FR2651119A1 - Phalangeal articular prosthesis - Google Patents

Phalangeal articular prosthesis Download PDF

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Publication number
FR2651119A1
FR2651119A1 FR8911164A FR8911164A FR2651119A1 FR 2651119 A1 FR2651119 A1 FR 2651119A1 FR 8911164 A FR8911164 A FR 8911164A FR 8911164 A FR8911164 A FR 8911164A FR 2651119 A1 FR2651119 A1 FR 2651119A1
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FR
France
Prior art keywords
prosthesis
portions
anchor
rod
portion
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Withdrawn
Application number
FR8911164A
Other languages
French (fr)
Inventor
Felman Daniel
Original Assignee
Felman Daniel
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Felman Daniel filed Critical Felman Daniel
Priority to FR8911164A priority Critical patent/FR2651119A1/en
Publication of FR2651119A1 publication Critical patent/FR2651119A1/en
Application status is Withdrawn legal-status Critical

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    • 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
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    • A61F2/30Joints
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    • A61F2/4241Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
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    • 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
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    • A61F2002/3006Properties of materials and coating materials
    • A61F2002/30092Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • A61F2002/30093Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
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    • A61F2002/30098Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply electrically, e.g. heated by resistor
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    • A61F2002/30331Connections 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
    • A61F2002/30377Protrusion and recess of constant polygonal, serrated or undulated cross-section
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    • A61F2002/30474Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using an intermediate sleeve interposed between both prosthetic parts to be coupled
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    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0019Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
    • AHUMAN NECESSITIES
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    • 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
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0023Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply
    • A61F2210/0033Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply electrically, e.g. heated by resistor
    • 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
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0023Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply
    • A61F2210/0042Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply using a fluid, e.g. circulating
    • AHUMAN NECESSITIES
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    • 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017Angular shapes
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures

Abstract

The prosthesis comprises three parts, namely two rod portions (1, 2) which are screwed into the two diaphyses of the two bones to be articulated, and an intermediate element (3) for articulating the two rod portions (1, 2). The articulation element (3) is fixed to the rod portions (1, 2) in the manner of tenons and mortices by means of expansion sleeves (7') made of "memory-type metal alloy". The intermediate element (3) is immobilised in translation with respect to the diaphyses thus joined. The prosthesis according to the invention is suitable for replacing hand and foot articulations implanted in tendon areas. <IMAGE>

Description

La présente invention concerne une prothèse articulaire destinée à remplacer une articulation métacarpa-phalanvienne, metatarso-phalangienne ou interphalangienne de la main ou du pied. The present invention relates to a joint prosthesis for replacing a métacarpa-phalanvienne joint, metatarsophalangeal or interphalangeal joint of the hand or foot.

La nécessité de procéder au remplacement dt une articulation peut être provoquée par des causes diverses. The need to replace a joint dt can be caused by various causes. Il peut s'agir d'un traumatisme, mais c'est rare. It can be a trauma, but it's rare. Il peut surtout s'agir d'une arthrose ou d'une arthrite rhumatolde. It may especially be an osteoarthritis or arthritis rhumatolde.

Deux os starticwlent l'un à l'autre par leur extrémité spongieuse recouverte de cartilage, ltépiphyse, qui termine la diaphyse formée de la couche corticale à l'in térieur de laquelle s'étend le canal médullaire, les deux épiphyses étant réunies par une capsule articulaire fibreuse. Starticwlent two bones to one another by their spongy end covered with cartilage, ltépiphyse, which terminates the shaft formed by the cortical layer in the in terior of which extends the medullary canal, the two being joined by a epiphyses fibrous joint capsule.

Il a déjà été proposé une prothèse formée d'une seale et simple tige en matière plastique, mise en place dans les deux canaux médullaires des deux os à articuler entre eux après ouverture de la zone d'articulation, écartement des deux os et découpe des deux épiphyses. It has already been proposed a prosthesis formed of a seale and simple plastic rod, inserted into the two lumens of the two bones articulate them after opening the hinge region, separation of the two bones and cutting two epiphysis. Une telle prothèse présentait toutefois l'inconvénient de provoquer, dans la couche corticale, la formation de géodes à cause de la mobilité de la tige dans les canaux médullaires, si bien qu'elle a depuis été abandonnée. Such a prosthesis, however, had the disadvantage of causing, in the cortical layer, geodes training because of the mobility of the stem in the medullary canals, so that it has since been abandoned.

