CN111513887B - Sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion - Google Patents
Sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion Download PDFInfo
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- CN111513887B CN111513887B CN202010351770.6A CN202010351770A CN111513887B CN 111513887 B CN111513887 B CN 111513887B CN 202010351770 A CN202010351770 A CN 202010351770A CN 111513887 B CN111513887 B CN 111513887B
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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
-
- 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
-
- 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
- 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
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
-
- 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
- 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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30462—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable
-
- 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
- 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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
-
- 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
- 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
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
-
- 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
- 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
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
-
- 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
- A61F2002/30996—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for sterno-clavicular joints
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention relates to the technical field of medical instruments, and provides a sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion. The sternum prosthesis is provided with a sternal lock bracket, two sides of the upper part of the sternal lock bracket are respectively and rotatably provided with a clavicle broach, two sides of the middle part of the sternal lock bracket are provided with a plurality of first grooves, each first groove is connected with one end of each titanium alloy woven belt, the other end of each titanium alloy woven belt is connected with a rib plate, and the lower part of the sternal lock bracket is provided with a sternal broach; each of the clavicle intramedullary nails can rotate 30 degrees upwards, 10 degrees downwards, 30 degrees forwards and 10 degrees backwards. The invention has the beneficial effects that: the motion range of the sternoclavicular joint is greatly improved and is larger than the motion angle of the self sternoclavicular joint of the human body, and the requirement of recovering the motion of the sternoclavicular joint of a patient can be basically met.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion.
Background
The sternum (sternum) is located in the center of the anterior chest wall, is a flat bone with wide upper part and narrow lower part, convex front part and concave rear part, and is divided into a sternal stem, a sternal body and a xiphoid process.
The sternum, ribs, spine and intercostal muscles form an osseous cage-shaped support, namely a thorax. The thorax contains important internal organs such as heart, lung, trachea, bronchus, mediastinum, etc., which are the bony base and the support of the chest wall and participate in the respiratory movement of the human body.
The support function of the sternum is very important for human body, therefore, after the sternum is cut off, the sternum structure needs to be reconstructed, and the existing reconstruction technology is usually to design a specifically matched sternum plate prosthesis according to the size of the cut part of the sternum of a patient, and unlike the fixing mode of the rib side, the prosthesis of the integral sternum rib plate is directly designed, or the rib plate is fixed on the sternum plate by nailing on the sternum plate.
The prior patents specifically illustrate some sternal reconstruction techniques of the prior art, such as chinese patent applications CN201710484103.3, CN201610641252.1, CN201910718312.9, etc., which disclose related sternal reconstruction techniques, but still suffer from the following drawbacks:
(1) Prostheses manufactured by the existing sternal reconstruction technology cannot completely restore the motion of the sternoclavicular joint.
(2) Prostheses manufactured by the existing sternal reconstruction technology cannot restore micromotion between sternocostal joints.
Disclosure of Invention
The invention aims to provide a sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion, which aims to solve the technical problems in the prior art.
In order to achieve the purpose, the invention adopts the technical scheme that: a sternum prosthesis for reconstructing sternoclavicular joint movement and sternocostal joint movement is provided with a sternoclavicular intramedullary pin, wherein two sides of the upper part of the sternoclavicular bracket are respectively and rotatably provided with a clavicle intramedullary pin, two sides of the middle part of the sternoclavicular bracket are provided with a plurality of first grooves, one end of each titanium alloy woven belt is connected through each first groove, the other end of each titanium alloy woven belt is connected with a costal plate, and the lower part of the sternoclavicular bracket is provided with a sternoclavicular intramedullary pin; each of the clavicle intramedullary nails can rotate 30 degrees upwards, 10 degrees downwards, 30 degrees forwards and 10 degrees backwards.
In an optional embodiment, two sides of the upper part of the chest lock bracket are respectively provided with a broach installation part, and the broach installation part is provided with external threads and an inner cavity.
