CN103705320B - 可调节高度的关节成形术板 - Google Patents

可调节高度的关节成形术板 Download PDF

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CN103705320B
CN103705320B CN201310449627.0A CN201310449627A CN103705320B CN 103705320 B CN103705320 B CN 103705320B CN 201310449627 A CN201310449627 A CN 201310449627A CN 103705320 B CN103705320 B CN 103705320B
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plate
actuator
fixed plate
arthroplasty
joint motions
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CN103705320A (zh
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J.M.查瓦里亚
S.A.鲁本斯基
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DePuy Products Inc
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Abstract

本发明公开了一种整形外科组件。所述整形外科组件包括能够联接到骨的第一构件和可调式连接器组件，所述可调式连接器组件包括具有螺纹端部和渐缩端部的调节器。所述组件还包括关节运动部件，所述关节运动部件包括支承表面并且能够联接到所述可调式连接器组件的渐缩端部。所述螺纹端部能够接合固定板。

Description

可调节高度的关节成形术板
相关申请的交叉引用
本申请要求2012年9月28日提交的名称为“Adjustable Height Arthroplasty Plate”的美国临时申请61/706916的优先权，其以引用方式全文并入本文。
技术领域
本发明一般涉及整形外科领域，并且更具体地，涉及用于修复长骨端部的骨折的关节成形术板。
背景技术
自然肩关节可能由于多种原因例如关节炎而遭受退行性病变。作为另外一种选择，肩关节可能由外力导致骨折或换句话讲损伤。当肩关节发生足够的变性或损伤时，可能必须用假体肩关节来置换自然关节。常规的肩关节假体包括肱骨假体，任选地具有关节盂假体。对于全关节成形术或反向关节成形术而言，植入关节盂部件；然而，对于半关节成形术，肱骨部件抵靠自然关节盂腔体作关节运动。
当肱骨的上端骨折时，肱骨一般会破碎成几块，通常为三块或四块。具体地，对于四块型骨折，肱骨头在解剖颈水平处分裂，较大和较小的结节与结节下方的肱骨干分离，并且结节沿着二头肌沟彼此分隔开。由于不再向肱骨头供血，可能开始坏死。对于三块型或四块型骨折的修复而言，在肱骨头的血液供给受损的情况下，对肱骨头进行置换，并且将较大和较小的结节重新附接到肱骨干。通常，肩关节假体的肱骨部件包括杆和关节运动部件，所述杆用于插入延伸至肱骨的髓内腔中的镗孔中，通常是沿着该骨的纵向轴线，所述关节运动部件可为凸形支承头（在全关节成形术的情况下）或凹形杯（在反向关节成形术的情况下）。通常，关节运动部件联接到所述杆的颈部分，所述杆从所述髓内腔相对于所述杆的远侧部分的纵向轴线成倾斜角延伸，以便重建自然关节的解剖结构。一般地，使用骨粘固剂将肱骨杆假体固定在髓内镗孔内的位置中。作为另外一种选择，所述杆可涂覆有促进骨生长以保持该杆就位的材料，诸如Porocoat®或羟基磷灰石。一种此类肱骨杆假体可以商标Global FX从DePuy Orthopaedics, Inc.商购获得。
作为肱骨杆植入物的替代方案，已知使用髓内钉来修复某些类型的近侧肱骨骨折，所述髓内钉沿着形成于髓内腔内的镗孔延伸。螺钉从肱骨的外侧进入，穿过形成于所述钉内的孔并且进入肱骨头和结节中。这种类型的固定也会在髓内腔中造成血管损伤。此外，一个显著的缺点是，由于肱骨头未被置换，因此必须将所述钉插入穿过形成于肱骨头的关节软骨中的孔中。必须将塞插入所述孔中，以恢复支承表面。
