CN205411291U - Be used for damaged bone handling device of big section bone of fine and close patient's upper arm bone of sclerotin - Google Patents
Be used for damaged bone handling device of big section bone of fine and close patient's upper arm bone of sclerotin Download PDFInfo
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- CN205411291U CN205411291U CN201521035916.7U CN201521035916U CN205411291U CN 205411291 U CN205411291 U CN 205411291U CN 201521035916 U CN201521035916 U CN 201521035916U CN 205411291 U CN205411291 U CN 205411291U
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Abstract
The utility model discloses a be used for damaged bone handling device of big section bone of fine and close patient's upper arm bone of sclerotin, squeeze into the interior main nail of marrow of sclerotin including being used for the axial, main nail has the identical range with human upper arm bone anatomical structure in the marrow, and both ends are opened to have and are used for locking the hole with ordinary set screw complex, its near -end still be provided with into the tool bore and with go into tool bore complex screw blade, the main both ends of following closely are opened and are had fixed screw in the marrow, still include a fixed bolster and a plurality of set screw, the set screw rear end is connected with the fixed bolster, and the front end is connected with the fixed screw cooperation on the interior main nail of marrow, still include and a plurality ofly can follow the main transport needle of following closely axial motion in the marrow, the bone piece and the interior main nail of no show marrow that need slide is radially implanted to transport needle one end, and the other end is connected on the fixed bolster.
Description
Technical field
This utility model relates to a kind of device using bone carrying art treatment long bone large segmental bone defect, a kind of device applying to the comparatively dense patient's humerus large segmental bone defect of sclerotin.
Background technology
Long bone large segmental bone defect be phalangeal fracture can not self-heal or be only capable of regenerating 10% Cranial defect, generally involve long bone diameter 2-3 times.Large segmental bone defect is generally caused by reasons such as High energy trauma, infection, tumors, is often accompanied by limb shortening, deformity, osteomyelitis, amyotrophy and adjacent joints stiff, one of its repairing and treating the biggest problem being always field of orthopaedics.Showing according to statistics, in Germany, bone collection operation is that patient the most often accepts one of front 50 kinds of treatments;Patient about 800,000 example of bone collection operation need to be carried out every year in the U.S.;The operation of row bone collection is needed just to exceed 3,000,000 examples at China's list every year because of wound;Large segmental bone defect gives patient and brings the injury of huge body and mind and financial burden, and the most how solving this difficult problem has become the important topic of field of orthopaedics.
The main method of clinical treatment long bone large segmental bone defect has autologous bone transplanting, Masquelet technology and Ilizarov technology at present.Autologous bone transplanting has optimal bone conduction, self-bone grafting and osteogenesis effect, is the standard for the treatment of Cranial defect.But autologous bone amount is limited, bone strength is not good enough, it is difficult to meet the demand of large segmental bone defect.Although the bone collection of anastomosis of blood vessel (such as fibula, ilium, rib etc.) is also the effective ways for the treatment of large segmental bone defect, but this operation wound is big, many for district's complication, bone graft completes moulding and to increase the thick time long, and patient can not early loading, easily there is stress fracture, amyotrophy etc. in the later stage.Additionally, this technological learning curve is long, patient is required of a relatively high, it is impossible to be widely used in clinic, be not the most the main stream approach for the treatment of large segmental bone defect.The treatment appearing as large segmental bone defect of Masquelet technology provides a kind of new way.This technology is the autologous bone transplanting treatment Segmental Bone Defect utilizing film to assist.This technology is specifically divided into two stages.First stage: implant PMMA bone cement spacer after thoroughly clear, use interior fixing or extenal fixation to be fixed, close wound surface, form induction film.Second stage: cut induction film after 6-8w, remove bone cement spacer, get through pulp cavity, fills autologous spongiosa bone, then Guan Bi induction film and otch in film.This induction film not only has to be avoided bone graft absorption, maintenance bone graft position and stops the effects such as soft tissue intrusion, and can secrete somatomedin and bone-inducing factor promotion bone tissue growth, such as [12] such as blood vessel endothelial factor, TGF-β 1, BMP-2.Although multinomial clinical research proves that Masquelet technology treatment Cranial defect can obtain certain clinical effectiveness, but there is also the biggest limitation.The defect of this technology maximum needs substantial amounts of autologous bone transplanting during being repairing bone defect, adds operation wound and for district's complication;And this technology can not effectively correct limb shortening and the line of force, also need to combine micro-flap technology if merging large area skin soft tissue defects.Additionally, patient can not take exercise by early loading after surgery, the complication such as stress fracture, bone resorption and bone does not connect easily occur, and the method need to carry out twice even Repeated Operation, length of patient stay's length, spend high.
