CN110446475B - 用于两个相对地布置的假体的锚定杆的连接套管 - Google Patents

用于两个相对地布置的假体的锚定杆的连接套管 Download PDF

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Publication number
CN110446475B
CN110446475B CN201880022303.XA CN201880022303A CN110446475B CN 110446475 B CN110446475 B CN 110446475B CN 201880022303 A CN201880022303 A CN 201880022303A CN 110446475 B CN110446475 B CN 110446475B
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fork
receiving
connection
mating
width
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CN110446475A (zh
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H.D.林克
U.博尔歇斯
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Waldemar Link GmbH and Co KG
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Waldemar Link GmbH and Co KG
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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
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Abstract

本发明涉及一种用于两个相对地布置的假体的锚定杆的连接套管。加强套管包括两个分别用于假体杆的容纳衬套和布置在这些容纳衬套之间的可分开的用于抗推拉和抗扭转地连接的耦联区域。根据本发明，这些容纳衬套在它们的面向耦联区域的一侧分别具有相互配合作用的叉形配对件的叉形件，在叉形件的底脚处布置有配合块件，配合块件的侧面具有与叉形件的内部宽度相等的间距，并且侧面被构造用于平面地贴靠在叉形件的侧翼上，至少一个固定螺钉横向地穿过叉形件布置。相比于已知的楔形连接件，叉形连接件更易于制造，却足够耐用。不同于楔形连接件，无需精确的配合；叉形件与配合块件之间的间隙配合基本上就足够了，其中，过度的间隙通过固定螺钉予以消除。

Description

用于两个相对地布置的假体的锚定杆的连接套管
技术领域
本发明涉及一种用于优选在细长的骨骼、比如大腿骨上的两个相对地布置的假体的锚定杆的连接套管。加强套管包括两个分别用于假体杆的容纳衬套和布置在这些容纳衬套之间的可分开的用于抗推拉和抗扭转地连接的耦联区域。
背景技术
尤其是细长的骨骼往往在两端设有关节。这尤其适用于细长的大的四肢骨骼、比如大腿骨或肱骨。由于患病或者磨损，会出现在一端或两端移植人造的关节、关节内用假体（Gelenkendoprothese）。在有些情况下，这首先发生在骨骼的一端，并且在另一端同时发生、在晚些时候发生，或者根本就不发生。
在有些情况下，细长的骨骼由于患病、特别是骨骼缺陷而变得太软弱而无法在其端部承载关节内用假体。此外已表明，最迟在另一端移植第二关节内用假体之后会出现并发症。并发症的原因尤其在于，在这种情况下从两端***到细长的骨骼中的锚定杆虽然引起在相应的端部区域（即在***杆之处）加强骨骼，但在没有两个锚定杆之一的中间区域内并不能加强骨骼。因此，该区域即使其在生理上本身是健康的，但相比于用锚定杆加强的端部区域仍相对软弱。在医疗实践中已表明，在这种情况下，由于力分布不均匀，因而负荷局部提高得较高，所以会出现骨骼破碎。
