CN110811930A

CN110811930A - Backbone prosthesis of post-rotation type tube expansion structure handle and use method

Info

Publication number: CN110811930A
Application number: CN201911111758.1A
Authority: CN
Inventors: 田东牧; 赵云龙; 张浩然; 胡永成; 考月岗; 任志鹏; 张净宇; 李建军; 王丰; 杨雄刚; 庞承刚
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-11-14
Filing date: 2019-11-14
Publication date: 2020-02-21

Abstract

The invention relates to a backbone prosthesis of a rotary expansion tube structure handle and a use method thereof, firstly, removing bone tissues of a femoral stem affected by a tumor, screwing a cylindrical end of an expansion bolt into a threaded hole I, and placing a circular table body of the expansion bolt outside the expansion hole I; screwing the cylindrical end of the other expansion bolt into the threaded hole II, and placing the circular table body of the expansion bolt outside the expansion hole II; inserting a handle I of a proximal part into a bone marrow cavity at the upper end of a femur, rotating an expansion bolt anticlockwise to enable a round table body of the expansion bolt to enter an expansion hole I of the handle I, and expanding 4 blades I to be tightly press-fitted with bone walls of the marrow cavity; inserting a handle II of the distal part into a diaphysis medullary cavity at the lower end of the femur, rotating the expansion bolt anticlockwise to enable the expansion bolt cone to enter an expansion hole II of the handle II, and expanding 4 blades II to be tightly press-fitted with the medullary cavity bone wall; the reconstruction portion I of the proximal member is secured to the reconstruction portion II of the distal member. The immediate postoperative three-dimensional stability of the prosthesis handle is achieved.

Description

Backbone prosthesis of post-rotation type tube expansion structure handle and use method

Technical Field

The invention relates to a backbone prosthesis of a post-rotation type expansion pipe structure handle and a use method thereof.

Background

As joint and stem prostheses mature in design, materials, manufacturing, and surgical techniques, prosthetic implant therapy has found increasing application in clinical therapy. Common areas of application for artificial prostheses include: end-stage diseases of joints, senile fractures, bone defects after resection of bone tumors, severe traumatic diseases of fractures and the like. With the increase in the number of prostheses and the increase in the survival rate of the prostheses, various defects and complications of the prostheses are also gradually emerging. In recent years, there have been ongoing attempts to improve prosthesis designs in an attempt to obtain better therapeutic results. The prosthesis stem is an important component of many joint and stem prostheses. The structure and the fixing mode of the prosthesis handle are related to a plurality of aspects such as an operation mode, postoperative prosthesis stability, prosthesis loosening risk and the like, and the design of the prosthesis handle is an important aspect of prosthesis design.

The artificial prosthesis handles currently used in clinical practice are mainly classified into two categories according to the difference of the fixing mode: bone cement fixed type and biological fixed type. The advantages and disadvantages of these two prosthesis stems are not the same.

(1) Bone cement fixed prosthesis handle: in the operation, bone cement is injected into the backbone medullary cavity, then the artificial prosthesis handle is inserted, after the bone cement is solidified, micro locking is formed between the bone cement and the trabecula, the prosthesis can obtain better stability, and the limb function can be recovered in a short time after the operation. The disadvantages are as follows: the cement has a high hardening speed, and the position and the force line of the handle are difficult to accurately adjust in the operation. The failure rate and the loosening rate of the long-term prosthesis are high, and the incidence rate of the prosthesis loosening after the operation is reported in the literature to be 30.6-42.7%. In addition, the bone cement fixing mode has the risk of generating bone cement diseases, namely a series of clinical symptoms such as hypotension, hypoxemia, arrhythmia, myocardial infarction, hemorrhage, asthma attack and the like caused by the bone cement, and the incidence rate of cardiac arrest in the bone cement type total hip replacement operation is reported to be 0.5-10% and the mortality rate is reported to be 0.6-1.0%.

(2) Biological fixation type prosthesis stem: the surface of the artificial prosthesis handle is rough, the artificial prosthesis handle has good osteoinductivity and osseointegration, the firm combination of the handle and the bone wall is realized by inducing the bone growth on the surface of the prosthesis handle, the medium and long-term stability of the prosthesis can be effectively improved, the service life of the prosthesis is prolonged, and the mechanical complications related to the prosthesis are reduced. Basic process of biological fixation type prosthesis handle operation: firstly, after a part of bone is cut off, a marrow expanding device (a marrow expanding drill) is used for expanding a marrow cavity of a backbone marrow cavity, a prosthesis handle is inserted into the marrow cavity after the marrow is expanded, and the handle is lightly knocked by a hammer, so that the prosthesis handle achieves the effect of tight press fit in the marrow cavity. The biological fixing mode of inducing the growth of the bone on the surface of the prosthesis handle can effectively improve the medium and long-term stability of the prosthesis, prolong the service life of the prosthesis, reduce the occurrence of mechanical complications such as prosthesis loosening, dislocation, periprosthetic bone dissolution, fracture and the like, and simultaneously avoid the occurrence of bone cement diseases. The disadvantages are as follows: the marrow cavities at different parts of the diaphysis are mostly irregular geometric shapes with different diameters, and due to the difference of human bodies, the inner diameters of the prosthesis handle and the marrow cavities often have certain difference and are difficult to be completely matched. The simple biological fixation type prosthesis handle can only realize the relative stability of a single part and a single plane, and the stability of a plurality of parts and a plurality of planes is difficult to realize. The force and safety of reaming the marrow and knocking the prosthesis handle in the operation are totally dependent on the experience of the operator, and are unknown and uncontrollable. If the dynamics of expanding marrow and knocking the false body handle is little, can't reach the effect of closely pressing fit, if the dynamics increase then can obviously increase the risk of fracture splitting. Because a certain time is needed for the bone on the surface of the biological prosthesis handle to grow in, the short-term stability of the biological fixation prosthesis after operation is poor. The long limb braking time of the patient seriously affects the postoperative early-stage weight bearing and rehabilitation training of the patient, and is also easy to cause joint stiffness, muscle strength reduction, deep vein thrombosis, bedsore, respiration and urinary infection.

