CN-115153798-B - Combined reduction dissecting steel plate for posterior approach acetabulum fracture and operation tool

Abstract

The invention discloses a combined type reduction dissecting steel plate and an operation tool for posterior approach acetabulum fracture, which comprise a locking steel plate and a reduction steel plate, wherein the locking steel plate is an arc-shaped strip steel plate which is attached to the upper part of a ischial great notch, a screw hole is formed in the locking steel plate, a screw rod is arranged on the locking steel plate, a nut is arranged on the screw rod, the reduction steel plate comprises a first steel plate, a second steel plate and a third steel plate, the first steel plate, the second steel plate and the third steel plate are integrally formed and are all provided with screw holes, the first steel plate is an dissecting structure which is in bending fit with the upper part of an acetabulum, the second steel plate is connected with the locking steel plate in an intersecting manner, and the third steel plate is an dissecting structure which is in bending fit with an acetabulum quadrilateral. According to the invention, the third steel plate is tightly attached to the quadrangle, the first screw hole of the locking steel plate is fixed with the ischial tuberosity through the screw, the reset steel plate assembly is pulled and twisted by the reset tool, and the quadrangle protruding into the pelvis is pulled outwards by the lifting action of the third steel plate on the quadrangle, so that the dislocation reset and fixation effects of the hip joint center are achieved.

Inventors

• CHEN LIN
• WU HONGYU
• QIN JIANPU
• CHENG JIE
• Bao Congshuai
• Yan Xuhang
• PU YIWEN
• AO JUN

Assignees

• 遵义医科大学附属医院

Dates

Publication Date

20260505

Application Date

20220815

Claims (9)

1. 1. Be used for the combination formula reduction dissecting steel sheet of posterior approach acetabulum fracture, characterized by that includes: The locking steel plate is an arc-shaped strip steel plate, is attached to the upper portion of the ischial tuberosity, and is provided with a screw hole, wherein the first screw hole is a curved anatomical structure matched with the upper portion of the ischial tuberosity, a screw rod is arranged on the locking steel plate, and a nut is arranged on the screw rod; The steel plate resets, the steel plate resets includes first steel sheet, second steel sheet and third steel sheet, first steel sheet, second steel sheet and third steel sheet integrated into one piece, and all be equipped with the screw, first steel sheet is the anatomical structure of crooked cooperation acetabulum top, the second steel sheet is connected with the intersection of locking nail steel sheet, the third steel sheet is the anatomical structure of crooked cooperation acetabulum quadrangle.
2. 2. The combination reduction anatomic steel plate for a posterior approach acetabular fracture of claim 1, wherein the screw holes in the second plate are kidney-shaped holes.
3. 3. The combination reduction anatomic steel plate for a posterior approach acetabular fracture of claim 1, wherein a first auxiliary plate is provided on the outside of the first plate.
4. 4. The combination reduction anatomical plate for a posterior approach acetabular fracture of claim 1, wherein a second auxiliary plate is provided at one end of the locking nail plate.
5. 5. An operative tool for operating the combined reduction anatomic steel plate for a posterior approach acetabular fracture according to any one of claims 1-4, comprising: the first resetting clamp comprises a first clamp arm and a second clamp arm, the middle parts of the first clamp arm and the second clamp arm are connected in a scissor shape, the front end of the first clamp arm is provided with a first positioning plate, the first positioning plate is provided with a screw hole, the front end of the second clamp arm is provided with a first clamping hook, and the first clamping hook is perpendicular to the second clamp arm and bends towards the direction of the first clamp arm; The second reset forceps comprise a third forceps arm and a fourth forceps arm, the middle parts of the third forceps arm and the fourth forceps arm are connected in a scissor shape, the front end of the third forceps arm is provided with a second positioning plate, the second positioning plate is provided with a screw hole, and the front end of the fourth forceps arm is provided with a second clamping hook which is bent relative to the fourth forceps arm; the crow bar is of a bar body structure.
6. 6. The manipulating tool according to claim 5, wherein the middle parts of the first and third arms are respectively provided with a stopper, a connecting shaft is arranged between the stopper and the first arm and between the stopper and the third arm, and the middle parts of the second and fourth arms are respectively provided with a stopper hole matched with the stopper.
7. 7. The manipulating tool according to claim 5, wherein the rear ends of the first arm, the second arm, the third arm and the fourth arm are provided with finger holes.
8. 8. The manipulation tool according to claim 5, wherein the rear ends of the second and fourth arms are respectively provided with a clamping block, the rear ends of the first and third arms are respectively connected with an L-shaped elastic piece, one side of the L-shaped elastic piece is provided with a plurality of clamping teeth, and the clamping teeth are clamped with the clamping blocks.
9. 9. The operating tool according to claim 5, wherein the rear end of the pry bar is provided with a handle, and the handle is provided with anti-slip particles.

