CN105011997B - Bone uptake device and method - Google Patents
Bone uptake device and method Download PDFInfo
- Publication number
- CN105011997B CN105011997B CN201510484965.7A CN201510484965A CN105011997B CN 105011997 B CN105011997 B CN 105011997B CN 201510484965 A CN201510484965 A CN 201510484965A CN 105011997 B CN105011997 B CN 105011997B
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- shell
- bone
- extension
- wheel hub
- permanent magnet
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Classifications
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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
- A61B17/56—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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
-
- 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
- A61B17/7225—Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression
-
- 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
- A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
-
- 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
- A61B17/8875—Screwdrivers, spanners or wrenches
-
- 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
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8886—Screwdrivers, spanners or wrenches holding the screw head
- A61B17/8888—Screwdrivers, spanners or wrenches holding the screw head at its central region
Abstract
It is a kind of including shell and drawing axis marrow in extend device.Extend device in the marrow and is placed in the cavity of two bone sections (in order to be inserted into the device, and separated or purposefully separate).The drawing axis for extending device in marrow is for example attached to a bone section in two bone sections through one or more connecting screws.The shell for extending device in marrow is attached to the second bone section using for example one or more attachment screw rods.During treatment, bone is continuously pulled and forms new separation, and bone generation can be carried out in the separation.In one embodiment, extending device in the marrow includes the actuator and extension rod that can be attached to each other.
Description
The application is to enter National Phase in China, PCT international application no on 03 05th, 2012 for PCT/US2010/
047842, the applying date is on 09 03rd, 2010, application No. is 201080039442.7, entitled " bone uptake dresses for China
Set and method " patent application divisional application, entire contents are hereby expressly incorporated by reference.
Related application
This application claims in the U.S. Provisional Patent Application submitted on the 4th of September in 2009 the 61/240,071st and in
On July 13rd, 2010 U.S. Provisional Patent Application submitted the 61/363,986th priority.240,071st and 363,986
Number temporary patent application be integrally hereby incorporated by by reference.
Technical field
The field of invention relates generally to treatment disease related with skeletal system is used for, more particularly to for bone
Grow the medical instrument of purposes.
Background technique
Distraction osteogenesis (also referred to as poroma drawing and bone stretching) has been successfully used to extend the long bone of body.In general, passing through
Lateral osteotomy art purposefully makes bone fracture (if not being broken) and gradually pulls two sections of bone, to permit
Perhaps new bone is formed in gap.If draw-down rate is excessively high, there is the danger that Bone nonunion occurs, if draw-down rate mistake
It is low, then there is the danger that this two sections of bones will merge completely each other before period of traction terminates.When reaching bone using the method
When desired length, then bone is allowed to merge.The application of distraction osteogenesis focuses primarily upon the growth of femur or shin bone, but may also comprise the upper arm
Bone, jawbone (micrognathia) or other bones.Make Limb lengthening or growth the reason of be it is a variety of, which includes but is not limited to:
Osteocarcinoma after osteosarcoma；Decorative extension (shank and femur and/or shin in dwarfism or nanism/achondroplasia
Bone)；The extension of one limbs is to adapt to another limbs (after congenital, wound, after skeletal diseases, artificial limb knee-joint), bone nonunion
Meet (non-union).
Many years are had been carried out using the distraction osteogenesis of external fixator, still, external fixator is not square for patients
Just.Be also likely to be pain, patient can by pin rail infection, joint stiffness, anorexia, depression, cartilage damage and its
The harm of his side effect.Installation external fixator can also postpone the beginning of rehabilitation.
The shortcomings that for external fixator drawing, traction nail in marrow is surgically implanted, has entirely been contained in
In bone.Certain methods are automatically extended by the rotation repeatedly of limbs of patient.Pain is brought to patient sometimes in this way
And it often carries out in an uncontrolled fashion.Therefore, this causes to be difficult to abide by stringent daily or weekly extension scheme, and this
Stringent extension scheme daily or weekly can avoid that Bone nonunion (if too fast) or early stage consolidation (if excessively slow) occurs.Under
Limb traction rate is about daily 1 millimeter or so.Other intramedullary nails have been developed, there is the motor of implantation and can be subject to distant
Control.The intramedullary nail of motor drive have need to be implanted into subcutaneous antenna, therefore complicates surgical operation and make its more infringement
Property.Therefore, these devices are designed to extend in a controlled manner, still, due to its complexity, it is thus possible to cannot be made
The product that price can be born.Other methods are Distraction Apparatus in the marrow comprising implantation magnet recommended, which can be with electromagnetism
Mode is driven by outer stator (that is, big electromagnet) and is drawn.Due to the complexity and size of outer stator, technique
It is not yet simplified to that the device for allowing patient to implement daily extended, simple tool high performance-price ratio can be taken home.
Summary of the invention
In the first embodiment, a kind of extension device is configured to be placed in the bone with the first segregation section and the second segregation section
The bone is passed through in the inside of bone.The device includes: shell, is configured to be attached to the first separation bone section and second
Separate one of bone section；Axis is pulled, there is inner cavity along its length, and is configured to be attached to the first separation bone section
With another bone section in the second separation bone section.Described device includes permanent magnet, is configured to relative to the shell
At least two poles are rotated and have, the permanent magnet is operatively coupled to driving screw, the driving screw and the drawing axis
Inner cavity threaded portion engagement.Thrust bearing is arranged in the shell and between the driving screw and the permanent magnet
Between, the thrust bearing is clipped between the first platform and the second platform in the shell.
In a second embodiment, extend device to be configured to be placed in the bone with the first segregation section and the second segregation section
In interior medullary canal.The device includes: shell, be configured to be attached to the first separation bone section and the second separation bone section it
One；With drawing axis, there is inner cavity along its length, and be configured to be attached to the first separation bone section and the second separation
Another bone section in bone section.Permanent magnet is arranged in the shell and is configured to for rotating and having at least two
Hole.Planetary gear set is provided with multiple gears, wherein is coupled to the permanent magnet to an operated gear in the gear
And it is configured to transmitting torque, and wherein, another gear in the multiple gear, which terminates at, is operatively coupled to guide screw
The output shaft of bar, the driving screw are engaged with the threaded portion of the inner cavity of the drawing axis.
In the third embodiment, extension system is configured to be placed in the interior medullary canal of bone.The system comprises: it actuates
Device, including the shell comprising rotatable permanent magnet and removable drawing axis, the removable drawing axis is relative to the shell
It telescopically installs, the removable drawing axis is operatively coupled to the rotatable permanent magnet through driving screw, wherein described
The distal end of drawing axis is configured to be attached to the firstth area of the bone, and wherein, the proximal end of the actuator includes geometry
Molding convex wheel hub.The system further comprises extension rod, and extension rod has the concave wheel hub of geometric molding in one end,
The concave wheel hub is configured to be fixed to the convex wheel hub for the geometric molding being arranged on the actuator, wherein described to prolong
The opposite end of boom is configured to be attached to the secondth area of the bone.
In yet another embodiment, extension system is configured to be placed in the interior medullary canal of bone.The system includes: to actuate
Device, including the shell comprising rotatable permanent magnet and removable drawing axis, the removable drawing axis is relative to the shell
It telescopically installs, the removable drawing axis is operatively coupled to the rotatable permanent magnet through driving screw, wherein described
The distal end of drawing axis is configured to be attached to the firstth area of the bone, and wherein, the proximal end of the actuator includes geometry
Molding concave wheel hub.The system further comprises extension rod, and extension rod has the convex wheel hub of geometric molding in one end,
The convex wheel hub is configured to be fixed to the concave wheel hub for the geometric molding being arranged on the actuator, wherein described to prolong
The opposite end of boom is configured to be attached to the secondth area of the bone.
