FR2605878A1 - Prosthesis for small joints, in particular metacarpophalangial and interphalangial joints - Google Patents

Prosthesis for small joints, in particular metacarpophalangial and interphalangial joints Download PDF

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Publication number
FR2605878A1
FR2605878A1 FR8615156A FR8615156A FR2605878A1 FR 2605878 A1 FR2605878 A1 FR 2605878A1 FR 8615156 A FR8615156 A FR 8615156A FR 8615156 A FR8615156 A FR 8615156A FR 2605878 A1 FR2605878 A1 FR 2605878A1
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Prior art keywords
surface
characterized
prosthesis
33b
rod
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FR8615156A
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French (fr)
Inventor
Jean-Luc Condamine
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Landos Applications Orthopediques Francaises
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Landos Applications Orthopediques Francaises
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Priority to FR8615156A priority Critical patent/FR2605878A1/en
Publication of FR2605878A1 publication Critical patent/FR2605878A1/en
Application status is Pending legal-status Critical

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30317The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30326The prosthesis having different structural features at different locations within the same prosthesis differing in height or in length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30317The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30327The prosthesis having different structural features at different locations within the same prosthesis differing in diameter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30818Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves castellated or crenellated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3082Grooves
    • A61F2002/30827Plurality of grooves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30879Ribs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891Plurality of protrusions
    • A61F2002/30892Plurality of protrusions parallel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
    • A61F2002/4228Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes for interphalangeal joints, i.e. IP joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4243Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for interphalangeal joints, i.e. IP joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4251Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special 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
    • A61F2250/0037Special 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 height or in length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special 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
    • A61F2250/0039Special 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 diameter

Abstract

A prosthesis comprises a first element 1 having a convex extreme surface 33a, 33b and a first rod 4, and a second element 2 having a concave extreme surface 53a, 53b, congruent with the convex surface, and a second rod 6. The concave surface is contained within a spherical sector less than 180 DEG , so that, after cementless implantation, the joint surfaces 33a, 33b and 53a, 53b slide over each other, and can be moved with respect to each other in a direction which is longitudinal to the rods 4, 6, in order to provide the movements of the joint. In order to stabilise the prosthesis transversely, and to oppose relapses of orbital deviation, a ridge 54 between two symmetrical concave surfaces 53a, 53b of the second element engages in a groove 34 between two symmetrical convex surfaces 33a, 33b of the first element. The prosthesis is stabilised in rotation by lateral indentations 35a, 35b in the first element, receiving chamfers of a resected bone. <IMAGE>

Description

Prothèse pour petites articulations notamment Prosthesis for small joints such
métacarpo-phalangiennes et interphalangiennes metacarpophalangeal and interphalangeal
La présente invention concerne une prothèse pour petites articulations, telles qu'articulations métacarpo-phalangiennes et interphalangiennes de la main ou du pied auxquelles on se référera dans la suite. The present invention relates to a prosthesis for small joints such qu'articulations metacarpophalangeal and interphalangeal joints of the hand or foot to which reference hereinafter.

les articulations métacarpo-phalangiennes et interphalangiennes représentent l'une des cibles d'élection de la maladie rhumatolde. the metacarpophalangeal and interphalangeal joints are one of the election of the rhumatolde disease targets.

Cette affection se traduit au niveau de ces articulations principalement par de la douleur associée à une desctruction des structures articulaires compromettant gravement la fonction de la main. This condition is reflected in these joints mainly pain associated with desctruction articular structures severely compromising the function of the hand.

les articulations malades sont frequemment déformées, disloquées et subluxées, dans le sens d'une dérivation cubitale pour l'articulation métacarpo-phalangienne. the diseased joints are frequently distorted and dislocated subluxated, in the direction of an ulnar bypass for the metacarpophalangeal joint. De même, les fractures articulaires G ce niveau entratnent destruction et raideur douloureuse. Similarly, G articular fractures that level entratnent destruction and painful stiffness.

Afin de soulager les souffrances de ces individus et de restaurer leur fonction de préhension, la solution d'une résection suivie d'un appareillage prothétique a été proposée. In order to alleviate the suffering of these people and restore their function grip, the solution resection followed by prosthetic devices has been proposed.

les prothèses proposées jusqu'ici pour ces petites articulations peuvent être classées en des premier et second groupes : les prothèses du. prosthetics so far proposed for these small joints can be divided into first and second groups prostheses. premier groupe sont en fait des "espaceurs" en matériau élastomère flexible au sein duquel s'effectue le mouvement ; first group are in fact "spacers" flexible elastomeric material within which completes the movement; les prothèses du second groupe sont réalisées en deux parties stabilisées l'une par rapport à l'autre par des dispositifs de liaison assurant leur mouvement relatif. prostheses of the second group are made of two stabilized portions relative to each other by connection devices ensuring their relative movement.

les prothèses du premier groupe sont réalisées en une seule pièce en matériau flexible, comportant trois parties : deux tiges coniques et une partie de liaison centrale favorisant le mouvement dans une direction. prostheses of the first group are made of a single piece of flexible material, comprising three parts: two conical pins and a central connecting portion promoting the movement in one direction.

les inconvénients relatés avec ce type de prothèse consistent en une détérioration du matériau, un résultat fonctionnel peu satisfaisant et une récidive fréquente des déviations axiales. recounted disadvantages with this type of prosthesis consist in a deterioration of the material, an unsatisfactory functional results and frequent recurrence axial deviations. La détérioration du matériau, tel qu'élastomère de silicone, aboutit à sa fragmentation, qui induit des réactions locales a corps étrangers suffisamment importantes pour obliger à l'ablation du matériel prothétique. The deterioration of the material, such as silicone elastomer, leads to fragmentation, which induces local reactions has sufficiently large foreign bodies to force the removal of prosthetic material. Le résultat fonctionnel est souvent limité en l'absence d'une liaison stable entre les membres de l'articulation qui se traduit par une force de préhension faible. The functional result is often limited in the absence of a stable bond between the members of the joint which results in a low grip strength. Le matériau flexible constituant la prothèse ne peut combattre l'effet de rappel latéral des tendons des fléchisseurs et des extenseurs et l'on assiste fréquemment à une récidive des déviations cubitales corrigées au moment de l'implantation. The flexible material constituting the prosthesis can fight side booster effect tendon flexors and extensors and is frequently present at a recurrence of ulnar deviations corrected at the time of implantation.

