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CN103505307B - 一种生物型人工髋关节股骨柄 - Google Patents

一种生物型人工髋关节股骨柄 Download PDF

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CN103505307B
CN103505307B CN201310385207.0A CN201310385207A CN103505307B CN 103505307 B CN103505307 B CN 103505307B CN 201310385207 A CN201310385207 A CN 201310385207A CN 103505307 B CN103505307 B CN 103505307B
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steel plate
perimyelis
hip joint
artificial hip
femoral component
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CN103505307A (zh
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刘效仿
刘礼初
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Abstract

本发明公开了一种生物型人工髋关节股骨柄，其包括假体股骨颈、颈领以及柄体；所述柄体包括固定端和分离端，分离端包括骨内膜承接钢板和骨内膜分离钢板，骨内膜承接钢板与固定端一体成型；其还包括一内撑装置，所述内撑装置将骨内膜分离钢板向股骨干的内侧撑开并将其固定于髓腔皮质骨上。本发明通过改进股骨柄的结构，使柄体远端与股骨干髓腔皮质骨紧密贴合， 达到稳定假体和改善重力传导方式使之接近自然的应力、应变模式，避免股骨柄假体松动和其周围的骨骨折；本发明的生物型人工髋关节股骨柄可以做成普通型和加长型，分别用于常规置换和翻修术。