In an alternative embodiment, the intramedullary clavicle needle comprises: a ball head, a neck and a broach part; the length of the medullary needle part is 30-70mm, the diameter of the top of the medullary needle part is 3-7mm, and the diameter of the root of the medullary needle part is 8-14mm; the diameter of the neck part is 6-12mm, and the length of the neck part is 3-8mm; the clavicle intramedullary nail has a certain radian, and the radian ranges from 5 degrees to 35 degrees
In an optional embodiment, an inner liner and an outer liner are installed in an inner cavity of the broach installation portion, the ball head is installed between the inner liner and the outer liner, the clavicle broach penetrates through the first through hole of the self-locking cap, the internal thread of the self-locking cap is matched with the external thread, and the arc-shaped portion of the self-locking cap is matched with the outer liner.
In an optional embodiment, the number of the first grooves of the chest lock support is 4, the main body part of the chest lock support is provided with 3 second through holes, and the main body part of the chest lock support is also provided with a grid structure; the sternum broach is provided with 3 third through holes, and two sides of the sternum broach are zigzag.
In an optional embodiment, 1 clamping block made of high polymer polyethylene material is respectively arranged in the first groove of the chest lock bracket and the second groove of the rib plate, the clamping block is provided with a ball head clamping groove, and two ball heads of the titanium alloy braided belt are respectively matched with the ball head clamping grooves of the two clamping blocks.
In an optional embodiment, a sternum pressing plate is clamped in the first groove, and a clamping block in the first groove is matched with a clamping groove I of the sternum pressing plate; the sternum pressing plate is provided with a first through groove for the titanium alloy woven belt to penetrate out, and the sternum pressing plate is fixed to the sternoclave bracket through two screws.
In an optional embodiment, a rib pressing plate is clamped in the second groove of the rib plate, the clamping block in the second groove is matched with the second clamping groove of the rib pressing plate, the rib pressing plate is provided with a second through groove for the titanium alloy woven belt to penetrate through, and the rib pressing plate is fixed to the rib plate through two screws.
In an alternative embodiment, the rib plate is symmetrical in structure at two sides and is respectively provided with an encircling structure; the rib plate is also provided with a boss and 2 screw holes for the screw holes to pass through, and the boss is matched with the groove III of the rib pressing plate.
The invention has the beneficial effects that:
(1) The artificial joint angle can reach the rotating ranges of 30 degrees upwards, 10 degrees downwards, 30 degrees forwards and 10 degrees backwards, and is larger than the motion angle of the sternoclavicular joint of a human body.
(2) The chest lock bracket, the sternum pressing plate, the titanium alloy woven belt, the clamping block, the rib pressing plate, the rib plate and other structures in the invention are flexible devices after being installed, but the reconstructed chest rib joint part in the prior art is a rigid structure, so that the chest rib motion mode of a patient cannot be well restored. The middle of the flexible device is replaced by a titanium alloy braided belt to reconstruct costal cartilage of a patient, the titanium alloy braided belt can move randomly in space according to the stress condition, and the micromotion of the thoracic rib joint of the patient is completed.
Drawings
In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed for the embodiments or the prior art descriptions will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings without creative efforts.
Fig. 1 is a schematic overall structural diagram of a sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion according to an embodiment of the present invention.
Fig. 2 is a schematic structural diagram of a clavicle intramedullary nail according to an embodiment of the invention.
Fig. 3 is a schematic structural diagram of a self-locking cap according to an embodiment of the present invention.
Fig. 4 is a schematic structural diagram of a chest lock bracket according to an embodiment of the present invention.
Fig. 5 (a) is a front view of a sternal compression plate provided by an embodiment of the present invention.
Fig. 5 (b) is a half sectional view of a sternal compression plate provided by an embodiment of the present invention.
Fig. 6 (a) is a front view of a latch according to an embodiment of the present invention.
Fig. 6 (b) is a half sectional view of a latch according to an embodiment of the present invention.
FIG. 7 (a) is an elevational, semi-sectional view of a rib clamp according to one embodiment of the present invention.
Fig. 7 (b) is a left side view of a rib clamp according to an embodiment of the present invention.
