CN111938874B - Ulna coronary process prosthesis device, installer and installation method thereof - Google Patents
Ulna coronary process prosthesis device, installer and installation method thereof Download PDFInfo
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- CN111938874B CN111938874B CN202010509468.9A CN202010509468A CN111938874B CN 111938874 B CN111938874 B CN 111938874B CN 202010509468 A CN202010509468 A CN 202010509468A CN 111938874 B CN111938874 B CN 111938874B
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- ulna
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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
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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
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
-
- 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
- A61F2002/2896—Ulna
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02P—CLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
- Y02P10/00—Technologies related to metal processing
- Y02P10/25—Process efficiency
Abstract
The invention discloses an ulna coronary process prosthesis device, an installer and an installation method thereof, wherein the ulna coronary process prosthesis device comprises a coronary process prosthesis, an ulna implantation bolt and a locking screw; the ulna coronary process prosthesis installer comprises a guide seat, a C-shaped fixing arm, a threaded sleeve, a positioning column drilling sleeve and a Kirschner wire sleeve. The ulna coronary process prosthesis device, the installer and the installation method thereof form a system of ulna coronary process replacement operation, well solve the installation problems of positioning, drilling, fixing and the like of the ulna coronary process prosthesis, have good stability and anti-rotation capability of the installed ulna coronary process prosthesis, shorten the treatment time of patients with ulna coronary process fracture, reduce the treatment pain of the patients, and provide a new choice for solving the treatment of the patients with coronary process comminuted fracture.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to an ulna coronary process prosthesis device, an installer and an installation method thereof.
Background
The choice of the treatment scheme for the ulna coronary process fracture is closely related to fracture typing, fracture block crushing degree, damage condition of inner and outer collateral ligaments and anterior joint capsules. The effect of the ulna coronary process is very important and fragile, once the comminuted fracture, especially the irreparable ulna coronary process fracture, the existing internal fixation modes such as a conventional steel plate, a screw, a Kirschner wire and the like can not be radically cured, the joint surface disunion of the aged with osteoporosis is easily caused, the ulna coronary process fracture treatment is slightly careless, and the elbow joint dislocation is easily caused. With the development of artificial prosthesis technology, the compatibility of artificial prosthesis and organism organ is increasingly improved, and the artificial prosthesis is utilized to replace the ulna coronary process prosthesis replacement operation of the ulna coronary process autogenous bone, so that the artificial prosthesis has become a new treatment direction of the ulna coronary process comminuted fracture in the future. However, there is currently no artificial prosthesis that can effectively replace the ulna coronary process autogenous bone.
Therefore, the Beijing water pool hospital and Zhejiang medical instruments and equipment limited company commonly develop an ulna coronary process prosthesis, and the ulna coronary process prosthesis is utilized to replace the ulna coronary process autologous bone, so that a very effective treatment effect specially aiming at the ulna coronary process comminuted fracture is achieved. However, because the surface shape of the ulna articular surface is irregular, the operations such as prosthesis positioning and drilling are not facilitated, the requirement on the compliance degree of the ulna coronary prosthesis to the ulna articular surface is high, the ulna coronary prosthesis is installed on the ulna by means of the conventional drilling tool, and a plurality of operation difficulties such as positioning of the ulna coronary prosthesis, drilling of the ulna and fixing of the ulna coronary prosthesis are difficult to complete; moreover, even if the installation can be completed, the cutting tools such as the drill bit and the like are easy to damage peripheral soft tissues; in addition, if the installation process is not well controlled, the clearance between the articular surface of the ulna coronary process prosthesis and the articular surface of the ulna is too large, so that the pressure of the surface of the joint after operation is increased, and the affected part of the patient is hard to be painful after operation.
In order to improve the operation accuracy of the doctor's ulna coronary process autologous bone replacement operation, save the training cost and shorten the training period, the operation level of the doctor needs to be strengthened and trained, so that the doctor obtains more operation opportunities on the ulna model to improve the operation level of the doctor.
Disclosure of Invention
The invention aims to provide an ulna coronary process prosthesis device which is used as an artificial prosthesis of an ulna coronary process autologous bone, and also provides an installer of the ulna coronary process prosthesis device which is used as an installation tool for installing the ulna coronary process prosthesis device specially.
The invention provides an ulna coronary process prosthesis device, which comprises a coronary process prosthesis, an ulna implantation bolt and at least one locking screw, wherein the coronary process prosthesis comprises a mushroom body and a positioning column, the outer surface of the mushroom body is surrounded by an outer curved surface and a bottom plane, at least one oblique perforation is penetrated in the lateral position of the mushroom body, the oblique perforation penetrates through the outer curved surface of the mushroom body and the bottom plane of the mushroom body, the locking screw penetrates through the oblique perforation on the outer curved surface of the mushroom body, and the screw head of the locking screw is exposed out of the bottom plane of the mushroom body; an interface layer of a bone-imitating trabecula porous structure is arranged at the contact position of the bottom plane of the mushroom body and the ulna osteotomy surface; the positioning column is vertically fixed in the middle of the bottom plane of the mushroom body, and a screw hole is formed in the bottom of the positioning column; the ulna implantation bolt is fixedly connected with the screw hole at the bottom of the positioning column through threads.
Preferably, the mushroom body and the positioning column are formed by 3D printing of titanium alloy materials, and the mushroom body and the positioning column are integrally formed; the bone-simulating trabecular porous structure interface layer is a bone-simulating trabecular porous structure formed by 3D printing of titanium alloy materials.
Preferably, a plurality of caliper clamping holes are formed in the outer curved surface of the mushroom body.
