CN113367856A - Calcaneus prosthesis - Google Patents

Calcaneus prosthesis Download PDF

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Publication number
CN113367856A
CN113367856A CN202110561367.0A CN202110561367A CN113367856A CN 113367856 A CN113367856 A CN 113367856A CN 202110561367 A CN202110561367 A CN 202110561367A CN 113367856 A CN113367856 A CN 113367856A
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CN
China
Prior art keywords
prosthesis
calcaneus
intramedullary
hole
limiting
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Granted
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CN202110561367.0A
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Chinese (zh)
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CN113367856B (en
Inventor
郝改平
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Beijing Lidakang Technology Co Ltd
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Beijing Lidakang Technology Co Ltd
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Priority to CN202110561367.0A priority Critical patent/CN113367856B/en
Publication of CN113367856A publication Critical patent/CN113367856A/en
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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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/30528—Means for limiting said movement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30688—Means for allowing passage or sliding of tendons or ligaments
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4212—Tarsal bones
    • A61F2002/4215—Lateral row of tarsal bones
    • A61F2002/4217—Calcaneum or calcaneus or heel bone

Abstract

The application relates to the technical field of medical prosthesis, in particular to a calcaneus prosthesis, which has the technical scheme that a fixing screw is arranged on the outer surface of the calcaneus prosthesis, the calcaneus prosthesis is provided with a fitting plate corresponding to a reserved bone, an intramedullary needle is arranged in the calcaneus prosthesis, and one end of the intramedullary needle extends out of the fitting plate; the intramedullary pin is provided with a first connecting piece for connecting the intramedullary pin with the calcaneus prosthesis; when the calcaneus prosthesis is replaced, firstly, a diseased calcaneus is cut off, the required calcaneus prosthesis is printed out in a 3D mode, secondly, a jack into which an intramedullary needle is inserted is formed in a medullary cavity of a reserved bone, the intramedullary needle is inserted into the jack, then the calcaneus prosthesis is driven to move towards the direction close to the intramedullary needle, then the connection between the intramedullary needle and the calcaneus prosthesis is achieved through a first connecting piece, and finally, a fixing screw is screwed into the calcaneus prosthesis and extends into the reserved bone; the design of the intramedullary pin ensures the connection strength and stability of the calcaneus prosthesis and the reserved bone.

Description

Calcaneus prosthesis
Technical Field
The application relates to the technical field of medical prostheses, in particular to a calcaneus prosthesis.
Background
The calcaneus is the largest tarsal bone of the foot, and the calcaneus joint surface and the talar joint surface form a calcaneus joint for bearing about 45% of the body weight of the human body.
When tumors or lesions occur in the calcaneus of a human body, the diseased calcaneus is usually removed through an operation, and then the removed diseased calcaneus is replaced by a calcaneus prosthesis; the calcaneus prosthesis is provided with an attaching plate corresponding to the reserved bone end face, and the attaching plate is made of a porous grid structure layer; when the prosthesis is replaced, the attaching plate of the calcaneus prosthesis is attached to the end face of the reserved bone, and then the fixing screw is screwed into the reserved bone of the patient through the calcaneus prosthesis, so that the calcaneus prosthesis is connected with the reserved bone.
Because blood vessels and soft tissues exist in the reserved bone, when the fixing screws are screwed into the reserved bone, the screwing position needs to be determined so as to avoid the injury to the blood vessels and the soft tissues, and the number of the fixing screws is not suitable to be too large due to the consideration; in view of the above-mentioned related art solutions, the inventors found that: the connection strength and stability of the calcaneus prosthesis and the reserved bone can be reduced due to the limitation of the installation position and the number of the fixing screws, so that difficulty is brought to the early growth of the calcaneus prosthesis, and the postoperative recovery time is greatly prolonged.
Disclosure of Invention
In order to guarantee calcaneus prosthesis and the joint strength and the stability of retaining bone, the application provides a calcaneus prosthesis.
The application provides a calcaneus prosthesis adopts following technical scheme:
a calcaneus prosthesis, the outer surface of which is provided with a fixing screw, the calcaneus prosthesis is provided with an attaching plate corresponding to a reserved bone, an intramedullary needle is arranged in the calcaneus prosthesis, and one end of the intramedullary needle extends out of the attaching plate; the intramedullary pin is provided with a first connecting piece for connecting the intramedullary pin with the calcaneus prosthesis.
By adopting the technical scheme, when the calcaneus prosthesis is replaced, firstly, the diseased calcaneus is removed through an operation, the required calcaneus prosthesis is printed out according to the mirror image healthy side calcaneus 3D, secondly, a jack for inserting an intramedullary needle is arranged in a medullary cavity of the reserved bone, the intramedullary needle is inserted into the jack, then, the calcaneus prosthesis is driven to move towards the direction close to the intramedullary needle, so that the calcaneus intramedullary needle is inserted into the calcaneus prosthesis until the calcaneus prosthesis is attached to the end face of the reserved bone, then, the connection between the intramedullary needle and the calcaneus prosthesis is realized by utilizing a first connecting piece, and finally, a fixing screw is screwed into the calcaneus prosthesis and extends to the position with more bone in the reserved bone, so that the connection between the calcaneus prosthesis and the reserved bone is realized; the intramedullary pin ensures the connection strength and stability of the calcaneus prosthesis and the reserved bone, and reduces the possibility that the calcaneus prosthesis and the reserved bone are easy to loosen due to the limitation of the installation position and the number of the fixing screws.
