Background
Fractures are classified according to the shape of the fracture line: fracture, infraperiosteal fracture, brachial fracture, lacerated fracture, transverse fracture, oblique fracture, spiral fracture, comminuted fracture (fracture pieces broken into three or more pieces called comminuted fracture), impaction fracture, depressed fracture, and compression fracture.
Compression fractures are one type of bone fracture. In the compressive fracture, the vertebral column vertebral body compression fracture is the most common fracture of human body, especially is commonly seen in the old people with osteoporosis. The domestic epidemiological research in 2017 shows that the prevalence rate of vertebral compression fracture of Beijing postmenopausal women increases with age, the prevalence rate is 13.4% at 50-59 years and is as high as 58.1% above 80 years.
The number of new vertebral body compression fracture cases is 127 ten thousand for people over 50 years old in 2015 in China; it is expected that 149 million cases will be reached by 2020; in 2050, 300 ten thousand cases can be obtained. For the compression fracture of vertebral body with unsatisfactory conservative treatment, minimally invasive vertebral body strengthening operation, especially kyphoplasty by using a balloon is the most commonly used effective treatment method.
When compression fracture occurs, the fracture time is more than 2-3 weeks, hardening of fracture ends and scar granulation tissue filling often occur in sub-fresh or old fractured bones, and then delayed healing or even no healing occurs. For delayed union or nonunion of a fracture, the most important treatment is to remove hardened scars and stale tissue at the fracture end, i.e., to freshen the fracture end, before the fresh bone tissue has the condition and space to grow well.
When the balloon kyphoplasty is clinically carried out, the fracture end cannot be directly exposed due to minimally invasive percutaneous surgery, the existing balloons are smooth surfaces, the hardened scar tissues cannot be directly removed, instruments such as a special curette have small action range and insufficient torsion force, and have risks such as instrument fracture, the clinical application is few and the risks are uncontrollable.
Therefore, for the very common delayed or nonunion of compression fracture, an effective means for the fracture end freshening is not available at present to achieve a good treatment effect, and the perfusion of bone cement cannot provide a complete basis for the regeneration of bone tissues. Therefore, when fracture occurs in the bone bodies of vertebrae, thighbones, shinbones, humerus and the like which can be subjected to interventional therapy by adopting the orthopedic balloon, old tissues need to be debrided so as to provide a foundation for bone repair and open a road.
SUMMERY OF THE UTILITY MODEL
The problem to unable "debridement" in the bone, the utility model provides a take orthopedics sacculus and orthopedics sacculus equipment of spinous process can solve the technical problem that can't carry out fracture end freshness among the prior art.
In order to solve the problem, the utility model provides a take orthopedics sacculus and orthopedics sacculus equipment of spinous process, its technical scheme as follows:
an orthopedic balloon with spinous processes, comprising: the spinous process is located on the outer surface of the balloon base body, the balloon base body is used for expanding a cavity in a bone, and the spinous process is used for grinding and/or cutting the surface of the cavity when the balloon base body is expanded, so that hardened scars and stale tissues at a fracture end are removed, and the fracture end is freshened.
The orthopedic balloon with spinous process as described above is further preferably: the sacculus basal body is any one of dumbbell type, ellipsoid type, calabash type or cylinder-like type after being expanded.
The orthopedic balloon with spinous process as described above is further preferably: the spinous process is a granular bulge or a cutting tool.
The orthopedic balloon with spinous process as described above is further preferably: the spinous processes are made of inorganic and/or organic materials.
The orthopedic balloon with spinous process as described above is further preferably: the inorganic material is selected from any one of alloy, single metal and ceramic.
The orthopedic balloon with spinous process as described above is further preferably: the organic material is engineering plastic.
