FR2680968A1 - Implant for subastragalar arthrorisis - Google Patents

Implant for subastragalar arthrorisis Download PDF

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Publication number
FR2680968A1
FR2680968A1 FR9111289A FR9111289A FR2680968A1 FR 2680968 A1 FR2680968 A1 FR 2680968A1 FR 9111289 A FR9111289 A FR 9111289A FR 9111289 A FR9111289 A FR 9111289A FR 2680968 A1 FR2680968 A1 FR 2680968A1
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implant
rod
implant according
head
nose
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FR2680968B1 (en
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Kralik Anton Christian
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PROCOM SA
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PROCOM SA
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/562—Implants for placement in joint gaps without restricting joint motion, e.g. to reduce arthritic pain
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30156—Convex polygonal shapes triangular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/3023—Three-dimensional shapes cylindrical wedge-shaped cylinders
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/3055—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting length
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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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    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30789—Plurality of holes perpendicular with respect to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
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    • A61F2002/4223—Implants for correcting a flat foot
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A61F2002/4638—Tools for performing screwing, e.g. nut or screwdrivers, or particular adaptations therefor
    • A—HUMAN NECESSITIES
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    • 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
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Abstract

The implant comprises an anchoring pin (1) and a head (T). The head (T) consists of two parts (2) and (3) which are mounted with a capacity for relative displacement in terms of translation in order to make it possible to vary the length of the implant in situ, one of the parts being integral with the pin (1).

Description

Implant pour arthrorise sous-astragalienne. Implant for subtalar arthritis.

L'invention concerne plus particulièrement, un implant pour corriger des pieds valgus très prononcés, et notamment le valgus calcanéen. The invention relates more particularly to an implant for correcting very pronounced valgus feet, and in particular the calcaneal valgus.

On rappelle que le valgus peut résulter d'un cas pathologique du développement squelettique du calcanéum ou de l'astragale, de l'appareil tendineux ou ligamentaire, de sorte que le calcanéum n'est pas complètement positionné sur l'astragale. Dans de tels cas, il est nécessaire d'aider le pied pour éviter l'aggravation du valgus et les déformations en essayant de les réduire définitivement. It is recalled that the valgus can result from a pathological case of the skeletal development of the calcaneus or the talus, the tendon or ligament apparatus, so that the calcaneus is not completely positioned on the talus. In such cases, it is necessary to help the foot to avoid aggravation of the valgus and deformities by trying to reduce them permanently.

Pour tenter d'obtenir ces résultats, on a proposé des orthèses plantaires de stimulation ou de correction. II apparait cependant que cette solution n'est pas satisfaisante. In an attempt to obtain these results, plantar orthotics for stimulation or correction have been proposed. However, it appears that this solution is not satisfactory.

Pour remédier à ces inconvénients, il a été développé une arthrorise sous astragalienne dont la finalité est de contrôler l'évolution du valgus calcanéen. L'arthrorise sous astragalienne a pour but de maintenir l'astragale à sa place, sans modifier les pièces squelettiques mais en rétablissant entre elles, des rapports harmonieux. To remedy these drawbacks, an astragalar arthrosis was developed, the purpose of which is to control the evolution of the calcaneal valgus. The aim of the astragalar under the talus is to keep the talus in its place, without modifying the skeletal parts but by restoring harmonious relationships between them.

Différentes solutions ont été proposées pour réaliser des arthrorises sous astragalienne. Notamment on connaît des implants métalliques présentant une tête cylindrique dont le sommet est arrondi et dont la base est taillée en oblique pour améliorer sa stabilité, en appui sur la partie correspondante de l'astragale. La tête est prolongée par une tige d'ancrage coopérant notamment avec l'astragale.  Different solutions have been proposed to perform arthrorises under astragalar. In particular, there are known metallic implants having a cylindrical head whose apex is rounded and whose base is cut obliquely to improve its stability, resting on the corresponding part of the talus. The head is extended by an anchor rod cooperating in particular with the talus.

Si ce type d'implant constitue une technique opératoire satisfaisante, il apparait cependant certains inconvénients. If this type of implant constitutes a satisfactory operating technique, there are however certain drawbacks.

