FR2724310A1 - Modular prosthesis for short bones in the hand or foot - Google Patents

Modular prosthesis for short bones in the hand or foot Download PDF

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Publication number
FR2724310A1
FR2724310A1 FR9410817A FR9410817A FR2724310A1 FR 2724310 A1 FR2724310 A1 FR 2724310A1 FR 9410817 A FR9410817 A FR 9410817A FR 9410817 A FR9410817 A FR 9410817A FR 2724310 A1 FR2724310 A1 FR 2724310A1
Authority
FR
France
Prior art keywords
rod
ring
prosthetic assembly
assembly according
bone
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.)
Granted
Application number
FR9410817A
Other languages
French (fr)
Other versions
FR2724310B1 (en
Inventor
Alain Perez
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.)
Medinov SA
Original Assignee
Medinov SA
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 Medinov SA filed Critical Medinov SA
Priority to FR9410817A priority Critical patent/FR2724310B1/en
Publication of FR2724310A1 publication Critical patent/FR2724310A1/en
Application granted granted Critical
Publication of FR2724310B1 publication Critical patent/FR2724310B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • 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
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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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    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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    • A61F2/02—Prostheses implantable into the body
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    • 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
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00203—Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide
    • 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
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

The prosthesis consists of a base (11) with a flat surface (12) for attaching to a partially resectioned bone, and a shank (15) which is implanted in the medullary canal of a finger or toe bone, the base and shank cooperating to form an articulated joint. The shank is of standard size and slightly smaller than the average dimensions of the bone canals and is fixed in place by one of a series of sleeves (20) of different sizes to suit different bone canals. The shank and sleeves have matching conical surfaces with an angle of taper of between 3 and 6 deg. and pref. 5 deg. The base and shank are made from an aluminium ceramic material and the sleeves can be made from the same material or from stainless steel or titanium, and the surfaces in contact with bone are coated with calcium hydroxyapatite.

Description

La présente invention a pour objet un ensemble prothétique modulaire pour articulations d'os courts des différents doigts de la main ou du pied. The subject of the present invention is a modular prosthetic assembly for joints of short bones of the different fingers of the hand or of the foot.

Dans le domaine de la chirurgie orthopédique, on connaît depuis quelques années des prothèses pour os courts qui correspondent à un certain besoin spécifique de reconstitution des articulations de petites dimensions pour les doigts de la main ou du pied. In the field of orthopedic surgery, prostheses for short bones have been known for a few years which correspond to a certain specific need for reconstitution of small joints for the fingers of the hand or the foot.

Ces prothèses comportent généralement une embase destinée à être fixée sur un os partiellement réséqué de la main ou du pied et une tige adaptée pour être implantée dans le canal médullaire d'un doigt ou d'un orteil. L'embase et la tige coopèrent l'une avec l'autre par une articulation. These prostheses generally comprise a base intended to be fixed on a partially resected bone of the hand or the foot and a rod adapted to be implanted in the medullary canal of a finger or a toe. The base and the rod cooperate with each other by a joint.

Les prothèses pour os courts utilisées jusqu'à présent font progresser la chirurgie orthopédique, mais elles ne permettent pas de résoudre réellement le problème de l'adaptation à la variation du diamètre et/ou de la longueur que présentent les canaux médullaires des différents doigts de la main ou du pied. De pll, les dimensions et la taille d'un même doigt varient également selon les sujets. The prostheses for short bones used until now advance orthopedic surgery, but they do not really solve the problem of adaptation to the variation in diameter and / or length presented by the medullary canals of the different fingers. hand or foot. In addition, the dimensions and size of the same finger also vary depending on the subject.

L'invention a pour but de proposer un ensemble prothétique modulaire pour articulations d'os courts de la main ou du pied qui permet de résoudre ce problème et qui est adaptable à la morphologie spécifique de l'os court à traiter, sans nuire à la qualité souhaitée de la liaison entre l'os et la prothèse. The object of the invention is to propose a modular prosthetic assembly for joints of short bones of the hand or of the foot which makes it possible to solve this problem and which is adaptable to the specific morphology of the short bone to be treated, without harming the desired quality of the connection between the bone and the prosthesis.

