CN112137766A

CN112137766A - Replacement scaphoid used in orthopedic surgery

Info

Publication number: CN112137766A
Application number: CN202010984987.0A
Authority: CN
Inventors: 段家骐; 王国华; 刘江; 宋坤; 邹炜民
Original assignee: Hunan Printer Medical Devices Co ltd
Current assignee: Hunan Huaxiang Medical Technology Co ltd
Priority date: 2020-09-18
Filing date: 2020-09-18
Publication date: 2020-12-29

Abstract

The invention relates to the field of interventional devices used in orthopedic surgery, in particular to a replacement scaphoid used in orthopedic surgery. Aims to solve the problems of long scaphoid rehabilitation time and high rehabilitation difficulty in the prior art. The invention comprises an upper bone block, a lower bone block and a limiting block for limiting the freedom degree of each assembling direction and assembling angle of the matching state of the upper bone block and the lower bone block, wherein the upper bone block, the lower bone block and the limiting block comprise metal tantalum structures printed by 3D, the upper bone block, the lower bone block and the limiting block form a scaphoid-like assembly, the assembly comprises metal holes with the diameters decreasing from inside to outside, and two ends of the limiting block are provided with operation suture cavities for suturing fascia and the assembly. Has the advantages that: the replacement scaphoid can firstly shorten the time for replacing scaphoid, and secondly can ensure the use strength and the use flexibility after operation, which are not possessed by the prior products.

Description

Replacement scaphoid used in orthopedic surgery

Technical Field

The invention relates to the field of scaphoid replacement used in orthopedic surgery, in particular to a scaphoid replacement used in orthopedic surgery.

Background

Fracture of scaphoid is a common fracture in clinic, accounting for 2 percent of the total fracture, accounting for 70 to 80 percent of the fracture of carpal bone, and being second only to the fracture of distal radius. There are many clinical methods for treating scaphoid fracture, but there is no clear selection standard at present. If the treatment is not performed or is not performed by mistake, complications such as serious deformity healing, bone nonunion, aseptic ischemic necrosis, hypertrophic scar pain and the like can be easily caused. Scaphoid necrosis easily occurs after scaphoid fracture, and no good treatment method exists at present. Currently, the treatment mainly adopts tenoglobulus transplantation or carpal fusion, and the effect is unsatisfactory. Anatomical features of scaphoid: the structure is irregular.

The carpal body is long and narrow, is the carpal bone with the largest volume in the far and near volleyball carpal bones, and is also the carpal bone with the largest mobility. The scaphoid is a complex three-dimensional anatomical structure, 5 joint surfaces are arranged around the scaphoid, the distal joint surface of the scaphoid is concave and is contacted with the capitate bone, the proximal joint surface protrudes out of the joint related to the radius, the other two joint surfaces on the distal side are respectively connected with the trapezium and the trapezium, and the inner joint surface is connected with the lunate bone. The distal end of the depression is the prominent scaphoid tubercle with the flexor carpi radialis tendon (12) and the volar radiocarpal ligament attached. 70-80% of the surface of the scaphoid of the wrist is covered by cartilage, and blood supply mainly comes from the radial artery branch, the radial artery branch enters the lumbar part of the scaphoid from the dorsal side to supply blood supply to 80% of the proximal end of the scaphoid, and the rest 20% of the blood supply enters the proximal tubercle part of the scaphoid from the palmar side of the radial artery to supply. Research shows that the sparse blood supply of the scaphoid is the main reason of ischemic necrosis and nonunion after the scaphoid fracture operation. The scaphoid prosthesis research is less at home and abroad, Chinese scholars have sporadic operation reports, the research level is low, and the large-scale application is not available. There are mature silica gel prostheses in foreign countries, which have unsatisfactory effects, and there are also metal prostheses, and the literature reports refer to: splingardi O, Rossello MI. The total scappoid titanium arthoplasty A15-year experiment [ J ]. hand (N Y), 2011, 6 (2): 179-.

Due to the special appearance and function of the scaphoid, limited movement in a narrow space is required, the scaphoid prosthesis manufactured by the traditional technology cannot meet the requirements, the prosthesis mainly made of metal has high elastic modulus and is easy to cause damage to other sclerotin of the scaphoid of the prosthesis, and secondly, the scaphoid of a human body is fixed in a wrist joint by a tendon, the prosthesis manufactured by the traditional technology cannot realize interface fusion of the prosthesis and surrounding ligaments, so that the position of the prosthesis is unstable after the prosthesis is implanted, and the function is influenced.