En effet, ces implants sont toujours de même diamètre mais présentent différentes tailles pour tenter de traiter la plupart des cas pathologiques existants. Or, il arrive fréquemment que la taille sélectionnée par le praticien ne corresponde pas exactement au cas pathologique à traiter. Dans ces conditions, il est nécessaire d'intervenir de nouveau, d'enlever l'implant et de le remplacer, ce qui peut s'avérer douloureux pour le patient. Indeed, these implants are always of the same diameter but have different sizes in an attempt to treat most of the existing pathological cases. However, it often happens that the size selected by the practitioner does not exactly correspond to the pathological case to be treated. In these conditions, it is necessary to intervene again, to remove the implant and to replace it, which can prove painful for the patient.

L'invention s'est fixée pour but de remédier à ces inconvénients1 d'une manière simple, sûre et efficace. The object of the invention is to remedy these drawbacks1 in a simple, safe and effective manner.

Le problème que se propose de résoudre l'invention est de créer un implant modulaire pour arthrorise sous astragalienne, de manière à s'adapter très exactement aux différents cas pathologiques à traiter. The problem which the invention proposes to solve is to create a modular implant for arthrorises under the talus, so as to adapt very exactly to the different pathological cases to be treated.

Pour résoudre un tel problème, il a été crée un implant dont la tête est agencée pour faire varier in situ la longueur de l'implant. To solve such a problem, an implant has been created, the head of which is arranged to vary the length of the implant in situ.

Pour résoudre le problème posé de faire varier la longueur de la tête, cette dernière est en deux parties montées avec capacité de déplacement en translation, I'une des partie étant solidaire de la tige. To solve the problem of varying the length of the head, the latter is in two parts mounted with the ability to move in translation, one of the parts being integral with the rod.

Avantageusement, la partie solidaire de la tige est fixe et présente un nez fileté pour le vissage de l'autre partie sous forme d'une douille cylindrique. Advantageously, the integral part of the rod is fixed and has a threaded nose for screwing the other part in the form of a cylindrical socket.

Pour résoudre le problème posé d'obtenir une bonne stabilité de l'implant, la partie solidaire de la tige présente une embase cylindrique disposée concentriquement au nez support, la face de ladite embase, opposée à celle présentant le nez, est taillée en oblique pour prendre appui sur la partie correspondante de l'astragale. To solve the problem of obtaining good implant stability, the integral part of the rod has a cylindrical base arranged concentrically with the support nose, the face of said base, opposite to that having the nose, is cut obliquely to lean on the corresponding part of the talus.

Le problème posé de faire varier la longueur de la tête, est résolu en ce que la douille présente des agencements périphériques pour assurer sa manoeuvre angulaire correspondant à son vissage ou dévissage par rapport au nez support, pour faire varier la longueur de la tête. The problem posed of varying the length of the head is solved in that the socket has peripheral arrangements to ensure its angular maneuver corresponding to its screwing or unscrewing relative to the support nose, to vary the length of the head.

Les agencements sont constitués par des trous radiaux aptes à coopérer avec un organe de manoeuvre. The arrangements consist of radial holes able to cooperate with an operating member.

Avantageusement, la tige et la partie fixe sont réalisées en une seule partie, en constituant un ensemble monobloc. Advantageously, the rod and the fixed part are produced in a single part, constituting a one-piece assembly.

Pour résoudre le problème posé d'assurer un parfait ancrage de l'implant, la partie de la tige débordant de la partie fixe présente une portée de section triangulaire. To resolve the problem posed of ensuring perfect anchoring of the implant, the part of the rod projecting from the fixed part has a bearing surface of triangular section.

Un autre problème que se propose de résoudre l'invention est de pouvoir bloquer temporairement en rotation la partie fixe de la tête pour permettre le dévissage de la douille, correspondant à la variation de longueur souhaitée de ladite tête. Another problem which the invention proposes to solve is to be able to temporarily block in rotation the fixed part of the head to allow the unscrewing of the sleeve, corresponding to the desired length variation of said head.

Un tel problème est résolu en ce que la partie fixe présente un trou apte à recevoir de manière temporaire, un moyen rapporté pour assurer son maintien en position lors du dévissage de la douille. Such a problem is solved in that the fixed part has a hole capable of temporarily receiving an added means for ensuring that it is held in position when the sleeve is unscrewed.

