CN100558324C - Self controlled intramedullary bone lengthening device - Google Patents

Self controlled intramedullary bone lengthening device Download PDF

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Publication number
CN100558324C
CN100558324C CNB2006100545916A CN200610054591A CN100558324C CN 100558324 C CN100558324 C CN 100558324C CN B2006100545916 A CNB2006100545916 A CN B2006100545916A CN 200610054591 A CN200610054591 A CN 200610054591A CN 100558324 C CN100558324 C CN 100558324C
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electric machine
machine support
sleeve
motor
inner sleeve
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CN1951342A (en
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唐朝伟
何栎
杨永齐
胡军
傅明怡
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Chongqing University
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Chongqing University
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Abstract

The present invention is a kind of self controlled intramedullary bone lengthening device, and it mainly is made up of left end fixing head (1), left adapter sleeve (3), motor (4), electric machine support (5), copper sheathing (6), feather key (7), outer sleeve (8), inner sleeve (9), center bolt (10), right-hand member fixing head (12).During operation, will connect with pin and bone photo in its human bone marrow that packs into.When motor rotated, center bolt rotated, and drove inner sleeve and move axially in inner sleeve around screw thread, thereby to skeleton drawing-off, prolongation.When motor did not rotate, described bone extension fixture remained static, and it plays the internal fixation effect to skeleton.If the motor counter-rotating can realize shrinking.Technique effect of the present invention is: wound is little, is placed in the long bone medullary cavity, and nursing, exercise are conveniently, and be attractive in appearance.Both can make inner fixer usefulness, and not need external force traction patient automatic control skeleton prolongation as required again, its length can be regulated arbitrarily, and the single extending length can be little of 0.1mm, prolongs the precision height.Do not disturb and destroy blood circulation, help union of fracture or limb lengthening.

