A temporary prosthesis device capable of extending beyond the limit and a method of use thereof

Abstract

The present application relates to the technical field of medical devices, and more specifically, to a temporary prosthesis device that can be extended beyond the limit and a method of use. The temporary prosthesis device that can be extended beyond the limit includes: an intramedullary nail, a medullary nail sleeve, and a temporary prosthesis, wherein the intramedullary nail is inserted into the femur, the medullary nail sleeve is sleeved on the outside of the intramedullary nail, the temporary prosthesis can slide up and down relative to the medullary nail sleeve, and the intramedullary nail can slide up and down relative to the medullary nail sleeve, and the temporary prosthesis is arranged between the femur and the tibia. The present invention can extend the distance between the femur and the tibia for a second time, solving the problem that the temporary prosthesis still has a shortage of extension distance after reaching the extension limit, and effectively adjusting the unpredictable unequal length of the limbs caused by the growth and development of children with malignant bone tumors after retaining their limbs.

Description

Technical Field

[0001] The present application relates to the technical field of medical devices, and in particular to a temporary prosthesis device capable of being extended beyond a certain limit and a method of using the same. Background Art

[0002] Children with limb bone tumors undergo artificial joint replacement surgery many years after surgery. As the children grow, their height and bones grow, resulting in unequal lengths of limbs, especially healthy limbs and affected limbs.

[0003] In the past, there were three main solutions for limb length inequality. The first was amputation; the second was replacement with an extendable artificial prosthesis. The replaced prosthesis was mechanically extended by 1 to 2 cm each year after the wound was opened. It could not be extended to the point in one go and required multiple surgeries. The third method required at least three surgeries. The first surgery was to remove the original prosthesis and insert a temporary bone cement prosthesis, while placing an external extension fixator. The second surgery was to extend the external fixator, remove the original temporary prosthesis (short), and then insert a temporary bone cement prosthesis (long). After 3 to 6 months, when it was confirmed that there was no infection in the external fixator in the limb nail channel, the temporary prosthesis was replaced with an artificial prosthesis to complete the revision surgery.

[0004] As the most effective treatment option, in the third method of extendable temporary prosthesis, when the extracorporeal fixator traction reaches the same length as the healthy limb or reaches the expected normal development length, the length that the extendable temporary prosthesis can extend is prone to be insufficient. For example, the child who had a distal femoral prosthesis made when he was 4 years old is now 10 years old, 140cm tall, and has a limb length discrepancy of 130mm. The extendable temporary prosthesis can meet the current 130mm gap, but as the child grows taller, to 170cm, it will cause new limb length discrepancy, and its length is unpredictable. Summary of the invention

[0005] The purpose of the present application is to provide a temporary prosthesis device that can be extended beyond the limit and a method of use, which can achieve secondary extension of the temporary prosthesis, ensure that the extended length of the temporary prosthesis meets the actual needs of the child's growth and development, and realize the extension and filling of unknown unequal limb lengths of individual children after they grow taller.

[0006] In order to achieve the above-mentioned objectives, in a first aspect, the present invention provides a temporary prosthesis device that can be extended beyond the limit, comprising: an intramedullary nail, a medullary nail sleeve and a temporary prosthesis, wherein the intramedullary nail is inserted into the femur, the medullary nail sleeve is sleeved on the outside of the intramedullary nail, the temporary prosthesis can slide up and down relative to the medullary nail sleeve and the intramedullary nail can slide up and down relative to the medullary nail sleeve, and the temporary prosthesis is arranged between the femur and the tibia.

[0007] In an optional embodiment, the proximal end of the intramedullary nail sleeve is provided with an annular sleeve boss, the sleeve boss is arranged on the upper part of the temporary prosthesis, and at least a portion of the intramedullary nail extends upward from the sleeve boss and is inserted into the distal end of the femur.

[0008] In an optional embodiment, at least a portion of the distal end of the medullary nail sleeve is inserted into the temporary prosthesis, and a sliding rail and a sliding groove that cooperate with each other are provided between the temporary prosthesis and the medullary nail sleeve.

[0009] In an optional embodiment, the distal end of the medullary nail sleeve and the proximal end of the temporary prosthesis are respectively provided with a sleeve connection hole and a prosthesis connection hole, so as to enable the temporary prosthesis extended into place to be fixedly connected to the medullary nail sleeve.

[0010] In an optional embodiment, the sleeve boss and the intramedullary nail are respectively provided with a boss connecting hole and an intramedullary nail connecting hole, which are used to fix the medullary nail sleeve to the intramedullary nail during the lengthening process of the temporary prosthesis and after the medullary nail sleeve is extended into place.

