CN113797001A

CN113797001A - Built-in artificial limb connecting device

Info

Publication number: CN113797001A
Application number: CN202111176261.5A
Authority: CN
Inventors: 郭卫
Original assignee: Peking University Peoples Hospital
Current assignee: Peking University; Peking University Peoples Hospital
Priority date: 2021-10-09
Filing date: 2021-10-09
Publication date: 2021-12-17

Abstract

The invention relates to an internal artificial limb connecting device, comprising: the bone stump fixing sleeve is of a tubular structure with openings at two ends, a first combining part is formed at the first end of the bone stump fixing sleeve, a bone stump fixing cavity is formed at the second end of the bone stump fixing sleeve, and the bone stump fixing cavity is configured to be sleeved outside a stump bone and fixedly connected with the stump bone; the intramedullary nail of the bone stump fixing handle is tightly connected with the first combination part of the bone stump fixing sleeve through the second connecting part after penetrating through the first end of the bone stump fixing sleeve, the intramedullary nail of the bone stump fixing handle is used for inserting the medullary cavity of the stump bone and is tightly connected with the medullary cavity, and the external connection part of the bone stump fixing handle is used for being connected with an external artificial limb. The invention can be widely applied to amputees with different reasons, realizes the integration of the connector and the stump bone, and is convenient for amputees to replace different more comfortable external artificial limbs according to the requirements of the amputees.

Description

Built-in artificial limb connecting device

Technical Field

The invention relates to an artificial limb connecting device, in particular to an internal artificial limb connecting device which can be used for amputees to randomly select different artificial limbs, and belongs to the technical field of medical appliances.

Background

Amputation, as the name implies, is the amputation of a limb that is not alive or severely life-threatening due to a localized disease. Specifically, an amputation is the removal of a portion of a limb through one or more bones. The reason for amputation is gradually changing, and amputees are more and more common due to peripheral vascular diseases or diabetes combined with the peripheral vascular diseases, especially in western countries (such as 50% of amputation incidence rate in the United states), and the first reason for amputation is rising, and in recent years, the amputation is also on the rise in China. In daily life, people are inevitably subjected to accidents (such as serious traffic accidents) and may suffer from serious diseases (such as malignant tumors of limbs) due to certain reasons. If the injury of the far end of the thigh is caused by accident trauma or malignant tumor is caused by treatment, the treatment can be carried out by amputation. Amputation must be performed by a surgeon with full knowledge of the principles of amputation, post-operative rehabilitation, and prosthesis design. Amputation should not be considered as a treatment failure, but as a first step in the patient's recovery to a more comfortable and effective life.

