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CN110338943B - Computer aided design individuation humerus prosthesis and manufacturing method - Google Patents

Computer aided design individuation humerus prosthesis and manufacturing method Download PDF

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Publication number
CN110338943B
CN110338943B CN201910647736.0A CN201910647736A CN110338943B CN 110338943 B CN110338943 B CN 110338943B CN 201910647736 A CN201910647736 A CN 201910647736A CN 110338943 B CN110338943 B CN 110338943B
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China
Prior art keywords
humerus
prosthesis
nail
matched
intramedullary nail
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CN201910647736.0A
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CN110338943A (en
Inventor
马信龙
马剑雄
王颖
柏豪豪
孙磊
卢斌
王岩
田爱现
董本超
杜育任
韩彪
赵兴文
郭超韡
滕延斌
邢飞
范峥睿
杨宝成
何伟伟
陈恒亭
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TIANJIN HOSPITAL
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TIANJIN HOSPITAL
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Priority to CN201910647736.0A priority Critical patent/CN110338943B/en
Publication of CN110338943A publication Critical patent/CN110338943A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2002/2853—Humerus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2240/001—Designing or manufacturing processes
    • A61F2240/002—Designing or making customized prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2240/001—Designing or manufacturing processes
    • A61F2240/007—Dummy prostheses

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Transplantation (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Manufacturing & Machinery (AREA)
  • Physics & Mathematics (AREA)
  • Geometry (AREA)
  • Prostheses (AREA)

Abstract

The application belongs to the field of bone surgery osteotomy orthoses, in particular to a computer aided design individuation humerus prosthesis and a manufacturing method, comprising the steps of establishing a humerus three-dimensional model; designing a humerus prosthesis by taking the shape of the biological humerus and the contralateral humerus of a patient as references; setting the convex parts of the upper and lower ends of the humerus prosthesis inserted into the humerus cavity according to the parameters of the upper and lower sections of the humerus cavity of the patient; the humerus prosthesis is fixed by using a humerus intramedullary nail, the diameter of the middle inner cavity is matched with the diameter of the humerus intramedullary nail, a handle part is arranged at the inner side of the upper end of the prosthesis, and a nail channel is arranged on the handle part; the protruding part of the upper end of the prosthesis is provided with a nail channel matched with the shank nail channel, an implanted screw is used for preventing the intramedullary nail from rotating in the humerus, a Kirschner wire guide device is arranged and is accurately matched with the lower end of the prosthesis, and a Kirschner wire is arranged to assist in the implantation of the intramedullary nail. The application has the beneficial effects that: the manufactured prosthesis and the guide plate are matched with the humerus of the patient through the information measurement of the humerus of the patient, the intramedullary nail is assisted to be quickly placed, the normal humerus and surrounding soft tissues are reserved, and the postoperative life quality is improved.

Description

Computer aided design individuation humerus prosthesis and manufacturing method
Technical Field
The application belongs to the field of osteotomy orthoses in bone surgery, and particularly relates to a computer aided design personalized humerus prosthesis and a manufacturing method thereof.
Background
Proximal humerus serves as the metaphyseal of the upper limb, which is a common site for primary tumors, one of the most common sites for metastatic cancers, and the third most common site for sarcomas. Common tumors are: metastatic carcinoma, osteosarcoma, chondrosarcoma, giant cell tumor, and the like. Approximately 50% of upper limb sarcomas occur in the scapular zone. The choice of treatment regimen will vary depending on factors such as the malignancy, recurrence rate, prognosis, etc. of each tumor. In the past, proximal humerus malignancies have often been treated with amputation, with only low grade malignancies being treated with amputation. Since 1977, it was reported that the efficacy of the limb-protecting operation was similar to that of the amputation operation, more and more surgeons treated the malignant tumor of the proximal humerus with the limb-protecting operation, and found that the long-term survival rate was not much affected. In recent decades, limb protection has been a very growing development in surgical treatment of malignant tumors in this area. For the operation of the limb protection treatment, the operation of obtaining a tumor-free boundary is a prerequisite, and is also an important factor for avoiding local recurrence. However, post-operative function is also a significant consideration for the surgeon. Thus, the focus of limb-preserving surgery is to ensure a balance between adequate range of tumor resection and preserving important structures and functions. The limb-protecting operation mainly comprises tumor excision, bone defect reconstruction and surrounding soft tissue reconstruction. The reconstruction of bone defect after tumor resection is an important procedure in the process of limb-protecting operation, which provides a mechanical foundation for the reconstruction of soft tissues, and the reconstruction mode mainly comprises: artificial prosthetic reconstruction, allograft bone graft composite prosthetic reconstruction, allograft bone joint implantation, shoulder joint fusion, vascular or non-vascularized implant reconstruction, collarbone rotational shift reconstruction, and the like. Among them, the artificial prosthesis is most widely used. Reasons for this may include excellent performance of the prosthesis, aesthetic appearance of the affected area, relatively low incidence of complications, and absence of risk of bone-in-foreign disease.
Although the existing humerus prosthesis has the advantages, the problems of prosthesis mismatching, prosthesis loosening, preoperative inconsistency of humerus length, difficult nail placement when intramedullary fixation is needed and the like can also occur for patients.
Disclosure of Invention
In order to solve the problem that prosthesis matching and intramedullary fixation are difficult in the existing humerus prosthesis manufacturing technology, the application provides a computer-aided design individuation humerus prosthesis and a manufacturing method, the application fully considers the characteristics of a humerus anatomical structure, the shape size and the biological characteristics of a humerus, accurately measures the size of a humerus marrow cavity of a patient and the position information of the prosthesis, and sets a prosthesis design matched with an intramedullary stationary phase, thereby individuation and accuracy are achieved, and surgical trauma can be reduced.
