FR2881945A1 - Trapezo-metacarpal prosthesis comprises trapezoid and metacarpal components with anchoring sections and interacting convex and concave surfaces - Google Patents

Trapezo-metacarpal prosthesis comprises trapezoid and metacarpal components with anchoring sections and interacting convex and concave surfaces Download PDF

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Publication number
FR2881945A1
FR2881945A1 FR0501460A FR0501460A FR2881945A1 FR 2881945 A1 FR2881945 A1 FR 2881945A1 FR 0501460 A FR0501460 A FR 0501460A FR 0501460 A FR0501460 A FR 0501460A FR 2881945 A1 FR2881945 A1 FR 2881945A1
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France
Prior art keywords
metacarpal
prosthesis
articulation surface
convex
trapezium
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Granted
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FR0501460A
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French (fr)
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FR2881945B1 (en
Inventor
Regis Legre
Emmanuel Favreul
Vincent Travers
Jean Jacques Martin
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Fixano SA
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Fixano SA
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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
    • A61F2/42—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
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A61F2002/3021—Three-dimensional shapes conical frustoconical
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30242—Three-dimensional shapes spherical
    • A61F2002/30245—Partial spheres
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30299—Three-dimensional shapes umbrella-shaped or mushroom-shaped
    • 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
    • A61F2002/30316—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
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • 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
    • A61F2002/30316—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
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • 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
    • A61F2002/30316—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
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • 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
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • 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
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4256—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints
    • A61F2002/4258—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints for trapezo-metacarpal joints of thumbs
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0067—Three-dimensional shapes conical
    • 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
    • A61F2230/0071—Three-dimensional shapes spherical
    • 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
    • A61F2230/0093—Umbrella-shaped, e.g. mushroom-shaped

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

Abstract

The prosthesis consists of a trapezoid component with an anchoring section (5) and a head (6) with a large-radius convex articulation surface (7), and a metacarpal component with an anchoring section (10) for the first metacarpal bone and a concave articulation surface (15) of at least the same radius as the trapezoid component's convex surface. The base of the metacarpal component has a proximal assembly surface (12) that engages with a matching distal (13) surface on an intermediate element (11) that can be adjusted to the length of the joint being treated to give an adequate ligament tension.

Description

La présente invention concerne une prothèse trapézo-métacarpienne et uneThe present invention relates to a trapezio-metacarpal prosthesis and a

gamme d'éléments permettant la constitution de cette prothèse.  range of elements allowing the constitution of this prosthesis.

Une prothèse trapézo-métacarpienne comprend généralemen: un élément trapézien sous forme d'une cupule délimitant une cavité hémisphérique, et un élément métacarpien sous forme d'une tige médu laire, comprenant une tête prothétique sphérique destinée à être engagée de manière ajustée dans la cavité de l'élément trapézien.  A trapezio-metacarpal prosthesis generally comprises: a trapezium element in the form of a cup delimiting a hemispherical cavity, and a metacarpal element in the form of a medullary stem, comprising a spherical prosthetic head intended to be fitly engaged in the cavity of the trapezian element.

Ce type de prothèse a pour inconvénient ne pas permettre une reproduction parfaitement fidèle du mouvement naturel de l'articu ation trapézométacarpienne, lequel est complexe. Il en résulte une gêne pour l'utilisateur et un risque d'usure prématurée des éléments de la prothèse.  This type of prosthesis has the drawback of not allowing a perfectly faithful reproduction of the natural movement of the trapezometacarpal joint, which is complex. This results in inconvenience for the user and a risk of premature wear of the elements of the prosthesis.

La présente invention vise à remédier à cet inconvénient essentiel.  The present invention aims to remedy this essential disadvantage.

