Intramedullary nail for percutaneous pelvis internal fixation

Abstract

The present invention relates to the technical field of orthopedic medical instruments, and relates to an intramedullary nail for percutaneous pelvis internal fixation, comprising an anterior column intramedullary nail and a general intramedullary nail, and being used in cooperation with an external guide frame. A hollow channel is formed in the anterior column intramedullary nail and used for allowing an anterior column screw guide pin to pass through, and the anterior column screw guide pin allows the anterior column intramedullary nail to pass through the acetabular dome and the acetabular anterior wall to the ramus superior ossis pubis; a hollow channel is formed in the general intramedullary nail and used for allowing a transcolumn screw guide pin or a posterior column screw guide pin to pass through, and the general intramedullary nail can be used as a transcolumn screw and a posterior column screw; when the general intramedullary nail is used as a transcolumn screw, the transcolumn screw guide pin allows the transcolumn screw to pass through the acetabular dome and reach the sacroiliac joint along the interior of the greater sciatic notch without passing through the sacroiliac joint; and when the general intramedullary nail is used as a posterior column screw, the posterior column screw guide pin passes through the acetabular posterior wall to the proximal end of the greater sciatic notch without penetrating out of the cortical bone.

Description

A percutaneous intrapelvic fixation intramedullary nail TECHNICAL FIELD

[0001] The present application relates to the technical field of orthopedic medical devices, in particular to a percutaneous intrapelvic fixation intramedullary nail. BACKGROUND

[0002] With the development of diagnosis and treatment of malignant tumors, the number of patients with bone metastatic cancer is increasing year by year. The pelvis and the surrounding acetabulum are not only important cross-linking parts of the human movement system, but also common sites of bone metastasis. The pelvis is the second most common site of bone metastasis after the spine. Once the tumor metastasizes around the acetabulum, the pelvic metastatic cancer often causes significant pain and limited mobility, which is manifested as severe pain, limited movement, inability to walk, decreased quality of life, pathological fractures and loss of motor function, leading to interruption of systemic treatment, seriously affecting the quality of life of patients, and even accelerating death.

[0003] There is currently a lack of effective methods for treating pelvic bone metastatic cancer, and the options are very limited, mainly including radiotherapy and surgical treatment. Radiotherapy can relieve the pain symptoms of patients to some extent, but the treatment cycle is long, the symptoms are slow to relieve, the efficacy is not certain, and more importantly, there is no way to treat pathological fractures. During treatment, patients still need to take a large amount of painkillers and repeatedly travel to hospitals. In addition, radiotherapy causes changes in the skin and soft tissue conditions of the irradiated area, which is not suitable for further surgical treatment within a few months, resulting in delayed treatment. In addition to radiotherapy, existing surgical treatment methods include tumor resection, fixation of pathological fractures, reconstruction of the medullary joint prosthesis, and even amputation. The existing surgical treatment methods have large trauma, high bleeding, high complication rate and high perioperative mortality, and high medical expenses. The postoperative rehabilitation process of the former is long, the symptom relief is not significant, and the ability to live independently is lost. More importantly, the interruption of systemic treatment leads to uncontrolled tumor progression, directly threatening the effective survival time of patients. There is an urgent need for a small trauma, few complications and low cost technology to quickly and effectively relieve symptoms, allowing patients to quickly recover their daily lives and continue to link systemic treatment.