In the prior art, the improvement on the technology is mainly achieved by the following technical levels:

in the published Chinese patent document, the application number is CN201920988387.4, named as a screw-in type ball-and-socket joint artificial scaphoid, in the disclosed technology, the scaphoid is an irregular shape which is composed of a head part, a body part and a tail part and is similar to the scaphoid of a human body, the support body is composed of a ball head, a neck collar and a handle, a spherical socket is arranged at the position of the body part of the scaphoid, which is opposite to the ball head of the support body, and forms a ball-and-socket joint with the ball head, the technical structure has the characteristics of stress dispersion, radial joint clearance maintenance, better mobility of the radial joint and favorable reconstruction of the wrist radial joint, however, the applicant thinks that the problems of inaccurate integral fixation of equipment and difficult achievement of the body strength;

there is also a direction for improving the positioning device, for example, in the published chinese patent document, application No. CN201810661303.6, entitled 3D positioning device for wrist navicular bone percutaneous nail placement and its manufacturing method, the disclosed 3D positioning device includes a panel formed by 3D printing, a bottom plate and a needle guide nozzle, the panel has a first cavity adapted to the palm surface dermatoglyph of the wrist, the bottom plate has a second cavity adapted to the back surface of the wrist; the panel is movably connected with the bottom plate, and the first cavity is vertically opposite to the second cavity; the guide needle mouth is formed on the panel and is provided with a guide needle channel communicated with the first cavity, the guide needle channel is configured to guide a guide needle to pass from the navicular tubercle to the proximal navicular pole, however, the problem that the later strength of the interventional device is not suitable for the use of a patient still exists;

related technical personnel also propose to protect tissues of an interventional part by improving prosthetic devices at other bone joints of a human body, for example, in published Chinese patent documents with the application number of CN201910104178.3 named as a talus split type ankle prosthesis, a tibialis joint tibialis side part is provided, and the talus joint tibialis side part also comprises a rotating matching part which comprises a calcaneal joint talus side part and a talus joint talus side part which are detachably connected, so that the problem of difficult surgical field of view is solved in a split mode, however, the problem that the strength is difficult to adapt to a patient in the bone joint interventional operation is still not solved, and meanwhile, due to the inconsistent bone types, an effective technical inspiration cannot be formed;

still the personnel propose a patent for can dismantle talus false body, its application number is CN201621249738.2, and the design aim at realizes a detachable structure of interveneeing, and subtalar articular surface and talonavicular articular surface are porous structure, have biological function, are convenient for the false body and the rapid fusion growth of calcaneus, scaphoid, nevertheless the sharp edge of its and the design of material still are difficult to improve the result of use of recovered stage.

In summary, the current technology has the following problems: 1. the operation time is long, and the positioning is difficult; 2. other bone joints are often involved in conflict during the later rehabilitation state, which causes secondary injury; 3. the joint is too common, the healing is slow, and the hidden trouble of secondary lesion exists.

Disclosure of Invention

The invention aims to solve the problems of long scaphoid rehabilitation time and great rehabilitation difficulty in the prior art.

The specific scheme of the invention is as follows:

the utility model provides a replacement scaphoid that uses among the orthopedic surgery, includes bone piece, lower bone piece and restriction go up the bone piece with the stopper of each assembly direction of bone piece cooperation state and assembly angle degree of freedom down, go up bone piece, lower bone piece and stopper and include the metal tantalum structure that 3D printed into, go up bone piece, lower bone piece and stopper and form the imitative scaphoid assembly, the assembly is from inside to outside including the metal hole that the aperture reduces in proper order, the both ends of stopper are provided with the operation and sew up the chamber in order to sew up the manadesma with the assembly, it has polishing layer to scribble on the fitting surface of replacement scaphoid and all round bones.

In specific implementation, a cross section with a shape of [ "is arranged between the upper bone block and the lower bone block, wherein two ends of the [" are respectively an upper end cross section and a lower end cross section, the upper end cross section and the lower end cross section are respectively provided with a longitudinal section, the upper end cross section is connected with the longitudinal section A, the lower end cross section is connected with the longitudinal section B, and the length of the upper end cross section is greater than or less than that of the lower end cross section; corresponding square bulges or corresponding square depressions are respectively arranged on two sides of the surface A, and corresponding square bulges or corresponding square depressions are also respectively arranged on two sides of the surface B; at least 3 prismatic through holes are arranged on the cross section by taking the cross section as a central plane so as to install a matched prismatic limiting block, a positioning block is arranged on the longitudinal section, and a limiting groove is arranged on the corresponding matching surface.