Description

Self controlled intramedullary bone lengthening device
Technical field
The present invention relates to a kind of medical device, specifically, is a kind of self controlled intramedullary bone lengthening device.
Background technology
The prolongation technology that is used for leg length discrepancy treatment comes from the design that Codivilla prolongs bone, through many scholars' improvement and perfect, progressively forms the situation of today.And extend to bone defect healing, abnormity orthopedics and human body heighten operation gradually.It is main realization means that traditional bone prolongs with the bone external fixator, and the bone external fixator is regarded as key technology and the equipment in the bone prolongation, therefore derives the bone external fixator of multiple steric configuration and function.But no matter how the bone external fixator improves, it places the limbs appearance and does not change in the fundamentum of external direct drawing-off, so being inconvenient to reach drawback such as not attractive in appearance and also can't overcoming during the pin site infection that external fixator brought, a large amount of cicatrix of skin of body surface, treatment.Since the nineties in 20th century, along with the progress of tissue regeneration rationale, and the progress of correlation technique such as material, engineering, be the improvement of extender structure and performance, created advantageous environment; Limbs dynamic synchronization extender, the combination of inner and outside prolong system and implant extender entirely, are exactly three quantum jumps of limb lengthening, have become development in future trend.But traditional extender also will be brought into play its due effect, particularly in the treatment of complexity leg length discrepancy, still have irreplaceable effect.Below generally acknowledge with regard to domestic academia, commonly used do one with influential several extenders and simply introduce.Bone elongation pad is the apparatus of the damaged and leg length discrepancy of treatment bone, also is the apparatus as heighten operation, so introduced in the lump at this.
1, loopful formula bone elongation pad: as shown in Figure 4, the Zha Nuofu of Erie of the former Soviet Union (Ilizarov) invention.Outer planting formula loopful formula configuration, connect by many tensile pencil rods by annulus up and down, annulus is enclosed within the limbs surface outward, intersect to wear to middle limbs through annulus and put draw point clamping skeleton, connect by support between the annulus, nut is installed on the support, manual twisting nut, the realization support extends, and drives annulus stretching skeleton.This loopful formula bone elongation pad, good stability, stressed even makes things convenient for the rectification of line of force deviation, can simply walk from bed.
Its shortcoming is: the prolongation amplitude is limited, treatment cycle is long, the draw point cicatrix is many, and operation easier is big, and is complete low by manual operation, performance accuracy, and the inherent complication of bone lengthening takes place easily.Outside the exposed skin of draw point, secondary infection easily needs often nursing.Support is external, and is not attractive in appearance, is not easy to protect patients ' privacy; Weight support frame is big, outdoor activities on a large scale and functional exercise.The fixing surrounding soft tissue of draw point influences joint motion during limb lengthening.
2, one-sided bone elongation pad: as shown in Figure 5, Wagner (Wagner 1971) and Bassini (Bastsiani 1984) have been developed single-side prolong device roughly the same respectively.What clinical practice now was more is Orthofix single-side prolong device (trade name) by name.The single-side prolong device mainly is that the annulus of loopful formula bone elongation pad is changed into flat structure, uses 4-6 piece of draw point, typically has a diameter from 5-6mm.Its control mode is that nut is installed on support equally, and manual twisting nut realizes that support extends, and drives support stretching skeleton.Advantage be easy, be easy to install, the pin hole cicatrix is few, is children's's orthopaedics extender commonly used.
Its shortcoming is: this extender stability maintenance is very poor, generally is unsuitable for adult operation, is used for children's more.The prolongation amplitude is limited, treatment cycle long, the draw point cicatrix is big, and pin hole infects easily.Because of eccentric force, misalignment of axe easily takes place, the inherent complication of easier generation bone lengthening.Outside the exposed skin of draw point, secondary infection easily.Support is external, and is not attractive in appearance, is not easy to the patient and protects privacy; Weight support frame is big, outdoor activities on a large scale and functional exercise.Need often nursing.The fixing surrounding soft tissue of draw point influences joint motion during limb lengthening.
3, interplantation formula bone elongation pad: as shown in Figure 6, Chinese patent 99249639.X discloses a kind of " extender in the long bone marrow ", and this extender is made up of cylindrical shell, pull bar, ratchet, spring, position-limitting pin, anti-rotation position-limitting pin etc.During operation it is packed in the human body long bone pulp cavity with pin and bone photo company, bone is truncated into two sections then, outwards draw back for cylindrical shell at traction device external force effect lower link, the ratchet of installing on the pull bar this moment moves along the row's ratchet on the cylinder inboard wall, self-locking is spacing after arriving the predetermined bone elongatedness, treats that new callus is long and reach this device to be taken out after moulding.Though this device has not injured nerve and blood vessel, can avoid wound infection and limb swelling and reduce the advantage of skin scar, but its shortcoming is: troublesome poeration, the patient can not implement to prolong voluntarily, the each prolongation needs the medical worker to help with traction device, and the traction dynamics is difficult to accurate control, so the practicality extreme difference.Because of being ratchet motion, it is relatively poor to prolong precision, and can not shrink, and that is to say, if because operate miss, outside pull strength are excessive, has drawn one even several ratchet many, can not retract at all; Once excessively prolong, with the major injury peripheral nerve, influence blood supply, severe patient can cause quadriplegia or necrosis.Its clinical practice risk is very big.
Having the total shortcoming of bone elongation pad now is, all adopts artificial external force control to realize the stretching of extender, and the control accuracy of stretching, extension is lower, and operation easier is big, and the risk that maloperation brings in the clinical practice is very big.But also disturb and destroy blood circulation easily, be unfavorable for the region of elongation knitting.
Summary of the invention