[0004] The application number 202311786273.9 discloses a periacetabular percutaneous internal fixation reinforced intramedullary nail external guiding frame, which includes a universal guiding frame, the universal guiding frame includes an arc-shaped assembly, the arc-shaped assembly includes a left arc-shaped guide plate, a middle guide plate and a right arc-shaped guide plate, the two ends of the middle plate are respectively detachably connected with the left arc-shaped guide plate and the right arc-shaped guide plate to splice into an arc-shaped assembly; the left arc-shaped guide plate or the right arc-shaped guide plate is provided with a cross-column nail guide pipe and a front column nail guide pipe, the middle plate is connected with at least one arc-shaped rod, and the end of the arc-shaped rod is fixed with a rear column nail guide pipe; three internal fixation reinforced intramedullary nails arranged in a tripod-like manner and staggered in space are placed in the pelvic bone around the diseased acetabulum through the cross-column nail guide pipe, the front column nail guide pipe and the rear column nail guide pipe, which can immediately and significantly relieve the pain symptoms of the patient and restore the motor function. The three internal fixation reinforced intramedullary nails are respectively a cross-column nail, a rear column nail and a front column nail, wherein the cross-column nail refers to: passing through one of the places between the anterior superior iliac spine and the anterior inferior iliac spine of the affected side ilium, taking the place as the starting point, passing through the top of the acetabulum, and reaching the sacroiliac joint along the cancellous bone of the ischial notch without penetrating the articular surface. The rear column nail refers to: passing through the ischial tuberosity of the hip, taking the ischial tuberosity as the starting point, passing through the acetabular posterior wall along the internal bone of the ischial branch, and penetrating to the proximal end of the ischial notch without penetrating the cortical bone. The front column nail refers to: passing through the iliac part of the acetabular vertex, taking the place as the starting point, passing through the acetabular vertex and the anterior wall of the acetabulum, and reaching the pubic upper limb of the acetabular vertex, and the end point reaches the affected side pubic symphysis without penetrating the cortical bone. Indeed, the application number 202311786273.9 solves the problems of long operation time, high incidence of surgical and wound complications, slow patient recovery and other problems of the existing treatment method for periacetabular metastatic cancer due to the use of traditional surgery, as well as the problems of high surgical technical difficulty, long learning curve, low complication tolerance rate of the freehand tripod-like internal fixation reinforced intramedullary nail surgery, significantly improves the surgical accuracy, reduces the surgical technical difficulty, and shortens the operation time, thereby benefiting the patients.

[0005] Although the application number 202311786273.9 discloses a periacetabular percutaneous internal fixation reinforced intramedullary nail external guiding frame, which can assist the percutaneous fixation of the intramedullary nail around the acetabulum, it still needs to be matched with the intramedullary nail. Only when the intramedullary nail is matched with the external guiding frame can the intramedullary nail be percutaneously placed in the body and internally fixed around the acetabulum. However, there is no special intramedullary nail on the market that can be matched with the external guiding frame, which restricts the promotion and application of pelvic bone metastatic cancer surgery. SUMMARY

[0006] To solve the above problems, the present application aims to provide a pelvic percutaneous internal fixation intramedullary nail, which is used to solve the problem that there is no special intramedullary nail for pelvic metastatic cancer on the market, and there is no special intramedullary nail that can be used with an external guiding frame of percutaneous internal fixation around the acetabulum, which restricts the promotion and application of minimally invasive surgery for pelvic bone metastatic cancer.

[0007] To achieve the above-mentioned purpose, the present application adopts the following technical solutions:

[0008] The present application discloses a kind of pelvic percutaneous internal fixation intramedullary nail, it is used with the external guiding frame of percutaneous internal fixation around the acetabulum, the external guiding frame of percutaneous internal fixation around the acetabulum includes cross column nail guide pipe, front column nail guide pipe and rear column nail guide pipe, this pelvic percutaneous internal fixation intramedullary nail includes front column intramedullary nail and general intramedullary nail, the hollow passage is arranged in the inside of the front column intramedullary nail, for being equipped with front column nail guide needle, front column nail guide needle is passed from the front column nail guide pipe of the external guiding frame of percutaneous internal fixation around the acetabulum of the acetabulum percutaneous internal fixation reinforcing intramedullary nail, so that the front column intramedullary nail passes through the acetabular apex iliac part, and this is starting point, passes through acetabular top and acetabular front wall, to suprapubic branch, terminal to sick side pubic symphysis but not break through cortical bone;The hollow passage is arranged in the inside of the general intramedullary nail, for being equipped with cross column nail guide needle or rear column nail guide needle, general intramedullary nail can be used as cross column nail and rear column nail;When general intramedullary nail is used as cross column nail, cross column nail guide needle is passed from the cross column nail guide pipe of the external guiding frame of percutaneous internal fixation around the acetabulum of the acetabulum percutaneous internal fixation reinforcing intramedullary nail, so that cross column nail passes through one of between iliac spine and iliac spine, and this is starting point, reaches sacroiliac joint but does not pass through along the skeleton inside of ischial notch;When general intramedullary nail is used as rear column nail, rear column nail guide needle is passed from the rear column nail guide pipe of the external guiding frame of percutaneous internal fixation around the acetabulum of the acetabulum percutaneous internal fixation reinforcing intramedullary nail, so that rear column nail passes through ischial tuberosity of hip, and this is starting point, passes through acetabular posterior wall along the skeleton inside of ischial branch, and reaches ischial notch proximal end but does not go out cortical bone.