In still yet another aspect of the present, the external adjusting device for adjusting adjustable implantation material includes power supply, control
Module and hand-held device comprising at least one permanent magnet.The hand-held device is configured to be placed on limbs of patient
Side, at least one permanent magnet are configured to rotate to the cylindrical magnet being located in adjustable implantation material.Control module quilt
It is configured to the revolution for the cylindrical magnet that limitation is located in adjustable implantation material.
Detailed description of the invention
Fig. 1 shows the side view for extending device in the marrow being located in bone according to one embodiment.
Fig. 2 shows the side views for extending device in the marrow of Fig. 1.
Fig. 3 A shows the sectional view of extension device in the marrow of Fig. 1 and Fig. 2 of the interception of the line 3A-3A in Fig. 2.
Fig. 3 B shows the partial enlarged view for extending the region of circle 3B of device in the marrow of Fig. 3 A.
Fig. 3 C shows the sectional view of extension device in the marrow of Fig. 1 and Fig. 2 of the interception of the line 3C in Fig. 2.
Fig. 4 A shows the view for extending multiple internal components of device in the marrow of earlier figures.
Fig. 4 B shows the lippacking for extending device in the marrow for being configured for aforementioned figures.
Fig. 5 shows the partial enlargement view for extending multiple internal components of driving mechanism of device in the marrow of aforementioned figures
Figure.
Fig. 6 shows the perspective view of external adjusting device.
Fig. 7 shows the exploded view of the magnetic force head (handpiece) of the external adjusting device of Fig. 6.
Fig. 8 shows the sectional view of the electromagnetism external device (ED) of the prior art around patient's lower thigh.
Fig. 9 shows the sectional view of the external adjusting device head of Fig. 6 and Fig. 7 on patient's lower thigh.
Figure 10 show in modularization marrow extend device can sterilizing complete component.
Figure 11, which is shown in the modularization marrow according to one embodiment, extends device.
Figure 12 shows the one end for extending the actuator of device in the marrow of Figure 11.
Figure 13 shows the extension rod for extending device in modularization marrow.
Figure 14 shows the second view of the extension rod of Figure 13.
Bore guiding element in the proximal end that Figure 15 shows insertion and the attachment for extending device in modularization marrow.
Figure 16 is shown for removing the removal tool for extending device in modularization marrow.
Figure 17 shows the torque limit drivers for extension rod to be attached to modularization intramedullary devices actuator.
Figure 18 shows the section for extending the actuator of device in modularization marrow.
Figure 19 shows the gap (G) extended between device in magnetic force head and marrow.
Figure 20 shows the locking screw driver for extending device in marrow.
Figure 21 A shows the locking screw for extending device in marrow.
Figure 21 B shows the locking screw of Figure 21 A of the line 21B-21B interception along Figure 21 A.
Specific embodiment
Fig. 1 shows the side view for extending device 110 in marrow, by hole or the inner hole being contained in bone 100
(bore) 108 and place.Hole or inner hole 108, and hole or the extensible warp of inner hole 108 is made using the methods of drilling, reaming
Cross compact substance bone (in end) and mesh-shape (spongy) bone.Extending device 110 in marrow shown in Fig. 1 includes shell 112
With drawing axis 114.In order to grow bone 100 or extend, bone 100 or with pre-existing separation 106 or had
Destination cutting is broken to form this separation 106, so that bone is divided into first segment 102 and second segment 104.Can insertion or
It can be cut off before extending device 110 in fixed marrow or after insertion apparatus 110, for example, being sawed using flexibility Gigli.
The drawing axis 114 for extending device 110 in marrow is attached to first segment 102 using one or more attachment screw rods 118.This field skill
Fastener other than screw rod 118 known to art personnel can also be used for that the first segment 102 that axis 114 is fixed to bone 100 will be pulled.Benefit
The shell 112 for extending device 110 in marrow is fixed to the second segment 104 of bone 100 with one or more attachment screw rods 116.This
Outside, the fastener other than screw rod 116 can be used for for shell 112 being fixed to the second segment 104 of bone 100.
During treatment, bone 100 is continuously drawn, to form new separation 106, can be sent out in separation 106
Raw bone generates.Continuously traction refers to is drawn with regular fashion (can be about 1 time a day or per several days 1 time).
Illustrative draw-down rate is daily 1 millimeter, but other draw-down rates can be used.That is, typical traction protocols can
Length including extending device 110 in marrow increases about 1 millimeter daily.The mode of progress can be, for example, having 4 to prolong daily
For a long time, each extended period has 0.25 millimeter of extension.Extending device 110 (following as shown in the figure) in marrow has magnetic drive system
System, the system allow to pull axis 114 and telescopically extend out of shell 112, thus force the first segment 102 of bone 100 with
Second segment 104 is separated from each other.When implementing traction, if bone 100 is a part of energy of shell 112 in displaced segments 120
It is enough to be slided in the hole of first segment 102 or inner hole 108.The direction for extending device 110 in marrow in bone can be with institute in Fig. 1
Show contrary.For example, drawing axis 114 can be couple to the second segment 104 of bone 100, shell 112 can be couple to bone 100
First segment 102.For example, extending device 110 in marrow can inversely place from the hole for the distal end for originating in bone 100 or inner hole.
Fig. 2 to Fig. 5 is turned to, extending device 110 in marrow has one or more drawing axis screw holes in drawing axis 114
122, screw rod 118 (Fig. 1) may be positioned such that across drawing axis screw hole.Similarly, shell 112, which is attached to, has one or more shells
The end cap 130 of body screw hole 124, screw rod 116 (Fig. 1) may be positioned such that across shell screw hole 124.Extend device 110 in marrow
Shell 112 includes: magnet case 128 and splines shell 126.Make these shells using welding, splicing or other combination technologies
126, it 128 is attached to each other.Using the attachment of end cap 130 at one end (opposite end engaged with splines shell 126) by magnet case
Body 128 is sealed shut.End cap 130 can be made to be attached to magnet case 128 by welding, splicing or other combination technologies.Make
In, released from shell 112 using driving screw 136 by axis 114 is pulled, driving screw 136 rotates in nut 140, the nut
It is fixed to the inner surface adjacent with the cavity 137 of drawing axis 114.Driving screw 136 is mechanically coupled to be contained in magnetic in an indirect way
Cylindrical permanent magnet 134 in body shell body 128.As explained in more detail below, it is driven by external adjusting device 180 using magnetic force
The rotation of the cylindrical permanent magnet 134 of dynamic (Fig. 6) leads to the rotation of driving screw 136.