[0011] In an optional embodiment, the intramedullary nail connection holes respectively include a middle connection hole located in the middle part of the intramedullary nail, and a distal connection hole located in the distal part of the intramedullary nail;

[0012] During the lengthening process of the temporary prosthesis, the intramedullary nail sleeve is fixedly connected to the intramedullary nail by screws inserted into the boss connection hole and the middle connection hole at the same time;

[0013] After the medullary nail sleeve is extended to the right position, the medullary nail sleeve is fixedly connected to the intramedullary nail by screws that are simultaneously inserted into the boss connecting hole and the distal connecting hole.

[0014] In an optional embodiment, it further comprises a support block for fixing the temporary prosthesis and the medullary nail sleeve after they are extended into place;

[0015] The support block comprises a lower support block abutting between the sleeve boss and the temporary prosthesis after the temporary prosthesis is extended to a position, and an upper support block abutting between the sleeve boss and the distal end of the femur after the medullary nail sleeve is extended to a position.

[0016] In an optional embodiment, the intramedullary nail is fixed to the femur by an extracorporeal fixator, the extracorporeal fixator is connected with a femoral fixation nail for fixing the intramedullary nail, and a tibial fixation nail for fixing the tibia, a sliding frame capable of adjusting and extending the distance between the femur and the tibia is provided between the femoral fixation nail and the tibial fixation nail, and a fixing hole for inserting the femoral fixation nail is provided at the proximal end of the intramedullary nail.

[0017] In an optional embodiment, the temporary prosthesis is movably connected to the tibia via a hinge assembly;

[0018] The hinge assembly comprises a hinge block and an insert block of an integral structure. The hinge block is connected to the distal end of the temporary prosthesis through a hinge shaft, and the insert block is inserted into the proximal end of the tibia.

[0019] In a second aspect, the present invention provides a method for using the temporary prosthetic device capable of being extended beyond a certain limit according to any one of the aforementioned embodiments, comprising the following steps:

[0020] An intramedullary nail is implanted in the femoral medullary cavity, and a temporary prosthesis is slidably connected to the distal end of the intramedullary nail sleeve;

[0021] The proximal end of the intramedullary nail is fixed to the femur through an external fixator, and the distal end of the tibia is fixed. At the same time, the intramedullary nail sleeve is fixedly connected to the intramedullary nail, and the distance between the femur and the tibia is adjusted to extend and move the temporary prosthesis downward.

[0022] After the temporary prosthesis is extended to its proper position, if the expected extension length exceeds the length that the temporary prosthesis can extend, the proximal end of the temporary prosthesis is fixedly connected to the distal end of the intramedullary nail sleeve, and the fixation of the intramedullary nail sleeve to the intramedullary nail is released, and the distance between the extended femur and tibia is adjusted so that the intramedullary nail sleeve is extended and moved downward to the expected extension length;

[0023] After the medullary nail sleeve is extended to the right position, the medullary nail sleeve is fixedly connected to the intramedullary nail, and the external fixation frame is removed, so that the patient can perform rehabilitation training in a state where the knee joint can be flexed and extended;

[0024] After 3 to 6 months, when it is confirmed that there is no infection in the nail channel of the external fixator in the limb, the extended temporary prosthesis is replaced and the artificial joint revision surgery is completed.

[0025] Through the above technical solution, the distance between the femur and the tibia can be extended for a second time, solving the problem of insufficient extension distance of the temporary prosthesis after reaching the maximum extension length, and effectively adjusting the unpredictable limb length inequality caused by growth and development after limb retention in children with malignant bone tumors.

[0026] Other features and advantages of the present application will be described in detail in the subsequent detailed description. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings required for use in the embodiments will be briefly introduced below. It should be understood that the following drawings only show certain embodiments of the present application and therefore should not be regarded as limiting the scope. For ordinary technicians in this field, other related drawings can be obtained based on these drawings without paying creative work.

[0028] Figure 1 It is a schematic diagram of the structure of the temporary prosthesis device capable of being extended beyond the limit in this application;

[0029] Figure 2 It is a schematic diagram of the structure of the medullary needle sleeve in this application;

[0030] Figure 3 It is a schematic diagram of the side view structure of the temporary prosthesis in this application;

[0031] Figure 4 It is a schematic diagram of the structure of the in vitro fixation frame in this application;

[0032] Figure 5 A top view of the matching relationship between the temporary prosthesis and the medullary nail sleeve in this application;

[0033] Figure 6 This is a schematic diagram of the position of the temporary prosthesis after one extension in this application;

[0034] Figure 7 This is a schematic diagram of the position of the medullary nail sleeve after secondary extension in this application;

[0035] Figure 8 This is a schematic diagram of the main structure of the hinge block and the plug-in block in this application;

[0036] Fig. 9 It is a side view structural diagram of the hinge block and the plug-in block in this application.

