CN204618489U - Proximal radioulnar joint merges orthopaedic prosthesis - Google Patents

Abstract

The utility model discloses proximal radioulnar joint and merge orthopaedic prosthesis, comprising: near-end assembly, comprise outer cup, liner and lock ring, liner and lock ring is coated is arranged on outer cup inner chamber; Outer cup outer surface scribbles hydroxyl apatite biological painting, and its inner surface bottom is provided with a ring-type locked groove at nearly opening part; Liner, lock ring are made by high crosslinked polyethylene; Distal component, it radius handle comprising connection handle and be connected with connection handle; Connection handle is possess standard to rub the cone column structure of this taper face; Radius handle is cylindrical-shaped structure, and its surface scribbles hydroxyl apatite biological painting; Rotating ballhead, is provided with the hole slot mated with connection handle below it, rotating ballhead to embed in liner and locked by lock ring and ring-type locked groove.The utility model has the advantages that: the center of rotation of ulnar-radial is transferred on prosthese, thus rebuild forearm function, decrease the risk of elbow joint degeneration, avoid the problem can not recovering forearm spinfunction in current therapeutic scheme.

Description

Proximal radioulnar joint merges orthopaedic prosthesis

Technical field

This utility model relates to a kind of human prostheses, particularly relates to a kind of orthopaedic prosthesis for the treatment of proximal radioulnar joint and merging on clinical medicine.

Background technology

It is a kind of more rare congenital malformation that congenital proximal radioulnar joint merges, and has household heredity factors more, thinks autosomal dominant genetic diseases more at present, for chi oar separation barrier on during embryo or mesoderm soft tissue generation bone or fiber are connected to form.It is generally acknowledged that forearm is fixed on neutral position little to function effect when revolving first 30 °, do not need special treatment, if but be fixed on revolve before more than 60 ° time, afunction is serious, needs operative treatment.Due to the reason (fascia tissue contracture, machine direction are abnormal, interosseous membrane is narrow, radius bowing deformity, supinator are abnormal or lack as, pronator contracture) on pathology, its treatment and prognosis are all difficult problems.

Found by clinical practice, the difficult point of primary disease treatment is how to solve the spinfunction of forearm and does not affect the function of bending and stretching of elbow joint, and ulna and radius separately after may merge again, also have the possibility of damage radial nerve.In current Therapeutic Method, have the connection of cutting bone property, capitulum radii displacement etc. to attempt to recover the art formula of spinfunction, but effect is unsatisfactory and add the probability of elbow joint regression; Also have various osteotomy, but also can only reduce and original revolve the front number of degrees, be difficult to recover the autonomous spinfunction of forearm, cannot complete unblank, twist a towel, the everyday actions such as to have a meal.In addition the long-term extenal fixation of the postoperative needs of existing art formula, even if but natural joint fixes the contracture that certain degree also can occur in 4 weeks, this type of patient itself loses forearm spinfunction, has more occurred that flexion-extension motion is limited, cause elbow joint function to be lost further after operation and extenal fixation.

Utility model content

The purpose of this utility model is to avoid the deficiencies in the prior art part, and provides a kind of proximal radioulnar joint to merge orthopaedic prosthesis.

For realizing above object, this utility model takes following technical scheme: proximal radioulnar joint merges orthopaedic prosthesis, and comprise, near-end assembly, comprise outer cup, liner and lock ring, liner is fitted in the top of outer cup inner chamber; Outer cup is the semicircle chondritic of bottom opening, and the bottom of its inner surface has a ring-type locked groove at opening part, and lock ring is set in annular lock groove;

Distal component, it radius handle comprising connection handle and be connected with connection handle; Connection handle is possess standard to rub the cone column structure of this taper face; Radius handle is cylindrical-shaped structure, and its diameter and skeleton diameter match;

Be provided with the hole slot mated with connection handle below rotating ballhead, rotating ballhead embeds in described liner, and the end of rotating ballhead is along being locked by described lock ring.

The semicircle chondritic of outer cup coordinates the geometry of ulna and radius pulp cavity to design, to obtain uniform stress distribution.Connection handle, the cylindrical-shaped structure radius handle of cone column structure, after distal component is inserted, stress distribution is average, and avoid the shortcoming that stress is concentrated, radius handle can arrange different diameters to be applicable to the skeleton of different-diameter; Space between lock ring and liner is just the volume of rotating ballhead, rotating ballhead to embed in liner and is locked by lock ring and ring-type locked groove, the setting of lock ring pulls power downwards in order to what resist that elbow joint bears, makes rotating ballhead rotate freely within the liner and can not deviate from simultaneously; Liner can make the wear extent of rotating ballhead reduce.