Fig. 7 (c) is a bottom view of a rib plate according to an embodiment of the present invention.
Fig. 8 is a front view of a ribbed plate according to one embodiment of the invention.
Fig. 9 is a schematic structural diagram of an outer liner according to an embodiment of the present invention.
Fig. 10 is a schematic structural diagram of a liner according to an embodiment of the present invention.
Wherein, the reference numbers in the figures are: 1. 1-1 parts of clavicle intramedullary nail, 1-2 parts of ball head, 1-3 parts of neck, 1-3 parts of intramedullary nail part, 2 parts of self-locking cap, 2-1 parts of through hole I, 2-2 parts of arc part, 2-3 parts of internal thread, 3 parts of chest lock bracket, 3-1 parts of external thread, 3-2 parts of intramedullary nail mounting part, 3-3 parts of through hole II, 3-4 parts of groove I, 3-5 parts of grid structure, 3-6 parts of sternum intramedullary nail, 3-7 parts of through hole III, 4 parts of sternum pressing plate, 4-1 parts of through groove I, 4-2 parts of screw hole, 4-3 parts of clamping groove I, 5 parts of titanium alloy woven band, 6 parts of clamping block, 6-1 parts of ball head clamping groove, 7 parts of rib pressing plate, 7-1 parts of clamping groove II, 7-2 parts of through groove II, 7-3 parts of groove III, 7-4 parts of screw hole, 8 parts of rib plate, 8-1 parts of boss, 8-2 parts of screw hole, 8-3 parts of groove II, 8-4 parts of clamping groove, 9 parts of surrounding structure, 9 parts of outer lining, 10 parts of lining and inner lining.
Detailed Description
In order to make the technical problems, technical solutions and advantageous effects to be solved by the present invention more clearly apparent, the present invention is further described in detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and do not limit the invention.
It will be understood that when an element is referred to as being "secured to" or "disposed on" another element, it can be directly or indirectly secured to the other element. When an element is referred to as being "connected to" another element, it can be directly or indirectly connected to the other element. The terms "upper", "lower", "left", "right", "front", "rear", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like indicate orientations or positions based on the orientations or positions shown in the drawings, and are for convenience of description only and not to be construed as limiting the technical solution. The terms "first", "second" and "first" are used merely for descriptive purposes and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features. The meaning of "plurality" is two or more unless specifically limited otherwise.
The present embodiment aims to provide a sternum prosthesis for reconstructing sternoclavicular joint motion and sternocostal joint motion, which comprises a intramedullary nail 1, a titanium alloy material, and 3D printing, as shown in fig. 2, the intramedullary nail 1 comprises three parts, namely a intramedullary nail part 1-3, a neck part 1-2 and a ball head 1-1, wherein the intramedullary nail part 1-3 is inserted into the medullary cavity of the patient on the left and right sides to fix the intramedullary nail 1, preferably, the length of the intramedullary nail 1 is 30-70mm, the top diameter of the intramedullary nail part 1-3 is 3-7mm, the root diameter of the intramedullary nail part 1-3 is 8-14mm, and the intramedullary nail 1 is designed to have a certain radian according to the medullary cavity of the patient, the radian range is 5-35 °.
Specifically, a ball head 1-1 of a clavicle broach 1 is matched with a self-locking cap 2, a sternoclavicular bracket 3, an outer lining 9 and an inner lining 10 to form a prosthesis structure capable of recovering the movement of a sternoclavicular joint of a patient, wherein the ball head 1-1 is directly contacted with the outer lining 9 and the inner lining 10, and the diameter of the ball head 1-1 is determined according to the diameter of the clavicle of the patient and is 10-18mm; the neck part 1-2 is the transition part of the medullary needle part 1-3 and the ball head 1-1, the diameter is 6-12mm, and the length is 3-8mm.
