CN214857835U - Integral type replacement scaphoid that uses among orthopedic operation - Google Patents
Integral type replacement scaphoid that uses among orthopedic operation Download PDFInfo
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- CN214857835U CN214857835U CN202022056200.2U CN202022056200U CN214857835U CN 214857835 U CN214857835 U CN 214857835U CN 202022056200 U CN202022056200 U CN 202022056200U CN 214857835 U CN214857835 U CN 214857835U
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- 238000001356 surgical procedure Methods 0.000 claims abstract description 13
- 238000005498 polishing Methods 0.000 claims abstract description 10
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- 238000013461 design Methods 0.000 claims description 12
- 210000000450 navicular bone Anatomy 0.000 claims description 8
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Images
Abstract
The invention relates to the field of interventional devices used in orthopedic surgery, in particular to an integrated replacement scaphoid used in orthopedic surgery. Aims to solve the problems of long scaphoid rehabilitation time and high rehabilitation difficulty in the prior art. The integrated scaphoid bone sewing machine comprises an integrated scaphoid formed by 3D printing, wherein the outer surface of the integrated scaphoid is provided with a polishing area and a sewing area, the inner surface of the integrated scaphoid is of a porous structure, the contact surface of the integrated scaphoid and a joint bone is provided with the polishing area, the joint of the integrated scaphoid and a tendon is provided with the sewing area, the sewing area comprises honeycomb-shaped meshes communicated with the internal porous structure, and auxiliary positioning holes for threading are arranged on the side surfaces among the meshes. Has the advantages that: the overall mechanical property is good, the human scaphoid is simulated to the maximum extent, the time for replacing the scaphoid can be shortened, and the use strength and the use flexibility after operation can be ensured, which are not possessed by the prior products.
Description
Technical Field
The utility model relates to an integral type replacement scaphoid field that uses among the bone surgery, especially an integral type replacement scaphoid that uses among the bone surgery.
Background
Fracture of scaphoid is a common fracture in clinic, accounting for 2 percent of the total fracture, accounting for 70 to 80 percent of the fracture of carpal bone, and being second only to the fracture of distal radius. There are many clinical methods for treating scaphoid fracture, but there is no clear selection standard at present. If the treatment is not performed or is not performed by mistake, complications such as serious deformity healing, bone nonunion, aseptic ischemic necrosis, hypertrophic scar pain and the like can be easily caused.
The carpal body is long and narrow, is the carpal bone with the largest volume in the far and near volleyball carpal bones, and is also the carpal bone with the largest mobility. The scaphoid is a complex three-dimensional anatomical structure, 5 joint surfaces are arranged around the scaphoid, the distal joint surface of the scaphoid is concave and is contacted with the capitate bone, the proximal joint surface protrudes out of the joint related to the radius, the other two joint surfaces on the distal side are respectively connected with the trapezium and the trapezium, and the inner joint surface is connected with the lunate bone. The distal end of the depression is the prominent scaphoid tubercle with the flexor carpi radialis tendon and the metacarpal radiocarpal ligament attached. 70-80% of the surface of the scaphoid of the wrist is covered by cartilage, and blood supply mainly comes from the radial artery branch, the radial artery branch enters the lumbar part of the scaphoid from the dorsal side to supply blood supply to 80% of the proximal end of the scaphoid, and the rest 20% of the blood supply enters the proximal tubercle part of the scaphoid from the palmar side of the radial artery to supply. Research shows that the sparse blood supply of the scaphoid is the main reason of ischemic necrosis and nonunion after the scaphoid fracture operation. Scaphoid necrosis easily occurs after scaphoid fracture, and no good treatment method exists at present. Currently, the treatment mainly adopts tenoglobulus transplantation or carpal fusion, and the effect is unsatisfactory.
