FR2805152A1 - Trapezo-metacarpal prosthesis has component substituting for trapezoid bone connected to metacarpal component by articulated joint - Google Patents

Trapezo-metacarpal prosthesis has component substituting for trapezoid bone connected to metacarpal component by articulated joint Download PDF

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Publication number
FR2805152A1
FR2805152A1 FR0009402A FR0009402A FR2805152A1 FR 2805152 A1 FR2805152 A1 FR 2805152A1 FR 0009402 A FR0009402 A FR 0009402A FR 0009402 A FR0009402 A FR 0009402A FR 2805152 A1 FR2805152 A1 FR 2805152A1
Authority
FR
France
Prior art keywords
metacarpal
prosthesis
component
trapezium
hand
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
FR0009402A
Other languages
French (fr)
Other versions
FR2805152B1 (en
Inventor
Yves Allieu
Philippe Escare
Robert Gomis
Jean Luc Roux
Henri Connes
Jean Pierre Pequignot
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.)
CREMASCOLLI ORTHO S A
Original Assignee
CREMASCOLLI ORTHO S A
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
Priority to FR0002099A priority Critical patent/FR2805151B1/en
Application filed by CREMASCOLLI ORTHO S A filed Critical CREMASCOLLI ORTHO S A
Priority to FR0009402A priority patent/FR2805152B1/en
Publication of FR2805152A1 publication Critical patent/FR2805152A1/en
Application granted granted Critical
Publication of FR2805152B1 publication Critical patent/FR2805152B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

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    • 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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    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
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    • 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
    • A61B17/58—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
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
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    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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Abstract

The prosthesis consists of a first component (2) inserted into the metacarpal bone of a patient's hand, and a component (24) substituting for the trapezoid bone, connected to the first component by an articulated joint (20) with a spherical head on one end and conical portion (23) on the other end engaging with a socket of matching shape in the first component. The joint also has a threaded section to receive a threaded locking member (21).

Description

La présente invention concerne une prothèse trapézo-métacarpienne à mobilité - liorée. Plus précisément, l'invention concerne une prothèse trapézo-métacarpienne permet de récupérer presque totalement les fonctions de l'articulation trapezo métacarpienne patient. The present invention relates to a trapezo-metacarpal prosthesis with mobility. More specifically, the invention relates to a trapezio-metacarpal prosthesis to recover almost completely the functions of the trapezo metacarpal patient joint.

Comme sait, suite à des pathologies arthrosiques affectant la main, les fonctions du pouce, c'est ' dire de l'articulation entre le trapèze et le métacarpe de la main, peuvent être fortement compromises au point que le patient, en plus de souffrir de douleurs inten ses, ne dispose plus des fonctions optimales du pouce et que, par conséquent, lors même tentatives de préhension tout à fait normales il ne peut réussir à achever cette opération. As is known, following osteoarthritic pathologies affecting the hand, the functions of the thumb, that is to say of the articulation between the trapezius and the metacarpal of the hand, can be strongly compromised to the point that the patient, in addition to suffering pain, no longer has the optimum functions of the thumb, and therefore, even in the most normal prehension attempts it can not succeed in completing this operation.

Pour faire face à une situation du type susmentionné, existent actuellement différen tes techniques ont pour objectif de récupérer les fonctions du trapèze et du métacarpe. Une premiere technique, connue, consiste à souder le trapèze et le métacarpe entre eux, avec pour résultat que le patient ne souffre plus, mais avec l'inconvénient de perdre les fonctions de la main. To cope with a situation of the aforementioned type, currently exist different techniques aim to recover the functions of trapezius and metacarpal. A first known technique is to weld the trapezium and the metacarpal between them, with the result that the patient no longer suffers, but with the disadvantage of losing the functions of the hand.

