CN1045531C - 使两构体彼此相对移动用的装置 - Google Patents

使两构体彼此相对移动用的装置 Download PDF

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Publication number
CN1045531C
CN1045531C CN95195943A CN95195943A CN1045531C CN 1045531 C CN1045531 C CN 1045531C CN 95195943 A CN95195943 A CN 95195943A CN 95195943 A CN95195943 A CN 95195943A CN 1045531 C CN1045531 C CN 1045531C
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Prior art keywords
attitude
protuberance
usefulness
pipe
recess
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CN95195943A
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CN1162349A (zh
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安德烈·阿尔诺·苏贝朗
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ANDRE ARNAUD SOUBERIAN
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ANDRE ARNAUD SOUBERIAN
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Abstract

本发明涉及一种使两构体彼此相对移动用的装置。该装置的基本特点在于，它包括分别与两构体(1，2)相连的两件(11，12)；在所述两件之间施加一力用的机构(15)；一固定于件(11)上的突出部(14)；一形成于另一件(12)上的、并与突出部(14)的至少一部分互补的凹处(13)；两件(11，12)以下面这样的方式彼此可相对移动地安装，即突出部配合于空腔，在其上制有凹处(13)的件(12)采用一种适于从一不可变形的硬的第一态到一可变形的软的第二态的第一材料制成，而固定于突出部(14)的件(11)采用基本上不可可变形的第二材料制成；以及，控制第一材料的、至少在凹处(13)周围的这部分(19)从第一态转变到第二态(并且反之亦然)用的机构。该装置特别适于制造用于植入人体内的假体。

Description

使两构体彼此相对移动用的装置
本发明涉及一种使两构体彼此相对移动用的装置，该装置在制造适合于植入人体中的假体或诸如此类方面有特别有利的用途。
在许多情况下，必须使两构体彼此相对移动而同时能控制这样的移动。当两构体未被覆盖或处在宽敞而易于接近的位置时，比较容易获得这样的移动并可控制该移动，但当不能直接触及到两构体时情况就不是这样了。例如，在一植入一儿童体内的假体的两部分的情况下，此时希望使其中的一部分能相对另一部分移动而保持儿童的生长能力，或者如在为矫正人体的可变形所用的一器械的两部分对人体加力的情况下，希望通过使该器械两部分的相对移动而能容易地更新。
本发明的目的是提供一种装置，它能使两构体(body)彼此相对移动并具有一结构，该结构即使在可接近性、环境和尺寸等方面的情况十分困难时也能方便地实施，从而使该装置在制造假体或可植入的器械方面有其特别有利的用途。