已知有加强移植物，它在其端部各有一个用于关节内用假体的杆的容纳衬套，且在这些端部之间具有刚性的耦联件（WO 2013/167655 A1）。该耦联件被设计成楔形连接器。该楔形连接器具有两个对称地、但相反地布置的楔形件，这些楔形件的尖端分别伸入到在另一容纳衬套上的袋槽形的内凹中。于是实现了可分开的耦联，其在闭合状态下具有良好的力传递和高的工作可靠性。但相比之下有如下缺点：即，对于这种楔形连接器而言要求高的制造精确度，以便实现所希望的高的固定可靠性。此外，制造袋槽形的内凹非常繁琐，但对于所力求的转动固定很重要。所有这些为更广泛的应用和小型化、比如用来在上臂骨（Oberarmknochen）上应用设定了限制。
发明内容
本发明的目的在于，提出一种改善的加强移植物，其不太繁琐，并且更加适合于较小的实施方式。
根据本发明的解决方案在于本公开内容的特征。有利的改进方案也是本发明所要求保护的主题。
一种优选在细长的骨骼、比如大腿骨上的用于两个相对地布置的假体的锚定杆的加强套管，该加强套管包括：在加强套管的一端的用于假体杆之一的第一容纳衬套；和在加强套管的相对端的用于第二假体杆的第二容纳衬套；和布置在这些容纳衬套之间的可分开的以及可抗推拉和抗扭转地连接的耦联区域，根据本发明规定，这些容纳衬套在它们的面向耦联区域的一侧分别具有相互配合作用的叉形配对件的叉形件，其中，每个叉形件都包括叉形件尖齿（Gabelzinke）和叉形件底部（Gabelgrund），并且在叉形件的底脚（叉形件底部）处布置有配合块件（Passblock），该配合块件的侧面具有与叉形件的内部宽度相等的间距，并且侧面被构造用于平面地贴靠在叉形件的侧翼上，其中，至少一个固定螺钉横向地穿过叉形件布置。
本发明基于如下认识，相比于已知的楔形连接件，用于耦联的叉构造方式可更加简便地制造，却满足了在力传递和工作可靠性方面的要求。特别地，至关重要的防止并非所愿的扭转的可靠性，即抗扭转性，通过根据本发明的叉结构得到良好的满足，确切地说，是在明显减小耗费的情况下满足的。本发明分别利用了如下情况：即，不同于由现有技术已知的楔形连接件，对于该叉结构，无需精确的匹配。叉形件与配合块件之间的间隙配合基本上就足够了，其中，过度的间隙通过固定螺钉予以消除。本发明由此以巧妙的方式实现了良好的力传递特性、高的抗扭转性的组合，并且对制造公差的要求较小。这在现有技术中尚无先例。
下面要介绍一些使用的术语：
叉形件是一种构造方式，其具有至少两个细长的、平行的尖齿式的凸起，这些凸起布置成U形，并且在它们之间具有叉形件底部。在此，叉形件底部也可以由另一构件构成，例如如下块件，该块件必要时也可以与叉形件一体地设计。
根据本发明，以较小的代价在假体的两个锚定杆之间形成传力桥（Kraftbrücke），而不依赖于在中间区域中的骨骼状态。传力桥在功能上完全够用，从而必要时可以切除（resezieren）中间区域中的骨骼。本发明由此也特别是适合于供应细骨骼、比如肱骨。
有益地，在配合块件中设置有横向于叉形件的延伸方向的用于固定螺钉的容纳孔，并且确切地说，优选在两个容纳衬套上开设。通过布置容纳孔，可以借助固定螺钉一方面实现稳固根据本发明被设计成叉形件的耦联件，并且另一方面实现有益的间隙减小。这尤其当在相应的配合块件中在两个容纳衬套上开设容纳孔时适用。优选给每个叉形件都设置自身的固定螺钉。
优选地，配合块件的横向侧面被设计成与叉形件侧翼互补。横向侧面由此用作叉形件的配合面，从而存在有利于力传递的平面接触。这不仅通常有利于力传递，而且提高了防止并非所愿的扭转的防护性，也就是抗扭转性。在此，有利地把横向侧面的间距选取成使其等于叉形件尖齿的间距。
