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
Authority
FR
France
Prior art keywords
articulation
anchoring
rod
prosthesis
portions
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Withdrawn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
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to FR8911164A priority Critical patent/FR2651119A1/en
Publication of FR2651119A1 publication Critical patent/FR2651119A1/en
Withdrawn legal-status Critical Current

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Classifications

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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30143—Convex polygonal shapes hexagonal
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30574—Special structural features of bone or joint prostheses not otherwise provided for with an integral complete or partial collar or flange
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
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    • A61F2210/0014—Particular 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
    • A61F2210/0023—Particular 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
    • A61F2210/0042—Particular 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures

Landscapes

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

Abstract

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.

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 intended to replace a metacarpa-phalanvian, metatarsophalangeal or interphalangeal joint of the hand or the foot.

La nécessité de procéder au remplacement d t une articulation peut être provoquée par des causes diverses. Il peut s'agir d'un traumatisme, mais c'est rare. Il peut surtout s'agir d'une arthrose ou d'une arthrite rhumatolde. The need to replace a joint can be caused by various causes. It may be a trauma, but it is rare. It can mainly be arthritis or rheumatoid arthritis.

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.Two bones start with each other by their spongy end covered with cartilage, ltépiphyse, which ends the diaphysis formed of the cortical layer inside which extends the medullary canal, the two epiphyses being joined by a 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. 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.There has already been proposed a prosthesis formed of a seale and simple plastic rod, placed in the two medullary canals of the two bones to be articulated between them after opening of the articulation zone, separation of the two bones and cutting of the two epiphyses. However, such a prosthesis had the drawback of causing geodes to form in the cortical layer because of the mobility of the rod 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. There has also been proposed a prosthesis formed by two portions of rod terminated at one end, one by a shell or quasi-hemispherical cavity, the other by a ball joint housed in said cavity, the other two ends of the two portions. rod being respectively introduced into the medullary canals of the two bones to be articulated between them and a quasi-spherical flange being fixed to the portion of rod with ball and surrounding ltensemblede the articulation of the two portions of rod.

L'inconvénient de cette deuxième prothèse à articulation sphérique réside essentiellement dans sa mauvaise tenue mécanique.The drawback of this second prosthesis with a spherical joint lies essentially 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. L'inconvénient de cette dernière prothèse réside dans son manque de stabilité articulaire générateur de luxation.There is a third known type of prosthesis, similar to the second presented above, with two portions of stem screwed into the cortical layers and an articulation of the portions of stem not spherical but rotunda, with disc, of one of the portions of rod, pivotally mounted in a corresponding recess in the lair of the rod portions. The drawback of this latter prosthesis lies in its lack of joint stability, which generates dislocation.

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 to be implanted in an area provided with tendons, comprising two portions of rod arranged to be anchored, by one of their ends, in the diaphyses of two bones to be articulated together, characterized by the fact that it comprises an intermediate articulation element of the two portions of anchoring rod which is fixed to these by means arranged to, with incidentally the action of the tendons of the articulation zone, immobilize the intermediate element in translation with respect to the diaphyses thus united.

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 element with respect to the diaphyses is in fact obtained by immobilization with respect to the stem portions of the prosthesis since these are anchored in the diaphyses.

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 is thanks to the structure in three parts perfectly integral with each other of the prosthesis of the invention that one obtains its advantageous functional characteristic of relative immobility of the prosthesis and of the bones to be articulated between them or of perfect securing of the prosthesis at its implantation 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 of fixing to the anchoring portions of the articulation element of the prosthesis of the invention can be arranged to lock in traction the articulation element on each anchoring portion, against the action, of the tendons. , compression of the anchoring portions on the articulation 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 that of said fixing means which are arranged to lock expanding the articulation element on the anchoring 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 anchor rod is split and arranged to receive an expansion means integral with the articulation element, therefore securing the articulation element to the portion of anchor rod considered, to undergo thus an expansion and perfecting the anchoring of this portion of anchoring rod in the associated diaphysis.