In this embodiment, the self-locking cap 2 is made of a titanium alloy material, as shown in fig. 3, the self-locking cap 2 is installed and matched with the chest lock support 3 in a threaded connection manner, the inner liner 10 is placed in a matching portion of the chest lock support 3, the outer liner 9 is placed in an arc-shaped portion 2-2 of the self-locking cap 2, the ball head 1-1 of the intramedullary nail 1 is arranged between the inner liner 10 and the outer liner 9, meanwhile, the neck 1-2 of the intramedullary nail 1 penetrates out of a through hole one 2-1 in the self-locking cap 2, and a gap is left between the neck 1-2 and the edge of the through hole one 2-1, so that the intramedullary nail 1, the self-locking cap 2 and the chest lock support 3 can rotate relatively by taking the center of the ball head 1-1 as an origin, and the rotation angle is larger than the clavicle rotation angle of a patient.
The inner diameter of a through hole I2-1 in the self-locking cap 2 is 10-20mm, and the length is 1-2mm; the size of the arc part 2-2 is 16-22mm, the length is 3-6mm, and the chamfer angle is R1-R3mm; the internal thread 2-3 is M18-M24mm, and the length of the thread part is 4-8mm; the maximum outer diameter of the self-locking cap 2 is 22-30mm, and the total length of the self-locking cap 3 is 8-14mm. In an alternative embodiment, a pin hole is added on the side surface of the self-locking cap 2, the pin hole is used for preventing the prosthesis from being pulled out caused by reverse rotation of the self-locking cap 2 after the prosthesis is installed, and the pin hole is arranged in the middle of the thread section of the internal thread 2-3 and faces towards the front side of the body, so that the installation and the prosthesis processing in operation are facilitated. The self-locking cap 2 is convenient to install in the operation and is convenient to detach in the later renovation.
As shown in attached figure 4, the chest lock bracket 3 is made of titanium alloy materials, 3D printing forming is conducted, external threads 3-1 are matched with internal threads 2-3 of the self-locking cap 2, the inner lining 9 is installed in a broach installation part 3-2 of the chest lock bracket 3, the outer lining 10 is installed in the self-locking cap 2 and is in contact with the bottom lining 9, a chest lock joint movement structure is formed, the thread length of the external threads 3-1 of the chest lock bracket 3 is 4-8mm, the diameter of the external threads 3-1 is M18-M24mm, and the size of the broach installation part 3-2 of the chest lock bracket 3 is the same as that of the inner lining 10.
The first grooves 3-4 are matched with the sternum pressing plate 4 and the fixture block 6, and meanwhile, the titanium alloy woven belt 5 is placed in the fixture block 6 to form flexible connection between the sternum ribs and reconstruct a micro-motion structure of the sternum rib joint; the sternal medullary needle 3-6 is inserted into the remaining sternal body after the tumor is removed, the sternal medullary needle section is designed with 3 through holes II 3-7, and the doctor in the operation nails pass through the through holes II 3-7 to prevent the prosthesis from being pulled out upwards. The two sides of the sternum medullary needle 3-6 are designed to be zigzag, which increases holding force for bone cement coating installation in operation and prevents falling out. The length of the sternum medullary needle 3-6 is 35-90mm, the root width of the medullary needle is 14-18mm, the thickness is 4-6mm, the top width of the sternum medullary needle 3-6 is 12-16mm, and the thickness is 3.5-5.5mm. The contour of the osteotomy segment is trimmed according to the bone of the patient, 3 through holes II 3-3 are arranged in the middle of the main body of the chest lock bracket 3, and the through holes II 3-3 not only reduce weight, but also increase the probability that the skin and mediastinal tissues on both sides of the prosthesis grow together, thereby improving the stability of the prosthesis.
The sternum pressing plate 4 is made of titanium alloy, fig. 5 (a) is a front view, fig. 5 (b) is a half-section view, the sternum pressing plate 4 is connected with the sternoclave bracket 3 through two screws, and the sternum pressing plate 4 can be just clamped in a first 3-4 part of the groove of the sternoclave bracket 3; the fixture block 6 can be placed in the first slot 4-3 of the sternum pressing plate 4; the size of the first clamping groove 4-3 is determined according to the size of the clamping block 6. The titanium alloy woven belt 5 is matched with the clamping block 6 and penetrates through the first through groove 4-1 of the sternum pressing plate 4, and the size of the first through groove 4-1 is adjusted according to the diameter and the distance of the titanium alloy woven belt 5 and is larger than the size of the titanium alloy woven belt 5 by about 0.5-1 mm.
