CN102497829A - 用于骨质疏松骨的肱骨头部固定装置 - Google Patents
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Abstract
一种装置,包括细长体,所述细长体被构造成联接于稳固骨的植入体,使得当所述稳固骨的植入体被安装至目标骨时,所述细长体从所述稳固骨的植入体以一角度向远处伸出,该角度选择为使得所述细长体穿入骨的目标部位。所述细长体限定其中的腔,该腔延伸至所述细长体的远端内的开口。所述装置还包括展开部件,所述展开部件被容纳于所述细长体的腔,用于在第一位置和第二位置之间移动。此外,所述装置包括多根线缆,所述多根线缆联接于所述展开部件,使得所述展开部件在所述腔内的移动使所述线缆在插入位置和展开位置之间移动,其中,所述线缆的远端刺入与所述细长体的远端邻接的骨的部位。
Description
优先权
本申请要求2009年9月14日递交的发明名称为“用于骨质疏松骨的肱骨头部固定装置”的第61/242,093号美国临时申请的优先权,其全文公开内容以引用方式并入本文。
技术领域
本发明涉及骨的治疗,尤其涉及一种采用预成型的线缆治疗骨质疏松骨的系统和方法,当力被施加于线缆的近端上时,预成型的线缆穿过骨。
背景技术
由于植入体不能被稳定地固定在骨上,故折骨的近端和远端的治疗对老年骨质疏松病人是极大的挑战。用于治疗折骨的近端和远端的手术方法通常引起并发症,例如,骨连接不正、骨不结合、骨端骨坏死、螺钉松动和/或不能复原。
发明内容
本发明涉及一种治疗骨的装置,其包括:细长体,其被构造成联接至接骨板,使得当所述接骨板被安装至目标骨的期望位置时,所述细长体从所述接骨板以一角度向远处延伸,所述角度被选择为,使得所述细长体沿期望路径穿入骨的目标部位,所述细长体限定其中的腔,该腔延伸至所述细长体的远端内的开口。此外,该装置包括容纳在所述细长体的腔内的展开部件,所述展开部件用于在第一位置和第二位置之间移动。该装置还包括多根线缆,所述线缆联接至所述展开部件,使得所述展开部件在所述腔中的移动使所述线缆在插入位置和展开位置之间移动,其中,在插入位置,所述线缆的远端被容纳在所述腔中,在展开位置,所述线缆的远端从所述细长体的远端的开口向远侧延伸出,以刺入骨的邻接于所述细长体的远端的部位。当所述线缆从所述细长体延伸出时,其被偏置成锚形。
附图说明
图1示出根据本发明的示例性实施方式的系统的透视图;
图2示出图1的所述系统在第一构型中的侧视剖面图;
图3示出图1的所述系统的装置在所述第一构型中的侧视剖面图;
图4示出图1的所述系统在第二构型中的侧视剖面图;
图5示出在所述第二构型中图3的所述装置的远侧部分的侧视剖面图;
图6示出在所述第一构型中,根据本发明的备选实施方式的装置的侧视剖面图;以及
图7示出图6的所述装置在第二构型中的侧视剖面图。
具体实施方式
参考以下描述及附图可以进一步理解本发明,附图中相同部件采用同样的附图标记表示。本发明涉及骨的治疗以及,尤其是涉及可能难以固定的骨质疏松骨的治疗。本发明的示例性实施方式描述了一种采用预成型的线缆治疗骨的系统和方法,当力被施加于线缆的近端上时,预成型的线缆穿过骨头。尽管所述示例性实施方式特别涉及到上肱骨的骨折的治疗,本领域技术人员可以理解,本发明可用于治疗身体上的任何骨。还应该注意,本文中所用的术语“近”和“远”旨在描述朝向(近)和远离(远)所述装置的外科医生或其他用户的方向。
