CN107890383A - 颞颌关节分离帽及其固定方法 - Google Patents

颞颌关节分离帽及其固定方法 Download PDF

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CN107890383A
CN107890383A CN201711313798.5A CN201711313798A CN107890383A CN 107890383 A CN107890383 A CN 107890383A CN 201711313798 A CN201711313798 A CN 201711313798A CN 107890383 A CN107890383 A CN 107890383A
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temporomandibular joint
fixed
cap
joint
separation cap
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CN107890383B (zh
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潘留国
曾昙
江云超
毛惠清
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Shanghai Wu Jian Medical Equipment Co Ltd
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    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • 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
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • 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
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    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • 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
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
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    • A61F2002/30378—Spherically-shaped protrusion and recess
    • 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
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • A61F2002/30991—Mandibular components
    • 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
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • A61F2002/30993—Temporal components
    • 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
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4616—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of temporo-mandibular joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A61F2002/4641—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis for disconnecting

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Abstract

本发明公开了一种颞颌关节分离帽及其固定方法，其由分离帽头和固定柄两部分组成；固定柄设置于分离帽头下部并与分离帽头连接，分离帽头为开口向下的圆球型凹槽结构或椭圆球型凹槽结构，在固定柄上均匀设置有1～6个螺钉固定孔。本发明可以有效将颞肌关节窝和下颌关节分离开，不需要截除下颌关节头及下颌骨组织，手术创伤小，便于患者术后康复。由于本发明中颞颌关节分离的厚度仅有0.1mm～0.6mm，所以能够有效减少患者的不适，提升咬合关系的稳定性，克服了现有技术中颞颌关节需要永久植入，替代原有骨组织的状况。颞颌关节强直治愈后，可以考虑将本发明中的颞颌关节分离帽拆除，从而能够有效避免给患者造成永久性损伤。

Description

颞颌关节分离帽及其固定方法
技术领域
本发明属于人工关节技术领域，具体的说是涉及一种颞颌关节分离帽及其固定方法。
背景技术
颞下颌关节强直是一种常见的颌面部多发病，颌面部的外伤有时会伤及颞颌关节，造成关节突、关节突颈的骨折及关节内组织挫裂伤，如果恢复不佳，则易导致颞颌关节强直。病人表现为张口和咀嚼受限，关节杂音、咬合关系紊乱及功能障碍等，大多数情况还伴有面下部发育障碍造成的畸形，如面部不对称、小下颌等，严重影响患者的咀嚼、语言及面部轮廓等功能。
颞颌关节强直大多通过颌面外科手术来治疗。由于人工颞颌关节假体修复具有精确、不可吸收而不会粘连、恢复周期短等优点，人工关节得到了大量的普及。文献《钛制关节头置换髁状突治疗颞下颌关节骨性强直71例》（整容整形杂志 2004年9月第1卷第2期）通过钛制人工关节置换，可以有效防止颞颌关节的粘连和愈合，显著降低强直复发率。
中国实用新型专利CN 2902227 Y发明了标准化系列化的颌骨人工关节；中国发明专利CN 104546225 A提供了一种全颞下颌关节假体，改善了颞下颌关节的生物力学形态，更加符合中国人的颞下颌关节特征，减少术中对关节的磨削导致手术对颅底的损伤；中国发明专利CN 107157624 A提供一种能同期修复波及颅底、颧弓、颞下颌关节等大范围的缺损，更符合正常解剖形态和相对位置的颅底-颞下颌关节联合假体，不同部位不同材质实现最好效果，个性化的颅底部，颧弓部和关节窝部，以及髁突头部和关节柄分别为异种材料一体连接，使得假体更加稳定牢固，固定效果更好。
但是现有技术中的人工关节置换，无法避免的会存在截骨切除范围大、剥离范围广、术后侧咬合力明显小于健侧等缺陷，而且术后关节的稳定性差，少数患者还会出现术后感染等问题。
发明内容
本发明为了克服现有技术存在的不足，提供一种能够将颞颌关节分离开，防止颞颌关节粘连，甚至能够将颞颌关节愈合在一起的颞颌关节分离帽及其固定方法。
本发明是通过以下技术方案实现的：一种颞颌关节分离帽，由分离帽头和固定柄两部分组成；固定柄设置于分离帽头下部并与分离帽头连接，分离帽头为开口向下的圆球型凹槽结构或椭圆球型凹槽结构，在固定柄上均匀设置有1～6个螺钉固定孔。
分离帽头是凹槽结构为半球型、三分之一球型或四分之一球型的深度结构。固定柄上的螺钉固定孔是单排固定孔或双排固定孔,螺钉固定孔的直径为1.6～2.8mm，固定柄上的螺钉固定孔能够与直径为1.5～2.7mm的骨钉配合使用。
固定柄为平面固定柄或管状固定柄。分离帽头和固定柄一体成型。颞颌关节分离帽采用不能够被人体吸收的植入材料制成，植入材料为不锈钢、纯钛、钛合金或高分子材料。制做分离帽头和固定柄的植入材料的厚度为0.1mm～0.6mm。
本发明还公开了一种颞颌关节分离帽的固定方法，具体包括如下步骤：
第一步：将颞颌关节中的关节窝和下颌关节分离；
第二步：将颞颌关节分离帽的分离帽头固定套设在下颌关节的关节头上；
第三步：在颅颌面内固定钛钉：根据固定柄的长度及螺钉固定孔的数量，由上到下依次用钛钉将固定柄固定在髁状突或升支上，颞颌关节分离帽即固定完成。
本发明的有益效果是：本发明提供了一种能够将颞颌关节分离开，防止颞颌关节粘连，甚至能够将颞颌关节愈合在一起的颞颌关节分离帽，手术中将该颞颌关节分离帽正确固定在关节头上，通过颞颌关节分离帽隔离了关节头和关节窝之间的骨组织面，以防止其粘连结合而再次复发强直。
本发明中的颞颌关节分离帽与现有技术相比，可以有效将颞肌关节窝和下颌关节分离开，不需要截除下颌关节头及下颌骨组织，手术创伤小，便于患者术后康复。由于本发明中颞颌关节分离的厚度仅有0.1mm～0.6mm，所以能够有效减少患者的不适，提升咬合关系的稳定性，克服了现有技术中颞颌关节需要永久植入，替代原有骨组织的状况。颞颌关节强直治愈后，可以考虑将本发明中的颞颌关节分离帽拆除，从而能够有效避免给患者造成永久性损伤。
附图说明
图1是人体头部颞颌关节的骨关节结构示意图；
图2是本发明颞颌关节分离帽已经安装在下颌关节上的结构示意图；
图3是本发明颞颌关节分离帽的立体结构示意图；
图4是本发明颞颌关节分离帽的正面结构示意图；
图5是本发明颞颌关节分离帽的侧面结构示意图；
图中：1-关节窝；2-下颌关节；3-下颌体；4-分离帽头；5-固定柄；6-螺钉固定孔；7-钛钉。
具体实施方式
以下结合附图和具体实施方式对本发明作详细描述。
如图1至图5所示，一种颞颌关节分离帽，由分离帽头4和固定柄5两部分组成；固定柄5设置于分离帽头4下部并与分离帽头4连接，分离帽头4为开口向下的圆球型凹槽结构或椭圆球型凹槽结构，在固定柄5上均匀设置有1～6个螺钉固定孔6。
分离帽头4是凹槽结构为半球型、三分之一球型或四分之一球型的深度结构。固定柄5上的螺钉固定孔6是单排固定孔或双排固定孔,螺钉固定孔6的直径为1.6～2.8mm，固定柄5上的螺钉固定孔6能够与直径为1.5～2.7mm的骨钉配合使用。
固定柄5为平面固定柄5或管状固定柄5。分离帽头4和固定柄5一体成型。颞颌关节分离帽采用不能够被人体吸收的植入材料制成，植入材料为不锈钢、纯钛、钛合金或高分子材料。制做分离帽头4和固定柄5的植入材料的厚度为0.1mm～0.6mm。
图1为颞颌关节示意图，颞颌关节包括关节窝1、下颌关节2和下颌体3，颞颌关节强直症的本质为关节窝1和下颌关节2粘连融合造成。
本发明还公开了一种颞颌关节分离帽的固定方法，具体包括如下步骤：
第一步：将颞颌关节中的关节窝1和下颌关节2分离；
第二步：将颞颌关节分离帽的分离帽头4固定套设在下颌关节2的关节头上；
第三步：在颅颌面内固定钛钉7：根据固定柄5的长度及螺钉固定孔6的数量，由上到下依次用钛钉7将固定柄5固定在髁状突或升支上，颞颌关节分离帽即固定完成。
最后应当说明的是，以上内容仅用以说明本发明的技术方案，而非对本发明保护范围的限制，本领域的普通技术人员对本发明的技术方案进行的简单修改或者等同替换，均不脱离本发明技术方案的实质和范围。

