pin 7 is screwed into the femoral neck by this screw. The length of the shank 71 of the posterior wall plate fixation pin 7 may be set so that its tip reaches the femoral head of the femur 90, or it may be formed short so that it does not reach a position near the femoral neck.

[0048] Next, an example of an operating procedure for femoral head fracture treatment surgery using the fracture treatment fixation device 1 according to this embodiment will be described. First, as preparation before surgery, the surgeon takes an X-ray of the patient's healthy limb and selects an intramedullary nail 2 suitable for the patient. Then, the intramedullary nail 2 is attached to a conventionally known targeting device (not shown). The patient is then placed in a supine position and immobilized with the affected limb in traction. The surgeon then reduces the fractured portion 92 of the patient's femur 90 while imaging the affected limb with a radiographic device (not shown).

[0049] Next, the skin near the femur 90 is incised, and a guide wire for the intramedullary nail is inserted into the femur 90. Using the guide wire as a guide, a hole is formed in the femur 90 with a drill (not shown), creating a fenestration in the femur 90. The intramedullary nail 2 connected to the targeting device is then inserted into the fenestration. At this time, a guide wire is passed through the intramedullary nail 2, and the intramedullary nail 2 is inserted using this as a guide. Note that when drilling the femur 90 and inserting the intramedullary nail 2 into the cavity (medullary cavity) of the femur 90, the pelvis gets in the way, so the intramedullary nail 2 is inserted at a slight angle from the proximal portion 21 side of the femur 90 relative to the cavity.

[0050] Next, the lag screw 3 is inserted into the femur 90 so as to pass through the lag screw insertion hole 24 of the intramedullary nail 2, and the lag screw 3 is advanced until the screw portion at the tip reaches the position of the femoral head 91. Similarly, the antirotation screw 8 is inserted into the femur 90 so as to pass through the antirotation screw insertion hole formed in the intramedullary nail 2, and the screw portion at the tip reaches the position of the femoral head 91.

[0051] Thereafter, with the posterior wall plate fixation pin 7 inserted through the plate through-hole 53 in the posterior wall plate 5, the tip of the shank 71 of the posterior wall plate fixation pin 7 is inserted into the second fixation pin insertion hole 27 formed in the intramedullary nail 2, and the male thread portion 71a formed on the shank 71 of the posterior wall plate fixation pin 7 is screwed into the female thread portion formed on the inner circumferential surface of the second fixation pin insertion hole 27 in the intramedullary nail 2. Note that, before inserting the posterior wall plate fixation pin 7, a drill is used to form a bore hole for inserting the fixation pin in the corresponding position on the femur 90. Note that the depth of the bore hole for inserting the posterior wall plate fixation pin 7 corresponds to the length of the shank 71 of the posterior wall plate fixation pin 7. As the posterior wall plate fixing pin 7 and the intramedullary nail 2 are threaded together, the distance between the posterior wall plate 5 and the posterior wall of the trochanter 94 decreases, as shown in Figure 3, and the trochanter 94 is held and fixed in place with the bone fragment Z of the posterior wall portion that has separated from the trochanter 94 attached to a predetermined position on the trochanter 94. The posterior wall plate 5 has three claws 52, so that the bone fragment Z of the posterior wall portion that has separated from the trochanter 94 can be stably placed in position and fixed in place.

[0052] Next, with the anterior wall plate fixation pin 6 inserted through the plate through-hole 43 in the anterior wall plate 4, the tip of the shank 61 of the anterior wall plate fixation pin 6 is inserted into the first fixation pin insertion hole 26 formed in the intramedullary nail 2, and the male thread portion 61a formed on the shank 61 of the anterior wall plate fixation pin 6 is threadedly engaged with the female thread portion formed on the inner circumferential surface of the first fixation pin insertion hole 26 in the intramedullary nail 2. Before inserting the anterior wall plate fixation pin 6, a drill is used to drill a hole for inserting the fixation pin at the corresponding position on the femur 90. As the anterior wall plate fixation pin 6 is threadedly engaged with the intramedullary nail 2, the anterior wall plate 4 can be fixed in contact with the anterior wall of the trochanter 94, as shown in FIGS. 13 and 14 , and the trochanter 94 of the femur can be sandwiched between the anterior wall plate 4 and the posterior wall plate 5, as shown in FIG. 3 . The posterior wall plate 5 and the posterior wall plate fixation pin 7 are omitted from FIGS. 13 and 14 .