The outer surface of described outer cup is Surface of Sphere; Outer cup inner surface top is divided into smooth ball minute surface, and it is equidistantly distributed with screw fixed hole; The bottom of outer cup inner surface is divided into flat cylindrical face, and the upper limb of the ring-type holding section of ring-type locked groove is inclined-plane, lower edge is plane.This kind of structure can effectively prevent lock ring from coming off.

Described liner is positioned at outer cup smooth ball minute surface place, and the internal diameter of its external diameter and outer cup matches.Rotating ballhead produces atomic little friction between smooth ball minute surface, liner and rotating ballhead after embedding liner, obtains optimum assembling position in convenient operation or proper motion.

Described lock ring is bonded in outer cup flat cylindrical face, and its outer surface is provided with an annular projection, when annular projection is fastened on after in described ring-type locked groove, and the bottom of the outer ring laminating outer cup inner surface of lock ring; The sidewall of described lock ring offers a breach, and breach runs through one section of sidewall, upper surface and lower surface of lock ring.The setting of breach, makes lock ring issue raw appropriate deformation in external force, and reduced, to enter outer cup, completes and has shape with restoring next time at elastic reaction after the mating of locked groove.

The inner face of described lock ring is provided with one for withstanding and the flange on edge under rotating ballhead described in clamping, and form the first inclined plane between flange and the end face of lock ring, form the second inclined plane between flange and the bottom surface of lock ring, the second inclined plane is towards the opening part of outer cup.The setting of the second inclined plane can be convenient to import rotating ballhead; Flange can be blocked after sliding into the inner chamber of outer cup on edge under rotating ballhead, makes it the inner chamber that can not depart from outer cup easily; First inclined plane and rotating ballhead are fitted, and rotate at inner chamber for it.

The cone column structure surface of described connection handle is provided with the micro-screw thread be equally spaced.Micro-screw thread coordinates tighter with the hole slot of rotating ballhead, there is not relative motion after making it coupling.

The proximal end face of described radius handle is coated with pearl knot curved surface, and its far-end is smooth, spherical curved surface, with the connection handle intersection outstanding neck portion formed for covering radius cortex of annular towards periphery; The smooth, spherical curved surface of radius handle is provided with fixing screw hole.The proximal end face of radius handle is coated with pearl knot curved surface, is beneficial to hyperosteogeny in wherein and improve the fixing strength of Using prosthesis.

Described neck portion is provided with mark line, and mark line aims at the center of circle of described fixing screw hole.The setting of mark line, conveniently observes and carries out holing and being screwed into screw after radius handle inserts pulp cavity.

Described hole slot is the hole slot of the cone-shaped with this tapering that rubs, and its tapering is identical with screw thread micro-on connection handle.

This utility model compared with prior art, tool has the following advantages: by artificial constructed prosthese, the center of rotation of ulnar-radial is transferred on prosthese, thus rebuild forearm function, simultaneously owing to remaining capitulum radii, can not elbow joint structure be destroyed, decrease the risk of elbow joint degeneration, avoid the problem can not recovering forearm spinfunction in current therapeutic scheme, there is simple, definite effect, few intercurrent disease advantage of performing the operation.

Accompanying drawing explanation

Fig. 1 is the profile of this utility model embodiment near-end assembly;

Fig. 2 is the partial enlarged drawing of Fig. 1;

Fig. 3 is the top view of this utility model embodiment near-end assembly;

Fig. 4 is the upward view of this utility model embodiment near-end assembly;

Fig. 5 is the top view of this utility model embodiment lock ring;

Fig. 6 is the profile of this utility model embodiment outer cup;

Fig. 7 is the structural representation of this utility model embodiment distal component;

Fig. 8 is the structural representation of this utility model embodiment rotating ballhead;

Fig. 9 is the structural representation of this utility model embodiment.

Reference numeral implication in figure: 1, near-end assembly; 11, outer cup; 111, inclined-plane; 112, plane; 113, screw fixed hole; 12, liner; 13, lock ring; 131, annular projection; 132, breach; 133, flange; 14, ring-type locked groove; 15, the second inclined plane; 151, the first inclined plane; 2, distal component; 21, connection handle; 22, radius handle; 23, fixing screw hole; 24, neck portion; 241, mark line; 25, pearl knot curved surface; 3, rotating ballhead; 31, hole slot.