Preferably, the calcaneus prosthesis is provided with a through hole for the extension of the intramedullary pin; the first connecting piece comprises a blocking block connected with the inner wall of the through hole, a limiting screw rod in threaded connection with one end of the intramedullary nail arranged in the calcaneal talus prosthesis, and a limiting nut integrally formed with the limiting screw rod; the diameter of the limiting nut is larger than the inner diameter of the through hole.
By adopting the technical scheme, when the calcaneal prosthesis is connected with the intramedullary pin, the intramedullary pin is firstly inserted into the insertion hole of the reserved bone, then the intramedullary pin is aligned with the through hole and drives the calcaneal prosthesis to move towards the direction close to the reserved bone, when the calcaneal prosthesis is attached to the end surface of the reserved bone, the end surface of the intramedullary pin extending into the calcaneal prosthesis is also abutted against the blocking block, at the moment, the limiting screw rod is screwed into the intramedullary pin until the end surface of the limiting screw cap is attached to the surface of the calcaneal prosthesis, and therefore the connection of the calcaneal prosthesis and the intramedullary pin can be realized; the arrangement of the first connecting piece greatly improves the convenience of connecting the intramedullary pin and the calcaneus prosthesis; the provision of the block reduces the possibility of the intramedullary pin being disengaged from the through hole to the outside.
Preferably, the intramedullary pin is provided with an anti-rotation groove matched with the blocking block on the peripheral surface of one end arranged in the calcaneus prosthesis.
By adopting the technical scheme, when the calcaneus prosthesis is attached to the end face of the reserved bone, the groove wall of the anti-rotation groove is attached to the surface of the blocking block, the possibility of rotation of the intramedullary needle in the process of connecting the calcaneus prosthesis and the intramedullary needle can be avoided through the design, and then the injury of the intramedullary needle to the reserved bone can be reduced.
Preferably, the calcaneus prosthesis is provided with a blind hole for the extension of the intramedullary pin; the first connecting piece is arranged on the side surface of the intramedullary nail; the first connecting piece comprises a first spring which is arranged in the intramedullary nail and is vertical to the axis of the intramedullary nail and a first limiting block which is connected with one end of the first spring far away from the intramedullary nail; the side of intramedullary nail is seted up and is supplied first standing groove that first spring placed, and the pore wall of through-hole is seted up and is used for prescribing a limit to the first limited groove of piece.
By adopting the technical scheme, when the calcaneal prosthesis is connected with the intramedullary pin, the intramedullary pin is firstly inserted into the jack, then the intramedullary pin is aligned with the blind hole, and the calcaneal prosthesis is driven to move towards the direction close to the intramedullary pin; the design greatly improves the convenience of operation, shortens the operation time and relieves the pain of patients.
Preferably, the calcaneus prosthesis is provided with at least one suture hole for the suture to pass through.
By adopting the technical scheme, after the calcaneus prosthesis is connected with the reserved bone, the suture is firstly connected with the ligament or the soft tissue, and then passes through the suture hole, so that the ligament and the soft tissue can be attached to the calcaneus prosthesis, and the postoperative recovery is facilitated; the suture holes are formed to provide a reconstruction point for the ligament and soft tissue, thereby facilitating attachment of the ligament and soft tissue to the calcaneus prosthesis.
Preferably, the fixing screw includes a first connecting portion, a second connecting portion coaxial with the first connecting portion, and a fixing nut connected with the second connecting portion; the thread pitch of the thread provided on the outer surface of the first connection portion is larger than the thread pitch of the thread provided on the outer surface of the second connection portion.
By adopting the technical scheme, the first connecting part is screwed into the reserved bone, and the second connecting part is screwed into the calcaneus prosthesis; meanwhile, the thread pitch of the threads arranged on the outer surface of the first connecting part is larger than that of the threads arranged on the outer surface of the second connecting part, so that when the fixing screw rotates for a circle, the advancing distance of the first connecting part is larger than the advancing distance of the second connecting part, namely, relative displacement can be generated between the first connecting part and the second connecting part, thereby improving the pretightening force between the first connecting part and the reserved bone and the pretightening force between the second connecting part and the calcaneus prosthesis, and further improving the connection strength and stability between the calcaneus prosthesis and the reserved bone.
Preferably, the outer diameter of the first connecting portion is smaller than the outer diameter of the second connecting portion; the outer peripheral surface of the end of the first connecting part, which is far away from the second connecting part, is provided with a chip removal groove.
