FR2726994A1 - Fixing cage for fractured upper end of humerus - Google Patents

Fixing cage for fractured upper end of humerus Download PDF

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Publication number
FR2726994A1
FR2726994A1 FR9413747A FR9413747A FR2726994A1 FR 2726994 A1 FR2726994 A1 FR 2726994A1 FR 9413747 A FR9413747 A FR 9413747A FR 9413747 A FR9413747 A FR 9413747A FR 2726994 A1 FR2726994 A1 FR 2726994A1
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FR
France
Prior art keywords
cage
osteo
humerus
permeable
metaphysis
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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
FR9413747A
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French (fr)
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FR2726994B1 (en
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CAFFINIERE JEAN YVES DE
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CAFFINIERE JEAN YVES DE
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Priority to FR9413747A priority Critical patent/FR2726994B1/en
Publication of FR2726994A1 publication Critical patent/FR2726994A1/en
Application granted granted Critical
Publication of FR2726994B1 publication Critical patent/FR2726994B1/en
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    • 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
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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
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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
    • 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
    • A61F2/40—Joints for shoulders
    • A61F2/4059—Humeral shafts
    • A61F2002/4062—Proximal or metaphyseal parts of shafts
    • A61F2002/4066—Proximal or metaphyseal parts of shafts for replacement or reinforcement of the greater tubercle
    • 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
    • A61F2230/0026—Angular shapes trapezoidal
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0082—Three-dimensional shapes parallelepipedal
    • 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

Landscapes

  • Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Biomedical Technology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (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 cage (I), which is osteo-permeable and osteo-conducting, is trapezoid in shape and designed to fit between the fractured head of the humerus and an intermediate insert (II) fitted into the metaphysis canal. The upper surface of the cage has spikes (1) which engage with the head of the humerus, while its under surface has a projection (2) to engage with the metal intermediate insert (II). The walls of the cage are in the form os a osteo-permeable grilles, all except one which has a large aperture to receive a graft or other bone substitute.

Description

CAGE AGRAFE POUR FRACTURE DE L'EXTREMITE SUPERIEURE DE L'HUMERUS
Certaines fractures complexes de l'extrémité supérieure de l'humérus désolidarisent la tête de l'humérus des éminences tubérositaires et du reste de l'humérus. Certaines de ces fractures, dites céphalo-tubérositaires, justifient un remplacement de la tête humérale par une prothèse articulaire tant le volume de la tête restante est réduit et voué à terme à la nécrose si elle est conservée. D'autres fractures au contraire ont encore une tête volumineuse et viable, mais à cause de l'impaction associée au moment du traumatisme, il y a une perte de substance osseuse entre les deux extrémités principales séparées.CLIP CAGE FOR FRACTURE OF THE UPPER END OF THE HUMERUS
Certain complex fractures of the upper end of the humerus separate the head of the humerus from the tuberous protrusions and the rest of the humerus. Some of these fractures, called cephalo-tuberous, justify replacement of the humeral head with an articular prosthesis as the volume of the remaining head is reduced and ultimately doomed to necrosis if it is preserved. Other fractures, on the contrary, still have a bulky and viable head, but because of the impaction associated with the moment of the trauma, there is a loss of bone substance between the two separate main ends.

Le dispositif présenté ici (figure 1) vise à remplacer cette solution de continuité entre la tete humérale et l'extrémité proximale de la métaphyse afin de permettre une reconstitution osseuse et non un remplacement par prothèse. The device presented here (Figure 1) aims to replace this continuity between the humeral head and the proximal end of the metaphysis to allow bone reconstruction and not replacement by prosthesis.

Le dispositif de base est une cage trapézoïdale (figure 2) dont les parois sont ostéo-perméables tel un grillage en métal lui-même ostéo-conducteur. La cage sera remplie de fragments osseux spongieux, prélevés sur l'opéré lui-même ou provenant d'une banque d'os. La cage est de forme globalement trapézoïdale. Elle présente deux faces principales, de préférence arrondies, afin de disposer d'un large contact avec les tranches de section de la tête humérale en haut, et de la métaphyse en bas. The basic device is a trapezoidal cage (Figure 2) whose walls are osteo-permeable like a metal mesh itself osteo-conductive. The cage will be filled with spongy bone fragments, taken from the patient himself or from a bone bank. The cage is generally trapezoidal in shape. It has two main faces, preferably rounded, in order to have a wide contact with the section slices of the humeral head at the top, and the metaphysis at the bottom.

