WO2022021681A1 - 一种基于榫卯固定的骨重建连接结构及方法 - Google Patents

一种基于榫卯固定的骨重建连接结构及方法 Download PDF

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WO2022021681A1
WO2022021681A1 PCT/CN2020/129708 CN2020129708W WO2022021681A1 WO 2022021681 A1 WO2022021681 A1 WO 2022021681A1 CN 2020129708 W CN2020129708 W CN 2020129708W WO 2022021681 A1 WO2022021681 A1 WO 2022021681A1
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bone
bone segment
segment
tenon
mortise
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PCT/CN2020/129708
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English (en)
French (fr)
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刘剑楠
张陈平
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上海交通大学医学院附属第九人民医院
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Priority to US17/583,937 priority Critical patent/US20220142687A1/en
Publication of WO2022021681A1 publication Critical patent/WO2022021681A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A61B17/8071—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for the jaw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B2017/681—Alignment, compression, or distraction mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2/2803—Bones for mandibular reconstruction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30385—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove the rib and groove having non-parallel, e.g. conically-tapered, cooperating sides, e.g. having a trapezoidal front cross-section
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387—Dovetail connection

Definitions

  • the invention belongs to the technical field of medical devices, and relates to a bone reconstruction connection structure and method based on mortise and tenon fixation.
  • vascularized autologous bone grafts are currently the gold standard for bone reconstruction.
  • Commonly used vascularized bone flaps often include: fibula, ilium, and scapula. How to fix the grafted bone with the broken end of the bone, there are two main options:
  • Kirschner wire fixation method that is, the internal fixation material commonly used in orthopaedics is used for fixation.
  • the specification of this internal fixation material is generally about 20 cm and the diameter is between 0.5-2 mm. It is mostly used to fix short fractures or tears. Fracture fixation with little stress, such as detachment fracture, is also often used in the fixation of temporary fracture fragments in orthopaedic surgery.
  • the Kirschner wire often needs to pass through the skin and be exposed on the surface. If the dressing is not changed in time, it is easy to cause wound infection and often requires a second operation to remove it.
  • Titanium plate strong internal fixation method that is, a titanium bone plate made of titanium or titanium alloy is used to fix both ends of the fracture line together with titanium nails, as shown in Figure 1, so as to stabilize the broken end of the bone and promote bone healing effect.
  • titanium or titanium alloys are used as raw materials in the strong internal fixation of titanium plates, and a few people have the phenomenon of rejection of titanium metal infection and need to be removed by a second operation; at the same time, the bearing method of titanium plates does not meet the requirements of mandibular biomechanics .
  • the purpose of the present invention is to provide a bone reconstruction connection structure and method based on tenon-and-mortise fixation, which is used to solve the lack of the ability to promote bone fracture without the help of foreign bodies such as fixation plates in the prior art. End-healed bone rebuilds the problem of fixed connection structures.
  • a first aspect of the present invention provides a bone reconstruction connection structure based on mortise and tenon fixation, comprising at least two bone segments, and the adjacent bone segments are connected by a first connection part and The second connection part is detachably connected; the first connection part includes a first tongue and a first shoulder, the first tongue protrudes from the first shoulder, and the second connection part includes There is a first slot and a first shoulder, the first slot is indented relative to the first shoulder, and the portion of the first tongue protruding from the first shoulder is opposite to the first slot. match.
  • the bone segment includes a first bone segment, a second bone segment and a third bone segment connected in sequence, and a first connection part or a second connection part provided at one end of the second bone segment is connected to the first bone segment.
  • the second connection part or the first connection part provided at one end of the bone segment is detachably connected, and the first connection part or the second connection part provided at the other end of the second bone segment is connected with the second connection part provided at one end of the third bone segment.
  • the connecting part or the first connecting part is detachably connected.
  • a first bending angle of 60-180° is formed between the second bone segment and the first bone segment; a second bending angle of 60-180° is formed between the second bone segment and the third bone segment. Bending angle; the bending directions of the first bone segment and the third bone segment relative to the second bone segment are opposite.
  • the connecting end between the second bone segment and the first bone segment and the connecting end between the second bone segment and the third bone segment are provided with bone rods
  • the bone rods include a first bone rod. a bone rod and a second bone rod; the first bone rod is arranged at the connecting end between the second bone segment and the first bone segment, and the first bone rod penetrates the first bone segment and the second bone segment ; The second bone rod is arranged at the connecting end between the second bone segment and the third bone segment, and the second bone rod penetrates the second bone segment and the third bone segment.
  • one end of the first bone segment is provided with a first perforation
  • both ends of the second bone segment are respectively provided with a second perforation and a third perforation
  • one end of the third bone segment is provided with a fourth perforation
  • the length of the portion of the first tongue protruding from the first shoulder is equal to the depth of the first slot.
  • the portion of the first tongue protruding from the first shoulder is a dovetail.