Il a aussi été proposé une prothèse formée de deux portions de tige terminées à une extrémité, l'une, par une coquille ou cavité quasi-hémisphérique, l'autre, par une rotule logée dans ladite cavité, les deux autres extrémités des deux portions de tige étant respectivement introduites dans les canaux médullaires des deux os à articuler entre eux et une colerette quasi-sphérique étant fixée à la portion de tige à rotule et entourant ltensemblede l'articulation des deux portions de tige. It has also been proposed a prosthesis formed of two rod portions closed at one end, one by a shell or quasi-hemispherical cavity, the other by a ball housed in said cavity, the other two ends of the two portions rod being introduced into the lumens respectively of the two bones articulate with each other and a quasi-spherical rim being attached to the ball pin portion and surrounding ltensemblede the articulation of the two stem portions.

L'inconvénient de cette deuxième prothèse à articulation sphérique réside essentiellement dans sa mauvaise tenue mécanique. The disadvantage of this second ball joint prosthesis which lies in its poor mechanical strength.

Il existe un troisième type de prothèse connu, semblable au deuxième présenté ci-dessus, avec deux portions de tige vissées dans les couches corticales et une articulation des portions de tige non pas sphérique mais rotonde, à disque, de l'une des portions de tige, monté pivotant dans un évidement correspondant de l'antre des portions de tige. There is a third type of known prosthesis, similar to the second presented above, with two stem portions screwed into the cortical layers and a joint portions of not spherical but rod rotunda disc, one of the portions rod, pivotally mounted in a corresponding recess of the antrum of the rod portions. L'inconvénient de cette dernière prothèse réside dans son manque de stabilité articulaire générateur de luxation. The downside of that prosthesis is its lack of joint stability dislocation generator.

La présente invention vise à pallier les inconvénients des prothèses existantes. The present invention aims to overcome the drawbacks of existing prostheses.

A cet effet, la présente invention concerne une prothèse articulaire phalangienne à implanter dans une zone pourvue de tendons, comprenant deux portions de tige agencées pour être ancrées, par l'une de leurs extrémités, dans les diaphyses de deux os à articuler entre eux, caractérisée par le fait qu'elle comporte un élément intermédiaire d'articulation des deux portions de tige d'ancrage qui est fixé à celles-ci par des moyens agencés pour, avec accessoirement l'action des tendons de la zone d'articulation, immobiliser l'élément intermédiaire en translation par rapport aux diaphyses ainsi réunies. To this end, the present invention relates to a phalangeal joint prosthesis implanted in a zone provided with tendons, comprising two rod portions arranged to be anchored, by one of their ends, in the diaphysis of two bones articulate between them, characterized in that it comprises an intermediate element of articulation of the two anchor rod portions which is fixed thereto by means arranged to, with an ancillary action of the tendons of the articulation zone, immobilising the intermediate member in translation with respect to the diaphysis as well met.

L'immobilisation en translation de l'élément intermédiaire par rapport aux diaphyses est en fait obtenue par immobilisation par rapport aux portions de tige de la prothèse puisque celles-ci sont ancrées dans les diaphyses. The immobilization in translation of the intermediate member relative to the diaphysis is actually obtained by immobilizing with respect to the prosthesis stem portions since they are anchored in the diaphysis.

C'est gracie à la structure en trois parties parfaitement solidaires les unes des autres de la prothèse de l'invention qu'on obtient sa caractéristique fonctionnelle avantageuse d'immobilité relative de la prothèse et des os à articuler entre eux ou de solidarisation parfaite de la prothèse à sa zone d'implantation. It's pardons structure into three perfectly integral parts of each other of the prosthesis of the invention obtained its advantageous functional characteristic relative immobility of the prosthesis and bones to articulate them or securing perfect the prosthesis to its location area.

Lesdits moyens de fixation aux portions d'ancrage de l'élément d'articulation de la prothèse de l'invention peuvent être agencés pour verrouiller en traction l'élément d'articulation sur chaque portion d'ancrage, contre l'action, des tendons, de compression desportions d'ancrage sur l'élément drarticulation. Said means for fixing to the anchor portions of the hinge member of the prosthesis of the invention can be arranged to lock the tensile hinge member on each anchor portion against the action, tendons , compression anchoring desportions on drarticulation element.

Dans la forme de réalisation préférée de la prothèse de l'invention, les tendons exercent leur action indépendamment de celle desdits moyens de fixation qui sont agencés pour verrouiller en expansion l'élément d'articulation sur les portions d'ancrage. In the preferred embodiment of the prosthesis of the invention, the tendons exert their action independently of said fixing means which are arranged to lock the expanding hinge member on the anchor portions.