[0053] Finally, the intramedullary nail 2 and the femur 90 are fixed with a locking screw 2b through the fixation hole 25 formed in the distal portion 23 of the intramedullary nail 2, and an end cap for preventing bone tissue from entering the inside of the intramedullary nail 2 is screwed into the cap hole 2a formed at the upper end of the intramedullary nail 2, and the incision is sutured to complete the surgery.

[0054] As described above, the fracture treatment fixation device 1 according to the present invention is configured to include the anterior wall plate fixation pin 6 that integrally engages with the intramedullary nail 2, and the anterior wall plate 4 that is placed against the anterior wall portion of the trochanteric portion 94 via the anterior wall plate fixation pin 6. Therefore, even if a load is applied to the fractured portion during rehabilitation such as walking training after the completion of surgery, the anterior wall plate 4 acts as a stopper, effectively preventing the tip of the intramedullary nail from moving posteriorly. As a result, it is possible to extremely effectively prevent the reduced femoral head fragment from shifting into the intramedullary form or the reduced posterior wall portion Z from separating again from the trochanteric portion. The fracture treatment fixation device 1 of the present invention is particularly useful when treating fractures in which a portion of the circumferential portion of the separated posterior wall bone fragment Z is located near the cortical bone at the outer end of the lag screw 3, or when it is located at the insertion position of the lag screw 3 and the cortical bone at the outer end of the lag screw 3 is not maintained in its entirety (as shown in image B of Figure 20; when the fracture line overlaps the outer end of the lag screw 4), or when treating a reverse oblique fracture.

[0055] Furthermore, as described above, the fracture treatment fixation device 1 according to this embodiment is configured to include the rear wall plate 5, and therefore, even if a fracture occurs in the rear wall of the trochanter 94 and the trochanter 94 is separated, the separated fracture fragment Z can be fixed in a state where it is pressed against a predetermined position on the trochanter 94. Furthermore, since the structure is such that the trochanter of the femur can be clamped between the front wall plate 4 and the rear wall plate 5, it is possible to firmly fix the fracture fragments and the fracture treatment fixation device 1 to the femur, and it is possible to effectively prevent the reduced posterior wall portion from being separated again from the trochanter 94 while preventing the intramedullary nail from becoming unstable.

[0056] Furthermore, the anterior wall plate fixation pin 6, which fixes the anterior wall plate 4 to the anterior wall surface, is configured to be threadably engageable with a female thread formed on the inner peripheral surface of the first fixation pin insertion hole 26 in the intramedullary nail 2. Since the anterior wall plate 4 is fixed to the anterior wall surface of the trochanteric region, by adjusting the degree of threading of the anterior wall plate fixation pin 6, the installation position of the intramedullary nail 2 in the inner cavity (medullary cavity) of the femur 90 can be adjusted to a state closer to the anterior wall or a state closer to the posterior wall. This makes it possible to adjust the reduction position of the separated posterior wall portion Z interposed between the posterior wall plate 5 and the intramedullary nail 2 relative to the trochanteric region. In other words, it is possible to adjust and reduce the fracture to an extramedullary type, which is a preferred reduction state for treating femoral fractures, and to effectively maintain that state, thereby effectively preventing excessive telescoping. Here, the extramedullary type refers to a state in which the medial cortex of the proximal bone fragment rests on the cortex of the distal bone fragment, and in the case where the posterior wall portion is fractured and separated, it refers to a state in which the medial cortex of the posterior wall portion rests on the cortex of the trochanter portion.

[0057] Furthermore, the front wall plate 4 and the rear wall plate 5 included in the fracture treatment fixation device 1 according to the present invention have at least three claws 42, 52, and are configured so that an imaginary line connecting the tips of the claws 42, 52 forms an isosceles triangle. With this configuration, even if there is only a relatively small installation space, it becomes possible to stably apply and fix the front wall plate 4 and the rear wall plate 5 to the front wall and the rear wall of the trochanter portion 94.