At present, for scaphoid necrosis, the tendon ball transplantation and the wrist joint fusion method are used for treatment, and the wrist strength, pain and mobility after the operation are not ideal. The scaphoid prosthesis research is less at home and abroad, Chinese scholars have sporadic operation reports, the research level is low, and the large-scale application is not available. There are mature silica gel prostheses in foreign countries, which have unsatisfactory effects, and there are also metal prostheses, and references are reported in The literature (Spingardio, Rossello MI. The total scar titanium arthoplasty: A15-year experiment [ J ]. hand (N Y), 2011, 6 (2): 179-184.).
Due to the special appearance and function of the scaphoid (requiring limited movement in a narrow space), the scaphoid prosthesis manufactured by the traditional technology cannot be met, in the published Chinese patent document, the application number is CN201920988387.4, namely a patent named as a screwed ball-and-socket joint artificial scaphoid, in the disclosed technology, the scaphoid is an irregular shape which is similar to the scaphoid of a human body and consists of a head part, a body part and a tail part, a support body consists of a ball head, a neck collar and a handle, a spherical socket is formed at the position, opposite to the ball head of the support body, of the body part of the scaphoid, and the spherical socket and the ball head form a ball-and-socket joint, the technical structural characteristics can disperse stress, keep the gap of the scaphoid, keep the better mobility of the scaphoid, and well reconstruct the scaphoid, however, the applicant still considers that the problems of inaccurate integral fixation of equipment and difficult achievement of the strength of the body exist;
there is also a direction for improving the positioning device, for example, in the published chinese patent document, application No. CN201810661303.6, entitled 3D positioning device for wrist navicular bone percutaneous nail placement and its manufacturing method, the disclosed 3D positioning device includes a panel formed by 3D printing, a bottom plate and a needle guide nozzle, the panel has a first cavity adapted to the palm surface dermatoglyph of the wrist, the bottom plate has a second cavity adapted to the back surface of the wrist; the panel is movably connected with the bottom plate, and the first cavity is vertically opposite to the second cavity; the guide needle mouth is formed on the panel and is provided with a guide needle channel communicated with the first cavity, the guide needle channel is configured to guide a guide needle to pass from the navicular tubercle to the proximal navicular pole, however, the problem that the later strength of the interventional device is not suitable for the use of a patient still exists;
related technical personnel also propose to protect tissues of an interventional part by improving prosthetic devices at other bone joints of a human body, for example, in published Chinese patent documents with the application number of CN201910104178.3 named as a talus split type ankle prosthesis, a tibialis joint tibialis side part is provided, and the talus joint tibialis side part also comprises a rotating matching part which comprises a calcaneal joint talus side part and a talus joint talus side part which are detachably connected, so that the problem of difficult surgical field of view is solved in a split mode, however, the problem that the strength is difficult to adapt to a patient in the bone joint interventional operation is still not solved, and meanwhile, due to the inconsistent bone types, an effective technical inspiration cannot be formed;
still the personnel propose a patent for can dismantle talus false body, its application number is CN201621249738.2, and the design aim at realizes a detachable structure of interveneeing, and subtalar articular surface and talonavicular articular surface are porous structure, have biological function, are convenient for the false body and the rapid fusion growth of calcaneus, scaphoid, nevertheless the sharp edge of its and the design of material still are difficult to improve the result of use of recovered stage. The main reason is that the elastic modulus of the prosthesis made of metal is high, which is easy to cause the damage of the scaphoid and other sclerotin of the prosthesis, and secondly, the scaphoid of a human body is fixed in a wrist joint by a tendon, the prosthesis made by the traditional process can not realize the interface fusion of the prosthesis and surrounding ligaments, so that the position of the prosthesis is unstable after the prosthesis is implanted, and the function is influenced.
In summary, the current technology has the following problems: 1. the operation time is long, and the positioning is difficult; 2. other bone joints are often involved in conflict during the later rehabilitation state, which causes secondary injury; 3. the joint is too common, the healing is slow, and the hidden trouble of secondary lesion exists.
SUMMERY OF THE UTILITY MODEL
The utility model aims at solving the problems that the positioning of the components in the operation is difficult, the recovery time of the scaphoid is long and the recovery difficulty is large in the prior art.