[0037] icon:

[0038] 1- intramedullary nail; 11- fixation hole; 12- intramedullary nail connection hole; 13- middle connection hole; 14- distal connection hole;

[0039] 2-temporary prosthesis; 21-slot; 22-prosthesis connection hole;

[0040] 3- hinge assembly; 31- hinge block; 32- hinge shaft; 33- hinge hole; 34- plug-in block;

[0041] 4-extracorporeal fixation frame; 41-femoral fixation nail; 42-tibia fixation nail; 43-sliding frame;

[0042] 5-support block; 51-lower support block; 52-upper support block;

[0043] 6-medullary nail sleeve; 61-sleeve boss; 62-sleeve connecting hole; 63-boss connecting hole; 64-slide rail; 10-femur; 20-tibia. DETAILED DESCRIPTION

[0044] In order to make the purpose, technical scheme and advantages of the embodiments of the present application clearer, the technical scheme in the embodiments of the present application will be clearly and completely described below in conjunction with the drawings in the embodiments of the present application. Obviously, the described embodiments are part of the embodiments of the present application, rather than all of the embodiments. The components of the embodiments of the present application described and shown in the drawings here can be arranged and designed in various different configurations.

[0045] In the description of this application, it should be noted that the terms "inside", "outside", etc. indicate the orientation or positional relationship based on the orientation or positional relationship shown in the drawings, or the orientation or positional relationship in which the product of the application is usually placed when in use, which is only for the convenience of describing this application and simplifying the description, and does not indicate or imply that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on this application. In addition, the terms "first", "second", etc. are only used to distinguish the description, and cannot be understood as indicating or implying relative importance.

[0046] In the description of this application, it should also be noted that, unless otherwise clearly specified and limited, the terms "disposed" and "connected" should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a direct connection, or an indirect connection through an intermediate medium, or it can be the internal communication of two elements. For ordinary technicians in this field, the specific meanings of the above terms in this application can be understood according to specific circumstances.

[0047] See also Figure 1-Figure 5 The temporary prosthesis device that can be extended beyond the limit in this application is mainly used to solve the problem of unequal length of limbs caused by children's bone growth after artificial joint replacement surgery.

[0048] After the conventional excision of limb bone tumors, especially after artificial joint replacement between the femur 10 and the tibia 20, the artificial joint fixed between the femur 10 and the tibia 20 does not change in length and cannot lengthen with the growth of the child's bones, resulting in unequal lengths between the affected limb and the healthy limb.

[0049] During the extension and replacement of the existing temporary prosthesis 2, as the child grows and develops, the maximum extension length of the temporary prosthesis 2 is easily insufficient. In addition, as the growth and development of different individual children are uncertain, the limb length inequality caused by the transition from infancy to adolescence is unpredictable. Therefore, simply relying on the extension of the temporary prosthesis 2 cannot fundamentally solve the problem of limb length inequality.

[0050] In the present application, by introducing the intramedullary nail 1 and the medullary nail sleeve 6, the secondary extension of the temporary prosthesis 2 can be facilitated, so that after the temporary prosthesis 2 is extended once relative to the medullary nail sleeve 6, it can be extended a second time relative to the intramedullary nail 1 through the medullary nail sleeve 6, thereby achieving the filling of unpredictable limb inequality.

[0051] The temporary prosthesis device capable of over-limit extension provided by the present invention has a main structure comprising an intramedullary nail 1, a medullary nail sleeve 6 and a temporary prosthesis 2 which are arranged in sequence from top to bottom. The intramedullary nail 1 is inserted and fixed on the femur 10, the medullary nail sleeve 6 is sleeved on the outside of the intramedullary nail, the temporary prosthesis 2 can slide up and down relative to the medullary nail sleeve 6, and the intramedullary nail 1 can slide up and down relative to the medullary nail sleeve 6, and the temporary prosthesis 2 is arranged between the femur 10 and the tibia 20.

[0052] By means of the intramedullary nail 1, the medullary nail sleeve 6 and the temporary prosthesis 2 connected in sequence from top to bottom and in combination with the relative sliding between the two, a segmented structure similar to a pull rod is formed, which enables the temporary prosthesis 2 to slide downward relative to the medullary nail sleeve 6 for a primary extension, and enables the medullary nail cylinder to slide downward relative to the intramedullary nail 1 for a secondary extension, thereby effectively achieving an over-limit extension of the temporary prosthesis 2 and making up for the deficiency of the temporary prosthesis 2 still having an unequal length extension after the primary extension.

