CN87101011A - Memory nail and extractor thereof in the forked humerus marrow - Google Patents
Memory nail and extractor thereof in the forked humerus marrow Download PDFInfo
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- CN87101011A CN87101011A CN 87101011 CN87101011A CN87101011A CN 87101011 A CN87101011 A CN 87101011A CN 87101011 CN87101011 CN 87101011 CN 87101011 A CN87101011 A CN 87101011A CN 87101011 A CN87101011 A CN 87101011A
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- karaoke club
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Abstract
In a kind of bone surgery set with the y-shaped humeral intramedullary nail of Ultimum Ti system and its extractor.This nail has the intermediate host portion in band V-arrangement cross section, is positioned at the fork-shaped arc intercross portion of its front end and the plane OK a karaoke club portion with holes of rear end.During operation, intramedullary pin enters the certain position of medullary cavity of humerus with low temperature flow state main part and arc intercross portion, and the bone marrow opening part is stayed in the embedding of OK a karaoke club portion.Postoperative is returned to the shape of design under human body temperature, to humeral fracture, to cross-section, comminuted and several sections of fracture, bone does not connect person, have self-pressuring ligation especially, need not external fixation, uses intramedullary pin of the present invention, and cure rate obviously improves.
Description
The present invention relates to bone surgery set, particularly a kind of humeral intramedullary nail and its extractor.
Humeral fracture is common wound, especially cross-section shape fracture and humeral nonunion all are difficult to the internal fixation, physiological persistent pressure, less surgical injury, good biomechanics adaptability and the effects such as normal function that do not influence shoulder, elbow joint that reach firm with the method for existing various treatment humeral fracture and material.
One of the internal fixation method of humeral shaft fracture and material are plate screws, only are adapted to the fracture on closed fracture or little inclined-plane.To open comminuted, transverse fracture or several sections of fracture, during with this internal fixation,, add that to peel off periosteum in the operation more because of the sagging weight of the bone resorption and the limbs of fracture end, often cause postoperative infection or bone does not connect.
In the fifties later stage, Switzerland AO association releases and uses compression steel plate to treat humeral shaft fracture.Though it improves to some extent the bone does not connect aspect after surgery, it makes periosteum stripping bigger than plate screw method, even the also blood supply of damaged bone folding part.Simultaneously, when the compression steel plate overload, cause complication such as bone does not connect and steel plate fracture on the contrary, compression steel plate more is not suitable for being used for treating humerus multi-section fracture, or open comminuted fracture.
The another kind of equipment of treatment humeral fracture is the V-arrangement intramedullary pin, this kind intramedullary pin is the V-shaped spike in cross section, analyzed from the anatomical features of humerus, the elongate tubular humerus is cutd open trisect along its length, can see that last 1/3 of humerus is long, its pulp cavity is round and wealthy, proximal diameter can reach 2-3 centimetre, in 1/3 long pulp cavity then gradually become triangle by circle, 1/3 long medullary cavity of humerus then almost is equilateral triangle down, the narrowest length of side only has 0.4-0.9 centimetre.Use the V-arrangement intramedullary nailing of humeral shaft fracture, also just in more suitable in the 1/3 long scope, moreover utilize this nail also not need to peel off periosteum, fixing also more firm, help the passive pressurization of fracture site, the stimulation knitting.But 1/3 is long on humerus, because the big V-arrangement intramedullary pin of this section pulp cavity can make the fracture end para-position bad.At following 1/3 long position of humerus, the V-arrangement nail when performing the operation, is not only squeezed into difficulty to typical equilateral triangle pulp cavity, the probability of coincideing is very little, but also the fracture far-end can be backed down.At present, for improving above-mentioned situation, the position of advancing nail changes greater tubercle portion into from shoulder joint, but the triangular muscle of need riving, so the possibility that has damage axillary nerve triangular muscle flesh to prop up causes the triangular muscle apraxia.In addition, the nail tail that postoperative is stayed the outside also influences shoulder joint function, will produce to some extent and lift obstacle on the abduction.