Selon l'invention, la prothèse comprend: - un élément trapézien comprenant une partie d'ancrage dans le trapèze 15 et une surface d'articulation arrondie convexe, ayant un rayon de courbure important, c'est-à-dire de l'ordre de 5 à 10 mm, et - un élément métacarpien comprenant une partie d'ancrage dans le premier métacarpien et une surface d'articulation arrondie concave, de rayon au moins égal à celui de la surface d'articulation de l'élément trapézien.  According to the invention, the prosthesis comprises: - a trapezium element comprising an anchoring part in the trapezium 15 and a convex rounded articulation surface, having a large radius of curvature, that is to say of the order from 5 to 10 mm, and - a metacarpal element comprising an anchoring portion in the first metacarpal and a concave rounded articulation surface of radius at least equal to that of the articulation surface of the trapezium element.

Ainsi, la prothèse selon l'invention comprend des parties d'articu ation convexe et concave inversées par rapport à une prothèse classique et permettant de larges possibilités de mouvements complexes d'un os par rapport à l'autre, à savoir: - deux possibilités de mouvements dans le sens de la flexion-extension 25 de l'articulation et dans le sens de l'antéposition-rétroposition, pouvant combiner des pivotements et des translations, et - une possibilité de pivotement des implants trapézien et métacarpien l'un par rapport à l'autre selon l'axe du premier métacarpien.  Thus, the prosthesis according to the invention comprises parts of concave and convex articulations inverted with respect to a conventional prosthesis and allowing wide possibilities of complex movements of one bone relative to the other, namely: - two possibilities movements in the direction of the flexion-extension of the joint and in the direction of the anteposition-retroposition, which can combine pivoting and translations, and - a possibility of pivoting of the trapezial and metacarpal implants with respect to to the other along the axis of the first metacarpal.

L'articulation trapézo-métacarpienne travaillant en compression, le caractère non contraint de l'articulation prothétique selon l'invention ne pose pas de problème particulier de luxation dès lors qu'une tension ligamentaire adéquate est obtenue par une longueur adaptée de la prothèse.  The trapezo-metacarpal joint working in compression, the unconstrained nature of the prosthetic joint according to the invention does not pose any particular problem of dislocation as soon as an adequate ligament tension is obtained by a suitable length of the prosthesis.

Dans ce but, la prothèse selon l'invention pourrait être obtenue à partir d'une gamme de plusieurs éléments trapéziens et/ou de plusieurs éléments métacarpiens de longueurs différentes, en choisissant un élément, ou les deux, ayant une longueur adaptée à l'articulation à traiter. De préférence, toutefois, - la partie d'ancrage de l'élément métacarpien comprend des mcyens proximaux d'assemblage, et - l'élément métacarpien comprend un élément intermédiaire présentant des moyens distaux d'assemblage complémentaires de ceux de la partie d'ancrage de l'élément métacarpien et présentant, du côté proximal, ladite surface d'articulation concave, cet élément intermédiaire ayant une longueur adaptée à l'articulation à traiter, en vue de l'obtention d'une tension ligamentaire adéquate.  For this purpose, the prosthesis according to the invention could be obtained from a range of several trapezial elements and / or several metacarpal elements of different lengths, by choosing one or both elements having a length adapted to the articulation to be treated. Preferably, however, the anchoring part of the metacarpal element comprises proximal assembly mcyens, and the metacarpal element comprises an intermediate element having distal assembly means complementary to those of the anchoring part. of the metacarpal element and having, on the proximal side, said concave articulation surface, this intermediate element having a length adapted to the joint to be treated, in order to obtain an adequate ligament tension.

La gamme d'éléments selon l'invention comprend ainsi deux éléments standard, à savoir l'élément trapézien et la partie d'ancrage de l'élément métacarpien, et une série d'éléments intermédiaires de différentes longueurs, pouvant être assemblés à ladite partie d'ancrage.  The range of elements according to the invention thus comprises two standard elements, namely the trapezial element and the anchoring part of the metacarpal element, and a series of intermediate elements of different lengths, which can be assembled to said part. anchor.

Les moyens d'assemblage sont de préférence constitués par: - une cavité conique à faible pente aménagée dans l'extrémité proximale 20 de la partie d'ancrage de l'élément métacarpien, et - un embout conique de même pente, aménagé dans l'extrémité distale de chaque élément intermédiaire.  The assembly means are preferably constituted by: - a conical cavity with a low slope arranged in the proximal end 20 of the anchoring part of the metacarpal element, and - a conical tip of the same slope, arranged in the distal end of each intermediate element.