优选地，配合块件的横向侧面相对于彼此倾斜地设计，确切地说，这些横向侧面朝向叉形件、即在叉形件尖齿所指向的方向上具有较小的间距。因而在横截面中观察，产生了横向侧面的锥形延伸，由此一方面便于插塞在一起，并且另一方面有利于实现无间隙。在此，叉形件面有利地与横向侧面互补地倾斜，并且确切地说，优选以与横向侧面相同的角度倾斜。通过这种方式，产生了全面的在角度方面的、对于高的力传递和抗扭转性最佳的一致性。
有益地，配合块件上的容纳孔经过如此设计，从而它与固定螺钉形成间隙配合。该间隙配合不仅提供了它可更简单地且以更小的耗费产生的优点，而且它提供了其适合于补偿一定的不准确性的优点。通过这种方式，通过拧紧固定螺钉，可以实现补偿因叉形件上的或配合块件上的公差或者由于其它原因造成的尺寸偏差。
根据本发明的一种特别有利的、必要时予以独立保护的方面，叉形件中的容纳孔相距叉形件底部的间距大于配合块件中的容纳孔相距叉形件底部本身的间距。这基于如下认识：即，通过这种方式，在叉形件底部靠置在分别相对的配合块件上之前，在***到彼此中时，两个叉形件在嵌合在分别相对地布置的配合块件上时到达其终止位置。由此确保力传递通过在配合块件上的横向侧面来进行。力可能会沿着双重的力传递路径并行地通过叉形件底部直接作用到配合块件上，这种双重的力传递路径由此得以防止；这是一个巨大的优势，因为由此能够可靠地避免静力学上不确定的状况。
有益地，在两个容纳衬套上的叉形件和/或配合块件彼此对称地设计。这简化了制造和应用，因为在有益的情况下，可以在两侧使用相同部件。由此避免了混淆。
叉形件的宽度优选设计成大于待容纳的假体杆的宽度。通过这种方式产生了有利的力传递情况。作用到叉形件尖齿上的力矩由此小于作用到锚定杆本身上的力矩。与叉形件耦联的区域过载的危险由此以简单的、却有效的方式得到抑制。
耦联区域中的宽度优选大于容纳衬套的区域中的宽度。因而考虑到了如下情况：即，在关键的耦联区中，略微增大的宽度提供了如下优点：即，能实现更好地支撑力矩，这有利于抗弯折以及抗扭转性。由此，整个组件仍保持比较紧凑，从而它仍适合于移植到更薄弱的细长的骨骼、比如肱骨中。有益地，该宽度取向于骨骼直径，优选大致相同大小，或者小或大至多10至20%。
有益地，叉形件和配合块件一体地设计。这提供了便于制造的优点，以及可以在整体上实现整个组件尺寸较小。
附图说明
下面参照附图借助实施例详述本发明。其中：
图1为连接套管的一个实施例的立体图；
图2在上下两部分中分别示出在图1中所示的实施例的俯视图以及侧视图；
图3为根据第一实施例的连接套管的零部件（Einzelteil）的视图；
图4为详细放大图，其示出带有叉形件和配合块件的耦联区域；并且
图5示出在移植于肱骨上的状态下的连接套管。
具体实施方式
下面介绍根据本发明的连接套管的一个实施例。该连接套管在其两端中的每一端上分别包括容纳衬套1、2以及位于其间的耦联区域3。在此，用附图标记1标明的容纳衬套指配给远端侧，而用附图标记2标明的容纳衬套指配给近端侧。
容纳衬套1、2基本上相同地构造。它们的区别仅在于相应的容纳孔的长度不同和宽度不同。例如借助布置在远端的容纳衬套1进行阐述。该容纳衬套基本上为带有平滑外壳的空心圆筒形设计，且优选由生物相容的材料、特别是金属比如钛或钴铬钼（CoCrMo）制成。该外直径与骨骼宽度一致，规定在该骨骼上进行移植。大多情况下，外直径通常选取成使得它与必要时切除的骨骼的直径大致一致。这意味着，外直径未选取得大于与骨骼宽度相等的情况。在当前实施例中，连接套管被设置用来移植在上臂骨（肱骨9）上。
容纳衬套1在其内腔中具有沿轴向方向延伸的空腔10。该空腔设计成柱形孔，但也可以为其它形状（锥形、孔段等）。空腔10通至容纳衬套1的外端侧。在容纳衬套1的外壳中，设置有分别成对地相对的几排孔（Lochreihe）。在正面或背面上，布置有多个孔15（见图2的下部分），而在轴向方向上错开地在两个横向侧面上布置有多个孔16（见图2的上部分）。孔15和16之间的错开间距（Versatz）在此经过如此选取，使得这几排孔相互间大致错开孔间距的一半。这在图1中示出。