An orthopedic balloon apparatus with spinous processes, comprising: the orthopedic balloon with the spinous process comprises an outer tube, a delivery tube and any one of the orthopedic balloons with the spinous process; the outer pipe is in a hollow pipe shape and is inserted into and fixed at the fracture end; the conveying pipe is matched with the outer pipe through any one of transition fit, clearance fit, threaded connection and guide rail connection, a central hole is formed in the axial direction of the conveying pipe, and the axis of the central hole is overlapped with the axis of the conveying pipe; the sacculus base member is installed through arbitrary one kind mode of bonding, butt fusion, joint on the conveyer pipe, and with the centre bore of conveyer pipe communicates with each other for expand the cavity in the bone, sacculus base member surface is equipped with the spinous process, the spinous process is used for grinding and/or cutting when the sacculus base member inflation the surface of cavity gets rid of the sclerosis scar and the not fresh tissue of fracture end, realizes the freshness of fracture end.
The spinous process-bearing orthopedic balloon device as described above is further preferably: the driving end is connected with the conveying pipe and provides power for the conveying pipe through manpower or electric power and is used for driving the conveying pipe to rotate and/or axially move and/or radially vibrate.
The spinous process-bearing orthopedic balloon device as described above is further preferably: the power source of the driving end is any one or the combination of an ultrasonic generator, a motor and manpower.
The spinous process-bearing orthopedic balloon device as described above is further preferably: the tail of the conveying pipe is provided with a matching part, and the matching part is movably connected or fixedly connected with the driving end through any one of gear connection, threaded connection and interference fit.
The spinous process-bearing orthopedic balloon device as described above is further preferably: the matching part is provided with a valve which is used for controlling the circulation of liquid in the balloon matrix.
The spinous process-bearing orthopedic balloon device as described above is further preferably: the outer tube is provided with a fixing part and a display part, the fixing part is provided with threads and/or a clamping groove and is fixedly connected with the bone body to fix the mounting position of the outer tube; the display part is provided with a developing material coating, the developing material is any one of gold, tungsten and platinum-iridium alloy, and the display part is used for displaying the position of the outer tube inserted into the fracture end.
The spinous process-bearing orthopedic balloon device as described above is further preferably: the balloon base body is characterized by further comprising a pilot wire, wherein the pilot wire is inserted into the conveying pipe, is in clearance fit or transition fit with the conveying pipe and is used for pilot positioning of the balloon base body.
The analysis can know, compare with prior art, the utility model discloses an advantage and beneficial effect lie in:
the outer tube of the utility model is inserted and fixed at the fracture end to provide a passage for the conveying tube and the balloon matrix to enter the fracture end; the balloon matrix is fixedly connected with the head of the conveying pipe, and the outer surface of the balloon matrix is provided with spinous processes; conveyer pipe and outer tube sliding connection, conveyer pipe take place the motion under the exogenic action to can drive the sacculus base member and take place relative slip with the cavity in the bone, make the spinous process on sacculus base member surface take place the friction with the cavity, thereby sclerosis scar and the not fresh tissue in the grinding and/or the cutting cavity realize the freshness of fracture end. The conveying pipe can rotate, axially float, radially vibrate and axially vibrate under the action of external force. When the conveying pipe rotates, the balloon base body rotates by taking the axis of the conveying pipe as a center; when the conveying pipe axially moves, the balloon base body reciprocates along the axial direction of the conveying pipe; when the conveying pipe generates radial vibration and/or axial vibration under the action of external force, the conveying pipe can drive the balloon base body to resonate, so that the spinous process can clear hardened scars and stale tissues in the cavity, the freshness of the fracture end is realized, the conveying pipe can be used in a bone body which can be subjected to interventional therapy by adopting the orthopedic balloon, and conditions and spaces can be provided for the good growth of the fresh bone tissues.
Detailed Description
The technical solutions in the embodiments of the present invention will be described clearly and completely with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative work belong to the protection scope of the present invention.
In the description of the present invention, the terms "longitudinal", "lateral", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of description of the present invention and do not require that the present invention must be constructed and operated in a particular orientation, and therefore, should not be construed as limiting the present invention.