L'assemblage d'un élément intermédiaire à la partie d'ancrage de l'élément métacarpien est ainsi réalisé de manière simple, rapide et résistante.  The assembly of an intermediate element to the anchoring portion of the metacarpal element is thus achieved in a simple, fast and resistant manner.

L'élément trapèzien a de préférence une forme "en champignon", dont la tête forme, du côté opposé à la base, ladite surface d'articulation convexe, et dont la base constitue une partie d'ancrage osseux.  The trapezium element preferably has a "mushroom" shape, the head of which forms, on the opposite side to the base, said convex hinge surface, and whose base constitutes a part of bone anchorage.

Cette forme permet d'aménager, autour des bords de ladite sL rface d'articulation convexe, un dégagement suffisant pour ne pas gênar le débattement de l'élément métacarpien dans les angles articulaires importants, et permet ainsi que ce débattement soit important.  This shape makes it possible to arrange, around the edges of said convex hinge surface, sufficient clearance to avoid disturbing the movement of the metacarpal element in the important joint angles, and thus allows this clearance to be significant.

Les surfaces d'articulation de l'élément trapézien et de l'élément métacarpien peuvent être de dimensions voisines. De préférence, toutefois, la surface d'articulation de l'élément trapézien a un diamètre nettement supérieur à celui de la surface d'articulation de l'élément métacarpien, c'est-à-dire un diamètre au moins 20 % supérieur à celui de cette première surface d'articulation.  The articulation surfaces of the trapezium element and the metacarpal element may be of similar size. Preferably, however, the articulation surface of the trapezial element has a diameter much greater than that of the articulation surface of the metacarpal element, that is to say a diameter at least 20% greater than that of this first articulation surface.

Des amplitudes respectives de l'ordre de 50 à 70 degrés et de 40 à 60 degrés sont ainsi rendues possibles pour le mouvement de flexionextension de l'articulation et le mouvement d'antéposition-rétroposition, avec conservation d'un contact étendu des surfaces d'articulation même dans les positions angulaires maximales de pivotement d'un élément par rapport à l'autre.  Respective amplitudes of the order of 50 to 70 degrees and 40 to 60 degrees are thus made possible for the flexionextension movement of the joint and the anteposition-retropositioning movement, with preservation of an extended contact of the surfaces of the joint. articulation even in the maximum angular positions of pivoting of one element relative to the other.

La surface d'articulation concave peut avoir un arrondi de rayon sensiblement identique à celui de la surface d'articulation convexe. Elle a toutefois de préférence un arrondi de rayon supérieur à celui de cette surface d'articulation convexe, de manière à permettre des mouvements complexes des surfaces d'articulation l'une par rapport à l'autre, combinant des translations et des pivotements, en conservant des surfaces de ccntact suffisantes entre les éléments.  The concave articulation surface may have a rounding radius substantially identical to that of the convex hinge surface. However, it preferably has a rounding radius greater than that of this convex hinge surface, so as to allow complex movements of the hinge surfaces relative to each other, combining translations and pivoting, keeping sufficient surface areas between the elements.

La partie d'ancrage de l'élément trapézien est de préférence constituée par une tige filetée, permettant un ancrage facilité et résistant de cet élément sur le trapèze, par vissage. L'élément trapézien peut alors comprendre des moyens pour son entraînement en rotation au moment de ce vissage, tels que des méplats.  The anchoring portion of the trapezium element is preferably constituted by a threaded rod, allowing easy and resistant anchoring of this element on the trapezium, by screwing. The trapezian element can then comprise means for its rotation drive at the time of this screwing, such as flats.

L'invention sera bien comprise, et d'autres caractéristiques et avantages de celle-ci apparaîtront, en référence au dessin schématique an iexé, représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de la prothèse trapézo-métacarpienne qu'elle concerne.  The invention will be better understood, and other features and advantages thereof will become apparent, with reference to the accompanying diagrammatic drawing, showing, by way of non-limiting example, a preferred embodiment of the trapezio-metacarpal prosthesis which 'it relates to.

