CN117084830A - True pelvis bionic assembled prosthesis - Google Patents
True pelvis bionic assembled prosthesis Download PDFInfo
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- CN117084830A CN117084830A CN202311351879.XA CN202311351879A CN117084830A CN 117084830 A CN117084830 A CN 117084830A CN 202311351879 A CN202311351879 A CN 202311351879A CN 117084830 A CN117084830 A CN 117084830A
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- assembly component
- sacral
- acetabulum
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- 239000011664 nicotinic acid Substances 0.000 title claims abstract description 33
- 210000001931 lesser pelvis Anatomy 0.000 title claims abstract description 29
- 210000000588 acetabulum Anatomy 0.000 claims abstract description 119
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 32
- 230000008878 coupling Effects 0.000 claims description 54
- 238000010168 coupling process Methods 0.000 claims description 54
- 238000005859 coupling reaction Methods 0.000 claims description 54
- 210000003689 pubic bone Anatomy 0.000 claims description 7
- 210000003903 pelvic floor Anatomy 0.000 claims 9
- 238000004519 manufacturing process Methods 0.000 abstract description 3
- 230000000694 effects Effects 0.000 abstract description 2
- 210000004061 pubic symphysis Anatomy 0.000 description 21
- 210000004197 pelvis Anatomy 0.000 description 15
- 210000003131 sacroiliac joint Anatomy 0.000 description 11
- 206010028980 Neoplasm Diseases 0.000 description 5
- 210000001696 pelvic girdle Anatomy 0.000 description 5
- 210000001503 joint Anatomy 0.000 description 4
- 210000003484 anatomy Anatomy 0.000 description 3
- 210000004394 hip joint Anatomy 0.000 description 3
- 210000003692 ilium Anatomy 0.000 description 3
- 238000002271 resection Methods 0.000 description 3
- 206010061336 Pelvic neoplasm Diseases 0.000 description 2
- 238000010146 3D printing Methods 0.000 description 1
- 208000018084 Bone neoplasm Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000003592 biomimetic effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 239000006185 dispersion Substances 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 210000003041 ligament Anatomy 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 238000003032 molecular docking Methods 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000002278 reconstructive surgery Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Classifications
-
- 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
- A61F2/32—Joints for the hip
- A61F2/34—Acetabular cups
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
A true pelvis bionic assembled prosthesis belongs to the technical field of medical appliances and consists of a femoral sacral arch assembled component, an acetabulum component and a connecting arch assembled component; the femoral-sacral arch assembly component connecting rod is sleeved in an acetabular component sleeve, a fixed bone plate is externally lined, and the femoral-sacral arch assembly component, the acetabular component and the fixed bone plate are fixed together through screws; the connecting rod of the connecting bow assembly component is sleeved in the sleeve of the other acetabulum component, the fixed bone plate is externally lined, and the acetabulum component, the connecting bow assembly component and the fixed bone plate are fixed together through screws; the invention is a universal assembled prosthesis, ensures accurate positioning and orientation of acetabulum by adjusting the femoral-sacral arch assembling component and the connecting arch assembling component, remarkably reduces manufacturing cost, improves rehabilitation effect and life quality of patients and reduces economic burden of the patients while meeting different requirements in semi-pelvic reconstruction operation.
Description
Technical Field
The invention belongs to the technical field of medical appliances, and particularly relates to a true pelvis bionic assembled prosthesis based on pelvis anatomy morphology and mechanics.
Background
The pelvis is a common good part of bone tumor, and due to the deep position and complex surrounding structure, the pelvis tumor usually has hidden diseases, the tumor volume is large when in treatment, the pelvic organs and vascular nerves are mostly involved, great difficulty is brought to the operation of resecting the tumor and reconstructing after the resections, and the treatment is a challenging clinical difficult problem worldwide. The main treatment for pelvic tumors is tumor resection reconstructive surgery, which requires a hemi-pelvic resection reconstruction when pelvic tumors invade the ilium, acetabulum and pubic region simultaneously. Currently, prostheses that reconstruct the half-pelvis are divided into modular half-pelvis prostheses and integral half-pelvis prostheses. The assembled half-pelvis prosthesis is of a non-anatomic bionic design, the reconstructed acetabulum can not realize anatomic positioning and orientation, the rotation center of the hip joint is changed, and complications such as dislocation of the hip joint, unequal limbs and the like are easy to occur. In addition, most of the assembled half-pelvic prostheses have no pubic ramus component, so that the pelvic ring is incomplete, and mechanical failure of the prosthesis is easy to cause. Most of the integrated half-pelvis prostheses are customized in a 3D printing mode, anatomic and mechanical bionic modes of the half-pelvis prostheses are achieved through mirror images of opposite-side pelvis prostheses, but the design and manufacturing periods of the half-pelvis prostheses are long, cost is high, and popularization and application are difficult.