The invention also relates to an ulna coronary process prosthesis installer which is used for the ulna coronary process prosthesis device and comprises a guide seat, a C-shaped fixing arm, a threaded sleeve, a positioning column drilling sleeve, a Kirschner wire sleeve, a positioning column through hole hollow drill bit and a bolt head hole hollow drill bit, wherein the threaded sleeve and the top end of the positioning column drilling sleeve are respectively provided with a fixing head, and the guide seat is connected with the threaded sleeve through threads so as to realize the height adjustment of the threaded sleeve; the positioning column drilling sleeve is arranged in the threaded sleeve in a penetrating mode, the Kirschner wire sleeve is arranged in the positioning column drilling sleeve in a penetrating mode, the bottom end of the positioning column drilling sleeve is detachably connected and locked with the bottom end of the threaded sleeve, and the bottom end of the Kirschner wire sleeve is detachably connected and locked with the lower end of the positioning column drilling sleeve; the top end of the C-shaped fixed arm is provided with a positioning block, and the bottom end of the C-shaped fixed arm is connected with the side wall of the guide seat; when a positioning column through hole needs to be drilled, the positioning column through hole hollow drill bit is arranged in the positioning column drilling sleeve and used for drilling through a positioning column through hole of an ulna installation positioning column and an ulna implantation bolt; when the bolt head hole is required to be drilled, the hollow drill bit of the bolt head hole is arranged in the threaded sleeve and is used for drilling a mounting hole for mounting the ulna implantation bolt.
Preferably, the bottom end of the threaded sleeve is provided with a first sleeve, and the inner wall of the lower end of the first sleeve is provided with an internal thread; the bottom end of the positioning column drilling sleeve is provided with a second sleeve, and the outer wall of the upper end of the second sleeve and the inner wall of the lower end of the second sleeve are respectively provided with an external thread and an internal thread; the bottom end of the Kirschner wire sleeve is provided with a third sleeve, and the outer wall of the upper end of the third sleeve is provided with external threads; the external thread of the outer wall of the upper end of the second sleeve is locked with the internal thread of the inner wall of the lower end of the first sleeve through threaded connection; the outer wall of the upper end of the third sleeve is provided with an external thread which is locked with the internal thread of the inner wall of the lower end of the second sleeve through threaded connection.
Preferably, the device further comprises a height fine adjustment mechanism, wherein the height fine adjustment mechanism comprises a dovetail groove guide rail, a connector and a locking bolt, the dovetail groove guide rail is arranged in the vertical direction of the side wall of the guide seat, the connector is arranged at the bottom end of the C-shaped fixed arm, a dovetail groove is arranged in the vertical direction of the side wall of the connector, and the C-shaped fixed arm is slidably arranged on the dovetail groove guide rail of the guide seat through the dovetail groove; the connector is internally provided with a locking bolt through hole, the locking bolt is arranged in the locking bolt through hole, and the screw rod of the locking bolt is fastened and abutted against the side wall of the guide seat so as to lock the displacement of the connector in the vertical direction.
Preferably, the lower surface of the positioning block is a plane, two side surfaces of the positioning block are cambered surfaces, and the lower surface of the positioning block is perpendicular to the central axis of the threaded sleeve.
The invention also relates to a method for installing the ulna coronary process prosthesis device, which adopts the ulna coronary process prosthesis installer to install the ulna coronary process prosthesis device on an ulna model, and comprises the following steps:
step A: drilling a positioning column through hole upwards on the lower surface of an ulna model by using an ulna coronary process prosthesis installer, wherein the positioning column through hole exposes a top hole on the upper surface of the ulna model and exposes a bottom hole on the lower surface of the ulna model; continuing to drill a bolt head hole for embedding a bolt head of the ulna implant bolt on the lower surface of the ulna model using the ulna coronary process prosthesis installer; the upper part of the positioning column through hole is used for installing a positioning column of the coronary process prosthesis, and the lower part of the positioning column through hole is used for installing an ulna implantation bolt;
and (B) step (B): placing a positioning post of the coronary process prosthesis from a top hole of the ulna model into the positioning post through hole;
placing the ulna implant bolt into the positioning column through hole from the bottom hole of the ulna model until the ulna implant bolt passes through the ulna model to collide with the positioning column, and the bolt head of the ulna implant bolt is close to the bottom hole of the ulna model;
screwing the ulna implantation bolt until the ulna implantation bolt is fixedly connected with the positioning column through threads, and the head of the ulna implantation bolt is just embedded into the periphery of the bottom hole of the ulna model 8;
penetrating the locking screw from the oblique through hole of the outer curved surface of the mushroom body, and screwing the locking screw until the screw head of the locking screw is fixed in the ulna model.