Detailed description of the invention

Below in conjunction with the drawings and specific embodiments, content of the present utility model is described in further details.

Embodiment

Consult Fig. 1 to Fig. 9, proximal radioulnar joint merges orthopaedic prosthesis, comprising:

Near-end assembly 1, comprise outer cup 11, liner 12 and lock ring 13, liner 12 is fitted in the top of outer cup 11 inner chamber; Outer cup 11 is for being made into integration and the semicircle chondritic of bottom opening with the biomedical material such as biocompatible titanium-base alloy (Ti-6Al-4V) or vitallium (Co-Cr-Mo), its outer surface scribbles hydroxyl apatite biological painting, the bottom of its inner surface has a ring-type locked groove 14 at opening part, and lock ring 13 is set in ring-type locked groove 14; Liner 12, lock ring 13 are made by high crosslinked polyethylene;

Distal component 2, it radius handle 22 comprising connection handle 21 and be connected with connection handle 21; Connection handle 21 to rub the cone column structure of this taper face for possessing standard; Radius handle 22 is cylindrical-shaped structure, and its surface scribbles hydroxyl apatite biological painting, and its diameter and skeleton diameter match;

Rotating ballhead 3, make by with biomedical materials such as biocompatible titanium-base alloy (Ti-6Al-4V) or vitalliums (Co-Cr-Mo), the hole slot 31 mated with connection handle 21 is provided with below it, rotating ballhead 3 embeds in liner 12, and the end of rotating ballhead 3 is along being locked by lock ring 13.

Rub this taper face, also known as Morse's taper face, transliteration, from Morse, is the territory, face with Morse's taper, sets forth in wikipedia: Morse's taper is the international standard about tapering in machined, is mainly used in the precision of rotary body in machinery and fixes.The endoporus of Morse's taper bar mating band tapering, utilizes frictional force to carry out transmitting torque.Be generally increasing carry-over moment, often add tang.Because its dismounting is easy, repeated removal can not affect precision, applies very extensive in machining.

The semicircle chondritic of outer cup 11 coordinates the geometry of ulna and radius pulp cavity to design, and to obtain uniform stress distribution, its outer surface scribbles hydroxyl apatite biological painting, is beneficial to Bone Ingrowth and reaches long-term fixing effect.Connection handle 21, the cylindrical-shaped structure radius handle 22 of cone column structure, make distal component 2 insert rear stress distribution average, and avoid the shortcoming that stress is concentrated, radius handle 22 can arrange different diameters to be applicable to the skeleton of different-diameter; Outer cup 11 space between lock ring 13 and liner 12 is just the volume of rotating ballhead 3, rotating ballhead 3 to embed in liner 12 and is locked by lock ring 13 and ring-type locked groove 14, the setting of lock ring 13 pulls power downwards in order to what resist that elbow joint bears, makes rotating ballhead 3 rotate freely in liner 12 and can not deviate from simultaneously; Liner 12 can make the wear extent of rotating ballhead 3 reduce.

The outer surface of outer cup 11 is Surface of Sphere and scribbles hydroxyl apatite biological painting; Outer cup 11 inner surface top is divided into smooth ball minute surface, it is equidistantly distributed with four screw fixed holes 113; The bottom of outer cup 11 inner surface is divided into flat cylindrical face, and the upper limb of the ring-type holding section of ring-type locked groove 14 is inclined-plane 111, lower edge is plane 112.

Liner 12 is positioned at outer cup 11 smooth ball minute surface place, and the internal diameter of its external diameter and outer cup 11 matches.After rotating ballhead 3 embeds liner 12, between smooth ball minute surface, liner 12 and rotating ballhead 3, produce atomic little friction, in convenient operation or proper motion, obtain optimum assembling position.

Lock ring 13 is bonded in outer cup 11 flat cylindrical face, and its outer surface is provided with an annular projection 131, when annular projection annular projection is fastened on after in ring-type locked groove 14, and the bottom of the bottom interior surface of the outer ring laminating outer cup 11 of lock ring 13; The sidewall of lock ring 13 offers a breach 132, and breach 132 runs through one section of sidewall, upper surface and lower surface of lock ring 13.The setting of breach 132, makes lock ring issue raw appropriate deformation in external force, and reduced, to enter outer cup 11, completes and has shape with restoring next time at elastic reaction after the mating of locked groove.