Therefore, there is a need to develop a universal modular hemi-pelvic prosthesis with an anatomic and mechanical biomimetic design, which is low cost and easy to popularize and apply.
The bionic design of the semi-pelvic prosthesis takes into account two factors: mechanical conduction of pelvis and positioning and orientation of acetabulum.
Firstly, the mechanical conduction of pelvis is mainly considered in the bearing state of hip joint, namely, the femoral-sacral arch and the coupling arch, wherein the femoral-sacral arch is the mechanical conduction region from the acetabulum to the sacrum through ilium, and the coupling arch is the mechanical dispersion region from the acetabulum to pubic symphysis. They correspond to the pelvic girdle consisting of the sacrum, sacroiliac joint and its ligaments, archwire, pubic comb, pubic bone and pubic symphysis. The complete pelvic ring structure is the basis for realizing mechanical conduction of the half-pelvic prosthesis and is the basic element of the bionic design of the half-pelvic prosthesis.
Second, the positioning of the acetabulum, i.e. its position in three dimensions (x, y and z axes), is anatomically correct. By measuring and analyzing anatomical big data of the true pelvis mouth (consisting of sacrum, upper edge of sacroiliac joint, arcuate line of ilium, upper edge of acetabulum, pubic comb and upper edge of pubic symphysis, forming entrance of true pelvis), the "true pelvis mouth bionic design theory" of acetabular anatomical positioning is summarized: (1) the true pelvic opening lies generally in one plane, so the height (z-axis) of the acetabulum is determined by the upper sacroiliac joint edge and the pubic symphysis upper edge of the true pelvic opening, i.e., the upper acetabular edge of the semi-pelvic prosthesis lies in one plane with the upper sacroiliac joint connection assembly edge and the upper pubic symphysis connection assembly edge; (2) the sacral width is substantially equal to the acetabular spacing, and the sacral width of the true pelvic opening determines the lateral position (x-axis) of the acetabulum of the semi-pelvic prosthesis, i.e., the acetabular inner rim of the semi-pelvic prosthesis is parallel to the auricular surface of the sacroiliac joint assembly; (3) the length of the true pelvic opening varies from person to person, but there is a constant relationship between the sacroiliac joint-acetabular-pubic symphysis, with the angle between the acetabular to sacroiliac joint line (corresponding to the femoral sacral arch) and the acetabular to pubic symphysis line (corresponding to the connective arch) being within 100±5°. This means: the length of the femoral-sacral arch line (the femoral-sacral arch assembly component) can be changed to adjust the longitudinal position (y axis) of the acetabulum in the semi-pelvic prosthesis, so that after the longitudinal position is consistent with that of the contralateral acetabulum, the contralateral semi-true pelvic opening can be mirrored only by designing an included angle of 100 degrees, and the pubic symphysis can be butted by adjusting the length and rotation of the coupling arch assembly component and the femoral-sacral arch assembly component of the semi-pelvic prosthesis, so that the length of the true pelvic opening and the integrity of a pelvic ring can be restored. It follows that according to the true pelvic-mouth bionic design theory, the z-axis and the x-axis of the acetabular positioning are consistent for each individual when the prosthesis is designed, and the y-axis is inconsistent for each individual, but can be adjusted by the assembly component, i.e. the anatomical bionic of the prosthetic acetabular positioning can be realized for each individual by adjusting the assembly component.
Again, the orientation of the acetabulum. Most students consider the placement of acetabular prostheses as abducted 45 ° and anteverted 15 ° to be more anatomically desirable. The acetabular prosthesis is oriented abducted 40 °, anteverted 15 ° due to the adjustment of the femoral-sacral arch assembly and the coupling arch assembly during the restoration of true pelvic length and pubic symphysis docking (rotation fine adjustment range within ±5°, impact on acetabular orientation within ±5°).
The sacrum of the human body is in a wedge-shaped structure with a wide upper part and a narrow lower part, and the shape of the sacroiliac joint ear surface of the human body can be mainly divided into a C shape and an L shape, so that the oblique structure with the wide upper part and the narrow lower part of the sacroiliac interface of the prosthesis is determined; the pubic symphysis interface of the human body is perpendicular to the ground, thereby determining the vertical structure of the pubic symphysis interface of the prosthesis.