De façon avantageuse, chaque portion de tige d'ancrage est fendue et agencée pour recevoir un moyen d'expansion solidaire de l'élément d'articulation, donc solidariser l'élément d'articulation à la portion de tige d'ancrage considérée, subir ainsi une expansion et parfaire l'ancrage de cette portion de tige d'ancrage dans la diaphyse associée. Advantageously, each portion of the anchor rod is slotted and arranged to receive a means of integral expansion of the hinge member, so interlock the hinge member to the portion of the anchor rod concerned, undergo and an expansion and improve the anchoring of that portion of the anchor rod in the associated shaft.

Ledit moyen d'expansion peut comprendre, monté sur une portion de tige, un manchon en "alliage métallique mémoire", prétransformé à une température déterminée et constitué pour, sous l'action d'une température supérieuretà la température de prétransformation, et par un effet mémoire, reprendre une forme d'origine expansée. Said expansion means may comprise, mounted on a shaft portion, a sleeve "memory metal alloy", is preconverted at a predetermined temperature and formed to, under the action of a temperature supérieuretà temperature preprocessing, and a memory effect and take a form of expanded origin.

Un tel alliage mémoire est par exemple décrit dans l'article"Nickel-titanium osteosynthesis clips, publié dans la revue Medical Cocus, Exportmarkt-Organisation, Vogel Such memory alloy is for example described in the article "Nickel-titanium osteosynthesis clips, published in the journal Medical Cocus, Exportmarkt-Organization Vogel
Verlag FJlirzburg, Heft 3/1983. FJlirzburg Verlag, Heft 3/1983.

De préférence encore, l'élément dtarticulation est un élément d'articulation rotonde comprenant une rotule solidaire d'une des portions d'ancrage et une coquille sphérique solidaire de l'autre des portions d'ancrage et recevant ladite rotule, la rotule étant prolongée par une barrette montée pivotante dans une fente ménagée dans la coquille. More preferably, the member is a rotunda dtarticulation hinge member comprising a ball secured to one of the anchor portions and an integral spherical shell of the other of the anchor portions and receiving said ball head being extended a bar pivotally mounted in a slot in the shell.

L'invention sera mieux comprise à l'aide de la description suivante de la forme de réalisation préférée de la prothèse de l'invention, en référence aux dessins annexés, sur lesquels - la figure 1 représente une vue en coupe de la prothèse The invention will be better understood using the following description of the preferred embodiment of the prosthesis of the invention, with reference to the accompanying drawings, in which - Figure 1 shows a sectional view of the prosthesis
articulaire de l'invention; joint of the invention; - la figure 2 représente une vue de l'élément intermédiaire - Figure 2 shows a view of the intermediate element
d'articulation de la prothèse de la figure 1 et - la figure 3 représente une vue, à plus petite échelle, of articulation of the prosthesis of Figure 1 and - Figure 3 shows a view, on a smaller scale,
d'une main pourvue de la prothèse des figures 1 et 2 with one hand provided with the prosthesis of Figures 1 and 2
implantée entre deux phalanges. located between two phalanges.

La prothèse articulaire qui va être décrite est destinée à remplacer une articulation métacarpa-phalangienne, métatarso-phalangienne ou interphalangienne de la main ou du pied. The joint prosthesis to be described is intended to replace a métacarpa-phalangeal joint, metatarsophalangeal or interphalangeal joint of the hand or foot. Elle comporte trois parties qui après implantation sont parfaitement solidaires les unes des autres - deux tiges 1, 2 à ancrer respectivement dans deux diaphyses à réunir, - un élément intermédiaire 3 d'articulation rotonde. It comprises three parts which after implantation are perfectly integral with each other - two rods 1, 2 to be anchored respectively in two diaphyses to be connected, - an intermediate member 3 rotunda joint.