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 portion of the rod, a sleeve made of "memory metal alloy", pre-transformed at a determined temperature and constituted for, under the action of a temperature higher than the pre-transformation temperature, and by a memory effect, resume 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
Verlag FJlirzburg, Heft 3/1983. Such a 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.

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 articulation element is a rotunda articulation element comprising a ball joint integral with one of the anchoring portions and a spherical shell integral with the other of the anchoring portions and receiving said ball joint, the ball joint being extended by 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
articulaire de l'invention; - la figure 2 représente une vue de l'élément intermédiaire
d'articulation de la prothèse de la figure 1 et - la figure 3 représente une vue, à plus petite échelle,
d'une main pourvue de la prothèse des figures 1 et 2
implantée entre deux phalanges.The invention will be better understood with the aid of the following description of the preferred embodiment of the prosthesis of the invention, with reference to the appended drawings, in which - FIG. 1 represents a sectional view of the prosthesis
articular of the invention; - Figure 2 shows a view of the intermediate element
of articulation of the prosthesis of FIG. 1 and - FIG. 3 represents a view, on a smaller scale,
with one hand provided with the prosthesis of figures 1 and 2
implanted 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. 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. The joint prosthesis which will be described is intended to replace a metacarpa-phalangeal, metatarsophalangeal or interphalangeal joint of the hand or foot. It has three parts which, after implantation, are perfectly integral with one another - two rods 1, 2 to be anchored respectively in two diaphyses to be joined, - an intermediate element 3 of rotunda articulation.

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. 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.Each anchor rod 1, 2 is here in the form of a screw, provided with an external thread 4 for its screwing, by an end 5 of narrowed section, in the cortical layer of the associated diaphysis, and in which a was provided a blind cavity 6, for receiving a bar 7 secured to the hinge member 3 and extending from the other end 8 of the screw, of enlarged section. The end 8 of each rod 1, 2, intended to be turned towards the articulation element 3, is extended by an annular flange 9 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. 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 cavity 6 of each anchor rod and the bar 7 of the articulation element 3 which it must receive are intended to cooperate in the manner of a mortise and a tenon. The cavities 6 and bars 7, of the same length, have the same section, one inside and the other outside, of polygonal shape, here hexagonal, the bars are considered to be sheathed with a sleeve 7 ′ of memory alloy whose outer section is in does the one, mentioned above, of the bars.

Les tiges 1, 2 sont fendues en 11 pour permettre leur 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. L'effet mémoire de l'alliage des manchons 7'peut se produire à la température du corps du patient. 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 rods 1, 2 are split at 11 to allow their expansion. After anchoring the rods 1, 2 in the corresponding diaphyses, then rough positioning of the articulation element 3 by the osteo-articular surgeon, each tenon 7, with its sleeve 7 ', of the element d 'articulation 3 is introduced and pressed into the cavity 6 of the associated rod then, under the action of heat, the sleeve 7' stexpanse to anchor in turn in the anchor rod 1, 2 and perfect the anchoring it in the associated shaft. The memory effect of the 7 'sleeve alloy can occur at the patient's body temperature. The alloy can also be such that its memory effect does not occur until after heating by an electrical resistance 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. 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 articulation element 3 comprises a shell 12, in fact two assembled half-shells, with a spherical cavity 13, in the wall of which is formed an opening or widened slot 14 with walls 15 parallel to and equidistant from an axial plane of the cavity 13. The slot 14 here extends substantially over an angular quadrant. The articulation element 3 also comprises a spherical ball joint 16, housed in the cavity 13, after introduction into the factory, and extended by a flat and fairly narrow end of rod 17, placed through the slot 14 and itself extended, on the other side, by the associated pin bar 7.

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. C'est une articulation rotolde.The corresponding screw 1, integral with the end of the flat rod and the ball joint 16, is therefore articulated to the shell 12 and can, under the action of the extensor tendons and the flexor tendons, pivot in rotation, about 900, around an axis passing through the center of the cavity 13 and of the ball joint 16 and orthogonal to the walls 15 of the slot 14, which serve to guide the end of the rod 17, with however a slight lateral clearance. It is a rotunda joint.