为实现上述目的，本发明提供一种使第一和第二构体彼此相对移动用的装置，该装置包括：第一件和第二件；连接第一件于第一构体用的第一机构；连接第二件于第二构体用的第二机构；在所述两件之间施加一力用的机构；一固定于两件之一上的突出部；一形成于另一件上的空腔，所述空腔的形状互补于所述突出部的至少一部分；所述第一和第二件安装得使它两以这样的方式彼此相对移动，即所述突出部配合于所述空腔；在其上制有所述空腔的这一件采用一种适于从一不可变形的硬的第一态转变到一可变形的软的第二态(并反之亦然)的第一材料制成，在不可变形的硬态时，在力的作用下所述突出部不能使所述的第一材料可变形，而在可变形的软态时，在力的作用下所述突出部能以这样的方式穿透到所述的第一材料中，即所述第一材料能绕着所述突出部蠕动，而携带所述突出部的那个件是用基本上不可变形的第二材料制成的；以及控制第一材料的至少在空腔周围的这部分从第一态转变到第二态(并且反之亦然)用的机构。
通过下面给出的、结合只起说明而无限制作用的诸附图的描述，对本发明的其他特点和优点将会理解得更清楚。
诸附图为：
图1和2表示本发明的使第一和第二构体彼此相对移动用的装置的一实施例的两个不同的操作状态；
图3是一图解性剖视图，表示了一例如要替换一儿童的胫骨的顶部用的假体的一部分的一实施例以及对本发明装置的使用；
图4是一图解性剖视图，表示对脊骨作外科矫正用的、其长度可变的杆的一实施例以及使用了本发明的装置；
图5和6是两个图解性纵向剖视图，表示利用本发明的装置将一长骨，如股骨拉长用的髓钉(骨钉)(medullar nail)的一实施例，其中图6是沿图5中的“Ⅵ-Ⅵ”剖取的，而图5是沿图6中的“Ⅴ-Ⅴ”剖取的。
为下面的描述所附的上述六个附图表示了本发明的几个实施例。然而，为便于理介下面的描述，诸附图中相同的标号指的是相同的另件，不管该标号出现在何图以及该标号所指的另件是如何图示的。
图1和2表示一使第一构体1和第二构体2彼此相对移动用的装置的一实施例。
该装置包括一第一件11、一第二件12、联结第一件11于第一构体1所用的第一机构16和联结第二件12于第二构体2所用的第二机构17。很清楚，将第一件11或第二件12联结于构体1或2所用的这些机构可取任何形式，并且，对于熟悉该技术领域的人员来说，尤其是按照组成这些构体的材料的特性、制造诸件用的材料的特性、组成该装置的诸构件的功能和该装置的用途等情况来实施这些机构应不会有困难。在下面对本发明装置的具体用途的描述中给出和/或提到了机构16和17的具体实施例。
机构15用来在第一件11和第二件12之间施加一作用力。该力可直接施加于所述两件之间，或例如按图1和2所示，可通过第二构体2间接地施加。这些在第一件11和第二件12之间加力所用的机构可用任何形式。它们可以拉力方式或推力方式工作，可为弹性之类的，并且可有各种不同的形状。下面将给出这些机构15的具体实施例。
一固定于两件之一，即所示实施例中的第一件11上的突出部14配合于一在另一件，即第二件12上的凹处13中，该空腔互补于突出部14的至少一部分。第一件11和第二件12彼此相关地安装，使之可如下所述地移动，并使突出部14能连续地配合于在第二件12上形成的空腔。
为便于第一件11和第二件12的相对移动并确保其安全，该装置还包括在两件移动时作导向用的机构。这些导向机构图解表示于22，下面将给出它们的具体实施例。
其上形成有凹处13的第二件12是用第一材料制成，该种材料适于从一不可变形的硬性第一态转变到一可变形的软性第二态，反之亦然。在其不可变形的硬态时，在加于所述突出部上的力的作用下该突出部14不会使材料可变形，而在其可变形的软态时在同一力的作用下该突出部14能移动或穿过该材料，以这样的方式，使该材料绕着突出部14蠕动。相比之下，其上固定有突出部14的第一件11是用基本上不可变形的第二材料做成的。
在本说明书里，有时用词“流动”取代“蠕动”，当然，这两个词覆盖了取得相同结果所需的相同的功能。
能以多种不同的方式使第一材料从第一态转变到第二态。为此而采用的最有利的方法之一对于第一材料适合于在吸收一可控制量的热量的作用下而软化。
