CN106264794B - Combined prosthesis for sternal reconstruction - Google Patents
Combined prosthesis for sternal reconstruction Download PDFInfo
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- CN106264794B CN106264794B CN201610612197.3A CN201610612197A CN106264794B CN 106264794 B CN106264794 B CN 106264794B CN 201610612197 A CN201610612197 A CN 201610612197A CN 106264794 B CN106264794 B CN 106264794B
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- sternal
- block
- sternum
- plate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
Abstract
The combined prosthesis for sternal reconstruction comprises at least two sternal blocks, wherein a left rib clamp and a right rib clamp are arranged on each sternal block, an inserting opening is formed in the middle of the lower side of each sternal block, a connecting lug which can be embedded into the inserting opening and matched with the inserting opening is arranged in the middle of the upper side of each sternal block, the connecting lugs of the lower side of each adjacent two sternal blocks are embedded into the inserting opening of the upper side sternal block, connecting fixing devices which are matched with each other are arranged at the connecting lugs and the inserting openings of the adjacent two sternal blocks, a sternal lock joint block or an upper sternal fixing block is arranged on the uppermost sternal block, and a lower sternal end block or a lower sternal fixing block is arranged on the lowermost sternal block; the invention provides the functions of transverse supporting force, longitudinal supporting and limiting to the thoracic cavity, and has good protective effect on thoracic organs such as thoracic cavity, heart, lung and the like; the size, shape and installation position of each component unit can be adjusted at any time according to the individual differences of patients and the operation condition, so that the operation is time-saving and labor-saving, and the operation effect is good.
Description
Technical Field
The invention relates to the technical field of artificial prostheses, in particular to a combined type prosthesis for sternal reconstruction, which can provide transverse supporting force and longitudinal supporting force, has good chest decompression effect, good organ protection effect in the chest, simple operation, time and labor saving and good postoperative rehabilitation effect.
Background
It is known that sternectomy reconstruction is a common technique after sternal tumor resection, and in order to protect organs in the chest cavity, a sternal reconstruction method, namely a sandwich method, is used, and the method is widely applied in large-area defects, usually, a polypropylene fiber (Marlex Mesh) or polypropylene textile fiber (Prolene) patch is sewn on the inner side surface of the residual sternum and ribs in a first layer, the rib cage rigidity reconstruction is completed in a second layer, methyl polypropylene methyl ester (used in early stage, hard to shape and fix in operation because of rigidity, less used in current use), a stainless steel Mesh/titanium Mesh and a titanium plate reconstruct rigid rib cage, and soft tissue coverage is completed in a third layer.
The existing prosthesis for completing the reconstruction of the rigidity of the chest comprises a connecting plate and a plurality of rib clamps, wherein the rib clamps have the following structures: the rib claw connected with the rib is arranged at one end of the connecting rod, and the other end of the connecting rod is connected with the connecting plate. After the prosthesis is implanted into a human body, only transverse supporting force is provided, no longitudinal supporting and limiting functions are provided, the decompression effect on the thoracic cavity is poor, and the protection effect on thoracic organs such as heart is poor; the size of the connecting plate and the connection position of the connecting rod and the connecting plate are fixed, the size of each sternum can not be adjusted at any time according to the difference between individuals and the size difference of each sternum, the operation is time-consuming and labor-consuming, and the postoperative rehabilitation effect is poor.
Disclosure of Invention
The invention aims to solve the defects of the prior art, and provides the combined type prosthesis for sternal reconstruction, which can provide transverse supporting force and longitudinal supporting force, has good chest decompression effect, good organ protection effect in the chest, simple operation, time and labor saving and good postoperative rehabilitation effect.
