DE19516712A1 - Finger joint prosthesis esp. for main hand to finger joint - Google Patents
Finger joint prosthesis esp. for main hand to finger jointInfo
- Publication number
- DE19516712A1 DE19516712A1 DE19516712A DE19516712A DE19516712A1 DE 19516712 A1 DE19516712 A1 DE 19516712A1 DE 19516712 A DE19516712 A DE 19516712A DE 19516712 A DE19516712 A DE 19516712A DE 19516712 A1 DE19516712 A1 DE 19516712A1
- Authority
- DE
- Germany
- Prior art keywords
- joint
- medullary
- pin
- finger
- joint prosthesis
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
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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
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30014—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30138—Convex polygonal shapes
- A61F2002/30143—Convex polygonal shapes hexagonal
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30224—Three-dimensional shapes cylindrical
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
-
- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
- A61F2002/30355—Cylinder of elliptical or oval basis
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/30364—Rotation about the common longitudinal axis
- A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/30387—Dovetail connection
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/305—Snap connection
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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- A61F2/02—Prostheses implantable into the body
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- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
Die Erfindung betrifft eine Gelenkprothese, vorzugsweise für ein Fingergelenk, bestehend aus einem Drehgelenk, einem Schubgelenk und zwei Verankerungsstegen. Sie dient der Wiederherstellung der Handfunktion bei fortgeschrittenen krankhaften Veränderungen eines oder mehrerer Fingergelenke und ist insbesondere zum Einsatz beim typischen Handbefall des Rheumatikers geeignet. Dem bei der rheumatischen Erkrankung typischerweise auftretenden Vielgelenkbefall wird in besonderer Weise dadurch Rechnung getragen, daß die Versorgung mehrerer Gelenke an einem Finger ermöglicht wird, in dem eine Koppelung mehrerer Fingergelenkprothesen im Sinne eines Fingerrekonstruktionssystems möglich ist.The invention relates to a joint prosthesis, preferably for a Finger joint consisting of a swivel, a Slide joint and two anchoring bars. It serves the Restoration of hand function in advanced pathological changes in one or more finger joints and is particularly suitable for the typical hand infestation of the Suitable for rheumatism. The one with rheumatic disease multi-joint involvement typically occurs in particular Way taken into account that the supply of several Joints on a finger is made possible in which a coupling several finger joint prostheses in the sense of one Finger reconstruction system is possible.
Die im Stand der Technik bekannten Prothesen sind mit verschiedenen Nachteilen behaftet. Beispielsweise können Prothesen mit nur einem Freiheitsgrad im Sinne eines Scharniergelenkes die Funktion des geschädigten Gelenkes nur mit eingeschränkten Bewegungsabläufen nachbilden, was den physiologischen Gegebenheiten nur ungenügend gerecht wird. Ferner kommt es hierdurch zu einer ungedämpften Kraftübertragung an der Grenzfläche zwischen Knochen und Prothesenkomponenten, was zur vorzeitigen Auslockerung führt. Weiterhin verursachen teilweise ungünstige Werkstoffpaarungen Komplikationen im Sinne einer sogen. Metallose, was den erwünschten Einheilungsprozeß verhindert oder aber sekundär zur Auslockerung des Implantates führt. Andere Prothesensysteme bestehen aus einer Silikonkautschuckmasse, die nur eine ungenügende Gelenkführung zulassen. Ferner kommt es hier durch Abrieb an der Knochenimplantatgrenze zu Fremdkörperreaktion mit Auflösung des Knochens. Andere bekannte Prothesen können nur mittels Knochenzement im Knochen verankert werden. Der Knochenzement unterliegt einem Alterungsprozeß, so daß es auch hier zwangsweise zu einer Lockerung des Implantates kommt. Dies führt zur Notwendigkeit der Entfernung des inliegenden Prothesenmateriales und des Knochenzementes. Hierbei kommt es im Regelfall zu einer erheblichen Schädigung der vorhandenen anatomischen Strukturen. Die Belastung des Implantatlagers mit Längskräften in den Fingergelenken führt zur Lockerung der Prothesen.The prostheses known in the prior art are included various disadvantages. For example Prostheses with only one degree of freedom in the sense of a Hinge joint the function of the damaged joint only with simulate restricted movements, what the physiological conditions are insufficient. This also results in undamped power transmission at the interface between bone and prosthetic components, which leads to premature loosening. Continue to cause sometimes unfavorable material combinations complications in the sense a so-called Metallose, which is the desired healing process prevented or secondary to loosening the implant leads. Other prosthesis systems consist of one Silicone rubber compound, which is only an insufficient joint guide allow. It also occurs here due to abrasion Bone implant limit to foreign body reaction with dissolution of the Bone. Other known prostheses can only be used Bone cement to be anchored in the bone. The bone cement is subject to an aging process, so here too the implant is loosened. This leads to the need to remove the underlying Prosthesis material and bone cement. Here it comes usually to a considerable damage to the existing anatomical structures. The load on the implant bearing with Longitudinal forces in the finger joints loosen the Prostheses.