The purpose of this invention is to provide a kind of easy to operately, wound is little, can lay in vivo, both can make inner fixer, has the self controlled intramedullary bone lengthening device of prolongation effect again.
Concrete scheme of the present invention is: a kind of self controlled intramedullary bone lengthening device, comprise left end fixing head and right-hand member fixing head, its key is: an end of left end fixing head is threaded with left adapter sleeve, this left side adapter sleeve other end and electric machine support are fastenedly connected, in the described electric machine support motor is installed, the output shaft of this motor is connected with center bolt, outside this center bolt, be set with the inner sleeve that is engaged with, between described inner sleeve and electric machine support, also be set with copper sheathing, at described copper sheathing and inner sleeve outside kink outer sleeve is arranged, this outer sleeve one end is fixedlyed connected with described electric machine support, have keyway on this outer sleeve, the feather key that is provided with on the described inner sleeve is positioned at the keyway of outer sleeve; The outer end of the described inner sleeve right-hand member fixing head interior with stretching into this inner sleeve is threaded.
The axial line of described left adapter sleeve, electric machine support and outer sleeve is on same straight line, and their maximum gauge equates.Make electric machine support and outer sleeve form one, outer surface smoother is attractive in appearance.
Be positioned at the electric machine support part of described motor output shaft periphery, the electric machine support of this smaller diameter end partly stretches in the described outer sleeve, and interference fit with it.Prevent to produce relative motion between outer sleeve and the inner sleeve.
The fixing first end of described left end stretches in the described left adapter sleeve and is threaded with it, has on the left end fixing head of this end and the extraneous cable-through hole that communicates.Being convenient to draw lead is connected with power supply or is connected with external circuit.
Described motor is interference fitted in the electric machine support, and the one end is spacing by step in the electric machine support, and the other end stretches in the described left adapter sleeve; On the cylindrical output shaft of described motor, be milled with a plane, end at described center bolt is drilled with a blind hole, a plane that matches with described motor output shaft is also arranged on the hole wall of this blind hole, and the output shaft of described motor inserts in the blind hole of described center bolt, fits in two planes.This structure is easy for installation firmly, and it is mobile both can to have prevented that motor from producing, and can drive the center bolt rotation again smoothly.
Self controlled intramedullary bone lengthening device of the present invention is laid in vivo, and wherein left end fixing head and right-hand member fixing head connect firmly by screw and bone marrow.When motor rotated, center bolt rotated, and it is axially mobile around center bolt to drive inner sleeve, thereby to skeleton drawing-off, prolongation.When motor did not rotate, described bone extension fixture remained static, and it plays the internal fixation effect to skeleton.If the motor counter-rotating in like manner also can realize shrinking.
Remarkable result of the present invention is: simple in structure, easy to operate; Disposable laying in vivo is convenient to nursing, and wound is little, for Wicresoft is fixed or extension fixture; It does not disturb and destroys blood circulation, helps union of fracture or limb lengthening; And can carry out skeleton drawing-off, prolongation at any time, the minimum extending length of single can reach 0.1 millimeter, prolongs the precision height.The patient can the each extending length of oneself control, can repeatedly prolong in one day, reach repeatedly stimulate, the purpose that prolongs of growth fast, shorten treatment time.During extension, do not need outside manpower or mechanical traction.
The present invention has not only overcome outside the exposed skin of draw point of external bone anchor existence; secondary infection easily; support is not external attractive in appearance; need the often shortcoming of nursing; and eliminated external bone elongation pad when limb lengthening draw point fixedly surrounding soft tissue, influence the hidden danger of joint motion, more do not have the shortcoming that inner fixer can only once prolong, the prolongation amplitude is limited.
The present invention compares with interplantation formula bone marrow extender of the prior art, and is simple in structure, easy to operate, do not need outside traction, and promptly the patient can oneself prolong as required, and its each extending length can be regulated arbitrarily, does not need doctor or other people help.For example, following difference is arranged with the contrast of Chinese utility model patent 99249639.X:
1, type of drive is different: the ZL99249639.X pull bar is relative with the cylindrical shell catch cropping to slide, and needs the traction apparatus traction, could move; This device is the rotation by motor, drives screw mandrel and rotates, and screw mandrel drives inner sleeve and rotates, thereby realizes that moving radially of inner sleeve advance, and overcoat not only plays the guide-localization effect, and purpose is to allow inner sleeve steadily advance, and prevents that inside and outside sleeve from rotating mutually.Do not need outside traction apparatus effect.
2, control accuracy is different: 99249639.X needs under the external force effect, spurs a ratchet of indentation at every turn, the 0.5mm that advances, and precision is quite coarse.Because operation is to carry out under not visible situation, outside pull strength in different size will cause not knowing one or several ratchet that advances, even half ratchet.If because maloperation, once excessively prolong, with the major injury peripheral nerve, influence blood supply, severe patient can cause quadriplegia or necrosis.Its clinical practice risk is very big.
This device is full automatic fully, does not need outside traction device, under controller control, can prolong accurately, and precision can arrive 0.1mm, and can be according to doctor or patient's needs, repeatedly accurately prolongs in one day.
3, mode of operation is different, practicality is different: the each prolongation of ZL99249369.X all need be by the traction device traction in operating room, just can reach the purpose of prolongation, this is concerning the patient, practicality is very limited, also pretty troublesome, need into operating room everyday, utilize traction device to finish prolongation by the doctor; And the present invention is under the hand-held controller effect, relies on the rotation of motor to reach the purpose of prolongation.Operation is simple, and the length that the patient can oneself prolong is as required regulated arbitrarily, do not need doctor or other people help.