[0009] Preferably, the shape of the front column intramedullary nail is arc-shaped.

[0010] Preferably, the surface of the front column intramedullary nail is smooth, for preventing the joint cavity from being penetrated.

[0011] Preferably, the front end of the front column intramedullary nail is cut to form a cutting surface.

[0012] Preferably, the front column intramedullary nail is provided with a tail cap, the outer wall of the tail cap is provided with close threads, for being firmly fixed on the cortical bone, and the tail end of the front column intramedullary nail is connected with the tail cap through threads.

[0013] Preferably, the tail cap comprises a screw rod part and a screw cap part, the screw rod part and the screw cap part are fixedly connected, the outer wall of the screw cap part is provided with close screw threads for fixing on the cortical bone, the outer wall of the screw rod part is provided with external screw threads, the inner wall of the hollow channel of the tail end of the anterior column intramedullary nail is provided with internal screw threads, the screw rod part of the tail cap is screwed into the hollow channel of the tail end of the anterior column intramedullary nail to realize the threaded connection of the two, and the end face of the end of the tail cap away from the screw rod part is provided with an internal hexagonal hole for penetrating an internal hexagonal tool to tighten the tail cap and fix the tail cap on the cortical bone.

[0014] Preferably, the tip of the universal intramedullary nail is a three-blade tip, the outer wall of the universal intramedullary nail is provided with screw threads, and the screw threads gradually change in density from the tail end to the tip of the universal intramedullary nail to form a gradually changing screw thread.

[0015] Preferably, the tail end of the universal intramedullary nail is thick and provided with close screw threads for fixing on the cortical bone and enhancing the firmness, the screw threads of the region close to the tip of the universal intramedullary nail are close, and the screw threads of the region between the tail end and the front end of the universal intramedullary nail are relatively sparse.

[0016] Preferably, the screw threads of the universal intramedullary nail are provided with reverse hook grooves for increasing the holding force by increasing the contact area of the bone body.

[0017] Preferably, the side wall of the front end of the universal intramedullary nail is provided with a bone cement outflow hole, the bone cement outflow hole is connected with the hollow channel of the universal intramedullary nail, and is used for flowing out bone cement to fill the gap between the universal intramedullary nail and the cortical bone or the cancellous bone.

[0018] Compared with the prior art, the present application has the beneficial effects that:

[0019] The application provides a percutaneous internal fixation intramedullary nail for a pelvis, which comprises a front column intramedullary nail and a universal intramedullary nail, and is used in cooperation with an extracorporeal guiding frame for percutaneous internal fixation of a pelvis, wherein the front column intramedullary nail is internally provided with a hollow channel for penetrating a front column nail guide needle, the front column nail guide needle is penetrated from a front column nail guide tube of the extracorporeal guiding frame for percutaneous internal fixation of the pelvis, and the front column intramedullary nail is penetrated through a pubic bone part of an acetabular vertex, and is penetrated through an acetabular vertex and an acetabular front wall, and is finally penetrated into a pubic ramus of the acetabular vertex and a part of the pubic bone, and the end point is on a pubic symphysis of a diseased side but does not penetrate through a cortical bone; the universal intramedullary nail is internally provided with a hollow channel for penetrating a cross column nail guide needle or a rear column nail guide needle, and the universal intramedullary nail can be used as the cross column nail and the rear column nail, when the universal intramedullary nail is used as the cross column nail, the cross column nail guide needle is penetrated from a cross column nail guide tube of the extracorporeal guiding frame for percutaneous internal fixation of the pelvis, and the cross column nail is penetrated through one of an anterior superior iliac spine and an anterior inferior iliac spine, and is penetrated through an acetabular vertex, a skeleton inside of an ischial tuberosity and a sacroiliac joint but does not penetrate through, when the universal intramedullary nail is used as the rear column nail, the rear column nail guide needle is penetrated from a rear column nail guide tube of the extracorporeal guiding frame for percutaneous internal fixation of the pelvis, and the rear column nail is penetrated through an ischial tuberosity of a hip, and is penetrated through a posterior wall of the acetabular, and is finally penetrated into a proximal end of the ischial tuberosity but does not penetrate out of a cortical bone. The percutaneous internal fixation intramedullary nail for the pelvis is used in cooperation with the extracorporeal guiding frame for percutaneous internal fixation of the pelvis, and is used in a percutaneous nail internal fixation operation, and has the advantages of small trauma, few complications and low cost, and can quickly and effectively relieve symptoms of a patient, so that the patient can quickly recover daily life, and can continue to connect a systemic treatment. BRIEF DESCRIPTION OF DRAWINGS