Cylindrical magnet 134 is fixedly contained in magnet case 158 using such as adhesive (such as epoxy resin).Magnet
Box 158 is rotated relative to magnet case 128.Cylindrical magnet 134 can be rare-earth magnet (such as Nd-Fe-B), and in addition to quilt
Parylene or other protective coatings also can be used to be coated with except protecting in magnet case 158, for example, hermetically using epoxy resin
It is filling.Magnet case 158 includes the axis 160 on the end being attached to inside transverse bearing 132.The outer diameter of axial bearing 132 is solid
Determine to the inside of end cap 130.This arrangement allows cylindrical magnet 134 to rotate under minimum torsional resistance.It is other opposite at it
End, magnet case 158 include the axis 161 for being attached to first planetary gear set 154.Axis 161 include first planetary gear set 154 too
Positive gear, the sun gear make the planetary gear rotation of first planetary gear set 154.First planetary gear set 154 for reducing
Revolving speed and increase, which are formed by from cylindrical magnet 134 to the torque of driving screw 136, transmits.Second planetary gear set 156 is also schemed
Show between first planetary gear set 154 and driving screw 136, for further decreasing speed and increasing torque.Adjustable planet
The quantity of gear set and/or the number of teeth of gear, to obtain desired speed and torque transmitting.For example, per inch has 80
(80) driving screw of screw thread be attached to two planetary gear sets that gear ratio is 4:1 (each gear set in 9 millimeters of device,
There are magnet positions in distal femoral), in the case where being greater than average distance or gap with external device (ED), can obtain to
Few 100 pounds of tractive force (Fig. 9 or Figure 19).Planetary gear set 154,156 is exported to planetary gear output shaft 144.Planetary gear
Output shaft 144 extends through thrust bearing 138 and fixed (using welding etc.) couples cap 146 to driving screw.Utilize locking pin
Driving screw 136 is fixed to driving screw connection cap 146 by 142, and locking pin 142 extends through hole and driving screw in driving screw 136
Couple the hole in cap 146.Locking pin holder 148 is to surround the cylinder of locking pin 14, this component is kept together.With this
Driving screw 136 is attached to magnet/gear assembly remainder by kind mode, it is ensured that and the design is not tied up by beam splitting, because
And driving screw 136 does not rub with nut 140.In addition, biocompatibility lubricating grease (such as KRYTOX) can be used for moving component and (lead
Screw rod, nut, bearing, shell and drawing axis) minimize friction loss.Driving screw 136 can be in drawing axis 114
Rotation in cavity 137, and the nut 140 short with length is only needed to engage, this feature also minimizes friction loss.
Thrust bearing 138 is for protecting magnet/gear assembly of driver not by any significant compression stress or stretching
The influence of stress.Thrust bearing 138 is made of two sseparated raceways, has ball bearing between two raceways.When the dress
It sets there are when compressing force, for example, thrust bearing 138 abuts when pulling bone 100 and therefore fighting the tensile strength of soft tissue
Magnet case platform or lip 150 in magnet case 128.In addition, although the device is generally not used for drawing on bone
To together, still, there are some purposes for wishing for bone to be drawn together.For example, in the application of certain compression nails, it is therefore an objective to will
The section of two fractures of bone is fixed together.Because bone 100 may be implanted with uneven or crushing mode fracture
With the desired length for being difficult to determining nail before complete attachment.In these cases, may be susceptible to erroneous judgement length, and it is such between
Gap can be present between bone.By placing the intramedullary devices 110 slightly extended and being fixed, bone is had been fixed in device 110
The device 110 can be shunk using magnetic force after in segment, so that device 110 applies desired compression between the two segments
Power.Nail is compressed at these to use on the way, will be tensioned on device 110, and thrust bearing 138 will abut splines shell branch
Platform or lip 152.In both cases, larger stress is born in the huttriall of a housing section in thrust bearing 138 and housing section,
Rather than the magnet of drive system/gear assembly bears larger stress.In particular, thrust bearing 138 is clipped in platform or lip 150
Between platform or lip 152.
Specifically, Fig. 4 A and Fig. 5 are turned to, housing member has been removed and has shown various internal features, including allows to pull
Axis 114 slides in shell 112 and is also prevented from the collar that drawing axis 114 can rotate in shell 112.This obtains bone 100
Obtain sufficient stability.Pulling axis 114 includes several axial grooves 166.Slot 166 has semicircular indentations section, this permission is several
Sphere 164 rolls inside it.Sphere 164 is limited in linear cage 162.Cooperate on sphere 164 and linear cage 162
Splines shell 126 along its inside diameter surface have axial groove 163 (Fig. 3 C), to drawing the axial groove 166 of axis 114 it is similar.?
In this respect, sphere 164 and cage 162 are between drawing axis 114 and splines shell 126.Therefore, sphere 164 is by linear cage
162 are held in place, and mechanically by each slot mutually locking, thus prevent rotation of the drawing axis 114 in shell 112.So
And sphere 164 can roll in linear cage 162, thus allow to pull axis 114 and sent out in the case where having very low friction
The axial displacement of the raw splines shell 126 relative to shell 112.Lip packing flange 168 includes customization section lippacking
169 (being shown in Fig. 4 B), which makes it possible to pull being slidingly sealed between axis 114 and splines shell 126, thus prevents
Only the content of entire component is influenced by physical environment.Lippacking 169 includes base portion 173, and base portion is close for lip shape
The internal diameter (therefore splines shell 126 for being attached to lip packing flange 168) of envelope flange 168 is sealed.Lip packing
Part 169 further includes the protrusion 171 for sealing slidingly against the axial groove 166 of drawing axis 114.The inner surface 175 of lippacking 169
Seal slidingly against the entire outer diameter of drawing axis 114.It should also be noted that lippacking 169 can by silicone, EPDM or
Other rubber materials are made, and can be coated with silicone oil to increase lubricity.In addition, silicone oil or liquid perfluoropolyether can be used (such as
KRYTOX it is coated with sphere, slot and cage) to increase lubricity.Fig. 5 shows a part of magnet case 158, be removed to
The South Pole 170 and the arctic 172 of cylindrical magnet 134 can be illustrated.
Fig. 6 shows external adjusting device 180, is used to non-invasively draw marrow using the magnetic coupling of transmitting torque
Interior extension device 110.External adjusting device 180 includes magnetic force head 178, control box 176 and power supply 174.Controlling box 176 includes
Control panel 182, control panel have one or more controllers (button, switch or touch sensor, movable sensor,
Audio sensor or optical sensor) and display 184.It is aobvious that display 184 can be visual displays, auditory displays, tactile
Show some combinations of device etc. or features described above object.External adjusting device 180 may include the software programmed by doctor.For example, doctor
Life may want to patient and take external adjusting device 180 home, so that the kinsfolk or friend of patient or patient are implanted into
Extend the daily traction of device 110 in the marrow of patient.However, doctor can prevent from grasping by being programmed in control box 176
The people of vertical external adjusting device 180 excessively pulls patient.For example, doctor can carry out preprogramming to control box 176, so as to
Implement the only traction of (1) millimeter daily.In addition, doctor can carry out preprogramming to control box 176, so that arbitrary 2
Distance drawn is not more than 0.5 millimeter during hour, or distance drawn is not more than 0.25 millimeter during 5 minutes.These
Setting can be used to ensure that patient can not cause seriously to damage to bone or tissue, will not upset extension process.
Preferably, this instruction or limitation can by doctor (or even by manufacturer) preprogramming in a secure manner so that
User cannot change the setting of preprogramming.For example, come pre-programmed and daily traction limit value can be changed using safety code
(or other parameters).In this example, the people for manipulating external adjusting device 180 cannot pull in 1 day is greater than (1) millimeter
(or being greater than 2 millimeters in 1 day), and the safety code that will not have this function that can change external adjusting device 180.It is made
For useful lock-in feature, the unexpected excessive extension for extending device 110 in marrow is prevented.The security feature can monitor for example external
The rotary motion of the magnet 186 of regulating device 180, as described in more detail below or the security feature can be via non-intruding
Property sensing device monitor the rotation for extending the cylindrical magnet 134 in device 110 in marrow.
