阅读说明：本技术 一种保留下尺桡关节功能的全反式腕关节假体 (Total trans-wrist joint prosthesis with function of lower ulnar joint reserved ) 是由 陈天宁 邵进 霍凯伦 于 2021-09-15 设计创作，主要内容包括：一种保留下尺桡关节功能的全反式腕关节假体,包括腕骨基座、腕骨关节窝、活动球体和桡骨柄,腕骨基座上设有腕骨髓针；腕骨关节窝通过连接板与腕骨基座相连接；活动球体为与腕骨关节窝下表面相配合的椭圆半球体结构；活动球体通过桡骨连接板与桡骨柄相连接,桡骨柄下方包括桡骨髓针和尺骨髓针,尺骨髓针上表面设置有锁孔,桡骨柄下方设置有限位锁扣,尺骨髓针通过锁孔连接在限位锁扣上。本发明克服了现有技术的不足,通过反式腕关节的设计以获得更大的活动范围；并通过腕骨关节窝和活动球体的可拆卸设计,极大地降低了翻修的材料费用,同时能够对假体关节面的角度进行调整,以便于调整最佳的掌倾角和尺偏角,提高术中截骨的容错率。(An all-trans wrist joint prosthesis with the function of the ulnar and radial joint reserved comprises a carpal bone base, a carpal bone joint socket, a movable ball body and a radial bone handle, wherein a carpal bone broach is arranged on the carpal bone base; the wrist bone joint socket is connected with the wrist bone base through a connecting plate; the movable sphere is an elliptical hemisphere structure matched with the lower surface of the wrist bone joint socket; the movable sphere is connected with the radius handle through the radius connecting plate, the lower portion of the radius handle comprises a radius broach and an ulna broach, a lock hole is formed in the upper surface of the ulna broach, a limiting lock catch is arranged below the radius handle, and the ulna broach is connected to the limiting lock catch through the lock hole. The invention overcomes the defects of the prior art, and obtains a larger moving range through the design of the trans-wrist joint; and through the detachable design of the wrist bone joint socket and the movable ball body, the material cost of the revision is greatly reduced, and simultaneously, the angle of the joint surface of the prosthesis can be adjusted, so that the optimal palm dip angle and the ruler declination angle can be adjusted conveniently, and the fault-tolerant rate of osteotomy in the operation is improved.)

1. An all-trans wrist prosthesis for preserving the function of the lower ulnar and radial joint, which is characterized in that: the wrist bone intramedullary nail comprises a wrist bone base (1), a wrist bone joint socket (2), a movable ball body (3) and a radius handle (4), wherein a wrist bone intramedullary nail (5) is arranged on the upper surface of the wrist bone base (1), and a first connecting hole (6) is formed in the lower surface of the wrist bone base (1); the upper surface of the wrist bone joint socket (2) is provided with a connecting plate (7), the wrist bone joint socket (2) is connected with a first connecting hole (6) through the connecting plate (7), and the lower surface of the wrist bone joint socket (2) is of an inwards concave spherical structure; the movable sphere (3) is of an elliptical hemisphere structure matched with the lower surface of the wrist joint socket (2), and a radius connecting plate (8) is arranged on the lower surface of the movable sphere (3); second connecting hole (9) have been seted up to radius handle (4) upper surface, activity spheroid (3) are connected with second connecting hole (9) through radius connecting plate (8), radius handle (4) below is including radius broach (10) and ulna broach (11), radius broach (10) and radius handle (4) formula design as an organic whole, ulna broach (11) upper surface is provided with lockhole (12), radius handle (4) below is provided with spacing hasp (13), ulna broach (11) are connected on spacing hasp (13) through lockhole (12).

2. An all-trans wrist prosthesis for preserving the function of the lower ulnar radial joint as claimed in claim 1 wherein: a first connecting port (14) is formed in the side surface of the carpal base (1), the first connecting port (14) is communicated with the first connecting hole (6), and a first limiting screw (15) is connected to the first connecting port (14) in a threaded manner; the surface of the connecting plate (7) is provided with a through hole, and the end part of the first limiting screw (15) penetrates through the first connecting port (14) and corresponds to the through hole.

