CN1271973C - 用于外科手术的扩孔钻的可连接/可拆卸的钻头 - Google Patents

用于外科手术的扩孔钻的可连接/可拆卸的钻头 Download PDF

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CN1271973C
CN1271973C CNB028224590A CN02822459A CN1271973C CN 1271973 C CN1271973 C CN 1271973C CN B028224590 A CNB028224590 A CN B028224590A CN 02822459 A CN02822459 A CN 02822459A CN 1271973 C CN1271973 C CN 1271973C
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drill bit
keeper
driving shaft
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far
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CN1585623A (zh
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詹姆斯·M·格林
小斯坦利·J·克米克
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Synthes USA LLC
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613Component parts
    • A61B17/1615Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A61B17/1617Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/164Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans intramedullary
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B2017/1602Mills
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00General characteristics of surgical instruments
    • A61B2217/002Auxiliary appliance
    • A61B2217/005Auxiliary appliance with suction drainage system

Abstract

本发明披露了一种用于快速地在髓管上扩孔的装置,其具有可拆卸的钻头。该装置包括一个连接在旋转驱动轴的远端上的钻头。该钻头具有一个切削头,其第一端具有多个刀片以及刀片之间的凹槽,其第二端具有多个弹性臂。该装置也可以包括一个套装在旋转驱动轴上的抽吸管和与钻头旋转地配合的钻头保持器。此外,通过使用一个钻头拆卸装置也可以将该钻头从扩孔钻装置上拆卸下来用于将来的再次使用。

Description

用于外科手术的扩孔钻的可连接/可拆卸的钻头
技术领域
本发明涉及一种用于骨组织切除的装置,特别是,涉及一种用来进行快速地在髓管上扩孔的具有可拆卸头部的装置。
背景技术