如图1-图5中所示,根据本发明的示例性实施方式的系统100包括装置102,装置102可联接至纵向板104或与纵向板104形成整体,用于固定例如股骨或肱骨的骨断片。如图1中所示,装置102联接于板104的第一端106并从第一端106以相对于板104的纵向轴线的一角度远离延伸,所述角度选择成使得,当板104被安装至目标骨的期望位置时,装置102沿期望路径延伸进入目标骨的头部。板104从第一端106延伸至第二端108,以及包括沿板104的长度的多个开口110,开口110用于接纳骨固定部件以将板104固定至目标骨。尽管示出了装置102与板104形成整体,本领域技术人员可以理解,在备选实施方式中,如图6-图7中所示,装置102′可被形成为构造成联接至板104的单独的构件、钉状物或其他锚固部件。例如,装置102′可借助在板104上的开口而插入所述骨。因为装置102′为单独的构件,本领域技术人员可以理解,装置102′的近端114′被构造成联接至板104。下文将进一步具体描述装置102′。本领域技术人员可以理解,尽管所示出的装置102附接至板104的第一端106,但是该装置102可被附接或接合至沿板104的长度上的任何点,只要当板104联接于目标骨的期望位置时,装置102沿期望路径延伸进入骨的头部。
装置102还包括细长体112,细长体112容纳螺栓120和多根线缆122,在插入构型中,线缆122接纳在细长体112中以及可移动成展开构型,在展开构型中,线缆122从细长体112延伸进入目标骨的头部。细长体112从近端114延伸到远端116并包括延伸穿过细长体112的腔118。细长体112的近端114附接或接合至板104,使得当细长体112延伸入骨时,板114可以从外部被放置到目标骨。腔118的尺寸和形状设计为容纳螺栓120和多根线缆122,使得螺栓120和多根线缆122相对于细长体112可纵向移动。在插入构型中,如图2和图3中所示,线缆122基本被容纳在腔118内。螺栓120围绕装置102的纵向轴线的旋转使多根线缆122沿纵向轴线移动,相对于细长体112向远侧移动进入图4和图5中所示的展开构型。
如图2-图5中特别示出,每根线缆122从近端146纵向延伸,近端146包括突出部150,突出部150径向向内延伸以联接至螺栓120的头部138的槽142,使得多根线缆122围绕螺栓120在周向上被隔开。线缆122和螺栓120可旋转地彼此联接,使得当螺栓120被旋转通过细长体112时,线缆122不旋转。线缆122的远端148优选包括用于骨穿过的末端152,其可以被削尖或被另外处理以借助线缆122便于穿过松质骨。从图5中可以看出,在展开构型中,线缆122的远侧部分向远侧延伸出细长体112的远端116,以穿过目标骨的被装置102插入的头部。在该实施方式中,线缆122被偏置成使得从细长体112出来后,线缆122朝具有弹性复原性的形状移动,在该形状时,线缆122从远端116向远侧延伸一段距离,并随后向近侧折回弯曲以使装置102锚固在目标骨内。例如,线缆122可由例如镍钛合金的形状记忆材料形成。由这样的材料形成的线缆122可被预成型为弯曲构型,在弯曲构型中,所述线缆的远侧部分154被弯曲成约90°~180°的角度。在插入构型中,线缆122在细长体112内被保持基本直线构型。然而,当线缆122被移动成展开构型时,远侧部分154延伸穿过细长体112的远端116以及当尖的末端152刺入骨时远侧部分154恢复成弯曲构型。根据具体病人的情况和装置102的负荷运载能力,可以改变线缆122的数量和线缆122的周向取向。
当线缆122沿这些弯曲路径移动成展开构型时,骨内的线缆122的长度被增大,同时防止线缆122太接近于目标骨的头部的外表面。本领域技术人员可以理解,远离头部的外表面的线缆122的弯曲导致高负荷,在线缆122被植入目标骨之后,伞型固定阻止了装置102的移动。尖的末端152刺入所述骨以形成与线缆122的基本相同形状和尺寸的凹陷,这导致稳定的界面。此外,弯曲构型引导线缆122远离骨的关节区的软骨,这防止对关节表面的破坏。该弯曲构型还便于用于压缩力和剪切力的平滑过渡所需的动力学行为。因此,本领域技术人员可以理解,多根线缆122从插入构型到展开构型的移动增加了在目标骨内的装置102的稳定和固定。
