A kind of proximal humerus shoulder joint prosthesis
Technical field
This utility model relates to a kind of articular prosthesis that surgery is implanted that is used for, and especially relates to and a kind ofly can be used for the proximal humerus bone, the part shoulder joint is overhauled a kind of proximal humerus shoulder joint prosthesis of displacement and serious proximal humeral comminuted.
Background technology
Proximal humerus bone tumor and proximal humerus seriousness comminuted fracture disease exist for a long time always, and for fear of amputation, reduction of patient pain, carrying out the displacement of proximal humerus tumor shoulder joint is the effective means that present orthopedics circle is treated this type of disease admittedly.To the malignant bone tumor of proximal humerus, particularly metastatic tumo(u)r, proximal humerus tumor joint replacement is very effective beyond doubt as a kind of palliative operation.In recent years, patient's value volume and range of product is also in continuous increase, and the proximal humerus shoulder joint prosthesis also is used to the serious comminuted fracture of part proximal humerus, part shoulder joint and disease such as overhauls.Proximal humerus shoulder joint replacement is the therapeutic modality of comparatively approving.
At present, be used for clinical proximal humerus shoulder joint prosthesis, as shown in Figure 8, it is done 28 two parts by head of humerus 27 and humerus and is welded.Because its structure is too simple, dissect not in full conformity with Human Physiology, less stable in use, sterile type is loosening and carrying out property bone dissolution phenomena is obvious.Simultaneously, existing proximal humerus shoulder joint prosthesis construction features has determined it is that customization mode with traditional is carried out processing such as turning, milling and welding, complex process, and implementation procedure is longer.Mode with welding in the course of processing connects the risk that has increased easy generation fatigue fracture in material degeneration and the use, and the time of operation early-stage preparations is longer, the delay that can cause conditions of patients to cure.
Summary of the invention
The purpose of this utility model is, overcomes the above-mentioned defective of existing proximal humerus shoulder joint prosthesis, and a kind of a kind of proximal humerus shoulder joint prosthesis of dissecting near Human Physiology more is provided.Technical solution of the present utility model is: articular prosthesis comprises humerus bulb, proximal humerus button, humerus intramedullary needle, screw, the humerus bulb is the ball-crown body of height less than radius, the planar central of humerus bulb has conical bore, dried cooperation of taper seat neck on conical bore and the proximal humerus button inclined-plane, have the syndesmosis hole on the side of proximal humerus button, the proximal humerus button axially has counterbore, through hole and conical bore successively, and the lower surface of proximal humerus button has stopper slot; The humerus intramedullary needle comprises screwed hole, the frustum of a cone, limiting stand, circular cone T-shape screw thread, the anti-spin slot of " L " shape, the frustum of a cone at humerus intramedullary needle top cooperates with the conical bore of proximal humerus button, the stopper slot clamping of the limiting stand of humerus intramedullary needle and proximal humerus button lower surface has the anti-spin slot of circular cone T-shape screw thread and " L " shape on the shank of humerus intramedullary needle bottom; Humerus bulb, proximal humerus button, humerus intramedullary needle connect as one by screw.
Described proximal humerus button joins for bone section and humerus intramedullary needle by humerus, humerus is provided with the frustum of a cone for bone section upper end, this frustum of a cone cooperates with the conical bore of proximal humerus button, humerus is provided with limiting stand for the top of bone section, the stopper slot clamping of this limiting stand and proximal humerus button lower end, humerus axially has through hole and a conical bore successively for the bone section, and humerus is opened stopper slot for the lower surface of bone section; The frustum of a cone at humerus intramedullary needle top cooperates with the conical bore of humerus for the bone section, the limiting stand of humerus intramedullary needle and humerus are for the stopper slot clamping of bone section lower surface, and humerus bulb, proximal humerus button, humerus connect as one by screw for bone section, humerus intramedullary needle.
Conical bore on the described humerus bulb and taper seat neck be dried to have identical cone angle, and the cone angle angle value is between 2 °~6 °, and the length that the taper seat neck is done is than the little 0.5mm~2mm of the degree of depth of conical bore.
Described humerus bulb is the ball-crown body of height less than radius, and height/radius ≈ 2/3~3/4, and polishing spherical face roughness Ra value is 0.5 μ m~1.6 μ m.
Syndesmosis hole on the described proximal humerus button is 2~6 manholes, the diameter value is 2mm~6mm, proximal humerus button top is biomimetic features, the bottom is straight round bar, external diameter is 17mm~26mm, and the angle angle value between dried axial line of taper seat neck and the conical bore axial line is 125 °~145 °.
Circular cone T-shape screw thread on the described humerus intramedullary needle equidistantly distributes, and the facewidth is identical with groove width, and the facewidth is 1mm~3mm, the anti-spin slot of " L " shape be 180 ° uniform.
