CN212816655U

CN212816655U - Greater tubercle prosthesis

Info

Publication number: CN212816655U
Application number: CN202020453745.4U
Authority: CN
Inventors: 李智尧; 郭艾; 李强
Original assignee: Beijing Friendship Hospital
Current assignee: Beijing Friendship Hospital
Priority date: 2020-04-01
Filing date: 2020-04-01
Publication date: 2021-03-30
Anticipated expiration: 2030-04-01

Abstract

The utility model discloses a prosthesis of the greater tubercle of the humerus, which comprises a joint part and a fixing part; the fixing part is connected with the joint part; , Bone-fit side and articular surface, the shape and size of the bone-fit bottom surface and the bone-fit side are the same, both are arcuate and connected with straight edges; the angle between the bone-fit bottom surface and the bone-fit side is 90 degrees; The joint surface connects the bottom surface of the bone fitting surface and the arc edge of the side surface of the bone fitting at the same time, and the joint surface is a spherical surface. In the utility model, the bone-fitting bottom surface, the bone-fitting side surface and the articular surface of the prosthesis form a specific geometric shape, which is a hemispherical crown shape. This design can effectively simulate the rotation curve of the humeral head, preserve the biomechanical characteristics of the shoulder joint, and improve the It is beneficial to the recovery of joint function of patients. The utility model has the advantages of simple structure and convenient preparation, can reduce the operation difficulty and operation cost, and has a good clinical application prospect.

Description

Greater tuberosity prosthesis

Technical Field

The utility model relates to a medical prosthesis, in particular to a humerus greater tuberosity prosthesis.

Background

Rotator cuff impairment is a common disease of multiple shoulder joints, is particularly common to old patients, and has increasingly large irreparable rotator cuff Injuries (IRCTs) caused by various reasons. The rotator cuff, which is the main anatomical structure for maintaining the stability and activity of the shoulder joint, mainly comprises a group of muscle groups with similar functions, which are composed of supraspinatus, infraspinatus, teres minor and infrascapular, and the tendon parts of the four muscles form a sleeve-shaped structure at the anatomical neck of the humeral head, surround the upper, the back and the front of the shoulder joint and are attached to the shoulder joint capsule. The shoulder joint (mainly a glenoid joint) is a typical multiaxial ball-and-socket joint, although a glenoid lip made of fibrocartilage is arranged on the periphery of the glenoid to deepen a glenoid fossa, the glenoid fossa can only accommodate 1/4-1/3 of the humeral head articular surface, and therefore, the rotator cuff tissue plays an important role in the stability of the shoulder joint. An irreparable rotator cuff lesion is defined internationally as: when the upper arm was placed in the medial side adduction position after the avascular tissue had been removed, the tendon tissue was so poor in quality that tendon-bone repair could not be performed directly. Other important indicators of irreparable damage include: acromion-humeral head distance <5mm, subluxation above the fixed humeral head, MRI showed severe atrophy of the rotator cuff muscle, progressive fatty infiltration. Patients with IRCTs often experience severe pain that severely affects quality of life.

IRCTs treatment has certain difficulties, and the current treatment options are: non-surgical treatment, i.e. only symptomatic treatment, such as physical therapy, drugs, corticoid intra-articular injection, etc. However, this treatment does not fundamentally treat the patient's condition. The surgical treatment comprises the following steps: (1) performing upper joint capsule reconstruction surgery; (2) performing rotator cuff operation on the graft patch; (3) large nodule arthroplasty (tuberoplasty) surgery; (4) reverse shoulder replacement. Among the above surgical options, the "macronodular angioplasty" is the simplest and the least invasive and disturbing to the patient, so this treatment is currently the most preferred option.

The purpose of "macronodular angioplasty" is to polish the macronodular nodules into a spherical shape to form a smooth articular surface. The technical problems of the existing large nodule forming operation are as follows: (1) the polishing technique of the operator has extremely high requirements, and the operator is difficult to polish an ideal cambered surface. (2) Even if the prior art grinds an ideal cambered surface, the prior grinding technology cannot form a smoother bone interface, and the friction force is still large. In view of the above two points, the current large nodule forming operation cannot be standardized, and more problems remain after the operation.

How to solve the problems of the prior art mentioned above is still a hot spot for those skilled in the art to study.

Disclosure of Invention

The technical problem to be solved by the utility model is to provide a greater tuberosity prosthesis for humerus, which can be used for treating shoulder joint dysfunction caused by huge irreparable rotator cuff injury or other shoulder joint injuries.

In order to achieve the above object, the utility model adopts the following technical scheme:

a greater tuberosity prosthesis comprising an articular portion and a fixation portion; the fixing part is connected with the joint part; the joint part has a specific geometric shape which has three surfaces, namely a bone joint bottom surface, a bone joint side surface and a joint surface; the bone-jointed bottom surface and the bone-jointed side surface are the same in shape and size, and both are arched and are connected with straight edges; the included angle between the bone joint bottom surface and the bone joint side surface is 90 degrees; the joint surface is simultaneously connected with the bottom surface of the bone attaching surface and the arc-shaped edge of the bone attaching side surface, and the joint surface is a spherical surface.