Also has a kind of intramedullary needle.Though specification has multiple, only on thickness and tail end style, difference is arranged, very this form is still the pattern of Rush pin.At present representative is the Ender's pin, and its biggest advantage is simple to operate, and it is also easy to pull out pin, is applicable to each section fracture of humerus.In operation,,, reduce aspects such as set time and promotion union of fracture and all can demonstrate superiority then in shearing resistance, loosing prevention, anti-rotation if can insert many Ender's pins in medullary cavity of humerus.But, in the humerus, the hypomere pulp cavity is triangle and following more narrow more, often is difficult to throw into two, three.Certainly will cause loosening, the rotation of fracture site etc. like this, cause bone does not connect.Intramedullary needle influences the shoulder joint function problem after also having the operation resemble the V-arrangement intramedullary pin equally.On the other hand, use the fixed patient of intramedullary needle, flexible because of the intensity of pin is low when pressurization function is trained, abnormal movement strengthens, and easily causes bone does not connect.Recently the someone takes inserting needle behind the condyle of humerus, but still can not overcome the danger that loosening, rotation, separation and pin skid off, and occurs bone does not connect inevitably or influences the function of elbow joint.Undoubtedly, the external fixation time lengthening also will influence shoulder joint function.
The objective of the invention is to utilize the performance of memorial alloy, the end, the bar portion and the head of V-shaped groove of making the band tang have the bifid intramedullary pin of arc, and it is forked that integral body is.Treat all kinds humeral shaft fracture and bone does not connect with it, can overcome the main disadvantage of all internal fixation apparatus of prior art described above, reach excellent curative.This intramedullary pin also is furnished with the injection-drawing out device tool, makes operation technique more convenient.
Task of the present invention will realize in the following manner: the memory nail total length is divided into three parts in the forked humerus marrow, and main body section is the bar in V-shaped cross section in the centre, and its front end is the bifid fork of arc, and the rear end is flat OK a karaoke club portion with holes.Two bifurcateds of arc intercross portion are the two walls extension laterally of V-type section bar, and alternate having angle.In operation, arc intercross portion enters last 1/3 segment length's pulp cavity of humerus.Main part then enter humerus in, following 1/3 segment length's pulp cavity, OK a karaoke club portion is then stayed on condyle of humerus outside the posterior bony cortex.In use, OK a karaoke club portion is that this nail imports and the position of extracting, and cooperates with the arc fork again, becomes the function position of OK a karaoke club fracture far-end.It tilts to be connected with the V-shaped groove wall circular arc of main part, makes its plane on the horizontal plane of V-shaped groove mouth.The used material of intramedullary pin of the present invention is a Nitinol, nickeliferous 50.8～51.8wt% in the alloy, and surplus is titanium.This alloy is after PROCESS FOR TREATMENT is made required form, under a certain cryogenic temperature, can produce comparatively ideal moulding deformation on request, arrive uniform temperature as reheat, it just can return to the shape of former processing design, and produce 85 kilograms/square millimeter restoring force, cooperation is with better hardness, elasticity and intensity.The present invention has utilized the shape memory effect and the mechanical characteristic of Nitinol just.
Described in detail below with reference to accompanying drawing.
Fig. 1 is the vertical view of intramedullary pin of the present invention.
Fig. 2 is the side view of intramedullary pin of the present invention.
Fig. 3 is the profile that Fig. 1 is done along the A-A line.
Fig. 4 is the vertical view of extractor of the present invention.
Fig. 5 is the front view of extractor of the present invention.
Fig. 6 A is the preceding X-ray photograph of 1/3 transverse fracture operation on the right humerus.
Fig. 6 B is with X-ray photograph behind the intramedullary pin internal fixation of the present invention.
Fig. 7 A is the preceding X-ray photograph of 1/3 comminuted fracture operation under the left humerus.
Fig. 7 B is with 1 year bone does not connect X-ray photograph behind the Ender's nail internal fixation.
Fig. 7 C is after Ender's nail takes out, and adds X-ray photograph behind self ilium bone grafting operation with intramedullary pin internal fixation of the present invention.