  • a second aspect of the present invention provides a method for bone reconstruction and connection based on mortise and tenon fixation, comprising connecting adjacent bone segments in the bone reconstruction and connection structure based on mortise and tenon fixation according to the first aspect of the present invention through two ends
  • the first connecting part and the second connecting part are detachably connected, wherein when the adjacent bone segments are connected, the first tongue in the first connecting part is connected with the second connecting part.
  • the first slotted eye in the section is matched to connect.
  • the bone segment includes a first bone segment, a second bone segment and a third bone segment that are connected in sequence
  • the bone reconstruction and connection method includes: connecting the first bone segment and the second bone segment through both ends The first connecting part and the second connecting part are detachably connected, wherein when the first bone segment and the second bone segment are connected, the first tongue in the first connecting part and the second connecting part are connected
  • the first grooves in the socket are matched and connected; the second bone segment and the third bone segment are detachably connected through the first connecting part and the second connecting part provided at the ends of the two, wherein the first connecting part and the second connecting part are detachably connected.
  • the first tongue in the first connection part is matched with the first groove in the second connection part for connection.
  • the first bone segment and the second bone segment are connected obliquely to form a first bending angle a of 60-180°; the second bone segment and the third bone segment are connected obliquely to form 60-180° ° second bending angle b; wherein, the bending directions of the first bone segment and the third bone segment relative to the second bone segment are opposite.
  • the first bone rod passes through the first perforation and the second perforation, and sequentially penetrates the connecting end between the first bone segment and the second bone segment, wherein the first bone rod is provided on the second bone segment
  • the connecting end with the first bone segment, the first perforation is provided at one end of the first bone segment, and the second perforation is provided at one end of the second bone segment; through the second bone rod through the third perforation and the fourth perforation, which run through the connecting end between the second bone segment and the third bone segment in sequence, wherein the second bone rod is arranged at the connecting end between the second bone segment and the third bone segment, so
  • the third through hole is arranged at the other end of the second bone segment, and the fourth through hole is arranged at one end of the third bone segment.
  • a third aspect of the present invention provides a method for promoting the healing of broken bone ends, comprising applying the bone reconstruction connection structure based on mortise and tenon fixation according to the first aspect of the present invention to a patient who needs to promote the healing of broken bone ends.
  • a kind of bone reconstruction connection structure and method based on mortise and tenon fixation provided by the present invention has the following beneficial effects:
  • a bone reconstruction connection structure and method based on mortise and tenon fixation provided by the present invention does not require foreign bodies such as a fixing plate, but is reinforced only by its own mortise and tenon structure, thereby reducing infection, rejection and even secondary operations and other risks.
  • a kind of bone reconstruction connection structure and method based on mortise and tenon fixation provided by the present invention through its own mortise and tenon structure, the biological force of the mandible can be effectively conducted along the tooth force track and the muscle force track, and then through the bone Further reinforcement of the rod can completely maintain the stability of the reconstructed bone segment and prevent dislocation, which is superior to the fixation method of the titanium plate in the prior art which is not conducive to the conduction of mandibular biological force.
  • a bone reconstruction connection structure and method based on mortise and tenon fixation provided by the present invention can ensure that each bone segment receives effective biomechanical stimulation while maintaining stability, thereby promoting the healing of broken bone ends, avoiding the prior art There is a problem that the bone segment is not effectively stimulated by biological force due to the fixation of the middle titanium plate.
  • a bone reconstruction connection structure and method based on mortise and tenon fixation provided by the present invention is ingenious in design, simple in structure, convenient in use, low in cost, and requires no extra cost, and is very worthy of popularization and application in practical work.
  • Figure 1 shows a schematic diagram of the fixation structure using the rigid internal fixation method of titanium plates.
  • FIG. 2 shows a schematic diagram of the structure of the human mandible, the dental force track, and the muscle force track.
  • FIG. 3 is a schematic structural diagram of the bone reconstruction connection structure based on mortise and tenon fixation in the connection state of the present invention.
  • FIG. 4 is a schematic structural diagram of the bone reconstruction connection structure based on mortise and tenon fixation in the disassembled state of the present invention.
  • the present invention provides a bone reconstruction connection structure based on mortise and tenon fixation, as shown in Figs. 3-4, comprising at least two bone segments 1, and the adjacent bone segments 1 are connected by a first connection part 2 and a second bone segment.
  • Two connecting parts 3 are detachably connected; the first connecting part 2 includes a first tongue 21 and a first shoulder 22, the first tongue 21 protrudes from the first shoulder 22, the
  • the second connecting portion 3 includes a first slot 31 and a first shoulder 32, the first slot 31 is indented relative to the first shoulder 32, and the first tongue 21 protrudes out of the first slot 32.
  • a portion of the shoulder 22 matches the first slot 31 .
  • the above-mentioned mortise-and-mortise fixation-based bone reconstruction connection structure is a specially designed connection part structure, which can be tightly assembled and disassembled to prevent vertical dislocation, and does not require the help of foreign bodies such as a fixing plate.
