CN1617692A - 假体装置 - Google Patents

假体装置 Download PDF

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Publication number
CN1617692A
CN1617692A CNA038023504A CN03802350A CN1617692A CN 1617692 A CN1617692 A CN 1617692A CN A038023504 A CNA038023504 A CN A038023504A CN 03802350 A CN03802350 A CN 03802350A CN 1617692 A CN1617692 A CN 1617692A
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CN
China
Prior art keywords
prosthetic appliance
fixed part
head
bone
prosthesis
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.)
Pending
Application number
CNA038023504A
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English (en)
Inventor
托姆·克里斯滕森
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CYPROMED AS
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CYPROMED AS
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Publication of CN1617692A publication Critical patent/CN1617692A/zh
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  • Health & Medical Sciences (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)
  • Orthopedic Medicine & Surgery (AREA)
  • Prostheses (AREA)
  • Materials For Medical Uses (AREA)

Abstract

用于具有被截上肢/下肢(10)的人的假体装置(1)，其中，该假体装置包括一个设置在残余髓骨(11)内部的固定部件(2)和一个外部假体(7)。该固定部件(2)为螺栓状形状，具有杆(3)和位于一端的伸展的头部(4)，其中该杆(3)能够插入并固定在残余髓骨(11)内部。该头部(4)形成该髓骨(11)的皮下末端和在该被截肢体的端部(10)的局部扩展部分(12)。该外部假体(7)具有适于该局部扩展部分(12)的内部结构(8)。

Description

假体装置
本发明涉及假体装置，用于具有被截去手臂/腿部的人，其中该假体装置包括一个设置在残余髓骨(marrow bone)内部的固定部件和一个外部假体。
传统上，例如用于被截去上臂者的外源假体利用真空或带子之类固定于人体上，其绕人的上部躯干，即颈部或肩部固定。这种假体在使用中很笨重并且很麻烦，不舒服并且使得使用者的活动受限。假体套的不良固定还减少假体的运动和对假体的感觉。使用假体者经常遇到磨损和撕裂的问题、背部问题、颈部问题、出汗和勒束等问题。这种假体的另一个问题是假体对被截去的骨头端部的压力能够引起剧烈的疼痛，并且在最坏的情况下骨头的残余部分在与假体的接触处能够透入皮肤。
DE 3 125 268 A1通过将螺栓插入骨头端部以吸收压力并起“吸振垫”的作用而解决了吸收上述压力的问题。但是，该公开没有提供改进外源假体的固定问题。
目前，另一种解决方案比上述方案提供了较好的假体功能。关于这方面请参考DE 4 338 746 A1，其包括用于被截去上臂/腿部者的假体装置。该假体装置包括一个设置在残余髓骨内部的固定部件和一个外部假体。该固定于骨头的固定部件或固定装置延伸通过皮肤，因此该方案不是一个闭合(皮下)系统。该固定部件或钛螺栓穿过皮肤，这对病人产生极大的感染危险。这种感染危险意味着病人必须每天对由钛螺栓穿过皮肤的区域的伤口进行消毒(该伤口将不会愈合)。这种感染危险还意味着只有少数病人具有这种植入物的资格。非闭合系统的另一个弱点是由于传热/传冷使病人感觉不舒服。暴露在外部环境的钛螺栓将热/冷传递到管状骨架。一些病人对颠簸非常敏感，因为颠簸通过螺栓蔓延并进入管状骨架。在骨头的残余部分和外部假体之间没有能够吸收这些力的柔性部分。这种方案需要在6-9月的期间内进行多次外科手术，这给病人带来极大的重负。
本发明的一个目的在于为截肢者提供假体装置，其中该假体套较好地固定于被截去的臂或腿部，因此改进了假体的功能。
另一个目的是该假体能够局部地简单固定于被截残肢，并且该假体能够在末端固定于该残肢。这种假体固定将增加自由度，即改进了活动能力。
第三个目的是这种假体的使者能够将重量放在假体的端部，并且能够将扭力从该残肢传递到假体。
第四个目的是该假体装置能够应用到所有被截肢体，例如，肱骨、股股、胫股、腓股、尺股、桡股等。
本发明的第五个目的是能够延伸被截的残肢以获得用于固定外部假体的理想残肢长度。
本发明的这些目的通过为被截去上肢/下肢者提供的假体装置实现，其中，该假体装置包括一个设置在残余髓骨内部的固定部件和一个外部假体，其特征在于该固定部件为螺栓状形状，具有一个杆和一个位于一端的伸展的头部，其中该杆能够插入并固定在残余髓骨内，并且该伸展的头部分别形成该髓骨的皮下末端和在被截肢体的端部的局部扩展部分，并且该外部假体具有适合于该局部扩展部分的内部形状。
该假体装置的优选实施例示于图2-9。
下面将参考附图说明本发明的优选实施例，其中
图1示出被截去上臂的人；
图2示出图1的人，其通过带子装有传统的假体；
图3示出图1中被截上臂，并示出了植入根据本发明的假体装置固定部件的方法的第一步；
图4示出了固定部件本身；
图5示出了插入图1中的人的上臂骨内的固定部件；
图6示出了固定部件插入后人的上臂的末端；
图7示意地示出了图4和图5的插入上臂骨中的固定部件；
图8示出了插入人的髓骨中的固定部件的第二实施例；
图9示出了根据本发明的假体装置的外部假体；
图10示出了利用插入的固定部件安装在人的上臂上的假体，其中从正面看此人；
图11示出了从背面看的图10的外部假体；
图12示出了已经安装了下臂的图11的假体装置；
图13示出了根据本发明的固定部件的第三实施例，它安装在大腿骨内部；
图14示出了用于大腿骨的外部假体；
图15示出了图13的外部假体安装在大腿骨上；
图16示出了根据本发明的固定部件的第四实施例；以及
图17示出了插入人的上臂的连接部件的第五实施例。
参考上述附图，应当注意，相同的附图标记在本发明的不同实施例中用于表示相应的部件。
图1示出被截去的上肢的人，图2示出了安装有传统的外源假体的人。如图2所示，该假体覆盖整个上臂、肩部并且还用带子绕颈部和肩部固定。该假体笨大并且其固定装置减少了人的活动性和对假体的感觉。此外，很明显，使用者还会遭受磨损、出汗等问题。
图3示出了植入根据本发明的假体装置1的固定部件的方法的第一步。在被截上肢10的端部进行外科手术13并且髓骨(上肢骨)11的被截端部外露。根据图4的具有杆3和伸展的头部4的固定部件2插入上臂骨或髓骨11中。在插入固定部件2之前，对髓骨11的内部钻孔并调节该固定部件2，该固定部件2接合在髓骨11内。固定部件的杆3具有一个或多个纵向槽6，优选用粘结剂填充。图6示出具有插入固定部件2的被截上臂10。正如图6所示，固定部件2的伸展的头部4在被截肢体的端部10形成局部扩展部分12，该扩展部分12能够很好地固定本发明的外部假体7。图7示意地示出插入并粘接在髓骨11内的固定部件2，并清楚地示出伸展的头部4形成髓骨11的皮下末端和在该被截肢体端部的局部扩展部分12。该固定部件的头部4为板形并稍稍弯曲。
图8示出固定部件2的第二实施例，其具有朝着伸展的头部4延伸的局部扩展部分5。该固定部件2第二实施例用于必须延长髓骨11以便更好地固定外部假体7的场合。这种场合是，例如，上臂被高位截肢到腋窝。图9示出作为该假体装置1的一部分的外部假体7。外部假体7适合于被截上臂10并且特别是植入固定部件2所得到的局部扩展部分12。图10从前面示出了整个假体装置，而图11从背面示出了整个假体装置。从图10和11可以看到，与图2的传统假体相比，本发明外部假体7明显地小并因此轻，并且使使用者感到比较舒服。外部假体7的局部固定还能够增加运动自由度并使使用者感到比较舒服。图12示出与可操作的人造下臂9连接的假体装置1。
图13示出安装在被截大腿骨中的固定部件2的第三实施例。如图所示，特别是头部4具有完全不同的形状并构造成能够吸收由于假腿经受较大的压力冲击造成的较大的压力。图14示出用于与被截大腿骨连接的外部假体7，其包含根据本发明的植入物。图15示出了用于高位截腿的人的整个假体。如图15所示，该局部扩展部分12和该外部假体7的合适的内部结构8提供了良好的固定。良好的“吸振垫”的作用通过该固定部件的伸展的头部实现。
图16示出该固定部件2的第四个实施例。该固定部件2的头部具有T形并稍稍弯曲。
图17示出该固定部件2的第五个实施例，该固定部件的杆3具有靠近头部4的扩展部分5。该扩展部分5在这种情况下用作髓骨11的延长部分，正如结合图8所描述的，并且在这种情况下将适合其手臂被切除到肘部以上的人。上臂骨11的延长能够较好地夹持该外部假体7并因此增加人的假体的功能。
应当说明，外科手术由矫形外科医生或外科医生进行，植入物或固定部件用粘结剂固定在髓骨(管状骨)11，这是一种在例如臀部接合假体应用中的已知技术。固定部件(骨节)的植入由外科医生进行并在3-4周内愈合。这意味着在手术4-6周后病人能够完全使用假体装置1。固定骨节可以用身体不排斥的材料钛生产。外科手术钢是另一种可以使用的材料，该植入物将处于闭合的环境，即皮下环境，这在很大的程度上减少了感染的危险和冷传递。
最后，应当说明，本发明不限于所示的实施例，它可以应用于身体的其他切除部分，并且在不脱离本发明构思的情况下可以进行适当的修改。

