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CN1505496A - 带有旋转轴承的假肢膝部 - Google Patents

带有旋转轴承的假肢膝部 Download PDF

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Publication number
CN1505496A
CN1505496A CNA028088085A CN02808808A CN1505496A CN 1505496 A CN1505496 A CN 1505496A CN A028088085 A CNA028088085 A CN A028088085A CN 02808808 A CN02808808 A CN 02808808A CN 1505496 A CN1505496 A CN 1505496A
Authority
CN
China
Prior art keywords
middleware
projection
artificial limb
tibia
tibial component
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CNA028088085A
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English (en)
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CN1250178C (zh
Inventor
A
A·凯勒
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Waldemar Link GmbH and Co KG
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Waldemar Link GmbH and Co KG
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Publication of CN1505496A publication Critical patent/CN1505496A/zh
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30364—Rotation about the common longitudinal axis
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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

本发明涉及一种假肢膝部，它包括有一个股骨部件(1)、一个胫骨部件(3)和一个连接它们的中间件(10)，中间件与股骨部件(1)形成一个弯曲轴承(11)，并与胫骨部件(3)形成一个旋转轴承(14，15)，该旋转轴承相对于胫骨部件(3)可以锁止。为使医生在手术时以决定是否采用一种旋转自由的或者旋转固定的假肢，规定了这中间件(10)有选择地设有一个突起，该突起嵌入到胫骨部件(4)的一个适配的空隙里。