Have the main part 1 in V-arrangement cross section with reference to Fig. 1 and Fig. 3, separate the geometric shape of portion in design according to medullary cavity of humerus, should make in main part 1 and the humerus, 1/3 triangle pulp cavity in long matches down, V-shaped part then places the length of side of humerus rear side pulp cavity.Ansa at the bottom of the V-arrangement is then corresponding with the pulp cavity anterior angle.Like this, the main part in V-arrangement cross section will be compatible with the triangle position of pulp cavity, under low temperature and stress, make slightly flow of V-arrangement main body, be beneficial to import pulp cavity, recovery of shape under body temperature, and favourable inherent anatomical reduction, it is tight to play compatible embedding, and non-loosening.Thereby reach anatomical reduction.The length of main part 1 is at 13 centimetres to 19 centimetres, and the width of V-arrangement body is 0.5 to 0.8 centimetre.The arc intercross portion 2 of front end extends laterally as V-arrangement main part 1 two walls, and its length is 3 centimetres to 5 centimetres, and the angle of y-bend branch is 30 °～50 °.Entering the marrow wall that can block behind the 1/3 long pulp cavity on the humerus by changing from small to big for adapting to arc intercross portion 2, the free-ended spacing of y-bend branch is greater than the maximum gauge of this section pulp cavity.In operation, utilize the characteristic of memorial alloy, intramedullary pin of the present invention is entered from the narrow triangle position of medullary cavity of humerus.After operation finishes, the memorial alloy intramedullary pin is returned to the state of processing or design under the body temperature effect, slide to justifying wealthy top gradually again in the time of y-bend side pressure marrow wall, reach the pressurization between knochenbruch automatically, fractures is connected, insert in the spongy bone of collum chirurgicum humeri portion because of fork again, the OK a karaoke club portion 3 of rear end is flat wide, width is at 1.2 to 1.8 centimetres, length is also at 1.2 to 1.8 centimetres, the centre have one with OK a karaoke club portion or play the perforate 4 that the instrument head portion of pulling out matches, perforate 4 diameters are 0.5 centimetre.OK a karaoke club portion 3 will stay outside the pulp cavity after the operation, and press to the fixedly effect in force of playing when sliding in the pulp cavity inboard when arc intercross portion 2.
Fracture that may cause and the elastic force that increases the fork branch for the stress concentration that reduces the arc fork, junction at arc intercross portion 2 and main part 1 is connected with arc section 5, arc radius is at 3.5～5.0 centimetres, and have aperture 6 on fork branch angle of cut summit, 0.1～0.15 centimetre in aperture, aperture is outside fork branch circular arc portion is open in.
And between the ansa of main part 1V shape and OK a karaoke club portion 3 planes side with circular arc inclination angle 7 (see figure 2) that links to each other, 6～8 centimetres of circular arc inclination angle radiuses, and make plane, OK a karaoke club portion 3 lower edge be higher than the plane that V-shaped part is formed, about 0.3～0.5 centimetre, favourable this nail that makes in this inclination angle imports pulp cavity, after treating union of fracture, extract conveniently.The plane raising of OK a karaoke club portion 3 can be stayed outside the pulp cavity, and is parallel with surface of bone, provides excellent operation condition, (see figure 2) for not influencing elbow joint function.
By 100 male and 100 women's humerus dry measure at random, Preliminary design, process memory nail in the forked humerus marrow of three kinds of specifications, the various sizes of its each specification see the following form:
Memory nail in the forked humerus marrow
From the end of the year one nine eight six so far, utilize intramedullary pin of the present invention to accept totally 10 of humeral fracture and bone does not connect persons for medical treatment.Wherein 6 new fracture patients by name 4 are called the preceding fixed humeral nonunion patients of Ender's intramedullary pin that use in addition.The visit post-surgical condition:
Case 1: patient Deng * *, the women, 30 years old, admission number 232769, X-ray numbers 151567, accompanying drawing 6A were 1/3 transverse fracture X-ray photograph on the right humerus of this patient, the X-ray photograph of Fig. 6 B after with the interior memory nail internal fixation of forked humerus marrow of the present invention.Visible this nail bifurcated enters spongy bone in the sheet, the fracture end rotation can not take place, when passive pressurization of patient self or functional exercise muscle contraction, can provide physiological stress to stimulate, promote knitting, moreover, its bifurcated can only slide to proximal humerus, and trailer card is pulled up to anti-centrifugation.The V-arrangement body is when human temperature, and the general intramedullary pin of intensity is big.The not flexible anatomical reduction that is easy to has guaranteed the no abnormal activity of fracture end, for knitting provides condition.Because without external spread frame and external fixation, patient has reduced misery.Because this nail does not relate to shoulder elbow joint, can begin functional exercise after two weeks, so can not make a difference to shoulder and elbow function.
Case 2: patient Qi * *, the women, 25 years old, admission number 222898, X-ray number 132593 accompanying drawing 7A are X-ray photograph when 1/3 comminuted fracture is damaged down in this patient's left humerus, Fig. 7 B is 1 year bone does not connect X-ray photograph of Ender's nail postoperative, and Fig. 7 C adds X-ray photograph behind self ilium bone grafting operation for intramedullary pin internal fixation of the present invention.Visible arc fork calibration is little in the sheet, and side pressure is on Compact bone, and it is also just big to do power.As described in Figure 6, the no abnormal activity of fracture end also provides the condition of osteogenesis for bone grafting portion.