The number of amputations performed each year is increasing, mainly for the elderly population. More than 90% of patients undergoing amputation in the west are secondary to peripheral vascular disease. In young patients, trauma is the primary cause, followed by malignancy. The only absolute indication for amputation is irreversible ischemia of the diseased or wounded limb. Amputation may also be for life preservation in uncontrollable infected patients and may be the best choice for patients with partial tumors, although in most cases, advances in bone and soft tissue oncology have allowed limb preservation treatment in patients with malignant tumors in the extremities. Similarly, certain congenital malformations of the lower extremities are best treated by amputation in combination with prostheses. The common amputation indications mainly include the following aspects: (1) peripheral vascular disease: peripheral vascular disease with or without diabetes, most commonly occurring in individuals aged 50-75 years, is the most common indication for amputation. If vascular disease progresses to a point where amputation is required, the affected limb is not limited. Of the diabetic patients, about half of the patients received amputation treatment. The most important predictor of amputation in diabetic patients is peripheral neuropathy, and other risk factors include past stroke, decreased transcutaneous oxygen levels, and decreased ankle brachial arterial blood pressure index. The diabetic must be informed of the importance of proper foot care and shoe selection and must frequently check the feet. While controlling the infection as efficiently as possible and evaluating the nutritional and immune status by simple screening tests. In elderly patients with a variety of underlying diseases, if amputation is at a proximal level, the patient's walking function may be affected after amputation. Amputation should be performed at the most distal level that provides a reasonable chance of healing in order to maximize the patient's post-operative limb function. (2) Trauma: trauma is a major indication of amputation in young patients. Amputation due to trauma is more common in men due to occupational and developmental hazards. These patients are often healthier and such injuries may have profound effects on their lives. The only absolute indication of an initial amputation is irreparable vascular damage to the ischemic limb. (3) And (3) burning: thermal or electrical injury to the limb may require amputation. The integrity of the tissue damage at the initial visit may not be apparent, especially with electrical damage. Treatment includes early debridement of devitalized tissue, fasciotomy if necessary, and active wound care, including repeated debridement in the operating room. Delayed amputation of unresectable limbs is associated with localized infection, systemic infection, myoglobin-induced renal failure and increased risk of death compared to early amputation. In addition, the time and cost of delaying the hospitalization of the amputation is greatly increased. Inadequate treatment is performed and an impractical desire to save the limb may put the patient at undue risk and amputation must be undertaken when necessary. (4) Chilblain: chilblain is the freezing of tissues of the extremities with or without hypothermia in the core. When the heat loss exceeds the body's ability to maintain homeostasis, the blood flow in the limb decreases to maintain core body temperature. The problem is more severe when exposed to wind or water. Actual tissue damage occurs through two mechanisms: directly causing tissue damage by forming crystals in the extracellular fluid; ischemic injury caused by vascular endothelial injury, blood clot formation, and increased sympathetic tone. Amputation may be required for severe ischemia after conservative treatment. (5) Infection: amputation may be required for acute or chronic infections that are unresponsive to antibiotics and surgical debridement. This can be done in one of two ways. In the case of poor infection control, amputation of the severed head type may be performed with repair at a more proximal level. Alternatively, open amputations may be performed at a defined level and the wound closed for secondary periods of 10-14 days. In acute settings, the most alarming is limb infection by gas-producing bacteria. Often associated with battlefield injuries, gas-forming infections may also be caused by traumatic factors such as battlefield injuries, motor vehicle accidents, and the like. Closing a contaminated wound without proper debridement presents a high risk of developing gas gangrene. (6) Tumor: advances in diagnostic imaging, chemotherapy, radiation therapy and reconstructive surgery techniques are now a logical choice among most patients with bone or soft tissue sarcomas. When considering limb protection therapy rather than amputation, 4 issues must be considered: (ii) is survival affected by treatment options? ② how do short-term and long-term morbidity compare? (iii) how does the original limb function compare to the prosthesis? (iv) is there any psychosocial consequences? Malignant amputation is relatively technically demanding and usually requires the use of non-standard skin flaps, bone grafts or prosthetic reinforcement to obtain a more functional residual limb. But limb protection has a greater incidence of perioperative complications than amputation. Limb amputation involves a wider range of surgical procedures, associated with risks of infection, wound dehiscence, skin flap necrosis, blood loss, and deep vein thrombosis. The long-term complications depend on the type of reconstitution. Including periprosthetic fractures, prosthetic loosening or dislocation, graft-host nonunion, allograft fracture, lower limb inequality and late stage infection. Most patients with peri-knee malignancies receive one of 3 surgical procedures, including extensive resection, artificial knee prosthesis replacement or extensive resection, allograft arthrodesis or transfemoral amputation. The limb-protecting patient is more likely to need multiple subsequent surgical treatments in the later period. After an initial successful limb amputation, about one third of the long-term survivors may eventually require amputation due to local tumor recurrence, infection after prosthetic replacement, rejection, osteolysis, and the like. Although healing is not an objective, amputation can significantly improve the functional status and relieve pain in some patients.