3. An all-trans wrist prosthesis for preserving the function of the lower ulnar radial joint as claimed in claim 1 wherein: the diameter of the carpal intramedullary nail (5) changes in a step-shaped manner, and the diameter gradually decreases from a position close to the carpal base (1) to a position far away from the carpal base (1).

4. An all-trans wrist prosthesis for preserving the function of the lower ulnar radial joint as claimed in claim 1 wherein: the side surface of the radius handle (4) is in threaded connection with a second limiting screw (16), and the end part of the second limiting screw (16) is abutted against the radius connecting plate (8).

5. An all-trans wrist prosthesis for preserving the function of the lower ulnar radial joint as claimed in claim 4 wherein: the side surface of the radius connecting plate (8) which is abutted against the second limiting screw (16) is uniformly provided with transverse rough surfaces (19).

6. An all-trans wrist prosthesis for preserving the function of the lower ulnar radial joint as claimed in claim 1 wherein: the lower surface of the wrist bone joint socket (2) is of a groove structure with two high sides and a low middle.

7. An all-trans wrist prosthesis for preserving the function of the lower ulnar radial joint as claimed in claim 1 wherein: the outer surface of the limiting lock catch (13) is provided with a limiting groove (17), the side surface of the lock hole (12) is in threaded connection with a limiting locking nail (18), and the end part of the limiting locking nail (18) is matched with the limiting groove (17).

Technical Field

The invention relates to articles for daily use of human beings, in particular to a medical instrument, and specifically relates to an all-trans wrist joint prosthesis for retaining the function of the lower ulnar joint.

Background

The wrist joint is one of the most flexible and complex joints of human body, and mainly comprises 4 mutually related joints, namely a radial wrist joint, a lower ulnar radial joint, a wrist-bone joint and a carpometacarpal joint. At present, clinical factors such as trauma, infection, rheumatism, tumor and the like can cause serious injury of the wrist joint, pain and limited functions are caused slightly, and the function of the wrist joint is completely lost seriously. The main treatment methods of the diseases comprise joint fusion and artificial wrist joint replacement.

The wrist joint replacement is to replace the affected joint with artificial joint prosthesis, and can maintain the moving function of the wrist joint while eliminating pain, joint rigidity, malformation and other problems. However, in clinical work, the existing wrist joint prosthesis mainly has the following problems: 1. the adjustment of the palm inclination angle and the ulnar deviation angle during the installation of the wrist joint prosthesis can be realized only by the osteotomy amount. 2. The prosthesis simulating the structure of a normal wrist joint can reduce the moving range to a certain extent after being implanted into a human body. 3. The functions of the lower ulnar and radial joints are neglected in the existing prosthesis. The contact movement of the prosthesis and the ulna can cause the movement range of the wrist joint to be more limited; although some researchers have addressed this problem by cutting off a portion of the distal ulna, they have essentially abandoned the function of the inferior ulnar joint. 4. The traditional two-part carpal joint prosthesis cannot realize the rotation movement of the radial wrist joint on one hand, and on the other hand, the later-stage joint revision is difficult.

Disclosure of Invention

Aiming at the defects of the prior art, the invention provides an all-trans wrist joint prosthesis with the function of the lower ulnar joint reserved, which overcomes the defects of the prior art, has reasonable design, and has a larger moving range by the design of the trans wrist joint and the movement of the rotating center to the near end of the limb compared with the traditional prosthesis; and through the detachable design of the wrist bone joint socket and the movable ball body, the operation difficulty and the material cost of the revision are greatly reduced, and the angle of the joint surface of the prosthesis can be adjusted to a certain degree, so that the optimal palm dip angle and the optimal ruler declination angle can be adjusted, and the fault-tolerant rate of osteotomy in the operation is improved.