Preferably, the bone-attaching bottom surface and the bone-attaching side surface are minor arc arches or semicircular arches.

Preferably, the chord length of the bone-attaching bottom surface and the bone-attaching side surface is 20-35 mm.

Preferably, the height of the bone-attached bottom surface and the height of the bone-attached side surface are 8-15 mm.

Wherein preferably, the curvature radius of the joint surface is 21-27 mm.

Preferably, the fixing portion is a fixing column, and the fixing column is fixedly connected with the bone-attached bottom surface or the bone-attached side surface.

Preferably, the fixing column is of a cylindrical structure, the diameter of the fixing column is 3-5 mm, and the height of the fixing column is 8-10 mm.

Preferably, the axis of the fixing column is perpendicular to the bone-attaching bottom surface or the bone-attaching side surface.

Preferably, the number of the fixing columns is two, and the fixing columns are arranged along the chord direction of the bottom surface of the bone joint or the side surface of the bone joint.

Preferably, the fixing part is a screw, and the joint part is provided with a nail hole matched with the screw.

In the utility model, the joint part can be made of titanium alloy, cobalt-chromium-molybdenum alloy, ceramic or polyethylene and other materials.

The utility model provides a big tubercle of upper arm bone false body can be used to in the big tubercle of upper arm bone shaping art, and the design of the bone laminating bottom surface of false body joint portion, bone laminating side and articular surface can realize the operation standardization, cuts the bone through simple, need not to polish and can fix false body and resume patient's joint function. The utility model discloses can effectively solve and grind the problem that the bone degree of difficulty is big, hardly grind out the arc bone face of ideal in the current shaping art, and can effectively solve and grind the problem that the bone face is coarse, and joint friction is big. The utility model discloses in, false body bone laminating bottom surface, bone laminating side and articular surface constitute specific geometry, for hemisphere crown shape, the rotation curve of humeral head can effectively be simulated in this design, remain the biomechanics characteristic of shoulder joint, more are favorable to the recovery of patient's joint function. Moreover, the geometry is more favorable for keeping the prosthesis stable and preventing the loosening. The utility model has the advantages of simple structure, preparation is convenient, can reduce the operation degree of difficulty and the operation cost, has fine clinical application prospect.

Drawings

Fig. 1 is a schematic side view of embodiment 1 of the present invention;

fig. 2 is a schematic perspective view of embodiment 1 of the present invention;

fig. 3 is a schematic view of a use state of embodiment 1 of the present invention;

fig. 4 is a schematic side view of embodiment 2 of the present invention;

fig. 5 is a schematic side view of embodiment 3 of the present invention.

Description of reference numerals:

the joint part 1, a bone joint bottom surface 11, a bone joint side surface 12, a joint surface 13 and a threaded hole 14; a fixed part 2, a fixed column 21 and a screw 22; greater humeral tuberosity a.

Detailed Description

In order to make the present invention more fully understood by those skilled in the art, the present invention will be described in further detail with reference to the accompanying drawings. It should be noted that the drawings of the present invention are schematic structural diagrams, and the processing and manufacturing drawings with non-precise proportions are only used for clearly assisting the purpose of explaining the present embodiment, and the prostheses with different sizes can be prepared according to the description structure of the present invention according to the needs of patients in actual manufacturing operation.

Example 1

As shown in fig. 1 and 2, the present embodiment discloses a greater tuberosity prosthesis of a humerus, which includes an articular portion 1 and a fixation portion 2; the fixing portion 2 is connected to the joint portion 1.

The joint 1 has a specific geometry, which approximates a hemispherical crown shape, with three faces, respectively a bone-engaging base 11, a bone-engaging side 12 and a joint face 13. The bone engaging bottom surface 11 and the bone engaging side surface 12 are the same in shape and size. In this embodiment both are arcuate, a pattern consisting of a chord and the arc subtended by it. The bone-engaging bottom surface 11 and the bone-engaging side surface 12 are connected by straight edges, i.e. chords of an arc. The included angle between the bone joint bottom surface 11 and the bone joint side surface 12 is 90 degrees; the joint surface 13 connects the arc edges of the bone-engaging surface bottom surface 11 and the bone-engaging side surface 12 at the same time, and the joint surface 13 is a spherical surface.

The following are preferred dimensions of the structures of the present embodiment, but do not limit the scope of the present invention.

The bone-bonding bottom surface 11 and the bone-bonding side surface 12 are minor arc arches or semicircular arches, which can be determined according to actual needs, do not affect the technical effect of the present case, and are minor arc arches in the present embodiment.

The chord length of the bone-adhering bottom surface 11 and the bone-adhering side surface 12 is preferably in the range of 20 to 35mm, and 28mm is adopted in the present embodiment.

The height of the bone-engaging bottom surface 11 and the bone-engaging side surface 12 is preferably in the range of 8 to 15mm, and 12mm is used in this embodiment.