At present, aiming at the defect of poor early stability of a biological fixation type prosthesis handle, some prostheses are improved, and the early stability of the prostheses is mainly achieved by adding steel plates and screw structures. These prostheses still suffer from a number of drawbacks and associated complications: increased exposed area of operation, increased wound, difficult screw implantation, increased operation difficulty and operation time, difficult matching of the implanted prosthesis handle and the medullary cavity, difficult adjustment of the force line of the prosthesis handle, concentrated stress after the operation, high fracture risk of the steel plate screw and the like.

Compared with the bone cement fixed prosthesis handle, the biological fixed prosthesis handle has better medium and long-term stability, longer prosthesis life and lower mechanical complications, so the biological fixed prosthesis handle is more and more accepted by patients and doctors. Achieving early stabilization and reducing complications by improving the design of a bio-fixation type prosthetic stem is also one of the hotspots and directions of current research.

Disclosure of Invention

In view of the state and deficiencies of the prior art, the present invention provides a stem prosthesis with a handle of a supination-type tube expansion structure and a method of use. The prosthesis adopts a biological fixed prosthesis handle, and the design of the prosthesis handle refers to a very mature fixing mode, namely an expansion bolt structure, in the building industry. The prosthesis handle increases the local diameter of the tip of the prosthesis handle by expanding the blades of the prosthesis handle, so that the prosthesis handle can be better matched and contacted with the medullary cavity bone wall. The expanded prosthesis handle blade can also increase the pressure between the prosthesis handle and the medullary cavity bone wall so as to obtain larger friction force, the prosthesis can bear larger traction and rotation loads, three-dimensional stability is realized, and the movement or dislocation of the prosthesis is effectively prevented.

The expansion bolt and the prosthesis handle blade structure are additionally arranged on the prosthesis handle with the expansion tube structure, so that the biological prosthesis can obtain the immediate stability after operation, a patient can bear load and perform functional rehabilitation training earlier, and the risks of deep vein thrombosis, urinary infection and the like are reduced. The prosthesis handle is simple in design and operation, has no obvious influence on the operation difficulty and the operation time, does not increase the operation wound, improves the operation effect, and provides a better design scheme for joint prostheses and backbone prostheses. The surface of the prosthesis handle is coated with metal coating, so that the prosthesis handle has better osteoinductivity and osseointegration.

In order to achieve the purpose, the invention adopts the technical scheme that: the utility model provides a backbone prosthesis of type expand tube structure handle revolves, its characterized in that: comprises a proximal part, a distal part and an expansion bolt, a connecting bolt and an anti-rotation plunger;

the proximal component consists of a reconstruction part I and a hollow handle part I which are of an integral structure;

the distal part consists of a reconstruction part II and a hollow handle part II which are integrally structured;

the blind holes I of the two expansion bolts are respectively provided with an anti-rotation plunger, the cylindrical end of one expansion bolt is arranged in the threaded hole I of the handle I through the expansion hole I of the handle I of the proximal part, the circular table body of the expansion bolt is arranged outside the expansion hole I,

the expansion bolt is retreated by anticlockwise rotating, the round table body of the expansion bolt enters the expansion hole I of the handle I, the 4 blades I are expanded, and the locking of the round table body of the expansion bolt and the positions of the 4 blades I can be realized by the arrangement of the anti-rotation plunger;

the other expansion bolt cylinder end is arranged in a threaded hole II of the shank II through an expansion hole II of the shank II of the distal part, the expansion bolt circular table body is arranged outside the expansion hole II,

the expansion bolt is retreated anticlockwise, the circular table body of the expansion bolt enters an expansion hole II of the handle part II, the 4 blades II are expanded, and the locking of the circular table body of the expansion bolt and the positions of the 4 blades II can be realized through the arrangement of the anti-rotation plunger;

the utility model discloses a quick-witted bolt, including distal part, near end part, two concave surfaces I and two concave surfaces I of proximal part component reconstruction portion I, inclined plane I and inclined plane II of proximal part component reconstruction portion I are connected together with two concave surfaces II and two convex surfaces II of distal part component reconstruction portion II, and inclined plane I and two concave surfaces I of proximal part component reconstruction portion I contact with two inclined plane IV and inclined plane III that inclined plane II corresponds to distal part component reconstruction portion II, two set up one respectively in connecting bolt's the blind hole II and prevent revolving plunger, two connecting bolt are in the same place through two counter bores of the distal part and two screw hole spiro couplings of proximal part respectively, fix proximal part and distal part together, prevent revolving plunger's setting and can realize the locking of proximal part and distal part.

A use method of a diaphysis prosthesis of a post-rotation type tube expansion structure handle is characterized by comprising the following steps:

firstly, cutting bone tissues of a femoral stem part affected by tumor, reaming bone marrow of backbone at two ends by using a reaming drill, then arranging anti-rotation plungers in blind holes I of two expansion bolts in vitro respectively, screwing a cylindrical end of one expansion bolt into a threaded hole I through an expansion hole I of a handle part I of a proximal part, and placing a circular table body of the expansion bolt outside the expansion hole I to ensure that 4 blades I do not expand;

screwing the other expansion bolt cylinder end into the threaded hole II through an expansion hole II of the distal part handle II, and placing the circular table body of the expansion bolt outside the expansion hole II to the extent that 4 blades II do not expand;

inserting a handle I of a proximal part element screwed in an expansion bolt into a backbone medullary cavity at the upper end of a femur, lightly knocking a proximal part reconstruction part I by a hammer to achieve tight press fit of the handle I and the medullary cavity bone wall, then inserting a screwdriver into a polygonal blind hole I of the expansion bolt, and rotating the expansion bolt anticlockwise to enable an expansion bolt cone to enter an expansion hole I of the handle I, expanding 4 blades I to realize tighter press fit with the medullary cavity bone wall, and locking the cone of the expansion bolt and the positions of the 4 blades I can be realized by arranging a rotation-proof plunger;

inserting a handle part II of a distal part screwed in an expansion bolt into a backbone medullary cavity at the lower end of a femur, lightly knocking a reconstruction part II of the distal part by a hammer to achieve tight press fit of the handle part II and the medullary cavity bone wall, then inserting a screwdriver into a polygonal blind hole I of the expansion bolt, and rotating the expansion bolt anticlockwise to enable a cone of the expansion bolt to enter an expansion hole II of the handle part II, expanding 4 blades II to realize tighter press fit with the medullary cavity bone wall, and locking the cone of the expansion bolt and the positions of the 4 blades II can be realized by arranging a rotation-proof plunger;

butting a reconstruction part I of the proximal part with a reconstruction part II of the distal part together, wherein two convex surfaces I and two concave surfaces I of the reconstruction part I of the proximal part are in contact with two concave surfaces II and two convex surfaces II of the reconstruction part II of the distal part;

the inclined plane I and the inclined plane II of the proximal part reconstruction part I are in contact with the inclined plane IV and the inclined plane III of the distal part reconstruction part II correspondingly;

the blind holes II of the two connecting bolts are respectively provided with the anti-rotation plungers, the two connecting bolts are respectively screwed with the two threaded holes of the proximal part through the two counter bores of the distal part, the proximal part and the distal part are fixed together, the prosthesis is successfully installed, and the positions of the proximal part and the distal part can be locked by the two anti-rotation plungers.