[0058] Furthermore, by forming the plate through holes 43, 53 formed in the front wall plate 4 and the rear wall plate 5 so that their centers do not coincide with the circumcenter of the triangular figure formed by the imaginary lines connecting the tips of the claw portions 42, 52, the front wall plate 4 and the rear wall plate 5 can be configured to have at least two different dimensions for the distance from the center (corresponding to the center of the plate through holes 43, 53) of the heads 62, 72 of the front wall plate fixing pin 6 and the rear wall plate fixing pin 7 inserted into the plate through holes 43, 53 to the tip end of each claw portion 42, 52 (claw tip portions 42b, 52b). With this configuration, by rotating the front wall plate 4 and the rear wall plate 5 around the front wall plate fixing pin 6 (around the rear wall plate fixing pin 7) to the position where you want to press the claw tips 42b, 52b against the anterior wall portion of the trochanter portion 94, it becomes easier to abut the claw tips 42b, 52b, and it becomes possible to press and fix the front wall plate 4 against the anterior wall of the trochanter portion 94 more stably and to apply the rear wall plate 5 to the separated rear wall portion.

[0059] Furthermore, the plate through holes 43, 53 formed in the base portions 41, 51 of the front wall plate 4 and the front wall plate 5 are formed so that the inner peripheral surface thereof has a bowl-shaped surface shape that decreases in diameter in the direction of insertion of the front wall plate fixing pin 6 or the front wall plate fixing pin 7, and further, the heads 62, 72 of the front wall plate fixing pin 6 or the rear wall plate fixing pin 7 are configured to have a bowl-shaped surface abutment surface that abuts along the inner peripheral surface (inner peripheral surface having a bowl-shaped surface shape) of the through holes of the front wall plate 4 or the rear wall plate 5, thereby making it possible to fix the front wall plate. In the process of inserting the anterior wall plate fixing pin 6 and the posterior wall plate fixing pin 7 into the intramedullary nail 2 and threading them into the first fixing pin insertion holes 26, 27, the anterior wall plate 4 and the posterior wall plate 5 are configured to be rotatable relative to the anterior wall plate fixing pin 6 and the posterior wall plate fixing pin 7, as shown in Figures 13 and 14, with the heads 62, 72 of the anterior wall plate fixing pin 6 and the posterior wall plate fixing pin 7 in contact with the inner circumferential surfaces of the plate through holes 43, 53. The ability of the anterior wall plate 4 and the posterior wall plate 5 to rotate in this manner allows the anterior wall plate 4 and the posterior wall plate 5 to be installed in the most stable position, making it possible to more stably apply and fix the anterior wall plate 4 to the anterior wall portion of the trochanter portion 94 and apply the posterior wall plate 5 to the separating posterior wall portion.

[0060] Furthermore, as described above, the plate through holes 43, 53 formed in the front wall plate 4 and the rear wall plate 5 are formed so that their centers do not coincide with the circumcenter of the triangular figure formed by the imaginary lines connecting the tips of the claw portions 42, 52. This means that the distance from the center of the heads 62, 72 of the front wall plate fixing pin 6 and the rear wall plate fixing pin 7 inserted into the plate through holes 43, 53 (corresponding to the center of the plate through holes 43, 53) to the tip of each claw portion 42, 52 (claw tips 42b, 52b) is longer than the other claw tips 42b, 52b. Furthermore, when the front wall plate 4 and the rear wall plate 5 are configured to be rotatable relative to the front wall plate fixing pin 6 and the rear wall plate fixing pin 7 as described above, the claw tips 42b, 52b with this longer distance have a larger spatial rotation range (movable area). This makes it easier to abut the claw tips 42b, 52b, which are located a long distance from the center of the heads 62, 72, against the surface of the trochanter portion 94, which has various uneven shapes (surface undulations), allowing the front wall plate 4 to be pressed and fixed more stably against the front wall of the trochanter portion 94 and the rear wall plate 5 to abut against the separating rear wall portion.