Chaque tige d'ancrage 1, 2 se présente ici sous forme d'une vis, pourvue d'un filetage extérieur 4 pour son vissage, par une extrémité 5 de section rétrécie, dans la couche corticale de la diaphyse associée, et dans laquelle a été ménagée une cavité borgne 6, de réception d'une barrette 7 solidaire de l'élément d'articulation 3 et s'étendant depuis l'autre extrémité 8 de la vis, de section élargie. Each anchor rod 1, 2 is shown here in form of a screw, provided with an external thread 4 for screwing with one end tapered section 5, in the cortical layer of the associated shaft, and wherein a was formed a blind cavity 6 for receiving a bar 7 integral with the hinge element 3 and extending from the other end 8 of the screw, of enlarged section. L'extrémité 8 de chaque tige 1, 2, destinée à être tournée vers l'élément d'articulation 3, se prolonge par une collerette annulaire 9 perpendiculaire à l'axe 10 de la tige d'ancrage. The end 8 of each rod 1, 2, intended to be turned towards the hinge member 3, is extended by an annular flange 9 is perpendicular to the axis 10 of the anchor rod.

La cavité 6 de chaque tige d'ancrage et la barrette 7 de l'élément d'articulation 3 qu'elle doit recevoir sont destinées à coopérer à la manière dtune mortaise et d'un tenon. The cavity 6 of each anchor rod and the web 7 of the hinge member 3 it is to receive are intended to cooperate in the manner dtune mortise and a tenon. Les cavités 6 et barrettes 7, de même longueur, ont une même section, les unes intérieure et les autres extérieure, de forme polygonale, ici hexagonale, les barrettestenons étant gainées d'un manchon 7'en alliage mémoire dont la section extérieure est en fait celle, évoquée cidessus, des barrettes. The cavities 6 and 7 bars of the same length have the same section, the inner one and the other outer, polygonal, here hexagonal, the barrettestenons being sheathed in a sleeve 7'en memory alloy whose outer section is fact that, as mentioned above, webs.

Les tiges 1, 2 sont fendues en 11 pour permettre leur expansion. The rods 1, 2 are slotted at 11 to allow expansion. Après ancrage des tiges 1, 2 dans les diaphyses correspondantes, puis mise en place grossière de l'élément d'articulation 3 par le chirurgien ostéo-articulaire, cha- que-tenon 7, avec son manchon 7', de l'élément d'articulation 3 est introduit et enfoncé dans la cavité 6 de la tige associée puis, sous l'action de la chaleur, le manchon 7' stexpanse pour s'ancrer à son tour dans la tige d'ancrage 1, 2 et parfaire l'ancrage de celle-ci dans la diaphyse associée. After anchorage of the rods 1, 2 in the corresponding diaphyses and coarse setting place of the hinge member 3 by the osteoarticular surgeon Cha- that driving lug 7, together with its sleeve 7 ', the element the joint 3 is inserted and pressed into the cavity 6 of the associated rod and under the action of heat, the sleeve 7 'stexpanse to anchor to turn in the anchor rod 1, 2 and improve the anchoring thereof in the associated shaft. L'effet mémoire de l'alliage des manchons 7'peut se produire à la température du corps du patient. The memory effect of the alloy 7'peut sleeves occur in the patient's body temperature. L'alliage peut aussi être tel que son effet mémoire ne se produise qu'après chauffage par une résistance électrique ou un liquide chaud. The alloy may also be such that the memory effect occurs after heating by an electric heater or a hot liquid.

L'élément d'articulation 3 comporte une coquille 12, en fait deux demi-coquilles assemblées, à cavité sphérique 13, dans la paroi de laquelle est ménagée une ouverture ou fente élargie 14 à parois 15 parallèles à et équidistantes d'un plan axial de la cavité 13. La fente 14 s'étend ici sensiblement sur un quadrant angulaire. The hinge member 3 comprises a shell 12, in fact the two half-shells are assembled, a spherical cavity 13 in the wall of which there is an opening or slot 14 extended in walls 15 parallel to and equidistant from an axial plane of the cavity 13. the slit 14 here extends substantially over an angular quadrant. L'élément d'articulation 3 comporte aussi une rotule sphérique 16, logée dans la cavité 13, après introduction en usine, et prolongée par un bout de tige 17 plate et assez étroite, placée à travers la fente 14 et lui-même prolongé, de l'autre côté, par la barrette-tenon 7 associée. The hinge element 3 also comprises a ball joint 16 housed in the cavity 13, after introduction in the factory, and extended by a rod end 17 flat and relatively narrow, placed through the slot 14 and itself extended, on the other side, by the tenon-strip 7 associated.