The appearance of bone carrying technology is considered as 20th century orthopaedic milestones, and a New Times has been started in the treatment for Cranial defect.Bone carrying technology is to be created by Russia orthopedist Ilizarov, it then follows the tension force of tissue regeneration-stress rule, meets " bone Natural Reconstruction " theory, is the goldstandard of current clinical treatment long bone large segmental bone defect.The core of bone carrying technology is the distraction osteogenesis of Ilizarov support, is specifically divided into three steps: 1. use Ilizarov support to fix suffering limb, it is provided that stability, maintenance limbs length and the line of force;2. the metaphysis of pair close Cranial defect carries out low-yield cortex osteotomy;3. regulation Ilizarov support by active bone section according to suitable speed with frequency to Cranial defect stump sliding, draw close, and Ilizarov support fix under complete bone defect healing.Compared with autologous bone transplanting art and Masquelet technology, bone carrying technology has the advantage that 1) repairing bone defect length is unrestricted, it is not necessary to autologous bone transplanting, it is to avoid autologous bone transplanting and the defect of Masquelet technology " with repair in trauma wound ";2) this technology can stretching same period soft tissue regeneration, be not required to use skin flap transplantation repair skin tissue defects;3) cacomelia of various complexity can be corrected the same period by support arm.4) belonging to Minimally Invasive Surgery, curative effect is reliable, low cost.
Though the various complicated Cranial defect determined curative effect of bone carrying technology treatment, there is also more complication, and these complication are closely related with the use of Ilizarov support.The Ilizarov support being currently used for bone carrying technology is mainly ring type exterior fixation bracket and single pole exterior fixation bracket.Ring type exterior fixation bracket is three dimensions configuration, and fixed, stress distribution is uniform.This support needs to squeeze into several pieces of draw points on the two ends metaphysis and sliding bone piece of long bone, to provide stable, to maintain limbs length and the effect of the line of force.But wear many draw points in many planes and sclerotin can be caused to cut, reduce local bone intensity, may result in iatrogenic fracture;And when many planes penetrate draw point to operating technology require height, damage severely injured want neurovascular risk.The Ilizarov support fixed cycle is long, clinical care difficulty, therefore pin site infection, needle track loosen, fracture and Soft tissue cutting complication often occur.And some patients toleration is poor, the psychic problems such as anxiety, depression be the most bigoted easily occur, also some patients is had to be likely to occur the complication such as disuse osteoporosis, refracture, bone delay in healing not even healing because of the lower ground weight training of the sense of discomfort such as limbs pain, swelling refusal, later stage.Single pole exterior fixation bracket has simple to operate, easy to carry, pin site infection is few and the advantage such as patient's easily tolerance, is suitable for the Cranial defect that length is less.But single pole exterior fixation bracket mechanical stability is poor, it is impossible to adjust the line of force, suffering limb can not early loading, the later stage may occur in which the complication such as bad, disuse osteoporosis, refracture, the bone delay in healing not even healing of the line of force.
Utility model content
For the technical problem of above-mentioned existence, this utility model provides one for eburnation patient's humerus large segmental bone defect bone Handling device, and sclerotin inserting needle is few, good stability.