在本领域中,用于切除骨组织的许多种类的装置已经是众所周知了。通常来说,这些装置利用一个位于驱动轴的远端类似于钻的旋转切削刀片。典型地,用于髓管扩孔的骨切割装置使用柔性驱动轴,这是因为骨头的髓管很少是直的,通常具有一定程度的曲率。多数扩孔钻还具有一个通过扩孔钻和驱动轴的中心孔。该中心孔用来容纳一个长的、小直径的定位销或导向线,在开始时将该定位销或导向线插入髓管中作为前进中的扩孔钻的路线。
扩孔钻用于整形外科手术,使髓管为多种外科手术过程作好准备,所述外科手术过程包括整个臀部和膝盖的置换、用于长骨骨折固定的钉子插入、髓内截骨术、和用于移植目的的骨的采集。
从机械学和生物学观点来看,骨髓的扩孔对于改进移植物的性能来说非常有益。特别是,扩孔扩大了髓管,从而能够插入较大直径的移植物。这些较大直径的移植物失败的可能性很低。事实上,某些骨折需要过度扩孔,从而能够使用较大直径的移植物。如果不扩孔,当选择移植物的直径时,外科医生必须使用一种“最佳推测”的估计值。医学文献包括报告了许多不精确估计的不利后果的个案研究。扩孔提供了对髓管直径的直接测量,因此允许选择能精确插入髓管的移植物。因此,通过实现骨内的接触能够改善骨折部位的固定。当移植物不能插入髓管时,位于移植物和骨之间的负载分配降低。这样将增加传递到移植物的载荷并引起移植物的失败和骨的应力保护。
除了这些益处,髓管扩孔也会产生消极后果。特别是,现有的骨髓腔扩孔的过程能够导致温度和压力的增加。如同在将材料去掉的工艺中,扩孔产生热量。此外,扩孔时,在骨髓腔中产生远远超过血压的液压。扩孔钻在骨腔中起液压活塞的作用,如果管中所含的物质(包括骨髓脂肪、血液、血液凝块和骨头残块的混合物)进入血流中,就会产生栓塞。多余的热量会产生皮质的无菌性坏死,增加的压力有产生脂肪栓塞的危险。当存在减弱的因素例如休克、已有的肺挫伤、多处外伤、或以前存在的肺部损伤时,患者更容易引起并发症。在这些情况下,由于存在这些增加的危险,通常不能执行扩孔的优选方法。
存在减小扩孔时所产生的髓内压力的多种装置和方法。例如,在修复的关节置换中,远端的通气孔、较大的插入孔、和用于牙骨质插入的改进技术在减小压力方面以及可能在减小脂肪栓塞方面显示出成功之处。骨中的通气孔只有很小的作用,这是因为其直径非常小,当扩孔钻通过时,可以假设其局部最大值。相似的,给骨髓腔扩孔不能防止压力增加。实际上,对于小直径的扩孔钻来说,其压力甚至可能很高。
试图减小温度和压力所使用的另一项技术是在多个步骤中扩孔,对于每个步骤,扩孔钻具有增加的尺寸。因此,随着应用缓和的压力和需要的多个通道,缓慢地进行扩孔过程。通常在1mm的直径增量上,进行扩孔,直到达到骨皮质,然后再以0.5mm的增量进行。在这点上,用很小的压缩力进行扩孔,并且使用利用这个缓慢工艺的多数扩孔装置,能够容易地减小髓内压力。为了减小操作时间及医药成本,需要一种利用较少通道的快速扩孔工艺。
在2000年2月2日提出了名称为“外科手术扩孔钻及其使用方法”的美国专利申请09/495,932,其全部内容引入此处,作为参考,在该申请中所披露的扩孔装置允许以增加的速度进行髓管的扩孔,而不产生髓管扩孔的负面影响(例如将骨组织切除后,增加了脂肪栓塞和热坏死的危险)。此外,扩孔装置可以单独使用,因此当外科手术过程结束后,可以丢掉柔性抽吸管和固定的钻头。
由于单独使用扩孔装置,可以避免由于长时间使用而使钻头变钝所产生的问题。例如,可以避免由于持续使用变钝的扩孔钻而产生的较大髓内压力和皮质温度的较大增加的问题。此外,由于使用一次扩孔装置,外科医生和操作人员就没有必要小心地处理扩孔钻。
