CN112137766B

CN112137766B - Replacement navicular bone used in orthopedic operation

Info

Publication number: CN112137766B
Application number: CN202010984987.0A
Authority: CN
Inventors: 王国华; 刘江; 宋坤; 邹炜民
Original assignee: Hunan Huaxiang Medical Technology Co ltd
Current assignee: Hunan Huaxiang Medical Technology Co ltd
Priority date: 2020-09-18
Filing date: 2020-09-18
Publication date: 2024-05-10
Anticipated expiration: 2040-09-18
Also published as: CN112137766A

Abstract

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

Description

Replacement navicular bone used in orthopedic operation

Technical Field

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

Background

The fracture of the carpal navicular bone is a common fracture in clinic, accounts for 2 percent of the total fracture, accounts for 70 to 80 percent of the fracture of the carpal bone, and is only inferior to the fracture of the distal radius. There are many methods for treating fracture of carpal navicular bone clinically, but no definite selection standard exists at present. If the treatment is lost or mishandled, complications such as severe malformation healing, bone nonunion, aseptic ischemic necrosis, hypertrophic scar pain and the like are easily caused. Navicular necrosis easily occurs after fracture of navicular bone, and no good treatment method exists at present. At present, tendon ball transplantation or carpal fusion treatment is mainly adopted, and the effect is unsatisfactory. Anatomical features of navicular bone: the structure is irregular.

The carpal navicular bone is long and narrow, and is the wrist bone with the largest volume in the far and near carpal bones and the wrist bone with the largest activity. The carpohemoral bone is a complex three-dimensional anatomical structure, 5 joint surfaces are arranged around the complex three-dimensional anatomical structure, the far side joint surface of the carpohemoral bone is concave and contacts with the cephalic bone, the near side joint surface protrudes to be connected with the radius phase joint, the other two far side joint surfaces are respectively connected with the trapezium bone and the trapezium bone, and the inner side joint surface is connected with the lunar bone. The distal end of the depression is a protruding navicular tuberosity with the flexor tendon of the radius (12) and the volar flexor ligament attached. The surface of the scaphoid is covered by cartilage in 70-80%, blood supply mainly comes from radial artery branches, the radial artery branches enter the scaphoid waist from the back side, 80% of blood supply at the proximal end of the scaphoid is supplied, and the rest 20% of blood supply is supplied from the radial artery palm branches into the proximal junction of the scaphoid. Research shows that the thin blood supply of the carpal navicular bone is a main cause of ischemic necrosis and bone nonunion after the fracture operation of the carpal navicular bone. The research on the navicular prosthesis is less at home and abroad, and the scholars in China have sporadic operation reports, the research level is low, and the navicular prosthesis is not applied on a large scale. Foreign mature silica gel prostheses have unsatisfactory effects, metal prostheses are also available, and literature reports are seen ：Spingardi O,Ｒossello MI． The total scaphoid titanium arthroplasty:A 15-year experience［J］． Hand( N Y) ,2011,6( 2) : 179-184.

Because of 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 requirement, mainly has high elastic modulus, is easy to cause damage of other bones of the scaphoid, and secondly has the advantages that the scaphoid of a human body is fixed in a wrist joint by tendons, and the interface fusion of the prosthesis and surrounding ligaments cannot be realized by the prosthesis manufactured by the traditional technology, so that the position is unstable after the prosthesis is implanted, and the function is affected.

In the prior art, the improvement of the technology in the patent mainly comprises the following technical layers:

In the published Chinese patent literature, the application number is CN201920988387.4, the patent is a screw-in ball-and-socket joint artificial navicular bone, in the disclosed technology, the navicular bone body is an irregular shape similar to human navicular bone formed by three parts of a head, a body and a tail, the supporting body is formed by a ball head, a neck collar and a handle, a spherical socket is formed at the position, opposite to the ball head, of the body of the navicular bone body, of the supporting body, and the ball head forms a ball-and-socket joint, the technical construction characteristics can disperse stress, maintain the gap of the wrist joint, keep the better activity of the wrist joint and well reconstruct the wrist joint, however, the applicant still considers that the whole equipment is not fixed accurately, and the strength of the body is difficult to reach;

There is also a direction of improving the positioning device, for example, in the published chinese patent document, the application number is CN201810661303.6, the name is 3D positioning device for wrist navicular percutaneous nailing 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 texture 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; a guide pin nozzle is formed on the panel and is provided with a guide pin channel communicated with the first cavity, and the guide pin channel is configured to guide a guide pin to penetrate from a navicular tuberosity to a navicular near pole, however, the problem that the later strength of the interventional device is not suitable for a patient to use still exists;

