CN212415998U

CN212415998U - Assembled tumor type artificial elbow joint prosthesis

Info

Publication number: CN212415998U
Application number: CN202020798756.6U
Authority: CN
Inventors: 郭卫
Original assignee: Peking University Peoples Hospital
Current assignee: Peking University; Peking University Peoples Hospital
Priority date: 2020-05-14
Filing date: 2020-05-14
Publication date: 2021-01-29
Anticipated expiration: 2030-05-14

Abstract

The utility model relates to a combined tumor type artificial elbow joint prosthesis, which comprises a distal humerus prosthesis and a proximal ulna prosthesis; the distal humeral prosthesis comprises: the humerus distal basic section is provided with a first suture hole on the external epicondyle and the internal epicondyle; a humeral taper segment, a first end of which tapers onto the distal humeral base segment; a humerus medullary needle, the first end of which is in taper joint with the second end of the humerus taper joint section; the ulnar proximal prosthesis comprises: the proximal ulna basic section is used for being articulated with the distal humerus basic section, and the proximal ulna basic section is provided with a second suture hole; an ulna tapered section, a first end of which is tapered on the ulna proximal end basic section; the first end of the ulna intramedullary pin is in taper joint with the second end of the ulna taper joint section. The utility model discloses can wide application in bone defect reconstruction that limbs continuity was interrupted after the excision of malignant tumor around elbow joints such as upper arm bone distal end or ulna near-end, realize the limb structure and resume the purpose, realize the perfect adaptation of elbow joint stable at once and stress reduction advantage simultaneously to make patient's long-term elbow joint function obtain showing and improve.

Description

Assembled tumor type artificial elbow joint prosthesis

Technical Field

The utility model relates to an artificial joint, in particular to a matched stack type artificial elbow joint prosthesis which can freely adjust the length of the distal defect section of humerus and/or the proximal defect section of ulna and is convenient for the attachment of soft tissues such as ligaments and the like with the consistent elbow joint shape of a patient.

Background

Elbow bone tumors account for approximately 1% of the incidence of systemic bone tumors. With the development of chemoradiotherapy technology, it becomes possible to locally remove tumor and retain upper limbs. However, due to the dense anatomy of the elbow, which is important, the partial resection may result in instability and loss of function of the wrist joint. After the resection of the tumor around the elbow joint, the elbow joint needs to be reconstructed to ensure the stable function of the elbow joint, and a few reconstruction methods can be selected. For small bone defects, arthrodesis or resection is often chosen, but arthrodesis results in limited elbow joint motion after surgery, while resection results in joint instability after surgery. For larger defects, allogenic elbow joint transplantation can be used, but the incidence of postoperative complications can be as high as 70%, and infection, joint instability and elbow joint dislocation can occur. Despite firm internal fixation, the chance of postoperative bone nonunion is still high, about 15%. Additional patients may develop allograft bone resorption.

Therefore, there is currently no better method for functional reconstruction after resection of a tumor around the elbow joint than artificial elbow joint replacement. In the past, total elbow replacement was usually selected for prosthetic reconstruction after resection of the tumor surrounding the elbow joint. The prior literature reports 18 patients with artificial elbow joint replacement of the humeral distal tumor type, and the complications comprise 3 cases of aseptic loosening, 2 cases of infection, 1 case of radial nerve injury and 1 case of periprosthetic fracture. I report 18 cases of reconstructing elbow joint function by artificial total elbow joint replacement after elbow joint peripheral tumor resection, the postoperative early complications are few, the loosening incidence rate is only l cases, the prosthesis stem penetrates out of cortical bone for 2 cases, and the cases of prosthesis stem fracture and prosthesis infection are not found.

The problems with the full elbow prosthesis are also apparent. As the ulna medullary cavity is thin and has a bending radian, the full elbow joint prosthesis is easy to mechanically loosen in the long term, so that the reconstruction of the elbow joint fails after the tumor is resected. Clinical experience has shown that the problem of stress concentration in the humeral or ulnar broach after reconstruction of the full elbow joint is often the main cause of reconstruction failure. Because the half elbow joint prosthesis does not have the hinge-like design like a full elbow joint prosthesis, the mechanical stress borne by the ulna or humerus side intramedullary nail of the prosthesis is obviously reduced, so that the incidence rate of long-term mechanical failure of the half elbow joint prosthesis is obviously reduced.

SUMMERY OF THE UTILITY MODEL

In view of the above problems, the present invention is to provide a combined artificial elbow joint prosthesis, which can freely adjust the length of the distal defect segment of humerus and/or the proximal defect segment of ulna, and is convenient for the attachment of soft tissues such as ligament and the like with the same shape of the elbow joint of a patient.