L'invention est exposée, ci-après plus en détail à l'aide des dessins annexés, dans lesquels:
La figure 1 est une vue en coupe montrant un exemple d'impaction de l'implant pour arthrorise sous astragalienne.The invention is set out below in more detail using the appended drawings, in which:
Figure 1 is a sectional view showing an example of impact of the implant for arthrorise under talus.

La figure 2 est une vue en coupe longitudinale montrant avant assemblage, les principaux éléments de l'implant. Figure 2 is a longitudinal sectional view showing before assembly, the main elements of the implant.

La figure 3 est une vue en coupe longitudinale correspondant à la figure 2, après assemblage des différents éléments. Figure 3 is a longitudinal sectional view corresponding to Figure 2, after assembly of the various elements.

La figure 4 est une vue semblable à la figure 3, montrant une variation de longueur de la tête. Figure 4 is a view similar to Figure 3 showing a variation in length of the head.

La figure 5 est une vue en coupe transversale considérée selon la ligne 5.5 de la figure 3. Figure 5 is a cross-sectional view taken along line 5.5 of Figure 3.

La figure 6 est une vue en coupe transversale considérée selon la ligne 6.6 de la figure 3. Figure 6 is a cross-sectional view taken along line 6.6 of Figure 3.

De manière connue, L'implant comprend une tête désignée dans son ensemble par (T) et une tige (1). Selon une caractéristique à la base de l'invention, la tête (T) est en deux parties (2) et (3) montées avec capacité de déplacement relatif en translation. Comme il sera indiqué dans la suite de la description, la partie (2) est solidaire de la tige d'ancrage (1). In known manner, the implant comprises a head designated as a whole by (T) and a rod (1). According to a characteristic underlying the invention, the head (T) is in two parts (2) and (3) mounted with relative displacement capacity in translation. As will be indicated in the following description, the part (2) is integral with the anchor rod (1).

Cette partie (2) est fixe, tandis que la partie (3) est mobile.This part (2) is fixed, while the part (3) is mobile.

On voit, figure 2, que la partie (2) présente un nez fileté (2a) pour le vissage de la partie (3) établie sous forme d'une douille cylindrique. Le nez (2a) est prolongé d'une manière concentrique par une embase circulaire (2b), dont la face (2c) est taillée en oblique. Cette face (2c), après impaction de l'ensemble de l'implant, prend appui sur la partie correspondante de l'astragale, assurant ainsi la stabilité dudit implant.  We see, Figure 2, that the part (2) has a threaded nose (2a) for screwing the part (3) established in the form of a cylindrical socket. The nose (2a) is extended in a concentric manner by a circular base (2b), the face (2c) of which is cut obliquely. This face (2c), after impaction of the entire implant, bears on the corresponding part of the talus, thus ensuring the stability of said implant.

La douille (3) présente un trou taraudé (3a), coopérant avec le nez fileté (2a). II apparait donc qu'en agissant angulairement sur la douille (3), ce qui correspond à une action de vissage ou dévissage, on provoque, d'une manière concomitante, la variation de la longueur de la tête (T) constituée des deux parties (2) et (3) (figures 3 et 4). La face (3c) de la douille (3) est plane pour prendre appui sur la face correspondante (2d) de l'embase circulaire (2b). La face (3d) est bombée. The sleeve (3) has a threaded hole (3a), cooperating with the threaded nose (2a). It therefore appears that by acting angularly on the sleeve (3), which corresponds to a screwing or unscrewing action, the variation in the length of the head (T) made up of the two parts is concomitantly produced. (2) and (3) (Figures 3 and 4). The face (3c) of the sleeve (3) is flat to bear on the corresponding face (2d) of the circular base (2b). The face (3d) is curved.

Pour assurer la rotation de la douille (3), cette dernière présente radialement des trous (3b) aptes à coopérer avec un organe de manoeuvre correspondant. A titre indicatif, la tête (3) présente quatre trous radiaux (3b) régulièrement répartis sur la circonférence en étant décalés angulairement de 90" (figure 5). To ensure the rotation of the sleeve (3), the latter has radially holes (3b) capable of cooperating with a corresponding operating member. As an indication, the head (3) has four radial holes (3b) regularly distributed over the circumference, being angularly offset by 90 "(Figure 5).