Related technicians also put forward to realize the protection to the tissue of the intervention place through the improvement of the prosthetic equipment at other bone joints of the human body, for example, in the published Chinese patent literature, the application number is CN201910104178.3, the split type total ankle prosthesis of talus is named, a shank-talus joint shank-side part is put forward, the split type total ankle prosthesis also comprises a rotating fit part, the rotating fit part comprises a calcaneal joint shank-side part and a talaro joint shank-side part which are detachably connected, the problem of the operation field is solved by split type, however, the problem that the strength is difficult to adapt to a patient in the bone joint intervention operation is still not solved, and meanwhile, the effective technical teaching cannot be formed due to inconsistent bone types;

Still other people put forward a patent named as a detachable talus prosthesis, the application number of which is CN201621249738.2, and the design aim is to realize a detachable intervention structure, the inferior articular surface and the navicular articular surface are porous structures, and the detachable talus prosthesis has biological functions, is convenient for the rapid fusion growth of the prosthesis, calcaneus and navicular, and the sharp edge and the material design of the detachable talus prosthesis still have difficulty in improving the use effect of the rehabilitation stage.

In summary, the following problems exist in the current technology: 1. long operation time and difficult positioning; 2. in the later rehabilitation state, other medical care bone joints often collide, so that secondary injury is caused; 3. the joint is too commonly used and heals slowly, so that the hidden trouble of secondary lesions exists.

Disclosure of Invention

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

The specific scheme of the invention is as follows:

the utility model provides a replace navicular bone that uses in orthopedic surgery, includes bone piece, lower bone piece and restriction go up bone piece with each assembly direction of bone piece cooperation state down and the stopper of assembly angle degree of freedom down, go up bone piece, lower bone piece and stopper and include the metal tantalum structure that 3D printed, go up bone piece, lower bone piece and stopper and form imitative navicular bone form assembly, the assembly includes the metal hole that the aperture reduces in proper order from inside to outside, the both ends of stopper are provided with the operation suture chamber in order to sew up the fascia with the assembly, the coating has the polishing layer on the cooperation face of replacement navicular bone and peripheral bone.

In specific implementation, a cross section with a shape of a cross section is arranged between the upper bone block and the lower bone block, wherein the two ends of the cross section 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 larger than or smaller than that of the lower end cross section; corresponding square protrusions or recesses are respectively arranged on two sides of the vertical section A, and corresponding square protrusions or recesses are respectively arranged on two sides of the vertical section B; at least 3 prismatic through holes are formed in the cross section and the cross section is taken as a central plane for installing matched prismatic limiting blocks, positioning blocks are arranged on the longitudinal section, and limiting grooves are formed in the corresponding matching surfaces.

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, rounded corners are arranged at the edges of two sides of the prismatic through hole so as to coat bone cement.

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

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

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

The position of the cross-section of the "[ -shape" is instead arranged obliquely with respect 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 of the replacement navicular bone formed by the combination is provided with a reinforcing element, the reinforcing element comprises a reinforcing belt which is more than 3mm in width and is designed around the waist, and the aperture of a metal hole in the reinforcing belt is less than 2mm.

In specific implementation, be equipped with auxiliary positioning element between the section, auxiliary positioning element is including corresponding setting up respectively vertical section B and recess and the self-locking fixture block on corresponding surface, self-locking fixture block includes spherical crown protruding, spherical crown protruding root's external diameter is less than the top external diameter.

The invention has the beneficial effects that:

The new 3D metal tantalum printing process is adopted for replacing the navicular bone, the metal tantalum ensures the strength of the navicular bone, and the 3D printing ensures the precision of the navicular bone;

Similar to the design of a mortise and tenon structure, the limitation of degrees of freedom of all angles after assembly is realized, parts interfere with each other and form a smooth navicular bone whole, so that on one hand, the assembly time can be shortened, on the other hand, the surface of the parts is smoothed, the healing in a rehabilitation stage is facilitated, and meanwhile, the parts do not interfere with other surrounding bones and tissues;

in the combination mode, when guaranteeing the self-locking after the assembly, the design of stopper provides the space for the suture of replacement part and surrounding tissue, and the space of suture line, the suture in the art of being convenient for, and the reasonable in design of suture point has both guaranteed the steadiness of suture, has guaranteed the maneuverability of this step again, has made the self-locking of replacement navicular bone itself, and the assembly position in intervention position is stable simultaneously.

