Fracture treatment fixation device
The fracture treatment fixation device stabilizes femoral fractures by using an intramedullary nail, lag screw, and anterior wall plate to prevent posterior movement, addressing the instability issues in conventional methods and ensuring stable fracture healing.
Patent Information
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- ACTYPOWER CO LTD
- Filing Date
- 2026-05-20
- Publication Date
- 2026-07-24
AI Technical Summary
Conventional intramedullary fixation methods for femoral fractures, particularly those involving the proximal part of the femur, fail to adequately treat fractures of the femoral trochanter when the posterior wall is fractured and separated, leading to instability during rehabilitation due to posterior movement of the intramedullary nail, which can result in complications such as excessive telescoping or cut-out.
A fracture treatment fixation device comprising an intramedullary nail, a lag screw, an anterior wall plate, and an anterior wall plate fixing pin, which are configured to stabilize the femoral head and trochanter, along with an optional posterior wall plate and fixing pin, to prevent posterior movement of the nail and maintain fracture stability.
The device effectively prevents the intramedullary nail from moving posteriorly, maintaining fracture stability and reducing the risk of complications like excessive telescoping or cut-out, even under weight-bearing conditions during rehabilitation.
Smart Images
Figure 2026121518000001_ABST
Abstract
Description
Technical Field
[0001] The present invention relates to a fixing device for fracture treatment. In particular, it relates to a fixing device for fracture treatment for treating fractures in the proximal part of the femur.
Background Art
[0002] Conventionally, a treatment method (intramedullary fixation method) for treating fractures in the proximal part of the femur with an intramedullary nail has been known. This intramedullary fixation method is performed by 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 part 101 and a distal part 102 longer than the proximal part 101 with a bent part in the middle, a locking screw 104 which is an engaging means for the bone provided at the distal part 102 of the nail 103, a through hole 105 obliquely penetrating through the proximal part 101 near the bent part of the nail 103, and a lag screw 107 having a screw 106 provided at the tip and inserted into the through hole 105 and screwed into the femoral head 91.
[0003] For the treatment of fractures in the proximal part of the femur, first, the nail 103 is driven into the inner cavity (medullary cavity) of the femur 90 from the proximal side. Then, the locking screw 104 is passed through the inner cavity of the femur 90 and the distal part of the nail 102, and the nail 103 is fixed at a predetermined position in the femoral cavity. Next, the screw 106 at the tip of the lag screw 107 is screwed into the femoral head 91 through the through hole 105 of the nail 103 and fixed to the femoral head 91, and the lag screw 106 is pulled forward so as to press the femoral head 91 against the fracture part 92. Further, if necessary, an anti-rotation screw 108 is driven into the femoral head 91 separately from the lag screw 106 so that the femoral head 91 into which the lag screw 106 is driven does not rotate with respect to the fracture part 92.
[0004] Here, the femoral trochanter is classified and named according to the type of muscle to which it attaches, as shown in Figures 17 and 18. The area indicated by A is where the gluteus minimus muscle attaches and is called the anterior facet. The area indicated by P is where the posterior fibers of the gluteus medius muscle attach and is called the posterior facet. The area indicated by L is where the anterior fibers of the gluteus medius muscle attach and is called the lateral facet. The area indicated by SP includes the apex of the trochanter and is where the piriformis muscle attaches and is called the superoposterior facet. Figure 18 shows the view from the direction T, as indicated by the arrow in Figure 17.
[0005] The conventional intramedullary fixation method described above is extremely useful when the fracture is located near the neck, which is interposed between the femoral bone and the trochanter, as shown in Figure 16. However, it has the problem that it cannot adequately treat fractures of the femoral trochanter when, for example, the posterior wall of the trochanter is also fractured and the posterior wall of the trochanter is separated.
[0006] To solve these problems, the applicant of this application has developed a fracture treatment fixation device comprising a posterior wall plate capable of pressing the separated posterior wall of the trochanter against the femoral trochanter (Patent Document 2). According to the fracture treatment fixation device described in Patent Document 2, the separated posterior wall can be repositioned to a favorable position relative to the trochanter. [Prior art documents] [Patent Documents]
[0007] [Patent Document 1] Japanese Patent Publication No. 2004-089259 [Patent Document 2] Japanese Patent Publication No. 2020-92795 [Overview of the project] [Problems that the invention aims to solve]
[0008] As described above, the fracture treatment fixation device described in Patent Document 2 can reduce the separated posterior wall to a favorable position relative to the trochanter. However, during the rehabilitation process, such as walking training, when the patient is subjected to load on the fracture site after the surgery, as shown by the arrow in Figure 19, the tip of the intramedullary nail moves posteriorly, causing instability. As a result, as shown in Figure 20, the reduced femoral head fragment may transition to an intramedullary type, or the reduced posterior wall portion may re-separate from the trochanter. An intramedullary type refers to a condition in which the femoral head fragment falls posteriorly and enters the medullary layer of the diaphysis fragment, increasing the risk of complications such as excessive telescoping (interlocking of bone fragments; excessive interlocking can lead to excessive shortening of the fracture site) or cut-out (the lag screw 107 protruding from the femoral head side). Furthermore, images A and B in Figure 20 are model images showing the reduced state immediately after surgery, while images C and D are model images showing a state in which movement has occurred in which the top of the intramedullary nail moves posteriorly to the human body. In addition, even in the treatment of femoral fractures in which the posterior wall portion is not separated, similar to the above, movement in which the top of the intramedullary nail moves posteriorly may occur due to weight-bearing after the completion of surgery, and such movement can be a factor in applying excessive external force to the neck fracture site, etc.
[0009] The present invention has been made to solve these problems and aims to provide a fracture treatment fixation device for femoral fractures that can more reliably treat proximal femoral fractures, including cases in which the posterior wall portion is not separated. [Means for solving the problem]
[0010] The above object of the present invention is achieved by a fracture treatment fixation device for treating a fracture of the femur, comprising: an intramedullary nail inserted into the femoral cavity; a lag screw positioned to penetrate the intramedullary nail diagonally 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 fixing pin positioned to penetrate the intramedullary nail and to fix the anterior wall plate to the anterior wall of the femoral trochanter, wherein the anterior wall plate fixing pin is configured to be screwable into the intramedullary nail.
[0011] In the above-described fracture treatment fixation device, it is preferable that the anterior wall plate has a claw portion that contacts the surface of the femoral trochanter.
