CN108309516B - 一种距骨假体 - Google Patents
一种距骨假体 Download PDFInfo
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- 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
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- 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
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- 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
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Abstract
本发明涉及一种距骨假体,属于医学技术领域,包括一体相连的距骨头、距骨颈和距骨体,所述距骨头、所述距骨颈和所述距骨体一体化成型,所述距骨头包括一个向前的距舟关节面,所述距骨颈的轴线有15°~20°的内倾,所述距骨体包括:上方的距骨滑车关节面,下方的前跟关节面、中跟关节面和后跟关节面,以及内侧的内踝关节面和外侧的外踝关节面。本发明所提出的距骨假体,其距骨头、距骨颈和距骨体一体化成型,使用寿命长,植入患者体内后无需更换零件,与人体不产生免疫排斥反应,经大数据统计并结合生物力学来进行设计,最大限度地保留了患者的关节功能。
Description
技术领域
本发明涉及医学技术领域,特别是涉及一种距骨假体。
背景技术
距骨是连接下肢和足部的枢纽,肩负重力传递和运动的耦联,是足部重要的功能单位。距骨位于踝穴内,分别与胫骨远端关节面,跟骨前、中、后关节面和舟状骨形成胫距关节(踝关节)、距下关节和距舟关节,周围韧带附着众多,外形不规则,解剖结构相对复杂。其表面约超过2/3的区域为关节软骨所覆盖,血液供应主要来自于内侧三角韧带、关节囊、跗骨窦、外侧距跟韧带及颈体交界处的踝关节前方关节囊。因创伤等原因造成的距骨缺血性坏死的患者,此类患者多数为单侧发病,踝关节疼痛、肿胀且病史较长,严重者行走困难,需进行手术。
当前手术方式主要有三种,第一种是关节融合术,其优点是症状改善明显,手术操作相对简单,疗效确切,是目前的标准手术,但缺点同样明显,术后康复时间长,有一定不愈合率,丧失关节活动,双侧患者对生活影响较大,周围关节继发退变加快;第二种是髓芯减压术,其优点是手术简单,风险低,缺点是适应症有限,有效率较低;第三种是全踝关节置换术,当前所用踝关节假体的优点是保留关节功能,减轻疼痛,但缺点是适应症很窄,手术操作复杂,风险高,费用高,假体与骨界面松动率较高,使用寿命较短。
现有技术中的踝关节假体大多由多个部件构成,主要作用是将距骨坏死的关节面替代掉,将距骨主要部分保留,因而设计上采用组配式的半踝关节或全踝关节,但是其主要结构复杂、易坏,且无法与骨形成良好的长入效果,寿命短。
发明内容
基于此,有必要针对现有技术中踝关节假体的结构复杂、易坏、长入效果不理想以及寿命短的问题,提供一种距骨假体,该距骨假体无假体-骨界面,避免了界面松动的问题,且使用寿命长。
为解决上述问题,本发明采取如下的技术方案:
一种距骨假体,包括一体相连的距骨头、距骨颈和距骨体,所述距骨头、所述距骨颈和所述距骨体一体化成型,
所述距骨头包括一个向前的距舟关节面,
所述距骨颈的轴线有15°~20°的内倾,
所述距骨体包括:上方的距骨滑车关节面,下方的前跟关节面、中跟关节面和后跟关节面,以及内侧的内踝关节面和外侧的外踝关节面。
本发明所提出的距骨假体,其距骨头、距骨颈和距骨体一体化成型,使用寿命长,植入患者体内后无需更换零件,与人体不产生免疫排斥反应,经大数据统计并结合生物力学来进行设计,最大限度地保留了患者的关节功能。
附图说明
图1为本发明其中一个实施例中距骨假体的前视图;
图2为本发明其中一个实施例中距骨假体的俯视图;
图3为本发明其中一个实施例中距骨假体的左视图;
图4为本发明其中一个实施例中距骨假体的仰视图;
图5为本发明其中一个实施例中距骨假体的右视图;
图6为本发明其中一个实施例中距骨假体的后视图。
具体实施方式
下面将结合附图及较佳实施例对本发明的技术方案进行详细描述。
图1至图6中相关术语的英文缩略词的含义如下:
TL(Talar Length)—距骨(假体)长度;
TW(Talar Width)—距骨(假体)宽度;
TH(Talar Height)—距骨(假体)高度;
TT(Talar Trochlea)—距骨滑车;
NAS(Navicular Articular Surface)—距舟关节面;
AAS(Anterior Articular Surface)—前跟关节面;
MAS(Middle Articular Surface)—中跟关节面;
