Intramedullary axial compression fixation prosthesis for metaphyseal bone defects
Technical Field
The application relates to the technical field of reconstruction of metaphyseal bone defect prostheses, in particular to an intramedullary axial compression fixation prosthesis for metaphyseal bone defects.
Background
Bone defect caused in pathological process, such as broken fracture, open fracture and massive bone tissue defect caused by factors such as wound, inflammation, bone disease, etc., osteonecrosis separation caused by inflammation, and defect caused by massive osteonecrosis caused by bone infarction or ischemic necrosis, etc., which belong to bone defect. For bone defects, the treatment may be performed by bone grafting, i.e. the patient's bone parts that have caused the bone defect are now cut off, and the fixation handles of the prosthesis are surgically transplanted to the remaining bone in the patient's body, where reinforcement or fusion is required. Referring to fig. 1, when it is required to fix the fixing shank to the reserved bone, the end surface of the fixing shank is abutted against the section of the reserved bone, and a steel plate is simultaneously installed and fixed on one side of the fixing shank and the reserved bone to achieve reconstruction.
In view of the above-mentioned related technical solution, the inventor found that although the long-term fixation is achieved by performing a coating treatment on the end face of the fixing handle, the coating includes but is not limited to 3D printing of a bone-like trabecular porous structure, a titanium/tantalum coating, a hydroxyapatite coating, etc., to promote the bone ingrowth effect, the healing and bone ingrowth difficulty still occurs due to the mutual tiny displacement between the fixing handle and the reserved bone in the wound healing process, and if a certain pressure is applied between the end face of the fixing handle and the reserved bone cross section, the end face of the fixing handle and the reserved bone can be more firmly abutted together in the early stage of operation, and the bone ingrowth effect is promoted.
Disclosure of Invention
In order to exert a constant pressure on the stem and the remaining bone, thereby promoting bone ingrowth and making the connection between the two more secure at the early stage of the operation, the present application provides an axially pressurized fixation prosthesis in the intramedullary canal of a metaphyseal bone defect.
The application provides a metaphyseal bone defect intramedullary axial compression fixation prosthesis, which adopts the following technical scheme:
The utility model provides a fixed prosthesis of axial pressurization in bone defect intramedullary canal of metaphysis, includes the pressure bar and is used for fixing the mounting of pressure bar position, and the pressure bar extends to in the fixed handle, and the fixed handle is inside to be provided with the tail cap of exerting pressure with pressure bar threaded connection, has offered the nut hole that supplies the tail cap of exerting pressure to put into on the fixed handle, and the axial position of tail cap of exerting pressure and nut hole is fixed and can rotate in nut hole inside.
According to the technical scheme, when the fixing handle and the reserved bone are required to be fixed together, the pressing rod is inserted into the intramedullary cavity of the reserved bone and fixed on the reserved bone through the fixing piece, at the moment, the pressing rod extends to the outside of the reserved bone and is inserted into the fixing handle, the pressing tail cap is rotated at the moment to enable the pressing tail cap to rotate on the pressing rod and move towards the direction close to the hole bottom of the nut hole until the pressing tail cap abuts against the hole bottom of the nut hole, at the moment, if the pressing tail cap is continuously rotated, the pressing tail cap drags the pressing rod and enables the pressing rod to move towards the outside of the intramedullary cavity along the axis direction of the pressing tail cap, in the process, the pressing tail cap pushes the whole fixing handle to move slightly towards the direction close to the reserved bone through the hole bottom of the nut hole and to be tightly pressed on the section of the reserved bone, and the pressing tail cap is mutually matched with the pressing tail cap and the hole bottom of the nut hole, so that pressing force exists between the end face of the fixing handle and the section of the reserved bone, the pressing effect of realizing the controllable pressure level of the bone interface through fixing torque is achieved, and the effect of keeping the end face of the fixing handle is achieved, and the fixing end face is further achieved, and the fixing effect is achieved.
Preferably, a locking piece for maintaining a continuous pressurizing state is arranged between the pressurizing tail cap and the hole bottom of the nut hole.
By adopting the technical scheme, the possibility of loosening the pressing tail cap is reduced.
Preferably, the circumferential surface of the pressure applying rod is provided with an anti-rotation groove extending radially along the pressure applying rod, the fixed handle is connected with an anti-rotation screw in a threaded manner, and the anti-rotation screw extends into the anti-rotation groove and is in sliding connection with the pressure applying rod.