By adopting the technical scheme, the first connecting part needs to be screwed into the reserved bone, and the second connecting part needs to be screwed into the calcaneal prosthesis, so that the outer diameter of the first connecting part is smaller than that of the second connecting part, and the injury to the reserved bone is reduced on the premise of ensuring that the calcaneal prosthesis and the reserved bone can be stably connected; the chip groove is convenient for discharging the bone chips outwards, thereby being convenient for driving the fixing screw to be screwed into the reserved bone.
Preferably, the intramedullary needle comprises a first portion and a second portion coaxial with the first portion, the first portion having an outer diameter greater than an outer diameter of the second portion.
Through adopting above-mentioned technical scheme, because the first part sets up in the calcaneus prosthesis and extends to in keeping the bone, the second portion sets up in keeping the bone, and consequently the external diameter of second portion is less than the external diameter of first portion, makes the diameter of jack be less than the diameter of through-hole to be convenient for under the prerequisite that guarantees that intramedullary needle and calcaneus prosthesis can be stably connected, reduce the injury to keeping the bone.
Preferably, the calcaneus prosthesis comprises a fitting portion and a base portion; the surface of the base part close to the attaching part is connected with a second connecting piece used for connecting the base part and the attaching part; the base portion is designed in a variety of sizes.
By adopting the technical scheme, when the calcaneal prosthesis is connected with the reserved bone, firstly, the diseased calcaneus is cut off, the required attaching part and the base part are printed out through 3D, secondly, the intramedullary pin is inserted into a medullary cavity of the reserved bone, then, the intramedullary pin is aligned with the blind hole, the attaching part is driven to move towards the direction close to the intramedullary pin, then, the connection between the intramedullary pin and the calcaneal prosthesis is realized by utilizing the first connecting piece, and finally, the attachment part is connected with the base part by utilizing the second connecting piece; because the calcaneus of different patients has different excision ranges, skin defect conditions and soft tissue tension, the base part is designed into various sizes, so that the possibility of complications such as difficult stitching, soft tissue adhesion failure and the like caused by overlarge graft is reduced under the condition of ensuring that the height of the calcaneus is not changed.
Preferably, the second connecting piece comprises a connecting rod fixedly connected to the surface of the base part close to the attaching part and a second spring arranged on the side face of the connecting rod, the second spring is arranged inside the connecting rod, and the axis of the second spring is perpendicular to the axis of the second connecting rod; the connecting rod is provided with a second placing groove for placing a second spring; the second connecting piece also comprises a second limiting block arranged at one end of the second spring far away from the connecting rod; the attaching portion is provided with an insertion hole for inserting the connecting rod, and the hole wall of the insertion hole is provided with a second limiting groove for limiting the second limiting block.
Through adopting above-mentioned technical scheme, when laminating part and base part realize being connected, at first align connecting rod and insert hole, and drive the base part and remove to the direction that is close to laminating part, because the existence of second spring and second standing groove, consequently second limited block and second spring will be compressed in the second standing groove all the time, treat to move to second limited block and second limited groove and be located same straight line after, the second limited block will move to the second limited inslot automatically under the effect of second spring elasticity, thereby alright make base part and laminating part realize being connected, such design is convenient for make base part and laminating part realize being connected, the convenience of operation has been improved.
In summary, the present application has the following technical effects:
1. when the calcaneus prosthesis is replaced, firstly, a diseased calcaneus is cut off, a needed calcaneus prosthesis is printed according to 3D, then, an intramedullary pin is inserted into a medullary cavity of a reserved bone, then, the calcaneus prosthesis is driven to move towards the direction close to the intramedullary pin until the calcaneus prosthesis is moved to be attached to the end face of the reserved bone, then, the connection between the intramedullary pin and the calcaneus prosthesis is realized by utilizing a first connecting piece, and finally, a fixing screw is screwed into the calcaneus prosthesis and extends to the position with more bone in the reserved bone, so that the connection between the calcaneus prosthesis and the reserved bone is realized; the design of the intramedullary pin ensures the connection strength and stability of the calcaneus prosthesis and the reserved bone, and reduces the possibility that the calcaneus prosthesis and the reserved bone are easy to loosen due to the limitation of the installation position and the number of the fixing screws;
2. when the calcaneus prosthesis is connected with the intramedullary needle, the intramedullary needle is firstly inserted into the reserved bone, then the intramedullary needle is aligned with the through hole and drives the calcaneus prosthesis to move towards the direction close to the reserved bone, when the calcaneus prosthesis is attached to the end surface of the reserved bone, the end surface of the intramedullary needle extending into the calcaneus prosthesis is also abutted against the blocking block, and at the moment, the limiting screw rod is screwed into the intramedullary needle until the end surface of the limiting screw cap is attached to the surface of the calcaneus prosthesis, so that the connection of the calcaneus prosthesis and the intramedullary needle can be realized; the arrangement of the first connecting piece greatly improves the convenience of connecting the intramedullary pin and the calcaneus prosthesis;
3. when the calcaneus prosthesis is attached to the end face of the reserved bone, the groove wall of the anti-rotation groove is attached to the surface of the blocking block, so that the possibility of rotation of the intramedullary needle in the process of connecting the calcaneus prosthesis and the intramedullary needle can be avoided, and further the injury of the intramedullary needle to the reserved bone can be reduced;
4. after the calcaneus prosthesis is connected with the reserved bone, firstly, the suture line is connected with the ligament or the soft tissue, and then the suture line penetrates through the suture hole, so that the ligament and the soft tissue can be attached to the calcaneus prosthesis, and the postoperative recovery is facilitated; the suture holes are formed to provide a reconstruction point for the ligament and soft tissue, thereby facilitating attachment of the ligament and soft tissue to the calcaneus prosthesis.
