WO2022013598A1 - Dispositif d'endoprothèse - Google Patents

Dispositif d'endoprothèse Download PDF

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Publication number
WO2022013598A1
WO2022013598A1 PCT/IB2020/056634 IB2020056634W WO2022013598A1 WO 2022013598 A1 WO2022013598 A1 WO 2022013598A1 IB 2020056634 W IB2020056634 W IB 2020056634W WO 2022013598 A1 WO2022013598 A1 WO 2022013598A1
Authority
WO
WIPO (PCT)
Prior art keywords
proximal
distal
endoprosthesis
section
removable
Prior art date
Application number
PCT/IB2020/056634
Other languages
English (en)
Spanish (es)
Inventor
Juvenal BAYONA
Daniella BAYONA
Nicolas BAYONA
Salena CANTILLO
Original Assignee
Bayona Juvenal
Bayona Daniella
Bayona Nicolas
Cantillo Salena
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 Bayona Juvenal, Bayona Daniella, Bayona Nicolas, Cantillo Salena filed Critical Bayona Juvenal
Priority to PCT/IB2020/056634 priority Critical patent/WO2022013598A1/fr
Publication of WO2022013598A1 publication Critical patent/WO2022013598A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • 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

Definitions

  • the present Invention is related to the field of Medical Sciences and more specifically to the field of internal implants or endoprostheses for the phalanges of the fingers that have suffered some type of amputation, due to mechanical accidents, diseases or other medical diagnoses, the The implant of the present invention replaces the phalanx lost by amputation.
  • Injuries to the distal phalanges of the fingers are one of the most frequent causes of upper limb accidents, and they generally occur in any activity in which the work includes these parts of the body; for example work accidents, home accidents. Also secondary to diseases such as vasculitis.
  • Injuries to the fingers of the hands are very varied and can range from a cut, crushing, partial amputations, complete amputations or disarticulations.
  • Mechanisms of trauma are also diverse and include crushing, avulsion or tearing, blunt trauma, sharp trauma, and short blunt trauma.
  • This type of injury to the fingers of the hand compromises different planes and tissues such as the skin and soft tissues such as tendons, fasciae, bone structures, the nail plate and its base tissues such as the matrix or bed.
  • the most common injuries are usually in the distal phalanges, these structures have a large number of nerve endings and great irrigation, making them extremely sensitive tissues; these distal phalanges present specialized structures, on the back there is the nail which is a conglomerate of horny cells arranged in successive layers; Underlying this, are the bed and the nail matrix, which is a multistratified epithelium and serves for the formation of the nail.
  • the distal portion In the palmar region is the pulpejo in which a proximal portion and a distal portion are distinguished; the distal portion is compartmentalized by fibrous septa that insert, on the one hand, into the deep aspect of the dermis and, on the other, into the periosteum of the phalangeal tuberosity.
  • This distal pad is divided into pyramidal compartments that ensure stability and resistance to the deformation to which the pads are subjected.
  • the organization of the proximal fingertip it is different, since it does not have the support that represents the body of the nail nor is it partitioned radially, so the lobes adopt a spherical shape.
  • stability is the characteristic of the distal pad, what characterizes the proximal pad, on the other hand, is its malleability, which, by adapting its contour to that of the grasped object, improves its adherence and allows a strong grip.
  • the affected part When injuries to the phalanges of the fingers result in amputations, the affected part must be surgically removed to prevent the spread of diseases or infections to the tissues surrounding the injury; on some occasions the tissues can be reimplanted, but in most cases, the trauma mechanism (crushing or avulsion), poor packaging of the lost part, lack of technical and human equipment in the first moments of the accident or loss tissue at the site of injury, contraindicate such a procedure.
  • the surgeon must perform stump remodeling, which may include amputation level elevation, tendon resection, and local or regional skin flaps.
  • a prosthesis is an artificial implant in the body that serves to replace the lost portion and restore the function and appearance of the part that is missing or has been removed from the body for the reasons stated above.
  • the type of prosthesis will depend on the location of the defect, where it will be installed, the length of the finger, the functional needs and the person's lifestyle.
  • a finger prosthesis will be able to restore the length of a partially amputated finger, allow thumb and finger opposition, if the hand is amputated through or above the wrist, even full arm prostheses can be had with one hand electrical or mechanical.
  • Aesthetic prostheses are personalized prostheses made of polymers that simulate the physical appearance of the finger, although they may be very similar to the image of a real finger, they do not have functionality in relation to the lost part, they do not have resistance to movements or common uses such as pressure or to actions such as holding or feeling. They usually have a short life cycle due to the frequency of use or the temperatures to which they are exposed, which makes frequent replacement necessary; further As the user does not have sensitivity in said part, there is also the risk of having more accidents when operating machines or objects that, due to their condition, could generate new traumatic events in the hands of the user who uses this type of prosthesis; in addition, they can also predispose to thermal trauma, local allergic reactions and infections.
  • Another type of prosthesis are the osseointegrated ones that, as its name indicates, integrate the prosthetic element to the bone exceeding the length of the stump, this type of prosthesis creates direct contact between the internal environment of the body and the external environment, increasing the risk of infectious diseases , especially osteomyelitis due to bone exposure, which deteriorate the affected limb and may require implant removal and increased amputation level, further affecting the user's well-being.
  • a passive rehabilitation orthosis of the digital exoskeleton type consisting of a robotic orthosis to carry out passive rehabilitation of the fingers of the hands that is made up of three mechatronic exoskeletons, the exoskeletons can work independently or be integrated according to the needs of each patient.