In this embodiment, the titanium alloy woven belt 5 is composed of 3 titanium alloy woven wires, two sides of the titanium alloy woven belt 5 are titanium alloy bulbs, the bulbs on the two sides are respectively fixed in the clamping blocks 6 on the two sides, and are matched with the pressing plates on the two sides (the sternum pressing plate 4, the rib pressing plate 7, the rib plate 8 and the chest lock bracket 3 to form a prosthesis structure for recovering the motion of the sternocostal joint), the diameter of the bulb of the titanium alloy woven belt 5 is 1.3 times of the diameter of the wire, and the length and the diameter are customized according to the requirements of a patient.
In the attached drawing 6, a fixture block 6 is made of high molecular weight polyethylene, ball heads on two sides of a titanium alloy braided belt 5 are clamped into a ball head clamping groove 6-1, the size of the ball head clamping groove 6-1 is determined according to the diameter of the ball head of the titanium alloy braided belt 5, the diameter is usually within the range of 1-2mm, the length of the fixture block 6 is 8-13mm, the width of the fixture block is 4-8mm, and the thickness of the fixture block is 2.5-5mm. The fixture block 6 is arranged in the first groove 3-4 of the chest lock bracket 3 and also in the second groove 8-3 of the rib plate 8, and one side of the titanium alloy braided belt 5 is respectively fixed at the two sides to form a structure for recovering the motion of the chest rib joint.
More specifically, the rib pressing plate 7 is made of titanium alloy material, fig. 7 (a) is a front half-sectional view, fig. 7 (b) is a left side view, fig. 7 (c) is a bottom view, the rib pressing plate 7 is matched with the rib plate 8, the titanium alloy woven belt 5 and the fixture block 6, the fixture block 6 is placed in a second clamping groove 7-1 of the rib pressing plate 7, and the size of the second clamping groove 7-1 is the same as that of the fixture block 6. The titanium alloy woven belt 5 which penetrates out of the clamping block 6 passes through the second through groove 7-2 to be matched with the clamping block 6 in the chest lock bracket 3 on the other side, and the connection of the sternum prosthesis and the rib plate 8 is completed. The rib pressing plate 7 is connected with the rib bone plate 8 through two screws, the groove III 7-3 is matched with a boss 8-1 in the rib bone plate 8 and used for positioning and fixing the rib bone plate 8 and the rib pressing plate 7, the thickness of the groove III 7-3 is 1-2mm, the length of the groove III 7-3 is smaller than the total length of the rib pressing plate 7 by 2-6mm, the width of the groove III 7-3 is larger than the diameter of a thread by 2-6mm, and the rib pressing plate 7 is completely bilaterally symmetrical.
In addition, the rib plate 8 is made of titanium alloy and can be bent, the rib plate 8 is bent to be attached to the rib of a patient through preoperative simulation, as shown in the attached drawing 8, two screw holes 8-2 are symmetrically distributed on the boss 8-1, the rib plate 8 and the rib pressing plate 7 are assembled through the two screw holes 8-2, the boss 8-1 plays a positioning role, the size of the boss 8-1 is the same as the size of the groove III 7-2 of the rib pressing plate 7, and the size of the screw holes 8-2 is designed according to actual conditions. The second groove 8-3 is matched with the fixture block 6, and the size of the second groove is the same as that of the fixture block 6. The rib plate 8 is connected with the rib through a self-locking cortical bone screw, after the surrounding structure 8-4 is used for installing the rib plate, the surrounding structure 8-4 is bent to just surround the rib, and the installation stability of the rib plate 8 is improved.
