CN115227454A

CN115227454A - Temporary prosthesis device capable of extending beyond limit and using method

Info

Publication number: CN115227454A
Application number: CN202210864034.XA
Authority: CN
Inventors: 张清; 邹明霞; 邓志平; 杨勇昆
Original assignee: Beijing Jishuitan Hospital
Current assignee: Beijing Jishuitan Hospital
Priority date: 2022-07-21
Filing date: 2022-07-21
Publication date: 2022-10-25

Abstract

The application relates to the technical field of medical instruments, in particular to a temporary prosthesis device capable of extending beyond a limit and a using method. Wherein the overextendable temporary prosthetic device comprises: the intramedullary nail is inserted on a femur, the intramedullary nail sleeve is sleeved outside the intramedullary nail, the temporary prosthesis can slide up and down relative to the intramedullary nail sleeve and the intramedullary nail, and the temporary prosthesis is arranged between the femur and a tibia. The invention can prolong the distance between the femur and the tibia for the second time, solves the problem that the temporary prosthesis still has the shortage of the extension distance after reaching the extension limit length, and effectively adjusts the unpredictable unequal limb length caused by the growth and development of the malignant bone tumor patient child after keeping the limb.

Description

Temporary prosthesis device capable of extending beyond limit and using method

Technical Field

The application relates to the technical field of medical instruments, in particular to a temporary prosthesis device capable of extending beyond the limit and a using method.

Background

Bone tumors of limbs of children are treated by surgical operation after the artificial joint replacement of children for many years, and the height and bones of the children grow along with the development of the children, so that the limbs, particularly healthy limbs, are unequal to affected limbs.

In previous solutions, there are three main approaches to limb unequal length, one of which is amputation; secondly, the replacement of the prolonged artificial prosthesis is carried out, the replaced prosthesis has the wound opened mechanically for prolonging the prosthesis by 1-2 cm each year, cannot be prolonged in place at one time and needs a plurality of operations; in the third method, at least three operations are needed, wherein the 1 st operation is performed to take out the original prosthesis, place the bone cement temporary prosthesis, arrange the external extension external fixing frame at the same time, take out the original temporary prosthesis (short) after the external fixing frame is extended in the 2 nd operation, place the bone cement temporary prosthesis (long) again, and when the external fixing frame is confirmed to be free of infection in the limb nail path after 3-6 months, replace the temporary prosthesis with the artificial prosthesis to complete the revision operation.

As a treatment scheme with the best effect, in the extendable temporary prosthesis of the third method, when the external fixator is drawn to reach the length equal to the healthy limb or the expected normal development length, the extendable temporary prosthesis is easy to be insufficient in the extendable length, for example, a femur far-end prosthesis made by a child at the age of 4 is currently 10 years old, 140cm in height and 130mm in unequal limb length difference, and the extendable temporary prosthesis can meet the current 130mm difference, but as the child grows to 170cm, the new limb is unequal and the length of the new limb is unpredictable.

Disclosure of Invention

The application aims to provide a temporary prosthesis device capable of extending beyond the limit and a using method, which can realize secondary extension of the temporary prosthesis, ensure that the extension length of the temporary prosthesis meets the practical requirement of growth and development of an infant patient, and realize the extension supplement of unequal lengths of unknown limbs after the height of an individual infant patient is increased.

To achieve the above object, in a first aspect, the present invention provides an overlimit elongatable temporary prosthetic device comprising: the intramedullary nail is inserted on a femur, the intramedullary nail sleeve is sleeved outside the intramedullary nail, the temporary prosthesis can slide up and down relative to the intramedullary nail sleeve and the intramedullary nail, and the temporary prosthesis is arranged between the femur and the tibia.

In an alternative embodiment, the proximal end of the intramedullary nail sleeve is provided with an annular sleeve boss disposed on the upper portion of the provisional prosthesis, at least a portion of the intramedullary nail projecting upwardly from the sleeve boss and being inserted into the distal end of the femur.

In an optional embodiment, at least a part of the distal end of the intramedullary nail sleeve is inserted into the temporary prosthesis, and a sliding rail and a sliding groove which are matched with each other are arranged between the temporary prosthesis and the intramedullary nail sleeve.

In an optional embodiment, a sleeve connection hole and a prosthesis connection hole are respectively formed at the distal end of the intramedullary nail sleeve and the proximal end of the temporary prosthesis, so that the temporary prosthesis after being extended in place can be fixedly connected with the intramedullary nail sleeve.

