FR2829688A1 - Total elbow joint prosthesis has regulating elements for angle formed between pivot pin and humeral axis - Google Patents
Total elbow joint prosthesis has regulating elements for angle formed between pivot pin and humeral axis Download PDFInfo
- Publication number
- FR2829688A1 FR2829688A1 FR0111956A FR0111956A FR2829688A1 FR 2829688 A1 FR2829688 A1 FR 2829688A1 FR 0111956 A FR0111956 A FR 0111956A FR 0111956 A FR0111956 A FR 0111956A FR 2829688 A1 FR2829688 A1 FR 2829688A1
- Authority
- FR
- France
- Prior art keywords
- pin
- spindle
- bore
- prosthesis
- proximal
- 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
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3804—Joints for elbows or knees for elbows
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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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- 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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- A61F2/00—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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- 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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- A61F2/00—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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- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
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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
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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
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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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- A61F2002/30329—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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Abstract
Description
<Desc/Clms Page number 1> <Desc / Clms Page number 1>
La présente invention concerne une prothèse totale d'articulation du coude. The present invention relates to a total elbow joint prosthesis.
Les prothèses existantes de coude peuvent être classées en trois catégories, à savoir les prothèses dites"contraintes", les prothèses dites"non contraintes"et les prothèses dites"semi-contraintes". The existing elbow prostheses can be classified into three categories, namely the so-called "constrained" prostheses, the so-called "non-constrained" prostheses and the so-called "semi-constrained" prostheses.
Dans les prothèses "contraintes", l'élément cubital est mobile par rapport à l'élément huméral seulement en pivotement autour d'un axe perpendiculaire à l'axe longitudinal de ces éléments. Ces prothèses ont pour inconvénient de présenter des problèmes de déscellement importants compte tenu des contraintes qu'elles génèrent au niveau des interfaces entre les éléments osseux et le ciment de scellement de ces éléments. In "constrained" prostheses, the ulnar element is movable relative to the humeral element only in pivoting about an axis perpendicular to the longitudinal axis of these elements. These prostheses have the drawback of presenting significant loosening problems taking into account the constraints which they generate at the interfaces between the bone elements and the cement for sealing these elements.
Dans les prothèses"non contraintes", l'élément cubital n'est pas relié à l'élément huméral. Ces prothèses ont pour inconvénients de n'être utilisables que pour traiter des articulations à systèmes ligamentaires peu détériorés et de présenter des risques de luxation non négligeables. In "unconstrained" prostheses, the ulnar element is not connected to the humeral element. These prostheses have the drawbacks of being usable only for treating joints with slightly deteriorated ligament systems and of presenting non-negligible risks of dislocation.
Dans les prothèses "semi-contraintes", les éléments osseux sont reliés l'un à l'autre au moyen d'une broche transversale mais avec un jeu permettant un pivotement de l'élément cubital par rapport à l'élément huméral autour de l'axe longitudinal de cet élément cubital. Ces prothèses restituent plus fidèlement le mouvement anatomique de l'articulation et présentent des risques de déscellement plus réduits que les prothèses "contraintes". Il apparaît toutefois que ces risques ne sont pas totalement éliminés et qu'un nombre de cas de déscellement non négligeable subsiste. In "semi-constrained" prostheses, the bone elements are connected to each other by means of a transverse pin but with a clearance allowing the ulnar element to pivot relative to the humeral element around the longitudinal axis of this ulnar element. These prostheses more faithfully reproduce the anatomical movement of the joint and present lower risk of loosening than "constrained" prostheses. However, it appears that these risks have not been completely eliminated and that a significant number of cases of loosening remain.
La présente invention vise à remédier à cet inconvénient essentiel. Son objectif principal est donc de fournir une prothèse de coude éliminant le risque de déscellement et pouvant être utilisée même avec un système ligamentaire détérioré. The present invention aims to remedy this essential drawback. Its main objective is therefore to provide an elbow prosthesis eliminating the risk of loosening and which can be used even with a damaged ligament system.
La prothèse qu'elle concerne comprend un élément huméral et un élément cubital reliés l'un à l'autre au moyen d'une broche, cette broche traversant des trous aménagés dans ces éléments. The prosthesis to which it relates comprises a humeral element and a ulnar element connected to one another by means of a pin, this pin passing through holes provided in these elements.
