CN108498149A - 一种钛缆牵拉骨搬移装置及其使用方法 - Google Patents
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 61
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 title claims abstract description 32
- 229910052719 titanium Inorganic materials 0.000 title claims abstract description 32
- 239000010936 titanium Substances 0.000 title claims abstract description 32
- 238000000034 method Methods 0.000 title description 2
- 230000007547 defect Effects 0.000 claims abstract description 13
- 208000010392 Bone Fractures Diseases 0.000 claims abstract description 8
- 238000000338 in vitro Methods 0.000 claims abstract description 5
- 230000001020 rhythmical effect Effects 0.000 abstract description 2
- 238000005516 engineering process Methods 0.000 description 7
- 238000010586 diagram Methods 0.000 description 2
- 238000001727 in vivo Methods 0.000 description 2
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- 230000011164 ossification Effects 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 208000020084 Bone disease Diseases 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 208000005214 Poroma Diseases 0.000 description 1
- 206010052428 Wound Diseases 0.000 description 1
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- 230000007774 longterm Effects 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 238000004804 winding Methods 0.000 description 1
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6416—Devices extending alongside the bones to be positioned with non-continuous, e.g. hinged, pin-clamp connecting element
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6441—Bilateral fixators, i.e. with both ends of pins or wires clamped
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/645—Devices extending alongside the bones to be positioned comprising a framework
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6491—Devices extending alongside the bones to be positioned allowing small-scale motion of bone ends
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Abstract
本发明公开了一种钛缆牵拉骨搬移装置，包括内植桥接锁定接骨板系统与外固定绞盘装置；桥接锁定接骨板系统桥接固定骨缺损区；外固定绞盘装置在骨搬移接受端由特制的Schanz钉和普通Schanz钉经皮固定于体外，特制的Schanz钉设有圆滑的中空滑道，钛缆经特制的Schanz钉中空滑道置入髓内，向截骨端延伸，一端固定于截骨的活性骨块上，另一端外接绞盘；外固定绞盘装置通过轴心的机械旋转，带动转盘单一方向卷绕钛缆，钛缆便可间断、有节律的牵拉截断的活性骨块，实现骨搬移成骨。
Description
技术领域
本发明涉及一种骨科医用器械，特别涉及一种钛缆牵拉成骨技术治疗长骨大段骨缺损装置。
背景技术
感染、创伤、骨病及肿瘤等均可导致骨缺损。骨缺损一直以来都是骨科医师面临的巨大挑战，而骨搬移技术现已成熟应用于长骨骨缺损的治疗。
骨搬移是将正常部位的骨截断，通过每天延长1mm的速度搬移活性骨块，使之与原正常骨组织之间成骨，使搬移段走过的部位出现连续的骨痂形成新的骨组织，填充原有的骨缺损。
目前针对骨搬移术所用的器械多为外固定支架，且现有的外固定支架设计笨重、不便于术后护理，尤其多枚钢针经皮固定骨缺损远近端，易出现钉道感染，关节僵硬等严重并发症。长期的软组织切割痛是接收外固定支架行骨搬移治疗中无法避免的，患者常常因难以忍受的疼痛产生放弃治疗的念头。
用于骨延长的髓内钉技术需要借助结构复杂的机械结构及外部能量，且价格十分昂贵，临床上应用较少。
为了适应骨搬移技术的发展，减少采用外固定支架进行治疗的诸多并发症，使骨搬移技术治疗更趋于简便化、无痛化，经济化，研制一种新型骨搬移装置势在必行。
发明内容