Preferably, the step a includes the steps of:
step S1: pre-treating the articular surface of the ulna of a patient before operation, and intercepting the original coronary process of the ulna to form an osteotomy surface, wherein the osteotomy surface is a plane, manufacturing a positioning block according to the side surface shape of the coronary process prosthesis, and determining the installation position of the coronary process prosthesis according to the position of the osteotomy surface and the compliance degree of the corresponding points of the articular surface of the ulna and the positioning block;
step S2: the lower surface of the positioning block is tightly attached to the upper surface of the ulna model, and the height position of the threaded sleeve on the guide seat is adjusted by rotating the threaded sleeve until the fixed head of the threaded sleeve is close to the lower surface of the ulna model;
step S3: the positioning column drilling sleeve is screwed into the threaded sleeve in sequence, the Kirschner wire sleeve is screwed into the positioning column drilling sleeve, the second sleeve is locked with the first sleeve through threaded connection, and the third sleeve is locked with the second sleeve through threaded connection;
step S4: penetrating a Kirschner wire with the outer diameter of 1.6mm into the Kirschner wire sleeve until the Kirschner wire penetrates out of the osteotomy surface, reserving the Kirschner wire, and withdrawing the Kirschner wire sleeve;
step S5: drilling the lower surface of the ulna model by using a fixing head of the positioning column drilling sleeve until the positioning column drilling sleeve drills into half of the height of the ulna model, and withdrawing the positioning column drilling sleeve;
step S6: connecting a drill rod with a hollow drill bit of the bolt head hole, placing the hollow drill bit of the bolt head hole in the threaded sleeve, and drilling the lower surface of the ulna by using the hollow drill bit of the bolt head hole until the hollow drill bit of the bolt head hole drills out a bolt head hole, wherein the depth of the bolt head hole is equal to the rear degree of the bolt head of the ulna implantation bolt;
step S7: connecting a drill rod with a positioning column through hole hollow drill bit, placing the positioning column through hole hollow drill bit in the positioning column drilling sleeve, and drilling the lower surface of the ulna model by using the positioning column through hole hollow drill bit until the ulna model is completely drilled from bottom to top to obtain a positioning column through hole, wherein the aperture of the positioning column through hole is equal to the outer diameters of the positioning column 12 and the ulna implantation bolt 2;
step S8: withdrawing the positioning column drilling sleeve and the Kirschner wire from the top down;
step S9: and rotating the threaded sleeve until the threaded sleeve leaves the lower surface of the guide seat.
Further, between the step S3 and the step S4, the following steps are added:
observing the matching degree of the ulna joint surface of the osteotomy position of the patient and the corresponding point of the positioning block, finely adjusting the distance between the positioning block and the fixed head according to the matching degree,
sliding the connector on the dovetail groove guide rail, and performing fine adjustment on the distance between the positioning block and the fixing head until the fixing head of the threaded sleeve vertically abuts against the lower surface of the ulna model;
the locking bolt is arranged in the locking bolt through hole and screwed through threads until the screw rod of the locking bolt is tightly abutted against the side wall of the guide seat so as to lock the displacement of the connector in the vertical direction.
The beneficial effects of the invention are as follows:
(1) The invention discloses an ulna coronary process prosthesis device, wherein a positioning column of the coronary process prosthesis and an ulna implantation bolt are respectively implanted into an ulna from the upper surface and the small surface of the ulna, the bolt head of the ulna implantation bolt is embedded into the ulna, and the ulna implantation bolt is fixedly connected with the positioning column through threads; the locking screw passes through and secures the coronary prosthesis to complete the installation of the ulnar coronary prosthesis device. The ulna coronary process prosthesis device disclosed by the invention has the advantages that the stability and the anti-rotation capacity of the coronary process prosthesis are improved, the problem that a single locking screw is not enough to provide long-term fixation for the implantation of the coronary process prosthesis is solved, the problems of frequent elbow movement and easy loosening of the prosthesis are favorably prevented, the treatment time of an ulna coronary process fracture patient is shortened, the treatment pain of the patient is reduced, and a new choice is provided for solving the treatment of the coronary process comminuted fracture of the patient.
(2) The invention discloses an ulna coronary process prosthesis device installer, which is characterized in that the lower surface of a positioning block is tightly attached to the upper surface of an ulna to position the ulna, a fixing head of a threaded sleeve acts on the lower surface of the ulna, the height of the threaded sleeve on a guide seat is adjustable to form compression clamping on the lower surface of the ulna, a Kirschner wire sleeve is penetrated to guide the ulna, a positioning column drilling sleeve is internally provided with a positioning column through hole hollow drill bit, a positioning column through hole penetrating the ulna is drilled from bottom to top, and a bolt head hole hollow drill bit is arranged in the threaded sleeve to drill a bolt head installation hole of an ulna implantation bolt. The upper part of the positioning column through hole is used as a mounting hole of the positioning column, and the lower part of the positioning column through hole is used as an implantation channel of the ulna implantation bolt. The method has the following advantages: as an installer specially used for installing the ulna coronary process prosthesis, the operations of positioning, drilling, fixing and the like in the installation process of the ulna coronary process prosthesis can be realized more smoothly; the convenience and the safety of operation are improved, the drill bit is operated in a closed-loop space in the sleeve, and the cutting tools such as the drill bit are protected from damaging peripheral soft tissues. The ulna coronary process prosthesis installer disclosed by the invention has the advantages of simple structure, accurate guide and convenience in operation, can be used for smoothly realizing the operations of positioning, drilling, fixing and the like in the process of installing the ulna coronary process prosthesis, and solves the installation problems of positioning, drilling, fixing and the like of the ulna coronary process prosthesis.
(3) The invention discloses a method for installing an ulna coronary process prosthesis device by using the installer for training a doctor on an ulna model, which can be applied to the ulna model, can reduce the training cost of the ulna coronary process replacement operation, shorten the training period of the doctor, further improve the professional degree and the accuracy of the doctor on the ulna coronary process replacement operation, and further reduce the trauma of a patient.
Drawings
FIG. 1 is a three-dimensional side view of an ulna coronary process prosthetic device provided in example 1 of the present invention;
FIG. 2 is a front view of an ulna coronary process prosthesis provided in example 1 of the present invention;
FIG. 3 is a side view of an ulna coronary process prosthesis provided in example 1 of the present invention;
FIG. 4 is a front three-dimensional view of an ulna coronary process prosthesis installer provided in example 2 of the present invention;
FIG. 5 is a side, three-dimensional view of an ulna coronary process prosthesis installer provided in example 2 of the present invention;
FIG. 6 is a three-dimensional view of a C-shaped stationary arm according to embodiment 2 of the present invention;
fig. 7 is a three-dimensional view of a connector of a C-shaped fixing arm according to embodiment 2 of the present invention;
fig. 8 is a three-dimensional view of a positioning block of a C-shaped fixing arm provided in embodiment 2 of the present invention;
fig. 9 is a schematic view showing an installation process of the ulna coronary process prosthesis device according to embodiment 3 of the present invention.