In a specific implementation, the number of prisms of the prismatic through hole is more than 3 and less than 7.

In a specific implementation, the edges of two sides of the prismatic through hole are provided with round corners for coating bone cement.

In specific implementation, the two ends of the limiting block and the two ends of the prismatic through hole are respectively provided with a line hole for passing a suture line.

In a specific implementation, the size of the metal pores is between 200nm and 400 nm.

In specific implementation, a dosing cavity is arranged in the metal hole in the center of the combination body and is communicated with the longitudinal section.

The position of the [ -shaped section is replaced by an inclined arrangement relative to the horizontal plane, the angle of inclination corresponding to the design angle at which the assembly length of the transverse plane is maximized.

In specific implementation, the waist part, which is formed by the combination and replaces the scaphoid, is provided with a reinforcing element, the reinforcing element comprises a reinforcing belt with the width larger than 3mm and designed around the waist part, and the diameter of a metal hole in the reinforcing belt is smaller than 2 mm.

In specific implementation, the stopper with be equipped with the assistance-localization real-time original paper between the section, the assistance-localization real-time original paper including correspond set up respectively the stopper with from locking-type fixture block and recess between the section, from locking-type fixture block including setting up the arch on the section, the recess include with protruding form and position unanimous concave station, the arch is the spherical crown shape, the external diameter of bellied root is less than the top external diameter.

The invention has the beneficial effects that:

the replacement scaphoid in the invention adopts a new 3D metal tantalum printing process, the metal tantalum ensures the strength of the scaphoid, and the 3D printing ensures the precision of the scaphoid;

the design similar to a mortise and tenon structure realizes the limitation of freedom degrees of all angles after assembly, parts can form a smooth scaphoid whole body while interfering with each other, on one hand, the assembly time can be shortened, on the other hand, the surface of the parts is smoothed, the healing in the rehabilitation stage is convenient, and meanwhile, the interference with other surrounding sclerotin and tissues can be avoided;

in the compound mode, when guaranteeing the auto-lock after the assembly, the design of stopper provides the space for the suture of replacement part and surrounding tissue, and the space of stylolite, the suture of the intraoperative of being convenient for, the reasonable in design of suture point has both guaranteed the stability of sewing up, has guaranteed the maneuverability of this step again, has accomplished the auto-lock of replacement navicular bone itself, and the position of assembling at the position of interveneeing simultaneously is stable.

The design scheme of the inclined contact surface further optimizes the stress effect of the equipment, and improves the assembly strength of the equipment;

the design of the change of the aperture of the metal tantalum hole ensures the surface strength on one hand and ensures that enough gaps are filled in the metal tantalum hole to fill the gradually melted medicine to promote the later joint rehabilitation, and meanwhile, a medicine bag can be designed in the metal tantalum hole to further facilitate the rehabilitation, so that the weight of equipment is further reduced, and the burden of a patient in the rehabilitation process and the uncomfortable feeling after an interventional operation are reduced;

the printed structure is more targeted, and reasonable and unique modeling can be made for each patient;

the positioning effect of the limiting block is further enhanced by the design of the auxiliary positioning element, and particularly the design of the snap fastener can limit the freedom degrees of 5 coordinate directions between the devices;

due to the design of the plurality of limiting blocks, the sewing needle can be conveniently placed at multiple angles, and the sewing effect is further improved;

the design of the polishing layer further reduces the abrasion between the joints after operation and further shortens the rehabilitation time.