该装置还包括控制第一材料从一状态转变到另一状态或相反情况下用的机构。在图1和2中用方块18图解表示了这些控制机构，该机构能控制第一材料的至少形成凹处13的壁的那部分19从第一态转变到第二态或反之亦然，该部分19在施加于固定在所述的突出部上的第一件11的力的作用下沿其移动方向位于突出部14的前面。
上述装置的操作如下所述：
先假定该装置最初处在其图一所示的状态，且第一材料处在硬的第一状态下。在这种情况下，突出部14沿其前进方向和后退方向均紧抵于凹处13的刚性壁。两构体1和2之间有一给定的间距。
当要使两构体1和2彼此移开时，在一确定的时间段里使用该机构18以使上述第一材料的至少部分19改变状态(从第一态到第二态)。由于第一材料变软，突出部14就不再被凹处13的硬壁所保持。在由机构15施加的力的作用下，第一件11和第二件12彼此移开并随之带动构体1和2一起移动。这里所述的施加的力在所示的实例中假定是一例如由一弹簧施加的弹性推力。
在第一件11相对第二件12的移动期间，第一材料的部分19围绕突出部14“蠕动”或“流动”，并填充于一间隙中，该间隙是由于第一件11的移动沿其移动方向在所述突出部之后处留下的。
当第一件11和第二件12以及两构体1和2彼此反向移离一确定的距离时，如通过控制机构18可停止第一材料的软化。该第一材料又回到其不可变形的硬的第一态，从而表示出突出部14抵着凹处13的前部的平动，而该凹处13如同从如图2中用虚线示出的其原始位置20“移动”到一第二位置上。但是，由于第二件12的、围绕穿透入第二件12的突出部的周围的所有材料也已回到硬态，则第一件11和第二件12的相对位置也就固定了。两件不再会反向移动或反向移离开。
利用如以连续的方式对机构18的控制，就能使构成件12的第一材料的至少部分19从第一态转变到第二态。因此能使两构体1和2逐渐反向移开，并以可控制的方式来进行。
很清楚，同样的工艺能被用来控制两构体的反向移动。在这种情况下，施加于第一件11和第二件12之间的力将是一拉力，而不是如上述实例中的一推力。
上述装置的结构是有利的，并使该装置能用于一些特别有利的应用中，尤其是可用来制造能植入人体内的医用假体。下面描述的是这样的三个实施例。
图3所示的第一实施例关于一段在切除如儿童的一长骨后使用的假体段(prosthetic segment)。该假体段包括所有如图1和2所示的另件。在本发明装置的该实施例中，两构体1和2是由如两圆筒形管32和33的两端部30和31组成，管32组成在其上形成上述突出部14的第一件11，用例如将该假体段连接于剩余的骨头用的机构构成端部30，而端部31是铰接所述假体段于另一假体以组成例如一关节用的机构。第二件12是由另一管子34组成，该管34有一中空的空腔35，而上述管32象一气缸-活塞组合似地配合于该空腔中，从而构成上述的导向机构22以引导管32相对于管34的移动。
在中空腔35中有一弹簧15，它在管34的端部与管32的端部之间施加一推力。
突出部14是一环绕在管32的外表面上的环，它配合于一在管34的内壁上形成的互补的环形槽13中。管34最好做成两个半壳方式以利于将它装在管32上。
管34的材料能被人体很好地适应，这种材料应是绝热和绝缘的，非磁性的，尤其在压缩时具有足够的机械强度，并在被加热至某一温度时能软化，其中所述温度低于能对该假体的其他组件所用的材料加热的温度，并且，当该材料被加热软化后冷却时，该材料能恢复到与其最初的特性相同或至少接近的特性。例如，该材料可用聚乙烯。
管32和突出部14可整体地做成单件，其用的材料应是绝热和绝缘的，非磁性的，具有足够的机械强度，并能被人体很好地适应，如氧化锆陶瓷，而管33也可氧化锆陶瓷制造。
在这种情况下，使凹处13周围的第一材料的至少部分19从第一态转变到第二态(并且，反之亦然)所用的机构18最好由一涂复在突出部14上以形成一闭合电路回路的导电涂层36所组成。例如，用一等离子喷灯在突出部14上喷一层有一定厚度的、为人体能很好地适应的导电材料，如金或钛，就能获得这样的一涂层，该涂层与上述第一材料的部分19相接触。这一闭合回路适于和一如下所述的磁场源合作以在回路中感应出一电流。按传统的方式，该感应电流利用焦耳效应加热导电层36，该导电层靠热传导又加热材料19的上述部分以使它软化。