[0012] Furthermore, the front wall plate comprises a base portion that is circular in plan view and a plurality of claw portions, each having a claw arm portion that protrudes radially outward from the base portion. A through hole is formed at the boundary position between each claw arm portion and the base portion, or in each claw arm portion, with its axis perpendicular to the thickness direction of the base portion. Preferably, the through hole has openings on one side and the other side of the claw arm portion.
[0013] Furthermore, it is preferable that a recess is formed on the outer circumferential surface of the base portion, and that the recess is connected to the inner circumferential surface of the through hole.
[0014] Furthermore, it is preferable that the intramedullary nail has a plurality of insertion holes for first fixing pins into which the anterior wall plate fixing pins can be inserted.
[0015] Furthermore, it is preferable that the front wall plate fixing pin is positioned at an inclination angle of 40° to 90° on the entrance side of the lag screw insertion hole with respect to the axis of the lag screw insertion hole.
[0016] In addition, the front wall plate is provided with three claw portions, and the plate through-hole formed in the front wall plate is preferably formed such that the center thereof does not coincide with the center position of the circumscribed circle of a triangular figure formed by a virtual line connecting the tip ends of the three claw portions.
[0017] In addition, the through-hole is configured to allow a wire to be inserted therethrough, and it is preferable that the wire can be wound around the greater trochanter of the femur.
[0018] In addition, the length of the shaft portion of the front wall plate fixing pin is preferably set to a length such that the tip thereof does not protrude from the intramedullary nail or protrudes slightly.
Advantages of the Invention
[0019] According to the present invention, it is possible to provide a fixing device for fracture treatment for the femur that can more reliably treat a fracture in the proximal part of the femur.
Brief Description of the Drawings
[0020] [Figure 1] It is a schematic configuration side view of a fixing device for fracture treatment according to the present invention. [Figure 2] It is a schematic configuration plan view seen from above of FIG. 1. [Figure 3] It is a schematic configuration diagram showing a state where a fixing device for fracture treatment 1 according to the present invention is attached to the femur. [Figure 4] It is a schematic configuration perspective view showing a state where a fixing device for fracture treatment according to the present invention is attached to the femur. [Figure 5] It is a schematic configuration diagram of an intramedullary nail included in a fixing device for fracture treatment according to the present invention. [Figure 6] It is a schematic configuration diagram showing a state where a fixing device for fracture treatment according to the present invention is attached to the femur. [Figure 7] It is an explanatory diagram of a front wall plate included in a fixing device for fracture treatment according to the present invention. [Figure 8]Regarding the fixing device for fracture treatment according to the present invention, it is a schematic cross-sectional view along the axis of the anterior wall plate fixing pin. [Figure 9] It is a plan view of the anterior wall plate fixing pin included in the fixing device for fracture treatment according to the present invention. [Figure 10] It is an explanatory view of the posterior wall plate included in the fixing device for fracture treatment according to the present invention. [Figure 11] Regarding the fixing device for fracture treatment according to the present invention, it is a schematic cross-sectional view along the axis of the posterior wall plate fixing pin. [Figure 12] It is a plan view of the posterior wall plate fixing pin included in the fixing device for fracture treatment according to the present invention. [Figure 13] It is a schematic cross-sectional view along the axis of the anterior wall plate fixing pin in the state where the fixing device for fracture treatment according to the present invention is attached to the femur. [Figure 14] It is a schematic cross-sectional view along the axis of the anterior wall plate fixing pin in the state where the fixing device for fracture treatment according to the present invention is attached to the femur. [Figure 15] It is an explanatory view regarding a modified example of the anterior wall plate included in the fixing device for fracture treatment according to the present invention. [Figure 16] It is a schematic cross-sectional view showing a conventional fixing device for fracture treatment. [Figure 17] It is an explanatory view for explaining the femoral trochanter region. [Figure 18] It is an explanatory view seen from the direction of arrow T in FIG. 17. [Figure 19] It is an explanatory view for explaining the sway in which the top of the intramedullary nail moves to the posterior side of the human body. [[ID=3,5]] [Figure 20] It is an explanatory view for explaining the problems when the sway in which the top of the intramedullary nail moves to the posterior side of the human body occurs.
Embodiments for Carrying Out the Invention
[0021] The fracture treatment fixation device according to the present invention will be described below with reference to the attached drawings. Note that each figure has been partially enlarged or reduced to facilitate understanding of the structure. Figure 1 is a schematic side view of the fracture treatment fixation device 1 according to the present invention, and Figure 2 is a schematic plan view of the structure as seen from above Figure 1. Figure 3 is a schematic diagram showing the fracture treatment fixation device 1 according to the present invention attached to the femur 90, and Figure 4 is a schematic perspective view showing the fracture treatment fixation device 1 attached to the femur 90. Note that Figure 4 is a perspective view as seen from the anterior wall side of the femoral trochanter 94.
[0022] The fracture treatment fixation device 1 according to the present invention is a fixation device for treating fractures of the femur, for example, fractures involving a femoral neck fracture in addition to a posterior femoral fragment Z, and as shown in Figures 1 to 4, it comprises at least an intramedullary nail 2 inserted into the lumen (intramedullary lumen) of the femur 90, a lag screw 3, an anterior wall plate 4, and an anterior wall plate fixing pin 6. The fracture treatment fixation device 1 may also be configured to further include a posterior wall plate 5 and a posterior wall plate fixing pin 7 as needed. Furthermore, the fracture treatment fixation device 1 is further equipped with an anti-rotation screw 8. The intramedullary nail 2, lag screw 3, anterior wall plate 4, posterior wall plate 5, anterior wall plate fixing pin 6, posterior wall plate fixing pin 7, anti-rotation screw 8, etc. that constitute the fracture treatment fixation device 1 are preferably made of a biocompatible metal material such as titanium alloy or stainless steel.
[0023] As shown in Figures 1 to 5, the intramedullary nail 2 comprises, from top to bottom, a proximal portion 21, a tapered portion 22, and a distal portion 23. Figure 5 is a schematic diagram of the intramedullary nail 2 included in the fracture treatment fixation device 1. The proximal portion 21, tapered portion 22, and distal portion 23 are integrally formed. The proximal portion 21 is formed in a cylindrical shape with a substantially constant diameter and is positioned on the femoral head 91 side of the femur 90. A cap hole 2a for inserting an end cap is formed at the upper end of the proximal portion 21. An internal thread is formed on the inner circumferential surface of the cap hole 2a, allowing the end cap to be screwed on.
