CN105434085A - 3D printed individualized customized full wrist joint and manufacturing method thereof - Google Patents
3D printed individualized customized full wrist joint and manufacturing method thereof Download PDFInfo
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- CN105434085A CN105434085A CN201610014924.6A CN201610014924A CN105434085A CN 105434085 A CN105434085 A CN 105434085A CN 201610014924 A CN201610014924 A CN 201610014924A CN 105434085 A CN105434085 A CN 105434085A
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- fixed tray
- distal aspect
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30026—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in wear resistance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
- A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
- A61F2002/4256—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
- A61F2002/4264—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists for radio-carpal joints
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
- A61F2240/002—Designing or making customized prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00413—Coating made of cobalt or of Co-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00419—Other metals
- A61F2310/00449—Coating made of chromium or Cr-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00419—Other metals
- A61F2310/00497—Coating made of molybdenum or Mo-based alloys
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a 3D printed individualized customized full wrist joint and a manufacturing method thereof. The wrist joint comprises a radius side joint handle, a palm side fixing tray, a palm side joint surface and a distal radius joint surface. The radius side joint handle can be designed according to a diameter size and form of a medullary space, the length is increased compared with a conventional product, the diameter accords with the size of the medullary space, the wrist joint can be directly matched with the medullary space of a patient without repeatedly marrow expanding or using bone cement caused by an unqualified diameter of the handle. Aiming at the individual patient, a bone lost part of the patient is rebuilt. A wrist joint has slide ways in two directions, motion of the wrist joint can be simplified into two-axial motion, so when a bending and stretching motion is finished, the stability of the joint is kept to the maximum degree, and a possibility of dislocation is reduced. An anatomic form of the patient is rebuilt, partial joint functions of the patient are recovered, a postoperative Cooney grade of the patient is improved, and a Gartland and Werley grade of the patient is reduced.
Description
Technical field
The present invention relates to a kind of 3D printing individuation and customize full carpal joint and preparation method thereof, for causing the patient of wrist severe bone because of wound or tumor, dissect normally and function with reconstruction patients wrist, the invention belongs to technical field of medical instruments.
Background technology
For relating to carpal serious complicated Cranial defect, conventional carpal joint prosthese or other implants cannot make up the destruction of its huge Cranial defect and joint position, cannot rebuild normal anatomic form and function.Existing measure prostheses, lack and exchange with the medical professionals between doctor, designed product is difficult to reach doctor's requirement, and the design cycle of measure prostheses is longer, manufacturing cost is higher, and the prosthetic surface treatment effect that the conventional means of production produces is poor, and Bone Ingrowth effect is bad.
Summary of the invention
The present invention is mainly for above situation, propose a kind of 3D printing individuation and customize full carpal joint and preparation method thereof, use 3D printing technique, carry out quick Individual design manufacture of intraocular joint according to the bone defects situation of patient and joint designs feature, really realize the reconstruction of patient anatomy and function.
The present invention for solving the problems of the technologies described above adopted technical scheme is:
A kind of 3D prints individuation and customizes full carpal joint, comprises radius side joint handle, palmar fixed tray, palmar articular surface and distal aspect of the radius; Below described palmar fixed tray, column and screw are set, screw orientation points to column, radius side joint handle is connected with distal aspect of the radius, palmar articular surface is positioned at below distal aspect of the radius, palmar articular surface cover palmar fixed tray surface, palmar articular surface with between distal aspect of the radius for being flexibly connected.
Further, the upper surface of described palmar articular surface is protruding semielliptical shape slideway contacting surface, lower surface is for carrying out the superhigh cross-linking polyethylene liner of assembling with palmar fixed tray, and described lower surface arranges and is used for and fixing hole that palmar fixed tray is fixed.
Further, the diameter of described column is 8mm, and length is 25mm, and tapering is 1:3.
Further again, the shape on described palmar fixed tray surface is oval, and the material of described distal aspect of the radius is vitallium.
