CN106073948B

CN106073948B - Ilium dummy

Info

Publication number: CN106073948B
Application number: CN201610538998.XA
Authority: CN
Inventors: 郭卫; 王彩梅; 姬涛
Original assignee: Peking University Peoples Hospital
Current assignee: Beijing AK Medical Co Ltd
Priority date: 2016-07-08
Filing date: 2016-07-08
Publication date: 2018-02-02
Anticipated expiration: 2036-07-08
Also published as: CN106073948A

Abstract

The invention provides a kind of ilium dummy, including：Repair main body, repair the domed structure of main body, repairing main body includes the first end being engaged with rumpbone and the second end being engaged with acetabular bone, it is taper hole that first the first screw hole of screw hole is provided with first end, the first nail seat is provided with first screw hole, the first nail seat has spherical inside surface；Rod structure is followed closely, nail rod structure includes connecting seat and barred body, and connecting seat is connected with repairing main body, and barred body is fixed on connecting seat；Escapement, escapement, which is folded in, to be repaired between main body and connecting seat, and escapement includes and the first anticreep feeler of the screw fit being contained in the first screw hole.It is unreliable that technical scheme can efficiently solve nail-stick system of the prior art support, the problem of easy fatigue fracture.

Description

Ilium dummy

Technical field

The present invention relates to medical instruments field, in particular to a kind of ilium dummy.

Background technology

Pelvis is the position that bone tumour is sent out well, and pelvic tumor can be divided into primary tumo(u)r and metastatic tumour.The former is predominantly soft Osteosarcoma, osteosarcoma and Ewing sarcoma, the latter are common in the Bone tumour of mastocarcinoma, kidney, prostate cancer, lung cancer etc..Pelvis swells Knurl incidence of occult and early diagnosis is difficult, it is very big to invade scope when often finding, it is complicated plus pelvis surrounding anatomic and with Many important organs adjoin, and operating difficulty is big, and complication is more, and curative effect is not good enough, and the death rate is high.At present, pelvic tumor is mainly adopted Half pelvis is taken to cut off or improve half pelvis excision amputation.But the excision of any pelvic tumor can cause Cranial defect, Cranial defect Patient's trunk and lower limb continuity can be caused to interrupt, influence to stand and walking with load, patient can not undertake body weight.And walk When can produce pain, and after patient's long-time walking with load, acetabular bone occurs introversion, moved up.It can cause after pelvic inclination Scoliosis, cause patient's postoperative life quality degradation.

Before twentieth century seventies, betiding most of malignant bone tumor of pelvic region needs row pelvis resection, passes The pelvis resection of system is to cut off lesion pelvis and homonymy lower limb in the lump, thus causes the handicap of patient.With change Treat and the developing of the auxiliary treating method such as radiotherapy, the appearance of advanced imaging methods and the raising of all kinds of surgical technics, some are former The tumour that amputation, which can only be leaned on, to treat can also implement limb-sparing surgery now, greatly reduce the deformity of patient.At present, it is right More than 80% Pelvic Malignant Tumor patients underwent's limb salvage treatment.

Because pelvic region anatomical structure is complicated, the limb-sparing surgery of pelvis malignant bone tumor is extremely challenging.Pelvic ring be by Rumpbone and the hipbone of both sides composition, are made up of per side hipbone ilium, ischium and pubis.The wide excision of pelvic tumor would generally be made Into larger Cranial defect, interrupt the continuity of pelvis, and lose the Portions of soft tissue of surrounding.Musculoskeletal system tumour association The parting of pelvic tumor resection art is proposed, by anatomical site (ilium is I areas, and region acetabularis is II areas, and closed pore area is III areas) Type of surgery is divided into：I types (ilium excision)；II types (acetabular bone excision)；Type III (excision of closed pore area)；IV types (are related to rumpbone Excision).If cutting off two or more regions simultaneously, excision type is the combination of respective regions, such as cuts off ilium and hip simultaneously Mortar area, then type of surgery is I, II type；Whole pelvis is cut off as I, II, type III；If cutting off femoral head simultaneously, for H types (such as II H；I, II H, II, III H).