La vis 1 correspondante, solidaire du bout de tige plate et de la rotule 16, est donc articulée à la coquille 12 et peut, sous l'action des tendons extenseurs et des tendons fléchisseurs, pivoter en rotation, sur environ 900, autour d'un axe passant par le centre de la cavité 13 et de la rotule 16 et orthogonal aux parois 15 de la fente 14, qui servent au guidage du bout de tige 17, avec toutefois un léger débattement latéral. The screw 1 corresponding, integral with the piece of flat bar and the ball 16, is hinged to the shell 12 and may, under the action of extensor tendons and flexor tendons, pivot rotation, about 900, around an axis passing through the center of the cavity 13 and the ball 16 and orthogonal to the walls 15 of the slot 14, which serve to guide the tip of rod 17, but with a slight lateral clearance. C'est une articulation rotolde. It is a rotolde joint.

Du côté de la vis articulée 1, la coquille 12 est sphérique. The side of the articulated screw 1, the shell 12 is spherical.

Du côté de l'autre vis d'ancrage 2, la coquille 13 est usinée pour présenter une surface plane 18 contre laquelle, après mise en place, stappaye la paroi plane d'extrémité 19 de la collerette 9 de cette autre vis d'ancrage 2. The side of the other anchoring screws 2, the shell 13 is machined to have a flat surface 18 against which, after positioning, stappaye the flat end wall 19 of the flange 9 of the other anchoring screws 2.

Ainsi, les deux vis d'ancrage 1, 2 sont articulées entre elles au moyen de l'articulation intermédiaire 3. Grâce à l'ancrage des vis dans les diaphyses associées et à l'ancrage des barrettes-tenons 7 dans ces vis, la prothèse ainsi constituée est, dans son ensemble, immobilisée en translation par rapport aux diaphyses réunies, comme illes- tré sur la figure 3 représentant la prothèse de l'invention articulant deux phalanges de l'index d'une main gauche. Thus, the two anchoring screws 1, 2 are hinged together by hinge means 3. With the anchoring screw in the associated diaphyses and anchoring webs tenon 7 in the screw, prosthesis thus formed is, as a whole, immobilized in translation relative to the combined diaphyses as illes- strated in FIG 3 showing the prosthesis of the invention articulating two phalanges of the index finger of a left hand.

La prothèse articulaire qui vient d'être décrite évite toute luxation articulaire post-opératoire. The joint prosthesis which has just been described avoids postoperative joint dislocation. Il est avantageux que les matériaux de la coquille et de la rotule soient respectivement différents, par exemple l'un de la céramique et l'autre un alliage de titane. It is advantageous that the materials of the shell and of the ball joint are respectively different, for example one of the ceramic and the other a titanium alloy. On notera qu'il est également préférable que les vis d'ancrage soient aussi en alliage de titane. Note that it is also preferred that the anchoring screws are also made of titanium alloy.

On a décrit ci-dessus la prothèse articulaire de l'invention en référence à la forme de réalisation préférée pourvue, comme moyen de fixation de l'élément intermédiaire d'articulation 3 aux vis d'ancrage 1 et 2 de manchons 7' en alliage métallique mémoire assurant le verrouillage de celui-là sur ceux-ci par expansion. We have described above the joint prosthesis of the invention with reference to the preferred embodiment provided as a means of fixing the intermediate hinge member 3 to the screw anchor 1 and 2 sleeves 7 'Alloy memory metal ensuring the locking of the former on the latter by expansion.

On pourrait également concevoir un verrouillage par traction, par exemple par effet de coins ou, plus généralement, de deux surfaces coniques, l'une sur les vis et l'autre sur l'élément intermédiaire d'articulation. One could also conceive a traction lock, eg corners effect or, more generally, of two conical surfaces, one on the screw and the other on the intermediate element of articulation. Dans ce cas, le blocage devrait être assuré par écartement mutuel des vis et de l'élément intermédiaire d'articulation. In this case, the blocking should be provided by mutual spacing of the screw and the intermediate hinge member. Mais comme les deux vis d'ancrage sont disposées de part et d'autre de l'élément intermédiaire dtarticulation, le blocage de cet élément sur l'une des vis devrait avoir tendance à rapprocher l'élément d'articulation de l'autre vis et, par conséquent, à les déverrouiller. But as the two anchoring screws are arranged on either side of the intermediate element dtarticulation, blocking this item to one of the screws should tend to bring the articulation of the other screw element and, therefore, unlocking the. En fait, il n'en serait rien. In fact, it would not. Les deux paires de coins associées aux deux vis d'ancrage assureraient le blocage, pour chaque vis, dans un sens, le blocage dans l'autre sens étant assuré par les tendons ---------- tendant, par leur action de compression, à rapprocher les vis d'ancrage de l'élément intermédiaire d'articulation, si bien que l'élément d'articulation resterait quand m#me immobilisée en translation par rapport aux diaphyses réifies par la prothèse. The two pairs of corners associated with the two anchoring screws would provide locking, for each screw in one direction, blocking in the other direction being effected by tendons ---------- tending by their compression action, to bring the anchoring screws of the intermediate element of articulation, so that the articulation element remain when m # me immobilized in translation relative to the diaphysis objectified by the prosthesis.