[0024] Furthermore, a lag screw insertion hole 24 is formed in the proximal portion 21 into which the lag screw 3 is inserted. The lag screw insertion hole 24 penetrates the proximal portion 21 so as to extend diagonally upward. With this configuration, the lag screw insertion hole 24 can guide the lag screw 3 diagonally upward toward the femoral head 91 of the femur 90.
[0025] Furthermore, in the proximal portion 21, insertion holes smaller in diameter than the lag screw insertion hole 24 are formed above and below (or above and below) the lag screw insertion hole 24. These insertion holes are for inserting the anti-rotation screw 8. The insertion holes for the anti-rotation screw also penetrate the proximal portion 21 in the same way as the lag screw insertion hole 24, extending diagonally upward. This configuration allows the anti-rotation screw 8 to be guided diagonally upward toward the femoral head 91 of the femur 90.
[0026] Here, it is preferable that the lag screw 3 and the anti-rotation screw 8 are configured to enter the femoral head 91 and femoral neck 93 so as to be parallel to each other. 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 fracture site 92, but it can be omitted if there is little risk of the femoral head 91 rotating relative to the fracture site.
[0027] The tapered portion 22 is formed in a substantially cylindrical shape, is integrally connected to the proximal portion 21, and is formed to decrease in diameter towards the distal portion 23. Furthermore, the axis of the tapered portion 22 is inclined with respect to the axis of the proximal portion 21 at an angle of, for example, 3° to 6°. Due to this structure, the intramedullary nail 2 as a whole has a slightly bent shape.
[0028] 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, and the distal tip is slightly tapered. The distal portion 23 is formed so that its axis is collinear with the axis of the tapered portion 22. In addition, multiple fixing holes 25 into which the locking screw-2b is inserted are formed in a vertical direction near the distal end of the distal portion 23. The fixing holes 25 are formed to penetrate the distal portion 23 substantially perpendicular to its axis. That is, the fixing holes 25 are designed to guide the locking screw-2b substantially horizontally. Although Figure 5 shows an example in which two fixing holes 25 for inserting the locking screw-2b are formed, the number of fixing holes 25 is not particularly limited, and it may be configured to form a single fixing hole 25, or to form three or more fixing holes 25.
[0029] The lag screw 3 is a fixing device for fixing a fractured bone fragment (femoral head 91 of the femur 90) separated by a neck fracture to the femur 90 (trochanter 94). As shown in the schematic configuration diagram in Figure 6, it is inserted diagonally upward toward the femoral head 91 of the femur 90. As shown in Figures 2 and 3, the lag screw 3 is formed in an elongated, roughly cylindrical shape, and a screw 31 is formed on the outer surface of its tip. It is inserted through the intramedullary nail 2 via the lag screw insertion hole 24 formed in the intramedullary nail 2, penetrating the intramedullary nail 2 diagonally upward, and the screw 31 at its tip is screwed into the femoral head 91, and positioned in a state where it has entered the femoral head 91 and the femoral neck 93. As a result, the separated fractured bone fragment (femoral head) is held in engagement with the lag screw 3, and the fractured bone fragment (femoral head) can be fixed to the trochanter 94 of the femur 90. Furthermore, the diameter of the lag screw 3 is configured to be slightly smaller than the diameter of the lag screw insertion hole 24 described above, allowing the lag screw 3 to slide within the lag screw insertion hole 24.
[0030] As shown in Figures 1 to 4, the anterior wall plate 4 is a member that is placed against the anterior wall of the trochanter 94 of the femur 90 and has the function of being pressed 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 gluteus minimus muscle attaches. As shown in the plan view in Figure 7(a), the side view from direction A in Figure 7(a) (Figure 7(b)), and the side view from direction B in Figure 7(a) (Figure 7(c)), the anterior wall plate 4 comprises a base portion 41 and a plurality of claw portions 42. In this embodiment, the anterior wall plate 4 is configured to have three claw portions 42. The base portion 41 is a plate-shaped member having a predetermined thickness, and each claw portion 42 comprises a claw arm portion 42a extending from the base portion 41 and a claw tip portion 42b provided at the tip of the claw arm portion 42a. The claw tip portion 42b is the part that 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 portion 42a. Each claw tip portion 42b is formed so that its protruding direction is in the same direction. Each claw arm portion 42a is configured to extend generally along the in-plane direction of the plate-shaped base portion 41. Furthermore, it is preferable that a portion of the three claw tip portions 42b be positioned near the base of the gluteus minimus muscle connected to the trochanter 94.
[0031] Furthermore, in this embodiment, the tip of each of the three claw portions 42 (claw tip 42b) is configured to be positioned at the vertices of a roughly isosceles triangle in a plan view. In other words, the position of each claw tip 42b is set such that the figure formed by the virtual lines connecting the tips of each of the three claw portions 42 (claw tip 42b) is an isosceles triangle. In the isosceles triangle formed by the virtual lines connecting the tips of each claw portion 42, the vertex angle is preferably set in the range of 15° to 50°, and more preferably in the range of 25° to 40°. If the tip of each claw portion 42 (claw tip 42b) is a sharp point, the angle range of the vertex angle can be set by forming an isosceles triangle with the virtual lines connecting these point-shaped tips. Furthermore, if the tip of the claw portion 42 (claw tip portion 42b) is tapered but has a predetermined width dimension, as shown in Figure 7(c), an isosceles triangle can be formed with the center of that width dimension as its vertex, and the angle range of the vertex angle can be set.
[0032] Furthermore, a plate through-hole 43 is formed in the base portion 41 of the front wall plate 4 into which the front wall plate fixing pin 6 is inserted. Preferably, the inner circumferential surface of the plate through-hole 43 is formed in a bowl-shaped surface that narrows in diameter as it approaches 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 the shaft portion 61 of the front wall plate fixing pin 6, which will be described later. It is also preferable that the center of the plate through-hole 43 does not coincide with the center position (circumcenter position) of the circumscribed circle of the triangular figure formed by the virtual line connecting each tip portion (each claw tip portion 42b) of each claw portion 42.
