FR2666221A1 - Module prothetique de croissance, extensible. - Google Patents

Module prothetique de croissance, extensible. Download PDF

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Publication number
FR2666221A1
FR2666221A1 FR9010981A FR9010981A FR2666221A1 FR 2666221 A1 FR2666221 A1 FR 2666221A1 FR 9010981 A FR9010981 A FR 9010981A FR 9010981 A FR9010981 A FR 9010981A FR 2666221 A1 FR2666221 A1 FR 2666221A1
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FR
France
Prior art keywords
module
tail
reconstruction
moving part
screw
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
FR9010981A
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English (en)
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FR2666221B1 (fr
Inventor
Missenard Gilles
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Individual
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Individual
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Publication of FR2666221A1 publication Critical patent/FR2666221A1/fr
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • 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
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    • A61F2/28—Bones
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    • 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
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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
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/005—Rosette-shaped, e.g. star-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
    • 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
    • A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0082—Additional features; Implant or prostheses properties not otherwise provided for specially designed for children, e.g. having means for adjusting to their growth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

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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

La présente invention concerne un module prothétique de croissance (10) extensible, comportant un corps (11), une pièce mobile (12) reliée à une queue de reconstruction à ancrage diaphysaire (1), et une bague introduite dans un évidement (15) du corps (11), la rotation de cette bague entraînant le déplacement longitudinal de la pièce mobile. Application aux implants prothétiques destinés principalement aux enfants.