Claims (8)

Revendications claims
1. Prothèse articulaire phalangienne à implanter dans une zone pourvue de tendons , comprenant deux portions de tige (1, 2) agencées pour etre ancrées, par l'une (5) de leurs extrémités, dans les diaphyses de deux os à articuler entre eux, caractérisée par le fait qu'elle comporte un élément intermédiaire (3) d'articulation des deux portions de tige d'ancrage (l, 2) qui est fixé à celles-ci par des moyens (7')agencés pour, avec accessoirement l'action des tendons de la zone d'articulation, immobiliser l'élément intermédiaire (3) en translation par rapport aux diaphyses ainsi réunies. 1. phalangeal joint prosthesis implanted in a zone provided with tendons, comprising two rod portions (1, 2) arranged to be anchored, by one (5) of their ends, in the diaphysis of two bones articulate them characterized in that it comprises an intermediate element (3) of articulation of the two anchor rod portions (l, 2) which is fixed thereto by means (7 ') arranged, with accessory the action of the tendons of the articulation zone, immobilize the intermediate member (3) in translation relative to the diaphysis as well met.
2. Prothèse selon la revendication 1, dans laquelle lesdits moyens de fixation aux portions d'ancrage de l'élément d'articulation de la prothèse de l'invention sont agencés pour verrouiller en traction ltéîément d'articulation sur chaque portion d'ancrage, contre l'action, des tendons, 2. The prosthesis of claim 1, wherein said fixing means to the anchor portions of the hinge member of the prosthesis of the invention are arranged to lock traction ltéîément hinge on each anchoring portion, against the action, tendons,
de de compression des portions d'ancrage sur 1' élément d'articulation. of compression of the anchoring portions of 1 'hinge member.
3. Prothèse selon la revendication l, dans laquelle lesdits moyens de fixation (7')sont agencés pour verrouiller en expansion ltélément d'articulation (3) sur les portions d'ancrage (1, 2). 3. Prosthesis according to claim l, wherein said fastening means (7 ') are arranged to lock expanding ltélément hinge (3) on the anchor portions (1, 2).
4. Prothèse selon la revendication 3, dans laquelle lesdits moyens de fixation comprennent, monté sur chaque portion de tige (1, 2), un manchon (7') en "alliage métallique mémoire", prétransformé a une température déterminée et constitué pour, sous l'action d'une température supérieure a la température de pré transformation, et par un effet mémoire,reprendre une forme d'origine expansée. 4. The prosthesis of claim 3, wherein said fixing means comprise, mounted on each rod portion (1, 2), a sleeve (7 ') "memory metal alloy", is preconverted has a determined and consisting temperature, under the action of a temperature above the temperature of pre processing, and a memory effect, take a form of expanded origin.
5. Prothèse selon l'une des revendications 3 et 4, dans laquelle chaque portion de tige d'ancrage (1; 2) est fendue (11) et agencée pour recevoir un moyen d'expansion (72) solidaire de l'élément d'articulation (3), donc solidariser l'élément d'articulation (3) à la portion de tige d'ancrage considérée(l; 2), subir ainsi une expansion et parfaire l'ancrage de cette portion de tige d'ancrage (1; 2) dans la diaphyse associée. 5. A prosthesis according to one of Claims 3 and 4, wherein each portion of the anchor rod (1; 2) is slotted (11) and arranged to receive an expansion means (72) integral with the element articulation (3), thus fasten the hinge element (3) to the anchor rod portion in question (l; 2), and undergo expansion and improve the anchoring of that portion of the anchor rod ( 1; 2) in the associated shaft.
6. Prothèse selon l'une des revendications 1 à 5, dans laquelle l'élément d'articulation (3) est un élément d'articulation rotonde comprenant une rotule (16) solidaire d'une (1) des portions d'ancrage et une coquille sphérique (12) solidaire de l'autre (2) des portions d'ancrage et recevant ladite rotule (16). 6. A prosthesis according to one of claims 1 to 5, wherein the hinge member (3) is a rotunda hinge member comprising a ball (16) integral with one (1) of anchor portions and a spherical shell (12) integral with the other (2) of the anchor portions and receiving said ball (16).
7.Prothèse selon la revendication 6, dans laquelle la rotule (16) est prolongée par une barrette (17, 7) montée pivotante dans une fente (14) ménagée dans la coquille (12). 7.Prothèse according to claim 6, wherein the ball (16) is extended by a bar (17, 7) pivotally mounted in a slot (14) in the shell (12).
8. Prothèse selon l'une des revendications 1 à 7, dans laquelle l'élément d'articulation (3) coopère avec chaque portion de tige d'ancrage (1; 2) à la manière d'un tenon et d'une mortaise. 8. A prosthesis according to one of claims 1 to 7, wherein the hinge member (3) engages with each portion of the anchor rod (1; 2) in the manner of a tenon and a mortise .
FR8911164A 1989-08-23 1989-08-23 Phalangeal articular prosthesis Withdrawn FR2651119A1 (en)