The invention has the beneficial effects that: the backbone prosthesis with the handle of the back-rotating type expanding tube structure can obtain immediate stability after operation, the wound, difficulty and time of the operation are hardly influenced, the blades with certain toughness can improve the rigid confrontation of the prosthesis handle and the bone wall, the expanded blades enable the local diameter of the prosthesis handle to be increased, the prosthesis handle is matched with the medullary cavity bone wall, and the metal coating has better bone inductivity and bone integration, so that the medium and long-term stability of the prosthesis is effectively improved.

1. The prosthesis can obtain immediate stability after operation; the backbone prosthesis of the handle with the rotary type expanding tube structure fully considers the defect of poor immediate stability of the biological artificial prosthesis after operation, and the expansion bolt extrudes the expansion blade to moderately increase the pressure between the prosthesis handle and the marrow cavity wall so as to generate larger friction force and achieve immediate three-dimensional stability of the prosthesis handle after operation.

It is well known that the amount of friction between the contact surfaces of two objects depends on two factors: roughness of the contact surface and pressure of the contact surface. Although the existing biological artificial prosthesis handle has a rough surface such as a metal coating or a hydroxyapatite coating, the design structure and the operation method thereof have difficulty in realizing continuous and sufficient pressure of the handle on the bone wall of the medullary cavity. The existing biological artificial prosthesis is usually placed into the prosthesis by knocking in the operation, and good friction force can be generated only when the condition that the prosthesis handle is tightly pressed with the medullary cavity bone wall is achieved. However, the strength which the bone wall of the medullary cavity can bear is influenced by various factors such as the age, the sex and the bone density of the patient, and the force for knocking the prosthesis is not controllable depending on the experience of the operator. If the dynamics of beating the false body is little, be difficult to reach the effect of closely pressing the dress, if the dynamics increase then can obviously increase the risk of fracture splitting. Therefore, it is often difficult to achieve a tight press fit of the stem of the prosthesis against the medullary cavity wall, to provide sufficient pressure on the medullary cavity wall, and to create sufficient friction between the stem of the prosthesis and the medullary cavity wall to stabilize the prosthesis. The biological artificial prosthesis often lacks sufficient stability in the early postoperative period, and a patient needs to stay in bed for a long time to wait for bone to grow in, so that the early load bearing, limb movement and rehabilitation training of the patient are difficult to realize.

The design of the type expand tube structure handle of backspin passes through expansion bolt extrusion prosthesis handle blade, the blade expands and with marrow cavity bone wall in close contact with and mutual extrusion, marrow cavity bone wall can lead to the blade to produce the deformation of certain degree to the extrusion of blade, metal material's blade has certain antagonism and warp the ability, antagonism between bone wall and the blade can make and produce between the two and last and stable pressure, this kind of pressure accessible expansion bolt perception and regulation and control, can cooperate the torsion screwdriver to use, the operation is simpler. And the blade with the metal coating and the bone wall are rough surfaces, so that a large friction force can be generated between the blade with the metal coating and the bone wall, the rotary shearing force and the longitudinal pulling force applied to the prosthesis can be effectively resisted, the postoperative immediate stability of the biological prosthesis is realized, and the early-stage load bearing, limb movement and rehabilitation training of a patient are facilitated. The titanium coating on the surface of the prosthesis handle has better osteoinductivity and osseointegration, thereby effectively improving the medium and long-term stability of the prosthesis.

2. The design of the handle of the post-screwing type expanding tube structure hardly influences the trauma, difficulty and time of the prosthesis implantation operation, has strong adaptability to the length of the residual medullary cavity, and the short handle can also achieve the stability of the prosthesis.

Aiming at the defect of poor early stability of the biological fixation type prosthesis handle, some prostheses are also improved, and the early stability of the prostheses is mainly achieved by adding structures such as steel plates, screws and the like. Unfortunately, these designs have many drawbacks and complications while improving prosthesis stability: increased exposed area of operation, increased wound, difficult screw implantation, increased operation difficulty and operation time, difficult adjustment of the force line of the prosthesis handle, concentrated stress after operation, high risk of fracture of the steel plate screw and the like. These deficiencies and complications have greatly limited the clinical use of bio-fixation prostheses.

The design of the handle of the post-rotation type expanding tube structure has little influence on the trauma, difficulty and time of the prosthesis implantation operation. The design of the handle of the rotary expansion tube structure is that the handle of the prosthesis is inserted into the diaphysis osteotomy plane, and the blades are expanded by an internal expansion bolt, so that the structure does not need to increase an operation incision or enlarge an operation exposure at all. The technique does not drill the bone wall, does not destroy the integrity of the bone wall, and avoids the operation trauma and bleeding caused by the operations. All the operations are simple, and the difficulty of positioning and drilling does not exist, and the difficulty of placing steel plates and screws does not exist. The technology has better adaptability to the length of the residual medullary cavity, and particularly has more obvious advantages of a short handle. In the case of small residual medullary cavity length, only short prosthesis handle can be selected, and the stability of the prosthesis can not be achieved easily by the common biological prosthesis without the auxiliary fixation of steel plates and screws. The design of the handle of the post-screwing type expansion pipe structure refers to the mature expansion bolt technology, the short medullary cavity bone wall can be fully utilized, and good friction force and stability can be obtained by expanding the blades to extrude the bone wall. The polyethylene anti-rotation plunger piston structure on the expansion bolt can also easily realize the position locking of the expansion bolt and the blade.

3. The design of the handle of the rotary expansion tube structure can improve the matching degree of the prosthesis handle and the medullary cavity bone wall, increase the stability of the prosthesis, and has higher centralization degree and better prosthesis force line.