[0033] Furthermore, as shown in Figures 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 anterior wall plate 4 to the surface (anterior wall) of the femoral trochanter 94. The intramedullary nail 2 has a first fixing pin insertion hole 26 for inserting the anterior wall plate fixing pin 6, as shown in the schematic cross-sectional view of Figure 8, and a female threaded portion is formed on its inner surface. Here, in Figure 8, the posterior wall plate 5 and the posterior wall plate fixing pin 7 are omitted from the diagram. The first fixing pin insertion hole 26 is formed above the lag screw insertion hole 24 described above. Also, 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, which will be described later. In this embodiment, as shown in Figure 8, the front wall plate fixing pin 6 is positioned at a predetermined angle inclined toward the entrance side of the lag screw insertion hole 24 with respect to the axis of the lag screw insertion hole 24. It is preferable to configure the inclination angle to be in the range of 40° to 90° with respect to the axis of the lag screw insertion hole 24, and more preferably set to a range of 50° to 70° with respect to the axis of the lag screw insertion hole 24.
[0034] As shown in the plan view of Figure 9, the anterior wall plate fixing pin 6 has a structure comprising a cylindrical shaft portion 61 and a head portion 62 provided at one end of the shaft portion 61, with a male threaded portion 61a formed on the outer surface of the central part of the shaft portion 61. The anterior wall plate fixing pin 6 is fixed to the intramedullary nail 2 by screwing the male threaded portion 61a formed on the shaft portion 61 of the anterior wall plate fixing pin 6 into the insertion hole 26 for the first fixing pin in the intramedullary nail 2. The diameter of the anterior wall plate fixing pin 6, excluding the head portion 62, is generally smaller than the minimum diameter of the plate through hole 43 formed in the anterior wall plate 4, and is configured to be inserted into the plate through hole 43. On the other hand, the diameter of the head portion 62 is formed to be 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, thereby fixing the anterior wall plate 4 to the anterior wall of the trochanter 94 of the femur 90. 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 these rotary tools, the anterior wall plate fixing pin 6 enters the first fixing pin insertion hole 26 in the intramedullary nail 2.
[0035] Furthermore, as shown in Figure 9, it is preferable that the head 62 of the front wall plate fixing pin 6 has a bowl-shaped contact surface 62a that abuts along the inner circumferential surface (the inner circumferential surface having a bowl-shaped surface) of the through hole of the front wall plate 4. This bowl-shaped contact surface 62a is mainly formed on the head surface side facing the shaft portion 61. Due to the 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 to be rotatable relative to the front wall plate fixing pin 6 while the head 62 of the front wall plate fixing pin 6 is in contact with the inner circumferential surface of the plate through hole 43.
[0036] Furthermore, it is preferable that the length of the shaft portion 61 of the anterior wall plate fixing pin 6 be such that its tip does not protrude from the intramedullary nail 2, or protrudes only slightly.
[0037] As shown in Figures 1 to 3, the posterior wall plate 5 is a member that is placed against the posterior wall of the trochanter 94 of the femur 90 and has the function of pressing the bone fragments Z of the posterior wall portion that are separated from the trochanter 94 against the trochanter 94 via the posterior wall plate fixing pins 7 described later. Here, the posterior wall refers to the part of the femur 90 at the trochanter 94 where the posterior fibers of the gluteus medius muscle attach. As shown in the plan view in Figure 10(a), the side view from direction A in Figure 8(a) (Figure 10(b)), and the side view from direction B in Figure 10(a) (Figure 10(c)), the posterior wall plate 5 comprises a base portion 51 and a plurality of claw portions 52. In this embodiment, the posterior wall plate 5 is configured to have three claw portions 52.
[0038] Furthermore, in this embodiment, similar to the front wall plate 4 described above, the tip of each of the three claw portions 52 (claw tip portion 52b) is configured to be positioned at the vertices of a roughly isosceles triangle in a plan view. In other words, the position of each claw tip portion 52b is set such that the figure formed by the virtual line connecting the tips of each of the three claw portions 52 (claw tip portion 52b) is an isosceles triangle. In the isosceles triangle formed by the virtual line connecting the tips of each of the claw portions 52, the vertex angle is preferably set in the range of 15° to 50°, and more preferably in the range of 25° to 40°. If the tip of each claw portion 52 (claw tip portion 52b) is a sharp point, the isosceles triangle shape can be formed by the virtual line connecting these point-shaped tips, and the angle range of the vertex angle can be set accordingly. Furthermore, if the tip of the claw portion 52 (claw tip portion 52b) is tapered but has a predetermined width dimension, as shown in Figure 10(c), an isosceles triangle can be formed with the center of the width dimension as its vertex, and the angle range of the vertex angle can be set. It is preferable that some of the three claw tip portions 52b be positioned near the base of the gluteus medius and gluteus minimus muscles, which are connected to the posterior wall of the trochanter portion 94. In addition, 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. It is preferable that the inner circumferential surface of the plate through-hole 53 is formed in a bowl-shaped surface that decreases in diameter as it approaches the insertion direction of the posterior wall plate fixing pin 7, as shown in Figure 11. The minimum opening diameter of the plate through-hole 53 is formed to be slightly larger than the maximum diameter of the shaft portion 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 its center does not coincide with the center of the circumcenter of the triangular figure formed by the imaginary line connecting each tip of each claw portion 52 (each claw tip portion 52b).
[0039] Furthermore, as shown in Figures 1 to 3, the posterior wall plate fixing pin 7 is inserted into the femur so as to penetrate the intramedullary nail 2, and is a fixing device for fixing the posterior wall plate 5 to the posterior wall of the femoral trochanter 94. The intramedullary nail 2 has a second fixing pin insertion hole 27 for inserting the posterior wall plate fixing pin 7, as shown in the schematic cross-sectional view of Figure 11, and a female screw portion is formed on its inner surface. The second fixing pin insertion hole 27 is formed above the first fixing pin insertion hole 26 for inserting the anterior wall plate fixing pin 6. In this embodiment, as shown in Figure 11, the posterior wall plate fixing pin 7 is positioned at a predetermined angle inclined toward the entrance side of the lag screw insertion hole 24 with respect to the axis of the lag screw insertion hole 24. This inclination angle is preferably set in the range of 40° to 90° with respect to the axis of the lag screw insertion hole 24, and more preferably in the range of 50° to 70° with respect to the axis of the lag screw insertion hole 24.