L'invention a donc pour objet un ensemble prothétique modulaire pour articulations d'os courts de la main ou du pied, du type comprenant une embase de fixation sur un os partiellement réséqué de la main ou du pied et une tige adaptée pour être implantée dans le canal médullaire d'un os de doigt, ladite embase et ladite tige coopérant l'une avec l'autre par une articulation, caractérisé en ce que la tige est standard et de dimensions sensiblement inférieures aux dimensions moyennes des canaux médullaires des os et en ce qu'il comprend un jeu de bagues destinées chacune à être emmanchée sur la tige pour rattraper le jeu entre ladite tige et les parois du canal médullaire et pour restaurer la longueur de l'os porté, chaque bague possédant des dimensions différentes en fonction des dimensions des canaux médullaires dans lesquels ladite tige est implantée. The invention therefore relates to a modular prosthetic assembly for joints of short bones of the hand or foot, of the type comprising a mounting base on a partially resected bone of the hand or foot and a rod adapted to be implanted in the medullary canal of a finger bone, said base and said rod cooperating with each other by an articulation, characterized in that the rod is standard and of dimensions substantially smaller than the average dimensions of the medullary canals of the bones and in what it includes a set of rings each intended to be fitted onto the rod to make up for the play between said rod and the walls of the medullary canal and to restore the length of the bone worn, each ring having different dimensions depending on the dimensions of the medullary canals in which said rod is implanted.

Selon d'autres caractéristiques de l'invention
- chaque bague possède un alésage de profil complémentaire au profil de la tige,
- la tige et l'alésage de chaque bague sont coniques dans une direction s'étendant de l'embase vers l'extrémité de ladite tige,
- l'angle de conicité de la tige et de l'alésage de chaque bague est compris entre 3 et 6" et de préférence égal à 5",
- la face externe de la tige et/ou la face interne de la bague comportent des rugosités pour réaliser un matage lors de l'emmanchement de ladite tige dans ladite bague,
- la tige et chaque bague ont une forme légèrement recourbée dans le cas d'un premier métacarpien,
- le rayon de courbure de la tige et de chaque bague est compris entre 25 et 35 cm,
- l'embase et la tige sont en céramique,
- chaque bague est en céramique,
- la céramique est de la céramique alumine,
- chaque bague est en acier inoxydable ou en titane,
- les faces externes de l'embase, de la tige et de chaque bague situées en contact avec l'os partiellement réséqué et les parois du canal médullaire sont recouvertes d'un biomatériau,
- le biomatériau est de l'hydroxyapatite de calcium.According to other features of the invention
- each ring has a complementary profile bore to the profile of the rod,
the rod and the bore of each ring are conical in a direction extending from the base towards the end of said rod,
- the taper angle of the rod and the bore of each ring is between 3 and 6 "and preferably equal to 5",
the external face of the rod and / or the internal face of the ring have roughnesses to achieve a matting during the fitting of said rod into said ring,
- the stem and each ring have a slightly curved shape in the case of a first metacarpal,
- the radius of curvature of the rod and of each ring is between 25 and 35 cm,
- the base and the rod are ceramic,
- each ring is ceramic,
- the ceramic is alumina ceramic,
- each ring is made of stainless steel or titanium,
- the external faces of the base, the rod and each ring located in contact with the partially resected bone and the walls of the medullary canal are covered with a biomaterial,
- the biomaterial is calcium hydroxyapatite.

D'autres caractéristiques et avantages de l'invention apparaîtront au cours de la description qui va suivre, faite en référence aux dessins annexés, sur lesquels
- la Fig. 1 est une vue schématique du squelette de la main dont le pouce est muni d'un ensemble prothétique modulaire selon l'invention,
- la Fig. 2 est une vue schématique en perspective d'un ensemble prothétique modulaire selon l'invention,
- la Fig. 3 est une vue schématique en perspective d'un jeu de bagues de rattrapage de jeux de l'ensemble prothétique modulaire selon l'invention.Other characteristics and advantages of the invention will become apparent during the description which follows, given with reference to the appended drawings, in which
- Fig. 1 is a schematic view of the skeleton of the hand, the thumb of which is provided with a modular prosthetic assembly according to the invention,
- Fig. 2 is a schematic perspective view of a modular prosthetic assembly according to the invention,
- Fig. 3 is a schematic perspective view of a set of play take-up rings of the modular prosthetic assembly according to the invention.