Drawings
FIG. 1 is a schematic view of a calcar prosthesis coupled to a retaining bone according to one embodiment of the present application;
FIG. 2 is a schematic structural view of a heel bone prosthesis with a concealed fitting plate according to an embodiment of the present application;
FIG. 3 is a cross-sectional view of a first connecting member protruding from a rear surface of a hidden attaching plate according to an embodiment of the present disclosure;
FIG. 4 is a schematic structural diagram of a fixing screw according to an embodiment of the present application;
FIG. 5 is a cross-sectional view of the second embodiment of the present application showing the first connecting member protruded from the rear of the concealed attaching plate;
FIG. 6 is an exploded view of the attachment portion and the base portion of the third embodiment of the present application;
fig. 7 is a sectional view of a second connector according to a third embodiment of the present application.
In the figures, 1, a calcaneus prosthesis; 11. a fitting portion; 111. an insertion hole; 12. a base portion; 13. a through hole; 14. sewing the hole; 15. blind holes; 151. a first limiting groove; 2. retaining the bone; 3. attaching a plate; 4. a set screw; 41. a first connecting portion; 42. a second connecting portion; 43. fixing a nut; 44. a chip groove; 5. an intramedullary pin; 51. a first portion; 511. a rotation prevention groove; 512. a first placing groove; 52. a second portion; 6. a first connecting member; 61. a blocking block; 62. a confining screw; 63. a confining nut; 64. a first spring; 65. a first limiting block; 7. a second connecting member; 71. a connecting rod; 711. a second placing groove; 72. a second spring; 73. a second limiting block.
Detailed Description
The present application is described in further detail below with reference to the attached drawings.
The first embodiment is as follows:
referring to fig. 1, 2 and 3, the present application provides a calcaneus prosthesis, wherein the calcaneus prosthesis 1 is provided with an attachment plate 3 corresponding to an end face of a retained bone 2, the attachment plate 3 is made of a porous grid structure layer, the thickness of the porous grid structure layer is 2mm, and the material of the porous grid structure layer can be one of a 3D-printed trabecular bone porous structure, a titanium/tantalum spraying coating or a hydroxyapatite coating; the outer surface of the calcaneus prosthesis 1 is provided with at least one fixing screw 4, one end of each fixing screw 4 penetrates through the calcaneus prosthesis 1 and extends into the reserved bone 2, in the embodiment of the application, three fixing screws 4 are provided, and in other examples, one or more fixing screws 4 can be provided; an intramedullary pin 5 extending into the reserved bone 2 is arranged in the calcaneal prosthesis 1, the intramedullary pin 5 is a biological intramedullary pin and has good biocompatibility, and in the embodiment of the application, the intramedullary pin 5 is made of a C3D/EP composite material; the intramedullary pin 5 comprises a first portion 51 arranged in the calcaneal prosthesis 1 and extending into the retained bone 2 and a second portion 52 arranged in the retained bone 2, the first portion 51 being integral and coaxial with the second portion 52, the first portion 51 having an external diameter greater than the external diameter of the second portion 52; the end of the first part 51 far away from the second part 52 is formed with a hemispherical end surface, the transition between the first part 51 and the second part 52 is smooth, and the outer edge of the end surface of the second part 52 far away from the first part 51 is rounded along the circumferential direction; the calcaneus prosthesis 1 is provided with a through hole 13 for extending the first part 51; the intramedullary pin 5 is provided with a first connecting member 6 at a position near one end of the calcaneus prosthesis 1.