Der Erfindung liegt die Aufgabe zugrunde, eine Fingergelenkprothese anzugeben, die es gestattet, die natürliche Gelenkmechanik weitestgehend wiederherzustellen, wobei das Gelenk trotz einer Verbindung der beiden Prothesengelenkteile mit dem Markraum der Fingerknochen eine begrenzte Drehbewegung um mehrere Achsen und eine begrenzte Bewegung in Fingerlängsrichtung zuläßt, wobei trotz dieser Beweglichkeit die Verbindung der Gelenkpartner dermaßen gesichert ist, daß ein Entkoppeln des Drehgelenkes unmöglich ist. Durch Ankopplung weiterer Prothesenkomponenten ist die Versorgung mehrerer Gelenke möglich.The invention has for its object a Specify finger joint prosthesis that allows the natural To restore joint mechanics as far as possible, whereby the Joint despite a connection of the two prosthetic joint parts with a limited rotational movement in the medulla of the finger bones around multiple axes and limited movement in Permits longitudinal direction of the fingers, whereby despite this mobility the Connection of the joint partners is so secured that a Uncoupling the swivel is impossible. By coupling other prosthesis components are the supply of several Joints possible.
Erfindungsgemäß gelingt die Lösung der Aufgabe dadurch, daß für eine Fingergrundgelenkprothese die Verankerungsstege als profilierte Markraumstifte ausgebildet sind, an einem Markraumstift ein kugelkalottenförmiger Reiter und zentrisch dazu ein teilkugelförmiges Teil befestigt sind und daß an dem anderen Markraumstift eine geneigte Halbkugel befestigt ist, die einen schlitz- und einen kugelförmigen Hohlraum aufweist.According to the invention the object is achieved in that for a finger joint prosthesis as the anchoring bars profiled marrow pins are formed on a marrow pin a spherical cap-shaped tab and centered on it part spherical part are attached and that to the other Medullary pin is attached to an inclined hemisphere has slit and a spherical cavity.
Bei der erfindungsgemäßen Fingermittelgelenkprothese sind die Markraumstifte über ein Gelenk verbunden, bei dem in einem zur Fingerlängsrichtung beugeseitig geneigten Halbzylinder oder einer Halbkugel im Mittelpunkt eine Achse bzw. Teilkugel eingelassen ist, die mittels eines Zapfens, welcher in einem Schlitz in dem Halbzylinder bzw. der Halbkugel gleitet, oder mittels zweier seitlicher Zapfen, mit einem Reiter verbunden ist, der auf der Halbkugel gleitet.In the middle finger joint prosthesis according to the invention Medullary canal pins connected by a joint, in which in a Finger longitudinal direction inclined half cylinder or one Hemisphere is embedded in the center of an axis or partial sphere, by means of a pin which is in a slot in the Half cylinder or the hemisphere slides, or by means of two lateral Tenon, connected to a rider on the hemisphere slides.
Die erfindungsgemäße Fingergelenkprothese weist insbesondere folgende Vorteile auf:The finger joint prosthesis according to the invention has in particular the following advantages:
- - Das System trägt dem bei der rheumatischen Erkrankung auftretendem Vielgelenkbefall Rechnung, indem es nicht nur die Versorgung mehrerer Gelenke an einem Finger ermöglicht, sondern auch eine Koppelung der Systemkomponenten zuläßt. Es verhindert außerdem das bei diesen Gelenken auftretende spontane Auslenken der Gelenke.- The system contributes to the rheumatic disease occurring multi-joint attack by not only the Allows supply of multiple joints on one finger, but also allows coupling of the system components. It prevents also the spontaneous one that occurs in these joints Deflect the joints.