By adopting the technical scheme, on one hand, the guiding function can be realized for the movement of the pressing rod, and on the other hand, the anti-rotation screw is rotated until the end part of the anti-rotation screw is abutted against the bottom of the anti-rotation groove, so that the further fixing function can be realized for the position of the pressing rod.
Preferably, the fixing piece is provided with one or more, and the fixing piece is a locking screw connected with the pressing rod, and an included angle exists between the axis of the locking screw and the axis of the pressing rod.
By adopting the technical scheme, because the axial line of the locking screw and the axial line of the pressing rod form an included angle, when the pressing rod is to be pulled out from the interior of the marrow cavity along the axial direction of the pressing rod, the locking screw can fix the position relation between the pressing rod and the reserved bone, and then when the pressing tail cap is rotated, the pressing rod can also drag the reserved bone so as to press the section of the reserved bone and the end face of the fixed handle.
Preferably, the end of the fixation handle is provided with an intramedullary rod for implantation into the remaining bone.
Through adopting above-mentioned technical scheme, on the one hand can hinder the fixed handle and keep the bone to take place radial dislocation, on the other hand, the intramedullary pole takes place the bone and goes into the phenomenon and then improves the fixed handle and keep the bone to go into the effect with the bone that keeps the bone.
Preferably, the surface of the intramedullary rod and the end surface of the fixation handle are coated to promote bone ingrowth.
By adopting the technical scheme, a better rehabilitation effect is brought.
Preferably, the fixing device comprises a steel plate for fixing the reserved bone and the fixing handle, wherein a plurality of fixing screws for fixing the steel plate on the reserved bone and the fixing handle are arranged on the steel plate, and a plurality of screw holes for the fixing screws to pass through are formed in one end, close to the locking screws, of the steel plate.
In summary, the application has the following technical effects:
1. The locking screw, the pressure applying rod and the pressure applying tail cap are arranged, and the nut hole is formed in the fixing handle, so that continuous pressing force exists between the end face of the fixing handle and the section of the reserved bone, on one hand, a more firm fixing effect is achieved between the fixing part and the reserved bone in the initial stage after operation, and on the other hand, the mutual pressure between the end face of the fixing handle and the section of the reserved bone promotes the bone ingrowth effect;
2. on the other hand, the anti-rotation screw is rotated until the end part of the anti-rotation screw is abutted against the bottom of the anti-rotation groove, so that a further fixing effect can be achieved for the position of the pressing rod.
Drawings
FIG. 1 is a schematic view of a structure in which a retaining bone and a fixation handle are mounted by a steel plate and a fixation screw;
FIG. 2 is a schematic view of the internal structure of a retaining bone and fixation handle according to an embodiment of the present application;
FIG. 3 is a schematic view of a partial structure of a fixing shank at an inner anti-rotation screw in an embodiment of the present application;
Fig. 4 is an exploded view of the torque wrench and the pressure applying tail cap in an embodiment of the present application.
In the figure, 1, reserved bone, 11, a medullary cavity, 2, a fixing handle, 21, a nut hole, 22, a pressing rod hole, 3, a pressing rod, 31, an anti-rotation groove, 32, an intramedullary rod, 4, a pressing tail cap, 41, a screwing part, 5, an anti-loosening element, 6, an anti-rotation screw, 7, a locking screw, 8, a steel plate, 81, a screw hole, 9, a fixing screw, 10 and a torque wrench.
Detailed Description
The present application will be described in further detail with reference to the accompanying drawings.