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 strength of the surface on one hand, and ensures that enough gaps are filled in the metal tantalum hole to gradually melt medicines so as to promote later joint rehabilitation, and meanwhile, the medicine bag can be designed in the metal tantalum hole so as to further facilitate the rehabilitation, further reduce the weight of the equipment and reduce the burden of patients in the rehabilitation process and discomfort after interventional operation;

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

The design of the auxiliary positioning element further enhances the positioning effect of the limiting block, particularly the design of the snap fastener, and can limit the freedom degree of 5 coordinate directions between devices;

the design of a plurality of limiting blocks is convenient for the suture needle under multiple angles, and the suture effect is further improved;

the polishing layer is designed to further reduce abrasion between joints after operation and further shorten recovery 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 structure 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;

the names of the components in the figure are as follows: 1. an upper bone block; 2. a lower bone piece; 3. a limiting block; 4. suturing the cavity; 5. an upper cross section; 6. a lower end cross section; 7. a longitudinal section A;8. a longitudinal section B;9. a dosing chamber; 10. a positioning block; 11. a limit groove; 12. tendons; 13. a protrusion; 14. a groove;

The tantalum metal holes are not shown for clarity of illustration.

Detailed Description

The preferred embodiments of the present invention will be described below with reference to the accompanying drawings, it being understood that the preferred embodiments described herein are for illustration and explanation of the present invention only, and are not intended to limit the present invention.

1-10, The replacement navicular that uses in the orthopedics operation is designed to be used in the orthopedics operation and is included last bone piece 1, lower bone piece 2 and restriction piece 3 that restrict each assembly direction and the assembly angle degree of freedom of the state of mating of last bone piece 1 and lower bone piece 2, go up bone piece 1, lower bone piece 2 and stopper 3 and include 3D and print the metal tantalum structure that becomes, go up bone piece 1, lower bone piece 2 and stopper 3 and form imitative navicular assembly, the assembly from inside to outside includes the metal hole that the aperture reduces in proper order, the both ends of stopper 3 are provided with operation suture chamber 4 in order to sew up fascia and the assembly, the coating has the polishing layer on the mating face of replacement navicular and peripheral bone. In the operation process, the replaced original bone is firstly taken out, then the upper bone block 1, the lower bone block 2 and the limiting block 3 are spliced, and the self-locking is formed after the splicing.

A cross section with a shape of a cross section is arranged between the upper bone block 1 and the lower bone block 2, wherein the two ends of the cross section are respectively 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 cross section, the upper end cross section 5 is connected with the longitudinal cross section A, the lower end cross section 6 is connected with the longitudinal cross section B, and the length of the upper end cross section 5 is larger than or smaller than the length of the lower end cross section 6; corresponding square protrusions or recesses are respectively arranged on two sides of the vertical section A, and corresponding square protrusions or recesses are respectively arranged on two sides of the vertical section B; at least 3 prismatic through holes are formed in the cross section and the cross section is taken as a central plane for installing the matched prismatic limiting block 3, a positioning block 10 is arranged on the longitudinal section, and a limiting groove 11 is formed in 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 the two sides of the prismatic through hole are provided with fillets so as to coat bone cement.

And two ends of the limiting block 3 are respectively provided with a wire hole for passing through a suture. Sutures are used to connect the tendon 12 to the fascia.

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

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. The design of the dosing cavity 9 is convenient for realizing internal drug placement through preset drugs in the later rehabilitation process, and is further convenient for rehabilitation.

The interface design in this embodiment may be used to apply a polishing layer to the bonding surface with other bone pieces in order to ensure its strength.

Example 2

The principle of this embodiment is the same as that of embodiment 1, except that the position of the cross-section of the "[" shape, as shown in fig. 9, is replaced by an inclined arrangement with respect to the horizontal plane, the inclined angle corresponding to the design angle at which the mounting length of the horizontal plane is maximized. To accommodate changes made on a case-by-case basis when lesions also occur in the relevant condyles, requiring special treatment.

The waist of the replacement navicular bone formed by the combination body is provided with a reinforcing element, the reinforcing element comprises a reinforcing belt which is wider than 3mm and is designed around the waist, and the aperture of a metal hole on the reinforcing belt is smaller than 2mm.

The auxiliary positioning elements are arranged between the sections and comprise grooves 14 and self-locking clamping blocks, the grooves 14 and the self-locking clamping blocks are correspondingly arranged on the vertical section B and the corresponding surfaces of the vertical section B, the self-locking clamping blocks comprise spherical crown-shaped protrusions 13, and the outer diameter of the root parts of the spherical crown-shaped protrusions 13 is smaller than the outer diameter of the top parts. Further facilitating positioning.

