CN103989502A - 股骨头坏死钻孔减压钻及其配套用骨水泥增强棒 - Google Patents

股骨头坏死钻孔减压钻及其配套用骨水泥增强棒 Download PDF

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CN103989502A
CN103989502A CN201410263541.3A CN201410263541A CN103989502A CN 103989502 A CN103989502 A CN 103989502A CN 201410263541 A CN201410263541 A CN 201410263541A CN 103989502 A CN103989502 A CN 103989502A
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bone cement
femoral head
drill
head necrosis
decompression
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王京生
林明霞
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1622—Drill handpieces
    • A61B17/1624—Drive mechanisms therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1635—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for grafts, harvesting or transplants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
    • A61B17/1668—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the upper femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material

Abstract

本发明提供了一种股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，包括软钻和骨水泥增强棒，软钻前端设有弹簧和钻头，软钻外部设有钻头导向器，钻头导向器内为变向导管，变向导管前端拐弯后形成侧向开口，骨水泥增强棒中设有中心通道，前端侧面设有多个侧孔；所述变向导管前端的侧向开口方向与主导管方向成120～140度夹角；骨水泥增强棒后端设有螺纹；钻头导向器后端设有手柄。本发明结构简单，操作简便，适用于I-II期股骨头坏死，无论股骨头坏死面积大小，均能够使股骨头坏死部分彻底减压而不降低股骨颈骨质强度，减压完成后拧入股骨头骨水泥增强棒，加压注入低粘骨水泥，骨水泥硬化后可以增强股骨头强度，延缓或阻止坏死股骨头破坏并塌陷。

Description

股骨头坏死钻孔减压钻及其配套用骨水泥增强棒
技术领域
本发明属于医疗器械领域，具体地说涉及一种股骨头坏死钻孔减压钻及其配套用骨水泥增强棒。
背景技术
股骨头缺血性坏死是一种进行性破坏性疾病，好发于20‐50岁成年人，如果不采取积极的治疗，绝大多数患者病情会继续进展，最终引起软骨下骨和关节面塌陷，出现日常生活能力受限，甚至丧失，需要行人工髋关节置换术，给患者造成巨大的躯体痛苦和沉重的经济负担。目前早期股骨头坏死无特效药物治疗，也无统一的手术治疗方法，大多数手术由于创伤加大，手术技术要求高及疗效无法预测等原因无法在临床上进行推广。目前对早期股骨头坏死比较常用的微创手术包括股骨头钻孔减压(可植骨或植入各种细胞因子)，钽棒植入支撑两种。传统股骨头钻孔减压包括粗通道单孔减压及细通道多空减压两种，以上两种方式每个减压通道均需经过股骨颈，如减压通道数量少则起不到彻底减压效果，增多减压通道则降低股骨颈及股骨头强度，容易引起股骨颈及股骨头骨折，虽然钻孔减压后进行植骨可部分增加股骨头强度，但细通道减压植骨困难，粗通道减压植骨只局限于通道内，无法达到整个坏死区域。钽棒植入支撑可以增强股骨头强度，延缓股骨头塌陷时间，但钽棒价格高昂，普通人难以承受，且股骨头坏死面积较大时钽棒难以对整个坏死区进行支撑，疗效大幅下降。应用骨水泥填充股骨头坏死区是目前治疗早期股骨头坏死的方向之一，但目前多采用切开关节，股骨头开窗刮除坏死组织后填充骨水泥，创伤较大，手术难度大，难以推广。
发明内容
本发明为了解决上述问题而提供了一种股骨头坏死钻孔减压钻及其配套用骨水泥增强棒。
本发明的技术方案是这样实现的：股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，包括软钻和骨水泥增强棒，软钻前端设有弹簧和钻头，软钻外部设有钻头导向器，钻头导向器内为变向导管，变向导管前端拐弯后形成侧向开口，骨水泥增强棒中设有中心通道，前端侧面设有多个侧孔；
所述变向导管前端的侧向开口方向与主导管方向成120～140度夹角；
骨水泥增强棒后端设有螺纹；
钻头导向器后端设有手柄。
本发明的有益效果是：本发明结构简单，操作简便，适用于I-II期股骨头坏死，无论股骨头坏死面积大小，均能够使股骨头坏死部分彻底减压而不降低股骨颈强度，减压完成后拧入股骨头骨水泥增强棒，加压注入低粘骨水泥，骨水泥硬化后可以增强股骨头强度，延缓或阻止坏死股骨头塌陷。
附图说明
图1为本发明减压钻的结构示意图；
图2为本发明骨水泥增强棒的结构示意图；
图3为本发明图2的A-A向剖面示意图；
图4为本发明骨水泥增强棒的左侧视图；
图5为本发明适用的坏死股骨头钻孔减压示意图；
图6为本发明图5的B-B向剖面示意图。
零件说明：1、手柄，2、变向导管，3、股骨，4、股骨孔，5、钻头导向器，6、软钻，7、弹簧，8、钻头，9、螺纹，10、侧孔，11、骨水泥增强棒，12、中心通道，13、侧向开口，14、内六角凹槽。
具体实施方式
为了更好地理解与实施，下面结合附图对本发明作进一步描述：股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，包括软钻6和骨水泥增强棒11，软钻6前端设有弹簧7和钻头8，软钻6外部设有钻头导向器5，钻头导向器5内为变向导管2，变向导管2前端拐弯后形成侧向开口13，侧向开口13方向与主导管方向成130度夹角，钻头8可以通过变向导管2前端的侧向开口13，弹簧7拐弯后能够推动钻头8继续直线前进，变向导管2后端设有手柄1，可通过操作手柄1来改变变向导管2前端的侧向开口13的方向，以钻出不同方向的股骨孔4，骨水泥增强棒11中设有中心通道12，前端侧面设有多个侧孔10，后端设有螺纹9，尾端为内六角凹槽14。
患者仰卧位，在股骨大粗隆下方5cm作1cm长纵切口直达股骨，在顺股骨颈中下1/3钻入普通导针，侧位透视证实导针位于中央，用直径1cm空心钻做骨通道直达距股骨头软骨下骨0.5cm处，退出空心钻及导针，插入钻头导向器5，将软钻6置于钻头导向器5内，在变向导管2引导下软钻6在股骨头内钻孔减压，注意不要钻透股骨头软骨下骨，通过操作手柄1来改变变向导管2前端的侧向开口13的方向，可以向股骨头不同方向钻孔；改变变向导管2深度，可以在股骨头内不同层面钻孔减压，待股骨头不同方向的股骨孔4钻好后彻底减压，退出软钻6及钻头导向器5，拧入骨水泥增强棒11，注意骨水泥增强棒11远段侧孔10部分向上，在骨水泥增强棒11尾端中心通道12连接骨水泥注射器，将低粘骨水泥经骨水泥增强棒11的中心通道12及侧孔10注入股骨头钻好的股骨孔4内，使之充满股骨头内各个骨道，待骨水泥硬化后缝合切口，结束手术。为避免骨水泥注射时股骨头内压增高，可在注射前在增强棒上方用细克氏针钻1-2个减压孔。本发明结构简单，操作简便，属于微创手术，经过简单学习就能够完成操作，便于在基层医院推广。