When the calcaneus prosthesis 1 is replaced, firstly, the diseased calcaneus is removed through an operation, the required calcaneus prosthesis 1 is printed out according to the mirror image healthy side calcaneus 3D, then, a socket for inserting the second part 52 is arranged in the medullary cavity of the reserved bone 2, the second part 52 is inserted into the medullary cavity of the reserved bone 2 along the extending direction of the socket until the end surface of the second part 52 far away from the first part 51 is abutted with the upper hole wall of the socket, then the first part 51 is aligned with the through hole 13, and the calcaneal prosthesis 1 is driven to move towards the direction close to the first part 51 until the joint plate 3 is jointed with the end surface of the remaining bone 2, then, the intramedullary pin 5 is connected with the calcaneal prosthesis 1 by using the first connecting piece 6, and finally, a plurality of fixing screws 4 are screwed into the calcaneal prosthesis 1 and extend to the position with more bone in the reserved bone 2, so that the calcaneal prosthesis 1 is connected with the reserved bone 2; the design of the intramedullary pin 5 ensures the connection strength and stability of the calcaneus prosthesis 1 and the reserved bone 2, reduces the possibility that the calcaneus prosthesis 1 and the reserved bone 2 are easy to loosen due to the limitation of the installation position and the number of the fixing screws 4, and achieves the effects of shortening the postoperative recovery time and relieving the pain of a patient; the outer diameter of the second part 52 is smaller than that of the first part 51, so that the diameter of the insertion hole is smaller than that of the through hole 13, the injury to the reserved bone 2 is reduced on the premise of ensuring the stable connection between the intramedullary nail 5 and the calcaneal prosthesis 1, and the postoperative recovery time is shortened; the end of the first part 51 far away from the second part 52 is formed with a hemispherical end surface, the transition between the first part 51 and the second part 52 is smooth, and the outer edge of the end surface of the second part 52 far away from the first part 51 is rounded along the circumferential direction, so that the harm to the reserved bone 2 of a patient can be further reduced; the arranged porous grid structure layer promotes bone ingrowth, shortens the time of primary ingrowth of the heel bone prosthesis 1 after the operation, and further shortens the postoperative recovery time.
Referring to fig. 2 and 3, the first connecting member 6 includes a plurality of blocking blocks 61 fixedly connected to the inner wall of the through hole 13, wherein the blocking blocks 61 are disposed at a position of the through hole 13 far from one end of the reserved bone 2, in the embodiment of the present application, two blocking blocks 61 are provided, and the two blocking blocks 61 are symmetrically arranged along the axis of the through hole 13; the first connecting piece 6 further comprises a limiting screw 62 in threaded connection with one end of the first part 51 arranged in the calcaneal prosthesis 1 and a limiting nut 63 integrally formed with the limiting screw 62, wherein the limiting screw 62 is coaxial with the limiting nut 63, the diameter of the limiting nut 63 is larger than the inner diameter of the through hole 13, one end of the first part 51 arranged in the calcaneal prosthesis 1 is provided with a threaded hole matched with the limiting screw 62, the end surface of the limiting nut 63 is provided with a rotating groove, and the cross section of the rotating groove is in a regular hexagon shape; the first portion 51 is provided with an antirotation groove 511 at one end of the calcaneus prosthesis 1 for cooperating with the arresting block 61.
When the intramedullary pin 5 is connected with the calcaneal prosthesis 1, firstly, the second part 52 is inserted into the medullary cavity of the reserved bone 2 along the extending direction of the insertion hole, secondly, the first part 51 is aligned with the through hole 13, and the calcaneal prosthesis 1 is driven to move towards the direction close to the first part 51 until the attachment plate 3 is attached to the end surface of the reserved bone 2, at the moment, the groove wall of the anti-rotation groove 511 is attached to the surface of the blocking block 61, then, the limiting screw 62 is screwed into the threaded hole of the first part 51 by using the rotation groove until the end surface of the limiting screw cap 63 is attached to the surface of the calcaneal prosthesis 1, and then the connection of the calcaneal prosthesis 1 and the intramedullary pin 5 is realized; the design greatly improves the convenience of connecting the intramedullary pin 5 and the calcaneus prosthesis 1; the arrangement of the blocking block 61 and the arrangement of the rotation preventing grooves 511 avoid the possibility of rotation of the intramedullary pin 5 in the process of connecting the calcaneal prosthesis 1 with the intramedullary pin 5, thereby reducing the damage of the intramedullary pin 5 to the reserved bone 2.
Referring to fig. 2 and 4, the fixing screw 4 includes a first coupling part 41 screwed into the remaining bone 2, a second coupling part 42 screwed into the calcaneal prosthesis 1, and a fixing nut 43 coupled to the second coupling part 42, the first coupling part 41, the second coupling part 42, and the fixing nut 43 being integrally formed and coaxial, the first coupling part 41 having an outer diameter smaller than that of the second coupling part 42; the pitch of the thread provided on the outer surface of the first connection portion 41 is greater than the pitch of the thread provided on the outer surface of the second connection portion 42; the outer peripheral surface of one end of the first connecting portion 41 away from the second connecting portion 42 is provided with a chip groove 44.