In order to solve above-mentioned technical problem, the technical solution adopted in the utility model is: a kind of for eburnation patient's humerus large segmental bone defect bone Handling device, including nail main in the marrow for axially squeezing into sclerotin, in described marrow, main nail has the amplitude matched with human body humerus anatomical structure, and two ends have for the lock hole with common fixing screw fit;Its near-end be additionally provided with into tool bore and with enter the screw blade that tool bore coordinates;In described marrow, main nail two ends have fixing threaded hole;Also include a fixed support and some fixing screws;Described fixing screw rear end is connected with fixed support, and the main fixing threaded hole nailed on is connected with in marrow in front end;Also include some can along marrow the carrying pin of main nail axially-movable, described carrying pin one end radially implants main nail in needing the bone piece of sliding and not arriving marrow, and the other end is connected on fixed support.
Improving as one, described fixed mount is syllogic, including two save the canned paragraph to be connected with fixing screw and middle for carry the carrying section that pin is connected;It is connected by universal joint between described canned paragraph with carrying section.Owing to the outside anatomical structure of bone is slightly different, the support of existing straight rod-shaped coordinates bad with it.Fixed support is set to syllogic, is connected by universal joint between section with section, so can adjust the radian of fixed mount to adapt to by universal joint.
Improve as one, described canned paragraph has the hole passed through for fixing screw;Described hole is run through in fixing screw rear end, and is fastened by bolt.First by fixing screw through the hole on canned paragraph, the main fixing threaded hole nailed in then inserting needle screws in marrow, last screwing bolts fastens.Its good stability, convenient regulation.Certainly also there is other connection fastening means, such as directly on canned paragraph, offer screw, first fixing screw is screwed in the when of use the screw on canned paragraph, the then main fixing threaded hole nailed in screwing in marrow.Fixing screw two ends are all threaded, the effect of main nail in both having served fixing marrow, itself lock with fixed support again, and it has arrived the effect of locking.
Improving as one, described carrying section is nested by some joint sleeves and forms;It is provided with the elongated hole that position is corresponding on adjacent sleeve, and utilizes the bolt running through elongated hole to fix.Human body long bone length is different, and between Different Individual, the length of identical skeleton also differs, and the carrying section on fixed support is set to adjustable in length, it is adaptable to the long bone of different length so that whole device wide adaptability.
Further improve as one, described sleeve is provided with scale.Indicate length sleeve, be conducive to accurately regulation.
Improving as one, also include a needle stand that can slide up and down along fixed support, described carrying pin is fixed on needle stand.The bone piece needing carrying is implanted in carrying pin front end, and its rear end is fixed on needle stand.When needs carrying bone piece, regulate needle stand position on fixed support.
Improve further as one, described fixed support has the scale indicating needle stand displacement.It is easy to accurately regulate the position of needle stand, the distance of bone piece carrying can be recorded again.
Improving as one, described fixed support is axially arranged tooth bar, is provided with the gear coordinated with tooth bar in described needle stand;Needle stand is outside equipped with the regulation bolt that driven gear rotates.In axially having squeezed into marrow due to long bone, main nail is fixed, and the power needed for bone piece to be carried is relatively big, is difficult to move.Utilize rack-and-pinion to coordinate, only need to rotate regulation bolt, needle stand just can be made along fixed support axially-movable, drive carrying pin carrying bone piece simultaneously.
Preferred as one, in described marrow, main nail two ends have for the lock hole with common fixing screw fit.Lock hole is often held and is preferably provided two, and is arranged on outside fixing threaded hole.After bone has been carried, it is possible to unload fixed support, by commonly fixing main nail in marrow fixed by screw, reduce patient's burden.
Preferred as one, in described marrow, main nail two ends are each provided with two fixing screws;Described carrying pin is two.Two ends respectively arrange two fixing screws so that whole system is more firm.In like manner, two carrying pins also can guarantee that stability when bone is carried.And if use many pieces of draw points fix same bone plane can cause local sclerotin cutting, reduce local sclerotin intensity, have iatrogenic risk of bone fracture, and metaphysis neural blood vessel be more, easily damage during operation.