The inner face of lock ring 13 is provided with one for withstanding and the flange 133 on clamping rotating ballhead 3 times edges, the first inclined plane 151 is formed between the end face of flange 133 and lock ring 13, the opening part of the second inclined plane 15, second inclined plane 15 towards outer cup 11 is formed between the bottom surface of flange 133 and lock ring 13.The setting of the second inclined plane 15 can be convenient to import rotating ballhead 3; Flange 133 can be blocked after rotating ballhead 3 times edges slide into the inner chamber of outer cup 11, makes it the inner chamber that can not depart from outer cup 11 easily; First inclined plane 151 is fitted with rotating ballhead 3, rotates at inner chamber for it.

The cone column structure surface of connection handle 21 is provided with the micro-screw thread be equally spaced.Micro-screw thread coordinates tighter with the hole slot 31 of rotating ballhead 3, there is not relative motion after making it coupling.

The proximal end face of radius handle 22 is coated with pearl knot curved surface 25, and its far-end is smooth, spherical curved surface, with the connection handle 21 intersection outstanding neck portion 24 formed for covering radius cortex of annular towards periphery; The smooth, spherical curved surface of radius handle 22 is provided with two fixing screw holes 23.The proximal end face of radius handle 22 is coated with pearl knot curved surface 25, is beneficial to hyperosteogeny in wherein and improve the fixing strength of Using prosthesis; The structure of radius is similar annular, skin is cortical bone, internal layer is spongy bone, spongy bone conveying compressive resistance is poor, cortical bone could stop the sinking of prosthese, therefore, radius handle 22 is that in conjunction with its later Bone Ingrowth of relief, annular projection forms neck portion 24 in order to a spongy bone, and the neck portion 24 of annular projection is to expand to surrounding to cover cortical bone.

Neck portion 24 is provided with mark line 241, and mark line 241 aims at the center of circle of described fixing screw hole 23.The setting of mark line 241, conveniently observes and carries out holing and being screwed into screw after radius handle 22 inserts pulp cavity.

Hole slot 31 is for having the hole slot 31 of the cone-shaped of this tapering that rubs, and its tapering is identical with micro-screw thread on connection handle 21.

For the patient suffering from the fusion of congenital proximal radioulnar joint, intend adopting surgical orthopaedic therapy.After successively cutting skin, subcutaneous tissue in art, in stealth separating muscle gap, expose radius near-end.

Brachioradialis and supinator between the attachment point of radius, 0.5-0.8cm under radial tuberosity, thus prevent from brachioradialis from lifting forward radius causing radial nerve injury; Note retaining capitulum radii to avoid the impact of infant elbow joint growth and the stable of elbow joint.

At proximal measurement pulp cavity diameter after radius osteotomy, and carry out pulp cavity shaping with the spherical file of respective diameters, subsequently outer cup 11 is implanted in proximal medullary cavity, suppress closely, screw in 4 hold-down screws.

Corresponding radius handle 22 is selected according to pulp cavity diameter, to implant in far-end pulp cavity and to suppress closely, make the projection between radius handle 22 and rotating ballhead 3 be close to radius cortex, under the guiding of C-arm, determine the projected position of radius handle 22 fixing screw hole 23 on radius, after boring, be screwed into hold-down screw.

In outer cup 11, insert liner 12 and the rotating ballhead 3 of respective model, insert draw-in groove subsequently, the snap ring in itself and outer cup 11 is matched.Connection handle 21 on radius handle 22 to be inserted in hole slot bottom rotating ballhead 3 31 and suitably pressurization is stable.

Wrap up the radius broken ends of fractured bone far away with band base of a fruit deep fascial flap after checking forearm spinfunction, prevent bone from healing again.Successively close otch subsequently.

Operation principle of the present utility model is the pathological change merged according to congenital proximal radioulnar joint.In the pathological change that congenital proximal radioulnar joint merges, the most importantly Bony union of ulna and radius upper end, makes radius cannot rotate centered by ulna, difficulty rear with choosing before there is the choosing of forearm.Therefore the purpose of design of this prosthese is, bone between ulna and radius is connected after being separated, radius is interrupted between supinator radius stop and annular ligament of radius, distal component 2 is inserted distal bone section, again rotating ballhead 3 is mated with distal component 2, and with lock ring 13, rotating ballhead 3 is fixed in outer cup 11 and liner 12, finally near-end assembly 1 is fixed on near-end bone section.By artificial constructed rotation prosthese, the center of rotation of ulnar-radial is moved on prosthese, thus rebuild forearm function; Simultaneously owing to remaining capitulum radii, therefore do not destroy elbow joint structure, decrease the risk of elbow joint degeneration.

