CN1618413A - 用于肩修复术的肩植入件 - Google Patents

用于肩修复术的肩植入件 Download PDF

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CN1618413A
CN1618413A CNA2004100855792A CN200410085579A CN1618413A CN 1618413 A CN1618413 A CN 1618413A CN A2004100855792 A CNA2004100855792 A CN A2004100855792A CN 200410085579 A CN200410085579 A CN 200410085579A CN 1618413 A CN1618413 A CN 1618413A
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China
Prior art keywords
unit
plug
implantation piece
cooperate
supporting member
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劳伦特·贝古因
琼·格林伯格
布鲁诺·里奥
丹尼斯·布顿斯
多米尼克·休格特
雅克·泰西尔
查尔斯·科恩
埃里克·莱斯皮里特
布鲁诺·图森特
格尔特·德克勒克
皮埃尔·马萨特
布鲁诺·齐珀里
Y·布伦纳里乌斯
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Biomet France SARL
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Biomet Merck France SRL
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Publication of CN1618413A publication Critical patent/CN1618413A/zh
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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

一种具适用性的肩植入件包括固定杆(1，8)和凸插件(6)或凹插件(30，31)，各插件能够分别与关节窝或关节植入件配合。所述肩植入件还包括可拆下的支承件(5)，可直接或间接地安装到固定杆(1，8)的上端(3)，可与中间颈部(7)配合，颈部设有与凸或凹植入件配合的机构。

