CN211884158U - 组合式半限定双极或多极人工腕关节 - Google Patents

组合式半限定双极或多极人工腕关节 Download PDF

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CN211884158U
CN211884158U CN201921902359.2U CN201921902359U CN211884158U CN 211884158 U CN211884158 U CN 211884158U CN 201921902359 U CN201921902359 U CN 201921902359U CN 211884158 U CN211884158 U CN 211884158U
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joint
wrist joint
semi
mortar
shaft
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朱红文
黄国富
董荣华
朱天谋
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Guizhou outras Technology Co.,Ltd.
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Tianjin Fuhua Medical Technology Co ltd
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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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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

本实用新型公开了一种组合式半限定双极或多极人工腕关节，是根据腕关节骨破坏的具体病理情况，如显示掌腕骨关节面完整、骨质尚好，可以保留大部分的远排腕骨(累及小多角骨、头状骨)，而近排腕骨(舟状骨及月骨)及腕挠骨关节面破环，及可行近排腕骨切除之选型组装；该人工腕关节还可以做另一种组配方式，即可称作“半限定多极人工腕关节”，可以对病理破坏的双排腕骨切除，形成掌、腕、挠各关节的互配组装，会给术者带来灵活、方便和理想的手术结果。

Description

组合式半限定双极或多极人工腕关节
技术领域
本实用新型涉及一种医疗专业上的人工关节假体，具体涉及一种手外科领域里的组合式半限定双极或多极人工腕关节。
背景技术
目前，采用人工关节替换手术治疗和修复人体关节的破环是国际医疗界共识的有效方法之一。特别是近年医疗科技的不断发展、新型生物材料的出现、高新技术的飞速发展，替换和修复人体关节的破坏及功能障碍已取得明显和良好的临床效果。人体髋、膝关节置换术的应用，在我国已被广泛的医生推广和使用，满意的临床效果使广大患者得以接受。
针对人体小微型关节假体的需求临床急待发展，特别是在手外科领域里，诸多疾病造成手腕部的骨破坏、畸形及功能障碍，严重影响着人们的生活质量，而目前我国医疗界利用人工关节矫形和功能重建技术期待快速发展。
现有的微小关节假体多依靠进口产品，类型、品种较单一、型号匹配不全。尚不能使众多地区的广大医疗单位所接受和使用。
值得重视的风湿、类风湿性关节炎，在我国的发生率还是较高的，四肢小关节的破坏、畸形和功能障碍可说是类风湿的“专利”，药物治疗难以奏效，给广大病患者带来极大的痛苦。
人体腕关节较为复杂，骨骼形态不一且数目繁多，其关节面多向吻合、功能运动可称万向。一旦因创伤和相关疾病等原因造成其破环、畸形和功能障碍，采用理想的人工关节替换性治疗，是目前医疗上值得推广的解决方案。
腕关节有着独特而复杂的解剖关系，它是由尺挠骨远端端面、近远两排腕骨和掌骨近端端面而组成的多向自由度形整关节，有着强力的屈伸，侧偏及内外向旋转的生物力学功能。
依据腕关节损伤和破环的具体病理变化，针对性分析，决定其手术方案，选择其关节假体。
临床现应用地进口关节假体多以非限定式或限定式为设计，往往不能很好的满足腕关节的解剖特点和功能活动及力学关系，稳定性存有疑虑。
由于上述原因，本发明人经多年的调研及临床研究，本实用新型设计出一种组合式半限定双极或多极人工腕关节，能够较好地克服以上缺陷。
实用新型内容
