FR2805151A1 - Prothese trapezo-metacarpienne a mobilite amelioree - Google Patents

Prothese trapezo-metacarpienne a mobilite amelioree Download PDF

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Publication number
FR2805151A1
FR2805151A1 FR0002099A FR0002099A FR2805151A1 FR 2805151 A1 FR2805151 A1 FR 2805151A1 FR 0002099 A FR0002099 A FR 0002099A FR 0002099 A FR0002099 A FR 0002099A FR 2805151 A1 FR2805151 A1 FR 2805151A1
Authority
FR
France
Prior art keywords
prosthesis
intended
prosthesis according
fact
coupling
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
FR0002099A
Other languages
English (en)
Other versions
FR2805151B1 (fr
Inventor
Yves Allieu
Philippe Escare
Robert Gomis
Jean Luc Roux
Henri Connes
Jean Pierre Pequignot
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
CREMASCOLLI ORTHO S A
Original Assignee
CREMASCOLLI ORTHO S A
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by CREMASCOLLI ORTHO S A filed Critical CREMASCOLLI ORTHO S A
Priority to FR0002099A priority Critical patent/FR2805151B1/fr
Priority to FR0009402A priority patent/FR2805152B1/fr
Publication of FR2805151A1 publication Critical patent/FR2805151A1/fr
Application granted granted Critical
Publication of FR2805151B1 publication Critical patent/FR2805151B1/fr
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • 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
    • 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
    • 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
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • 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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
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    • A61F2002/30233—Stepped cylinders, i.e. having discrete diameter changes
    • A—HUMAN NECESSITIES
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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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
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    • A—HUMAN NECESSITIES
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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
    • 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
    • A61F2002/30329—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
    • A61F2002/30362—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
    • 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
    • A61F2002/30362—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
    • A61F2002/30369—Limited lateral translation of the protrusion within a larger 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A—HUMAN NECESSITIES
    • 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
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
    • A61F2002/30398—Sliding
    • A61F2002/30401—Sliding with additional means for preventing or locking said sliding
    • A—HUMAN NECESSITIES
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A—HUMAN NECESSITIES
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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
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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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
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30495—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking ring
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30574—Special structural features of bone or joint prostheses not otherwise provided for with an integral complete or partial collar or flange
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
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Landscapes

  • 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 une prothèse trapézo-métacarpienne comprenant un premier élément (2) destiné à être inséré dans le métacarpe de la main d'un patient, un second élément (6) destiné à relier ce premier élément à un troisième élément (7) destiné à être inséré dans le trapèze de la main du patient. Selon l'invention l'accouplement entre le second élément et le premier élément permet le jeu radial entre le premier élément et le second élément.