In order to achieve the purpose, the invention is realized by the following technical scheme:

an all-trans wrist joint prosthesis with the function of the ulnar and radial joint reserved comprises a carpal bone base, a carpal bone joint socket, a movable ball body and a radial bone handle, wherein a carpal bone broach is arranged on the upper surface of the carpal bone base, and a first connecting hole is formed in the lower surface of the carpal bone base; the upper surface of the wrist bone joint socket is provided with a connecting plate, the wrist bone joint socket is connected with a first connecting hole through the connecting plate, and the lower surface of the wrist bone joint socket is of an inwards concave spherical structure; the movable sphere is of an elliptical hemisphere structure matched with the lower surface of the wrist joint socket, and a radius connecting plate is arranged on the lower surface of the movable sphere; the radius handle upper surface has seted up the second connecting hole, the activity spheroid is connected with the second connecting hole through the radius connecting plate, radius stylette and ulna stylette are drawn together to radius handle below, radius stylette and radius handle formula design as an organic whole, ulna stylette upper surface is provided with the lockhole, radius handle below is provided with spacing hasp, the ulna stylette passes through the lockhole and connects on spacing hasp.

Preferably, a first connecting port is formed in the side surface of the carpal base and communicated with the first connecting hole, and a first limiting screw is connected to the first connecting port in a threaded manner; the surface of the connecting plate is provided with a through hole, and the end part of the first limiting screw penetrates through the first connecting port and corresponds to the through hole.

Preferably, the diameter of the carpal intramedullary nail is changed in a step manner, and the diameter of the carpal intramedullary nail is gradually reduced from a position close to the carpal base to a position far away from the carpal base.

Preferably, the side surface of the radius shaft is in threaded connection with a second limiting screw, and the end of the second limiting screw is abutted against the radius connecting plate.

Preferably, the side surface of the radius connecting plate, which is abutted against the second limiting screw, is uniformly provided with a transverse rough surface.

Preferably, the lower surface of the wrist bone socket is of a groove structure with two high sides and a low middle.

Preferably, the outer surface of the limiting lock catch is provided with a limiting groove, the side surface of the lock hole is in threaded connection with a limiting locking nail, and the end part of the limiting locking nail is matched with the limiting groove.

The invention provides an all-trans wrist joint prosthesis with the function of the lower ulnar and radial joint reserved. The method has the following beneficial effects: by providing the distal portion of the wrist joint surface as a reverse wrist joint design of the wrist bone socket, the range of motion of the prosthesis can be further increased compared to conventional wrist joint prostheses; the dynamic connection of the ulna intramedullary nail and the radius handle is realized through a freely rotatable 'lock catch type' structure matched with the lock hole and the limiting lock catch so as to recover the function of the lower ulna radial joint and further correct the problem of limited forearm rotation function of a patient; and through the detachable design of the wrist bone joint socket and the movable ball body, only the damaged ceramic joint surface needs to be replaced during the revision surgery, and the whole joint prosthesis does not need to be replaced. Thereby greatly reducing the difficulty of the renovation operation and greatly reducing the cost of the renovation operation of the patient. The movable ball body can be firmly fixed at any position after being adjusted by the design of the transverse rough surface; meanwhile, the length of the long axis of the forearm can be adjusted within a certain range, and the fault-tolerant rate of the ulna and radius osteotomy amount is increased.

Drawings

In order to more clearly illustrate the present invention or the prior art solutions, the drawings that are needed in the description of the prior art will be briefly described below.

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is an expanded view of the structure of the present invention;

FIG. 3 is a schematic view of the carpal tunnel in the present invention;

FIG. 4 is a schematic view of the wrist joint socket of the present invention;

FIG. 5 is a schematic view of the movable ball of the present invention;

FIG. 6 is a schematic view of the structure of the radial stem of the present invention;

FIG. 7 is a schematic view of the radial stem of the present invention shown separated from the ulnar broach;

the reference numbers in the figures illustrate:

1. a carpal base; 2. the wrist bone joint socket; 3. a movable sphere; 4. a radius stem; 5. a carpal broach; 6. a first connection hole; 7. a connecting plate; 8. a radius junction plate; 9. a second connection hole; 10. a medullary radius needle; 11. an ulnar broach; 12. a lock hole; 13. limiting and locking; 14. a first connection port; 15. a first limit screw; 16. a second limit screw; 17. a limiting groove; 18. a limit locking nail; 19. rough surface is horizontally arranged.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be described clearly and completely with reference to the accompanying drawings.