The combined prosthesis for sternal reconstruction is characterized by comprising at least two sternal blocks, wherein a left rib clamp and a right rib clamp are arranged on each sternal block, an inserting opening is formed in the middle of the lower side of each sternal block, a connecting lug which can be embedded into the inserting opening and matched with the inserting opening is formed in the middle of the upper side of each sternal block, the connecting lugs of the lower side of each adjacent two sternal blocks are embedded into the inserting opening of the upper side of each sternal block, a connecting fixing device which is matched with each other is arranged at the connecting lug and the inserting opening of each adjacent two sternal blocks, a sternal lock joint block or a sternal upper fixing block is arranged on the uppermost sternal block, and a sternal lower end block or a sternal lower fixing block is arranged on the lowermost sternal block; wherein, the structure that is equipped with chest lock joint piece on the topside sternum piece does: the chest lock joint block comprises a chest lock plate, the middle part of the lower side of the chest lock plate is provided with an inserting port matched with a connecting lug on the upper side of the sternum block, the chest lock plate is provided with a left clavicle connecting rod and a right clavicle connecting rod connected with the clavicle, the connecting lug of the uppermost sternum block is embedded into the inserting port of the chest lock plate, and the inserting port of the chest lock plate and the connecting lug of the uppermost sternum block are provided with mutually matched connecting and fixing devices; the structure of the upper sternum fixing block arranged on the uppermost sternum block is as follows: the upper sternum fixing block comprises an upper fixing plate, the middle part of the lower side of the upper fixing plate is provided with an inserting opening matched with the connecting convex block on the upper side of the sternum block, the middle part of the upper side of the upper fixing plate is provided with a sternum connecting plate connected with the sternum, the sternum connecting plate is provided with a connecting screw hole, the connecting convex block of the uppermost sternum block is embedded into the inserting opening of the upper fixing plate, and the inserting opening of the upper fixing plate and the connecting convex block of the uppermost sternum block are provided with connecting fixing devices matched with each other; the structure of the lower sternum end block arranged on the lowest sternum block is as follows: the lower sternal end block comprises a lower sternal end plate, a connecting lug matched with the insertion opening at the lower side of the lower sternal end plate is arranged in the middle of the upper side of the lower sternal end plate, four rib clamps connected with the 6 th rib and the 7 th rib are arranged on the lower sternal end plate, the connecting lug of the lower sternal end plate is embedded into the insertion opening at the lowest side of the lower sternal end plate, and a connecting and fixing device matched with each other is arranged at the insertion opening of the lowest side of the lower sternal end plate and on the connecting lug of the lower sternal end plate; the structure of the substernal fixed block arranged on the lowest substernal sternal block is as follows: the lower sternum fixing block comprises a lower fixing plate, a connecting lug matched with the insertion opening at the lower side of the sternum block is arranged in the middle of the upper side of the lower fixing plate, a sternum connecting plate connected with the sternum is arranged in the middle of the lower side of the lower fixing plate, a connecting screw hole is formed in the sternum connecting plate, the connecting lug of the lower fixing plate is embedded into the insertion opening of the lowermost sternum block, and a connecting fixing device matched with each other is arranged at the insertion opening of the lowermost sternum block and on the connecting lug of the lower fixing plate.
The connecting and fixing device provided by the invention comprises the following components: the connecting convex blocks and the inserting openings of the two prosthesis units which are connected with each other are dovetail-shaped, two opposite connecting holes are arranged on the connecting convex blocks and the inserting openings of the two prosthesis units, and connecting bolts are arranged in the two connecting holes. The connecting bolt is U-shaped, two arms of the U-shaped connecting bolt are respectively inserted into two opposite connecting holes at the connecting convex blocks and the inserting ports of the two prosthesis units which are mutually embedded and connected, the function of fixedly connecting the two prosthesis units is achieved, the connecting operation is simple and convenient, the dovetail-shaped connecting convex blocks and the inserting ports play a role of longitudinal positioning, no radial shearing is caused to the connecting bolt, and the connecting bolt is safe to use and long in service life.
The connecting and fixing device provided by the invention comprises the following components: the connecting lug and the inserting opening of the two prosthesis units which are connected with each other are dovetail-shaped, a limit bottom plate is arranged on the rear side face of the inserting opening, rivet holes are respectively formed in the prosthesis units on two sides of the inserting opening, a big head rivet is arranged in each rivet hole, and one side of the head of the big head rivet is pressed on the front side face of the connecting lug. During installation, the connecting lug of the prosthesis unit is installed in the inserting opening from the front side surface of the inserting opening, the rear side surface of the connecting lug is contacted with the limiting bottom plate and positioned, the large-head rivet is riveted on the rivet hole, the head one side pressure of the large-head rivet is enabled to be on the front side surface of the connecting lug, the connecting lug is limited to be incapable of being separated from the front side of the inserting opening, the connecting operation is simple and convenient, the dovetail-shaped connecting lug and the inserting opening play a longitudinal positioning role, the stress of the large-head rivet is slight or almost no, and the large-head rivet is safe to use and long in service life.