The terms "connected" and "connected" used in the present invention should be understood in a broad sense, and may be, for example, either fixed or detachable; they may be directly connected or indirectly connected through intermediate members, and specific meanings of the above terms will be understood by those skilled in the art as appropriate.
Referring to fig. 1 to 9, fig. 1 is a schematic view of a connection structure of an orthopedic balloon device with spinous processes according to the present invention; fig. 2 is a schematic structural view of the orthopedic balloon with spinous process of the present invention; fig. 3 is a schematic structural view of the orthopedic balloon with spinous process of the present invention; FIG. 4 is a schematic connection diagram of an orthopedic balloon device with spinous processes with a motor as a power source; FIG. 5 is a schematic connection diagram of an orthopedic balloon apparatus with spinous processes with a manual power source; fig. 6 is a schematic structural diagram of an outer tube of an orthopedic balloon apparatus with spinous processes; FIG. 7 is a first schematic view of the balloon body of the orthopedic balloon with spinous processes in cooperation with the spinous processes; FIG. 8 is a second schematic view of the balloon body of the orthopedic balloon with spinous processes in cooperation with the spinous processes; FIG. 9 is a schematic view of the alignment wire and the delivery tube.
As shown in fig. 1 to 3, the utility model provides an orthopedic balloon device with spinous process, which mainly comprises an outer tube 4, a delivery tube 3, a balloon base body 2 and spinous process 21; the outer tube 4 is in a hollow tubular shape, and the outer tube 4 is inserted into and fixed at the fracture end; the conveying pipe 3 is matched with the outer pipe 4 through any one of transition fit, clearance fit, threaded connection and guide rail connection, so that the conveying pipe 3 is inserted into the outer pipe 4 to realize the movable connection of the conveying pipe 3 and the outer pipe 4, a central hole is formed in the axial direction of the conveying pipe 3, and the axis of the central hole is overlapped with the axis of the conveying pipe 3; the sacculus base member 2 is arranged on the conveying pipe 3 in any one of bonding, welding and clamping modes, is communicated with a central hole of the conveying pipe 3 and is used for swelling a cavity in a bone, the spinous process 21 is positioned on the outer surface of the sacculus base member 2, and the spinous process 21 is used for grinding and/or cutting the surface of the cavity when the sacculus base member 2 is swelled, so that hardened scars and stale tissues at a fracture end are removed, and the fracture end is freshened.
Particularly, the outer tube 4 of the utility model is inserted and fixed at the fracture end to provide a channel for the conveying tube 3 and the balloon matrix 2 to enter the fracture end; the balloon base body 2 is fixedly connected to the head of the conveying pipe 3 (two ends of the balloon base body 2 are fixedly connected to the conveying pipe 3, one end of the balloon base body 2 is 1-5 mm away from the end of the conveying pipe 3, so that the balloon base body 2 can be conveyed into a bone conveniently, the balloon base body 2 radially contracts and expands on the conveying pipe 3, when the balloon base body 2 expands, the axis of the balloon base body 2 is overlapped with the axis of the conveying pipe 3), the balloon base body 2 is communicated with the central hole of the conveying pipe 3, the tail of the conveying pipe 3 is connected with the injection device 5, the injection device 5 injects liquid into the conveying pipe 3, so that the balloon base body 2 expands to form a cavity in the bone, and the liquid is selected from solutions such as developer; the spinous process 21 on the outer surface of the balloon base body 2 is fixed on the outer surface of the balloon base body 2 in a bonding and/or welding mode, and can also be integrally formed with the balloon base body 2; conveyer pipe 3 and 4 sliding connection of outer tube adopt transition fit or clearance fit to realize the cooperation, and conveyer pipe 3 takes place the motion under the exogenic action to can drive sacculus base member 2 and the relative slip takes place for the spinous process 21 on sacculus base member 2 surface takes place the friction with the cavity, thereby the sclerosis scar and the not fresh tissue in grinding and/or the cutting cavity realize the freshness of fracture end. Specifically, the conveying pipe 3 can rotate (rotate along the axis of the conveying pipe) under the action of external force, and can axially float, vibrate in the radial direction and vibrate in the axial direction. When the delivery pipe 3 rotates, the balloon base body 2 rotates along the axis of the delivery pipe 3, and the spinous process 21 cuts and scrapes the surface of the cavity, so that hardened scars and