为了克服上述问题，本发明人进行了锐意研究，设计出一种组合式半限定双极或多极人工腕关节，又可称作“半限定双极人工腕关节”，是根据腕关节骨破坏的具体病理情况，如显示掌腕骨关节面完整、骨质尚好，可以保留大部分的远排腕骨(累及小多角骨、头状骨)，而近排腕骨(舟状骨及月骨)及腕挠骨关节面破环，即可行近排腕骨切除之选型组装；该人工腕关节还可以做另一种组配方式，即可称作“半限定多极人工腕关节”，可以对病理破坏的双排腕骨切除，形成掌、腕、挠各关节的互配组装，会给术者带来灵活、方便和理想的手术结果。
具体来说，本实用新型的目的在于提一种组合式半限定双极人工腕关节，该人工腕关节包括两棵腕骨植入针1，
所述腕骨植入针1是远排保留腕骨的植入体，
所述腕骨植入针1安装在轴杆2上，
在轴杆2外侧套设有轴套3；
轴杆2和轴套3可做关节轴向运动。
本实用新型还提供一种组合式半限定多极人工腕关节，该人工腕关节包括掌骨近端偏颈球形柱体6，
所述掌骨近端偏颈球形柱体6上设置有平台二61、球颈二 62和球头二63，
其中掌骨近端偏颈球形柱体6的球颈二62与掌骨近端偏颈球形柱体6的轴线呈8～15°倾角。
本实用新型所具有的有益效果包括：
(1)组合式半限定双极或多极人工腕关节是由关节球体、臼内衬、关节臼组成，球体和臼衬的组配采用球径，臼内径的超半径工艺，在配装外臼杯呈臼衬周边向内紧缩状态，球体不易脱出，而整体配装其轴向的幅度，留有一定的紧缩空间距离，使整体关节做功状态，具有轴向拉伸、收缩微动调节的缓冲作用。而关节在软组织配合收缩多向、稳定的模拟生理性做工。
(2)组合式半限定双极或多极人工腕关节符合腕关节的生理解剖学关系，更加近似于腕关节复杂的运动医学特点。
(3)组合式半限定双极或多极人工腕关节组配简单，在一定受力条件下，能使其运动灵活，可完成多向运动功效。
(4)组合式半限定双极或多极人工腕关节通用性强，其组合功能可据腕关节骨组织的病理情况，半侧腕骨及双侧腕骨随机选择，给手术操作带来更好的成功率。
(5)组合式半限定双极或多极人工腕关节手术操作简单，组配方便，非常便于推广和应用。
附图说明
图1示出根据本实用新型一种优选实施方式的组合式半限定双极人工腕关节整体组配示意图；
图2示出根据本实用新型一种优选实施方式的组合式半限定双极人工腕关节正、侧两个向面的组装顺序分解示意图；
图3示出根据本实用新型一种优选实施方式的组合式半限定多极人工腕关节整体组配示意图；
图4示出根据本实用新型一种优选实施方式的组合式半限定多极人工腕关节组装顺序分解示意图；
图5-9图中分别示出了根据本实用新型一种优选实施方式的组合式半限定双极人工腕关节中各个部件的结构示意图；
图10-14图中分别示出了根据本实用新型一种优选实施方式的组合式半限定多极人工腕关节中各个部件的结构示意图。
附图标号说明：
1-腕骨植入针
2-轴杆
3-轴套
4-关节动连接部件
41-轴架
42-关节臼
43-臼内衬一
44-凸起一
5-球型柱体
51-平台一
52-球颈一
53-球头一
6-掌骨近端偏颈球形柱体
61-平台二
62-球颈二
63-球头二
7-臼内衬二
71-凸起二
8-双关节动连接部件
具体实施方式
下面通过附图和实施例对本实用新型进一步详细说明。通过这些说明，本实用新型的特点和优点将变得更为清楚明确。
在这里专用的词“示例性”意为“用作例子、实施例或说明性”。这里作为“示例性”所说明的任何实施例不必解释为优于或好于其它实施例。尽管在附图中示出了实施例的各种方面，但是除非特别指出，不必按比例绘制附图。
严重的腕关节创伤、腕骨粉碎性骨折、畸形愈合、类风湿性关节炎累及腕关节破坏，不明原因的腕骨坏死性疾病及腕关节肿瘤等疾病，专科临床已成常见病，且易造成病人关节的畸形、疼痛和功能障碍，严重影响其生活质量，并带来极大的痛苦，为此我们多年的临床观察、精心研究实用新型设计出一种组合式半限定双极或多极人工腕关节，并可分为两种组配方式，其两种组配方式的主体可互配换装，根据病状而灵活选择、兼顾应用。
根据本实用新型提供的组合式半限定双极或多极人工腕关节可分为两种的组装方式，以便于术者的操作成功性。
优选地，在一种组装方式中，该方式中只需要腕关节的近排部分腕骨切除，如图1和图2中所示，附图标记1示出的腕骨植入针，设计为两棵，是远排保留腕骨的植入体，近端与关节轴杆两端机械连接，可以通过卡扣固定，也可以通过过盈配合固定。
其中附图标记2、3是可做关节轴向运动的轴杆和轴套，轴杆为2由金属材料制成，而与其配合在表面的轴套3由非金属材料制成，从而能够降低轴杆2与轴套3之间的磨损率，提高腕关节的使用寿命。
所述轴套3套设在轴杆2的中部位置，所述腕骨植入针1分别安装在轴杆2的两端，轴套和腕骨植入针1之间留有一定的距离，以免彼此干扰摩擦。