4, reliability is different: the 99249369.X externally effect of pull strength prolongs down, but can not shrink, and that is to say, if because operate miss, outside pull strength are excessive, how draw one even several ratchet, can not retract at all, will cause operative failure.The present invention can reach the purpose of withdrawal by the counter-rotating of motor, even extending length is big, also can in time shrink, and operation is simple especially, convenient.
Description of drawings
Fig. 1 is a front view of the present invention;
Fig. 2 is the A-A cutaway view of Fig. 1;
Fig. 3 is the B-B cutaway view of Fig. 1;
Fig. 4 is an annular bone elongation pad structural representation in the background technology;
Fig. 5 is an one-sided bone elongation pad structural representation in the background technology;
Fig. 6 is the structural representation of the interior extender of long bone marrow in the background technology.
The specific embodiment
Please referring to Fig. 1, Fig. 2, Fig. 3, the present invention mainly is made up of left end fixing head 1, steel washer 2, left adapter sleeve 3, motor 4, electric machine support 5, copper sheathing 6, feather key 7, outer sleeve 8, inner sleeve 9, center bolt 10, steel washer 11, right-hand member fixing head 12, wherein an end of left end fixing head 1 is threaded with left adapter sleeve 3, the other end of this left side adapter sleeve 3 and electric machine support 5 are fastenedly connected, and this is fastenedly connected to adopt and is threaded or interference fit.Motor 4 parts are installed in the electric machine support 5, the output shaft of this motor 4 is connected with center bolt 10, outside this center bolt 10, be set with the inner sleeve 9 that is engaged with, between described inner sleeve 9 and electric machine support 5, go back sliding sleeve copper sheathing 6 is arranged, on the one hand to center bolt 10 location, on the other hand center bolt 10 suffered axial force transmission are fallen on the electric machine support 5, avoid motor stressed.At described copper sheathing 6 and inner sleeve 9 outside kinks outer sleeve 8 is arranged, these outer sleeve 8 one ends are fixedlyed connected with described electric machine support 5, have keyway on this outer sleeve 8, and the feather key 7 that is provided with on the described inner sleeve 9 is positioned at the keyway of outer sleeve 8; The outer end of described inner sleeve 9 is threaded with right-hand member fixing head 12 in stretching into this inner sleeve 9.Between the end face of described left end fixing head 1 and left adapter sleeve 3, steel washer 2 is installed, steel washer 11 is installed between the end face of described right-hand member fixing head 12 and inner sleeve 9.
As shown in Figure 1 and Figure 2: be positioned at electric machine support 5 parts of described motor 4 output shaft peripheries, electric machine support 5 parts of this smaller diameter end stretch in the described outer sleeve 8, and interference fit with it.Described motor 4 is interference fitted in the electric machine support 5, and the one end is spacing by step in this electric machine support 5, and the other end stretches in the described left adapter sleeve 3; The output shaft of this motor 4 inserts in the blind hole of described center bolt 10.Owing on the output shaft of motor 4, be milled with the plane, a plane that matches with it (as shown in Figure 2) is also arranged on the hole wall of the blind hole of described center bolt 10, fit in two planes, can prevent to produce relative motion between the output shaft of center bolt 10 and motor 4, make motor 4 drive center bolts 10 and rotate more reliable.
Described left end fixing head 1 one ends stretch in the described left adapter sleeve 3 and are threaded with it, have on the left end fixing head 1 of this end and the extraneous cable-through hole 13 that communicates.From cable-through hole 13, draw the conduction machine and be connected, can control the rotation of adjusting motor easily with extraneous power supply or controller.
On same straight line, and their maximum gauge equates present embodiment the axial line of left adapter sleeve 3, electric machine support 5 and outer sleeve 8.The three is considered as one, and smooth in appearance is clean and tidy.
Above-mentioned and part assembles left end fixing head, left adapter sleeve, electric machine support, outer sleeve to be regarded as afterwards and is one, and they can not move under normal stressing conditions mutually.
As Fig. 1, shown in Figure 3, a feather key 7 is arranged between inner sleeve 9 and outer sleeve 8, can limit the motion that rotates in a circumferential direction mutual between them, and can (100mm) freely-movable in stroke range at length direction.Motion between them is exactly the motion between left end fixing head and the right-hand member fixing head.
The width of feather key 7 is less than the groove of outer sleeve 8, equates (what in fact adopt in design process is interference fit, i.e. tight fit) with the well width of inner sleeve 9.Key is being packed into like this
Figure C20061005459100121
Can stick together with inner sleeve closely, can not come off out.Install also very conveniently like this, only the groove of inner sleeve 9 and outer sleeve 8 need be aimed at, key is put into, and certain pressure is embedded in the groove of inner sleeve 9 by it, promptly finish the installation of key.
The effect of feather key 7 can be found out by Fig. 3, can make inner sleeve 9 at circumferencial direction relative rotation not take place with outer sleeve 8, and outer sleeve 8 and electric machine support 5 connect firmly together, so inner sleeve 9 just can not occur in the relative motion of circumferencial direction with respect to electric machine support; The axle of center bolt 10 and motor is circumferencial direction fixed (the mutual motion of circumferencial direction promptly can not take place); Center bolt 10 rotates under the drive of motor shaft like this, and inner sleeve 9 is directed to key 7 restrictions with motor 4 in the motion of circumferencial direction again, so center bolt 10 with regard to energy and inner sleeve 9 relative motion of circumferencial directions takes place, moves forward and backward thereby drive inner sleeve 9.
In sum, the effect of feather key 7 is to prevent that inner sleeve 9 and outer sleeve 8 from circumferential movement taking place, and moves forward and backward thereby make center bolt 10 promote inner sleeve smoothly.
Slip in axial direction among the present invention between left end fixing head and the right-hand member fixing head realizes by motor exactly.Implementation procedure is as follows: whole motion is driven by direct current generator, the built-in decelerator of direct current generator.Motor 4 output shafts will drive center bolt 10 rotations.Center bolt 10 promotes to be subjected to feather key 7 circumferential fixed inner sleeves 9 by screw thread and advances then.Inner sleeve 9 relative outer sleeve 8 axial advancement, thus right-hand member fixing head and left end fixing head smooth sliding are in axial direction advanced.Whole like this device has just been realized elongation under the drive of motor, if the motor counter-rotating in like manner also can realize shrinking.