然而,对于一次使用带有固定钻头的扩孔装置存在一些缺陷。典型地,患者的骨骼不同,需要不同的扩孔钻和钻头来调节患者骨骼的变化。例如,某些患者具有需要较大钻头的较长的骨。由于钻头固定在扩孔装置的其余部位,外科医生和操作人员不得不保持不同扩孔钻的全部清单的存货以适应不同患者的骨骼。保持全部清单的存货需要很大的空间,并且成本很高。因此,需要带有可拆卸钻头的一次使用的扩孔装置以避免保持扩孔钻的全部清单的存货所带来的问题。由于使用可拆卸的钻头,外科医生和操作人员只保持带有全部清单的存货的钻头的几种扩孔装置。这将需要较小的空间并且成本较低。
此外,钻头通常是耐用的,少量的使用不会削弱钻头的可靠性和效力。因此,具有可拆卸钻头允许将来再次使用钻头,因此减少扩孔过程中所消耗的成本。
因此,需要一种装置,在切除骨组织时,该装置以提高的速度用于髓管扩孔而不会增加脂肪栓塞和热坏死的危险,并允许将钻头拆下来用于将来的再次使用。
发明内容
本发明涉及一种用于骨头的髓管扩孔的装置。该装置包括一个连接在旋转的驱动元件的近端上的旋转的驱动轴和一个旋转地连接在驱动轴的远端上的可拆卸的钻头。钻头具有一个带有弹性臂的管状杆,该弹性臂连接在驱动轴的远端,该钻头还具有一个与所述杆为一体的切削头,该切削头具有多个刀片。相邻刀片之间具有凹槽。
驱动轴和钻头都可以具有一个插管。当管状杆和弹性臂与驱动轴相配合来形成一个中心管道时,这两个插管对齐。这个管道的一个作用是容纳可以用来引导髓管中的装置的导向线。
该装置也可以包括一个抽吸管用来移除由钻头产生的切削材料。该抽吸管具有一个位于近端的歧管组件和一个管腔,所述管腔的设置和尺寸用于容纳驱动轴。抽吸管还通过位于远端的一个夹持环连接在钻头保持器上。优选地,中心管道与冲洗源保持流体连通,以便向切削头提供清洗。歧管组件可以包括一个连接在冲洗源上的冲洗口和一个与冲洗口保持流体连通的冲洗腔室。冲洗液体通过位于驱动轴上的一个开口从冲洗腔室传送到中心管道中。
通过一个内侧轴肩和钻头的弹性臂,钻头保持器旋转地与钻头相接合。钻头保持器还具有多个端口,该多个端口与钻头的凹槽和抽吸管的管腔的远端保持流体连通。抽吸管的管腔的近端与抽吸源保持流体连通。优选地,歧管组件包括一个连接在抽吸源上的吸气口,以有助于将切削材料移除。
本发明还涉及通过使用钻头拆卸装置而将钻头从钻头保持器上除去用于将来的再次使用。钻头拆卸装置与钻头的弹性臂相接合,使弹性臂从钻头保持器上脱离,因此允许将钻头从钻头保持器上拆卸下来。
附图说明
在附图中披露了本发明的优选特征,其中相同的附图标记表示全部视图的相同的元件,其中:
图1A为根据本发明的扩孔钻装置的一种实施例的左侧远端方向的立体图。
图1B为图1A装置的右侧近端方向的立体图。
图2为图1A和1B的扩孔钻装置的俯视图。
图3为沿图2中A-A剖开的截面图。
图4为根据本发明的驱动轴组件的一种实施例的立体图。
图5为根据本发明的钻头的一种实施例的侧视图。
图6为图5的钻头的主视图。
图7为图5的钻头的后视图。
图8为图5的钻头的前方立体图。
图9为图5的钻头的后方立体图。
图10为图5的一个部分的放大视图。
图11为图4的驱动轴组件的一个部分的立体图,图中导向线插入驱动轴的插管中。
图12为沿图11的线A-A剖开的驱动轴组件的截面图。
图13为根据本发明的钻头的另一种实施例的俯视图。
图14为根据本发明的钻头保持器的一种实施例的截面图。
图15为图14的钻头保持器的立体图。
图16为根据本发明的夹持环的立体图。
图17为与图16的夹持环相接合的图14的钻头保持器的局部剖开的截面图和侧视图。
图18为图13的钻头的立体图,该钻头与图14的钻头保持器和图16的夹持环对齐。
图19为图1A和1B所示的扩孔钻的放大和局部剖开的侧视图和截面图。
图20为根据本发明的钻头拆卸装置的一种实施例的立体图。
图21为图1A和1B所示的带有图20的钻头拆卸装置的扩孔钻的局部剖开的侧视图和截面图。
图22为根据本发明的钻头保持器的另一种实施例的截面图。
图23为图22的钻头保持器的立体图。
具体实施方式