The connecting and fixing device provided by the invention comprises the following components: the connecting convex blocks and the inserting ports of the two prosthesis units which are connected with each other are mutually matched rectangular, the rear side surfaces of the inserting ports are provided with limiting bottom plates, the rear parts of the two sides of the connecting convex blocks are provided with inserting clamping strips, and the rear parts of the inner walls of the two sides of the inserting ports are provided with inserting sliding ways matched with the inserting clamping strips; the connection lug is provided with a jacking screw hole, and a jacking screw is arranged in the jacking screw hole. Further improved, a positioning groove is arranged on the limiting bottom plate at the position opposite to the jacking screw. When the connecting lug is used, the connecting lug is upwards inserted into the inserting opening from the opening at the lower side of the inserting opening, the inserting clamping strip is clamped in the inserting slideway, the connecting lug is limited to longitudinally slide along the inserting clamping strip, the limiting bottom plate limits the connecting lug to move backwards, the connecting lug is limited to move forwards by the mutual matching of the inserting clamping strip and the positioning groove, and the jacking screw applies front and back jacking force to the connecting lug to compress the connecting lug in the inserting opening. The end part of the jacking screw is embedded into the positioning groove, and the connecting convex block is positioned so that the jacking screw cannot slide up and down. Simple structure, firm in connection, easy operation is convenient.
The invention discloses a collarbone connecting rod which is a locking intramedullary nail, wherein an angle positioning tooth is arranged on the rear end of the locking intramedullary nail, an intramedullary nail connecting hole is arranged at the rear part of the locking intramedullary nail, intramedullary nail mounting grooves are respectively arranged at the left side and the right side of the upper part of a chest locking plate, groove bottom connecting holes matched with the intramedullary nail connecting holes are arranged at the bottom of the intramedullary nail mounting grooves, at least two positioning tooth grooves matched with the angle positioning tooth are distributed on the side wall of the intramedullary nail mounting grooves in an arc shape, the rear end part of the locking intramedullary nail is arranged in the intramedullary nail mounting grooves, the angle positioning tooth is meshed with the positioning tooth grooves, and connecting bolts are arranged in the intramedullary nail connecting holes and the groove bottom connecting holes. The front end of the bone marrow locking needle is provided with a puncture tip. When the locking intramedullary nail is used, the angle between the locking intramedullary nail and the chest locking plate is adjusted according to the actual operation condition, then the rear end of the locking intramedullary nail is arranged in the intramedullary nail mounting groove, the angle positioning teeth are meshed with the corresponding positioning tooth grooves, the mounting angle between the locking intramedullary nail and the chest locking plate is positioned, and finally the locking intramedullary nail and the chest locking plate are fixedly connected by penetrating the connecting bolt into the opposite intramedullary nail connecting hole and the groove bottom connecting hole; the connecting bolt can be a rivet or other connecting pieces such as a bolt. The angle between the intramedullary needle and the chest lock plate can be adjusted according to individual differences and operation needs, thereby being more beneficial to operation and having good operation effect.
The rib clamp comprises a connecting rod, wherein the front end part of the connecting rod is provided with rib claws for connecting with ribs, and the rear end part of the connecting rod is connected with a prosthesis unit through a connecting bolt.
The invention discloses a connecting rod, which is characterized in that an angle positioning tooth is arranged on the rear end of the connecting rod, a connecting rod connecting hole is arranged at the rear end of the connecting rod, connecting rod installation grooves (with open outer sides) are respectively arranged on the left side and the right side of the prosthesis unit, a groove bottom connecting hole matched with the connecting rod connecting hole is arranged at the bottom of the connecting rod installation groove, at least two positioning tooth grooves matched with the angle positioning tooth are arranged on the side wall of the connecting rod installation groove in an arc shape, the rear end of the connecting rod is arranged in an intramedullary needle installation groove, the angle positioning tooth is meshed with the positioning tooth groove, and connecting bolts are arranged in the connecting rod connecting hole and the groove bottom connecting hole. The connecting bolt is a connecting piece such as a rivet or a screw. The angle between the connecting rod and the prosthesis unit can be adjusted according to individual differences of patients and actual conditions in operation. The operation is simple and convenient, and the operation effect is good.
The front end part of the connecting rod is bent upwards by 10-30 degrees, and rib claws are arranged at the upward bending position of the front end part of the connecting rod. The shape and the size of the rib clip connecting rod can be selected according to individual differences of patients and actual conditions in operation.
The substernal endplate and the connecting convex blocks on the substernal endplate form an included angle of 140-170 degrees. After the connection with the rib claw, the shape requirement of the prosthesis implantation is met, the connection between the rib claw and the 6 th and 7 th ribs is more suitable, the connection is simple and convenient, and the time and the labor are saved.
The prosthesis unit is a sternum block or a sternal lock joint block or an upper sternum fixing block or a lower sternum end block or a lower sternum fixing block.