  • the bone segment 1 includes a first bone segment 11 , a second bone segment 12 and a third bone segment 13 connected in sequence, and the second bone segment 12
  • the first connecting part 2 or the second connecting part 3 at one end is detachably connected with the second connecting part 3 or the first connecting part 2 at one end of the first bone segment 11
  • the other end of the second bone segment 12 is detachably connected.
  • the provided first connecting portion 2 or the second connecting portion 3 is detachably connected to the second connecting portion 3 or the first connecting portion 2 provided at one end of the third bone segment 13 .
  • a first bending angle a of 60-180° is formed between the second bone segment 12 and the first bone segment 11 ;
  • a second bending angle b of 60-180° is formed between the third bone segments 13 ; the bending directions of the first bone segment 11 and the third bone segment 13 relative to the second bone segment 12 are opposite.
  • the first bending angle a formed between one end of the second bone segment 12 and one end of the first bone segment 11 can make the first bone segment 11 and the second bone segment 12 follow the muscle force track c as shown in FIG. 2 .
  • the second bending angle b formed between the other end of the second bone segment 12 and one end of the third bone segment 13 can make the second bone segment 12 and the third bone segment 13 follow the dental force track d as shown in FIG. 2 . It has good retention force to prevent dislocation.
  • the connection end between the second bone segment 12 and the first bone segment 11 and the connection between the second bone segment 12 and the third bone segment 13 Both ends are provided with bone rods, the bone rods include a first bone rod 41 and a second bone rod 42 ; the first bone rod 41 is arranged between the second bone segment 12 and the first bone segment 11. The connecting end, the first bone rod 41 penetrates the first bone segment 11 and the second bone segment 12; the second bone rod 42 is provided at the connecting end between the second bone segment 12 and the third bone segment 13, so The second bone rod 42 penetrates the second bone segment 12 and the third bone segment 13 .
  • the first bone rod 41 can further strengthen and maintain the stability of the reconstructed bone segment between the second bone segment 12 and the first bone segment 11 , and prevent the second bone segment 12 and the first bone segment 11 from being dislocated from the vertical direction.
  • the second bone rod 42 can further strengthen and maintain the stability of the reconstructed bone segment between the second bone segment 12 and the third bone segment 13, and prevent the second bone segment 12 and the third bone segment 13 from being dislocated from the vertical direction.
  • the bone rod is cylindrical and can fix the bone segment 1 without falling off.
  • one end of the first bone segment 11 is provided with a first through hole 51
  • two ends of the second bone segment 12 are respectively provided with a second through hole 52 and a third through hole 53
  • one end of the third bone segment 13 is provided with a fourth through hole 54
  • the second through hole 52 is aligned with the first through hole 51
  • the third through hole 53 is aligned with the fourth through hole 54 .
  • the first bone rod 41 After the second through hole 52 is aligned with the first through hole 51, it is convenient for the first bone rod 41 to pass through the first bone segment 11 and the second bone segment 12. After the third through hole 53 is aligned with the fourth through hole 54 , it is convenient for the second bone rod 42 to penetrate the second bone segment 12 and the third bone segment 13 .
  • the material of the bone segment 1 can be human bone.
  • the osteotomy and drilling operations of the bone segment 1 can be realized by a power saw, a drill or other osteotomy devices.
  • Personalized osteotomy plans can also be precisely implemented with surgical guides, optical navigation, and robotic equipment.
  • the part of the first tongue 21 protruding from the first shoulder 22 is matched with the first slot 31 means that the part of the first tongue 21 protruding from the first shoulder 22 can be completely inserted into the first slot In 31, the two are matched to form a tightly connected tenon-and-mortise structure.
  • the length of the portion of the first tongue 21 protruding from the first shoulder 22 is equal to the depth of the first slot 31 .
  • the portion of the first tongue 21 protruding from the first shoulder 22 is a dovetail.
  • the part of the first tongue 21 protruding from the first shoulder 22 is in the shape of a quadrangular pyramid, and the part of the first tongue 21 protruding from the first shoulder 22 has an end face and a bone segment 1 is connected, the area of the other end surface of the part of the first tongue 21 protruding from the first shoulder 22 to the connecting surface with the bone segment 1 gradually decreases.
  • the first groove 31 that matches the part of the first tongue 21 protruding from the first shoulder 22 has one end and two sides open, and the first groove 31 is in the shape of a quadrangular pyramid. , the area from the open end face of the first groove hole 31 to the end face connected with the indented portion of the first groove shoulder 32 gradually decreases.
  • the bone reconstruction connection structure based on mortise and tenon fixation in the present invention is used in the case of a fracture of the patient's mandible and needs to be reconstructed.
  • first bone segment 11 and the second bone segment 12 are detachably connected through the first connecting portion 2 and the second connecting portion 3 provided at the ends of the two.
  • the first bone segment 11 and the second bone segment 12 are connected obliquely to form a first bending angle a of 60-180°.
  • first tongue 21 in the first connection part 2 is matched with the first groove 31 in the second connection part 3 for connection.
  • the part of 21 protruding from the first shoulder 22 is a dovetail tenon, and the shape of the first slot 31 is matched with it, and the two can be effectively connected.