Description

La présente invention concerne une prothèse trapézo-métacarpienne à
mobilité amé-
liorée. Plus précisément, l'invention concerne une prothèse trapézométacarpienne qui
permet de récupérer presque totalement les fonctions de l'articulation trapézo-
métacarpienne d'un patient.
Comme l'on sait, suite à des pathologies arthrosiques affectant la main, les fonctions du pouce, c'est-à-dire de l'articulation entre le trapèze et le métacarpe de la main, peuvent
être fortement compromises au point que le patient, en plus de souffrir de douleurs inten-
ses, ne dispose plus des fonctions optimales du pouce et que, par conséquent, lors même de
tentatives de préhension tout à fait normales il ne peut réussir à achever cette opération.
Pour faire face à une situation du type susmentionné, existent actuellement différen-
tes techniques qui ont pour objectif de récupérer les fonctions du trapèze et du métacarpe.
Une première technique, connue, consiste à souder le trapèze et le métacarpe entre eux, avec pour résultat que le patient ne souffre plus, mais avec l'inconvénient de perdre
les fonctions de la main.
Une seconde technique, également de type chirurgical, prévoit de prélever des liga-
ments d'une région du corps différente de la main et d'implanter ces ligaments entre le trapèze et le métacarpe pour pouvoir en récupérer les fonctions. Toutefois, cette seconde
technique n'a pas la faveur des spécialistes car on obtient des résultats non satisfaisants.
Une troisième technique opératoire prévoit d'insérer entre le trapèze et le métacarpe une prothèse appropriée. L'insertion de la prothèse doit avoir lieu en réséquant des portions
des deux os de façon à pouvoir définir des logements pour la prothèse.
Les prothèses de type connu prévoient une tige destinée à être insérée dans le méta-
carpe, un col qui est inséré d'un côté dans la tige et se termine à l'extrémité opposée avec une tête sphérique qui s'engage dans un logement complémentaire défini dans une cotyle
qui est elle-même bloquée dans le trapèze de la main.
L'emploi du type de prothèse décrit pâtit toutefois de certains inconvénients, princi-
palement dus au fait que l'alignement entre la tige insérée dans le métacarpe et la cotyle
insérée dans le trapèze, n'est pas toujours optimal, soit en raison d'une différence congé-
nitale entre trapèze et métacarpe de patient à patient, soit parce que la définition des em-
placements dans le métacarpe et dans le trapèze peut ne pas être suffisamment précise pour
permettre un alignement parfait entre la tige et la cotyle correspondante.
En outre, l'opération de flexion du pouce en opposition à la paume de la main provo-
que un effet de rotation de la cotyle dans le logement correspondant qui peut conduire à un déboîtement de la cotyle hors du logement, compromettant ainsi l'implantation prothéti- que.
La fonction principale de la présente invention est de réaliser une prothèse trapézo-
métacarpienne qui permette d'éliminer la nécessité d'un alignement parfait entre la portion de prothèse insérée dans le métacarpe et la portion de prothèse destinée à être insérée dans
le trapèze.
Dans le cadre de cette fonction, l'un des buts de la présente invention est de réaliser une prothèse trapézo-métacarpienne qui permette d'avoir un certain jeu entre la portion de
prothèse insérée dans le métacarpe et la portion de prothèse insérée dans le trapèze.
Un autre but de la présente invention est celui de réaliser une prothèse trapézo-
métacarpienne qui permette une flexion optimale du pouce en opposition à la paume de la main.
Un autre but de la présente invention est de réaliser une prothèse trapézo-
métacarpienne qui permette une mobilité, aussi bien dans le sens rotatoire que dans un sens
radial entre la portion de prothèse insérée dans le métacarpe et la portion de prothèse insé-
rée dans le trapèze.
Un autre but, qui n'est pas le dernier, de la présente invention est de réaliser une prothèse trapézo-métacarpienne qui soit d'une grande fiabilité, de réalisation relativement
facile et à des coûts compétitifs.
Cette fonction, ainsi que ces buts et d'autres qui apparaîtront mieux par la suite, sont
obtenus grâce à une prothèse trapézo-métacarpienne comprenant un premier élément des-
tiné à être inséré dans le métacarpe de la main d'un patient, un second élément destiné à relier ce premier élément à un troisième élément prothétique destiné à être inséré dans le trapèze de la main du patient, ladite prothèse étant caractérisée par le fait que l'accouplement entre ce second élément et le premier élément permet un jeu radial entre le
premier élément et le second élément.
D'autres caractéristiques et avantages de l'invention ressortiront mieux de la des-
cription d'un mode de réalisation adopté, mais non exclusif, de la prothèse selon l'invention, illustré à titre indicatif et non limitatif, dans les dessins en annexe, o: la figure 1 est une vue en perspective, éclatée, de la prothèse trapézo-métacarpienne selon la présente invention;
la figure 2 est une vue en section transversale illustrant l'accouplement entre un pre-
mier et un second élément de la prothèse selon la présente invention;
la figure 3 est une vue en section transversale illustrant le premier et le second élé-
ment de la prothèse selon l'invention en position d'accouplement; la figure 4 est une vue en perspective du troisième élément de la prothèse selon la présente invention; la figure 5 est une vue en section de la composante substitutive du trapèze en cas de révision. En référence aux figures susmentionnées, la prothèse selon l'invention, globalement