In an optional embodiment, the sleeve boss and the intramedullary nail are respectively provided with a boss connecting hole and an intramedullary nail connecting hole, so as to fixedly connect the intramedullary nail sleeve and the intramedullary nail during the extension of the temporary prosthesis and after the intramedullary nail sleeve is extended in place.

In an alternative embodiment, the intramedullary nail connecting holes respectively comprise a middle connecting hole positioned at the middle part of the intramedullary nail and a distal connecting hole positioned at the distal part of the intramedullary nail;

in the process of lengthening the temporary prosthesis, the intramedullary nail sleeve is fixedly connected with the intramedullary nail through screws which are simultaneously connected in the boss connecting hole and the middle connecting hole in a penetrating manner;

and after the intramedullary nail sleeve is extended in place, the intramedullary nail sleeve is fixedly connected with the intramedullary nail through screws which are simultaneously connected in the boss connecting hole and the far-end connecting hole in a penetrating manner.

In an optional embodiment, the intramedullary nail sleeve further comprises a supporting block for fixing the temporary prosthesis and the intramedullary nail sleeve after being extended into position;

the supporting block comprises a lower supporting block which is abutted between the sleeve boss and the temporary prosthesis after the temporary prosthesis is extended in place, and an upper supporting block which is abutted between the sleeve boss and the distal end of the femur after the intramedullary nail sleeve is extended in place.

In an optional embodiment, the intramedullary nail is fixed on the femur through an external fixing frame, the external fixing frame is connected with a femur fixing nail for fixing the intramedullary nail and a tibia fixing nail for fixing the tibia, a sliding frame capable of adjusting and extending the distance between the femur and the tibia is arranged between the femur fixing nail and the tibia fixing nail, and a fixing hole for inserting the femur fixing nail is arranged at the near end of the intramedullary nail.

In an alternative embodiment, the provisional prosthesis is articulatable with the tibia by a hinge assembly;

the hinge assembly comprises a hinge block and an insertion block which are of an integral structure, the hinge block is connected to the far end of the temporary prosthesis through a hinge shaft, and the insertion block is inserted into the near end of the tibia.

In a second aspect, the present invention provides a method of using the over-limit prolongable temporary prosthetic device of any one of the preceding embodiments, comprising the steps of:

implanting an intramedullary nail in the femoral medullary cavity, and connecting the temporary prosthesis to the distal end of the medullary nail sleeve in a sliding manner;

fixing the near end of the intramedullary nail on the femur through an external fixing frame, fixing the far end of the tibia, fixedly connecting the intramedullary nail sleeve with the intramedullary nail, adjusting and extending the distance between the femur and the tibia, and enabling the temporary prosthesis to extend and move downwards;

after the temporary prosthesis is extended in place, if the expected extension length exceeds the extension length of the temporary prosthesis, fixedly connecting the near end of the temporary prosthesis with the far end of the intramedullary nail sleeve, simultaneously releasing the fixation of the intramedullary nail sleeve and the intramedullary nail, adjusting the distance between the extension femur and the tibia, and enabling the intramedullary nail sleeve to be extended and moved down to the expected extension length;

after the intramedullary nail sleeve is extended in place, the intramedullary nail sleeve is fixedly connected with the intramedullary nail, and the external fixing frame is removed, so that the patient can perform rehabilitation training under the state that the knee joint can move in flexion and extension;

and after 3 to 6 months, when the nail channel of the external fixator in the limb is confirmed to be free of infection, replacing the prolonged temporary prosthesis to finish the artificial joint revision surgery treatment.

Through above-mentioned technical scheme, can make the interval between thighbone and the shin bone carry out the secondary extension, solve the temporary prosthesis and still have the problem of extension distance shortage after reaching extension limit length, effectively adjusted because of malignant bone tumour infant keeps the unequal length of limbs of unpredictable that the growth and development brought after the limbs.

Additional features and advantages of the present application will be described in detail in the detailed description which follows.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are required to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present application and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained from the drawings without inventive effort.

FIG. 1 is a schematic view of a temporary prosthetic device that may be over-extended according to the present application;

FIG. 2 is a schematic view of the configuration of the broach sleeve in the present application;

FIG. 3 is a side view of a temporary prosthesis of the present application;

FIG. 4 is a schematic structural diagram of an extracorporeal fixing frame of the present application;

FIG. 5 is a top view of the provisional prosthesis of the present application in mating relationship with the intramedullary nail sleeve;

FIG. 6 is a schematic illustration of the position of the temporary prosthesis of the present application after one elongation;

FIG. 7 is a schematic view of the intramedullary nail sleeve of the present application in a position after a secondary extension;

FIG. 8 is a schematic front view of the hinge block and the insertion block of the present application;

fig. 9 is a side view of the hinge block and the insertion block of the present application.