The technical scheme of the application is as follows: a method of computer aided design of a personalized humeral prosthesis comprising the steps of:
a method of computer aided design of a personalized humeral prosthesis comprising the steps of:
step 1: establishing a three-dimensional model of the humerus;
step 2: measuring a patient's humeral parameter;
step 3: designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of the patient as a reference and taking measured parameters of the humerus of the patient as standards;
step 4: in the three-dimensional model of the humerus, the upper end and the lower end of the humerus prosthesis are respectively provided with an upper end bulge and a lower end bulge, and the upper end bulge and the lower end bulge are inserted into intramedullary cavities at the upper end and the lower end of the humerus to be connected and fixed;
step 5: in the three-dimensional model of the humerus, a proper intramedullary nail is selected according to the diameter of the humerus cavity of a patient, and a cavity matched with the intramedullary nail is reserved in the humerus prosthesis, so that the intramedullary nail is convenient to insert;
step 6: in the three-dimensional model of the humerus, a handle is arranged on the inner side of the upper end of the humerus prosthesis, and a handle nail channel is arranged on the handle;
step 7: in the three-dimensional model of the humerus, the upper end bulge of the humerus prosthesis is provided with an upper end bulge nail channel;
step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
Further, in the step 1, a three-dimensional humerus model is built, specifically, tomographic CT data of the complete humerus of the patient is collected and stored in a DICOM image format, and the three-dimensional humerus model is built through three-dimensional reconstruction software.
Further, measuring the humeral parameter of the patient in step 2 includes humeral cavity length, humeral cavity diameter;
preferably, the humeral cavity diameter is measured, in particular the humeral cavity minimum diameter.
Further, in the step 3, the upper end and the lower end of the humerus prosthesis are matched with the humerus;
preferably, the modeling software employs a mimics reconstruction software.
Further, in the step 4, the upper end bulge and the lower end bulge of the humerus prosthesis are matched with the diameters and the shapes of the corresponding humerus lacuna.
Further, in step 5, the humeral prosthesis adopts a hollow structure, the hollow structure adopts a cylinder, and the cylinder is matched with the intramedullary nail.
Further, 2 handle nail channels are arranged on the handle in the step 6, after the intramedullary nail is put in, screws are put in the handle nail channels, the screws are positioned at two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus;
preferably, the upper end of the humerus prosthesis in step 7 is provided with 2 upper end convex spikes and is matched with the stem spikes.
Further, the step of arranging the Kirschner wire guide is included between the step 7 and the step 8;
preferably, the kirschner wire guide arranged in the kirschner wire guide step is matched with the protrusion at the lower end of the humerus prosthesis;
preferably, the external diameter of the Kirschner wire guide is matched with the internal diameter of the hollow structure protruding from the lower end of the humerus prosthesis, the internal diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the hollow structure protruding from the lower end of the humerus prosthesis through the Kirschner wire guide, the Kirschner wire guide is placed from the humerus head and used as a guide pin, and the Kirschner wire is sleeved on the intramedullary nail and is accurately placed into the humerus.
The computer aided design individuation humerus prosthesis comprises a humerus prosthesis and is characterized in that the humerus prosthesis adopts a hollow structure, a handle is arranged on the inner side of the upper end of the humerus prosthesis, and an upper end bulge and a lower end bulge are respectively arranged at the upper end and the lower end of the humerus prosthesis.
Further, a handle nail path is arranged on the handle; the upper end bulge is provided with an upper end bulge nail channel which is matched with the handle nail channel;
preferably, the humerus prosthesis outer surface adopts a reticular structure;
preferably, the hollow structure adopts a cylinder, and the cylinder is matched with an intramedullary nail;
preferably, the shank lanes are arranged in pairs, and the upper protruding lanes are also arranged in pairs;
preferably, the upper protruding tack way comprises an upper protruding tack way and an upper protruding tack way;
preferably, the number of the shank lanes is 2;
preferably, the hollow structure is internally provided with an intramedullary nail, the shank nail channel is internally provided with a screw, the screw sequentially passes through the upper end bulge nail inlet channel and the upper end bulge nail outlet channel, and the screw is positioned at two sides of the intramedullary nail to prevent the intramedullary nail from rotating in the humerus;
preferably, the shank tack way has a diameter of 3-5mm.
The application has the beneficial effects that: (1) The application realizes accurate design, simulation and manufacture of the preoperative humerus prosthesis, further realizes simulated osteotomy correction, simulated humerus prosthesis installation, shortens the operation time and reduces the operation risk of patients, and reduces the radiation exposure time of the patients and operators.
(2) The humerus prosthesis is reasonable in design, the upper end bulges and the lower end bulges at the two ends of the humerus prosthesis are respectively inserted into the connected humerus medullary cavity, so that accurate matching is achieved, the humerus prosthesis adopts a hollow structure, the diameter of the hollow structure is matched with that of an intramedullary nail, and the intramedullary nail is convenient to pass through and fix. The lower end of the humerus prosthesis is provided with a Kirschner wire guide in a matched mode, and the intramedullary nail is conveniently placed. The inner side of the upper end of the prosthesis is provided with a handle structure, 2 nail channels are arranged on the handle, meanwhile, 2 matched nail channels are arranged at the protruding part of the upper end of the prosthesis, and screws are arranged in the operation and correspond to the positions of intramedullary nails, so that the function of blocking nails is achieved. Fully considers the anatomical structure characteristics of the humerus of an individual and the intramedullary fixation characteristics of the humerus, and achieves the aims of accurate matching, firm fixation and reduction of operation time.
Drawings
FIG. 1 is a schematic structural view of example 1 of the computer aided design of a personalized humeral prosthesis of the present application;
FIG. 2 is a right side view of FIG. 1;
FIG. 3 is a top view of FIG. 1;
FIG. 4 is a schematic structural view of example 3 of the computer aided design of the personalized humeral prosthesis of the present application;
FIG. 5 is a right side view of FIG. 1;
FIG. 6 is a top view of FIG. 1;
FIG. 7 is a schematic illustration of the structure of embodiments 4 and 5 of the computer aided design of the personalized humeral prosthesis of the present application;
in the figure, 1, a humerus prosthesis, 2, a lower end bulge, 3, an upper end bulge, 4, an upper end bulge nail way, 4-1, an upper end bulge nail way, 4-2, an upper end bulge nail way, 5, a handle, 6, a handle nail way, 7, a Kirschner wire guide, 8, a hollow structure, 9, a counter bore, 10 and a net structure.