L'ensemble prothétique modulaire représenté sur les figures 1 et 2 et désigné dans son ensemble par la référence 10 est d'adaptable aux différents doigts de la main ou du pied. The modular prosthetic assembly shown in Figures 1 and 2 and designated as a whole by the reference 10 is adaptable to the different fingers of the hand or foot.

Dans un exemple représente à la Fig. 1, l'ensemble prothétique modulaire 10 a été implante dans le pouce de la main d'un patient. In an example shown in FIG. 1, the modular prosthetic assembly 10 has been implanted in the thumb of a patient's hand.

Pour cela, le chirurgien a partiellement réséqué le trapèze 1 de la main pour former sur celui-ci une section plane 2 destinée à recevoir l'ensemble prothétique 10. For this, the surgeon partially resected the trapezium 1 with his hand to form on it a flat section 2 intended to receive the prosthetic assembly 10.

Ainsi que représenté à la Fig. 2, cette ensemble prothétique modulaire 10 comprend une embase 11 par exemple de forme générale hémisphérique et comportant une face plane 12 destinée à être appliquée sur la section plane 2 du trapèze 1 réséqué. As shown in FIG. 2, this modular prosthetic assembly 10 comprises a base 11 for example of generally hemispherical shape and comprising a planar face 12 intended to be applied to the planar section 2 of the resected trapezium 1.

La face plane 12 de l'embase 11 est munie d'une vis 14 d'ancrage dans le trapèze 1. The flat face 12 of the base 11 is provided with a screw 14 for anchoring in the trapezoid 1.

L'ensemble prothétique 10 comprend également une tige 15 qui est destinée à être implantée dans le canal médullaire 3 d'un os de la main et du pied après calibrage de ce canal médullaire, par exemple du premier métacarpien 4 comme représenté à la Fig. 1. The prosthetic assembly 10 also comprises a rod 15 which is intended to be implanted in the medullary canal 3 of a bone of the hand and of the foot after calibration of this medullary canal, for example of the first metacarpal 4 as shown in FIG. 1.

La tige 15 est reliée à l'embase 11 par une articulation 16 permettant des débattements de la tige 15 pratiquement identiques aux débattements angulaires du doigt. The rod 15 is connected to the base 11 by an articulation 16 allowing the deflections of the rod 15 practically identical to the angular deflections of the finger.

Dans un but d'économie, la tige 5 est standard et de dimensions sensiblement inferieures aux dimensions moyennes des canaux médullaires des os des doigts de la main ou du pied. In the interests of economy, the rod 5 is standard and of dimensions substantially smaller than the average dimensions of the medullary canals of the bones of the fingers of the hand or of the foot.

Pour résoudre le problème de l'adaptation à la variation du diamètre et de la longueur que présentent les canaux médullaires des différents doigts ou un même doigt selon les patients, l'ensemble prothétique 10 comprend un jeu de bagues 20 destinées chacune à être emmanchée sur la tige 15 pour rattraper le jeu entre cette tige 15 et les parois du canal médullaire 3 et pour restaurer la longueur de l'os porté. To solve the problem of adapting to the variation in diameter and length presented by the medullary canals of different fingers or the same finger depending on the patient, the prosthetic assembly 10 comprises a set of rings 20 each intended to be fitted onto the rod 15 to make up for the play between this rod 15 and the walls of the medullary canal 3 and to restore the length of the bone carried.

Chaque bague 20 possède des dimensions différentes en fonction des dimensions des canaux médullaires dans lesquels la tige 15 est implantée. Each ring 20 has different dimensions depending on the dimensions of the medullary canals in which the rod 15 is implanted.

La tige 15 présente toujours les mêmes dimensions et les bagues 20 de rattrapage sont calculées pour être en nombre relativement réduit et correspondent à des valeurs moyennes de diamètre des canaux médullaires rencontrés. The rod 15 always has the same dimensions and the take-up rings 20 are calculated to be relatively small in number and correspond to average values of the diameter of the medullary canals encountered.

Par exemple, le chirurgien peut avoir à sa disposition un jeu de bagues 20 de différentes longueurs, comme par exemple une bague longue 20a (Fig. 3a), une bague moyenne 20b çFig. 3b) et une bague courte 20c (Fig. For example, the surgeon may have at his disposal a set of rings 20 of different lengths, such as for example a long ring 20a (FIG. 3a), a medium ring 20b çFig. 3b) and a short ring 20c (Fig.