As shown in figure 9, the outer lining 9 is made of high molecular weight polyethylene, the outer lining 9 is placed in the self-locking cap 2, the size of the outer lining 9 is the same as that of an arc-shaped part 2-2 in the self-locking cap 2, the outer lining 9 and the bottom lining 10 are mainly used for separating a ball head 1-1 of the clavicle broach 1 from being in direct contact with the chest lock bracket 3, the friction between metals is changed into the friction between the metals and the polyethylene, and the wear rate of the high molecular weight polyethylene is low. As shown in FIG. 10, the material of the liner 10 is high molecular weight polyethylene, and the liner 10 is installed in the chest lock bracket 3.
As shown in fig. 1, the installation process of the prosthesis is as follows: inserting the sternum broach 3-6 of the sternum bracket 3 into the residual bone of the sternum body, coating bone cement, driving three costal nails into the three costal nails, leading the three costal nails to pass through the three through holes II 3-7 of the sternum broach 3-6, leading the sternum bracket 3 to be capable of fixing, placing the inner lining 10 into the sternum bracket 3, placing the outer lining 9 into the self-locking cap 2, and leading the two to penetrate into the broach parts 1-3 of the clavicle broach 1 together; then the marrow needle part 1-3 of the clavicle marrow needle 1 is inserted into the residual bone of the clavicle, then the ball head 1-1 of the clavicle marrow needle 1 is put into the liner 10, the self-locking cap 2 is screwed with the chest lock bracket 3, and the other side is fixed in the same way. Then, a clamping block 6 is placed on the rib plate 8, a ball head on one side of the titanium alloy woven belt 5 is placed in the clamping block 6, the clamping block 6 is placed in a corresponding position on the rib pressing plate 7, the rib pressing plate 7 and the clamping block 6 are fixed on the rib plate 8 together through screws, and the rib plate 8 is fixed at a proper position on the left rib of the first rib through a rib nail; the fixture block 6 is arranged at the corresponding position on the chest lock bracket 3, the ball head at the other side of the titanium alloy braided belt 5 is placed in the fixture block 6 arranged on the chest lock bracket 3, another same fixture block 6 is placed at the corresponding position of the sternum pressing plate 4, the sternum pressing plate 4 is placed on the chest lock bracket 3 and is fixedly connected through screws at two sides, and the rest ribs are fixedly arranged in the same way, so that the micromotion of the sternal rib joint can be recovered.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.
Claims (4)
1. A sternum prosthesis for reconstructing sternoclavicular joint movement and sternocostal joint movement is provided with a sternoclavicular bracket (3), two sides of the upper part of the sternoclavicular bracket (3) are respectively and rotatably provided with a clavicle broach (1), two sides of the middle part of the sternoclavicular bracket (3) are provided with a plurality of grooves I (3-4), each groove I (3-4) is connected with one end of each titanium alloy woven belt (5), the other end of each titanium alloy woven belt (5) is connected with a costal plate (8), and the lower part of the sternoclavicular bracket (3) is provided with a sternoclavicular broach (3-6);
the method is characterized in that: each clavicle intramedullary pin (1) can rotate upwards by 30 degrees, downwards by 10 degrees, forwards by 30 degrees and backwards by 10 degrees;
two sides of the upper part of the chest lock bracket (3) are respectively provided with a broach mounting part (3-2), and the broach mounting part (3-2) is provided with an external thread (3-1) and an inner cavity; the intramedullary clavicle needle (1) comprises: a ball head (1-1), a neck part (1-2) and a broach part (1-3); the length of the medullary needle part (1-3) is 30-70mm, the diameter of the top of the medullary needle part (1-3) is 3-7mm, and the diameter of the root of the medullary needle part (1-3) is 8-14mm; the diameter of the neck part (1-2) is 6-12mm, and the length is 3-8mm; the clavicle intramedullary nail (1) has a certain radian, and the radian ranges from 5 degrees to 35 degrees;
an inner lining (10) and an outer lining (9) are installed in an inner cavity of the broach installation part (3-2), the ball head (1-1) is installed between the inner lining (10) and the outer lining (9), the clavicle broach (1) penetrates through a first through hole (2-2) of the self-locking cap (2), an internal thread (2-3) of the self-locking cap (2) is matched with the external thread (3-1), and an arc-shaped part (2-1) of the self-locking cap (2) is matched with the outer lining (9);
the number of the first grooves (3-4) of the chest lock support (3) is 4, the main body part of the chest lock support (3) is provided with a second through hole (3-3), and the main body part of the chest lock support (3) is also provided with a grid structure (3-5); the sternum broach (3-6) is provided with 3 through holes III (3-7), and two sides of the sternum broach (3-6) are zigzag; 1 clamping block (6) made of high polymer polyethylene material is arranged in each of the first groove (3-4) of the chest lock bracket (3) and the second groove (8-3) of the rib plate (8), each clamping block (6) is provided with a ball head clamping groove (6-1), and two ball heads of the titanium alloy braided belt (5) are respectively matched with the ball head clamping grooves (6-1) of the two clamping blocks (6).