  • the robotic orthosis features a skin-orthosis interface with leather and neoprene inserts to protect the patient's skin. This type of device does not totally or partially replace any member of the hand, but rather its intention is to reinforce its functions.
  • an orthopedic implant that wears very little despite numerous joint movements
  • an orthopedic implant used in finger arthroplasty comprising a first element for a proximal phalanx and a second element for an adjacent distal phalanx, each element having a respective stem for implantation in bone and an interphalangeal pivot head, the head of the first element having a biconvex condylar pivot surface, having a central valley , and the head of the second element having a biconcave pivot surface designed to spin complementary to the biconvex surface and having a central ridge, characterized in that the surfaces at rest are congruent in the frontal plane of the pivot in the area of the condyles and are not congruent in the sagittal plane.
  • This type of device such as the one in the United States of America patent, is quite common and attempts to replace joint surfaces damaged by different causes such as trauma, infection, arthropathies, etc. or they are also indicated where there are no traumas, to reconstruct and recover the articular movement of the interphalangeal and metacarpophalangeal joints of the fingers.
  • Figure 1 presents a perspective view of the stent device of the present invention.
  • Figure 2 presents a spatial breakdown view of the constituent elements of the endoprosthesis device.
  • Figure 3 presents a detailed view of the removable distal element (3) of the endoprosthesis device.
  • Figure 4 presents a detailed view of the proximal element (5) of the endoprosthesis device.
  • Figure 5 presents another perspective view of the proximal element (5) of the endoprosthesis device where details of the accessories arranged at its lower end are shown.
  • Figure 6 presents a perspective view of the additional element (12) used for the formation of distal pads.
  • Figure 7 presents a perspective view of the coupling of the additional element (12) with the upper element (2) of the prosthesis of the present application.
  • Figure 8 a perspective view of the upper element (2) with the additional element (12) assembled for the formation of distal pads.
  • said device is made up of two main parts, the first of which is a removable distal part (2) through of threaded mechanisms or threaded elements;
  • the second component of the endoprosthesis is a proximal element (5) that has a guide stop (8) that has a starting point and separates the two threads of the screw in a first section which goes to this guide stop (8) and a second section.
  • the removable distal element has an ellipse geometric shape that has a distal end (3) and a proximal end (4), the proximal end (4) of the first part of the endoprosthesis ends in a truncated cut that internally has a thread mechanism (6) that serves to adequately connect this distal part with the fixing thread element of the head (7) of the second proximal element (5) of the endoprosthesis.
  • This distal element (2) can also house an additional element (12), this element (12) has three clearly differentiated sections, the first of which is an upper section that has a fastening device or element or hook (18) to which A guide element (14) is attached and inserted into a hole (20) in the distal end (3) of the removable element (2).
  • the central section (17) has the shape of an ellipse which is truncated in its lower part of the additional element (12) through the lower section (15) of the additional element (12) which also has a threaded hole (16), said central section (17) is fixed by a suitable means, such as a screw, to a threaded hole (19) made in the palmar surface of the removable distal component of the prosthesis (2).
  • This distal element (2) with the additional element (12) can be covered with other materials such as polymers to resemble the structure and characteristics of a distal pad, in such a way that a larger contact area is formed and the friction index is increased. reducing the displacement of the skin of the flap on the prosthesis; the additional element (12) will be used depending on the type of amputation and depending on the flap required for the reconstruction of the affected finger.
  • the proximal element (5) in a threaded conical shape generally has three sections, the first of which is a head where there is a fixing thread element (7) that receives said removable distal element (2); the first section also has, as indicated above, a stop element (8); this element stops the advancement of the first part of the endoprosthesis or distal element (2) until said mark, said mark or guide defines the point where the central part of said lower element is inserted in the intramedullary canal of the phalanx of the hand of the user; this second part of the lower element is housed in the middle phalanx of the second to fourth finger and in the proximal phalanx of the thumb of the user's hand.
  • the endoprosthesis configuration shown here is intended to replace the distal phalanx lost by a person due to some underlying pathology or trauma to this part of the fingers.
  • the second section of the proximal element (5) of the endoprosthesis has in its proximal part some point elements (9) and (10) that serve to self-drill the hole in the head of the middle phalanx and the intramedullary canal and make the thread.
  • some point elements (9) and (10) that serve to self-drill the hole in the head of the middle phalanx and the intramedullary canal and make the thread.
  • of the same screw in the phalanx that is, it has the ability to advance as it is rotated, creating its own thread at the same time. This capacity is possible thanks to a gap in the continuity of the screw thread, so that the edges of the screw cut a thread as the screw enters the bone, the cutting point pierces the bone, leaving a hole through it.
  • the optimal performance measures of the endoprosthesis (1) of the present invention are, in terms of the removable upper element (2), a height that is between 8 mm to 35 mm and a width between 6 mm to 20 mm and a thickness of 4 mm to 15 mm.
  • the height dimensions can be between 12 mm to 30 mm and a width between 2 mm to 8 mm.
  • the proximal element of the endoprosthesis can also be coated with materials based on calcium, phosphorus or other material that promotes osseointegration of the endoprosthesis element on the bone surface of the human body.