Detailed Description
Example 1
Example 1 provides an ulna coronary process prosthetic device, the structure of which is described in detail below.
Referring to fig. 1 to 3, the ulna coronary prosthesis device includes a coronary prosthesis 1, an ulna implant bolt 2, and a locking screw 3.
Wherein, this coronary false body 1 includes mushroom body 11 and reference column 12, and mushroom body 11 and reference column 12 fixed connection. Preferably, the positioning column 12 is vertically fixed in the middle of the bottom plane of the mushroom 11, and a screw hole 7 is arranged in the bottom of the positioning column 12. Wherein, ulna implantation bolt 2 comprises screw rod and bolt head, wherein is provided with the screw thread on the screw rod.
The outer surface of the mushroom 11 is defined by an outer curved surface and a basal plane, wherein the basal plane is in contact with the ulnar articular surface. In order to facilitate the fixation and movement of the coronary prosthesis 1, the outer curved surface of the mushroom 11 is provided with a plurality of caliper clamping holes 4, and the caliper clamping holes 4 facilitate the fixation and movement after the caliper is clamped. Preferably, the number of the caliper holding holes 4 on the outer curved surface of the mushroom 11 is two, and the caliper holding holes 4 are uniformly distributed on the outer curved surface of the mushroom 11, and as a specific embodiment, the number of the caliper holding holes 4 on the outer curved surface of the mushroom 11 is four.
The lateral position of the mushroom body 11 is provided with an oblique perforation 5 in a penetrating way, and the oblique perforation 5 penetrates through the outer curved surface of the mushroom body 11 and the bottom plane of the mushroom body 11. And the central axis of the oblique through hole 5 is not coplanar with the longitudinal central axis of the positioning column 12.
The locking screw 3 penetrates from the oblique perforation 5 on the outer curved surface of the mushroom 11 and the screw head of the locking screw 3 is exposed from the bottom plane of said mushroom 11, which exposed screw head is used for fixedly connecting the ulna model 8 to improve the stability and anti-rotation capacity of the coronary prosthesis 1.
The contact part of the bottom plane of the mushroom 11 and the ulna osteotomy surface is provided with an imitated bone trabecula porous structure interface layer 6, the imitated bone trabecula porous structure interface layer 6 is of an imitated bone trabecula porous structure formed by 3D printing of titanium alloy materials, the imitated bone trabecula porous structure is a porous plane, the bone later growth is facilitated to grow into the imitated bone trabecula porous structure interface layer 6, and the prosthesis is fixed for a long time. The technology is the prior art, and the details refer to China patent application No. CN201610222225.0 for 3D printing bone-simulating trabecular porous load-bearing reinforced metal prosthesis, wherein the porosity of an interface layer 6 of a bone-simulating trabecular porous structure is 60-80%.
It should be noted that whether the coronary prosthesis 1 can effectively overcome frictional wear is a key to whether the operation is successful or not, that is, the outer curved surface of the prosthesis joint surface, i.e., the mushroom body 11, is required to be polished to have a surface roughness of at most ra 0.1. In order to reduce the wear of the articular surface and the precipitation of metal ions and to increase the stability of the coronary prosthesis 1 after implantation, it is necessary to prepare a TiN coating on its surface. The method is characterized in that black water and fretting wear are generated through movable friction after the coronary process prosthesis is implanted into a human body, fatigue strength of the implant is rapidly reduced, fracture is caused, and a layer of TiN coating is prepared on the joint surface of the prosthesis due to poor wear resistance of TC4 material, so that the wear resistance and corrosion resistance of the prosthesis can be improved, and meanwhile, the metal ion release performance is improved.
Preferably, the mushroom 11 and the positioning column 12 are formed by 3D printing of titanium alloy materials, and the mushroom 11 and the positioning column 12 are integrally formed.
The ulna implantation bolt 2 is fixedly connected with a screw hole 7 at the bottom of the positioning column 12 through threads.
Example 2
Example 2 provides an ulna coronary process prosthesis installer for performing an operation of replacing the ulna coronary process of the patient with the ulna coronary process prosthesis of example 1, the structure of which will be described in detail below.
Referring to fig. 4 and 5, the ulna coronary process prosthesis installer includes a guide holder 10, a C-shaped fixing arm 20, a threaded sleeve 30, a pilot drill sleeve 40, a k-wire sleeve 50, a pilot through hole hollow drill bit, and a bolt head hole hollow drill bit. Wherein, the maximum external diameter of the positioning column through hole hollow drill bit is equal to the external diameter of the positioning column 12, and the maximum external diameter of the bolt head hole hollow drill bit is equal to the external diameter of the ulna implanted bolt 2.
The top and bottom ends of the screw socket 30 are provided with a fixing head 300 and a first sleeve 310, respectively, wherein the front end of the fixing head 30 is uniformly provided with a plurality of fixing teeth.
The guide holder 10 is internally provided with a threaded sleeve hole, the inner wall of the threaded sleeve hole is provided with internal threads, the outer pipe wall of the threaded sleeve 30 is provided with external threads, the guide holder 10 is sleeved with the threaded sleeve 30 through the threaded sleeve hole, and the threaded sleeve hole of the guide holder 10 is in threaded connection with the external threads of the threaded sleeve 30 to realize the height adjustment of the threaded sleeve 30 on the guide holder 10. The external thread of the threaded sleeve 30 can be used for being connected with the threaded sleeve hole of the guide seat 10 by threads, and the height position of the threaded sleeve 30 on the guide seat 10 can be adjusted up and down by screwing in or screwing out, so that the mode of adjusting the distance between the positioning block 200 and the fixing head 300 is called a height rough adjustment mode.