The utility model has the following concrete scheme:
the design one kind that uses among the orthopedic operation replaces the navicular bone, prints fashioned integral type navicular bone including 3D, the surface of integral type navicular bone is equipped with polishing district and sews up the district, the internal surface of integral type navicular bone sets up to porous structure, the contact surface of integral type navicular bone and joint bone sets up to polishing district, sets up to sew up the district with the junction of tendon, sew up the district and include the cellular mesh that is linked together with inside porous structure, be equipped with the supplementary locating hole of threading with on the side between the mesh.
In a specific implementation, the porous structure comprises a honeycomb structure on a three-dimensional space, and the pore diameter of the honeycomb structure is gradually reduced from inside to outside.
In specific implementation, still be equipped with bone cement intercommunication punch combination in the honeycomb structure, bone cement intercommunication punch combination includes that a plurality of endings connect gradually and the column hole that the center pin was crisscross to be arranged, the both sides of bone cement intercommunication punch combination respectively are located on the suture district of integral type navicular bone both sides.
In specific implementation, two ends of the bone cement communication hole group are respectively provided with a line hole for passing a suture line.
In a specific implementation, the size of the honeycomb-shaped meshes is between 400nm and 200 nm.
In specific implementation, be equipped with the chamber of adding medicine in the porous structure, it is equipped with the anther sac that the biological semipermeable membrane supported to add the intracavity, pack the bony growth promotion liquid in the anther sac, it is linked together with longitudinal section to add the chamber of medicine.
Can also be, still including sewing up the district buckle, sew up the outline of district buckle with the outline of honeycomb mesh is unanimous, the center of sewing up the district buckle is equipped with the through-hole for the connection, it includes the regulation inner shell of making with the mimicry outer surface shell that the scaphoid joint appearance is unanimous, flexible material outward to sew up the district buckle, adjust the inner shell with the design has the buckle formula to be connected between the honeycomb mesh, and its inner wall is equipped with the beam form recess in order to accomodate the tendon, the outer surface shell with it bonds to be equipped with biological adhesive between the inner shell to adjust. The half moon-shaped plates are lapped, the lapping part is correspondingly provided with a bulge and a notch, and the central line of the through hole for connection is positioned on an interface formed by lapping.
A processing and mounting method for forming an integrated replacement scaphoid comprises the following steps:
(1) collecting data, customizing the overall dimensions of the integrated scaphoid: scanning the scaphoid joint of a patient, modeling by using scanning data, and forming to the position of 1/3 height by 3D printing to form a semi-finished product A;
(2) printing a dosing cavity: continuously printing on the basis of the semi-finished product A, enabling the middle part of the semi-finished product A to flow out of the dosing cavity, placing the medicine bag when the dosing cavity is molded to be a half, continuously printing to form a semi-finished product B until the dosing cavity is printed, and meanwhile placing a suture line reserved line in the bone cement communicating hole group;
(3) printing a stitching area buckle: based on the outer contour size of the sewing area of the semi-finished product B and the size data in the step (1), independently printing a simulated outer shell made of metal tantalum, an adjusting inner shell made of flexible materials, and printing a meniscus forming a buckle;
(4) installing a buckle: after the integrated scaphoid positioning is completed, the integrated scaphoid is positioned by utilizing bone cement to connect the tendon together with the hole group, the tendon after the suture is received by the through hole of the meniscus plate and is clamped, and the clamp buckle for clamping is buckled on the two sides of the suture area of the integrated scaphoid.
The beneficial effects of the utility model reside in that:
the integral replacement scaphoid adopts a new 3D metal tantalum printing process, the metal tantalum ensures the strength, and the 3D printing ensures the precision;
the bone cement communicating hole group further provides space for bone growth and tendon suture;
the design of the change of the aperture of the metal tantalum hole ensures the surface strength on one hand and ensures that enough gaps are filled in the metal tantalum hole to fill the gradually melted medicine to promote the later joint rehabilitation, and meanwhile, a medicine bag can be designed in the metal tantalum hole to further facilitate the rehabilitation, so that the weight of equipment is further reduced, and the burden of a patient in the rehabilitation process and the uncomfortable feeling after an interventional operation are reduced;
the printed structure is more targeted, and reasonable and unique modeling can be made for each patient;
partial stitches are preset during printing, so that the stitching difficulty is reduced, and the positioning effect is improved;
the design of the medicine bag is convenient for postoperative rehabilitation, medicine is added from the inside to be better absorbed, and the growth of bone is not influenced;
the section of sewing up the buckle assemble be in the stage that whole operation is close the tail sound, further protect the tendon to and improve and sew up the effect, promote the comfortable degree of patient of postoperative, two-layer design makes its adjustable interchangeability high, and surface size 3D prints simultaneously, in other words with single demand customization, strong to free adaptability.