[0061] The front wall plate 4 is not limited to the above-described configuration and may be configured, for example, as shown in FIG. 15 . FIG. 15( a) is a plan view of a front wall plate 4 according to a modified example, FIG. 15( b) is a side view seen from direction A in FIG. 15( a), and FIG. 15( c) is a side view seen from direction B in FIG. 15( a). The front wall plate 4 shown in FIG. 15 includes a base portion 41 that is circular in plan view and a pair of claw portions 42. A plate through-hole 43 into which a front wall plate fixing pin 6 is inserted is formed in the center of the circular base portion 41 in plan view. The inner circumferential surface of the plate through-hole 43 is preferably formed into a bowl-shaped surface shape whose diameter decreases in the direction in which the front wall plate fixing pin 6 is inserted. The claw portions 42 are provided on both sides of the center of the base portion 41. Each claw 42 has a claw arm 42a that protrudes slightly radially outward from the circular base 41 in a plan view. A claw tip 42b is provided at the distal end of the claw arm 42a. The claw tip 42b abuts against the anterior wall of the femoral trochanter 94 and is formed to protrude at a 90-degree angle relative to the claw arm 42a. A through-hole 45 is formed at the boundary between the claw arm 42a and the base 41. The through-hole 45 is formed with its axis perpendicular to the thickness direction of the base 41, and has openings on both sides of the claw arm 42a. Instead of forming the through-hole 45 at the boundary between the claw arm 42a and the base 41, a configuration in which the through-hole 45 is formed in the claw arm 42a may be adopted. A recess 46 is formed on the outer peripheral surface of the circular base 41 in a plan view. The recess 46 is preferably configured to smoothly connect with the inner peripheral surface of the through hole 45. The recess 46 may be formed using a separate cutting tool or device after the through hole 45 is formed using a tool or device such as a drill, or may be formed simultaneously with the through hole 45 being formed using a tool or device such as a drill. The rear wall plate 5 may be configured as shown in FIG. 15. The above-described through hole 45 may also be formed in the claw arm portion 42a (52a) of the front wall plate 4 having the configuration shown in FIG. 7 or the rear wall plate 5 having the configuration shown in FIG. 10.Further, a recess 46 may be formed on the outer peripheral surface of the base portion 41 of the front wall plate 4 in the form shown in FIG. 7 or the rear wall plate 5 in the form shown in FIG.

[0062] When using a front wall plate 4 (rear wall plate 5) of the type shown in Figure 15, it is possible to insert a wire into each through hole 45 and wrap this wire around the trochanter portion 94 of the femur.Even if a fracture occurs in the posterior wall of the trochanter portion 94 and the trochanter portion 94 is separated, it is possible to firmly press the separated bone fragment Z against a predetermined position on the trochanter portion 94, allowing for more reliable fixation of the fracture fragment Z and the fracture treatment fixation device 1 to the femur, and effectively preventing the reduced posterior wall portion from separating again from the trochanter portion 94 while preventing the intramedullary nail from becoming unstable.

[0063] In addition, a recess 46 is formed on the outer surface of the base portion 41, which is circular in plan view and has a front wall plate 4 (rear wall plate 5), so that the wire, which is arranged to be wound along the outer surface of the base portion 41, can be effectively prevented from slipping over the outer surface of the base portion 41 and coming out on the upper or lower side of the base portion 41.

[0064] Although one embodiment of the present invention has been described above, the present invention is not limited to the above embodiment. For example, in the above embodiment, the fracture treatment fixation device 1 according to the present invention is configured to include the posterior wall plate 5 and the posterior wall plate fixation pin 7 and to be able to reduce the separated posterior wall portion to the trochanteric portion. However, since the fracture treatment fixation device 1 according to the present invention can also be used to treat femoral fractures in which the posterior wall portion is not separated, the fracture treatment fixation device 1 can be configured in an embodiment that does not include the posterior wall plate 5 and the posterior wall plate fixation pin 7. Even in this configuration that includes the anterior wall plate 4 and the anterior wall plate fixation pin 6 but does not include the posterior wall plate 5 and the posterior wall plate fixation pin 7, it is possible to effectively prevent the tip of the intramedullary nail 2 from moving backward even if a load is applied to the fractured portion during rehabilitation such as gait training after surgery, and to prevent excessive external force from being applied to the neck fracture portion, etc.

[0065] Furthermore, in the above embodiment, a configuration may be adopted in which a plurality of anti-rotation screws 8 can be inserted into the femoral head 91 via the intramedullary nail 2, or alternatively, a configuration may be adopted in which no anti-rotation screws are provided.

[0066] Furthermore, for example, in the above embodiment, the tip portions of the three claw portions 42, 52 of the front wall plate 4 and the rear wall plate 5 are configured to be positioned at the vertices of a substantially isosceles triangle, but the present invention is not limited to this configuration, and the tip portions of the three claw portions 42, 52 may be formed to correspond to the vertices of various triangles other than an isosceles triangle. Furthermore, for example, in the above embodiment, the front wall plate 4 and the rear wall plate 5 are configured to have three claw portions 42, 52, but they may be configured to have four or more claw portions 42, 52.