As a specific embodiment, the upper end of the first sleeve 310 may be fixed to the outer wall of the bottom end of the threaded sleeve 30 by a detachable connection manner such as a threaded connection manner, or may be fixedly connected to the bottom end of the threaded sleeve 30 by a non-detachable connection manner such as a welding manner or an integral molding manner. The inner wall of the lower end of the first sleeve 310 is provided with an internal thread.
The bottom end of the positioning column drilling sleeve 40 is provided with a second sleeve 410, and the outer wall of the upper end and the inner wall of the lower end of the second sleeve 410 are respectively provided with an external thread and an internal thread; the bottom end of the k-wire sleeve 50 is provided with a third sleeve 510, and an outer wall of the upper end of the third sleeve 510 is provided with external threads.
The positioning column drilling sleeve 40 is arranged in the threaded sleeve 30 in a penetrating manner, and the Kirschner wire sleeve 50 is arranged in the positioning column drilling sleeve 40 in a penetrating manner. The external thread of the outer wall of the upper end of the second sleeve 410 is in threaded connection with the internal thread of the inner wall of the lower end of the first sleeve 310, so as to realize the detachable connection and locking of the positioning column drilling sleeve 40 and the bottom end of the threaded sleeve 30; the external thread of the outer wall of the upper end of the third sleeve 510 is in threaded connection with the internal thread of the inner wall of the lower end of the second sleeve 410, so as to realize the detachable connection and locking of the bottom end of the k-wire sleeve 50 and the bottom end of the positioning column drilling sleeve 40.
Referring to fig. 4 to 6, the C-shaped fixing arm 20 has a "C" shape, a positioning block 200 is disposed at a top end thereof, and a bottom end thereof is connected to a side wall of the guide holder 10.
As a connection manner, the bottom end of the C-shaped fixing arm 20 may be directly and fixedly connected with the side wall of the guide holder 10, or even integrally formed. However, in order to enhance the versatility of the ulna coronary prosthesis installer application for different patients, in addition to the highly rough adjustment, there is another adjustment of the spacing between the positioning block 200 and the fixed head 300 by providing a highly fine adjustment mechanism, otherwise known as a highly fine adjustment.
Specifically, the height fine adjustment mechanism includes a connector 210, a dovetail rail 1100, and a lock bolt 60.
The vertical direction of the lateral wall of the guide holder 10 is provided with a dovetail groove guide rail 1100, referring to fig. 7, the bottom end of the C-shaped fixing arm 20 is provided with a connector 210, the vertical direction of the lateral wall of the connector 210 is provided with a dovetail groove 110, wherein the cross section of the dovetail groove 110 is trapezoidal, the dovetail groove guide rail 1100 is also called a trapezoidal guide rail, the dovetail groove 110 and the dovetail groove guide rail 1100 are mutually matched for use, and the C-shaped fixing arm 20 is slidably arranged on the dovetail groove guide rail 1100 of the guide holder 10 through the dovetail groove 110. The connector 210 can slide on the dovetail groove guide rail 1100 through the dovetail groove 110, and can restrict the displacement of the connector 210 relative to the guide holder 10 in the front-back and left-right directions, and only allow the displacement of the connector 210 relative to the guide holder 10 in the up-down directions, thereby playing a role of guiding in the vertical direction.
The connector 210 is internally provided with a locking bolt through hole 600, the inner wall of the locking bolt through hole 600 is provided with internal threads, and the locking bolt 60 is arranged in the locking bolt through hole 600 and screwed through threads until the screw of the locking bolt 60 is tightly abutted against the side wall of the guide holder 10 so as to lock the displacement of the connector 210 in the vertical direction.
It should be noted that, when the height of the guide holder 10 on the threaded sleeve 30 is unchanged, the relative positions of the connector 210 and the guide holder 10 may be adjusted by the relative sliding of the dovetail groove 110 and the dovetail groove guide rail 1100, and finally the connector 210 is locked by the locking bolt 60, so as to achieve fine adjustment of the distance between the positioning block 200 and the fixed head 300. Because the dovetail groove 110 slides relatively on the dovetail groove guide rail 1100, the height of the positioning block 200 relative to the guide seat 10 can be changed until the height meets the requirement, and when the dovetail groove 110 limits the displacement of the connector 210 relative to the guide seat 10 in the front-back left-right direction, the locking bolt 60 passes through the locking bolt through hole 600 and is screwed by threads, the displacement of the connector 210 relative to the guide seat 10 in the up-down direction is continuously limited, the locking of the connector 210 in the vertical direction is realized, and finally, the adjustment of the relative position of the guide seat 10 and the C-shaped fixing arm 1 in the height is realized.
The lower surface of the positioning block 200 is tightly attached to the upper surface of the ulna, the lower surface of the threaded sleeve 30 acts on the ulna, and the height of the guide seat 10 on the threaded sleeve 30 is adjusted, so that the upper surface and the lower surface of the ulna are tightly clamped in a compression mode. The matching degree of the ulna joint surface of the patient and the corresponding point of the positioning block 200 is observed, and the distance between the positioning block 200 and the fixing head 300 is finely adjusted according to the matching degree, so that the surgical fault tolerance is improved. In addition, in the fine tuning process, the compliance degree between the articular surface of the ulna coronary process prosthesis and the articular surface of the ulna is favorable for meeting the requirements, and no pain is left on the affected part of the patient after operation.