Detailed Description
The following describes specific embodiments of the present application with reference to the drawings.
A method of computer aided design of a personalized humeral prosthesis comprising the steps of:
step 1: establishing a three-dimensional model of the humerus;
step 2: measuring a patient's humeral parameter;
step 3: designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of the patient as a reference and taking measured parameters of the humerus of the patient as standards;
step 4: in the three-dimensional model of the humerus, the upper end and the lower end of the humerus prosthesis are respectively provided with an upper end bulge and a lower end bulge, and the upper end bulge and the lower end bulge are inserted into intramedullary cavities at the upper end and the lower end of the humerus to be connected and fixed;
step 5: in the three-dimensional model of the humerus, a proper intramedullary nail is selected according to the diameter of the humerus cavity of a patient, and a cavity matched with the intramedullary nail is reserved in the humerus prosthesis, so that the intramedullary nail is convenient to insert;
step 6: in the three-dimensional model of the humerus, a handle is arranged on the inner side of the upper end of the humerus prosthesis, and a handle nail channel is arranged on the handle;
step 7: in the three-dimensional model of the humerus, the upper end bulge of the humerus prosthesis is provided with an upper end bulge nail channel;
step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
In the step 1, a three-dimensional model of the humerus is established, specifically, tomographic CT data of the complete humerus of a patient are collected and stored in a DICOM image format, and the three-dimensional model of the humerus is established through three-dimensional reconstruction software.
Measuring humeral parameters of the patient in step 2, including humeral cavity length and humeral cavity diameter;
the humeral cavity diameter is measured, in particular the minimum humeral cavity diameter.
In the step 3, the upper end and the lower end of the humerus prosthesis are matched with the humerus;
the modeling software adopts the mimics reconstruction software.
In the step 4, the upper end bulge and the lower end bulge of the humerus prosthesis are matched with the diameters and the shapes of corresponding humerus cavities.
In the step 5, the humerus prosthesis adopts a hollow structure, the hollow structure adopts a cylinder, and the cylinder is matched with the intramedullary nail.
In the step 6,2 handle nail channels are arranged on the handle, after the intramedullary nail is put in, screws are put in the handle nail channels, the screws are positioned at two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus;
and 2 upper-end convex nail channels are arranged at the upper end of the humerus prosthesis in a protruding manner in the step 7 and are matched with the handle nail channels.
The step of arranging the Kirschner wire guide is included between the step 7 and the step 8;
the Kirschner wire guide arranged in the Kirschner wire guide step is matched with the bulge at the lower end of the humerus prosthesis;
the external diameter of the Kirschner wire guide is matched with the internal diameter of the hollow structure protruding from the lower end of the humerus prosthesis, the internal diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the hollow structure protruding from the lower end of the humerus prosthesis through the Kirschner wire guide, the Kirschner wire guide is placed from the humerus head and used as a guide wire, and the Kirschner wire is sleeved on the intramedullary nail and is accurately placed into the humerus.
The computer aided design of the personalized humerus prosthesis comprises a hollow structure 8, wherein a handle 5 is arranged on the inner side of the upper end of the humerus prosthesis 1, and an upper end bulge 3 and a lower end bulge 2 are respectively arranged on the upper end and the lower end of the humerus prosthesis 1.
The handle 5 is provided with a handle nail channel 6; the upper end bulge 3 is provided with an upper end bulge nail channel 4, and the upper end bulge nail channel 4 is matched with the handle nail channel 6;
the external surface of the humerus prosthesis 1 adopts a reticular structure, which is beneficial to bone ingrowth and recovery;
the hollow structure 8 adopts a cylinder which is matched with the intramedullary nail;
the shank nail channels 6 are arranged in pairs, the shank nail channels 6 are provided with counter bore structures, the protruding abrasion of the nail caps to soft tissues is avoided, recovery is facilitated, and the upper protruding nail channels 4 are also arranged in pairs;
the upper end protruding nail way 4 comprises an upper end protruding nail inlet way 4-1 and an upper end protruding nail outlet way 4-2; the upper protruding nail feeding channel 4-1 is arranged close to the handle part 5, and the upper protruding nail discharging channel 4-2 is arranged far away from the handle part 5.
2 shank nail channels 6 are provided;
the intramedullary nail is arranged in the hollow structure, the screw is arranged in the shank nail channel, the screw sequentially passes through the upper protruding nail inlet channel and the upper protruding nail outlet channel, the screw is positioned at two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus; the prosthesis and the humerus are fixed through the humerus screw, and meanwhile, the two screws play a role of blocking the screw, so that the intramedullary nail is prevented from rotating in the humerus, and the stability is improved;
the diameter of the shank nail channel is 3-5mm;
a Kirschner wire guide 9 is arranged below the lower end bulge 2 and is matched with the lower end bulge of the humerus prosthesis;
the Kirschner wire guide adopts the existing product, the outer diameter of the Kirschner wire guide is matched with the inner diameter of the raised hollow structure at the lower end of the humerus prosthesis, the inner diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the raised hollow structure at the lower end of the humerus prosthesis through the Kirschner wire guide, is placed from the humerus head and is used as a guide wire, and the Kirschner wire is sleeved on the intramedullary nail to be accurately placed into the humerus.