[0053] Combination Figure 6-Figure 7 When the temporary prosthesis 2 is extended once, the intramedullary nail 1 and the intramedullary nail sleeve 6 are in a fixed connection relationship, so that the temporary prosthesis 2 slides downward relative to the overall structure composed of the intramedullary nail cylinder and the intramedullary nail 1.

[0054] When the temporary prosthesis 2 is extended for the second time, since the extension has already been performed, the distal end of the intramedullary nail sleeve 6 is fixedly connected to the proximal end of the temporary prosthesis 2, and the fixed connection between the intramedullary nail 1 and the intramedullary nail sleeve 6 is released, so that the overall structure composed of the intramedullary nail sleeve 6 and the temporary prosthesis 2 slides downward.

[0055] Through the above-mentioned secondary lengthening process, the temporary prosthesis 2 can be fully extended first, and when the temporary prosthesis 2 reaches the limit extension length, the medullary nail sleeve 6 can be extended for a second time to allow the temporary prosthesis 2 to move further downward, ultimately achieving the same length of both limbs.

[0056] In one specific embodiment, the proximal end of the medullary nail sleeve 6 is provided with an annular sleeve boss 61, which mainly plays the role of limiting the docking with the temporary prosthesis 2 to prevent the proximal end of the medullary nail sleeve 6 from extending into the temporary prosthesis 2. At the same time, the sleeve boss 61 facilitates the support of the extended temporary prosthesis 2 and the medullary nail sleeve 6.

[0057] The sleeve boss 61 is arranged on the upper part of the temporary prosthesis 2, and at least a part of the intramedullary nail 1 extends upward from the sleeve boss 61 and is inserted into the distal end of the femur 10. Specifically, the sleeve boss 61 is arranged outside the proximal end of the temporary prosthesis 2, and the proximal end of the intramedullary nail 1 extends upward from the sleeve boss 61 and is inserted into the distal end of the femur 10.

[0058] At least a portion of the distal end of the medullary nail sleeve 6 is inserted into the temporary prosthesis 2, and a slide rail 64 and a slide groove 21 that cooperate with each other are provided between the temporary prosthesis 2 and the medullary nail sleeve 6. During the extension process of the temporary prosthesis 2, in order to prevent the temporary prosthesis 2 and the medullary nail sleeve 6 from rotating, the extension path of the temporary prosthesis 2 is limited by the slide rail 64 and the slide groove 21.

[0059] Specifically, based on the lower half of the intramedullary nail 1 being inserted into the intramedullary nail sleeve 6, the slide rail 64 in this embodiment is arranged on the outside of the intramedullary nail sleeve 6, including a fin connected to the outer wall of the intramedullary nail sleeve 6, and the slide groove 21 is arranged inside the temporary prosthesis 2, including a groove arranged on the inner wall of the temporary prosthesis 2. Through the mutual cooperation of the fin and the groove, the temporary prosthesis 2 can be prevented from rotating on the intramedullary nail sleeve 6, thereby improving the stability and reliability of the extended movement.

[0060] Based on the primary extension of the temporary prosthesis 2 and the secondary extension of the medullary nail sleeve 6 described above, the distal end of the medullary nail sleeve 6 and the proximal end of the temporary prosthesis 2 are respectively provided with a sleeve connecting hole 62 and a prosthesis connecting hole 22, so as to fix the temporary prosthesis 2 and the medullary nail sleeve 6 after being extended into place.

[0061] The temporary prosthesis 2 is generally extended to its maximum length that can be fully stretched during one extension process. After being extended to the full length, a screw is passed through the sleeve connecting hole 62 at the distal end of the medullary nail and the prosthesis connecting hole 22 at the proximal end of the temporary prosthesis 2, and the temporary prosthesis 2 is fixedly connected to the medullary nail sleeve 6.

[0062] In order to prevent fibrous tissue from growing into the temporary prosthesis 2 during the extension process of the temporary prosthesis 2, a nail cap is provided on the prosthesis connecting hole 22. When the temporary prosthesis 2 is moved down to its proper position, the nail cap is removed and the screw is inserted.

[0063] During the lengthening process of the temporary prosthesis 2 , the intramedullary nail 1 and the intramedullary nail sleeve 6 are in a fixed connection relationship, which prevents the intramedullary nail sleeve 6 from moving downward, thereby preventing the temporary prosthesis 2 from moving downward normally.

[0064] Preferably, the sleeve boss 61 and the intramedullary nail 1 are respectively provided with a boss connection hole 63 and an intramedullary nail connection hole 12 for fixing the intramedullary nail sleeve 6 to the intramedullary nail 1 during the lengthening process of the temporary prosthesis 2 and after the intramedullary nail sleeve 6 is extended into place.