[0067] Furthermore, in the above embodiment, the anterior wall plate fixing pin 6 is positioned closer to the tip of the intramedullary nail 2 than the posterior wall plate fixing pin 7, and the anterior wall plate 4 is positioned closer to the tip of the intramedullary nail 2 than the posterior wall plate 5, but this is not particularly limited to such an embodiment, and the posterior wall plate fixing pin 7 may be positioned closer to the tip of the intramedullary nail 2 than the anterior wall plate fixing pin 6, and the posterior wall plate 5 may be positioned closer to the tip of the intramedullary nail 2 than the anterior wall plate 4.

[0068] In the above embodiment, two or more first fixation pin insertion holes 26 may be formed in a vertically aligned manner at a predetermined position of the intramedullary nail 2, and the anterior wall plate 4 may be attached to each of the first fixation pin insertion holes 26 via the anterior wall plate fixation pins 6. When forming a plurality of first fixation pin insertion holes 26 in this manner, the anterior wall plate 4 may be attached via the anterior wall plate fixation pins 6 by selecting and using some of the first fixation pin insertion holes 26, or the anterior wall plate 4 may be attached via the anterior wall plate fixation pins 6 to all of the first fixation pin insertion holes 26. Here, when forming a plurality of first fixation pin insertion holes 26, the hole axes of the first fixation pin insertion holes 26 may be configured to be parallel to each other or may be configured to be at different angles. In this way, forming a plurality of first fixation pin insertion holes 26 in the intramedullary nail 2 expands the options for the attachment position of the anterior wall plate 4, making it possible to treat various femoral fractures that differ from patient to patient. Furthermore, when the front wall plates 4 are attached to all of the first fixation pin insertion holes 26 via the front wall plate fixation pins 6, the fracture treatment fixation device 1 can be more firmly fixed to the femur using multiple front wall plates 4. Therefore, even if a load is applied to the fractured area during rehabilitation such as walking training after the surgery is completed, each front wall plate 4 will act as a stopper, and it is possible to more effectively prevent the tip of the intramedullary nail from moving backward.

[0069] Similarly, two or more second fixation pin insertion holes 27 may be formed in a predetermined position of the intramedullary nail 2, aligned in the vertical direction, so that the posterior wall plate 5 can be attached to each second fixation pin insertion hole 27 via the posterior wall plate fixation pin 7. When forming a plurality of second fixation pin insertion holes 27 in this manner, the posterior wall plate 5 may be attached to some of the second fixation pin insertion holes 27 via the posterior wall plate fixation pins 7, or the posterior wall plate 5 may be attached to all of the second fixation pin insertion holes 27 via the posterior wall plate fixation pins 7. Here, when forming a plurality of second fixation pin insertion holes 27, the hole axes of the second fixation pin insertion holes 27 may be configured to be parallel to each other or may be configured to be at different angles. In this way, forming a plurality of second fixation pin insertion holes 27 in the intramedullary nail 2 expands the options for the attachment position of the posterior wall plate 5, making it possible to treat a variety of femoral fractures that differ from patient to patient. Furthermore, when the rear wall plates 5 are attached to all of the second fixation pin insertion holes 27 via the rear wall plate fixation pins 7, even if a fracture occurs in the rear wall of the trochanter 94 and the trochanter 94 is separated, the separated bone fragment Z can be firmly pressed against a predetermined position on the trochanter 94 by the multiple rear wall plates 5, and since the trochanter of the femur can be clamped over a wide area between the front wall plate 4 and the rear wall plate 5, the fracture fragment Z and the fracture treatment fixation device 1 can be fixed to the femur more reliably and firmly, and the intramedullary nail can be prevented from moving while effectively preventing the reduced rear wall portion Z from being separated again from the trochanter 94.

[0070] Furthermore, in the above embodiment, the front wall plate fixing pin 6 and the rear wall plate fixing pin 7 are arranged at a predetermined angle inclined toward the entrance of the lag screw insertion hole 24 with respect to the axis of the lag screw insertion hole 24 (axis of the lag screw 3), but the angle of inclination of the front wall plate fixing pin 6 with respect to the axis of the lag screw insertion hole 24 (axis of the lag screw 3) and the angle of inclination of the rear wall plate fixing pin 7 with respect to the axis of the lag screw insertion hole 24 (axis of the lag screw 3) may be configured to be the same angle. With this configuration, the fracture treatment fixture 1 can be used to treat fractures of either the right or left femur. [Explanation of symbols]

