JPH02501447A - 大腿股関節用の義肢 - Google Patents

大腿股関節用の義肢

Info

Publication number
JPH02501447A
JPH02501447A JP63505694A JP50569488A JPH02501447A JP H02501447 A JPH02501447 A JP H02501447A JP 63505694 A JP63505694 A JP 63505694A JP 50569488 A JP50569488 A JP 50569488A JP H02501447 A JPH02501447 A JP H02501447A
Authority
JP
Japan
Prior art keywords
prosthesis
shaft
prosthetic
intramedullary nail
femoral hip
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.)
Pending
Application number
JP63505694A
Other languages
English (en)
Japanese (ja)
Inventor
マテツク,クラウス
ベルナー,マルテイン
Original Assignee
ケルンフオルシユングスツエントルム カールスルーエ ゲゼルシヤフト ミツト ベシユレンクテル ハフツング
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by ケルンフオルシユングスツエントルム カールスルーエ ゲゼルシヤフト ミツト ベシユレンクテル ハフツング filed Critical ケルンフオルシユングスツエントルム カールスルーエ ゲゼルシヤフト ミツト ベシユレンクテル ハフツング
Publication of JPH02501447A publication Critical patent/JPH02501447A/ja
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • 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
    • A61F2/30721—Accessories
    • A61F2/30728—Collars; Bone edge protectors
    • 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
    • A61F2/30721—Accessories
    • A61F2/30739—Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of shafts
    • 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
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • 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
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • 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
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
    • 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

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
JP63505694A 1987-07-10 1988-07-08 大腿股関節用の義肢 Pending JPH02501447A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE3722853.6 1987-07-10
DE19873722853 DE3722853A1 (de) 1987-07-10 1987-07-10 Endoprothese fuer ein femurhueftgelenk

Publications (1)

Publication Number Publication Date
JPH02501447A true JPH02501447A (ja) 1990-05-24

Family

ID=6331322

Family Applications (1)

Application Number Title Priority Date Filing Date
JP63505694A Pending JPH02501447A (ja) 1987-07-10 1988-07-08 大腿股関節用の義肢

Country Status (5)

Country Link
US (1) US5167666A (en:Method)
EP (1) EP0367779B1 (en:Method)
JP (1) JPH02501447A (en:Method)
DE (1) DE3722853A1 (en:Method)
WO (1) WO1989000414A1 (en:Method)

Families Citing this family (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GR1000872B (el) * 1989-10-31 1993-03-16 Konstantinos Protogirou Αγκύρωσις των προ?έσεων ισχίου και γόνατος δια προεντάσεως και ε την παρεμβολή αρ?ρώσεως.
US5571203A (en) * 1993-06-18 1996-11-05 Masini; Michael A. Bone-conserving hip system
US5458654A (en) * 1993-07-14 1995-10-17 Ao-Forschungsinstitut Davos Screw-fixed femoral component for hip joint prosthesis
GB2299941A (en) * 1995-04-20 1996-10-23 Halifax Orthopaedic Research L Securing means for an intramedullary rod
US5776194A (en) * 1996-04-25 1998-07-07 Nuvana Medical Innovations, Llc Intermedullary rod apparatus and methods of repairing proximal humerus fractures
DE19725269C2 (de) * 1997-06-16 1999-11-04 Gamal Baroud Schenkelhals-Totalhüftendoprothese
DE19925829A1 (de) * 1999-06-07 2000-12-14 Hubert Michael Hirt Verfahren zur dynamischen metaphysären Krafteinleitung bei Femurkomponenten in der Hüftgelenksendoprothetik
BR0110445A (pt) * 2000-05-25 2003-04-08 Lionel C Sevrain Sistema de ancoramento para fixar objetos a ossos
US7963966B2 (en) 2000-06-06 2011-06-21 Cole J Dean Bone fixation system and method of use
US6527775B1 (en) 2000-09-22 2003-03-04 Piper Medical, Inc. Intramedullary interlocking fixation device for the distal radius
US20060015101A1 (en) 2004-07-15 2006-01-19 Wright Medical Technology, Inc. Intramedullary fixation assembly and devices and methods for installing the same
US7588577B2 (en) 2004-07-15 2009-09-15 Wright Medical Technology, Inc. Guide assembly for intramedullary fixation and method of using the same
US20090157078A1 (en) * 2007-12-17 2009-06-18 Mikol Edward J Apparatus and Methods of Repairing Bone Defects
US8771283B2 (en) 2007-12-17 2014-07-08 Wright Medical Technology, Inc. Guide assembly for intramedullary fixation and method of using the same
EP2468216B1 (de) * 2010-12-23 2014-05-14 Baumgart, Rainer, Dipl.-Ing. Dr. med. Implantierbare Prothese zum Ersatz des menschlichen Hüft- oder Kniegelenks und der angrenzenden Knochenabschnitte
US8652136B2 (en) 2011-08-15 2014-02-18 Zimmer, Gmbh Femoral fracture fixation device
US8262709B1 (en) * 2011-09-24 2012-09-11 Powlan Roy Y Device and method for femoral neck fracture fixation
US9289304B1 (en) 2013-03-28 2016-03-22 Robert A. Kaufmann Prosthesis for partial and total joint replacement
US10492803B2 (en) 2016-09-22 2019-12-03 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
US11083503B2 (en) 2016-09-22 2021-08-10 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
US10299847B2 (en) 2016-09-22 2019-05-28 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
US11045242B2 (en) 2016-09-22 2021-06-29 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
US10751096B2 (en) 2016-09-22 2020-08-25 Bala Sundararajan Systems and methods for intramedullary nail implantation
US12594108B2 (en) 2016-09-22 2026-04-07 Globus Medical Inc. Systems and methods for intramedullary nail implantation
US10492839B2 (en) * 2017-04-30 2019-12-03 Felasfa Wodajo Expandable osseointegration bone fixation apparatus for use in a variety of settings
MX2020003481A (es) 2017-10-11 2020-12-07 Howmedica Osteonics Corp Guias para placa de fijacion de la cabeza humeral.
US10828147B1 (en) 2018-01-21 2020-11-10 Robert A. Kaufmann Ligament retention device
KR20220024218A (ko) * 2019-06-12 2022-03-03 더 거벌먼트 오브 디 유나이티드 스테이츠 오브 아메리카 애즈 리프레젠티드 바이 더 디파트먼트 오브 베테랑스 어페어스 대퇴골두 관절성형 시스템
US11633219B2 (en) 2019-06-26 2023-04-25 Globus Medical, Inc. Fenestrated pedicle nail
CN121512753B (zh) * 2026-01-15 2026-03-27 北京爱康宜诚医疗器材有限公司 一种股骨柄假体