Sur la face supérieure (A), sont disposées deux, trois ou quatre pointes (1), type agrafes, qui seront plantées dans la surface osseuse de la tête humérale. La face inférieure (B) de la cage (I) est appliquée sur la face supérieure d'une pièce intermédiaire de prothèse (II) préalablement introduite et fixée dans le canal médullaire de la métaphyse de l'humérus. L'emboitement entre les deux pièces est assuré par tout dispositif, par exemple de type Cône Morse propre aux modèles de prothèse variés utilisés en chirurgie de l'épaule. Sur la figure 1, le schéma c'est le modèle Cône Morse qui a été choisi, dont la pièce mâle (2) est du côté de la cage, I'inverse est possible ou tout autre mode de liaison. L'intégralité de la cage est limitée par des parois ostéoperméables grillagées ou de toute autre forme, sauf du côté le plus haut adossé aux tubérosités après qu'elles aient été fixées par cerclage. A cet endroit, est ménagée une large fenêtre (3) pour permettre d'introduire dans la cage le maximum de greffe osseuse.  On the upper face (A), are arranged two, three or four points (1), type staples, which will be planted in the bony surface of the humeral head. The lower face (B) of the cage (I) is applied to the upper face of an intermediate prosthesis piece (II) previously introduced and fixed in the medullary canal of the metaphysis of the humerus. The interlocking between the two parts is ensured by any device, for example of the Morse Cone type specific to the various prosthesis models used in shoulder surgery. In FIG. 1, the diagram is the Morse Cone model which has been chosen, the male part (2) of which is on the side of the cage, the reverse is possible or any other mode of connection. The entirety of the cage is limited by osteopermeable walls of mesh or any other shape, except on the highest side leaning against the tuberosities after they have been fixed by strapping. At this location, a large window (3) is provided to allow the maximum amount of bone grafting to be introduced into the cage.

Claims (4)

REVENDICATIONS 1- Cage ostéo-perméable et ostéo-conductrice (I) de forme trapézoïdale visant à être interposée entre la téte humérale séparée par fracture de l'extrémité supérieure de la métaphyse humérale dans laquelle est placée la pièce intermédiaire (II) d'une prothèse d'épaule.1- Trapezoidal osteo-permeable and osteo-conductive cage (I) intended to be interposed between the humeral head separated by fracture from the upper end of the humeral metaphysis in which the intermediate part (II) of a prosthesis is placed shoulder. 2- Cage selon la revendication 1 caractérisée en ce que cette cage présente à sa face supérieure (A) des pointes d'agrafes (1) destinées à être fichées dans la tête humérale.2- A cage according to claim 1 characterized in that this cage has on its upper face (A) staple tips (1) intended to be inserted into the humeral head. 3- Cage selon les revendications 1 et 2 caractérisée en ce que la face inférieure présente un dispositif d'emboitement (2) avec la pièce métallique (II) placée préalablement dans la métaphyse humérale.3- A cage according to claims 1 and 2 characterized in that the lower face has a fitting device (2) with the metal part (II) placed beforehand in the humeral metaphysis. 4- Cage selon les revendications 1 à 3 caractérisée en ce que les parois de la cage sont entièrement ostéo-perméables grillagées, sauf sur son plus grand côté où est ménagée une large ouverture (3) destinée à introduire à l'intérieur une greffe osseuse ou tout autre substitut osseux. 4- Cage according to claims 1 to 3 characterized in that the walls of the cage are fully osteo-permeable mesh, except on its largest side where a large opening (3) is provided for introducing a bone graft inside or any other bone substitute.
FR9413747A 1994-11-17 1994-11-17 CLIP CAGE FOR FRACTURE OF THE UPPER END OF THE HUMERUS Expired - Fee Related FR2726994B1 (en)

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FR9413747A FR2726994B1 (en) 1994-11-17 1994-11-17 CLIP CAGE FOR FRACTURE OF THE UPPER END OF THE HUMERUS