Conical bore on the described proximal humerus button and humerus are for the structure of the conical bore on the bone section and measure-alike, humerus is for the structure of the frustum of a cone on the bone section and the frustum of a cone on the humerus intramedullary needle and measure-alike, the stopper slot of proximal humerus button lower surface and humerus be for the structure of the stopper slot of bone section lower surface and measure-alike, and humerus is for the structure of the limiting stand of the limiting stand of bone section both sides and humerus intramedullary needle and measure-alike.
Conical bore on the described proximal humerus button, humerus have identical cone angle with humerus for the frustum of a cone on the bone section, the frustum of a cone on the humerus intramedullary needle for the conical bore on the bone section, the angle of taper value is between 3 °~8 °, after proximal humerus button and humerus make up realization self-locking close fit respectively for bone section, humerus intramedullary needle, axially has the gap of 1mm~3mm each other.
Described humerus is identical with proximal humerus button lower end external diameter for bone section external diameter, and humerus is that 20mm~240mm is adjustable for the length of bone section.
The beneficial effects of the utility model are:
This utility model in the course of processing except the proximal humerus button and on the one-step casting molding of syndesmosis hole, all the other parts all directly carry out machined can be realized, has abandoned the welding procedure of existing proximal humerus shoulder joint prosthesis, has reduced risk.
2. the many curved surfaces of prosthese profile are along degree of slipping over, and the round bar external diameter is 17mm~26mm, and the angle angle value between dried axial line of taper seat neck and the conical bore axial line is 125 °~145 °, near human body bone biomimetic features.More meet the Human Physiology anatomical features.
3. the proximal humerus button is realized closely being connected for bone section, humerus intramedullary needle, direct interference fit by the frustum of a cone and conical bore with humerus, utilizes the screw second consolidation to carry out any assembly simultaneously, strengthens reliability; Humeral ball adjunction on first watch person of modern times body dissect physiology, the best bright finish of polishing sphere has reduced the wearing and tearing in the use, has reduced the possibility that the bone dissolution phenomena takes place.Simplified time before processing technique and the art.
4. can select for use (or need not) to increase humerus according to patient's focus practical situation, and humerus can regulate for the length of bone section, shorten time before the art in a large number for the bone section; Simultaneously, humerus intramedullary needle length and external diameter can carry out selecting in the scope, satisfy multiple focus demand.
5. the humerus intramedullary needle adopts and to have circular cone T-shape helicitic texture, effectively prevents the disengaging of prosthese, and the anti-spin slot of " L " shape of side axial can effectively prevent the back-out of prosthese, strengthens the stability behind the prosthese implant into body effectively.
This utility model is according to humerus dissect physiology characteristics and upper limb shoulder stressing conditions, and each building block has frustum or taper hole structure, realizes each other tight connection by the interference fit between frustum and the taper hole, and utilizes the reinforcement by connection of screw thread.The humerus bulb meets the Human Physiology anatomical features; The humerus intramedullary needle adopts has circular cone T-shape helicitic texture, effectively prevents the disengaging of prosthese, and the anti-spin slot of " L " shape of side axial can effectively prevent the back-out of prosthese.This kind proximal humerus shoulder joint prosthesis can satisfy proximal humerus bone tumor, needs and overhaul different patient demands such as displacement and the serious comminuted fracture of part proximal humerus.This utility model proximal humerus shoulder joint prosthesis technology is simple, easy to process, and time shortens before the art, simultaneously the operative process simple and fast.This utility model has partly solved the proximal humerus shoulder joint prosthesis and has in use produced loosening problem, has solved the problem that there are defective in implementation procedure complexity and processing technique simultaneously.Thereby make the proximal humerus shoulder joint prosthesis convenient and practical, satisfy patient and doctor's different demands, time before the desmopyknosis, make operation technique more convenient.
Description of drawings
Fig. 1 installs the assembly structure sketch map of humerus for the bone section additional for this utility model.
Fig. 2 is the generalized section of this utility model humerus bulb.
Fig. 3 does not install the assembly structure sketch map of humerus for the bone section additional for this utility model
Fig. 4 is the sketch map of this utility model proximal humerus button.
Fig. 5 is the sketch map of this utility model humerus for the bone section.
Fig. 6 is the sketch map of this utility model humerus intramedullary needle.
Fig. 7 is the sketch map of this utility model screw.
Fig. 8 is for being used for clinical proximal humerus shoulder joint prosthesis at present.