Drawings
FIG. 1 is a schematic view of the installation effect of the structure of the present invention under test simulation;
FIG. 2 is a perspective view of the structure of the present invention;
FIG. 3 is a front sectional view of the present invention;
fig. 4 is a left side view of the structure of the present invention;
FIG. 5 is a right side view of the structure of the present invention;
FIG. 6 is a view of the snap-fit mounting structure of the scaphoid suture region of the present invention;
names of components in the drawings: 1. a polishing zone; 2. a suture; 3. a group of bone cement communication holes; 4. a medicine adding cavity; 5. a tendon; 6. the sewing area is buckled; 7. a metallic tantalum via; 8. the connection is in a buckling manner; 9. a biological adhesive; 10. an outer surface shell; 11. adjusting the inner shell; 12. a half moon shaped plate.
Detailed Description
The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it will be understood that they are presented herein only to illustrate and explain the present invention, and not to limit the present invention.
Example 1
The utility model provides an integral type replacement scaphoid that uses among orthopedic surgery, refer to fig. 1 to 5, the design includes that 3D prints fashioned integral type scaphoid, the surface of integral type scaphoid is equipped with polishing zone 1 and sews up the district, the internal surface of integral type scaphoid sets up to porous structure, the contact surface of integral type scaphoid and joint bone sets up to polishing zone 1, set up to sewing up the district with the junction of tendon 5, sew up the district and include the cellular mesh that is linked together with inside porous structure, be equipped with the supplementary locating hole of threading on the side between the mesh.
The porous structure comprises a honeycomb structure on a three-dimensional space, and the pore diameter of the honeycomb structure is gradually reduced from inside to outside.
A bone cement communicating hole group 3 is also arranged in the honeycomb structure, the bone cement communicating hole group 3 comprises a plurality of columnar holes which are sequentially connected in a ending way and are distributed with central shafts in a staggered way, and two sides of the bone cement communicating hole group 3 are respectively positioned on the suture areas on two sides of the integral scaphoid.
Both ends of the bone cement communication hole group 3 are each provided with a thread hole to pass through the suture thread 2.
The size of the honeycomb-shaped mesh is 400nm to 200 nm.
A medicine adding cavity 4 is arranged in the porous structure, a medicine bag supported by a biological semipermeable membrane is arranged in the medicine adding cavity 4, the medicine bag is filled with the liquid for promoting the growth of sclerotin, and the medicine adding cavity 4 is communicated with the longitudinal section.
In the course of the work, the replacement scaphoid is laid to the regulation position, later utilizes the suture district to sew up it with the tendon, realizes the location, and the low wearing and tearing cooperation of polishing district and other condyles simultaneously is favorable to the recovery, and is further, the structure of metal tantalum embeds the bone cement of a certain quantity, the production of the sclerotin in the replacement of being convenient for, and the anther sac further promotes its production, and the combination of above-mentioned technique effectively shortens postoperative rehabilitation time.