Example 1
A method of computer aided design of a personalized humeral prosthesis comprising the steps of:
step 1: establishing a three-dimensional model of the humerus;
step 2: measuring a patient's humeral parameter;
step 3: designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of the patient as a reference and taking measured parameters of the humerus of the patient as standards;
step 4: in the three-dimensional model of the humerus, the upper end and the lower end of the humerus prosthesis are respectively provided with an upper end bulge and a lower end bulge, and the upper end bulge and the lower end bulge are inserted into intramedullary cavities at the upper end and the lower end of the humerus to be connected and fixed;
step 5: in the three-dimensional model of the humerus, a proper intramedullary nail is selected according to the diameter of the humerus cavity of a patient, and a cavity matched with the intramedullary nail is reserved in the humerus prosthesis, so that the intramedullary nail is convenient to insert;
step 6: in the three-dimensional model of the humerus, a handle is arranged on the inner side of the upper end of the humerus prosthesis, and a handle nail channel is arranged on the handle;
step 7: in the three-dimensional model of the humerus, the upper end bulge of the humerus prosthesis is provided with an upper end bulge nail channel;
step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
The computer aided design individuation humerus prosthesis comprises a humerus prosthesis 1, wherein the humerus prosthesis 1 adopts a hollow structure 8, a handle 5 is arranged on the inner side of the upper end of the humerus prosthesis 1, and an upper end bulge 3 and a lower end bulge 2 are respectively arranged on the upper end and the lower end of the humerus prosthesis 1.
Example 2
A method of computer aided design of a personalized humeral prosthesis comprising the steps of:
step 1: establishing a three-dimensional model of the humerus;
step 2: measuring a patient's humeral parameter;
step 3: designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of the patient as a reference and taking measured parameters of the humerus of the patient as standards;
step 4: in the three-dimensional model of the humerus, the upper end and the lower end of the humerus prosthesis are respectively provided with an upper end bulge and a lower end bulge, and the upper end bulge and the lower end bulge are inserted into intramedullary cavities at the upper end and the lower end of the humerus to be connected and fixed;
step 5: in the three-dimensional model of the humerus, a proper intramedullary nail is selected according to the diameter of the humerus cavity of a patient, and a cavity matched with the intramedullary nail is reserved in the humerus prosthesis, so that the intramedullary nail is convenient to insert;
step 6: in the three-dimensional model of the humerus, a handle is arranged on the inner side of the upper end of the humerus prosthesis, and a handle nail channel is arranged on the handle;
step 7: in the three-dimensional model of the humerus, the upper end bulge of the humerus prosthesis is provided with an upper end bulge nail channel;
step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
In the step 1, a three-dimensional model of the humerus is established, specifically, tomographic CT data of the complete humerus of a patient are collected and stored in a DICOM image format, and the three-dimensional model of the humerus is established through three-dimensional reconstruction software.
Measuring humeral parameters of the patient in step 2, including humeral cavity length and humeral cavity diameter;
the humeral cavity diameter is measured, in particular the minimum humeral cavity diameter.
In the step 3, the upper end and the lower end of the humerus prosthesis are matched with the humerus;
the modeling software adopts the mimics reconstruction software.
In the step 4, the upper end bulge and the lower end bulge of the humerus prosthesis are matched with the diameters and the shapes of corresponding humerus cavities.
In the step 5, the humerus prosthesis adopts a hollow structure, the hollow structure adopts a cylinder, and the cylinder is matched with the intramedullary nail.
The computer aided design of the personalized humerus prosthesis comprises a hollow structure 8, wherein a handle 5 is arranged on the inner side of the upper end of the humerus prosthesis 1, and an upper end bulge 3 and a lower end bulge 2 are respectively arranged on the upper end and the lower end of the humerus prosthesis 1.
The handle 5 is provided with a handle nail channel 6; the upper end bulge 3 is provided with an upper end bulge nail channel 4, and the upper end bulge nail channel 4 is matched with the handle nail channel 6;
the external surface of the humerus prosthesis 1 adopts a reticular structure, which is beneficial to bone ingrowth and recovery;
the hollow structure 8 adopts a cylinder which is matched with the intramedullary nail;
example 3
A method of computer aided design of a personalized humeral prosthesis comprising the steps of:
step 1: establishing a three-dimensional model of the humerus;
step 2: measuring a patient's humeral parameter;
step 3: designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of the patient as a reference and taking measured parameters of the humerus of the patient as standards;
step 4: in the three-dimensional model of the humerus, the upper end and the lower end of the humerus prosthesis are respectively provided with an upper end bulge and a lower end bulge, and the upper end bulge and the lower end bulge are inserted into intramedullary cavities at the upper end and the lower end of the humerus to be connected and fixed;
step 5: in the three-dimensional model of the humerus, a proper intramedullary nail is selected according to the diameter of the humerus cavity of a patient, and a cavity matched with the intramedullary nail is reserved in the humerus prosthesis, so that the intramedullary nail is convenient to insert;
step 6: in the three-dimensional model of the humerus, a handle is arranged on the inner side of the upper end of the humerus prosthesis, and a handle nail channel is arranged on the handle;
step 7: in the three-dimensional model of the humerus, the upper end bulge of the humerus prosthesis is provided with an upper end bulge nail channel;
step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
In the step 1, a three-dimensional model of the humerus is established, specifically, tomographic CT data of the complete humerus of a patient are collected and stored in a DICOM image format, and the three-dimensional model of the humerus is established through three-dimensional reconstruction software.
Measuring humeral parameters of the patient in step 2, including humeral cavity length and humeral cavity diameter;
the humeral cavity diameter is measured, in particular the minimum humeral cavity diameter.
In the step 3, the upper end and the lower end of the humerus prosthesis are matched with the humerus;
the modeling software adopts the mimics reconstruction software.
In the step 4, the upper end bulge and the lower end bulge of the humerus prosthesis are matched with the diameters and the shapes of corresponding humerus cavities.
In the step 5, the humerus prosthesis adopts a hollow structure, the hollow structure adopts a cylinder, and the cylinder is matched with the intramedullary nail.
In the step 6,2 handle nail channels are arranged on the handle, after the intramedullary nail is put in, screws are put in the handle nail channels, the screws are positioned at two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus;
and 2 upper-end convex nail channels are arranged at the upper end of the humerus prosthesis in a protruding manner in the step 7 and are matched with the handle nail channels.