The specific embodiment
It is medical titanium or titanium alloy that this utility model is made used metal material, or medical vitallium.Referring to Fig. 1~Fig. 7, the proximal humerus shoulder joint prosthesis comprises humerus bulb 1, proximal humerus button 2, humerus intramedullary needle 4, screw 5.The proximal humerus shoulder joint prosthesis of humerus bulb 1, proximal humerus button 2, humerus intramedullary needle 4, an integral body of screw 5 one-tenth capable of being combined.Described humerus bulb 1 comprises conical bore 6, polishing sphere 7; Described proximal humerus button 2 comprises: the taper seat neck does 8, counterbore 9, through hole 10, syndesmosis hole (11), conical bore 12, stopper slot 13; Described humerus intramedullary needle 4 comprises screwed hole 19, the frustum of a cone 20, limiting stand 21, circular cone T-shape screw thread 22, the anti-spin slot 23 of " L " shape; Screw 5 comprises lug 24, interior hexagonal hole 25, screw tip 26.
The proximal humerus shoulder joint prosthesis can also replace bone section 3, humerus intramedullary needle 4, screw 5 be combined into the proximal humerus shoulder joint prosthesis of an integral body by humerus bulb 1, proximal humerus button 2, humerus.Described humerus bulb 1 comprises conical bore 6, polishing sphere 7; Described proximal humerus button 2 comprises: the taper seat neck does 8, counterbore 9, through hole 10, syndesmosis hole 11, conical bore 12, stopper slot 13; Humerus comprises through hole 14, the frustum of a cone 15, limiting stand 16, conical bore 17 and stopper slot 18 for bone section 3; Described humerus intramedullary needle 4 comprises screwed hole 19, the frustum of a cone 20, limiting stand 21, circular cone T-shape screw thread 22, the anti-spin slot 23 of " L " shape; Screw 5 comprises lug 24, interior hexagonal hole 25, screw tip 26.
Conical bore 6 is done 8 interference fit with the taper seat neck, thereby realizes the self-locking of humerus bulb 1 and proximal humerus button 2; Spacing by stopper slot 13 and limiting stand 16 or limiting stand 21 makes conical bore 12 and the frustum of a cone 15 or the frustum of a cone 20 interference fit, thereby realizes that proximal humerus button 2 and humerus replace the self-locking compression fit between bone section 3, the humerus intramedullary needle 4; Spacing by stopper slot 18 and limiting stand 21 under external force, realized the interference fit of the conical bore 15 and the frustum of a cone 20, and then realized the self-locking compression fit of humerus for bone section 3 and humerus intramedullary needle 3.Utilize at last screw rod 5 pass through hole 10 and (or) through hole 14, and screw tip 26 screwed in screwed holes 19 carry out second consolidation, strengthen the firm reliability of prosthese.
Among Fig. 2 embodiment, the central lines of conical bore 6 axis and humerus bulb 1.Humerus bulb 1 is the spherical crown of height (H)/radius (R) ≈ 2/3~3/4.Conical bore 6 cone angle angle values are between 2 °~6 °.Polishing sphere 7 is high polishing, and the surface roughness Ra value is 0.5 μ m~1.6 μ m.According to the characteristics of adult's humerus, humerus bulb 1 place radius of sphericity is 18mm~26mm, and 1mm increases progressively.
Among Fig. 4 embodiment, proximal humerus button 2 one piece casting modes realize that 2~6 syndesmosis holes 11 are arranged on it, are manhole, and the diameter value is 2mm~6mm.Top is biomimetic features, and the bottom is straight round bar, and external diameter is 17mm~26mm.The angle that the taper seat neck is done between 8 axial lines and conical bore 12 axial lines is 125 °~145 °.Stopper slot 13 and limiting stand 16 or limiting stand 21 correspondences are inserted the frustum of a cone 15 or the frustum of a cone 20 in the conical bore 12.Pass screw rod 5 in the through hole 10
Among Fig. 5 embodiment, humerus is identical with proximal humerus button 2 lower ends for bone section 3 outside diameters, and length is 20mm~240mm, in order to satisfy different length osteotomy section patient's needs.Through hole 14 is used to pass screw rod 5.The frustum of a cone 15 inserts conical bore 12, limiting stand 16 and stopper slot 13 correspondences, inserts the frustum of a cone 20, stopper slot 18 and limiting stand 21 correspondences in the conical bore 17.
Among Fig. 6 embodiment, described circular cone T-shape screw thread 22 equidistantly distributes, and the facewidth is identical with groove width, and the facewidth is 1mm~3mm, effectively prevents the disengaging of prosthese; The anti-spin slot 23 of " L " shape be 180 ° uniform, effectively prevent the back-out of prosthese.Limiting stand 21 and stopper slot 18 correspondences, the frustum of a cone 20 is used to insert conical bore 12 or conical bore 17.Screw in screw tip 26 in the screwed hole 19.
Among Fig. 7 embodiment, screw rod 5 pass through hole 10 and (or) through hole 14.Screw tip 26 screws in screwed hole 19, and lug 24 is screwed in the counterbore 9 by hexagonal hole in the turn 25, and proximal humerus button 2, humerus intramedullary needle 4 or humerus further are strained and fixed between the bone section 3.