La figure 1 en est une vue de côté, sensiblement à l'échelle 1; la figure 2 en est une vue en coupe selon la ligne II-II de la figure 1; la figure 3 en est une vue similaire à la figure 2, avant assemblage de ses trois éléments constitutifs; la figure 4 en est une vue similaire à la figure 3, à échelle agrandie; la figure 5 en est une vue similaire à la figure 4, dans une position de pivotement de l'élément métacarpien par rapport à l'élément trapézien, et la figure 6 en est une vue après implantation.  Figure 1 is a side view, substantially scale 1; Figure 2 is a sectional view along the line II-II of Figure 1; Figure 3 is a view similar to Figure 2, before assembly of its three components; Figure 4 is a view similar to Figure 3, on an enlarged scale; Figure 5 is a view similar to Figure 4, in a pivoting position of the metacarpal element relative to the trapezian element, and Figure 6 is a view after implantation.

Les figures représentent une prothèse trapézo-métacarpienne 1, comprenant un élément trapézien 2 et un élément métacarpien 3.  The figures represent a trapezio-metacarpal prosthesis 1, comprising a trapezian element 2 and a metacarpal element 3.

L'élément trapézien 2 a une forme "en champignon", c'est-à-dire comprend une partie de base 5 et une tête 6.  The trapezian element 2 has a "mushroom" shape, that is to say comprises a base portion 5 and a head 6.

La partie de base 5 est sous forme d'une tige filetée auto-taraudeuse et permet ainsi l'ancrage osseux de l'élément trapèzien 2.  The base portion 5 is in the form of a self-tapping threaded rod and thus allows bone anchoring of the trapezium element 2.

La tête 6 est circulaire et forme, du côté opposé à la partie de base 5, une surface d'articulation convexe 7, en forme de calotte sphérique ayant un 10 rayon de 7,5 mm. La tête 6 a un diamètre de 8,5 mm.  The head 6 is circular and forms, on the opposite side to the base portion 5, a convex hinge surface 7 in the form of a spherical cap having a radius of 7.5 mm. The head 6 has a diameter of 8.5 mm.

L'implant trapézien 2 comprend, dans une zone intermédiaire entre la partie de base 5 et la tête 6, des méplats permettant son entraînement en rotation lors de sa mise en place par vissage sur le trapèze 100.  The trapezian implant 2 comprises, in an intermediate zone between the base portion 5 and the head 6, flats allowing its driving in rotation when it is put in place by screwing on the trapezium 100.

L'élément métacarpien 3 comprend une partie de base 10 et une pièce 15 intermédiaire 11.  The metacarpal element 3 comprises a base portion 10 and an intermediate piece 11.

La partie de base 10 est constituée par une tige médullaire de forme adaptée à la forme du canal médullaire du premier métacarpien 101. Cette tige médullaire présente une cavité conique proximale à faible pente 12.  The base portion 10 is constituted by a medullary stem of a shape adapted to the shape of the medullary canal of the first metacarpal 101. This medullary stem has a conical cavity cone of low slope 12.

L'élément intermédiaire 11 présente un embout conique distal 13 de même pente que la cavité 12, et, du côté proximal, une tête 14 évasée, arrondie au niveau de son bord proximal périphérique et dont la face proximale forme une surface d'articulation concave 15, en forme de calotte sphérique. Cette surface d'articulation concave 15 a un rayon supérieur à celui de la surface 7, de l'ordre de 10 mm, et a un diamètre de 5,5 mm.  The intermediate element 11 has a distal conical tip 13 of the same slope as the cavity 12, and on the proximal side, a flared head 14, rounded at its peripheral proximal edge and whose proximal face forms a concave articulation surface. 15, shaped spherical cap. This concave articulation surface 15 has a radius greater than that of the surface 7, of the order of 10 mm, and has a diameter of 5.5 mm.