Because the existing biological prosthesis handle has fixed shape and can not be adjusted, the perfect matching of the handle and the medullary cavity bone wall is difficult to achieve. Most of the marrow cavities of the diaphysis are in irregular geometric shapes, the inner diameters of the marrow cavities at different parts of the same diaphysis are different, and the manufacture and the placement of the prosthesis handle which is completely matched with the marrow cavity of a patient are difficult. In recent years, 3D printing technology is also increasingly applied to the prosthesis manufacturing industry, and 3D printing technology brings hopes for manufacturing individualized prostheses, but the use of the technology is still limited to a certain extent. An important factor to be considered in manufacturing a prosthesis by using a 3D printing technique is that the inner diameters of the medullary cavities of different parts of the diaphysis are different, because the osteotomy plane needs to be adjusted according to actual conditions in an operation, the smallest inner diameter of the medullary cavity can appear at different parts of the residual diaphysis, the smallest inner diameter of the medullary cavity can appear at any part of the residual diaphysis, such as the osteotomy part, the middle section of the diaphysis, and the like, and an operator cannot completely control the same. While it is theoretically possible to manufacture a prosthetic stem that exactly matches the patient's medullary cavity using 3D printing techniques, such an ideal prosthetic stem is in fact difficult to insert into the stem medullary cavity, subject to the different inner diameters of the stem medullary cavity. The problem of prosthetic stem implantation must be considered in manufacturing prosthetic stems using 3D printing techniques, and in actual manufacturing processes, compromise methods must often be used to manufacture prosthetic stems "relatively" matching the patient's medullary cavity to ensure successful implantation of the prosthetic stem. To facilitate insertion into the medullary cavity, the tip of the prosthetic stem is often designed with a tapered conical or bullet-head shape that is difficult to perfectly match the medullary cavity. Because of the above limitations, the tight press fit of the stem of the bioprosthetic to the medullary cavity bone wall is often actually centered on one plane, and it is very difficult to achieve a tight press fit of two planes. The result of the tight press fit between the stem of the prosthesis and the bone wall with only one plane is to form a lever with the contact plane as a fulcrum, which makes it difficult to achieve the overall stability of the prosthesis.

The design of the handle of the rotary expansion pipe structure can expand the blade through the expansion bolt to increase the diameter of the top end of the prosthesis handle, and fine adjustment can be carried out within a certain range. The adjustable characteristic can help the top end of the prosthesis handle to easily realize the tight press fit with the bone wall of the medullary cavity, and the defects that the diameter of the existing prosthesis handle can not be adjusted and can not be matched with the medullary cavity are overcome. The pressure of the blades on the bone wall is continuous, stable, sensible and adjustable, so that the generated friction force can effectively resist the rotating shearing force and the longitudinal pulling force, and the three-dimensional stability of the prosthesis is quickly realized. The stabilization of the stem of the prosthesis is achieved in two steps: 1) knocking the implanted prosthesis handle, so that the most compact part of the prosthesis handle and the medullary cavity bone wall is stably pressed; 2) the blades of the prosthesis handle are expanded and form good press fit with the medullary cavity bone wall, and the top end of the prosthesis handle realizes reliable and durable stability. The stability of one part is not real stability, a lever fulcrum is easy to form, the stability of two parts is real stability, and the three-dimensional stability of the prosthesis is realized.

The force line is difficult to adjust after the handle of the common biological artificial prosthesis is placed. The design of the rotary expansion pipe structure handle is that the expansion bolt extrudes the expansion blade, the force between the blade and the expansion bolt is mutual, the blade extrudes the expansion bolt to enable the expansion bolt to move towards the center of the medullary cavity, and the position of the expansion bolt is well adjusted. The expansion bolt is the center of the prosthesis handle, the more the expansion bolt is matched with the axis of the medullary cavity, the better the centering of the prosthesis handle is, the better the force line of the prosthesis handle is, the better the bionic effect of the prosthesis is, and the lower the possibility of complications such as prosthesis loosening, fracture and the like is.

4. The design of the handle of the rotary expansion tube structure utilizes the elasticity and the deformation of the metal blade, can buffer and adjust the stress between the prosthesis handle and the bone wall to a certain degree, changes the 'hard confrontation' of the top end of the prosthesis handle and the bone wall, and reduces the stress concentration. This "Duokengjust" change can reduce the occurrence of prosthesis fractures and periprosthetic fractures to some extent.

In a word, the invention overcomes the defects of poor immediate stability after operation, mismatching of the diameter of the prosthesis handle and the medullary cavity, difficult adjustment of the force line, rigid confrontation between the handle and the bone wall, stress concentration and the like of the existing biological prosthesis. The invention realizes double-level fixation by moderately increasing the pressure of the blade at the top end of the prosthesis handle and the medullary cavity wall to generate larger friction force, thereby achieving the immediate three-dimensional stability of the prosthesis handle after operation. Can help patients to realize early-stage load bearing, limb movement and rehabilitation training. The metal coating has better osteoinductivity and osseointegration, thereby effectively improving the medium and long-term stability of the prosthesis. The design of the handle of the rotary front type expansion tube structure inserts the prosthesis handle through the diaphysis osteotomy plane, and expands the blades by the expansion bolt inside, so that the operation incision is not required to be increased or the operation exposure is not required to be enlarged, the operation trauma and bleeding can be obviously reduced, and the operation time can be shortened. The prosthesis has strong adaptability to the length of the residual medullary cavity, and the short handle can also achieve the stability of the prosthesis. The prosthesis realizes the purposes of good matching of the top end of the prosthesis handle and the medullary cavity, adjustment of the force line of the prosthesis and better centralization of the prosthesis, utilizes the elasticity and deformation of the metal blades, can buffer and adjust the stress between the prosthesis handle and the bone wall to a certain degree, and can reduce the occurrence of prosthesis fracture and the fracture around the prosthesis to a certain degree.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a cross-sectional view A-A of the structure of FIG. 1;

FIG. 3 is an exploded view of the structure of the present invention;

FIG. 4 is a schematic structural view of a proximal member of the present invention;

FIG. 5 is a structural cross-sectional view of the proximal member of the present invention;

FIG. 6 is a schematic view of the distal member of the present invention;

FIG. 7 is a structural cross-sectional view of the distal member of the present invention;

FIG. 8 is a schematic structural view of an expansion bolt of the present invention;

FIG. 9 is a schematic view of the construction of the connecting bolt of the present invention;

FIG. 10 is a schematic view of the anti-rotation plunger of the present invention;

fig. 11 is a state diagram of the present invention in use.