The reconstruction of the postoperative pelvic ring of pelvic tumor resection is very necessary, can so conduct the weight of trunk to lower limb. The pelvis of defect is rebuild it is different according to patient's experience, patient profiles' means of different, conventional method for reconstructing have it is spacious put art, Hip joint transposition, fusion of bone, structural allosome autologous bone transplanting, artificial prosthesis and the compound allogenic bone transplantation of artificial prosthesis.

The compound nail-stick system of Sacrectomy is rebuild.Above-mentioned reconstruction mode can reach the effect of load-bearing in short term, but from length From the point of view of phase follow-up observation, nail-stick system has following shortcomings：Nail rod in nail-stick system is easily broken off, and fixing glue easily loosens, Sclerotin is easily destroyed, the state that patient is absorbed in the walking that can not stand once again, life can not take care of oneself, it is therefore necessary to be again carried out Fixed operation.Moreover, the operating difficulty is big, precision requires very high, careless slightly in art, you can to cause mortality massive haemorrhage Or other severe complications.

The content of the invention

The present invention is intended to provide a kind of ilium dummy, unreliable to solve nail-stick system support of the prior art, hold The problem of fatiguability is broken.

To achieve these goals, the invention provides a kind of ilium dummy, including：Main body is repaired, repairing main body is in Domes, repairing main body includes the first end being engaged with rumpbone and the second end being engaged with acetabular bone, the The first screw hole is provided with one end, the first screw hole is taper hole, and the first nail seat, the first nail seat are provided with the first screw hole With spherical inside surface；Rod structure is followed closely, nail rod structure includes connecting seat and barred body, and connecting seat is connected with repairing main body, barred body It is fixed on connecting seat；Escapement, escapement, which is folded in, to be repaired between main body and connecting seat, and escapement includes and receiving First anticreep feeler of the screw fit in the first screw hole.

Further, the second screw hole is provided with the second end, the second screw hole is taper hole, is set in the second screw hole There is the second nail seat, the second nail seat has spherical inside surface.

Further, connecting seat includes：Attachment screw, one end of attachment screw are connected with repairing main body, attachment screw The other end has spherical ailhead；Barred body fixed part, to fixed barred body, one end of barred body fixed part has to match with spherical ailhead The spherical pore of conjunction, so that barred body fixed part can be rotatably set on attachment screw.

Further, barred body fixed part includes U-shaped bearing and locking cap, and barred body is folded between U-shaped bearing and locking cap.

Further, it is hollow truss structure to repair main body, repairs main body and is molded by 3D printing.

Further, first end and/or the second end are provided with loose structure.

Further, first end and/or the second end are provided with needle-like projection.

Further, repair main body towards the surface of pelvic cavity be smooth surface.

Further, escapement also includes anticreep main body, and anticreep main body, which is folded in, repairs between main body and connecting seat, prevents Release mechanism also includes the second anticreep feeler, and the first anticreep feeler and the second anticreep feeler are connected with anticreep main body and to extensions Stretch, the stop collar coordinated with barred body is provided with the second anticreep feeler.

Apply the technical scheme of the present invention, ilium dummy includes repairing main body, and repairing main body includes contacting with rumpbone matching somebody with somebody The first end of conjunction and the second end being engaged with acetabular bone.The above-mentioned domed structure of reparation main body, there is good power Performance is learned, improves the internal force distribution of structure.In the case where bearing higher stress and shearing force, ilium reparation is able to maintain that The rigidity of body so that sclerotin is not readily susceptible to destroy.Therefore said structure solves nail-stick system support of the prior art not Reliably, easy fatigue fracture, the problem of ultimately resulting in sclerotin sensitive for damages.Apply the technical scheme of the present invention, follow closely rod structure bag Connecting seat and barred body are included, connecting seat is connected with repairing main body, and barred body is fixed on connecting seat.Said structure strengthens reparation master Fixation between body and rumpbone, the stability of rumpbone is added, so as to avoid lumbar vertebrae position.In addition, the application present invention Technical scheme, ilium dummy includes escapement, and escapement includes the screw fit with being contained in the first screw hole The first anticreep feeler, said structure can prevent screw from deviating from out of first screw hole.