细长体112的远侧部分124的壁厚比细长体112的近侧部分126的壁厚大,使得腔118的延伸穿过远侧部分124的部分在直径上大于腔118的延伸穿过近侧部分126的部分。远侧部分124包括螺纹128,螺纹128沿远侧部分124的内表面130的至少一部分且用于接合螺栓120的杆136。远侧部分124还可包括多个开口132,开口132沿远侧部分124的长度延伸并与细长体112的近侧部分126的内表面134对齐,使得每根线缆122可沿内表面134延伸进入其中的一个开口132。因此,本领域技术人员可以理解,开口132的尺寸和形状设计为容纳线缆122。
螺栓120包括头部138和杆136,杆136从头部138向远侧延伸。头部138包括例如六角凹部的驱动部件140,用于接合驱动工具以穿过细长体112的腔118向远侧驱动螺栓120,从而在插入构型和展开构型之间移动线缆。头部138还包括围绕其周向的槽142,用于联接线缆122的近端146。杆136包括沿杆136长度的螺纹144,用于接合细长体112的远侧部分124的螺纹128。因此,螺栓120围绕装置102的纵向轴线的旋转使装置102在插入构型和展开构型之间移动。在插入构型中,螺栓120基本被容纳在细长体112的腔118内,而在展开构型中,螺栓120的远端从细长体112向远侧延伸。此外,螺栓120可包括头部138,头部138构造成使得当装置102移动成展开构型时,头部138邻接细长体112的远侧部分124的近端156,使得螺栓120不能进一步向远侧移动。
本领域技术人员还可以理解,通过沿着与用于将装置102移动成展开构型的方向相反的方向围绕纵向轴线旋转螺栓120,可从骨移除装置102。这使螺栓120沿近侧方向返回到细长体112内,从而沿弯曲路径缩回线缆122,通过缩回线缆122,线缆122被折返回腔118内成为插入构型。此时,装置102不再被锚固在目标骨的头部并且可以从头部被移除,这可以被本领域技术人员理解。
如图6和图7中所示,如上文根据系统100的描述,装置102′可基本类似于装置102。装置102′可以是钉状物、螺钉或借助板104的开口可以插入目标骨的头部的其他锚固部件。与装置102类似,装置102′包括从近端114′延伸到远端116′的细长体112′和延伸穿过细长体112′的腔118′。腔118′的尺寸和形状设计为容纳螺栓120′和多根线缆122′,使得螺栓120′和线缆122′相对于腔118′可在图6中示出的插入构型和在图7中示出的展开构型之间纵向移动。细长体112′的近端114′包括用于联接至板104的联接机构。例如,近端114′可包括沿近端114′外表面的螺纹115′,用于接合接骨板104的开口处的螺纹。
在插入构型中,线缆122′基本被容纳在细长体112′内。与螺栓120类似,螺栓120′可相对于细长体112′移动以使线缆122′移动进入展开构型,在展开构型中,按照远侧部分154′的弯曲路径,远侧部分154响远侧延伸经过细长体112′的远端116′并进入骨的头部。然而,螺栓120′相对于细长体112′不是旋转的以展开线缆122′。螺栓120′不可旋转地联接于线缆122′的近端146′。螺栓120′还可包括在螺栓120′近端的销钉158′,使得销钉158′可用于推动螺栓120′和线缆122′向远侧通过腔118′并进入展开构型。为从骨上移除装置102′,螺栓120′可借助销钉158′被向近侧牵引通过腔118′,使线缆122′沿线缆122′展开的弯曲路径缩回插入构型。此时,装置102′不再被锚固在骨的头部,使得装置102可以从骨的头部被移除。
