CN1057580A - 一种再造腕关节的装置 - Google Patents

一种再造腕关节的装置 Download PDF

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CN1057580A
CN1057580A CN91103332A CN91103332A CN1057580A CN 1057580 A CN1057580 A CN 1057580A CN 91103332 A CN91103332 A CN 91103332A CN 91103332 A CN91103332 A CN 91103332A CN 1057580 A CN1057580 A CN 1057580A
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佩-英瓦尔·布兰尼马克
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    • A61F2/02—Prostheses implantable into the body
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    • 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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    • A61F2002/30474—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using an intermediate sleeve interposed between both prosthetic parts to be coupled
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • A—HUMAN NECESSITIES
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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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    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
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Abstract

一种再造关节、特别是再造腕关节的装置，具有 3个组件，第一组件(1)有一个夹持紧固件的前平板 (2)，该紧固件可拧入紧靠关节的骨组织中，至少有一 个部分中空的销(5)从前平板向骨组织伸展。第二组 件(14)有一个夹持紧固件(17)的前平板(15)，紧固件 (17)放入邻近关节的骨组织中，而且至少有一个部分 中空的销(20)从前平板15朝骨组织伸展。第三组 件(33)是弹性材料的人造连接机构、它借助从其上突 伸出的销定位并固定在第一、二组件(1；14)的对置的 前平板(2；15)上的上述中空销和/或连接螺杆中。