Les prothèses du second groupe répondent aux critiques des prothèses du premier groupe, et ont deux parties réalisées en des matériaux plus rigides, reliées ensemble par une liaison. The prostheses of the second group address critical prostheses of the first group, and two parts made of stiffer materials, joined together by a bond. Cette liaison entre les deux parties de la prothèse est rigide et assure également la mobilité articulaire dans un plan de l'espace par une articulation de type charnière ou rotule (GB-A-2 049 435). This connection between the two parts of the prosthesis is rigid and also ensures joint mobility in a plane in space by a hinge type joint or ball joint (GB-A-2049435). L'ancrage diaphysaire de ces prothèses est le plus fréquemment assuré par scellement intramédullaire, au moyen de ciment orthopédique. Anchoring diaphyseal these prostheses is most frequently provided by intramedullary sealing, using bone cement.

Cette liaison mécanique rigide entre les parties proximales et distales de ces prothèses entrain, lors des mouvements habituels de l'extrémité prothésée, des contraintes en cisaillement très élevées au niveau des ancrages de la prothèse, ainsi que des efforts importants autour de l'axe assurant la liaison. This rigid mechanical link between the proximal and distal portions of these prostheses spirits, during normal movements of the prosthetic end, very high shear stresses at the anchorage of the prosthesis, as well as considerable effort around the axis ensuring the link. Ces phénomènes entraient fréquemment des descellements prothétiques, ainsi que des risques d'usure et de fracture de l'articulation prothétique. These phenomena frequently entered prosthetic loosening, and the risks of wear and fracture of the prosthetic joint. Ce type de prothèse est en effet très sensible aux efforts en torsion le plus souvent amplifiés par le bras de levier distal et répercutés directement au niveau de l'axe de liaison et des ancrages. This type of prosthesis is indeed very sensitive to torsion efforts often amplified by the distal lever arm and passed directly to the axis connecting and anchors.

Enfin, l'utilisation de ciment orthopédique pour la fixation de ces prothèses ' est très critiquée, car elle aboutit à une détérioration du capital osseux local et rend très délicats les parfois nécessaires changements de prothèse, Finally, the use of bone cement for fixation of these prostheses is highly criticized, because it results in a deterioration of the local bone density and makes it very difficult sometimes necessary changes prosthesis
La présente invention vise à fournir une prothèse pour petites articulations, telles qu'articulations métacarpo-phalangiennes et interphalangiennes, réalisée en deux éléments non reliés entre eux par un quelconque élément de liaison, s'implantant sans utilisation de ciment, et stabilisée au moins partiellement en rotation. The present invention aims to provide a prosthesis for small joints such qu'articulations metacarpophalangeal and interphalangeal, carried out in two unrelated elements to each other by any connecting element that is found without the use of cement, and stabilized at least partially in rotation.

A cette fin, une prothèse pour petites articulations comprenant un premier élément ayant un premier about à surface extrémale convexe et une première tige, et un second élément ayant un second about à surface extrémale concave congruente a la surface convexe et une seconde tige, est caractérisée en ce que la surface concave est une surface sensiblement de révolution comprise dans un secteur sphérique inférieur à 1800 afin que les surfaces convexe et concave glissent l'une sur l'autre et soient déplaçables l'une par rapport à l'autre longitudinalement aux tiges. To this end, a prosthesis for small joints comprising a first member having a first about convex extremal surface and a first rod and a second member having a second about to concave extremal surface congruent to the convex surface and a second rod, is characterized in that the concave surface is a surface substantially comprised in a revolution to 1800 lower spherical sector so that the convex and concave surfaces slide on one another and are movable relative to each other longitudinally to the rods .

Après implantation, le glissement de l'une des surfaces concave et convexe sur l'autre assure la stabilité des mouvements de l'articulation. After implantation, the sliding of one of the concave and convex surfaces on the other ensures the stability of joint movements. Des efforts notamment en cisaillement ne sont pas pratiquement répercutés sur la prothèse, du fait que les deux éléments ne sont pas liés directement, mais sont en contact l'un avec l'autre, et que la surface convexe n'est pas encastrée dans la surface concave et est déplaçable librement par rapport à la surface convexe et longitudinalement suivant l'axe de tige. including shear forces are not substantially passed on to the prosthesis, because the two elements are not directly connected, but are in contact with each other, and that the convex surface is not embedded in the concave surface and is freely movable relative to the convex surface and longitudinally along the axis of shaft.

Selon une autre caractéristique de l'invention visant à stabiliser la prothèse dans un plan transversal aux axes des tiges afin de s'opposer aux récidives de déviation cubitale, la surface convexe est composée de deux surfaces convexes, de préférence symétriques par rapport à un plan longitudinal du premier élément contenant l'axe de la première tige, et formant entre elles un sillon, et la surface concave est composée de deux surfaces concaves congruentes aux deux surfaces convexes, de préférence symétriques par rapport à un plan longitudinal du second élément contenant l'axe de la seconde tige, et formant entre elles une crete engageable dans ledit sillon. According to another feature of the invention to stabilize the prosthesis in a plane transverse to the axes of the rods in order to oppose the ulnar deviation recurrences, the convex surface is composed of two convex surfaces, preferably symmetric with respect to a plane longitudinal of the first member containing the axis of the first shaft and forming between them a groove, and the concave surface is comprised of two concave surfaces congruent to the two convex surfaces, preferably symmetric with respect to a longitudinal plane of the second element containing axis of the second shaft and forming between them a ridge engageable in said groove.