Brief description of the drawings

The Figure of description for forming the part of the application is used for providing a further understanding of the present invention, and of the invention shows Meaning property embodiment and its illustrate be used for explain the present invention, do not form inappropriate limitation of the present invention.In the accompanying drawings：

Fig. 1 shows the assembling schematic diagram of an angle of the embodiment of the ilium dummy according to the present invention；And

Fig. 2 shows the assembling schematic diagram of another angle of Fig. 1 ilium dummy.

Fig. 3 shows the dimensional structure diagram of the connecting seat of Fig. 1 ilium dummy；

Fig. 4 shows the vertical profile structural representation of Fig. 3 connecting seat；

Fig. 5 shows the dimensional structure diagram of another connecting seat of Fig. 1 ilium dummy；

Fig. 6 shows the vertical profile structural representation of Fig. 5 connecting seat；

Fig. 7 shows the dimensional structure diagram of Fig. 1 ilium dummy for being provided with escapement；And

Fig. 8 shows the dimensional structure diagram of the escapement of Fig. 7 sacrum bone repair.

Wherein, above-mentioned accompanying drawing marks including the following drawings：

1st, rumpbone；2nd, acetabular bone；10th, main body is repaired；11st, first end；111st, the first screw hole；12nd, the second end；121、 Second screw hole；21st, connecting seat；211st, attachment screw；2111st, spherical ailhead；212nd, barred body fixed part；2121st, U-shaped bearing； 2122nd, locking cap；22nd, connecting seat；221st, attachment screw；2211st, spherical ailhead；222nd, barred body fixed part；2221st, U-shaped bearing； 2222nd, locking cap；23rd, barred body；30th, escapement；31st, the first anticreep feeler；32nd, anticreep main body；33rd, the second anticreep feeler； 34th, stop collar.

Embodiment

It should be noted that in the case where not conflicting, the feature in embodiment and embodiment in the application can phase Mutually combination.Describe the present invention in detail below with reference to the accompanying drawings and in conjunction with the embodiments.

As shown in Fig. 1 and Fig. 2 and Fig. 7, the ilium dummy of the present embodiment includes repairing main body 10, nail rod structure and prevented Release mechanism 30.Wherein, 10 domed structure of main body is repaired, repairs the first end 11 that main body 10 includes being engaged with rumpbone 1 And the second end 12 being engaged with acetabular bone 2, the first screw hole 111, the first screw hole 111 are provided with first end 11 For taper hole, the first nail seat is provided with the first screw hole 111, the first nail seat has spherical inside surface；Rod structure is followed closely, follows closely rod structure Including connecting seat 22 and barred body 23, connecting seat 22 is connected with repairing main body 10, and barred body 23 is fixed on connecting seat 22；Anti- off line Structure 30, escapement 30, which is folded in, to be repaired between main body 10 and connecting seat 22, and escapement 30 is included with being contained in the first screw First anticreep feeler 31 of the screw fit in hole 111.

Using the technical scheme of the present embodiment, ilium dummy includes repairing main body 10, and repairing main body 10 includes and rumpbone 1 The first end 11 being engaged and the second end 12 being engaged with acetabular bone.The above-mentioned domed structure of reparation main body, tool There is good mechanical property, improve the internal force distribution of structure.In the case where bearing higher stress and shearing force, Neng Gouwei Hold the rigidity of ilium dummy so that sclerotin is not readily susceptible to destroy.Therefore said structure solves nail rod of the prior art System supports unreliable, easy fatigue fracture, the problem of ultimately resulting in sclerotin sensitive for damages.Using the technical side of the present embodiment Case, nail rod structure include connecting seat 22 and barred body 23, and connecting seat 22 is connected with repairing main body 10, and barred body 23 is fixed on connecting seat On 22.Said structure strengthens the fixation repaired between main body 10 and rumpbone 1, the stability of rumpbone 1 is added, so as to avoid Lumbar vertebrae position sinks.In addition, using the technical scheme of the present embodiment, ilium dummy also includes escapement 30, escapement 30 include that with the first anticreep feeler 31 of the screw fit being contained in the first screw hole 111, said structure screw can be prevented Deviate from out of first screw hole 111.