The radius of curvature of the articular surface 13 is preferably in the range of 21 to 27mm, and 25mm is used in this embodiment.

The prosthesis joint part 1 obtained by the size can effectively simulate the rotation curve of the humeral head, keeps the biomechanical characteristics of the shoulder joint and is more beneficial to the recovery of the joint function of a patient.

The utility model discloses still include fixed part 2, fixed part 2 is fixed column 21 in this embodiment, fixed

column

21 and 11 fixed connection in bone laminating bottom surface adopt a body coupling in this embodiment. The axis of the fixation post 21 is perpendicular to the bone engaging bottom surface 11 in this embodiment. The fixing column 21 can be of a structure capable of achieving the effect of fixing with bones, and is cylindrical in the embodiment, the diameter of the fixing column is preferably 3-5 mm, the height of the fixing column is preferably 8-10 mm, and the diameter of the fixing column is preferably 5mm, and the height of the fixing column is preferably 10 mm.

The surface of the fixing column 21 can be sprayed with a coating for increasing bone fixation; or, the surface of the fixing column 21 is provided with a structure which is beneficial to the bone to climb and grow in. The number of the fixing posts 21 is not particularly limited, and may be preferably selected according to actual needs and stabilization effects, and in this embodiment, the number of the fixing posts 21 is two, so that the prosthesis can be prevented from rotating while the prosthesis is fixed, and the two fixing posts 21 are arranged along the chord direction of the bone-fitted bottom surface 11.

Fig. 3 is a schematic view of a use state (i.e., a simulated operation installation state diagram) of embodiment 1 of the present invention. The utility model discloses in the actual operation, operation accessible deltoid muscle small incision is implemented. After the soft tissue of the greater tubercle A of the humerus is cleaned, the horizontal and vertical osteotomy surfaces are determined. The bone is cut by an electric saw, the horizontal plane is vertical to the vertical plane, and the greater tuberosity of the humerus is completely cut off. Measuring the size of the osteotomy surface, smearing bone cement, and selecting a proper prosthesis for installation. After installation, the prosthesis forms a spherical whole with the cartilage of the humeral head.

Example 2

As shown in fig. 4, the fixing post 21 of the present embodiment is disposed on the bone-engaging side 12, and in the present embodiment, the two are integrally connected. In the present embodiment, the number of the fixing posts 21 is two, so that the prosthesis can be fixed while the rotation of the prosthesis is prevented, and the two fixing posts 21 can be arranged along the chord direction of the bone-engaging side 12. The other structure is the same as that of embodiment 1.

Example 3

As shown in fig. 5, the fixing portion 2 in this embodiment is a screw 22, the screw 22 is a self-tapping screw, and the number of screws is two, and the screws are provided along the chord direction of the bone-attaching bottom surface 11. The joint part 1 is provided with a nail hole 14 matched with the screw 22. The other structure is the same as that of embodiment 1.

Claims

1. A greater tuberosity prosthesis, characterized by comprising an articular portion and a fixation portion; the fixing part is connected with the joint part; the joint part has a specific geometric shape which is provided with three surfaces, namely a bone attaching bottom surface, a bone attaching side surface and a joint surface, wherein the bone attaching bottom surface and the bone attaching side surface have the same shape and size, and are both arched and connected with straight edges; the included angle between the bone joint bottom surface and the bone joint side surface is 90 degrees; the joint surface is connected with the bone joint bottom surface and the arc-shaped edge of the bone joint side surface at the same time, and the joint surface is a spherical surface.

2. The greater humeral tuberosity prosthesis of claim 1, wherein:

the bone-attached bottom surface and the bone-attached side surface are minor arc arches or semicircular arches.

3. The greater humeral tuberosity prosthesis of claim 1, wherein:

the chord length of the bone joint bottom surface and the bone joint side surface is 20-35 mm.

4. The greater humeral tuberosity prosthesis of claim 1, wherein:

the height of the bone joint bottom surface and the bone joint side surface is 8-15 mm.

5. The greater humeral tuberosity prosthesis of claim 1, wherein:

the curvature radius of the joint surface is 21-27 mm.

6. The greater humeral tuberosity prosthesis of claim 1, wherein:

the fixing part is a fixing column, and the fixing column is fixedly connected with the bone-attached bottom surface or the bone-attached side surface.

7. The greater humeral tuberosity prosthesis of claim 6, wherein:

the fixed column is of a cylindrical structure, the diameter of the fixed column is 3-5 mm, and the height of the fixed column is 8-10 mm.

8. The greater humeral tuberosity prosthesis of claim 7, wherein:

the axis of the fixing column is perpendicular to the bone-attached bottom surface or the bone-attached side surface.

9. The greater humeral tuberosity prosthesis of claim 8, wherein:

the number of the fixing columns is two, and the fixing columns are arranged along the chord direction of the bottom surface of the bone joint or the side surface of the bone joint.

10. The greater humeral tuberosity prosthesis of claim 1, wherein:

the fixing part is a screw, and the joint part is provided with a screw hole matched with the screw.