[0040] As shown in the plan view of Figure 12, the posterior wall plate fixing pin 7 has a structure comprising a cylindrical shaft portion 71 and a head portion 72 provided at one end of the shaft portion 71, with a male threaded portion 71a formed on the outer surface of the central part of the shaft portion 71. The posterior wall plate fixing pin 7 is fixed to the intramedullary nail 2 by screwing the male threaded portion 71a formed on the shaft portion 71 of the posterior wall plate fixing pin 7 into the insertion hole 27 for the second fixing pin in the intramedullary nail 2. The diameter of the posterior wall plate fixing pin 7, excluding the head portion 72, is generally smaller than the minimum diameter of the plate through hole 53 formed in the posterior wall plate 5, and is configured to be inserted into the plate through hole 53. On the other hand, the diameter of the head portion 72 is formed to be 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, thereby fixing the posterior wall plate 5 to the posterior wall of the trochanter 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 these rotary tools, the posterior wall plate fixing pin 7 enters the insertion hole 26 for the first fixing pin in the intramedullary nail 2.
[0041] Furthermore, as shown in Figure 12, it is preferable that the head 52 of the rear wall plate fixing pin 7 has a bowl-shaped contact surface 72a that abuts along the inner circumferential surface (the inner circumferential surface having a bowl-shaped surface) of the through hole of the rear wall plate 5. This bowl-shaped contact surface 72a is mainly formed on the head surface side facing the shaft portion 71. Due to the 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 relative to the rear wall plate fixing pin 7 while the head 72 of the rear wall plate fixing pin 7 is in contact with the inner circumferential surface of the plate through hole 53.
[0042] Furthermore, the length of the shaft portion 71 of the posterior wall plate fixing pin 7 is set so that its tip reaches a position near the femoral neck. By setting it to this length, the tip of the posterior wall plate fixing pin 7 engages with the femoral neck via the intramedullary nail 2, thereby further preventing the femoral head 91 into which the lag screw 3 is driven from rotating relative to the fracture site 92. In this embodiment, the posterior wall plate fixing pin 7 is configured without a screw formed on the tip of the shaft portion 71, but it is also possible to form a screw on the surface of the tip of the shaft portion 71 so that the tip of the posterior wall plate fixing pin 7 is screwed into the femoral neck by this screw. Regarding the length of the shaft portion 71 of the posterior wall plate fixing pin 7, it may be set to a length so that its tip reaches the femoral head of the femur 90, or it may be made shorter so that it does not reach a position near the femoral neck.
[0043] Next, an example of the operating procedure for a 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. The intramedullary nail 2 is then attached to a conventionally known target device (not shown). The patient is then placed in a supine position and fixed in place with the affected limb under traction. The surgeon then performs reduction of the fracture 92 of the patient's femur 90 while imaging the affected limb with a radiographic imaging device (not shown).
[0044] Next, an incision is made in the skin near the femur 90, and a guide wire for the intramedullary nail is inserted into the femur 90 through this incision. Using the guide wire as a guide, a perforation is made in the femur 90 with a drill (not shown), creating a window in the femur 90. Then, the intramedullary nail 2, which is connected to the target device, is inserted into the window. At this time, the guide wire is passed through the intramedullary nail 2, and the intramedullary nail 2 is inserted using the guide wire as a guide. Note that when drilling into the femur 90 and inserting into the lumen of the femur 90 (medullary cavity), the pelvis gets in the way, so the intramedullary nail 2 is inserted slightly obliquely from the proximal part 21 of the femur 90 relative to the lumen.
[0045] Next, the lag screw 3 is inserted into the femur 90 so as to pass through the lag screw insertion hole 24 in the intramedullary nail 2, and the lag screw 3 is advanced until the tip of the screw reaches the femoral head 91. Similarly, the anti-rotation screw 8 is inserted into the femur 90 so as to pass through the insertion hole for the anti-rotation screw formed in the intramedullary nail 2, and the screw tip is advanced until the tip of the screw reaches the femoral head 91.
[0046] Subsequently, with the posterior wall plate fixing pin 7 inserted through the plate through hole 53 in the posterior wall plate 5, the tip of the shaft portion 71 of the posterior wall plate fixing pin 7 is inserted into the second fixing pin insertion hole 27 formed in the intramedullary nail 2, while screwing the male threaded portion 71a formed on the shaft portion 71 of the posterior wall plate fixing pin 7 with the female threaded portion formed on the inner circumference of the second fixing pin insertion hole 27 in the intramedullary nail 2. When inserting the posterior wall plate fixing pin 7, a drill for inserting the fixing pin is made in advance at the corresponding position in the femur 90 by drilling. The depth of this drill for inserting the posterior wall plate fixing pin 7 corresponds to the length of the shaft portion 71 of the posterior wall plate fixing pin 7. As the screwing of the posterior wall plate fixing pin 7 and the intramedullary nail 2 progresses, as shown in Figure 3, the distance between the posterior wall plate 5 and the posterior wall of the trochanter 94 decreases, and the trochanter 94 is held and fixed in place with the bone fragments Z of the posterior wall portion that are separated from the trochanter 94 attached to the predetermined position on the trochanter 94. Since the posterior wall plate 5 is equipped with three claw portions 52, it can stably bring the bone fragments Z of the posterior wall portion that are separated from the trochanter 94 into place and fix them in contact with the predetermined position.
[0047] Next, with the anterior wall plate fixing pin 6 inserted through the plate through hole 43 in the anterior wall plate 4, the tip of the shaft portion 61 of the anterior wall plate fixing pin 6 is inserted into the first fixing pin insertion hole 26 formed in the intramedullary nail 2, while screwing the male threaded portion 61a formed on the shaft portion 61 of the anterior wall plate fixing pin 6 with the female threaded portion formed on the inner circumference of the first fixing pin insertion hole 26 in the intramedullary nail 2. When inserting the anterior wall plate fixing pin 6, a drill for fixing pin insertion is made in advance at the corresponding position of the femur 90 by drilling. As the screwing of the anterior wall plate fixing pin 6 and the intramedullary nail 2 progresses, the anterior wall plate 4 can be fixed in contact with the anterior wall wall of the trochanter 94, as shown in Figures 13 and 14, and the femoral trochanter 94 can be sandwiched between the anterior wall plate 4 and the posterior wall plate 5, as shown in Figure 3. Note that the posterior wall plate 5 and posterior wall plate fixing pin 7 are omitted in Figures 13 and 14.