When the invention is used, the prosthesis units, rib clamps, collarbone connecting rods and the like which are needed to be used, such as the chest sternum block, the chest lock joint block, the upper sternum fixing block, the lower sternum end block, the lower sternum fixing block and the like which are matched are selected according to the actual physical condition and the needs of a patient, are combined and connected, and the prosthesis for sternal reconstruction which meets the individual needs of the patient is assembled. The combined prosthesis can quickly replace a certain component unit in the operation process due to structural reasons, and is suitable for emergency events in the operation and unpredictability of the operation. The invention provides the functions of transverse supporting force, longitudinal supporting and limiting to the thoracic cavity, has good decompression effect to the thoracic cavity and good protection effect to thoracic organs such as heart, lung and the like; the size, shape and installation position of each component unit can be adjusted at any time according to the individual differences of patients and the operation condition, so that the operation is time-saving and labor-saving, and the operation effect is good.
Drawings
Fig. 1, 2, 3 and 4 are schematic structural views of the present invention, wherein fig. 1 is a prosthesis for reconstruction after total sternal resection, fig. 2 is a prosthesis for reconstruction after lower sternal resection, fig. 3 is a prosthesis for reconstruction after upper sternal resection, and fig. 4 is a prosthesis for reconstruction after middle sternal resection.
Fig. 5 is a schematic structural view of the chest lock plate according to the present invention.
FIG. 6 is a schematic view showing the structure of the locking intramedullary pin according to the present invention.
Fig. 7 is a schematic view of a first construction of two interconnected sternal blocks according to the invention.
Fig. 8 is a schematic view of a second construction of two interconnected sternal blocks according to the invention.
Fig. 9 is a schematic view of a third construction of two interconnected sternal blocks according to the invention.
FIG. 10 is a schematic view of a rib clip according to the present invention.
FIG. 11 is a schematic view of another embodiment of a rib clip of the present invention.
Detailed Description
The combined prosthesis for sternal reconstruction shown in fig. 1-11 comprises at least two sternum blocks 4, wherein a left rib clip and a right rib clip are arranged on each sternum block 4, each rib clip comprises a connecting rod 2, a rib claw 6 for connecting ribs is arranged at the front end part of each connecting rod 2, and the rear end part of each connecting rod 2 is connected with the sternum block through a connecting bolt. The middle part of the lower side of the sternum block 4 is provided with an inserting opening, the middle part of the upper side of the sternum block 4 is provided with an inserting opening which can be embedded into the adjacent sternum block or the positioning block and a connecting lug 16 matched with the inserting opening, the adjacent two sternum blocks are connected through the connecting lug and the inserting opening, the connecting lug of the lower side sternum block in the adjacent two sternum blocks is embedded into the inserting opening of the upper side sternum block, and the connecting lug and the inserting opening of the adjacent two sternum blocks are provided with mutually matched and detachable connecting and fixing devices, and the connecting and fixing devices shown in fig. 7 are as follows: the connecting convex blocks and the inserting ports 18 of the two mutually connected sternum blocks are in a dovetail shape with big upper part and small lower part and embedded and matched, two opposite connecting holes are arranged on the connecting convex blocks 16 and the inserting ports 18 of the two sternum blocks, and connecting bolts 17 are arranged in the two connecting holes; the connecting bolt is U-shaped, and two arms of the U-shaped connecting bolt are respectively inserted into two opposite connecting holes at the connecting convex blocks and the inserting and closing ports of two sternum blocks which are mutually embedded and connected, so that the function of fixedly connecting two prosthesis units is achieved, the connecting operation is simple and convenient, the dovetail-shaped connecting convex blocks and the inserting and closing ports play a role of longitudinal positioning, no radial shearing is caused to the connecting bolt, and the connecting bolt is safe to use and long in service life. The connection fixing device as shown in fig. 8 is: the connecting convex blocks 16 and the inserting openings of the two mutually connected sternum blocks are in a dovetail shape with big upper part and small lower part and embedded and matched, the rear side surfaces of the inserting openings are provided with limiting bottom plates 20, the sternum blocks at the two sides of the inserting openings are respectively provided with rivet holes, big head rivets 19 are arranged in the rivet holes, and one side of the head of each big head rivet 19 is pressed on the front side surfaces of the connecting convex blocks; during installation, the connection lug of the sternum block is installed in the insertion opening from the front side surface of the insertion opening, the rear side surface of the connection lug is contacted with the limiting bottom plate and positioned, the large-head rivet is riveted on the rivet hole, one side of the head of the large-head rivet is pressed on the front side surface of the connection lug, the connection lug is limited to be unable to deviate from