Referring to fig. 8, the upper surface and the lower surface of the positioning block 200 are both planes, two sides of the positioning block 200 are arc surfaces, and the side shape of the positioning block 200 is consistent with the side shape of the coronary process prosthesis 1, so as to ensure that the impression of the positioning block 200 on the ulna is suitable for accommodating the side of the coronary process prosthesis 1. The lower surface of the positioning block 200 is perpendicular to the central axis of the threaded sleeve 30, so that the k-wire can vertically pass through the bone-cutting surface when passing through the k-wire sleeve 50, and the straightness of the k-wire is ensured.
Specifically, by performing a size statistical analysis on the ulna of a great number of people, the size requirements of the threaded sleeve 30, the positioning post drilling sleeve 40 and the Kirschner wire sleeve 50 which meet the operation of replacing the ulna coronary process of a patient by the ulna coronary process prosthesis are as follows: the external diameter of the threaded sleeve 30 is 12mm, the external thread specification is metric thread M12, and the internal diameter is 8mm; the outer diameter of the positioning column drilling sleeve 40 is 8mm, and the inner diameter is 6mm; the Kirschner wire sleeve 50 has an outer diameter of 6mm and an inner diameter of 1.6mm; the maximum external diameter of the positioning column through hole hollow drill bit is 6mm, and the maximum external diameter of the bolt head hole is 8mm.
In addition, the ulna coronary process prosthesis installer further comprises a positioning column through hole hollow drill bit and a bolt head hole hollow drill bit, wherein when the positioning column through hole needs to be drilled, the positioning column through hole hollow drill bit is arranged in the positioning column drilling sleeve 4; when a bolt head hole is needed, the hollow drill bit of the bolt head hole is arranged in the threaded sleeve 3.
Wherein, the space between the positioning block 200 and the fixed head 300 is used for placing the ulna model 8;
the inner diameter of the threaded sleeve 30 is equal to the outer diameter of the ulna implantation bolt 2, and is used for placing a positioning column through hole hollow drill bit into the ulna implantation bolt 2 to drill a mounting hole for mounting the ulna implantation bolt 2;
the inner diameter of the positioning column drilling sleeve 40 is equal to the outer diameter of the positioning column 12 of the coronary process prosthesis 1, and is used for placing a hollow drill bit of a bolt head hole, and drilling through ulna from bottom to top to obtain a positioning column through hole, wherein the upper part of the positioning column through hole is used as a mounting hole of the positioning column 12;
the k-wire sleeve 50 is used for penetrating the k-wire and mainly serves as a guide for ensuring the straightness of the mounting holes drilled by the threaded sleeve 30 and the positioning column drilling sleeve 40.
Example 3
step A: drilling a positioning column through hole upwards on the lower surface of the ulna model 8 by using an ulna coronary process prosthesis installer, wherein the positioning column through hole exposes a top hole on the upper surface of the ulna model 8 and exposes a bottom hole on the lower surface of the ulna model 8; continuing to drill a bolt head hole for embedding a bolt head of an ulna implant bolt on the lower surface of the ulna model 8 using the ulna coronary process prosthesis installer; the upper part of the positioning column through hole is used for installing a positioning column 12 of the coronary process prosthesis 1, and the lower part of the positioning column through hole is used for installing an ulna implantation bolt;
and (B) step (B): the coronary process prosthesis 1 is arranged: the coronary prosthesis 1 is moved by clamping any two clamping holes 4 of the calipers, and a positioning column 12 of the coronary prosthesis 1 is placed into a positioning column through hole from the top hole of the ulna model 8;
setting an ulna implantation bolt 2: placing the ulna implant bolt 2 into the positioning column through hole from the bottom hole of the ulna model 8 until the ulna implant bolt 2 passes through the ulna model 8 to collide with the positioning column 12, and the bolt head of the ulna implant bolt 2 approaches the bottom hole of the ulna model 8;
connecting the coronary prosthesis 1 and the ulna implant bolt 2: clamping the two caliper clamping holes 4 by using a caliper clamp to fix the coronary process prosthesis 1, screwing the bolt head of the ulna implantation bolt 2 until the ulna implantation bolt 2 is fixedly connected with the positioning column 12 through threads, and the bolt head of the ulna implantation bolt 2 is just embedded into the periphery of the bottom hole of the ulna model 8;
continuing to strengthen the connection of the coronary prosthesis 1 to the ulna model 8: the locking screw 3 is threaded through the oblique perforation 5 of the outer curved surface of the mushroom 11 and the locking screw 3 is screwed until the screw head of the locking screw 3 is fixed in the ulna model 8.