L'élément intermédiaire 11 fait partie d'une gamme d'éléments de différentes longueurs, comprenant tous un embout conique distal 13 et une tête 14 tels que décrits ci-dessus. L'élément intermédiaire 11 ayant: une longueur adaptée à l'articulation à traiter pour permettre l'obtention d'une tension ligamentaire adéquate est choisi au sein de cette gamme est assemblé à la partie de base 10. L'élément trapézien 2 et la tige médulla re 10 sont quant à eux des éléments standard.  The intermediate element 11 is part of a range of elements of different lengths, all including a distal conical tip 13 and a head 14 as described above. The intermediate element 11 having: a length adapted to the joint to be treated to obtain a suitable ligament tension is selected within this range is assembled to the base portion 10. The trapezian element 2 and the rod medulla re 10 are standard elements.

Grâce à l'aménagement d'une surface d'articulation convexe 7 sur l'élément trapézien 2 et d'une surface d'articulation concave 15 sur l'élément métacarpien 3, ainsi qu'aux rayons de ces surfaces 7 et 15, la prothèse 1 selon l'invention permet de larges possibilités de mouvements complexes d'un os par rapport à l'autre, à savoir: - deux possibilités de mouvements dans le sens de la flexion-extension 5 de l'articulation et dans le sens de l'antéposition-rétroposition, pouvant combiner des pivotements et des translations, et - une possibilité de pivotement des implants trapézien 2 et métacarpien 3 l'un par rapport à l'autre selon l'axe du premier métacarpien 101.  By providing a convex hinge surface 7 on the trapezian element 2 and a concave articulation surface 15 on the metacarpal element 3, as well as the radii of these surfaces 7 and 15, the prosthesis 1 according to the invention allows wide possibilities of complex movements of a bone relative to each other, namely: - two possibilities of movements in the direction of flexion-extension 5 of the joint and in the direction of the anteposition-retroposition, which can combine pivoting and translations, and - a possibility of pivoting the trapezial implants 2 and metacarpal 3 with respect to each other along the axis of the first metacarpal 101.

La dimension plus importante de la tête 6 par rapport à la tête 14 permet des amplitudes respectives de l'ordre de 50 à 70 degrés et de 40 à 60 degrés pour le mouvement de flexion-extension de l'articulation et pour le mouvement d'antéposition-rétroposition, avec conservation d'un contact étendu des surfaces d'articulation 7 et 15 même dans les positions angulaires maximales de pivotement d'un élément 2, 3 par rapport à l'autre, ainsi que le montre la figure 5.  The larger size of the head 6 relative to the head 14 allows respective amplitudes of the order of 50 to 70 degrees and 40 to 60 degrees for the flexion-extension movement of the joint and for the movement of anteposition-retroposition, with preservation of an extended contact of the articulation surfaces 7 and 15 even in the maximum angular positions of pivoting of one element 2, 3 with respect to the other, as shown in FIG. 5.

La figure 6 montre plus particulièrement que l'élément trapèzien.2 est destiné à être implanté sans venue de la face de la tête 6 opposée à la surface d'articulation 7 au contact de l'os. Cette absence de contact, combinée à la forme "en champignon" de l'élément trapèzien 2, permet d'aménager un dégagement suffisant autour des bords de la surface d'articulation convexe 7 pour ne pas gêner le débattement de l'élément métacarpien 3 dans les aigles articulaires importants. Ce débattement peut ainsi être important.  Figure 6 shows more particularly that the trapezial element 2 is intended to be implanted without coming from the face of the head 6 opposite to the articulation surface 7 in contact with the bone. This absence of contact, combined with the "mushroom" shape of the trapezium element 2, makes it possible to arrange a sufficient clearance around the edges of the convex hinge surface 7 so as not to hinder the movement of the metacarpal element 3 in the important articular eagles. This travel can be important.

Comme cela apparaît de ce qui précède, l'invention fournit une prothèse présentant l'avantage déterminant de permettre une reproduction parfaitement fidèle du mouvement naturel de l'articulation trapézométacarpienne.  As appears from the foregoing, the invention provides a prosthesis having the decisive advantage of allowing a perfectly faithful reproduction of the natural movement of the trapezometacarpal joint.

