CN1183878C - 管状骨骨折用的定位定型骨针 - Google Patents

管状骨骨折用的定位定型骨针 Download PDF

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CN1183878C
CN1183878C CNB961946849A CN96194684A CN1183878C CN 1183878 C CN1183878 C CN 1183878C CN B961946849 A CNB961946849 A CN B961946849A CN 96194684 A CN96194684 A CN 96194684A CN 1183878 C CN1183878 C CN 1183878C
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CN1187761A (zh
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格尔德·沃丁
威利·施奈德尔
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7275—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with expanding cylindrical parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7266—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with fingers moving radially outwardly
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

本发明涉及一种使折断的管状骨定位和定型的骨针，该骨针具有一个针杆(1)，该针杆(1)具有一个或多个在其长度上延伸的空腔状的扩大体(4)，该扩大体(4)可通过液体或气体从内部施压使之径向扩大。

Description

管状骨骨折用的定位定型骨针
技术领域
本发明涉及一种使折断的管状骨定位和定型的骨针。
背景技术
迄今为止，为从内部稳定折断的管状骨，通常使用的是僵硬而且尺寸相对较大的钢针，其截面多为U形或V形。它按照三点支承理论从始端、尾端和中部稳定断骨。为装入这种钢针，必须在骨表面和骨髓腔铣出与要植入的钢针相适合的大尺寸的通槽。其缺点是，为铣出这种通槽，几乎整个骨髓腔都要被铣掉，其结果使骨的供血受到破坏。而且按照这种三点支承方式，力的传递只通过较小的面积进行。为了确保转动稳定性，必须使用附加机构，如锁定螺钉等。
康复后要取出这种骨针也相对麻烦。要取出卡在骨髓腔中的针必须使用专用工具和较大力量。这可能造成骨髓腔再度严重损伤。
DE-C-3201056的权利要求1的前序部分公开了一种骨针，其针杆是由记忆合金制成的空心体，根据不同温度可有两种不同的形状。这种骨针的截面可就地从较小形状转变为较大形状，或者反之。这种已知的骨针的缺点是骨和骨髓有受热负担，这种受热负担是由于为使针杆扩大所必须进行加热造成的。
发明内容
本发明的任务是，提供一种管状骨骨折定位定型骨针，它具有更好的稳定性，而且能在不大面积损伤骨髓腔的情况下被植入，同时对骨和骨髓不造成受热负担。
本发明的任务的一个技术解决方案在于一种管状骨骨折用的定位定型骨针，其具有一个针杆，该针杆具有一个中心基体和在基体的长度上延伸的空腔状的扩大体，所述扩大体可就地通过液体或气体从内部施加压力使之径向扩大，其中，有多个所述的扩大体在中央基体的长度上延伸并且围绕在其周围分布。
本发明的任务的另一个技术解决方案在于一种管状骨骨折用的定位定型骨针，其具有一个针杆，该针杆具有一个在该针杆的纵轴线延伸的空腔状的扩大体，该扩大体可就地通过将流体引入该扩大体而膨胀和径向扩大，所述扩大体包括肋条，所述肋条沿上述纵轴线延伸并从所述扩大体径向凸出
按照本发明的骨针可在不扩大状态下，也就是小截面情况下，通过相对较小的皮质通道(Corticalis-kanal)推入骨髓腔，无须大面积损伤骨髓腔。完全植入后，骨针的截面不须加热就可扩大到稳定断骨所需的程度。其支撑力的分布面积大，通过面接触和与骨髓腔相配合，实现转动稳定性。
按照本发明，由于扩大的截面可以回缩，所以康复后又能在不损伤细胞组织的条件下把骨针取出。
附图说明
现在参照附图说明本发明的各种优选实施例。
图1是本发明的一个实施例的纵截面，
图2是图1中的B-B横截面，
图3是图1中的A-A横截面，
图4是图1中的A-A横截面处已被引入并处于扩大状态的扩大体，
图5是相应于图4的横截面的另一个实施例的杆基体和扩大体，
图6是相应于图4的横截面的另一个实施例的杆基体和扩大体，
图7是相应于图4的横截面的另一个实施例，该实施例具有一个位于中心的扩大体，在其圆周上有轴向延伸的径向支撑肋，
图8是与图7类似与图4相应的实施例，它具有与图7类似的径向支撑肋，该支撑肋与中心扩大体成为一体，
图9是与图4相应的一个实施例的横截面，它显示折叠起来，处于没有扩大状态的扩大体，
图10是一个置于图1所示的骨针头部内的阀的实施例的纵向截面，
图11是一个与图10相应的实施例，其骨针头部做成为阀的一部分，
图12是一个与图11相似的实施例，但是用一个小球代替活塞作为关闭体，
图13的实施例中，用一个穿透膜取代了阀，
图14是图1所示骨针的斜视图，
图15a和15b是本发明的一个具有螺纹顶部实施例的纵向断裂视图，
图16a和16b是骨针的侧视图和前视图，从顶部可以看到，针尖处有叉开装置。
具体实施方式
图1所示用于管状骨的骨针具有一个带有基体2的杆1，基体2最好由细胞组织能接受的合成材料制成。基体2的形状很稳定但又有一定的弯曲弹性，在本实施例中它的横截面是环形并带有三个在圆周方向互成120度的纵向延伸的槽3，其中容纳横截面有弹性的、可拉伸软管状的、同样最好也由细胞组织能接受的合成材料制成的扩大体4。在无负荷的静止状态时，扩大体4最好不从基体2的外廓凸出。针头5作为注入和抽取阀的连接件，如图10所示，上面有为阀设置的连接螺纹6。针尖上有一个使骨针便于引导的最好是锥形的端帽7。在针尖内最好有一个金属销8，在X射线控制下该销是可见的，以便引导骨针。同样可以考虑一个在骨针的全长上延伸的金属条。
当用气体或液体-从医学角度看最好用生理盐水-从内部向每个具有空腔的扩大体4加压时，扩大体4就会如图4所示那样膨胀，以致针杆1的横截面也随着扩大，形成一个星形横截面。最向外凸出部分只占圆周横截面的一部分，因此还留有足够的空间容纳骨髓。相应的扩大体横截面形状以及其类型和尺寸大小会影响与骨头的接触面。基体2和杆1的弯曲弹性使杆1能随着骨髓腔的弯曲而弯曲，再加上扩大体的特性，就能在全长均匀地附在骨头上。
图5所示实施例的扩大体不是可拉伸的，而是可折叠的，在无载状态下扩大体卧在沟形槽3内。
在图6所示的实施例中，无载时折叠在一起的扩大体的横截面在扩大体膨胀后成为尖部变圆的三角形。
图7到图9显示了骨针杆1的几个实施例。它们没有前面所示的那种中央基体，而是在中央形成一个可膨胀的或在无载时可折叠在一起的软管形扩大体4。其外周面上有与之一体或安装上的轴向延伸并径向凸起的肋条10。肋条的形状稳定并具有所需的弯曲弹性。扩大体无负载时，各肋条紧靠在一起，杆的横截面积变小。向扩大体内充入气体或液体，特别是生理盐水后，针杆的横截面大小取决于横截面扩大后的扩大体，其上的肋条10仍然作为骨针杆支撑力的元件贴在骨上。
为使针杆膨胀，在针头5内有一个例如图10所示的阀。图11和图12所示的针头5中，针头本身构成阀的一部分。同一个阀可从一个或多个扩大体4内抽出或注入扩张介质。
图13所示的最佳实施例中，针头5内只有一个穿透膜12和针管14，通过它们向扩大体内注入液体。扩大过程结束后，针管14被取出，穿透膜自行封闭。康复后抽出注入的液体时，再度把针管插入，抽出注入的液体。
图14以斜视图显示了图1中以截面方式显示的骨针。适合大腿骨的骨针的典型长度在25到35cm之间。
图15a和15b显示的实施例具有螺纹顶部16，这是一种把骨针固定在骨内的特殊措施。另一种特殊措施见图16a和图16b所示的叉开机构18。
另一个最佳实施例的骨针可用能被身体吸收的材料制成。这样，在康复后不必再将针取出。