the front side of the insertion opening, the connection operation is simple and convenient, the dovetail-shaped connection lug and the insertion opening play a longitudinal positioning role, the large-head rivet is lightly stressed or hardly stressed, and the large-head rivet is safe to use and long in service life. The connection fixing device as shown in fig. 9 is: the connecting convex blocks and the inserting ports of the two mutually connected sternum blocks are in a rectangle shape which is mutually inserted and matched, a limit bottom plate is arranged on the rear side surface of the inserting port, inserting clamping strips are arranged at the rear parts of the two sides of the connecting convex blocks, and inserting sliding ways matched with the inserting clamping strips are arranged at the rear parts of the inner walls of the two sides of the inserting port; the connection lug is provided with a jacking screw hole, and a jacking screw 21 is arranged in the jacking screw hole; further improvement, a positioning groove 22 is arranged on the limiting bottom plate at the position opposite to the jacking screw; when the connecting lug is used, the connecting lug is upwards inserted into the inserting opening from the opening at the lower side of the inserting opening, the inserting clamping strip is clamped in the inserting slideway, the connecting lug is limited to longitudinally slide along the inserting clamping strip, the limiting bottom plate limits the connecting lug to move backwards, the connecting lug is limited to move forwards by the mutual matching of the inserting clamping strip and the positioning groove, and the jacking screw applies front and back jacking force to the connecting lug to compress the connecting lug in the inserting opening. The end part of the jacking screw is embedded into the positioning groove, and the connecting convex block is positioned so that the jacking screw cannot slide up and down. Simple structure, firm in connection, easy operation is convenient. The uppermost sternum block is provided with a sternal lock joint block 3 or an upper sternal fixing block, and the lowermost sternum block is provided with a lower sternal end block or a lower sternal fixing block; wherein, the structure that is equipped with chest lock joint piece on the topside sternum piece does: the chest lock joint block comprises a chest lock plate 3, an inserting opening 10 matched with a connecting lug on the upper side of the sternum block is formed in the middle of the lower side of the chest lock plate 3, two left and right collarbone connecting rods connected with collarbone are arranged on the chest lock plate 3, a connecting lug 16 of the uppermost sternum block is embedded into the inserting opening 10 of the chest lock plate, mutually matched and detachable connecting fixing devices are arranged at the inserting opening of the chest lock plate and the connecting lug of the uppermost sternum block, and the connecting fixing devices are any one of the connecting fixing devices shown in figures 7, 8 and 9. The structure of the upper sternum fixing block arranged on the uppermost sternum block is as follows: the upper sternum fixing block comprises an upper fixing plate 9, an inserting opening matched with a connecting lug 16 on the upper side of the sternum block is formed in the middle of the lower side of the upper fixing plate 9, a sternum connecting plate connected with the sternum is arranged in the middle of the upper side of the upper fixing plate 9, a connecting screw hole is formed in the sternum connecting plate, the connecting lug of the uppermost sternum block is embedded into the inserting opening of the upper fixing plate, mutually matched and detachable connecting fixing devices are arranged at the inserting opening of the upper fixing plate and the connecting lug of the uppermost sternum block, and the connecting fixing devices are any one of the connecting fixing devices shown in fig. 7, 8 and 9. The structure of the lower sternum end block arranged on the lowest sternum block is as follows: the lower sternum end block comprises a lower sternum end plate 7, a connecting lug matched with an insertion opening at the lower side of the lower sternum end plate 7 is arranged in the middle of the upper side of the lower sternum end plate 7, four rib clamps connected with the 6 th rib and the 7 th rib are arranged on the lower sternum end plate, the connecting lug of the lower sternum end plate 7 is embedded into the insertion opening of the lowest sternum block, mutually matched and detachable connecting and fixing devices are arranged at the insertion opening of the lowest sternum block and the connecting lug of the lower sternum end plate, and the connecting and fixing devices are any one of the connecting and fixing devices shown in figures 7, 8 and 9; the structure of the substernal fixed block arranged on the lowest substernal sternal block is as follows: the lower sternum fixing block comprises a lower fixing plate 8, a connecting lug matched with the inserting opening at the lower side of the sternum block is arranged in the middle of the upper side of the lower fixing plate 8, a sternum connecting plate connected with the sternum is arranged in the middle of the lower side of the lower fixing plate, a connecting screw hole is formed in the sternum connecting plate, the connecting lug of the lower fixing plate is embedded into the inserting opening of the lowermost sternum block, mutually matched and detachable connecting fixing devices are arranged at the inserting opening of the lowermost sternum block and the connecting lug of the lower fixing plate, and the connecting fixing devices are any one of the connecting fixing devices shown in figures 7, 8 and 9.