Description

用于肩修复术的肩植入件
技术领域
本发明涉及矫形术植入件领域，具体地涉及肩修复术的领域。
背景技术
一般地，这种类型的修复术可采用不同的形式。当关节窝完整无损时，特别是在粉碎性骨折的情况下，肩修复术包括固定到肱部髓管的肩构件，肩构件设有球形的凸植入件，可直接与关节窝配合。在下面介绍的情况下，这类构件称作“肩植入件”。在关节窝受到破坏的情况下，修复术具有植入到关节窝中的支承件的形式，并设有凸或凹插件，可与设置在肩构件的对应形状配合。
本发明专门涉及具适应性的肩植入件，因其设计成可接受凸插件或凹插件，这取决于所涉及肩部的关节联接发生的情况。在下面的介绍中，用语“凸插件”表示假体的肱骨头，实际形状是球形或半球形，可直接或通过具有对应凹形，实际上是杯体，的支承件与关节窝配合。类似地，用语“凹插件”表示凹进的构件，实际上是杯体件，可与实际上为球形或半球形的凸构件配合，并设置在植入到关节窝区域的支承件上。
法国专利FR-A-2 652 498介绍了相同类型的肩植入件，其包括固定杆，其上部连接带有凹部的头部，设计成可接受以施加方式设置的凸插件或凹插件。这种杆的缺点是，由于所述杆的头部的尺寸，必须对松质骨进行很大的切除。此外，杆的位置导致了肱骨头原来位置的改动，从而使其转动中心变动，这样带来危险，可导致肱部干骺端区破裂。
发明内容
因此，本发明的目的是提出一种具适应性的肩植入件，没有前面提到的缺点，尤其是在切除和解剖学方面的缺点。
从而，本发明的目的是提出一种具适应性的肩植入件，其包括固定杆和凸插件或凹插件，所述插件能够与关节窝或关节植入件配合。该植入件的特征在于，还包括可拆下的支承件，可直接或间接地安装到固定杆的上端，可与中间颈部配合，颈部设有与凸或凹植入件配合的机构。
换句话，本发明用可拆下的支承件来代替法国专利FR-A-2 652498介绍的肩固定杆顶部的锥体，支承件具有筐形并设计成可通过颈部与杆件结合，可接受凸插件或凹插件。
为了防止各构件在修复术已经完成植入后发生相对位移，凸插件或凹插件以及杆的上端设有互相配合的机构。
实际上，支承件或筐形件具有环形座的形式，并设有通孔和至少三个相同的支叉。最好是四个相同的支叉，基本上具有圆弧形式，互相以一定距离间隔开，并使所述支承件有普通半球形状。该半球形状实际上很有必要，因为如下面所介绍的，凸插件和凹插件也具有半球形，可与支承件密切配合。一般地，可以采用任何使支承件有普通半球形的机构，要认识到，半球形通过其顶点和颈部与固定杆的上部配合，密切地固定到并互相穿透肱部的松质骨。
为了使支承件或筐形件定位到到杆件的上端，所述上端具有以一定距离间隔开的连续的凹槽或刻槽，可与支承件的对应支叉的座配合。
支承件或筐形件通过前面提到的颈部固定到杆件。为了避免一旦修复术完成植入后支承件相对杆件位移，固定杆还在其上部设置了圆柱形或锥形的凹部，能够与所述颈部配合。实际上，该凹部的直径稍小于支承件的座的直径，以便可在杆件上进行调整。
在优选的实施例中，圆柱形凹部设有内螺纹，所以能够与颈部底区形成的螺纹配合。
根据本发明的另一特征，杆件具有圆柱形截面，其直径几乎不变。实际上上端的直径稍大于其余部分，这种情况下截面是椭圆形，具有双锥形扩展。
在优选实施例中，杆件在其远区设有凹槽，这样可增加与粘结剂或骨头的接触面积，可强化与肱骨轴的二次固定。
如上面已经讲到的，根据本发明的肩植入件属于具适应性的类型，因为可以接受凸插件，也就是假体的肱骨头，或凹插件，也就是杯体件。
当植入件接受凸插件，所述插件具有半球形的形状，在其基部设有锥形凹部，能够与所述颈部的上端配合。所述颈部的另一端穿过所述支承件的座，以安装到或螺纹连接到杆件的上端凹部。
当植入件是凹插件，所述插件具有杯体形，其连接具有位于端部的中心轴，可具有前面提到的颈部的功能。可与杆件的上端凹部配合。实际上，杯体的直径选择使其可安装到半球形的支承件或筐形件。
本发明及其优点可通过下面的说明性实施例和参考附图更清楚的了解，其中实施例给出了说明性的而非限制性的示例。
附图说明
图1和图2分别是根据本发明的包括假体肱骨头的肩植入件的示意性的侧视图和分解图；
图3和图4是根据本发明另一实施例的图1和图2的植入件上部的更详细的示意图；
图5到图7分别是根据本发明的假体肱骨头的示意透视图和底视图；
图8和图9分别是根据本发明的设有杯体件或凹插件的肩植入件的示意性侧视图和分解图；
图10是图8和图9实施例的变化的更详细的示意性分解图；
图11是根据本发明的带有杯体件的支承件或筐形件的示意性透视图；
图12和图13分别是本发明的杯体件的示意性顶视和底视透视图；
图14是可卡到图12和13的杯体件的聚乙烯插件的示意性透视图；
图15到图17是根据本发明的与植入杆件配合的颈部的示意性透视图；
图18和图19是根据本发明的支承件或筐形件的示意性透视图；
图20和图21是可用于本发明的另外元件的示意性透视图；
图22和图23是根据本发明的杆件的示意性的两个不同方向的透视图。
具体实施方式
根据本发明，肩植入件包括三个单独构件，即固定杆1或8，支承件5，和凸插件或凹插件。
如图1和2所示，以及图22和23所示，固定杆1具有圆柱形，截面几乎不变。但是，上部的直径稍大于杆的其余部分，在这个区域的截面是椭圆的，具有双锥形扩展。
此外，固定杆的远端设有凹槽12，有利于其在肱骨的二次固定。
根据本发明，杆件1可接受具有筐形的支承件5，支承件可接受凸或凹插件。
筐形件5，其在图18和19中清楚地显示，包括圆柱形座13，从座延伸出多个相同的支叉14，支叉以一定距离互相分隔开。这些支叉一般具有圆弧形，形成基本为半球形的外周面。支叉的外表面设有齿，可促进所述支承件固定到肱骨的松质骨。此外，圆柱形座13设有通孔17，允许颈部7通过。颈部将在下面详细介绍。另外，在座13的下表面设有一组径向齿16，互相以一定距离间隔开，可使筐形件5正确定位到固定杆1的上端3，或固定到中间件或短杆8的上表面18，这将参考图20和21进行介绍。
实际上，中间件8的上表面18和固定杆的上端3设有具有对应形状的突出肋9，14和可与这些径向齿16配合齿间距。
凸插件或假体的肱骨头6包括基本为半球形的顶盖，可用不锈钢、铬钴合金或其他材料制成。顶盖的基部10设有孔11，孔可以设在中心(见图6)或是偏心的(见图7)，取决于医师确定的位置。该孔用于接受颈部7的上端20。上端具有莫氏锥度的形式，能够配合具有对应形状的孔11。可注意到所述上端20还设置了具有多边形截面的孔21，能够放入器具以将所述颈部(7)安装到所述固定杆1的上端3。上端20以共线的方式连接有大直径部分22，所述凸插件6位于其上。该部分22也以共线方式继续连接到圆柱区23，然后是具有莫氏锥度或螺纹25的底端区24，这两个区域被较小截面的区26分隔。区26可使底端24具有一定的柔韧性。
圆柱区23用于与筐形件5的座13的孔17配合，其实际延伸的距离基本对应于所述座的高度，其直径对应于所述孔的内径，只有很小的间隙。
该底端24可与所述杆件1的上端3形成的凹部27配合，或与中间件或短杆8形成的凹部28配合，以便确保所述颈部固定到这两个构件上，固定筐形件5和植入件6到固定杆1上。凹部27，28实际设置的形状可与所述底端24的莫氏锥度形状配合，也可以设置内螺纹，其螺距对应于所述底端24的螺纹25。
在凸插件的情况下，筐形件5能够保证杆件的稳定性，另外还能促进植入件固定到肱骨。
凹插入件，具体显示于图11到14，包括杯体件30，聚乙烯插件31可卡入杯体件中。
杯体件30具有基本为半球的形状，连接有从其底端延伸的轴32，所述轴32具有前面提到的颈部7的功能，类似于颈部杯体件设有：
圆柱形中间区35，可与筐形件5的座13的孔17配合；
底区36，可与固定杆1的上端3的凹部27配合，或与中间件8的凹部28配合。
杯体件30的外周面基本对应于筐形件5形成的内部体积。
聚乙烯插件31要卡到杯体件30中。为此，插件31设有环形肋34，可与沿杯体件形成的体积方向突出的在所述杯体件上沿附近形成的突出部33配合。插件31的周面上还设有凸缘37，可支承于杯体件30之上。
应当知道，本发明包括两个主要的实施例。一个使用长杆件1，可插入肱骨的髓管。另一个使用短杆8，在不必植入长杆件的情况下使用。该短杆使得肩植入件可直接植入肱骨。
如上面所述，这种植入件的一个优点是对松质骨只要求进行有限的切除。植入件通过十字形器具位于适当位置，该器具可与筐形支承件的形状配合，这样实际上限制了骨头的松脱。
一旦位于适当位置，由于各个构件之间的紧密配合，凸或凹插件不会移动。
本发明及其优点可从上面的介绍清楚了解，尤其要注意固定杆的解剖学的形状和植入件的适应性。