[0048] Finally, the intramedullary nail 2 and the femur 90 are fixed together by a locking screw 2b through a fixation hole 25 formed in the distal portion 23 of the intramedullary nail 2. An end cap is then screwed into a cap hole 2a formed in the upper end of the intramedullary nail 2 to prevent bone tissue from entering the interior of the intramedullary nail 2, and the incision is sutured to complete the surgery.
[0049] As described above, the fracture treatment fixation device 1 according to the present invention is configured to include an anterior wall plate fixing pin 6 that integrally engages with the intramedullary nail 2, and an anterior wall plate 4 that is positioned against the anterior wall portion of the trochanter 94 via the anterior wall plate fixing pin 6. Therefore, even if weight is applied to the fracture site during rehabilitation such as walking training after the completion of surgery, the anterior wall plate 4 acts as a stopper, effectively preventing movement of the apex of the intramedullary nail to the posterior side. As a result, it is extremely effective in preventing the reduced femoral head fragment from shifting to an intramedullary type, or the reduced posterior wall portion Z from separating again from the trochanter. In particular, the fracture treatment fixation device 1 according to the present invention is extremely useful when treating fractures in cases where a portion of the circumferential part of the separated posterior wall bone fragment Z is located near the cortical bone at the lateral end of the lag screw 3, or where it is located at the insertion site of the lag screw 3 and the cortical bone at the lateral end of the lag screw 3 is not preserved circumferentially (as shown in Figure 20, Image B; when the fracture line overlaps the lateral end of the lag screw 4), or when treating reverse oblique fractures.
[0050] Furthermore, as described above, the fracture treatment fixation device 1 according to this embodiment is configured to include a posterior wall plate 5. Therefore, even if a fracture occurs in the posterior wall of the trochanter 94 and the trochanter 94 is separated, the separated fracture fragment Z can be fixed in a position pressed against the predetermined location of the trochanter 94. In addition, since the anterior wall plate 4 and the posterior wall plate 5 are configured to sandwich the femoral trochanter, it is possible to firmly fix the fracture fragment and the fracture treatment fixation device 1 to the femur, thereby preventing movement of the intramedullary nail and effectively preventing the reduced posterior wall portion from separating again from the trochanter 94.
[0051] Furthermore, the anterior wall plate fixing pin 6, which secures the anterior wall plate 4 to the anterior wall surface, is configured to be screwable with the female thread formed on the inner circumferential surface of the insertion hole 26 for the first fixing pin in the intramedullary nail 2. Since the anterior wall plate 4 is fixed to the anterior wall surface of the trochanter, the amount of screwing in the anterior wall plate fixing pin 6 can be adjusted to position the intramedullary nail 2 within the lumen (medullary cavity) of the femur 90 closer to the anterior wall or closer to the posterior wall. This allows adjustment of 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 trochanter. In other words, it becomes possible to adjust and reduce the fracture to the extramedullary type, which is a desirable reduction state in the treatment of femoral fractures, and to effectively maintain that state, thereby effectively preventing excessive telescoping. Here, the extramedullary type refers to a condition where the medial cortex of the proximal bone fragment rests on the cortex of the distal bone fragment, and in cases where the posterior wall is fractured and separated, it refers to a condition where the medial cortex of the posterior wall rests on the cortex of the trochanter.
[0052] Furthermore, the anterior wall plate 4 and posterior wall plate 5 of the fracture treatment fixation device 1 according to the present invention are each equipped with at least three claw portions 42, 52, and the virtual line connecting the tips of each of these claw portions 42, 52 is configured to form an isosceles triangle. With this configuration, even in a relatively narrow installation space, the anterior wall plate 4 and posterior wall plate 5 can be stably applied to and fixed to the anterior and posterior walls of the trochanter 94.
[0053] Furthermore, with respect to the plate through holes 43 and 53 formed in the front wall plate 4 and the rear wall plate 5, by forming them so that their centers do not coincide with the circumcenter position of the triangular figure formed by the virtual line connecting the tips of each claw portion 42 and 52, the front wall plate 4 and the rear wall plate 5 can be configured to have at least two different dimensions regarding the distance from the center of the heads 62 and 72 of the front wall plate fixing pins 6 and the rear wall plate fixing pins 7 inserted through the plate through holes 43 and 53 (corresponding to the center of the plate through holes 43 and 53) to the tips of each claw portion 42 and 52 (claw tip portions 42b and 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 (or rear wall plate fixing pin 7) to position where the claw tips 42b and 52b are to be pressed more firmly against the front wall portion of the trochanter portion 94, it becomes easier to bring the claw tips 42b and 52b into contact with the front wall portion of the trochanter portion 94. This allows the front wall plate 4 to be pressed and fixed against the front wall of the trochanter portion 94, and the rear wall plate 5 to be applied to the rear wall portion that is separated.
[0054] Furthermore, with respect to the plate through holes 43 and 53 formed in the base portions 41 and 51 of the front wall plate 4 and the front wall plate 5, the inner circumferential shape is formed to be a bowl-shaped surface that decreases in diameter as it approaches the insertion direction of the front wall plate fixing pin 6 and the front wall plate fixing pin 7. Moreover, with respect to the heads 62 and 72 of the front wall plate fixing pin 6 and the rear wall plate fixing pin 7, the contact surface is configured to have a bowl-shaped surface that abuts along the inner circumferential surface (the inner circumferential surface having a bowl-shaped surface) of the through holes in the front wall plate 4 and the rear wall plate 5, thereby enabling the front wall plate fixing In the process of inserting the fixing pins 6 and posterior wall plate fixing pins 7 into the intramedullary nail 2 and screwing them into the first fixing pin insertion holes 26 and 27, thereby driving the anterior wall plate fixing pins 6 and posterior wall plate fixing pins 7 into the intramedullary nail 2, the anterior wall plate 4 and posterior wall plate 5 are configured to rotate relative to the anterior wall plate fixing pins 6 and posterior wall plate fixing pins 7, as shown in Figures 13 and 14, with the heads 62 and 72 of the anterior wall plate fixing pins 6 and posterior wall plate fixing pins 7 in contact with the inner circumferential surface of the plate through holes 43 and 53. This rotation allows the anterior wall plate 4 and posterior wall plate 5 to be positioned in the most stable orientation, enabling the anterior wall plate 4 to be more stably fitted against the anterior wall portion of the trochanter portion 94 and fixed in place, and the posterior wall plate 5 to be fitted against the posterior wall portion that separates them.