De même, la partie fixe (2) présente un trou (2f) disposé perpendiculairement à l'axe longitudinal de la tête, ce trou (2f) permettant l'engagement d'un organe rapporté pour assurer le maintien en position de ladite partie fixe, au moment du dévissage de la douille (3). Likewise, the fixed part (2) has a hole (2f) arranged perpendicular to the longitudinal axis of the head, this hole (2f) allowing the engagement of an added member to maintain said fixed part in position. , when unscrewing the sleeve (3).

La tige d'ancrage (I) est solidaire de la partie fixe (2) de la tête, en constituant un ensemble monobloc. En outre, la partie débordante de la tige (I) présente une portée de section triangulaire (lob) (figure 6). The anchor rod (I) is integral with the fixed part (2) of the head, constituting a one-piece assembly. In addition, the projecting part of the rod (I) has a bearing surface of triangular section (lob) (Figure 6).

Compte-tenu de ces caractéristiques, il apparait donc que pour faire varier la longueur de l'implant et plus particulièrement de sa tête, afin de l'adapter aux différents cas pathologiques, il suffit de visser ou dévisser plus ou moins la douille (3), par rapport à l'embase cylindrique (2b). Given these characteristics, it therefore appears that to vary the length of the implant and more particularly of its head, in order to adapt it to different pathological cases, it suffices to screw or unscrew more or less the socket (3 ), relative to the cylindrical base (2b).

II est donc possible d'avoir des implants de même taille au niveau de leur longueur, seuls les diamètres étant différents. Le praticien a donc la possibilité d'adapter très exactement la longueur de l'implant après impaction, en respectant le cas pathologique à traiter. It is therefore possible to have implants of the same size in terms of their length, only the diameters being different. The practitioner therefore has the possibility of very precisely adapting the length of the implant after impaction, while respecting the pathological case to be treated.

Les avantages ressortent bien de la description.  The advantages are apparent from the description.

Claims (8)

REVENDICATIONS -1- Implant pour arthrorise sous-astragalienne présentant une tige d'ancrage (1) et une tête cylindrique (T), caractérisé en ce que la tête (T) est en deux parties (2) et (3) montées avec capacité de déplacement relatif en translation pour faire varier in situ la longueur de l'implant, I'une des partie (2) étant solidaire de la tige (1).-1- Implant for sub astragalar arthritis with an anchor rod (1) and a cylindrical head (T), characterized in that the head (T) is in two parts (2) and (3) mounted with capacity for relative displacement in translation to vary the length of the implant in situ, one of the part (2) being integral with the rod (1). -2- Implant selon la revendication 1, caractérisé en ce que la partie (2) solidaire de la tige (1) est fixe et présente un nez fileté (2a) pour le vissage de l'autre partie (3) sous forme d'une douille cylindrique.-2- Implant according to claim 1, characterized in that the part (2) integral with the rod (1) is fixed and has a threaded nose (2a) for screwing the other part (3) in the form of a cylindrical socket. -3- Implant selon la revendication 1, caractérisé en ce que la partie (2) solidaire de la tige (1) présente une embase cylindrique (2b) disposée concentriquement au nez support (2a), la face (2c) de ladite embase, opposée à celle présentant le nez, est taillée en oblique pour prendre appui sur la partie correspondante de l'astragale.-3- Implant according to claim 1, characterized in that the part (2) integral with the rod (1) has a cylindrical base (2b) arranged concentrically with the support nose (2a), the face (2c) of said base, opposite to that presenting the nose, is cut obliquely to bear on the corresponding part of the talus. -4- Implant selon la revendication 2, caractérisé en ce que la douille (3) présente des agencements périphériques (3b) pour assurer sa manoeuvre angulaire correspondant à son vissage ou dévissage par rapport au nez support (2a), pour faire varier la longueur de la tête.-4- Implant according to claim 2, characterized in that the sleeve (3) has peripheral arrangements (3b) to ensure its angular operation corresponding to its screwing or unscrewing relative to the support nose (2a), to vary the length of the head. -5- Implant selon la revendication 4, caractérisé en ce que les agencements (3b) sont constitués par des trous radiaux aptes à coopérer avec un organe de manoeuvre.-5- Implant according to claim 4, characterized in that the arrangements (3b) are constituted by radial holes adapted to cooperate with an operating member. -6- Implant selon la revendication 2, caractérisé en ce que la tige (1) et la partie fixe (2) sont réalisées en une seule partie, en constituant un ensemble monobloc. -6- Implant according to claim 2, characterized in that the rod (1) and the fixed part (2) are made in a single part, constituting a one-piece assembly. -7- Implant selon la revendication 6, caractérisé en ce que la partie de la tige (1) débordant de la partie fixe (2) présente une portée de section triangulaire (il). -7- Implant according to claim 6, characterized in that the part of the rod (1) projecting from the fixed part (2) has a bearing surface of triangular section (it). -8- Implant selon la revendication 2, caractérisé en ce que la partie fixe (2) présente un trou (2f) apte à recevoir de manière temporaire, un moyen rapporté pour assurer son maintien en position lors du dévissage de la douille (3). -8- Implant according to claim 2, characterized in that the fixed part (2) has a hole (2f) adapted to receive temporarily, an added means to ensure its maintenance in position when unscrewing the sleeve (3) .
FR9111289A 1991-09-05 1991-09-05 IMPLANT FOR SUB-ASTRAGALIAN ARTHRORISA. Expired - Fee Related FR2680968B1 (en)