为了方便起见,在附图中所示的本发明的不同实施例中的相同或相似的元件用相同的附图标记表示。进一步地,在随后的描述中,对方位或方向的任何参考主要是用于描述的方便,而不是以任何方式来限定本发明的保护范围。
参考图1-3,根据本发明的扩孔钻10的一种优选实施例包括安装在扩孔钻10的远端上用来进行髓管扩孔的一个扩孔钻钻头20、一个用来抽吸和去掉乳化骨头和由钻头20所产生的其他材料的柔性抽吸管13、扩孔钻钻头保持器14和夹持环11,该夹持环11用来将钻头20保持在抽吸管13上而仍然允许钻头20相对于抽吸管13和钻头保持器14旋转,还包括安装在扩孔钻10的近端上的歧管组件12。因此,如在该申请中所使用的,术语“远”表示靠近钻头20并朝着扩孔钻10的前面的一端或方向,术语“近”表示靠近歧管组件12并朝着扩孔钻10的后面的一端或方向。术语“纵向”表示以抽吸管13中心轴的方向。
抽吸管13是柔性的,从而其能够弯曲以适应骨头的曲率,优选地,该抽吸管13由透明材料制成,从而能够观察到所吸出的材料。歧管组件12具有一个冲洗口15和一个吸气口16,分别用来连接冲洗源和吸气装置。驱动轴联轴器17位于歧管组件12的近端。可以将驱动轴联轴器17轻易地连接到驱动轴或使钻头20旋转的其他装置上,且可轻易地从其上拆卸下来。
图4示出了驱动轴组件100,所述驱动轴组件100可以与扩孔钻10一同使用,从而以足够的速度旋转钻头20以给髓管扩孔。驱动轴组件100和扩孔钻10的使用(或将该驱动装置容纳在一个独立于扩孔钻的单元中的任何模组系统)允许再次使用带有许多不同的扩孔钻的驱动轴组件100。这种模组化具有优越性,这是因为不同的患者和临床的条件将需要不同尺寸的钻头。再者,扩孔钻10能够单独地一次性使用,而驱动轴组件100可以被长期使用。
驱动轴组件100包括一个柔性驱动轴102,其在远端具有一个钻头的连接部104,用于可拆卸地连接钻头20,从而当柔性驱动轴102旋转时,使钻头20旋转,还包括连接到电源以使驱动轴102开始旋转的电源连接部106以及位于钻头和电源连接部106之间用于连接驱动轴联轴器17的歧管接头108。驱动轴102的尺寸适于放入抽吸管13的管腔中。然而,如在后面将更详细地描述的那样,在驱动轴102的外壁和抽吸管13的内壁之间存在着足够的空间,以允许将所吸的材料从钻头20通过抽吸管13传送到吸气口16。在对于抽吸管13的情况中,驱动轴102是柔性的以便与被钻的骨头的任意曲率一致。驱动轴102具有一个插管110,用于容纳导向线120。
如图11和12所示,导向线120的外壁和插管110的内壁之间存在着足够的空间以允许冲洗液体从冲洗口15通过管110传送到钻头20。驱动轴102具有一个开口126,所述开口126从驱动轴102的外表面延伸到插管110。开口126位于驱动轴102上,使得当驱动轴组件100连接在扩孔钻装置10上时,开口126与冲洗口15保持流体连通以允许冲洗通过插管110流动。开口126具有弯曲壁128、130。弯曲壁128向外弯曲以具有凸形轮廓,弯曲壁130向内弯曲以具有凹形轮廓。随着驱动轴102旋转(对于图14为逆时针方向),弯曲壁128、130的曲率有助于带动水流进入插管110中。
可以使用用于可拆卸地连接歧管接头108和驱动轴联轴器17的任何合适的装置。优选地,使用一种快速连接机构,用来快速连接和分离。例如,歧管接头108可以具有带压紧机构的弹簧,例如球轴承,其与驱动轴联轴器17中的凹槽相配合。相似地,可以使用确保驱动轴组件100和动力源之间连接的任何合适的装置和动力源。如同气动工具广泛地用于整形外科手术中,优选地,动力源是气体驱动,例如从宾夕法尼亚州Paoli的Synthes(美国)可得到的Compact Air Drive(紧密的气体驱动)。