When the fixing screw 4 is screwed into the calcaneal prosthesis 1 and the retained bone 2, the first connecting part 41 is screwed into the retained bone 2, the second connecting part 42 is screwed into the calcaneal prosthesis 1, and bone fragments generated in the rotating process are discharged outwards through the chip discharge groove 44, so that the fixing screw 4 is driven to be screwed into the retained bone 2; the outer diameter of the first connecting part 41 is smaller than that of the second connecting part 42, so that the injury to the reserved bone 2 is reduced on the premise that the calcaneus prosthesis 1 and the reserved bone 2 can be stably connected; meanwhile, as the thread pitch of the thread arranged on the outer surface of the first connecting part 41 is greater than the thread pitch of the thread arranged on the outer surface of the second connecting part 42, when the fixing screw 4 rotates for a circle, the advancing distance of the first connecting part 41 is greater than the advancing distance of the second connecting part 42, namely, relative displacement can be generated between the first connecting part 41 and the second connecting part 42, so that the pretightening force between the first connecting part 41 and the reserved bone 2 and the pretightening force between the second connecting part 42 and the calcaneus prosthesis 1 are improved, and the connection strength and stability between the calcaneus prosthesis 1 and the reserved bone 2 are improved.
Referring to fig. 2, the calcaneal prosthesis 1 is provided with at least one suture hole 14 for suturing ligament or soft tissue conveniently, the suture hole 14 is designed as a through hole, and the suture hole 14 is formed according to actual conditions; in the present embodiment, the suture holes 14 are provided in five, and in other examples, the suture holes 14 may be provided in one or more.
After the calcaneal prosthesis 1 is connected with the reserved bone 2, firstly connecting a suture line with a suture needle, then connecting the suture line with a ligament or a soft tissue, and then penetrating the suture line through the suture hole 14, so that the ligament and the soft tissue can be attached to the calcaneal prosthesis 1, and the postoperative recovery is facilitated; the suture holes 14 provide a reconstruction point for the ligament and the soft tissue, thereby facilitating the attachment of the ligament and the soft tissue to the calcaneus prosthesis 1 and further shortening the post-operation recovery time.
To sum up, the application process of this application is: when the replacement of the calcaneus prosthesis 1 is realized, firstly, a diseased calcaneus is removed through an operation, and the required calcaneus prosthesis 1 is printed out according to the mirror image healthy side calcaneus 3D; secondly, a jack for inserting the second part 52 is arranged in the medullary cavity of the reserved bone 2, and the second part 52 is inserted into the medullary cavity of the reserved bone 2 along the extending direction of the jack until the end surface of the second part 52 far away from the first part 51 is abutted with the upper hole wall of the jack; then aligning the first part 51 with the through hole 13 and driving the calcaneal prosthesis 1 to move towards the direction close to the first part 51 until the attachment plate 3 is attached to the end surface of the retained bone 2 and the wall of the anti-rotation groove 511 is attached to the surface of the stopping block 61; then, the limiting screw 62 is screwed into the threaded hole of the first part 51 until the end surface of the limiting nut 63 is attached to the surface of the calcaneal prosthesis 1, and a plurality of fixing screws 4 are screwed into the calcaneal prosthesis 1 and extend to positions where much bone is reserved in the bone 2; finally, the suture is connected with the ligament or the soft tissue, and the suture is passed through the suture hole 14, so that the ligament or the soft tissue can be attached to the calcaneal prosthesis 1.
Example two:
referring to fig. 5, the difference between the second embodiment and the first embodiment is: the calcaneus prosthesis 1 is provided with a blind hole 15 for extending the first part 51; the first connecting pieces 6 are arranged on the side of the first part 51, and a plurality of first connecting pieces 6 are arranged, in the embodiment of the application, two first connecting pieces 6 are arranged, wherein two first connecting pieces 6 are symmetrically arranged along the axis of the first part 51; the first connecting piece 6 comprises a first spring 64 arranged in the first part 51, the axis of the first spring 64 is vertical to the axis of the first part 51, a first placing groove 512 for placing the first spring 64 is arranged on the side surface of the intramedullary nail 5, and one end of the first spring 64 is fixedly connected with the groove wall of the first placing groove 512; the first connecting block further comprises a first limiting block 65 fixedly connected with one end of the first spring 64 far away from the intramedullary nail 5, and a first limiting groove 151 for extending the first limiting block 65 is formed in the hole wall of the blind hole 15.
When the calcaneal prosthesis 1 is connected with the intramedullary nail 5, firstly, the second part 52 is inserted into the intramedullary canal of the reserved bone 2 along the extending direction of the insertion hole, secondly, the first part 51 is aligned with the blind hole 15, and the calcaneal prosthesis 1 is driven to move towards the direction close to the first part 51, in the moving process, due to the existence of the first spring 64 and the first placing groove 512, the first limiting block 65 and the first spring 64 are always compressed in the first placing groove 512 when moving in the blind hole 15, after the first limiting block 65 and the first limiting groove 151 are positioned on the same straight line, the first limiting block 65 can automatically move into the first limiting groove 151 under the action of the elastic force of the first spring 64, and therefore, the relative movement of the calcaneal prosthesis 1 and the intramedullary nail 5 can be stopped; the design not only facilitates the connection of the calcaneus prosthesis 1 and the intramedullary needle 5, but also greatly improves the convenience of operation, shortens the operation time and relieves the pain of patients.