The invention is further improved, and the clavicle connecting rod is a clavicle intramedullary pin 5; as shown in fig. 5 and 6, an angle positioning tooth 14 is arranged on the rear end of the locking intramedullary nail 5, an intramedullary nail connecting hole 15 is arranged on the rear part of the locking intramedullary nail 5, intramedullary nail mounting grooves 11 with open outer sides are respectively arranged on the left side and the right side of the upper part of the chest locking plate 3, groove bottom connecting holes 13 matched with the intramedullary nail connecting holes are arranged at the bottom of the intramedullary nail mounting grooves 11, at least two positioning tooth grooves 12 matched with the angle positioning tooth 14 are distributed on the side wall of the intramedullary nail mounting grooves 11 in an arc shape, the rear end part of the locking intramedullary nail is arranged in the intramedullary nail mounting grooves 11, the angle positioning tooth 14 is meshed with the positioning tooth grooves 12, and connecting bolts are arranged in the intramedullary nail connecting holes 15 and the groove bottom connecting holes 13. The front end of the bone marrow locking needle is provided with a puncture tip. When the locking intramedullary nail is used, the angle between the locking intramedullary nail and the chest locking plate is adjusted according to the actual operation condition, then the rear end of the locking intramedullary nail is arranged in the intramedullary nail mounting groove, the angle positioning teeth are meshed with the corresponding positioning tooth grooves, the mounting angle between the locking intramedullary nail and the chest locking plate is positioned, and finally the locking intramedullary nail and the chest locking plate are fixedly connected by penetrating the connecting bolt into the opposite intramedullary nail connecting hole and the groove bottom connecting hole; the connecting bolt can be a rivet or other connecting pieces such as a bolt. The angle between the intramedullary needle and the chest lock plate can be adjusted according to individual differences and operation needs, thereby being more beneficial to operation and having good operation effect.
The rib clamp is further improved, the rear end of the connecting rod is provided with angle positioning teeth, the rear end of the connecting rod is provided with connecting rod connecting holes, the left side and the right side of the prosthesis unit are respectively provided with connecting rod installation grooves with open outer sides, the bottoms of the connecting rod installation grooves are provided with groove bottom connecting holes matched with the connecting rod connecting holes, the side walls of the connecting rod installation grooves are provided with at least two positioning tooth grooves matched with the angle positioning teeth in an arc shape, the rear end of the connecting rod is arranged in the intramedullary needle installation groove, the angle positioning teeth are meshed with the positioning tooth grooves, and connecting bolts are arranged in the connecting rod connecting holes and the groove bottom connecting holes. The connecting bolt is a connecting piece such as a rivet or a screw. The angle between the connecting rod and the prosthesis unit can be adjusted according to individual differences of patients and actual conditions in operation. The operation is simple and convenient, and the operation effect is good. The rib claw at the front end of the link as shown in fig. 11 is bent upward by 10 to 30 degrees, namely: the included angle between the middle line of the unbent connecting rod and the middle line of the rib claw at the bending part is 10-30 degrees; the shape and the size of the rib clip connecting rod can be selected according to individual differences of patients and actual conditions in operation.
The substernal endplate and the connecting convex blocks on the substernal endplate form an included angle of 140-170 degrees. After the connection with the rib claw, the shape requirement of the prosthesis implantation is met, the connection between the rib claw and the 6 th and 7 th ribs is more suitable, the connection is simple and convenient, and the time and the labor are saved.
The prosthesis unit is a sternum block or a sternal lock joint block or an upper sternum fixing block or a lower sternum end block or a lower sternum fixing block.
When the invention is used, the prosthesis units, rib clamps, collarbone connecting rods and the like which are needed to be used, such as the chest sternum block, the chest lock joint block, the upper sternum fixing block, the lower sternum end block, the lower sternum fixing block and the like which are matched are selected according to the actual physical condition and the needs of a patient, are combined and connected, and the prosthesis for sternal reconstruction which meets the individual needs of the patient is assembled. Each prosthesis unit adopts a modularized design, is suitable for patients with different sizes and different excision ranges through the splicing of the universal modules, does not need to customize the prosthesis for each patient, saves the prosthesis manufacturing time and saves the cost. The combined prosthesis can quickly replace a certain component unit in the operation process due to structural reasons, and is suitable for emergency events in the operation and unpredictability of the operation. The invention provides the functions of transverse supporting force, longitudinal supporting and limiting to the thoracic cavity, has good decompression effect to the thoracic cavity and good protection effect to thoracic organs such as heart, lung and the like; the size, shape and installation position of each component unit can be adjusted at any time according to the individual differences of patients and the operation condition, so that the operation is time-saving and labor-saving, and the operation effect is good.
