CN87201185U - Memory alloy humeral inner-marrow nial, and its setting and taking down device - Google Patents
Memory alloy humeral inner-marrow nial, and its setting and taking down device Download PDFInfo
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- CN87201185U CN87201185U CN 87201185 CN87201185U CN87201185U CN 87201185 U CN87201185 U CN 87201185U CN 87201185 CN87201185 CN 87201185 CN 87201185 U CN87201185 U CN 87201185U CN 87201185 U CN87201185 U CN 87201185U
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Abstract
The utility model relates to a Y-shaped humeral intramedullary nail made of nickel titan memory alloy and an extractor which are used in a bone surgery apparatus. The intramedullary nail is provided with a main body part which is provided with a V-shaped section in the middle of the intramedullary nail, a fork-shaped arc-fork part arranged at the front end of the intramedullary nail, and a clamping and pulling part of which the plane is arranged with holes at the rear end of the intramedullary nail. The main body part in a cryogenic plastic deforming state and the arc-fork part enter a certain part of humeral marrow, and the clamping and pulling part is embedded at the opening of the humeral marrow during the operation. The intramedullary nail can revert to the designing shape under the condition of the temperature of a human body after operations. The utility model has self-pressing and connecting effects on humerus fracture, and particularly has effects on transversal fracture, comminuted fracture and segmental fracture, and nonunion. The utility model does not need external fixation. By using the utility model, the successful rate of the operations is obviously increased.
Description
This utility model 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 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 be 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 the dried fracture of upper arm amount.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 ill effects such as bone does not connect and steel plate jackknifing 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 last 1/3 length of humerus, 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 fracture, the stimulation knitting.But 1/3 is long on humerus, owing to 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, V-arrangement is followed closely typical equilateral triangle pulp cavity when performing the operation, not only squeeze into difficulty, the probability of coincideing is very little, but also can cause the fracture far-end to back 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 have a kind of intramedullary pin, though that specification has is multiple, only on thickness and tail end style difference is arranged, grown form is still the pattern of Rush pin.At present representative is Ender ' s pin, and its biggest advantage is simple to operate, and it is also easy to dial pin, is applicable to each section fracture of humerus.In operation, if can insert many Enders pins in medullary cavity of humerus, then in shearing resistance, anti-relax one's efforts, anti-rotation, reduce the set time and promote aspects such as union of fracture all can demonstrate superiority.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 the relaxing one's efforts of fracture site, rotation etc. like this, cause bone does not connect.Intramedullary pin 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; when pressurization function is trained; because of the intensity of pin is low, flexible, abnormal movement strengthens; easily cause bone does not connect; recently the someone takes inserting needle behind the humerus ankle, 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 purpose of this utility model is to utilize the performance of memorial alloy, and not the bar portion and the head of end, V-shaped groove of making the band tang have the bifid intramedullary pin of arc.Integral body is the y shape.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 to beat and dials utensil, makes operation technique more convenient.
The purpose of this utility model will realize in the following manner: the y-shaped intramedullary pin total length of memorial alloy is divided into three parts, 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.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 transfering to, 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 memorial alloy 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, it can produce comparatively ideal moulding deformation on request in a certain cryogenic temperature, 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.This utility model has utilized the shape memory effect and the mechanical behavior of Nitinol just.
Described in detail below with reference to accompanying drawing:
Fig. 1 is the vertical view of this utility model intramedullary pin.
Fig. 2 is the side view of intramedullary pin of the present utility model.
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 utility model.
Fig. 5 is the front view of extractor of the present utility model.
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 this utility model intramedullary pin internal fixation.
Fig. 7 A is the preceding X-ray photograph of 1/3 comminuted fracture operation under the left humerus.
Fig. 7 B uses 1 year bone does not connect X-ray photograph behind Ender ' the s nail internal fixation.
Fig. 7 C is after Ender ' s nail takes out, and adds X-ray photograph behind the ilium bone grafting operation with intramedullary pin internal fixation of the present utility model.
The main part (1) that has the V-arrangement cross section with reference to Fig. 1 and Fig. 3, the geometric shape of dissecting in design according to medullary cavity of humerus, should make main part (1) and humerus in, 1/3 triangle pulp cavity in long matches down, V-shaped part then places the company commander 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 0.9 centimetre.The arc intercross portion of front end (2) extends laterally as V-arrangement main part (1) two wall, 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 feature of memorial alloy, intramedullary pin of the present utility model 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, play anti-turning effort.The OK a karaoke club portion 3 of rear end is flat wide, and width is at 1.2 to 1.8 centimetres, and length is also at 1.2 to 1.8 centimetres, and the centre has one with OK a karaoke club portion or play the perforate 4 that the tool head portion of exchanging work matches, and perforate 4 diameters are 0.5 centimetre.OK a karaoke club portion 3 will stay outside the pulp cavity after the operation, and play the fixedly effect in force when arc intercross portion 2 upwards slides in the pulp cavity inboard.
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 0.3～0.7 centimetre, this inclination angle is favourable to make this nail import pulp cavity, treat union of fracture after, it is convenient to transfer to, 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 the excellent operation condition for not influencing elbow joint function.(see figure 2).
By 100 male and 100 women's humerus dry measure at random, Preliminary design, process the y-shaped intramedullary pin of memorial alloy of three kinds of specifications, each size of its each specification sees the following form.