Of the present utility model have the beneficial effect that 1. devices omnidistance can maintain the key line of force and length, it is to avoid bone handling process occurs the line of force is bad, shortened deformity and lateral displacement;2. this device is fixing reliable, is feasible exercise of joint function and lower ground loaded exercise, reduces disuse osteoporosis, ankylosis agent postoperative refracture incidence rate after operation in patients;3. the draw point quantity that this device is implanted is few, decreases pin site infection, iatrogenic fracture and Soft tissue cutting incidence rate;4. this device operating technology is relatively easy, and learning curve is short, is suitable for situation of all-level hospitals popularity and carries out;5. this device is light, and clinical care is convenient, and does not affect patient's daily life, and patient compliance is good, reduces the mental symptom such as patient anxiety, depression;6. carrying pin is unrestricted, can be made comparison sturdy, increase its intensity.
Accompanying drawing explanation
Fig. 1 is structural representation of the present utility model.
Fig. 2 is main pin structure schematic diagram in marrow.
Labelling in figure: main nail in 1 marrow, 11 fixing threaded holes, 13 lock holes, 14 enter tool bore, 15 screw blades, 2 fix screw, 3 carrying pins, 4 fixed supports, 41 canned paragraphs, 42 carrying sections, 43 bolts, 44 elongated holes, 45 regulation bolt, 46 needle stands, 47 universal joints.
Detailed description of the invention
Below in conjunction with the accompanying drawings, this utility model is described in detail.
In order to make the purpose of this utility model, technical scheme and advantage clearer, below in conjunction with drawings and Examples, this utility model is further elaborated.Should be appreciated that specific embodiment described herein, only in order to explain this utility model, is not used to limit this utility model.
As shown in Figure 1 and Figure 2, this utility model is main nail 1 in including the marrow for axially squeezing into sclerotin, and in described marrow, main nail 1 has the amplitude matched with human body humerus anatomical structure, and two ends have for the lock hole 13 with common fixing screw fit;Its near-end be additionally provided with into tool bore 14 and with enter the screw blade 15 that cutter 14 hole coordinates.In described marrow, main nail 1 two ends have fixing threaded hole 11;Also include a fixed support 4 and some fixing screws 2;Described fixing screw 2 rear end is connected with fixed support 4, and the fixing threaded hole 11 on main nail 1 is connected with in marrow in front end;Also include some can along marrow the carrying pin 3 of main nail 1 axially-movable, described carrying pin 3 one end radially implants main nail in needing the bone piece of sliding and not arriving marrow, and the other end is connected on fixed support 4.In marrow, main nail 1 two ends are each provided with two fixing screws 2;Described carrying pin 3 is two.
Fixed support 4 is syllogic, saves the canned paragraph 41 to be connected with fixing screw 2 including two and middle for the carrying section 42 being connected with carrying pin 3;Connect 47 by universal joint between described canned paragraph 41 and carrying section 42 to connect.The hole passed through for fixing screw 2 is had on canned paragraph 42;Described hole is run through in fixing screw rear end, and is fastened by bolt.Carrying section 42 is nested by some joint sleeves and forms;It is provided with elongated hole corresponding to position 44 on adjacent sleeve, and utilizes the bolt 43 running through elongated hole 44 to fix.Scale it is provided with on sleeve.Indicate length sleeve, be conducive to accurately regulation.
Including a needle stand 46 that can slide up and down along fixed support 4, described carrying pin 3 is fixed on needle stand 46.Described fixed support 4 is axially arranged tooth bar, is provided with, in described needle stand 46, the gear coordinated with tooth bar;Needle stand 46 is outside equipped with the regulation bolt 45 that driven gear rotates.There is on described fixed support 4 scale indicating needle stand 46 displacement.It is easy to accurately regulate the position of needle stand 46, the distance of bone piece carrying can be recorded again.
In marrow, main nail 1 two ends have for the lock hole 13 with common fixing screw fit.Lock 13 holes often to hold and be preferably provided two, and be arranged on outside fixing threaded hole 11.