A processing and mounting method for forming an integrated replacement scaphoid comprises the following steps:
(1) collecting data, customizing the overall dimensions of the integrated scaphoid: scanning the scaphoid joint of a patient, modeling by using scanning data, and forming to the position of 1/3 height by 3D printing to form a semi-finished product A;
(2) printing dosing chamber 4: continuously printing on the basis of the semi-finished product A, enabling the middle part of the semi-finished product A to flow out of the dosing cavity 4, placing a medicine bag when the dosing cavity 4 is molded to be a half, continuously printing to form a semi-finished product B until the dosing cavity 4 is completely printed, and meanwhile placing a reserved line of the suture line 2 in the bone cement communicating hole group 3;
(3) printing stitching area buckle 6: based on the outer contour size of the sewing area of the semi-finished product B and the size data in the step 1, independently printing a simulated outer shell made of metal tantalum, an adjusting inner shell 11 made of flexible material, and printing a meniscus 12 forming a buckle;
(4) installing a buckle: after the integrated scaphoid positioning is completed, the bone cement and the hole group are connected with the tendon 5 to position the integrated scaphoid, the tendon 5 after being sewed is contained and clamped by the through hole of the meniscus, and the buckle formed by clamping is buckled and arranged on two sides of the sewing area of the integrated scaphoid.
Example 2
The principle of the present embodiment is different from that of embodiment 1 in that: the outer contour of the sewing region buckle 6 is consistent with that of the honeycomb-shaped mesh, a through hole for connection is formed in the center of the sewing region buckle 6, the sewing region buckle 6 comprises a simulated outer surface shell 10 which is consistent with the appearance of a scaphoid joint and an adjusting inner shell 11 which is made of a flexible material from outside to inside, a buckle type connection 8 is designed between the adjusting inner shell 11 and the honeycomb-shaped mesh, a bunch-shaped groove is formed in the inner wall of the adjusting inner shell to accommodate a tendon 5, and a biological adhesive 9 is arranged between the outer surface shell 10 and the adjusting inner shell for adhesion. The design further ensures the stability and low trauma of the tendon connection. The design of the inner shell and the outer shell is equivalent to that the areas, contacted with the suture areas, of the tendons are all provided with flexible connections, abrasion is reduced, the bunched grooves form reasonable guide for the tendons, meanwhile, the overlapped shells can be processed in a more targeted mode, and interchangeability of the outer shells is not affected.
The half-moon-shaped connecting plate comprises two half-moon-shaped plates 12 formed by folding, wherein the half-moon-shaped plates 12 are lapped, the lapping part is correspondingly provided with a bulge and a notch, and the central line of a through hole for connection is positioned on an interface formed by lapping.
The technical advantages of 3D printing of the multi-empty tantalum scaphoid prosthesis:
1. the elastic modulus of the 3D printed porous tantalum is similar to that of the bone, so that the damage to the surrounding bone is avoided;
2. the 3D printed porous tantalum can generate good interface fusion with surrounding tendon 5 ligaments, and the ligaments and the tendons 5 for fixing the prosthesis around can grow into the prosthesis to play a good fixing role. The method is difficult to realize by the traditional technology and has certain significance.
3. The scaphoid is a complex three-dimensional anatomical structure, and the conventional technology is difficult to design a prosthesis as before an operation; scanning is adopted to scan the data of the lateral wrist joint, and a scaphoid on the affected side is designed according to a normal scaphoid mirror image on the opposite side, so that perfect reconstruction is realized.
Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that modifications may be made to the embodiments described in the foregoing embodiments, or equivalents may be substituted for elements thereof. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (8)
1. An integral type replacement scaphoid that uses in orthopedic surgery which characterized in that: print fashioned integral type navicular including 3D, the surface of integral type navicular is equipped with polishing district (1) and sews up the district, the internal surface of integral type navicular sets up to porous structure, the contact surface of integral type navicular and joint bone sets up to polishing district (1), sets up to sew up the district with the junction of tendon (5), sew up the district and include the cellular mesh that is linked together with inside porous structure, be equipped with the supplementary locating hole of threading with on the side between the mesh.
2. The one-piece replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the porous structure comprises a honeycomb structure in a three-dimensional space, and the pore diameter of the honeycomb structure is gradually reduced from inside to outside.
3. The integrated replacement scaphoid for use in orthopedic surgery of claim 2, wherein: still be equipped with bone cement intercommunication punch combination (3) in the honeycomb structure, bone cement intercommunication punch combination (3) include a plurality of endings connect gradually and the column hole that the center pin was crisscross to be arranged, the both sides of bone cement intercommunication punch combination (3) respectively are in on the suture district of integral type navicular bone both sides.