The specific implementation mode is as follows:

in order to make those skilled in the art better understand the technical solution of the present invention, the following description will be made with reference to the accompanying drawings.

As shown in fig. 1 to 10, the diaphysis prosthesis of a post-rotation type expanding tube structure handle comprises a proximal part 1, a distal part 2, an expansion bolt 3, a connecting bolt 4 and an anti-rotation plunger 5;

the proximal component 1 consists of a reconstruction part I1-1 and a hollow handle part I1-2 which are of an integrated structure;

the distal part 2 is composed of a reconstruction part II 2-1 and a hollow handle part II 2-2 which are of an integral structure.

The base end of the reconstruction part I1-1 is a cylinder I1-1-1, the connecting end is a semi-cylinder I1-1-2, a semi-circular groove I1-1-3 is vertically arranged on the plane of the semi-cylinder I1-1-2, two threaded holes 1-1-3-1 are vertically arranged on the outer circular surface of the semi-cylinder I1-1-2 at intervals, the two threaded holes 1-1-3-1 are communicated with the semi-circular groove I1-1-3, two convex surfaces I1-1-4 and two concave surfaces I1-1-5 are symmetrically arranged on the two side walls of the semi-circular groove I1-1-3, an inclined surface I1-1-6 is arranged below the semi-cylinder I1-1-2, an inclined surface II 1-1-7 is arranged below the cylinder I1-1-1, a middle hole I1-1-1-1 is arranged on the inclined plane II 1-1-7;

the upper part of the handle I1-2 is horizontally provided with 4 round holes I1-2-1 at intervals, hollow holes of the handle I1-2 between the 4 round holes I1-2-1 and the mesopores I1-1-1-1 of the cylinder I1-1-1 are threaded holes I1-2-2, the threaded holes I1-2-2 are communicated with the semicircular grooves I1-1-3 through the mesopores I1-1-1-1, 4 gaps I1-2-3 are arranged between the 4 round holes I1-2-1 and the spherical surface of the tail end of the handle I1-2, 4 gaps I1-2-3 are formed between the 4 gaps I1-2-3, the hollow holes of the 4 blades I1-2-4 are expansion holes I1-2-5, the expansion holes I1-2-5 are communicated with the threaded holes I1-2-2, and the tail end faces of the 4 blades I1-2-4 are cambered surfaces 1-2-6;

the outer surface of the handle part I1-2 is provided with a titanium coating I1-2-7.

The base end of the reconstruction part II 2-1 is a cylinder II 2-1-1, the connecting end is a semi-cylinder II 2-1-2, a semi-circular groove II 2-1-3 is vertically arranged on the plane of the semi-cylinder II 2-1-2, two counter bores 2-1-3-1 are vertically arranged on the outer circular surface of the semi-cylinder II 2-1-2 at intervals, the two counter bores 2-1-3-1 are communicated with the semi-circular groove II 2-1-3, two convex surfaces II 2-1-4 and two concave surfaces II 2-1-5 are symmetrically arranged on the two side walls of the semi-circular groove II 2-1-3, the upper surface of the semi-cylinder II 2-1-2 is an inclined surface III 2-1-6, the upper surface of the cylinder II 2-1-1 is an inclined surface IV 2-1-7, a middle hole II 2-1-1-1 is arranged on the inclined plane IV 2-1-7;

the lower part of the handle part II 2-2 is horizontally provided with 4 round holes II 2-2-1 at intervals, the hollow hole of the handle part II 2-2-2-1 between the 4 round holes II 2-2-1 and the mesopore II 2-1-1-1 of the cylinder II 2-1 is a threaded hole II 2-2-2, the threaded hole II 2-2-2 is communicated with the semicircular groove II 2-1-3 through the mesopore II 2-1-1, 4 gaps II 2-2-3 are arranged between the 4 round holes II 2-2-1 and the spherical surface at the tail end of the handle part II 2-2, 4 blades II 2-2-4 are formed between the 4 gaps II 2-2-3, the hollow hole of the 4 blades II 2-2-4 is an expansion hole II 2-2-5, the expansion holes II 2-2-5 are communicated with the threaded holes II 2-2-2, and the tail end faces of the 4 blades II 2-2-4 are cambered surfaces 2-2-6;

the outer surface of the handle part II 2-2 is provided with a titanium coating II 2-2-7.

One end of the expansion bolt 3 is a cylinder 3-1, the other end of the expansion bolt is a cone 3-2, the end face of the cone 3-2 is a spherical surface 3-2-1, an external thread II 3-1-1 and a blind hole I3-1-2 are arranged on the cylinder, and a polygonal blind hole I3-1-3 is arranged on the tail end face of the cylinder.

The screw part of the connecting bolt 4 is provided with a blind hole II 4-1, and the head part of the connecting bolt 4 is provided with a polygonal blind hole II 4-2.

The anti-rotation plunger 5 is a cylinder; the anti-rotation plunger 5 is made of polyethylene.

The blind holes I3-1-2 of the two expansion bolts 3 are respectively provided with an anti-rotation plunger piston 5, the cylindrical 3-1 end of one expansion bolt 3 is arranged in the threaded hole I1-2-2 of the handle I1-2 through the expansion hole I1-2-5 of the handle I1-2 of the proximal part 1, the circular table body 3-2 of the expansion bolt 3 is arranged outside the expansion hole I1-2-5,

the expansion bolt 3 is rotated anticlockwise, the circular table body 3-2 of the expansion bolt 3 starts to enter the expansion hole I1-2-5 of the handle I1-2, 4 blades I1-2-4 are expanded, and the locking of the positions of the circular table body 3-2 of the expansion bolt 3 and the positions of the 4 blades I1-2-4 can be realized through the arrangement of the anti-rotation plunger 5;

the end of a cylinder 3-1 of another expansion bolt 3 is arranged in a threaded hole II 2-2-2 of a handle II 2-2 through an expansion hole II 2-2-5 of a distal part 2, a circular table body 3-2 of the expansion bolt 3 is arranged outside the expansion hole II 2-2-5, the expansion bolt 3 is rotated anticlockwise, the circular table body 3-2 of the expansion bolt 3 starts to enter the expansion hole II 2-2-5 of the handle II 2-2, 4 blades II 2-2-4 are expanded, and the locking of the positions of the circular table body 3-2 of the expansion bolt 3 and the positions of the 4 blades II 2-2-4 can be realized through the arrangement of an anti-rotation plunger 5;