In conclusion, the true pelvis bionic assembled prosthesis has the characteristics of being capable of achieving bionic design of anatomy and mechanics, low in cost, universal, easy to popularize and the like.
Disclosure of Invention
The invention provides a true pelvis bionic assembled prosthesis, which aims to solve the defects of the current half pelvis prosthesis. The invention provides a bionic design conforming to human anatomy morphology and biomechanics characteristics for half pelvis reconstruction operation based on a true pelvis bionic design theory, can effectively reproduce pelvis morphology, improves mechanical stability of the prosthesis, and reduces failure risk of the prosthesis.
A true pelvis bionic assembled prosthesis consists of a femoral sacral arch assembled component, an acetabulum component and a connecting arch assembled component;
the femoral-sacral arch assembly component comprises a femoral-sacral arch assembly component main body and a femoral-sacral arch assembly component connecting rod, wherein the femoral-sacral arch assembly component connecting rod is arranged at the lower end of the femoral-sacral arch assembly component main body, a sacral pile screw hole is formed in the auricular surface of the femoral-sacral arch assembly component main body, and a plurality of femoral-sacral arch assembly component screw holes are formed in the femoral-sacral arch assembly component main body and the femoral-sacral arch assembly component connecting rod;
the acetabulum component comprises an acetabulum component main body and two acetabulum component sleeves, wherein the acetabulum component main body is hemispherical, the two acetabulum component sleeves are arranged on two sides of the acetabulum component main body, a jack is formed in each acetabulum component sleeve, and a plurality of acetabulum component screw holes are formed in the walls of the two acetabulum component sleeves;
the connecting bow assembly component comprises a connecting bow assembly component main body and a connecting bow assembly component connecting rod, wherein the connecting bow assembly component connecting rod is arranged at one end of the connecting bow assembly component main body, a plurality of connecting bow assembly component screw holes are formed in the connecting bow assembly component main body and the connecting bow assembly component connecting rod, and a plurality of pubic bone fixing screw holes are formed in the other end of the connecting bow assembly component main body;
the femoral sacral arch assembly component connecting rod is sleeved in an acetabular component sleeve in a penetrating manner, the fixed bone plate is externally lined, and the femoral sacral arch assembly component, the acetabular component and the fixed bone plate are fixed together through screws;
the connecting rod of the connecting bow assembly component is sleeved in the sleeve of the other acetabulum component, the fixed bone plate is externally lined, and the acetabulum component, the connecting bow assembly component and the fixed bone plate are fixed together through screws.
And a cushion block is arranged between the femoral sacral arch assembly component and the acetabulum component.
A cushion block is arranged between the acetabulum component and the coupling bow assembly component.
The thickness of the cushion block is 10-30 mm.
The upper edge of the femoral sacral arch assembly component, the upper edge of the acetabular component and the upper edge of the coupling arch assembly component are both positioned on the true pelvis mouth plane.
The included angle between the femoral-sacral arch assembly component and the femoral-sacral arch line where the coupling arch assembly component is positioned and the coupling arch line is within the range of (100+/-5);
the acetabular component is oriented 40 ° abducted and 15 ° anteverted.
The ear-shaped surface of the femoral sacral arch assembly component is in a C shape or an L shape.
The length of the connecting rod of the femoral sacral arch assembly component is 20-40mm.
The length of the connecting rod of the connecting bow assembling component is 20-40mm.
The depth of the inner part of the acetabular component sleeve is 20-30mm.
The working principle of the invention is as follows:
the upper edge of the femoral sacral arch assembly component and the upper edge of the acetabular component and the upper edge of the coupling arch assembly component are both positioned on the true pelvis mouth plane; the upper edge of the acetabulum component can be defined through the upper edge of the sacroiliac joint and the upper edge of pubic symphysis, so that the height (z axis) of the acetabulum is determined; the plane of the femoral-sacral arch assembly 1 is parallel to the inner edge of the acetabular assembly, and the lateral position (x-axis) of the acetabular assembly can be determined by the width of the sacrum.
The angle between the femoral-sacral arch assembly component and the femoral-sacral arch line where the coupling arch assembly component is positioned and the coupling arch line is relatively fixed and is within the range of 100+/-5 degrees; the longitudinal position (y-axis) of the acetabular component may be adjusted by changing the length of the femoral-sacral arch assembly on the femoral-sacral archwire; the joint of pubic symphysis is realized by adjusting the length and rotation of the coupling bow assembly and the femoral-sacral bow assembly of the half-pelvic prosthesis, so that the length of the true pelvis and the integrity of the pelvis ring are restored; the adjustment of the length and width of the true pelvis and the position of the acetabulum can realize the butt joint of the sacroiliac joint interface and the pubic symphysis interface and restore the anatomical position of the acetabulum.