  • the first bone rod 41 can also pass through the first through hole 51 and the second through hole 52, and pass through the connecting end between the first bone segment 11 and the second bone segment 12 in turn, so as to reinforce and maintain the first bone segment 11 and the second bone segment 11.
  • the stability of the reconstructed bone segment between the segments 12 prevents the dislocation of the first bone segment 11 and the second bone segment 12 from the vertical direction.
  • the second bone segment 12 and the third bone segment 13 are detachably connected through the first connecting portion 2 and the second connecting portion 3 provided at the ends of the two, and the second bone segment 12 and the third bone segment 12 are detachably connected.
  • the segments 13 are connected obliquely to form a second bending angle b of 60-180°.
  • the first tongue 21 in the first connection part 2 is matched with the first groove 31 in the second connection part 3 for connection.
  • the part of 21 protruding from the first shoulder 22 is a dovetail tenon, and the shape of the first slot 31 is matched with it, and the two can be effectively connected.
  • the second bone rod 42 can also pass through the connecting end between the second bone segment 12 and the third bone segment 13 through the third through hole 53 and the fourth through hole 54 in turn to reinforce and maintain the second bone segment 12 and the third bone segment 13.
  • the stability of the reconstructed bone segment between the segments 13 prevents the dislocation of the second bone segment 12 and the third bone segment 13 from the vertical direction. This ensures that the second bone segment 12 and the third bone segment 13 have a good retention force along the dental force track d to prevent dislocation.
  • the present invention provides a bone reconstruction connection structure and method based on mortise and tenon fixation, which is only reinforced by its own mortise and tenon joint structure, thereby reducing infection, rejection and even secondary surgery caused by implant fixation. risk and promote bone fracture healing. Therefore, the present invention effectively overcomes various shortcomings in the prior art and has high industrial utilization value.