Description

本发明涉及一种再造关节，特别是再造腕关节的方法和装置。
迄今为止，用于关节的再造装置极少，且不太有效。Swanson假体在这方面是最常见的一种，它具有由高弹性材料制作的一个导向体，该导向体带有向外伸出的销钉（Spikes），以使其固定在各个狭窄的腔室的空间内。
固定用的销钉与相邻组织间的持续摩擦会引起损伤及随后的炎症和松动，而且，所使用的弹性材料也不具备足够的耐磨性。然而，这些公知关节假体最严重的缺点是它们只能部分地解决问题;它们虽然可以允许肘腕“正常”弯曲，但不能同时也使肘腕转动。
再造桡骨尺骨末端关节的装置的另一个新近的例子并不涉及到替换手上一部分骨头的问题，具体情况参见1990、10、20的美国专利申请630518。
现在，已经令人意外地发现，公知的关节替代装置的那些缺点能够借助本发明来克服。本发明允许肘腕“正常”弯曲，且在必要时也能使肘腕转动。因此，本发明提供了一个几乎与天然关节有同样功能的关节替代装置。
下面结合附图所示的实施例介绍本发明的另外一些目的和特点。
图1表示具有正常关节的手的结构;
图2是本发明的关节再造装置所包含的各种组件的立体图，
图3和图4是本发明装置的第一主要组件的不同方向的立体视图，
图5和图6是本发明装置的第二个主要组件的不同方向的立体视图，
图7表示根据本发明使用的装置。
图1表明正常腕关节的结构。用本发明的装置再造腕关节时，图1阴影部分A所示的那一部分用外科手术除去，并用下面要介绍的一个人造关节来取代。
本发明的关节再造装置用简图表示在图2上。图中，第一主要组件用数字1表示。第一主要组件有一个前平板2，在放到腕部时，前平板2的背侧（视图的后侧一面）朝向手掌3。前平板2至少配置有2个部分空心的销5，这两个销5彼此分开且朝手掌3伸出，其末端6是封闭的。在销5之间配置有一个孔7，用于容纳螺杆状紧固件8，该紧固件具有公知的式样且是部分空心的，在其开口端10上配有切制的槽缝9。
第一主要组件的更具体的细节展示在图3和图4上。
第一主要组件既可以完全由如钛那样的生物可适应的材料制作，也可以至少在其表面涂覆上一层这种材料。前平板2沿其两条对置的长侧边适当配置些沟槽11。槽11沿其嵌入方向设置以改善前平板2与放入放入其中的骨组织的结合性能。如图4所示，前平板2的上侧表面4也是适度地不平整，例如可在此表面上设置些沟槽12。前平板2上的孔7切有卡持紧固件8的上法兰13的凹座。
本装置的第二主要组件14表示在图5、6和7上，它向后突伸入臂部。
第二主要组件也有一个前平板15，其上设有容纳螺杆状紧固件17的孔16，象紧固件8一样，紧固件17也部分中空且在其开口端19上切有槽缝18。
一个具有封闭端21的空心销20位于孔16的横向一侧并从平板15向外突出。在孔16的横向另一侧，平板15与套筒状的导向体22连成一体。导向体22从平板15沿与销20同一方向向外突伸，其上配置有一个基本是椭圆形的孔23，此孔用于容纳一个基本上是椭圆形的插入件24。插入件24的底部25至少部分地与导向体22的向内突伸缘26接触。插入件24上设有一个槽形纵向滑道（guide）26′，该滑道用于安装一个带有头部28的控制件27，头部28安装得使之大约接触槽26′的上端边29，从而使控制件27的与头部28邻接的光滑部分30基本上处于插入件24内。
控制件27上还设置有螺纹部分31，这部分永久地拧入一个事先设置在有关的骨组织中的定位器32中。
除插入件24之外，第二主要组件的全部零件由生物能适应的材料、最好是由钛制造，而插入件可由塑料制作，合适的材料如高密度聚乙烯。
本发明的装置还有一个第三主要组件33，它是由一个连接机构，例如可以是由硅树脂塑料（silicon  plastic）制作的一个弹性减震器，减震器安放于第一、二主要组件1、14的前平板2和15之间。减震器借助于从其上突伸出的、并插入前平板2上的空心销5以及第二主要组件上的空心销20和连接螺杆17上部的空心部分的一些销来固定。
本发明的装置以下述方式使用。
首先，将腕的已损伤的或有缺陷的原来的部位去掉，去掉部分包括图1所示阴影线部分A。然后将一个钛制作的定位器32以公知的方法放入有关的骨组织中（尺骨），用于与控制件27上的螺纹部分31连接。
在进行必要的预先修正后，将第一主要组件的前平板2放入，其放入的方式使它的基本上是平坦的前表面C与图1所示的直线D位于同一平面内。
通过将连接螺杆8拧入图7所示的掌骨Ⅲ中使前平板2位置固定。
在按要求预先修正后，将第2主要组件的前平板15放入，放入的方式使其平整的侧面E与图1所示的直线F基本处于同一平面内，然后，将连接螺杆17拧入桡骨中而使前平板15定位。再将插入件24放入导向体22内，控制件27从上插入插入件24，并将其上的螺纹部分引拧入定位器32中，螺纹部分31拧入的长度可以借助螺母或其他类似形式的止动件而变化。最后将连接机构33放在2个前平板之间并以前述方式加以固定。
所介绍的以上述方式使用的装置提供了一种与正常关节不相上下的关节功能，腕的主要弯曲运动通过连接机构33达到，而所希望的腕的转动（即桡骨绕尺骨的转动）借助于控制件27的设置也是可以实现的-它可以在±90°范围内转动。
本发明当然不局限于附图中所示的那些实施例，而是变换许多方式。
虽然本发明是以最佳实施例的方式介绍的，但其它形式的改进和变更对本领域专业人员来说也是很容易的，因此，本发明的范围并不是由在本文中的特定描述来确定的，而是由权利要求来限定。

Claims (9)