Une seconde technique, également de type chirurgical, prévoit de prélever des liga ments d'une région du corps différente de la main et d'implanter ces ligaments entre le trapèze et le métacarpe pour pouvoir en récupérer les fonctions. Toutefois, cette seconde technique n'a la faveur des spécialistes car on obtient des résultats non satisfaisants. A second technique, also of the surgical type, provides for collecting liga ments from a region of the body different from the hand and implanting these ligaments between the trapezium and the metacarpus to be able to recover the functions. However, this second technique is favored by specialists because unsatisfactory results are obtained.

Une troisieme technique opératoire prévoit d'insérer entre le trapèze et le métacarpe une prothèse appropriée. L'insertion de la prothèse doit avoir lieu en réséquant des portions des deux os de façon à pouvoir définir des logements pour la prothèse. A third operative technique involves inserting a suitable prosthesis between the trapezium and the metacarpal. The insertion of the prosthesis must take place resecting portions of the two bones so as to define housing for the prosthesis.

Les prothèses de type connu prévoient une tige destinée à être insérée dans le méta carpe, un col est inséré d'un côté dans la tige et se termine à l'extrémité opposée avec une tête sphérique qui s'engage dans un logement complémentaire défini dans une cotyle qui est elle-meme bloquée dans le trapèze de la main. Prostheses of known type provide a rod intended to be inserted into the meta carp, a neck is inserted on one side into the rod and ends at the opposite end with a spherical head which engages in a complementary housing defined in an acetabulum which is itself locked in the trapezium of the hand.

L'emploi du type de prothèse décrit pâtit toutefois de certains inconvénients, princi palement dus au fait que l'alignement entre la tige insérée dans le métacarpe et la cotyle insérée dans le trapèze, n'est pas toujours optimal, soit en raison d'une différence congé nitale entre trapèze et métacarpe de patient à patient, soit parce que la définition des placements dans le métacarpe et dans le trapèze peut ne pas être suffisamment précise pour permettre un alignement parfait entre la tige et la cotyle correspondante. The use of the type of prosthesis described however suffers from certain disadvantages, mainly due to the fact that the alignment between the rod inserted into the metacarp and the acetabulum inserted into the trapezium is not always optimal, either because of a difference in nitrate leave between trapezius and metacarpal from patient to patient, either because the definition of the placements in the metacarpal and in the trapezius may not be precise enough to allow a perfect alignment between the stem and the corresponding acetabulum.

En outre, l'opération de flexion du pouce en opposition à la paume de la main provo que un effet de rotation de la cotyle dans le logement correspondant qui peut conduire à un déboîtement de la cotyle hors du logement, compromettant ainsi l'implantation prothéti que. In addition, the operation of flexing the thumb in opposition to the palm of the hand causes a rotation effect of the acetabulum in the corresponding housing which can lead to dislocation of the acetabulum out of the housing, thus compromising prosthetic implantation. than.

La fonction principale de la présente invention est de réaliser une prothèse trapézo métacarpienne qui permette d'éliminer la nécessité d'un alignement parfait entre la portion de prothèse insérée dans le métacarpe et la portion de prothèse destinée à être insérée dans le trapèze. The main function of the present invention is to provide a metacarpal trapezoid prosthesis that eliminates the need for a perfect alignment between the prosthesis portion inserted in the metacarpal and the portion of prosthesis to be inserted into the trapezium.

Dans le cadre de cette fonction, l'un des buts de la présente invention est de réaliser une prothèse trapézo-métacarpienne qui permette d'avoir un certain jeu entre la portion prothèse insérée dans le métacarpe et la portion de prothèse insérée dans le trapèze. In the context of this function, one of the aims of the present invention is to provide a trapeziometacarpal prosthesis that allows a certain clearance between the prosthesis portion inserted into the metacarpal and the portion of prosthesis inserted into the trapezium.

Un autre but de la présente invention est celui de réaliser une prothèse trapézo métacarpienne qui permette une flexion optimale du pouce en opposition à la paume de main. Another object of the present invention is to provide a metacarpal trapezoid prosthesis which allows an optimal flexion of the thumb in opposition to the palm of hand.