Claims (6)

1. self controlled intramedullary bone lengthening device, comprise left end fixing head (1), right-hand member fixing head (12), it is characterized in that: an end of left end fixing head (1) is threaded with left adapter sleeve (3), the other end of this left side adapter sleeve (3) and electric machine support (5) are fastenedly connected, motor (4) is installed in the described electric machine support (5), the output shaft of described motor (4) is connected with center bolt (10), outside this center bolt (10), be set with the inner sleeve (9) that is engaged with, between described inner sleeve (9) and electric machine support (5), also be set with copper sheathing (6), at described copper sheathing (6) and inner sleeve (9) outside kink outer sleeve (8) is arranged, these outer sleeve (8) one ends are fixedlyed connected with described electric machine support (5), have keyway on this outer sleeve (8), described inner sleeve (9) is gone up the keyway that the feather key (7) that is provided with is positioned at outer sleeve (8); The outer end of described inner sleeve (9) the right-hand member fixing head (12) interior with stretching into this inner sleeve (9) is threaded.
2. self controlled intramedullary bone lengthening device according to claim 1 is characterized in that: the axial line of described left end adapter sleeve (3), electric machine support (5) and outer sleeve (8) is on same straight line, and their maximum gauge equates.
3. self controlled intramedullary bone lengthening device according to claim 1 and 2, it is characterized in that: electric machine support (5) part that is positioned at described motor (4) output shaft periphery, the electric machine support of this smaller diameter end (5) part stretches in the described outer sleeve (8), and interference fit with it.
4. self controlled intramedullary bone lengthening device according to claim 1, it is characterized in that: described left end fixing head (1) one end stretches in the described left adapter sleeve (3) and is threaded with it, has on the left end fixing head (1) of this end and the extraneous cable-through hole (13) that communicates.
5. self controlled intramedullary bone lengthening device according to claim 1 is characterized in that: described motor (4) is interference fitted in the electric machine support (5), and the one end is spacing by the interior step of this electric machine support (5), and the other end stretches in the described left adapter sleeve (3).
6. self controlled intramedullary bone lengthening device according to claim 1 or 5, it is characterized in that: on the cylindrical output shaft of described motor (4), be milled with a plane, end at described center bolt (10) is drilled with a blind hole, a plane that matches with described motor (4) output shaft is also arranged on the hole wall of this blind hole, the output shaft of described motor (4) inserts in the blind hole of described center bolt (10), fits in two planes.
CNB2006100545916A 2006-11-10 2006-11-10 Self controlled intramedullary bone lengthening device Expired - Fee Related CN100558324C (en)

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Publication number Priority date Publication date Assignee Title
BR112012030791A2 (en) * 2010-06-03 2016-11-01 Smith & Nephew Inc orthopedic implants
CN104382639B (en) * 2014-11-20 2017-02-22 新疆医科大学第一附属医院 Intramedullary bone extending bone transport device
CN108143477B (en) * 2017-12-18 2020-05-19 武汉大学 Intramedullary bone lengthening device using memory alloy spring electromagnetic heating
CN108158640A (en) * 2018-01-17 2018-06-15 湖北理工学院 Self-adjustable outer fixed bone elongation pad
CN109045445A (en) * 2018-09-19 2018-12-21 河南豫乾技术转移中心有限公司 Uterus cleaning plant for gynemetrics

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