3c) et un jeu de bagues de différents diamètres, comme par exemple une bague de grand diamètre, une bague de moyen diamètre et une bague de petit diamètre.3c) and a set of rings of different diameters, such as for example a large diameter ring, a medium diameter ring and a small diameter ring.

Les bagues 20 peuvent également présenter des épaisseurs différentes. The rings 20 can also have different thicknesses.

Ainsi, le chirurgien dispose d'un ensemble modulaire de bagues 20 lui donnant neuf possibilites, à savoir, pour chacune des trois longueurs, trois bagues 20 de diamètre extérieur différent. Thus, the surgeon has a modular set of rings 20 giving him nine possibilities, namely, for each of the three lengths, three rings 20 of different outside diameter.

Chaque bague 20 possède un alésage 21 de profil complémentaire au profil de la tige 15. Each ring 20 has a bore 21 with a profile complementary to the profile of the rod 15.

La tige 15 et l'alésage 21 de chaque bague 20 sont coniques dans une direction s'étendant de l'embase 11 vers l'extrémité de ladite tige 15. The rod 15 and the bore 21 of each ring 20 are conical in a direction extending from the base 11 towards the end of said rod 15.

Ainsi, la liaison entre la bague 20 et la tige 15 est réalisée par la conicité complémentaire entre la tige 15 et l'alésage 21 de la bague 20 de sorte qu'un blocage se produise après emmanchement de ces deux éléments entre eux et qu'aucun frottement entre ces deux éléments ne puisse se produire. Thus, the connection between the ring 20 and the rod 15 is achieved by the complementary conicity between the rod 15 and the bore 21 of the ring 20 so that a blockage occurs after fitting these two elements together and that no friction between these two elements can occur.

Pour augmenter cet effet de blocage entre la face externe de la tige 15 et la face interne de la bague 20, ces faces ou l'une des deux peuvent comporter des stries ou des rugosités permettant de réaliser un matage lors de l'emmanchement de ces deux pièces. To increase this blocking effect between the external face of the rod 15 and the internal face of the ring 20, these faces or one of the two may have ridges or roughness making it possible to achieve a matting during the fitting of these two pieces.

L'angle de conicité de la tige 15 et de l'alésage 21 de chaque bague 20 est compris entre 3 et 6" et de préférence égal à 5 .  The taper angle of the rod 15 and the bore 21 of each ring 20 is between 3 and 6 "and preferably equal to 5.

Plus particulièrement, pour un ensemble prothétique trapézo-métacarpien, la tige 15 peut avoir une forme légèrement recourbée pour correspondre à la courbure du premier os métacarpien. More particularly, for a trapezo-metacarpal prosthetic assembly, the rod 15 may have a slightly curved shape to correspond to the curvature of the first metacarpal bone.

Sa courbure correspond à un rayon compris entre 25 et 35 cm.  Its curvature corresponds to a radius between 25 and 35 cm.

Dans ce cas, la bague 20 présente la même courbure. In this case, the ring 20 has the same curvature.

D'autre part, l'ensemble prothétique 10, c'est à dire l'embase 11, la tige 15 et la bague 20 sont en céramique, par exemple en ceramique d'alumine, de sorte que les faces en contact développent une production de résidus de frottement le plus faible possible. On the other hand, the prosthetic assembly 10, that is to say the base 11, the rod 15 and the ring 20 are made of ceramic, for example of alumina ceramic, so that the faces in contact develop a production the lowest possible friction residue.

En effet, le frottement entre deux faces en céramique d'alumine génère des residus en quantité extrêmement faible ce qui permet d'éliminer la formation de granulomes de résorbtion dans le cas d'une utilisation d'une prothèse polyéthylène-métal utilisée jusqu'à présent et de ce fait de réduire l'action de descellement mécanique de la prothèse. In fact, the friction between two alumina ceramic faces generates residues in an extremely small amount, which makes it possible to eliminate the formation of resorbtion granulomas in the case of the use of a polyethylene-metal prosthesis used up to present and thereby reduce the mechanical loosening action of the prosthesis.

De plus, les prothèses de l'invention permettent d'éviter également la formation de calcification périprothétique. In addition, the prostheses of the invention also make it possible to avoid the formation of periprosthetic calcification.