The step of arranging the Kirschner wire guide is included between the step 7 and the step 8;
the Kirschner wire guide arranged in the Kirschner wire guide step is matched with the bulge at the lower end of the humerus prosthesis;
the external diameter of the Kirschner wire guide is matched with the internal diameter of the hollow structure protruding from the lower end of the humerus prosthesis, the internal diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the hollow structure protruding from the lower end of the humerus prosthesis through the Kirschner wire guide, the Kirschner wire guide is placed from the humerus head and used as a guide wire, and the Kirschner wire is sleeved on the intramedullary nail and is accurately placed into the humerus.
The computer aided design individuation humerus prosthesis comprises a humerus prosthesis 1, wherein the humerus prosthesis 1 is integrated, the prosthesis 1 adopts a hollow structure 8 according to the humerus anatomical structure and parameter setting of a patient's humerus structure, the intramedullary nail is used for being placed in, the handle 5 is arranged on the inner side of the upper end of the humerus prosthesis 1, the shape is attached to a connected humerus part, and the upper end and the lower end of the humerus prosthesis 1 are respectively provided with an upper end bulge 3 and a lower end bulge 2. The shape and the size of the protruding 3 part at the lower end of the humerus prosthesis are matched with those of the connected humerus medullary cavity, and the shape and the size of the protruding part at the upper end of the humerus prosthesis are matched with those of the connected humerus medullary cavity, so that the humerus prosthesis is convenient to fix.
The handle 5 is provided with a handle nail channel 6; the upper end bulge 3 is provided with an upper end bulge nail channel 4, and the upper end bulge nail channel 4 is matched with the handle nail channel 6;
the external surface of the humerus prosthesis 1 adopts a reticular structure 10, which is beneficial to bone ingrowth and recovery;
the hollow structure 8 adopts a cylinder which is matched with the intramedullary nail;
the shank nail channels 6 are arranged in pairs, and the shank nail channels 6 are provided with counter bore structures, so that protruding abrasion of the nail caps on the upper end of soft tissues is avoided, and the protruding nail channels 4 are also arranged in pairs;
the upper end protruding nail way 4 comprises an upper end protruding nail inlet way 4-1 and an upper end protruding nail outlet way 4-2; the upper protruding nail feeding channel 4-1 is arranged close to the handle part 5, and the upper protruding nail discharging channel 4-2 is arranged far away from the handle part 5.
2 shank nail channels 6 are provided;
the intramedullary nail is arranged in the hollow structure, the screw is arranged in the shank nail channel, the screw sequentially passes through the upper protruding nail inlet channel and the upper protruding nail outlet channel, the screw is positioned at two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus; the prosthesis and the humerus are fixed through the humerus screw, and meanwhile, the two screws play a role of blocking the screw, so that the intramedullary nail is prevented from rotating in the humerus, and the stability is improved;
the diameter of the shank nail channel is 3-5mm;
a Kirschner wire guide 9 is arranged below the lower end bulge 2 and is matched with the lower end bulge of the humerus prosthesis;
the Kirschner wire guide adopts the existing product, the outer diameter of the Kirschner wire guide is matched with the inner diameter of the raised hollow structure at the lower end of the humerus prosthesis, the inner diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the raised hollow structure at the lower end of the humerus prosthesis through the Kirschner wire guide, is placed from the humerus head and is used as a guide wire, and the Kirschner wire is sleeved on the intramedullary nail to be accurately placed into the humerus.
Example 4
A method for making a computer-aided design of a personalized humeral prosthesis, characterized by comprising the steps of:
step 1, acquiring CT data of a patient's humerus tomography, storing the CT data in a DICOM image format, and establishing a humerus three-dimensional model through three-dimensional reconstruction software; the three-dimensional model of the humerus in step 1 includes both the affected side and contralateral models.
Step 2, measuring humeral parameters of a patient, including the diameter and the length of a humeral cavity; an appropriate intramedullary nail is selected based on the measured humeral cavity diameter and length.
Step 3, designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of the patient as a reference and taking measured humerus parameters of the patient as a standard, and determining the length of the needed humerus prosthesis according to the actual condition of the patient;
step 4, arranging protrusions with the length of about 5-15mm at the upper end and the lower end of the humerus prosthesis respectively, and inserting the protrusions into the upper end and the lower end of the humerus to be fixedly connected; the convex parts at the upper and lower ends of the humerus prosthesis are matched with the diameters and the shapes of the connected humerus cavities, and are slightly smaller than the humerus cavities, so that the convex parts are convenient to be inserted into the humerus marrow cavities for fixation.
Step 5, selecting a proper intramedullary nail according to the diameter of the humerus cavity of a patient, and reserving a cavity gap matched with the intramedullary nail in the humerus prosthesis so as to facilitate the insertion of the intramedullary nail; the humerus prosthesis is internally cylindrical hollow, and the diameter of the hollow part is slightly larger than the diameter of the selected intramedullary nail so as to facilitate the insertion of the intramedullary nail.
Step 6, designing a handle part on the inner side of the upper end of the humerus prosthesis, designing 2 nail channels with the diameter of 3-5mm on the handle part, designing two corresponding nail channels on the convex part of the upper end of the prosthesis, fixing the prosthesis and the humerus by using screws, and simultaneously, preventing the intramedullary nail from rotating in the humerus by using the two screws, thereby improving the stability;
step 7, designing a Kirschner wire guider which is matched with the convex part at the lower end of the humerus prosthesis; the outer diameter of the guide device is slightly smaller than the diameter of the cavity of the convex part at the lower end of the humerus prosthesis, so that the kirschner wire guide device is convenient to connect with the prosthesis, and the inner diameter of the guide device is matched with the diameter of the selected kirschner wire; the guide device is inserted into the cavity of the protruding part at the lower end of the prosthesis, the Kirschner wire is inserted from the lower end of the prosthesis through the guide device, is arranged from the head of the humerus and is used as an intramedullary nail guide wire, and the Kirschner wire is accurately arranged into the humerus when the intramedullary nail is sleeved to reach the preoperative planning position, so that the aim of rapidly and accurately arranging the intramedullary nail is fulfilled.