[0065] Furthermore, the intramedullary nail connection holes 12 include a middle connection hole 13 located in the middle of the intramedullary nail 1 and a distal connection hole 14 located in the distal end of the intramedullary nail 1;

[0066] During the extension process of the temporary prosthesis 2, the position of the medullary nail sleeve 6 does not change. The medullary nail sleeve 6 is fixedly connected to the intramedullary nail 1 by screws that are simultaneously inserted into the boss connecting hole 63 and the middle connecting hole 13. Based on the anchoring of the intramedullary nail 1 on the femur 10, the temporary prosthesis 2 can be reliably extended relative to the medullary nail sleeve 6.

[0067] When the medullary nail sleeve 6 is extended to the position relative to the intramedullary nail 1, since the position of the intramedullary nail 1 does not change, the sleeve boss 61 of the medullary nail sleeve 6 moves down to the distal position of the intramedullary nail 1, and the medullary nail sleeve 6 is fixedly connected to the intramedullary nail 1 by screws that are simultaneously inserted into the boss connecting hole 63 and the distal connecting hole 14.

[0068] Through the above-mentioned connection structure and different forms, the temporary prosthesis 2 can be effectively extended once and the nail sleeve 6 can be extended twice, ensuring the stability and reliability of the over-limit extension process.

[0069] When the temporary prosthesis 2 and the intramedullary nail sleeve 6 are respectively extended, it is necessary to provide support between the temporary prosthesis 2 and the intramedullary nail sleeve 6, as well as between the femur 10 and the intramedullary nail sleeve 6 through the support block 5 to enhance the strength of the extended structure. In combination with different states, the intramedullary nail sleeve 6 and the temporary prosthesis 2 are fixedly connected, as well as the intramedullary nail 1 and the intramedullary nail sleeve 6 are fixedly connected, and at the same time, the failure of the operation caused by the retraction of the external fixator after removal can be prevented.

[0070] Specifically, the support block 5 includes a lower support block 51 which abuts between the bottom end surface of the sleeve boss 61 and the proximal end of the temporary prosthesis 2 after the temporary prosthesis 2 is extended into place, and an upper support block 52 which abuts between the top end surface of the sleeve boss 61 and the distal end of the femur 10 after the medullary nail sleeve 6 is extended into place.

[0071] The lower support block 51 is arranged outside the medullary needle sleeve to support the extended temporary prosthesis 2, so that the lower support block 51 is supported in the interval between the sleeve boss 61 and the temporary prosthesis 2, thereby enhancing the structural strength of the outer part of the medullary needle sleeve.

[0072] The upper support block 52 is arranged outside the intramedullary needle to support the extended intramedullary needle sleeve, so that the upper support block 52 supports the interval between the intramedullary needle and the sleeve boss 61, thereby enhancing the structural strength of the outer part of the intramedullary needle.

[0073] When installing the support block 5, the support block 5 is embedded and fixed in the front and rear parts of the medullary needle sleeve or the intramedullary needle according to the exposed distance of the medullary needle sleeve or the intramedullary needle, and is fastened by screws passing through the support block 5 and the screw holes of the medullary needle sleeve or the intramedullary needle to maintain the stability of the connection between the support block 5 and the medullary needle sleeve or the intramedullary needle.

[0074] By means of the temporary prosthesis device capable of over-limit extension in the present invention, the intramedullary nail can be used as the main anchoring structure, the intramedullary nail and the tibia 20 can be fixed by means of the extracorporeal fixation frame 4, and the distance between the femur 10 and the tibia 20 can be stretched by means of the extracorporeal fixation frame 4, so that the temporary prosthesis 2 and the intramedullary nail sleeve can be moved downward and extended respectively in different time periods.

[0075] In one embodiment, the external fixator 4 fixes the proximal end of the femur 10 and the distal end of the tibia 20 respectively, and the distance between the distal end of the femur 10 and the proximal end of the tibia 20 is stretched and extended by the sliding frame 43 on the external fixator 4 .

[0076] A femoral fixing nail 41 for fixing the intramedullary nail 1 is connected to the external fixing frame 4. In this embodiment, the position of the femur 10 in the body is fixed, the proximal end of the intramedullary nail 1 is fixed to the proximal end of the femur 10, and the distal end of the intramedullary nail 1 extends from the distal end of the femur 10 for the movable sleeve of the intramedullary nail sleeve 6. By inserting the femoral fixing nail 41 from the outside into the body and passing through the fixing hole 11 at the proximal end of the intramedullary nail 1, the installation position of the intramedullary nail 1 is fixed, and the anchoring effect of the intramedullary nail 1 is guaranteed.