The clinical using method of memory nail in the forked humerus marrow.At first, according to pulp cavity bore shown in the length of patient's humerus and the X-ray sheet, determine forked intramedullary pin specification.Then, standby through routine disinfection.Expose patient's humeral fracture end in the art, the ectocondyle rear side line outside 1/3rd is a measurement point in humerus again, cutting skin and subcutaneous on the medullary cavity axis of 2.5～3.0 centimetres of this points, slitting fascia, the triceps muscle of riving reach sclerotin, then opening an acclivitous bone groove communicates with pulp cavity, about 1.5～2.5 centimetres of bone flute length, width be with one side of pulp cavity, spare nail inserted in 4～10 ℃ the sterilization cold water or frozen water, make outer bifurcated branch and pull out, and make the main part head end in V-arrangement cross section slightly curved.By making V-shaped part insert intramedullary pin towards the state that parallels with pulp cavity bone groove rear surface, squeeze into the fracture near-end under the direct-view again, the circular arc tilting position enters pulp cavity up to OK a karaoke club portion, rear end shoulder and the bone groove of band circular arc that makes OK a karaoke club portion is mutually till the embedding, routine is closed wound, triangular bandage suspension, and operation finishes.
Ultimum Ti used in the present invention biocompatibility in anticorrosive, wear-resistant and transplanting human body or animal all is better than medical stainless steel and titanium alloy.So as intramedullary pin of the present invention is foolproof.Intramedullary pin of the present invention can select for use thick 0.1～0.18 centimetre Nitinol plate to make the V-arrangement main body, has enough big intensity and toughness.
Extractor of the present invention is seen Figure 4 and 5.A long handle 8 is arranged, there is the portion of knocking 9 with two flat surfaces the front portion, in the middle of them is connecting rod portion 10, the free end that knocks portion has a cylinder plush copper 11, this just in time has same size with the hole of the OK a karaoke club portion of intramedullary pin, slidably insert the hole of OK a karaoke club portion, the convex edge portion 12 of a smooth extension is arranged at the top of plush copper 11, it equates to OK a karaoke club portion end plane vertical dimension to the vertical dimension at plush copper center and the circular hole center of OK a karaoke club portion, in plush copper when match in OK a karaoke club portion hole, but the end plane sliding is gone under the convex edge.Its nail hole along two ends and insertion is wired to △ shape makes nail stable.
Deft design of the present invention, rational in infrastructure, make the interior memory nail of forked humerus marrow can be fit to various types of fracture of shaft of humerus, particularly other intramedullary nail, steel plate are insoluble, such as cross-section shape, open comminuted, several sections of fracture or fixing in other due to bone nonunion etc. And it is few to have a damage, and healing is fast, and it is tightly firm to dissect compatible embedding, is easy to spontaneous pressurization reset, and promotes the strong point of knitting. Its operation that is also advantageous in that does not relate to shoulder, elbow joint, so do not have shoulder, elbow joint dysfunction problem due to traditional surgical approaches and the material. Therefore, with the bone nonunion due to intramedullary nail treatment humeral shaft all kinds fracture of the present invention or other method, its cure rate can obviously improve.
Claims (9)
1, memory nail in the forked humerus marrow of a kind of Nitinol, it is characterized in that total length divides three partly, the bar in V-shaped cross section in the middle of main part 1 is positioned at, its front end is the arc intercross portion 2 that is fork branch shape, the rear end is flat OK a karaoke club portion 3 with holes, two walls that said arc intercross portion 2 is a main part 1 are elongated end laterally, and alternate having angle.
2, intramedullary pin according to claim 1 is characterized in that connecting with circular arc 5 between the fork branch of the wall of said main part 1 and arc intercross portion 2, and the place has an aperture 6 in the fork angular vertex.
3, intramedullary pin according to claim 1 is characterized in that the V-arrangement ansa of said main part 1 is connected with circular arc inclination angle 7 with the interplanar side of OK a karaoke club portion 3.And the plane, lower edge that makes OK a karaoke club portion 3 is higher than 0.3～0.5 centimetre on plane that V-shaped part is formed.
4, intramedullary pin according to claim 1, it is characterized in that 1 long 13-19 centimetre of said main part, arc intercross portion 2 long 3-5 centimetres, the 3 long 1-1.6 of OK a karaoke club portion centimetres, arc fork angle is 30 °-50 °, the wide 0.5-0.9 of V-arrangement section A-A centimetre, the high 0.5-0.9 in V-arrangement cross section centimetre, the 3 wide 1-1.6 of OK a karaoke club portion centimetres.Hole on the OK a karaoke club facial planes, aperture 0.3-0.5 centimetre.