1、一种再造关节，特别是再造腕关节的装置，它具有：
一个第一主要组件(1)，组件(1)具有一个第一前平板，该前平板具有一个朝向手的向外的侧面和一个相反的向内朝向的侧面，一个支承在第一前平板上的第一连接销，从第一前平板的外侧伸出，并朝一块在第一前平板的朝外侧面上的骨头延伸；
一个第二主要组件(14)，组件(14)有一个第二前平板，第二前平板有一个背离手方向的朝内的侧面和一个朝相反方向的第二朝外侧面，一个支承在第二前平板上的第二连接销突伸入在第二前平板的第二内侧面上的那块骨头中；
一个第三主要组件(33)，它由弹性材料构成，配置在第一前平板的朝内侧面与第二前平板的第二朝外侧面之间，并具有在第一、二平板和第三组件上的、将三者连接在一起的装置，第三组件的弹性材料是易于变形的，以允许手在腕上运动。
2、如权利要求1所述的装置，其中的将第三组件连接到第一、二组件上去的连接件是一些从第三组件突伸入第一、二组件中的销。
3、如权利要求1所述的装置，它还有在第二组件上形成的一个导向机构和一个从导向机构伸入腕的尺骨中的控制件，导向机构与第二前平板连接，导向机构的形状和安装方式使之能允许再造的腕关节转动。
4、如权利要求3的装置，其中的第2连接销伸入腕的桡骨中。
5、如权利要求3所述的装置，其中的导向机构包括具有一个导向体的第二前平板，导向体上有一个槽形导向通孔，控制件伸入尺骨中并紧固在那儿，控制件置于导向体及导向体的导向孔之内，它和导向体的配合能够使手在腕上运动。
6、如权利要求5所述的装置，其中的控制件和槽形导向孔的制成的形状使控制件可以相对槽形导向孔在横向和垂直方向两个方向上转动和移动。
7、如权利要求6所述的装置，它还具有一个聚合物材料制成的套状体，它插入导向体中，且在插入体上有一个槽形导向孔。
8、如权利要求7所述的装置，其中的套状体插入件是由聚合物材料构成的。
9、如权利要求8所述的装置，其中的各个零件，除插入件和连接机构外均是由钛制作的。
CN91103332A 1990-04-26 1991-04-25 一种再造腕关节的装置 Expired - Fee Related CN1026753C (zh)

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SE9001521A SE9001521D0 (sv) 1990-04-26 1990-04-26 System och metod foer rekonstruktion av leder, i synnerhet handleder
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CN104720938A (zh) * 2015-04-09 2015-06-24 徐永清 镍钛记忆金属人工全腕关节假体

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CN104720938A (zh) * 2015-04-09 2015-06-24 徐永清 镍钛记忆金属人工全腕关节假体

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DK0454646T3 (da) 1994-04-18
SK279534B6 (sk) 1998-12-02
NO911646D0 (no) 1991-04-25
DE59100646D1 (de) 1994-01-13
US5133762A (en) 1992-07-28
CS9101204A2 (en) 1991-11-12
RU2074676C1 (ru) 1997-03-10
AU7591791A (en) 1991-11-07
CZ280547B6 (cs) 1996-02-14
CN1026753C (zh) 1994-11-30
EP0454646A1 (de) 1991-10-30
FI912015A (fi) 1991-10-27
ATE97797T1 (de) 1993-12-15
KR970001819B1 (ko) 1997-02-17
ZA913110B (en) 1992-03-25
NO175667C (no) 1994-11-16
HU208917B (en) 1994-02-28
CA2041194C (en) 1995-07-18
NO911646L (no) 1991-10-28
AU637487B2 (en) 1993-05-27
AR243761A1 (es) 1993-09-30
NO175667B (no) 1994-08-08
CA2041194A1 (en) 1991-10-27
BR9101679A (pt) 1991-12-10
HUT57030A (en) 1991-11-28
FI912015A0 (fi) 1991-04-25
HU911393D0 (en) 1991-10-28
EP0454646B1 (de) 1993-12-01
JP2620420B2 (ja) 1997-06-11
JPH04227256A (ja) 1992-08-17
ES2049102T3 (es) 1994-04-01
KR910017999A (ko) 1991-11-30
SE9001521D0 (sv) 1990-04-26

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