[0077] In order to facilitate the insertion and installation of the femoral fixing nail 41 on the intramedullary nail 1, the fixing hole 11 includes an elliptical through hole that runs through the radial direction of the intramedullary nail 1. The short diameter of the elliptical through hole is the same as the diameter of the femoral fixing nail 41, the long diameter of the elliptical through hole is 1.5 times the short diameter, and the spacing is 2 cm, which is conducive to the insertion of the femoral fixing nail 41.

[0078] The external fixation frame 4 is also connected with a tibial fixation nail 42 for connecting and fixing the tibia 20. The tibial fixation nail 42 is inserted from the outside into the body and passes through the tibia 20 to connect the external fixation frame 4 to the tibia 20. The stretching and extension of the distance between the femur 10 and the tibia 20 is specifically performed by the sliding frame 43 between the femur fixation nail 41 and the tibial fixation nail 42. By stretching and extending the distance between the femur 10 and the tibia 20 by the sliding frame 43, combined with the sliding sleeve connection between the intramedullary nail sleeve 6 and the intramedullary nail 1, the sliding connection between the temporary prosthesis 2 and the sleeve, and the anchoring effect of the intramedullary nail 1, the temporary prosthesis 2 and the medullary nail sleeve 6 can slide downward at different stages, thereby adjusting the length of the affected limb.

[0079] See also Figure 8-Figure 9In order to facilitate rehabilitation training in a state where the knee joint can be flexed and extended after the temporary prosthesis 2 and the medullary nail sleeve 6 are extended into place and the external fixator 4 is removed, the temporary prosthesis 2 is movably connected to the proximal end of the tibia 20 through the hinge assembly 3.

[0080] By connecting the hinge assembly 3 between the temporary prosthesis 2 and the tibia 20, the knee joint can be freed from the constraint of maintaining a specific connection state between the temporary prosthesis 2 and the tibia 20, ensuring that the knee joint can be flexed and extended. After the temporary prosthesis 2 and the medullary needle sleeve are extended in place, the knee joint can be trained as soon as possible, effectively ensuring the recovery of the knee joint function.

[0081] The articulation assembly 3 includes an articulation block 31 and an insertion block 34 of an integral structure. The articulation block 31 is connected to the distal end of the temporary prosthesis 2 via an articulation shaft 32, and the insertion block 34 is inserted into the proximal end of the tibia 20. The articulation shaft 32 passes through the articulation block 31 and is fixedly connected to the distal end of the temporary prosthesis 2. The articulation block 31 can deflect and move on the articulation shaft 32.

[0082] Specifically, the hinge block 31 is provided with a hinge hole 33, through which the hinge shaft 32 passes, and both ends of the hinge shaft 32 are fixedly connected to the distal end of the temporary prosthesis 2. The hinge hole 33 enables the hinge block 31 to deflect on the hinge shaft 32, thereby facilitating the flexion and extension activities between the temporary prosthesis 2 and the tibia 20.

[0083] The plug block 34 includes a wedge-shaped structure connected to the proximal end of the tibia 20. This arrangement enables the articulated block 31 to drive the tibia 20 to flex and extend relative to the temporary prosthesis 2, thereby facilitating the extension of the temporary prosthesis 2 and the medullary needle sleeve to the proper position, and performing knee joint rehabilitation training after removing the external fixator 4.

[0084] By extending the temporary prosthesis 2 relative to the intramedullary needle sleeve once in the present invention, and when the expected extension length cannot be reached after the first extension, the intramedullary needle sleeve is extended for a second time relative to the intramedullary needle, the temporary prosthesis 2 can be extended beyond the limit, effectively overcoming the uncertainty factors brought about by the growth and development of individual children, and realizing the extension and supplementation of the unknown unequal length of the limbs of individual children after they grow taller.

[0085] The present invention also provides a method for using the above-mentioned temporary prosthesis device capable of being extended beyond a certain limit, comprising the following steps:

[0086] The initial artificial prosthesis at the distal end of the femur 10 is removed, an intramedullary nail 1 is implanted in the medullary cavity of the femur 10, a medullary nail sleeve 6 is sleeved on the intramedullary nail 1, and a temporary prosthesis 2 is slidably connected to the distal end of the medullary nail sleeve 6;

[0087] The proximal end of the intramedullary nail 1 is fixed to the femur 10 and the distal end of the tibia 20 by an extracorporeal fixator 4. At the same time, the medullary nail sleeve 6 is fixedly connected to the intramedullary nail 1. The distance between the femur 10 and the tibia 20 is adjusted and extended so that the temporary prosthesis 2 is extended and moved downward. The distance between the femur 10 and the tibia 20 is extended by 1 mm every day, which drives the temporary prosthesis 2 to move downward by 1 mm every day. For example, if it is extended by 10 cm, it will take about 100 days.