Selon l'invention, - la prothèse comprend des moyens de réglage de l'angle que forme l'axe de ladite broche avec l'axe longitudinal de l'élément huméral, et - l'élément cubital et la broche sont respectivement dimensionés et/ou conformés de telle sorte qu'il existe une laxité de l'élément cubital par rapport à la broche, According to the invention, - the prosthesis comprises means for adjusting the angle which the axis of said pin forms with the longitudinal axis of the humeral element, and - the ulnar element and the pin are respectively sized and / or shaped so that there is a laxity of the ulnar element with respect to the spindle,
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ledit angle et ladite laxité étant tels qu'en position maximale de flexion de l'articulation, les axes longitudinaux des deux os sont sensiblement parallèles l'un à l'autre dans le plan frontal, c'est-à-dire dans le plan contenant les axes longitudinaux des deux os en position d'extension de l'articulation, et qu'en position d'extension maximale de l'articulation, ces axes forment entre eux un angle de valgus de zéro à huit degrés dans ce même plan. said angle and said laxity being such that in the maximum flexion position of the joint, the longitudinal axes of the two bones are substantially parallel to each other in the frontal plane, that is to say in the plane containing the longitudinal axes of the two bones in the position of extension of the joint, and in the position of maximum extension of the joint, these axes form between them a valgus angle of zero to eight degrees in this same plane.
La prothèse selon l'invention permet ainsi que l'angle de valgus entre les deux os soit sensiblement nul en position de flexion maximale de l'articulation et que ce même angle de valgus puisse atteindre huit degrés, selon le patient traité, en position d'extension maximale de l'articulation. The prosthesis according to the invention thus allows the angle of valgus between the two bones to be substantially zero in the position of maximum flexion of the joint and that this same angle of valgus can reach eight degrees, depending on the patient treated, in position d maximum extension of the joint.
Il apparaît en effet que l'angle formé par l'axe longitudinal de l'humérus et l'axe longitudinal du cubitus varie dans le plan frontal, au cours du mouvement de l'articulation, entre les valeurs précitées. Dans la prothèse selon l'invention, l'orientation de la broche et/ou ladite laxité permettent de restituer cette variation de l'angle de valgus. It indeed appears that the angle formed by the longitudinal axis of the humerus and the longitudinal axis of the ulna varies in the frontal plane, during the movement of the joint, between the aforementioned values. In the prosthesis according to the invention, the orientation of the spindle and / or said laxity make it possible to restore this variation in the angle of valgus.
De préférence, la position de la broche est réglée de manière à ce que l'axe de cette broche forme, dans ledit plan frontal, un angle de trois à sept degrés avec la perpendiculaire à l'axe longitudinal de l'élément huméral. Preferably, the position of the spindle is adjusted so that the axis of this spindle forms, in said frontal plane, an angle of three to seven degrees with the perpendicular to the longitudinal axis of the humeral element.
La prothèse selon l'invention combine ainsi un axe de pivotement "incliné" et ladite laxité de l'élément cubital, ce qui permet à la prothèse de restituer ladite variation de l'angle de valgus tout en
conservant une laxité d'amplitude limitée. Cette amplitude limitée permet d'assurer un guidage suffisant du mouvement de l'avant-bras par rapport au bras le long de la course de mouvement de l'articulation. The prosthesis according to the invention thus combines an “inclined” pivot axis and said laxity of the ulnar element, which allows the prosthesis to restore said variation in the angle of valgus while
retaining a laxity of limited amplitude. This limited amplitude ensures sufficient guidance of the movement of the forearm relative to the arm along the movement stroke of the joint.
Avantageusement, lesdits moyens de réglage sont conformés pour permettre, à partir des mêmes éléments osseux de base, de régler ladite orientation de la broche en fonction de l'articulation à traiter. Advantageously, said adjustment means are shaped to allow, from the same basic bone elements, to adjust said orientation of the spindle as a function of the joint to be treated.