容纳孔15、16还经过如此定向，使得它们指向内腔10的中轴线19。它们用于容纳固定螺钉，以便固定内用假体（Endoprothese）的***到容纳腔10中的锚定杆。容纳孔15、16为此分别设有螺纹17、18，以便容纳设计成埋头螺钉的固定螺钉18（见图3）。
近端的容纳衬套2被相应地构造为带有空腔20、孔25、26和中轴线29。为避免重复，参见针对容纳衬套1所作的有益地适用的上述说明。在所示的实施例中，容纳衬套2构造得比容纳衬套1更短。
耦联区域3位于近端的或远端的容纳衬套1、2的与相应的端侧相对的端部上。在两个容纳衬套1、2中的每个容纳衬套上，分别布置有叉形件31、32，这些叉形件分别具有两个正相对的叉形件尖齿33、33'。两个叉形件尖齿33、33'分别镜对称地设计。它们在其端部上分别具有相互对齐的、用于容纳固定螺钉5的开口35、35'。为此，开口35'具有内螺纹，该内螺纹设计成与在固定螺钉5的螺栓上的外螺纹配合作用。开口35构造成通孔，并且具有用于容纳固定螺钉5的头部的沉降部（Versenkung）。
两个叉形件尖齿33、33'被布置成U形，且带有位于它们之间的叉形件底部34。在叉形件底部34上分别设置有配合块件4。该配合块件4可以如所示实施例中那样与相应的叉形件31、32一体地设计。两个配合块件4中的每个配合块件都具有容纳孔45，该容纳孔横向于相应的容纳衬套1、2的纵轴线19或29构造。它用于容纳固定螺钉5的杆。容纳孔43的直径经过如此选取，从而与固定螺钉5的杆形成间隙配合。在固定螺钉5的螺纹区域上，可分别容纳有用于螺钉固定的PE-销51。
配合块件4具有两个相对的横向侧面44，容纳孔45分别起始或终止于这些横向侧面。这些横向侧面44的间距等于两个叉形件尖齿33、33'的间距。这些横向侧面44优选相对于彼此略微倾斜地地定向，从而它们在其面向容纳孔10、20的一侧，相比于其面向叉形件尖齿33、33'的一侧相互间具有较大的间距。有益地，所夹成的角度α约为5°。
与之相应地，叉形件尖齿33、33'在其内侧面上同样圆锥形地略微展宽。这意味着，它们在其外面的自由端上，相比于朝向带有配合块件4的叉形件底部34，具有略微较大的间距。优选地，为此同样选取所夹成的角度β，该角度与配合面44的角度α一致。通过使得这些角度一致，叉形件尖齿33、33'的内侧面与配合块件4的横向侧面44产生了有利于力传递的平面的贴靠。另外，通过这些角度，补偿了一定的公差偏差，从而即使在制造未绝对地精确时也能产生可靠的力锁合的连接。
装配按如下方式进行：即，使得两个叉形件31、32处于彼此相对的位置，其中，一个叉形件31相对于另一个叉形件32扭转90°（见图4）。两个容纳衬套1、2于是以它们的叉形件31、32彼此相向地移动如此远的间距，从而它们***到彼此中（见图1）。在此，一个叉形件31的叉形件尖齿33、33'与相对的叉形件32的配合块件4的横向侧面44贴靠，反之亦然。由此使得两个叉形件31、32中的每一个叉形件的开口35、35'与相应另一叉形件32、31上的配合块件4的容纳孔45对准。然后把固定螺钉5中的每一个都穿过开口35、35'和容纳孔45进行插接，并且拧紧。通过拧紧，在与叉形件31、32的圆锥形设计的内部面的配合作用下，实现了两个容纳衬套1、2彼此相对的补偿间隙的、可靠的且对公差不敏感的固定。因此在两个容纳衬套1、2之间产生了刚性的且抗扭转的力传递。
此外参见图4。在那里，配合块件4中的容纳孔45的孔中心的间距量度用字母d表示。另外，在叉形件尖齿33、33'上的开口35、35'的孔中心的间距的相应量度用量度D表示。有利地，这些量度经过如此选取，使得量度D不等于量度d，而是略大。由此保证叉形件31和32之间的连接通过固定螺钉5进行，而不是使得力以一种静力学上不确定的方式沿着配合块件4的端面导引。通过这种方式实现进一步提高对于公差偏差的不敏感性。
