CN213993858U - Femoral isthmus forming porous steel plate system - Google Patents

Abstract

The utility model discloses a porous steel sheet system of thighbone isthmus shaping, its characterized in that: comprises a steel plate main body and an isthmus forming block; a porous structure is formed on the inner side surface of the steel plate main body, which is in contact with the cortical bone; the isthmus forming block is convexly arranged on the inner side surface of the steel plate main body, the side surface of the isthmus forming block, which is in contact with cortical bone, is formed into a pressing surface with a lower height, and a porous structure is formed on the pressing surface; the utility model discloses make the serious bone defect patient of thighbone obtain the form reconstruction of gorges, improve the effective fixed length of non-bone cement femoral stem false body and thighbone, improve the initial and long-term fixed effect that non-bone cement femoral stem false body is used for treating the serious bone defect of thighbone. In addition, the porous structure can ensure that the steel plate system can obtain long-term bone ingrowth and fixation after operation, can improve the overall strength of the femur-prosthesis, reduce the risk of fracture around the long-term prosthesis, improve the near-term and long-term curative effects of the hip joint operation, and ensure that a patient obtains better hip joint function.

Description

Femoral isthmus forming porous steel plate system

Technical Field

The utility model relates to a device for treating serious defect of thighbone in the artificial hip joint revision operation, in particular to a porous steel plate system of thighbone isthmus shaping belongs to medical instrument technical field.

Background

Artificial hip replacement is an effective means for treating various terminal coxitis. Artificial hip arthroplasty is a procedure to treat various artificial hip replacement failures. Due to severe osteolysis, stress shielding, infection around the prosthesis, multiple surgical history, osteoporosis, iatrogenic bone defects caused by perforation or windowing when the original prosthesis or residual bone cement is taken out and the like caused by loosening or abrasion, the femur side is often subjected to bone defects of different degrees in the artificial hip revision surgery. The difficulty in reconstruction is that there is often a severe bone defect on the femoral side, and the femur often incorporates proximal anatomical remodeling during revision, such as varus or retroversion remodeling. Thus, the femoral side bone defect reconstruction strategy is determined based on the severity of the bone defect, the amount and quality of bone remaining, and anatomical remodeling changes.

Many scholars have proposed the typing of femoral side bone defects, the most widely used type being the Paprosky type, which takes into account the three factors of bone defect site (metaphysis or diaphysis), residual bone mass and support of the proximal femur, and the length of the isthmus of the shaft available for distal fixation. The physician can objectively assess the femoral bone defect based on the typing and select an appropriate reconstruction method based on the defect typing. For severe femoral bone defects, particularly for bone defects caused by the fact that a medullary cavity forms a horn-shaped structure expanding downwards or the medullary cavity of the femur expands to form a chimney-pipe shape (chimney-pipe shape), a bone-free stem isthmus is used for fixing a femoral stem, and at present, traditional reconstruction methods such as assembling a conical ridged titanium stem, pressing bone grafting, proximal femoral allograft bone-prosthesis compound and proximal femoral replacement can be selected. The incidence of early prosthesis subsidence after the operation of assembling the conical titanium handle with the ridge is higher, the risk of fracture in the operation or after the operation is increased, and a series of complications such as stress concentration, stress shielding, insufficient effective fixed length, unstable prosthesis fixation and the like can be caused. Proximal femoral allograft bone-prosthesis composites present potential risks of disease transmission, resorption and nonunion of the graft, aseptic loosening, periprosthetic fractures and infection. The proximal femoral replacement dislocation rate is high and the long-term survival rate is low, and is only suitable for treating the elderly patients with low activity and a great deal of serious bone defects. The pressing bone grafting has the potential of reconstructing the bone mass of a patient in theory, but has the defects of higher risks of fracture in operation, postoperative prosthesis sinking and the like, higher technical requirements of the operation, time consumption, risk of disease transmission, bone grafting absorption and the like.

Disclosure of Invention

In view of the above, the present invention provides a femoral isthmus shaped porous steel plate system, which is suitable for reconstruction of severe femoral bone defects, and can overcome the disadvantages of the conventional reconstruction methods, and improve the curative effect of patients with severe femoral bone defects and hip revision.