参考前面的图3,容纳在歧管组件12中的是一个密封元件34和一个套筒轴承31。密封元件34和套筒轴承31限定一个冲洗腔室35,并提供一个密封以防止在操作的过程中,冲洗液体从冲洗腔室35流入吸气口16或流出扩孔钻装置10的近端。此外,套筒轴承31防止吸出的乳化材料进入冲洗腔室35。
虽然可以使用金属材料、聚合体材料、陶瓷材料或适于切割骨头的组合材料,优选地,钻头20由不锈钢制成。扩孔钻插管22从远端延伸到钻头20的近端(图6、7、8)。扩孔钻插管22与驱动轴102的插管110对齐,使得导向线从驱动轴102的近端通过钻头20的远端延伸。
虽然可以将很多不同的钻头和扩孔钻10一起使用,图5-10只示出了一种实施例。如这些图中所示出的,钻头20由一个和管状杆25成一体的切削头40组成。管状杆25的表面为圆柱形,并具有位于钻头20的近端的多个弹性的保持臂26,其与钻头保持器14内侧的轴肩弹性接合,允许钻头20旋转同时保持在抽吸管13的远端沿纵向的固定位置。如图9所示,管状杆25在近端具有一个驱动轴接收部23,所述驱动器接收部23的构成能够容纳驱动轴102的钻头连接部104,使得驱动轴102旋转时,钻头20一定旋转。虽然驱动轴接收部23可以是与钻头连接部104的外部轮廓一致的任何形状,优选地,其为凹形六面体。
钻头20的切削头40具有多个刀片41,优选地至少有五个刀片,所述刀片从扩孔钻插管22处沿径向向外延伸以形成基本为螺旋的形式。当提供足够的切割时,为了允许移除适当数量的骨材料,使刀片的数目与特定的刀片几何形状和旋转速度相关联是具有优越性的。当对于一种给定的刀片形状使用很多的刀片时,凹槽就会变得非常窄,因此只能移除少量的骨材料。当使用的刀片的数目不足时,钻头不能有效地切割骨组织。实际上,在切割骨头材料时,钻头会被粘合或阻塞。
如图10所示,每个刀片41具有多个角状的磨平远端,所述磨平远端具有连接在螺旋侧面切削刃44上的直的正向切削刃42。正向切削刃42由刀片内壁45和平坦的第一刀刃面51之间的交叉处来限定。刀片内壁45和第一刀刃面51之间的角度为锐角。平面的第二刀刃面52以一个钝角与第一刀刃面51相交以形成第一刀刃边缘56。平面的第三前刃面53以一个钝角与第二刀刃面52相交以形成一个后面刀刃边缘58。侧面切削刃44由刀片内壁45和刀片外表面46的交叉处来限定,该侧面切削刃44与纵轴相距固定的径向距离并以螺旋方式沿纵向延伸。刀片外表面46沿着面向相邻刀片的内壁的圆弧,从侧面切削刃44处向内沿径向盘旋。所述相邻刀片之间的空间限定一个凹槽43(如图9所示),在操作的过程中,所述凹槽起着向钻头20的近端传送切除的髓管材料的作用,用来在真空下从骨腔中通过抽吸管13移走这些材料。刀片内壁45和刀片外表面46在切削头40上沿纵向延伸,在台肩表面48的近端终止。台肩表面48抵靠在管状杆25上。
图13示出了根据本发明钻头20′的另一种实施例。钻头20′没有任何侧面切削刃,因此使横向扩孔通过骨头的皮质的危险基本最小。每个刀片41具有带有直的正向切削刃42的多个角状磨平远端。正向切削刃42由刀片内壁45和平坦的第一刀刃面51之间的交叉处限定。刀片内壁45和第一刀刃面51之间的角度为锐角。平面的第二刀刃面52以一个钝角与第一刀刃面51相交以形成第一刀刃边缘56。刀片外表面46沿着面向相邻刀片的刀片内壁的圆弧,向内沿径向盘旋。所述相邻刀片之间的空间限定一个凹槽43,在操作的过程中,所述凹槽起着向钻头20′的近端传送切除的髓管材料的作用,用来在真空下从骨腔中通过抽吸管13移走这些材料。