indiquée par le chiffre de référence 1, comprend un premier élément 2, de forme essentiel-
lement tronconique, destiné à être implanté dans le métacarpe de la main d'un patient. Le premier élément 2 est à dessein doté, à l'extrémité opposée à celle qui est destinée à être insérée dans le métacarpe du patient, d'un élément à collet 3, circulaire, sur lequel est fixé un élément annulaire 4, surélevé par rapport à la surface de l'élément 3, de façon à définir une cavité 5 d'accouplement pour un second élément de la prothèse, indiqué par le chiffre
de référence 6.
Dans le détail, le second élément 6 de la prothèse, par exemple réalisé en polyéthy-
lène, constitue un élément intermédiaire d'accouplement entre le premier élément 2 et un troisième élément 7 de la prothèse qui est destiné à être implanté dans le trapèze de la main
du patient.
En observant la figure 1, et plus spécialement les figures 2 et 3, on note que le second élément 6 est de forme essentiellement cylindrique, avec une surface destinée à s'accoupler
avec le troisième élément de la prothèse profilée en selle, et indiquée par le chiffre de réfé-
rence 8.
La figure 2 et la figure 3 illustrent l'accouplement entre le second élément 6 de la prothèse et le premier élément 2 et plus particulièrement l'accouplement entre l'élément annulaire 4 du premier élément 2 et sa cavité 5, avec un logement annulaire adéquat 10
défini sur la surface du second élément 6 qui est destinée à s'accoupler avec l'élément an-
nulaire 4. En détail, l'élément annulaire 4 est doté de bords arrondis avec un plan incliné 11 qui
s'accouple avec un plan incliné 12 défini en correspondance sur la paroi latérale du loge-
ment 10 du second élément 6.
Le bord du logement 10 a un diamètre inférieur à celui de l'élément annulaire 4 de
façon que l'élément 6 puisse être monté de force sur l'élément 2.
Le logement 10 du second élément 6 a une dimension supérieure à celle de la portion
d'élément annulaire 4 qui est destinée à s'accoupler dans ce logement.
Cela permet, comme le montre l'illustration de la figure 3, d'avoir un accouplement
avec jeu entre le second élément 6 et le premier élément 2.
L'accouplement avec jeu, dans lequel on peut donc avoir un mouvement radial entre
le second élément 6 et le premier élément 2, permet d'éviter la nécessité d'avoir un ali-
gnement parfait entre le premier élément prothétique 2 inséré dans le métacarpe de la main
et le troisième élément prothétique solidaire du trapèze.
En outre, le second élément prothétique 6 peut effectuer une rotation de 360 autour
de l'élément annulaire 4 du premier élément prothétique 2.
Cela permet aussi d'améliorer les fonctions du pouce du patient, car la prothèse selon l'invention, en permettant un mouvement aussi bien radial entre le premier 2 et le troisième 7 élément de la prothèse, que rotatoire entre les deux, permet de pourvoir à l'absence de
mobilité qui est un inconvénient typique affectant les prothèses de type connu.
En outre, le troisième élément prothétique 7 présente, sur sa surface destinée à s'accoupler avec la surface en selle 8 de l'élément prothétique 6, une surface profilée elle aussi en selle, 15, complémentaire de la surface en selle 8, de façon à ne pas permettre de
rotation entre le second élément 6 et le troisième élément 7.
Ce choix d'une surface d'accouplement entre le second élément 6 et le troisième
élément 7 réalisée en selle est dicté par le fait que l'on entend ainsi copier la forme natu-
relle que présentent le métacarpe et le trapèze dans leur accouplement.
Le troisième élément prothétique est doté, sur la face opposée à la face 15 s d'accouplement avec la surface en selle 8 du second élément prothétique 6, d'une paire de
pivots saillants 16, 17 destinés à permettre l'accouplement du troisième élément prothéti-
que 7 avec le trapèze de la main du patient. A dessein, le troisième élément prothétique 7 est en outre doté d'au moins une ailette 18 sur laquelle est défini au moins un trou 19 pour l'insertion d'une vis de fixation du troisième élément prothétique 7 au trapèze de la main
du patient.
La figure 5 illustre, avec une vue en section, la composante substitutive du trapèze en
cas de révision ou bien quand le trapèze est irrémédiablement abîmé.
Dans ce cas, un élément d'articulation 20, à tête sphérique et à zone intermédiaire
filetée est fixé à l'élément annulaire 4 de l'élément 2 par une frette 21 munie d'une ouver-
ture latérale 22 pour son introduction sur l'élément annulaire 4. En serrant la frette 21, l'élément d'articulation 20 se bloque sur l'élément 2 grâce à une surface d'accouplement conique 23. Sur la tête sphérique de l'élément d'articulation 20 est articulé un trapèze substitutif 24 qui peut tourner par rapport à la tête sphérique de l'élément 20 et est réalisé
de préférence en polyéthylène contenu dans une coquille métallique.
On a, dans la pratique, constaté que la prothèse selon l'invention remplit pleinement le rôle fixé car elle permet d'obtenir une articulation optimale du pouce du patient, à savoir
entre métacarpe et trapèze de la main, en reproduisant essentiellement l'articulation exis-
tant naturellement entre ces deux os.
La prothèse ainsi conçue est susceptible de nombreuses modifications et variantes, qui entrent toutes dans le cadre du concept de l'invention; en outre tous les éléments de
détail pourront être remplacés par d'autres éléments techniquement équivalents.
En pratique, les matériaux employés, pourvu qu'ils soient compatibles avec l'usage spécifique, ainsi que les dimensions, pourront être de quelque nature que ce soit selon les
besoins et l'état de la technique.