In order to achieve the above purpose, the utility model adopts the following technical scheme: a femoral isthmus shaped porous steel plate system comprises a steel plate main body and an isthmus shaped block; a porous structure is formed on the inner side surface of the steel plate main body, which is in contact with the cortical bone; the isthmus shaping block is arranged on the inner side surface of the steel plate main body in a protruding mode, the side face, in contact with cortical bone, of the isthmus shaping block forms an extrusion surface with a low height, and a porous structure is formed on the extrusion surface.

In some embodiments, the isthmus-shaped block is a wedge-shaped projection longitudinally disposed on an inner side of the steel plate body, and a side of the wedge-shaped projection contacting cortical bone is a low-high slope.

In some embodiments, the isthmus forming block is a plurality of first protrusions which are longitudinally arranged on the inner side surface of the steel plate main body at intervals, the height of the first protrusions is gradually increased from top to bottom, and the side surfaces of the first protrusions, which are far away from the steel plate main body, jointly form the pressing surface.

In some embodiments, a side surface of each first protrusion, which is away from the steel plate main body, is an inclined surface, and a plurality of side surfaces of the first protrusions, which are away from the steel plate main body, are all located on the same inclined surface, and the inclined surface is arranged in a downward inclination manner relative to the steel plate main body.

In some embodiments, a plurality of second protrusions are arranged on the inner side surface and the pressing surface at intervals along the length direction of the steel plate body, and a porous structure is formed on the second protrusions.

In some embodiments, the second protrusion is an arc-shaped strip-shaped protrusion extending in a width direction of the inner side surface or the squeezing surface.

In some embodiments, the isthmus-forming blocks each have a porous structure formed on a face thereof adjacent to the extrusion face.

In some embodiments, the porous structure is a trabecular porous structure.

In some embodiments, the cross section of the steel plate main body has an arc-shaped cross section, a rectangular cross section or a trapezoidal cross section, the thickness of the steel plate main body gradually decreases from the middle portion to both ends, and a plurality of cable grooves are arranged on the outer side surface of the steel plate main body at intervals along the length direction of the steel plate main body.

In some embodiments, the steel plate body and the isthmus forming block are integrally formed, the total length of the steel plate body is 6cm to 18cm, the width of the steel plate body is 1cm to 2cm, the thickness of the porous structure of the steel plate body is 1mm to 3mm, and the overall thickness of the steel plate body is 3mm to 11 mm; the length of the isthmus forming block is 2-6 cm, the width of the isthmus forming block is 0.5-1.5 cm, the height of the maximum cross section on the isthmus forming block is the diameter of a medullary cavity which is the same as the isthmus forming block in the horizontal direction minus 12-16 mm, and the best height is 3-20 mm; the pore diameter of the porous structure is 700 mu m +/-300 mu m.

The utility model adopts the above technical scheme, it has following advantage: the utility model provides a porous steel plate system, become the piece including steel sheet main part and gorge, be formed with porous structure on the medial surface of steel sheet main part and cortex bone contact, gorge becomes the piece protrusion and sets up on the medial surface of steel sheet main part, the side that gorge becomes with the cortex bone contact is low high extrusion face in the top down, steel sheet main part accessible titanium cable or steel wire are fixed in the outside of thighbone, the tongue shape cortex bone strip that forms after gorge becomes the piece extrusion osteotomy, make femoral medullary cavity take place to warp, form artificial femoral gorge in femoral medullary cavity, make the serious bone defect patient of thighbone obtain the form reconstruction of gorge, improve the effective fixed length of non-bone cement femoral stem prosthesis and thighbone, improve the initial and long-term fixed effect that non-bone cement femoral stem prosthesis is used for treating the serious bone defect of thighbone. Meanwhile, the porous structure can ensure that the steel plate system can obtain long-term bone ingrowth fixation after operation, can improve the overall strength of the femur-prosthesis, reduce the risk of fracture around the long-term prosthesis, improve the short-term and long-term curative effects of the hip joint operation and ensure that a patient obtains better hip joint function; the utility model discloses a porous steel plate system can design according to patient's specificity, can avoid adopting xenogeneic bone-false body complex, suppress and plant traditional methods such as bone joint long cement handle or near-end thighbone replacement, improves and accompanies serious thighbone defect hip revision patient's treatment curative effect.