Above-listed detailed description is illustrating for this utility model possible embodiments, and this embodiment is also not used to limit the scope of the claims of the present utility model, does not allly depart from the equivalence that this utility model does and implements or change, and all should be contained in the scope of the claims of this case.

Claims (9)

1. proximal radioulnar joint merges orthopaedic prosthesis, it is characterized in that: comprise,

Near-end assembly (1), comprise outer cup (11), liner (12) and lock ring (13), liner (12) is fitted in the top of outer cup (11) inner chamber; The semicircle chondritic that outer cup (11) is bottom opening, the bottom of its inner surface has a ring-type locked groove (14) at opening part, and lock ring (13) is set in ring-type locked groove (14);

Distal component (2), it radius handle (22) comprising connection handle (21) and be connected with connection handle (21); Connection handle (21) to rub the cone column structure of this taper face for possessing standard; Radius handle (22) is cylindrical-shaped structure, and its diameter and skeleton diameter match;

Rotating ballhead (3) below is provided with the hole slot (31) mated with connection handle (21), rotating ballhead (3) embeds in described liner (12), and the end of rotating ballhead (3) is along being locked by described lock ring (13).

2. proximal radioulnar joint according to claim 1 merges orthopaedic prosthesis, it is characterized in that: the outer surface of described outer cup (11) is Surface of Sphere; Outer cup (11) inner surface top is divided into smooth ball minute surface, it is equidistantly distributed with screw fixed hole (113); The bottom of outer cup (11) inner surface is divided into flat cylindrical face, and the upper limb of the ring-type holding section of ring-type locked groove (14) is inclined-plane (111), lower edge is plane (112).

3. proximal radioulnar joint according to claim 1 merges orthopaedic prosthesis, it is characterized in that: described liner (12) is positioned at outer cup (11) smooth ball minute surface place, and the internal diameter of its external diameter and outer cup (11) matches.

4. proximal radioulnar joint according to claim 2 merges orthopaedic prosthesis, it is characterized in that: described lock ring (13) is bonded in outer cup (11) flat cylindrical face, its outer surface is provided with an annular projection (131), when annular projection (131) is fastened on after in described ring-type locked groove (14), the bottom of outer ring laminating outer cup (11) inner surface of lock ring (13); The sidewall of described lock ring (13) offers a breach (132), and breach (132) runs through one section of sidewall, upper surface and lower surface of lock ring (13).

5. proximal radioulnar joint according to claim 4 merges orthopaedic prosthesis, it is characterized in that: the inner face of described lock ring (13) is provided with one for withstanding and the flange (133) on edge under rotating ballhead (3) described in clamping, the first inclined plane (151) is formed between the end face of flange (133) and lock ring (13), form the second inclined plane (15) between the bottom surface of flange (133) and lock ring (13), the second inclined plane (15) is towards the opening part of outer cup (11).

6. proximal radioulnar joint according to claim 1 merges orthopaedic prosthesis, it is characterized in that: the cone column structure surface of described connection handle (21) is provided with the micro-screw thread be equally spaced.

7. proximal radioulnar joint according to claim 1 merges orthopaedic prosthesis, it is characterized in that: the proximal end face of described radius handle (22) is coated with pearl knot curved surface (25), its far-end is smooth, spherical curved surface, with connection handle (21) the intersection outstanding neck portion (24) formed for covering radius cortex of annular towards periphery; The smooth, spherical curved surface of radius handle (22) is provided with fixing screw hole (23).

8. proximal radioulnar joint according to claim 7 merges orthopaedic prosthesis, it is characterized in that: described neck portion (24) is provided with mark line (241), and mark line (241) aims at the center of circle of described fixing screw hole (23).

9. proximal radioulnar joint according to claim 1 merges orthopaedic prosthesis, it is characterized in that: described hole slot (31) is for having the hole slot (31) of the cone-shaped of this tapering that rubs, and its tapering is identical with the upper micro-screw thread of connection handle (21).