Claims (8)

1.一种颞颌关节分离帽，其特征在于：所述颞颌关节分离帽由分离帽头和固定柄两部分组成；所述固定柄设置于所述分离帽头下部并与所述分离帽头连接，所述分离帽头为开口向下的圆球型凹槽结构或椭圆球型凹槽结构，在所述固定柄上均匀设置有1～6个螺钉固定孔。
2.根据权利要求1所述的颞颌关节分离帽，其特征在于：所述分离帽头是凹槽结构为半球型、三分之一球型或四分之一球型的深度结构。
3.根据权利要求1所述的颞颌关节分离帽，其特征在于：所述固定柄上的螺钉固定孔是单排固定孔或双排固定孔,所述螺钉固定孔的直径为1.6～2.8mm。
4.根据权利要求1、2或3所述的颞颌关节分离帽，其特征在于：所述固定柄为平面固定柄或管状固定柄。
5.根据权利要求1、2或3所述的颞颌关节分离帽，其特征在于：所述分离帽头和所述固定柄一体成型。
6.根据权利要求1、2或3所述的颞颌关节分离帽，其特征在于：所述颞颌关节分离帽采用不能够被人体吸收的植入材料制成，所述植入材料为不锈钢、纯钛、钛合金或高分子材料。
7.根据权利要求6所述的颞颌关节分离帽，其特征在于：制做分离帽头和固定柄的所述植入材料的厚度为0.1mm～0.6mm。
8.一种权利要求1所述的颞颌关节分离帽的固定方法，其特征在于：所述颞颌关节分离帽的固定方法具体包括如下步骤：
第一步：将颞颌关节中的关节窝和下颌关节分离；
第二步：将颞颌关节分离帽的分离帽头固定套设在下颌关节的关节头上；
第三步：在颅颌面内固定钛钉：根据固定柄的长度及螺钉固定孔的数量，由上到下依次用钛钉将固定柄固定在髁状突或升支上，颞颌关节分离帽即固定完成。
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