Cette prothèse est ainsi parfaitement adaptable à cette articulation à traiter. En particulier, la prothèse est en mesure d'être adaptée à une variation d'un angle de valgus de l'ordre de quatre degrés pour un patient de sexe masculin et de l'ordre de six degrés pour un patient de sexe féminin. This prosthesis is thus perfectly adaptable to this joint to be treated. In particular, the prosthesis is able to be adapted to a variation of a valgus angle of the order of four degrees for a male patient and of the order of six degrees for a female patient.
Selon une posibilité de réalisation de l'invention, According to one possibility of carrying out the invention,
<Desc/Clms Page number 3><Desc / Clms Page number 3>
- l'élément huméral présente une chape dont les parois latérales sont percées de trous, et - lesdits moyens de réglage comprennent des paires de pièces de positionnement interchangeables, pouvant être mises en place dans ces trous, les deux pièces de positionnement d'une même paire définissant conjointement des alésages de réception de la broche selon l'orientation désirée. - The humeral element has a yoke, the side walls of which are pierced with holes, and - said adjustment means comprise pairs of interchangeable positioning pieces, which can be placed in these holes, the two positioning pieces of the same pair jointly defining spindle receiving bores according to the desired orientation.
Les pièces de positionnement permettant l'obtention de cette orientation désirée sont ainsi sélectionnées et mises en place sur l'élément huméral pour adapter la prothèse à cette orientation. The positioning pieces enabling this desired orientation to be obtained are thus selected and placed on the humeral element to adapt the prosthesis to this orientation.
Selon une forme de réalisation avantageuse de l'invention, dans ce cas : - chaque paire de pièces de positionnement comprend une pièce de positionnement proximale et une pièce de positionnement distale, par rapport au sens d'insertion de la broche au travers de ces pièces ; la pièce de positionnement proximale comprend un épaulement permettant sa prise d'appui contre la face interne de la paroi latérale proximale de ladite chape, un alésage proximal taraudé et un alésage distal destiné à être traversé par la broche ; la pièce de positionnement distal présente un épaulement permettant sa prise d'appui contre la face interne de la paroi latérale distale de ladite chape et un alésage borgne ; et - la broche présente une zone filetée et des moyens pour l'entraînement en rotation de cette broche en vue du vissage de celle-ci ; en dehors de cette zone filetée, la broche est propre à être engagée étroitement dans ledit alésage distal de la pièce de positionnement proximale et dans ledit alésage borgne de la pièce de positionnement distale ; la zone filetée est propre à être vissée dans ledit alésage proximal taraudé de la pièce de positionnement proximale. According to an advantageous embodiment of the invention, in this case: - each pair of positioning pieces comprises a proximal positioning piece and a distal positioning piece, relative to the direction of insertion of the spindle through these pieces ; the proximal positioning piece comprises a shoulder allowing it to bear against the internal face of the proximal side wall of said clevis, a tapped proximal bore and a distal bore intended to be traversed by the spindle; the distal positioning part has a shoulder allowing it to bear against the internal face of the distal side wall of said clevis and a blind bore; and - the spindle has a threaded zone and means for driving this spindle in rotation with a view to screwing it; outside this threaded zone, the spindle is capable of being tightly engaged in said distal bore of the proximal positioning part and in said blind bore of the distal positioning part; the threaded zone is suitable for being screwed into said threaded proximal bore of the proximal positioning part.
Ce vissage de la broche dans ledit alésage proximal taraudé assure le montage des pièces de positionnement et de la broche dans la chape. This screwing of the spindle into said tapped proximal bore ensures the mounting of the positioning parts and of the spindle in the clevis.
Avantageusement, l'élément cubital comprend une pièce formant une tige médullaire et une tête d'articulation assemblée à cette pièce, cette tête d'articulation étant sélectionnée parmi une pluralité de têtes d'articulation susceptibles d'être assemblées à la pièce formant tige Advantageously, the ulnar element comprises a part forming a medullary rod and an articulation head assembled with this part, this articulation head being selected from a plurality of articulation heads capable of being assembled with the rod forming part.
<Desc/Clms Page number 4><Desc / Clms Page number 4>
médullaire, chacune de ces têtes d'articulation présentant un alésage de diamètre et/ou de conformation adapté à l'orientation de la broche. each of these articulation heads having a diameter and / or conformation bore adapted to the orientation of the spindle.