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US5458646A (en) * 1991-09-24 1995-10-17 A. Alan Giachino Wrist prosthesis
US5360450A (en) * 1992-03-09 1994-11-01 Howmedica International Div.Ne Pfizer Italiana S.P.A. Prosthesis for the correction of flatfoot
US7641697B2 (en) 1999-10-22 2010-01-05 Inbone Technologies, Inc. Systems and methods for installing ankle replacement prostheses
US6860902B2 (en) 1999-10-22 2005-03-01 Advanced Total Ankles, Inc. Ankle replacement system
US6875236B2 (en) 1999-10-22 2005-04-05 Advanced Total Ankles, Inc. Intramedullary guidance systems and methods for installing ankle replacement prostheses
US7314488B2 (en) 1999-10-22 2008-01-01 Inbone Technologies, Inc. Intramedullary guidance systems and methods for installing ankle replacement prostheses
US9308097B2 (en) 1999-10-22 2016-04-12 Inbone Technologies, Inc. Ankle replacement system
US7717920B2 (en) 1999-10-22 2010-05-18 Inbone Technologies, Inc. Ankle replacement prostheses
US11951013B2 (en) 1999-10-22 2024-04-09 Inbone Technologies, Inc. Systems and methods for installing ankle replacement prostheses
US10743999B2 (en) 1999-10-22 2020-08-18 Inbone Technologies, Inc. Systems and methods for installing ankle replacement prostheses
US6663669B1 (en) 1999-10-22 2003-12-16 Mark A Reiley Ankle replacement system
US8034115B2 (en) 1999-10-22 2011-10-11 Inbone Technologies, Inc. Ankle replacement system
US8034114B2 (en) 1999-10-22 2011-10-11 Inbone Technologies, Inc. Systems and methods for installing ankle replacement prostheses
US8048164B2 (en) 1999-10-22 2011-11-01 Inbone Technologies, Inc. Ankle replacement system
US9629730B2 (en) 1999-10-22 2017-04-25 Inbone Technologies, Inc. Ankle replacement system
US7935118B2 (en) 2002-06-21 2011-05-03 Depuy Products, Inc. Prosthesis removal cutting guide, cutting tool and method
US8491596B2 (en) 2002-06-21 2013-07-23 Depuy Products, Inc. Method for removal of bone
US7915046B2 (en) 2004-06-30 2011-03-29 Depuy Products, Inc. System and method for determining the operating state of orthopaedic admixtures
US10398561B2 (en) 2007-09-26 2019-09-03 DePuy Synthes Products, Inc. Talar implant system and method
US11446153B2 (en) 2007-09-26 2022-09-20 DePuy Synthes Products, Inc. Talar implant system and method
US8110006B2 (en) 2007-10-18 2012-02-07 Inbone Technologies, Inc. Fibular stiffener and bony defect replacer
US7875082B2 (en) * 2008-05-09 2011-01-25 Remi Sciences, Inc. Ulnar head prosthesis system

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