Icon:

1-intramedullary nail; 11-a fixation hole; 12-intramedullary nail connection holes; 13-a middle connection hole; 14-distal connection hole;

2-a temporary prosthesis; 21-a chute; 22-prosthesis attachment holes;

3-a hinge assembly; 31-a hinged block; 32-articulated shaft; 33-hinge holes; 34-a plug-in block;

4-external fixing frame; 41-femoral fixation nail; 42-tibial fixation pegs; 43-a carriage;

5-a support block; 51-a lower support block; 52-an upper support block;

6-intramedullary nail sleeve; 61-sleeve boss; 62-sleeve attachment holes; 63-boss connection hole; 64-a slide rail; 10-femur; 20-tibia.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application. It should be apparent that the embodiments described are some, but not all embodiments of the present application. The components of the embodiments of the present application, generally described and illustrated in the figures herein, can be arranged and designed in a wide variety of different configurations.

In the description of the present application, it should be noted that the terms "inside", "outside", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings or orientations or positional relationships that the products of the application usually place when using, and are only used for convenience in describing the present application and simplifying the description, but do not indicate or imply that the devices or elements that are referred to must have a specific orientation, be constructed in a specific orientation, and operate, and thus, should not be construed as limiting the present application. Furthermore, the terms "first," "second," and the like are used merely to distinguish one description from another, and are not to be construed as indicating or implying relative importance.

In the description of the present application, it is also to be noted that, unless otherwise explicitly specified or limited, the terms "disposed" and "connected" are to be interpreted broadly, e.g., as being either fixedly connected, detachably connected, or integrally connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in this application will be understood to be a specific case for those of ordinary skill in the art.

Referring to fig. 1-5, the temporary prosthesis device capable of over-extending according to the present application is mainly used for solving the problem of unequal limb length caused by bone growth of children after the artificial joint replacement of children.

After the existing limb bone tumor is resected, particularly after the artificial joint replacement is carried out between a thigh femur 10 and a shank tibia 20, the length of the artificial joint fixed between the femur 10 and the tibia 20 is not changed, so that the artificial joint cannot be lengthened along with the growth of the skeleton of the child, and the affected limb and the healthy limb are unequal.

In the process of extending and replacing the existing temporary prosthesis 2, the situation that the limit extension length of the temporary prosthesis 2 is insufficient along with the growth and development of the infant patient is easily caused, and the variable length of limbs caused by the transition from the infant stage to the adolescence stage has unpredictability along with the uncertainty of the infant patient in the growth and development process of different individuals, so that the problem of variable length of limbs cannot be fundamentally solved only by the extension of the temporary prosthesis 2.

Through the form of introducing intramedullary nail 1 and medullary nail sleeve 6 in this application, can do benefit to the secondary extension of temporary prosthesis 2, make temporary prosthesis 2 carry out the extension of once relatively medullary nail sleeve 6 after, still can carry out the secondary extension through medullary nail sleeve 6 relatively intramedullary nail 1 to the realization is filled unpredictable limbs unequal length.

The invention provides a temporary prosthesis device capable of extending beyond the limit, which comprises an intramedullary nail 1, a intramedullary nail sleeve 6 and a temporary prosthesis 2 which are sequentially arranged from top to bottom, wherein the intramedullary nail 1 is inserted and fixed on a femur 10, the intramedullary nail sleeve 6 is sleeved outside the intramedullary nail, the temporary prosthesis 2 can slide up and down relative to the intramedullary nail sleeve 6 and the intramedullary nail 1, and the temporary prosthesis 2 is arranged between the femur 10 and a tibia 20.

Through the intramedullary nail 1, the intramedullary nail sleeve 6 and the temporary prosthesis 2 which are sequentially connected from top to bottom, the relative sliding between every two parts is combined, the segmental structure similar to a pull rod is formed, the temporary prosthesis 2 can slide downwards relative to the intramedullary nail sleeve 6 to be extended for one time, and the intramedullary nail barrel can slide downwards relative to the intramedullary nail 1 to be extended for the second time, so that the overrun extension of the temporary prosthesis 2 is effectively realized, and the defect that the temporary prosthesis 2 is short due to unequal length extension after being extended for one time is overcome.

