Artificial half pelvic prosthesis with support structure

Abstract

The invention discloses an artificial half pelvic prosthesis with a support structure, comprising an ilium side prosthesis and an acetabulum side prosthesis which are provided with a plurality of bolt holes, and a hook-like support structure arranged at the sacrum part justly is arranged at the edge end of the ilium side prosthesis; the ilium side prosthesis is hemispherical, an extension arm is arranged inwards, and a hook-like support structure arranged below the public rami at the same side or the opposite side is arranged at the tail end below the arm. In the invention, by adopting the support structure, interfacial stress between the prosthesis and the residual pelvis is converted into pressure stress from shearing or tensile stress, so as to improve the stability of the prosthesis. Moreover, a special inserted support structure or an inserted intramedullary stem structure is adopted at the connecting part of the prosthesis and a horizontal ramus of pubis, more femoral blood vessels and nerves on the surface are not needed to be exposed in the operation, the inserted type support structure or the intramedullary stem is directly inserted in the stump of the horizontal ramus of pubis, so as to simplify the operation and reduce risks of bleeding and injuring vital nerves and blood vessels.

Description

technical field [0001] The invention relates to the field of prosthesis replacement, more specifically, to an artificial half-pelvic prosthesis. Background technique [0002] Huge pelvic tumors or severe lesions are common diseases of the pelvis. Since pelvic tumors or destructive lesions often involve the acetabulum, and the scope is huge, surgery often requires hemipelvic amputation. Hemipelvetomy in the traditional sense refers to the amputation of half of the pelvis and the lower limbs on the same side, also known as posterior quarter amputation (hindquarter-amputation), which will bring permanent damage to the patient. Disabled and severely mentally handicapped. With the development of the concept of bone tumor treatment, the concept of comprehensive treatment of limb salvage has been widely recognized. Simply resect the half pelvis with tumors, that is, internal hemipelvetomy, while preserving the patient's limbs. After internal hemipelvectomy, the reconstruction of ...

AI Technical Summary

Problems solved by technology

[0004] There are many shortcomings in the existing commonly used techniques, such as (1) using internal fixation (such as Steinmann nails) + bone cement + bone graft + revision total hip prosthesis for combined hemipelvic reconstruction, it needs to be based on the The specific position of the ilium, pubic bone and ischium, adjust the correct position and direction of the acetabulum, and install it temporarily during the operation, and adjust the relative position of each component to meet the needs of anatomical matching

However, the surgeon cannot see or touch the position of the contralateral pelvis and acetabulum during the operation, and it is difficult to achieve bilateral symmetry.

Moreover, the adjustment of the position of the prosthesis must be three-dimensional, which significantly complicates the structure of the prosthesis, increases the number of spare parts, that is, the price, and the overall strength and stability of the prosthesis will be compromised, and the operation time and difficulty will also increase. , the probability of prosthetic loosening, fracture, and dislocation in the middle and long term after surgery also increases significantly

(2) Using restrictive hip joint tumor prosthesis + autogenous fibula graft + limb shortening, in fact, after resection of the lesioned hemipelvis, a restrictive hip joint is placed in the abnormal position of the hip joint The prosthesis, the bilateral hip joints are not at the same level, and the limbs on the affected side are significantly shortened, causing a large degree of disability and difficulty walking to the patient after surgery

(3) Saddle-shaped prosthesis requires enough ilium to be retained to obtain mechanical support for the saddle rest, and cannot be used for patients with subtotal or total iliac resection

Moreover, the postoperative hip flexion range is generally less than 50°, and patients can only half sit, let alone squat.

(4) Artificial hemipelvic prosthesis assembled in separate parts (Chinese invention patent application publication CN 101390781A), it is difficult to correctly adjust the three-dimensional position of each assembly during the operation and be symmetrical with the opposite side, and the joints between the assemblies and the bones Strength and stability are difficult to maintain for a long time

There are femoral blood vessels and nerves on the superficial surface of the horizontal branch of the pubic bone, while there is the obturator nerve (the urethra in the midline) on the deep surface, which will obviously affect the surgical exposure of the horizontal branch and the placement and fixation of the prosthesis, making the operation more difficult

At present, the general hemipelvic prosthesis is only fixed with bolts or screws, which is difficult to bear the reciprocating shear load

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