En outre, l'invention prévoit que le premier about comprend des moyens de stabilisation en rotation autour d'un axe longitudinal du premier élément, afin de stabiliser parfaitement la prothèse dans un plan transversal aux os de l'articulation. In addition, the invention provides that the first rotation about comprises stabilizing means about a longitudinal axis of the first member to perfectly stabilize the prosthesis in a plane transverse to the bones of the joint. Selon une réalisation préférée, les moyens de stabilisation en rotation sont constituées par deux entailles latérales pratiquées dans le premier about au niveau de la jonction entre celui-ci et la première tige, lesdites entailles étant destinées à recevoir des biseaux d'un os réséqua d'articulation. In a preferred embodiment, the rotational stabilization means are constituted by two lateral notches formed in the first about the level of the junction between the latter and the first rod, said notches being for receiving a bevel réséqua bones 'joint. Deux côtés des entailles sont dans un plan commun oblique à l'axe de la première tige, et de préférence symétriques par rapport à cet axe. Both sides of the notches are in a common plane oblique to the axis of the first rod, and preferably symmetrical relative to this axis.

D'autres avantages et caractéristiques de l'invention apparartront plus clairement à la lecture de la description suivante de plusieurs réalisations préférées de l'invention en référence aux dessins annexés correspondants dans lesquels Other advantages and features of the invention apparartront more clearly on reading the following description of several preferred embodiments of the invention with reference to the corresponding accompanying drawings in which
- les Figs.1 et 2 sont des vues longitudinales de côté et de dessus d'un premier élément d'une prothèse selon l'invention, respectivement ; - the Figs.1 and 2 are longitudinal side views and top views of a first component of a prosthesis according to the invention, respectively;
- les Figs. - Figs. 3 et 4 sont des vues en coupe prises le long de lignes III-III et IV-IV de la Fig. 3 and 4 are sectional views taken along lines III-III and IV-IV of Fig. 1, respectivement 1, respectively
- la Fig. - Fig. 5 est une vue en bout, côté tige, du premier élément ; 5 is an end view, side rod, the first member;
- les Figs.6 et 7 sont des vues longitudinales de côté et de dessus d'un second élément de la prothèse, respectivement ; - the Figs.6 and 7 are longitudinal side views and top views of a second element of the prosthesis, respectively; et and
- la Fig.8 est une vue frontale d'une surface concave du second élément propre à glisser contre une surface convexe du premier élément. - Fig.8 is a front view of a concave surface of the second specific element to slide against a convex surface of the first member.

Une prothèse selon l'invention comprend un premier élément monobloc 1, dit élément proximal, et un second élément monobloc 2, dit élément distal. A prosthesis according to the invention comprises a first monobloc element 1, said proximal member and a second one-piece element 2, said distal member.

Comme montré aux Figs.1 et 2, l'élément proximal 1 est symétrique par rapport à un plan longitudinal ayant pour trace X1-X dans la Fig.2, et comporte un about 3 et une tige tronconique 4. As shown in Figs.1 and 2, the proximal element 1 is symmetrical about a longitudinal plane whose trace X1-X in Fig.2, and comprises an end piece 3 and a frustoconical shank 4.

Comme illustré en détail notamment dans les Figs. As illustrated in detail in particular in FIGS. 3 à 5, l'about proximal 3 a une séction transversale sensiblement contenue dans un rectangle et offre deux petits côtés plans parallèles et symétriques 31a et 31b. 3 to 5, the proximal about 3 has a cross section substantially contained in a rectangle and has two short sides parallel and symmetrical planes 31a and 31b. Ces deux petits côtés ainsi qu'un grand côte supérieur 32 délimitent une surface convexe 33a-33b en partie frontale à l'about 3, comme montré aux Figs. These two narrow sides and an upper large side 32 define a convex surface 33a-33b in the front part to about 3, as shown in FIGS. 2 et 4, et en partie sous-jacente à l'about 3, comme montré aux Figs. 2 and 4, and partly underlies the end piece 3, as shown in FIGS. 3 et 5.La surface convexe est constituée, selon la réalisation illustrée, par deux surfaces 33a et 33b de portions de deux calottes sensiblement sphériques, symétriques et accolées dans le plan X1-X1. 3 and 5.La convex surface is formed, according to the illustrated embodiment, by two surfaces 33a and 33b of portions of two substantially spherical domes, symmetrical and placed side by side in the X1-X1 plan. les calottes ont des centres Ca et Cb alignés perpendiculairement au plan de symétrie X1-X1 et donc aux petits côtés 31a et 31b, et coplanairement s l'axe de la tige 4.Vues de coté, comme montré à la the caps have centers Ca and Cb aligned perpendicular to the plane of symmetry X1-X1 and therefore to the short sides 31a and 31b and coplanar s 4.Vues the axis of the stem from the side, as shown in
Fig. Fig. 1, les surfaces 33a et 33b ont des contours en forme d'hémicycle. 1, the surfaces 33a and 33b have contours in the shape of semicircle. Typiquement, les calottes ont un rayon sensiblement supérieur a la moitié de la largeur de l'about 3 prise entre les côtés 31a et 31b, et la distance entre les centres Ca et Cb est sensiblement supérieure au tiers de cette largeur et de la moitié de la grande base 41 de la tige 4. Typically, the caps have a substantially larger radius is half the width of the connector 3 held between the sides 31a and 31b, and the distance between the centers Ca and Cb is substantially greater than one third of this width and half the large base 41 of the rod 4.

Selon d'autres variantes, les surfaces convexes 33a et 33b pont des portions de calottes de révolution par exemple ellipsoidales. In other embodiments, the convex surfaces 33a and 33b bridge portions revolution caps for example ellipsoidal.

La surface frontale convexe de l'about 3 présente ainsi une ligne de rebroussement contenue dans le plan de symétrie X1-X1 et formant un sillon central 34. The convex front surface of the connector 3 and has a line reversal contained in the X1-X1 plane of symmetry and forming a central groove 34.