[0020] Fig. 1 is a schematic diagram of the front column intramedullary nail (the same as the front column nail), the universal intramedullary nail used as the cross column nail and the rear column nail and placed into the pelvis according to the embodiment 1 of the application;

[0021] Fig. 2 is a front view of the front column intramedullary nail for percutaneous internal fixation of the pelvis according to the embodiment 2 of the application;

[0022] Fig. 3 is a back view of the front column intramedullary nail for percutaneous internal fixation of the pelvis according to the embodiment 2 of the application;

[0023] Fig. 4 is a schematic diagram of the front column intramedullary nail for percutaneous internal fixation of the pelvis and used in cooperation with a tail cap according to the embodiment 2 of the application;

[0024] Fig. 5 is a schematic diagram of the front column intramedullary nail for percutaneous internal fixation of the pelvis and penetrated into the pelvis according to the embodiment 2 of the application;

[0025] Fig. 6 is a schematic diagram of the overall external structure of the universal intramedullary nail for percutaneous internal fixation of the pelvis according to the embodiment 3 of the application;

[0026] Fig. 7 is a plan view of a universal intramedullary nail for percutaneous internal fixation of the pelvis according to the third embodiment of the present application;

[0027] Fig. 8 is a three-dimensional view of a tip of the universal intramedullary nail for percutaneous internal fixation of the pelvis according to the third embodiment of the present application;

[0028] Fig. 9 is a partially enlarged view of the outer structure of a region where a tapered thread is formed of the universal intramedullary nail for percutaneous internal fixation of the pelvis according to the third embodiment of the present application;

[0029] Fig. 10 is a sectional view of the region where the tapered thread is formed of Fig. 9.

[0030] Reference numeral: 1 - anterior column intramedullary nail, 10 - tail cap;

[0031] 2 - universal intramedullary nail, 21 - reverse hook groove, 22 - bone cement outflow hole. DETAILED DESCRIPTION

[0032] Exemplary embodiments of the present application will be described in detail below with reference to the accompanying drawings. Although exemplary embodiments of the present application are shown in the drawings, it is to be understood that the present application can be implemented in various forms and should not be limited by the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the present application to those skilled in the art.

[0033] To address the current lack of specialized intramedullary nails for pelvic metastatic cancer and the absence of compatible external guide frames, which hinders the promotion and application of minimally invasive surgery for pelvic bone metastases, this invention provides a percutaneous intramedullary nail for pelvic fixation, comprising an anterior column intramedullary nail and a universal intramedullary nail, for use with an external guide frame for percutaneous intramedullary fixation and reinforcement of the acetabulum. The anterior column intramedullary nail has a hollow channel for inserting a guide pin. The guide pin passes through the anterior column conduit of the external guide frame for percutaneous intramedullary fixation and reinforcement of the acetabulum, allowing the anterior column intramedullary nail to pass through the iliac crest of the acetabulum. Starting from this point, it passes through the acetabular roof and anterior wall until it penetrates the superior pubic ramus and part of the iliac bone at the acetabular apex, ending at the pubic symphysis on the affected side without penetrating the cortical bone. The universal intramedullary nail has a hollow channel inside for inserting a transpillar or posterior column guide pin. It can be used as both a transpillar and posterior column nail. When used as a transpillar nail, the transpillar guide pin passes through the transpillar conduit of the external guide frame for percutaneous internal fixation of the intramedullary nail around the acetabulum, allowing the transpillar nail to pass between the anterior superior iliac spine and the anterior inferior iliac spine. From this point, it passes through the acetabular roof and along the bone of the greater sciatic notch to reach the sacroiliac joint without penetrating it. When used as a posterior column nail, the posterior column guide pin passes through the posterior column conduit of the external guide frame for percutaneous internal fixation of the intramedullary nail around the acetabulum, allowing the posterior column nail to pass through the ischial tuberosity of the buttock. Starting from the ischial tuberosity of the ischial tuberosity, it passes along the bone of the ischial ramus, through the posterior wall of the acetabulum, and reaches the proximal end of the greater sciatic notch without exiting the cortical bone. The intramedullary nail for percutaneous pelvic fixation disclosed in this invention, used in conjunction with an external guide frame for percutaneous intramedullary nail reinforcement around the acetabulum, enables percutaneous nail placement and internal fixation surgery. This not only has the advantages of minimal trauma, fewer complications, and low cost, but also can quickly and effectively relieve patient symptoms, allowing patients to resume their daily lives as soon as possible and continue with systemic treatment.