Claims (8)

1.一种适用的肩植入件，包括：
固定杆(1，8)；
凸插件(6)或凹插件(30，31)，所述插件能够与关节窝或关节植入件配合；
可拆下的支承件(5)，可直接或间接地安装到固定杆(1，8)的上端(3)，可与中间颈部(7，32)配合，所述颈部设有与凸或凹植入件配合的机构；
其特征在于，所述可拆下的支承件(5)具有筐形，并设有带通孔(17)的环形座(13)，包括至少三个相同的基本为圆弧形的支叉(14)，其互相以一定距离间隔开，使所述支承件形成半球形。
2.根据权利要求1所述适用的肩植入件，其特征在于，所述支叉(14)的外表面设有齿(15)，用于与松质骨配合。
3.根据权利要求1或2所述适用的肩植入件，其特征在于，所述支承件(5)的圆柱形座(13)的底表设有以一定距离间隔开的一组径向齿(16)，用于将所述筐形件(5)正确定位在所述固定杆(1，8)的上端(3，18)。
4.根据权利要求1到3中任一项所述适用的肩植入件，其特征在于，所述固定杆(1，8)在上端(3)区域设有截头圆锥形的凹部(27，28)，可与所述颈部(7)也是截头圆锥形的下端配合。
5.根据权利要求1到3中任一项所述适用的肩植入件，其特征在于，所述固定杆(1，8)在上端(3)区域具有圆筒形的凹部(27，28)，并设有内部螺纹，可与所述颈部(7)设有对应螺纹(25)的下端配合。
6.根据权利要求1到5中任一项所述适用的肩植入件，其特征在于，所述中间颈部(7)具有三个共线的部分：
具有莫氏锥度的上端(20)，能够与所述凸插件(6)配合；
较大直径部分(22)，所述凸插件(6)位于其上；
圆柱区(23)，可与所述筐形件(5)的座(13)的通孔(17)配合，并连接有下端(24)区，所述下端可具有莫氏锥度或螺纹(25)，这两个区之间被截面较小的区26分隔。
7.根据权利要求6所述适用的肩植入件，其特征在于，所述凸插件或假体肱骨头(6)形成半球形，其基部(10)设有锥形凹部(11)，可以是位于中心的或偏心的，可与所述颈部(7)的上端(20)配合。
8.根据权利要求6所述适用的肩植入件，其特征在于，所述凹插件(30，31)形成杯体件(30)，其外圆周基本对应所述筐形件(5)形成的内部体积，与位于其顶点的中心轴(32)连接，并形成与所述颈部(7)相同的功能，可与所述杆件(1)的凹部(17)配合，所述杯体件(30)可接受卡到杯体件(30)的聚乙烯插件(31)。
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EP1520560B1 (fr) 2006-10-04
CA2480574A1 (fr) 2005-04-01
ES2273188T3 (es) 2007-05-01
ATE341292T1 (de) 2006-10-15
DE602004002647T2 (de) 2007-08-16
EP1520560A1 (fr) 2005-04-06
CA2475154C (fr) 2009-04-14
FR2860425B1 (fr) 2006-05-26
DE602004002647D1 (de) 2006-11-16
CA2475154A1 (fr) 2005-04-01
JP2005103258A (ja) 2005-04-21
AU2004203300A1 (en) 2005-04-21
AU2004203300B2 (en) 2010-07-29
ZA200405897B (en) 2006-09-27
JP4624041B2 (ja) 2011-02-02
CA2480574C (fr) 2010-05-04

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