[0055] Furthermore, as described above, with respect to the plate through holes 43 and 53 formed in the front wall plate 4 and the rear wall plate 5, by forming them so that their centers do not coincide with the circumcenter position of the triangular figure formed by the virtual line connecting the tips of each claw portion 42 and 52, the distance from the center of the heads 62 and 72 of the front wall plate fixing pins 6 and the rear wall plate fixing pins 7 inserted through the plate through holes 43 and 53 (corresponding to the center of the plate through holes 43 and 53) to the tips of each claw portion 42 and 52 (claw tips 42b and 52b) is longer than that of the other claw tips 42b and 52b. Moreover, when the front wall plate 4 and the rear wall plate 5 are configured to rotate relative to the front wall plate fixing pins 6 and the rear wall plate fixing pins 7 as described above, these claw tips 42b and 52b with longer distances have a larger rotational range (movable area) spatially. This makes it easier to bring the claw tips 42b and 52b, which are located at a longer distance from the center of the heads 62 and 72, into contact with the surface of the trochanter portion 94, which has various uneven shapes (surface undulations). This allows the front wall plate 4 to be pressed more stably against the front wall of the trochanter portion 94 and fixed in place, and the rear wall plate 5 to come into contact with the rear wall portion that separates it.
[0056] Here, the front wall plate 4 described above is not limited to the above-described form, and may be configured in a form such as that shown in Figure 15. Figure 15(a) is a plan view of a modified front wall plate 4, Figure 15(b) is a side view seen from direction A in Figure 15(a), and Figure 15(c) is a side view seen from direction B in Figure 15(a). The front wall plate 4 shown in Figure 15 comprises a circular base portion 41 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. Preferably, the inner circumferential surface of the plate through-hole 43 is formed in a bowl-shaped surface that decreases in diameter as it approaches the insertion direction of the front wall plate fixing pin 6. Each claw portion 42 is provided on both sides of the center of the base portion 41. Each claw portion 42 has a claw arm portion 42a that protrudes slightly radially outward from a circular base portion 41 in plan view, and a claw tip portion 42b is provided at the tip of this claw arm portion 42a. The claw tip portion 42b is the part that 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 portion 42a. A through hole 45 is formed at the boundary between the claw arm portion 42a and the base portion 41. This through hole 45 is formed with an axis perpendicular to the thickness direction of the base portion 41 and has openings on one side and the other side of the claw arm portion 42a. Alternatively, the through hole 45 may be formed in the claw arm portion 42a instead of at the boundary between the claw arm portion 42a and the base portion 41. A recess 46 is formed on the outer circumferential surface of the circular base portion 41 in plan view. It is preferable that the recess 46 be configured to smoothly connect with the inner circumferential surface of the through hole 45. The recess 46 may be formed using a separate cutting tool or device after the through hole 45 has been formed using a tool or device such as a drill, or it may be formed simultaneously with the drill or device when the through hole 45 is being made using the same tool or device. The rear wall plate 5 may be configured in the form shown in Figure 15. Alternatively, the above-mentioned through hole 45 may be formed in the claw arm portion 42a (52a) of the front wall plate 4 in the form shown in Figure 7, or the rear wall plate 5 in the form shown in Figure 10.Furthermore, recesses 46 may be formed on the outer circumferential surface of the base portion 41 in the front wall plate 4 as shown in Figure 7, or the rear wall plate 5 as shown in Figure 10.
[0057] When using an anterior wall plate 4 (posterior wall plate 5) in the form shown in Figure 15, it is possible to insert a wire through each through-hole 45 and wrap this wire around the femoral trochanter 94. Even if a fracture occurs in the posterior wall of the trochanter 94 and the trochanter 94 is separated, it is possible to firmly press the separated bone fragment Z into a predetermined position on the trochanter 94. This makes the fixation of the fracture fragment Z and the fracture treatment fixation device 1 to the femur even more secure, and effectively prevents the posterior wall portion of the reduction from separating again from the trochanter 94 while preventing movement of the intramedullary nail.
[0058] Furthermore, since a recess 46 is formed on the outer circumferential surface of the circular base portion 41 of the front wall plate 4 (rear wall plate 5), it is possible to effectively prevent the wire, which is arranged to be wound along the outer circumferential surface of the base portion 41, from sliding on the outer circumferential surface of the base portion 41 and coming out to the upper or lower side of the base portion 41.
[0059] 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 posterior wall plate 5 and the posterior wall plate fixing pin 7 are provided and configured to reposition the separated posterior wall portion to the trochanter. However, since the fracture treatment fixation device 1 according to the present invention can also be used for the treatment of 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 fixing pin 7. Even in such a configuration, which includes an anterior wall plate 4 and an anterior wall plate fixing pin 6 and does not include a posterior wall plate 5 and the posterior wall plate fixing pin 7, even if weight is applied to the fracture site during the rehabilitation process such as walking training after the completion of surgery, it is possible to effectively prevent instability such as the top of the intramedullary nail 2 moving posteriorly, and to prevent excessive external force from being applied to the neck fracture portion, etc.
[0060] Furthermore, in the above embodiment, the system may be configured so that multiple anti-rotation screws 8 can enter the femoral head 91 via the intramedullary nail 2, or it may be configured without anti-rotation screws.
[0061] Furthermore, for example, in the above embodiment, the tips 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 roughly isosceles triangle, but the configuration is not limited to this, and the tips of the three claw portions 42, 52 may be formed to correspond to the vertices of various triangles other than isosceles triangles. Also, 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.
[0062] 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. However, the embodiment is not particularly limited to this configuration, 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.