Step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
Wherein: the measurement of the humeral cavity diameter in step 2 measures the minimum diameter to select the appropriate intramedullary nail.
In the step 3, the convex parts of the upper end and the lower end of the humerus prosthesis are matched with the humerus medullary cavity.
In the step 4, the convex parts of the upper and lower ends of the humerus prosthesis are matched with the corresponding humerus cavity diameter and shape, and are slightly smaller than the humerus cavity, so that the humerus prosthesis is conveniently inserted into the humerus marrow cavity for fixation.
In the step 5, the internal cylinder of the humerus prosthesis is hollow, and the diameter of the hollow part is slightly larger than the diameter of the intramedullary nail selected in the step 2, so that the intramedullary nail can be conveniently inserted.
And (6) arranging 2 nail channels at the upper end of the humerus prosthesis, after the intramedullary nail is put in, arranging screws in the nail channels, wherein the screws are positioned at two sides of the intramedullary nail, so as to play a role of blocking the intramedullary nail, prevent the intramedullary nail from rotating in the humerus and improve the stability.
The Kirschner wire guide designed in the step 7 has the outer diameter slightly smaller than the diameter of the cavity at the lower end of the humerus prosthesis, is convenient for the Kirschner wire guide to be connected with the prosthesis, has the inner diameter matched with the diameter of the selected Kirschner wire, is placed from the lower end of the prosthesis through the guide, is placed from the humerus head and is used as a guide pin, and the Kirschner wire is sleeved on the intramedullary nail to be accurately placed into the humerus to reach the preoperative planning position.
In the step 8, the humerus prosthesis is manufactured by adopting a 3D printing technology, the material is metal, and the titanium alloy is adopted for forming the humerus prosthesis with good effect.
The computer aided design of the personalized humerus prosthesis comprises a hollow structure 8, wherein a handle 5 is arranged on the inner side of the upper end of the humerus prosthesis 1, and an upper end bulge 3 and a lower end bulge 2 are respectively arranged on the upper end and the lower end of the humerus prosthesis 1.
The handle 5 is provided with a handle nail channel 6; the upper end bulge 3 is provided with an upper end bulge nail channel 4, and the upper end bulge nail channel 4 is matched with the handle nail channel 6;
the external surface of the humerus prosthesis 1 adopts a reticular structure, which is beneficial to bone ingrowth and recovery;
the hollow structure 8 adopts a cylinder which is matched with the intramedullary nail;
the shank nail channels 6 are arranged in pairs, and the shank nail channels 6 are provided with counter bore structures, so that protruding abrasion of the nail caps on the upper end of soft tissues is avoided, and the protruding nail channels 4 are also arranged in pairs;
the upper end protruding nail way 4 comprises an upper end protruding nail inlet way 4-1 and an upper end protruding nail outlet way 4-2; the upper protruding nail feeding channel 4-1 is arranged close to the handle part 5, and the upper protruding nail discharging channel 4-2 is arranged far away from the handle part 5.
2 shank nail channels 6 are provided;
the intramedullary nail is arranged in the hollow structure, the screw is arranged in the shank nail channel, the screw sequentially passes through the upper protruding nail inlet channel and the upper protruding nail outlet channel, the screw is positioned at two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus; the prosthesis and the humerus are fixed through the humerus screw, and meanwhile, the two screws play a role of blocking the screw, so that the intramedullary nail is prevented from rotating in the humerus, and the stability is improved;
the diameter of the shank nail channel is 3-5mm;
a Kirschner wire guide 9 is arranged below the lower end bulge 2 and is matched with the lower end bulge of the humerus prosthesis;
the Kirschner wire guide adopts the existing product, the outer diameter of the Kirschner wire guide is matched with the inner diameter of the raised hollow structure at the lower end of the humerus prosthesis, the inner diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the raised hollow structure at the lower end of the humerus prosthesis through the Kirschner wire guide, is placed from the humerus head and is used as a guide wire, and the Kirschner wire is sleeved on the intramedullary nail to be accurately placed into the humerus.
Example 5
The embodiment is a manufacturing method of a computer aided design individuation humerus prosthesis applied to a right humerus proximal tumor case.
1. Reconstructing a three-dimensional model of the humerus of the patient by using mimics software and CT data of the patient, wherein the three-dimensional model comprises a model of the humerus on the affected side and a model of the humerus on the contralateral side;
2. and measuring parameters such as the resection range of the humerus tumor, the diameter and the length of the humerus cavity gap and the like. The measurement parameters can be increased according to actual requirements.
3. Designing the appearance of the humerus prosthesis by using modeling software and taking the appearance of the humerus at the corresponding position on the opposite side as a reference; the length of the main body of the humerus prosthesis is set to be 48mm according to the tumor resection range;
4. the required intramedullary nail length is selected according to the humerus length of a patient, the intramedullary nail diameter is matched with the minimum diameter of an intramedullary cavity of the humerus where the intramedullary nail is arranged, and the intramedullary nail diameter is selected to be 7mm; the internal part of the humerus prosthesis is provided with a cylindrical hollow structure with the diameter of 7.2mm, which is matched with the diameter of the intramedullary nail, thereby being beneficial to intramedullary fixation;
5. the shape and the size of the protruding part at the lower end of the humerus prosthesis are matched with those of the marrow cavity of the connected humerus part, the fixation of the prosthesis is facilitated, the hollow structure of the protruding part is consistent with that of the main body of the prosthesis, and the length of the protruding part at the lower end is 10mm;
6. the inner side of the upper end of the humerus prosthesis is provided with a handle part, the length of the handle part is 15mm, the shape of the handle part is attached to the connected humerus part, 2 nail paths of 4.7mm are arranged on the handle part, the 2 nail paths are positioned on two sides of the intramedullary nail, the prosthesis and the humerus are fixed through screws, and meanwhile, the two screws play a role of blocking the nail, so that the intramedullary nail is prevented from rotating in the humerus, and the stability is improved; the surface of the humerus prosthesis is of a reticular structure, which is beneficial to bone ingrowth.