Selon une variante et dans un but d'économie, la céramique étant un matériau relativement onéreux, l'embase 11 et la tige 15 peuvent être en céramique et les bagues 20 peuvent être en titane ou en acier inoxydable ou en tout autre matériau rigide équivalent. According to a variant and for the sake of economy, the ceramic being a relatively expensive material, the base 11 and the rod 15 can be made of ceramic and the rings 20 can be made of titanium or stainless steel or any other equivalent rigid material .

Enfin, pour accroître de façon très significative la réduction des descellements de prothèses articulaires de petites dimensions, l'ensemble prothétique selon l'invention permet de réaliser deux types successifs de stabilisation. Finally, to significantly increase the reduction in loosening of small joint prostheses, the prosthetic assembly according to the invention makes it possible to carry out two successive types of stabilization.

Pour cela, les faces en contact de l'ensemble prothétique 10 avec le tissu osseux sont recouvertes d'un biomatériau, notamment d'hydroxyapatite de calcium. For this, the faces in contact with the prosthetic assembly 10 with the bone tissue are covered with a biomaterial, in particular calcium hydroxyapatite.

Ainsi, grâce à ce revêtement d'hydroxyapatite de calcium, il devient possible après avoir réalisé une fixation primaire par l'ancrage de la vis 14 dans l'os réséqué, de réaliser une fixation secondaire de nature physico-chimique, qui vient renforcer la fixation primaire dans les premiers mois consécutifs à l'opération. Thus, thanks to this coating of calcium hydroxyapatite, it becomes possible after having made a primary fixation by anchoring the screw 14 in the resected bone, to make a secondary fixation of physicochemical nature, which reinforces the primary fixation in the first months following the operation.

Cette fixation secondaire est obtenue par l'absorption des différents constituants des tissus osseux sur les dépôts de l'hydroxyapatite de calcium. This secondary fixation is obtained by the absorption of the various constituents of bone tissue on the deposits of calcium hydroxyapatite.

Ainsi, il se produit une double fixation en deux temps, d'abord mécanique lors de la pose de l'ensem- ble prothétique, puis mécanique et physico-chimique quelques mois plus tard par adsorption des constituants osseux sur l'hydroxyapatite de calcium. Thus, a double fixation takes place in two stages, first mechanical during the fitting of the prosthetic assembly, then mechanical and physicochemical a few months later by adsorption of the bone constituents on the calcium hydroxyapatite.

La stabilité primaire qui est immédiate permet d'attendre le temps nécessaire de la prise osseuse pour atteindre la stabilité secondaire entre le capital osseux reconstitué et le revêtement spécifique d'hy- droxyapatite de calcium lié à l'ensemble prothétique. The primary stability which is immediate makes it possible to wait the time necessary for bone setting to reach the secondary stability between the reconstituted bone capital and the specific coating of calcium hydroxyapatite linked to the prosthetic assembly.

Mais, pour atteindre une stabilité secondaire de bonne qualité, celle-ci ne peut se faire qu'avec une stabilité primaire préalable aussi parfaite que possible, d'où la nécessité de remplir complètement le diamètre des canaux médullaires pour éviter tout jeu mécanique qui est à l'origine du descellement des prothèses. However, in order to achieve good quality secondary stability, this can only be done with prior perfect primary stability as perfect as possible, hence the need to completely fill the diameter of the medullary canals to avoid any mechanical play which is at the origin of the loosening of prostheses.

L'ensemble prothétique modulaire selon l'invention revêtu d'hydroxyapatite de calcium et dont la tige et l'embase sont en céramique présente pratiquement le minimum possible de failles au descellement et assure une tenue maximale dans le temps. The modular prosthetic assembly according to the invention coated with calcium hydroxyapatite and whose rod and base are made of ceramic has practically the minimum possible loopholes in loosening and ensures maximum resistance over time.

De plus, l'ensemble prothétique modulaire selon l'invention est adaptable à la morphologie spécifique de l'os court à traiter, sans nuire à la qualité de liaison entre l'os court et la prothèse. In addition, the modular prosthetic assembly according to the invention is adaptable to the specific morphology of the short bone to be treated, without harming the quality of connection between the short bone and the prosthesis.