Du côté de la tige 4 à la grande base de laquelle est accolé l'about 3, deux entailles symétriques 35a et 35b sont pratiquées à l'arrière des calottes et sont ouvertes en direction de la tige. The side of the rod 4 to the large base of which is attached the end piece 3, two symmetrical notches 35a and 35b are formed at the rear of the caps and are open towards the rod. les entailles sont sensiblement analogues à des dièdres délimités par un plan commun 351, diamétral aux calottes, incliné sensiblement à 450 par rapport à l'axe de la tige 11 et perpendiculaire au plan de symétrie XI'XI, et respectivement par deux surfaces respectives 352a et 352b convergeant symétriquement vers un diamètre de la grande base 41 de la tige perpendiculaire à la ligne des centres Ca et Cb. the notches are substantially similar to the dihedral defined by a common plane 351, the diametral caps, inclined substantially at 450 with respect to the axis of the shaft 11 and perpendicular to Xi'xi symmetry plane, and respectively by two respective surfaces 352a and 352b symmetrically converging towards a diameter of the large base 41 of the rod perpendicular to the line of centers Ca and Cb.

les entailles forment ainsi entre elles, un fuseau central 36 le long du plan X1-X1. nicks and make them a central zone 36 along the X1-X1 plan.

La tige proximale 4 est terminée au niveau de sa petite base, par un congé hémisphérique 42. Elle offre entre la grande base 41 et le congé 42 une surface tronconique irrégulière qui, selon la réalisation illustrée, est composée de collerettes 43 formant entre elles des gorges annulaires 44 régulièrement réparties le long de la tige. The proximal shaft 4 is closed at its minor base by a hemispherical leave 42. It provides between the large base 41 and 42 leave an irregular frustoconical surface which, in the illustrated embodiment is composed of flanges 43 forming therebetween annular grooves 44 evenly distributed along the rod. les irrégularités de la surface tronconique peuvent être réalisées en n'importe quel matériau implantable et ont une forme telle qu'elles assurent à la prothèse un ancrage osseux direct sans interposition de ciment. irregularities of the frustoconical surface may be made of any implantable material and are shaped such that they ensure the prosthesis anchoring a direct bone without cement interposed.

En référence maintenant aux Figs.6 à 8, l'élément distal 2 offre également un about 5 propre 2 coopérer avec l'about proximal 3, et une tige tronconique 6 analogue à la tige proximale 4. Referring now to Figs.6 to 8, the distal member 2 also provides about 5 clean 2 cooperate with the proximal about 3, and a tapered rod 6 similar to the proximal shaft 4.

l'élément 2 est également symétrique par rapport à un plan longitudinal X2-X2 venant sensiblement en prolongement-du plan X 1-X1 lors de l'implantation de la prothèse. the element 2 is also symmetrical about a longitudinal plane X2-X2 coming substantially in extension of the plane X-X1-1 upon implantation of the prosthesis.

L'about distal 5 a une forme générale parallélépipédique ayant deux petits cotés plans 51a et 51b et deux grands côtés plans 52 respectivement parallèles et perpendiculaires au plan de symétrie Distal about 5 has a generally parallelepiped shape having two short sides 51a and 51b plans and two long sides planes respectively parallel and perpendicular 52 to the plane of symmetry
X2-X2. X2-X2. Une face arrière de l'about 2 définit une grande base 61 de la tige 6. A rear face of the end piece 2 defines a large base 61 of the rod 6.

Comme montré en particulier à la Fig.8, une face frontale de l'about 5 offre une surface concave composée de deux surfaces sensiblement sphériqués 53a et 53b, symétriques et accolées le long du plan de symétrie X2-X-2 et perpendiculairement à l'axe de la tige 6. les surfaces concaves 53a et 53b sont congruentes aux surfaces convexes 33a et 33b de l'about proximal 3, et ont des centres ca et cb disposés à l'extérieur de l'about, devant celui-ci, et alignés perpendiculairement au plan Xl-Xl et coplanairement à l'axe de la tige 6. les surfaces concaves 33a et 33b forment ainsi entre elles une crete centrale 54 complémentaire du sillon proximal 34 et contenue dans le plan X2-X2. As shown in particular in Fig.8, a front face of the connector 5 has a concave surface composed of two surfaces 53a and 53b substantially spherical, symmetrical and placed side by side along the X2-X2 plane of symmetry and perpendicular to the axis of the rod 6. the concave surfaces 53a and 53b are congruent to the convex surfaces 33a and 33b of the proximal about 3, and have centers ca and cb disposed outside of the connector, in front thereof, and aligned perpendicularly to the plane XI-XI and coplanar to the axis of the rod 6. the concave surfaces 33a and 33b thus form between them a central ridge 54 complementary of the proximal groove 34 and contained in the X2-X2 plane.

Comme cela est visible en comparant les Figs.1 et 2 et les As can be seen by comparing Figs.1 and 2 and
Figs.6 et 7, les surfaces concaves 53a et 53b de l'about distal sont des portions de surfaces sphériques comprises dans des secteurs de sphère ayant un angle au sommet nettement inférieur à 1800, typiquement de l'ordre de 30 , de sorte que les surfaces convexes 33a et 33b de l'about proximal ne sont pas encastrées et retenues dans les surfaces concaves, contrairement à une articulation a rotule, et ont une liberté de déplacement dans l'espace à trois dimensions par rapport aux surfaces concaves. Figs.6 and 7, the concave surfaces 53a and 53b of the distal about are parts of spherical surfaces included in the sphere sectors having an apex angle significantly less than 1800, typically of the order of 30, so that the convex surfaces 33a and 33b of the proximal about are not embedded and retained in the concave surfaces, as opposed to a ball joint, and have a freedom of movement in the three-dimensional space with respect to the concave surfaces.