本发明提供了一种钛缆牵拉骨搬移装置。该装置利用绞盘单一方向卷绕原理，通过绞动钛缆，从而牵拉截断的活性骨块，使之与原正常骨组织之间发生成骨效应，达到骨搬移治疗骨缺损的临床目的。骨缺损远、近端采用桥接锁定接骨板系统桥接固定，Schanz钉经皮固定一绞缆座，其中临近骨缺损的Schanz钉设有中空的钛缆滑道。体外绞缆座上设有绞盘，绞盘接一端钛缆，另一端通过Schanz钉中空滑道，由体外置入骨髓腔，固定于截断的活性骨块上。体外绞盘向单一方向卷绕钛缆，钛缆在牵拉成骨过程中防止钛缆激惹软组织，可有效实现骨搬移技术的简便化与无痛化。
本发明的有益效果：
采用该种骨搬移装置，可将内植桥接锁定接骨板系统与外固定绞盘装置有机结合，通过钛缆单一方向牵拉截断的活性骨块，可实现一种简单、有效、无痛的骨搬移技术。
附图说明
图1是本发明的立体结构示意图。
图2是本发明的牵拉固定装置剖视图。
图3是本发明的局部立体示意图。
具体实施方式
如图1、图2和图3所示，本发明包括钛缆1（注：设有刻度）、特制的Schanz钉2（注：设有圆滑的中空滑道）、绞盘3、绞缆座4；在体外水平安装一绞缆座4，根据需要于骨搬移接收端（长骨远端或近端）经皮置入两枚Schanz钉2、6，将绞缆座4经孔道41套在两枚Schanz钉2、6尾端上，两端用锁定螺栓42挤压固定。绞缆座4装有绞盘3，绞盘3外周设有转盘32，钛缆一端12固定于转盘32上，另一端经特制Schanz钉2的中空滑道置入骨髓腔（注：11为Schanz钉2滑道内的钛缆，其体外从Schanz钉22口入，其体内从Schanz钉21口出），经螺钉13固定于截断的活性骨块之上。骨缺损区通过锁定接骨板5桥接固定，长骨远、近端各置入三至四枚锁定螺钉51固定。
本发明的工作过程：
在进行长骨干骨缺损骨搬移手术操作中，首先选择合适的锁定接骨板5，置入锁定螺钉51，桥接固定长骨远、近端。
根据需要选择一合适的绞缆座4，在骨搬移接收端（长骨远端或近端）经皮置入两枚Schanz钉2、6，然后将绞缆座4通过两端的孔道41套入Schanz钉尾端，两端用锁定螺栓42挤压固定，绞缆座4上的绞盘3也随之固定。
根据需要选择一长度合适的钛缆1，钛缆一端从Schanz钉2上的体外入口22插入，经中空滑道穿出体内出口21，将钛缆1沿着长骨髓腔延长，用螺钉13将末端固定于截断的活性骨块上。拉直钛缆另一端12，减掉多余部分，然后固定在转盘32上。
最后在骨搬移截骨端（长骨远端或近端）行截骨操作。
轴心31在机械扳手驱动下沿单一方向转动绞盘3，转盘32随之绕单一方向卷绕钛缆1。轴心31每转动一下，
钛缆1卷绕在转盘32上的长度为0.25mm，钛缆1会牵拉截端的活性骨块向远端搬移0.25mm。每次转动完成后轴心31会自动锁死。轴心31每天转动四次，钛缆1会牵拉截断的活性骨块向接收端搬移1mm。
该装置通过绞盘上轴心的机械旋转，带动转盘单一方向卷绕钛缆，钛缆便可间断、有节律的牵拉截断的活性骨块，实现骨搬移成骨。
Claims (5)
1.一种钛缆牵拉骨搬移装置，其特征在于：由特制钛缆1、特制的Schanz钉2、绞盘3、绞缆座4、桥接锁定接骨板系统5、普通Schanz钉6构成。
2.所述的桥接锁定接骨板系统5桥接固定骨缺损区。
3.在骨搬移接收端由特制的Schanz钉2和普通Schanz钉6经皮置入骨内，绞缆座4套在两枚Schanz钉尾端固定于体外；绞盘3安装固定于绞缆座4上。
4.所述的钛缆1经特制的Schanz钉2的中空滑道置入髓内，向截骨端延伸，一端固定于截骨的活性骨块上，另一端外接绞盘3。
5.所述的钛缆1设有刻度；Schanz钉2设有中空滑道。
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Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5429638A (en) * | 1993-02-12 | 1995-07-04 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
| US5626579A (en) * | 1993-02-12 | 1997-05-06 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
| US20030144669A1 (en) * | 2001-12-05 | 2003-07-31 | Robinson Randolph C. | Limb lengthener |
| CN101836888A (zh) * | 2009-03-16 | 2010-09-22 | 周小军 | 多功能外固定钢板系统 |
| CN203873847U (zh) * | 2014-02-19 | 2014-10-15 | 花奇凯 | 胫骨横向骨搬移技术治疗辅助装置 |
| CN205514864U (zh) * | 2016-03-23 | 2016-08-31 | 延安大学附属医院 | 一种髌骨骨折内固定装置 |
-
2018
- 2018-07-13 CN CN201810617886.2A patent/CN108498149A/zh active Pending
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5429638A (en) * | 1993-02-12 | 1995-07-04 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
| US5626579A (en) * | 1993-02-12 | 1997-05-06 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
| US20030144669A1 (en) * | 2001-12-05 | 2003-07-31 | Robinson Randolph C. | Limb lengthener |
| CN101836888A (zh) * | 2009-03-16 | 2010-09-22 | 周小军 | 多功能外固定钢板系统 |
| CN203873847U (zh) * | 2014-02-19 | 2014-10-15 | 花奇凯 | 胫骨横向骨搬移技术治疗辅助装置 |
| CN205514864U (zh) * | 2016-03-23 | 2016-08-31 | 延安大学附属医院 | 一种髌骨骨折内固定装置 |
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