Un autre but de la présente invention est de réaliser une prothèse trapézo métacarpienne qui permette une mobilité, aussi bien dans le sens rotatoire que dans un sens radial entre la portion de prothèse insérée dans le métacarpe et la portion de prothèse insé rée dans le trapeze. Another object of the present invention is to provide a metacarpal trapezoid prosthesis which allows mobility, both in the rotational and in a radial direction between the prosthesis portion inserted in the metacarpal and the prosthesis portion inserted into the trapezium.

Un autre , qui n'est pas le dernier, de la présente invention est de réaliser une prothèse trapézo métacarpienne qui soit d'une grande fiabilité, de réalisation relativement facile et à des coûts compétitifs. Another, which is not the last, of the present invention is to provide a metacarpal trapezoid prosthesis that is of high reliability, relatively easy to achieve and at competitive costs.

Cette fonction, ainsi que ces buts et d'autres qui apparaîtront mieux par la suite, sont obtenus grâce à une prothèse trapézo-métacarpienne comprenant un premier élément des tiné à être inséré dans le métacarpe de la main d'un patient, un second élément destiné à relier ce premier élément à un troisième élément prothétique destiné à être inséré dans le trapèze de la main du patient, ladite prothèse étant caractérisée par le fait que l'accouplement entre ce second élément et le premier élément permet un jeu radial entre le premier élément et le second élément. D'autres caractéristiques et avantages de l'invention ressortiront mieux de des cription d'un mode de réalisation adopté, mais non exclusif, de la prothèse selon l'invention, illustré titre indicatif et non limitatif, dans les dessins en annexe, où la figure 1 une vue en perspective, éclatée, de la prothèse trapézo-métacarpienne selon la présente invention ; la figure 2 est une vue en section transversale illustrant l'accouplement entre pre mier et un second élément de la prothèse selon la présente invention ; la figure 3 est une vue en section transversale illustrant le premier et le second élé ment de la prothèse selon l'invention en position d'accouplement<B>;</B> la figure 4 une vue en perspective du troisième élément de la prothèse selon la présente invention la figure 5 est une vue en section de la composante substitutive du trapèze en de révision. This function, as well as these and other objects which will appear better later, are obtained thanks to a trapezio-metacarpal prosthesis comprising a first element of the tine to be inserted into the metacarpal of the hand of a patient, a second element intended to connect this first element to a third prosthetic element intended to be inserted into the trapezium of the patient's hand, said prosthesis being characterized in that the coupling between this second element and the first element allows radial clearance between the first element and the second element. Other features and advantages of the invention will emerge more clearly from the description of an embodiment adopted, but not exclusive, of the prosthesis according to the invention, illustrated by way of non-limiting indication, in the appended drawings, in which the Figure 1 an exploded perspective view of the trapezio-metacarpal prosthesis according to the present invention; Fig. 2 is a cross sectional view illustrating the coupling between first and second prosthesis members according to the present invention; FIG. 3 is a cross-sectional view illustrating the first and second elements of the prosthesis according to the invention in the coupling position. FIG. 4 is a perspective view of the third element of the prosthesis. according to the present invention Figure 5 is a sectional view of the substitute component of the trapezium in revision.

En référence aux figures susmentionnées, la prothèse selon l'invention, globalement indiquée par le chiffre de référence 1, comprend un premier élément 2, de forme essentiel lement tronconique, destiné à être implanté dans le métacarpe de la main d'un patient. Le premier élément 2 à dessein doté, à l'extrémité opposée à celle qui est destinée à etre insérée dans le métacarpe du patient, d'un élément à collet 3, circulaire, sur lequel est fixé un élément annulaire surélevé par rapport à la surface de l'élément 3, de façon à définir une cavité 5 d'accouplement pour un second élément de la prothèse, indiqué par le chiffre de référence 6. With reference to the above figures, the prosthesis according to the invention, generally indicated by the reference numeral 1, comprises a first element 2, essentially of frusto-conical shape, intended to be implanted in the metacarpal of the hand of a patient. The first design element 2 endowed, at the end opposite to that which is to be inserted into the metacarpal of the patient, a collar element 3, circular, on which is fixed an annular element raised with respect to the surface of the element 3, so as to define a coupling cavity for a second element of the prosthesis, indicated by the reference numeral 6.