La tige distale 6 comporte, comme la tige proximale 4, une extrémité hémisphérique 62, et une surface porteuse d'irrégularités réalisées en n'importe quel matériau implantable et de forme telle qu'elles assurent à la prothèse un ancrage osseux direct, sans interposition -de ciment ~ cette surface peut se présenter, comme dans la réalisation illustrée, sous la forme de collerettes 63 et de gorges annulaires 44 régulièrement réparties le long de la tige 6. The distal stem 6 comprises, as the proximal shaft 4, a hemispherical end 62, and a carrier surface irregularities made of any implantable material and shaped so that they provide the prosthesis direct bone anchor, without interposition -from cement ~ this surface may be provided, as in the illustrated embodiment, in the form of flanges 63 and annular grooves 44 evenly distributed along the rod 6.

les éléments 1 et 2 sont réalisés en une ou plusieurs parties assemblées rigidement entre elles. the elements 1 and 2 are made in one or several parts assembled rigidly together. Ces éléments ou parties d'éléments sont obtenus par usinage ou moulage et sont en des matériaux rigides, tels que l'élément proximal 1 est réalisé au moins partiellement en métal au niveau de la surface articulaire 33a, 33b et que l'élément distal 2 est réalisé au moins partiellement en matériau thermoplastique au niveau de la surface articulaire 53a, 53b. These elements or parts of elements are obtained by machining or molding and are of stiff material, such as one proximal member is made at least partially of metal at the joint surface 33a, 33b and the distal element 2 is made at least partially of thermoplastic material at the joint surface 53a, 53b. La réalisation en plusieurs parties de chaque élément prothétique se justifie par l'association dans un même élément de matériaux différents pour lesquels des propriétés particulières sont recherchées. The embodiment in many parts of each prosthetic element is justified by the association in the same element of different materials for which special properties are desired.

Après l'implantation de la prothèse, l'élément proximal 1 et l'élément distal 2 ne sont pas liés mécaniquement entre eux. After implantation of the prosthesis, the proximal member and the distal member 1 2 are not mechanically connected to each. La stabilité des mouvements est assurée par le glissement des surfaces convexes 33a et 33b respectivement sur les surfaces concaves congruentes 53a et 53b sans qu'il y ait embottement d'une surface convexe dans une surface concave comme dans une articulation à rotule. The stability of movement is ensured by the sliding concave convex surfaces 33a and 33b respectively on the surfaces congruent 53a and 53b without embottement a convex surface to a concave surface as in a ball joint. Le maintien du contact entre ces surfaces articulaires, nécessaire à la stabilité et au mouvement articulaire, est assuré par le réglage de la tension des structures péri-articulaires ajusté au moment de l'intervention, par le rapport entre l'encombrement des éléments implantés et celui des résections osseuses. Maintaining contact between the joint surfaces, required for the stability and range of movement is ensured by the adjustment of the tension of the periarticular structures adjusted at the time of the intervention, by the ratio of the bulk of the implanted elements and the bone resections. Les efforts de torsions sont donc absorbés par des structures souples, sans transmission de ceux-ci aux ancrages de la prothèse. The twists efforts are absorbed by flexible structures without transmitting them to the anchors of the prosthesis.

La prothèse selon l'invention constitue ainsi une prothèse articulaire à glissement pour petites articulations de la main ou du pied métacarpo-phalangiennes et interphalangiennes proximales. The prosthesis according to the invention thus constitutes a joint prosthesis for sliding small joints of the hand or foot metacarpophalangeal and proximal interphalangeal.

La stabilité de la prothèse dans le plan frontal nécessaire pour s'opposer aux récidives de déviation cubitale des doigts est assurée par le dédoublement des surfaces articulaires. The stability of the prosthesis in the frontal plane necessary to oppose the ulnar deviation of recurrence of the fingers is provided by duplication of the articular surfaces. les surfaces articulaires convexes 33a et 33b sont à peu près sphériques et jointives, et dans le sillon sagittal 34 entre ces surfaces convexes s'engage la crête distale 54 ménagée entre les surfaces articulaires concaves correspondantes 53a et 53b. the convex joint surfaces 33a and 33b are roughly spherical and contiguous, and in the sagittal groove 34 between these convex surfaces engages the distal ridge 54 formed between the corresponding concave articular surfaces 53a and 53b. Cette disposition est proche de l'anatomie où deux condyles proximaux s'articulent avec la base concave de la phalange distale. This arrangement is close to the anatomy in which two proximal condyles articulate with the concave base of the distal phalanx. On peut dès lors dénommer "bycondylien" ce type d'articulation, stabilisée dans le plan frontal par l'encombrement de deux surfaces articulaires et par leur emboîtement, notamment au niveau de la crête 54 dans le sillon 34. It can therefore be denominated "bycondylien" this type of joint, stabilized in the frontal plane by the size of two articular surfaces and their nesting, including at the ridge 54 in the groove 34.

L'ancrage des éléments prothétiques 1 et 2 est assuré par les tiges 4 et 6 qui s'engagent dans des fûts diaphysaires exposés après la résection des surfaces articulaires. The anchorage of the prosthetic elements 1 and 2 is provided by the rods 4 and 6 which engage in diaphyseal shafts exposed after resection of the articular surfaces. les surfaces à structure irrégulière 43-44 et 63-64 des tiges proximale 4 et distale 6 sont en contact avec les os et sont progressivement envahies par la régénération du tissu osseux. surfaces uneven structure 43-44 and 63-64 proximal 4 and distal stems 6 are in contact with the bone and are gradually overgrown by the regeneration of bone tissue. Cette régénération assure ainsi l'ancrage sans ciment de la prothèse selon l'invention. This regeneration ensures anchoring of the prosthesis without cement according to the invention.

Afin de favoriser la repousse osseuse dans les anfractuosités de la prothèse, telles que les gorges 44 et 64, il est nécessaire de stabiliser la prothese, notamment en rotation pour l'élément proximal 1. Si les structures péri-articulaires limitent pour une bonne part les efforts de torsion transmis aux éléments prothétiques, l'encastrement de ces derniers dans les structures osseuses protège leur ancrage contre ces sollicitations. To promote bone regrowth in the crevices of the prosthesis, such as grooves 44 and 64, it is necessary to stabilize the prosthesis, notably in rotation to the proximal member 1. If the periarticular structures limit to a great extent torsional forces transmitted to the prosthetic elements, embedding them into bone structures protect their anchors against these stresses. En particulier, l'about proximal 3 à surfaces convexes s'appuie sur l'os réséqué selon le plan oblique 351 et non pas selon un plan transversal à l'axe de la tige 4. En d'autres termes, l'os réséqué en biseaux vient s'engager dans les entailles 35a et 35b ménagées latéralement à la jonction de l'about 3 et de la tige 4 de l'élément proximal. In particular, the proximal about 3 to convex surfaces rests on the resected bone as the inclined plane 351 and not along a transverse plane to the axis of the rod 4. In other words, bone resected diagonally engages in the notches 35a and 35b formed laterally at the junction of the connector 3 and the rod 4 of the proximal member. Ces coupes obliques sur le profil de l'about 3, non perpendiculaires au grand axe de l'os, ont donc un effet antirotatoire stabilisant. These oblique cuts Profile of about 3, not perpendicular to the long axis of the bone, thus have a stabilizing effect antirotation.