[0063] Furthermore, in the above embodiment, two or more first fixation pin insertion holes 26 are formed in a predetermined position on the intramedullary nail 2, arranged vertically, and the anterior wall plate 4 can be attached to each first fixation pin insertion hole 26 via anterior wall plate fixing pins 6. When multiple first fixation pin insertion holes 26 are formed in this manner, some of the first fixation pin insertion holes 26 may be selected and used to attach the anterior wall plate 4 via the anterior wall plate fixing pins 6, or the anterior wall plate 4 may be attached to all of the first fixation pin insertion holes 26 via the anterior wall plate fixing pins 6. When multiple first fixation pin insertion holes 26 are formed, the hole axes of each first fixation pin insertion hole 26 may be configured to be parallel to each other, or they may be configured to be at different angles. By forming multiple first fixation pin insertion holes 26 in the intramedullary nail 2 in this way, the options for the attachment position of the anterior wall plate 4 are expanded, making it possible to treat various types of femoral fractures that differ from patient to patient. Furthermore, when the anterior wall plates 4 are attached to all of the first fixation pin insertion holes 26 via the anterior wall plate fixation pins 6, the fracture treatment fixation device 1 can be more firmly fixed to the femur by the multiple anterior wall plates 4. Therefore, even if weight is applied to the fracture site during rehabilitation such as walking training after the surgery, each anterior wall plate 4 acts as a stopper, more effectively preventing instability that would cause the top of the intramedullary nail to move posteriorly.
[0064] Similarly, two or more insertion holes 27 for second fixation pins may be formed in a predetermined position on the intramedullary nail 2, arranged vertically, so that the posterior wall plate 5 can be attached to each of the second fixation pin insertion holes 27 via posterior wall plate fixing pins 7. When multiple insertion holes 27 for second fixation pins are formed in this manner, some of the insertion holes 27 may be selected and used to attach the posterior wall plate 5 via the posterior wall plate fixing pins 7, or the posterior wall plate 5 may be attached to all of the insertion holes 27 via the posterior wall plate fixing pins 7. When multiple insertion holes 27 for second fixation pins are formed, the hole axes of each insertion hole 27 may be configured to be parallel to each other, or they may be configured to be at different angles. By forming multiple insertion holes 27 for second fixation pins in the intramedullary nail 2 in this way, the options for the attachment position of the posterior wall plate 5 are expanded, making it possible to treat various types of femoral fractures that differ from patient to patient. Furthermore, when the posterior wall plate 5 is attached to all of the second fixation pin insertion holes 27 via the posterior wall plate fixation pins 7, even if a fracture occurs in the posterior wall of the trochanter 94 and the trochanter 94 is separated, the separated bone fragment Z can be firmly pressed against the predetermined position of the trochanter 94 by the multiple posterior wall plates 5. In addition, the femoral trochanter can be sandwiched over a wide area between the anterior wall plate 4 and the posterior wall plate 5, making it possible to fix the fracture fragment Z and the fracture treatment fixation device 1 to the femur even more reliably and firmly, and effectively preventing the reduced posterior wall portion Z from separating again from the trochanter 94 while preventing movement of the intramedullary nail.
[0065] Furthermore, in the above embodiment, the anterior wall plate fixing pin 6 and the posterior wall plate fixing pin 7 are positioned at a predetermined angle inclined toward the entrance side 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). However, the inclination angle of the anterior wall plate fixing pin 6 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 as the inclination angle of the posterior wall plate fixing pin 7 with respect to the axis of the lag screw insertion hole 24 (axis of the lag screw 3). By configuring it in this way, the fracture treatment fixation device 1 can be used to treat fractures of either the left or right femur. [Explanation of symbols]
[0066] 1 Fixed device for fracture treatment 2 Intramedullary nail 21 Proximal part of the intramedullary nail 22 Tapered portion of intramedullary nail 23 Distal part of the intramedullary nail 24 Lag screw insertion holes 25 Fixing hole 26 Insertion hole for the first fixing pin 27 Through hole for second fixing pin 2a Cap hole 2b Locking screw 3 lag screws 4 Front wall plate 41 Base 42 Nail part 42a Claw arm section 42b Tip of the nail 43 Plate through holes 5. Rear wall plate 51 Base 52 Claw part 52a Claw arm section 52b Tip of the nail 53 Plate through holes 6 Front wall plate fixing pins 61 Shaft 61a Male threaded portion 62 Head 62a Contact surface 7. Rear wall plate fixing pins 71 Shaft 71a Male threaded portion 72 Head 72a Contact surface 8 Anti-rotation screws 90 Femur 91 Bone head 92 Neck fracture 93 Femoral neck 94 Trochanter
Claims
1. A fracture treatment fixation device for treating femoral fractures, An intramedullary nail is inserted into the femoral cavity, A lag screw positioned to penetrate the intramedullary nail diagonally upward and enter the femoral head and femoral neck, An anterior wall plate that is applied to the anterior wall of the femoral trochanter, It comprises an anterior wall plate fixing pin that is positioned to penetrate the intramedullary nail and fixes the anterior wall plate to the anterior wall of the femoral trochanter, The fixation device for treating fractures is characterized in that the anterior wall plate fixing pin is configured to be screwable into the intramedullary nail.
2. The fracture treatment fixation device according to claim 1, characterized in that the anterior wall plate has a claw portion that contacts the surface of the femoral trochanter.
3. The front wall plate comprises a circular base portion in plan view and a plurality of claw portions, each having a claw arm portion projecting radially outward from the base portion, and through holes are formed at the boundary position between each claw arm portion and the base portion, or in each claw arm portion, with the axis perpendicular to the thickness direction of the base portion, and the through holes have openings on one side and the other side of the claw arm portion, respectively, as described in claim 1 or 2.
4. The fracture treatment fixation device according to claim 3, characterized in that a recess is formed on the outer circumferential surface of the base portion, and the recess is connected to the inner circumferential surface of the through hole.
5. The fracture treatment fixation device according to claim 1 or 2, characterized in that the intramedullary nail is provided with a plurality of insertion holes for first fixation pins into which the anterior wall plate fixation pins can be inserted.
6. The fracture treatment fixation device according to claim 1 or 2, characterized in that the anterior wall plate fixing pin is arranged at an inclination angle of 40° to 90° on the entrance side of the lag screw insertion hole with respect to the axis of the lag screw insertion hole.
7. The anterior wall plate is provided with three claw portions, and the plate through-hole formed in the anterior wall plate is formed such that its center does not coincide with the center of the circumscribed circle of a triangular figure formed by a virtual line connecting the tips of each of the three claw portions, as described in claim 1 or 2.
8. The fracture treatment fixation device according to claim 3, characterized in that a wire can be inserted through the through hole, and the wire can be wrapped around the trochanter of the femur.
9. The fracture treatment fixation device according to claim 1 or 2, characterized in that the length of the shaft portion of the anterior wall plate fixing pin is set to such a length that its tip does not protrude from the intramedullary nail, or protrudes only slightly.