Dans le détail, second élément 6 de la prothèse, par exemple réalisé en polyéthy lène, constitue un élément intermédiaire d'accouplement entre le premier élément 2 et un troisième élément 7 de la prothèse qui est destiné à être implanté dans le trapèze de la main du patient. In detail, the second element 6 of the prosthesis, for example made of polyethylene, constitutes an intermediate coupling element between the first element 2 and a third element 7 of the prosthesis which is intended to be implanted in the trapezium of the hand. of the patient.

En observant la figure 1, et plus spécialement les figures 2 et 3, on note que le second élément 6 est de forme essentiellement cylindrique, avec une surface destinée à s'accoupler avec le troisième élément de la prothèse profilée en selle, et indiquée par le chiffre de réfé rence 8. La figure et la figure 3 illustrent l'accouplement entre le second élément 6 de la prothèse et le premier élément 2 et plus particulièrement l'accouplement entre l'élément annulaire 4 du premier élément 2 et sa cavité 5, avec un logement annulaire adéquat 10 défini sur la surface du second élément 6 qui est destinée à s'accoupler avec l'élément an nulaire 4. By observing FIG. 1, and more particularly FIGS. 2 and 3, it is noted that the second element 6 is essentially cylindrical in shape, with a surface intended to mate with the third element of the saddle-shaped prosthesis, and indicated by FIG. 8 and FIG. 3 illustrate the coupling between the second element 6 of the prosthesis and the first element 2 and more particularly the coupling between the annular element 4 of the first element 2 and its cavity 5. with a suitable annular recess 10 defined on the surface of the second element 6 which is intended to mate with the annular element 4.

En détail, l'élément annulaire 4 est doté de bords arrondis avec un plan incliné 11 s'accouple avec plan incliné 12 défini en correspondance sur la paroi latérale du loge ment 10 du second élément 6. In detail, the annular element 4 is provided with rounded edges with an inclined plane 11 mates with inclined plane 12 defined in correspondence on the side wall of the housing 10 of the second element 6.

Le bord du logement 10 a un diamètre inférieur à celui de l'élément annulaire 4 de façon que l'élément 6 puisse être monté de force sur l'élément 2. The edge of the housing 10 has a diameter smaller than that of the annular element 4 so that the element 6 can be force-fitted to the element 2.

Le logement 10 du second élément 6 a une dimension supérieure à celle de la portion d'élément annulaire 4 qui est destinée à s'accoupler dans ce logement. The housing 10 of the second element 6 has a dimension greater than that of the annular element portion 4 which is intended to mate in this housing.

Cela permet, comme le montre l'illustration de la figure 3, d'avoir un accouplement avec jeu entre le second élément 6 et le premier élément 2. This allows, as shown in the illustration of Figure 3, to have a coupling with play between the second element 6 and the first element 2.

L'accouplement avec jeu, dans lequel on peut donc avoir un mouvement radial entre le second élément 6 et le premier élément 2, permet d'éviter la nécessité d'avoir un ali gnement parfait entre le premier élément prothétique 2 inséré dans le métacarpe de la main et le troisième élément prothétique solidaire du trapèze. The coupling with clearance, in which one can thus have a radial movement between the second element 6 and the first element 2, makes it possible to avoid the need to have a perfect alignment between the first prosthetic element 2 inserted into the metacarpal of the hand and the third prosthetic element integral with the trapezium.

En outre, le second élément prothétique 6 peut effectuer une rotation de 360 autour de l'élément annulaire 4 du premier élément prothétique 2. In addition, the second prosthetic element 6 can rotate 360 around the annular element 4 of the first prosthetic element 2.