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  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Engineering & Computer Science (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
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Abstract

一种基于榫卯固定的骨重建连接结构及方法。该基于榫卯固定的骨重建连接结构包括有至少两个骨段（1），相邻的骨段（1）之间经第一连接部（2）和第二连接部（3）可拆卸式连接；该第一连接部（2）包括有第一榫舌（21）和第一榫肩（22），第一榫舌（21）凸出于第一榫肩（22），第二连接部（3）包括有第一槽眼（31）和第一槽肩（32），第一槽眼（31）相对于第一槽肩（32）内缩进，第一榫舌（21）凸出于第一榫肩（22）的部分与第一槽眼（31）相匹配。这种基于榫卯固定的骨重建连接结构及方法，仅通过自身的榫卯结构进行加固，从而减少植入物固定引起的感染、排异甚至二次手术等风险，促进骨断端愈合。

Description

一种基于榫卯固定的骨重建连接结构及方法 技术领域
本发明属于医疗器械的技术领域，涉及一种基于榫卯固定的骨重建连接结构及方法。
背景技术
由肿瘤、外伤、炎症等因素引起的骨缺损会对患者身心产生极为严重的影响。而目前血管化的自体骨移植是骨重建的金标准。常用的血管化骨瓣常常包括：腓骨、髂骨及肩胛骨等。如何将移植骨与骨断端固定，主要有以下2种方案：
(1)克氏针固定法：即采用骨科常用的内固定材料进行固定，这种内固定材料的规格一般在二十公分左右，直径在0.5-2毫米之间，多用于固定短小骨折或撕脱骨折等应力不大的骨折固定，也常被用在骨科手术中临时骨折块的固定中。但克氏针常需穿过皮肤外露在表面，如换药不及时，易造成伤口感染，往往需要二次手术取出。
(2)钛板坚强内固定法：即采用钛或钛合金制造的钛接骨板，配合钛钉一起应用于固定骨折线两端，具体见图1，从而起到稳定骨断端，促进骨愈合的作用。但钛板坚强内固定法中采用钛或钛合金作为原料，有少数人对钛金属有感染排异现象，需二次手术取出；同时，钛板的承力方式不符合下颌骨生物力学的要求。
因此，有必要对骨重建中现有固定方式进行进一步的研究及探讨。
发明内容
鉴于以上所述现有技术的缺点，本发明的目的在于提供一种基于榫卯固定的骨重建连接结构及方法，用于解决现有技术中缺乏无需借助于固定板等异物就能够促进骨断端愈合的骨重建固定连接结构的问题。
为实现上述目的及其他相关目的，本发明第一方面提供一种基于榫卯固定的骨重建连接结构，包括有至少两个骨段，相邻的所述骨段之间经第一连接部和第二连接部可拆卸式连接；所述第一连接部包括有第一榫舌和第一榫肩，所述第一榫舌凸出于所述第一榫肩，所述第二连接部包括有第一槽眼和第一槽肩，所述第一槽眼相对于所述第一槽肩内缩进，所述第一榫舌凸出于第一榫肩的部分与第一槽眼相匹配。
优选地，所述骨段包括有依次连接的第一骨段、第二骨段及第三骨段，所述第二骨段一端设置的第一连接部或第二连接部与所述第一骨段一端设置的第二连接部或第一连接部可拆卸式连接，所述第二骨段另一端设置的第一连接部或第二连接部与所述第三骨段一端设置的 第二连接部或第一连接部可拆卸式连接。
更优选地，所述第二骨段与第一骨段之间形成60-180°的第一折弯角；所述第二骨段与第三骨段之间形成60-180°的第二折弯角；所述第一骨段与第三骨段相对第二骨段的折弯方向相反。
更优选地，所述第二骨段与第一骨段之间的连接端和所述第二骨段与第三骨段之间的连接端均设有骨棒，所述骨棒包括有第一骨棒和第二骨棒；所述第一骨棒设于所述第二骨段与第一骨段之间的连接端，所述第一骨棒贯穿第一骨段和第二骨段；所述第二骨棒设于第二骨段与第三骨段之间的连接端，所述第二骨棒贯穿第二骨段和第三骨段。
更优选地，所述第一骨段一端设有第一穿孔，所述第二骨段两端分别设有第二穿孔和第三穿孔，所述第三骨段一端设有第四穿孔，所述第二骨段与第一骨段连接时，所述第二穿孔与第一穿孔相对准；所述第二骨段与第三骨段连接时，所述第三穿孔与第四穿孔相对准。
优选地，所述第一榫舌凸出于第一榫肩的部分的长度与第一槽眼的深度相等。
优选地，所述第一榫舌凸出于第一榫肩的部分为燕尾榫。
本发明第二方面提供一种基于榫卯固定的骨重建连接方法，包括将本发明第一方面所述基于榫卯固定的骨重建连接结构中相邻的所述骨段之间通过两者端部设置的第一连接部与第二连接部进行可拆卸式连接，其中相邻的所述骨段之间连接时，通过所述第一连接部中的第一榫舌与所述第二连接部中的第一槽眼相匹配进行连接。
优选地，所述骨段包括依次连接的第一骨段、第二骨段及第三骨段，所述骨重建连接方法包括：将第一骨段与第二骨段之间通过两者端部设置的第一连接部与第二连接部进行可拆卸式连接，其中，所述第一骨段与第二骨段连接时，通过第一连接部中的第一榫舌与第二连接部中的第一槽眼相匹配进行连接；将第二骨段与第三骨段之间通过两者端部设置的第一连接部与第二连接部进行可拆卸式连接，其中，所述第二骨段与第三骨段连接时，通过第一连接部中的第一榫舌与第二连接部中的第一槽眼相匹配进行连接。