[0088] Regular check-up: after the temporary prosthesis 2 is extended to the right position, a second operation is required. If the expected extension length exceeds the length that the temporary prosthesis 2 can be extended, the medullary needle sleeve is slid and extended for the second time, and the proximal end of the temporary prosthesis 2 is fixedly connected with the distal end of the medullary nail sleeve 6. At the same time, the fixed connection between the medullary nail sleeve 6 and the intramedullary nail 1 is released, and the support block 5 is fixed outside the medullary needle sleeve to prevent the temporary prosthesis 2 from retracting. Then, the distance between the extended femur 10 and the tibia 20 is adjusted through the extracorporeal fixator 4, so that the medullary nail sleeve 6 is extended and moved downward to the expected extension length.

[0089] After the medullary nail sleeve 6 is extended to its full extent, three operations are required to fix the medullary nail sleeve 6 to the intramedullary nail 1, and to fix the support block 5 outside the intramedullary nail to prevent the medullary nail sleeve from retracting. The external fixator 4 is removed, and the patient is allowed to undergo rehabilitation training while the knee joint can be flexed and extended. After waiting for 3 to 6 months, the fixation pin holes of the external fixator 4 on the femur 10 and the tibia 20 are healed, and regular check-ups are performed to ensure that there is no infection or inflammation in the bone nail channel in the body.

[0090] In the fourth operation, the extended temporary prosthesis 2 was replaced and a prosthesis of the appropriate length was implanted into the body to complete the revision surgery for the artificial joint.

[0091] Through the above-mentioned method of use, the patient can perform flexion and extension activities of the knee joint between the temporary prosthesis 2 and the tibia 20 during the recovery process after three operations, which is conducive to early exercise for the patient.

[0092] In one specific implementation process, the original artificial prosthesis is removed, and an intramedullary nail with a diameter of 12 mm that can be fixed by an external fixator 4 is implanted in the proximal end of the femur 10. One end of the nail is implanted in the proximal end of the femur 10 below the intertrochanteric line, and the distal end is as long as possible to the maximum effective extension length of the temporary prosthesis 2.

[0093] It is placed in the temporary prosthesis 2, and then a medullary needle sleeve is made that can be slidably extended relative to the intramedullary needle. The medullary needle sleeve is sleeved on the outside of the intramedullary nail 1, and its diameter is only larger than the intramedullary needle implanted at the proximal end of the femur 10, and the total body diameter is 13mm; the outer diameter of the medullary needle sleeve at the starting end is 28mm, and after 15mm to the distal end, the outer diameter becomes 18mm. The above-mentioned 15mm interval constitutes the sleeve boss 61 of the medullary needle sleeve, and the wall thickness of the sleeve boss 61 is 7.5mm, and the wall thickness of the medullary needle sleeve at the bottom of the sleeve boss 61 is 2.5mm. The length of the medullary needle sleeve is equal to the maximum length of the intramedullary nail 1 placed in the temporary prosthesis 2 minus 15mm.

[0094] The intramedullary nail 1, the medullary nail sleeve 6 and the temporary prosthesis 2 can slide relative to each other. At the beginning of extension, the intramedullary nail is fixed with a screw in the middle connecting hole 13. When the temporary prosthesis 2 is extended distally and slides to the end 20mm, it is necessary to position and cut the soft tissue in vitro, and fix the temporary prosthesis 2 and the medullary nail sleeve 6 with two screws with a diameter of 3.5mm. The soft tissue is positioned and cut in vitro to remove the screws that fix the intramedullary nail and the medullary nail sleeve 6, so that the medullary nail sleeve 6 can be extended relative to the intramedullary nail 1, and the extension distance is increased by sliding. At the same time, the lower support block 51 is fixed between the proximal end of the temporary prosthesis 2 and the sleeve boss 61.

[0095] When the external fixator 4 is extended to the expected target length, the intramedullary nail 1 and the nail sleeve 6 are fixed with screws, and the outer part of the intramedullary nail is reinforced with the upper support block 52 to prevent the external fixator from retracting after removal.

[0096] Through the method of using the temporary prosthesis device that can be extended beyond the limit in the present invention, the overall length of the artificial prosthesis can be extended by sliding the medullary needle sleeve, thereby achieving the technical purpose of super-lengthening the temporary prosthesis 2 and filling the uncontrollable unequal lengths of the two limbs caused by unknown factors.

[0097] It should be noted that, in the absence of conflict, the features in the embodiments of this application may be combined with each other.

