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CN107405203A - 用于拇指的大多角骨‑掌骨关节的假体 - Google Patents

用于拇指的大多角骨‑掌骨关节的假体 Download PDF

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CN107405203A
CN107405203A CN201680016513.9A CN201680016513A CN107405203A CN 107405203 A CN107405203 A CN 107405203A CN 201680016513 A CN201680016513 A CN 201680016513A CN 107405203 A CN107405203 A CN 107405203A
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prosthesis
prosthesis according
bone
trapezium
metacarpal
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马可·兰泽塔
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Abstract

一种用于拇指的大多角骨‑掌骨关节的假体(1)，该假体(1)包括适于布置在拇指的舟骨(31)与掌骨(30)之间的本体(2)，这种本体(2)具有阿基米德立体的形状并且用作所述舟骨(31)与掌骨(30)之间的间隔件。

Description

用于拇指的大多角骨-掌骨关节的假体
技术领域
本发明涉及一种根据主要权利要求的前序部分的用于拇指的大多角骨-掌骨关节的假体。
背景技术
众所周知，大多角骨-掌骨关节的关节病是一种决定这种关节逐步退化的疾病，并且在限制手以及首先地拇指在正常的个人和工作活动中的使用。所有这一切都与疼痛相关联。
这种疾病可以用药物治疗，但是对于最重要的形式的关节病，需要进行手部外科手术。
可能产生非常好的结果的手术是这样的：其意味着完全去除大多角骨并且以由生物相容性材料制成的间隔件替代大多角骨，该间隔件用作拇指的大多角骨-掌骨关节的假体并且具有使舟骨与掌骨之间的相对位置保持稳定的目的。
EP1112753描述了一种由包括热解碳的材料制成的植入物，该植入物将置于两个可移动的骨头表面之间，并且没有任何装置将植入物固定至植入物布置在其之间的骨头。该专利文献描述了在任何情况下总是呈现连续的圆形表面的植入物的多种实施方式。由于这种圆形表面的存在，该解决方案无法保证植入物最佳地固定至骨头。
US2013/0226306描述了一种由聚碳酸酯聚氨酯制成的植入物，该植入物适于布置在骨头之间并且承受压缩力和剪切力。在该现有技术的专利文献中，对该发明的多种实施方式进行了描述；多数这样的实施方式包括适于置于相邻的骨头之间的本体并且销钉从本体突出成适于插入形成在骨头中的孔中。还描述了以下实施方式：其中，未设置这种销钉，而只有置于相邻的骨头之间的本体；这种本体可以具有呈凹形表面和/或凸形表面和/或平坦表面的形状，该表面与相应表面配合，该相应表面通过在骨头上进行手术、并且以适当的方式成形而获得，以便完美地与植入物的表面接触。为了使用根据文献US2013/0226306的植入物，必须在患者的骨头上进行手术以使其准备与植入物的表面和/或杆配合。在未设置杆的任何位置，植入物的本体都几乎不能固定至面向它的骨头，这可能导致骨头之间以及骨头与植入物之间的不期望的偏移。
发明内容
本发明的目的是提供一种所提及类型的假体，该假体相对于已知假体得到改进，并且允许掌骨的基部获得相对于舟骨的最佳稳定性。
另一目的是提供一种所提及类型的假体，与用于布置已知假体以替代大多角骨的那些方式相比，可以以更简单的方式实现将该假体插入手中。
再一目的是提供一种可以快速融入手的组织中的假体。
另一目的是提供一种在X射线检查期间可识别的假体。
这些目的和其他目的对于本领域的普通技术人员而言将是明显的并且可以通过根据所附权利要求的假体来实现。
附图说明
为了更好地理解本发明，附图仅用于说明、因此非限制性的目的，在附图中：
图1示出了根据本发明的假体的正视图；
图2示出了图1中的假体的俯视图；
图3示出了插入了图3中的假体的手的示意性透明视图；
图4示出了图1中的假体的立体图，为了清晰起见，局部被剖开；
图5示出了图1中的假体的变型的正视图；
图6示出了插入了图5中的假体的手的示意性透明视图；以及
图7示出了图5中的假体的立体图，为了清晰起见，局部被剖开。
具体实施方式
在附图中，相同的或对应的部件以相同的附图标记标识。
参照图1至图4，它们示出了本发明的第一实施方式，其中，通常用附图标记1表示假体，并且假体包括由生物相容性材料制成的实心本体2。例如，实心本体2可以由戈尔特斯、涤纶或聚四氟乙烯制成。
如图4所示，本体2可以包括适于使假体1在X射线检查中可见的金属芯3。
这种本体2具有阿基米德立体的形状以便最多“占据”由手中的大多角骨占据的空间。在外科手术期间，每当这种骨头(大多角骨)被从手中移除时，都会产生大致呈立方体的空间，假体的阿基米德立体的形状最多刚好填满该空间。因此本体2位于手的掌骨30和舟骨31之间并且用作这些骨头之间的间隔件；掌骨30的基部32搁置在本体2上。
有利地，本体2由例如尼龙、聚丙烯纺织纤维或其他材料制成的不可吸收的线10卷绕，该线10有助于将本体2融入并固定至手的组织，以便刺激本体的纤维反应或周围组织的纤维反应。
为了将本体固定到位，这种网包括至少两个位于相反位置的孔眼或孔12和13，通过孔眼或孔12和13，可以使得一条或多条优选地为不可吸收类型的缝合线(未示出)穿过腱或囊状结构，以便将假体1锚定在腱或囊状结构之间。
网10可以包括两个以上的孔眼，以确定地将假体约束至手的骨头。
在图5、图6和图7中，假体1具有规则的二十面体的形状，即，具有多个切面的实心本体。此处考虑的本体可以在假体的独立的六边形和五边形面17之间具有表面凹槽16，或者可以不具有这种表面凹槽16；在这种凹槽中或在任何情况下在本体2的表面上，如图1至图4所示的实施方式那样，放置有网或网格10(例如由尼龙或聚丙烯纺织纤维制成)。
假体1还包括多个与本体2成一体的突出的孔眼18，孔眼18用于(借助于缝合线)将假体约束至腱或囊状结构。
图5中所示的解决方案还可以具有金属芯，使得可以通过X射线检查检测到假体。
将假体1插入手中的方式与已经参照图1至图4描述的方式类似，因此不再对这种插入模式进行描述。
由于假体1的形状，假体1可以容易地插入手中的在移除大多角骨时腾出的空间中。事实上，因为本体2具有阿基米德立体的形状并且该形状不具有任何用于与相邻的骨头接触的优选部分，所以这种插入方式不存在优选方向。本体2的切面形状确保了在相邻的骨头的表面(相邻的骨头的表面不一定需要表面处理以与假体的表面相配合)上的有限滑动；由于假体的平坦表面与骨头之间产生的摩擦力大于根据现有技术状态的假体的弯曲表面与骨头之间产生的摩擦力，因此发生这种情况。
此外，这种本体易于运用并且由于卷绕本体的部分(网10)的网状构造，本体可以容易地融入相邻的假体周围组织中。事实上，这种网或网格10促进接收假体的本体的纤维增生，因此促进本体的锚定和强度，并且促进置换区域中的植入物的融合和植入物的假体的强度。
已经对本发明的各种实施方式进行了描述。但是，基于前面的描述，其他实施方式被认为是可获得的：例如，本体2可以具有多个与二十面体的切面不同的切面，同时保留各种已知的阿基米德立体的形状。本发明的这种变型也应该被认为落入所附权利要求的范围内。