stale tissues in the cavity can be cleared; when the conveying pipe 3 axially moves, the balloon base body 2 reciprocates along the axial direction of the conveying pipe 3, and the spinous process 21 cuts and scrapes the surface of the cavity, so that hardened scars and stale tissues in the cavity can be removed; when the conveying pipe 3 generates radial vibration and/or axial vibration under the action of external force, the balloon base body 2 can be driven to resonate, so that the spinous process 21 can remove hardened scars and stale tissues in the cavity, the freshness of the fractured end is realized, the orthopedic balloon can be used in bone bodies (such as vertebra, femur, tibia and humerus) which can be subjected to interventional therapy by adopting the orthopedic balloon, and conditions and spaces can be provided for the good growth of new bone tissues.
Meanwhile, as shown in fig. 2 and 3, the utility model also provides an orthopedic balloon with spinous process, which comprises a balloon base body 2 and a spinous process 21, wherein the spinous process 21 is located on the outer surface of the balloon base body 2. The utility model discloses a take orthopedics sacculus of spinous process can assemble and use on current orthopedics equipment, and when using, sacculus base member 2 is used for the cavity that expands in the bone, and spinous process 21 is used for grinding and/or the surface of cutting the cavity when sacculus base member 2 expands, gets rid of the sclerosis scar and the not fresh tissue of fracture end, realizes the freshness of fracture end, provides condition and space for the good growth of new bone tissue.
As an improvement to the present invention, as shown in fig. 1 to 9, the present invention further provides the following improvement:
as shown in fig. 1, fig. 4 and fig. 5, the present invention further includes a driving end 6, the driving end 6 is connected to the conveying pipe 3, and the driving end 6 provides power for the conveying pipe 3 through manpower or electric power, so as to drive the conveying pipe 3 to rotate and/or axially move and/or radially vibrate. Further, the power source of the driving end 6 is any one or a combination of an ultrasonic generator, a motor 61 and manpower, and an air cylinder and a hydraulic cylinder can also be adopted. When realizing being connected of conveyer pipe 3 and power supply, the tail end of conveyer pipe 3 is equipped with cooperation portion, and cooperation portion passes through any one of gear connection, threaded connection, interference fit and drive end 6 swing joint or fixed connection. Specifically, when the power source is manual power, the driving end 6 is a handle and is fixedly connected with a matching part at the tail end of the conveying pipe 3 (in threaded connection, interference fit and clamping connection), the handle enables the conveying pipe 3 to rotate and/or move under the action of the manual power, and scales are arranged on the handle for marking the movement amplitude; when the power source is the motor 61, the motor 61 can be movably connected with the matching part at the tail end of the conveying pipe 3 through gear connection, at the moment, the axis of a rotating shaft of the motor 61 can be overlapped or not overlapped with the axis of the conveying pipe 3, the motor 61 can also realize coaxial connection of the axis of the rotating shaft and the axis of the conveying pipe 3 through the coupler 62 and a clamping means, when the motor 61 is used as the power source, the moving mode of the balloon base body 2 is rotation around the axis of the conveying pipe 3 as a rotation center, preferably, the motor 61 is a speed regulating motor, and the speed can be regulated; when the power source is an ultrasonic generator, the ultrasonic generator is fixedly connected with the conveying pipe 3, the connection modes can be divided into three modes, wherein the axial direction of the conveying pipe 3 is parallel to the vibration direction of the ultrasonic generator, the balloon matrix 2 generates high-frequency vibration along the axial direction of the conveying pipe 3 under the action of the ultrasonic generator, the axial direction of the conveying pipe 3 is perpendicular to the vibration direction of the ultrasonic generator, the balloon matrix 2 generates high-frequency vibration along the radial direction of the conveying pipe 3 under the action of the ultrasonic generator, the included angle between the axial direction of the conveying pipe 3 and the vibration direction of the ultrasonic generator is an acute angle, and the balloon matrix 2 performs high-frequency vibration along the vibration direction under the action of the ultrasonic generator; when the power supply is the cylinder or pneumatic cylinder, the flexible direction of power supply is parallel with the axis direction of conveyer pipe 3, and sacculus base member 2 is along the axis direction swing of conveyer pipe 3 under the drive of conveyer pipe 3.
