Plate used for clavicle fracture or the like

Abstract

To address such a problem that in a case of distal clavicle fractures requiring osteosynthesis, even when being fixed using a hook plate or tension band fixation, problems such as rotator cuff tears, restricted range of motion, acromial resorption, or insufficient fixation strength have been observed.SOLUTION: A distal end of a plate stem and a bent part allow for fixation of a distal bone fragment to a proximal bone fragment. When a locking screw is fixed within a bone marrow through a hole in the bent part, complications associated with hooks of conventional hook plates are eliminated and an effect similar to that of a hook plate is achieved. In addition, a tension band fixing method, etc. can be performed through the hole of the bent part. This solves problems such as the rotator cuff tears, restricted range of motion, acromial resorption, or insufficient fixation strength. It can also be applied to fractures other than acromioclavicular joint dislocation and distal clavicle fractures.SELECTED DRAWING: Figure 5

Description

Detailed Description of the Invention [Technical Field]

[0001] The present disclosure relates to methods and tools for fixating fractures such as clavicle fractures and acromioclavicular joint dislocations in the field of orthopedic surgery. [Background technology]

[0002] For example, in the case of a distal clavicle fracture, as shown in Figure 1, there is a method called a hook plate 1, in which a hook 3 is hooked onto the acromion 2, and the fracture 5 of the clavicle 4 is secured with a plate 6 and a screw 7. In this case, the hook is positioned above the rotator cuff 8 of the shoulder joint.

[0003] As shown in Figure 2, there was also a method called tension band fixation, in which steel wire 9 and soft steel wire 10 were fastened together in a figure-eight pattern to fix the fracture 5 to the proximal clavicle.

[0004] Summary of the Invention Problems with the prior art

[0005] However, this type of fixation method had the following problems. With the hook plate method shown in Figure 1, the hook 3 extended below the acromion 2, which could cause contact with the rotator cuff 8 of the shoulder joint, resulting in rotator cuff injury. Contact with the hook 3 could also cause osteolysis of the acromion 2. Furthermore, shoulder elevation was restricted for a long period after surgery, leading to shoulder contracture. Furthermore, with the tension band fixation method shown in Figure 2, if the distal clavicle bone fragment 11 was small, only a thin steel wire 9 could be used. However, due to the strong traction force of muscles such as the sternocleidomastoid muscle, a thin steel wire 9 sometimes provided insufficient fixation.

[0006] In consideration of these problems, the present invention fastens the proximal clavicle with the plate stem 12 (the portion positioned along the longitudinal axis of the clavicle) and screws 7, as shown in Figure 3, and holds down the distal clavicle fragment 11 at the bent portion A13 (the portion bent so that it can be placed on the surface of the distal clavicle, corresponding to the articular surface of the acromion of the acromioclavicular joint). This fixes the distal clavicle fragment 11 to a certain extent. As shown in Figures 3 and 4, this bent portion A13 has holes 14. By inserting screws 15 or steel wires 9 through the holes 14 toward the proximal medullary cavity of the fracture, as shown in Figures 5 and 6, the distal clavicle fragment 11 can be further fixed. Instead of placing the hook 3 portion under the acromion 2 as in conventional hook plates 1, this internal fixator covers the distal clavicle with the bent portion A13 side of the plate stem 12 and the bent portion A13, and by inserting screws 15 or steel wires 9 into the clavicle, the fixation force is increased. Means for Solving the Problems

[0007] In the hook plate 1, the hook 3 is positioned below the acromion, which inhibits movement of the distal clavicle fragment 11 and generates a force to fix the fracture. However, instead of this function, the distal clavicle fragment 11 is held down by the bent portion A13 side of the plate trunk 12 and the bent portion A13. By making this bent portion A13 sufficiently wider than the hook 3, the bone fragment 11 is held down sufficiently. The hook 3 does not have this function. Furthermore, by inserting a screw 15 or steel wire 9 through the hole 14 of this bent portion A13 into the longitudinal axis of the medullary canal proximal to the fracture or in a direction similar to that (such as passing through the longitudinal axis of the medullary canal and having the tip perforate the cortical bone), the distal clavicle fragment 11 can be further fixed. In this way, instead of placing the hook 3 portion below the acromion, by creating a bent portion A13 and inserting the screw 15 or steel wire 9 into the clavicle, the fixation force is increased. Effects of the Invention