举例说，弹簧15由一能储存并返回机械能的系统组成，如用一种能为人体很好适应的强材料，如“PHYNOX”(商标)制成的压缩弹簧，或实际上的两只反旋式弹簧之类另件。
例如通过以图上的一孔37表示的一通孔使空腔35与周围的介质相连通，从而使血液里的气体能补偿该空腔35容积的变动，这是有利的。
此外，最好是，例如将一其一端配合于在两管32和34中之一上形成的一槽中的销子固定于另一管，就可使管32在管34中被直线引导地移动。图3中的虚线表示了该销子和槽。
熟悉该技术领域的人员知道如何植入该假体，对此不在此描述。
假体段的上述实施例使从植入该假体的人体的外部使用感应方法来控制作为对称的健康骨头生长的函数的该假体段的几何变化成为可能。
当需要按照图3所示的方式修改例如替换儿童的胫骨的顶部用的假体段的长度时，要使含有所述假体段的腿的长度足以置于一磁场中，该磁场的方向最好是垂直于由导电层36组成的闭合的电路回路，且该磁场是足够强和变化快，使在形成闭合回路用的具一定厚度的导电材料中感应一电流，从而产生足够的焦耳效应损耗以利用传导加热，并因此软化环状地邻接于突出部14的第一材料的部分19(不过，要避免由于加热过头而分解所述的材料)。管34则不再被突出部14牢固地保持。被软化的部分19围绕突出部14从较高压力区到较低压力区流动或蠕动，而这种流动或蠕动发生的快慢取决于软化部分19的黏度以及弹簧15产生的力的大小，其设计特征确保所述力适当大于阻止突出部14通过第一材料的部分19移动的阻力。
最终的流动导致内管32相对于管34沿着与软化部分围绕突出部14流动的方向相反的方向移动。在该位移期间，内管32继续被管34的不软化部分和可能被配合于相应槽中的销子的端部所引导。在加热的时间和力度受控制的情况下，软化部分19在任何时候被封闭在不软化部分之间，从而保持了管34的形状。
一旦管34的材料的部分19冷却后，聚乙烯恢复其不可变形的硬黏度，胫骨段又能发挥其机械功能。
图4表示了一可植入的器械的实施例，其中使用了由一杆组成的本发明装置，其用途在于例如作逐渐的脊骨矫正期间不需要在中间阶段手术解入。
在图4所示的实施例中，第一件11由两圆柱杆41和42组成，这两杆相互平行地安装于在第二件12上形成的互补孔45和46中，而突出部14在图示的实施例中是由至少一刚性的细丝43所组成，最好是多根这样的细丝连接于杆41和42并通过在位于该两杆之间的第二件12的部分49上形成的凹处13。
上述导向机构22在这实施例中是由两配合于两互补的孔45和46中的圆柱杆41和42组成。
两杆41和42，以及细丝43是由导电材料组成，但每单位长度的细丝43的电阻适当地大于每单位长度的杆41和42的电阻。
如图4所示，第二件12可做成两件12-1和12-2。然而，在这种情况下，在其上制造有凹处13的部分12-1可仅是在上述第一材料上制造的部分，而另一部分12-2用电绝缘材料，如陶瓷制造，以便使假体杆获得好的总体刚度。
在这个实例中，没有具体地图示出在杆41和42于第二件12之间施加力用的机构15。在这种情况下，如上述的这些为获得两构体1和2的移动所需的机构可由任何合适的机构，如熟知的使病人的脊骨处于被拉伸状态的外部机构，或诸如此类所组成，此时的这种机构是利用按通常的方式在杆与脊骨之间用钩子相连的方法，分别作用在两杆41和42的端部47和48及第二件12的端部44上。
为使杆更强劲，在第二件12外包绕一硬材料，如钛制造的套40，这是有利的。
在这个实施例中，构体1可由两杆41和42的端部47和48组成，而构体2则可由件12-1的端部44和/或套40的至少一部分组成。
为使两杆41和42能相对于第二件12移动，可使一电流通过两杆和细丝43，该电流可由一如图示意表示的任何类型的电源供给，该电源和杆、细丝组成上述的控制机构18。沿着细丝43流动的电流足够强以将它们加热，并软化邻接于所述细丝的第二件12的材料的部分19，并使杆以与上述相同的方式相对于第二件12移动。