优选地，将第一骨段与第二骨段之间倾斜连接，形成60-180°的第一折弯角a；将第二骨段与第三骨段之间倾斜连接，形成60-180°的第二折弯角b；其中，所述第一骨段与第三骨段相对第二骨段的折弯方向相反。
优选地，通过第一骨棒经第一穿孔、第二穿孔，依次贯穿第一骨段与第二骨段之间的连接端，其中，所述第一骨棒设于所述第二骨段与第一骨段之间的连接端，所述第一穿孔设于所述第一骨段一端，所述第二穿孔设于所述第二骨段一端；通过第二骨棒经第三穿孔、第四穿孔，依次贯穿第二骨段与第三骨段之间的连接端，其中，所述第二骨棒设于所述第二骨段 与第三骨段之间的连接端，所述第三穿孔设于所述第二骨段另一端，所述第四穿孔设于所述第三骨段一端。本发明第三方面提供一种促进骨断端愈合的方法，包括将本发明第一方面所述基于榫卯固定的骨重建连接结构施用于需要促进骨断端愈合的患者。
如上所述，本发明提供的一种基于榫卯固定的骨重建连接结构及方法，具有以下有益效果：
(1)    本发明提供的一种基于榫卯固定的骨重建连接结构及方法，无需借助于固定板等异物，仅通过自身的榫卯结构进行加固，从而减少了感染、排异甚至二次手术等风险。
(2)    本发明提供的一种基于榫卯固定的骨重建连接结构及方法，通过自身的榫卯结构，使下颌骨的生物力沿着牙力轨道和肌力轨道得到有效传导，再通过骨棒进一步加固可完全保持重建骨段的稳定性，防止脱位，优于现有技术中不利于下颌骨生物力的传导的钛板的固定方式。
(3)    本发明提供的一种基于榫卯固定的骨重建连接结构及方法，能够保证各骨段在保持稳定性的同时接受有效生物力学刺激，从而促进骨断端愈合，避免了现有技术中钛板固定使骨段并未接受到生物力的有效刺激的问题。
(4)    本发明提供的一种基于榫卯固定的骨重建连接结构及方法，设计巧妙，结构简单，使用方便，成本低廉，无需额外花费，非常值得在实际工作中推广应用。
附图说明
图1显示为采用钛板坚强内固定法的固定结构示意图。
图2显示为人体下颌骨的结构及牙力轨道、肌力轨道的示意图。
图3显示为本发明中基于榫卯固定的骨重建连接结构在连接状态时的结构示意图。
图4显示为本发明中基于榫卯固定的骨重建连接结构在分拆状态时的结构示意图。
附图标记
1       骨段
11      第一骨段
12      第二骨段
13      第三骨段
2       第一连接部
21      第一榫舌
22      第一榫肩
3       第二连接部
31      第一槽眼
32      第一槽肩
41      第一骨棒
42      第二骨棒
51      第一穿孔
52      第二穿孔
53      第三穿孔
54      第四穿孔
a       第一折弯角
b       第二折弯角
c       肌力轨道
d       牙力轨道
具体实施方式
以下由特定的具体实施例说明本发明的实施方式，熟悉此技术的人士可由本说明书所揭露的内容轻易地了解本发明的其他优点及功效。
请参阅图2至图4。须知，本说明书所附图式所绘示的结构、比例、大小等，均仅用以配合说明书所揭示的内容，以供熟悉此技术的人士了解与阅读，并非用以限定本发明可实施的限定条件，故不具技术上的实质意义，任何结构的修饰、比例关系的改变或大小的调整，在不影响本发明所能产生的功效及所能达成的目的下，均应仍落在本发明所揭示的技术内容得能涵盖的范围内。同时，本说明书中所引用的如“上”、“下”、“左”、“右”、“中间”及“一”等的用语，亦仅为便于叙述的明了，而非用以限定本发明可实施的范围，其相对关系的改变或调整，在无实质变更技术内容下，当亦视为本发明可实施的范畴。
本发明提供一种基于榫卯固定的骨重建连接结构，如图3-4所示，包括有至少两个骨段1，相邻的所述骨段1之间经第一连接部2和第二连接部3可拆卸式连接；所述第一连接部2包括有第一榫舌21和第一榫肩22，所述第一榫舌21凸出于所述第一榫肩22，所述第二连接部3包括有第一槽眼31和第一槽肩32，所述第一槽眼31相对于所述第一槽肩32内缩进，所述 第一榫舌21凸出于第一榫肩22的部分与第一槽眼31相匹配。上述基于榫卯固定的骨重建连接结构为具有特殊设计的连接部结构，能够紧密装卸连接，防止垂直方向脱位，无需借助于固定板等异物。
在一个优选实施例中，如图3-4所示，所述骨段1包括有依次连接的第一骨段11、第二骨段12及第三骨段13，所述第二骨段12一端设置的第一连接部2或第二连接部3与所述第一骨段11一端设置的第二连接部3或第一连接部2可拆卸式连接，所述第二骨段12另一端设置的第一连接部2或第二连接部3与所述第三骨段13一端设置的第二连接部3或第一连接部2可拆卸式连接。
在进一步优选的实施例中，如图3所示，所述第二骨段12与第一骨段11之间形成60-180°的第一折弯角a；所述第二骨段12与第三骨段13之间形成60-180°的第二折弯角b；所述第一骨段11与第三骨段13相对第二骨段12的折弯方向相反。
上述第二骨段12一端与第一骨段11一端之间形成的第一折弯角a，能够使第一骨段11与第二骨段12沿着如图2所示肌力轨道c有良好的固位力，防止脱位。上述第二骨段12另一端与第三骨段13一端之间形成的第二折弯角b，能够使第二骨段12与第三骨段13沿着如图2所示牙力轨道d有良好的固位力，防止脱位。