Gracie à la modularité de l'ensemble prothétique selon l'invention et notamment grâce à la restauration de la longueur de l'os porté, il est possible de restaurer les bras de levier des muscles longs du pouce et de ce fait la force globale de ce pouce.  Thanks to the modularity of the prosthetic assembly according to the invention and in particular thanks to the restoration of the length of the bone carried, it is possible to restore the lever arms of the long muscles of the thumb and therefore the overall strength of that inch.

Claims (13)

REVENDICATIONS 1. Ensemble prothétique modulaire pour articulations d'os courts de la main ou du pied, du type comprenant une embase (11) de fixation sur un os (1) partiellement réséqué de la main ou du pied, et une tige (15) adaptée pour être implantée dans le canal médullaire (3) d'un os d'un doigt ou d'un orteil, ladite embase (11) et ladite tige (15) coopérant l'une avec l'autre par une articulation (16), caractérisé en ce que la tige (15) est standard et de dimensions sensiblement inférieures aux dimensions moyennes des canaux médullaires des os et en ce qu'il comprend un jeu de bagues (20) destinées chacune à être emmanchée sur la tige (15) pour rattraper le jeu entre ladite tige (15) et les parois du canal médullaire (3) et pour restaurer la longueur de l'os porté, chaque bague (20) présentant les dimensions différentes en fonction des dimensions des canaux médullaires (3) dans lesquels ladite tige (15) est implantée. 1. Modular prosthetic assembly for joints of short bones of the hand or of the foot, of the type comprising a base (11) for attachment to a bone (1) partially resected of the hand or of the foot, and an adapted rod (15) to be implanted in the medullary canal (3) of a bone of a finger or toe, said base (11) and said rod (15) cooperating with each other by a joint (16), characterized in that the rod (15) is standard and of dimensions substantially smaller than the average dimensions of the medullary canals of the bones and in that it comprises a set of rings (20) each intended to be fitted on the rod (15) for make up for the play between said rod (15) and the walls of the medullary canal (3) and to restore the length of the bone carried, each ring (20) having different dimensions as a function of the dimensions of the medullary canals (3) in which said rod (15) is implanted. 2. Ensemble prothétique selon la revendication 1, caractérisé en ce que chaque bague (20) possède un alésage (21) de profil complémentaire au profil de la tige (15). 2. Prosthetic assembly according to claim 1, characterized in that each ring (20) has a bore (21) of profile complementary to the profile of the rod (15). 3. Ensemble prothétique selon les revendications 1 et 2, caractérisé en ce que la tige (15) et l'alésage (21) de chaque bague (20) sont coniques dans une direction s'étendant de l'embase (11) vers l'extrémité de ladite tige (15). 3. Prosthetic assembly according to claims 1 and 2, characterized in that the rod (15) and the bore (21) of each ring (20) are conical in a direction extending from the base (11) towards l end of said rod (15). 4. Ensemble prothétique selon la revendication 3, caractérisé en ce que l'angle de conicité de la tige (15) et de l'alésage (21) de chaque bague (20) est compris entre 3 et 6 et de préférence égal à 5".  4. Prosthetic assembly according to claim 3, characterized in that the taper angle of the rod (15) and the bore (21) of each ring (20) is between 3 and 6 and preferably equal to 5 ". 5. Ensemble prothétique selon l'une quelconque des revendications précédentes, caractérisée en ce que la face externe de la tige (15) et/ou la face interne de la bague (20) comportent des rugosités pour réaliser un matage lors de l'emmanchement de ladite tige (15) dans ladite bague (20). 5. Prosthetic assembly according to any one of the preceding claims, characterized in that the external face of the rod (15) and / or the internal face of the ring (20) have roughness to achieve a matting during fitting of said rod (15) in said ring (20). 6. Ensemble prothétique selon l'une quelconque des revendications précédentes, caractérisé en ce que la tige (15) et chaque bague (20) ont une forme légèrement recourbée dans le cas d'un premier métacarpien. 6. Prosthetic assembly according to any one of the preceding claims, characterized in that the rod (15) and each ring (20) have a slightly curved shape in the case of a first metacarpal. 7. Ensemble prothétique selon la revendication 6, caractérisé en ce que le rayon de courbure de la tige (15) et de chaque bague (20) est compris entre 25 et 35 cm. 7. Prosthetic assembly according to claim 6, characterized in that the radius of curvature of the rod (15) and of each ring (20) is between 25 and 35 cm. 8. Ensemble prothétique selon l'une quelconque des revendications précédentes, caractérisé en ce que l'embase (11) et la tige (15) sont en céramique. 8. Prosthetic assembly according to any one of the preceding claims, characterized in that the base (11) and the rod (15) are made of ceramic. 9. Ensemble prothétique selon l'une quelconque des revendications 1 à 7, caractérisé en ce que chaque bague (20) est en céramique. 9. Prosthetic assembly according to any one of claims 1 to 7, characterized in that each ring (20) is ceramic. 10. Ensemble prothétique selon les revendications 8 et 9, caractérisé en ce que la céramique est de la céramique d'alumine. 10. Prosthetic assembly according to claims 8 and 9, characterized in that the ceramic is alumina ceramic. 11. Ensemble prothétique selon l'une quelconque des revendications 1 à 7, caractérisé en ce que chaque bague (20) est en acier inoxydable ou en titane. 11. Prosthetic assembly according to any one of claims 1 to 7, characterized in that each ring (20) is made of stainless steel or titanium. 12. Ensemble prothétique selon l'une quelconque des revendications précédentes, caractérisé en ce que les faces externes de l'embase (lui), de la tige (15) et de chaque bague (20) situées en contact avec l'os (1) partiellement réséqué et les parois du canal médullaire (3) sont recouvertes d'un biomatériau. 12. Prosthetic assembly according to any one of the preceding claims, characterized in that the external faces of the base (him), of the rod (15) and of each ring (20) located in contact with the bone (1 ) partially resected and the walls of the medullary canal (3) are covered with a biomaterial. 13. Ensemble prothétique selon la revendication 12, caractérisé en ce que le biomatériau est de l'hydroxyapatite de calcium.  13. Prosthetic assembly according to claim 12, characterized in that the biomaterial is calcium hydroxyapatite.
FR9410817A 1994-09-09 1994-09-09 MODULAR PROSTHETIC ASSEMBLY FOR JOINTS OF THE SHORT HAND OR FOOT Expired - Fee Related FR2724310B1 (en)