Cela permet aussi d'améliorer les fonctions du pouce du patient, car la prothèse selon l'invention, en permettant un mouvement aussi bien radial entre le premier 2 et le troisième 7 élément de la prothèse, que rotatoire entre les deux, permet de pourvoir à l'absence de mobilité qui est un inconvénient typique affectant les prothèses de type connu. This also makes it possible to improve the functions of the patient's thumb, since the prosthesis according to the invention, by allowing a radial movement between the first 2 and the third element of the prosthesis, as well as a rotation between the two, makes it possible to provide the absence of mobility which is a typical disadvantage affecting prostheses of known type.

En outre, le troisième élément prothétique 7 présente, sur sa surface destinée à s'accoupler avec la surface en selle 8 de l'élément prothétique 6, une surface profilée elle aussi en selle, 15, complémentaire de la surface en selle 8, de façon à ne pas permettre de rotation entre le second élément 6 et le troisième élément 7. Ce choix d'une surface d'accouplement entre le second élément 6 et le troisième élément 7 réalisée en selle est dicté par le fait que l'on entend ainsi copier la forme natu relle présentent le métacarpe et le trapèze dans leur accouplement. In addition, the third prosthetic element 7 has, on its surface intended to mate with the saddle surface 8 of the prosthetic element 6, a surface which is also saddle-shaped, 15, complementary to the saddle surface 8, of so as not to allow rotation between the second element 6 and the third element 7. This choice of a coupling surface between the second element 6 and the third element 7 made in the saddle is dictated by the fact that we mean thus copying the natural form presents the metacarpus and the trapezium in their mating.

troisième élément prothétique est doté, sur la face opposée à la face 15 d'accouplement avec la surface en selle 8 du second élément prothétique d'une paire de pivots saillants 16, 17 destinés à permettre l'accouplement du troisième élément prothéti que 7 avec le trapèze de la main du patient. A dessein, le troisième élément prothétique 7 est en outre doté d'au moins une ailette 18 sur laquelle est défini au moins trou 19 pour l'insertion d'une vis de fixation du troisième élément prothétique 7 au trapèze de la main du patient. third prosthetic element is provided, on the face opposite to the coupling face with the saddle surface 8 of the second prosthetic element of a pair of projecting pivots 16, 17 intended to allow the coupling of the third prosthetic element 7 with the trapezius of the patient's hand. On purpose, the third prosthetic element 7 is further provided with at least one fin 18 on which is defined at least one hole 19 for the insertion of a screw for fixing the third prosthetic element 7 to the trapezium of the patient's hand.

La figure 5 illustre, avec une vue en section, la composante substitutive trapèze en cas révision ou bien quand le trapèze est irrémédiablement abîmé. FIG. 5 illustrates, with a sectional view, the trapezoidal substitutive component in case of revision or when the trapezium is irreparably damaged.

ce cas, un élément d'articulation 20, à tête sphérique et à zone intermédiaire filetée est fixé à l'élément annulaire 4 de l'élément 2 par une frette 21 munie d'une ouver ture latérale 22 pour son introduction sur l'élément annulaire 4. En serrant la frette 21, l'élément d'articulation 20 se bloque sur l'élément 2 grâce à une surface d'accouplement conique 23. Sur la tête sphérique de l'élément d'articulation 20 est articulé un trapèze substitutif 24 qui peut tourner par rapport à la tête sphérique de l'élément 20 et est réalisé de préférence en polyéthylène contenu dans une coquille métallique. in this case, a hinge element 20 with a spherical head and a threaded intermediate zone is fixed to the annular element 4 of the element 2 by a hoop 21 provided with a lateral opening 22 for its introduction on the element 4. By tightening the hoop 21, the hinge member 20 locks on the element 2 through a conical coupling surface 23. On the spherical head of the hinge member 20 is articulated a trapezoidal replacement 24 which is rotatable relative to the spherical head of the element 20 and is preferably made of polyethylene contained in a metal shell.