From the end of the year one nine eight six so far, utilize intramedullary pin of the present utility model 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 y-shaped humeral intramedullary nail fixation of memorial alloy of the present invention.Visible y 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, and 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 were 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.Fig. 7 C is that this utility model intramedullary pin fixation adds X-ray photograph behind self ilium bone grafting operation.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 the y-shaped humeral intramedullary nail of memorial alloy.At first, according to pulp cavity bore shown in the length of patient's humerus and the X-ray sheet, determine y-shaped 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, on the medullary cavity axis of 2.5～3.0 centimetres of this points, cutting skin and subcutaneous, the slitting fascia, the triceps muscle of riving reaches sclerotin, then open the bone groove that is inclined upwardly and communicate with pulp cavity, about 1.5～2.5 centimetres of bone flute length, width is with one side of pulp cavity.Spare nail inserted in 4～10 ℃ the sterilization cold water or frozen water, outer bifurcated branch is closed up, and make the main part head end in V-arrangement cross section slightly curved, and insert intramedullary pin by making V-shaped part towards the state that parallels with pulp cavity bone groove rear surface, under direct-view, squeeze into the fracture near-end, perhaps squeezing into near-end under the anatomical reduction fully, the circular arc tilting position enters pulp cavity up to OK a karaoke club portion, and rear end shoulder and the bone groove of band circular arc that makes OK a karaoke club portion is mutually till the embedding, and routine is closed wound, triangular bandage suspension, operation finishes.
The employed memory nickel alloy of the utility model biocompatibility in anticorrosive, wear-resistant and Transplanting Human or animal all is better than medical stainless steel and titanium alloy. So it is foolproof being used as intramedullary nail of the present utility model. Intramedullary nail of the present utility model can select thick 0.1～0.18 centimetre Nitinol plate to make the V-arrangement main body, has enough big hardness, intensity.
Extractor of the present utility model 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 it 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 top of plush copper 11 be a convex edge 12 its equate 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 transverse plane sliding is not gone under the convex edge.Its nail hole along two ends and insertion is wired to △ shape makes nail stable.
This utility model deft design, rational in infrastructure, make y-shaped intramedullary pin can be fit to that various types of humerus are done folding, particularly other intramedullary pin, steel plate is insoluble, open comminuted as cross-section shape, the bone does not connect due to several sections of fracture or other internal fixation etc.And it is few to have a damage, and healing is fast, and it is tightly firm to dissect compatible embedding, produces self-generated pressure, promotes knitting.Its operation that is also advantageous in that does not relate to shoulder, elbow joint.So there is not the shoulder and elbow function problem on obstacle due to traditional surgical approaches and the material.Therefore, with the bone does not connect due to the dried all kinds fracture of intramedullary nail treatment humerus of the present utility model or other method, its cure rate can obviously improve.
Claims (9)
1, a kind of humeral intramedullary nail, the main part 1 that comprises a V-shaped section bar in centre, the front end that it is characterized in that said main part 1 is bifid arc intercross portion 2 in addition, with the rear end flat OK a karaoke club portion 3 with holes is arranged, the two walls elongated end laterally that said arc intercross portion 2 is a main part 1, and alternate having angle, said humeral intramedullary nail is made by marmem.
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 makes the plane, lower edge of OK a karaoke club portion 3 be higher than V-shaped part to form plane 0.3-0.5 centimetre.
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, angle 30-50 ° of arc fork, 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, according to claim 1,2,3 or 4 described intramedullary pins, it is characterized in that circular arc connects between the wall of said main part 1 and the arc fork branch, arc radius is 3.5-5 centimetre, 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, intramedullary pin according to claim 7 is characterized in that said marmem is a niti-shaped memorial alloy, and wherein nickeliferous is 50.8-51.8Wt%,
9, a kind of extractor according to right 1 described humeral intramedullary nail, comprise that a handle portion 8 and two knock portion 9, it is characterized in that the said front portion that portion 9 is positioned at extractor of knocking, and two flat surfaces are arranged, said handle portion 8 is a link rod part 10 with knocking portion 9 centres, knock that there is a cylinder plush copper 11 below in the free end of portion 9, the convex edge portion 12 that has flat surfaces to extend with the top, the diameter of said plush copper 11 and OK a karaoke club portion aperture cunning are joined, and the vertical dimension of the convex edge, center 12 of plush copper 11 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.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 87201185 CN87201185U (en) | 1987-03-31 | 1987-03-31 | Memory alloy humeral inner-marrow nial, and its setting and taking down device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 87201185 CN87201185U (en) | 1987-03-31 | 1987-03-31 | Memory alloy humeral inner-marrow nial, and its setting and taking down device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN87201185U true CN87201185U (en) | 1987-12-26 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 87201185 Expired - Lifetime CN87201185U (en) | 1987-03-31 | 1987-03-31 | Memory alloy humeral inner-marrow nial, and its setting and taking down device |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN87201185U (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2003055399A1 (en) * | 2001-12-29 | 2003-07-10 | Benwen Qian | An intramedullary pin |
| CN112353482A (en) * | 2020-11-10 | 2021-02-12 | 无锡市第九人民医院 | Minimally invasive intramedullary broken nail extractor |
-
1987
- 1987-03-31 CN CN 87201185 patent/CN87201185U/en not_active Expired - Lifetime
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2003055399A1 (en) * | 2001-12-29 | 2003-07-10 | Benwen Qian | An intramedullary pin |
| CN112353482A (en) * | 2020-11-10 | 2021-02-12 | 无锡市第九人民医院 | Minimally invasive intramedullary broken nail extractor |
| CN112353482B (en) * | 2020-11-10 | 2022-07-05 | 无锡市第九人民医院 | Minimally invasive intramedullary broken nail extractor |
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| C06 | Publication | ||
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| C17 | Cessation of patent right | ||
| CX01 | Expiry of patent term |