图14和15示出了钻头保持器14。虽然钻头保持器14可以是具有任何数量的端口69的任何形状,优选地,保持器14基本为圆柱形,并具有围绕着保持器14的圆周以相同的距离隔开的四个端口69。保持器14的远端是开口62和孔63,所述孔63的尺寸和形状适合容纳管状杆25和钻头20的弹性臂26。在图18中可以清楚地看到。位于孔63末端的是与弹性臂26相配合的轴肩64。优选地,钻头保持器14的近端的直径比远端的小。钻头保持器14的近端还具有多个开口68和孔66,优选地,所述孔66的直径比孔63的直径大。位于保持器14的近端和远端之间的是用来与夹持环11相接合的轴肩67。
图16示出了夹持环11。优选地,夹持环11是具有一个孔72和配置在其圆周上的一系列开口74的管状体。
图17和18示出了通过轴肩67与保持器14相配合的夹持环11。虽然夹持环11可以用很多方式固定在保持器14上,优选地,通过激光焊将夹持环11固定在保持器14上。此时夹持环11的固定开口74与保持器14的开口68对齐。这些开口用于将抽吸管13固定地连接在夹持环11和保持器14上。如图17和19中清楚地示出的,抽吸管13安装在保持器14和夹持环11之间的空间中。一旦将抽吸管13设置在夹持环11和保持器14之间,通过抽吸管13和保持器14中的开口68,在开74上将夹持环11固定(stake),抽吸管13永久地固定在夹持环11和保持器14上。
图22和23示出了钻头保持器114的另一种实施例。虽然钻头保持器114可以是具有任何数量的端口169的任何形状,优选地,保持器114基本为圆柱形,并具有围绕着保持器114的圆周以相同的距离隔开的四个端口169。保持器114的远端是开口162和孔163,所述开口162和孔163的尺寸和形状适合容纳管状杆25和钻头20的弹性臂26。位于孔163末端的是与弹性臂26相接合的轴肩164。优选地,钻头保持器114的近端的直径比远端的小。钻头保持器114的近端还具有多个开口168和孔166,优选地,所述孔166的直径比孔163的直径大。面向保持器114的近端的是用来将抽吸管13固定地连接在钻头保持器114上的凸起101。由于具有将抽吸管13固定地连接在钻头保持器114上的凸起101,就不需要夹持环11。
现在将主要参考图19来描述可以在开放(open)外科、经由皮肤的、或其他最小程度的侵入性过程中的扩孔钻10的使用。当接近要扩孔的骨头后,将导向线120插入骨头124的髓管122中。典型地,使用荧光透视法将导向线120插入以保证导向线120的正确的部位。然后将具有连接并耦合在驱动轴100上的适当的切割器(例如钻头20或20′)的扩孔钻10设置在导向线120上,使得导向线120完全通过抽吸管13并提供了一个轨迹,当扩孔钻给髓管122扩孔时,扩孔钻10沿着所述轨迹进行。优选地,在插入髓管122之前,将连接在驱动轴100上的扩孔钻10连接在驱动装置上。因此,导向线120实际上穿过驱动轴102的插管110和钻头20的插管22。此外,在使用的过程中,驱动轴102和导向线120上的钻头20的同步旋转能保证将该插管引入髓管中时所述插管具有开放性。
髓管122的扩孔、冲洗和吸气同时进行。冲洗大体冷却钻头20、髓管122和骨124。在足够的速度和压力下释放冲洗液体的优选冲洗源是一个悬挂在冲洗口15之上一米的正常的盐袋。应该指出的是,除了一个盐袋,任何适于溶解和释放的生物学系统可以用作冲洗源。冲洗液体从冲洗源流入冲洗口15,并进入冲洗腔室35。冲洗液体沿着箭头I所述路径前进,通过插管110在插管和导向线120的内壁以及钻头20的外部之间的空间中流动。
吸气减轻了髓内的压力并有助于从钻头20中移走乳化材料。材料的移走不仅改善了扩孔,而且提供了获得用于移植目的的乳化材料的可能性。由吸气源产生的抽吸沿着箭头A所述的路径前进。特别是,冲洗液体有助于引导由钻头20所产生的乳化材料通过凹槽43,并进入驱动轴102的外壁和抽吸管13的内壁之间的空间,用来从扩孔钻20处通过保持器14上的端口69、抽吸管13和吸气口16传送乳化材料,并进入适当的容器。