[0008] With this configuration, the hook 3 does not come under the acromion as with the hook plate 1, so shoulder plate damage does not occur. Furthermore, acromion lysis due to the hook 3 does not occur because there is no such structure. Furthermore, there is no need to impose postoperative range of motion restrictions as with the hook plate 1 (for example, not allowing the shoulder to be elevated above 90 degrees for several months to half a year), so there are no restrictions on shoulder range of motion training, which is advantageous for preventing postoperative contracture. Furthermore, compared to conventional tension band fixation alone, this plate allows the distal bone fragment 11 to be returned to its original position by fastening the stem with a screw, and the distal bone fragment 11 can be fixed to the proximal clavicle by holding it down on the bending portion A13 side of the plate stem 12 and at bending portion A13. Furthermore, by inserting steel wire 9 into the medullary cavity proximal to the fracture via hole 14 and using soft steel wire 10 for figure-of-eight fixation, the conventional plate method plus tension band fixation can be performed, further increasing the fixation force between the distal clavicle fragment 11 and the proximal clavicle fracture. Furthermore, by cutting threads into the hole 14, the threads of the screw 15 can engage and provide locking fixation. This is because a similar effect can be achieved by placing the hook 3 portion of a conventional hook plate 1 within the medullary cavity of the clavicle rather than under the acromion 2, and the absence of the hook 3 portion prevents complications. Furthermore, when the bone fragment 11 is extremely small or in cases where there is damage to the acromioclavicular joint ligament rather than a fracture, a guide 16 such as that shown in Figure 7 can be used to insert a steel wire 9 or screw via the arrow 17 through the acromion, allowing for fixation of the acromioclavicular joint via the acromion.

[0009] [Brief explanation of the drawings]

[0010] [Figure 1] An explanatory diagram of a conventional method for fixing a fracture [Figure 2] An explanatory diagram of a conventional method for fixing a fracture [Figure 3] An explanatory diagram of a method for fixing a fracture according to the present technology. [Figure 4] An explanatory diagram of a method for fixing a fracture according to the present technology. [Figure 5] FIG. 1 is an explanatory diagram of a method for fixing a fracture according to the present invention (first embodiment); [Figure 6] FIG. 2 is an explanatory diagram of a method for fixing a fracture according to the present invention (second embodiment); [Figure 7] FIG. 3 is an explanatory diagram of a method for fixing a fracture according to the present invention (third embodiment). [Figure 8] FIG. 3 is an explanatory diagram of a method for fixing a fracture according to the present invention (third embodiment). [Figure 9]FIG. 4 is an explanatory diagram of a method for fixing a fracture according to the present invention (fourth embodiment). DETAILED DESCRIPTION OF THE INVENTION

[0011] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0012] First Embodiment In the first embodiment, as shown in Figure 3, the proximal clavicle fracture is secured to the plate stem 12 (the portion positioned along the longitudinal axis of the clavicle) with a screw 7, thereby compressing the distal clavicle fragment 11 (from above relative to the body in this figure). The distal clavicle fragment 11 is then compressed by the bending portion A13 (the portion bent to allow placement on the surface of the distal clavicle, corresponding to the articular surface of the acromion of the acromioclavicular joint) so as to apply axial pressure to the longitudinal axis of the clavicle from the articular surface side. This fixes the distal clavicle fragment 11 to a certain extent. As shown in Figures 3 and 4, a hole 14 is drilled in the bending portion A13. The distal clavicle fragment 11 can be further fixed by inserting a screw 15 through the hole 14 toward the medullary canal proximal to the fracture, as shown in Figure 5. Furthermore, by cutting a thread into the hole 14, the threads of the screw 15 can be engaged to achieve locking fixation. When locking fixation is achieved, the hole 14 and the screw 15 are rigidly fixed, eliminating any play. A similar effect can be achieved by placing the hook 3 portion of a conventional hook plate 1 in the medullary cavity of the clavicle rather than under the acromion 2. Furthermore, since there is no conventional hook 3 portion, no complications arise.

[0013] With this configuration, the distal clavicle fragment 11 can be fixed by being held down by the plate stem 12 and the bent portion A13. The distal clavicle fragment 11 can also be further fixed with the screw 15. While the locking fixation provides an effect similar to that of the conventional hook 3 portion, the absence of the conventional hook 3 portion eliminates the associated complications. In other words, there is no risk of shoulder plate damage, acromion lysis, or contracture due to limited range of motion after surgery.