对于股骨颈的骨折修复而言，已知的是提供通常被称作推力板假体的假体形式。在PCT专利公开WO2007/024980-A2中公开了一种此类形式的推力板假体。所述假体包括待附接到近侧股骨的外侧表面的板部分。
在处理长肢关节成形术中的一个问题是，适应多种解剖结构的尺寸。当期望尺寸的链接部件必须接合和解除并且具有机械稳定性时，这面临甚至更多的挑战。另外，外科医生期望调整在外科手术期间产生的附加问题的能力，外科医生还期望具有无限的可调节性，而不是有限的尺寸供给。
本发明的实施例的目的是，避免或缓解现有技术的问题中的一个或更多问题，不论是在本文或在其它地方指出的问题。
发明内容
根据本发明的一个实施例，提供了一种整形外科组件。所述组件包括能够联接到骨的第一构件和包括调节器的可调式连接器组件，所述调节器具有螺纹端部和渐缩端部。所述组件还包括关节运动部件，所述关节运动部件包括支承表面并且能够联接到可调式连接器组件的渐缩端部。所述螺纹端部能够接合固定板。
根据本发明的另一个实施例，提供了一种关节成形术板。所述关节成形术板包括固定板和可调式连接器组件，所述固定板能够固定到骨的表面，并且具有带有多个渐缩部的凹槽，所述可调式连接器组件包括调节器，所述调节器具有在第一端部上的多个渐缩部和在第二端部上的渐缩部。还包括关节运动部件，并且所述关节运动部件具有支承表面并能够联接到可调式连接器组件的渐缩的第二端部。所述多个渐缩部能够接合所述固定板的凹槽中的多个渐缩部中的至少一个。
根据本发明的另一个实施例，一种修复骨的骨折端部的方法包括在骨的端部处，移除关节运动骨表面的骨折部分。所述方法还包括将固定板固定到所述骨的骨折端部的外侧表面。将所述固定板联接到可调式连接器组件，所述可调式连接器组件包括具有螺纹端部和渐缩端部的调节器。将所述调节器螺纹旋入或旋出所述固定板的螺纹镗孔，以调节所述调节器从固定板的镗孔延伸的长度。将所述调节器的位置锁定在螺纹镗孔内。
附图说明
图1是根据本发明的一个实施例的关节成形术板的额状面视图。
图2是图1的关节成形术板的剖面图。
图3是根据图1的关节成形术板的分解图。
图4是根据本发明的另一个实施例的关节成形术板的剖面图。
图5是图4的关节成形术板的分解图。
图6是根据本发明的另一个实施例的关节成形术板的剖面图。
图7是图6的关节成形术板的分解图。
具体实施方式
在整个下述描述和附图中，类似的附图标记是指类似的部件。
关于肱骨假体，并且更具体地，关于半关节成形术板，给出了下面的描述。然而，应当理解，本发明可用于其它类型的假体中并且半关节成形术板仅仅用作一个例子。例如，可使用杆或其它关节成形术部件来替代固定板。另外，同样可使用任何关节运动构件，而不仅仅是肱骨头。
首先参见图1，这是根据本发明的一个实施例的已装配的关节成形术板10的额状面视图，所述关节成形术板用于修复骨折的近侧肱骨。所述关节成形术板包括固定板（或整形外科组件的第一构件）12，用于附接至骨的表面，在该情况下，即患者的近侧肱骨的外侧外部部分。为了帮助固定到骨，固定板12可包括能够容纳骨螺钉（未示出）的多个固定孔13。关节运动部件14置换自然肱骨头。关节运动部件14包括凸形支承表面并且其尺寸和形状设定成与自然关节盂表面或植入的关节盂假体作关节运动以重建肩关节。关节运动部件14经由连接器组件16联接到固定板12，所述连接器组件定位在形成于近侧肱骨中的镗孔中。
现在参见图2，该图示出了图1的关节成形术板的连接器组件的剖面图，以更好地示出连接器组件16的细节。在该实施例中，连接器组件16为可调式组件，以允许使用者调节关节成形术板10的颈长度。可调式连接器组件16包括调节器18、锁定螺钉20、轴环22和组装螺钉24。轴环22被用作占位器或更大缝合轴环的替代物（图4）。
参见图2和图3，将进一步描述可调式连接器组件16的不同结构。调节器18包括第一端部26和第二端部28。第一端部26包括连接部结构30，所述连接部结构能够联接到轴环22的对应连接部结构32。在示出的实施例中，第一端部26的连接部结构30为凸形渐缩部，轴环22的连接部结构32是凹形渐缩部。根据一些实施例，所述凸形渐缩部和凹形渐缩部为锁定渐缩部，能够将调节器18锁定至轴环22。在一些实施例中，调节器18可直接锁定至关节运动部件14中。在那些实施例中，调节器18的第一端部26的连接部结构30为凸形渐缩部，并且能够插入关节运动部件14中的对应渐缩凹槽。调节器18还包括通孔29，所述通孔在第一端部26和第二端部28之间延伸。