Drawings

Fig. 1 is a schematic structural diagram of a perforated steel plate system according to an embodiment of the present invention;

fig. 2 is a schematic structural diagram of a perforated steel plate system according to another embodiment 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.

It should be noted that all the directional indicators (such as proximal end, distal end, front end, rear end, inner side, outer side, upper end, lower end, etc.) in the present embodiment are only used for explaining the relative position relationship, motion condition, etc. of the patient parts in general in medical science, i.e. the side close to the head of the patient is called proximal end, and the side far away from the head of the patient is called distal end; the front of the patient is the front side, and the back is the back side; medial near the patient's midline and lateral away from the patient's midline.

As shown in fig. 1, the present embodiment provides a femoral isthmus shaped cellular steel plate system, which includes a steel plate body 100 and an isthmus shaped block 200; a porous structure is formed on the inner side surface 101 of the steel plate main body 100, which is in contact with cortical bone; the isthmus forming block 200 is convexly arranged on the inner side surface 101 of the steel plate body 100, the side surface of the isthmus forming block 200 contacting with the cortical bone is formed into a pressing surface 201 with a low height, and a porous structure is formed on the pressing surface 201.

When the utility model is used, the steel plate main body 100 is fixed on the femur, the isthmus forming block 200 extrudes the tongue-shaped cortical bone strip formed after osteotomy to the inner side, the extrusion surface 201 of the isthmus forming block 200 is abutted against cortical bone, so that femoral medullary cavity is deformed, thereby forming artificial femoral isthmus with big top and small bottom in the femoral medullary cavity, overcoming the problem that no-bone stem isthmus is used for fixing femoral stem caused by that the medullary cavity is formed into a horn-shaped structure expanding downwards or the femoral medullary cavity expands to expand to be chimney tube shape due to a large amount of bone defects in the prior art, realizing reconstruction of the isthmus shape in the femoral medullary cavity of a patient with serious bone defect of the femur, being capable of enhancing the fixation of a non-bone cement prosthesis, a porous structure is formed on the inner side surface 101 of the steel plate main body 100 and the extrusion surface 201 of the isthmus forming block 200, the porous structure on the extrusion surface 201 of the steel plate main body 100 and the isthmus forming block 200 is contacted with the cortical bone, bone ingrowth can be obtained in a long term, the overall strength of the femur-prosthesis can be improved, and the near term and long term curative effects of hip joint surgery can be improved.

In the above embodiment, preferably, the isthmus forming block 200 is a wedge-shaped protrusion 200a longitudinally disposed on the inner side surface 101 of the steel plate body 100, and the side surface of the wedge-shaped protrusion 200a contacting with the cortical bone is a slope surface with a low height and a high height, which is the pressing surface 201; when the femoral neck bone fracture fixation device is used, the steel plate main body 100 can be fixed on a femur through a titanium cable or a steel wire, the wedge-shaped projection 200a extrudes a tongue-shaped cortical bone strip formed after osteotomy towards the inside of a femoral medullary cavity, and the slope surface of the wedge-shaped projection 200a is abutted against the cortical bone, so that the femoral medullary cavity deforms, and a femoral isthmus is formed in the femoral medullary cavity.

In the above embodiment, preferably, as shown in fig. 2, the isthmus forming block 200 is a plurality of first protrusions 200b longitudinally arranged on the inner side surface of the steel plate body 100 at intervals, the height of the first protrusions 200b gradually increases from top to bottom, and a plurality of side surfaces of the first protrusions 200b away from the steel plate body 100 jointly form the pressing surface 201.

In the above embodiment, preferably, a side surface of each first protrusion 200b away from the steel plate main body 100 is an inclined surface, and a side surface of the plurality of first protrusions 200 away from the steel plate main body 100 is located on the same inclined surface, and the inclined surface is inclined downward relative to the steel plate main body 100.