Wherein, the step A comprises the following steps:
step S1: pre-treating the articular surface of the ulna of a patient before operation, and intercepting the original coronary process of the ulna to form an osteotomy surface, wherein the osteotomy surface is a plane, manufacturing a positioning block 200 according to the side surface shape of the coronary process prosthesis 1, and determining the installation position of the coronary process prosthesis 1 according to the position of the osteotomy surface and the compliance degree of the corresponding points of the articular surface of the ulna and the positioning block 200;
step S2: the lower surface of the positioning block 200 is tightly attached to the upper surface of the ulna model 8, and the height position of the threaded sleeve 30 on the guide seat 10 is adjusted by rotating the threaded sleeve 30 until the fixing head 300 of the threaded sleeve 30 is close to the lower surface of the ulna model 8;
step S3: sequentially screwing the positioning column drilling sleeve 40 into the threaded sleeve 30, screwing the Kirschner wire sleeve 50 into the positioning column drilling sleeve 40, locking the second sleeve 410 and the first sleeve 310 through threaded connection, and locking the third sleeve 510 and the second sleeve 410 through threaded connection;
step S4: penetrating a Kirschner wire with the outer diameter of 1.6mm into the Kirschner wire sleeve 50 until the Kirschner wire penetrates out of the osteotomy face, retaining the Kirschner wire, and withdrawing the Kirschner wire sleeve 50;
step S5: drilling the lower surface of the ulna model 8 by using the fixing head of the positioning column drilling sleeve 40 until the positioning column drilling sleeve 40 drills into half the height of the ulna model 8 and exits the positioning column drilling sleeve 40;
step S6: the hollow drill bit of the bolt head hole is connected with a drill rod, the hollow drill bit of the bolt head hole is arranged in the threaded sleeve 30, the lower surface of the ulna 8 is drilled by the hollow drill bit of the bolt head hole until the hollow drill bit of the bolt head hole drills out a bolt head hole, and the depth of the bolt head hole is equal to the rear degree of the bolt head of the ulna implantation bolt 2;
step S7: connecting a drill rod with a positioning column through hole hollow drill bit, placing the positioning column through hole hollow drill bit in the positioning column drilling sleeve 40, and drilling the lower surface of the ulna model 8 by using the positioning column through hole hollow drill bit until the ulna model 8 is completely drilled from bottom to top to obtain a positioning column through hole, wherein the aperture of the positioning column through hole is equal to the outer diameters of the positioning column 12 and the ulna implantation bolt 2;
step S8: withdrawing the column drilling cannula 40 and the k-wire together from top to bottom;
step S9: the threaded sleeve 30 is rotated until the threaded sleeve 30 is clear of the lower surface of the guide holder 10.
Preferably, between step S3 and step S4, the following steps are added:
observing the matching degree of the ulna joint surface of the patient at the osteotomy position and the corresponding point of the positioning block 200, finely adjusting the distance between the positioning block 200 and the fixed head 300 according to the matching degree,
sliding the connector 210 on the dovetail groove guide rail 1100, and performing fine adjustment on the distance between the positioning block 200 and the fixing head 300 until the fixing head 300 of the threaded sleeve 30 vertically abuts against the lower surface of the ulna model 8;
the locking bolt 60 is disposed in the locking bolt through hole 600 and screwed until the screw of the locking bolt 60 is tightly abutted against the side wall of the guide holder 10, so as to lock the displacement of the connector 210 in the vertical direction.
While the invention has been described in detail in the foregoing general description and specific examples, it will be apparent to those skilled in the art that modifications and improvements can be made thereto. Accordingly, such modifications or improvements may be made without departing from the spirit of the invention and are intended to be within the scope of the invention as claimed.
Claims (5)
1. An ulna coronary prosthesis installer for installing an ulna coronary prosthesis device comprising an ulna coronary prosthesis (1), an ulna implant bolt (2) and at least one locking screw (3),
the ulna coronary process prosthesis (1) comprises a mushroom body (11) and a positioning column (12),
the outer surface of the mushroom body (11) is surrounded by an outer curved surface and a bottom plane, at least one oblique perforation (5) is penetrated in the lateral position of the mushroom body (11), the oblique perforation (5) penetrates through the outer curved surface of the mushroom body (11) and the bottom plane of the mushroom body (11), the locking screw (3) penetrates from the oblique perforation (5) on the outer curved surface of the mushroom body (11), and the screw head of the locking screw (3) is exposed out of the bottom plane of the mushroom body (11);
an interface layer (6) of a bone-imitating trabecula porous structure is arranged at the contact position of the bottom plane of the mushroom body (11) and the ulna osteotomy surface;
the positioning column (12) is vertically fixed in the middle of the bottom plane of the mushroom body (11), and a screw hole (7) is formed in the bottom of the positioning column (12);
the ulna implantation bolt (2) is fixedly connected with a screw hole (7) at the bottom of the positioning column (12) through threads;
the mushroom body (11) and the positioning column (12) are formed by 3D printing of titanium alloy materials, and the mushroom body (11) and the positioning column (12) are integrally formed; the bone-like trabecula porous structure interface layer (6) is a bone-like trabecula porous structure formed by 3D printing of titanium alloy materials;
a plurality of caliper clamping holes (4) are formed in the outer curved surface of the mushroom body (11);
it is characterized in that the ulna coronary process prosthesis installer comprises a guide seat (10), a C-shaped fixing arm (20), a threaded sleeve (30), a positioning column drilling sleeve (40), a Kirschner wire sleeve (50), a positioning column through hole hollow drill bit and a bolt head hole hollow drill bit,
the top ends of the threaded sleeve (30) and the positioning column drilling sleeve (40) are respectively provided with a fixed head (300), and the guide seat (10) is in threaded connection with the threaded sleeve (30) so as to realize the height adjustment of the threaded sleeve (30) on the upper surface;
the positioning column drilling sleeve (40) is arranged in the threaded sleeve (30) in a penetrating mode, the Kirschner wire sleeve (50) is arranged in the positioning column drilling sleeve (40) in a penetrating mode, the bottom end of the positioning column drilling sleeve (40) is detachably connected and locked with the bottom end of the threaded sleeve (30), and the bottom end of the Kirschner wire sleeve (50) is detachably connected and locked with the bottom end of the positioning column drilling sleeve (40);
the top end of the C-shaped fixed arm (20) is provided with a positioning block (200), and the bottom end of the C-shaped fixed arm (20) is connected with the side wall of the guide seat (10);
the positioning column through hole hollow drill bit is arranged in the positioning column drilling sleeve (40) and used for penetrating and drilling a positioning column through hole, the upper part of the positioning column through hole is used for installing a positioning column (12), and the lower part of the positioning column through hole is used for installing an ulna implantation bolt (2);
the bolt head hole core drill bit is placed in the threaded sleeve (30) for drilling a mounting hole for a bolt head of an ulnar implant bolt (2).