The artificial limbs can be divided into the following categories according to the plane of amputation: foot prosthesis, calf prosthesis, knee amputation prosthesis, thigh prosthesis, hip amputation prosthesis, hemipelvic resection prosthesis. The artificial limb assembly mainly has the following requirements on the residual limb: (1) the residual limb should be of appropriate length. The stump should have a moderate soft tissue coverage. Ensuring sufficient leverage and good muscle control power. Since any prosthesis must be attached to the residual limb to function. If the residual limb is too short, the lever force of the artificial limb is weakened, and the artificial limb is difficult to play. Because the artificial limb joint part needs a certain space, the residual limb is too long and is not suitable, and therefore, the length of the residual limb cannot be emphasized on one side. (2) The residual joint should retain its original physiological function as far as possible without contracture deformity. (3) The stump should not have tenderness, bony spur and neuroma. (4) The stump has good skin condition, is healthy and flat, has little scar adhesion and has no sinus ulcer. In the above four aspects, the length of the residual limb is related to the selected position of the amputation, the residual limb is not changed after the operation is finished, and the other three aspects are related to various factors such as operation technique, postoperative care, treatment, exercise and the like. After the operation, the stump is wrapped by an elastic bandage, and the swelling of the stump is eliminated and the shaping of the stump is promoted by various nursing means. In many areas of China, because the surgical operation and the artificial limb assembly of a hospital are still in a disjointed state, doctors do not have to ask questions after the operation, so that the basic stump dressing is not implemented after amputation of many patients, and the stump needs to be dressed again when the artificial limb is not configured, thereby wasting time, increasing the burden of the patients and influencing the exertion of the stump function. The four limbs of the human body function in various movements under the coordination of the nervous system and other systems, the contraction of skeletal muscles is the motive power of movement in the movement, bones play a lever role, and joints are the movement pivots. The compensation function after wearing the artificial limb is realized by playing the function of the residual limb and utilizing the characteristics of the artificial limb structure, the muscle force of the residual limb is the motive power of movement, and the residual limb plays a lever role in dominating the movement process of the artificial limb. The physiology of a healthy human limb movement and the compensation function of an amputee wearing a prosthesis are realized in the form of movement. The motion of the artificial limb is completed by the domination and the coordinated action of the residual limb, and the residual limb is an active part of the motion and is a motion organ different from a healthy limb. Therefore, the assembly of a prosthesis that fits well with a residual limb and can perform a satisfactory compensation function is critical to the quality of life and limb function of an amputee after surgery.

Disclosure of Invention

In view of the above problems, the present invention is to provide an internal prosthesis connecting device for amputees to select different external prostheses at will, which can be tightly fixed on the stump bone and can be replaced by postoperative patients at will, so that the patients can move more conveniently and comfortably.

In order to achieve the purpose, the invention adopts the following technical scheme: an endoprosthesis prosthesis coupling device comprising: the bone stump fixing sleeve is of a tubular structure with openings at two ends, a first combining part is formed at the first end of the bone stump fixing sleeve, a bone stump fixing cavity is formed at the second end of the bone stump fixing sleeve, and the bone stump fixing cavity is configured to be sleeved outside and fixedly connected with a stump bone; the intramedullary nail of the bone stump fixing handle is fixedly connected with the first combining part of the bone stump fixing sleeve through the second connecting part after penetrating through the first end of the bone stump fixing sleeve, the intramedullary nail of the bone stump fixing handle is used for being inserted into a medullary cavity of a stump bone and being fixedly connected with the medullary cavity, and the external connecting part of the bone stump fixing handle is used for being connected with an external artificial limb.

The artificial limb connecting device, preferably, bone stub fixed cavity is three minutes fork tubular structure, promptly bone stub fixed cavity includes along three fixed arms of axial extension, and three the fixed arm is arranged along circumference equidistance first joining portion upper portion, three the fixed arm encloses into the bone stub fixed cavity that is used for holding the stub bone jointly.

Preferably, a plurality of first muscle suture holes are axially and alternately processed on the three fixing arms.

The prosthesis connecting device preferably has an outwardly protruding flange formed at the connection between the second connecting portion and the external joint, and a plurality of second muscle suture holes are formed in the flange at intervals along the circumferential direction.

The prosthesis connecting device preferably has a screw connector on the external connecting portion, and the external connecting portion is detachably connected with the external prosthesis through the screw connector.

The prosthesis connecting device preferably has an internal thread formed on an inner wall of the first coupling portion, and correspondingly, an external thread formed on an outer wall of the second coupling portion, wherein the first coupling portion and the second coupling portion are screwed together.

The artificial limb connecting device preferably adopts a 3D printing technology to prepare a porous metal bone trabecula structure with the pore size of 400-600 mu m and complete communication on the inner contact surface of each fixing arm contacting with the outer surface of the stump bone, wherein the porosity is more than 80%, and the pore layer thickness is 2 mm.

The surface of the flange is preferably designed as a coating structure.

Due to the adoption of the technical scheme, the invention has the following advantages:

1. the invention can insert the broach into the medullary cavity of the stump bone after assembling the two parts through the stump fixing sleeve with the three-forked tubular structure and the stump fixing handle with the broach, and the outer side of the sleeve is fixed through the stump fixing sleeve, thereby tightly fixing the artificial limb connecting device on the stump bone, facilitating the integration and stable fixation of the connecting device and the stump bone, realizing the stable fixation of the connector and the bone and fully playing the mechanical stability.