Specifically, in the present embodiment, repair and escapement 30 is provided with main body, escapement 30 is folded in reparation master Between body and connecting seat 22, the first anticreep that escapement 30 includes the screw fit with being contained in the first screw hole 111 touches Angle 31.In use, screwing connecting seat 22, the first anticreep feeler 31 withstands the screw being contained in the first screw hole 111, connecting seat 22 attachment screw 221 is tighter, and the power that the first anticreep feeler 31 withstands screw is bigger.Therefore said structure can prevent screw Deviate from out of first screw hole 111.In addition, in the prior art, the attachment screw 221 for being screwed into bone often loosens. Can also be that connecting seat 22 provides pretightning force to prevent connecting seat 22 from loosening using above-mentioned escapement 30.

As shown in figure 4, in the present embodiment, nail rod structure also includes connecting seat 21, and connecting seat 21 is connected with lumbar vertebral body, rod Body 23 is fixed on connecting seat 21, and connecting seat 21 includes：Attachment screw 211, one end of attachment screw 211 are connected with rumpbone 1, even Connecing the other end of screw 211 has spherical ailhead 2111；Barred body fixed part 212, to fixed barred body 23, barred body fixed part 212 One end there is the spherical pore that is engaged with spherical ailhead 2111.Said structure causes barred body fixed part 212 to be rotatably arranged On attachment screw 211.So so that doctor can be according to the position for being actually needed adjustment barred body 23, so that installation position It is more accurate to put, and installation process is simpler.

As shown in figure 3, in the present embodiment, barred body fixed part 212 includes U-shaped bearing 2121 and locking cap 2122, barred body 23 are folded between U-shaped bearing 2121 and locking cap 2122.Specifically, the U-shaped inwall of U-shaped bearing 2121 forms installing space, Barred body 23 is inserted in above-mentioned installing space.The top of the U-shaped inwall of U-shaped bearing 2121 has internal thread, and locking cap 2122 has The external screw thread being adapted with the internal thread of U-shaped bearing 2121.When installing barred body 23, it is necessary to first by barred body 23 from installing space Pass, then locking cap 2122 is screwed onto on U-shaped bearing 2121.Said structure is simple, easy for installation.

As shown in fig. 6, in the present embodiment, connecting seat 22 includes：Attachment screw 221, one end of attachment screw 221 is with repairing Multiple main body 10 connects, and the other end of attachment screw 221 has spherical ailhead 2211；Barred body fixed part 222, to fixed barred body 23, one end of barred body fixed part 222 has the spherical pore being engaged with spherical ailhead 2211.Said structure causes barred body fixed part 222 can be rotatably set on attachment screw 221.So so that the position that doctor can adjust barred body 23 according to being actually needed, So that installation site is more accurate, installation process is simpler.

As shown in figure 5, in the present embodiment, barred body fixed part 222 includes U-shaped bearing 2221 and locking cap 2222, barred body 23 are folded between U-shaped bearing 2221 and locking cap 2222.Specifically, the U-shaped inwall of U-shaped bearing 2221 forms installing space, Barred body 23 is inserted in above-mentioned installing space.The top of the U-shaped inwall of U-shaped bearing 2221 has internal thread, and locking cap 2222 has The external screw thread being adapted with the internal thread of U-shaped bearing 2221.When installing barred body 23, it is necessary to first by barred body 23 from installing space Pass, then locking cap 2222 is screwed onto on U-shaped bearing 2221.Said structure is simple, easy for installation.

As depicted in figs. 1 and 2, in the present embodiment, it is hollow truss structure to repair main body 10, on the one hand, above-mentioned truss Structure can greatly reduce the quality for repairing main body 10, improve stock utilization, while can also ensure that and repair main body 10 Intensity and rigidity.On the other hand, enable to repair main body 10 closer to adjacent bone using said structure, so that Obtain the better of Bony union.Because Anatomical Reconstruction not only needs to meet requirement precisely, complicated after pelvic tumor resection, very As for also needing to meet requirement that is disposable, making to measure.Therefore, in the present embodiment, repair main body 10 by 3D printing into Type.Above-mentioned technique in itself have precisely, can manufacture complex parts and can customization of individual character the characteristics of.