The elastic modulus and the bone quality of the 3D printing porous tantalum are similar, and the positioning is further facilitated. The peripheral bone is not damaged;

3D prints many empty tantalum can produce good interface fusion with the tendon 12 ligament in every side, and the ligament and the tendon 12 of the fixed prosthesis in every side can grow into the prosthesis, plays good stationary action. This is difficult to achieve by the conventional technology and has a certain meaning. The carpal navicular bone is a complex three-dimensional anatomical structure, and the conventional technology is difficult to design a prosthesis which is the same as that before operation; the method adopts scanning contralateral wrist joint data, designs a navicular bone on the affected side according to the mirror image of a navicular bone on the normal contralateral side, and realizes perfect reconstruction.

For the effect of artificial navicular bone, 3D printing is used for printing multiple hollow tantalum navicular bone after navicular necrosis, so that human navicular bone is replaced, wrist pain after navicular necrosis is reduced, and wrist joint function is rebuilt to the maximum extent.

Finally, it should be noted that: the foregoing description is only a preferred embodiment of the present invention, and the present invention is not limited thereto, but it is to be understood that modifications and equivalents of some of the technical features described in the foregoing embodiments may be made by those skilled in the art, although the present invention has been described in detail with reference to the foregoing embodiments. Any modification, equivalent replacement, improvement, etc. 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 navicular bone for use in orthopedic surgery, comprising: the novel artificial boat bone comprises an upper bone block (1), a lower bone block (2) and a limiting block (3) for limiting the degree of freedom of the assembly direction and the assembly angle of the upper bone block (1) and the lower bone block (2) in the matching state, wherein the upper bone block (1), the lower bone block (2) and the limiting block (3) comprise 3D-printed metal tantalum structures, the upper bone block (1), the lower bone block (2) and the limiting block (3) form an artificial boat bone-shaped assembly, the assembly comprises metal holes with sequentially reduced pore diameters from inside to outside, two ends of the limiting block (3) are provided with operation suture cavities (4) for suturing fascia and the assembly, and a polishing layer is coated on the matching surface of a replacement boat bone and peripheral bones; a cross section with a shape of a cross section is arranged between the upper bone block (1) and the lower bone block (2), wherein the two ends of the cross section are respectively 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 larger than or smaller than that of the lower end cross section (6); corresponding square protrusions or recesses are respectively arranged on two sides of the vertical section A, and corresponding square protrusions or recesses are respectively arranged on two sides of the vertical section B; at least 3 prismatic through holes are formed in the cross section and the cross section is taken as a central plane for installing matched limiting blocks (3), positioning blocks (10) are arranged on the longitudinal section, and limiting grooves (11) are formed in the corresponding matching surfaces; the auxiliary positioning elements are arranged between the sections and comprise grooves (14) and self-locking clamping blocks, the grooves (14) and the self-locking clamping blocks are correspondingly arranged on the vertical section B and the corresponding surfaces of the vertical section B, the self-locking clamping blocks comprise spherical crown-shaped protrusions (13), and the outer diameter of the root parts of the spherical crown-shaped protrusions (13) is smaller than the outer diameter of the top parts.

2. A replacement navicular for use in orthopedic surgery as claimed in claim 1 wherein: the number of prisms of the prismatic through holes is more than 3 and less than 7.

3. A replacement navicular for use in orthopedic surgery as claimed in claim 1 wherein: the edges of the two sides of the prismatic through hole are provided with fillets so as to coat bone cement.

4. A replacement navicular for use in orthopedic surgery as claimed in claim 1 wherein: two ends of the limiting block (3) are respectively provided with a thread hole for passing through a suture thread.

5. A replacement navicular for use in orthopedic surgery as claimed in claim 1 wherein: the size of the metal hole is between 200nm and 400 nm.

6. A replacement navicular for use in orthopedic surgery as claimed in 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.

7. A replacement navicular for use in orthopedic surgery as claimed in claim 1 wherein: the position of the cross-section of the "[ -shape" is instead arranged obliquely with respect to the horizontal plane, the angle of inclination corresponding to the design angle at which the assembly length of the transverse plane is maximized.

8. A replacement navicular for use in orthopedic surgery as claimed in claim 1 wherein: the waist of the replacement navicular bone formed by the combination body is provided with a reinforcing element, the reinforcing element comprises a reinforcing belt which is wider than 3mm and is designed around the waist, and the aperture of a metal hole on the reinforcing belt is smaller than 2mm.