Description

Combined reduction dissecting steel plate for posterior approach acetabulum fracture and operation tool Technical Field The invention belongs to the technical field of medical appliances, and particularly relates to an acetabular fracture reduction steel plate and an operation tool thereof. Background With the increase in the incidence of traffic accidents and industrial accidents, the incidence of acetabular fractures due to high energy injuries is also increasing. Studies have shown that the incidence of acetabular fractures increases year by year, with increasing age of onset, as well as increasing proportions of acetabular fractures that require internal fixation by incision reduction. The anatomical position of acetabulum is deeper, a plurality of important blood vessels and nerves exist around the acetabulum, and the acetabulum fracture often has more combined injuries, so that the incidence rate of postoperative complications is higher. Acetabular fractures are highly dependent on surgical reduction fixation treatment, while complex acetabular fractures include posterior column and wall fractures, transverse and wall fractures, T-shaped fractures, anterior and posterior semi-transverse fractures, double-column fractures, of the type that involve the quadrilateral of the pelvis, often with severe dislocation of the hip joint center. Therefore, the fracture reduction and fixation are difficult, the operation bleeding is more, the wound is large, the residue is easy, the sequelae is easy, and the like during the operation treatment. The traditional pelvis steel plate has the problems of difficult steel plate molding in operation, poor lamination of the steel plate and the pelvis resolving part structure, single steel plate fixing point and difficulty in supporting the quadrilateral fracture, and can not meet the treatment requirements of accurate reduction and strong fixation of the complex acetabulum fracture. Therefore, a large number of novel pelvic steel plates and novel surgical techniques are widely applied clinically, such as quadrilateral dissecting rigid plates, chinese patent publication No. CN105055010A, patent name is a tetragonal supporting steel plate for acetabulum comminuted fracture, publication No. CN208404810U, patent name is a combined fixing steel plate for acetabulum fracture. The novel pelvis steel plate has a certain supporting and blocking effect on quadrilateral fracture, and the steel plate is completed through an anterior approach and is only suitable for anterior wall fracture, anterior column fracture and transverse fracture, and can be suitable for anterior column and rear half transverse fracture when being combined with a rear column lag screw. Complex acetabular fractures such as posterior column and posterior wall fracture, transverse and posterior wall fracture, T-shaped fracture, double-column fracture and the like often need to be combined with posterolateral approach to complete the reduction fixation of the acetabular posterior column. Therefore, the front-back combined approach operation has the defects of increasing the anesthesia time and risk of the patient in operation, prolonging the operation time, increasing the bleeding amount in operation, aggravating the operation wound and the like. The traditional clinical dislocation reduction of the posterior column of the acetabulum and the ischial body which are moved to the pelvic cavity and the center of the hip joint of the femoral head usually uses tools such as bone hooks and the like to hang the fractured quadrangle, then the operation assistant pulls the quadrangle outwards, and simultaneously the lower limb traction is matched to reduce the hip joint, the reduction technology is difficult to realize the anatomical reduction of the acetabulum, the reason is that the manual assistant has limited physical strength, the other end of the fracture has no corresponding resistance, the patient is easy to be lifted off the operation bed surface when the traction is large, and the reduction of the patient cannot be realized in an anatomical way for part of patients, in clinical practice, the pelvis steel plate is used for lifting and resetting, one end of the steel plate is fixed on the ischial tuberosity and the large notch edge, and the proximal end of the fracture is pressed by lifting and pulling the steel plate, so that resultant force is generated to reset the acetabulum, however, the screw fixed on the ischial tuberosity and the large notch edge is not easy to cause nail pulling phenomenon due to insufficient holding force, in addition, when the acetabulum posterior column is reset through the steel plate, the reset moment only acts on the posterior half part of the acetabulum, when the posterior half part of the acetabulum is lifted and pulled, the whole posterior column can be twisted, and the dislocated quadrangle cannot be horizontally reset with the posterior half part of the acetabulum at the same time.