Selon une forme de réalisation préférée de l'invention, dans ce cas, l'alésage de chaque tête d'articulation destiné à recevoir la broche présente une forme en deux tronc de cône coaxiaux communiquant l'un avec l'autre par le plus petit diamètre de ces troncs de cône ; ce plus petit diamètre est légèrement supérieur au diamètre de la broche et la pente de chacun de ces troncs de cône est déterminé en fonction des positions extrêmes de débattement de la tête d'articulation devant être obtenues. According to a preferred embodiment of the invention, in this case, the bore of each articulation head intended to receive the spindle has a shape in two coaxial truncated cones communicating with each other by the smallest diameter of these truncated cones; this smaller diameter is slightly greater than the diameter of the spindle and the slope of each of these truncated cones is determined as a function of the extreme positions of movement of the articulation head to be obtained.
Les zones diamétralement opposées de chacune de ces parties d'alésage en tronc de cône forment ainsi des butées que rencontre la broche dans ces positions extrêmes de débattement de la tête d'articulation. The diametrically opposite zones of each of these truncated cone bore portions thus form stops which the spindle encounters in these extreme positions of movement of the articulation head.
Pour sa bonne compréhension, l'invention est à nouveau décrite ci-dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de la prothèse qu'elle concerne. For a good understanding, the invention is again described below with reference to the appended diagrammatic drawing representing, by way of nonlimiting example, a preferred embodiment of the prosthesis that it relates to.
La figure 1 en est une vue en perspective ; la figure 2 est une vue en perspective de l'élément huméral qu'elle comprend ; la figure 3 est une vue en perspective d'une tête d'articulation que comprend son élément cubital ; la figure 4 est une vue en coupe transversale de cette tête d'articulation ; la figure 5 est une vue de côté de cette même tête ; la figure 6 est une vue en perspective de la pièce formant la tige médullaire dudit élément cubital ; les figures 7 à 9 sont des vues, respectivement en perspective et de côté selon deux angles différents, d'une pièce de positionnement que comprend la prothèse ; les figures 10 à 12 sont des vues, respectivement en perspective et de côté selon deux angles différents, d'une autre pièce de positionnement que comprend la prothèse ; la figure 13 est une vue partielle de la prothèse, en coupe et à échelle agrandie ; Figure 1 is a perspective view; Figure 2 is a perspective view of the humeral element which it comprises; Figure 3 is a perspective view of a hinge head that includes its ulnar element; Figure 4 is a cross-sectional view of this hinge head; Figure 5 is a side view of the same head; Figure 6 is a perspective view of the part forming the medullary rod of said ulnar element; Figures 7 to 9 are views, respectively in perspective and side from two different angles, of a positioning piece that includes the prosthesis; Figures 10 to 12 are views, respectively in perspective and from the side at two different angles, of another positioning piece that includes the prosthesis; Figure 13 is a partial view of the prosthesis, in section and on an enlarged scale;
<Desc/Clms Page number 5><Desc / Clms Page number 5>
la figure 14 est une vue, dans le plan frontal, d'un humérus et d'une partie d'un cubitus dans lesquels est implantée la prothèse, en position de flexion maximale de l'articulation du coude, et la figure 15 est une vue similaire à la figure 14 de l'humérus, de la partie de cubitus et de la prothèse, en position d'extension maximale de l'articulation du coude. FIG. 14 is a view, in the frontal plane, of a humerus and part of a ulna in which the prosthesis is implanted, in the position of maximum flexion of the elbow joint, and FIG. 15 is a view similar to FIG. 14 of the humerus, the part of the ulna and the prosthesis, in the position of maximum extension of the elbow joint.
La figure 1 représente une prothèse totale 1 d'articulation du coude, qui comprend un élément huméral 2 et un élément cubital 3, et la figure 13 montre plus particulièrement que ces éléments 2 et 3 sont reliés l'un à l'autre, de manière pivotante, au moyen d'une broche 4. FIG. 1 represents a total prosthesis 1 for elbow articulation, which comprises a humeral element 2 and a ulnar element 3, and FIG. 13 shows more particularly that these elements 2 and 3 are connected to each other, swivel, by means of a spindle 4.
Comme cela apparaît sur la figure 2, l'élément huméral 2 comprend une tige médullaire 5 et une partie distale d'articulation 6. As shown in FIG. 2, the humeral element 2 comprises a medullary rod 5 and a distal articulation part 6.