Claims (12)

REVENDICATIONS
1 - Prothèse pour petites articulations comprenant un premier élément (1) ayant un premier about (3) à surface extrémale convexe (33a, 33b) et une première tige (4), et un second élément (2) ayant un second about (5) à surface extrémale concave (53a, 53b) congruente à la surface convexe et une seconde tige (6), caractérisée en ce que la surface concave est une surface sensiblement de révolution comprise dans un secteur sphérique inférieur à 1800 afin que les surfaces convexe (33a, 33b) et concave (53a, 53b) glissent l'une sur l'autre et soient déplaçables l'une par rapport à l'autre longitudinalement aux tiges (4, 6). 1 - Prosthesis for small joint comprising a first member (1) having a first piece (3) convex extremal surface (33a, 33b) and a first rod (4), and a second member (2) having a second piece (5 ) concavely extremal surface (53a, 53b) congruent with the convex surface and a second rod (6), characterized in that the concave surface is a surface substantially comprised revolution in a spherical sector less than 1800 so that the convex surfaces ( 33a, 33b) and concave (53a, 53b) slide one on the other and are movable relative to each other longitudinally to the rods (4, 6).
2 - Prothèse conforme à la revendication 1, caractérisée en ce que la surface convexe est composée de deux surfaces convexes (33a, 33b), de préférence symétriques par rapport à un plan longitudinal (X1-Xl) du premier élément ( ] ) contenant l'axe de la première tige (4), et formant entre elles un sillon (34), et en ce que la surface concave est composée de deux surfaces concaves (53a, 53b congruentes aux deux surfaces convexes (33a, 33b), de #préférence symétriques par rapport à un plan longitudinal (X2-X2) du second élément (2) contenant l'axe de la seconde tige (6), et formant entre elles une crête (54) engageable dans ledit sillon (34). 2 - A prosthesis according to claim 1, characterized in that the convex surface is composed of two convex surfaces (33a, 33b), preferably symmetrical relative to a longitudinal plane (X1-Xl) of the first member (]) containing axis of the first rod (4) and forming between them a groove (34), and in that the concave surface is comprised of two concave surfaces (53a, 53b congruent with two convex surfaces (33a, 33b) of # preferably symmetrical with respect to a longitudinal plane (X2-X2) of the second element (2) containing the axis of the second rod (6), and forming between them a ridge (54) engageable in said groove (34).
3 - Prothèse conforme à la revendication 1 ou 2, caractérisée en ce que les surfaces congruentes (33a, 33b ; 53a, 53b) sont maintenues en contact par tension de structures péri-articulaires. 3 - A prosthesis according to claim 1 or 2, characterized in that the congruent surfaces (33a, 33b; 53a, 53b) are pressed together by voltage periarticular structures.
4 - Prothèse conforme à l'une quelconque des revendications 1 à 3, caractérisée en ce que les première et seconde tiges (4 ; 6) sont destinées à être ancrées dans des fûts diaphysaires de segments osseux. 4 - A prosthesis according to any one of claims 1 to 3, characterized in that the first and second rods (4; 6) are intended to be anchored in drums diaphyseal bone segments.
5 - Prothèse conforme à l'une quelconque des revendications 1 à 4, caractérisée en ce que les tiges (4 ; 6) ont des anfractuosités superficielles (44 ; 64) destinées à etre réhabitues par des tissus osseux et à assurer seules l'ancrage de la prothèse. 5 - A prosthesis according to any one of claims 1 to 4, characterized in that the rods (4; 6) have surface crevices (44; 64) intended to be réhabitues by bone tissue and ensure only the anchor the prosthesis.
6 - Prothèse conforme à la revendication 5, caractérisée en ce que les tiges (4, 6) sont tronconiques, et les anfractuosités sont des gorges annulaires (44 ; 64), de préférence équiréparties le long des tiges. 6 - A prosthesis according to claim 5, characterized in that the rods (4, 6) are frustoconical and crevices are annular grooves (44; 64), preferably uniformly distributed along the rods.
7 - Prothèse conforme à l'une quelconque des revendications 1 à 6, caractérisée en ce que le premier about (3) comprend des moyens de stabilisation en rotation (35a, 35b) autour d'un axe longitudinal du premier élément (1). 7 - A prosthesis according to any one of claims 1 to 6, characterized in that the first piece (3) comprises rotating stabilizing means (35a, 35b) about a longitudinal axis of the first element (1).
8 - Prothèse conforme à la revendication 7, caractérisée en ce que les moyens de stabilisation en rotation comprennent deux entailles latérales (35a, 35b) pratiquées dans le premier about (3) au niveau de la jonction entre celui-ci et la première tige (4), lesdites entailles étant destinées à recevoir des biseaux d'un os réséqué d'articulation. 8 - A prosthesis according to claim 7, characterized in that the rotational stabilization means comprise two lateral notches (35a, 35b) formed in the first piece (3) at the junction between it and the first shaft ( 4), said notches being for receiving bevels a hinge resected bone.
9 - Prothèse conforme à la revendication 8, caractérisée en ce que deux cotés des entailles (35a, 35b) sont dans un plan commun (351) oblique à l'axe de la première tige (4), et de préférence symétriques par rapport à cet axe. 9 - A prosthesis according to claim 8, characterized in that both sides of notches (35a, 35b) are in a common plane (351) oblique to the axis of the first rod (4), and preferably symmetrical with respect to this axis.
10 - Prothèse conforme à l'une quelconque des revendications 1 à 9, caractérisée en ce que la surface convexe (33a, 33b) forme à la fois une surface frontale et une surface sous-jacente au premier about (3) et est comprise entre deux côtés plans (31a, 31b) du premier about (3) parallèle à l'axe de la première tige (4). 10 - A prosthesis according to any one of claims 1 to 9, characterized in that the convex surface (33a, 33b) forming both a front surface and an underlying surface to the first piece (3) is included between two planar sides (31a, 31b) of the first piece (3) parallel to the axis of the first rod (4).
11 - Prothèse conforme à l'une quelconque des revendications 1 à 10, caractérisée en ce que la surface concave (53a, 53b) est comprise entre deux paires perpendiculaires de côtés plans (51a, 51b ; 52) du second about (5) parallèles à l'axe de la seconde tige (6). 11 - A prosthesis according to any one of claims 1 to 10, characterized in that the concave surface (53a, 53b) is between two perpendicular pairs of flat sides (51a, 51b; 52) of the second piece (5) parallel to the axis of the second rod (6).
12 - Prothèse conforme à l'une quelconque des revendications 1 à 11, caractérisée en ce que les premier et second abouts (3,5) au moins au niveau des surfaces extrémales convexe (33a, 33b) et concave (53a, 53b) sont en métal et en matériau thermoplastique, respectivement. 12 - A prosthesis according to any one of claims 1 to 11, characterized in that the first and second end pieces (3,5) at least at the extremal convex surfaces (33a, 33b) and concave (53a, 53b) are metal and thermoplastic material, respectively.
FR8615156A 1986-10-30 1986-10-30 Prosthesis for small joints, in particular metacarpophalangial and interphalangial joints Pending FR2605878A1 (en)