Fig. 7 shows the details of the magnetic force head 178 of external adjusting device 180, to illustrate the magnet 186 of external device (ED)
The mode for causing the cylindrical magnet 134 for extending device 110 in marrow to rotate.As shown in Figure 7, there are two (2) cylinders
The magnet 186 of shape shape.Magnet 186 is made of rare-earth magnet.Magnet 186 can have and cylindrical magnet 134 shown in Fig. 5
Two poles of same radial construct.Magnet 186 is bonded or is otherwise secured in porcelain cup 187.Porcelain cup 187 includes
It is attached respectively to the axis 198 of the first magnet gears 212 and the second magnet gears 214.Using gear train assembly (in
Heart gear 210 engages with the first magnet gears 212 and the second magnet gears 214) maintain each of two magnets 186
Pole direction relative to each other.For example, it may be desirable to whenever the South Pole of a magnet 186 downward when, another magnet
186 South Pole is upward.This arrangement for example makes to act on the torque on the cylindrical magnet 134 for extending device 110 in marrow most
Bigization.
Between magnet plates 190 and foreboard 192, each component of magnetic force head 178 is fixed together.Most of component quilt
Lid 216 is protected.Magnet 186 rotates in static magnets lid 188, so that magnetic force head 178 can be directly placed on patient,
Without transmitting any movement to the outer surface of patient.Before extending device 110 in drawing marrow, operator is by magnetic force head 178
It is placed on the position of the close cylindrical magnet 134 of patient, as shown in Figure 9.Magnet support between two magnets 186
194 include observation window 196, helps to place.For example, can be it is observed that window 196 be seen using the marking pen for being difficult to remove in patient
The label that appropriate location on skin is made.In order to implement to draw, operator holds magnetic force head 178 using handle 200 and presses
Lower drawing switch 228, so that motor 202 drives in a first direction.Motor 202 has gear-box 206, so that output gear
The revolving speed of wheel 204 is different from the revolving speed (such as compared with slow-speed of revolution) of motor 202.Then, the rotation of output gear 204 and central gear
The reduction gearing 208 of 210 engagements is rotated so as to cause it with the revolving speed for being different from reduction gearing 208.Central gear 210 and
One magnet gears 212 and the engagement of the second magnet gears 214, rotate them with mutually the same revolving speed.According to being placed with outside
The body position of the magnet 186 of regulating device 180, it is generally desirable to, this revolving speed is controlled, to make by having magnet 186 and cylinder
What magnet 134 was assigned minimizes by the formed induced current density of bodily tissue and body fluid.E.g., including 60RPM or
Magnet revolving speed below, but other speed can be used, such as 35RPM or following.At any time, it can be bounced back by pressure
Switch 230 draws to reduce.For example, increasing if numbness of the patient feels to obvious pain or in the region is positive.
Cutting the patient's lower thigh 218 extended in 110 implanted femur 220 of device in marrow is shown in Fig. 8 and Fig. 9
Face.In Fig. 9,178 position of magnetic force head of shown external adjusting device of the present invention 180 can be filled to extending in marrow
110 cylindrical magnet 134 is set to be adjusted.However, in fig. 8, prior art magnetic stator " annulus (donut) " 222
Ratio chart show both design relative efficiency (Fig. 8, which is shown, to be placed in prior art magnetic stator " annulus " 222
Extend device 110 in the marrow of type described herein).The larger, price of prior art magnetic stator " annulus " 222, and it is difficult
It is adjusted daily with being transported to patient house.In addition, making circular cross-section be used as one is dimensioned for all devices, not right and wrong
Chang Youxiao, this is because several reasons: the section of most of limbs is simultaneously non-circular, and bone is usually not on the center of limbs simultaneously
And the limbs of patient have many different sizes.In fig. 8, circle femur bone being placed through in magnetic stator " annulus "
Hole, and the rear portion 232 of thigh rests on the lower part 226 of magnetic stator " annulus " 222.The intensity in magnetic field is according to the power of distance
(such as inverse square) and decline, this depend on specific magnetic fields geometry complexity.Therefore, in the design of any magnetic, reason
Think, so that the distance between driving magnetic field and driven magnet are as small as possible.The size of patient's lower thigh 218 and such as
The judgement what is placed thigh in magnetic stator " annulus " 222 in fig. 8 will generate geometry, so that cylindrical magnet
The distance between 134 and the top 224 of magnetic stator " annulus " 222 L1It is substantially equal to cylindrical magnet 134 and magnetic stator " circle
The distance between the lower part 226 of ring " 222 L2.However, if the front 234 of thigh is placed against magnetic stator " annulus "
222 top 224, then length L1It will become smaller and length L2It will become larger.Because each patient has various sizes of limbs simultaneously
And because small limbs (such as upper arm) and big limbs (such as thigh) expectation obtain medical treatment, the magnetic stator " annulus " 222 of Fig. 8
Almost impossible optimization.Therefore, standard Magnetic Field of the super large magnetic field as the device need to be generated, thus more expenditures is needed (to use
In the hardware powered to this larger magnetic field).This further means that, each patient will be exposed to than actually required bigger magnetic field and more
In big tissue and body fluid current density.In some embodiments it may be desirable to maintain patient institute during the work of device
Exposed magnetic field is in 2.0 or less teslas.According to another embodiment, it is also desirable to maintain the tissue and body fluid of patient
The current density exposed is not more than 0.04 amperes per meter2(rms).In addition, because extending device 110 in marrow is fixed on bone
On 100, so unnecessary big magnetic field will lead to the unwanted movement of bone 100, for example, appointing in cylindrical magnet 134
What is in the radial direction.If magnetic field is excessively high, the shank of patient can be removed ideal position, and can even cause to patient
Some worries (including pain).
As shown in figure 9, the construction of the magnetic force head 178 of external adjusting device 180 delivers torque to magnet 186 in marrow
The ability for extending the cylindrical magnet 134 of device 110 optimizes, and is exposed to patient in big magnetic field.This also allows in marrow
The cylindrical magnet 134 for extending device 110 is designed to be small as best one can, to reduce the shape of implantation material, so as to embeddable small
The humerus or shin bone and femur of sized patients' (such as may want to the patient of decorative limb lengthening).As described above, 9 millimeters
100 pounds of tractive force can be transmitted by extending device in the marrow of diameter, or even cover the device that diameter is 8 millimeters and 7 millimeters.Two
Magnet 186 alternating change direction (that is, the arctic of a magnet 186 correspond to another magnet 186 South Pole) generate for
The torque of cylindrical magnet 134 transmits summation action, therefore makes to lead for the size of any specific cylindrical magnet 134
Gravitation maximizes.In addition, separation (S) between two magnet 186 (such as 70 millimeters) centers and being formed by recessed profile
238 (Fig. 6 and Fig. 7) are consistent with the curvature of most of limbs outer surface so that each magnet 186 and cylindrical magnet 134 it
Between distance L3And L4It is small as best one can.This can be assisted in particular with the recessed profile 238 of magnetic force head 178.In addition, skin
Skin and fat can be compressed by magnet cover 188, to form notch 236 in side and two sides, this allows each magnet 186 and cylinder
The distance between magnet 134 L3And L4Become smaller.
Figure 10 shows the sterilizing complete component 400 including multiple extension rods 406, and extension rod is configured to be attached to and actuate
Device 412 (Figure 11) extends device 410 (Figure 11) to constitute in modularization marrow.In one embodiment, actuator 412 be with
What sterile form provided, and the remaining content of extension rod 406 and sterilizing complete component 400 can be using autoclave (for example, water
Steam), ethylene oxide or other methods well known by persons skilled in the art sterilize.400 content of sterilizing complete component
Including one or more extension rods 406 and attachment 408, attachment is for extending insertion, the attachment of device 410 in modularization marrow.It adjusts
Section and dismounting.Content is located in the first disinfection pallet 402 and the second disinfection pallet 404.Second disinfection pallet 404 and first disappears
Malicious pallet 402 has the multiple holes 405 allowed gas into.It, will be to kit 400 in several attached drawings in the following figures
In other objects be described.