包括扩孔钻10、可拆卸的钻头20和驱动轴组件100的系统的显著的优点是在一次过程中将髓管扩孔至所需直径的能力,亦即,不需要使用多个直径逐渐增加的钻头,直到取得所扩孔的需要的尺寸。关于这一点,在提供吸气的同时,向钻头20供应冲洗,并使用带有有效的正向切削几何形状(及任意的侧面切削几何形状)的钻头能比现有技术的扩孔装置产生较小的压力和热量。
一旦扩孔工艺结束,根据钻头的磨损程度,外科医生可能想要把钻头拆卸下来用于将来的再次使用。为了拆卸钻头,首先将驱动轴组件100从钻头20和抽吸管13上脱离并去掉。然后在邻近夹持环的近端的位置上将抽吸管13切下来,将抽吸管13的剩余部分丢掉。如图20和21中所示出的,然后临近地将具有大体为圆柱形的底部82和配合部分84的钻头拆卸装置80插入,依次通过抽吸管13的剩余部分,通过夹持环11并进入保持器14。随着拆卸装置80的配合部分84朝着保持器14的远端推进,配合部分84与钻头20的弹性臂26相接触,将之向内推进,并从保持器14的轴肩64上将其拆卸。然后可以将钻头20从保持器14上去掉并储存起来用于将来再次使用。
由于对本发明进行了描述,应该理解,不同的特征可以单独使用或结合使用。因此,本发明不限于此处所描述的特定的优选实施例。
此外,应该理解,对本领域的普通技术人员来说可以在本发明的主题和范围之内作出属于本发明的变化和修改。因此,由本领域的技术人员根据此处所披露的内容所得到的落入本发明的范围和主题内的所有有利的修改都被包括作为本发明的进一步的实施例。因此,本发明的范围由所附的权利要求来限定。

Claims (8)

1.一种用于在骨头的髓管上扩孔的装置,其包括:
一个具有近端和远端的旋转驱动轴,所构成的近端适于连接到驱动元件上以旋转驱动轴;以及
一个连接在驱动轴的远端而被旋转的钻头,所述钻头包括:
一个具有一个纵轴和多个弹性臂的管状杆,所述弹性臂用于与驱动轴的远端相接合;以及
一个用于骨切割和扩孔的切削头,所述切削头与所述杆连接,并具有多个刀片、和在刀片之间的多个凹槽;
驱动轴和钻头都具有一个插管,当管状杆和弹性臂与驱动轴相配合以形成通过该装置的中心管道时,驱动轴插管与钻头插管对准;
所述装置还包括:
一个用于移除由钻头产生的切削材料的抽吸管,所述抽吸管具有一个位于近端的歧管组件和一个管腔,所述管腔的构成和尺寸用来与驱动轴连接;以及
一个具有近端和远端的钻头保持器,其近端的构成和尺寸是用来连接抽吸管的远端的,其远端的构成和尺寸用来与钻头连接;
钻头保持器具有多个与抽吸管的管腔保持流体连通的端口。
2.如权利要求1所述的装置,其特征在于,歧管组件具有至少一个端口,其构成适于与冲洗源保持连通,所述至少一个端口与中心管道保持流体连通。
3.如权利要求1所述的装置,其特征在于,
所述歧管组件包括一个可连接在冲洗源上的冲洗口和一个与冲洗口保持流体连接的冲洗腔室;以及
驱动轴具有一个开口,所述开口从驱动轴的外表面延伸至驱动轴插管,并位于冲洗腔室之内。
4.如权利要求1所述的装置,其特征在于,歧管组件包括一个可连接在抽吸源上的吸气口。
5.如权利要求1所述的装置,其特征在于,钻头保持器与钻头连接,并允许钻头相对于钻头保持器旋转。
6.如权利要求5所述的装置,其特征在于,钻头保持器具有一个内侧轴肩用于与钻头的弹性臂相接合。
7.如权利要求1所述的装置,还包括:
连接在钻头保持器的近端上的扩孔钻夹持环,其构成和尺寸用来将抽吸管的远端固定地连接在钻头保持器的近端。
8.如权利要求1所述的装置,其特征在于,钻头保持器具有至少一个位于钻头保持器近端附近的凸起,用来将抽吸管的远端固定地连接在钻头保持器的近端。
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