La tige médullaire 5 est destinée à être insérée dans le canal médullaire de l'humérus pour permettre la fixation de l'élément 2 à cet humérus 2. Cette fixation peut être réalisée au moyen d'un ciment de scellement ou par ostéogénèse. Dans ce deuxième cas, la tige 5 peut être recouverte d'un revêtement poreux, notamment en hydroyapatite de calcium. The medullary rod 5 is intended to be inserted into the medullary canal of the humerus to allow the element 2 to be fixed to this humerus 2. This fixing can be carried out by means of a cement or by osteogenesis. In this second case, the rod 5 can be covered with a porous coating, in particular made of calcium hydroyapatite.
La partie distale articulation 6 présente deux joues parallèles 10 formant une chape. Chacune de ces joues 10 est percée d'un trou 11 en forme de segment de cercle, c'est-à-dire présente un méplat 12. The distal articulation part 6 has two parallel cheeks 10 forming a yoke. Each of these cheeks 10 is pierced with a hole 11 in the form of a segment of a circle, that is to say has a flat 12.
L'élément cubital 3 est constitué par l'assemblage de la tête d'articulation 15 représentée sur les figures 3 à 5 et de la pièce 16 représentée sur la figure 6. The ulnar element 3 is constituted by the assembly of the articulation head 15 shown in FIGS. 3 to 5 and of the part 16 shown in FIG. 6.
La tête d'articulation 15 présente une forme aplatie et est traversée par un alésage 17 débouchant au niveau de ses faces latérales planes 18. Comme le montre la figure 4, l'alésage 17 est en forme de deux tronc de cône coaxiaux, d'axe formant un angle de quatre degrés avec la perpendiculaire à l'axe longitudinal de la tête 15. Ces deux troncs de cône communiquent l'un avec l'autre au niveau du plan médian de la tête 15, par leur plus petit diamètre et ont une pente de quatre degrés. Ce plus petit diamètre est légèrement supérieur au diamètre de la broche 4, et il apparaît sur la figure 13 que la pente des troncs de cône permet une laxité de la tête 15, et donc de l'élément cubital 3, par rapport à l'élément huméral 2 entre des positions extrêmes de débattement définies par la venue en butée The articulation head 15 has a flattened shape and is crossed by a bore 17 opening at its flat lateral faces 18. As shown in FIG. 4, the bore 17 is in the form of two coaxial truncated cones, of axis forming an angle of four degrees with the perpendicular to the longitudinal axis of the head 15. These two truncated cones communicate with each other at the median plane of the head 15, by their smallest diameter and have a slope of four degrees. This smaller diameter is slightly greater than the diameter of the spindle 4, and it appears in FIG. 13 that the slope of the truncated cones allows a laxity of the head 15, and therefore of the ulnar element 3, relative to the humeral element 2 between extreme travel positions defined by the abutment
<Desc/Clms Page number 6><Desc / Clms Page number 6>
de la broche 4 contre les parois de la tête 15 qui délimitent ces troncs de cône. of the pin 4 against the walls of the head 15 which delimit these truncated cones.
La tête 15 présente en outre un plot 20 en forme de cône morse et un téton 21 faisant saillie de la face destinée à être reliée à la pièce 16. The head 15 also has a stud 20 in the form of a Morse cone and a stud 21 projecting from the face intended to be connected to the part 16.
Ainsi que le montre la figure 6, cette pièce 16 présente une partie effilée 22 et un plateau proximal 23. As shown in FIG. 6, this part 16 has a tapered part 22 and a proximal plate 23.
La partie effilée 22 forme une tige médullaire destinée à être insérée dans le canal médullaire du cubitus pour permettre la fixation de l'élément 3 à ce cubitus. De la même façon que précitée, cette fixation peut être réalisée au moyen d'un ciment de scellement ou par ostéogénèse, auquel cas la partie effilée 22 peut être recouverte d'un revêtement poreux, notamment en hydroyapatite de calcium. The tapered portion 22 forms a medullary rod intended to be inserted into the medullary canal of the ulna to allow the attachment of the element 3 to this ulna. In the same way as above, this fixing can be carried out by means of a sealing cement or by osteogenesis, in which case the tapered part 22 can be covered with a porous coating, in particular in calcium hydroyapatite.