[0014] Second Embodiment In the second embodiment, as shown in Figure 6, the distal clavicle fragment 11 can be further fixed by inserting a steel wire 9 into the longitudinal axis of the medullary canal of the fracture 5 proximal to the fracture 5 or in a direction equivalent thereto (such as passing through the longitudinal axis of the medullary canal and allowing the tip to perforate the cortical bone) via the hole 14 in the bent portion A13. The fixation force can be increased by creating a bent portion 13 and inserting a screw 15 or steel wire 9 into the clavicle. A tension band fixation method can be performed by wrapping a soft steel wire 10 in a figure-eight pattern using the steel wire 9 or screw 7 as an anchor.

[0015] Third Embodiment In the third embodiment, when the bone fragment 11 is extremely small or when the acromioclavicular joint ligament is damaged rather than fractured, a guide 16 as shown in FIG. 7 is used to insert a steel wire 9 or a screw from the arrow 17 via the acromion, thereby enabling tension band fixation of the acromioclavicular joint via the acromion as shown in FIG. 8.

[0016] <Fourth embodiment> In the fourth embodiment, as shown in Figure 9, the bending portion B18 is located in front or behind the longitudinal axis of the plate trunk 12. The bending portion B may have a hole 19. A screw or steel wire can be inserted through the hole 19. This hole may have a thread to enable locking fixation with a screw. [Industrial Applicability]

[0017] It can be used primarily for the treatment of fractures in the field of medical orthopedics, particularly clavicle fractures (especially distal clavicle fractures) and acromioclavicular joint dislocations. [Explanation of symbols]

[0018] 1 hook plate 2 acromion 3 hooks 4 clavicle 5 fractures 6 plates 7 screws 8 Rotator Cuff 9 Steel Wire 10 mild steel wire 11 bone fragments 12 Plate Executives 13 Bend A 14 holes 15 screws 16 Guide 17 arrows 18 Bend part B 19 holes

Claims

1. This plate is used for distal clavicle fractures (or clavicle fractures) and consists of a plate stem and a bending section A. The plate stem is placed on the long axis of the clavicle. The bending section A can be placed so as to cover the distal end of the clavicle at the acromioclavicular joint (covering the bone on the acromioclavicular joint space side, i.e., the part bending at an angle close to 90 degrees to the long axis). This bending section A has a hole. This plate allows screws or steel wires to be inserted into the bone marrow of the clavicle in the direction of the long axis of the clavicle medullary cavity or at an angle similar to that. This hole is used for screw fixation, steel wire fixation, and tension band fixation. The plate stem also has a screw hole for fastening the clavicle with a screw.

2. 2. The plate of claim 1, which is used for fractures of the distal end of the clavicle (or clavicle fracture) or similar structures, wherein one end of the bending portion A is bent into a hook shape, and the hook portion can be driven into the clavicle.

3. The plate of claim 1 includes a guide that can be attached to the plate and the screw that passes through it, so that a screw or steel wire can be fixed to the hole in the flexion part A via the acromion. This allows it to be used when the distal bone fragment is very small or when the acromioclavicular ligament is being reduced.

4. The plate of claim 1 has a bending portion B in front or behind the stem of the plate. This bending portion B is located at a position that includes at least 3 cm from the proximal end of bending portion A in the human body (or the stem end of bending portion A as seen from the stem of the plate). This bending portion B has a hole through which a screw or steel wire can be inserted at an angle of 50 degrees or more relative to the screw installed on the long axis of the clavicle. In other words, while the screws in the stem of the plate are generally inserted in the vertical direction, this hole can be used to insert a screw or steel wire in the anterior-posterior direction. The hole may or may not be threaded to allow for locking fixation.

5. In the plate of claims 1-4, when the plate is fixed to the hole of the bending portion A with a screw, threads are cut on both the hole and the screw so that locking fixation can be achieved.

6. A plate according to any one of claims 1 to 5, wherein the bending portion A has no holes.

7. A plate according to claims 1-6, wherein the inside of the bending portion A (the side in contact with the distal end of the clavicle) is 5 mm or more in width and 3 mm or more in depth so as to cover the side of the distal end of the clavicle facing the articular surface of the acromion of the acromioclavicular joint.

8. A plate according to claims 1-7, having a bent portion B of the same structure as bent portion A, the inner surface of which is the same as the inside of bent portion A, with a width of 5 mm or more and a depth of 3 mm or more.

9. The plates of claims 1-8 include plates for fractures other than clavicle fractures that have a similar structure consisting of a plate portion (plate stem) that is aligned with the axis, which is the columnar portion when the bone is likened to a cylinder, and a bent portion that is installed in the circular portion of the cylinder. The angle between the plate stem and the bent portion does not need to be 90 degrees, as long as the plate stem and the bent portion are installed on two surfaces that can be recognized as separate surfaces.

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