[0034] Example 1: An intramedullary nail for percutaneous pelvic fixation

[0035] Embodiment 1 of the present invention provides an intramedullary nail for percutaneous pelvic fixation, and its structure is described in detail below with reference to the accompanying drawings.

[0036] Referring to Figure 1, the intramedullary nail for percutaneous pelvic fixation includes an anterior column intramedullary nail 1 and a universal intramedullary nail 2, which are used in conjunction with an external guide frame for percutaneous intramedullary fixation and reinforcing intramedullary nails around the acetabulum. The external guide frame for percutaneous intramedullary fixation and reinforcing intramedullary nails around the acetabulum includes a cross-column nail conduit, an anterior column nail conduit, and a posterior column nail conduit.

[0037] The anterior column intramedullary nail 1 has a hollow channel inside for inserting the anterior column nail guide pin. The anterior column nail guide pin passes through the anterior column nail conduit of the external guide frame of the percutaneous internal fixation and reinforcing intramedullary nail around the acetabulum, so that the anterior column intramedullary nail 1 passes through the iliac bone part of the acetabulum apex, and from there it passes through the acetabular roof and the anterior wall of the acetabulum to the superior pubic ramus, and ends at the pubic symphysis on the affected side without penetrating the cortical bone.

[0038] The Universal Intramedullary Nail 2 has a hollow channel inside for inserting cross-column nail guide pins or posterior column nail guide pins. The Universal Intramedullary Nail 2 can be used as both a cross-column nail and a posterior column nail.

[0039] When the Universal Intramedullary Nail 2 is used as a transpillar nail, the transpillar nail guide pin passes through the transpillar nail conduit of the external guide frame of the percutaneous intramedullary nail reinforcing the acetabulum around the acetabulum, allowing the transpillar nail to pass through one of the points between the anterior superior iliac spine and the anterior inferior iliac spine. Starting from this point, it passes through the acetabular roof and along the bone of the greater sciatic notch to reach the sacroiliac joint but does not penetrate it. When the Universal Intramedullary Nail 2 is used as a posterior column nail, the posterior column nail guide pin passes through the posterior column nail conduit of the external guide frame of the percutaneous intramedullary nail reinforcing the acetabulum around the acetabulum, allowing the posterior column nail to pass through the ischial tuberosity of the buttock. Starting from the ischial tuberosity of the ischial tuberosity, it passes along the bone of the ischial ramus, through the posterior wall of the acetabulum, and reaches the proximal end of the greater sciatic notch but does not penetrate the cortical bone.

[0040] When the universal guide frame is placed on the patient, the transpiled pin cannula, posterior pin cannula, and anterior pin cannula are respectively positioned between the anterior superior iliac spine and the anterior inferior iliac spine around the acetabulum on the affected side of the patient's pelvis, the ischial tuberosity of the buttock, and the pubic limb direction of the acetabulum.

[0041] The transpillar screw conduit is used to insert and guide the transpillar screw guide pin, so that the transpillar screw passes through one of the points between the anterior superior iliac spine and the anterior inferior iliac spine, and from this point, it passes through the acetabular roof and along the bone of the greater sciatic notch to reach the sacroiliac joint but does not pass through it.

[0042] The posterior column nail conduit is used to insert and guide the posterior column nail guide pin, so that the posterior column nail passes through the ischial tuberosity of the buttock, and starts from the ischial tuberosity of the ischial tuberosity, along the interior of the ischial ramus bone, through the posterior wall of the acetabulum, and passes to the proximal end of the greater sciatic notch but does not pass through the cortical bone.