- - Die einzelnen Gelenkkomponenten sind so gestaltet, daß sie die natürliche Gelenkmechanik weitestgehend wiederherstellen. Dies ermöglicht, daß der natürliche Kapselbandapparat in die Gelenkmechanik wieder reintegriert werden kann, um erneut gelenkstabilisierende Funktion zu übernehmen.- The individual joint components are designed so that they restore natural joint mechanics as far as possible. This enables the natural capsular ligament apparatus into the Joint mechanics can be reintegrated to again to take over the joint stabilizing function.
- - Bei Reintegration des natürlichen Kapselbandapparates oder ersatzweise beim Ausbilden entsprechender Narbenzüge wirken nur geringere Kräfte auf die Prothesenkomponenten, so daß eine rasche Auslockerung mit Ausbrechen der Markraumstifte durch den Knochen, wie sie von dem im Stand der Technik bekannten starren Scharnieren her bekannt ist, unwahrscheinlich wird.- With reintegration of the natural capsular ligament apparatus or as an alternative, only appropriate scar features are effective lower forces on the prosthetic components, so that a quick Loosening with breaking out of the medullary canals by the Bones as stiff from that known in the art Known hinges, is unlikely.
- - Beim Versagen des Bandapparates wird die Beweglichkeit des Fingergrundgelenkes auf ein Ausmaß limitiert, welches eine sicher geführte Fingerbeweglichkeit zu läßt, so daß der geschädigte Bandapparat zusammen mit der sich ausbildenden Narbe später u. U. erneut die Kräfte aufnehmen kann.- If the ligament apparatus fails, the mobility of the Finger joint limited to an extent that is safe guided finger mobility, so that the injured Ligament together with the scar that develops later u. U. can absorb the forces again.
- - Die erfindungsgemäßen Prothesenkomponenten ermöglichen in der Prothese eine Teleskopbewegung, so daß die Zugkräfte nicht auf die Markraumstifte übertragen werden, diese aber gleichzeitig unbewegt zum Knochen Kontakt haben und somit Einheilen können.- The prosthetic components according to the invention allow in the prosthesis a telescopic movement so that the tensile forces are not transferred to the medullary canals, but at the same time are still in contact with the bone and can therefore heal.
Die Erfindung wird im folgenden anhand eines Ausführungsbeispieles näher erläutert. In der zugehörigen Zeichnung zeigen:The invention is based on a Embodiment explained in more detail. In the associated Show drawing:
Figur I Eine Ausführungsform für eine Fingergrundgelenkskomponente.Figure I An embodiment for a Finger joint component.
Figur II Die Befestigung der Halbkugel mit einem druckknopfartigen Verbindungsteil an dem Markraumstift. Figure II The fastening of the hemisphere with a push button-like Connection part on the medullary canal.
Figur III Eine Ausführungsform für eine Fingermittelgelenkskomponente.Figure III An embodiment for a Finger center joint component.
Die in Figur I dargestellte Fingergrundgelenkskomponente besteht aus zwei Markraumstiften. Zur Verankerung im Markraum des Mittelhandknochens (1) und im Markraum des Fingergrundgliedes (2). Die Markraumstifte 1 und 2 sind aus rauhgestrahltem Titan gefertigt oder sind alternativ mit Hydroxylapatit beschichtet, was nachdem derzeitigen Stand ein bestmögliches knöchernes Einwachsen ermöglicht. Die zusätzlich längsgeriffelte Oberfläche dieser Markraumstifte 1 und 2 bewirkt eine Knochen- Implantatgrenzflächenvergrößerung zur Verbesserung des Einheilungsverhaltens und eine Vergrößerung der Haftreibung zur rotationsstabilen Markraumstiftverankerung. Außerdem wird durch die Riffelung ein leichteres Implantieren und im Komplikationsfall auch ein leichteres Explantieren ermöglicht.The component of the basic finger joint shown in FIG. 1 consists of two medullary canal pins. For anchoring in the medulla of the metacarpal bone ( 1 ) and in the medulla of the base of the finger ( 2 ). The medullary canals 1 and 2 are made of rough-blasted titanium or are alternatively coated with hydroxyapatite, which, according to the current status, enables the best possible bone ingrowth. The additionally longitudinally grooved surface of these medullary pins 1 and 2 causes an enlargement of the bone implant interface to improve the healing behavior and an increase in static friction for anchoring the medullary pin in rotation. In addition, the corrugation enables easier implantation and, in the event of complications, easier explantation.