With reference to fig. 6-7, during the primary extension of the temporary prosthesis 2, the intramedullary nail 1 and the intramedullary nail sleeve 6 are in a fixed connection relationship, so that the temporary prosthesis 2 moves downwards in a sliding manner relative to the overall structure formed by the intramedullary nail barrel and the intramedullary nail 1.

When the temporary prosthesis 2 is extended for the second time, because the temporary prosthesis 2 is extended, the distal end of the intramedullary nail sleeve 6 is fixedly connected with the proximal end of the temporary prosthesis 2, and the fixed connection relationship between the intramedullary nail 1 and the intramedullary nail sleeve 6 is released, so that the integral structure formed by the intramedullary nail sleeve 6 and the temporary prosthesis 2 moves downwards in a sliding manner.

Through the secondary extension process, the temporary prosthesis 2 can be fully extended firstly, and after the temporary prosthesis 2 reaches the limit extension length, the secondary overrun extension of the intramedullary nail sleeve 6 can be performed, so that the temporary prosthesis 2 can be further moved downwards, and finally the lengths of the two limbs can reach the same purpose.

In one specific embodiment, the proximal end of the intramedullary nail sleeve 6 is provided with an annular sleeve boss 61, which mainly plays a role of limiting and butting with the temporary prosthesis 2, so as to prevent the proximal end of the intramedullary nail sleeve 6 from extending into the temporary prosthesis 2, and meanwhile, the sleeve boss 61 is convenient for supporting the extended temporary prosthesis 2 and the intramedullary nail sleeve 6.

A sleeve boss 61 is provided at the upper part of the provisional prosthesis 2, and at least a part of the intramedullary nail 1 protrudes upwards from the sleeve boss 61 and is inserted into the distal end of the femur 10. Specifically, the sleeve boss 61 is arranged outside the proximal end of the provisional prosthesis 2, and the proximal end of the intramedullary nail 1 protrudes upwards from the sleeve boss 61 and is inserted into the distal end of the femur 10.

At least one part of the far end of the intramedullary nail sleeve 6 is inserted in the temporary prosthesis 2, and a sliding rail 64 and a sliding groove 21 which are matched with each other are arranged between the temporary prosthesis 2 and the intramedullary nail sleeve 6. During the extension of the provisional prosthesis 2, the extension path of the provisional prosthesis 2 is limited by the sliding track 64 and the sliding groove 21 in order to prevent a rotational relationship between the provisional prosthesis 2 and the intramedullary nail sleeve 6.

Specifically, based on the lower half of the intramedullary nail 1 inserted in the intramedullary nail sleeve 6, the sliding rail 64 in this embodiment is disposed outside the intramedullary nail sleeve 6, and includes a fin connected to the outer side wall of the intramedullary nail sleeve 6, and the sliding groove 21 is disposed inside the temporary prosthesis 2, and includes a groove disposed on the inner side wall of the temporary prosthesis 2, and by the cooperation of the fin and the groove, the temporary prosthesis 2 can be prevented from rotating on the intramedullary nail sleeve 6, so as to improve the stability and reliability of the extension movement.

Based on the above-mentioned primary extension of the provisional prosthesis 2 and the secondary extension of the intramedullary nail sleeve 6, the distal end of the intramedullary nail sleeve 6 and the proximal end of the provisional prosthesis 2 are respectively provided with a sleeve connection hole 62 and a prosthesis connection hole 22, so as to be able to fixedly connect the provisionally extended provisional prosthesis 2 to the intramedullary nail sleeve 6.

The temporary prosthesis 2 is generally extended to the limit length capable of being fully extended in one extension process, and after the temporary prosthesis 2 is extended in place, the screw penetrates through the sleeve connecting hole 62 at the distal end of the intramedullary nail and the prosthesis connecting hole 22 at the proximal end of the temporary prosthesis 2 and is fixedly connected with the intramedullary nail sleeve 6 through the temporary prosthesis 2.

In the process of extending the temporary prosthesis 2, in order to prevent the fiber tissue from growing into the temporary prosthesis 2, the prosthesis connecting hole 22 is provided with a screw cap, and when the temporary prosthesis 2 moves down to the right position, the screw cap is taken down to thread the screw.

In the process of extending the temporary prosthesis 2, the intramedullary nail 1 and the intramedullary nail sleeve 6 are fixedly connected, so that the intramedullary nail sleeve 6 is prevented from moving downwards, and the normal downward movement of the temporary prosthesis 2 is influenced.