Figure 11 is turned to, the component for extending device 410 in modularization marrow is shown in figure.Actuator 412 is designed to place
(along the direction opposite with device 110 is extended in the marrow of Fig. 1) in the bone of patient.Therefore, the orientation of axis 413 is pulled towards bone
The distal end (be distally Figure 11 in downward direction) of bone.Distal end screw hole 415 in drawing axis 413 allows to place far-end locking screw rod
420.Far-end locking screw rod 420 (Figure 21 A and Figure 21 B) has for the proximal threads 417 with bone engagement, and far-end locking spiral shell
The remainder of the axis 419 of bar 420 has constant diameter, for obtaining maximum strength and stability.In actuator 412
There are the convex wheel hub 414 of hexagonal shape, convex wheel hub includes the threaded hole 429 in hexagon convex wheel hub 414 for proximal end 421
Interior located lateral screw 416 (Figure 12).Extension rod 406 (Figure 13 and Figure 14) has corresponding hexagonal hole 428 or concave end
The hexagon convex wheel hub 414 in portion, actuator 412 is placed on the hexagonal hole or concave end.Located lateral screw 416 is nested
In the screw hole 429 of hexagon convex wheel hub 414, so that when located lateral screw 416 and hexagonal hole 428 are put together
It does not influence the hexagonal hole 428 of extension rod 406.There are two set screw holes 422 in the wall of extension rod 406, the two are fixed
Position screw hole is aligned each other.Actuator 412 and extension rod 406 are put together, so that set screw hole 422 and positioning spiral shell
Silk 416 coaxially extends.This allows to tighten set screw driver (such as the torque limit driver 488 of Figure 10 and Figure 17)
Positive turret head 490 is inserted into the hexagonal hole of set screw 416.It is controlled when torque limit driver 488 is tightened and set at it
When progressive under torque, the other end (being threaded or non-threaded hook) of set screw 416 is inserted into opposite positioning spiral shell
Wire hole 422, thus actuator 412 is securely fixed on extension rod 406.Set screw hole 422 is dimensioned to permit
Perhaps positive turret head 490 is smoothly through, and still, the non-threaded hook of set screw 416 passes through very slightly, to realize
The static connection that cannot be unclamped easily during implantation.If desired, bone cement can be placed in the annulus of set screw hole 422,
Even further bond set screw 416.In addition, the second screw rod can be tightened into set screw 416 behind set screw head
In initially nested internal screw thread.The head of this second screw rod will increase additional resistance to the shear fracture of set screw 416.This
Outside, the second screw rod can be tightened, so that it gets into set screw 416, thus make set screw 416 back-outs unlikely hair
It is raw.Any noncircular cross section can be used to replace hexagonal cross-section, such as the section of square or ellipse.
Proximal end locking screw 418 is inserted through the locking screw hole 430 in extension rod 406.Extension rod 406 can be straight type
Or can have specific pars convoluta 432, for example, for being matched with the proximal end of femur or shin bone.It is understood that module
Changing arrangement allows for actuator 412 to be attached to different length, curvature (including straight type), diameter, bore dia and angulation
One in many different model extension rods 406.First disinfection pallet 402 may include these many different extension rods 406, can
To properly select extension rod 406 and attach it to actuator 412.Because actuator 412 is provided with sterile form,
So this arrangement is also ideal, because only needing to provide a single model.However, if desired, the rush of several types may be present
Dynamic device, for example, different diameters (10.5 centimetres, 12.0 centimetres, 9 centimetres, 7.5 centimetres) or different distal end screw holes are straight
Diameter, construction or angulation.The preferable configuration for a large amount of patients and different bone types and size can be obtained, and there is minimum
The sterile actuator model of quantity.
Figure 15 is turned to, proximal end is shown in figure and bores guiding element 434 and is configured to be attached to extension device in modularization marrow
410, simplify to insert it into interior medullary canal, the drilling in bone and proximal end locking screw 418 is attached to bone.
It includes the adjutage 436 for being attached to connecting tube 446 that guiding element 434 is bored in proximal end, and locking level 448 is inserted into connecting tube 446.Locking level 448
With the hook knob 450 and external screw thread at the far end 452 in proximal end.In order to which proximal end brill guiding element 434 is temporarily attached to mould
Extend device 410 in block marrow, and the lock tabs 454 that guiding element 434 is bored in proximal end are inserted into the lock slots 424 of extension rod 406
And rotate hook knob 450, so that the external screw thread 452 of locking level 448 be made to be screwed into the internal screw thread 426 of extension rod 406.Herein
Before step, adjutage 436 is attached to by guiding element extension 438 is bored using knob 440.By the medullary canal reaming of bone to slightly
After diameter (such as 11 millimeters) greater than the outer diameter for extending device 410 in modularization marrow, device 410 will be extended in modularization marrow
Distal end insertion medullary canal, and beat the flat proximal end face of hook knob 450 with hammer, to allow to extend in modularization marrow
Device 410 is inserted into correct depth.Size X is enough to make big femur or buttocks by (in worst case, being to be applied to stock
Bone).For example, being suitable with 8 to 10 centimetres.Once extending device 410 in modularization marrow is placed in appropriate position in medullary canal,
Then make proximal end bore guiding element 434 to be left attached state and guide sleeve 442 is passed through a hole in hole 456,458,460,462
And it places in place and slides so that distal end 443 reaches the skin of patient.Guiding element extension 438, adjutage 436 and hole will be bored
456,458,460,462 size and direction are designed to, so that guide sleeve 442 is positioned at precise angle, to make the brill of screw rod
The placement of the tight screw hole 430 of hole and process extension rod 406 and process bone is possibly realized.Cut the skin and process of patient
Operative incision places drill bushing 444, and tapered tip 445 passes through tissue and reaches drilled bone.For example, can be by drill bit
It is downwardly into drill bushing 444 with locking screw, or alternatively, drill bit is downwardly into drill bushing 444, then after drilling
It removes drill bushing 444 and proximal end locking screw 418 is downwardly into guide sleeve 442.The guide sleeve 464 and drill bushing 466 of substitution can be with
It is placed across hole 460 and 462, as shown in Figure 10.