Die Markraumstifte der Grundgelenkkomponenten können zur Erhöhung der Elastizität zur besseren Anpassung an die Elastizität des Knochens und zur Anpassung an den nicht ideal röhrenförmigen Markraum längsgeschlitzt sein. Der Markraumstift zur Verankerung im Mittelhandknochen hat in Annäherung an den natürlichen Markraum eine zylinderische Form und ist einfach oder kreuzweise geschlitzt. Er läuft gelenknah gemäß der inneren Knochenform in eine exzentrische konusförmige Erweiterung aus, welche zur besseren Verankerung mehrere Aussparungen zeigt. Der Markraumstift (2) zur Verankerung im Fingergrundglied (10) ist in Annäherung an die natürliche flachere Dreiecksform flachoval geformt und aus den o. g. Gründen längsgeschlitzt. Beide Markraumstifte haben eine zentrale Bohrung, ggf. mit Gewinde, welche ggf. den Anschluß weiterer Systemkomponenten ermöglicht.The medullary canal pins of the basic joint components can be slit longitudinally to increase the elasticity for better adaptation to the elasticity of the bone and to adapt to the not ideal tubular medullary cavity. The medullary canal pin for anchoring in the metacarpus has a cylindrical shape approximating to the natural medullary canal and is slit or cross-slit. It runs close to the joint in accordance with the inner shape of the bone in an eccentric conical extension, which shows several recesses for better anchoring. The medullary canal pin ( 2 ) for anchoring in the base of the finger ( 10 ) is shaped flat oval to approximate the natural, flatter triangular shape and is longitudinally slotted for the reasons mentioned above. Both medullary canals have a central hole, possibly with a thread, which may allow the connection of further system components.
Gelenknah enden beide Markraumstifte (1, 2) in Aufsitzplätzen (3, 4), welche ein Einsintern der Markraumstift 1 und 2 in die Markräume unter Stauchungsbelastung verhindern soll. Die Aufsitzplatten 3 und 4 sind exzentrisch ausgeformt und zeigen streckseitig eine tiefere und beugeseitig eine angedeutet flache, flatte Aussparung, um ein Scheuern der angrenzenden Sehnen an der jeweiligen Metallkante, insbesondere bei möglichen Knochendefekten zu verhindern.Both medullary canal pins ( 1 , 2 ) end near the joint in seating positions ( 3 , 4 ) which are intended to prevent the medullary canal pins 1 and 2 from sintering into the medullary canals under compression. The seat plates 3 and 4 are eccentrically shaped and have a deeper cutout on the extension side and a hinted flat, flat cutout on the flexure side to prevent the adjacent tendons from rubbing against the respective metal edge, in particular in the event of possible bone defects.
Den unterschiedlichen Größen der natürlichen Fingergrundgelenke wird durch verschiedene Größen der Komponente Rechnung getragen.The different sizes of the natural finger joints is calculated by different component sizes carried.
Da die Fingergrundgelenkmechanik natürlicherweise dem eines Kugelgelenkes nahe kommt, besteht der bewegliche Anteil des künstlichen Fingergrundgelenkes aus einer in Relation zur Fingergelenksachse 45° nach beugeseitig geneigten - beispielsweise aus Polyaethylen bestehenden - Teilkugel 5. Hierdurch wird der Drehmittelpunkt der Fingergrundgelenkkomponente exzentrisch nach beugeseitig verlagert, was dem natürlichen gemittelten Gelenkdrehpunkt nahekommt, was sowohl ein Wiederanheilen des natürlichen Kapselbandapparates als auch eine bessere Streckkraft ermöglicht. In die Teilkugel 5 ist im Kugelmittelpunkt eine Kugel 7 eingelassen. Diese ist mittels eines Zapfens mit einem schalenförmigen Reiter 8 verbunden, welcher auf der Teilkugel 5 gleitet. Der schalenförmige Reiter 8 ist beuge- und streckseitig relativ scharfkantig, um aufwachsendes Narbengewebe abzuschieben. Die Teilkugel 5 ist dermaßen geschlitzt, daß der Zapfen sowohl in Beuge- und Streckbewegungen, in auf 15° begrenzte Seitführung und freier Rotation bewegt werden kann. Die Rotation wird durch einen zusätzlich vom schalenförmigen Reiter 8 in den Schlitz der Teilkugel 5 reichenden Stift oder aber durch längsovale Ausführung des Verbindungszapfens zwischen der Kugel 7 und dem Reiter 8 auf ca. 15° begrenzt.Since the basic mechanism of the finger joint naturally comes close to that of a ball joint, the movable part of the artificial joint of the finger consists of a partial ball 5 which is inclined 45 ° in relation to the axis of the joint of the finger, for example made of polyethylene, 5 . As a result, the center of rotation of the basic finger joint component is displaced eccentrically towards the flexion side, which is close to the natural averaged pivot point, which enables both the natural capsular ligament apparatus to heal and a better stretching force. A ball 7 is let into the partial ball 5 at the center of the ball. This is connected by means of a pin to a cup-shaped tab 8 which slides on the partial ball 5 . The cup-shaped tab 8 has relatively sharp edges on the flexion and extension sides in order to push off growing scar tissue. The partial ball 5 is slotted to such an extent that the pin can be moved both in bending and stretching movements, in lateral guidance limited to 15 ° and in free rotation. The rotation is limited to approximately 15 ° by an additional pin extending from the bowl-shaped tab 8 into the slot of the partial ball 5 or by a longitudinal oval design of the connecting pin between the ball 7 and the tab 8 .