Drawings

FIG. 1 is a schematic diagram of the explosion effect in the structure of the present invention;

FIG. 2 is a front view of the structure of FIG. 1 in accordance with the present invention;

FIG. 3 is a left side view of the structure of FIG. 1 in accordance with the present invention;

FIG. 4 is a right side view of the structure of FIG. 1 in accordance with the present invention;

FIG. 5 is a perspective view of the assembly effect in the construction of the present invention;

FIG. 6 is a front view of the structure shown in FIG. 5;

FIG. 7 is a left side view of the structure of FIG. 5 in accordance with the present invention;

FIG. 8 is a right side view of the structure of FIG. 5 in accordance with the present invention;

FIG. 9 is a front view of another embodiment of the present invention;

FIG. 10 is a schematic view of the present invention being surgically sutured to the fascia;

names of components in the drawings: 1. bone setting; 2. setting the bone block; 3. a limiting block; 4. a suture cavity; 5. the cross section of the upper end; 6. the cross section of the lower end; 7. a longitudinal section A; 8. a longitudinal section B; 9. a medicine adding cavity; 10. positioning blocks; 11. a limiting groove; 12. a tendon; 13. a protrusion; 14. a groove;

the tantalum vias are not shown for clarity of view.

Detailed Description

The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it will be understood that they are described herein for the purpose of illustration and explanation and not limitation.

Example 1

The utility model provides a replacement scaphoid that uses among orthopedic surgery, refer to fig. 1 to 10, the replacement scaphoid that uses among the design orthopedic surgery includes bone piece 1, bone piece 2 and restriction go up bone piece 1 and the stopper 3 of each assembly direction of bone piece 2 cooperation state and assembly angle degree of freedom down, go up bone piece 1, bone piece 2 and stopper 3 include the metal tantalum structure that 3D printed, go up bone piece 1, bone piece 2 and stopper 3 down and form imitative scaphoid bone-shaped assembly, the assembly is from inside to outside including the metal hole that the aperture reduces in proper order, the both ends of stopper 3 are provided with the operation and sew up chamber 4 in order to sew up the manadesma with the assembly, the fitting surface of replacement scaphoid and all around bone is covered with polishing layer. In the operation process, the replaced original bone is taken out firstly, then the upper bone block 1, the lower bone block 2 and the limiting block 3 are spliced, and self-locking is formed after splicing.

A cross section with a shape of [ "is arranged between the upper bone block 1 and the lower bone block 2, wherein two ends of the shape of [" are an upper end cross section 5 and a lower end cross section 6 respectively, the upper end cross section 5 and the lower end cross section 6 are provided with longitudinal vertical sections respectively, the vertical section connected with the upper end cross section 5 is A, the vertical section connected with the lower end cross section 6 is B, and the length of the upper end cross section 5 is greater than or less than that of the lower end cross section 6; corresponding square protrusions 13 or corresponding depressions are respectively arranged on two sides of the surface A, and corresponding square protrusions 13 or corresponding depressions are also respectively arranged on two sides of the surface B; at least 3 prismatic through holes are arranged on the cross section by taking the cross section as a central plane so as to install the matched prismatic limiting block 3, a positioning block 10 is arranged on the longitudinal vertical section, and a limiting groove 11 is arranged on the corresponding matching surface.

The number of prisms of the prismatic through holes is more than 3 and less than 7. This design provides a connection space for later connection with the tendon 12.

The edges of two sides of the prismatic through hole are provided with round corners for coating bone cement.

The two ends of the limiting block 3 and the two ends of the prismatic through hole are respectively provided with a line hole for passing a suture line. Sutures are used to attach the tendon 12 to the fascia.

The size of the metal pores is between 200nm and 400 nm.

A dosing cavity 9 is arranged in a metal hole in the center of the combination body, and the dosing cavity 9 is communicated with the longitudinal section. The design of the medicine adding cavity 9 is convenient for realizing internal medicine placing through preset medicines in the later rehabilitation process, and is further convenient for rehabilitation.

In order to ensure the strength of the interface in the embodiment, in an actual working condition, a polishing layer can be coated on the surface of the interface combined with other bone blocks.

Example 2

The principle of this embodiment is the same as that of embodiment 1, and specifically differs therefrom in that, as shown in fig. 9, the position of the "[" shaped cross section is replaced with an inclined position with respect to the horizontal plane, the inclined angle corresponding to the design angle at which the assembly length of the transverse plane is maximized. To adapt to changes made to the specific situation when the associated condyle is also diseased requiring special treatment.

The waist of the replacement scaphoid that the combination formed is equipped with strengthens the original paper, strengthen the original paper including the width be greater than 3mm around the reinforcing band of waist design, the aperture of metal pore is less than 2mm on the reinforcing band.