Figure 16 is turned to, shows removal tool 468 in figure.Removal tool is used after period of traction and consolidation phase
468.In order to will in modularization marrow extend device 410 be removed from medullary canal, and cut skin and by bone be exposed to proximal end and
Extend the proximal end of device 410 in the position of far-end locking screw rod 418,420 and modularization marrow.Top 476 is engaged by insertion
It is screwed into internal screw thread 426 (being fixed in hook knob 472) with by external screw thread 474, and is connected to dismounting bar 470 in modularization marrow
Extend the internal screw thread 426 of the extension rod 406 of device 410.Hook knob 472 includes internal screw thread 478, and internal screw thread 487, which makes to remove, to be prolonged
The attachment of the external screw thread 486 of extending portion 480 is possibly realized, and removing extension 480 has effect knob 482 and remove hammer 484.It utilizes
External screw thread 486 is couple to by the pivotal axis 477 for pivoting pedestal 479 removes extension 480.By promptly effect knob 482 and its
Rotation, and external screw thread 486 is fixed to internal screw thread 478.It is removing in modularization marrow before extension device 410, by proximal end and far
Locking screw 418,420 is held to remove.Locking screw 418,420 is removed into (Figure 10 and figure using locking screw driver 498
20), locking screw driver 498 has the positive turret head top 497 engaged with the proximal end of locking screw 418,420.Screw rod is caught
Bar 500 (Figure 10 and Figure 20) is obtained to be downwardly into the center of locking screw driver 498 and there is external screw thread top 501.It is passing through
The deeper portion (Figure 21 A and Figure 21 B) for the concave turret head 513 crossed in locking screw 418,420 is internal screw thread 511.Screw rod is caught
The external screw thread top 501 for obtaining bar 500 is screwed into the internal screw thread 511 of locking screw 418,420, and twisting using screw rod capture bar 500
Tight handle 503 is tightened, and the handle end 509 that handle 503 is located at locking screw driver 498 is tightened, so as to once from bone
Locking screw 418,420 is removed, they, which appoint, is so fixed on locking screw driver 498, and will not become prematurely to shift.Example
Such as, patient's body will not be lost or be fallen into locking screw 418,420.Now, can by hold remove hammer 484 and
It is fast moved on direction (D) to hammer striking face 485 into shape and to strike knob striking face 483, will extend device 410 in modularization marrow
It is removed from medullary canal.The operation is carried out, is completely removed until extending device 410 in modularization marrow.It should be pointed out that Figure 15
Proximal end bore guiding element 434 hook knob 450 also have internal screw thread (not shown) so that insertion modularization marrow in extend device
During 410, if it is expected to remove in the device for any reason, the external screw thread 486 of removal tool 468 could attach to locking rotation
The internal screw thread of button 450, and dismounting hammer 484 can be used to act on the effect knob 482, extend device to remove in modularization marrow
410。
The torque limit driver 488 of Figure 17 includes handle 496 and axis 492, and axis 492 has connection handle 496 and axis 492
The dedicated ratchet 494 of torque.Positive turret head top 490 is embedded in the hexagonal hole of set screw 416 or even insertion locks spiral shell
The hexagon socket head 513 of bar 418,420.It is 9 in-lbs (1.0 Newton meter (n.m.)) for the illustrative ratchet torque of set screw 416,
The size of exemplary turret head is 1/16 " (1.59 millimeters).
Figure 18 shows the actuator 412 of Figure 11 with section view diagram form.The visible distal end screw hole 415 in drawing axis 413.
Show that drawing axis 413 is in the fully extended position relative to shell 312 in figure.Cavity 337 has been opened to its maximum length.?
In this embodiment, drawing axis 413 has pure circle cylindrical surface, and is dynamically sealed to shell using two O-ring sealing elements 502
Body 312.O-ring sealing element 502 can be made of silicone, EPDM or other rubber materials, and can be coated with silicone oil to increase
Lubricity.There are 4 axially extending slots 326 on the inner wall of shell 312.Tab 504 in drawing 413 end of axis is embedded in this
A little slots 326, to prevent drawing axis 413 from can rotate relative to shell 312.Shell 312 is welded to magnet case 328, magnet case
Body 328 is welded to hexagon convex wheel hub 414.Set screw 416 on hexagon convex wheel hub 414 is used for actuator 412
It is attached to extension rod 406.Using epoxy resin sealing cylindrical permanent magnet 334, it is placed in the magnet case 358 with end pin 360
It is interior.End pin 360 is inserted through transverse bearing 332, to can rotate in low friction.Make when using external magnets
When magnet 334 rotates, first planetary gear set 354, the second planetary gear set 356 and third planet gear set 357 be can be realized
The total reduction of 64:1 (4 × 4 × 4).Each gear set can be realized the deceleration of 4:1.Using locking pin 342 by planetary gear output shaft
344 are attached to driving screw 336, and utilize the 348 fixing lock rationed marketing 342 of cylinder-type lock rationed marketing retainer.Thrust bearing 338 and shell
Body platform or lip 352 and magnet case platform or lip 350 adjoin (thrust bearing 338 be clipped in shell platform or lip 352 with
Between magnet case platform or lip 350).Therefore, thrust bearing 338 adjoins shell platform or lip 352 simultaneously with tension
And with compressive state adjacent magnets shell platform or lip 350.It should be pointed out that interlayer arrangement allows in thrust bearing
There are part side slope (slop) or clearance between 338 and shell platform or lip 352 and magnet case platform or lip 350.It leads
Screw rod 336 is engaged with nut 340, and nut 340 is fixed in drawing axis 413.Using the 64:1 The gear deceleration of the present embodiment, utilize
It is 2 inches (5.08 centimetres) extending the gap (G in Figure 19) between device 110 in magnetic force head 178 and marrow, obtains always
Greater than the tractive force of 300 pounds (1334 newton).This is enough for pulling large-scale typical patient.
It should be pointed out that although the embodiment for extending device in given marrow is used in privileged direction (distally relatively
In proximal end), but any embodiment in these embodiments can be used for distally directed or proximal end drawing axis.In addition, the present invention
It can be applied to not be located in interior medullary canal and be located at outside bone and pull bone plate.
The substitution other than scheme illustrated above can also be used and extend scheme.For example, a kind of alternative solution includes, purposefully
Excessively extend (with further stimulating growth) followed by portion rebounds (so that pain minimization).For example, 4 daily 0.25 millimeter
Extended period can be respectively made of 0.35 millimeter of the retraction for extending then 0.10 millimeter.
The material of attachment 408 is medical grade stainless steel, but can be according to desired weight with required size and using Bu Tong close
The other materials of degree.The most of component for extending device in marrow is preferably titanium or titanium alloy, but partial internal component can
It is made of stainless steel.
Although having revealed that and describing the embodiment of the present invention, can do in the case without departing from the scope of the present invention various
Modification.As an example, device described herein can be used to extend or change some other bones (such as mandibular or
Skull).Therefore, other than being limited by the following claims and their equivalents, the present invention should not be restricted.
Claims (49)
1. a kind of extension system is configured to be placed in the bone with the firstth area and the secondth area or pass through the bone,
The extension system includes:
Actuator, the drawing axis that the actuator has shell and can movably install relative to the shell, wherein the shell
Body accommodates rotatable permanent magnet, and the drawing axis is operatively coupled to the rotatable permanent magnet through driving screw, described to lead
The distal end of pulling shaft is configured to be attached to the firstth area of the bone, and the proximal end of the actuator includes non-circular raised wheel
Hub；And
Extension rod has first end, second end, length and curvature, wherein the length and the curvature pair of the extension rod
The length and curvature in secondth area of bone described in Ying Yu；
Wherein, the first end of the extension rod includes non-circular concave wheel hub, and the concave wheel hub is configured to fix
To the non-circular convex wheel hub of the actuator；Also,
Wherein, the second end of the extension rod includes one or more locking screws hole, and is configured for being attached to
Secondth area of the bone.
2. extension system according to claim 1, wherein the non-circular convex wheel hub and the non-circular concave
Wheel hub is the shape of polygon.
3. extension system according to claim 1, wherein the non-circular convex wheel hub and the non-circular concave
Wheel hub is the shape of hexagon.
4. extension system according to claim 1, wherein the non-circular convex wheel hub and the non-circular concave
Wheel hub is square shape.
5. extension system according to claim 1, wherein the non-circular convex wheel hub and the non-circular concave
Wheel hub is the shape of ellipse.
6. extension system according to claim 1, wherein utilize set screw by the actuator and the extension rod phase
It is mutually fixed.