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Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999037254A1 (en) * 1998-01-22 1999-07-29 Sulzer Orthopedics, Ltd. Humeral head prosthesis
EP1088533A1 (en) * 1999-09-28 2001-04-04 Sulzer Orthopedics Ltd. Basket-style container for implanting bone tissue
WO2004100838A1 (en) * 2003-05-16 2004-11-25 Jean-Maxwell Cyprien Composite shoulder prosthesis
FR2871369A1 (en) * 2004-06-15 2005-12-16 Tornier Sas Glenoidal component for shoulder prosthesis, has metallic unit defining convex articulation surface which has semi-sphere shape and centered on symmetry axis that is not perpendicular to rear side of component
EP1607067A1 (en) * 2004-06-15 2005-12-21 Tornier Glenoid component, set of such elements and shoulder prosthesis comprising such a glenoid component
WO2007040917A2 (en) * 2005-10-03 2007-04-12 Zimmer, Inc. Graft prosthetic composite for proximal humerus
FR2909858A1 (en) * 2006-12-18 2008-06-20 Sem Sa Shoulder articulation prosthesis for treating proximal fractures, has connecting wedge connecting humeral rod to humeral bony tuberosity to be healed by osteosynthesis, where rod is implanted in medullar channel of humerus
FR2916961A1 (en) * 2007-06-20 2008-12-12 Tornier Sas Complete prosthesis for reversed shoulder of patient, has protection unit covering lateral surface of bone graft, which is not in contact with cord, and forming support for part of opposite surface of glenoidal component
WO2010146545A1 (en) 2009-06-18 2010-12-23 Compagnie Financiere Et Medicale Set of reconstruction of a fractured shoulder joint
NL2009592C2 (en) * 2012-10-09 2014-04-14 Cornelis Pieter Jan Visser A medical device for the operative treatment of a proximal humerus fracture.
US9089435B2 (en) 2007-01-30 2015-07-28 Tornier Sas Intra-articular joint replacement
US9408652B2 (en) 2010-04-27 2016-08-09 Tornier Sas Intra-articular joint replacement and method
US10251755B2 (en) 2007-01-30 2019-04-09 Tornier Sas Method and apparatus for fitting a shoulder prosthesis
US10631993B2 (en) 2010-10-22 2020-04-28 Tornier, Inc. Set of glenoid components for a shoulder prosthesis
US10898336B2 (en) 2006-03-21 2021-01-26 Tornier, Inc. Femoral and humeral stem geometry and implantation method for orthopedic joint reconstruction

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US7887544B2 (en) 2003-03-10 2011-02-15 Tornier Sas Ancillary tool for positioning a glenoid implant
EP1607069B1 (en) 2004-06-15 2009-12-23 Tornier Inverse-type total shoulder prosthesis
WO2007109291A2 (en) 2006-03-21 2007-09-27 Axiom Orthopaedics, Inc. Non-spherical articulating surfaces in shoulder and hip prosthesis
US9474619B2 (en) 2006-03-21 2016-10-25 Tornier, Inc. Glenoid component with improved fixation stability
FR2899790B1 (en) 2006-04-13 2008-06-13 Tornier Sas GLENOIDAL COMPONENT FOR TOTAL SHOULDER PROSTHESIS, SET OF SUCH COMPONENTS, AND TOTAL SHOULDER PROSTHESIS COMPRISING SUCH A COMPONENT
FR2900045B1 (en) 2006-04-21 2009-01-16 Tornier Sas PROSTHESIS OF SHOULDER OR HIP

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EP0307241A2 (en) * 1987-09-11 1989-03-15 John W. Brantigan Surgical prosthetic implant
US4865604A (en) * 1987-04-27 1989-09-12 Chaim Rogozinski Prosthetic bone joint
FR2669528A1 (en) * 1990-11-23 1992-05-29 Doursounian Levon Implant intended for osteosynthesis of fractures of the upper end of the humerus

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Publication number Priority date Publication date Assignee Title
US2537070A (en) * 1948-12-27 1951-01-09 Puy Mfg Company Inc De Surgical appliance and method for fixation of bone fragments
US4865604A (en) * 1987-04-27 1989-09-12 Chaim Rogozinski Prosthetic bone joint
EP0307241A2 (en) * 1987-09-11 1989-03-15 John W. Brantigan Surgical prosthetic implant
FR2669528A1 (en) * 1990-11-23 1992-05-29 Doursounian Levon Implant intended for osteosynthesis of fractures of the upper end of the humerus

