Combined tibial plateau back outer side dissection steel plate (2023)

[0007] The purpose of the present invention is to provide a combined posterolateral tibial plateau anatomical plate, aiming at the splitting and collapse of the posterolateral area of ​​the tibial plateau, it can complete the good fixation...

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[0026] From the above, it can be known that compared with the improved anterolateral approach in the prior art (Gerdy tuberosity osteotomy, fibular head osteotomy, biceps femoris fibular head osteotomy, lateral epicondyle osteotomy), posterolateral approach (Carlson posterolateral approach, osteotomy through the fibular neck and fibula head) and posteromedial inverted "L"-shaped approach, the present invention adopts an anterolateral single incision, and the non-weight-bearing area of ​​...

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[0017] The present invention will be described in further detail below in conjunction with the accompanying drawings.

[0018] like Figure 4 As shown, the present invention provides a combined posterolateral tibial plateau anatomical plate, which is composed of a bone plate body 2, a front fixation wing 4, a side fixation wing 3 and a rear baffle 1; the bone plate body 2 is The longitudinal strip-shaped plate surface, the front fixed wings 4 and the side fixed wings 3 are respectively located on both sides of the upper end of the bone plate body 2, the front fixed wings 4 and the side fixed wings 3 are integrated with the bone plate body 2, The inner surface of the anatomical steel plate composed of the bone plate body 2, the front fixed wing 4, the side fixed wing 3 and the rear baffle plate 1 matches the anatomical structure of the anterior, lateral and posterior surface of the proximal tibia; Two locking screw holes are arranged in the length direction of the front fixed wing 4, and the direction of the locking screw holes is toward the posterolateral platform of the tibia, which is used to support and fix the posterolateral fracture fragment; There are two locking screw holes arranged in a row, the direction of the locking screw holes is towards the posterolateral side of the tibial plateau, the screw holes at the front end of the rear baffle plate 1 and the screw holes at the rear end of the lateral fixation wing 3 are connected by the same screw; used for support and fixation posterolateral fracture fragment; the rear end of the rear baffle 1 is arranged with two internally threaded holes that are in the same direction as the screws of the front fixed wing 4 and match, and there is a locking screw hole in the middle of the length direction of the rear baffle 1 for locking The direction of the screw hole is toward the posterolateral side of the tibial plateau, which is used to support and fix the posterolateral fracture block; the distance between the locking screw hole of the front fixed wing 4 and the locking screw hole of the lateral fixed wing 3 is a screw hole diameter; The bone plate body 2 described above is located at the level of the fibula head and has a locking screw at a distance of 1 screw hole diameter lower than the locking screw hole of the front fixed wing. Line up the 3 locking screw holes. The front, front and rear ends of the present invention are the same as figure 1 The directions of division of the regions on the tibial plateau are consistent, and the distal end is the end away from the tibial plateau.

[0019] The anatomical steel plate of the present invention is processed and formed by 3D printing, the arc-shaped part width of the front fixed wing is 1.4-2.2cm, and the inner edge does not exceed the patellar ligament; the width of the lateral fixed wing is 1.1cm, and the length The distance between the screw holes is 3.5-4.0cm, the distance between the screw holes is 0.8-1.0cm; the width of the rear baffle is 1.1cm, the length is designed according to the CT data, the distance between the screw holes is 0.6-0.8cm, and the inner edge does not exceed the center of the rear side column; The width of the bone plate is 1.1cm, the length is determined according to the specific fracture type, the length is 7.0-15cm, and the distance between screw holes is 1.0cm.

[0020] like figure 2 and 3 Shown, for merge posterolateral platform fracture patient, the use step of the present invention is as follows:

[0021] 1. Take an anterolateral tibial plateau incision, bluntly dissect to the periosteum, perform an osteotomy in the anterolateral non-weight-bearing area of ​​the tibial plateau, expose the posterolateral fracture site of the tibial plateau, reduce and temporarily fix the posterolateral fracture.

[0022] 2. Put the rear baffle 1 behind the tibial plateau, temporarily fix it with fine Kirschner wires, drill through the locking screw hole of the rear baffle 1 from outside to back and measure the depth, and insert a locking screw.

[0023] 3. Restore the osteotomy block, place the "posterolateral tibial plateau anatomical plate", connect the screw hole at the front end of the rear baffle plate 1 with the screw hole at the rear end of the lateral fixation wing 3 through the same screw, and apply a fine gram Temporary fixation of the steel plate with pins. Through the lateral fixation wing 3, holes were drilled from outside to back and the depth was measured. Two locking screws were selected to fix the posterolateral fracture fragment. The direction of the screw holes on the lateral fixation wing 3 was determined by the position of the posterolateral fracture fragment.

[0024] 4. After the screws of the lateral fixed wing 3 are placed, use an electric drill to drill holes through the front fixed wing and measure the depth. Select 1-2 locking screws to fix the posterolateral fracture fragment. The direction of the screw holes on the front fixed wing 4 follows the posterolateral direction. Depending on the position of the fracture fragment, the direction of the screw is consistent with and matches the inner thread of the rear baffle, which can play a role in compression.

[0025] 5. After the front fixation wing screw is placed, insert the locking screw at the proximal end of the bone plate body 2, facing the inner platform, to pressurize and fix the osteotomy block, and finally insert the 2- 3 locking screws complete the fixation.

[0026] From the above, it can be known that compared with the improved anterolateral approach in the prior art (Gerdy tuberosity osteotomy, fibular head osteotomy, biceps femoris fibular head osteotomy, lateral epicondyle osteotomy), posterolateral approach (Carlson posterolateral approach, osteotomy through the fibular neck and fibula head) and posteromedial inverted "L"-shaped approach, the present invention adopts an anterolateral single incision, and the non-weight-bearing area of ​​the lateral platform is osteotomized, which can be reduced and fixed Posterolateral tibial plateau fractures can also be used to fix lateral plateau fractures. The insertion method is simple and easy, and its structure does not interfere with or damage the nerves and blood vessels around the knee joint, which greatly reduces the amount of blood loss and the risk of nerve injury during the operation. Satisfactory clinical treatment effect and postoperative functional recovery were achieved.