Example three:
referring to fig. 6 and 7, the third embodiment is different from the second embodiment in that: the calcaneus prosthesis 1 comprises an attaching part 11 and a base part 12 corresponding to the end face of the remaining bone 2, wherein the attaching part 11 is provided with a blind hole for extending the first part 51, and the base part 12 can be designed into various sizes; in the embodiment of the present application, the surface of the fitting portion 11 close to the base portion 12 is a smooth plane, and the surface of the base portion 12 close to the fitting portion 11 is also a smooth plane; the fitting part 11 and the base part 12 are designed in an assembling way; a plurality of second connecting pieces 7 are uniformly distributed on the surface of the base part 12 close to the attaching part 11, and in the embodiment of the application, two second connecting pieces 7 are arranged; the second connecting piece 7 comprises a connecting rod 71 fixedly connected with the surface of the base part 12 and a plurality of second springs 72 arranged on the side surfaces of the connecting rod 71, the second springs 72 are arranged in the connecting rod 71, the axes of the second springs 72 are vertical to the axis of the connecting rod 71, the connecting rod 71 is provided with a second placing groove 711 for placing the second springs 72, and one end of each second spring 72 is fixedly connected with the groove wall of the second placing groove 711; in the present embodiment, the second springs 72 are provided in two, and the two second springs 72 are symmetrically arranged along the axis of the connecting rod 71; the attaching portion 11 is provided with an insertion hole 111 into which the connecting rod 71 is inserted; the second connecting member 7 further includes a second limiting block 73, one end of the second limiting block 73 is fixedly connected to one end of the second spring 72 far away from the connecting rod 71, and a second limiting groove for extending the second limiting block 73 is formed in the hole wall of the insertion hole 111.
When the calcaneal prosthesis 1 is replaced, firstly, the affected calcaneus is removed through operation, the needed attaching part 11 and the base part 12 are printed according to the 3D mirror image healthy side calcaneus, secondly, the second part 52 is inserted into the medullary cavity of the reserved bone 2 along the extending direction of the inserting hole until the end surface of the second part 52 far away from the first part 51 is abutted with the upper hole wall of the inserting hole, then the first part 51 is aligned with the blind hole 15, the attaching part 11 is driven to move towards the direction close to the first part 51 until the first limiting block 65 automatically moves into the first limiting groove 151 under the action of the elastic force of the first spring 64, then the connecting rod 71 is aligned with the inserting hole 111, and the base part 12 is driven to move towards the attaching part 11, during the moving process, due to the existence of the second spring 72 and the second placing groove 711, the second limiting block 73 and the second spring 72 are always compressed in the second placing groove 711 when moving in the inserting hole 111, after the second limiting block 73 and the second limiting groove are positioned in the same straight line, the second limiting block 73 can automatically move into the second limiting groove under the action of the elastic force of the second spring 72, so that the relative movement of the base part 12 and the attaching part 11 can be stopped; this design facilitates the connection of the base portion 12 with the attachment portion 11; meanwhile, because the calcaneus of different patients are different in resection range, skin defect condition and soft tissue tension, the base part 12 is designed into various sizes, so that the possibility of complications such as difficult stitching, soft tissue adhesion failure and the like caused by overlarge graft is reduced under the condition of ensuring that the height of the calcaneus is not changed.
The present embodiment is only for explaining the present application, and it is not limited to the present application, and those skilled in the art can make modifications of the present embodiment without inventive contribution as needed after reading the present specification, but all of them are protected by patent law within the scope of the claims of the present application.

Claims (10)

1. The utility model provides a calcaneum prosthesis, the surface of calcaneum prosthesis (1) is provided with set screw (4), and calcaneum prosthesis (1) has and keeps corresponding rigging board (3) of bone (2), its characterized in that: an intramedullary pin (5) is arranged in the calcaneal prosthesis (1), and one end of the intramedullary pin (5) extends out of the joint plate (3); the intramedullary nail (5) is provided with a first connecting piece (6) for connecting the intramedullary nail (5) with the calcaneal prosthesis (1).
2. A calcaneus prosthesis according to claim 1, wherein: the calcaneal prosthesis (1) is provided with a through hole (13) for the extension of the intramedullary pin (5); the first connecting piece (6) comprises a blocking block (61) connected with the inner wall of the through hole (13), a limiting screw rod (62) in threaded connection with one end of the intramedullary nail (5) arranged in the calcaneal talus prosthesis, and a limiting nut (63) integrally formed with the limiting screw rod (62); the diameter of the limiting nut (63) is larger than the inner diameter of the through hole (13).
3. A calcaneus prosthesis according to claim 2, wherein: the outer peripheral surface of one end of the intramedullary nail (5) arranged in the calcaneus prosthesis (1) is provided with an anti-rotation groove (511) matched with the stopping block (61).