A kind of 3D prints the complete carpal manufacture method of individuation customization, comprises the following steps:
S1: print radius side joint handle according to pulp cavity diameter and form Design, concrete steps are in medical 3 D reconstruction software Mimics, utilize the DICOM formatted data of patient's CT scan to rebuild strong side radius, after Ipsilateral and strong side are compared, determine the position chosen needed for strong side and scope, after deriving stp file, stp file is imported in industrial software, contrast with Ipsilateral after mirror image, the part that Ipsilateral lacks is differed, near-end cutting, far-end carries out simplified design according to strong side carpal joint width, the end of described radius side joint handle forms one for being fixedly connected with the bionical base of distal aspect of the radius, the groove of distal aspect of the radius is installed in the indwelling of base center, metal 3D printing technique is adopted to print medical Ti 6Al4V alloy, form radius side joint handle blank, print the excessive powder in rear ultrasonic removal blank,
S2: design distal aspect of the radius, distal aspect of the radius adopts the semielliptical shape slideway contacting surface of depression, slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, the position that described distal aspect of the radius is connected with radius side joint handle adopts protruding columnar design, make it and radius side joint handle matching grooves, the distal aspect of the radius complete to design adopts metal 3D printing technique to print vitallium, form distal aspect of the radius blank, the excessive powder in the distal aspect of the radius blank after ultrasonic removal has printed;
S3: after the contact site polishing of distal aspect of the radius and radius side joint handle, combines the two;
S4: design and produce palmar articular surface, concrete steps are: the upper surface of palmar articular surface is designed to the protrusion semielliptical shape slideway contacting surface corresponding with distal aspect of the radius, slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, the lower surface that palmar articular surface contacts with palmar fixed tray arranges the superhigh cross-linking polyethylene liner being used for carrying out with palmar fixed tray assembling, lower surface is also provided with the fixing hole for being fixed with palmar fixed tray, the palmar articular surface that printed design is complete;
S5: design and produce palmar fixed tray, concrete steps are for import in industrial software by Ipsilateral metacarpal bone, in industrial software with remaining metacarpal bone for benchmark, set up coordinate axes, according to the size of patient's metacarpal bone, draw palmar fixed tray, according to the position of residue metacarpal bone, the position of adjustment palmar fixed tray upper pillar stand and screw, design rear employing metal 3D printing technique to print medical Ti 6Al4V alloy powder, form palmar fixed tray blank, the excessive powder in ultrasonic removal blank, polishes to palmar fixed tray blank;
S6: palmar articular surface is installed on palmar fixed tray, distal aspect of the radius after combination is connected with the palmar articular surface after combination and palmar fixed tray with radius side joint handle, wherein radius side joint handle and distal aspect of the radius install when prosthese is produced, and palmar articular surface and palmar fixed tray assemble in art.
Further, the method obtaining DICOM formatted data in step S1 is: gather the carpal CT tomography of patient's bilateral and at defect near-end and far-end complete scanned image, obtain Dicom format-pattern.
Further, determine in step S1 that the method for position and the scope chosen needed for strong side is: will be good for side and the alignment of Ipsilateral near-end, parallelly put together, line intercepts in the position of Ipsilateral Cranial defect, drawn intercepting line simultaneously through strong side, thus intercepts the Ipsilateral position corresponding in strong side.
Further again, the industrial software described in step S1 refers to UG, SolidWorks or ProE.
The invention has the beneficial effects as follows: the present invention is according to pulp cavity diameter and form Design radius side joint handle, and product length increased more in the past, and diameter meets pulp cavity size, can directly mate, without the need to repeatedly expanding marrow or Cement because shank diameter is defective in art.Radius side joint handle far-end designs according to original anatomic form, and the object of design like this rebuilds anatomic form on the one hand, on the other hand for joint slideway provides bionical base.Carpal articular surface, according to carpal motion mode, is designed with the slideway of both direction, and carpal motion can be reduced to two axle movement, mode be mainly in the wrong, stretch, receive, open up, thus while completing drawing-stretch and tighten-unfolding motion, at utmost ensure the stability in joint, reduce the possibility of dislocation.Palmar fixed tray of the present invention carries out the Individual design of column and screw for the remaining metacarpal bone of patient, preoperatively just can grasp best fixed solution, farthest ensure that the fixing of palmar fixed tray, avoids conventional prosthetic and fixes defect loosely.The material of distal aspect of the radius adopts vitallium, and palmar adopts superhigh cross-linking polyethylene liner to strengthen wearability.The present invention has rebuild the anatomic form of patient, has recovered patient part's function of joint, improves the Cooney after operation in patients and marks, and reduces the GartlandandWerley scoring of patient.
Above-mentioned explanation is only the general introduction of technical solution of the present invention, in order to better understand technological means of the present invention, and can be implemented according to the content of description, coordinates accompanying drawing to describe in detail below with preferred embodiment of the present invention.