7. extension system according to claim 6, wherein the set screw is at least partly nested in described non-circular
Convex wheel hub in.
8. extension system according to claim 1, wherein the extension rod is opposite with the non-circular wheel hub at it
One end includes female thread portion.
9. extension system according to claim 8 further comprises be configured to engage with the female thread portion one
A or multiple work packages.
10. extension system according to claim 1, wherein the extension rod is opposite with the non-circular wheel hub at it
One end include receiving unit, the receiving unit is configured to engage with one or more work packages.
11. a kind of extension system is configured to be placed in the bone with the firstth area and the secondth area or pass through the bone,
The extension system includes:
Actuator, the drawing axis that the actuator has shell and can movably install relative to the shell, wherein the shell
Body accommodates rotatable permanent magnet, and the drawing axis is operatively coupled to the rotatable permanent magnet through driving screw, described to lead
The distal end of pulling shaft is configured to be attached to the firstth area of the bone, and the proximal end of the actuator includes non-circular concave type wheel
Hub；And
Extension rod has first end, second end, length and curvature, wherein the length and the curvature pair of the extension rod
The length and curvature in secondth area of bone described in Ying Yu；
Wherein, the first end of the extension rod includes non-circular convex wheel hub, and the convex wheel hub is configured to fix
To the non-circular concave wheel hub of the actuator；Also,
Wherein, the second end of the extension rod includes one or more locking screws hole, and is configured for being attached to
Secondth area of the bone.
12. extension system according to claim 11, wherein utilize set screw by the actuator and the extension rod
It is fixed to each other.
13. extension system according to claim 12, wherein the set screw is at least partly nested in described non-circular
In the convex wheel hub of shape.
14. extension system according to claim 11, wherein the non-circular concave wheel hub and described non-circular convex
Type wheel hub is the shape of polygon.
15. extension system according to claim 11, wherein the non-circular concave wheel hub and described non-circular convex
Type wheel hub is the shape of hexagon.
16. extension system according to claim 11, wherein the non-circular concave wheel hub and described non-circular convex
Type wheel hub is square shape.
17. one group of kit, the component include:
Extension system is configured to be placed in the bone with the firstth area and the secondth area or pass through the bone, described to prolong
Long system includes: actuator, the drawing axis that the actuator has shell and can movably install relative to the shell,
In, the shell accommodates rotatable permanent magnet, and the drawing axis is operatively coupled to the rotatable permanent magnetic through driving screw
The distal end of body, the drawing axis is configured to be attached to the firstth area of the bone, and the proximal end of the actuator includes non-circular
Convex wheel hub；And
Multiple extension rods, wherein each extension rod has first end, second end, length and curvature, wherein the extension rod
The length and the curvature correspond to the length and curvature in secondth area of the bone；
Wherein, the first end of the extension rod includes non-circular concave wheel hub, and the concave wheel hub is configured to fix
To the non-circular convex wheel hub of the actuator；Also,
Wherein, the second end of the extension rod includes one or more locking screws hole, and is configured for being attached to
Secondth area of the bone.
18. kit according to claim 17, wherein each extension rod includes non-circular concave wheel hub, described
Concave wheel hub is configured to be fixed to the non-circular convex wheel hub.
19. one group of kit, the component include:
Extension system is configured to be placed in the bone with the firstth area and the secondth area or pass through the bone, described to prolong
Long system includes: actuator, the drawing axis that the actuator has shell and can movably install relative to the shell,
In, the shell accommodates rotatable permanent magnet, and the drawing axis is operatively coupled to the rotatable permanent magnetic through driving screw
Body, wherein the distal end of the drawing axis is configured to be attached to the firstth area of the bone, and the proximal end of the actuator includes non-
Circular concave wheel hub；And
Multiple extension rods, wherein each extension rod has first end, second end, length and curvature, wherein the extension rod
The length and the curvature correspond to the length and curvature in secondth area of the bone；
Wherein, the first end of the extension rod includes non-circular convex wheel hub, and the convex wheel hub is configured to fix
To the non-circular concave wheel hub of the actuator；Also,
Wherein, the second end of the extension rod includes one or more locking screws hole, and is configured for being attached to
Secondth area of the bone.
20. kit according to claim 19, wherein each extension rod includes non-circular convex wheel hub, described
Convex wheel hub is configured to be fixed to the non-circular concave wheel hub.
21. a kind of extension device is configured to be placed in the bone with the first segregation section and the second segregation section or pass through
The bone, the extension device include:
Shell, the shell are configured to for being attached to one of first segregation section and second segregation section, wherein described
The inner wall of shell includes the first platform and the second platform；
Axis is pulled, the drawing axis is configured to another point for being attached in first segregation section and second segregation section
From in section and including inner cavity along its length, wherein the drawing axis is telescopically installed and is constructed relative to the shell
At telescopically extending out of described shell；
Magnetic driving system, the Magnetic driving system are configured to drive the drawing axis telescopically to extend from the shell,
To force first segregation section and second segregation section to be separated from each other, wherein the drawing axis is by mechanical in an indirect way
It is coupled to the driving screw driving of permanent magnet；And
Thrust bearing, thrust bearing setting are described in the shell and between the driving screw and permanent magnet
Thrust bearing is located between first platform and second platform.
22. extension device according to claim 21 further comprises being operatively coupled to the permanent magnet and institute
State at least one gear of driving screw.
23. extension device according to claim 21 further comprises being arranged in the permanent magnet and the driving screw
Between multiple intermediate gears.
24. extension device according to claim 21, wherein the threaded portion of the driving screw and the drawing axis taps
It closes.
25. extension device according to claim 24, wherein permanent magnet multi-turn rotation in a first direction makes
The driving screw is placed under compressive state, and wherein, permanent magnet multi-turn rotation in a second direction, so that institute
Driving screw is stated to be placed under tension.
26. extension device according to claim 21, further comprise operationally with the driving screw and described permanent
The connector of magnet coupling.
27. extension device according to claim 26, wherein the connector is configured to ensure the drive system not
It is tied up by beam splitting.
28. extension device according to claim 21, further comprise be coupled in an indirect way the permanent magnet and
The connector of the driving screw, wherein the connector is configured to ensure between the permanent magnet and the driving screw
It is coupled indirectly and is not tied up by beam splitting.
29. extension device according to claim 26, wherein the driving screw is fixed to the connector by pin.
30. a kind of extension device, the extension device include:
Shell, the shell are configured to be attached to one of the first bone section and the second bone section, wherein the inner wall of the shell
Including the first platform and the second platform；
Axis is pulled, there is inner cavity along its length, and be configured to be attached to first bone section and second bone
Another bone section in section, wherein the drawing axis and the shell are configured to allow for the drawing axis relative to the shell
Axial displacement；
Actuator, the actuator include:
Permanent magnet has at least two poles, and is configured to rotate relative to the shell；And
Driving screw is operatively coupled to the permanent magnet；
Wherein, the rotation of the permanent magnet is so that driving screw rotation, the driving screw and the inner cavity of the drawing axis
Threaded portion engages；And
Thrust bearing, thrust bearing setting are described in the shell and between the driving screw and permanent magnet
Thrust bearing is located between first platform and second platform.
31. extension device according to claim 30, wherein the actuator further comprises being operatively coupled on institute
State at least one gear between permanent magnet and the driving screw.
32. extension device according to claim 30 further comprises being arranged in the permanent magnet and the driving screw
Between multiple intermediate gears.
33. extension device according to claim 30 further comprises at least one thrust disposed in the housing
Bearing.
34. extension device according to claim 31 further comprises at least one thrust disposed in the housing
Bearing.