Claims (8)

REVENDICATIONS
1. Prothèse trapézo-métacarpienne, comprenant un premier élément (2) destiné à être inséré dans le métacarpe de la main d'un patient, un second élément (6) destiné à relier le premier élément à un troisième élément (7) destiné à être inséré dans le trapèze de la main
du patient, ladite prothèse (1) étant caractérisée par le fait que l'accouplement entre le se-
cond élément (6) et le premier élément (2) permet un jeu radial entre le premier élément et
le second élément.
2. Prothèse selon la revendication 1, caractérisée par le fait que l'accouplement entre le premier élément et le second élément permet une rotation du second élément par rapport
au premier élément.
3. Prothèse selon l'une quelconque des revendications précédentes, caractérisée par
le fait que le premier élément comprend un corps de forme essentiellement tronconique, terminé à une extrémité par un collet (3) sur lequel est accouplé un élément annulaire (4) définissant entre sa surface inférieure et le collet une cavité (5) destinée à permettre
l'accouplement du second élément.
4. Prothèse selon l'une quelconque des revendications précédentes, caractérisée par
le fait que le second élément (6) présente, sur sa surface destinée à s'accoupler avec le
premier élément un logement annulaire (10) de dimensions supérieures à celles de la por-
tion de l'élément annulaire destinée à s'engager dans ce logement, pour permettre le jeu
radial entre le premier et le second élément de la prothèse.
5. Prothèse selon l'une quelconque des revendications précédentes, caractérisée par
le fait que le second élément présente, sur la surface opposée à la surface d'accouplement
avec le premier élément, une surface (8) profilée en selle.
6. Prothèse selon l'une quelconque des revendications précédentes, caractérisée par
le fait que le troisième élément (7) comprend une surface (15) profilée en selle complé-
mentaire de la surface en selle du second élément.
7. Prothèse selon l'une quelconque des revendications précédentes, caractérisée par
le fait que le troisième élément (7) présente une paire de pivots saillants (16, 17) aptes à s'engager dans le trapèze, et au moins une ailette (18) dotée d'un trou (19) pour le passage
d'une vis de fixation pour fixer ce troisième élément au trapèze.
8. Prothèse selon l'une quelconque des revendications précédentes, caractérisée par
le fait que le second élément (6) est réalisé en polyéthylène.
FR0002099A 2000-02-21 2000-02-21 Prothese trapezo-metacarpienne a mobilite amelioree Expired - Fee Related FR2805151B1 (fr)