In a first embodiment, as shown in fig. 1 to 7, an all-trans wrist prosthesis with a function of ulnar and radial joints reserved comprises a carpal bone base 1, a carpal joint socket 2, a movable ball 3 and a radial stem 4, wherein a carpal broach 5 is arranged on the upper surface of the carpal bone base 1, and a first connecting hole 6 is arranged on the lower surface of the carpal bone base 1; the upper surface of the wrist bone joint socket 2 is provided with a connecting plate 7, the wrist bone joint socket 2 is connected with a first connecting hole 6 through the connecting plate 7, and the lower surface of the wrist bone joint socket 2 is of an inwards concave spherical structure; the movable sphere 3 is an elliptical hemisphere structure matched with the lower surface of the wrist joint socket 2, and the lower surface of the movable sphere 3 is provided with a radius connecting plate 8; the upper surface of the radius handle 4 is provided with a second connecting hole 9, the movable sphere 3 is connected with the second connecting hole 9 through a radius connecting plate 8, the lower part of the radius handle 4 comprises a radius broach 10 and an ulna broach 11, the radius broach 10 and the radius handle 4 are designed into an integral type, the upper surface of the radius broach 11 is provided with a lock hole 12, the lower part of the radius handle 4 is provided with a limit lock catch 13, and the ulna broach 11 is connected onto the limit lock catch 13 through the lock hole 12.

The working principle is as follows:

in this embodiment, the wrist bone broach 5 sets up in the middle of the 1 upper surface of carpal bone base to with the design of 1 formula as an organic whole of carpal bone base, make carpal bone base 1 and wrist bone broach 5 be the T style of calligraphy, thereby can enough install on the carpal bone, the effect of the bearing base of performance carpal bone articular surface simultaneously, and in this application, carpal bone base 1 is the design of oval column shape, with the cross-section of the at utmost laminating carpal bone, prevent because of not matching the leather face uplift that causes. The wrist joint socket 2 is connected to the lower surface of the wrist bone base 1 through the connecting plate 7, the upper surface of the wrist joint socket 2 is in an oval shape and is matched with the wrist bone base 1, and through the reverse wrist joint type design, the range of motion of the prosthesis can be further increased compared with the traditional wrist joint prosthesis; the movable ball body 3 is matched with the lower surface of the wrist bone joint socket 2 through an elliptical hemisphere structure to form a main movable contact surface of the prosthesis so as to adjust the palm inclination angle and the ruler declination angle of the prosthesis; the movable sphere 3 and the radius handle 4 are connected and fixed through radius connecting plates 8 on two sides; the radius handle 4 mainly plays a role in receiving the movable sphere 3 and fixing the movable sphere with the ulna, wherein a radius broach 10 and an ulna broach 11 below the radius handle 4 are respectively inserted into medullary cavities of the radius and the ulna; the radius broach 10 is fixed by screws; and because the ulna is tiny, the ulna broach 11 can be fixed by bone cement, and the ulna broach 11 can be dynamically connected with the radius handle 4 through a 'lock catch type' structure which is matched with the limiting lock catch 13 through the lock hole 12 and can rotate freely, so as to recover the function of the lower ulna radial joint, thereby correcting the problem that the forearm rotation function of a patient is limited.