7. The shape and the size of the protruding part at the upper end of the humerus prosthesis are matched with those of the marrow cavity of the connected humerus part, the fixation of the prosthesis is facilitated, and the length of the protruding part at the upper end is 7mm; 2 nail channels with the diameter of 4.7mm are arranged at the protruding part of the upper end and are matched with 2 nail channels of the handle part;
8. designing a Kirschner wire guider which is matched with the convex part at the lower end of the humerus prosthesis; the outer diameter of the guide device is 7mm, so that the kirschner wire guide device is convenient to connect with the prosthesis, the inner diameter of the guide device is 3.2mm, and the guide device is matched with the diameter of the selected kirschner wire; the guide device is inserted into a cavity of a bulge part at the lower end of the prosthesis, the Kirschner wire is inserted from the lower end of the prosthesis through the guide device and is put out from the humerus head to be used as an intramedullary nail guide pin, and the Kirschner wire is sleeved on the intramedullary nail to be accurately put into the humerus so as to reach a planning position before operation, thereby achieving the aim of quickly and accurately putting into the intramedullary nail;
9. the humerus prosthesis is manufactured by adopting a 3D printing technology, the material is metal, and the titanium alloy is adopted for forming the humerus prosthesis with good effect.
The computer aided design of the personalized humerus prosthesis comprises a humerus prosthesis 1, wherein the length of the humerus prosthesis 1 is 48mm according to the resection range of the humerus tumor of a patient, so that the length of the humerus of the patient after operation is kept unchanged; the diameter of the intramedullary nail is 7mm according to the diameter of the humerus marrow cavity, so the diameter of the hollow structure 8 in the humerus prosthesis 1 is 7.2mm, which is beneficial to the fixation of the intramedullary nail; the shape and the size of the convex part 2 at the lower end of the humerus prosthesis 1 are matched with those of the connected humerus marrow cavity, the diameter of the hollow structure in the convex part 2 at the lower end is 7.2mm, and the length is 10mm; the inner side of the upper end of the humerus prosthesis 1 is provided with a handle 5, the length of the handle 5 is 15mm, the size is reasonable, the shape is fit with the connected humerus part, 2 handle nail channels 6 are designed on the handle, the 2 handle nail channels 6 are positioned on two sides of an intramedullary nail, the humerus prosthesis 1 and the humerus are fixed through screws, meanwhile, two screws play a role of blocking nails of the intramedullary nail, the intramedullary nail is prevented from rotating in the humerus, the stability is improved, the diameter of the handle nail channel 6 is 4.7mm, and the diameter of the handle nail channel 6 is matched with that of the used screw; the shape and the size of the convex part 3 at the upper end of the humerus prosthesis 1 are matched with those of the marrow cavity of the connected humerus part, the humerus prosthesis 1 is easy to fix, the height of the convex part 3 at the upper end is 7mm, the height of the convex part 2 at the lower end is 10mm, and the size is reasonable; the protruding position in upper end sets up 2 4.7mm nail ways, matches with 2 nail ways of stalk portion, does benefit to the fixed of humerus prosthesis and humerus, wholly adopts titanium alloy material, and structural setting is reasonable, has certain intensity, and the light burden that reduces the patient, and the surface adopts network structure 10, does benefit to the growth of bone and is favorable to the patient to resume.
The humerus prosthesis is reasonable in design, and the fixing stability of the humerus prosthesis is improved through the convex parts at the upper end and the lower end of the prosthesis to be inserted into the humerus; meanwhile, an intramedullary nail fixing nail channel is prefabricated on the humerus prosthesis, so that the fixation is convenient; the handle part is designed on the inner side of the upper end of the humerus prosthesis, 2 nail channels are designed, the effect of fixing the prosthesis and the humerus is achieved, meanwhile, the effect of blocking nails of the intramedullary nail is skillfully achieved, the intramedullary nail is prevented from rotating in the humerus, and the stability is improved; the Kirschner wire guide device for the intramedullary nail is designed, so that the intramedullary nail can be conveniently and rapidly and accurately placed. The scheme fully considers the anatomical structure characteristics of the individual humerus and the internal fixation characteristics of the humerus marrow, improves the fixation stability of the prosthesis and reduces the time in operation.
Compared with the prior art, the application realizes accurate design, simulation and manufacture of the preoperative humerus prosthesis, further realizes simulated osteotomy correction, simulated humerus prosthesis installation, shortens the operation time, reduces the operation risk of patients, reduces the radiation exposure time of the patients and operators, is suitable for further popularization in the field of accurate orthopaedics operation, fully considers the characteristics of the anatomical structure of the humerus of an individual, the difficulty of fixation in the humerus marrow and the like, accurately measures the positions of the humerus and the intramedullary cavity of the patient and the placement of the prosthesis and the intramedullary nail, achieves individuation and accuracy, and can reduce the operation trauma.
The humerus prosthesis is reasonable in design, the upper end bulges and the lower end bulges at the two ends of the humerus prosthesis are respectively inserted into the connected humerus medullary cavity, so that accurate matching is achieved, the humerus prosthesis adopts a hollow structure, the diameter of the hollow structure is matched with that of an intramedullary nail, and the intramedullary nail is convenient to pass through and fix. The lower end of the humerus prosthesis is provided with a Kirschner wire guide in a matched mode, and the intramedullary nail is conveniently placed. The inner side of the upper end of the prosthesis is provided with a handle structure, 2 nail channels are arranged on the handle, meanwhile, 2 matched nail channels are arranged at the protruding part of the upper end of the prosthesis, and screws are arranged in the operation and correspond to the positions of intramedullary nails, so that the function of blocking nails is achieved. Fully considers the anatomical structure characteristics of the humerus of an individual and the intramedullary fixation characteristics of the humerus, and achieves the aims of accurate matching, firm fixation and reduction of operation time.