Claims (1)

1.管状骨骨折用的定位定型骨针，具有一个针杆(1)，该针杆(1)具有一个在该针杆的纵轴线延伸的空腔状的扩大体(4)，该扩大体(4)可就地通过将流体引入该扩大体而膨胀和径向扩大，所述扩大体包括设置在所述扩大体的外周面上的肋条(10)，所述肋条沿上述纵轴线延伸并从所述扩大体径向凸出。
CNB961946849A 1995-04-21 1996-04-19 管状骨骨折用的定位定型骨针 Expired - Lifetime CN1183878C (zh)

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DE19514758A DE19514758C2 (de) 1995-04-21 1995-04-21 Nagel zur Lage- und Formfixierung von gebrochenen Röhrenknochen
DE19514758.8 1995-04-21

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CN1183878C true CN1183878C (zh) 2005-01-12

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EP (1) EP0827385B1 (zh)
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AT (1) ATE196984T1 (zh)
BR (1) BR9608183A (zh)
DE (1) DE59606028D1 (zh)
ES (1) ES2153107T3 (zh)
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AU724544B2 (en) 2000-09-28
WO1996032899A1 (de) 1996-10-24
RU2180813C2 (ru) 2002-03-27
BR9608183A (pt) 1999-05-04
ES2153107T3 (es) 2001-02-16
EP0827385B1 (de) 2000-10-18
EP0827385A1 (de) 1998-03-11
ATE196984T1 (de) 2000-11-15
AU5690796A (en) 1996-11-07
DE59606028D1 (de) 2000-11-23
US6025537A (en) 2000-02-15
JPH11503639A (ja) 1999-03-30
JP3715652B2 (ja) 2005-11-09
CN1187761A (zh) 1998-07-15

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