The femoral sacral arch assembly component and the coupling arch assembly component can restore the true pelvic mouth length and pubic symphysis butt joint after being adjusted (the rotation fine adjustment range is +/-5 degrees, the influence on the acetabulum orientation is within +/-5 degrees), and the acetabulum prosthesis is oriented to abduct 40 degrees and anteverted 15 degrees.
The femoral-sacral arch assembly component is fixed on the sacrum auricular surface through a sacrum stake screw, the upper part of the connecting part is wide and the lower part is narrow, the back side is fixed on the back of the sacrum through a sacrum back side bone plate and a screw, and the sacrum back side bone plate is connected with the prosthesis through a connecting screw; the hitch bow assembly is secured to the contralateral pubic symphysis with a pubic fixation screw.
The length of the connecting rod of the femoral sacral arch assembly component is 20-40mm, the pubic symphysis interface of the connecting arch assembly component is perpendicular to the ground, and the length of the connecting rod of the connecting arch assembly component is 20-40mm, preferably 20-30mm.
The patient's stature will vary and the need for a prosthesis will vary from person to person. At this time, the cushion blocks with different heights can be replaced to adapt to different requirements of patients.
The invention has the beneficial effects that:
1. the invention accords with the bionic design of human anatomy morphology and biomechanics, can effectively reproduce the complete pelvic ring structure, matches the biomechanics of the normal human pelvis, further improves the mechanical stability of the prosthesis and reduces the failure risk of the prosthesis.
2. The invention provides a true pelvis bionic design theory, and through anatomical morphology measurement, the relation between parameters such as true pelvis plane, sacrum width, femoral-sacral archwire, connecting archwire and the like and acetabulum positioning orientation is clarified, so that a theoretical basis is provided for the design improvement of a half pelvis prosthesis, and the development and progress of pelvis tumor excision reconstruction are promoted.
3. The invention is a universal assembled prosthesis, ensures accurate positioning and orientation of acetabulum by adjusting the femoral-sacral arch assembling component and the connecting arch assembling component, remarkably reduces manufacturing cost, improves rehabilitation effect and life quality of patients and reduces economic burden of the patients while meeting different requirements in semi-pelvic reconstruction operation.
4. The invention has perfect reconstruction theory and complete reconstruction flow, can rapidly and accurately finish half pelvis reconstruction, improves operation efficiency, and accelerates postoperative rehabilitation of patients.
Drawings
Fig. 1 is a front view of the overall structure of an embodiment of the present invention.
Fig. 2 is an enlarged detail view of a femoral sacral arch assembly according to an embodiment of the invention.
Fig. 3 is an enlarged detail view of an acetabular component of an embodiment of the invention.
Fig. 4 is an enlarged detail view of a coupling bow assembly according to an embodiment of the present invention.
Fig. 5 is a side view of a connection structure according to an embodiment of the present invention.
Fig. 6 is a schematic view of a lumbosacral archwire, a linking archwire, and a spatial coordinate system in accordance with an embodiment of the present invention.
Fig. 7 is a rear view of the overall structure of an embodiment of the present invention.
Fig. 8 is a front view of a "C" shaped ear surface of a femoral sacral arch assembly according to an embodiment of the invention.
Fig. 9 is a front view of an "L" shaped aural surface of a femoral sacral arch assembly according to an embodiment of the invention.
Detailed Description
Example 1
Please refer to fig. 1, 2, 3, 4, 5, 6, 7 and 9, which are a first embodiment of the present invention.
The embodiments described in this example are applicable to male patients.
A true pelvis bionic assembled prosthesis consists of a femoral sacral arch assembled component 1, an acetabulum component 2 and a connecting arch assembled component 3.
The femoral-sacral arch assembly component 1 comprises a femoral-sacral arch assembly component main body 11 and a femoral-sacral arch assembly component connecting rod 12, wherein the length of the femoral-sacral arch assembly component connecting rod 12 is 30mm; the femoral-sacral arch assembly component connecting rod 12 is arranged at the lower end of the femoral-sacral arch assembly component main body 11, a sacral pile screw hole 14 is formed in an ear-shaped surface 13 of the femoral-sacral arch assembly component main body 11, and three femoral-sacral arch assembly component screw holes 15 are formed in the femoral-sacral arch assembly component main body 11 and the femoral-sacral arch assembly component connecting rod 12; the ear surface 13 is "L" shaped.