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Cited By (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2692776A1 (en) * 1992-06-30 1993-12-31 Impact Total replacement prosthesis for bone joint esp. in hand or foot - has cotylar portion implanted into bone surface, cooperating with shaft implanted in medullary canal of second bone via intermediate pin
US5326366A (en) * 1993-02-16 1994-07-05 Wright Medical Technology, Inc. Biomechanical great toe implant
DE4337922A1 (en) * 1993-11-06 1995-05-11 Ilmenauer Implantate Manufaktu Joint prosthesis
FR2717071A1 (en) * 1994-03-11 1995-09-15 Procerati Joint prosthesis esp. for finger
EP0684024A2 (en) * 1994-04-26 1995-11-29 Zsuzsa Cserhati Joint prosthesis
FR2725892A1 (en) * 1994-10-21 1996-04-26 Felman Daniel Vertebral implant insertion process using shape memory material
DE19512854C1 (en) * 1995-04-06 1996-08-01 Eska Medical Gmbh & Co Finger joint prosthesis
WO1997020525A1 (en) * 1995-12-05 1997-06-12 Metagen, Llc Modular prosthesis
US5725585A (en) * 1997-02-27 1998-03-10 Zobel; Robert A. Anatomically correct great toe implant and surgical procedure for implanting the same
WO1999003430A1 (en) * 1997-07-16 1999-01-28 Knapp John G Joint prosthesis
US5984970A (en) * 1996-03-13 1999-11-16 Bramlet; Dale G. Arthroplasty joint assembly
FR2783702A1 (en) * 1998-09-29 2000-03-31 Maurice Bertholet Self-locking prosthesis for bone insert has heat activated anchor flanges formed on central core
US6695844B2 (en) 1996-03-13 2004-02-24 Orthopedic Designs, Inc. Surgical fastener assembly
EP2403433A1 (en) * 2009-02-19 2012-01-11 Nextremity Solutions, Llc Bone joining apparatus and method
US8529611B2 (en) 2010-03-16 2013-09-10 Competitive Global Medical, Llc Distal interphalangeal fusion method and device
US8685067B2 (en) 2010-12-21 2014-04-01 Competitive Global Medical, Llc Compression plate apparatus
US8715326B2 (en) 2009-08-28 2014-05-06 Competitive Global Medical, Llc Distal interphalangeal fusion device and method of use
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
US9498273B2 (en) 2010-06-02 2016-11-22 Wright Medical Technology, Inc. Orthopedic implant kit
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
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
US10357299B2 (en) 2017-06-26 2019-07-23 Nextremity Solutions, Inc. Bone joining apparatus and method

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GB2164114A (en) * 1984-09-06 1986-03-12 Mark George Dziecielewski Securing an alloy section to a body
EP0229578A1 (en) * 1985-12-24 1987-07-22 Christian Mai Self-clamping medical prostheses and process for manufacturing same