On a, dans la pratique, constaté que la prothèse selon l'invention remplit pleinement le rôle fixé car elle permet d'obtenir une articulation optimale du pouce du patient, à savoir entre métacarpe et trapèze de la main, en reproduisant essentiellement l'articulation exis tant naturellement entre ces deux os. In practice, it has been found that the prosthesis according to the invention fully fulfills the fixed role because it makes it possible to obtain an optimal articulation of the patient's thumb, namely between the metacarpus and the trapezius of the hand, essentially reproducing the articulation. both naturally exist between these two bones.

La prothèse ainsi conçue est susceptible de nombreuses modifications et variantes, qui entrent toutes dans le cadre du concept de l'invention ; en outre tous les éléments de détail pourront être remplacés par d'autres éléments techniquement équivalents. The prosthesis thus conceived is capable of numerous modifications and variations, all of which fall within the scope of the concept of the invention; in addition, all details may be replaced by other technically equivalent elements.

En pratique, les matériaux employés, pourvu qu'ils soient compatibles avec l'usage spécifique, ainsi que les dimensions, pourront être de quelque nature que ce soit selon les besoins et l'état de la technique.In practice, the materials used, provided they are compatible with the specific use, as well as the dimensions, may be of any nature whatsoever according to the needs and the state of the art.

Claims (5)

REVENDICATIONS 1. Prothèse trapézo-métacarpienne, comprenant un premier élément (2) destiné être inséré dans le métacarpe de la main d'un patient, caractérisée par le fait qu'elle comprend un 'lément (24) substitutif du trapèze de la main, apte à être relié au premier élément par un élément d'articulation (20) relié solidairement au premier élément et, en pivotant, à l'élément substitutif du trapèze.A trapezio-metacarpal prosthesis, comprising a first element (2) intended to be inserted into the metacarpal of a patient's hand, characterized in that it comprises a replacement element (24) for the trapezium of the hand, capable of to be connected to the first element by a hinge element (20) integrally connected to the first element and, pivotally, to the substitute element of the trapezium. 2. Prothèse selon la revendication 1, caractérisée par le fait que l'élément d'articulation (20) est doté, sur l'extrémité apte à être insérée dans cet élément substitutif du trapèze d'une tête sphérique.2. Prosthesis according to claim 1, characterized in that the hinge element (20) is provided on the end adapted to be inserted in this substitute element of the trapezium of a spherical head. 3. Prothèse selon la revendication 2, caractérisée par le fait que l'élément d'articulation (20) a, à l'extrémité opposée à cette tête sphérique, une portion terminale conique (23) apte à s'engager dans une portion profilée complémentaire du premier élé ment.3. Prosthesis according to claim 2, characterized in that the hinge element (20) has, at the end opposite this spherical head, a conical end portion (23) adapted to engage in a profiled portion. complementary to the first element. 4. Prothèse selon la revendication 1, caractérisée par le fait que l'élément d'articulation (20) est doté d'une zone intermédiaire filetée, un élément à frette (21) pou- être vissé sur cette zone filetée pour bloquer l'élément d'articulation contre le premier élément.4. Prosthesis according to claim 1, characterized in that the hinge element (20) is provided with a threaded intermediate zone, a hoop element (21) to be screwed on this threaded zone to block the hinge element against the first element. 5. Prothèse selon la revendication 4, caractérisée par le fait que l'élément (24) subs titutif du trapèze réalisé en polyéthylène est contenu dans une coquille métallique.5. Prosthesis according to claim 4, characterized in that the element (24) substituting the trapezium made of polyethylene is contained in a metal shell.
FR0009402A 2000-02-21 2000-07-18 TRAPEZO-METACARPIEN PROSTHESIS WITH IMPROVED MOBILITY Expired - Fee Related FR2805152B1 (en)

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