2. The sternal prosthesis for reconstructing sternal lock joint movement and sternal rib joint movement according to claim 1, wherein the first groove (3-4) is provided with a sternal pressing plate (4) therein, and the fixture block (6) in the first groove (3-4) is matched with the first groove (4-3) of the sternal pressing plate (4); the sternum pressing plate (4) is provided with a first through groove (4-1) for the titanium alloy woven belt (5) to penetrate out, and the sternum pressing plate (4) is fixed on the sternum lock bracket (3) through two screws.
3. The sternum prosthesis for reconstructing sternoclavicular joint movement and sternocostal joint movement according to claim 2, wherein a rib pressing plate (7) is clamped in the second groove (8-3) of the rib plate (8), the clamping block (6) in the second groove (8-3) is matched with the second clamping groove (7-1) of the rib pressing plate (7), the rib pressing plate (7) is provided with a second through groove (7-2) for the titanium alloy woven belt (5) to penetrate through, and the rib pressing plate (7) is fixed on the rib plate (8) through two screws.
4. The sternal prosthesis for the reconstruction of sternoclavicular and sternocostal joint movements according to claim 3, characterized in that said costal plate (8) is symmetrical on both sides, provided with respective embracing means (8-4); the rib plate (8) is further provided with a boss (8-1) and 2 screw holes (8-2) for the screw holes to pass through, and the boss (8-1) is matched with a groove III (7-3) of the rib pressing plate (7).
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CN105496537A (en) * | 2015-12-31 | 2016-04-20 | 林列 | Internal fixation steel plate for sternoclavicular joint |
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CN109199644A (en) * | 2018-10-30 | 2019-01-15 | 西安交通大学 | A kind of costal cartilage prothesis implant body of Bionic Design and preparation method thereof |
WO2019038647A1 (en) * | 2017-08-21 | 2019-02-28 | Conalmédicas Sas | Prosthetic device for reconstructing sterna, ribs and collarbones |
CN110680563A (en) * | 2019-10-31 | 2020-01-14 | 北京爱康宜诚医疗器材有限公司 | Sternum prosthesis |
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ES2748777T3 (en) * | 2015-02-24 | 2020-03-17 | Neuro France Implants | Prosthetic sternum device with handlebar |
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CN105496537A (en) * | 2015-12-31 | 2016-04-20 | 林列 | Internal fixation steel plate for sternoclavicular joint |
CN106264794A (en) * | 2016-07-31 | 2017-01-04 | 上海市肺科医院 | Sternal reconstruction modular hip implant |
WO2019038647A1 (en) * | 2017-08-21 | 2019-02-28 | Conalmédicas Sas | Prosthetic device for reconstructing sterna, ribs and collarbones |
CN108186165A (en) * | 2017-12-29 | 2018-06-22 | 云南大学 | The artificial sternum with turning joint of 3D printing and Artificial Rib connection structure |
CN109199644A (en) * | 2018-10-30 | 2019-01-15 | 西安交通大学 | A kind of costal cartilage prothesis implant body of Bionic Design and preparation method thereof |
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