Le plateau 23 présente des dimensions adaptées à recevoir la tête 15. Deux cavités 24,25 aménagées au travers de lui et dans la base de la partie 22 débouchent dans sa face proximale. Ces cavités 24,25 ont des formes complémentaires respectivement de celle du plot 20 et du téton 21, et permettent, par insertion de ces derniers en elles, de réaliser un assemblage résistant de la tête 15 sur la pièce 16. The plate 23 has dimensions adapted to receive the head 15. Two cavities 24, 25 arranged through it and in the base of the part 22 open into its proximal face. These cavities 24.25 have complementary shapes respectively to that of the stud 20 and of the stud 21, and allow, by insertion of the latter into them, to produce a resistant assembly of the head 15 on the part 16.
En référence à la figure 13, il apparaît que, dans l'exemple représenté, l'axe de la broche 4 forme un angle de quatre degrés avec la perpendiculaire à l'axe longitudinal de l'élément huméral 2 et que la prothèse 1 comprend également des pièces 30,31 de positionnement de cette broche 4 par rapport à l'élément huméral 2. With reference to FIG. 13, it appears that, in the example shown, the axis of the pin 4 forms an angle of four degrees with the perpendicular to the longitudinal axis of the humeral element 2 and that the prosthesis 1 comprises also parts 30, 31 for positioning this pin 4 relative to the humeral element 2.
La broche 4 présente, à une extrémité, une zone filetée et une cavité hexagonale 32 pour son entraînement en rotation en vue de son vissage. The spindle 4 has, at one end, a threaded zone and a hexagonal cavity 32 for its rotational drive for its screwing.
En référence aux figures 7 à 9 et 13, il apparaît que l'une des pièces de positionnement 30, dite"distale"par rapport au sens d'insertion de la broche 4 dans ladite chape, présente une partie de base 35 et une collerette 36. Referring to Figures 7 to 9 and 13, it appears that one of the positioning pieces 30, called "distal" relative to the direction of insertion of the pin 4 in said yoke, has a base part 35 and a flange 36.
La partie de base 35 présente une forme correspondant à celle du trou 11 "distal" mais ayant des dimensions légèrement inférieures à celles de ce trou 11. Cette partie 35 peut ainsi être engagée étroitement dans ce trou 11, dans la position angulaire déterminée montrée sur la figure
13 ; cette position est définie par la coopération du méplat 12 de ce trou
11 avec le méplat 37 de la partie 35. The base part 35 has a shape corresponding to that of the hole 11 "distal" but having dimensions slightly smaller than those of this hole 11. This part 35 can thus be engaged closely in this hole 11, in the determined angular position shown on the figure
13; this position is defined by the cooperation of the flat 12 of this hole
11 with the flat part 37 of part 35.
<Desc/Clms Page number 7> <Desc / Clms Page number 7>
La collerette 36 présente une face axiale "proximale" 38 inclinée et forme, avec la partie 35, un épaulement 39 permettant la prise d'appui
de la pièce 30 contre la face interne de la joue 10"distale". The flange 36 has an inclined "proximal" axial face 38 and forms, with the part 35, a shoulder 39 allowing the support to be taken
of the part 30 against the internal face of the "distal" cheek 10.
Cette pièce 30 comprend en outre un alésage borgne central 40 pouvant recevoir étroitement la broche 4 comme le montre la figure 13. This part 30 further comprises a central blind bore 40 which can receive pin 4 closely as shown in FIG. 13.
En référence aux figures 10 à 12 et 13, il apparaît que la pièce de positionnement "proximale" 31 présente une partie de base 45 et une collerette 46 conformées de manière identique à la partie de base 35 et à la collerette 36 en ce qui concerne le méplat 47, la face inclinée 48 de la collerette 46 et l'épaulement 49. La position angulaire déterminée de cette pièce 31 est telle que la face 48 est parallèle à la face 38, comme le montre la figure 13. With reference to FIGS. 10 to 12 and 13, it appears that the "proximal" positioning part 31 has a base part 45 and a collar 46 conformed identically to the base part 35 and to the collar 36 as regards the flat 47, the inclined face 48 of the flange 46 and the shoulder 49. The determined angular position of this part 31 is such that the face 48 is parallel to the face 38, as shown in FIG. 13.