The acetabulum component 2 comprises an acetabulum component main body 21 and two acetabulum component sleeves 22, wherein the acetabulum component main body 21 is hemispherical, the two acetabulum component sleeves 22 are arranged on two sides of the acetabulum component main body 21, a jack 23 is formed in each acetabulum component sleeve 22, and two acetabulum component screw holes 24 are formed in the walls of the two acetabulum component sleeves 22.
The connecting bow assembly component 3 comprises a connecting bow assembly component main body 31 and a connecting bow assembly component connecting rod 32, and the length of the connecting bow assembly component connecting rod 32 is 30mm; the connecting rod 32 of the coupling bow assembling component is arranged at one end of the main body 31 of the coupling bow assembling component, three screw holes 33 of the coupling bow assembling component are arranged on the main body 31 of the coupling bow assembling component and the connecting rod 32 of the coupling bow assembling component, and two screw holes 34 of pubic bone fixing screws are arranged at the other end of the main body 31 of the coupling bow assembling component.
The femoral sacral arch assembly component connecting rod 12 is sleeved in an acetabular component sleeve 22, the fixing bone plate 4 is externally lined, and the femoral sacral arch assembly component 1, the acetabular component 2 and the fixing bone plate 4 are fixed together through screws 41.
The connecting rod 32 of the coupling bow assembling component is sleeved in the other acetabulum component sleeve 22, the fixed bone plate 4 is externally lined, and the acetabulum component 2, the coupling bow assembling component 3 and the fixed bone plate 4 are fixed together through the screws 41.
A cushion block 5 is arranged between the femoral sacral arch assembly component 1 and the acetabulum component 2, and the thickness of the cushion block 5 is 10mm.
A cushion block 5 is arranged between the acetabulum component 2 and the coupling bow assembly component 3, and the thickness of the cushion block 5 is 10mm.
The depth of the acetabular component sleeve 22 is 20mm.
The upper edge of the femoral sacral arch assembly component 1, the upper edge of the acetabulum component 2 and the upper edge of the connecting arch assembly component 3 are all positioned on the true pelvis mouth plane.
The angle between the femoral-sacral arch assembly component 1 and the femoral-sacral arch line 6 and the joint arch line 7 where the joint arch assembly component 3 is positioned is within the range of 100+/-5 degrees;
the acetabular component 2 is oriented 40 ° abducted and 15 ° anteverted.
Example two
Please refer to fig. 1, 2, 3, 4, 5, 6, 7 and 8, which illustrate a second embodiment of the present invention.
The embodiments described in this example are suitable for female patients. Embodiment case 2:
a true pelvis bionic assembled prosthesis consists of a femoral sacral arch assembled component 1, an acetabulum component 2 and a connecting arch assembled component 3.
The femoral-sacral arch assembly component 1 comprises a femoral-sacral arch assembly component main body 11 and a femoral-sacral arch assembly component connecting rod 12, wherein the length of the femoral-sacral arch assembly component connecting rod 12 is 20 mm; the femoral-sacral arch assembly component connecting rod 12 is arranged at the lower end of the femoral-sacral arch assembly component main body 11, a sacral pile screw hole 14 is formed in an ear-shaped surface 13 of the femoral-sacral arch assembly component main body 11, and three femoral-sacral arch assembly component screw holes 15 are formed in the femoral-sacral arch assembly component main body 11 and the femoral-sacral arch assembly component connecting rod 12; the ear surface 13 is "C" shaped.
The acetabulum component 2 comprises an acetabulum component main body 21 and two acetabulum component sleeves 22, wherein the acetabulum component main body 21 is hemispherical, the two acetabulum component sleeves 22 are arranged on two sides of the acetabulum component main body 21, a jack 23 is formed in each acetabulum component sleeve 22, and two acetabulum component screw holes 24 are formed in the walls of the two acetabulum component sleeves 22.
The connecting bow assembly component 3 comprises a connecting bow assembly component main body 31 and a connecting bow assembly component connecting rod 32, and the length of the connecting bow assembly component connecting rod 32 is 30mm; the connecting rod 32 of the coupling bow assembling component is arranged at one end of the main body 31 of the coupling bow assembling component, three screw holes 33 of the coupling bow assembling component are arranged on the main body 31 of the coupling bow assembling component and the connecting rod 32 of the coupling bow assembling component, and two screw holes 34 of pubic bone fixing screws are arranged at the other end of the main body 31 of the coupling bow assembling component.
The femoral sacral arch assembly component connecting rod 12 is sleeved in an acetabular component sleeve 22, the fixing bone plate 4 is externally lined, and the femoral sacral arch assembly component 1, the acetabular component 2 and the fixing bone plate 4 are fixed together through screws 41.