在进一步优选的实施例中，如图3所示，所述第二骨段12与第一骨段11之间的连接端和所述第二骨段12与第三骨段13之间的连接端均设有骨棒，所述骨棒包括有第一骨棒41和第二骨棒42；所述第一骨棒41设于所述第二骨段12与第一骨段11之间的连接端，所述第一骨棒41贯穿第一骨段11和第二骨段12；所述第二骨棒42设于第二骨段12与第三骨段13之间的连接端，所述第二骨棒42贯穿第二骨段12和第三骨段13。
所述第一骨棒41可进一步加固并保持第二骨段12与第一骨段11之间的重建骨段的稳定性，防止第二骨段12与第一骨段11从垂直方向脱位。所述第二骨棒42可进一步加固并保持第二骨段12与第三骨段13之间的重建骨段的稳定性，防止第二骨段12与第三骨段13从垂直方向脱位。
具体来说，如图3所示，所述骨棒呈圆柱形，能够固定骨段1且不脱落。在进一步优选的实施例中，如图4所示，所述第一骨段11一端设有第一穿孔51，所述第二骨段12两端分别设有第二穿孔52和第三穿孔53，所述第三骨段13一端设有第四穿孔54，所述第二骨段12与第一骨段11连接时，所述第二穿孔52与第一穿孔51相对准；所述第二骨段12与第三骨段13连接时，所述第三穿孔53与第四穿孔54相对准。
所述第二穿孔52与第一穿孔51相对准后，便于第一骨棒41贯穿第一骨段11、第二骨 段12。所述第三穿孔53与第四穿孔54相对准后，便于第二骨棒42贯穿第二骨段12、第三骨段13。
在一个优选实施例中，所述骨段1的材质可为人骨。当骨段1为人骨时，可通过动力锯、钻头或其他截骨装置实现骨段1的截骨、钻孔操作。也可凭借手术导板、光学导航及机器人装备精准实施个性化的截骨方案。
所述第一榫舌21凸出于第一榫肩22的部分与第一槽眼31相匹配是指，第一榫舌21凸出于第一榫肩22的部分能够完全插入第一槽眼31中，两者吻合，能够形成紧密连接的榫卯结构。
在一个优选实施例中，如图4所示，所述第一榫舌21凸出于第一榫肩22的部分的长度与第一槽眼31的深度相等。
在一个优选实施例中，如图4所示，所述第一榫舌21凸出于第一榫肩22的部分为燕尾榫。具体来说，即所述第一榫舌21凸出于第一榫肩22的部分呈四棱台形，所述第一榫舌21凸出于第一榫肩22的部分的一端面与骨段1相连接，所述第一榫舌21凸出于第一榫肩22的部分的另一端面至与骨段1连接面的面积逐渐变小。同时，与所述第一榫舌21凸出于第一榫肩22的部分相匹配的所述第一槽眼31，其一端面及两侧开口，所述第一槽眼31呈四棱台形，所述第一槽眼31的开口端面至与第一槽肩32内缩进部分相连接的端面的面积逐渐变小。
下面结合图2-4，说明本发明中一种基于榫卯固定的骨重建连接方法。
使用者获得如图2-4所示的一种基于榫卯固定的骨重建连接结构后，针对患者下颌骨存在骨折需要重建情况使用本发明中基于榫卯固定的骨重建连接结构。
首先，将第一骨段11与第二骨段12之间通过两者端部设置的第一连接部2与第二连接部3进行可拆卸式连接，第一骨段11与第二骨段12之间倾斜连接，形成60-180°的第一折弯角a。第一骨段11与第二骨段12连接时，通过第一连接部2中的第一榫舌21与第二连接部3中的第一槽眼31相匹配进行连接，由于第一榫舌21凸出于第一榫肩22的部分为燕尾榫，而第一槽眼31的形状与之相匹配，两者能够有效连接。还可通过第一骨棒41经第一穿孔51、第二穿孔52，依次贯穿第一骨段11与第二骨段12之间的连接端，加固并保持第一骨段11与第二骨段12之间的重建骨段的稳定性，防止第一骨段11与第二骨段12从垂直方向脱位。从而保证第一骨段11与第二骨段12沿着肌力轨道c有良好的固位力，防止脱位。
然后，再将第二骨段12与第三骨段13之间通过两者端部设置的第一连接部2与第二连接部3进行可拆卸式连接，第二骨段12与第三骨段13之间倾斜连接，形成60-180°的第二折弯角b。第二骨段12与第三骨段13接时，通过第一连接部2中的第一榫舌21与第二连接 部3中的第一槽眼31相匹配进行连接，由于第一榫舌21凸出于第一榫肩22的部分为燕尾榫，而第一槽眼31的形状与之相匹配，两者能够有效连接。还可通过第二骨棒42经第三穿孔53、第四穿孔54，依次贯穿第二骨段12与第三骨段13之间的连接端，加固并保持第二骨段12与第三骨段13之间的重建骨段的稳定性，防止第二骨段12与第三骨段13从垂直方向脱位。从而保证第二骨段12与第三骨段13沿着牙力轨道d有良好的固位力，防止脱位。
综上所述，本发明提供的一种基于榫卯固定的骨重建连接结构及方法，仅通过自身的榫卯结构进行加固，从而减少植入物固定引起的感染、排异甚至二次手术等风险，促进骨断端愈合。所以，本发明有效克服了现有技术中的种种缺点而具高度产业利用价值。
上述实施例仅例示性说明本发明的原理及其功效，而非用于限制本发明。任何熟悉此技术的人士皆可在不违背本发明的精神及范畴下，对上述实施例进行修饰或改变。因此，举凡所属技术领域中具有通常知识者在未脱离本发明所揭示的精神与技术思想下所完成的一切等效修饰或改变，仍应由本发明的权利要求所涵盖。

Claims (11)