Du côté de la vis articulée 1, la coquille 12 est sphérique.On 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.On the side of the other anchor screw 2, the shell 13 is machined to present a flat surface 18 against which, after positioning, the flat end wall 19 of the flange 9 of the flange 9 of this other anchor screw 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 anchor screws 1, 2 are articulated to each other by means of the intermediate articulation 3. Thanks to the anchoring of the screws in the associated diaphyses and to the anchoring of the pin bars 7 in these screws, the prosthesis thus constituted is, as a whole, immobilized in translation relative to the combined diaphyses, as shown in FIG. 3 representing the prosthesis of the invention articulating two phalanges of the index finger with a left hand.

La prothèse articulaire qui vient d'être décrite évite toute luxation articulaire post-opératoire. 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. On notera qu'il est également préférable que les vis d'ancrage soient aussi en alliage de titane.The joint prosthesis which has just been described avoids any post-operative joint dislocation. It is advantageous that the materials of the shell and of the ball joint are respectively different, for example one of ceramic and the other a titanium alloy. Note that it is also preferable that the anchor 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.The articular prosthesis of the invention has been described above with reference to the preferred embodiment provided, as a means of fixing the intermediate articulation element 3 to the anchoring screws 1 and 2 of 7 'alloy sleeves metallic memory ensuring the locking of this one on these 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. Dans ce cas, le blocage devrait être assuré par écartement mutuel des vis et de l'élément intermédiaire d'articulation. 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. En fait, il n'en serait rien. 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. One could also conceive a locking by traction, for example by wedge effect or, more generally, of two conical surfaces, one on the screws and the other on the intermediate articulation element. In this case, blocking should be ensured by mutual spacing of the screws and the intermediate articulation element. But as the two anchor screws are arranged on either side of the intermediate articulation element, the blocking of this element on one of the screws should tend to bring the articulation element closer to the other screw and therefore unlock them. In fact, it would not be. The two pairs of wedges associated with the two anchoring screws would ensure blocking, for each screw, in one direction, blocking in the other direction being provided by the tendons ---------- tending, by their compression action, to bring the anchoring screws closer to the intermediate articulation element, so that the articulation element would remain immobilized in translation relative to the diaphyses reified by the prosthesis.

Claims (8)

RevendicationsClaims 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 to be implanted in an area provided with tendons, comprising two portions of rod (1, 2) arranged to be anchored, by one (5) of their ends, in the diaphyses of two bones to be articulated between them , characterized in that it comprises an intermediate element (3) for articulation of the two anchor rod portions (l, 2) which is fixed to these by means (7 ') arranged for, with incidentally the action of the tendons in the articulation zone, immobilizing the intermediate element (3) in translation relative to the diaphyses thus united. 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. Prosthesis according to claim 1, in which said means for fixing to the anchoring portions of the articulation element of the prosthesis of the invention are arranged to lock in articulation the articulation element on each anchoring portion, against action, tendons, de de compression des portions d'ancrage sur 1' élément d'articulation. compression of the anchoring portions on one articulation element. 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 fixing means (7 ') are arranged to lock in expansion ltélément articulation (3) on the anchoring 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. Prosthesis according to claim 3, in which said fixing means comprise, mounted on each portion of rod (1, 2), a sleeve (7 ′) made of “memory metal alloy”, pre-transformed at a determined temperature and constituted for, under the action of a temperature higher than the pre-transformation temperature, and by a memory effect, resume 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. Prosthesis according to one of claims 3 and 4, wherein each portion of anchor rod (1; 2) is split (11) and arranged to receive an expansion means (72) integral with the element d 'articulation (3), therefore securing the articulation element (3) to the portion of anchoring rod considered (l; 2), thus undergoing expansion and perfecting the anchoring of this portion of anchoring rod ( 1; 2) in the associated diaphysis. 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. Prosthesis according to one of claims 1 to 5, in which the articulation element (3) is a rotunda articulation element comprising a ball joint (16) integral with one (1) of the anchoring portions and a spherical shell (12) integral with the other (2) of the anchoring portions and receiving said ball joint (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. Prosthesis according to claim 6, wherein the ball joint (16) is extended by a bar (17, 7) pivotally mounted in a slot (14) formed 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. Prosthesis according to one of claims 1 to 7, wherein the articulation element (3) cooperates with each portion of 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 (31)