[0043] The anterior column screw conduit is used to insert and guide the anterior column screw guide pin, so that the anterior column screw passes through the iliac bone portion at the apex of the acetabulum, and from there it passes through the acetabular roof and anterior wall to the pubic limb, ending at the pubic symphysis on the affected side without penetrating the cortical bone; and the transposition screw, the posterior column screw and the anterior column screw are spatially interwoven to form a percutaneous acetabular tripod to reinforce the area around the acetabulum to be reinforced.

[0044] Among them, the anterior column intramedullary nail 1 is only used to penetrate the superior pubic ramus and part of the iliac bone;

[0045] Further, the universal intramedullary nail 2, in addition to being used as a trans-column nail and a posterior column nail, can also be used for the fixation of bone destruction applied to other parts of the pelvis except the superior pubic branch and part of the ilium, including the inferior pubic branch, the ischium, the ilium, the sacroiliac joint and the sacral vertebral body.

[0046] The intramedullary nail for percutaneous internal fixation of the pelvis disclosed in the present application is used in conjunction with the external guide frame for percutaneous placement of the intramedullary nail for internal fixation of the acetabulum disclosed in the application with application number 202311786273.9 to carry out percutaneous nail placement internal fixation surgery. The doctor only needs to sequentially pass the universal intramedullary nail 2 and the anterior column intramedullary nail 1 as the trans-column nail and the posterior column nail along the trans-column nail guide tube, the posterior column nail guide tube and the anterior column nail guide tube in the order of time, which significantly shortens the operation time, reduces the incidence of surgical complications, improves the accuracy of the operation and significantly reduces the difficulty of the operation.

[0047] Embodiment 2: An anterior column intramedullary nail for percutaneous internal fixation of the pelvis

[0048] The present application embodiment 2 provides an anterior column intramedullary nail for percutaneous internal fixation of the pelvis, the structure and its connection relationship are described in detail below in conjunction with the drawings.

[0049] Referring to FIGS. 2 to 5, the anterior column intramedullary nail 1 is internally provided with a hollow channel for passing the anterior column nail guide needle, and the anterior column nail guide needle makes the anterior column intramedullary nail 1 only used for passing the superior pubic branch and part of the ilium.

[0050] Specifically, the shape of the anterior column intramedullary nail 1 is arc-shaped.

[0051] Specifically, the surface of the anterior column intramedullary nail 1 is smooth, which is used to prevent the passage into the joint cavity.

[0052] Specifically, the front end of the anterior column intramedullary nail 1 is cut to form a cut surface.

[0053] In order to prevent the nail from being pulled out, the anterior column intramedullary nail 1 is provided with a tail cap 10, the outer wall of the tail cap 10 is provided with a tight thread for firm fixation on the cortical bone, and the tail end of the anterior column intramedullary nail 1 is connected with the tail cap 10 through the thread.

[0054] As a specific embodiment for realizing the threaded connection between the anterior column intramedullary nail 1 and the tail cap 10, the tail cap 10 includes a screw rod part and a nut part, which are fixedly connected, and the outer wall of the nut part is provided with a tight thread for fixation on the cortical bone.

[0055] The outer wall of the screw rod part is provided with an external thread, the inner wall of the hollow channel of the tail end of the anterior column intramedullary nail 1 is provided with an internal thread, the screw rod part of the tail cap 10 is screwed into the hollow channel of the tail end of the anterior column intramedullary nail 1 to realize the threaded connection of the two.

[0056] The end face of the tail cap 10 away from the screw rod part is provided with an internal hexagonal hole for penetrating an internal hexagonal tool to tighten the tail cap 10 and fix the tail cap 10 on the cortical bone.

[0057] In order to ensure that the screw rod part of the tail cap 10 can be smoothly screwed into the hollow channel of the tail end of the anterior column intramedullary nail 1, preferably, the tail end of the anterior column intramedullary nail 1 is relatively thick in the middle and front part and is connected with the screw rod part of the tail cap 10 through threads.

[0058] More specifically, different models are designed according to different lengths, and different models are designed according to different diameters, that is, intramedullary nails of different lengths and thicknesses.

[0059] Embodiment 3: A universal intramedullary nail for percutaneous internal fixation of the pelvis

[0060] Embodiment 3 of the present application provides a universal intramedullary nail for percutaneous internal fixation of the pelvis, and the structure and connection relationship thereof will be described in detail below with reference to the accompanying drawings.