Eine vorteilhafte Ausführung der erfindungsgemäßen Gelenkprothese ermöglicht eine dem beim natürlichen Gelenk, insbesondere bei Lockerung der gelenkführenden Bänder, vorhandene Längsbeweglichkeit der zu verbindenden Fingerglieder. Dies wird dadurch erreicht, daß einer der Markraumstifte 1 und 2 mit dem Drehgelenk über ein zusätzlich angebrachtes Schubgelenk verbunden ist. In der dargestellten Ausführungsform wird dies durch einen Gleitführungsstift 9 erreicht, der sich in einer zugehörigen Buchse im Markraumstift des Mittelgelenkes bewegt. Dieser Gleitführungsstift ist zur Vermeidung von Rotationsbewegungen im Schubgelenk als Profilstift, beispielsweise als Sechskantstift (alternativ 3 -, 4 -, 5 - Kantstift) oder als ovalgeformter Profilstift gestaltet, der in einer im Markraumstift 1 oder 2 befestigten Buchse gleitet.An advantageous embodiment of the joint prosthesis according to the invention enables the longitudinal mobility of the phalanges to be connected in the natural joint, in particular when the ligament-guiding ligaments are loosened. This is achieved in that one of the medullary canal pins 1 and 2 is connected to the swivel joint via an additionally attached thrust joint. In the illustrated embodiment, this is achieved by a sliding guide pin 9 , which moves in an associated bushing in the medullary canal pin. This sliding guide pin is designed to avoid rotational movements in the thrust joint as a profile pin, for example as a hexagon pin (alternatively 3 -, 4 -, 5 - square pin) or as an oval-shaped profile pin that slides in a bush attached in the medullary pin 1 or 2 .
Durch den Kapselbandapparat wird die Beweglichkeit beim natürlichen Gelenk auf eine Überstreckfähigkeit von ca. 30°, eine Beugefähigkeit von ca. 100°, eine Seitführbarkeit von ca. 30° nach ellenseitig und ca. 10° nach speichenseitig und auf eine Rotation von ca. 10° eingeschränkt. Für den Alltagsgebrauch erscheint eine Beugefähigkeit von 90°, eine geringe Überstreckbarkeit, eine Rotationsfähigkeit von 10° und eine Seitneigung von jeweils 10° hinreichend. Dieser Bewegungsumfang wird durch die erfindungsgemäße Komponente gewährleistet und sogar etwas übertroffen. Hierdurch wird es möglich, daß die bei Rotation und Seitneigung des Fingers auftretenden Kräfte im wesentlichen auf den natürlichen, postoperativ etwas narbig geschrumpften Bandapparat übertragen werden können, da dieser nach narbiger Schrumpfung nur geringe Rotations- und Seitneigungsbewegungen zuläßt.Through the capsular ligament apparatus, the mobility is natural joint to a hyperextensibility of about 30 °, a Flexibility of approx. 100 °, a sideways movement of approx. 30 ° after on the elbow side and about 10 ° to the spoke side and on one rotation restricted by approx. 10 °. A appears for everyday use Flexibility of 90 °, a low overstretchability, a Rotation ability of 10 ° and a lateral inclination of 10 ° each sufficient. This range of motion is determined by the Component according to the invention guaranteed and even something surpassed. This makes it possible that the rotation and Forces that arise from the lateral inclination of the finger essentially occur the natural, slightly scarred post-operative Band apparatus can be transmitted because this is pitted Shrinkage only slight rotational and lateral movements allows.