As shown in fig. 1, in order to control the liquid amount in the sacculus base member 2, guarantee the inflation volume of sacculus base member 2, the utility model discloses a cooperation portion of conveyer pipe 3 is equipped with the valve, and the valve is used for controlling the circulation of liquid in the sacculus base member 2, can guarantee that the volume of sacculus base member 2 is unchangeable when sacculus base member 2 moves.
As shown in fig. 1 and fig. 6, the outer tube 4 of the present invention is provided with a fixing portion 41 and a display portion 42, the fixing portion 41 is provided with threads and/or a slot to realize a relative fixed connection with the shaft, and fix the mounting position of the outer tube 4 to ensure that the outer tube 4 and the shaft do not displace; display portion 42 is equipped with the development material cladding material, and the development material is gold, tungsten, platinum iridium alloy's arbitrary one, and display portion 42 is used for showing the position that outer tube 4 inserted the fracture end, marks for the operation provides, and is further, the utility model discloses an outer tube 4 also can adopt with the utility model discloses a bone cement screw of sacculus base member 2, conveyer pipe 3 adaptation, here adaptation indicate that bone cement screw can realize the utility model discloses a function of outer tube 4, and the internal diameter is not less than conveyer pipe 3 external diameters.
As shown in fig. 1 and fig. 9, the utility model discloses still including leading positive silk 1, leading positive silk 1 alternates in conveyer pipe 3, with conveyer pipe 3 clearance fit or transition fit, conveyer pipe 3 is bilayer structure, and the centre bore is divided into mating holes 32 and liquid circulation hole 31, mating holes 32 with lead positive silk 1 clearance fit or transition fit, liquid circulation hole 31 communicates with each other with sacculus base member 2 for the circulation liquid. The utility model discloses a lead 1 positions of just being used for leading sacculus base member 2, guarantees that 2 initial positions of sacculus base member inflation are located conveyer pipe 3 axis direction, the resistance that sacculus base member 2 received when reducing the motion after the inflation to provide certain holding power when 2 motions of sacculus base member.
As shown in fig. 1 to 3, in order to ensure that the balloon base body 2 is uniformly expanded in the radial direction of the delivery pipe 3, the balloon base body 2 is expanded to be any one of a dumbbell shape, an ellipsoid shape, a gourd shape or a cylinder-like shape, and the circumferential stress is balanced in the expansion process and after the expansion.