Preferably, the sleeve boss 61 and the intramedullary nail 1 are respectively provided with a boss coupling hole 63 and an intramedullary nail coupling hole 12 for fixedly coupling the intramedullary nail sleeve 6 to the intramedullary nail 1 during extension of the provisional prosthesis 2 and after extension of the intramedullary nail sleeve 6 in place.

Furthermore, the intramedullary nail connecting holes 12 respectively comprise a middle connecting hole 13 positioned at the middle part of the intramedullary nail 1 and a far end connecting hole 14 positioned at the far end part of the intramedullary nail 1;

in the process of lengthening the temporary prosthesis 2, the position of the intramedullary nail sleeve 6 is not changed, the intramedullary nail sleeve 6 is fixedly connected with the intramedullary nail 1 through screws which are simultaneously connected in the boss connecting hole 63 and the middle connecting hole 13 in a penetrating manner, and the temporary prosthesis 2 can be reliably lengthened relative to the intramedullary nail sleeve 6 based on the fact that the intramedullary nail 1 is anchored on the femur 10.

After the intramedullary nail sleeve 6 is extended in position relative to the intramedullary nail 1, because the position of the intramedullary nail 1 is not changed, the sleeve boss 61 of the intramedullary nail sleeve 6 moves down to the distal position of the intramedullary nail 1, and the intramedullary nail sleeve 6 is fixedly connected with the intramedullary nail 1 through screws which are simultaneously threaded in the boss connecting hole 63 and the distal connecting hole 14.

Through the connection structure and different forms, the primary extension of the temporary prosthesis 2 and the secondary extension of the intramedullary nail sleeve 6 can be effectively carried out, and the stability and the reliability of the overrun extension process are ensured.

After the provisional prosthesis 2 and the intramedullary nail sleeve 6 are respectively extended, the support blocks 5 are required to be supported between the provisional prosthesis 2 and the intramedullary nail sleeve 6 and between the femur 10 and the intramedullary nail sleeve 6, so as to enhance the strength of the extended structure, and in combination with different states, the fixation connection between the intramedullary nail sleeve 6 and the provisional prosthesis 2 and the fixation connection between the intramedullary nail 1 and the intramedullary nail sleeve 6 can be prevented, and the failure of the operation caused by the retraction after the external fixing frame is removed can be prevented.

Specifically, the support blocks 5 include a lower support block 51 that is hooped and abutted between the bottom end face of the sleeve boss 61 and the proximal end of the provisional prosthesis 2 after the provisional prosthesis 2 is extended into position, and an upper support block 52 that is hooped and abutted between the top end face of the sleeve boss 61 and the distal end of the femur 10 after the intramedullary nail sleeve 6 is extended into position.

Wherein, the lower supporting block 51 is arranged at the outer side of the broach sleeve to support the lengthened temporary prosthesis 2, so that the lower supporting block 51 is supported at the section between the sleeve boss 61 and the temporary prosthesis 2, and the structural strength outside the broach sleeve is enhanced.

The upper support block 52 is provided at the outer side of the intramedullary nail to support the extended intramedullary nail sleeve, so that the upper support block 52 is supported at the section between the intramedullary nail and the sleeve boss 61, thereby enhancing the structural strength of the outer portion of the intramedullary nail.

When the supporting block 5 is installed, the supporting block 5 is fixedly embedded in the front and rear parts of the intramedullary nail sleeve or the intramedullary nail according to the exposed distance of the intramedullary nail sleeve or the intramedullary nail, and is fastened by passing a screw through the supporting block 5 and the screw hole of the intramedullary nail sleeve or the intramedullary nail, so that the stability of the connection between the supporting block 5 and the intramedullary nail sleeve or the intramedullary nail is maintained.

The temporary prosthesis device capable of extending beyond the limit can take the intramedullary needle as a main anchoring structure, fix the intramedullary needle and the tibia 20 through the external fixing frame 4, and stretch the distance between the femur 10 and the tibia 20 through the external fixing frame 4, so that the temporary prosthesis 2 and the intramedullary needle sleeve respectively move downwards and extend in different time periods.

In one embodiment, the external fixator 4 fixes the proximal end of the femur 10 and the distal end of the tibia 20, respectively, and the distance between the distal end of the femur 10 and the proximal end of the tibia 20 is extended by the sliding rack 43 on the external fixator 4.