图5示出连接套管移植在肱骨9上的状态。可看到布置在远端的容纳衬套1、布置在近端的容纳衬套2，连同位于它们之间的耦联区域3。耦联区域3的区域内的宽度略大于容纳衬套1、2的宽度。在所示实施例中，该宽度约要大10%。通过这种方式，两个容纳衬套1、2彼此相对地产生了改善的固定，并且在两个容纳衬套1、2之间的关键的耦联区域3中的扩张在实际应用中可忽略不计且在生理上可良好地耐受。

Claims (14)

1.一种在细长的骨骼上的用于两个相对地布置的假体的锚定杆的连接套管，该连接套管包括：在加强套管的一端的用于假体杆之一的第一容纳衬套(1)；和在加强套管的相对端的用于第二假体杆的第二容纳衬套(2)；和布置在这些容纳衬套之间的能够分开的以及能够抗推拉和抗扭转地连接的耦联区域(3)，
其特征在于，
这些容纳衬套(1、2)在它们的面向所述耦联区域(3)的一侧分别具有相互配合作用的叉形配对件的叉形件(31、32)，其中，每个叉形件(31、32)都包括叉形件尖齿(33、33')和叉形件底部(34)；并且
在叉形件底部处布置有配合块件(4)，该配合块件的侧面(44)具有与所述叉形件(31、32)的内部宽度相等的间距，并且所述侧面(44)被构造用于平面地贴靠在所述叉形件(31、32)的侧翼上，
其中，至少一个固定螺钉(5)横向地穿过所述叉形件(31、32)布置；
所述配合块件(4)的横向侧面的间距等于所述叉形件尖齿(33、33')的间距，且所述侧面(44)朝向叉形件(31、32)以减小的间距相对于彼此倾斜。
2.如权利要求1所述的连接套管，其特征在于，在所述配合块件(4)中、在两个容纳衬套(1、2)上设置有横向于所述叉形件(31、32)的延伸方向的用于所述固定螺钉(5)的容纳孔(45)。
3.如权利要求1所述的连接套管，其特征在于，所述配合块件(4)的横向侧面作为配合面被设计成与叉形件侧翼互补。
4.如权利要求2所述的连接套管，其特征在于，所述配合块件(4)的横向侧面作为配合面被设计成与叉形件侧翼互补。
5.如权利要求1至4任一项所述的连接套管，其特征在于，所述叉形件侧翼以与所述侧面相同的角度互补地倾斜。
6.如权利要求1至4中任一项所述的连接套管，其特征在于，所述配合块件(4)上的容纳孔(45)与所述固定螺钉(5)形成间隙配合。
7.如权利要求1至4中任一项所述的连接套管，其特征在于，所述叉形件(31、32)中的容纳开口(35、35')相距所述叉形件底部(34)的间距大于所述配合块件(4)中的容纳孔(45)相距所述叉形件底部(34)的间距。
8.如权利要求1至4中任一项所述的连接套管，其特征在于，两个容纳衬套的叉形件(31、32)和/或配合块件(4)相对于彼此对称地设计。
9.如权利要求1至4中任一项所述的连接套管，其特征在于，所述叉形件(31、32)的宽度设计成大于待容纳的假体杆的宽度。
10.如权利要求1至4中任一项所述的连接套管，其特征在于，所述耦联区域中的宽度以但不超过四分之一为幅度大于所述容纳衬套(1、2)的区域中的宽度。
11.如权利要求1至4中任一项所述的连接套管，其特征在于，所述叉形件(31、32)和所述配合块件(4)一体地设计。
12.如权利要求1至4中任一项所述的连接套管，其特征在于，给每个叉形件(31、32)都设置自身的固定螺钉(5)。
13.如权利要求1所述的连接套管，其特征在于，所述细长的骨骼是指大腿骨。
14.如权利要求1至4中任一项所述的连接套管，其特征在于，所述耦联区域中的宽度以最大十分之一为幅度大于所述容纳衬套(1、2)的区域中的宽度。
CN201880022303.XA 2017-03-31 2018-03-29 用于两个相对地布置的假体的锚定杆的连接套管 Expired - Fee Related CN110446475B (zh)

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