Figur II zeigt die erfindungsgemäße Befestigung der Teilkugel 5 mit einem druckknopfartigen Verbindungsteil 6 an den Markraumstift 1. Da die Prothese in Einzelteilen implantiert werden muß, ist ein Zusammenfügen der Einzelteile unter den räumlich beengten Verhältnissen des Operationssitus nach dem Implantieren der Einzelteile erforderlich. Dies wird durch das dargestellte druckknopfartige Verbindungsteil 6 ermöglicht.FIG. II shows the attachment of the partial ball 5 according to the invention to the medullary pin 1 with a push-button-like connecting part 6 . Since the prosthesis has to be implanted in individual parts, it is necessary to assemble the individual parts under the spatially confined conditions of the surgical site after the individual parts have been implanted. This is made possible by the push button-like connecting part 6 shown .
Die Verbindung wird dadurch ermöglicht, daß das Polyaethylenteil eine schwalbenschwanzförmige Ausfräsung enthält und an dem Ende des Markraumstiftes ein schwalbenschwanzförmiges Gegenstück angebracht ist, an dem eine Fläche mit einem Radius versehen ist. Das Einrasten kann dabei von beugseitig nach streckseitig erfolgen. Zur weiteren Verstärkung der druckknopfartigen Verbindung können zusätzlich ein bis zwei Sicherungsschrauben 19 durch das Polyaethylenteil in das schwalbenschwanzförmige Gegenstück des Markraumes eingebracht werden. Zur Ermöglichung des Einschraubens unter den beengten Verhältnissen des Operationssitus ist die Ausrichtung der Sicherungsschrauben und des dazugehörigen Gewindes etwa in Richtung des Markraumstiftes 1 zu wählen.The connection is made possible in that the polyethylene part contains a dovetail cut and a dovetail counterpart is attached to the end of the medullary pin, on which a surface is provided with a radius. The engagement can take place from the flexion side to the stretching side. To further strengthen the push-button-like connection, one or two locking screws 19 can additionally be inserted through the polyethylene part into the dovetail-shaped counterpart of the medullary canal. To enable screwing in under the cramped conditions of the surgical site, the alignment of the locking screws and the associated thread should be selected approximately in the direction of the medullary pin 1 .
Die in Figur III dargestellte Fingermittelgelenkprothese dient in Kombination mit den anzukoppelnden modularen Markraumstiften zur Versorgung von Fingergrundglied 10, Fingermittelglied 11 und Fingerendglied 12. Die bewegliche Fingergelenkkomponente ist gemäß der natürlichen Beweglichkeit als Gelenk ausgebildet, welches eine Drehbewegung um eine Achse ermöglicht. In einem um 45° zur Fingerlängsrichtung beugeseitig geneigten Halbzylinder ist im Mittelpunkt eine metallische Achse eingelassen, die mittels eines Zapfens, der in einem Schlitz des Halbzylinders 15 gleitet, oder mittels zweier Bügel seitlich der Halbzylinders mit einem Reiter verbunden, der auf dem Halbzylinder gleitet. Der Halbzylinder kann aus Polyaethylen, aus Keramik, aus einer beschichteten Titanlegierung oder aus anderen Materialen bestehen. Die Beuge-/ Streckbeweglichkeit ist zwischen voller Streckung und 90° Beugung möglich.The finger middle joint prosthesis shown in FIG. III, in combination with the modular medullary canal pins to be coupled, serves to supply the basic finger member 10 , middle finger member 11 and end finger member 12 . The movable finger joint component is designed according to the natural mobility as a joint, which enables a rotary movement about an axis. In a half-cylinder inclined at 45 ° to the longitudinal direction of the finger, a metallic axis is embedded in the center, which is connected to a rider that slides on the half-cylinder by means of a pin that slides in a slot of the half-cylinder 15 or by means of two brackets on the side of the half-cylinder. The half cylinder can be made of polyethylene, ceramic, a coated titanium alloy or other materials. Flexibility is possible between full extension and 90 ° flexion.