The external fixation frame 4 is connected with a femur fixing nail 41 for fixing the intramedullary nail 1, in this embodiment, the position of the femur 10 in the body is fixed, the proximal end of the intramedullary nail 1 is fixed at the proximal end of the femur 10, and the distal end of the intramedullary nail 1 extends out of the distal end of the femur 10 for the movable sleeve joint of the intramedullary nail sleeve 6. The fixing of the mounting position of the intramedullary nail 1 is realized by inserting the femoral fixing nail 41 into the body from the outside and penetrating the fixing hole 11 at the proximal end of the intramedullary nail 1, thus ensuring the anchoring effect of the intramedullary nail 1.

In order to facilitate the insertion and mounting of the femoral fixation nail 41 on the intramedullary nail 1, the fixation holes 11 comprise oval through holes extending in the radial direction of the intramedullary nail 1. The short diameter of the oval through hole is the same as the diameter of the femur fixing nail 41, the long diameter of the oval through hole is 1.5 times of the short diameter, the distance is 2cm, and the insertion of the femur fixing nail 41 is facilitated.

The external fixator 4 is also connected with a tibia fixing nail 42 for connecting and fixing the tibia 20, and the tibia fixing nail 42 is inserted into the body from the outside and penetrates through the tibia 20 to connect the external fixator 4 with the tibia 20. The stretching of the distance between the femur 10 and the tibia 20 is performed in particular by means of a carriage 43 between the femoral fixation nail 41 and the tibial fixation nail 42. The distance between the femur 10 and the tibia 20 is extended by stretching the sliding frame 43, and the provisional prosthesis 2 and the intramedullary nail sleeve 6 can slide and move downwards at different stages by combining the sliding sleeve connection of the intramedullary nail sleeve 6 and the intramedullary nail 1, the sliding connection of the provisional prosthesis 2 and the sleeve, and the anchoring effect of the intramedullary nail 1, so that the length of the affected limb is extended and adjusted.

Referring to fig. 8-9, in order to facilitate rehabilitation training when the external fixator 4 is removed after the temporary prosthesis 2 and the intramedullary nail sleeve 6 are extended in place and the knee joint is in a flexible and stretchable state, the temporary prosthesis 2 and the proximal end of the tibia 20 are movably connected through the hinge assembly 3.

By connecting the hinge assembly 3 between the provisional 2 and the tibia 20, the knee joint can be released from the constraint that the provisional 2 and the tibia 20 maintain a specific connection state, and the knee joint can be ensured to be able to flex and extend. After the temporary prosthesis 2 and the broach sleeve are prolonged in place, the knee joint can be trained as soon as possible, and the recovery of the knee joint function is effectively ensured.

The hinge assembly 3 comprises a hinge block 31 and a socket block 34 of an integral structure, the hinge block 31 is connected to the distal end of the prosthesis 2 through a hinge shaft 32, and the socket block 34 is plugged to the proximal end of the tibia 20. An articulation axis 32 is inserted through the articulation block 31 and is fixedly connected to the distal end of the prosthesis 2, the articulation block 31 being capable of a deflecting movement on the articulation axis 32.

Specifically, the hinge block 31 is provided with a hinge hole 33, the hinge shaft 32 is penetrated through the hinge hole 33, and both ends of the hinge shaft 32 are fixedly coupled to the distal end of the temporary prosthesis 2. The articulation hole 33 enables the articulation block 31 to deflect on the articulation axis 32, facilitating flexion-extension movements between the prosthesis 2 and the tibia 20.

The insertion block 34 includes a wedge-shaped structure that attaches to the proximal end of the tibia 20. Through the arrangement mode, the hinging block 31 can drive the tibia 20 to bend and stretch relative to the temporary prosthesis 2, so that the temporary prosthesis 2 and the broach sleeve are favorably prolonged in place, and the rehabilitation training of the knee joint is carried out after the external fixing frame 4 is removed.

By means of the primary extension of the temporary prosthesis 2 relative to the intramedullary nail sleeve and the secondary extension of the intramedullary nail sleeve relative to the intramedullary nail when the expected extension length can not be reached after the primary extension, the overrun extension of the temporary prosthesis 2 can be realized, the uncertain factors brought by the growth and development of an individual infant patient can be effectively overcome, and the extension of different lengths of unknown limbs of the single infant patient after the infant patient grows to be supplemented.