2. The ulna coronary process prosthesis installer of claim 1 wherein,
the bottom end of the threaded sleeve (30) is provided with a first sleeve (310), and the inner wall of the lower end of the first sleeve (310) is provided with an internal thread; the bottom end of the positioning column drilling sleeve (40) is provided with a second sleeve (410), and the outer wall of the upper end and the inner wall of the lower end of the second sleeve (410) are respectively provided with an external thread and an internal thread; the bottom end of the Kirschner wire sleeve (50) is provided with a third sleeve (510), and the outer wall of the upper end of the third sleeve (510) is provided with external threads;
the external thread of the outer wall of the upper end of the second sleeve (410) is locked with the internal thread of the inner wall of the lower end of the first sleeve (310) through threaded connection; the outer wall of the upper end of the third sleeve (510) is provided with external threads which are locked with the internal threads of the inner wall of the lower end of the second sleeve (410) through threaded connection.
3. The ulna crown prosthesis installer of claim 1 further comprising a height fine adjustment mechanism comprising a dovetail rail (1100), a connector (210) and a locking bolt (60),
the dovetail groove guide rail (1100) is arranged in the vertical direction of the side wall of the guide seat (10), the connector (210) is arranged at the bottom end of the C-shaped fixed arm (20), a dovetail groove (110) is arranged in the vertical direction of the side wall of the connector (210), and the C-shaped fixed arm (20) is slidably arranged on the dovetail groove guide rail (1100) of the guide seat (10) through the dovetail groove (110);
the connector (210) is internally provided with a locking bolt through hole (600), the locking bolt (60) is arranged in the locking bolt through hole (600) and the screw rod of the locking bolt (60) is fastened and abutted against the side wall of the guide seat (10) so as to lock the displacement of the connector (210) in the vertical direction.
4. The ulna coronary process prosthesis installer of claim 1 wherein,
the lower surface of the positioning block (200) is a plane, two side surfaces of the positioning block (200) are cambered surfaces,
the lower surface of the positioning block (200) is perpendicular to the central axis of the threaded sleeve (30).
5. A method of installing an ulna coronary prosthesis device, using the ulna coronary prosthesis installer of any one of claims 1 to 4, on an ulna model (8), characterized in that the method of installing comprises the steps of:
step A: drilling a positioning column through hole upwards on the lower surface of an ulna model (8) by using an ulna coronary process prosthesis installer, wherein the positioning column through hole exposes a top hole and a bottom hole on the upper surface and the lower surface of the ulna model (8) respectively; continuing to drill a bolt head hole for embedding a bolt head of an ulna implant bolt on the lower surface of the ulna model (8) using the ulna coronary process prosthesis installer; the upper part of the positioning column through hole is used for installing a positioning column (12) of the ulna coronary process prosthesis (1), and the lower part of the positioning column through hole is used for installing an ulna implantation bolt;
and (B) step (B): placing a positioning post (12) of the ulna coronary process prosthesis (1) from a top hole of the ulna model (8) into the positioning post through hole;
placing the ulna implant bolt (2) from the bottom hole of the ulna model (8) to the positioning post through hole until the ulna implant bolt (2) passes through the ulna model (8) to be abutted against the positioning post (12), and the bolt head of the ulna implant bolt (2) is close to the bottom hole of the ulna model (8);
screwing the ulna implantation bolt (2) until the ulna implantation bolt (2) and the positioning column (12) are fixedly connected through threads, and the bolt head of the ulna implantation bolt (2) is just embedded into the periphery of the bottom hole of the ulna model (8);
penetrating the locking screw (3) from the inclined through hole (5) of the outer curved surface of the mushroom body (11), and screwing the locking screw (3) until the screw head of the locking screw (3) is fixed in the ulna model (8).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010509468.9A CN111938874B (en) | 2020-06-04 | 2020-06-04 | Ulna coronary process prosthesis device, installer and installation method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010509468.9A CN111938874B (en) | 2020-06-04 | 2020-06-04 | Ulna coronary process prosthesis device, installer and installation method thereof |
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| CN111938874A CN111938874A (en) | 2020-11-17 |
| CN111938874B true CN111938874B (en) | 2023-06-09 |
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| CN113827377B (en) * | 2021-09-24 | 2023-06-16 | 北京积水潭医院 | Joint prosthesis assisting forearm rotation |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050049710A1 (en) * | 2003-08-28 | 2005-03-03 | O'driscoll Shawn W. | Prosthesis for partial replacement of an articulating surface on bone |
| CA2490963C (en) * | 2003-12-30 | 2010-02-09 | Medicinelodge, Inc. | Implant systems with fastener for mounting on an articulation surface of an orthopedic joint |
| CN201168071Y (en) * | 2008-03-13 | 2008-12-24 | 王友华 | Ulna coronal process prosthesis |
| CN103479450A (en) * | 2013-10-16 | 2014-01-01 | 中国人民解放军总医院 | Condyle prosthesis and manufacturing method thereof |
| CN204158482U (en) * | 2014-09-26 | 2015-02-18 | 北京积水潭医院 | A kind of for coronoid process fracture locating guider under surgery elbow arthroscopy |
| CN106137465A (en) * | 2016-07-21 | 2016-11-23 | 北京爱康宜诚医疗器材有限公司 | Borrowed structure |
| CN206630736U (en) * | 2016-08-29 | 2017-11-14 | 宁波市北仑区人民医院 | A kind of ulna coronal process prosthesis |
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