The connecting rod 32 of the coupling bow assembling component is sleeved in the other acetabulum component sleeve 22, the fixed bone plate 4 is externally lined, and the acetabulum component 2, the coupling bow assembling component 3 and the fixed bone plate 4 are fixed together through the screws 41.
And a cushion block 5 is not arranged between the femoral sacral arch assembly component 1 and the acetabulum component 2.
A cushion block 5 is arranged between the acetabulum component 2 and the coupling bow assembly component 3, and the thickness of the cushion block 5 is 10mm.
The depth of the acetabular component sleeve 22 is 20mm.
The upper edge of the femoral sacral arch assembly component 1, the upper edge of the acetabulum component 2 and the upper edge of the connecting arch assembly component 3 are all positioned on the true pelvis mouth plane.
The angle between the femoral-sacral arch assembly component 1 and the femoral-sacral arch line 6 and the joint arch line 7 where the joint arch assembly component 3 is positioned is within the range of 100+/-5 degrees;
the acetabular component 2 is oriented 40 ° abducted and 15 ° anteverted.
Example III
Referring to fig. 1, 2, 3, 4, 5, 6, 7 and 8, a third embodiment of the present invention is shown.
The embodiments described in this example are suitable for female patients.
A true pelvis bionic assembled prosthesis consists of a femoral sacral arch assembled component 1, an acetabulum component 2 and a connecting arch assembled component 3.
The femoral-sacral arch assembly component 1 comprises a femoral-sacral arch assembly component main body 11 and a femoral-sacral arch assembly component connecting rod 12, wherein the length of the femoral-sacral arch assembly component connecting rod 12 is 40mm; the femoral-sacral arch assembly component connecting rod 12 is arranged at the lower end of the femoral-sacral arch assembly component main body 11, a sacral pile screw hole 14 is formed in an ear-shaped surface 13 of the femoral-sacral arch assembly component main body 11, and three femoral-sacral arch assembly component screw holes 15 are formed in the femoral-sacral arch assembly component main body 11 and the femoral-sacral arch assembly component connecting rod 12; the ear surface 13 is "C" shaped.
The acetabulum component 2 comprises an acetabulum component main body 21 and two acetabulum component sleeves 22, wherein the acetabulum component main body 21 is hemispherical, the two acetabulum component sleeves 22 are arranged on two sides of the acetabulum component main body 21, a jack 23 is formed in each acetabulum component sleeve 22, and two acetabulum component screw holes 24 are formed in the walls of the two acetabulum component sleeves 22.
The connecting bow assembly component 3 comprises a connecting bow assembly component main body 31 and a connecting bow assembly component connecting rod 32, and the length of the connecting bow assembly component connecting rod 32 is 40mm; the connecting rod 32 of the coupling bow assembling component is arranged at one end of the main body 31 of the coupling bow assembling component, three screw holes 33 of the coupling bow assembling component are arranged on the main body 31 of the coupling bow assembling component and the connecting rod 32 of the coupling bow assembling component, and two screw holes 34 of pubic bone fixing screws are arranged at the other end of the main body 31 of the coupling bow assembling component.
The femoral sacral arch assembly component connecting rod 12 is sleeved in an acetabular component sleeve 22, the fixing bone plate 4 is externally lined, and the femoral sacral arch assembly component 1, the acetabular component 2 and the fixing bone plate 4 are fixed together through screws 41.
The connecting rod 32 of the coupling bow assembling component is sleeved in the other acetabulum component sleeve 22, the fixed bone plate 4 is externally lined, and the acetabulum component 2, the coupling bow assembling component 3 and the fixed bone plate 4 are fixed together through the screws 41.
A cushion block 5 is arranged between the femoral sacral arch assembly component 1 and the acetabulum component 2, and the thickness of the cushion block 5 is 10mm.
A cushion block 5 is arranged between the acetabulum component 2 and the coupling bow assembly component 3, and the thickness of the cushion block 5 is 10mm.
The acetabular component sleeve 22 is 30mm deep.
The upper edge of the femoral sacral arch assembly component 1, the upper edge of the acetabulum component 2 and the upper edge of the connecting arch assembly component 3 are all positioned on the true pelvis mouth plane.
The angle between the femoral-sacral arch assembly component 1 and the femoral-sacral arch line 6 and the joint arch line 7 where the joint arch assembly component 3 is positioned is within the range of 100+/-5 degrees;
the acetabular component 2 is oriented 40 ° abducted and 15 ° anteverted.