Claims (9)

1.一种假体(1)，所述假体(1)用于拇指的大多角骨-掌骨关节，所述假体(1)包括适于布置在拇指的舟骨(31)与掌骨(30)之间的本体(2)，所述本体适于用作所述舟骨(31)与所述掌骨(30)之间的间隔件，其特征在于，所述本体(2)具有阿基米德立体的形状。
2.根据权利要求1所述的假体，其特征在于，在所述本体(2)的面(17)之间能够设置有表面凹槽(16)。
3.根据权利要求1所述的假体，其特征在于，在所述本体(2)周围能够设置有网或网格(10)。
4.根据权利要求3所述的假体，其特征在于，所述网格(10)插入所述本体(2)的所述表面凹槽(16)中。
5.根据权利要求3所述的假体，其特征在于，所述网格(10)的线是不可吸收的线，例如由聚丙烯纺织纤维或尼龙制成的线。
6.根据权利要求1所述的假体，其特征在于，所述本体由戈尔特斯、涤纶、聚四氟乙烯或其他生物相容性塑料或金属材料制成，抑或由其他材料制成。
7.根据权利要求1所述的假体，其特征在于，设置有固定装置(13、18)，所述固定装置(13、18)适于允许将所述假体的所述本体(2)约束至手的骨头上。
8.根据权利要求3和7所述的假体，其特征在于，所述固定装置是至少两个所述网格(10)的孔眼(13)或者至少两个直接从所述假体的所述本体(2)突出并且与所述本体(2)成一体的孔眼(18)。
9.根据权利要求1所述的假体，其特征在于，所述本体具有二十面体等的形状。
CN201680016513.9A 2015-04-13 2016-04-07 用于拇指的大多角骨‑掌骨关节的假体 Pending CN107405203A (zh)

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