In the above embodiment, preferably, the plurality of second protrusions 300 are arranged on the inner side surface 101 and the pressing surface 201 at intervals along the length direction of the steel plate main body 100, the second protrusions 300 are formed with a porous structure, and the second protrusions 300 are in contact with the cortical bone, so that the contact area between the inner side surface 101 and the pressing surface 201 and the cortical bone can be greatly reduced, and the interference on the blood circulation of the cortical bone can be reduced.

In the above embodiment, preferably, the second protrusion 300 is an arc-shaped strip-shaped protrusion extending in the width direction of the inner side surface 101 or the pressing surface 201.

In the above embodiment, it is preferable that a plurality of cable grooves 400 are provided on the outer side surface of the steel plate main body 100 at intervals in the length direction thereof to facilitate fixing of the titanium cable or the steel wire.

In the above embodiment, it is preferable that the porous structure is formed on the face of the isthmus-forming block 200 adjacent to the pressing face 201.

In the above embodiment, preferably, the cross section of the steel plate main body 100 may be an arc section, a rectangular section or a trapezoidal section, the thickness of the steel plate main body 100 gradually decreases from the middle portion to both ends, so that the structure of the steel plate main body 100 is more suitable for human anatomy and biomechanics, and the steel plate main body 100 can be more snugly fixed on the outer side of the femur, thereby enhancing the stability of fixation.

In the above embodiment, preferably, the porous structure is a trabecular bone porous structure, and the long-term bone ingrowth fixation of the steel plate system can improve the overall reconstruction strength of the femur-prosthesis.

In the above embodiment, the steel plate body 100 and the isthmus forming block 200 are preferably integrally formed, and specifically, the steel plate body 100 and the isthmus forming block 200 are integrally formed by 3D printing, for example, by electron beam melting and 3D printing, and the printing material is, but not limited to, titanium alloy (Ti6Al 4V).

In the above embodiment, preferably, the total length of the steel plate body 100 is 6cm to 18cm, preferably 11cm to 14cm, the specific length of the steel plate body 100 may be determined according to the isthmus forming length, the width of the steel plate body 100 (the width may be an actual width or an arc length, depending on the cross-sectional shape of the steel plate body 100) is 1cm to 2cm, the thickness of the porous structure of the steel plate body 100 is 1mm to 3mm, and the overall thickness of the steel plate body 100 is 3mm to 11 mm.

In the above embodiment, the isthmus-forming block 200 preferably has a length of 2-6 cm and a width of 0.5-1.5 cm, and the height of the maximum cross-section of the isthmus-forming block 200 is, in principle, the diameter of the medullary cavity minus 12-16 mm.

In the above embodiment, the height of the maximum cross section on the isthmus-forming block 200 is preferably 3mm to 20 mm.

In the above embodiment, preferably, the pore diameter of the porous structure is 700 μm ± 300 μm, and the porosity on the isthmus shaped block 200 is 50% to 80%.

Additionally, the present invention also provides a method for implanting a porous steel plate system, comprising the steps of:

1) filing and grinding the medullary cavity by using a medullary cavity drill until the medullary cavity drill is in close contact with the cortical bone, and then pulling out the medullary cavity drill;

2) the tongue-shaped osteotomy is made at the outer side of the proximal end of the relatively complete femoral cortical bone fracture end by 2-3 cm far away, and the distal end of the tongue-shaped osteotomy is arc-shaped, so that the fracture during and after the operation caused by stress concentration is avoided. The aim of doing so is to reserve the relatively intact femoral cortical bone of 2cm-3cm at the proximal end of the osteotomy, reduce the risk of intraoperative fracture, and simultaneously utilize the relatively intact femoral cortical bone of 2cm-3cm to be used for fixing the femoral stem together with the lingual cortical bone strip;

3) reinserting the medullary cavity drill until the medullary cavity drill is tightly contacted with the cortical bone, placing the steel plate main body 100 on the surface of the tongue-shaped osteotomy block, and binding 2-3 titanium cables on the outer side of the steel plate main body 100 corresponding to the isthmus forming block; the first titanium cable is located on the outer side of the maximum cross section of the isthmus forming block 200, the second titanium cable is located at the position 2cm-4cm away from the proximal end of the first titanium cable, and a third titanium cable can be tied to the position 2cm-3cm away from the distal end of the first titanium cable or the position 2cm-3cm away from the proximal end of the second titanium cable according to the condition that whether the steel plate main body 100 is tightly pressed on the lateral femur or not. The tightness degree of the titanium cable is preferably that the isthmus forming block 200 tightly extrudes the tongue-shaped osteotomy block to the surface of the medullary cavity drill, so that the forming degree of the isthmus can be well controlled, and the tongue-shaped cortical bone strip can just form tight press fit on the femoral stem.