Il va de soi que l'invention n'est pas limitée à la forme de réali:,ation décrite ci-dessus à titre d'exemple mais qu'elle s'étend à toutes les formes de réalisations couvertes par les revendications ci-annexées.  It goes without saying that the invention is not limited to the form of embodiment described above by way of example but that it extends to all forms of embodiments covered by the appended claims. .

Claims (9)

REVENDICATIONS 1 Prothèse (1) trapézo-métacarpienne (1) caractérisée en ce qu'elle comprend: - un élément trapézien (2) comprenant une partie (5) d'ancrage dans le 5 trapèze (100) et une surface d'articulation arrondie convexe (7) , ayant un rayon important, et - un élément métacarpien (3) comprenant une partie (10) d'ancrage dans le premier métacarpien (101) et une surface d'articulation arrondie cor cave (15), de rayon au moins égal à celui de la surface d'articulation convexe (7) de l'élément trapézien (2).  1 Prosthesis (1) trapezio-metacarpal (1) characterized in that it comprises: - a trapezian element (2) comprising a portion (5) anchoring in the trapezium (100) and a convex rounded articulation surface (7), having a large radius, and - a metacarpal element (3) comprising an anchoring part (10) in the first metacarpal (101) and a rounded articulation surface cor cave (15), of radius at least equal to that of the convex hinge surface (7) of the trapezium element (2). 2 Prothèse (1) selon la revendication 1, caractérisée en ce que: - la partie de base (10) de l'élément métacarpien (3) comprend des moyens proximaux d'assemblage (12), et - l'élément métacarpien (3) comprend un élément intermédiaire (11) présentant des moyens distaux d'assemblage (13) complémentaires de ceux de la partie de base (10) de l'élément métacarpien (3) et présentant, du côté proximal, ladite surface d'articulation concave (7), cet élément intermédiaire (11) ayant une longueur adaptée à l'articulation à traiter, en vue de l'obtention d'une tension ligamentaire adéquate.  2 prosthesis (1) according to claim 1, characterized in that: - the base portion (10) of the metacarpal element (3) comprises proximal assembly means (12), and - the metacarpal element (3) ) comprises an intermediate element (11) having distal assembly means (13) complementary to those of the base portion (10) of the metacarpal element (3) and having, on the proximal side, said concave articulation surface (7), this intermediate element (11) having a length adapted to the joint to be treated, in order to obtain an adequate ligament tension. 3 Prothèse (1) selon la revendication 2, caractérisée en ce que les moyens d'assemblage sont constitués par: - une cavité conique (12) à faible pente aménagée dans l'extrémité proximale de la partie de base (10) de l'élément métacarpien (3), et - un embout conique (13) de même pente, aménagé dans l'extrémité distale de chaque élément intermédiaire (11).  3 prosthesis (1) according to claim 2, characterized in that the assembly means are constituted by: - a conical cavity (12) with a low slope arranged in the proximal end of the base portion (10) of the metacarpal element (3), and - a conical tip (13) of the same slope, arranged in the distal end of each intermediate element (11). 4 Prothèse (1) selon l'une des revendications 1 à 3, caractérisée lan ce que l'élément trapèzien (2) a une forme "en champignon", dont la tête (6) forme, du côté opposé à la base (5), ladite surface d'articulation convexe (7), et dont la base constitue une partie d'ancrage osseux.  4. Prosthesis (1) according to one of claims 1 to 3, characterized in that the trapezium element (2) has a "mushroom" shape, the head (6) of which forms on the opposite side to the base (5). ), said convex hinge surface (7), and whose base is a bone anchoring part. 5 Prothèse (1) selon l'une des revendications 1 à 4, caractérisée en ce que la surface d'articulation (7) de l'élément trapézien (2) a un diamètre nettement supérieur à celui de la surface d'articulation (15) de l'élément métacarpien (3), c'est-à-dire un diamètre au moins 20 % supérieur à celui de cette première surface d'articulation (7).  Prosthesis (1) according to one of claims 1 to 4, characterized in that the articulation surface (7) of the trapezium element (2) has a diameter much greater than that of the articulation surface (15). ) of the metacarpal element (3), that is to say a diameter at least 20% greater than that of this first articulation surface (7). 6 Prothèse (1) selon l'une des revendications 1 à 5, caractérisée en ce que la surface d'articulation concave (15) a un arrondi de rayon supérieur à celui de la surface d'articulation convexe (7), de manière à permettre des mouvements complexes des surfaces d'articulation l'une par rapport à l'autre, combinant des translations et des pivotements, en conservant des surfaces de contact suffisantes entre les éléments (2, 3).  6 prosthesis (1) according to one of claims 1 to 5, characterized in that the concave articulation surface (15) has a radius radius greater than that of the convex hinge surface (7), so as to allow complex movements of the articulation surfaces relative to each other, combining translations and pivoting, maintaining sufficient contact surfaces between the elements (2, 3). 7 Prothèse (1) selon l'une des revendications 1 à 6, caractérisée en ce 10 que la partie de base (5) de l'élément trapézien (2) est constituée par une tige filetée.  7 prosthesis (1) according to one of claims 1 to 6, characterized in that the base portion (5) of the trapezian element (2) is constituted by a threaded rod. 8 Prothèse (1) selon la revendication 7, caractérisée en ce que l'élément trapézien (2) comprend des moyens pour son entraînement en rotation, tels que des méplats.  8 prosthesis (1) according to claim 7, characterized in that the trapezian element (2) comprises means for driving it in rotation, such as flats. 9 Gamme d'éléments permettant la constitution de la prothèse (1) selon l'une des revendications 2 à 8, caractérisée en ce qu'elle comprend au moins deux éléments standard, à savoir l'élément trapézien (2) et la pari:le de base (10) de l'élément métacarpien (3), et une série d'éléments intermédiaires (11) de différentes longueurs, pouvant être chacun assemblé à ladite parsie de base (10).  9 range of elements for constituting the prosthesis (1) according to one of claims 2 to 8, characterized in that it comprises at least two standard elements, namely the trapezian element (2) and the bet: the base (10) of the metacarpal element (3), and a series of intermediate elements (11) of different lengths, each of which can be assembled to said base parsie (10).
FR0501460A 2005-02-14 2005-02-14 TRAPEZO-METACARPIAN PROSTHESIS AND RANGE OF ELEMENTS PERMITTING THE CONSTITUTION OF THIS PROSTHESIS Expired - Fee Related FR2881945B1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2912899A1 (en) * 2007-02-28 2008-08-29 Small Bone Innovations Interna Trapezo-metacarpal joint prosthesis, has trapezo-scaphoid component with body screwed in scaphoid, and metacarpal component with part forming rod inserted in cavity in metacarpal and with another cavity cooperated with joint head