图5和6是通过另一植入器械的一实施例的两纵向剖视图，该器械使用了本发明的装置，组成一能使骨头被拉长或移动用的髓钉(骨钉)。
该器械用来例如在可能要先修整后插入要被处理的骨头的髓道(medullarchannel)中，通常将它几乎完全插入。钉子的每一端用一相应的外部紧固件固定于其中待慢慢移离另一段的一骨头段，使逐渐伸展，在通常的骨头切开术之后形成在两骨头段之间的伤疤组织，而伸展在组织巩固后进行。该钉子可在固定于骨头的两端部的位置之间拉伸，例如，每天将各部分反向拉开1/4至1毫米。
这一实施例包括一由一中空的圆柱管51组成的第一件11；第二件12配合于该管51中，并且它本身安置在一加强件52中，而件52组成为第二构体2。
第二件12由一插入一在加强件52中的空隙60中的如由聚乙烯制成的插件53组成。该插件的形状能确保它可被牢固地固定在收置它的加强件52中。
在中空管51的端部与第二件12及构体2之间设有弹簧机构15。
突出部14由一键54组成，该键通过插件53位于一组成上述凹处13的通孔55中。该键由一例如用机械强度高的材料，如“PHYNOX”制成的芯子组成，该材料上又有一起到绝缘和绝热作用的其他材料的涂层，该种材料具有足够的机械强度并例如用等离子喷管喷洒如氧化锆陶瓷以作绝缘之用。
在该绝缘涂层上缠绕有如“PHYNOX”(直经为0.1-0.3毫米)的导电材料的细丝56，并将该涂层按需要加工出一条螺旋形槽，使两圈细丝不接触。细丝的一端57例如用激光焊到管51上，而另一端58则联结于一导电体62如金丝的第一端61，该金丝由一如聚四氟乙烯套绝缘并沿着一在管51外面上的槽走向所述管的封闭端59。
正是在绕在键的绝缘层上的细丝上，感应的焦耳效应损耗足以软化键54周围的第一材料的部分19。该键可制成流线形，使有利于它在被软化时沿所需的方向移动通过第一材料。
管51和导电体62的第二端63被连接于一例如皮下植入人体内的电路回路(未图示)。该回路能受到迅速变化的磁场的作用以在该回路中感应出一电流，从而使细丝在上述的焦耳效应损耗的作用下而被加热。
图5和6所述的钉子的工作方式从上述假体的工作方式中能容易地推导出，故不在此作详细的描述了。
在上面的描述中，给出导向机构的几个具体实例。将第一件11和第二件12连接于构体1和2用的机构16和17可采取多种形式。例如，在图3所示的实施例中，机构17由与管33配合的管34组成，而管34也用其他手段，如粘合、键配合、一螺母，或诸如此类的，固定于管33。在那个实施例中，机构16由第一件11本身的至少一部分或一通过任何合适的手段，如焊接以使两者连成整体等，固定于第一件11的辅助件组成。在图4或图5和6中所示的实施例中，没有对第一机构16和17进行详细描述，但熟悉该技术领域的人员能毫无困难地实施。
在上述诸实例中，两构体彼此的相对移动是由直线平动组成的，然而，很清楚，本发明可适用于任何其他种类的运动，诸如旋转、扭转，或这些运动方式与平动的任何组合。

Claims (14)

1．一种使第一和第二构体(1,2)彼此相对移动用的装置，它包括：第一件和第二件(11,12)、连接第一件于第一构体用的第一机构(16)和连接第二件于第二构体用的第二机构(17)；
其特征在于，该装置还包括：
在所述两件之间施加一力用的机构(15)；
一固定于两件之一(11)上的突出部(14)；
一形成于另一件(12)上的凹处(13)，所述空腔的形状互补于所述突出部(14)的至少一部分；
所述第一件和第二件安装得使它两以这样的方式彼此相对移动，即所述突出部配合于所述空腔；
在其上制有所述凹处(13)的这一件(12)采用一种适于从一不可变形的硬的第一态到一可变形的软的第二态(并反之亦然)的第一材料，在不可变形的硬态时，在力的作用下所述突出部不能使所述的第一材料可变形，而在可变形的软态时，在力的作用下所述突出部能以这样的方式穿透到所述的第一材料中，即所述第一材料能绕着所述突出部蠕动，而携带所述突出部(14)的那件(11)是用基本上不可变形的第二材料制成的；以及