Der Markraumstift zur Verankerung im Grundglied besteht aus einer Hülse, die an die verbleibende Länge des Grundgliedes die nach Implantation des Markraumstiftes der Grundgelenkprothese verbleibt, angepaßt wird, und einem darin befestigten Zapfen 14, an dessen einem Ende das druckknopfartige Verbindungselement befestigt ist. Der Markraumstift endet in einer Abstützplatte, die ein Einsintern des Kunstgelenkes in das Grundglied verhindern soll. Sowohl für die bewegliche als auch für die unbewegliche Mittelgelenkkomponente stehen verlängerte Markraumstift 17 zur Verfügung, welche eine Überbrückung über das (operativ resezierte) Endgelenk bis in das Fingerendglied 12 ermöglichen.The marrow pin for anchoring in the base member consists of a sleeve which is adapted to the remaining length of the base member which remains after implantation of the marrow pin of the base joint prosthesis, and a pin 14 fastened therein, at one end of which the push-button-like connecting element is attached. The medullary canal ends in a support plate which is intended to prevent the artificial joint from sintering into the base member. Extended medullary pin 17 are available for both the movable and the immovable central joint component, which enable bridging over the (surgically resected) end joint into the finger end member 12 .
Eine weitere erfindungsgemäße Ausführung dient als unbewegliche Komponente zur Versteifung des Mittelgelenkes in einer funktionell günstigen Stellung von ca. 45°. Es handelt sich hierbei um ein im Knochen zu versenkendes 45°-Winkelstück, welches mittels eines dünnen Zapfens an den Markraumstift der Grundgelenkkomponente angeschlossen wird. Another embodiment according to the invention serves as immovable Component for stiffening the central joint in a functional favorable position of approx. 45 °. It is an im 45 ° contra-angle handpiece to be countersunk thin pin on the medullary pin of the basic joint component is connected.
Eine gesonderte Fingerendgelenkkomponente ist nicht erforderlich. Hier ist die Versteifung des Gelenks durch einen verlängerten Markraumstift 17 der erfindungsgemäßen Mittelgelenkkomponenten vorgesehen.A separate finger end joint component is not required. Here the stiffening of the joint is provided by an elongated medullary pin 17 of the central joint components according to the invention.
BezugszeichenlisteReference list
1, 2 Markraumstift
3, 4 Aufsitzplatte
5 Teilkugel
6 druckknopfartiges Verbindungsteil
7 kugelförmiges Teil
8 schalenförmiger Reiter
9 Gleitführungsstift
10 Fingergrundglied
11 Fingermittelglied
12 Fingerendglied
13 Hülse
14 Zapfen
15 Halbzylinder
16 Achse
17 verlängerter Markraumstift
18 Bügel
19 Sicherungsschraube. 1 , 2 medullary canal
3 , 4 seat plate
5 partial spheres
6 push button-like connecting part
7 spherical part
8 bowl-shaped tabs
9 sliding guide pin
10 phalanges
11 middle finger
12 finger end link
13 sleeve
14 cones
15 half cylinders
16 axis
17 extended medullary canal
18 brackets
19 locking screw.
Claims (12)
- - die Verankerungsstege als profilierte Markraumstifte (1, 2) ausgebildet sind und
- - an einem Markraumstift (2) ein schalenförmiger Reiter (8) und zentrisch dazu eine Teilkugel (7) gefestigt sind und
- - an dem Markraumstift (1) eine geneigte Teilkugel (5) befestigt ist, die einen Schlitz und einen kugelförmigen Hohlraum aufweist und
- - der Rotationsmittelpunkt der Teilkugel (5) exzentrisch zur Längsachse des Markraumstiftes (1) nach beugeseitig versetzt ist.