butting a reconstruction part I1-1 of a proximal part 1 and a reconstruction part II 2-1 of a distal part 2 together, wherein two convex surfaces I1-1-4 and two concave surfaces I1-1-5 of the reconstruction part I1-1 of the proximal part 1 correspond to two concave surfaces II 2-1-5 and two convex surfaces II 2-1-4 of the reconstruction part II 2-1 of the distal part 2, and a bevel I1-1-6 and a bevel II 1-1-7 of the reconstruction part I1-1 of the proximal part 1 correspond to a bevel IV 2-1-7 and a bevel III 2-1-6 of the reconstruction part II 2-1 of the distal part 2;

the blind holes II 4-1 of the two connecting bolts 4 are respectively provided with an anti-rotation plunger 5, the two connecting bolts 4 are respectively screwed with the two threaded holes 1-1-3-1 of the proximal part 1 through the two counter bores 2-1-3-1 of the distal part 2 to fix the proximal part 1 and the distal part 2 together, and the locking of the proximal part 1 and the distal part 2 can be realized through the arrangement of the anti-rotation plunger 5.

As shown in fig. 11, taking femoral shaft tumor as an example, the individual customized prosthesis can be performed before operation according to the anatomical features such as specific part and size of diseased bone tissue of a patient, and the individually customized prosthesis can improve the accuracy of the operation and the treatment effect of the prosthesis.

A method for using a diaphysis prosthesis with a handle of a back-screwing type tube expansion structure comprises the following steps:

firstly, 6 parts of bone tissues of a femur affected by tumor are cut off, bone marrow expanding is carried out on bone shafts at two ends by using a marrow expanding drill, then blind holes I3-1-2 of two expansion bolts 3 are externally screwed into threaded holes I1-2-2 through expansion holes I1-2-5 of a handle I1-2 of a proximal part 1 by an end of a cylinder 3-1 of one expansion bolt 3, a circular table body 3-2 of the expansion bolt 3 is arranged outside the expansion holes I1-2-5, and the expansion degree is that 4 blades I1-2-4 are not expanded;

screwing the cylindrical body 3-1 end of the other expansion bolt 3 into the threaded hole II 2-2-2 through an expansion hole II 2-2-5 of the handle II 2-2 of the distal part 2, and placing the circular table body 3-2 of the expansion bolt 3 outside the expansion hole II 2-2-5 to the extent that 4 blades II 2-2-4 are not expanded;

inserting a handle part I1-2 of a proximal part component 1 screwed in an expansion bolt 3 into a bone marrow cavity at the upper end of a femur 6, lightly knocking a reconstruction part I1-1 of the proximal part component 1 by a hammer to achieve tight press fit of the handle part I1-2 and a bone wall of the marrow cavity, inserting a screwdriver into a polygonal blind hole I3-1-3 of the expansion bolt 3, and rotating the expansion bolt 3 anticlockwise to enable a circular table body 3-2 of the expansion bolt 3 to enter an expansion hole I1-2-5 of the handle part I1-2, expanding 4 blades I1-2-4 to achieve tighter press fit with the bone wall of the marrow cavity, and locking positions of the circular table body 3-2 and the 4 blades I1-2-4 of the expansion bolt 3 can be achieved by arranging an anti-rotation plunger 5;

inserting a handle part II 2-2 of a distal part 2 screwed in an expansion bolt 3 into a diaphysis medullary cavity at the lower end of a femur 6, lightly knocking a reconstruction part II 2-1 of the distal part 2 by a hammer to achieve tight press fit of the handle part II 2-2 and the medullary cavity bone wall, inserting a screwdriver into a polygonal blind hole I3-1-3 of the expansion bolt 3, and rotating the expansion bolt 3 anticlockwise to enable a circular table body 3-2 of the expansion bolt 3 to enter an expansion hole II 2-2-5 of the handle part II 2-2 and expand 4 blades II 2-2-4 to be more tightly pressed fit with the medullary cavity bone wall, and locking positions of the circular table body 3-2 and the 4 blades II 2-2-4 of the expansion bolt 3 can be realized by arranging an anti-rotation plunger 5;

butting the reconstruction part I1-1 of the proximal part 1 and the reconstruction part II 2-1 of the distal part 2 together, wherein two convex surfaces I1-1-4 and two concave surfaces I1-1-5 of the reconstruction part I1 of the proximal part 1 are in contact with two concave surfaces II 2-1-5 and two convex surfaces II 2-1-4 of the reconstruction part II 2-1 of the distal part 2;

the inclined planes I1-1-6 and the inclined planes II 1-1-7 of the reconstruction part I1-1 of the proximal part 1 are in contact with the inclined planes IV 2-1-7 and the inclined planes III 2-1-6 of the reconstruction part II 2-1 of the distal part 2;

the blind holes II 4-1 of the two connecting bolts 4 are respectively provided with an anti-rotation plunger 5, the two connecting bolts 4 are respectively screwed with the two threaded holes 1-1-3-1 of the proximal part 1 through the two counter bores 2-1-3-1 of the distal part 2, the proximal part 1 and the distal part 2 are fixed together, the prosthesis is successfully installed, and the two anti-rotation plungers 5 can realize the locking of the positions of the proximal part 1 and the distal part 2.

The proximal and distal components, the expansion bolts and the connecting bolts of the present diaphysis prosthesis are made of titanium alloy and the anti-rotation plug is made of polyethylene.

The biomechanical experiment of the backbone prosthesis:

biomechanical experiments are reliable methods for assessing tension and compression, and have become one of the most important methods in orthopedic biomechanics. The practicability of the backbone prosthesis is verified by adopting a biomechanics experiment. The backbone prosthesis is arranged on a BOSEElectroForce 3510(Bose Co, MN, America) instrument and is used for biomechanical experiments. Three backbone prostheses are tested in a biomechanical experiment, a male adult cadaver femur specimen is selected in the experiment, the femur embedded with the backbone prostheses is fixed on a BOSEElectroForce 3510 instrument, the tension and the pressure of both ends of the femur are both 2000 cattle, and the embedded backbone prostheses are observed to have displacement and separation. The experimental results are as follows: after the backbone prostheses of the three rotating type tube expansion structure handles are arranged in the femoral shaft, the tensile force and the pressure of 2000 cows can be effectively resisted, and the three backbone prostheses do not displace and separate. And (4) conclusion: biomechanical experiments verify the practicability of the backbone prosthesis of the handle with the back-screwing type tube expansion structure.