[0061] The universal intramedullary nail 2 is internally provided with a hollow channel for penetrating a trans-column nail guide pin or a posterior column nail guide pin. In addition, the universal intramedullary nail 2 can also be used to penetrate the pelvic bone except the superior pubic ramus and part of the ilium, including the inferior pubic ramus, the ischium, the ilium, the sacroiliac joint and the sacral vertebral body.

[0062] Referring to FIGS. 6-10, the tip of the universal intramedullary nail 2 is a three-blade tip, the outer wall of the universal intramedullary nail 2 is provided with threads, and the degree of sparseness of the threads gradually changes from the tail end to the tip of the universal intramedullary nail 2 to form a gradually changing thread.

[0063] The form of the gradually changing thread is that the thread is dense in the front and sparse in the back, which helps to make it have tension. The nail tail and the nail body are integrated, but the nail tail is tightly threaded to facilitate the fixation of the nail tail on the cortical bone. The three-blade tip design can be self-tapping into the bone without the need for tapping.

[0064] As a specific embodiment for realizing the gradual change in the degree of sparseness of the threads, the tail end of the universal intramedullary nail 2 is thick and the thread is tight, which is used to fix on the cortical bone and enhance the firmness; the thread of the region close to the tip of the universal intramedullary nail 2 is tight, while the thread of the region between the tail end and the front end of the universal intramedullary nail 2 is relatively sparse.

[0065] In order to enhance the bonding effect of the universal intramedullary nail 2 and the bone body, the thread of the universal intramedullary nail 2 is provided with an anti-hook groove 21 for increasing the holding force by increasing the contact area of the bone body.

[0066] Further, a bone cement outflow hole 22 is formed in the sidewall of the front end of the universal intramedullary nail 2, which is connected with the hollow channel of the universal intramedullary nail 2, and is used for flowing out bone cement to fill the gap between the universal intramedullary nail 2 and the cortical bone or the spongy bone in the diseased area.

[0067] In order to facilitate the tool operation, the end face of the tail end of the universal intramedullary nail 2 is provided with an internal hexagonal hole, which is used for penetrating an internal hexagonal tool to tighten the tail end of the universal intramedullary nail 2 and fix the tail end of the universal intramedullary nail 2 on the cortical bone.

[0068] More specifically, different models are designed according to different lengths, and different models are designed according to different diameters, that is, intramedullary nails with different lengths and diameters.

[0069] The nearly 100 cases of clinical application of Examples 2 and 3 show that the pelvic percutaneous internal fixation intramedullary nail disclosed in the application, which is used in combination with the periacetabular percutaneous internal fixation reinforced intramedullary nail and the external guide frame, can significantly improve the symptoms of patients, has very low complications, and can be used for ground activities a few hours after the operation, thereby significantly reducing medical expenses and shortening the hospitalization time.

[0070] Finally, it should be noted that: the above examples are only used to illustrate the technical solutions of the present application, and not to limit them; although the present application has been described in detail with reference to the foregoing examples, those skilled in the art should understand that: it can still modify the technical solutions recorded in the foregoing examples, or make equivalent replacement for part of the technical features; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application.