Accompanying drawing explanation
Fig. 1 is right view of the present invention;
Fig. 2 is front view of the present invention;
Fig. 3 is left view of the present invention;
Fig. 4 is rearview of the present invention.
Detailed description of the invention
Below in conjunction with drawings and Examples, the specific embodiment of the present invention is described in further detail.Following examples for illustration of the present invention, but are not used for limiting the scope of the invention.
A kind of 3D of the present invention prints individuation and customizes full carpal joint, as Figure 1-4, comprises radius side joint handle 1, palmar fixed tray 2, palmar articular surface 3 and distal aspect of the radius 4; Arrange column 5 and screw below described palmar fixed tray 2, screw orientation points to column, and the diameter of column 5 is 8mm, and length is 25mm, and tapering is 1:3, and column as shown in Figure 2.Radius side joint handle is connected with distal aspect of the radius, and palmar articular surface 3 is positioned at below distal aspect of the radius 4, palmar articular surface be arranged on palmar fixed tray 2 surface, palmar articular surface with between distal aspect of the radius for being flexibly connected.
The upper surface of palmar articular surface 3 is protruding semielliptical shape slideway contacting surface, and lower surface is for carrying out the superhigh cross-linking polyethylene liner of assembling with palmar fixed tray, and described lower surface arranges and is used for and fixing hole that palmar fixed tray is fixed.
The shape on described palmar fixed tray 2 surface is oval, and the material of distal aspect of the radius is vitallium.
A kind of 3D prints the complete carpal manufacture method of individuation customization, comprises the following steps:
S1: print radius side joint handle according to pulp cavity diameter and form Design, concrete steps are in medical 3 D reconstruction software Mimics, utilize the DICOM formatted data of patient's CT scan to rebuild strong side radius, after Ipsilateral and strong side are compared, determine the position chosen needed for strong side and scope, after deriving stp file, stp file is imported in industrial software, contrast with Ipsilateral after mirror image, the part that Ipsilateral lacks is differed, near-end cutting, far-end carries out simplified design according to strong side carpal joint width, the end of described radius side joint handle forms one for being fixedly connected with the bionical base of distal aspect of the radius, the groove of distal aspect of the radius is installed in the indwelling of base center, metal 3D printing technique is adopted to print medical Ti 6Al4V alloy, form radius side joint handle blank, print the excessive powder in rear ultrasonic removal blank.
Wherein, the method obtaining DICOM formatted data is: gather the carpal CT tomography of patient's bilateral and at defect near-end and far-end complete scanned image, obtain Dicom format-pattern.
Determine that the method for position and the scope chosen needed for strong side is: will be good for side and the alignment of Ipsilateral near-end, parallelly put together, line intercepts in the position of Ipsilateral Cranial defect, drawn intercepting line simultaneously through strong side, thus intercepts the Ipsilateral position corresponding in strong side.
S2: design distal aspect of the radius, distal aspect of the radius adopts the semielliptical shape slideway contacting surface of depression, slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, the position that described distal aspect of the radius is connected with radius side joint handle adopts protruding columnar design, make it and radius side joint handle matching grooves, the distal aspect of the radius complete to design adopts metal 3D printing technique to print vitallium, form distal aspect of the radius blank, the excessive powder in the distal aspect of the radius blank after ultrasonic removal has printed.
S3: after the contact site polishing of distal aspect of the radius and radius side joint handle, combines the two.
S4: design and produce palmar articular surface, concrete steps are: the upper surface of palmar articular surface is designed to the protrusion semielliptical shape slideway contacting surface corresponding with distal aspect of the radius, slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, the lower surface that palmar articular surface contacts with palmar fixed tray arranges the superhigh cross-linking polyethylene liner being used for carrying out with palmar fixed tray assembling, lower surface is also provided with the fixing hole for being fixed with palmar fixed tray, the palmar articular surface that printed design is complete.
S5: design and produce palmar fixed tray, concrete steps are for import in industrial software by Ipsilateral metacarpal bone, in industrial software with remaining metacarpal bone for benchmark, set up coordinate axes, according to the size of patient's metacarpal bone, draw palmar fixed tray, according to the position of residue metacarpal bone, the position of adjustment palmar fixed tray upper pillar stand and screw, design rear employing metal 3D printing technique to print medical Ti 6Al4V alloy powder, form palmar fixed tray blank, the excessive powder in ultrasonic removal blank, polishes to palmar fixed tray blank.