The above description specifically describes the preferred embodiment of the present invention, but the present invention is not limited to the above femur example, and may be used for long bone shafts such as tibia and humerus, and the design of the handle with the rotary type expanding tube structure is not only suitable for the biological fixation type bone shaft prosthesis, but also suitable for the technical fields of bone cement fixation type bone shaft prosthesis, joint prosthesis, and the like. Those skilled in the art can make various equivalent changes or substitutions without departing from the spirit of the invention, and such equivalent changes or substitutions are included in the scope of the invention defined by the claims of the present application.

Claims

1. The utility model provides a backbone prosthesis of type expand tube structure handle revolves, its characterized in that: comprises a proximal part (1), a distal part (2), an expansion bolt (3), a connecting bolt (4) and an anti-rotation plunger (5);

the proximal part (1) is composed of a reconstruction part I (1-1) and a hollow handle part I (1-2) which are of an integral structure;

the distal part (2) consists of a reconstruction part II (2-1) and a hollow handle part II (2-2) which are of an integral structure;

the blind holes I (3-1-2) of the two expansion bolts (3) are respectively provided with an anti-rotation plunger piston (5), the end of the cylinder (3-1) of one expansion bolt (3) is arranged in the threaded hole I (1-2-2) of the handle I (1-2) through the expansion hole I (1-2-5) of the handle I (1-2) of the proximal part (1), the circular table body (3-2) of the expansion bolt (3) is arranged outside the expansion hole I (1-2-5),

the expansion bolt (3) is retreated counterclockwise, the round table body (3-2) of the expansion bolt (3) enters the expansion hole I (1-2-5) of the handle I (1-2), 4 blades I (1-2-4) are expanded, and the round table body (3-2) of the expansion bolt (3) and the 4 blades I (1-2-4) can be locked by the aid of the anti-rotation plunger (5);

the other end of the cylinder (3-1) of the expansion bolt (3) is arranged in the threaded hole II (2-2-2) of the handle II (2-2) through the expansion hole II (2-2-5) of the handle II (2-2) of the distal part (2), the circular table body (3-2) of the expansion bolt (3) is arranged outside the expansion hole II (2-2-5),

the expansion bolt (3) is retreated counterclockwise, the round table body (3-2) of the expansion bolt (3) enters the expansion hole II (2-2-5) of the handle II (2-2), 4 blades II (2-2-4) are expanded, and the locking of the round table body (3-2) of the expansion bolt (3) and the positions of the 4 blades II (2-2-4) can be realized through the arrangement of the anti-rotation plunger (5);

the reconstruction part I (1-1) of the proximal part (1) is butted with the reconstruction part II (2-1) of the distal part (2), two convex surfaces I (1-1-4) and two concave surfaces I (1-1-5) of the reconstruction part I (1-1) of the proximal part (1) are corresponding to two concave surfaces II (2-1-5) and two convex surfaces II (2-1-4) of the reconstruction part II (2-1) of the distal part (2),

the inclined planes I (1-1-6) and the inclined planes II (1-1-7) of the reconstruction part I (1-1) of the proximal part (1) are in contact with the inclined planes IV (2-1-7) and the inclined planes III (2-1-6) of the reconstruction part II (2-1) of the distal part (2),

the blind holes II (4-1) of the two connecting bolts (4) are respectively provided with an anti-rotation plunger (5), the two connecting bolts (4) are respectively screwed with the two threaded holes (1-1-3-1) of the proximal part (1) through the two counter bores (2-1-3-1) of the distal part (2) to fix the proximal part (1) and the distal part (2), and the anti-rotation plunger (5) can lock the proximal part (1) and the distal part (2).

2. The stem prosthesis of a supinated tube expander stem of claim 1, wherein:

the base end of the reconstruction part I (1-1) is a cylinder I (1-1-1), the connecting end is a semi-cylinder I (1-1-2), a semi-circular groove I (1-1-3) is vertically arranged on the plane of the semi-cylinder I (1-1-2), two threaded holes (1-1-3-1) are vertically arranged on the outer circular surface of the semi-cylinder I (1-1-2) at intervals, the two threaded holes (1-1-3-1) are communicated with the semi-circular groove I (1-1-3), two convex surfaces I (1-1-4) and two concave surfaces I (1-1-5) are symmetrically arranged on two side walls of the semi-circular groove I (1-1-3), an inclined surface I (1-1-6) is arranged below the semi-cylinder I (1-1-2), an inclined plane II (1-1-7) is arranged below the cylinder I (1-1-1), and a mesopore I (1-1-1-1) is arranged on the inclined plane II (1-1-7);

4 round holes I (1-2-1) are horizontally arranged at intervals at the upper part of a handle I (1-2), hollow holes of the handle I (1-2) between the 4 round holes I (1-2-1) and a mesopore I (1-1-1-1) of a cylinder I (1-1-1) are threaded holes I (1-2-2), the threaded holes I (1-2-2) are communicated with a semicircular groove I (1-1-3) through the mesopore I (1-1-1-1), 4 gaps I (1-2-3) are arranged between the 4 round holes I (1-2-1) and the tail end spherical surface of the handle I (1-2), 4 blades I (1-2-4) are formed between the 4 gaps I (1-2-3), the hollow holes of the 4 blades I (1-2-4) are expansion holes I (1-2-5), the expansion holes I (1-2-5) are communicated with the threaded holes I (1-2-2), and the tail end faces of the 4 blades I (1-2-4) are cambered surfaces (1-2-6);

the outer surface of the handle I (1-2) is provided with a titanium coating I (1-2-7).