4. The integrated replacement scaphoid for use in orthopedic surgery of claim 3, wherein: two ends of the bone cement communicating hole group (3) are respectively provided with a line hole for passing through a suture line (2).
5. The one-piece replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the size of the honeycomb-shaped mesh is 400nm to 200 nm.
6. The integrated replacement scaphoid for use in orthopedic surgery of claim 3, wherein: the bone growth promoting liquid is characterized in that a medicine adding cavity (4) is arranged in the porous structure, a medicine bag supported by a biological semipermeable membrane is arranged in the medicine adding cavity (4), the medicine bag is filled with a bone growth promoting liquid, and the medicine adding cavity (4) is communicated with the longitudinal section.
7. The one-piece replacement scaphoid for use in orthopedic surgery of claim 1, wherein: still including sewing up district buckle (6), the outer profile of sewing up district buckle (6) with the outer profile of honeycomb mesh is unanimous, the center of sewing up district buckle (6) is equipped with the through-hole for the connection, sew up district buckle (6) from the outside and in include with the mimicry outer surface shell (10) of the same appearance of scaphoid joint, regulation inner shell (11) that flexible material made, adjust inner shell (11) with the design has buckle formula to be connected (8) between honeycomb mesh, its inner wall is equipped with the beam form recess in order to accomodate tendon (5), outer surface shell (10) with it bonds to be equipped with biological adhesive (9) between the regulation inner shell.
8. The one-piece replacement scaphoid for use in orthopedic surgery of claim 1, wherein: the semi-moon-shaped plate comprises two semi-moon-shaped plates (12) formed by folding, wherein the semi-moon-shaped plates (12) are lapped, a bulge and a notch are correspondingly arranged at the lapping position, and the central line of a through hole for connection is positioned on an interface formed by lapping.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202022056200.2U CN214857835U (en) | 2020-09-18 | 2020-09-18 | Integral type replacement scaphoid that uses among orthopedic operation |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202022056200.2U CN214857835U (en) | 2020-09-18 | 2020-09-18 | Integral type replacement scaphoid that uses among orthopedic operation |
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| CN214857835U true CN214857835U (en) | 2021-11-26 |
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| CN202022056200.2U Withdrawn - After Issue CN214857835U (en) | 2020-09-18 | 2020-09-18 | Integral type replacement scaphoid that uses among orthopedic operation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112137767A (en) * | 2020-09-18 | 2020-12-29 | 湖南普林特医疗器械有限公司 | Integrated replacement scaphoid used in orthopedic surgery and matched processing and mounting method |
-
2020
- 2020-09-18 CN CN202022056200.2U patent/CN214857835U/en not_active Withdrawn - After Issue
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112137767A (en) * | 2020-09-18 | 2020-12-29 | 湖南普林特医疗器械有限公司 | Integrated replacement scaphoid used in orthopedic surgery and matched processing and mounting method |
| CN112137767B (en) * | 2020-09-18 | 2024-04-12 | 湖南华翔医疗科技有限公司 | Integrated replacement navicular bone used in orthopedic operation and matched machining and installing method |
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Effective date of registration: 20221103 Address after: 410600 room 205, building 1, Hunan University Science and Technology Industrial Park, No. 001, Jinzhou North Road, Ningxiang high tech Industrial Park, Changsha City, Hunan Province Patentee after: Hunan Huaxiang Medical Technology Co.,Ltd. Address before: 410000 No.001 Jinzhou North Road, high tech Zone, Ningxiang County, Changsha City, Hunan Province Patentee before: Hunan Printer Medical Devices Co.,Ltd. |
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Inventor after: Wang Guohua Inventor after: Liu Jiang Inventor after: Song Kun Inventor after: Zou Weimin Inventor before: Duan Jiaqi Inventor before: Wang Guohua Inventor before: Liu Jiang Inventor before: Song Kun Inventor before: Zou Weimin |
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