- - The anchoring webs are designed as profiled medullary pins ( 1 , 2 ) and
- - On a medullary canal pin ( 2 ) a bowl-shaped rider ( 8 ) and a partial sphere ( 7 ) are fixed centrally and
- - On the medullary pin ( 1 ) an inclined partial ball ( 5 ) is attached, which has a slot and a spherical cavity and
- - The center of rotation of the partial sphere ( 5 ) is offset eccentrically to the longitudinal axis of the medullary pin ( 1 ) on the flexion side.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19516712A DE19516712A1 (en) | 1995-05-06 | 1995-05-06 | Finger joint prosthesis esp. for main hand to finger joint |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19516712A DE19516712A1 (en) | 1995-05-06 | 1995-05-06 | Finger joint prosthesis esp. for main hand to finger joint |
Publications (1)
Publication Number | Publication Date |
---|---|
DE19516712A1 true DE19516712A1 (en) | 1996-11-07 |
Family
ID=7761275
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19516712A Withdrawn DE19516712A1 (en) | 1995-05-06 | 1995-05-06 | Finger joint prosthesis esp. for main hand to finger joint |
Country Status (1)
Country | Link |
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DE (1) | DE19516712A1 (en) |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
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DE10354601B3 (en) * | 2003-11-21 | 2005-06-23 | Chiropro Gmbh | Finger joint prosthesis comprises a ball-and-socket joint in which the rotatable part is a ball-like disk with a peripheral opening in which a distal shaft extension is borne in a movable manner |
WO2013130902A1 (en) * | 2012-03-01 | 2013-09-06 | Solana Surgical, Llc | Grommet for use with surgical implant |
RU2548743C1 (en) * | 2013-11-07 | 2015-04-20 | Федеральное государственное бюджетное образовательное учреждение высшего профессионального образования "Пермский государственный национальный исследовательский университет" | Phalanx endoprosthesis |
RU2577452C1 (en) * | 2014-10-30 | 2016-03-20 | Федеральное государственное бюджетное образовательное учреждение высшего профессионального образования "Пермский государственный национальный исследовательский университет" | Metacarpophalangeal endoprosthesis with intermediate layer of carbon nanotubes |
RU2599351C2 (en) * | 2014-10-30 | 2016-10-10 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Пермский государственный национальный исследовательский университет" | Phalangeal joint endoprosthesis with carbon coating |
RU170825U1 (en) * | 2016-07-18 | 2017-05-11 | Общество с ограниченной ответственностью "Мойе Керамик-Имплантате" | Interphalangeal endoprosthesis of the hand |
RU202476U1 (en) * | 2020-11-24 | 2021-02-19 | Общество с ограниченной ответственностью «НЕОТЕХ» | ENDOPROTHESIS OF THE PROXIMAL INTERPHALANGE JOINT OF THE BRUSH |
-
1995
- 1995-05-06 DE DE19516712A patent/DE19516712A1/en not_active Withdrawn
Cited By (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE10354601B3 (en) * | 2003-11-21 | 2005-06-23 | Chiropro Gmbh | Finger joint prosthesis comprises a ball-and-socket joint in which the rotatable part is a ball-like disk with a peripheral opening in which a distal shaft extension is borne in a movable manner |
WO2013130902A1 (en) * | 2012-03-01 | 2013-09-06 | Solana Surgical, Llc | Grommet for use with surgical implant |
CN104144657A (en) * | 2012-03-01 | 2014-11-12 | 索拉纳外科器械有限公司 | Grommet for use with surgical implant |
JP2015511853A (en) * | 2012-03-01 | 2015-04-23 | ソラナ・サージカル・リミテッド・ライアビリティ・カンパニーSolana Surgical, Llc | Grommets for use with surgical implants |
AU2013225850B2 (en) * | 2012-03-01 | 2015-07-16 | Wright Medical Technology, Inc. | Grommet for use with surgical implant |
RU2548743C1 (en) * | 2013-11-07 | 2015-04-20 | Федеральное государственное бюджетное образовательное учреждение высшего профессионального образования "Пермский государственный национальный исследовательский университет" | Phalanx endoprosthesis |
RU2577452C1 (en) * | 2014-10-30 | 2016-03-20 | Федеральное государственное бюджетное образовательное учреждение высшего профессионального образования "Пермский государственный национальный исследовательский университет" | Metacarpophalangeal endoprosthesis with intermediate layer of carbon nanotubes |
RU2599351C2 (en) * | 2014-10-30 | 2016-10-10 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Пермский государственный национальный исследовательский университет" | Phalangeal joint endoprosthesis with carbon coating |
RU170825U1 (en) * | 2016-07-18 | 2017-05-11 | Общество с ограниченной ответственностью "Мойе Керамик-Имплантате" | Interphalangeal endoprosthesis of the hand |
RU202476U1 (en) * | 2020-11-24 | 2021-02-19 | Общество с ограниченной ответственностью «НЕОТЕХ» | ENDOPROTHESIS OF THE PROXIMAL INTERPHALANGE JOINT OF THE BRUSH |
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