CN110575240A - 一种内植入式解剖型肘关节稳定器 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
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- A—HUMAN NECESSITIES
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- 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
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
Abstract
一种内植入式解剖型肘关节稳定器,包括置入肱骨小头转动轴心内、作为肱骨旋转轴的横杆、通过螺钉固定在尺骨鹰嘴上的固定板以及将横杆与固定板连接的连接杆,所述连接杆与尺骨、桡骨和肱骨之间设有间距,所述间距使得屈伸活动时连接杆与尺骨、桡骨和肱骨不干涉,所述横杆、连接杆、固定板和螺钉均为可降解植入材料制作而成,本装置手术后可保持屈伸活动、且在屈伸活动下可维持肘关节稳定性,手术后不影响肘部外观和穿衣服,无针道感染,降低伤口感染和皮肤坏死的风险,无需二次手术取出。
Description
技术领域
本发明涉及医疗器械领域,尤其涉及一种内植入式解剖型肘关节稳定器。
背景技术
由损伤或松解手术导致的肘关节不稳定在骨科临床工作中的处理较为困难。如果肘关节不稳不进行固定处理,将影响患者的上肢功能;如果处理不当则容易导致二次或多次手术,给患者增加额外的痛苦。下述情况都属于复杂的肘关节不稳的例子:1、肘关节三联征损伤和不稳定的冠突骨折;2、严重软组织损伤的肘关节脱位;3、肘关节僵直的患者在进行关节周围软组织的彻底松解和/或切除异位骨化之后。上述复杂肘关节损伤在骨性结构固定和韧带修复后可能仍然不稳定,而现有对于肘关节不稳定的传统处理方法包括:1、直接采用克氏针将肘关节钉住;2、屈曲位以石膏夹板或支具固定,3、外固定架固定。但直接采用克氏针固定肘关节容易损伤关节软骨,针道感染导致化脓性关节炎,并且肘部肌肉自然收缩力会给用于固定的钢针一个较大的反作用力,常导致肘关节固定不牢和克氏针断裂;石膏夹板及支具同样无法提供足够的稳定性,尤其对于肥胖的患者,其固定效果不佳;更重要的是,上述方式均将肘关节固定在一个静止的状态,肘关节无法进行屈伸活动,长时间的制动可能导致患者肘关节再次僵直,屈伸活动受限。铰接式外固定架虽然既可以稳定肘关节防止脱位,又可以保证在术后康复阶段肘关节屈伸活动,但外固定架体积大,较为笨重,置于上臂影响美观和穿衣服,由于重力的作用,患者较为难受,同样还存在较高的针道疼痛、感染及松动的发生率以及置钉时损伤桡神等风险。
发明内容
本发明拟解决现有技术的不足而提供一种手术后可保持屈伸活动、且在屈伸活动下可维持肘关节稳定性,手术后不影响肘部外观和穿衣服,无针道感染,降低伤口感染和皮肤坏死的风险的内植入式解剖型肘关节稳定器。
一种内植入式解剖型肘关节稳定器,包括置入肱骨小头转动轴心内、作为肱骨旋转轴的横杆、通过螺钉固定在尺骨鹰嘴上的固定板以及将横杆与固定板连接的连接杆,所述连接杆与尺骨、桡骨和肱骨之间设有间距,所述间距使得屈伸活动时连接杆与尺骨、桡骨和肱骨不干涉。本装置利用简单的结构使得横杆作为尺骨绕肱骨转动时的转轴,固定板则稳定尺骨,防止肘关节在屈伸活动下尺骨滑离肱骨,保证了肘关节的稳定,使得肘关节脱位患者恢复速度快,而且恢复期间肘关节可活动,对正常生活影响小,恢复后无肘关节僵直的风险,而且本装置体积小,完全置入体内不影响外观和穿衣服,无针道感染,降低伤口感染和皮肤坏死的风险。
进一步的,横杆、连接杆为一体成型,所述横杆、连接杆、固定板和螺钉均为可降解植入材料制作而成,优选的所述横杆、连接杆、固定板和螺钉采用骨固定镁银钇合金植入材料。采用可降解植入材料,一次植入即可,无需二次手术取出,大大降低了患者的痛苦。
进一步的,所述横杆和连接杆直径为2.0-2.5mm,固定板长度15-25mm,宽度8-10mm,厚度1.0-2.0mm。
进一步的,所述横杆长度为30-45mm。
进一步的,所述连接杆与尺骨、桡骨和肱骨之间间距1-3mm。
由于采用上述技术手段,本发明结构简单,一体成型,手术时仅需在肱骨小头转动圆心和尺骨鹰嘴上钻孔,即可将本装置置入肘关节,本装置包括置入肱骨小头转动圆心的横杆,横杆通过连接杆与固定板连接,固定板固定在尺骨鹰嘴上,利用简单的结构使得横杆作为尺骨绕肱骨转动时的转轴,而固定板则稳定尺骨,防止肘关节在屈伸活动下尺骨滑离肱骨,保证了肘关节的稳定,使得肘关节脱位患者恢复速度快,而且恢复期间肘关节可活动,对正常生活影响小,恢复后无肘关节僵直的风险,而且本装置体积小,完全置入体内不影响外观和穿衣服,无针道感染,降低伤口感染和皮肤坏死的风险,本结构采用可降解植入材料制作而成,可在体内自动降解,无需二次手术取出,大大降低了患者的痛苦。
