CN1236737C - 用于部分或全部替换人或动物体内长骨的模块假肢 - Google Patents
用于部分或全部替换人或动物体内长骨的模块假肢 Download PDFInfo
- Publication number
- CN1236737C CN1236737C CNB018206069A CN01820606A CN1236737C CN 1236737 C CN1236737 C CN 1236737C CN B018206069 A CNB018206069 A CN B018206069A CN 01820606 A CN01820606 A CN 01820606A CN 1236737 C CN1236737 C CN 1236737C
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- China
- Prior art keywords
- artificial limb
- collar
- diaphysis
- bone
- knochenbruch
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61F2/30721—Accessories
- A61F2/30739—Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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Abstract
本发明公开了一种用于形成假肢的模块系统,假肢适于替换人或动物体内的长骨。该系统提供的假肢包括形成假肢关节元件的近端或远端元件,例如转节(1)或髁头,用于与远端或近端元件装配的骨体(5),和用于与断骨接合的骨梗(8)。该系统使得能够用有限的元件组装定做的合适假肢。
Description
本发明涉及用于部分或全部替换人或动物体内长骨的假肢。
在肢体被严重损坏或者大量骨头必须被外科手术去除的情况下,例如,在治疗骨癌的情形下,需要能够替换大部分自然骨骼的假肢,而且假肢能够被外科医生组装以适应各种各样的情况。本发明提供了一种模块系统,以便有效构造定制的假肢,满足这种外科手术的需求。代表性的需求可以是,例如,替换近端或远端股骨,或者也许是整个股骨的替换。
根据本发明的一个方面,提供了一种部分或全部替换人或动物体内长骨的假肢,所述假肢包括:形成假肢关节元件的近端或远端元件,与远端或近端元件装配的骨体,和适于接入被切除的骨头中的骨梗,骨体、骨梗和远端或近端元件由凸锥体或凹锥体相连,每个凸锥体含有一个突出物,其沿着假肢的纵向延伸,但偏离轴线,并可以接合入凹锥体相应的凹进处,为了用拆卸工具横向通入凹锥体末端的区域,提供了一个十字形的孔,其中所述突出物在所需的角度下,维持临近的元件。
本发明还包括其它的特征,包括能够被组装到骨体或其延伸物上的套环,套环被加工成邻接骨的切断面所需要的尺寸,假肢能够装入其中,套环具有与朝向横断面的锥体相适应的部分,还有为促使骨头生长越过套环锥体表面而设计的表面处理。
在近端股骨替换假肢的情况下,假肢优选地含有能够与骨体和骨梗装配的转节替换元件,转节替换元件被制成与解剖学上的转节大约相应的形状,还包括一个用于接受股骨球的股骨颈,和一个与股骨颈相对的总体平坦的表面,以便于残余骨或软组织相连接。
从附图中,根据本发明的假肢详细特征显而易见,其中:
图1是近端股骨假肢装配元件的侧视图;
图2是根据本发明的远端股骨假肢的侧视图;
图3显示了根据本发明的转节替换元件的各种视图;
图4显示了用于本发明的骨体模块的各种视图;
图5显示了用于本发明的股骨梗的各种视图;
图6显示了用于根据本发明假肢中的股骨梗的各种视图;
图7显示了用于本发明的骨体延伸模块的几种视图。
首先参照图1,该图示意性地显示了一个近端股骨组装假肢,包括一个具有股骨颈2的转节元件1,股骨颈2逐渐变细,能够以常规的方式接受股骨球。转节元件在图3所示的视图中更加详细地展现,可以看出它与解剖学形状大致相应,具有一个为附着在任何残余骨头或软组织上的总体上平坦的表面3。转节元件1具有一个内部的凹锥形,在图3中清晰显现,其被组装到骨体5携带的凸锥体上。骨体5的详细结构由图4所示,能够看出骨体5的一端有一个凸锥体33,用于接入转头元件1的凹锥体,另外一端有一个凹锥体7,用于与骨梗8的一端接合(详见图5)。
通过压入配合或者通过使用骨接合,骨梗8被装入被切断的股骨9。环绕着骨体5远端的是套环10,其在图6中更为详细地显现。套环10具有一个与多孔骨邻接的低末端11,形成了断骨9的表面。套环10的尺寸经过选择,使得套环10的末端表面与骨9的外缘相接。点刻或者骨生长刺激物质如羟磷灰石形成于套环10的外表面。这些措施促使多孔骨能够生长越过套环10的表面,并有助于更加牢固地将假肢锁入残余的断骨9。
通常情况下,有可能在去除被损伤的骨头或肿瘤的同时,保留转节残余的部分12。这块残余的骨头可以带有韧带或者附着于其上的其它软组织,利用这一点有助于稳固转节替换元件。通过用板13夹住转节元件的表面3,可以使残余的骨头12附于转节元件上。
图2显示了远端组装假肢的视图,包括一个能够形成膝关节一部分的髁头元件21,其与骨体5相连接,连接方式类似于图1所示转节元件1与骨体5的连接方式。类似的,骨体5与骨梗8相连,连接方式类似于上文图1所述。而且,如上文图1所述,套环10滑过骨体5逐渐变细的部分,其具有一个与股骨9的断面邻接的渐缩的部分11。类似地,这促使骨长满套环10的表面。
转节元件1的细节如图3所示。可以看出,转节元件1的平面3以长钉30的方式形成。这种长钉的方式能够确保与任何残余骨12的紧密连接(见图1),并起到进一步稳固假肢的作用。能够看到转节元件具有一个凹锥体,内部终结于偏移的凹进处31。凹进处31被加工成与突出物32相衔接的形状,突出物32形成于骨体5的凸锥体33(见图4)。转节元件有一个横向孔34,拆卸工具能够插入其中,迫使转节元件和骨体在需要拆分处分离。如图4所示,骨体5也有一个凹锥体7,形成一个与转节元件凹进处31相类似的凹进处35。骨体5也有一个横向孔36,拆卸工具能够插入其中,迫使骨体和为插入锥体7而设计的骨梗元件分离。