When the wrist joint prosthesis is surgically connected, firstly, the osteotomy is required to be performed according to the characteristics of the wrist joint prosthesis, including part of the carpal bone and part of the distal ulna and radius. A hole is then made in the middle of the carpal cross-section to facilitate placement of the intramedullary nail 5. In addition, the ulna and radius medullary cavities need to be reamed to install the radius broach 10 and the ulna broach 11. And after the osteotomy is finished, the prosthesis is installed. The carpal base 1 is first installed and secured with screws. And then sequentially installing an ulna broach 11 and a radius broach 10, fixing the ulna broach 11 through bone cement, firmly fixing the radius broach 10 with the radius through screws, and installing a limiting locking nail. Then, the proximal part of the wrist joint surface is installed, the palm inclination angle and the ruler declination angle determined according to the imaging results of the preoperative X-ray, CT and the like of the patient are adjusted, meanwhile, the length of the forearm of the patient is finely adjusted, and the position of the movable sphere 3 is fixed through a screw; finally, the wrist bone joint socket 2 is installed and fixed. Finally, the wrist joint function of the patient is checked, and the operative incision is sutured after the intraoperative imaging result is confirmed to be correct.

And in the present application, due to the detachable design of the wrist socket 2 and the movable ball 3, only the damaged ceramic joint surface needs to be replaced during the revision surgery, and the whole joint prosthesis does not need to be replaced. Thereby greatly reducing the difficulty of the renovation operation and greatly reducing the cost of the renovation operation of the patient.

In the second embodiment, as shown in fig. 3-4, as a further preferable scheme of the first embodiment, a first connection port 14 is formed on a side surface of the carpal bone base 1, the first connection port 14 is communicated with the first connection hole 6, and a first limit screw 15 is connected to the first connection port 14 in a threaded manner; the surface of the connecting plate 7 is provided with a through hole, and the end part of the first limit screw 15 passes through the first connecting port 14 and corresponds to the through hole. The first limit screw 15 is connected with a through hole on the surface of the connecting plate 7 so as to realize the firm connection between the carpal bone base 1 and the carpal bone joint socket 2; thereby ensuring the stability of the connection.

In the third embodiment, as a further preferable scheme of the first embodiment, the diameter of the carpal broach 5 is changed in a step shape, and gradually becomes smaller from a position near the carpal base 1 to a position far away from the carpal base 1. So as to effectively improve the fixing firmness of the carpal bone base 1.

In a fourth embodiment, as shown in fig. 5-6, as a further preferable scheme of the first embodiment, a second limit screw 16 is connected to the side surface of the radius shaft 4 in a threaded manner, and the end of the second limit screw 16 abuts against the radius connecting plate 8. Wherein, the side surface of the radius connecting plate 8 which is abutted against the second limit screw 16 is uniformly provided with transverse rough surfaces 19. By arranging the lateral surface of the radius connecting plate 8 as the transverse rough surface 19, on one hand, the local friction force can be increased, so that after the second limiting screw 16 on the side of the radius handle 4 is pressurized, the radius connecting plate 8 can be firmly fixed; on the other hand, the positions of the proximal parts of the wrist joint surfaces have certain differences after the inclination angle and the ulnar deviation angle of the prosthesis are adjusted by different patients, and the movable ball 3 can be firmly fixed at any adjusted position by the design of the transverse rough surface 19. Meanwhile, the length of the long axis of the forearm can be adjusted within a certain range, and the fault-tolerant rate of the ulna and radius osteotomy amount is increased.

In the fifth embodiment, as a further preferable scheme of the first embodiment, the lower surface of the wrist bone socket 2 has a groove structure with two high sides and a low middle. The two sides of the lower surface of the wrist bone joint socket 2 are high, so that the wrist bone joint socket can be effectively prevented from being dislocated towards the left and right sides; while a lower medial aspect may facilitate the flexion and extension of the prosthetic joint.

Sixth, as a further preferred scheme of the first embodiment, the outer surface of the limiting lock 13 is provided with a limiting groove 17, the side surface of the lock hole 12 is in threaded connection with a limiting locking nail 18, and the end of the limiting locking nail 18 is matched with the limiting groove 17. The radius intramedullary nail 10 is fixed with the radius shaft 4 in a limiting way through a limiting locking nail 18.

The above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.