Description

带有旋转轴承的假肢膝部
采用假肢膝部的膝部韧带装置的维护状况越差，假肢所要求的内在稳定性就越高。若是一种稳定性较小的韧带装置，那可能需要使用一种型式的假肢，其中通过一个稳定的中间件使股骨部件和胫骨部件之间的相对运动限制于围绕一个水平横轴的弯曲运动和一个围绕基本上平行胫骨的轴的旋转运动(DE-C-2744710)。为此必须使韧带装置至少还能够控制这旋转运动。若这种能力也没有获得，那么这旋转运动就得排除在外了，而这假肢的自由度就局限于弯曲运动了。通常对于这两种使用情况应用了不同的假肢结构类型。如果手术中间才要决定：是否选一种旋转自由的或旋转固定的假肢，那么就可以应用一种其部件可以部分地可换的假肢系统(EP-B-539634)，其方法是有一种协调一致的股骨部件和各种不同的胫骨部件。最后也已经有人建议(DE-A-2636816)：对于这两种使用情况采用一种设计成旋转自由的假肢，其中可以装有一种定位夹紧装置，这种装置在希望的时候就排除了旋转运动。这是按如下进行的：在植入之后穿过骨头和旋转轴承打一个孔，在这孔里装入一个定位夹紧销钉，这个销钉就阻止了旋转轴承的转动。这很明显是不可行的。替代这种方法的是也可以使一个定位夹紧销钉只是在假肢内穿过一个旋转轴向轴承并阻止其旋转。该项建议是否曾经被实践加以考虑过并不了解。事实上有许多实际的困难。一种作用已经起到了，就是与一种只包含有一个弯曲活动关节的假肢相比较，应用一种附带设有一个施转轴承的假肢并接着将其止动住那就相对来说就化费多了。
尽管如此本发明仍努力要设计一种假肢，这种假肢可以允许在手术中旋转自由的和旋转固定的方案之间方便地作出决定，采用后者方案并通过权利要求1的特征而使其适合实践使用。根据此就使连接股骨部件与胫骨部件并与胫骨部件构成旋转轴承的中间件设有一个突起，它嵌入胫骨部件的一个适合的空隙中。
这种设想有利地通过以下方法来实现：假肢系统包括一个可选择插入的中间件(或者中间件的零件)，具有和没有突起，其中这种突起仍与中间件(或中间件的零件)连接。因而医生就可以在植入了股骨部件和胫骨部件之后通过另一种方案选择了具有突起的零部件来决定选用这一种或者另外一种假肢方案，而且必要时对这两种方案都试一下。替代这种方法的是也可以使这中间件(或它的零件)装设有一个连接装置用来有选择地与突起连接。
若这胫骨部件有一块支承板，板上至少有一个凹槽用以接纳一个胫骨高台，那么这个突起最好设计用来与这凹槽共同作用。由于这个凹槽设计成大腔室的，因而允许一个很稳定的旋转连接。此外可以在两种应用类型里应用没有任何变化的胫骨部件。在这种实施方案中这突起最好由一个适配于这凹槽的板构成，它在其中和/或以凹槽为界形成空缺用于设置一个胫骨高台的部分。
以下根据表示出有利的实施例的附图对本发明进行详细的叙述。所示为：
图1：假肢的一个背视图；
图2：具有中间件的胫骨部件的立体图；
图3：胫骨高台的立体俯视图；
图4：胫骨部件的支承板的立体视图；
图5：一个正常的胫骨高台的立体仰视图；
图6：一个正常中间件的立体图；
图7：一个阻止旋转的中间件的立体图；
图8：插入有阻碍旋转的中间件的胫骨部件的立体视图；
图9：一个应用在与阻碍旋转的中间件的连接中的胫骨高台的立体仰视图。
假肢具有一个股骨部件1，它有一个用于植入在人股骨里的芯棒2，还具有一个胫骨部件，它有一个用于植入在人胫骨里的芯棒4。股骨部件有翼状滑座5，它们放置在一个有利于滑动的胫骨高台6上，该高台由小腿部件的一个支承板7支承着。为使这两个部件相互保持稳定设有一个中间件10，它与大腿部件构成了一个在图1中用轴线11表示出的活动关节。在图2中可见一个伸出中间件10的对接轴端12，它与股骨部件1里的未示出的轴承孔共同作用。它置于中间件的一个孔13里。
另外这中间件10与胫骨部件构成一个旋转轴承，也就是说通过与中间件成一体连接的轴颈14，该轴颈支承在胫骨部件的一个轴承孔15里。轴承孔15基本上平行于通过芯棒4在假肢上可以辨识到的胫骨方向。中间件10因此使股骨部件和胫骨部件之的相对运动局限于围绕关节轴线11的弯曲运动和围绕旋转轴承14，15的轴线的旋转运动。中间件10还可以设有一个卡圈16，该卡圈与胫骨高台6的一个台阶17联合作用阻止了股骨部件从胫骨部件上发生不希望的抬起。
胫骨高台6例如由聚乙烯制成，而且其上面按已知的方式作成这样的形状，从而如果有旋转的话这股骨部件就相对于胫骨部件略有抬起，从而产生复位力，这个力就力图使它在传递负荷的作用下返回至中性的中间位置。
胫骨高台6由支承板7最好是整个面地支撑住。在底面上有一个马蹄形的突起20，其高度和轮廓尺寸都设计得适配于支承板7里的一个马蹄形凹槽。胫骨高台在支承板上的正确位置通过突起20和凹槽21的联合作用而得以保证。通过胫骨高台的一个螺钉孔2 2就可以借助于一个未表示出的螺钉和支承板里的一个螺纹孔23使之在装完的位置上固定住。支承板7上设有螺纹孔28，而制动板25在对应的位置上则设有螺钉孔29，这个孔允许制动板与胫骨部件刚性拧紧固定住。
正常结构形式的中间件为图6所示的结构。另一种可选择的方案可以使用图7所示的中间件10’，它与正常的中间件10的区别在于：它与一个制动板25刚性连接，其轮廓外形正好与支承板7里的凹槽21的相同。若中间件10’插入在胫骨部件3里，那么制动板25就基本上完全填满了这凹槽21。其表面与支承板7的包围住这凹槽21的边缘处于相同高度上。因而就得到一个整个都是平的用于支承胫骨高台6’的支承面。为了保证其在正确的位置上，设有突起20’，它们进入到正常的胫骨高台6的马蹄形突起20的位置上并设计成适配于制动板25里的缺口26。在装配完的状态下这些突起20’就正好卡入缺口26里，并因而确保了胫骨高台的位置。此外同样也可以象正常的胫骨高台那样借助一个螺钉穿过高台的孔22和制动板的一个孔27而固定在支承板7的螺纹孔23上。
制动板25在这样的高度上固定在中间件10’上，从而使得制动板25和中间件的活动关节轴线11’之间的距离正好等于活动关节轴线11的通过滑座5和高台6的高度所确定的位置。换句话说，由滑座5和高台6所确定的弯曲轴线11应该准确地与中间件10’的轴线11’协调一致。这样就应该确保了：大部分的负荷传递就继续通过在滑座5和胫骨高台6之间的大面积的接触而进行。若希望不通过中间件传递力，那么就使制动板25不是刚性地与中间件10’相连接，而是轴向可以滑动，但不可转动。这例如可以按如下方法实现：卡圈16设有孔，而且制动板25具有平行于轴颈4的销钉，这销钉穿过这些孔。制动板25则可以在轴向方面上相对于中间件10’滑动，但是通过销钉和孔与之连接不能旋转。
按本发明设计的假肢的其它细节问题可见本申请人同时申请的专利文件，其全权代理的档案号为：LIN0515PEP和LIN0516PEP。

Claims (5)

1.假肢膝部，它包括有一个股骨部件(1)，一个胫骨部件(3)和一个连接它们的中间件(10，10’)，这中间件与这股骨部件构成一个弯曲轴承(11)，而与胫骨部件(3)则构成一个旋转轴承(14，15)，这旋转轴承在一定条件下可以相对于胫骨部件(3)锁止，其特征在于，中间件(10’)可以选择设有一个突起(25)，它嵌入在胫骨部件的一个适配的空隙(25)里。
2.按权利要求1所述的假肢膝部，其特征在于，可选择插入的中间件(10，10’)设置具有或没有突起(25)，其中这突起与一个中间件(10’)保持连接。
3.按权利要求1所述的假肢膝部，其特征在于，中间件设置有一个用于可选择地与突起(25)相连接的连接装置。
4.按权利要求1至3中任意一项所述的假肢膝部，其特征在于，胫骨部件(3)有一个支承板(7)，该板至少有一个凹槽(25)用于安放一个胫骨高台(6)或这高台的部件，而且这突起(25)与这凹槽(21)联合作用。
5.按权利要求4所述的假肢膝部，其特征在于，突起(25)由一个配合入凹槽(21)里的板构成，这个板在其中和/或与凹槽(21)的分界形成了空缺(26)用于安放一个胫骨高台(6’)的部件(20’)。
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