Description

MODULE PROTHETIQUE DE CROISSANCE, EXTENSIBLE.
La présente invention concerne un module prothetique de croissance, extensible, et destiné principalement au traitement des tumeurs osseuses primitives chez les enfants.
Les modules de croissance connus fonctionnent tous sur le principe du ridoir, c'est-à-dire qu'ils comportent une vis sans fin tournant dans deux butées situées chacune à une extrémité du module.
Ces modules présentent deux inconvénients.
En effet, sous l'action de contraintes de rotation, ces modules se de' verrouillent constamment et la vis sans fin n'est alors plus bloquée en rotation.
De plus, ces modules ne sont pas adaptables à des queues de reconstruction anatomique à ancrage diaphysaire conique autobloquant, et, en fin de croissance, la mise en place d'une prothèse définitive oblige à changer le module, mais également la queue de reconstruction alors que son scellement diaphysaire est généralement bon.
La présente invention a pour but d'éliminer ces inconvénients.
Le module selon l'invention permet un blocage efficace, indépendant des contraintes de rotation, de sa pièce mobile par rapport à sa pièce fixe, un blocage efficace entre ce module et une queue de reconstruction à ancrage diaphysaire, et aussi une désolidarisation aisée de ce module avec la queue de reconstruction à ancrage diaphysaire.
La présente invention a pour objet un module prothétique de croissance, extensible, comportant un corps relié de manière articulée ou non à un autre module fixé dans un os en regard, et une pièce mobile reliée à â une queue de reconstruction à ancrage diaphysaire.
Selon l'invention, ce module comporte une bague tournante, introduite dans un évidement du corps et munie d'un orifice central fileté et traversé par la pièce mobile, le corps comportant au moins une vis empêchant la rotation de la pièce mobile, la rotation de la bague entraînant alors le déplacement longitudinal de la pièce mobile, ce qui rend ce module extensible.
Selon une autre caractéristique de 1 invention, la ou les vis qui empêchent la rotation de la pièce mobile, assurent également un blocage longitudinal efficace de la pièce mobile, après réglage de la longueur du module.
Selon une autre caractéristique de 1 invention, la pièce mobile comporte une embase munie d'un orifice borgne comportant un cône morse femelle et un crantage permettant la réception d'une queue de reconstruction à ancrage diaphysaire munie d'un cône morse mâle et d'un crantage complémentaire, ce qui rend ais la désolidarisation entre le module et la queue de reconstruction à ancrage diaphysaire.
Selon une autre caractéristique de 1 invention, l'embase comporte une vis dont une extrémité est engagée dans une rainure de la queue de reconstruction à ancrage diaphysaire, cette vis assurant une bonne immobilisation de la queue sur le module prothétique.
Il est décrit ci-après, à titre d'exemple et en référence aux dessins annexés, un module prothétique selon l'invention.
La figure 1 montre le module et une partie d'une queue de reconstruction à ancrage diaphysaire;
la figure 2 est une coupe selon Il de la figure 1.
Dans la figure , le module 10 comporte un corps 11, une pièce mobile 12 et une bague filetée 13.
Le corps 10 comporte, sur pratiquement toute sa longueur, un orifice central 14 à paroi lisse, un évidement 15 permettant l'introduction de la bague 13 et enfin deux orifices filetés 16 et 17 permettant l'introduction de deux vis de guidage et de blocage 24,25. Ce corps comporte également un orifice 27 assurant sa fixation à un autre module fixé dans l'os en regard qui peut être, par exemple, le tibia.
La pièce mobile 12 est constituée principalement d'une partie filetée 18 qui pénètre dans l'orifice 14 du corps 11, et une embase 19 qui reçoit l'extrémité d'une queue de reconstraction 1 logée dans le fémur, par exemple.
La partie 18 de la pièce mobile 12 du module comporte, sur toute la longueur filetée, une encoche 29 mieux visible en figure 2, dans laquelle viennent s engager les vis 24 et 25.
L'embase 19 comporte, en regard de la partie filetée, un orifice comportant un cône morse femelle 20 et une partie cylindrique munie d'un crantage 21. Ce cône morse 20 reçoit un cône mâle complémentaire 2 de la queue 1 et le crantage 21 reçoit un crantage complémentaire 4 de la queue 1. Entre le cône morse mâle 2 et le crantage mâle 4, la queue est munie d'une rainure 3 et, entre le cône morse femelle 20 et le crantage femelle 21, l'embase 19 est munie d'un orifice fileté 22 recevant une vis 23 dont l'extrémité s'engage dans la rainure 3 de la queue 1, afin de solidariser en translation la queue 1 et la pièce mobile 12 du module.
La bague filetée 13, engagée dans l'évidement 15 du corps 11, comporte huit orifices 26 répartis sur sa circonférence et permettant sa rotation au moyen d'un outil spécial engagé dans un orifice 26.
La queue de reconstruction 1 est une queue à ancrage sans ciment, fabriquée en titane pour augmenter sa résistance et avoir une élasticité plus proche de celle de l'os. Seule l'extrémité de cette queue est représentée, mais bien entendu, cette queue a une forme conique adaptée au canal médullaire de l'os, de façon à favociser l'augmentation de la surface de contact ainsi que l'ancrage osseux. Cet ancrage se fera directement sur la queue après recouvrement de celle-ci d'une substance ostéo-inductrice.
La queue 1 comporte en outre un orifice 5 qui permet le verrouillage de cette queue sur l'os.
Un tel module est mis en place de la manière suivante
après avoir engage la queue à ancrage diaphysaire dans l'os, le module est mis en place suc l'extcémité de la queue, et la vis 23 est bloquée, assurant ainsi l'immobilisation longitudinale entre la queue et le module. Le corps du module est ensuite connecté, au moyen de l'orifice 27, au module en vis-à-vis.
Quand l'enfant grandit, il est nécessaire de temps à autre, de rallonger le module et l'opération s'effectue alors de la manière suivante
après déblocage des vis 24 et 25, le chirurgien fait tourner, àa'l'aide d'un outil spécial engagé successivement dans les orifices 26, la bague 13 dans le sens approprié à l'allongement de ce module.
arrivé à l'allongement désiré, on bloque les deux vis 24 et 25.
En cas de nécessités techniques, on peut facilement enlever le module prot'nétique pour le remplacer par un autre module, ou en fin de croissance, on peut remplacer le module par un module adulte, sans retirer la queue de reconstruction 1. Pour ce faire, il suffit de débloquer la vis 23 et de désolidariser 1'embase 19 de la queue 1.

Claims (4)

REVENDICATIONS
1. Module prothFtique de croissance (10), extensible, comportant un corps (11) relié à un autre module fixé dans un os en regard, une pièce mobile (12) reliée à une queue de reconstruction (1) à ancrage diaphysaire, caractérisé en ce qa'il comporte une bague (13) tournante, introduite dans un évidement (15) du corps et munie d'un orifice central fileté et traversé par la pièce mobile, le corps comportant au moins une vis (24,25) empêchant la rotation de la pièce mobile, la rotation de la bague entraînant alors le déplacement longitudinal de la pièce mobile.
2. Module selon la revendication 1, caractérisé en ce que la vis (24,25) du corps qui empêche la rotation de la pièce mobile, assure également le blocage longitudinal de la pièce mobile, après réglage de la longueur du module.
3. Module selon l'une des revendications 1 ou 2, caractérisé en ce que la pièce mobile (12) comporte une embase (19) munie d'un orifice borgne comportant un cône morse femelle (20) et un crantage (21), permettant la réception de la queue de reconstruction à ancrage diaphysaire (1) munie d'un cône morse mâle (2) et d'un crantage (4) complémentaire.
4. Module selon l'une des revendications 1 à 3, caractérisé en ce que l'embase (19) de la pièce mobile (12) comporte une vis (23) dont une extrémité est engagée dans une rainure (3) de la queue de reconstruction (1).
FR9010981A 1990-09-04 1990-09-04 Module prothetique de croissance, extensible. Expired - Fee Related FR2666221B1 (fr)