3. The stem prosthesis of a supinated tube expander stem of claim 1, wherein:

the base end of the reconstruction part II (2-1) is a cylinder II (2-1-1), the connecting end is a semi-cylinder II (2-1-2), a semi-circular groove II (2-1-3) is vertically arranged on the plane of the semi-cylinder II (2-1-2), two counter bores (2-1-3-1) are vertically arranged on the outer circular surface of the semi-cylinder II (2-1-2) at intervals, the two counter bores (2-1-3-1) are communicated with the semi-circular groove II (2-1-3), two convex surfaces II (2-1-4) and two concave surfaces II (2-1-5) are symmetrically arranged on the two side walls of the semi-circular groove II (2-1-3), an inclined surface III (2-1-6) is arranged on the semi-cylinder II (2-1-2), an inclined plane IV (2-1-7) is arranged on the upper surface of the cylinder II (2-1-1), and a middle hole II (2-1-1-1) is arranged on the inclined plane IV (2-1-7);

4 round holes II (2-2-1) are horizontally arranged at intervals at the lower part of the handle II (2-2), a hollow hole of the handle II (2-2) between the 4 round holes II (2-2-1) and a mesopore II (2-1-1-1) of the cylinder II (2-1-1) is a threaded hole II (2-2-2), the threaded hole II (2-2-2) is communicated with the semicircular groove II (2-1-3) through the mesopore II (2-1-1), 4 gaps II (2-2-3) are arranged between the 4 round holes II (2-2-1) and the spherical surface of the tail end of the handle II (2-2), 4 blades II (2-2-4) are formed between the 4 gaps II (2-2-3), the hollow holes of the 4 blades II (2-2-4) are expansion holes II (2-2-5), the expansion holes II (2-2-5) are communicated with the threaded holes II (2-2-2), and the tail end surfaces of the 4 blades II (2-2-4) are cambered surfaces (2-2-6);

the outer surface of the handle II (2-2) is provided with a titanium coating II (2-2-7).

4. The stem prosthesis of a supinated tube expander stem of claim 1, wherein:

one end of the expansion bolt (3) is a cylinder (3-1), the other end of the expansion bolt is a cone (3-2), the end face of the cone (3-2) is a spherical surface (3-2-1), an external thread II (3-1-1) and a blind hole I (3-1-2) are arranged on the cylinder, and a polygonal blind hole I (3-1-3) is arranged on the tail end face of the cylinder.

5. The stem prosthesis of a supinated tube expander stem of claim 1, wherein:

the screw rod part of the connecting bolt (4) is provided with a blind hole II (4-1), and the head part of the connecting bolt (4) is provided with a polygonal blind hole II (4-2).

6. The stem prosthesis of a supinated tube expander stem of claim 1, wherein:

the anti-rotation plunger (5) is a cylinder; the anti-rotation plunger (5) is made of polyethylene.

7. A method of using a stem prosthesis employing the post-rotation expansion-tube stem of claim 1, comprising the steps of:

firstly, removing bone tissues of a thighbone (6) affected by tumor, reaming bones at two ends by using a reaming drill, then screwing the ends of cylinders (3-1) of two expansion bolts (3) into threaded holes I (1-2-2) through expansion holes I (1-2-5) of a handle I (1-2) of a proximal part (1) in vitro, wherein the blind holes I (3-1-2) of the two expansion bolts (3) are respectively provided with an anti-rotation plunger (5), a circular table body (3-2) of each expansion bolt (3) is arranged outside the corresponding expansion hole I (1-2-5), and 4 blades I (1-2-4) are not expanded to the degree;

screwing the cylindrical body (3-1) end of the other expansion bolt (3) into the threaded hole II (2-2-2) through the expansion hole II (2-2-5) of the handle II (2-2) of the distal part (2), placing the circular table body (3-2) of the expansion bolt (3) outside the expansion hole II (2-2-5), and taking 4 blades II (2-2-4) not to expand to the degree;

inserting a handle I (1-2) of a proximal part (1) screwed in an expansion bolt (3) into a bone marrow cavity at the upper end of a femur (6), lightly knocking a reconstruction part I (1-1) of the proximal part (1) by a hammer to achieve tight press fit of the handle I (1-2) and the bone wall of the marrow cavity, inserting a screwdriver into a polygonal blind hole I (3-1-3) of the expansion bolt (3), and the expansion bolt (3) is rotated anticlockwise to enable the round table body (3-2) of the expansion bolt (3) to enter the expansion hole I (1-2-5) of the handle I (1-2), the 4 blades I (1-2-4) are expanded to be in more tight press fit with the medullary cavity bone wall, and the locking of the positions of the round table body (3-2) of the expansion bolt (3) and the 4 blades I (1-2-4) can be realized by the arrangement of the anti-rotation plunger (5);

inserting a handle part II (2-2) of a distal part (2) screwed in an expansion bolt (3) into a diaphysis medullary cavity at the lower end of a femur (6), lightly knocking a reconstruction part II (2-1) of the distal part (2) by a hammer to achieve tight press fit of the handle part II (2-2) and the medullary cavity bone wall, then inserting a screwdriver into a polygonal blind hole I (3-1-3) of the expansion bolt (3), and the expansion bolt (3) is rotated anticlockwise to enable the round table body (3-2) of the expansion bolt (3) to enter the expansion hole II (2-2-5) of the handle II (2-2), expanding 4 blades II (2-2-4) to be in closer press fit with the medullary cavity bone wall, and locking the positions of the round table body (3-2) of the expansion bolt (3) and the 4 blades II (2-2-4) by the arrangement of the anti-rotation plunger (5);

butting a reconstruction part I (1-1) of the proximal part (1) and a reconstruction part II (2-1) of the distal part (2) together, wherein two convex surfaces I (1-1-4) and two concave surfaces I (1-1-5) of the reconstruction part I (1-1) of the proximal part (1) are corresponding to two concave surfaces II (2-1-5) and two convex surfaces II (2-1-4) of the reconstruction part II (2-1) of the distal part (2);

the inclined plane I (1-1-6) and the inclined plane II (1-1-7) of the reconstruction part I (1-1) of the proximal part (1) are in contact with the inclined plane IV (2-1-7) and the inclined plane III (2-1-6) of the reconstruction part II (2-1) of the distal part (2);

the anti-rotation plunger piston (5) is arranged in each blind hole II (4-1) of each connecting bolt (4), the two connecting bolts (4) are in threaded connection with the two threaded holes (1-1-3-1) of the proximal part (1) through the two counter bores (2-1-3-1) of the distal part (2) respectively, the proximal part (1) and the distal part (2) are fixed together, the prosthesis is successfully installed, and the locking of the positions of the proximal part (1) and the distal part (2) can be realized through the arrangement of the two anti-rotation plunger pistons (5).