The foregoing detailed description of the embodiments of the application has been presented only to illustrate the preferred embodiments of the application and should not be taken as limiting the scope of the application. All equivalent changes and modifications within the scope of the present application are intended to be covered by the present application.

Claims (6)

1. A method of computer aided design of a personalized humeral prosthesis comprising the steps of:
step 1: establishing a three-dimensional model of the humerus;
step 2: measuring a patient's humeral parameter;
step 3: designing the appearance of a humerus prosthesis by using modeling software and taking the appearance of the contralateral humerus of a patient as a reference and taking measured parameters of the humerus of the patient as standards, wherein the upper end and the lower end of the humerus prosthesis are matched with the humerus;
step 4: in the three-dimensional model of the humerus, the upper end and the lower end of the humerus prosthesis are respectively provided with an upper end bulge and a lower end bulge, the upper end bulge and the lower end bulge of the humerus prosthesis are matched with the diameters and the shapes of corresponding humerus cavities, and the upper end bulge and the lower end bulge are inserted into intramedullary cavities at the upper end and the lower end of the humerus to be fixedly connected;
step 5: in the three-dimensional model of the humerus, a proper intramedullary nail is selected according to the diameter of the humerus cavity of a patient, and a cavity matched with the intramedullary nail is reserved in the humerus prosthesis, so that the intramedullary nail is convenient to insert; the humerus prosthesis adopts a hollow structure, the hollow structure adopts a cylinder, and the cylinder is matched with the intramedullary nail;
step 6: in the three-dimensional model of the humerus, a handle part is arranged at the inner side of the upper end of the humerus prosthesis, 2 handle part nail channels are arranged on the handle part, after the intramedullary nail is put in, screws are put in the handle part nail channels, the screws are positioned at the two sides of the intramedullary nail, and the intramedullary nail is prevented from rotating in the humerus;
step 7: in the three-dimensional model of the humerus, 2 upper-end convex nail channels are arranged at the upper end of the humerus prosthesis in a protruding way and are matched with the shank nail channels;
setting a Kirschner wire guide; the Kirschner wire guide is matched with the bulge at the lower end of the humerus prosthesis, the outer diameter of the Kirschner wire guide is matched with the inner diameter of the hollow structure of the bulge at the lower end of the humerus prosthesis, the inner diameter of the Kirschner wire guide is matched with the diameter of the selected Kirschner wire, the Kirschner wire is placed from the hollow structure of the bulge at the lower end of the humerus prosthesis through the Kirschner wire guide, is placed out from the humerus head and is used as a guide wire, and the Kirschner wire is sleeved on the intramedullary nail and is accurately placed into the humerus;
step 8: and (3) acquiring parameters of the humerus prosthesis in the humerus three-dimensional model to manufacture the humerus prosthesis.
2. The method for constructing a three-dimensional model of a humerus, particularly for acquiring tomographic CT data of a complete humerus of a patient, stored in DICOM image format, and constructed by three-dimensional reconstruction software.
3. The method of computer aided design personalized humeral prosthesis construction of claim 1, wherein measuring patient humeral parameters in step 2 includes humeral cavity length, humeral cavity diameter.
4. The method for the manufacture of a computer aided design personalized humerus prosthesis according to claim 1 or 2, characterized in that the modeling software adopts mimics reconstruction software.
5. A humerus prosthesis manufactured by the method for manufacturing the computer-aided design individuation humerus prosthesis according to any one of claims 1 to 4, comprising the humerus prosthesis, and being characterized in that the humerus prosthesis adopts a hollow structure, a handle part is arranged on the inner side of the upper end of the humerus prosthesis, and an upper end bulge and a lower end bulge are respectively arranged on the upper end and the lower end of the humerus prosthesis;
the handle is provided with a handle nail channel; the upper end bulge is provided with an upper end bulge nail channel which is matched with the handle nail channel;
the outer surface of the humerus prosthesis adopts a reticular structure;
the hollow structure adopts a cylinder which is matched with the intramedullary nail;
the shank nail channels are arranged in pairs, and the upper protruding nail channels are also arranged in pairs;
the upper end protruding nail channel comprises an upper end protruding nail inlet channel and an upper end protruding nail outlet channel;
the number of the handle nail channels is 2;
the intramedullary nail is arranged in the hollow structure, the screw is arranged in the shank nail channel, the screw sequentially passes through the upper protruding nail inlet channel and the upper protruding nail outlet channel, and the screw is positioned at two sides of the intramedullary nail to prevent the intramedullary nail from rotating in the humerus.
6. The humeral prosthesis of claim 5, in which the stem tack tract is 3-5mm in diameter.
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CN102813564A (en) * 2012-08-23 2012-12-12 中国人民解放军第四军医大学 Titanium alloy artificial bone/intramedullary nail compression fixation system and preparation method thereof
CN205234702U (en) * 2015-11-06 2016-05-18 郝明仲 Titanium alloy four limbs bone skeleton false body
CN107307925A (en) * 2017-06-23 2017-11-03 天津市天津医院 CAD individuation breastbone prosthese and preparation method
CN107252364A (en) * 2017-07-06 2017-10-17 武汉市黄陂区人民医院 A kind of humerus model of 3D printing and preparation method thereof
CN208958301U (en) * 2018-07-20 2019-06-11 河北瑞鹤医疗器械有限公司 Humeral intramedullary nail
CN109620476A (en) * 2019-02-25 2019-04-16 无锡市人民医院 A kind of tibial mid-distal segment tumor-type prosthesis and preparation equipment and preparation method thereof
CN211512194U (en) * 2019-07-17 2020-09-18 天津市天津医院 Computer-aided design of individualized humeral prosthesis

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