5, intramedullary pin according to claim 4 is characterized in that circular arc connects between the wall of said main part 1 and the arc fork branch, and arc radius is 3.5-5 centimetre, and the diameter of fork angular vertex aperture is 0.1-0.15 centimetre.
6, intramedullary pin according to claim 5 is characterized in that the V-arrangement ansa of said main part 1 and circular arc inclination angle, the plane radius of OK a karaoke club portion 3 are 6-8 centimetre.
7, intramedullary pin according to claim 6 is characterized in that said intramedullary pin material thickness is 0.1-0.18 centimetre.
8, the extractor of the forked intramedullary pin of a kind of memorial alloy, it is characterized in that it has a handle portion 8, there is the portion of knocking 9 of two flat surfaces the front portion, is connecting rod portion 10 in the middle of them, the free end that knocks portion has a cylinder plush copper 11, and the top of plush copper 11 is a convex edge 12.
9, extractor according to Claim 8, it is characterized in that the diameter of said plush copper 11 equals the aperture in OK a karaoke club portion hole, and can slip in the OK a karaoke club portion in the hole, 12 vertical dimension equals the circular hole hole heart of OK a karaoke club portion 3 to the planar vertical dimension of OK a karaoke club portion tail end to the convex edge at the center of plush copper 11.And when plush copper 11 is harmonious with OK a karaoke club portion hole 4, but the sliding of tail end plane go into convex edge 12 below, the both sides of convex edge 12 and protruding 11 form the triangle line, fixedly OK a karaoke club portion 3.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 87101011 CN87101011A (en) | 1987-03-31 | 1987-03-31 | Memory nail and extractor thereof in the forked humerus marrow |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 87101011 CN87101011A (en) | 1987-03-31 | 1987-03-31 | Memory nail and extractor thereof in the forked humerus marrow |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN87101011A true CN87101011A (en) | 1988-02-24 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 87101011 Pending CN87101011A (en) | 1987-03-31 | 1987-03-31 | Memory nail and extractor thereof in the forked humerus marrow |
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| Country | Link |
|---|---|
| CN (1) | CN87101011A (en) |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102727293A (en) * | 2011-03-30 | 2012-10-17 | 财团法人金属工业研究发展中心 | Medical equipment with three-dimensional fixed pressure memory intramedullary nail |
| US9522022B2 (en) | 2013-11-18 | 2016-12-20 | Biomedical Enterprises, Inc. | Method and appparatus for an intramedullary implant and method of implantation therefor |
| US9636155B2 (en) | 2013-11-18 | 2017-05-02 | Biomedical Enterprises, Inc. | Method and apparatus for an intramudullary implant and method of implantation thereof |
| US9775659B2 (en) | 2010-10-04 | 2017-10-03 | Biomedical Enterprises, Inc. | Method and system for storing and inserting an implant |
| CN110393613A (en) * | 2019-08-14 | 2019-11-01 | 北京市春立正达医疗器械股份有限公司 | A kind of elbow joint prosthese |
| CN113558739A (en) * | 2021-08-18 | 2021-10-29 | 南方科技大学 | Novel minimally invasive intramedullary fixation instrument and fixation method for distal humerus fracture |
-
1987
- 1987-03-31 CN CN 87101011 patent/CN87101011A/en active Pending
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9775659B2 (en) | 2010-10-04 | 2017-10-03 | Biomedical Enterprises, Inc. | Method and system for storing and inserting an implant |
| CN102727293A (en) * | 2011-03-30 | 2012-10-17 | 财团法人金属工业研究发展中心 | Medical equipment with three-dimensional fixed pressure memory intramedullary nail |
| US9522022B2 (en) | 2013-11-18 | 2016-12-20 | Biomedical Enterprises, Inc. | Method and appparatus for an intramedullary implant and method of implantation therefor |
| US9636155B2 (en) | 2013-11-18 | 2017-05-02 | Biomedical Enterprises, Inc. | Method and apparatus for an intramudullary implant and method of implantation thereof |
| US9775656B2 (en) | 2013-11-18 | 2017-10-03 | Biomedical Enterprises, Inc. | Method and appparatus for an intramedullary implant and method of implantation therefor |
| CN110393613A (en) * | 2019-08-14 | 2019-11-01 | 北京市春立正达医疗器械股份有限公司 | A kind of elbow joint prosthese |
| CN113558739A (en) * | 2021-08-18 | 2021-10-29 | 南方科技大学 | Novel minimally invasive intramedullary fixation instrument and fixation method for distal humerus fracture |
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