Claims (8)
1. The combined prosthesis for sternal reconstruction is characterized by comprising at least two sternal blocks, wherein a left rib clamp and a right rib clamp are arranged on each sternal block, an inserting opening is formed in the middle of the lower side of each sternal block, a connecting lug which can be embedded into the inserting opening and matched with the inserting opening is formed in the middle of the upper side of each sternal block, the connecting lugs of the lower side of each adjacent two sternal blocks are embedded into the inserting opening of the upper side of each sternal block, a connecting fixing device which is matched with each other is arranged at the connecting lug and the inserting opening of each adjacent two sternal blocks, a sternal lock joint block or a sternal upper fixing block is arranged on the uppermost sternal block, and a sternal lower end block or a sternal lower fixing block is arranged on the lowermost sternal block; wherein, the structure that is equipped with chest lock joint piece on the topside sternum piece does: the chest lock joint block comprises a chest lock plate, the middle part of the lower side of the chest lock plate is provided with an inserting port matched with a connecting lug on the upper side of the sternum block, the chest lock plate is provided with a left clavicle connecting rod and a right clavicle connecting rod connected with the clavicle, the connecting lug of the uppermost sternum block is embedded into the inserting port of the chest lock plate, and the inserting port of the chest lock plate and the connecting lug of the uppermost sternum block are provided with mutually matched connecting and fixing devices; the structure of the upper sternum fixing block arranged on the uppermost sternum block is as follows: the upper sternum fixing block comprises an upper fixing plate, the middle part of the lower side of the upper fixing plate is provided with an inserting opening matched with the connecting convex block on the upper side of the sternum block, the middle part of the upper side of the upper fixing plate is provided with a sternum connecting plate connected with the sternum, the sternum connecting plate is provided with a connecting screw hole, the connecting convex block of the uppermost sternum block is embedded into the inserting opening of the upper fixing plate, and the inserting opening of the upper fixing plate and the connecting convex block of the uppermost sternum block are provided with connecting fixing devices matched with each other; the structure of the lower sternum end block arranged on the lowest sternum block is as follows: the lower sternal end block comprises a lower sternal end plate, a connecting lug matched with the insertion opening at the lower side of the lower sternal end plate is arranged in the middle of the upper side of the lower sternal end plate, four rib clamps connected with the 6 th rib and the 7 th rib are arranged on the lower sternal end plate, the connecting lug of the lower sternal end plate is embedded into the insertion opening at the lowest side of the lower sternal end plate, and a connecting and fixing device matched with each other is arranged at the insertion opening of the lowest side of the lower sternal end plate and on the connecting lug of the lower sternal end plate; the structure of the substernal fixed block arranged on the lowest substernal sternal block is as follows: the lower sternum fixing block comprises a lower fixing plate, a connecting lug matched with the insertion opening at the lower side of the sternum block is arranged in the middle of the upper side of the lower fixing plate, a sternum connecting plate connected with the sternum is arranged in the middle of the lower side of the lower fixing plate, a connecting screw hole is formed in the sternum connecting plate, the connecting lug of the lower fixing plate is embedded into the insertion opening at the lowest side of the sternum block, and a connecting fixing device matched with each other is arranged at the insertion opening of the lowest side of the sternum block and the connecting lug of the lower fixing plate; the novel bone locking device is characterized in that the clavicle connecting rod is a bone locking intramedullary needle, an angle positioning tooth is arranged on the rear end of the bone locking intramedullary needle, an intramedullary needle connecting hole is formed in the rear portion of the bone locking intramedullary needle, intramedullary needle mounting grooves are formed in the left side and the right side of the upper portion of the chest locking plate respectively, groove bottom connecting holes matched with the intramedullary needle connecting holes are formed in the bottoms of the intramedullary needle mounting grooves, at least two positioning tooth grooves matched with the angle positioning tooth are formed in the side walls of the intramedullary needle mounting grooves in an arc shape, the rear end portion of the bone locking intramedullary needle is arranged in the intramedullary needle mounting grooves, the angle positioning tooth is meshed with the positioning tooth grooves, and connecting bolts are arranged in the intramedullary needle connecting holes and the groove bottom connecting holes.
2. The modular prosthesis for sternal reconstruction of claim 1, wherein the attachment and fixation means comprises: the connecting convex blocks and the inserting openings of the two prosthesis units which are connected with each other are dovetail-shaped, two opposite connecting holes are arranged on the connecting convex blocks and the inserting openings of the two prosthesis units, and connecting bolts are arranged in the two connecting holes.
3. The modular prosthesis for sternal reconstruction of claim 1, wherein the attachment and fixation means comprises: the connecting lug and the inserting opening of the two prosthesis units which are connected with each other are dovetail-shaped, a limit bottom plate is arranged on the rear side face of the inserting opening, rivet holes are respectively formed in the prosthesis units on two sides of the inserting opening, a big head rivet is arranged in each rivet hole, and one side of the head of the big head rivet is pressed on the front side face of the connecting lug.