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5466261A (en) * 1992-11-19 1995-11-14 Wright Medical Technology, Inc. Non-invasive expandable prosthesis for growing children
WO1997047258A1 (fr) * 1996-06-07 1997-12-18 Ulrich, Heinrich Implant a inserer entre des vertebres pour occuper un espace vide
FR2758976A1 (fr) * 1997-01-31 1998-08-07 Jean Louis Herve Prothese de croissance, et notamment prothese femorale
EP1093777A3 (fr) * 1999-10-22 2002-04-10 Keramed Medizintechnik GmbH Endoprothèse d'épaule
EP1332732A2 (fr) * 2002-01-18 2003-08-06 Depuy Orthopaedics, Inc. Prothèse d'os long reglable
EP1088530B1 (fr) * 1999-09-24 2006-06-28 WALDEMAR LINK GmbH & Co. KG Prothése alloplastique pour un os long
WO2011154156A1 (fr) * 2010-06-11 2011-12-15 Waldemar Link Gmbh & Co. Kg Prothèse pour le remplacement partiel d'un os long

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1501453B2 (fr) 2003-05-14 2010-06-30 Kilian Kraus Implant reglable en hauteur destine a etre insere entre des vertebres et outil de manipulation
CN105662663B (zh) * 2016-03-18 2017-12-26 王威 一种可自动延伸的假体

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0000549A1 (fr) * 1977-07-29 1979-02-07 Bayer Ag Endoprothèse
DE3336004A1 (de) * 1983-10-04 1985-06-27 S + G Implants GmbH, 2400 Lübeck Endoprothese als ersatz fuer knochen mit zu entfernendem kranken knochenteil
EP0290767A1 (fr) * 1987-05-15 1988-11-17 Howmedica GmbH Endoprosthèse pour parties d'articulation fémorales ou tibiales et parties osseuses voisines

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0000549A1 (fr) * 1977-07-29 1979-02-07 Bayer Ag Endoprothèse
DE3336004A1 (de) * 1983-10-04 1985-06-27 S + G Implants GmbH, 2400 Lübeck Endoprothese als ersatz fuer knochen mit zu entfernendem kranken knochenteil
EP0290767A1 (fr) * 1987-05-15 1988-11-17 Howmedica GmbH Endoprosthèse pour parties d'articulation fémorales ou tibiales et parties osseuses voisines

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5466261A (en) * 1992-11-19 1995-11-14 Wright Medical Technology, Inc. Non-invasive expandable prosthesis for growing children
WO1997047258A1 (fr) * 1996-06-07 1997-12-18 Ulrich, Heinrich Implant a inserer entre des vertebres pour occuper un espace vide
US6015436A (en) * 1996-06-07 2000-01-18 Heinrich Ulrich Implant for filling a space between vertebrae
FR2758976A1 (fr) * 1997-01-31 1998-08-07 Jean Louis Herve Prothese de croissance, et notamment prothese femorale
EP1088530B1 (fr) * 1999-09-24 2006-06-28 WALDEMAR LINK GmbH & Co. KG Prothése alloplastique pour un os long
EP1093777A3 (fr) * 1999-10-22 2002-04-10 Keramed Medizintechnik GmbH Endoprothèse d'épaule
US6524342B1 (en) 1999-10-22 2003-02-25 Keramed Medizintechnik Gmbh Shoulder endoprosthesis
EP1332732A2 (fr) * 2002-01-18 2003-08-06 Depuy Orthopaedics, Inc. Prothèse d'os long reglable
EP1332732A3 (fr) * 2002-01-18 2005-04-13 Depuy Orthopaedics, Inc. Prothèse d'os long reglable
WO2011154156A1 (fr) * 2010-06-11 2011-12-15 Waldemar Link Gmbh & Co. Kg Prothèse pour le remplacement partiel d'un os long
RU2532891C2 (ru) * 2010-06-11 2014-11-10 Вальдемар Линк Гмбх Унд Ко. Кг Протез для частичной замены трубчатой кости
KR101493922B1 (ko) 2010-06-11 2015-02-16 발데마르 링크 게엠베하 운트 코.카게 관형 뼈의 부분 교체용 보철물

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