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FR8615156A FR2605878A1 (en) 1986-10-30 1986-10-30 Prosthesis for small joints, in particular metacarpophalangial and interphalangial joints

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FR8615156A FR2605878A1 (en) 1986-10-30 1986-10-30 Prosthesis for small joints, in particular metacarpophalangial and interphalangial joints

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Cited By (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1989009580A1 (en) * 1988-04-12 1989-10-19 Bahaa Botros Seedhom Prosthetic finger joint
EP0420794A1 (en) * 1989-09-28 1991-04-03 SULZER Medizinaltechnik AG Finger joint prosthesis
WO1992000709A1 (en) * 1990-07-07 1992-01-23 University Of Strathclyde Joint prosthesis
US5326366A (en) * 1993-02-16 1994-07-05 Wright Medical Technology, Inc. Biomechanical great toe implant
FR2701388A1 (en) * 1993-02-16 1994-08-19 Landanger Landos prosthetic element for small joints.
FR2705559A1 (en) * 1993-05-28 1994-12-02 Lafosse Laurent Finger joint prosthesis with shield
US5405401A (en) * 1993-10-05 1995-04-11 Orthomet, Inc. Prosthesis for replacement of joints between long bones in the hand
US5549690A (en) * 1993-12-17 1996-08-27 Avanta Orthopaedics Prosthetic thumb joint and method of manufacture
US5674297A (en) * 1995-12-08 1997-10-07 Lane; Lewis B. Metacarpophalangeal prosthesis
US5776202A (en) * 1993-09-07 1998-07-07 Copf; Franz Joint prosthesis
US5782927A (en) * 1996-11-06 1998-07-21 Ascension Orthopedics, Inc. Metacarpal-phalangeal joint replacement
FR2763835A1 (en) * 1997-05-30 1998-12-04 Michel Lahille Carpometacarpal implant
ES2129338A1 (en) * 1995-12-11 1999-06-01 Merck Biomaterial France Socie Prosthesis for total phalangeal joint.
EP1203569A1 (en) * 2000-11-03 2002-05-08 Finsbury (Development) Limited Metacarpo-phalangeal joint prosthesis
US7641695B2 (en) 2004-09-08 2010-01-05 Arthrex, Inc. Modular system for replacement of radial head
US8945232B2 (en) 2012-12-31 2015-02-03 Wright Medical Technology, Inc. Ball and socket implants for correction of hammer toes and claw toes
US9044287B2 (en) 2010-06-02 2015-06-02 Wright Medical Technology, Inc. Hammer toe implant method
US9474561B2 (en) 2013-11-19 2016-10-25 Wright Medical Technology, Inc. Two-wire technique for installing hammertoe implant
US9498266B2 (en) 2014-02-12 2016-11-22 Wright Medical Technology, Inc. Intramedullary implant, system, and method for inserting an implant into a bone
US9498273B2 (en) 2010-06-02 2016-11-22 Wright Medical Technology, Inc. Orthopedic implant kit
US9545274B2 (en) 2014-02-12 2017-01-17 Wright Medical Technology, Inc. Intramedullary implant, system, and method for inserting an implant into a bone
US9603643B2 (en) 2010-06-02 2017-03-28 Wright Medical Technology, Inc. Hammer toe implant with expansion portion for retrograde approach
US9724139B2 (en) 2013-10-01 2017-08-08 Wright Medical Technology, Inc. Hammer toe implant and method
US9724140B2 (en) 2010-06-02 2017-08-08 Wright Medical Technology, Inc. Tapered, cylindrical cruciform hammer toe implant and method
US9808296B2 (en) 2014-09-18 2017-11-07 Wright Medical Technology, Inc. Hammertoe implant and instrument
US10080597B2 (en) 2014-12-19 2018-09-25 Wright Medical Technology, Inc. Intramedullary anchor for interphalangeal arthrodesis