Cited By (50)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2692776A1 (en) * 1992-06-30 1993-12-31 Impact Total replacement prosthesis for bone joint esp. in hand or foot - has cotylar portion implanted into bone surface, cooperating with shaft implanted in medullary canal of second bone via intermediate pin
US5326366A (en) * 1993-02-16 1994-07-05 Wright Medical Technology, Inc. Biomechanical great toe implant
DE4337922A1 (en) * 1993-11-06 1995-05-11 Ilmenauer Implantate Manufaktu Joint prosthesis
DE4337922B4 (en) * 1993-11-06 2004-10-07 Jakob, Charles B. joint prosthesis
FR2717071A1 (en) * 1994-03-11 1995-09-15 Procerati Joint prosthesis esp. for finger
EP0684024A2 (en) * 1994-04-26 1995-11-29 Zsuzsa Cserhati Joint prosthesis
EP0684024A3 (en) * 1994-04-26 1996-04-24 Zsuzsa Cserhati Joint prosthesis.
FR2725892A1 (en) * 1994-10-21 1996-04-26 Felman Daniel Vertebral implant insertion process using shape memory material
EP0736293A1 (en) * 1995-04-06 1996-10-09 ESKA Implants GmbH &amp; Co. Finger joint
US5702471A (en) * 1995-04-06 1997-12-30 Eska Medical Gmbh & Co. Finger joint
DE19512854C1 (en) * 1995-04-06 1996-08-01 Eska Medical Gmbh & Co Finger joint prosthesis
WO1997020525A1 (en) * 1995-12-05 1997-06-12 Metagen, Llc Modular prosthesis
AU730597B2 (en) * 1995-12-05 2001-03-08 Orthopaedic Innovations, Inc. Modular prosthesis
US5858020A (en) * 1995-12-05 1999-01-12 Metagen, Llc Modular prosthesis
EA000291B1 (en) * 1995-12-05 1999-02-25 Митаджен, Ллс The modular prosthesis
WO1998055051A1 (en) * 1995-12-05 1998-12-10 Metagen, Llc Modular prosthesis
US6695844B2 (en) 1996-03-13 2004-02-24 Orthopedic Designs, Inc. Surgical fastener assembly
US5984970A (en) * 1996-03-13 1999-11-16 Bramlet; Dale G. Arthroplasty joint assembly
US6475242B1 (en) 1996-03-13 2002-11-05 Dale G. Bramlet Arthroplasty joint assembly
US5725585A (en) * 1997-02-27 1998-03-10 Zobel; Robert A. Anatomically correct great toe implant and surgical procedure for implanting the same
US6099571A (en) * 1997-07-16 2000-08-08 Knapp; John G. Joint prosthesis
US6284001B1 (en) 1997-07-16 2001-09-04 John G. Knapp Joint prosthesis
WO1999003430A1 (en) * 1997-07-16 1999-01-28 Knapp John G Joint prosthesis
FR2783702A1 (en) * 1998-09-29 2000-03-31 Maurice Bertholet Self-locking prosthesis for bone insert has heat activated anchor flanges formed on central core
EP3037067A1 (en) * 2009-02-19 2016-06-29 Nextremity Solutions, LLC Bone joining apparatus and method
EP2403433A1 (en) * 2009-02-19 2012-01-11 Nextremity Solutions, Llc Bone joining apparatus and method
US9687286B2 (en) 2009-02-19 2017-06-27 Nextremity Solutions, Inc. Bone joining apparatus and method
EP2403433A4 (en) * 2009-02-19 2014-06-11 Nextremity Solutions Llc Bone joining apparatus and method
US8715326B2 (en) 2009-08-28 2014-05-06 Competitive Global Medical, Llc Distal interphalangeal fusion device and method of use
US8529611B2 (en) 2010-03-16 2013-09-10 Competitive Global Medical, Llc Distal interphalangeal fusion method and device
US9603643B2 (en) 2010-06-02 2017-03-28 Wright Medical Technology, Inc. Hammer toe implant with expansion portion for retrograde approach
US9072564B2 (en) 2010-06-02 2015-07-07 Wright Medical Technology, Inc. Hammer toe implant and method
US9949775B2 (en) 2010-06-02 2018-04-24 Wright Medical Technology, Inc. Hammer toe implant with expansion portion for retrograde approach
US9877753B2 (en) 2010-06-02 2018-01-30 Wright Medical Technology, Inc. Orthopedic implant kit
US9498273B2 (en) 2010-06-02 2016-11-22 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
US9044287B2 (en) 2010-06-02 2015-06-02 Wright Medical Technology, Inc. Hammer toe implant method
US8685067B2 (en) 2010-12-21 2014-04-01 Competitive Global Medical, Llc Compression plate apparatus
US8945232B2 (en) 2012-12-31 2015-02-03 Wright Medical Technology, Inc. Ball and socket implants for correction of hammer toes and claw toes
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
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
US10299840B2 (en) 2014-09-18 2019-05-28 Wright Medical Technology, Inc. Hammertoe implant and instrument
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
US10357299B2 (en) 2017-06-26 2019-07-23 Nextremity Solutions, Inc. Bone joining apparatus and method

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