Landscapes

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

Abstract

La présente invention a pour objet un dispositif d'endoprothèse qui est conçu pour remplacer le composant osseux des phalanges distales des doigts de la main qui ont subi un quelconque type d'amputation à cause d'accidents ou de maladies et permettre la reconstruction de ladite partie amputée du corps de l'utilisateur.
PCT/IB2020/056634 2020-07-14 2020-07-14 Dispositif d'endoprothèse WO2022013598A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/IB2020/056634 WO2022013598A1 (fr) 2020-07-14 2020-07-14 Dispositif d'endoprothèse

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IB2020/056634 WO2022013598A1 (fr) 2020-07-14 2020-07-14 Dispositif d'endoprothèse

Publications (1)

Publication Number Publication Date
WO2022013598A1 true WO2022013598A1 (fr) 2022-01-20

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PCT/IB2020/056634 WO2022013598A1 (fr) 2020-07-14 2020-07-14 Dispositif d'endoprothèse

Country Status (1)

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WO (1) WO2022013598A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2651119A1 (fr) * 1989-08-23 1991-03-01 Felman Daniel Prothese articulaire phalangienne.
US7291175B1 (en) * 2005-01-06 2007-11-06 David J Gordon Metatarsal phalangeal implant with locking screw
US20080195233A1 (en) * 2006-10-13 2008-08-14 Irene Ferrari Ankle prosthesis for the arthrodesis of the calcaneum
US20120296439A1 (en) * 2011-05-16 2012-11-22 Slavitt Jerome A Joint Resurfacing Prosthetic Implant System
US20140107712A1 (en) * 2012-10-12 2014-04-17 Smith & Nephew, Inc. Fusion implant
US20150351921A1 (en) * 2014-06-04 2015-12-10 Sarah Miller Apparatus and method for replacement of a metatarsophalangeal joint with interphalangeal fusion
US20180049881A1 (en) * 2014-08-12 2018-02-22 Neutin Orthopedics, LLC Titanium Plasma Coated Medical Grade Thermoplastic Or Polymer Proximal and Distal Interphalangeal Toe Implant

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2651119A1 (fr) * 1989-08-23 1991-03-01 Felman Daniel Prothese articulaire phalangienne.
US7291175B1 (en) * 2005-01-06 2007-11-06 David J Gordon Metatarsal phalangeal implant with locking screw
US20080195233A1 (en) * 2006-10-13 2008-08-14 Irene Ferrari Ankle prosthesis for the arthrodesis of the calcaneum
US20120296439A1 (en) * 2011-05-16 2012-11-22 Slavitt Jerome A Joint Resurfacing Prosthetic Implant System
US20140107712A1 (en) * 2012-10-12 2014-04-17 Smith & Nephew, Inc. Fusion implant
US20150351921A1 (en) * 2014-06-04 2015-12-10 Sarah Miller Apparatus and method for replacement of a metatarsophalangeal joint with interphalangeal fusion
US20180049881A1 (en) * 2014-08-12 2018-02-22 Neutin Orthopedics, LLC Titanium Plasma Coated Medical Grade Thermoplastic Or Polymer Proximal and Distal Interphalangeal Toe Implant

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