4) After the titanium cable is bound, the titanium cable is driven into the femoral stem by a conventional method.

The present invention has been described only with reference to the above embodiments, and the structure, arrangement position and connection of the components may be changed. On the basis of the technical scheme of the utility model, the all sides according to the utility model discloses the principle is all not excluded to the improvement that individual part goes on or the transform of equivalence the utility model discloses a protection scope is outside.

Claims (10)

1. A femoral isthmus shaped cellular steel plate system, characterized in that: comprises a steel plate main body and an isthmus forming block; a porous structure is formed on the inner side surface of the steel plate main body, which is in contact with the cortical bone; the isthmus shaping block is arranged on the inner side surface of the steel plate main body in a protruding mode, the side face, in contact with cortical bone, of the isthmus shaping block forms an extrusion surface with a low height, and a porous structure is formed on the extrusion surface.

2. The femoral isthmus shaped cellular steel plate system of claim 1, wherein: the isthmus shaping piece is the wedge-shaped lug that vertically sets up on the medial surface of steel sheet main part, the side that wedge-shaped lug and cortex bone contact is the high slope face of low height in the top.

3. The femoral isthmus shaped cellular steel plate system of claim 1, wherein: the isthmus shaping piece is a plurality of first archs that longitudinal interval set up on the medial surface of steel sheet main part, first bellied height top-down crescent, a plurality of first protruding side of keeping away from the steel sheet main part constitutes the extrusion face jointly.

4. The femoral isthmus shaped cellular steel plate system of claim 3, wherein: each first arch is kept away from the side of steel sheet main part is the inclined plane, and is a plurality of the side that the steel sheet main part was kept away from to first arch all is located same inclined plane, the inclined plane for the steel sheet main part is the downward sloping setting.

5. The femoral isthmus shaped cellular steel plate system of claim 1, wherein: and a plurality of second bulges are arranged on the inner side surface and the extrusion surface at intervals along the length direction of the steel plate main body, and porous structures are formed on the second bulges.

6. The femoral isthmus shaped cellular steel plate system of claim 5, wherein: the second protrusion is an arc-shaped strip-shaped protrusion extending along the width direction of the inner side surface or the extrusion surface.

7. The femoral isthmus shaped cellular steel plate system of claim 1, wherein: and porous structures are formed on the surfaces of the isthmus forming blocks, which are adjacent to the extrusion surface.

8. The femoral isthmus shaped cellular steel plate system of claim 1, 5 or 7, wherein: the porous structure is a trabecular bone porous structure.

9. The femoral isthmus shaped cellular steel plate system of claim 1, wherein: the cross section of steel sheet main part is arc cross-section, rectangular cross-section or trapezoidal cross-section, the thickness of steel sheet main part reduces from its middle part to both ends gradually set up a plurality of cable troughs on the lateral surface of steel sheet main part and along its length direction interval.

10. The femoral isthmus shaped cellular steel plate system of claim 1, wherein: the steel plate main body and the isthmus forming block are integrally formed, the total length of the steel plate main body is 6 cm-18 cm, the width of the steel plate main body is 1 cm-2 cm, the thickness of the porous structure of the steel plate main body is 1 mm-3 mm, and the overall thickness of the steel plate main body is 3mm-11 mm; the length of the isthmus forming block is 2-6 cm, the width of the isthmus forming block is 0.5-1.5 cm, and the height of the maximum cross section on the isthmus forming block is obtained by subtracting 12-16 mm from the diameter of the medullary cavity on the same level with the isthmus forming block; the pore diameter of the porous structure is 700 mu m +/-300 mu m.

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