In order to achieve the purpose, the utility model adopts the following technical proposal: a matched stack type tumor type artificial elbow joint prosthesis comprises a humerus far-end prosthesis and an ulna near-end prosthesis;

wherein the distal humerus prosthesis comprises: the humerus distal basic segment is characterized in that a plurality of first suture holes used for reconstructing soft tissues around an elbow joint around the humerus distal basic segment or suturing artificial ligaments around the humerus distal basic segment are formed in the external epicondyle and the internal epicondyle of the humerus distal basic segment; a humeral tapered section, a first end of which tapers onto the distal humeral base section; a first end of the humerus medullary needle is in conical connection with a second end of the humerus conical connection section, and the second end of the humerus medullary needle is used for being inserted into a humerus medullary cavity and fixed with the humerus medullary needle;

the ulnar proximal prosthesis comprises: the proximal ulna basic segment is used for articulating with the distal humerus basic segment to form a humeral ulna joint, and a plurality of second suture holes for reconstructing soft tissues around the elbow joint around the proximal ulna basic segment or suturing artificial ligaments around the proximal ulna basic segment are formed in the proximal ulna basic segment except for an ulna pulley incisura track; an ulnar awl section, a first end of the ulnar awl section being awl connected to the ulnar proximal base section; the first end of the ulna intramedullary nail is in taper joint with the second end of the ulna taper joint section, and the second end of the ulna intramedullary nail is used for being inserted into and fixed with the ulna medullary cavity.

The assembled tumor type artificial elbow joint prosthesis preferably has the length of the humeral conical joint section which can be freely adjusted according to the length of the humeral defect of a patient.

Preferably, the length of the ulna conical joint section can be freely adjusted according to the ulna defect length of the patient.

Preferably, the distal humerus basic segment and the proximal ulna basic segment are prostheses which are customized by a 3D printing technology and have the same shapes as the distal humerus defect segment and the proximal ulna defect segment of the patient.

The assembled tumor type artificial elbow joint prosthesis is preferably characterized in that the humeral broach and the ulnar broach are designed into two types of broach, namely a biological broach and a cement broach.

The assembled tumor type artificial elbow joint prosthesis is preferably designed to be a thick thread type ulna intramedullary nail.

The utility model discloses owing to take above technical scheme, it has following advantage: 1. the utility model discloses can rebuild the elbow joint and bend and stretch the function, resume limbs normal length, provide the condition for the mechanics conduction that upper limbs tumour section was normal after amputated. 2. The utility model discloses a matched stack formula design can freely adjust elbow joint main part length according to patient's upper arm bone distal end and ulna near-end tumor section excision scope, the defective condition of skin and soft tissue tension to the defective length of upper arm bone distal end and ulna near-end is rebuild to the individuation. 3. The utility model discloses a 3D printing technique customization is with the identical false body of patient's upper arm bone distal end or the defective section shape of ulna near-end, more accords with the normal physiological characteristics of patient, is convenient for resume normal joint activity and function. 4. The utility model discloses a with ligament structure reconstruction around the elbow joint in the prosthesis suture hole or through artifical ligament reconstruction around the prosthesis, realize the reconstruction of elbow joint stability, avoid the problem of the humerus side or the ulna side broach stress concentration that all elbow joint hinge type design caused in the past to reduce the not hard up incidence of and mechanical failure of elbow joint.

Drawings

Fig. 1 is a schematic perspective view of a distal humerus prosthesis according to the present invention;

fig. 2 is a front view of the distal humerus prosthesis of the present invention;

FIG. 3 is a schematic perspective view of the ulna proximal prosthesis of the present invention;

fig. 4 is a side view of the ulnar proximal prosthesis of the present invention.

Detailed Description

The preferred embodiments of the present invention will be described in detail below with reference to the accompanying drawings so that the objects, features and advantages of the invention can be more clearly understood. It should be understood that the embodiments shown in the drawings are not intended as limitations on the scope of the invention, but are merely illustrative of the true spirit of the technical solution of the invention.

As shown in fig. 1 and 3, the assembled tumor-type artificial elbow joint prosthesis provided by the present invention comprises a distal humerus prosthesis 10 and a proximal ulna prosthesis 20.

As shown in fig. 1 and 2, the humerus distal prosthesis 10 includes: the humerus distal basic segment 11, the external epicondyle and the internal epicondyle of the humerus distal basic segment 11 are provided with a plurality of first suture holes 14 for reconstructing soft tissues around the elbow joint around the humerus distal basic segment 11 or suturing artificial ligaments around the humerus distal basic segment 11; a humeral conical joint section 12, a first end of the humeral conical joint section 12 is conical jointed on the humeral distal basic section 11; a humeral broach 13, a first end of the humeral broach 13 is connected with a second end of the humeral osteotomy section 12 in a conical manner, and the second end of the humeral broach 13 is used for being inserted into the humeral medullary cavity and fixed with the humeral medullary cavity.