35. extension device according to claim 33, wherein the thrust bearing abuts intracorporal at least positioned at the shell
One platform.
36. extension device according to claim 33, wherein the thrust bearing is configured to protect the actuator
The influence for stress under compression or the tensile stress of not being pressurized at least partially.
37. extension device according to claim 34, wherein the thrust bearing is configured to protect the permanent magnet
With the influence of at least one of at least one gear be not pressurized stress under compression or tensile stress.
38. extension device according to claim 30, wherein the driving screw is engaged with the threaded portion of the inner cavity.
39. a kind of extension device is configured to be placed in the interior medullary canal of the bone with the first segregation section and the second segregation section,
The extension device includes:
Shell, the shell are configured for being attached to one of first segregation section and second segregation section, wherein institute
The inner wall for stating shell includes the first platform and the second platform；
Axis is pulled, there is inner cavity along its length, and be configured to be attached in first segregation section and the second segregation section
Another segregation section；
Permanent magnet is arranged in the shell, and is configured to for rotating and having at least two poles；
Output shaft is operatively coupled to driving screw, the threaded portion split-phase of the driving screw and the inner cavity for pulling axis
Engagement；
Thrust bearing, thrust bearing setting are described in the shell and between the driving screw and permanent magnet
Thrust bearing is located between first platform and second platform；And
Multiple gears the permanent magnet and are configured to pass wherein a gear in the multiple gear is operably connected
Torque delivery, and wherein another gear of the multiple gear terminates at the output shaft.
40. extension device according to claim 39, wherein the multiple gear includes at least one planetary gear set,
The planetary gear set includes multiple planetary gears.
41. extension device according to claim 40, wherein the multiple gear includes having multiple planetary gears the
One planetary gear set and the planetary gear set last with multiple planetary gears, wherein the rotation of the permanent magnet so that
The sun gear of the first planetary gear set rotates, and the output of the last planetary gear set is operably coupled to described
Output shaft.
42. a kind of extension device, the extension device include:
Shell, the shell are configured to be attached to one of the first separation bone section and the second separation bone section, wherein described
The inner wall of shell includes the first platform and the second platform；
Axis is pulled, the drawing axis is configured to for being attached in the first separation bone section and the second separation bone section
Another separation bone section on and can move relative to the shell, the drawing axis includes:
Inner cavity along its length；
Threaded portion；
Actuator, the actuator include:
Permanent magnet has at least two poles and is configured to rotate relative to the shell；And
Driving screw, the driving screw have the screw thread for being configured to engage with the first threaded portion of the drawing axis；
Driving screw couples cap, and the permanent magnet is coupled to the driving screw indirectly by the driving screw connection cap, wherein institute
Driving screw connection cap is stated to be configured to for ensuring being coupled indirectly not by excessive between the permanent magnet and the driving screw
Constraint；And
Thrust bearing, thrust bearing setting are described in the shell and between the driving screw and permanent magnet
Thrust bearing is located between first platform and second platform；
Wherein, the actuator is constructed such that the drawing axis is telescopically moved relative to the shell.
43. extension device according to claim 42, wherein the driving screw is fixed to the driving screw by pin and couples
Cap.
44. extension device according to claim 42, further comprises planetary gear set, the planetary gear set includes more
A gear a, wherein gear in the multiple gear is operatively coupled to the permanent magnet and is configured to transmitting torsion
Square, and wherein another gear of the multiple gear terminates at the output shaft for being operatively coupled to driving screw, the guide screw
Bar has the screw thread for being configured to engage with the first threaded portion of the drawing axis.
45. extension device according to claim 42 further comprises being arranged in the permanent magnet and the driving screw
Between multiple intermediate gears.
46. a kind of extension device, the extension device include:
Shell, the shell are configured to be attached to the first position on bone, wherein the inner wall of the shell includes the first platform
With the second platform；
Axis is pulled, the drawing axis is telescopically installed relative to the shell and is configured to relative on the bone
The second position is attached；
Magnetic driving system, the Magnetic driving system are configured to drive the drawing axis telescopically to extend from the shell,
To force the first bone section and the second bone section to be separated from each other, wherein the drawing axis by being mechanically coupled to forever in an indirect way
The driving screw driving of long magnet, the permanent magnet have at least two poles；
Thrust bearing, disposed in the housing, the thrust bearing is between the driving screw and permanent magnet, the thrust
Bearing is located between first platform and second platform and is configured to protect at least one of the Magnetic driving system
Divide the influence of be not pressurized stress under compression or tensile stress.
47. extension device according to claim 46, wherein the Magnetic driving system further comprises being operatively coupled to
To at least one gear of the permanent magnet and output shaft, the output shaft is operatively coupled to the driving screw.
48. extension device according to claim 46, wherein the Magnetic driving system further comprise be arranged in it is described forever
Multiple intermediate gears between long magnet and driving element.
49. extension device according to claim 47, wherein at least one described gear includes having multiple planetary gears
At least one planetary gear set, wherein the permanent magnet is operably connected sun gear, also, it is described at least one
Planetary gear set is operably coupled to the output shaft.
Applications Claiming Priority (5)
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| US24007109P | 2009-09-04 | 2009-09-04 | |
| US61/240,071 | 2009-09-04 | ||
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| US61/363,986 | 2010-07-13 | ||
| CN201080039442.7A CN102905625B (en) | 2009-09-04 | 2010-09-03 | Osteogenesis device and method |
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| CN201080039442.7A Division CN102905625B (en) | 2009-09-04 | 2010-09-03 | Osteogenesis device and method |
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| CN105011997B true CN105011997B (en) | 2019-04-26 |
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| CN201510484722.3A Pending CN105193485A (en) | 2009-09-04 | 2010-09-03 | Bone growth device and method |
| CN201510484965.7A Active CN105011997B (en) | 2009-09-04 | 2010-09-03 | Bone uptake device and method |
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| US10136952B2 (en) * | 2016-06-16 | 2018-11-27 | Zimmer, Inc. | Soft tissue balancing in articular surgery |
| US11229489B2 (en) | 2016-06-16 | 2022-01-25 | Zimmer, Inc. | Soft tissue balancing in articular surgery |
| CN109259836B (en) * | 2018-08-09 | 2020-12-18 | 盐城日升月恒智能科技有限公司 | Intramedullary and extramedullary combined belt pulley bone lengthening device |
| CN109276298B (en) * | 2018-08-09 | 2020-12-18 | 盐城日升月恒智能科技有限公司 | Intramedullary and extramedullary combined rope sheave bone lengthening device |
| CN109276299B (en) * | 2018-08-09 | 2020-12-18 | 盐城日升月恒智能科技有限公司 | Belt pulley bone extension fixture |
| CN111528968B (en) * | 2020-04-14 | 2022-02-18 | 武汉优联百康医疗科技有限公司 | Adjustable sacrum osteotomy guide plate |
| CN111603233A (en) * | 2020-06-15 | 2020-09-01 | 四川大学华西医院 | Bone extension intramedullary nail device |
| CN112915389A (en) * | 2021-01-20 | 2021-06-08 | 清华大学 | Bone growth assisting system and flexible magnetic field generator |
| CN112754635B (en) * | 2021-01-20 | 2022-06-14 | 清华大学 | Bone growth assisting system and magnetic control device |
| CN113101016B (en) * | 2021-05-13 | 2022-08-16 | 北京爱康宜诚医疗器材有限公司 | Prosthesis connecting element and prosthesis assembly |
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| CN105193485A (en) | 2015-12-30 |
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