S6: palmar articular surface is installed on palmar fixed tray, distal aspect of the radius after combination is connected with the palmar articular surface after combination and palmar fixed tray with radius side joint handle, wherein radius side joint handle and distal aspect of the radius install when prosthese is produced, and palmar articular surface and palmar fixed tray assemble in art.
In one embodiment, the present invention includes four large parts, be respectively: radius side joint handle 1, palmar fixed tray 2, palmar articular surface 3, distal aspect of the radius 4.Palmar articular surface is fixed on palmar fixed tray, and distal joint face, radius side is fixed on the far-end of radius joint handle.
Radius side joint handle carries out bionical simplified design according to original anatomical angulation and profile, has both met the angle that radius is outstanding, also compensate for prosthese in the past and cannot rebuild the problem of anatomic form.Concrete steps gather patient's bilateral carpal CT tomoscan image, during scanning need defect near-end and far end scan complete, be convenient to post-processed.Import to Mimics after obtaining Dicom format-pattern to carry out rebuilding strong side radius, rear intercepting corresponding site is compared with Ipsilateral, derive after stp file through above-mentioned steps equally, import in the industrial softwares such as UG, contrast with Ipsilateral after mirror image, the part that Ipsilateral lacks differed, near-end cutting, far-end carries out simplified design according to strong side carpal joint width.3D prints carpal marrow and is to copy the carpal joint of normal contra lateral (strong side) to design, far-end designs according to the carpal width in strong side, but when distal bone defect scope is less, in order to ensure that anatomic form is simultaneously easy for installation, full carpal joint end length and width designed by the present invention and angle all copy strong side carpal joint, but are not simple bionical blocks design.
In Mimics, the radioulnaris distalis lacked as (medical terminology) has the needs bearing prosthese long handle, after being separated this part separately, extracting pulp cavity, measure the upper and lower diameter of pulp cavity, can be designed to joint handle after fairing in mimics or Geomagic.
Radius side of the present invention joint handle designs according to pulp cavity diameter and form, and radius side joint handle far-end designs according to original anatomic form, and the object of design like this rebuilds anatomic form on the one hand, on the other hand for joint slideway provides bionical base.Carpal articular surface is according to carpal motion mode, adopt motion biomimetics design, be designed with the slideway of both direction, carpal motion can be reduced to two axle movement, mode be mainly in the wrong, stretch, receive, open up, thus while completing drawing-stretch and tighten-unfolding motion, at utmost ensure that the stability in joint, decrease the possibility of dislocation.Carpal articular surface refers to the part that palmar articular surface contacts with distal aspect of the radius.
The present invention is according to the radius side joint handle of pulp cavity diameter and form Design, and product length increases more in the past, and diameter meets pulp cavity size, can directly mate, without the need to repeatedly expanding marrow or Cement because shank diameter is defective in art.
The upper surface of palmar articular surface and slideway contacting surface are designed to semielliptical shape slideway contacting surface, and slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, and this design is identical with carpal joint actual motion.The lower surface that palmar articular surface contacts with palmar fixed tray is designed for be assembled with palmar fixed tray, and palmar articular surface material is superhigh cross-linking polyethylene, designs fixing hole with palmar fixed tray contact surface, is convenient to be fixed on palmar fixed tray.
Palmar fixed tray designs diameter is 8mm, length is 25mm, tapering is the column of 1:3, be one piece of hold-down screw bottom palmar fixed tray, screw orientation points to column, ensures that column and screw can be implanted in remaining metacarpal bone to greatest extent.Design and produce the concrete steps of palmar fixed tray for import in the industrial softwares such as UG by Ipsilateral metacarpal bone, in the industrial softwares such as UG with remaining metacarpal bone for benchmark, set up coordinate axes, according to the size of patient's metacarpal bone, draw palmar fixed tray, according to the position of residue metacarpal bone, the position of adjustment palmar fixed tray upper pillar stand and screw, design rear employing metal 3D printing technique to print with Ti6Al4V powder, form blank, excessive powder in ultrasonic removal blank, polishes, and palmar articular surface is installed on palmar fixed tray.