The invention also provides a using method of the temporary prosthesis device capable of extending beyond the limit, which comprises the following steps:

taking out the artificial prosthesis at the far end of the initial femur 10, implanting an intramedullary nail 1 into a medullary cavity of the femur 10, sleeving a medullary nail sleeve 6 on the intramedullary nail 1, and connecting a temporary prosthesis 2 at the far end of the medullary nail sleeve 6 in a sliding manner;

the proximal end of the intramedullary nail 1 is fixed on the femur 10 through the external fixing frame 4, the distal end of the tibia 20 is fixed, the intramedullary nail sleeve 6 is fixedly connected with the intramedullary nail 1, the distance between the extension femur 10 and the tibia 20 is adjusted, the temporary prosthesis 2 is extended and moved downwards, the distance between the femur 10 and the tibia 20 is extended by 1mm every day, and the temporary prosthesis 2 is driven to move downwards by 1mm every day, for example, the length is extended by 10cm, and about 100 days are required.

And (3) periodically rechecking, after the temporary prosthesis 2 is extended in place, performing secondary operation, if the expected extension length exceeds the extension length of the temporary prosthesis 2, performing secondary sliding extension of the intramedullary nail sleeve, fixedly connecting the near end of the temporary prosthesis 2 with the far end of the intramedullary nail sleeve 6, simultaneously releasing the fixed connection relation between the intramedullary nail sleeve 6 and the intramedullary nail 1, fixing a supporting block 5 outside the intramedullary nail sleeve to prevent the temporary prosthesis 2 from retracting, and adjusting the distance between the extension femur 10 and the tibia 20 through an external fixing frame 4 to enable the intramedullary nail sleeve 6 to be extended and moved down to the expected extension length.

After the intramedullary nail sleeve 6 is extended to the right position, three operations are needed, the intramedullary nail sleeve 6 is fixedly connected with the intramedullary nail 1, a supporting block 5 is fixed outside the intramedullary nail, the retraction of the intramedullary nail sleeve is prevented, the external fixing frame 4 is removed, so that a patient can carry out rehabilitation training under the state that the knee joint can move in a flexion-extension mode, the patient waits for 3-6 months, the fixing needle holes of the external fixing frame 4 on the femur 10 and the tibia 20 are healed, and the patient is periodically rechecked to determine that the nail path of the bone in vivo is free from infection and inflammation.

And in the fourth operation, the extended temporary prosthesis 2 is replaced, and the prosthesis with the length matched with the length is implanted into the body to complete the artificial joint revision operation treatment.

By the use method, the flexion and extension movement of the knee joint between the temporary prosthesis 2 and the tibia 20 can be performed in the recovery process after three operations of the patient, and the patient can exercise early.

In one specific implementation, the original prosthesis is removed, the proximal end of the femur 10 is implanted into an intramedullary nail that can be fixed by the external fixator 4, the intramedullary nail has a diameter of 12mm, one end of the length is implanted into the proximal end of the femur 10 to a position below the line between the tuberosities, and the distal end of the length is as long as possible to the maximum effective extension length of the prosthesis 2.

Placing the intramedullary nail sleeve into the temporary prosthesis 2, and manufacturing a intramedullary nail sleeve which can slide and extend relative to the intramedullary nail, wherein the intramedullary nail sleeve is sleeved outside the intramedullary nail 1, the diameter of the intramedullary nail sleeve is only larger than that of the intramedullary nail implanted into the proximal end of the femur 10, and the inner diameter of the whole body is 13mm; the outer diameter of the starting end of the intramedullary nail sleeve is 28mm, after 15mm towards the far end, the outer diameter is 18mm, the 15mm section forms a sleeve boss 61 of the intramedullary nail sleeve, the wall thickness of the sleeve boss 61 is 7.5mm, the wall thickness of the intramedullary nail sleeve at the lower part of the sleeve boss 61 is 2.5mm, and the length of the intramedullary nail sleeve is equal to the maximum length of the intramedullary nail 1 placed in the temporary prosthesis 2 minus 15mm.

Intramedullary nail 1, intramedullary nail sleeve 6 and temporary prosthesis 2 three can relative slip, the extension is original, the intramedullary nail is with screw fixation middle part connecting hole 13, when temporary prosthesis 2 slides to terminal 20mm to distal end extension, need external location to cut the soft tissue, fix temporary prosthesis 2 and intramedullary nail sleeve 6 with two 3.5mm diameter screws, external location cuts the soft tissue and takes out the screw of fixing intramedullary nail and intramedullary nail sleeve 6, make intramedullary nail sleeve 6 can prolong relative intramedullary nail 1, slide and increase the extension distance, fix lower part supporting shoe 51 between temporary prosthesis 2 near-end and sleeve boss 61 simultaneously.

When the external fixing frame 4 is extended to the expected target length, the intramedullary nail 1 and the intramedullary nail sleeve 6 are fixed by screws, and the external part of the intramedullary nail is reinforced by the upper supporting block 52, so that the external fixing frame is prevented from retracting after being detached.