PAS(Posterior Articular Surface)—后跟关节面;
MMAS(Medial Malleolus Articular Surface)—内踝关节面;
LMAS(Lateral Malleolus Articular Surface)—外踝关节面;
NASL(Navicular Articular Surface Length)—距骨头长度;
NASW(Navicular Articular Surface Width)—距骨头宽度;
ABT(Anterior Breadth of Trochlea)—滑车前宽;
MBT(Middle Breadth of Trochlea)—滑车中宽;
PBT(Posterior Breadth of Trochlea)—滑车后宽;
LLMAS(Length of Lateral Malleolus Articular Surface)—外踝关节面长度;
BLMAS(Breadth of Lateral Malleolus Articular Surface)—外踝关节面宽度;
RLMAS(Radian of Lateral Malleolus Articular Surface)—外踝关节面弧度;
LMMAS(Length of Medial Malleolus Articular Surface)—内踝关节面长度;
BMMAS(Breadth of Medial Malleolus Articular Surface)—内踝关节面宽度;
RMMAS(Radian of Medial Malleolus Articular Surface)—内踝关节面弧度。
在其中一个实施例中,如图1-6所示,本实施例提供了一种距骨假体,包括一体相连的距骨头、距骨颈和距骨体,距骨头、距骨颈和距骨体一体化成型,距骨头包括一个向前的距舟关节面,距骨颈的轴线有15°~20°的内倾,距骨体包括:上方的距骨滑车关节面,下方的前跟关节面、中跟关节面和后跟关节面,以及内侧的内踝关节面和外侧的外踝关节面。
本实施例提供的距骨假体是对正常人足踝部进行CT扫描,将距骨数据在计算机上进行三维重建,通过一系列光滑平顺处理后制作而成,距骨头、距骨颈和距骨体经一体化成型,使用寿命长,植入患者体内后无需更换零件,与人体不产生免疫排斥反应,经大数据统计并结合生物力学来进行设计,最大限度地保留了患者的关节功能。同时,本实施例所提出的距骨假体具有如下技术效果:
(1)解决了保守治疗时间长且疗效不确切的问题;
(2)解决了踝关节融合术术后康复时间长,存在不愈合的现象,降低关节活动度,周围关节退变加快的问题;
(3)解决了髓内减压术适应范围小,有效率较低的问题;
(4)解决了全踝关节置换术适应范围窄,手术复杂,风险高,费用高,假体寿命有限的问题;
(5)本实施中的距骨假体可有效治疗距骨缺血性坏死引起的疼痛以及活动受限。
作为一种具体的实施方式,距骨假体分为男女两组,每组的距骨假体的长度与宽度之比的范围、宽度与高度之比的范围和长度与高度之比的范围分别为:
男组:长度与宽度之比为1.11~1.44,宽度与高度之比为1.22~1.62,长度与高度之比为1.44~1.55;
女组:长度与宽度之比为1.08~1.46,宽度与高度之比为1.21~1.67,长度与高度之比为1.52~2.1;
每组的距骨假体的距骨头的长度与宽度之比的范围为:
男组:1.16~1.78;
女组:1.24~1.86。
本实施方式中每组的距骨假体的长度、宽度和高度之间的比例关系如下:
男组:距骨假体的长度:宽度为1.11~1.44,宽度:高度为1.22~1.62,长度:高度为1.44~1.55;
女组:距骨假体的长度:宽度为1.08~1.46,宽度:高度为1.21~1.67,长度:高度为1.52~2.1;
同时,男组的距骨头的长度:宽度为1.16~1.78;
女组的距骨头的长度:宽度为1.24~1.86。
满足本实施方式所提出的比例关系的距骨假体结构设计合理,可以满足不同患者的需求,具有较强的适用性,同时有利于假体与跟骨、舟骨的快速融合生长,帮助患者快速恢复关节功能,具有较高的医学价值。
作为一种具体的实施方式,如图1所示,每组的距骨头的尺寸为:
男组:距骨头的长度范围为28.95mm~35.17mm,宽度范围为19.8mm~24.98mm;
女组:距骨头的长度范围为28.12mm~32.89mm,宽度范围为17.7mm~22.61mm。
优选地,每组距骨头的尺寸为:
男组:距骨头的长度为32.046mm,宽度为22.409mm;
女组:距骨头的长度为30.367mm,宽度为21.039mm。
作为一种具体的实施方式,如图3所示,每组的内踝关节面的尺寸为:
男组:内踝关节面的长度范围为31.76mm~37.88mm,宽度范围为9.42mm~11.79mm,弧度为范围0.384π~0.44π;
女组:内踝关节面的长度范围为30.17mm~35.88mm,宽度范围为8.71mm~11.8mm,弧度范围为0.396π-0.454π。
作为一种具体的实施方式,如图5所示,每组的外踝关节面的尺寸为:
男组:外踝关节面的长度范围为27.72mm~34.71mm,宽度范围为8.76mm~12.03mm,弧度范围为0.431π~0.48π;
女组:外踝关节面的长度范围为29.3mm~35.73mm,宽度范围为7.96mm~11.36mm,弧度范围为0.427π~0.476π。
作为一种具体的实施方式,如图2、图4和图6所示,每组的距骨假体的尺寸为:
男组:距骨假体的长度范围为54.26mm~61.93mm,宽度范围为43.09mm~48.87mm,高度范围为30.15mm~35.07mm;
女组:距骨假体的长度范围为49.23mm~57.56mm,宽度范围为39.41mm~45.65mm,高度范围为27.4mm~32.33mm。
优选地,每组的距骨假体的尺寸为:
男组:距骨假体的长度为58.32mm,宽度为46.07mm,高度为32.45mm;
女组:距骨假体的长度为53.02mm,宽度为43.73mm,高度为29.84mm。
本发明中所涉及的以上数据,包括距骨头的尺寸、内踝关节面的尺寸、外踝关节面的尺寸和距骨假体的尺寸,均是通过测量若干个志愿者的CT距骨数据并对测量得到的距骨数据进行多维度的统计分析后获得的,当距骨假体满足上述条件时,距骨假体能够更好地与患者的胫骨远端关节面、跟骨前、中、后关节面和舟状骨形成胫距关节、距下关节和距舟关节,从而更好地帮助患者恢复关节功能。
以上所述实施例的各技术特征可以进行任意的组合,为使描述简洁,未对上述实施例中的各个技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。
以上所述实施例仅表达了本发明的几种实施方式,其描述较为具体和详细,但并不能因此而理解为对发明专利范围的限制。应当指出的是,对于本领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干变形和改进,这些都属于本发明的保护范围。因此,本发明专利的保护范围应以所附权利要求为准。
Claims (3)
1.一种距骨假体,其特征在于,包括一体相连的距骨头、距骨颈和距骨体,所述距骨头、所述距骨颈和所述距骨体一体化成型,
所述距骨头包括一个向前的距舟关节面,
所述距骨颈的轴线有15º~20º的内倾,
所述距骨体包括:上方的距骨滑车关节面,下方的前跟关节面、中跟关节面和后跟关节面,以及内侧的内踝关节面和外侧的外踝关节面;
距骨假体分为男女两组,每组的所述距骨假体的长度与宽度之比的范围、宽度与高度之比的范围和长度与高度之比的范围分别为:
男组:长度与宽度之比为1.11~1.44,宽度与高度之比为1.22~1.62,长度与高度之比为1.44~1.55;
女组:长度与宽度之比为1.08~1.46,宽度与高度之比为1.21~1.67,长度与高度之比为1.52~2.1;
每组的所述距骨假体的所述距骨头的长度与宽度之比的范围为:
男组:1.16~1.78;
女组:1.24~1.86;
每组的所述内踝关节面的尺寸为:
男组:所述内踝关节面的长度范围为31.76mm~37.88mm,宽度范围为9.42mm~11.79mm,弧度为范围0.384π~0.44π;
女组:所述内踝关节面的长度范围为30.17mm~35.88mm,宽度范围为8.71mm~11.8mm,弧度范围为0.396π-0.454π;
每组的所述外踝关节面的尺寸为:
男组:所述外踝关节面的长度范围为27.72mm~34.71mm,宽度范围为8.76mm~12.03mm,弧度范围为0.431π~0.48π;
女组:所述外踝关节面的长度范围为29.3mm~35.73mm,宽度范围为7.96mm~11.36mm,弧度范围为0.427π~0.476π;
每组的所述距骨头的尺寸为:
男组:所述距骨头的长度范围为28.95mm~35.17mm,宽度范围为19.8mm~24.98mm;
女组:所述距骨头的长度范围为28.12mm~32.89mm,宽度范围为17.7mm~22.61mm;
每组的所述距骨假体的尺寸为:
男组:所述距骨假体的长度范围为54.26mm~61.93mm,宽度范围为43.09mm~48.87mm,高度范围为30.15mm~35.07mm;
女组:所述距骨假体的长度范围为49.23mm~57.56mm,宽度范围为39.41mm~45.65mm,高度范围为27.4mm~32.33mm。
2.根据权利要求1所述的距骨假体,其特征在于,每组的所述距骨头的尺寸为:
男组:所述距骨头的长度为32.046mm,宽度为22.409mm;
女组:所述距骨头的长度为30.367mm,宽度为21.039mm。
3.根据权利要求1所述的距骨假体,其特征在于,每组的所述距骨假体的尺寸为:
男组:所述距骨假体的长度为58.32mm,宽度为46.07mm,高度为32.45mm;
女组:所述距骨假体的长度为53.02mm,宽度为43.73mm,高度为29.84mm。
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