* Cited by examiner, † Cited by third party
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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
US9724140B2 (en) 2010-06-02 2017-08-08 Wright Medical Technology, Inc. Tapered, cylindrical cruciform hammer toe implant and method
US9724139B2 (en) 2013-10-01 2017-08-08 Wright Medical Technology, Inc. Hammer toe implant and method
US9808296B2 (en) 2014-09-18 2017-11-07 Wright Medical Technology, Inc. Hammertoe implant and instrument
CN108042245A (en) * 2017-12-31 2018-05-18 天津市赛宁生物工程技术有限公司 A kind of anti-dislocation and the small joint prosthesis of fracture
US10080597B2 (en) 2014-12-19 2018-09-25 Wright Medical Technology, Inc. Intramedullary anchor for interphalangeal arthrodesis
CN110638510A (en) * 2018-06-27 2020-01-03 奥微医学科技股份有限公司 Arthritis correction fixing device and operation method thereof
WO2022013598A1 (en) * 2020-07-14 2022-01-20 Bayona Juvenal Endoprosthesis device

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Cited By (56)

* 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 & 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
WO1998055051A1 (en) * 1995-12-05 1998-12-10 Metagen, Llc Modular prosthesis
US5858020A (en) * 1995-12-05 1999-01-12 Metagen, Llc Modular prosthesis
EA000291B1 (en) * 1995-12-05 1999-02-25 Митаджен, Ллс Modular prosthesis
US6475242B1 (en) 1996-03-13 2002-11-05 Dale G. Bramlet Arthroplasty joint assembly
US5984970A (en) * 1996-03-13 1999-11-16 Bramlet; Dale G. Arthroplasty joint assembly
US6695844B2 (en) 1996-03-13 2004-02-24 Orthopedic Designs, Inc. Surgical fastener 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
US10357299B2 (en) 2009-02-19 2019-07-23 Nextremity Solutions, Inc. 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
US9072564B2 (en) 2010-06-02 2015-07-07 Wright Medical Technology, Inc. Hammer toe implant and method
US10736676B2 (en) 2010-06-02 2020-08-11 Wright Medical Technology, Inc. Orthopedic implant kit
US9498273B2 (en) 2010-06-02 2016-11-22 Wright Medical Technology, Inc. Orthopedic implant kit
US9044287B2 (en) 2010-06-02 2015-06-02 Wright Medical Technology, Inc. Hammer toe implant 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
US9603643B2 (en) 2010-06-02 2017-03-28 Wright Medical Technology, Inc. Hammer toe implant with expansion portion for retrograde approach
US9724140B2 (en) 2010-06-02 2017-08-08 Wright Medical Technology, Inc. Tapered, cylindrical cruciform hammer toe implant and method
US8685067B2 (en) 2010-12-21 2014-04-01 Competitive Global Medical, Llc Compression plate apparatus
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
US9504582B2 (en) 2012-12-31 2016-11-29 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
US9545274B2 (en) 2014-02-12 2017-01-17 Wright Medical Technology, Inc. Intramedullary implant, system, and method for inserting an implant into a bone
US9498266B2 (en) 2014-02-12 2016-11-22 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
CN108042245A (en) * 2017-12-31 2018-05-18 天津市赛宁生物工程技术有限公司 A kind of anti-dislocation and the small joint prosthesis of fracture
CN108042245B (en) * 2017-12-31 2024-04-02 天津市美兰生物科技有限公司 Dislocation and fracture prevention ossicular joint prosthesis
CN110638510A (en) * 2018-06-27 2020-01-03 奥微医学科技股份有限公司 Arthritis correction fixing device and operation method thereof
CN110638510B (en) * 2018-06-27 2021-05-14 奥微医学科技股份有限公司 Arthritis correction fixing device and operation method thereof
WO2022013598A1 (en) * 2020-07-14 2022-01-20 Bayona Juvenal Endoprosthesis device

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