调节器18的第二端部28包括连接部结构34，所述连接部结构能够连接至固定板12中的对应连接部结构36。在图2和图3所示出的实施例中，第二端部28的连接部结构34带有螺纹，并且固定板12中的连接部结构36为对应的螺纹形式。在使用中，将调节器18插入固定板12内的通孔38中。如图所示，将通孔38螺纹旋入，以便接合第二端部28的连接部结构34的螺纹。一旦调节器18达到期望的长度，则将锁定螺钉20拧入固定板12的连接部结构36中，从而将调节器18锁定就位。为了将调节器18锁定就位，锁定螺钉20包括镗孔37和外螺纹39。锁定螺钉20的外螺纹39接合固定板12的螺纹通孔38，如图2所示。调节器18和锁定螺钉20相对于彼此锁定，并且借助于锁定螺母而锁定至固定板12。调节器螺纹34与所述板12的结构36的螺纹的顶部侧面接触，并且锁定螺钉螺纹39与所述板12的螺纹的相对侧面或底部侧面接触，从而使得不可能发生相对移动。然后将轴环22放在调节器18的第一端部26的上面。然后将轴环22的渐缩连接部结构32与调节器18的第一端部26的渐缩连接部结构30一起锁定就位。然后可将关节运动部件14放在轴环22上。
组装螺钉24包括螺纹端部40，并且关节运动部件14包括对应的螺纹开口42（示出于图2中）。在将关节运动部件14放在轴环22上以后，将组装螺钉24插入锁定螺钉20、调节器18和固定板各自的镗孔37, 29, 38中。然后将组装螺钉24的螺纹端部40螺纹旋入关节运动部件14的螺纹开口42的螺纹中，并将所有部件锁定在一起。
现在转向图4和图5，其示出了本发明的另一个实施例。如图所示，关节成形术板组件10包括固定板12、关节运动部件14、组装螺钉24、锁定螺钉20、调节器18和轴环22a。在该实施例中，所有部件是相同的，除了轴环22a是板，该板具有凸缘44，所述凸缘向外延伸并邻接关节运动部件14的向外延伸的凸缘46（图5）。
现在转向图6和图7，其示出了本发明的另一个实施例。该实施例是具有固定板72、可调式连接器74和关节运动部件14的关节成形术板70（图1）。在该实施例中，固定板72包括通孔78，所述通孔具有产生系列渐缩部80a, 80b, 80c的螺纹形式。如图所示，所述螺纹形式是连续螺纹，但是在其它实施例中，其可为不连续的。在该实施例中，可调式连接器74为调节器，并且包括多个对应渐缩部82a, 82b, 82c。使用者将可调式连接器74插入固定板72的通孔78中，并且一旦达到适当的长度，则撞击以接合渐缩部80a, 82a，以将调节器74在固定板72中锁定就位。在一些实施例中，多个渐缩部会以适当的长度接合。在调节器的另一端处的为凸形渐缩部84。凸形渐缩部84能够装配在关节运动部件14的凹形渐缩部（未示出）内（图1）。然后将关节运动部件14撞击到调节器74上，从而锁定渐缩部84。在一些实施例中，可使用组装螺钉。
本发明的上述描述仅仅是示例性的，并且无意将本发明的范围限制为阐述的精确术语。此外，尽管已经参考某些示例性实施例详细描述了本发明，在下述权利要求所描述和限定的本发明的范围和实质内存在变型和修改形式。

Claims (4)

1.一种关节成形术板，包括：
固定板，所述固定板能够固定到骨的表面，具有带有多个渐缩部的凹槽；
可调式连接器组件，所述可调式连接器组件包括调节器，所述调节器具有在第一端部上的多个渐缩部和在第二端部上的渐缩部；和
关节运动部件，所述关节运动部件包括支承表面并且能够联接到所述可调式连接器组件的渐缩的第二端部；
其中所述多个渐缩部能够接合所述固定板的凹槽中的多个渐缩部中的至少一个。
2.根据权利要求1所述的关节成形术板，其中所述固定板包括能够容纳骨螺钉的多个固定通孔。
3.根据权利要求1所述的关节成形术板，其中所述固定板能够固定到肱骨上。
4.根据权利要求1所述的关节成形术板，其中所述关节运动部件能够接合关节盂。
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US9398928B2 (en) 2016-07-26
US20140094855A1 (en) 2014-04-03
US20160302934A1 (en) 2016-10-20
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US9883948B2 (en) 2018-02-06
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