附图标记4所示的是关节动连接部件，该部件的一侧端面上设有42关节轴架，与上述带套的关节轴动配合组装，即所述轴杆为2及其上的轴套3一半嵌入并到所述关节轴架42中。所述关节轴架42包括内凹的固定钳口，所述轴套3及轴杆2嵌入到该固定钳口中，从而使得轴套3及轴杆2安装固定在关节动连接部件4上。
而相对应的另一侧为半球形内凹的关节臼杯41，臼杯内配装有臼内衬一43，所述臼内衬一43由非金属材料制成。
附图标记5为球型柱体，是挠骨远端的植入体，柱体本身可为实心柱体或中空状柱体，其中空柱体表面生物材料喷涂，其远端设有与球型柱体5的轴线呈90°角的平台一51，即所述平台一51与所述球型柱体垂直设置，平台一51上端为球颈一52 和球头一53，其球头一53与关节臼内衬一43超半径压配组合，即所述球头一53***到关节臼内衬一43中的深度值比球头一 53的半径值大。所述球头一呈类球形，在安装到臼内衬一中以后能够与臼内衬一之间相对转动，实现类关节功能；所述球颈一52呈圆柱状，用以连接球头一53与球型柱体5。
在臼内衬一43整体为类半球形，且在其半球形切面处向内凹陷出用以容纳球型柱体5上球头一53的凹坑，在所述凹坑的开口端设置具有弹性的凸起一44，所述凸起一44朝向球形的中心方向，在球头一***到凹坑的过程中，挤压所述凸起一44，使得凸起一44产生弹性形变，然后才能使得球头一顺利地进入到凹坑中，在球头一完全进入到所述凹坑中以后，所述凸起一 44回复原状，并且临近球颈一，防止球头一51从凹坑中退出。
优选地，在另一种组装方式中，同样是一种半限定的且呈多极化腕关节，适用于双排部分腕骨切除的手术矫形方案，它是由与掌骨相对应型号的两个球型柱体、一个双关节动连接部件，相符的内衬向近端腕骨、挠骨端的连接组装部件与前述所说的双极腕关节假体同样方式的压配合连接组装，即形成掌、腕关节；腕、腕间关节及腕、挠骨关节的多向自由度的多极运动整腕关节，如图3、图4中所示，能够保持上述特点的基础上，较好满意地解决了手术需解决双排部分腕骨切除的矫形整复方案。
根据腕骨损伤、破环的病理变化所需要切除双排腕骨的多极腕骨关节假体。如图3、图4中所示，它是包括掌骨近端偏颈球形柱体6，其形态、工艺与前说明的腕骨植入针雷同，其不同点在于掌骨近端偏颈球形柱体的球颈二62与掌骨近端偏颈球形柱体6的轴线呈8～15°倾角，优选为10°倾角，本实用新型人发现当将该角度设置为10度倾角时，能够最为适应该位置关节的解剖形态，还能够方便于与人体股骨组织及假体上其他构件之间匹配关联。
所述掌骨近端偏颈球形柱体6上设置有平台二61、球颈二 62和球头二63，所述平台二61上朝向掌骨近端偏颈球形柱体6 主体的一面与掌骨近端偏颈球形柱体6的轴线呈90度角，其另一面与球颈二62的轴线垂直。
附图标记7表示的仍然是臼内衬，此处称之为臼内衬二7。
所述球头二呈类球形，在安装到臼内衬二中以后能够与臼内衬二之间相对转动，实现类关节功能；所述球颈二62呈圆柱状，用以连接球头二63与掌骨近端偏颈球形柱体6。
在臼内衬二7整体为类半球形，且在其半球形切面处向内凹陷出用以容纳掌骨近端偏颈球形柱体6上球头二63的凹坑，在所述凹坑的开口端设置具有弹性的凸起二71，所述凸起二71 朝向球形的中心方向，在球头二***到凹坑的过程中，挤压所述凸起二71，使得凸起二71产生弹性形变，然后才能使得球头二顺利地进入到凹坑中，在球头二完全进入到所述凹坑中以后，所述凸起二71回复原状，并且临近球颈二62，防止球头二61 从凹坑中退出。
附图标记8表示双关节动连接部件，其运动端向面设计为一体的双臼杯，两杯逆向成角，与成角的偏颈球型柱体相互压配，其部件的另一向面设有前述相同的轴杆和轴套。优选地，所述两杯逆向成角是指两个杯体开口面不平行，其所成的角度为150～170度，优选为170度，从而使得同时安装在双关节动连接部件8上的掌骨近端偏颈球形柱体6、球型柱体5能够彼此平行。即所述双关节动连接部件8能够在需要的时候替换关节动连接部件4进行腕关节的置换作业，
该组装方式中仍然包括上文所述的轴杆2、轴套3，还设置有与球型柱体5类似的纳掌骨近端偏颈球形柱体6等部件；其功能及组装方式都基本相同，只需根据病理情况和医生的手术需要，灵活方便的选择配装，已达到满意的手术效果。
上述假体两种配装方式可根据术中腕骨的具体病理情况，可随机选择、相互兼顾、灵活性强，有效提供了手术操作可靠性、各部件组装简便易行。这一组合式半限定多极人工腕关节进一步高仿真于人体腕关节复杂的生理功能。
以上结合了优选的实施方式对本实用新型进行了说明，不过这些实施方式仅是范例性的，仅起到说明性的作用。在此基础上，可以对本实用新型进行多种替换和改进，这些均落入本实用新型的保护范围内。