4. The modular prosthesis for sternal reconstruction of claim 1, wherein the attachment and fixation means comprises: the connecting convex blocks and the inserting ports of the two prosthesis units which are connected with each other are mutually matched rectangular, the rear side surfaces of the inserting ports are provided with limiting bottom plates, the rear parts of the two sides of the connecting convex blocks are provided with inserting clamping strips, and the rear parts of the inner walls of the two sides of the inserting ports are provided with inserting sliding ways matched with the inserting clamping strips; the connection lug is provided with a jacking screw hole, and a jacking screw is arranged in the jacking screw hole.
5. The combined prosthesis for sternal reconstruction according to claim 2, 3 or 4, wherein the rib clip comprises a link, the front end of the link is provided with rib claws for connecting with ribs, and the rear end of the link is connected with the prosthesis unit via a connecting bolt.
6. The combined prosthesis for sternal reconstruction according to claim 5, wherein the rear end of the connecting rod is provided with angle positioning teeth, the rear end of the connecting rod is provided with connecting rod connecting holes, the left and right sides of the prosthesis unit are respectively provided with connecting rod mounting grooves, the bottoms of the connecting rod mounting grooves are provided with groove bottom connecting holes matched with the connecting rod connecting holes, the side walls of the connecting rod mounting grooves are provided with at least two positioning tooth grooves matched with the angle positioning teeth in an arc shape, the rear end of the connecting rod is arranged in the intramedullary pin mounting grooves, the angle positioning teeth are meshed with the positioning tooth grooves, and connecting bolts are arranged in the connecting rod connecting holes and the groove bottom connecting holes.
7. The modular prosthesis for sternal reconstruction of claim 5, wherein the front end portion of the connecting rod is bent upward by 10-30 degrees, and rib claws are provided at the upward bending portion of the front end portion of the connecting rod.
8. The combined prosthesis for sternal reconstruction of claim 5, wherein the connection projection of the lower sternal end plate and the upper side thereof form an angle of 140 ° -170 °.
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| CN201610612197.3A CN106264794B (en) | 2016-07-31 | 2016-07-31 | Combined prosthesis for sternal reconstruction |
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| CN201610612197.3A CN106264794B (en) | 2016-07-31 | 2016-07-31 | Combined prosthesis for sternal reconstruction |
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| US10543027B2 (en) | 2017-01-11 | 2020-01-28 | Zimmer Biomet CMF and Thoracic, LLC | Adjustable rib and sternal implant |
| CN107468383A (en) * | 2017-07-19 | 2017-12-15 | 北京爱康宜诚医疗器材有限公司 | Centrum prosthese |
| CO2017008458A1 (en) * | 2017-08-21 | 2017-08-31 | Conalmedicas S A S | Prosthetic device for reconstruction of the sternum, ribs and clavicles |
| CN108056844A (en) * | 2017-12-26 | 2018-05-22 | 云南大学 | A kind of multisection type 3D printing Artificial Rib with retractable structure |
| CN109077831A (en) * | 2018-10-23 | 2018-12-25 | 北京爱康宜诚医疗器材有限公司 | Breastbone prosthetic appliance |
| CN111513887B (en) * | 2020-04-28 | 2022-10-25 | 北京市春立正达医疗器械股份有限公司 | Sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion |
| IT202000013486A1 (en) * | 2020-06-08 | 2021-12-08 | Marco Ceccarelli | STERNUM PROSTHESIS DEVICE |
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| CN206350771U (en) * | 2016-07-31 | 2017-07-25 | 上海市肺科医院 | Sternal reconstruction modular hip implant |
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| US20050277939A1 (en) * | 2004-05-27 | 2005-12-15 | Miller Archibald S Iii | Surgical device for capturing, positioning and aligning portions of a horizontally severed human sternum |
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| CN201453359U (en) * | 2009-06-25 | 2010-05-12 | 杨立群 | Thoracic wall fixing system |
| FR2952522B1 (en) * | 2009-11-13 | 2012-04-27 | Neuro France Implants Nfi | DEVICE FOR RECOVERING AND STABILIZING A VERTEBRAL COLUMN |
| WO2016034778A1 (en) * | 2014-09-05 | 2016-03-10 | Neuro France Implants (Nfi) | Prosthetic sternum device |
| CN204428212U (en) * | 2015-01-09 | 2015-07-01 | 中南大学湘雅三医院 | A kind of artificial sternum's skeleton repaired for chest wall defect |
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| CN206350771U (en) * | 2016-07-31 | 2017-07-25 | 上海市肺科医院 | Sternal reconstruction modular hip implant |
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