Claims (4)

1.股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，包括软钻(6)和骨水泥增强棒(11)，软钻(6)前端设有弹簧(7)和钻头(8)，其特征在于软钻(6)外部设有钻头导向器(5)，钻头导向器(5)内为变向导管(2)，变向导管(2)前端拐弯后形成侧向开口(13)，骨水泥增强棒(11)中设有中心通道(12)，前端侧面设有多个侧孔(10)。
2.根据权利要求1所述的股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，其特征在于所述变向导管(2)前端的侧向开口(13)方向与主导管方向成120～140度夹角。
3.根据权利要求1所述的股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，其特征在于骨水泥增强棒(11)后端设有螺纹(9)。
4.根据权利要求1所述的股骨头坏死钻孔减压钻及其配套用骨水泥增强棒，其特征在于钻头导向器(5)后端设有手柄(1)。
CN201410263541.3A 2014-06-13 2014-06-13 股骨头坏死钻孔减压钻及其配套用骨水泥增强棒 Pending CN103989502A (zh)

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CN109998633A (zh) * 2019-04-19 2019-07-12 中国人民解放军联勤保障部队第九0四医院 一种股骨头坏死髓芯减压装置
CN110693568A (zh) * 2019-09-23 2020-01-17 寿光市妇幼保健院 一种用于掌骨钢板钻孔的瞄准器

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* Cited by examiner, † Cited by third party
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CN109998633A (zh) * 2019-04-19 2019-07-12 中国人民解放军联勤保障部队第九0四医院 一种股骨头坏死髓芯减压装置
CN109998633B (zh) * 2019-04-19 2024-04-05 中国人民解放军联勤保障部队第九0四医院 一种股骨头坏死髓芯减压装置
CN110693568A (zh) * 2019-09-23 2020-01-17 寿光市妇幼保健院 一种用于掌骨钢板钻孔的瞄准器

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Application publication date: 20140820