4. A calcaneus prosthesis according to claim 1, wherein: the calcaneus prosthesis (1) is provided with a blind hole (15) for the extension of the intramedullary nail (5); the first connecting piece (6) is arranged on the side surface of the intramedullary nail (5); the first connecting piece (6) comprises a first spring (64) which is arranged inside the intramedullary nail (5) and is vertical to the axis of the intramedullary nail (5) and a first limiting block (65) which is connected with one end of the first spring (64) far away from the intramedullary nail (5); the side surface of the intramedullary nail (5) is provided with a first placing groove (512) for placing a first spring (64), and the hole wall of the through hole (13) is provided with a first limiting groove (151) for limiting a first limiting block (65).
5. A calcaneus prosthesis according to claim 1, wherein: the calcaneus prosthesis (1) is provided with at least one suture hole (14) for a suture to pass through.
6. A calcaneus prosthesis according to claim 1, wherein: the fixing screw (4) comprises a first connecting part (41), a second connecting part (42) coaxial with the first connecting part (41) and a fixing nut (43) connected with the second connecting part (42); the outer surface of the first connecting portion (41) is provided with a thread pitch larger than that of the outer surface of the second connecting portion (42).
7. A calcaneus prosthesis according to claim 6, wherein: the outer diameter of the first connecting portion (41) is smaller than the outer diameter of the second connecting portion (42); the outer peripheral surface of one end of the first connecting part (41) far away from the second connecting part (42) is provided with a chip groove (44).
8. A calcaneus prosthesis according to claim 1, wherein: the intramedullary needle (5) comprises a first portion (51) and a second portion (52) coaxial to the first portion (51), the first portion (51) having an outer diameter greater than the outer diameter of the second portion (52).
9. A calcaneus prosthesis according to claim 1, wherein: the calcaneus prosthesis (1) comprises a fitting part (11) and a base part (12); the surface of the base part (12) close to the attaching part (11) is connected with a second connecting piece (7) used for connecting the base part (12) and the attaching part (11); the base portion (12) is designed in a variety of sizes.
10. A calcaneus prosthesis according to claim 9, wherein: the second connecting piece (7) comprises a connecting rod (71) fixedly connected to the surface of the base part (12) close to the attaching part (11) and a second spring (72) arranged on the side surface of the connecting rod (71), the second spring (72) is arranged inside the connecting rod (71), and the axis of the second spring (72) is perpendicular to the axis of the second connecting rod (71); the connecting rod (71) is provided with a second placing groove (711) for placing the second spring (72); the second connecting piece (7) also comprises a second limiting block (73) which is arranged at one end of the second spring (72) far away from the connecting rod (71); the attaching portion (11) is provided with an insertion hole (111) into which the connecting rod (71) is inserted, and the hole wall of the insertion hole (111) is provided with a second limiting groove for limiting the second limiting block (73).
CN202110561367.0A 2021-05-22 2021-05-22 Calcaneus prosthesis Active CN113367856B (en)

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Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100114315A1 (en) * 2008-10-31 2010-05-06 Manderson Easton L Intramedullary locked compression screw for stabilization and union of complex ankle and subtalar deformities
CN202714915U (en) * 2012-05-15 2013-02-06 冯小庆 Bone-setting screw
CN205019150U (en) * 2015-08-31 2016-02-10 禹宝庆 Pressurization intramedullary nail
CN206729967U (en) * 2017-01-17 2017-12-12 叶川 A kind of pollex merges hollow compress intramedullary nail with doublejointed
CN107569305A (en) * 2017-10-18 2018-01-12 北京大学人民医院 A kind of artificial calcaneum prosthese of assembly type
US20200129302A1 (en) * 2017-06-13 2020-04-30 Wright Medical Technology, Inc. Calcaneal prosthesis
CN211381993U (en) * 2019-08-29 2020-09-01 广州市康峻医疗器械有限公司 Hip joint prosthesis assembly
CN111839701A (en) * 2020-07-13 2020-10-30 北京市春立正达医疗器械股份有限公司 Novel pedicle screw and implantation method thereof

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100114315A1 (en) * 2008-10-31 2010-05-06 Manderson Easton L Intramedullary locked compression screw for stabilization and union of complex ankle and subtalar deformities
CN202714915U (en) * 2012-05-15 2013-02-06 冯小庆 Bone-setting screw
CN205019150U (en) * 2015-08-31 2016-02-10 禹宝庆 Pressurization intramedullary nail
CN206729967U (en) * 2017-01-17 2017-12-12 叶川 A kind of pollex merges hollow compress intramedullary nail with doublejointed
US20200129302A1 (en) * 2017-06-13 2020-04-30 Wright Medical Technology, Inc. Calcaneal prosthesis
CN107569305A (en) * 2017-10-18 2018-01-12 北京大学人民医院 A kind of artificial calcaneum prosthese of assembly type
CN211381993U (en) * 2019-08-29 2020-09-01 广州市康峻医疗器械有限公司 Hip joint prosthesis assembly
CN111839701A (en) * 2020-07-13 2020-10-30 北京市春立正达医疗器械股份有限公司 Novel pedicle screw and implantation method thereof

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