As shown in fig. 3 and 4, the ulnar proximal prosthesis 20 includes: the proximal ulna basic section 21 is used for articulating with the distal humerus basic section 11 to form a humeral ulnar joint, and a plurality of second suture holes 24 used for reconstructing soft tissues around the elbow joint around the proximal ulnar basic section 21 or suturing artificial ligaments around the proximal ulnar basic section 21 are formed in the proximal ulnar basic section 21 except for an ulnar pulley incisal track; an ulna tapered section 22, a first end of the ulna tapered section 22 being tapered on the ulna proximal end basic section 21; an ulnar broach 23, a first end of the ulnar broach 23 is tapered with a second end of the ulnar taper joint section 22, and the second end of the ulnar broach 23 is used for being inserted into and fixed with the ulnar medullary cavity.

In the above embodiment, the length of the humeral conical joint section 12 is preferably adjustable, so that the assembly of different humeral defect lengths in the operation can be realized by assembling humeral conical joint sections 12 with different lengths according to the length of the humeral defect, so as to adapt to patients with different degrees of humeral defects.

In the above embodiment, preferably, the length of the ulnar awl joint part 22 is adjustable, so that the combination of different ulnar defect lengths in the operation can be realized by assembling the ulnar awl joint parts 22 with different lengths according to the length of the ulnar defect, so as to adapt to patients with different ulnar defect degrees.

In the above embodiment, the distal humerus basic segment 11 and the proximal ulna basic segment 21 are preferably prostheses that are customized by 3D printing technology to conform to the shape of the distal humerus and proximal ulna defect segments of the patient.

In the above embodiment, the humeral broach 13 and the ulnar broach 23 may be preferably designed as two types of broach, a biological type or a cement type, so as to select different fixing manners according to different needs.

In the above embodiment, preferably, since the ulnar medullary canal is thin and less cement is poured, the ulnar broach 23 may be designed as a thick thread type to facilitate cement fixation and prevent rotation and loosening of the ulnar proximal prosthesis 20.

Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it should be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; such modifications and substitutions do not depart from the spirit and scope of the present invention in its corresponding aspects.

Claims

1. An assembled tumor type artificial elbow joint prosthesis is characterized by comprising a humerus far-end prosthesis (10) and an ulna near-end prosthesis (20);

wherein the distal humerus prosthesis (10) comprises:

the humerus distal basic segment (11), wherein a plurality of first suture holes (14) used for reconstructing soft tissues around an elbow joint around the humerus distal basic segment (11) or suturing artificial ligaments around the humerus distal basic segment (11) are formed in the external epicondyle and the internal epicondyle of the humerus distal basic segment (11);

a humeral conical joint section (12), a first end of which (12) is conical-jointed to the distal humeral basic section (11);

a humeral broach (13), a first end of the humeral broach (13) is connected with a second end of the humeral conical connection section (12) in a conical manner, and the second end of the humeral broach (13) is used for being inserted into a humeral marrow cavity and fixed with the humeral medullary cavity;

the ulnar proximal prosthesis (20) includes:

the proximal ulna basic section (21) is used for being jointed with the distal humerus basic section (11) to form a humeral ulna joint, and a plurality of second suture holes (24) used for reconstructing soft tissues around the elbow joint around the proximal ulna basic section (21) or suturing artificial ligaments around the proximal ulna basic section (21) are formed in the proximal ulna basic section (21) except for an ulna pulley incisura track;

an ulnar awl section (22), a first end of the ulnar awl section (22) awl to the ulnar proximal base section (21);

the first end of the ulna intramedullary nail (23) is in taper joint with the second end of the ulna taper joint section (22), and the second end of the ulna intramedullary nail (23) is used for being inserted into and fixed with the ulna medullary cavity.

2. The assembled tumor-type artificial elbow joint prosthesis according to claim 1, wherein the length of the humeral conical joint section (12) is freely adjustable according to the length of the humeral defect of the patient.

3. The assembled tumor-type artificial elbow joint prosthesis according to claim 1, wherein the length of the ulnar awl segment (22) is freely adjustable according to the length of the ulnar defect of the patient.

4. A modular tumor-type artificial elbow prosthesis according to any one of claims 1 to 3, characterized in that the distal humeral basic segment (11) and the proximal ulnar basic segment (21) are prostheses customized by 3D printing techniques to conform to the shape of the distal humeral and proximal ulnar defect segments of the patient.

5. A modular tumoral artificial elbow prosthesis according to any one of claims 1 to 3, characterized in that the humeral broach (13) and the ulnar broach (23) are designed as two broach, biological or cement.

6. The assembled tumor-type artificial elbow joint prosthesis according to claim 5, wherein the ulnar broach (23) is designed in the form of a coarse thread.