Description

一种生物型人工髋关节股骨柄
技术领域
本发明涉及髋关节表面置换术技术领域，具体涉及一种生物型人工髋关节股骨柄。
背景技术
髋关节是人体最大份负重关节，它是由股骨头、髋臼和关节囊及周围的软组织构成。人工髋关节置换术是指通过手术方法用生物相容性和机械性能良好的材料制成的人工关节假体，置换被疾病或损伤所破坏的股骨头和（或）髋臼关节面，其目的是切除病灶，清除疼痛，恢复关节的活动与原有的功能。
目前的生物型（非骨水泥型）人工髋关节股骨柄假体插入到骨髓腔后，没有保持其长期稳定性的结构，这种结构的股骨柄的承重方式是通过柄体挤压松质骨和小梁骨将人体的重力传到至皮质骨，而不是直接将重力传到至皮质骨。因此这种重力的传导方式所产生的非正常的应力、应变模式可能会引起局部的骨吸收，导致假体周围的骨质疏松和假体松动；更严重的甚至会造成假体周围骨折。另外，这种插入式的股骨柄假体还会影响到局部细胞之间的相互作用，对局部骨组织的塑形产生负面效果。
发明内容
为了克服现有技术的不足，本发明的目的在于提供一种生物型人工髋关节股骨柄，通过改进股骨柄的结构改变人体重力的传导方式，增加假体的长期稳定性，避免股骨柄假体松动和假体周围骨折。
为解决上述问题，本发明所采用的技术方案如下：
一种生物型人工髋关节股骨柄，其包括假体股骨颈、颈领以及柄体；所述柄体包括固定端和分离端，分离端包括骨内膜承接钢板和骨内膜分离钢板，骨内膜承接钢板与固定端一体成型；所述骨内膜分离钢板上端设有连接块，柄体固定端与骨内膜承接钢板的连接处设有与连接块相匹配的连接槽，骨内膜承接钢板和骨内膜分离钢板的外壁上均设有纹理和若干微钉齿；其还包括一内撑装置，所述内撑装置将骨内膜分离钢板向股骨干的内侧撑开并将其固定于髓腔皮质骨上。
本发明还可以通过以下方案实现：
作为本发明的一种优选的方案，所述内撑装置包括主螺钉，柄体固定端设有与主螺钉相匹配的螺纹孔，主螺钉通过螺纹孔伸入到柄体中骨内膜承接钢板和骨内膜分离钢板之间，在主螺钉旋紧的过程中骨内膜承接钢板和骨内膜分离钢板向股骨干的内侧撑开并将其固定于髓腔皮质骨上。作为本发明的一种优选的方案，所述内撑装置包括至少两个异形螺钉；所述异形螺钉包括第一径螺纹段和第二径螺纹段，第一径螺纹段的直径大于第二径螺纹段的直径；所述骨内膜承接钢板设有与第一径螺纹段相匹配的第一螺孔，所述骨内膜分离钢板设有与第二径螺纹段相匹配的第二螺孔；在异形螺钉的旋紧过程中将骨内膜承接钢板和骨内膜分离钢板向股骨干的内侧撑开并将其固定于髓腔皮质骨上。在上述方案的基础上，优选的，所述异形螺钉的数量为4-8个。
作为本发明的一种优选的方案，所述股骨柄柄体近端为网梁状结构，网梁间设有螺纹孔。螺纹孔的作用是既利于新骨长入也可用于翻修术时将骨碎片固定于假体。优选的所述柄体近端螺纹孔直径为1.5-2.5毫米，数量为6-30个。
作为本发明的一种优选的方案，本发明所述的生物型人工髋关节股骨柄还包括一加强钢板，所述加强钢板通过异形螺钉固定在内膜钢板对应的股骨骨皮质外侧。
作为本发明的一种优选的方案，所述假体柄体的表面设有波浪形纹。
相比现有技术，本发明的有益效果在于：本发明通过改进股骨柄的结构，通过骨内膜承接钢板和骨内膜分离钢板使假体柄与骨皮质紧密结合，柄体上微钉齿或异形螺钉将人体重力直接传导到皮质骨，而不需要通过柄体挤压松质骨和小梁骨来传导重力，这种接近正常的应力、应变模式将减少应力不良引起的骨吸收，增加假体长期稳定性，避免股骨柄假体松动和其周围的骨骨折；柄体近端的网梁状结构和螺纹孔，即利于新骨长入也可用于翻修术时将骨碎片固定于假体；还可能影响局部细胞之间的相互作用，对局部骨组织的塑形产生正面效果；本发明的生物型人工髋关节股骨柄可以做成普通型和加长型，分别用于常规置换和翻修术。
下面结合附图和具体实施方式对本发明作进一步详细说明。
附图说明
图1为本发明一种优选的实施方式结构示意图；
图2为本发明一种优选的实施方式的使用状态示意图；
图3为本发明一种优选的实施方式立体结构示意图；
图4为本发明一种优选的实施方式的结构示意图；
图5为本发明一种优选的实施方式的使用状态图。。
具体实施方式
如图1-5所示，本发明所述的生物型人工髋关节股骨柄，其包括假体股骨颈1、颈领2以及柄体3；所述柄体包括固定端31和分离端，分离端包括骨内膜承接钢板32和骨内膜分离钢板4，骨内膜承接钢板32与固定端31一体成型；所述骨内膜分离钢板4上端设有连接块41，固定端31与骨内承接钢板32的连接处设有与连接块41相匹配的连接槽34，内膜钢板4的外壁上设有若干微钉齿42；其还包括一内撑装置，所述内撑装置将骨内膜分离钢板4向股骨干10的内侧骨皮质撑开。在本发明中，由于内撑装置的挤压作用使得骨内膜承接钢板32和骨内膜分离钢板4向股骨的内侧撑开的同时，骨内膜承接钢板32和骨内膜分离钢板4上的钉刺插入到股骨干的骨皮质中将骨内膜承接钢板32和骨内膜分离钢板4与股骨固定；从而柄体可以直接将人体重量传导到股骨干骨皮质，起到了增加假体柄稳定性，减少应力遮挡、防止股骨柄松动和假体周围骨折的作用。本发明可以用于常规置换和对骨质疏松和假体周围骨折患者的翻修术。
本发明还可以通过以下方案实现：
实施例1
如图1所示，在上述方案的基础上，所述内撑装置包括主螺钉5，假体柄3的固定端31设有与主螺钉5相匹配的螺纹孔33，主螺钉5通过螺纹孔33伸入到骨内膜分离钢板4与骨内膜承接钢板32之间，在主螺钉5旋紧的过程中将内膜钢4板向股骨干10的内侧撑开。主螺钉5不仅能撑开内膜分离钢板4，还能将骨内膜承接钢板32固定在股骨中。这种结构主要用于普通置换术，针对的患者大粗隆附近和股骨上段的骨质仍然比较坚固，没有明显骨质疏松；此时手术时使用实施例1的这种普通置换结构，不需要额外切口安装螺钉来分离和固定骨内膜钢板，只需要假体植入后，在同一个创口处使用主螺钉撑开内膜钢板即可。
实施例2
如图4所示在上述方案的基础上，所述内撑装置包括至少两个异形螺钉6；所述异形螺钉6包括第一径螺纹段和第二径螺纹段，第一径螺纹段的直径大于第二径螺纹段的直径；所述骨内膜承接钢板32设有与第一径螺纹段相匹配的第一螺孔35，所述骨头内膜分离钢板4设有与第二径螺纹段相匹配的第二螺孔43；在异形螺钉6的旋紧过程中将内膜钢板4向股骨10的内侧骨皮质撑开。在该实施例的基础上，进一步的改进，所述异形螺钉6的数量为4-8个。由于异形螺钉6的由两段直径不等的螺纹段组成，在旋紧固定骨内膜承接钢板32和内膜钢板4的过程中，当直径大的一段接触到内膜钢板4时，就会将内膜钢板4撑离假体柄骨内膜承接钢板32。
实施例3
如图5所示，在上述实施例1或2的基础上，对假体柄整体加长，并在固定端31表面设置若干小螺孔36。这种结构的股骨柄适用于翻修术，采用这种结构通常是针对患者的大粗隆周围骨质疏松，甚至出现粉碎骨折的情况下，不能再用短柄的假体进行修补，体柄体近端表面上的小螺孔36可用于固定碎骨块40。多出的小孔有利于新骨的长入。采用这种长柄假体可以将骨内膜承接钢板和骨内膜承分离板固定到离大粗隆较远的和骨质较强的股骨干，即适用于大粗隆周围骨质疏松也适用于假体周围骨折病人的翻修术。由于不需要使用骨水泥，对翻修术新骨的生长和骨折愈合都有积极作用。同时， 用小螺钉将碎骨块固定于假体，简化了手术操作，有利于碎骨片间植骨和促进骨组织再生与愈合。因为股骨近端骨质的疏松或破坏，在使用长柄假体进行翻修时不再采用主螺钉5挤压，而是采用四个以上异形螺钉6将假体牢固的固定在股骨干上。必要时还可在骨皮质外侧安一加强钢板。
在上述方案的基础上，优选的，所述异形螺钉的数量为4-8个。
如图3所示，作为本发明的一种优选的方案，所述股骨柄柄体近端为网梁状结构，网梁间设有螺纹孔37。螺纹孔的作用是既利于新骨长入也可用于翻修术时将骨碎片固定于假体。优选的所述柄体近端螺纹孔直径为1.5-2.5毫米，数量为10-30个。
作为本发明的一种优选的方案，本发明所述的生物型人工髋关节股骨柄还包括一加强钢板（图未示），所述加强钢板通过异形螺钉固定在内膜钢板对应的股骨骨皮质外侧。
作为本发明的一种优选的方案，所述假体柄体的表面设有波浪形纹。
上述实施方式仅为本发明的优选实施方式，不能以此来限定本发明保护的范围，本领域的技术人员在本发明的基础上所做的任何非实质性的变化及替换均属于本发明所要求保护的范围。