Cited By (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6406496B1 (en) 1998-01-22 2002-06-18 Sulzer Orthopedics Ltd. Humerus head prosthesis
WO1999037254A1 (en) * 1998-01-22 1999-07-29 Sulzer Orthopedics, Ltd. Humeral head prosthesis
EP1088533A1 (en) * 1999-09-28 2001-04-04 Sulzer Orthopedics Ltd. Basket-style container for implanting bone tissue
US6447543B1 (en) 1999-09-28 2002-09-10 Sulzer Orthopedics Ltd. Basket-like container for implanting bone tissue
WO2004100838A1 (en) * 2003-05-16 2004-11-25 Jean-Maxwell Cyprien Composite shoulder prosthesis
US10610363B2 (en) 2004-06-15 2020-04-07 Tornier Sas Glenoidal component, set of such components and shoulder prosthesis incorporating such a glenoidal component
FR2871369A1 (en) * 2004-06-15 2005-12-16 Tornier Sas Glenoidal component for shoulder prosthesis, has metallic unit defining convex articulation surface which has semi-sphere shape and centered on symmetry axis that is not perpendicular to rear side of component
EP1607067A1 (en) * 2004-06-15 2005-12-21 Tornier Glenoid component, set of such elements and shoulder prosthesis comprising such a glenoid component
US11523907B2 (en) 2004-06-15 2022-12-13 Tornier Sas Glenoidal component, set of such components and shoulder prosthesis incorporating such a glenoidal component
WO2007040917A2 (en) * 2005-10-03 2007-04-12 Zimmer, Inc. Graft prosthetic composite for proximal humerus
WO2007040917A3 (en) * 2005-10-03 2007-08-23 Zimmer Inc Graft prosthetic composite for proximal humerus
US8617249B2 (en) 2005-10-03 2013-12-31 Zimmer, Inc. Graft prosthetic composite for proximal humerus
US10898336B2 (en) 2006-03-21 2021-01-26 Tornier, Inc. Femoral and humeral stem geometry and implantation method for orthopedic joint reconstruction
FR2909858A1 (en) * 2006-12-18 2008-06-20 Sem Sa Shoulder articulation prosthesis for treating proximal fractures, has connecting wedge connecting humeral rod to humeral bony tuberosity to be healed by osteosynthesis, where rod is implanted in medullar channel of humerus
US11185417B2 (en) 2007-01-30 2021-11-30 Tornier Sas Method and apparatus for fitting a shoulder prosthesis
US9089435B2 (en) 2007-01-30 2015-07-28 Tornier Sas Intra-articular joint replacement
US10251755B2 (en) 2007-01-30 2019-04-09 Tornier Sas Method and apparatus for fitting a shoulder prosthesis
US10413416B2 (en) 2007-01-30 2019-09-17 Tornier Sas Method and apparatus for fitting a shoulder prosthesis
US11547572B2 (en) 2007-01-30 2023-01-10 Tornier Sas Intra-articular joint replacement
FR2916961A1 (en) * 2007-06-20 2008-12-12 Tornier Sas Complete prosthesis for reversed shoulder of patient, has protection unit covering lateral surface of bone graft, which is not in contact with cord, and forming support for part of opposite surface of glenoidal component
WO2010146545A1 (en) 2009-06-18 2010-12-23 Compagnie Financiere Et Medicale Set of reconstruction of a fractured shoulder joint
FR2946863A1 (en) * 2009-06-18 2010-12-24 Cie Financiere Et Medicale RECONSTRUCTION ASSEMBLY OF A JOINT OF THE FRACTURE SHOULDER.
US9408652B2 (en) 2010-04-27 2016-08-09 Tornier Sas Intra-articular joint replacement and method
US11771568B2 (en) 2010-04-27 2023-10-03 Tornier Sas Intra-articular joint replacement and method
US10695195B2 (en) 2010-04-27 2020-06-30 Tornier Sas Intra-articular joint replacement and method
US10631993B2 (en) 2010-10-22 2020-04-28 Tornier, Inc. Set of glenoid components for a shoulder prosthesis
US11304815B2 (en) 2010-10-22 2022-04-19 Howmedica Osteonics Corp. Set of glenoid components for a shoulder prosthesis
US9615928B2 (en) 2012-10-09 2017-04-11 Implant Service B.V. Medical device for reconstruction of a humerus for the operative treatment of a proximal humerus fracture
NL2009592C2 (en) * 2012-10-09 2014-04-14 Cornelis Pieter Jan Visser A medical device for the operative treatment of a proximal humerus fracture.
WO2014058314A1 (en) * 2012-10-09 2014-04-17 Visser Cornelis Pieter Jan A medical device for reconstruction of a humerus for the operative treatment of a proximal humerus fracture

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