控制第一材料的、至少在凹处(13)周围的这部分(19)从第一态转变到第二态(并且反之亦然)用的机构。
2．按权利要求1的装置，其特征在于，它还包括引导所述第一和第二件(11,12)移动用的机构(22)。
3．按权利要求1或2的装置，其特征在于，控制第一材料的、至少在凹处(13)周围的这部分(19)从第一态转变到第二态(并且反之亦然)用的机构是这样的机构，即用于软化第一材料的、至少形成在正对所述突出部(14)、沿着固定所述突出部的件(11)的移动方向的凹处(13)的壁的那部分的机构，所述软化是通过受控的热吸收的作用而获得的。
4．按权利要求3的装置，其特征在于，所述第一件(11)由一第一管(32)组成，所述第二件(12)由一具有一中空的第一腔(35)的第二管(34)组成，所述第一管(32)配合于所述中空的第一腔。
5．按权利要求4的装置，其特征在于，在所述两件之间施加一力用的所述机构由一弹簧(15)组成，该弹簧位于所述中空的第一腔(35)且在第一管与第二管(32,34)的相应端部之间。
6．按权利要求4或5的装置，其特征在于，突出部(14)是一环，它环绕所述第一管(32)并在该管的外表面上，并且配合于所述凹处(13)，该空腔是一形成在所述第二管(34)的内壁上的环状空间。
7．按权利要求6的装置，其特征在于，控制第一材料的、至少在凹处(13)周围的这部分(19)从第一态转变到第二态(并且反之亦然)用的机构(18)包括一导电涂层(36)，该涂层涂复在所述环状突出部(14)上以形成一闭合电路回路，并适合于与一磁场源共同工作。
8．按权利要求3的装置，其特征在于，所述第一件(11)由两圆柱形杆(41,42)组成，该两杆相互平行安装在两形成于所述第二件(12)上的互补孔(45,46)中，突出部(14)由至少一将两所述杆(41,42)互连用的刚性细丝(43)组成。
9．按权利要求8的装置，其特征在于，控制第一材料的、至少在凹处(13)周围的这部分(19)从第一态转变到第二态(并且反之亦然)用的机构(18)包括至少一连接于两杆(41,42)的电流源，所述杆(41,42)和所述刚性细丝(43)由一种导电材料构成，所述细丝(43)的单位长度的电阻大于所述杆(41,42)的单位长度的电阻，制造所述第二件(12)用的所述第一材料是不导电的。
10．按权利要求3的装置，其特征在于，第一件(11)由一中空的第三圆柱管(51)组成，所述第二件(12)配合于所述第三管(51)。
11．按权利要求10的装置，其特征在于，所述第二件(12)由一位于一形成于一加强件(52)中的槽(60)内的插入件(53)组成。
12．按权利要求11的装置，其特征在于，所述突出部(14)由至少一正好通过所述插入件(53)的键(54)组成。
13．按权利要求12的装置，其特征在于，所述键(54)由一机械强度高的材料制造的芯子组成，芯子由一层具有高机械强度且能绝缘的材料进行绝缘和绝热。
14．按权利要求13的装置，其特征在于，控制第一材料的、至少在空腔周围的这部分从第一态转变到第二态(并且反之亦然)用的机构包括至少一缠绕在所述键(54)上的导电材料制的细丝(56)、一电流源和将所述电流源连接于所述细丝(56)用的机构。
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AU4179296A (en) 1996-06-06
CN1162349A (zh) 1997-10-15
PL320060A1 (en) 1997-09-01
WO1996015377A1 (fr) 1996-05-23
EP0792419A1 (fr) 1997-09-03
US5720746A (en) 1998-02-24
DE69507333D1 (de) 1999-02-25
BR9509689A (pt) 1997-09-30
JPH10508524A (ja) 1998-08-25

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