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FR9410817A FR2724310B1 (en) 1994-09-09 1994-09-09 MODULAR PROSTHETIC ASSEMBLY FOR JOINTS OF THE SHORT HAND OR FOOT

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL1009832C2 (en) * 1998-08-10 2000-02-11 Novarticulate Bv Hip replacement.
EP1066807A1 (en) * 1998-05-06 2001-01-10 Bernd Schäfer Wrist prosthesis
WO2001003613A1 (en) * 1999-07-14 2001-01-18 Implants International Limited Metatarsal phalangeal implant device
DE20120241U1 (en) * 2001-12-14 2003-04-24 Keramed Medizintechnik Gmbh Endoprosthesis
FR2881945A1 (en) * 2005-02-14 2006-08-18 Fixano Soc Par Actions Simplif Trapezo-metacarpal prosthesis comprises trapezoid and metacarpal components with anchoring sections and interacting convex and concave surfaces

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4158893A (en) * 1976-10-12 1979-06-26 Swanson Alfred B Protective sleeve for implantable prosthesis and method of protecting the prosthesis
GB2045085A (en) * 1979-03-05 1980-10-29 Howmedica Joint Prosthesis

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4158893A (en) * 1976-10-12 1979-06-26 Swanson Alfred B Protective sleeve for implantable prosthesis and method of protecting the prosthesis
GB2045085A (en) * 1979-03-05 1980-10-29 Howmedica Joint Prosthesis

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1066807A1 (en) * 1998-05-06 2001-01-10 Bernd Schäfer Wrist prosthesis
NL1009832C2 (en) * 1998-08-10 2000-02-11 Novarticulate Bv Hip replacement.
WO2000009038A3 (en) * 1998-08-10 2000-09-21 Novarticulate Bv Anchoring means for a joint prosthesis or other component
WO2001003613A1 (en) * 1999-07-14 2001-01-18 Implants International Limited Metatarsal phalangeal implant device
DE20120241U1 (en) * 2001-12-14 2003-04-24 Keramed Medizintechnik Gmbh Endoprosthesis
FR2881945A1 (en) * 2005-02-14 2006-08-18 Fixano Soc Par Actions Simplif Trapezo-metacarpal prosthesis comprises trapezoid and metacarpal components with anchoring sections and interacting convex and concave surfaces

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