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WO2007056678A3 (fr) * 2005-11-04 2008-03-20 Zimmer Tech Inc Insert contraint rotatif
FR2912051A1 (fr) * 2007-02-07 2008-08-08 Jean Pierre Pequignot Implant trapezo-metacarpien
US7625408B2 (en) * 2003-07-22 2009-12-01 Avanta Orthopaedics, Llc Prosthetic wrist implant
US7794504B2 (en) 2005-04-12 2010-09-14 Zimmer Technology, Inc. Method for making a metal-backed acetabular implant
US7985259B2 (en) 2006-04-11 2011-07-26 Zimmer Technology, Inc. Acetabular cup conversion ring
EP2349109A2 (fr) * 2008-09-17 2011-08-03 Ascension Orthopedics, Inc. Implant métacarpien du pouce
EP2364674A1 (fr) * 2010-03-10 2011-09-14 Aequos Endoprothetik Gmbh Joint mécanique en dos d'âne
US8308811B2 (en) 2006-04-11 2012-11-13 Zimmer, Inc. Acetabular cup conversion ring
US9078758B2 (en) 2011-05-12 2015-07-14 Howmedica Osteonics Corp. Wrist implant for carpal hemiarthroplasty
WO2020193079A1 (fr) * 2019-03-25 2020-10-01 Loci Orthopaedics Limited Implant d'articulation d'hémi-arthroplastie
US10799365B1 (en) 2019-03-25 2020-10-13 Loci Orthopaedics Limited Bone joint implants
US11213401B2 (en) 2016-02-10 2022-01-04 National University Of Ireland, Galway Implant for a bone joint

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US7625408B2 (en) * 2003-07-22 2009-12-01 Avanta Orthopaedics, Llc Prosthetic wrist implant
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EP1762201A1 (fr) * 2005-09-08 2007-03-14 Biomet Manufacturing Corporation Procédé et appareil pour une prothèse glénoidienne.
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EP2349109A2 (fr) * 2008-09-17 2011-08-03 Ascension Orthopedics, Inc. Implant métacarpien du pouce
EP2349109A4 (fr) * 2008-09-17 2013-12-04 Ascension Orthopedics Inc Implant métacarpien du pouce
EP2364674A1 (fr) * 2010-03-10 2011-09-14 Aequos Endoprothetik Gmbh Joint mécanique en dos d'âne
US9078758B2 (en) 2011-05-12 2015-07-14 Howmedica Osteonics Corp. Wrist implant for carpal hemiarthroplasty
US11213401B2 (en) 2016-02-10 2022-01-04 National University Of Ireland, Galway Implant for a bone joint
US11399950B2 (en) 2016-02-10 2022-08-02 National University Of Ireland, Galway Implant for a bone joint
WO2020193079A1 (fr) * 2019-03-25 2020-10-01 Loci Orthopaedics Limited Implant d'articulation d'hémi-arthroplastie
US10799365B1 (en) 2019-03-25 2020-10-13 Loci Orthopaedics Limited Bone joint implants
US20220218492A1 (en) * 2019-03-25 2022-07-14 Loci Orthopaedics Limited Hemi arthroplasty joint implant
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FR2805152A1 (fr) 2001-08-24
FR2805151B1 (fr) 2003-08-15

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