  1. 一种基于榫卯固定的骨重建连接结构，其特征在于，包括有至少两个骨段(1)，相邻的所述骨段(1)之间经第一连接部(2)和第二连接部(3)可拆卸式连接；所述第一连接部(2)包括有第一榫舌(21)和第一榫肩(22)，所述第一榫舌(21)凸出于所述第一榫肩(22)，所述第二连接部(3)包括有第一槽眼(31)和第一槽肩(32)，所述第一槽眼(31)相对于所述第一槽肩(32)内缩进，所述第一榫舌(21)凸出于第一榫肩(22)的部分与第一槽眼(31)相匹配。
  2. 根据权利要求1所述的基于榫卯固定的骨重建连接结构，其特征在于，所述骨段(1)包括有依次连接的第一骨段(11)、第二骨段(12)及第三骨段(13)，所述第二骨段(12)一端设置的第一连接部(2)或第二连接部(3)与所述第一骨段(11)一端设置的第二连接部(3)或第一连接部(2)可拆卸式连接，所述第二骨段(12)另一端设置的第一连接部(2)或第二连接部(3)与所述第三骨段(13)一端设置的第二连接部(3)或第一连接部(2)可拆卸式连接。
  3. 根据权利要求2所述的基于榫卯固定的骨重建连接结构，其特征在于，所述第二骨段(12)与第一骨段(11)之间形成60-180°的第一折弯角a；所述第二骨段(12)与第三骨段(13)之间形成60-180°的第二折弯角b；所述第一骨段(11)与第三骨段(13)相对第二骨段(12)的折弯方向相反。
  4. 根据权利要求2所述的基于榫卯固定的骨重建连接结构，其特征在于，所述第二骨段(12)与第一骨段(11)之间的连接端和所述第二骨段(12)与第三骨段(13)之间的连接端均设有骨棒，所述骨棒包括有第一骨棒(41)和第二骨棒(42)；所述第一骨棒(41)设于所述第二骨段(12)与第一骨段(11)之间的连接端，所述第一骨棒(41)贯穿第一骨段(11)和第二骨段(12)；所述第二骨棒(42)设于第二骨段(12)与第三骨段(13)之间的连接端，所述第二骨棒(42)贯穿第二骨段(12)和第三骨段(13)。
  5. 根据权利要求2所述的基于榫卯固定的骨重建连接结构，其特征在于，所述第一骨段(11)一端设有第一穿孔(51)，所述第二骨段(12)两端分别设有第二穿孔(52)和第三穿孔(53)，所述第三骨段(13)一端设有第四穿孔(54)，所述第二骨段(12)与第一骨段(11)连接时，所述第二穿孔(52)与第一穿孔(51)相对准；所述第二骨段(12)与第三骨段(13)连接时，所述第三穿孔(53)与第四穿孔(54)相对准。
  6. 根据权利要求1所述的基于榫卯固定的骨重建连接结构，其特征在于，所述第一榫舌(21)凸出于第一榫肩(22)的部分为燕尾榫。
  7. 一种基于榫卯固定的骨重建连接方法，其特征在于，包括步骤：
    提供如权利要求1所述的基于榫卯固定的骨重建连接结构；
    将相邻的所述骨段(1)之间通过两者端部设置的第一连接部(2)与第二连接部(3)进行可拆卸式连接，其中相邻的所述骨段(1)之间连接时，通过所述第一连接部(2)中的第一榫舌(21)与所述第二连接部(3)中的第一槽眼(31)相匹配进行连接。
  8. 根据权利要求7所述的基于榫卯固定的骨重建连接方法，其特征在于，所述骨段(1)包括有依次连接的第一骨段(11)、第二骨段(12)及第三骨段(13)，所述骨重建连接方法包括以下步骤；
    将第一骨段(11)与第二骨段(12)之间通过两者端部设置的第一连接部(2)与第二连接部(3)进行可拆卸式连接，其中，所述第一骨段(11)与第二骨段(12)连接时，通过第一连接部(2)中的第一榫舌(21)与第二连接部(3)中的第一槽眼(31)相匹配进行连接；
    将第二骨段(12)与第三骨段(13)之间通过两者端部设置的第一连接部(2)与第二连接部(3)进行可拆卸式连接，其中，所述第二骨段(12)与第三骨段(13)连接时，通过第一连接部(2)中的第一榫舌(21)与第二连接部(3)中的第一槽眼(31)相匹配进行连接。
  9. 根据权利要求8所述的基于榫卯固定的骨重建连接方法，其特征在于：
    将第一骨段(11)与第二骨段(12)之间倾斜连接，形成60-180°的第一折弯角a；
    将第二骨段(12)与第三骨段(13)之间倾斜连接，形成60-180°的第二折弯角b；
    其中，所述第一骨段(11)与第三骨段(13)相对第二骨段(12)的折弯方向相反。
  10. 根据权利要求8所述的基于榫卯固定的骨重建连接方法，其特征在于：
    通过第一骨棒(41)经第一穿孔(51)、第二穿孔(52)，依次贯穿第一骨段(11)与第二骨段(12)之间的连接端，其中，所述第一骨棒(41)设于所述第二骨段(12)与第一骨段(11)之间的连接端，所述第一穿孔(51)设于所述第一骨段(11)一端，所述第二穿孔(52)设于所述第二骨段(12)一端；
    通过第二骨棒(42)经第三穿孔(53)、第四穿孔(54)，依次贯穿第二骨段(12)与第三骨段(13)之间的连接端，其中，所述第二骨棒(42)设于所述第二骨段(12)与第三骨段(13)之间的连接端，所述第三穿孔(53)设于所述第二骨段(12)另一端，所述第四穿孔(54)设于所述第三骨段(13)一端。
  11. 一种促进骨断端愈合的方法，其特征在于，将权利要求1-6所述基于榫卯固定的骨重建连接结构施用于需要促进骨断端愈合的患者。
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