附图说明
图1为本发明的结构示意图。
图2为本发明置入肘关节上后的背侧图。
图3为本发明置入肘关节上后的俯视图。
图4为本发明置入肘关节上后尺侧图。
图5为本发明置入肘关节上后桡侧图。
图6为本发明置入肘关节上后前侧图。
图标记为:1、横杆,2、连接杆,3、固定板,4、固定孔,5、肱骨小头,6、尺骨鹰嘴,7、肱骨滑车,8、桡骨头。
具体实施方法
下面结合附图和实施例对本发明进行进一步具体说明,为了更清楚的说明本专利实施例或现有技术中的技术方案,下面将对实施例或现有技术描述中所需使用的附图做简单的介绍,显而易见的,下面描述中的附图仅仅是本发明的一些实施例,对于本领域普通技术人员来讲,在不付出创造性劳动前提下,还可以根据这些附图获取其他的附图。
如图1至6所示,内植入式解剖型肘关节稳定器,包括置入肱骨小头5转动轴心内、作为肱骨旋转轴的横杆1、通过螺钉固定在尺骨鹰嘴6上的固定板3以及将横杆1与固定板3连接的连接杆2,所述连接杆2与尺骨、桡骨和肱骨之间设有间距,所述间距使得屈伸活动时连接杆2与尺骨、桡骨和肱骨不干涉,所述连接杆2与尺骨、桡骨和肱骨之间间距1-3mm,这样连接杆2在肘关节屈伸活动时既不会碰到尺骨、桡骨和肱骨,而且也不会凸出尺骨、桡骨和肱骨太多,导致占用体积大,影响皮肤缝合;横杆、连接杆两者一体成型,然后再与固定板3固定或横杆1、连接杆2、固定板3三者一体成型,连接杆2弯折的形状以固定板3固定在尺骨鹰嘴6上位置以及横杆1置入肱骨小头5转动轴心的位置为基准,为了取得更好的手术效果,可以按照患者骨骼形状定做。
作为本装置的一种实施方式,所述横杆1、连接杆2、固定板3和螺钉均为骨固定镁银钇合金植入材料,本实施例中,骨固定镁银钇合金植入材料为专利号为:CN201510833664.0通过铸锭冶金、抛光打磨等方法制备一体成型的低切迹解剖型可降的骨固定镁银钇合金植入材料,采用可降解植入材料,一次植入即可,无需二次手术取出,大大降低了患者的痛苦。
本实施例中,按照绝大部分人的肘关节的尺寸,设置本装置的具体尺寸,所述横杆1和连接杆2直径为2.0-2.5mm,所述横杆1长度为30-45mm,固定板3长度15-25mm,宽度8-10mm,厚度1-2mm。
本装置具体置入方式:以陈旧性肘关节脱位为例,患者手术时采用侧卧位,将患肢置于手术床侧方支撑架上,采用肘关节后方入路,切开皮肤及皮下组织,在尺侧显露肱骨滑车7,游离出尺神经并予以保护,桡侧采用kocher入路暴露桡骨小头和肱骨小头5,在肱三头肌肌腱两侧切开筋膜,将肘关节尺骨鹰嘴6窝、桡骨头8和肱骨小头5之间的疤痕予以切除彻底松解。使用膝关节前交叉韧带重建导向器,分别置于肱骨小头5转动圆心和肱骨內髁前下缘,采用2.5或3.0mm克氏针沿肱骨小头5转动圆心钻孔,然后复位肘关节,使肱尺关节、肱桡关节匹配后将本装置的横杆1插入肱骨小头5圆心的钻孔内,然后旋转固定板3部分,使固定板3刚好贴服在尺骨鹰嘴6上。使用2.5mm钻花沿固定板3固定孔4在尺骨鹰嘴6上钻孔、测深,然后拧入2枚直径为3.5mm的皮质骨螺钉。如果横杆1插入肱骨小头5部分过长,在术中将其剪短,使得横杆1端部不穿出肱骨滑车,避免损伤尺神经。然后术中屈伸活动肘关节检查是否稳定,如无再脱位则清洗伤口进行缝合。
此外,需要说明的是,本专利不局限于上述实施方式,只要其零件未说明具体尺寸或形状的,则该零件可以为与其结构相适应的任何尺寸或形状,且不论在其材料构成上作任何变化,凡是采用本发明所提供的结构设计,都是本发明的一种变形,均应认为在本发明保护范围之内。
Claims (6)
1.一种内植入式解剖型肘关节稳定器,其特征在于:包括置入肱骨小头(5)转动轴心内、作为肱骨旋转轴的横杆(1)、通过螺钉固定在尺骨鹰嘴(6)上的固定板(3)以及将横杆(1)与固定板(3)连接的连接杆(2),所述连接杆(2)与尺骨、桡骨和肱骨之间设有间距,所述间距使得屈伸活动时连接杆(2)与尺骨、桡骨和肱骨不干涉。
2.根据权利要求1所述的内植入式解剖型肘关节稳定器,其特征在于:所述横杆(1)、连接杆(2)一体成型,且横杆(1)、连接杆(2)、固定板(3)和螺钉均为可降解植入材料制作而成。
3.根据权利要求2所述的内植入式解剖型肘关节稳定器,其特征在于:所述横杆(1)、连接杆(2)、固定板(3)和螺钉采用骨固定镁银钇合金植入材料。
4.根据权利要求1所述的内植入式解剖型肘关节稳定器,其特征在于:所述横杆(1)和连接杆(2)直径为2.0-2.5mm,固定板(3)长度15-25mm,宽度8-10mm,厚度1-2mm。
5.根据权利要求4所述的内植入式解剖型肘关节稳定器,其特征在于:所述横杆(1)长度为30-45mm。
6.根据权利要求3所述的内植入式解剖型肘关节稳定器,其特征在于:所述连接杆(2)与尺骨、桡骨和肱骨之间间距1-3mm。
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