It should be noted that 3D printing rapid shaping technique is a kind of brand-new manufacturing technology based on material stacking method, area Not in traditional removal materials processing technology, also known as increasing material manufacturing (AKYCM, AKYCdditive MAKYCnufAKYCcturing).3D printing technique is the data using three-dimensional CAKYCD, will from level to level by rapidform machine Material stacking into entity.Different types of rapid prototyping system moulding material because used in is different, forming principle and system features Also it is each variant, but general principle is the same, that is, " Layered manufacturing, being successively superimposed ", just as one " three-dimensional printing machine ", because This gains the name.With manufacturing technology, digital modeling techniques, Numeric Control Technology, information technology, material science and chemistry, biotechnology etc. The fast development of cutting edge technology and multi-disciplinary hand-in-glove, the exploitation of 3D printing technique have become current most popular new One of technology.3D printing future wide application prospect will be presented in field of orthopaedics, and its basic reason is just the spy of 3D printing Point meets the particular/special requirement of orthopaedics.One, bone tissue are the Typical Representatives of labyrinth, and existing bionics techniques is difficult to replicate Its distinctive three-dimensional configuration and physiological function.And 3D printing is just being adapted to the quick manufacture of labyrinth, approximate ideal can be obtained Bone renovating material；Secondly, the individual specificity of height be present due to human body, tradition is extensive, the medical product of mass production Can not meet personalization needs, and produced in the past by manufacturing process such as moulds personalization, customed product into This height, cycle length.As digitized image technology is in the extensive use of medical field, bone is to be easiest to obtain precision digitization The organ of image, it is combined with 3D printing, the medical product of personalization can be produced accurately and fast, at low cost；Cause This, by 3D printing technique, the short time " can cast " the implants product for going out random appearance, preferable biomechanical strength, Make individuation, customize bone implantation product and be developed into reality.

As depicted in figs. 1 and 2, the first screw hole 111 is provided with first end 11, the first screw hole 111 is taper hole, the The first nail seat is provided with one screw hole 111, the first nail seat has spherical inside surface.When doctor needs to pass through reparation main body 10 When screw is fixed on rumpbone 1, screw is penetrated into the first screw hole 111 first, because the first screw hole 111 is taper hole, screw Head be bulb, the first nail seat has the spherical inside surface coordinated with bulb, therefore screw can rotate within the specific limits, Doctor can hammer into direction according to actual conditions selection screw.Said structure enables the surgeon to choose spiral shell according to actual conditions Follow closely fixed position so that the fixed effect between reparation main body and rumpbone 1 is more preferably.It should be noted that the dotted line in Fig. 1 is spiral shell The direction hammered into.Similarly, it is provided with the second screw hole 121 on the second end 12, the second screw hole 121 is taper hole, the second spiral shell The second nail seat is provided with nail 121, there is the second nail seat spherical inside surface said structure to enable the surgeon to according to actual feelings Condition chooses screw fixed position so that the fixed effect between reparation main body and acetabular bone 2 is more preferably.

In the present embodiment, first end 11 is provided with the first loose structure (not shown).Said structure can be very Facilitate osteocyte to generate soon, be easy to be integrated with sclerotin (rumpbone), so as to reach the fixed effect of medium-long term.With traditional operation Pattern is compared, and has the advantages of high intensity, high stability, strong Integrated implant ability.

In the present embodiment, the second end 12 is provided with the second loose structure (not shown).Said structure can be very Facilitate osteocyte to generate soon, be easy to be integrated with sclerotin (acetabular bone), so as to reach the fixed effect of medium-long term.With traditional operation Pattern is compared, and has the advantages of high intensity, high stability, strong Integrated implant ability.In addition, in the arc long side face of the second end 12 On be provided with muscle ligament fixing hole.

In the present embodiment, first end 11 is provided with the first needle-like projection (not shown).Above-mentioned first needle-like is convex Play a part of with cuttage grappling, so that rumpbone 1 is fixed together with repairing the first end 11 of main body 10.

In the present embodiment, the second end 12 is provided with the second needle-like projection (not shown).Above-mentioned second needle-like is convex Play a part of with cuttage grappling, so that acetabular bone 2 is fixed together with repairing the second end 12 of main body 10.

In the present embodiment, repair main body 10 towards the surface of pelvic cavity be smooth surface (not shown).Said structure Contusion of the ilium dummy to soft tissues such as enteron aisles in pelvic cavity can be reduced, and then the soft tissues such as enteron aisle in the pelvic cavity of patient are risen To certain protective effect.