Use step is as follows: 1. implant in advance in marrow main nail 1 and locked, and recovers key length, the line of force;
2. mounting and fixing bracket 4, first by fixing screw 2 through the hole on canned paragraph 41, the fixing threaded hole 11 on main nail 1 in then inserting needle screws in marrow, last screwing bolts fastens.
3., in metaphysis target site osteotomy, then carrying pin 3 is implanted through carrying elongated hole 12 and need in sliding bone piece;
4. by rotating the needle stand 46 drive carrying pin 3 sliding sclerite on regulation bolt 45 sliding fixed support 4, precise flow is carried out according to fixed support high scale, until sliding onto docking site, finally take out fixed support 4, in marrow main nail 1 retains always to fracture heal completely.
The foregoing is only preferred embodiment of the present utility model, not in order to limit this utility model, all any amendment, equivalent and improvement etc. made within spirit of the present utility model and principle, within should be included in protection domain of the present utility model.
Claims (10)
1. one kind is used for eburnation patient's humerus large segmental bone defect bone Handling device, including nail main in the marrow for axially squeezing into sclerotin, in described marrow, main nail has the amplitude matched with human body humerus anatomical structure, and two ends have for the lock hole with common fixing screw fit;Its near-end be additionally provided with into tool bore and with enter the screw blade that tool bore coordinates;It is characterized in that: in described marrow, main nail two ends have fixing threaded hole;Also include a fixed support and some fixing screws;Described fixing screw rear end is connected with fixed support, and the main fixing threaded hole nailed on is connected with in marrow in front end;Also include some can along marrow the carrying pin of main nail axially-movable, described carrying pin one end radially implants main nail in needing the bone piece of sliding and not arriving marrow, and the other end is connected on fixed support.
One the most according to claim 1 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterized in that: described fixed mount is syllogic, save the canned paragraph to be connected with fixing screw including two and middle for the carrying section being connected with carrying pin;It is connected by universal joint between described canned paragraph with carrying section.
One the most according to claim 2 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: have the hole passed through for fixing screw on described canned paragraph;Described hole is run through in fixing screw rear end, and is fastened by bolt.
One the most according to claim 2 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: described carrying section is nested by some joint sleeves and forms;It is provided with the elongated hole that position is corresponding on adjacent sleeve, and utilizes the bolt running through elongated hole to fix.
One the most according to claim 4 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: it is provided with scale on described sleeve.
One the most according to claim 1 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: also including a needle stand that can slide up and down along fixed support, described carrying pin is fixed on needle stand.
One the most according to claim 6 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: there is on described fixed support the scale indicating needle stand displacement.
One the most according to claim 6 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: described fixed support is axially arranged tooth bar, is provided with the gear coordinated with tooth bar in described needle stand;Needle stand is outside equipped with the regulation bolt that driven gear rotates.
One the most according to claim 1 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: in described marrow, main nail two ends have for the lock hole with common fixing screw fit.
One the most according to claim 1 is used for eburnation patient's humerus large segmental bone defect bone Handling device, it is characterised in that: in described marrow, main nail two ends are each provided with two fixing screws;Described carrying pin is two.
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN108606828A (en) * | 2016-12-13 | 2018-10-02 | 常州奥斯迈医疗器械有限公司 | It is carried for bone, the marrow combination of inner and outside device of Limb lengthening |
CN109157276A (en) * | 2018-09-26 | 2019-01-08 | 深圳市龙华区中心医院 | It is a kind of to digitize controllable constant force bone Filtting device |
-
2015
- 2015-12-14 CN CN201521035916.7U patent/CN205411291U/en not_active Expired - Fee Related
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN108606828A (en) * | 2016-12-13 | 2018-10-02 | 常州奥斯迈医疗器械有限公司 | It is carried for bone, the marrow combination of inner and outside device of Limb lengthening |
CN109157276A (en) * | 2018-09-26 | 2019-01-08 | 深圳市龙华区中心医院 | It is a kind of to digitize controllable constant force bone Filtting device |
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