Claims (9)

1.一种用于具有被截上肢/下肢(10)的人的假体装置(1)，其中，该假体装置包括一个设置在残余髓骨(11)内部的固定部件(2)和一个外部假体(7)，其中该固定部件(2)为螺栓状形状，具有杆(3)和位于一端的头部(4)，其中该杆(3)能够插入并固定在残余髓骨(11)内部，并且该头部(4)形成该髓骨(11)的皮下末端，其特征在于，该固定部件的头部(4)的宽度超过该残肢(10)的宽度，以便在被截肢体端部(10)具有局部扩展部分/凸起(12)，并且该外部假体(7)具有适于该局部扩展部分(12)的内部形状(8)，从而形成该假体套的局部固定、悬挂和支撑。
2.根据权利要求1的假体装置，其特征在于该杆(3)具有朝向头部(4)的扩展部分。
3.根据权利要求1或2的假体装置，其特征在于该杆(3)具有至少一个纵向槽(6)。
4.根据前述每一项权利要求的假体装置，其特征在于该头部(4)为板形。
5.根据权利要求4的假体装置，其特征在于该板形的头部(4)稍稍弯曲。
6.根据权利要求1-3每一项的假体装置，其特征在于该头部(4)为T形。
7.根据权利要求6的假体装置，其特征在于该T形头部(4)稍稍弯曲。
8.根据前述每一项权利要求的假体装置，其特征在于该假体装置(1)由钛制造。
9.根据权利要求1-7每一项的假体装置，其特征在于该假体装置(1)由外科手术钢制造。
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