La pièce 31 présente en outre un alésage proximal taraudé 50 aménagé dans la partie de base 45, destiné à recevoir la zone filetée de la broche 4 par vissage, et un alésage distal 51 délimité par la collerette 46, destiné à être traversé par la broche 4. The part 31 also has a threaded proximal bore 50 arranged in the base part 45, intended to receive the threaded zone of the spindle 4 by screwing, and a distal bore 51 delimited by the flange 46, intended to be traversed by the spindle 4.
Comme cela se déduit de la figure 13, l'engagement de la broche 4 dans les pièces 31 puis 30, et le vissage de cette broche 4 dans l'alésage 50, assure le montage des pièces 30,31 dans l'élément 2 et l'assemblage de la prothèse 1. As can be deduced from FIG. 13, the engagement of the spindle 4 in the parts 31 then 30, and the screwing of this spindle 4 in the bore 50, ensures the mounting of the parts 30, 31 in the element 2 and prosthesis assembly 1.
La figure 14 montre que la laxité précitée de l'élément cubital 3 par rapport à l'élément huméral 2 permet à l'axe longitudinal du cubitus 100 de venir dans une position sensiblement parallèle à l'axe longitudinal de l'humérus 101 lorsque l'articulation est en position maximale de flexion. FIG. 14 shows that the aforementioned laxity of the ulnar element 3 with respect to the humeral element 2 allows the longitudinal axis of the ulna 100 to come into a position substantially parallel to the longitudinal axis of the humerus 101 when the hinge is in maximum bending position.
La figure 15 montre que cette même laxité permet à l'axe longitudinal du cubitus 100 de venir former un angle de quatre degrés environ avec l'axe longitudinal de l'humérus 101 lorsque l'articulation est en position maximale d'extension. Entre la position maximale de flexion et la position maximale d'extension, les faces 38 et 48 des pièces 30 et 31 assurent un guidage suffisant du mouvement de l'avant-bras par rapport au bras. FIG. 15 shows that this same laxity allows the longitudinal axis of the ulna 100 to come to form an angle of about four degrees with the longitudinal axis of the humerus 101 when the joint is in the maximum extension position. Between the maximum flexion position and the maximum extension position, the faces 38 and 48 of the parts 30 and 31 ensure sufficient guidance of the movement of the forearm relative to the arm.
Ainsi qu'il apparaît de ce qui précède, l'invention apporte une amélioration déterminante à la technique antérieure, en fournissant une prothèse totale d'articulation du coude qui élimine le risque de déscellement des éléments 2,3 et qui peut être utilisée même avec un système ligamentaire détérioré. As appears from the above, the invention brings a decisive improvement to the prior art, by providing a total elbow joint prosthesis which eliminates the risk of loosening of the elements 2,3 and which can be used even with a damaged ligament system.
<Desc/Clms Page number 8> <Desc / Clms Page number 8>
Il va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais qu'elle en embrasse au contraire toutes les variantes de réalisation entrant dans le champ de protection défini par les revendications ci-annexées. Ainsi, l'orientation de la broche 4 peut être différente de quatre degrés dès lors que lesdits troncs de cône présentent des pentes permettant l'obtention des positions maximales de débattement recherchées. It goes without saying that the invention is not limited to the embodiment described above by way of example but that, on the contrary, it embraces all the variant embodiments falling within the scope of protection defined by the claims. appended. Thus, the orientation of the spindle 4 can be different from four degrees as soon as said truncated cones have slopes allowing the desired maximum deflection positions to be obtained.