Referring to fig. 1 and 2, the application provides a metaphyseal bone defect intramedullary axial pressurizing fixing prosthesis, which comprises a pressurizing rod 3 inserted into a reserved bone 1, wherein the pressurizing rod 3 is inserted into a intramedullary cavity 11, a fixing piece for fixing the pressurizing rod 3 on the reserved bone 1 is arranged on the reserved bone 1, the pressurizing rod 3 extends to the outside of the intramedullary cavity 11 and coaxially extends into a fixing handle 2, one end of the pressurizing rod 3 far away from the reserved bone 1 is fixed on the fixing handle 2, the fixing handle 2 is further provided with a pressurizing rod hole 22 for inserting the pressurizing rod 3 coaxially, one end of the fixing handle 2 close to the reserved bone 1 is coaxially and integrally provided with an intramedullary rod 32 inserted into the intramedullary cavity 11, the intramedullary rod 32 can be made into a cylinder or a cone according to the shape of the intramedullary cavity, in the embodiment, the intramedullary rod 32 is of a cylindrical structure, the pressurizing rod 3 simultaneously penetrates through the intramedullary rod 32, in order to provide a better bone growth effect, the surface of the intramedullary rod 32 and the end face of the fixing handle 2 are coated with a coating capable of promoting bone growth, the coating is not limited by a steel plate 9, namely, the steel plate is arranged close to one end of the fixing handle 2 is connected with one end of the fixing handle 2, and the fixing handle 2 is respectively fixed with one end of the fixing handle 2, namely, the fixing handle 2 is fixed by a steel plate 8 is fixed with one end of the fixing handle 2, and the fixing handle 2 is fixed by a steel plate 8, and one end is kept close to the fixing handle 2 is fixed by a3 and one end is respectively, and the fixing handle 2 is fixed by a3 is fixed by a steel plate and 8, and has a fixing structure is fixed by a fixing structure and has is fixed.
The fixing part is at least provided with one locking screw 7 penetrating through the reserved bone 1, in the embodiment, the number of the locking screws 7 is two, in other embodiments, one or more locking screws can be arranged, the horizontal direction can be at any angle, the locking screws are vertical to the pressing rod in the coronal direction or the losing-shape direction, the locking screws 7 penetrate through the pressing rod 3 along the radial direction of the pressing rod 3 and are connected with the pressing rod 3, an included angle exists between the two locking screws 7 along the radial direction of the pressing rod 3, when the pressing rod 3 is about to be misplaced with the reserved bone 1 along the radial direction, the axial dislocation of the two locking nuts can further prevent the movement trend of the pressing rod 3, namely the pressing rod 3 can be more firmly fixed on the reserved bone 1, a plurality of screw holes 81 for selectively inserting the locking screws 7 are formed in the steel plate 8, and the positions of the locking screws 7 can be selected according to the positions of the fixing screws 9.
Referring to fig. 2 and 3, in order to allow a mutual pressure capable of promoting bone ingrowth to exist between the end surface of the fixing shank 2 and the cross section of the reserved bone 1, a nut hole 21 communicating with a pressing rod hole 22 is formed at one end of the fixing shank 2 far from the reserved bone 1, the nut hole 21 is formed through the end surface of the fixing shank 2 far from the reserved bone 1, a pressing tail cap 4 is threaded at one end of the pressing rod 3 far from the reserved bone 1 and is arranged inside the nut hole 21, at least one pressing tail cap 4 is arranged, in this embodiment, the two pressing tail caps 4 are in contact with each other, at least one locking piece 5 is arranged between the pressing tail cap 4 at one side close to the reserved bone 1 and the hole bottom of the pressing rod hole 22, the locking piece 5 can be a spring washer or a butterfly washer, in this embodiment, the locking piece 5 adopts a spring washer and is arranged at two, and the spring washer is pressed between the hole bottom of the pressing rod hole 22 and the pressing tail cap 4 at one side close to the reserved bone 1.
After the installation of the pressing rod 3, the fixing handle 2, the steel plate 8 and the fixing screw 9 is completed, the two pressing tail caps 4 are screwed into the nut holes 21 in sequence, and meanwhile, the pressing tail caps 4 are screwed onto the pressing rod 3 until the pressing tail caps 4 compress the spring washers on the bottoms of the nut holes 21, and the pressing tail caps 4 on the side far from the reserved bones 1 are compressed on the pressing tail caps 4 on the side close to the reserved bones 1; in this process, the pressing tail cap 4 drags the pressing rod 3 and makes the pressing rod 3 have a tendency to move to the outside of the medullary cavity 11 along the axial direction of the pressing tail cap 4, in this process, the pressing tail cap 4 pushes the fixing handle 2 and makes the fixing handle 2 have a tendency to move to the direction close to the retaining bone 1 and further compress the fixing handle 2 on the section of the retaining bone 1, in addition, because the pressing rod 3 also has a tendency to move to the outside of the medullary cavity 11, the pressing rod 3 further drives the retaining bone 1 to have a tendency to move to the direction close to the fixing handle 2, the mutual matching of the pressing tail cap 4 and the pressing rod 3, the mutual abutting of the pressing tail cap 4 and the hole bottom of the nut hole 21 and the fixed connection of the pressing rod 3 and the retaining bone 1 jointly make the mutual pressure exist between the end face of the fixing handle 2 and the section of the retaining bone 1 in the direction close to each other, so that on one hand, a firm fixing effect is achieved between the end face of the fixing handle 2 and the section of the retaining bone 1 at the initial stage after operation, and on the other hand, the mutual pressure between the end face of the fixing handle 2 and the section of the retaining bone 1 promotes the ingrowth effect of bone.