2. According to the invention, the porous metal bone trabecular structure is prepared on the inner contact surface of each fixed arm, which is contacted with the outer surface of the stub bone, by using a 3D printing technology, so that the bone grows in conveniently, and the long-term stability is realized, thereby increasing the long-term osseointegration effect and reducing the occurrence of long-term mechanical complications.

3. According to the invention, the spiral interface is designed on the external connection part, and the external connection part is detachably connected with the artificial limb through the spiral interface, so that a patient can freely replace different more comfortable external artificial limbs according to the self requirement.

In conclusion, the external artificial limb replacement device can be widely applied to amputation patients with different reasons, the integration of the connector and the stump bone is realized, and the amputation patients can conveniently replace different more comfortable external artificial limbs according to the requirements of the amputation patients.

Drawings

FIG. 1 is a schematic structural view of a bone stump fixing sleeve according to an embodiment of the present invention;

FIG. 2 is a schematic structural view of a bone stub fixation stem provided in accordance with the present embodiment of the invention;

fig. 3 is a schematic view of the overall structure of the prosthesis coupling device according to the embodiment of the present invention.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings. It is to be understood that the embodiments described are only a few embodiments of the present invention, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

In the description of the present invention, it should be noted that the terms "upper", "lower", "inside", "outside", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the system or element referred to must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like, are used to define elements only for convenience in distinguishing between the elements, and unless otherwise stated have no special meaning and are not to be construed as indicating or implying any relative importance.

In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "disposed," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

The invention provides an internal artificial limb connecting device, which comprises: the bone stump fixing sleeve is of a tubular structure with openings at two ends, a first combining part is formed at the first end of the bone stump fixing sleeve, a bone stump fixing cavity is formed at the second end of the bone stump fixing sleeve, and the bone stump fixing cavity is configured to be sleeved outside a stump bone and fixedly connected with the stump bone; the intramedullary nail of the bone stump fixing handle is tightly connected with the first combination part of the bone stump fixing sleeve through the second connecting part after penetrating through the first end of the bone stump fixing sleeve, the intramedullary nail of the bone stump fixing handle is used for inserting the medullary cavity of the stump bone and is tightly connected with the medullary cavity, and the external connection part of the bone stump fixing handle is used for being connected with an external artificial limb. The invention can be widely applied to amputees with different reasons, realizes the integration of the connector and the stump bone, and is convenient for amputees to replace different more comfortable external artificial limbs according to the requirements of the amputees.

Hereinafter, an endoprosthesis connecting device according to an embodiment of the present invention will be described in detail with reference to the accompanying drawings.

As shown in FIGS. 1 to 3, the prosthesis coupling device according to the present embodiment includes a bone stump fixing sleeve 10 and a bone stump fixing stem 20. Wherein, incomplete end fixed sleeve 10 is both ends open-ended tubular structure, and the first end of incomplete end fixed sleeve 10 forms the first joint portion 11 of being connected with incomplete end fixed handle 20, and the second end of the fixed sleeve 10 of incomplete end forms incomplete end fixed chamber 12 of bone, and incomplete end fixed chamber 12 of bone is configured to can overlap and establish incomplete end bone outside and be connected with it fastening. The bone stump fixing handle 20 comprises a broach 21, a second combining part 22 and an external connecting part 23 which are integrally connected, the broach 21 of the bone stump fixing handle 20 penetrates through the first end of the bone stump fixing sleeve 10 and then is tightly connected with the first combining part 11 of the bone stump fixing sleeve 10 through a second connecting part 22, the broach 21 of the bone stump fixing handle 20 is used for being inserted into a medullary cavity of a stump bone and is tightly connected with the medullary cavity, and the external connecting part 23 of the bone stump fixing handle 20 is used for being connected with an external prosthesis.

In the above embodiment, preferably, the bone stump fixing cavity 12 is a three-forked tubular structure, that is, the bone stump fixing cavity 12 includes three fixing arms 13 extending along the axial direction, the three fixing arms 13 are equidistantly arranged on the upper portion of the first combining portion 11 along the circumferential direction, and the three fixing arms 13 together enclose the bone stump fixing cavity 12 for accommodating the stump bone, so that the bone stump fixing sleeve 10 can be easily sleeved into the tubular stump bone through the three-forked tubular structure.