Claims (8)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0111956A FR2829688B1 (en) | 2001-09-14 | 2001-09-14 | TOTAL ELBOW JOINT PROSTHESIS |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0111956A FR2829688B1 (en) | 2001-09-14 | 2001-09-14 | TOTAL ELBOW JOINT PROSTHESIS |
Publications (2)
Publication Number | Publication Date |
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FR2829688A1 true FR2829688A1 (en) | 2003-03-21 |
FR2829688B1 FR2829688B1 (en) | 2003-11-21 |
Family
ID=8867322
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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FR0111956A Expired - Fee Related FR2829688B1 (en) | 2001-09-14 | 2001-09-14 | TOTAL ELBOW JOINT PROSTHESIS |
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FR (1) | FR2829688B1 (en) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2912898A1 (en) * | 2007-02-28 | 2008-08-29 | Small Bone Innovations Interna | Elbow joint prosthesis, has block laterally mounted on proximal part of humeral element, where shape of block is similar to that of condyle such that block permits to occupy space occupied by condyle, in case of ablation of condyle |
US20140277525A1 (en) * | 2013-03-13 | 2014-09-18 | Biomet Manufactruing Corp. | Adjustable lateral articulating condyle |
US20170246002A1 (en) * | 2014-10-21 | 2017-08-31 | Tecres S.P.A. | Elbow prosthesis |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
ES2748898T3 (en) * | 2014-10-21 | 2020-03-18 | Tecres Spa | Elbow Spacer |
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US4219893A (en) * | 1977-09-01 | 1980-09-02 | United States Surgical Corporation | Prosthetic knee joint |
DE8814434U1 (en) * | 1987-11-20 | 1989-03-02 | Heise, Ulrich, Dr.med., 2000 Hamburg | Endoprosthesis for replacement of the humerus |
US5376121A (en) * | 1991-08-06 | 1994-12-27 | Techmedica, Inc. | Dual constraint elbow prosthesis |
EP1016386A2 (en) * | 1997-11-03 | 2000-07-05 | Depuy Orthopaedics, Inc. | Modular elbow prosthesis |
-
2001
- 2001-09-14 FR FR0111956A patent/FR2829688B1/en not_active Expired - Fee Related
Patent Citations (4)
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US4219893A (en) * | 1977-09-01 | 1980-09-02 | United States Surgical Corporation | Prosthetic knee joint |
DE8814434U1 (en) * | 1987-11-20 | 1989-03-02 | Heise, Ulrich, Dr.med., 2000 Hamburg | Endoprosthesis for replacement of the humerus |
US5376121A (en) * | 1991-08-06 | 1994-12-27 | Techmedica, Inc. | Dual constraint elbow prosthesis |
EP1016386A2 (en) * | 1997-11-03 | 2000-07-05 | Depuy Orthopaedics, Inc. | Modular elbow prosthesis |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2912898A1 (en) * | 2007-02-28 | 2008-08-29 | Small Bone Innovations Interna | Elbow joint prosthesis, has block laterally mounted on proximal part of humeral element, where shape of block is similar to that of condyle such that block permits to occupy space occupied by condyle, in case of ablation of condyle |
US20140277525A1 (en) * | 2013-03-13 | 2014-09-18 | Biomet Manufactruing Corp. | Adjustable lateral articulating condyle |
US9039779B2 (en) * | 2013-03-13 | 2015-05-26 | Biomet Manufacturing, Llc | Adjustable lateral articulating condyle |
AU2014241352B2 (en) * | 2013-03-13 | 2017-11-09 | Biomet Manufacturing, Llc | Adjustable lateral articulating condyle |
US20170246002A1 (en) * | 2014-10-21 | 2017-08-31 | Tecres S.P.A. | Elbow prosthesis |
CN107735054A (en) * | 2014-10-21 | 2018-02-23 | 泰克里斯公司 | Elbow joint prosthese |
US10299932B2 (en) * | 2014-10-21 | 2019-05-28 | Tecres S.P.A. | Elbow prosthesis |
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FR2829688B1 (en) | 2003-11-21 |
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FR2941863A1 (en) | Prosthetic femoral stems for use during installation of hip prosthesis on patient, has forming part projected from femur, where positioning between part and hole is conceived so that distance between center and axis is identical to stems | |
FR2854320A1 (en) | Hip articulation prosthesis, has femoral stem with neck including one end that is inserted and fixed according to angular position in off-centered canal of intermediate sleeve, where neck end and canal are tapered | |
FR2689757A1 (en) | Shank, esp. for hip prosthesis - has connecting piece between head and main body, incorporating conical coupling with fixing screw | |
FR2881945A1 (en) | Trapezo-metacarpal prosthesis comprises trapezoid and metacarpal components with anchoring sections and interacting convex and concave surfaces |
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