As shown in fig. 1, 2, 3, 7 and 8, the spinous process 21 of the present invention is a granular protrusion or a cutting tool. Further, the spinous process 21 is made of an inorganic material selected from any one of an alloy, a single metal, and a ceramic, and/or an organic material; the organic material is engineering plastic. Specifically, when the spinous process 21 is a granular protrusion, as shown in fig. 2 and 7, the granular protrusions are regularly arranged on the surface of the balloon base 2, specifically, the granular protrusions may be arranged in aligned rows and columns, or in irregular rows and columns, and further, the granular protrusions may be regular-shaped protrusions or irregular-shaped protrusions. As shown in fig. 2 and 8, when the spinous process 21 is a cutting tool, the cutting tool may have a disk shape, a shuttle shape, or an irregular shape, and the projection of the contour of the cutting tool in the axial direction of the delivery tube 3 is preferably able to cover the surface of the balloon base body 2, so that the purpose of cutting without dead angle can be achieved. When the spinous process 21 is a granular protrusion, the material of the spinous process 21 can be the same as that of the balloon base body 2, and the balloon base body 2 and the spinous process 21 are integrally formed; the spinous process 21 may also be made of a material different from that of the balloon base 2, and at this time, the spinous process 21 may be made of an inorganic material and/or an organic material, and fixed on the surface of the balloon base 2 by means of hot melting and adhesion, or may be added into the balloon base 2 as an additive when the balloon base 2 is processed and molded, so as to achieve the engagement between the spinous process 21 and the surface of the balloon base 2, and the molding may be performed by a mold, which is preferable in terms of process means, specifically, as shown in fig. 7, the volume of the engagement between the spinous process 21 and the balloon base 2 is greater than the volume of the spinous process 21 exposed on the balloon base 2, so as to ensure that the spinous process. Correspondingly, when the spinous process 21 is a cutting tool, the material of the spinous process 21 may be an inorganic material and/or an organic material, or may be integrally formed with the balloon base body 2, and when the spinous process 21 is integrally formed, the angle of the cutting tool is a right angle or an acute angle, so as to ensure the sharpness of the cutting tool. When the cutting tools are arranged, the resistance force of the balloon substrate 2 during conveying in the outer tube 4 and the cavity is small, for example, when the cutting tools are in a shuttle shape, the connecting line of the sharp corners at two ends of the shuttle shape is parallel to the axis of the conveying tube 3.
As shown in fig. 1 to fig. 9, the following will be taken as an example to treat the compression fracture of vertebral body of spine, and the working process of the present invention will be explained in detail:
the method comprises the following steps: puncturing cortical bone, and enabling the outer tube 4 to enter a proper position of a vertebral fracture end of the spine and be fixed;
step two: the conveying pipe 3 drives the balloon matrix 2 to enter the fracture end, the pilot wire 1 is inserted, and the position of the balloon matrix 2 is adjusted;
step three: the delivery pipe 3 is connected with the injection device 5, the injection device 5 injects liquid into the balloon base body 2, the balloon base body 2 is inflated by the liquid, a cavity is expanded in the spinal vertebral body, the valve is closed after the preset size is reached, and the injection device 5 is detached from the delivery pipe 3 (the injection device 5 can be detached according to the actual motion state of the delivery pipe 3, and the injection device 5 does not influence the motion of the delivery pipe 3 preferably);
step four: the matching part of the conveying pipe 3 is connected with the driving end 6, the driving end 6 drives the balloon base body 2 to move, and the spinous process 21 removes hardened scars and non-fresh tissues at the fracture end at the moment, so that the fracture end is freshened;
step five: connecting the delivery tube 3 and the injection device 5, opening the valve, pumping out the liquid in the balloon base body 2, shrinking the balloon base body 2 (when the balloon base body 2 shrinks, the hardness of the spinous process 21 is larger than that of the balloon base body 2, so that the part of the balloon base body 2 fixedly connected with the spinous process 21 does not shrink, and the part of the balloon base body 2 without the spinous process 21 deforms and collapses), and pumping out the delivery tube 3 and the balloon base body 2 from the outer tube 4;
step six: the outer tube 4 is connected with a bone cement injector, the bone cement is injected into the cavity which is fresh through the outer tube 4, and the outer tube 4 is taken out after the bone cement is solidified.
It will be appreciated by those skilled in the art that the invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The embodiments disclosed above are therefore to be considered in all respects as illustrative and not restrictive. All changes which come within the scope of the invention or which are equivalent to the scope of the invention are embraced by the invention.