In the design of palmar fixed tray, column is arranged on pallet centre position by conventional carpal joint often, and to side, two angles are arranged two hold-down screws at a certain angle.Fixing comparatively firm for this design conventional patient.But for the patient of Cranial defect on a large scale, this screw angle design cannot be fixed on sclerotin, and palmar fixed tray of the present invention carries out the Individual design of column and screw for the remaining metacarpal bone of patient, preoperatively just can grasp best fixed solution, farthest ensure that the fixing of palmar fixed tray, avoid conventional prosthetic and fix defect loosely.
The material of distal aspect of the radius adopts vitallium, and palmar articular surface adopts superhigh cross-linking polyethylene liner to strengthen wearability.The concrete steps designing and producing distal aspect of the radius are polished to vitallium for adopting ArcamA1EBM metallic print machine, form distal aspect of the radius blank, distal aspect of the radius blank is printed the excessive powder in rear ultrasonic removal blank, after the contact site polishing of printed palmar articular surface and distal aspect of the radius, prosthesis handle entirety be connected with palmar articular surface, two all the other positions of articular surface retain the not only sliding surface printing and formed.
It should be noted that, the commercial carpal joint prosthese of latest generation, because production technology is limited, vitallium can only be adopted to complete the making of full handle, vitallium is as prosthesis handle, and its Bone Ingrowth effect is poor, and long-term fixed effect is not good enough.
Smallbones carpal joint prosthese, belongs to forth generation carpal joint, have passed through the improvement of decades, has been the carpal joint prosthese of present success rate.But its prosthesis handle is shorter, is only only applicable to the patient that the articular surfaces such as rheumatoid arthritis occur to destroy, for the patient of bulk Cranial defect below articular surface, even cannot completes fixing, say nothing of the reconstruction carrying out anatomic form and function.The carpal joint handle that 3D prints then according to patient's defect situation, by above step, by rebuilding subjects bones, can design the prosthesis handle that can make up the defect of patient meeting patient's length, diameter.
For the clinical trial carried out in early stage: male patient, 40 years old, right side wrist open injury more than 2 years, to infect after debridement more than 1 year.Patient causes right ulna and radius fracture,compound,comminuted, near-end metacarpal bone comminuted fracture, dorsal forearm tendon and soft tissue defects, in his institute's row debridement Fracture internal fixaiion transfer of skin flap prothesis etc. because of machine pusher before 2 years.Postoperative infection, twice row expands wound lavation art and right side ulna and radius inside-fixture taking-up osteomyelitis focus debridement.Infection control is not good, expands wound sequestrectomy the year before in his institute's row.Because high energy wound causes severe bone, rear formation osteomyelitis, the not good Cranial defect scope that causes of osteomyelitis treatment increases, and finally cause far-end ulna and radius and metacarpal bone near-end defect, patient now shows as wrist drop, and the activity of carpal joint main passive flexion and extension is all limited.Treat the full carpal joint replacement that this patient needs row individuation, but it is domestic without corresponding prosthese, though there is full carpal joint prosthese in external smallbone company, be only limitted to carpal surface replacement, this patient's defect is larger, existing prosthese cannot be applied, re-establishing anatomical structure for meeting patient, the requirement of recovered part function, participating in after clinical experiment through patient's informed consent, prosthetic designs is carried out according to patient self anatomical structure, finally for this patient customizes full carpal joint prosthese with the present invention.Routine operation, postoperatively carries out rehabilitation guide.After operation in patients 6 months by preoperative vertical wrist-like state, to independently using mobile phone.Cooney scoring reaches postoperative 60 points (more high better) from preoperative 30 points, and GartlandandWerley scoring reduction is reduced to 11 points (more low better) from preoperative 28 points.
The present invention is only described with above-mentioned embodiment the most common; the conversion that every other forms of unit of obtaining under enlightenment of the present invention and ultimate principle according to the present invention are carried out individual part or the unit that improvement obtains, all within its protection domain.
Claims (8)
1. 3D prints individuation and customizes a full carpal joint, it is characterized in that: comprise radius side joint handle (1), palmar fixed tray (2), palmar articular surface (3) and distal aspect of the radius (4); Described palmar fixed tray (2) below arranges column (5) and screw, screw orientation points to column, radius side joint handle is connected with distal aspect of the radius, palmar articular surface (3) is positioned at distal aspect of the radius (4) below, palmar articular surface cover palmar fixed tray (2) surface, palmar articular surface with between distal aspect of the radius for being flexibly connected.