In addition, the anti-loose piece 5, namely the spring washer or the butterfly washer, also plays a role in preventing loose, and further explains that after the pressing tail cap 4 presses the spring washer or the butterfly washer, the spring washer or the butterfly washer can generate continuous elastic force, so that the threaded connection pair of the pressing tail cap 4 and the pressing rod 3 continuously keeps a larger friction force to generate a resisting moment, thereby reducing the possibility of loosening the pressing tail cap 4.
Referring to fig. 4, in order to achieve the above-mentioned "screwing the pressing tail cap 4 onto the pressing rod 3", it is further provided that a screwing part 41 is integrally formed at an end of the pressing tail cap 4 remote from the retained bone 1, the screwing part 41 has a polygonal structure, in this embodiment, the screwing part 41 has a quadrangular structure, two opposite sides of the screwing part 41 are straight sides and the other opposite sides are arc sides having the same curvature as the pressing tail cap 4, when the pressing tail cap 4 needs to be screwed, a torque wrench 10 is required, a groove having a shape adapted to the shape of the screwing part 41 is formed at an end of the torque wrench 10, and thus, the torque wrench 10 is mounted on the screwing part 41, and the pressing tail cap 4 can be screwed onto the pressing rod 3 by rotating the torque wrench 10.
Referring to fig. 2 and 3, further, an anti-rotation groove 31 is formed on the circumferential surface of the pressing rod 3 along the axial direction of the pressing rod, an anti-rotation screw 6 is connected with the circumferential wall penetrating through the fixing handle 2 in a threaded manner, the axis of the anti-rotation screw 6 is perpendicular to the axis of the pressing rod 3, the anti-rotation screw 6 extends into the anti-rotation groove 31, the groove width of the anti-rotation groove 31 along the direction perpendicular to the axis of the pressing rod 3 is equal to the diameter of the anti-rotation screw 6, when the pressing tail cap 4 is rotated to enable the pressing rod 3 to slightly move along the axial direction of the pressing rod, the anti-rotation groove 31 and the anti-rotation screw 6 are mutually matched, on one hand, so that the movement of the pressing rod 3 can be guided, and on the other hand, when the position of the pressing rod 3 is determined, the anti-rotation screw 6 is rotated until the end of the anti-rotation screw 6 abuts against the groove bottom of the anti-rotation groove 31, and further fixing effect can be achieved for the position of the pressing rod 3.
In summary, the use process of the application comprises the steps of inserting the pressing rod 3 into the intramedullary canal 11 and installing two locking screws 7 on the pressing rod 3, inserting the fixing handle 2 onto the shaft end of the pressing rod 3 extending to the outside of the reserved bone 1 until the end face of the fixing handle 2 is attached to the section of the reserved bone 1, sequentially sleeving the anti-loose piece 5 and the pressing tail cap 4 on the pressing rod 3, rotating the pressing tail cap 4 through the torque wrench 10 until the pressing tail cap 4 tightly presses the anti-loose piece 5 on the hole bottom of the nut hole 21, wherein at the moment, the fixing handle 2 and the reserved bone 1 have a mutually approaching movement trend, so that mutual pressure is generated between the attached surfaces of the fixing handle 2 and the reserved bone 1, on one hand, a firmer fixing effect is achieved between the initial fixing part after operation and the reserved bone 1, on the other hand, the mutual pressure between the end face of the fixing handle 2 and the section of the reserved bone 1 promotes the bone in effect, and finally, selecting proper screw holes 81 to fix the steel plates 8 on the fixing handle 2 and the reserved bone 1 through the fixing screws 9.
The present embodiment is only for explanation of the present application and is not to be construed as limiting the present application, and modifications to the present embodiment, which may not creatively contribute to the present application as required by those skilled in the art after reading the present specification, are all protected by patent laws within the scope of claims of the present application.