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3793650A (en) * 1971-09-24 1974-02-26 Nat Res Dev Prosthetic bone joint having a spacer device
JPS5740777A (en) * 1980-08-22 1982-03-06 Victor Co Of Japan Ltd High-speed tape feed system of recordng and reproducing device
JPS58206746A (ja) * 1982-04-19 1983-12-02 ウイリアム・エツチ・ハリス 尻部補綴用大腿要素

Family Cites Families (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH529552A (de) * 1970-10-13 1972-10-31 Mathys Robert Schenkelhalsprothese
US3843975A (en) * 1973-04-09 1974-10-29 R Tronzo Prosthesis for femoral shaft
DE2832555A1 (de) * 1978-07-25 1980-02-07 Sigri Elektrographit Gmbh Hueftgelenkprothese
FR2483218B1 (fr) * 1980-05-30 1986-06-27 Cuilleron J Tige femorale pour prothese de hanche
DE3028393A1 (de) * 1980-07-26 1982-02-11 Efstathios Thessaloniki Koutrolikos Femur-endoprothese
CH650400A5 (fr) * 1981-12-08 1985-07-31 Jean Butel Procede de fabrication d'une prothese de hanche a tige flexible.
CH652911A5 (de) * 1982-01-29 1985-12-13 Sulzer Ag Gerader, blattartiger schaft fuer eine gelenkendoprothese.
DE8206558U1 (de) * 1982-03-05 1983-10-27 Faensen, Michael, Dr.med., 1000 Berlin Vorrichtung, bestehend aus einem hohlen Knochennagel und einer mit diesem verbundenen Hüftgelenkprothese
DE3216538A1 (de) * 1982-05-03 1983-11-03 Waldemar Link (Gmbh & Co), 2000 Hamburg Knochenimplantat, insbesondere femorale hueftgelenkprothese
DE3334058C2 (de) * 1983-09-21 1985-07-25 Ulrich Dr.-Ing. 5600 Wuppertal Witzel Oberschenkelteil für eine Hüftgelenkendoprothese
DE3426947C2 (de) * 1984-06-07 1986-10-16 Harry Prof. Dr.med. 1000 Berlin Buse Oberschenkelteil einer Hüftgelenk-Endoprothese
DE3526204A1 (de) * 1984-07-26 1986-03-06 Ivica 7200 Tuttlingen Jerković Gelenkendoprothese, insbesondere hueftgelenkprothese
SU1255122A1 (ru) * 1985-04-01 1986-09-07 Ленинградский Ордена Ленина Государственный Институт Усовершенствования Врачей Им.С.М.Кирова Эндопротез тазобедренного сустава
DE3516203A1 (de) * 1985-05-06 1986-11-06 Metripond Mérleggyár, Hódmezövásárhely Hueftgelenkprothese
CH666178A5 (de) * 1985-06-12 1988-07-15 Sulzer Ag Femurkopfprothese.
DE3522692A1 (de) * 1985-06-25 1987-01-08 S & G Implants Gmbh Femurhueftgelenk-endoprothese
FR2591885B1 (fr) * 1985-12-24 1990-06-15 Mai Christian Prothese autobloquante, procedes pour la fabriquer et la mettre en place
DE3775707D1 (de) * 1986-10-25 1992-02-13 Paulo Gallinaro Hueftgelenksprothese.
FR2614524B1 (fr) * 1987-04-30 1992-07-31 Butel Jean Perfectionnement aux parties femorales de protheses de hanche

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3793650A (en) * 1971-09-24 1974-02-26 Nat Res Dev Prosthetic bone joint having a spacer device
JPS5740777A (en) * 1980-08-22 1982-03-06 Victor Co Of Japan Ltd High-speed tape feed system of recordng and reproducing device
JPS58206746A (ja) * 1982-04-19 1983-12-02 ウイリアム・エツチ・ハリス 尻部補綴用大腿要素

Also Published As

Publication number Publication date
US5167666A (en) 1992-12-01
DE3722853A1 (de) 1989-01-19
DE3722853C2 (en:Method) 1991-01-10
EP0367779B1 (de) 1992-04-15
WO1989000414A1 (fr) 1989-01-26
EP0367779A1 (de) 1990-05-16

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