As shown in Figure 7 and Figure 8, in the present embodiment, escapement 30 also includes anticreep main body 32, the sandwiched of anticreep main body 32 Repairing between main body and connecting seat 22, escapement 30 also includes the second anticreep feeler 33, the first anticreep feeler 31 and the Two anticreep feelers 33 are connected and stretched out with anticreep main body 32, are provided with what is coordinated with barred body 23 on the second anticreep feeler 33 Stop collar 34.Preferably, the first anticreep feeler 31 is multiple with the cooperation of the first screw hole 111.Because multiple first anticreeps touch Angle 31 is extended out in the first screw hole 111, and anticreep main body 32 is folded in and repaired between main body and connecting seat 22, therefore anti- Release mechanism 30, which is limited, to be rotated.Again due to being provided with stop collar 34, stop collar 34 and barred body 23 on the second anticreep feeler 33 Coordinate, therefore barred body 23 is also limited and can not rotated.Said structure avoids barred body 23 from rotating, so as to add the stabilization of system Property.

Preferably, escapement 30 is spring leaf, and the tail end of the second anticreep feeler 33 of spring leaf is upturned, stop collar 34 are arranged on the tail end of the second anticreep feeler 33.

The preferred embodiments of the present invention are the foregoing is only, are not intended to limit the invention, for the skill of this area For art personnel, the present invention can have various modifications and variations.Within the spirit and principles of the invention, that is made any repaiies Change, equivalent substitution, improvement etc., should be included in the scope of the protection.

Claims

A kind of 1. ilium dummy, it is characterised in that including：

Main body (10), described reparation main body (10) domed structure are repaired, the reparation main body (10) includes contacting with rumpbone (1) The first end (11) of cooperation and the second end (12) being engaged with acetabular bone (2), set on the first end (11) There is the first screw hole (111), first screw hole (111) is taper hole, and the first nail is provided with first screw hole (111) Seat, first nail seat have spherical inside surface；

Rod structure is followed closely, the nail rod structure includes connecting seat (22) and barred body (23), the connecting seat (22) and the reparation Main body (10) is connected, and the barred body (23) is fixed on the connecting seat (22)；

Escapement (30), the escapement (30) are folded between the reparation main body (10) and the connecting seat (22), The escapement (30) includes and the first anticreep feeler of the screw fit being contained in first screw hole (111) (31), the escapement (30) also includes anticreep main body (32), and the anticreep main body (32) is folded in the reparation main body (10) between the connecting seat (22), the escapement (30) also includes the second anticreep feeler (33), first anticreep Feeler (31) and the second anticreep feeler (33) are connected and stretched out with the anticreep main body (32), and described second is anti- The stop collar (34) coordinated with the barred body (23) is provided with de- feeler (33).
2. ilium dummy according to claim 1, it is characterised in that the connecting seat (22) includes：

Attachment screw (221), one end of the attachment screw (221) are connected with the reparation main body (10), the attachment screw (221) the other end has spherical ailhead (2211)；

Barred body fixed part (222), to the fixation barred body (23), one end of the barred body fixed part (222) have with it is described The spherical pore that spherical ailhead (2211) is engaged, so that the barred body fixed part (222) can be rotatably set in the connection spiral shell Follow closely on (221).
3. ilium dummy according to claim 2, it is characterised in that the barred body fixed part (222) includes U-shaped bearing (2221) and locking cap (2222), the barred body (23) be folded in the U-shaped bearing (2221) and the locking cap (2222) it Between.
4. ilium dummy according to claim 1, it is characterised in that the reparation main body (10) is hollow truss knot Structure, the reparation main body (10) are molded by 3D printing.
5. ilium dummy according to claim 1, it is characterised in that be provided with the second spiral shell on the second end (12) Nail (121), second screw hole (121) are taper hole, and the second nail seat is provided with second screw hole (121), described Second nail seat has spherical inside surface.
6. ilium dummy according to claim 1, it is characterised in that the first end (11) and/or described second End (12) is provided with loose structure.
7. ilium dummy according to claim 1, it is characterised in that the first end (11) and/or described second End (12) is provided with needle-like projection.
8. ilium dummy according to claim 1, it is characterised in that the main body (10) of repairing is towards the surface of pelvic cavity For smooth surface.