By the use method of the temporary prosthesis device capable of extending the overlength, the whole length of the temporary prosthesis can be extended in a sliding manner by extending the broach sleeve, the technical purpose of the overlength supplement and extension of the temporary prosthesis 2 can be achieved, and the uncontrollable unequal lengths of the two limbs caused by unknown factors can be filled.

It should be noted that the features of the embodiments in the present application may be combined with each other without conflict.

The above description is only a preferred embodiment of the present application and is not intended to limit the present application, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present application shall be included in the protection scope of the present application.

Claims

1. An overextendable temporary prosthetic device, comprising: the intramedullary nail is inserted on a femur, the intramedullary nail sleeve is sleeved outside the intramedullary nail, the temporary prosthesis can slide up and down relative to the intramedullary nail sleeve and the intramedullary nail, and the temporary prosthesis is arranged between the femur and a tibia.

2. The over-extendable temporary prosthesis device according to claim 1, wherein the proximal end of the intramedullary nail sleeve is provided with an annular sleeve boss disposed at an upper portion of the temporary prosthesis, and wherein at least a portion of the intramedullary nail protrudes upwardly from the sleeve boss and is inserted into the distal end of the femur.

3. The device as claimed in claim 1, wherein at least a portion of the distal end of the intramedullary nail sleeve is inserted into the temporary prosthesis, and a sliding rail and a sliding groove are disposed between the temporary prosthesis and the intramedullary nail sleeve.

4. The over-limit extendable temporary prosthesis device of claim 1, wherein the distal end of the intramedullary nail sleeve and the proximal end of the temporary prosthesis are provided with a sleeve coupling hole and a prosthesis coupling hole, respectively, for enabling the temporary prosthesis after extension in place to be fixedly coupled to the intramedullary nail sleeve.

5. The over-extendable temporary prosthesis device according to claim 2, wherein the sleeve boss and the intramedullary nail are respectively provided with a boss coupling hole and an intramedullary nail coupling hole for fixedly coupling the intramedullary nail sleeve to the intramedullary nail during extension of the temporary prosthesis and after the intramedullary nail sleeve is extended in place.

6. The over-extendable temporary prosthetic device of claim 5, wherein the intramedullary nail connection holes comprise a middle connection hole at a middle portion of the intramedullary nail and a distal connection hole at a distal portion of the intramedullary nail, respectively;

7. The over-extendable temporary prosthesis device of claim 6, further comprising a support block for securing the temporary prosthesis after extension into position with the intramedullary nail sleeve;

8. The temporary prosthesis device capable of ultralimit extension according to any one of claims 1 to 7, wherein the intramedullary nail is fixed on a femur through an external fixing frame, a femur fixing nail for fixing the intramedullary nail and a tibia fixing nail for fixing a tibia are connected to the external fixing frame, a sliding frame capable of adjusting the distance between the extension femur and the tibia is arranged between the femur fixing nail and the tibia fixing nail, and a fixing hole for inserting the femur fixing nail is arranged at the proximal end of the intramedullary nail.

9. The over-extendable temporary prosthetic device of claim 8, wherein said temporary prosthetic is movably connected to said tibia by a hinge assembly;

the hinge assembly comprises a hinge block and an insertion block which are of an integrated structure, the hinge block is connected to the far end of the temporary prosthesis through a hinge shaft, and the insertion block is inserted into the near end of the tibia.

10. A method of using the over-limit prolongable temporary prosthetic device of any one of claims 1-9, comprising the steps of:

the proximal end of the intramedullary nail is fixed on the femur through an external fixing frame, the distal end of the tibia is fixed, and meanwhile, the intramedullary nail sleeve is fixedly connected with the intramedullary nail, so that the distance between the femur and the tibia is adjusted and extended, and the temporary prosthesis is extended and moved downwards;

after the temporary prosthesis is extended in place, if the expected extension length exceeds the extension length of the temporary prosthesis, fixedly connecting the near end of the temporary prosthesis with the far end of the intramedullary nail sleeve, simultaneously removing the fixation of the intramedullary nail sleeve and the intramedullary nail, secondarily adjusting the distance between the extension femur and the tibia, and enabling the intramedullary nail sleeve to be extended and moved down to the expected extension length;

and after 3-6 months, when the nail channel of the external fixator in the limb is confirmed to be free from infection, replacing the extended temporary prosthesis to finish the artificial joint revision surgery treatment.