Stopper 3 with be equipped with the assistance-localization real-time original paper between the section, the assistance-localization real-time original paper including correspond set up respectively in stopper 3) with from locking-type fixture block and recess 14 between the section, from locking-type fixture block including setting up protruding 13 on the section, recess 14 include with protruding 13 form and position unanimous concave station, protruding 13 is the spherical crown shape, the external diameter of the root of protruding 13 is less than the top external diameter. Further facilitating positioning.

The elastic modulus of the 3D printed porous tantalum is similar to that of the bone, so that the damage to the surrounding bone is avoided;

the 3D printing porous tantalum can generate good interface fusion with surrounding tendon 12 ligaments, and the ligaments and the tendons 12 for fixing the prosthesis around can grow into the prosthesis to play a good fixing role. The method is difficult to realize by the traditional technology and has certain significance. The scaphoid is a complex three-dimensional anatomical structure, and the conventional technology is difficult to design a prosthesis as before an operation; scanning is adopted to scan the data of the lateral wrist joint, and a scaphoid on the affected side is designed according to a normal scaphoid mirror image on the opposite side, so that perfect reconstruction is realized.

The artificial scaphoid has the effects that after the scaphoid is necrotized, the 3D printed porous tantalum scaphoid is used for replacing the scaphoid of the human body, the pain of the wrist after the scaphoid necrosis is reduced, and the function of the wrist joint is reconstructed to the maximum extent.

Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that changes may be made in the embodiments and/or equivalents thereof without departing from the spirit and scope of the invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A replacement scaphoid for use in orthopedic surgery, comprising: including last bone (1), lower bone (2) and restriction go up bone (1) with each assembly direction of bone (2) cooperation state down and stopper (3) of assembly angle degree of freedom, go up bone (1), lower bone (2) and stopper (3) including the metal tantalum structure that 3D printed, go up bone (1), lower bone (2) and stopper (3) and form the imitative boat bone form assembly, the assembly is from inside to outside including the metal hole that the aperture reduces in proper order, the both ends of stopper (3) are provided with the operation and sew up chamber (4) in order to sew up the manadesma and the assembly, it has the polishing layer to coat on the fitting surface of replacement boat bone and all round bones.

2. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: a cross section with a shape of [ "is arranged between the upper bone block (1) and the lower bone block (2), wherein two ends of the [" are an upper end cross section (5) and a lower end cross section (6), the upper end cross section (5) and the lower end cross section (6) are respectively provided with a longitudinal section, the upper end cross section (5) is connected with the longitudinal section A, the lower end cross section (6) is connected with the longitudinal section B, and the length of the upper end cross section (5) is greater than or less than that of the lower end cross section (6); corresponding square bulges (13) or corresponding depressions are respectively arranged on two sides of the surface A, and corresponding square bulges (13) or corresponding depressions are also respectively arranged on two sides of the surface B; at least 3 prismatic through holes are arranged on the cross section by taking the cross section as a central plane so as to install a matched prismatic limiting block (3), a positioning block (10) is arranged on the longitudinal section, and a limiting groove (11) is arranged on the corresponding matching surface.

3. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the number of prisms of the prismatic through holes is more than 3 and less than 7.

4. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the edges of two sides of the prismatic through hole are provided with round corners for coating bone cement.

5. The replacement scaphoid for use in orthopedic surgery of claim 4, wherein: the two ends of the limiting block (3) and the two ends of the prismatic through hole are respectively provided with a line hole for passing a suture line.

6. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the size of the metal pores is between 200nm and 400 nm.

7. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: a dosing cavity (9) is arranged in the metal hole at the center of the combination body, and the dosing cavity (9) is communicated with the longitudinal section.

8. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the position of the [ -shaped section is replaced by an inclined arrangement relative to the horizontal plane, the angle of inclination corresponding to the design angle at which the assembly length of the transverse plane is maximized.

9. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the waist of the replacement scaphoid that the combination formed is equipped with strengthens the original paper, strengthen the original paper including the width be greater than 3mm around the reinforcing band of waist design, the aperture of metal pore is less than 2mm on the reinforcing band.

10. The replacement scaphoid for use in orthopedic surgery of claim 1, wherein: stopper (3) with be equipped with the auxiliary positioning original paper between the section, the auxiliary positioning original paper including correspond set up respectively in stopper (3) with from locking-type fixture block and recess (14) between the section, from locking-type fixture block including setting up arch (13) on the section, recess (14) include with protruding (13) form and position unanimous concave station, arch (13) are the spherical crown shape, the external diameter of the root of arch (13) is less than the top external diameter.