对本领域的技术人员来说是明显的是,本发明的结构和方法可以做出各种变形和变化,而不违背本发明的精神和范围。因此,只要这些变形和变化在本权利要求及等同权利要求的范围内,则本发明旨在覆盖这些变形和变化。
Claims (17)
1.一种治疗骨的装置,所述装置包括:
细长体,所述细长体被构造成联接于稳固骨的植入体,使得当所述稳固骨的植入体被安装至目标骨的期望部位时,所述细长体从所述稳固骨的植入体以一角度向远处延伸,所述角度被选择为使得所述细长体沿期望路径穿入骨的目标部位,所述细长体限定有腔,该腔延伸至所述细长体的远端内的开口;
展开部件,所述展开部件容纳于所述细长体的腔中,用于在第一位置和第二位置之间移动;以及
多根线缆,所述多根线缆联接于所述展开部件,使得所述展开部件通过所述腔的的移动使所述线缆在插入位置和展开位置之间移动,其中,在插入位置,所述线缆的远端被容纳在所述腔内,在展开位置,所述线缆的远端从所述细长体的远端内的开口向远侧延伸出,以穿过骨的与所述细长体的远端邻接的部位,当所述线缆从所述细长体伸出时,所述线缆被偏置以呈锚形。
2.根据权利要求1所述的装置,其中,所述细长体和所述稳固骨的植入体彼此一体地成形。
3.根据权利要求1所述的装置,其中,所述细长体的近端被构造为可选择地联接至所述稳固骨的植入体的开口处。
4.根据权利要求3所述的装置,其中,所述细长体的近端具有螺纹,该螺纹对应于所述稳固骨的植入体内的开口内壁处的螺纹。
5.根据权利要求1所述的装置,其中,当所述线缆在锚形时,所述线缆从所述细长体向远侧延伸第一距离,并接着径向弯曲远离所述细长体的纵向轴线。
6.根据权利要求5所述的装置,其中,当所述线缆在所述锚形时,所述线缆的远端面向近侧。
7.根据权利要求6所述的装置,其中,当所述线缆在所述锚形时,所述线缆中的第一线缆和第二线缆以大约90°~180°之间的角度弯曲。
8.根据权利要求1所述的装置,其中,所述线缆的远端被形成为骨穿过末端。
9.根据权利要求1所述的装置,其中,所述线缆包括形状记忆材料。
10.根据权利要求9所述的装置,其中,所述形状记忆材料为镍钛合金。
11.根据权利要求1所述的装置,其中,所述展开部件为螺栓,以及所述螺栓的螺纹与所述腔的内壁上对应的螺纹接合。
12.根据权利要求11所述的装置,其中,所述线缆不可旋转地联接至所述细长部件并可旋转地联接至所述展开部件,使得随着所述展开部件被旋转以纵向移动通过所述细长体,所述线缆没有相对于所述细长体旋转而纵向移动通过所述腔。
13.根据权利要求1所述的装置,其中,所述稳固骨的植入体为接骨板、钉状物和锚固部件中的一者。
14.一种用于治疗骨的方法,包括:
将装置插入到目标骨的头部内的期望位置,所述装置包括细长体和展开部件,所述细长体包括腔,所述腔延伸通过所述细长体直至所述细长体的远端内的开口,所述展开部件可移动地容纳在所述腔内,所述展开部件被联接至多根线缆,所述线缆在插入构型中被容纳在所述腔内;以及
当所述装置在期望位置时,移动所述展开部件通过所述腔,以将所述线缆自所述腔向远侧驱出并穿过目标骨的与所述细长体的远端邻接的部位,从使所述装置锚固至所述目标骨。
15.根据权利要求14所述的方法,还包括:
将所述装置联接至与所述目标骨的外部联接的稳固骨的植入体。
16.根据权利要求14所述的方法,其中,所述线缆中的第一线缆和第二线缆被偏置成锚形,其中,所述线缆的远侧部分相对于所述细长体的纵向轴线径向向外弯曲。
17.根据权利要求14所述的方法,其中,所述展开部件为螺纹接合于所述腔的内表面的螺栓,所述螺栓相对于所述腔的旋转使所述螺栓纵向移动通过所述腔。
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