[0098] The above description is only the preferred embodiment of the present application and is not intended to limit the present application. For those skilled in the art, the present application may have various modifications and variations. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application shall be included in the protection scope of the present application.

Claims

1. A temporary prosthetic device capable of being extended beyond a certain limit, characterized in that: include: An intramedullary nail, a medullary nail sleeve and a temporary prosthesis, wherein the intramedullary nail is inserted into the femur, the medullary nail sleeve is sleeved on the outside of the intramedullary nail, the temporary prosthesis can slide up and down relative to the medullary nail sleeve and the intramedullary nail can slide up and down relative to the medullary nail sleeve, and the temporary prosthesis is arranged between the femur and the tibia; The proximal end of the intramedullary nail sleeve is provided with an annular sleeve boss, the sleeve boss is arranged on the upper part of the temporary prosthesis, and at least a part of the intramedullary nail extends upward from the sleeve boss and is inserted into the distal end of the femur; At least a portion of the distal end of the medullary nail sleeve is inserted into the temporary prosthesis, and a slide rail and a slide groove that cooperate with each other are provided between the temporary prosthesis and the medullary nail sleeve; The distal end of the medullary nail sleeve and the proximal end of the temporary prosthesis are respectively provided with a sleeve connection hole and a prosthesis connection hole, so as to be able to fix the temporary prosthesis after being extended into place and connect it to the medullary nail sleeve; The sleeve boss and the intramedullary nail are respectively provided with a boss connection hole and an intramedullary nail connection hole, which are used to fix the medullary nail sleeve and the intramedullary nail during the extension process of the temporary prosthesis and after the medullary nail sleeve is extended to its full position; The intramedullary nail connection holes respectively include a middle connection hole located in the middle part of the intramedullary nail, and a distal connection hole located in the distal part of the intramedullary nail; During the lengthening process of the temporary prosthesis, the intramedullary nail sleeve is fixedly connected to the intramedullary nail by screws inserted into the boss connection hole and the middle connection hole at the same time; After the medullary nail sleeve is extended to the position, the medullary nail sleeve is fixedly connected to the intramedullary nail by screws inserted into the boss connection hole and the distal connection hole at the same time; It also includes a support block for fixing the temporary prosthesis and the medullary nail sleeve after they are extended into place; The support block comprises a lower support block abutting between the sleeve boss and the temporary prosthesis after the temporary prosthesis is extended into place, and an upper support block abutting between the sleeve boss and the distal end of the femur after the medullary nail sleeve is extended into place; The intramedullary nail is fixed to the femur through an external fixator, the external fixator is connected to a femoral fixation nail for fixing the intramedullary nail, and a tibial fixation nail for fixing the tibia, a sliding frame capable of adjusting and extending the distance between the femur and the tibia is arranged between the femoral fixation nail and the tibial fixation nail, and a fixing hole for inserting the femoral fixation nail is arranged at the proximal end of the intramedullary nail.

2. The temporary prosthetic device capable of being extended beyond a certain limit according to claim 1, characterized in that: The temporary prosthesis is movably connected to the tibia via a hinge assembly; The hinge assembly comprises a hinge block and an insert block of an integral structure. The hinge block is connected to the distal end of the temporary prosthesis through a hinge shaft, and the insert block is inserted into the proximal end of the tibia.

3. The over-extendable temporary prosthetic device according to claim 1, characterized in that: The use of the over-extended temporary prosthetic device includes the following steps: An intramedullary nail is implanted in the femoral medullary cavity, and a temporary prosthesis is slidably connected to the distal end of the intramedullary nail sleeve; The proximal end of the intramedullary nail is fixed to the femur through an external fixator, and the distal end of the tibia is fixed. At the same time, the intramedullary nail sleeve is fixedly connected to the intramedullary nail, and the distance between the femur and the tibia is adjusted to extend and move the temporary prosthesis downward. After the temporary prosthesis is extended to the right position, if the expected extension length exceeds the length that the temporary prosthesis can extend, the proximal end of the temporary prosthesis is fixedly connected to the distal end of the intramedullary nail sleeve, and the fixation of the intramedullary nail sleeve and the intramedullary nail is released. The distance between the femur and the tibia is adjusted for the second time, so that the intramedullary nail sleeve is extended and moved downward to the expected extension length; After the medullary nail sleeve is extended to the right position, the medullary nail sleeve is fixedly connected to the intramedullary nail, and the external fixation frame is removed, so that the patient can perform rehabilitation training in a state where the knee joint can be flexed and extended; After 3 to 6 months, when it is confirmed that there is no infection in the nail channel of the external fixator in the limb, the extended temporary prosthesis is replaced and the artificial joint revision surgery is completed.

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