Example IV
Referring to fig. 1, 2, 3, 4, 5, 6, 7 and 9, a fourth embodiment of the present invention is shown.
The embodiments described in this example are applicable to male patients.
A true pelvis bionic assembled prosthesis consists of a femoral sacral arch assembled component 1, an acetabulum component 2 and a connecting arch assembled component 3.
The femoral-sacral arch assembly component 1 comprises a femoral-sacral arch assembly component main body 11 and a femoral-sacral arch assembly component connecting rod 12, wherein the length of the femoral-sacral arch assembly component connecting rod 12 is 40mm; the femoral-sacral arch assembly component connecting rod 12 is arranged at the lower end of the femoral-sacral arch assembly component main body 11, a sacral pile screw hole 14 is formed in an ear-shaped surface 13 of the femoral-sacral arch assembly component main body 11, and three femoral-sacral arch assembly component screw holes 15 are formed in the femoral-sacral arch assembly component main body 11 and the femoral-sacral arch assembly component connecting rod 12; the ear surface 13 is "L" shaped.
The acetabulum component 2 comprises an acetabulum component main body 21 and two acetabulum component sleeves 22, wherein the acetabulum component main body 21 is hemispherical, the two acetabulum component sleeves 22 are arranged on two sides of the acetabulum component main body 21, a jack 23 is formed in each acetabulum component sleeve 22, and two acetabulum component screw holes 24 are formed in the walls of the two acetabulum component sleeves 22.
The connecting bow assembly component 3 comprises a connecting bow assembly component main body 31 and a connecting bow assembly component connecting rod 32, and the length of the connecting bow assembly component connecting rod 32 is 20 mm; the connecting rod 32 of the coupling bow assembling component is arranged at one end of the main body 31 of the coupling bow assembling component, three screw holes 33 of the coupling bow assembling component are arranged on the main body 31 of the coupling bow assembling component and the connecting rod 32 of the coupling bow assembling component, and two screw holes 34 of pubic bone fixing screws are arranged at the other end of the main body 31 of the coupling bow assembling component.
The femoral sacral arch assembly component connecting rod 12 is sleeved in an acetabular component sleeve 22, the fixing bone plate 4 is externally lined, and the femoral sacral arch assembly component 1, the acetabular component 2 and the fixing bone plate 4 are fixed together through screws 41.
The connecting rod 32 of the coupling bow assembling component is sleeved in the other acetabulum component sleeve 22, the fixed bone plate 4 is externally lined, and the acetabulum component 2, the coupling bow assembling component 3 and the fixed bone plate 4 are fixed together through the screws 41.
A cushion block 5 is arranged between the femoral sacral arch assembly component 1 and the acetabulum component 2, and the thickness of the cushion block 5 is 20mm.
No cushion block 5 is arranged between the acetabulum component 2 and the coupling bow assembly component 3.
The depth of the acetabular component sleeve 22 is 20mm.
The upper edge of the femoral sacral arch assembly component 1, the upper edge of the acetabulum component 2 and the upper edge of the connecting arch assembly component 3 are all positioned on the true pelvis mouth plane.
The angle between the femoral-sacral arch assembly component 1 and the femoral-sacral arch line 6 and the joint arch line 7 where the joint arch assembly component 3 is positioned is within the range of 100+/-5 degrees;
the acetabular component 2 is oriented 40 ° abducted and 15 ° anteverted.
The working principle of the four embodiments is as follows:
the upper edge of the femoral sacral arch assembly component 1, the upper edge of the acetabulum component 2 and the upper edge of the connecting arch assembly component 3 are all positioned on the true pelvic mouth plane; the upper edge of the acetabulum component 2 can be defined by the upper edge of the sacroiliac joint and the upper edge of the pubic symphysis, so that the height (z axis) of the acetabulum can be further determined; the plane of the femoral-sacral arch assembly 1 is parallel to the inner edge of the acetabular assembly 2, and the lateral position (x-axis) of the acetabular assembly 2 can be determined by the sacral width.
The angle between the femoral-sacral arch assembly component 1 and the femoral-sacral arch line 6 and the joint arch line 7 where the joint arch assembly component 3 is positioned is relatively fixed within the range of 100+/-5 degrees; the longitudinal position (y-axis) of the acetabular component 2 can be adjusted by changing the length of the femoral-sacral arch assembly 1 on the femoral-sacral archwire 6; the joint of pubic symphysis is realized by adjusting the length and rotation of the coupling bow assembly 3 and the femoral sacral bow assembly 1 of the half-pelvis prosthesis, so that the length of the true pelvis mouth and the integrity of the pelvis ring are restored; the adjustment of the length and width of the true pelvis and the position of the acetabulum can realize the butt joint of the sacroiliac joint interface and the pubic symphysis interface and restore the anatomical position of the acetabulum.