进而参照图3,可以看到转节元件也包含孔36。这些孔是为了在没有残余骨的情形下,将转节元件与如肌腱这样的软组织缝合在一起而设的,肌腱附于其上,其能够被夹到带有点刻的表面上。
尽管应当有左和右视图,转节元件是作为模块系统的标准元件而提供的。还可以有其它的转节元件,其中股骨颈的偏移度不同,以适应特殊患者的需要。
由图4可见,尽管就锥体而言,股骨的骨体已经标准化了,骨体还有长度为15mm的间隔。股骨的骨体还提供了为了与相应的耳38接合而设计的凹槽37,耳38与套环10形成一个整体。由图6可见,套环10有一个内部的锥体39,适合装入骨体5一端相应的锥体40。骨体5上接合的套环和凹槽37内接合的耳38,使套环能够安全地装入骨体。由图6可见,套环配备有多种直径,D1和D2。
图5显示了骨梗元件8的各种视图。由横切视图可见,为了与皮层骨接合,骨梗上有凹槽形成,骨梗可以是直的或曲的,以适应骨管内的任何曲率。骨体近端有锥体42,其与骨体元件的内部锥体7相应。骨体还包括突出物43,其与骨体元件的凹进处35相应。骨体元件5包含为拆卸目的而设的横向孔36,在那里,通过对骨梗和骨体相应末端的平面施加压力,插过孔的工具能够压迫分开骨梗和骨体。由图5可见,可以得到多种尺寸和长度的骨梗,骨梗可以是曲的或直的,以适应安装这种假肢时可能遇到的各种外科手术问题。
图7显示了延伸骨体模块,它能够使如图1和图2所示的全部组装被延伸。骨体延伸模块50具有凸锥体和位于相反末端的凹锥体,它们分别相应于骨体模块的锥体7和骨梗模块的锥体42。当然,骨体延伸模块50能够用于与标准骨体接合,或者单独用于将转节元件1或髁头元件21与骨梗8相连接。
尽管没有详细显示,通过省去骨体8和套环10,图1和图2所示的假肢能够结合形成完整的股骨替换假肢。同样的,类似形成的元件能够用于替换其它长骨,例如肱骨。
如上所述,在试组装或修复手术之后,通过在每一个锥体连接处将拆卸工具插入横切壁,假肢元件能够被轻易拆除。
除了股骨头部之外,优选使用的物质全部是使用钛合金,在股骨头部,优选使用钴、铬或陶瓷头。
Claims (7)
1.一部分或全部替换人或动物体内长骨的假肢,所述假肢包括形成假肢关节元件的近端或远端组件、与近端或远端组装的骨体和用于在断骨的断面处接入断骨的骨梗,骨体、骨梗和近端或远端组件通过凸锥体和凹锥体相连,每个凸锥体包括一个凸出物,所述的凸出物沿着假肢纵向延伸但偏移假肢的轴线并接入凹锥体相应的凹进处,每个凹锥体具有一个横向延伸至其凹进处的十字形的孔,所述十字形的孔用于拆卸工具横向进入凸锥体的末端区域,其中所述凸出物以所需的角度维持临近的组件。
2.根据权利要求1所述的假肢,其还包括与骨体组装的套环,套环的尺寸被加工成与假肢装入其中的断骨的断面相邻,套环具有一部分,所述的一部分具有朝向断骨的断面渐尖的锥形表面,套环还具有为了促进骨生长越过套环的锥形表面而设计的表面处理。
3.根据权利要求1所述的假肢,其还包括延伸骨体的骨体延伸模块及套环,套环组装到骨体延伸模块上,套环的尺寸被加工成与假肢装入其中的断骨的断面相邻,套环具有一部分,所述的一部分具有朝向断骨的断面渐尖的锥形表面,套环还具有为了促进骨生长越过套环的锥形表面而设计的表面处理。
4.根据权利要求2或3所述的假肢,其中套环形成外部带有点刻的表面,或者被羟磷灰石或其它骨生长促进物质所包覆。
5.根据权利要求1、2或3中的任何一项权利要求所述的假肢,其是近端股骨替换假肢,假肢包括与骨体或骨梗装配的转节替换元件。
6.根据权利要求5所述的假肢,其中转节替换元件被加工成与解剖学转节大致相应的形状,并包括一个可接受股骨球的股骨颈,和与股骨颈相对的总体平坦的表面以便与残余骨或软组织相连接。
7.根据权利要求6所述的假肢,其中所述总体平坦的表面带有点刻,用于与断骨接合。
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GB2370041C (en) * | 2000-12-15 | 2007-01-25 | Stanmore Implants Worldwide | A modular system for formation of a prosthesis |
US7799086B2 (en) | 2002-04-25 | 2010-09-21 | Zimmer Technology, Inc. | Modular bone implant, tools, and method |
US7306629B2 (en) * | 2003-07-03 | 2007-12-11 | Zimmer, Inc. | Femoral head assembly with variable offset |
US7476255B2 (en) * | 2003-12-30 | 2009-01-13 | Depuy Products, Inc. | Soft tissue attachment system and method |
US7867282B2 (en) | 2004-12-17 | 2011-01-11 | Depuy Products, Inc. | Modular implant system and method with diaphyseal implant and adapter |
EP1824425B1 (en) * | 2004-12-17 | 2016-05-11 | DePuy Products, Inc. | Modular diaphyseal and collar implant |
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