In the above embodiment, preferably, a plurality of first muscle suture holes 14 are formed on each of the three fixing arms 13 at intervals along the axial direction, so that the muscle of the stump after amputation can be tightly wrapped outside the bone stump fixing sleeve 10 through ligament suture lines, thereby facilitating the muscle covering and adhesion, reducing the infection risk of the prosthesis and increasing the power of the stump prosthesis.

In the above embodiment, it is preferable that a flange 24 protruding outward is formed at the connection point of the second connection portion 22 and the external interface 23, and a plurality of second muscle suture holes 25 are formed on the flange 24 at intervals along the circumferential direction, so that a deep fascia can be fixed on the surface of the flange 24 by ligament suture, thereby achieving good attachment of the dynamic muscle group, increasing the dynamic effect of the prosthesis movement, enabling the prosthesis connection device to be well coated by the muscle, and reducing the occurrence of complications such as infection.

In the above embodiment, the external connection portion 23 preferably has a screw interface (not shown), and the external connection portion 23 is detachably connected to the external prosthesis through the screw interface, so that the patient can freely change different external prostheses which are more comfortable according to his or her needs.

In the above embodiment, preferably, the inner wall of the first coupling portion 11 is formed with an internal thread, and correspondingly, the outer wall of the second coupling portion 22 is formed with an external thread, and the first coupling portion 11 and the second coupling portion 22 are threadedly coupled, whereby the bone stump fixing sleeve 10 and the bone stump fixing stem 20 can be screwed to each other to be assembled and coupled together.

In the above embodiment, preferably, a porous metal bone trabecular structure with a pore size of 400-.

In the above embodiment, preferably, the surface of the flange 24 may be designed as a coating structure to increase soft tissue attachment.

Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims

1. An endoprosthesis prosthesis coupling device, comprising:

the bone stump fixing sleeve (10) is of a tubular structure with two open ends, a first combining part (11) is formed at the first end of the bone stump fixing sleeve (10), a bone stump fixing cavity (12) is formed at the second end of the bone stump fixing sleeve (10), and the bone stump fixing cavity (12) is configured to be sleeved outside a stump bone and fixedly connected with the stump bone;

the bone stump fixing handle (20) comprises a broach (21), a second joint part (22) and an external joint part (23) which are integrally connected, wherein the broach (21) of the bone stump fixing handle (20) penetrates through the first end of the bone stump fixing sleeve (10) and then passes through the second joint part (22) and the first joint part (11) of the bone stump fixing sleeve (10) in a fastening mode, the broach (21) of the bone stump fixing handle (20) is used for being inserted into a medullary cavity of a stump bone and is in fastening connection with the medullary cavity, and the external joint part (23) of the bone stump fixing handle (20) is used for being connected with an external prosthesis.

2. A prosthetic connection device according to claim 1, characterized in that the bone stub fixing cavity (12) is a three-pronged tubular structure, i.e. the bone stub fixing cavity (12) comprises three fixing arms (13) extending in axial direction, and three fixing arms (13) are arranged circumferentially at equal distances on the upper part of the first joint part (11), three fixing arms (13) together enclosing a bone stub fixing cavity (12) for receiving a stub bone.

3. A prosthetic connector device according to claim 2, characterised in that a plurality of first muscle suture holes (14) are axially spaced in each of the three said retaining arms (13).

4. A prosthetic connection device according to claim 1, characterized in that an outwardly projecting flange (24) is formed at the junction of the second connection portion (22) and the external joint (23), and a plurality of second muscle suture holes (25) are formed at circumferentially spaced intervals in the flange (24).

5. A prosthetic connection device according to claim 1, characterised in that the extension portion (23) has a screw connection, by means of which the extension portion (23) is detachably connected to the external prosthesis.

6. A prosthetic connection device according to claim 1, characterized in that the first coupling portion (11) is internally threaded on its inner wall and correspondingly the second coupling portion (22) is externally threaded on its outer wall, the first (11) and second (22) coupling portions being threadedly engaged.

7. A prosthetic connection device according to claim 2, characterized in that a porous metal trabecular bone structure with a pore size of 400 and 600 μm and complete connectivity is prepared on the inner contact surface of each of the fixation arms (13) contacting the outer surface of the stump bone by means of 3D printing technology, the porosity is above 80% and the pore layer thickness is 2 mm.

8. A prosthetic connection device according to claim 4, characterized in that the surface of the flange (24) is designed as a coating structure.