The femoral sacral arch assembly component 1 and the joint arch assembly component 3 can restore the true pelvic mouth length and pubic symphysis butt joint after being adjusted (the rotation fine adjustment range is +/-5 degrees, the influence on the acetabulum orientation is within +/-5 degrees), and the acetabulum prosthesis is oriented to abduct 40 degrees and anteverted 15 degrees.
The femoral-sacral arch assembly component 1 is fixed on the sacrum auricular surface through a sacrum stake screw 16, the connecting part is wide in upper part and narrow in lower part, the back side is fixed on the sacrum back through a sacrum back bone plate 17 and screws, and the sacrum back bone plate 17 is connected with the prosthesis through connecting screws; the hitch bow assembly 3 is secured to the contralateral pubic symphysis by a pubic fixation screw 35.
Claims (10)
1. A true pelvis bionic assembled prosthesis, which is characterized in that: consists of a femoral-sacral arch assembly component (1), an acetabulum component (2) and a connecting arch assembly component (3);
the femoral-sacral arch assembly component (1) comprises a femoral-sacral arch assembly component main body (11) and a femoral-sacral arch assembly component connecting rod (12), the femoral-sacral arch assembly component connecting rod (12) is arranged at the lower end of the femoral-sacral arch assembly component main body (11), a sacral pile screw hole (14) is formed in an ear-shaped surface (13) of the femoral-sacral arch assembly component main body (11), and a plurality of femoral-sacral arch assembly component screw holes (15) are formed in the femoral-sacral arch assembly component main body (11) and the femoral-sacral arch assembly component connecting rod (12);
the acetabulum component (2) comprises an acetabulum component main body (21) and two acetabulum component sleeves (22), wherein the acetabulum component main body (21) is hemispherical, the two acetabulum component sleeves (22) are arranged on two sides of the acetabulum component main body (21), a jack (23) is formed in each acetabulum component sleeve (22), and a plurality of acetabulum component screw holes (24) are formed in the walls of the two acetabulum component sleeves (22);
the connecting bow assembly component (3) comprises a connecting bow assembly component main body (31) and a connecting bow assembly component connecting rod (32), the connecting bow assembly component connecting rod (32) is arranged at one end of the connecting bow assembly component main body (31), a plurality of connecting bow assembly component screw holes (33) are formed in the connecting bow assembly component main body (31) and the connecting bow assembly component connecting rod (32), and a plurality of pubic bone fixing screw holes (34) are formed in the other end of the connecting bow assembly component main body (31);
the femoral sacral arch assembly component connecting rod (12) is sleeved in an acetabular component sleeve (22), and an outer liner fixed bone plate (4) is used for fixing the femoral sacral arch assembly component (1), the acetabular component (2) and the fixed bone plate (4) together through screws (41);
the connecting rod (32) of the coupling bow assembly component is sleeved in the sleeve (22) of the other acetabular component, the fixed bone plate (4) is externally lined, and the acetabular component (2), the coupling bow assembly component (3) and the fixed bone plate (4) are fixed together through screws (41).
2. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: a cushion block (5) is arranged between the femorosacral arch assembly component (1) and the acetabulum component (2).
3. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: a cushion block (5) is arranged between the acetabulum component (2) and the coupling bow assembly component (3), and the thickness of the cushion block (5) is 10-30 mm.
4. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the upper edge of the femoral sacral arch assembly component (1), the upper edge of the acetabulum component (2) and the upper edge of the connecting arch assembly component (3) are all positioned on the true pelvis mouth plane.
5. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the included angle between the femoral sacral arch assembly component (1) and the femoral sacral arch line (6) and the connecting arch line (7) where the connecting arch assembly component (3) is located is within the range of (100+/-5) °.
6. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the acetabulum component (2) is oriented to abduct 40 degrees and anteverted 15 degrees.
7. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the auricular surface (13) of the femoral sacral arch assembly component (1) is of a C shape or an L shape.
8. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the length of the connecting rod (12) of the femoral sacral arch assembly component is 20-40mm.
9. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the length of the connecting rod (32) of the connecting bow assembling component is 20-40mm.
10. A true pelvic floor bionic assembled prosthesis according to claim 1, wherein: the depth of the interior of the acetabular component sleeve (22) is 20-30mm.
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| CN117084830B (en) | 2024-01-02 |
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