Claims

1. A percutaneous trans-pelvic internal fixation intramedullary nail to be used in conjunction with an extracorporeal guiding frame for periacetabular internal fixation intramedullary nail, said extracorporeal guiding frame for periacetabular internal fixation intramedullary nail comprising a trans-columnar nail guide tube, an anterior column nail guide tube and a posterior column nail guide tube, characterized in that, The pelvic percutaneous internal fixation intramedullary nail comprises a front column intramedullary nail (1) and a general intramedullary nail (2), The front column intramedullary nail (1) is internally provided with a hollow channel for penetrating a front column nail guide pin, the front column nail guide pin is penetrated through a front column nail guide tube of an extracorporeal guiding frame of the percutaneous internal fixation intramedullary nail from around the acetabulum, so that the front column intramedullary nail (1) penetrates through the iliac bone part of the acetabular apex, and starts from the iliac bone part of the acetabular apex, penetrates through the acetabular apex and the acetabular anterior wall, reaches the superior pubic ramus, and ends at the pubic symphysis of the affected side but does not penetrate through the cortical bone; The general intramedullary nail (2) is internally provided with a hollow channel for penetrating a cross column nail guide pin or a rear column nail guide pin, and the general intramedullary nail (2) can be used as a cross column nail and a rear column nail; When the general intramedullary nail (2) is used as a cross column nail, the cross column nail guide pin is penetrated through a cross column nail guide tube of the extracorporeal guiding frame of the percutaneous internal fixation intramedullary nail from around the acetabulum, so that the cross column nail penetrates through one of the anterior superior iliac spine and the anterior inferior iliac spine, and starts from the one of the anterior superior iliac spine and the anterior inferior iliac spine, penetrates through the acetabular apex, reaches the sacroiliac joint along the inside of the ischial major notch but does not penetrate through the cortical bone; when the general intramedullary nail (2) is used as a rear column nail, the rear column nail guide pin is penetrated through a rear column nail guide tube of the extracorporeal guiding frame of the percutaneous internal fixation intramedullary nail from around the acetabulum, so that the rear column nail penetrates through the ischial tuberosity of the hip, and starts from the ischial tuberosity, penetrates through the acetabular posterior wall along the inside of the ischial ramus, and reaches the proximal end of the ischial major notch but does not penetrate out of the cortical bone.

2. The pelvic percutaneous internal fixation intramedullary nail according to claim 1, wherein The front column intramedullary nail (1) is arc-shaped.

3. The pelvic percutaneous internal fixation intramedullary nail according to claim 1, wherein The surface of the front column intramedullary nail (1) is smooth, so as to prevent the penetration into the joint cavity.

4. The pelvic percutaneous internal fixation intramedullary nail according to claim 1, wherein The front end of the front column intramedullary nail (1) is cut to form a cut surface.

5. The pelvic percutaneous internal fixation intramedullary nail according to claim 1, wherein The front column intramedullary nail (1) is provided with a tail cap (10), the outer wall of the tail cap (10) is provided with a tight thread for firm fixation on the cortical bone, and the tail end of the front column intramedullary nail (1) is threadedly connected with the tail cap (10).

6. The pelvic percutaneous internal fixation intramedullary nail according to claim 5, wherein The tail cap (10) comprises a screw rod part and a screw cap part, the screw rod part and the screw cap part are fixedly connected, and the outer wall of the screw cap part is provided with a tight thread for fixation on the cortical bone; The outer wall of the screw rod part is provided with an external thread, the inner wall of the hollow channel of the tail end of the front column intramedullary nail (1) is provided with an internal thread, the screw rod part of the tail cap (10) is screwed into the hollow channel of the tail end of the front column intramedullary nail (1), and the screw rod part and the tail end are threadedly connected; The end face of the end of the tail cap (10) away from the screw rod part is provided with an internal hexagonal hole for penetrating an internal hexagonal tool to tighten the tail cap (10) and fix the tail cap (10) on the cortical bone.

7. The pelvic percutaneous internal fixation intramedullary nail according to claim 1, wherein The tip of the universal intramedullary nail (2) is a three-blade tip, the outer wall of the universal intramedullary nail (2) is provided with threads, and the degree of sparsity of the threads gradually changes from the tail end to the tip of the universal intramedullary nail (2) to form a gradually changing thread.

8. The intramedullary nail for percutaneous internal fixation of the pelvis according to claim 7, characterized in that, The tail end of the universal intramedullary nail (2) is thick and the threads are dense, which is used for fixing on the cortical bone and enhancing the firmness; The threads near the tip of the universal intramedullary nail (2) are dense, while the threads in the area between the tail end and the tip of the universal intramedullary nail (2) are relatively sparse.

9. The intramedullary nail for percutaneous internal fixation of the pelvis according to claim 8, characterized in that, The universal intramedullary nail (2) is provided with an anti-hook groove (21) on the threads, which is used for increasing the holding force by increasing the contact area of the bone body.

10. The intramedullary nail for percutaneous internal fixation of the pelvis according to claim 9, characterized in that, The universal intramedullary nail (2) is provided with a bone cement outflow hole (22) on the side wall of the tip, which is connected with the hollow channel of the universal intramedullary nail (2) and is used for flowing out the bone cement to fill the gap between the universal intramedullary nail (2) and the cortical bone or the cancellous bone in the diseased area.

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