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FR2370465A1 (en) * 1976-11-15 1978-06-09 Sulzer Ag Prosthesis for ankle joint
US4231121A (en) * 1979-07-05 1980-11-04 Wright Dow Corning Metacarpal-phalangeal prosthesis
US4242759A (en) * 1979-03-12 1981-01-06 Ontario Research Foundation M.C.P. Joint replacement
GB2056862A (en) * 1979-08-17 1981-03-25 Weightman B O Endoprosthetic bone joint devices
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FR2142028A1 (en) * 1971-06-18 1973-01-26 Howmedica
FR2370465A1 (en) * 1976-11-15 1978-06-09 Sulzer Ag Prosthesis for ankle joint
US4242759A (en) * 1979-03-12 1981-01-06 Ontario Research Foundation M.C.P. Joint replacement
US4231121A (en) * 1979-07-05 1980-11-04 Wright Dow Corning Metacarpal-phalangeal prosthesis
GB2056862A (en) * 1979-08-17 1981-03-25 Weightman B O Endoprosthetic bone joint devices
GB2126097A (en) * 1982-07-05 1984-03-21 Howmedica Prosthetic finger joint

Cited By (40)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0338715A1 (en) * 1988-04-12 1989-10-25 Bahaa Botros Seedhom Prosthetic finger joint
WO1989009580A1 (en) * 1988-04-12 1989-10-19 Bahaa Botros Seedhom Prosthetic finger joint
EP0420794A1 (en) * 1989-09-28 1991-04-03 SULZER Medizinaltechnik AG Finger joint prosthesis
US5092896A (en) * 1989-09-28 1992-03-03 Protek Ag Finger joint prosthesis
WO1992000709A1 (en) * 1990-07-07 1992-01-23 University Of Strathclyde Joint prosthesis
US5413609A (en) * 1990-07-07 1995-05-09 University Of Strathclyde Metacarpal-phalangeal (MCP) joint prosthesis
FR2701388A1 (en) * 1993-02-16 1994-08-19 Landanger Landos prosthetic element for small joints.
EP0611560A1 (en) * 1993-02-16 1994-08-24 LANDANGER- LANDOS, Société Anonyme Prosthetic element for small joints
US5326366A (en) * 1993-02-16 1994-07-05 Wright Medical Technology, Inc. Biomechanical great toe implant
FR2705559A1 (en) * 1993-05-28 1994-12-02 Lafosse Laurent Finger joint prosthesis with shield
EP0639360A1 (en) * 1993-05-28 1995-02-22 Laurent Lafosse Finger articulation prosthesis with one dish shaped element
US5776202A (en) * 1993-09-07 1998-07-07 Copf; Franz Joint prosthesis
US5405401A (en) * 1993-10-05 1995-04-11 Orthomet, Inc. Prosthesis for replacement of joints between long bones in the hand
US5549690A (en) * 1993-12-17 1996-08-27 Avanta Orthopaedics Prosthetic thumb joint and method of manufacture
US5674297A (en) * 1995-12-08 1997-10-07 Lane; Lewis B. Metacarpophalangeal prosthesis
ES2129338A1 (en) * 1995-12-11 1999-06-01 Merck Biomaterial France Socie Prosthesis for total phalangeal joint.
US5782927A (en) * 1996-11-06 1998-07-21 Ascension Orthopedics, Inc. Metacarpal-phalangeal joint replacement
US6159247A (en) * 1996-11-06 2000-12-12 Ascension Orthopedics, Inc. Metacarpal-phalangeal joint replacement
FR2763835A1 (en) * 1997-05-30 1998-12-04 Michel Lahille Carpometacarpal implant
EP1203569A1 (en) * 2000-11-03 2002-05-08 Finsbury (Development) Limited Metacarpo-phalangeal joint prosthesis
US6689169B2 (en) 2000-11-03 2004-02-10 Finsbury (Development) Limited Prothesis
US7641695B2 (en) 2004-09-08 2010-01-05 Arthrex, Inc. Modular system for replacement of radial head
US9949775B2 (en) 2010-06-02 2018-04-24 Wright Medical Technology, Inc. Hammer toe implant with expansion portion for retrograde approach
US9044287B2 (en) 2010-06-02 2015-06-02 Wright Medical Technology, Inc. Hammer toe implant method
US9072564B2 (en) 2010-06-02 2015-07-07 Wright Medical Technology, Inc. Hammer toe implant and method
US9877753B2 (en) 2010-06-02 2018-01-30 Wright Medical Technology, Inc. Orthopedic implant kit
US9724140B2 (en) 2010-06-02 2017-08-08 Wright Medical Technology, Inc. Tapered, cylindrical cruciform hammer toe implant and method
US9498273B2 (en) 2010-06-02 2016-11-22 Wright Medical Technology, Inc. Orthopedic implant kit
US9603643B2 (en) 2010-06-02 2017-03-28 Wright Medical Technology, Inc. Hammer toe implant with expansion portion for retrograde approach
US9504582B2 (en) 2012-12-31 2016-11-29 Wright Medical Technology, Inc. Ball and socket implants for correction of hammer toes and claw toes
US10278828B2 (en) 2012-12-31 2019-05-07 Wright Medical Technology, Inc. Ball and socket implants for correction of hammer toes and claw toes
US8945232B2 (en) 2012-12-31 2015-02-03 Wright Medical Technology, Inc. Ball and socket implants for correction of hammer toes and claw toes
US9724139B2 (en) 2013-10-01 2017-08-08 Wright Medical Technology, Inc. Hammer toe implant and method
US9474561B2 (en) 2013-11-19 2016-10-25 Wright Medical Technology, Inc. Two-wire technique for installing hammertoe implant
US9675392B2 (en) 2013-11-19 2017-06-13 Wright Medical Technology, Inc. Two-wire technique for installing hammertoe implant
US9498266B2 (en) 2014-02-12 2016-11-22 Wright Medical Technology, Inc. Intramedullary implant, system, and method for inserting an implant into a bone
US9545274B2 (en) 2014-02-12 2017-01-17 Wright Medical Technology, Inc. Intramedullary implant, system, and method for inserting an implant into a bone
US9808296B2 (en) 2014-09-18 2017-11-07 Wright Medical Technology, Inc. Hammertoe implant and instrument
US10299840B2 (en) 2014-09-18 2019-05-28 Wright Medical Technology, Inc. Hammertoe implant and instrument
US10080597B2 (en) 2014-12-19 2018-09-25 Wright Medical Technology, Inc. Intramedullary anchor for interphalangeal arthrodesis

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