Claims (8)

1.一种组合式半限定双极人工腕关节，其特征在于，该人工腕关节包括两棵腕骨植入针(1)，
所述腕骨植入针(1)是远排保留腕骨的植入体，
所述腕骨植入针(1)安装在轴杆(2)上，
在轴杆(2)外侧套设有轴套(3)；
轴杆(2)和轴套(3)可做关节轴向运动。
2.根据权利要求1所述的组合式半限定双极人工腕关节，其特征在于，
所述轴杆(2)为由金属材料制成，所述轴套(3)由非金属材料制成。
3.根据权利要求1所述的组合式半限定双极人工腕关节，其特征在于，
轴杆(2)和轴套(3)都安装在关节动连接部件(4)上。
4.根据权利要求3所述的组合式半限定双极人工腕关节，其特征在于，
在所述关节动连接部件(4)的一侧端面上设有与轴杆(2)、轴套(3)相配合的关节轴架(42)；
在所述关节动连接部件(4)的另一侧为半球形内凹的关节臼杯(41)，在关节臼杯(41)内安装有臼内衬一(43)；所述臼内衬一(43)由非金属材料制成。
5.根据权利要求4所述的组合式半限定双极人工腕关节，其特征在于，
该人工腕关节还包括球型柱体(5)，所述球型柱体(5)是挠骨远端的植入体，球型柱体(5)本身可为中空状柱体；在其中空柱体表面喷涂有生物材料层。
6.根据权利要求5所述的组合式半限定双极人工腕关节，其特征在于，
在球型柱体(5)远端设有与球型柱体(5)的轴线呈90°角的平台一(51)，在平台上端设置有球颈一(52)和球头一(53)，所述球头一(53)与关节臼杯(41)超半径压配组合。
7.一种组合式半限定多极人工腕关节，其特征在于，该人工腕关节包括掌骨近端偏颈球形柱体(6)，
所述掌骨近端偏颈球形柱体(6)上设置有平台二(61)、球颈二(62)和球头二(63)，
其中掌骨近端偏颈球形柱体(6)的球颈二(62)与掌骨近端偏颈球形柱体(6)的轴线呈8～15°倾角；
该组合式半限定多极人工腕关节还包括双关节动连接部件(8)，
在双关节动连接部件(8)内部安装有臼内衬二(7)，
所述掌骨近端偏颈球形柱体(6)与臼内衬二(7)配合；
所述双关节动连接部件(8)的动端向面为一体的双臼杯，两杯逆向成角，与成角的掌骨近端偏颈球形柱体(6)相互压配，其另一向面设有轴杆(2)和轴套(3)。
8.根据权利要求7所述的组合式半限定多极人工腕关节，其特征在于，
轴杆(2)和轴套(3)可做关节轴向运动；
轴杆(2)和轴套(3)都安装在关节动连接部件(4)上，
所述关节动连接部件(4)的一侧端面上设有与轴杆(2)、轴套(3)相配合的关节轴架(42)；
在所述关节动连接部件(4)的另一侧设置有设为关节所示的关节臼杯(41)，关节臼杯(41)内配装有臼内衬一(43)。
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