[0071] 1 Fixed device for fracture treatment 2 Intramedullary nail 21 Proximal part of intramedullary nail 22 Tapered portion of intramedullary nail 23 Distal part of intramedullary nail 24 Lag screw insertion hole 25 Fixing hole 26 First fixing pin insertion hole 27 Second fixing pin insertion hole 2a Cap hole 2b Locking screw 3 lag screws 4 Front wall plate 41 Base 42 Claw 42a Claw arm part 42b Tip of the claw 43 Plate through hole 5 Rear wall plate 51 Base 52 Claw 52a Claw arm 52b Tip of the claw 53 Plate through hole 6 Front wall plate fixing pin 61 Shaft 61a Male thread 62 Head 62a Contact surface 7 Rear wall plate fixing pin 71 Shaft 71a Male thread 72 Head 72a Contact surface 8 Anti-rotation screw 90 Femur 91 Bone head 92 Neck fracture 93 Femoral neck 94 Trochanter

Claims

1. A fracture treatment fixation device for treating a femur fracture, an intramedullary nail inserted into the femoral cavity; a lag screw disposed so as to penetrate the intramedullary nail obliquely upward and enter the femoral head and femoral neck; an anterior wall plate that is applied to the anterior wall of the femoral trochanter; a front wall plate fixing pin that is arranged to penetrate the intramedullary nail and fixes the front wall plate to the anterior wall of the femoral trochanter.

2. 2. The bone fracture treatment fixation device according to claim 1, wherein the front wall plate fixing pin is configured to be able to be screwed onto the intramedullary nail.

3. 3. The fixation device for treating a bone fracture according to claim 1, wherein the front wall plate has a claw portion that abuts against the surface of the femoral trochanter.

4. The fixation device for treating fractures according to claim 1 or 2, characterized in that the front wall plate has a base portion that is circular in a plan view and a plurality of claw portions that protrude radially outward from the base portion, each of the claw portions having a through hole formed in a direction perpendicular to the thickness direction of the base portion, and the through hole has openings on one side and the other side of the claw portion.

5. 5. The bone fracture treatment fixation device according to claim 4, wherein a recess is formed on the outer peripheral surface of the base portion, and the recess is connected to the inner peripheral surface of the through hole.

6. 3. The fixation device for treating bone fracture according to claim 1, wherein the intramedullary nail has a plurality of first fixation pin insertion holes into which the front wall plate fixation pins can be inserted.

7. 3. The fixation device for treating a fracture according to claim 1 or 2, which is intended to treat a fracture accompanied by a posterior femoral fragment in addition to a femoral neck fracture.

8. 3. The bone fracture treatment fixation device according to claim 1, further comprising a posterior wall plate that is applied to the posterior wall of the femoral trochanter, and a posterior wall plate fixation pin that is arranged to pass through the intramedullary nail and fixes the posterior wall plate to the posterior wall of the femoral trochanter.

9. The bone fracture treatment fixture according to claim 8, wherein the anterior wall plate and the posterior wall plate are configured to be able to clamp a trochanteric portion of the femur.

10. 9. The bone fracture treatment fixation device according to claim 8, wherein the rear wall plate fixing pin is configured to be able to be screwed onto the intramedullary nail.

11. 9. The fixation device for treating a bone fracture according to claim 8, wherein the rear wall plate has a claw portion that abuts against the surface of the femoral trochanter.

12. 9. The bone fracture treatment fixation device according to claim 8, wherein the front wall plate fixing pin is arranged closer to the tip of the intramedullary nail than the rear wall plate fixing pin.

13. 9. The fracture treatment fixation device according to claim 8, wherein the inclination angle of the anterior wall plate fixation pin relative to the axis of the lag screw and the inclination angle of the posterior wall plate fixation pin relative to the axis of the lag screw are the same angle, and the device is suitable for treating fractures of either the left or right femur.

14. 9. The fixation device for treating bone fracture according to claim 8, wherein the intramedullary nail has a plurality of second fixation pin insertion holes into which the rear wall plate fixation pins are inserted.

15. The bone fracture treatment fixation device according to claim 8, characterized in that the intramedullary nail has a plurality of first fixation pin insertion holes into which the front wall plate fixation pins can be inserted, and a plurality of second fixation pin insertion holes into which the rear wall plate fixation pins can be inserted.

Images