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2724310A1 (en) * 1994-09-09 1996-03-15 Medinov Sa Modular prosthesis for short bones in the hand or foot
US6459948B1 (en) * 1996-07-03 2002-10-01 The Trustees Of Columbia University In The City Of New York Anatomically correct prosthesis and method and apparatus for manufacturing prosthesis
US20040236431A1 (en) * 2001-06-28 2004-11-25 Ronald Sekel Universal prosthesis

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2724310A1 (en) * 1994-09-09 1996-03-15 Medinov Sa Modular prosthesis for short bones in the hand or foot
US6459948B1 (en) * 1996-07-03 2002-10-01 The Trustees Of Columbia University In The City Of New York Anatomically correct prosthesis and method and apparatus for manufacturing prosthesis
US20040236431A1 (en) * 2001-06-28 2004-11-25 Ronald Sekel Universal prosthesis

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2912899A1 (en) * 2007-02-28 2008-08-29 Small Bone Innovations Interna Trapezo-metacarpal joint prosthesis, has trapezo-scaphoid component with body screwed in scaphoid, and metacarpal component with part forming rod inserted in cavity in metacarpal and with another cavity cooperated with joint head
WO2008104889A2 (en) * 2007-02-28 2008-09-04 Small Bone Innovations International Trapezometacarpal joint prosthesis
WO2008104889A3 (en) * 2007-02-28 2008-11-20 Small Bone Innovations Interna Trapezometacarpal joint prosthesis

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