2. 3D according to claim 1 prints individuation and customizes full carpal joint, it is characterized in that: the upper surface of described palmar articular surface (3) is protruding semielliptical shape slideway contacting surface, lower surface is for carrying out the superhigh cross-linking polyethylene liner of assembling with palmar fixed tray, and described lower surface arranges and is used for and fixing hole that palmar fixed tray is fixed.
3. 3D according to claim 1 prints individuation and customizes full carpal joint, it is characterized in that: the diameter of described column (5) is 8mm, and length is 25mm, and tapering is 1:3.
4. print individuation according to the 3D one of claim 1-3 Suo Shu and customize full carpal joint, it is characterized in that: the shape on described palmar fixed tray (2) surface is for oval, and the material of described distal aspect of the radius is vitallium.
5. 3D prints the complete carpal manufacture method of individuation customization, it is characterized in that, comprises the following steps:
S1: print radius side joint handle according to pulp cavity diameter and form Design, concrete steps are in medical 3 D reconstruction software Mimics, utilize the DICOM formatted data of patient's CT scan to rebuild strong side radius, after Ipsilateral and strong side are compared, determine the position chosen needed for strong side and scope, after deriving stp file, stp file is imported in industrial software, contrast with Ipsilateral after mirror image, the part that Ipsilateral lacks is differed, near-end cutting, far-end carries out simplified design according to strong side carpal joint width, the end of described radius side joint handle forms one for being fixedly connected with the bionical base of distal aspect of the radius, the groove of distal aspect of the radius is installed in the indwelling of base center, metal 3D printing technique is adopted to print medical Ti 6Al4V alloy, form radius side joint handle blank, print the excessive powder in rear ultrasonic removal blank,
S2: design distal aspect of the radius, distal aspect of the radius adopts the semielliptical shape slideway contacting surface of depression, slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, the position that described distal aspect of the radius is connected with radius side joint handle adopts protruding columnar design, make it and radius side joint handle matching grooves, the distal aspect of the radius complete to design adopts metal 3D printing technique to print vitallium, form distal aspect of the radius blank, the excessive powder in the distal aspect of the radius blank after ultrasonic removal has printed;
S3: after the contact site polishing of distal aspect of the radius and radius side joint handle, combines the two;
S4: design and produce palmar articular surface, concrete steps are: the upper surface of palmar articular surface is designed to the protrusion semielliptical shape slideway contacting surface corresponding with distal aspect of the radius, slideway main movement direction is horizontally slipping of bionic pattern and slides up and down, the lower surface that palmar articular surface contacts with palmar fixed tray arranges the superhigh cross-linking polyethylene liner being used for carrying out with palmar fixed tray assembling, lower surface is also provided with the fixing hole for being fixed with palmar fixed tray, the palmar articular surface that printed design is complete;
S5: design and produce palmar fixed tray, concrete steps are for import in industrial software by Ipsilateral metacarpal bone, in industrial software with remaining metacarpal bone for benchmark, set up coordinate axes, according to the size of patient's metacarpal bone, draw palmar fixed tray, according to the position of residue metacarpal bone, the position of adjustment palmar fixed tray upper pillar stand and screw, design rear employing metal 3D printing technique to print medical Ti 6Al4V alloy powder, form palmar fixed tray blank, the excessive powder in ultrasonic removal blank, polishes to palmar fixed tray blank;
S6: palmar articular surface is installed on palmar fixed tray, distal aspect of the radius after combination is connected with the palmar articular surface after combination and palmar fixed tray with radius side joint handle, wherein radius side joint handle and distal aspect of the radius install when prosthese is produced, and palmar articular surface and palmar fixed tray assemble in art.
6. 3D as claimed in claim 5 prints the complete carpal manufacture method of individuation customization, it is characterized in that: the method obtaining DICOM formatted data in step S1 is: gather the carpal CT tomography of patient's bilateral and at defect near-end and far-end complete scanned image, obtain Dicom format-pattern.
7. 3D as claimed in claim 5 prints the complete carpal manufacture method of individuation customization, it is characterized in that: in step S1, determine that the method for position and the scope chosen needed for strong side is: side and the alignment of Ipsilateral near-end will be good for, parallelly to put together, in the position of Ipsilateral Cranial defect, line intercepts, drawn intercepting line simultaneously through strong side, thus intercepts the Ipsilateral position corresponding in strong side.
8. 3D as claimed in claim 5 prints the complete carpal manufacture method of individuation customization, it is characterized in that: the industrial software described in step S1 refers to UG, SolidWorks or ProE.
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