Claims (8)

1.一种生物型人工髋关节股骨柄，其包括假体股骨颈、颈领以及柄体；其特征在于：所述柄体包括固定端和分离端，分离端包括骨内膜承接钢板和骨内膜分离钢板，骨内膜承接钢板与固定端一体成型；所述骨内膜分离钢板上端设有连接块，柄体固定端与骨内膜承接钢板的连接处设有与连接块相匹配的连接槽，骨内膜承接钢板和骨内膜分离钢板的外壁上均设有纹理和若干微钉齿；所述生物型人工髋关节股骨柄还包括一内撑装置，所述内撑装置将骨内膜分离钢板向股骨干的内侧撑开并将生物型人工髋关节股骨柄固定于髓腔皮质骨上。
2.根据权利要求1所述的生物型人工髋关节股骨柄，其特征在于：所述内撑装置包括主螺钉，柄体固定端设有与主螺钉相匹配的螺纹孔，主螺钉通过螺纹孔伸入到柄体中骨内膜承接钢板和骨内膜分离钢板之间，在主螺钉旋紧的过程中骨内膜承接钢板和骨内膜分离钢板向股骨干的内侧撑开并将生物型人工髋关节股骨柄固定于髓腔皮质骨上。
3.根据权利要求1所述的生物型人工髋关节股骨柄，其特征在于：所述内撑装置包括至少两个异形螺钉；所述异形螺钉包括第一径螺纹段和第二径螺纹段，第一径螺纹段的直径大于第二径螺纹段的直径；所述骨内膜承接钢板设有与第一径螺纹段相匹配的第一螺孔，所述骨内膜分离钢板设有与第二径螺纹段相匹配的第二螺孔；在异形螺钉的旋紧过程中将骨内膜承接钢板和骨内膜分离钢板向股骨干的内侧撑开并将生物型人工髋关节股骨柄固定于髓腔皮质骨上。
4.根据权利要求3所述的生物型人工髋关节股骨柄，其特征在于：所述异形螺钉的数量为4-8个。
5.根据权利要求4所述的生物型人工髋关节股骨柄，其特征在于：柄体固定端为网梁状结构，网梁间设有螺纹孔。
6.根据权利要求5所述的生物型人工髋关节股骨柄，其特征在于：所述柄 体固定端的螺纹孔直径为1.5-2.5毫米，数量为6-30个。
7.根据权利要求3-6任一项所述的生物型人工髋关节股骨柄，其特征在于：其还包括一加强钢板，所述加强钢板通过异形螺钉固定在内膜钢板对应的股骨骨皮质外侧。
8.根据权利要求1所述的生物型人工髋关节股骨柄，其特征在于：所述假体柄体的表面设有波浪形纹。
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