JP3746290B2 - モジュラー式補綴物 - Google Patents
モジュラー式補綴物 Download PDFInfo
- Publication number
- JP3746290B2 JP3746290B2 JP50957993A JP50957993A JP3746290B2 JP 3746290 B2 JP3746290 B2 JP 3746290B2 JP 50957993 A JP50957993 A JP 50957993A JP 50957993 A JP50957993 A JP 50957993A JP 3746290 B2 JP3746290 B2 JP 3746290B2
- Authority
- JP
- Japan
- Prior art keywords
- head
- humerus
- locking
- dimensioned
- lumen
- 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.)
- Expired - Lifetime
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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
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/031—Automatic limiting or abutting means, e.g. for safety torque limiting
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- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
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Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
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- 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)
- Materials For Medical Uses (AREA)
Description
本発明は肩関節の一部の置換のための人工補綴物に関する。より特定すれば、本発明は上腕骨上部部分の置換のためのモジュラー式人工補綴物に関する。
上腕骨上部部分の置換のための従来の補綴物は通常一体式の構造をなしており、一般に上腕骨内の窩洞へ向かって下向きに延出するように設計された支柱を含む。従来の補綴物の支柱は上腕骨の骨内へ骨セメントにより固定するか、支柱を固定するように骨の内側への成長を刺激する被覆を用いることにより固定する。支柱は上腕骨の解剖学的骨頚部の近傍で上腕骨の一部を置換するように設計した本体部分に装着する。従来の肩関節補綴物は上腕骨骨頭を置換するように作成した一般に球形の骨頭部分も含む。切断した上腕骨に補綴物を安定させるため骨頭部分と支柱の間には一般にカラーを設ける。一般に、カラーは上腕骨の切断表面上に位置して補綴物に掛かる負荷を骨の広い領域へ分散する役割を有する。
従来の一体式肩関節補綴物の難点の1つは骨寸法の異なる患者に対応するべく異なる大きさの補綴物を広く取り揃えておく必要があることである。このような一体式肩関節補綴物では、患者をX線により評価して骨置換に必要となる適切な寸法の補綴物を決定する。多数の寸法が異なる補綴物をこの評価をもとにした考え得る骨置換の候補として選択し、適切な補綴物の最終的選択は骨置換手術の間に行なう。
多数の在庫を抱えるという問題を軽減しうる全面的または部分的モジュラー式補綴物は、大腿骨置換での使用が周知となっている。たとえば、米国特許第4,051,559号では、大腿骨内に用意した窩洞内へネジ止めするのに適した分割式接合用支柱を含む補綴物を開示している。該補綴物は支柱へ接合させるのに好適な頚部と套管を含む骨頭部分とを別々に含む。この補綴物は患者に装着する以前に組み立てるようには設計されていない。支柱を第1に大腿骨内の窩洞内に螺子止めする必要がある。次に装着した支柱へボルトを用いて骨頭部分を装着する。套管は大腿骨の切断表面上に位置して補綴物に加わる負荷を支持するように設計してある。支柱の設計のため、骨頭部分は補綴物に加えられる体重を支える目的で套管を含む必要がある。この補綴物の分割構造は頚部と套管が一体構造のため制限されている。
支柱と別個の骨頭部分とを有する別の補綴物が米国特許第3806957号に示してあり、該特許では近心側端部を広げてある分離式支柱を含む補綴物を開示している。支柱の広げてある近心端は骨頭および螺子止め式骨頚部部分を受け入れて完全な補綴物を構成するように構成してある。骨頚部は特定患者の解剖学的相違に基づいて長くするまたは短くすることが出来る。この補綴物は、米国特許第4051559号に開示の補綴物同様、可撓性において制限を有しており、これは骨頭部分および骨頚部部分が一体型の構造であるためと、骨頭部分および骨頚部部分を支柱内へ直接接着するようになしてあるためである。
支柱が1つ以上の部材を含むような補綴物は米国特許第3,987,499号に示されている。米国特許第3,987,499号では、固定部分と移行部分の2つの部分を含む支柱または骨柄軸部材を有する補綴物を開示している。移行部分には関節球が接続する。さらに、関節球と大腿骨の一部の間にはカラーを含めることが出来る。固定部分には大腿骨へねじ込むのに適した外螺子を設けてある。移行部分は固定部分と案内ピンおよび固定螺子で係合する。関節球は移行部分の自由端に螺子止めするのに適している。該補綴物は体内の所定位置に部材ごとに配置してから順次組み立てるように設計してある。
モジュラー式大腿骨様補綴物以外にも部分的モジュラー式上腕骨補綴物が開示されている。たとえば、ダインズら(Dines et al.)の米国特許第4,865,605号では、上腕骨部材と関節窩部分とを有する肩関節補綴物を開示している。上腕骨部分は支柱と一体式に装着するカラーを含む。球形の骨頭部分が上腕骨部材の支柱内の先細になった空洞に係止自在になして骨頭部分と上腕骨部材の支柱の間で摩擦による密着を提供するための支柱を有することも開示されている。上腕骨部材の骨頭部分と支柱部分の双方に異なる寸法を用いることが出来る。
本発明では、上腕骨の一部の置換のための肩関節補綴物の組み立てのためのキットを提供する。このキットは寸法の異なる少なくとも2種類の支柱を含み、各々の本体が置換する上腕骨の一部の大きさになしてある。さらに、本キットは少なくとも2種類の骨頭部材を含み、それぞれの骨頭部材は置換する上腕骨骨頭の大きさになしてある。少なくとも2種類の骨頭部材のうちの1つを少なくとも2種類の本体部材の1つに固定的に取り付けるための装着手段も提供する。任意で、本キットは少なくとも2種類のカラーを含み、それぞれのカラーは少なくとも2種類の骨頭部材のうちの1つと少なくとも2種類の本体の1つの間に配置して、上腕骨に当接するように挿入した肩関節補綴物の位置を安定させるように構成することが出来る。
望ましくは、本発明のキットは複数の支柱、本体、カラー、および骨頭部材よりなり、その全てが異なる寸法および形状を有するのがよい。これらの独立した部材は相互の組み合わせによって所望の寸法形状をなす注文製作補綴物を構成するのに適している。この特徴の1つの利点は、所望の寸法と形状の肩関節補綴物を施術時にキットから組み立てることが出来る点である。もう1つの利点は、病院の中央材料室に在庫する肩関節補綴物の構成部材数量を増加させることなく、構成部材から組み立てることが出来る大量の肩関節補綴物の組み合わせに由来する。
本発明の別の好適実施例では、上腕骨の一部を置換するための、内部に空洞を形成するように構成した本体を含む埋め込み装置を提供する。置換する上腕骨の大きさに合わせてある骨頭部材を、本体に対して偏心してまたは同軸上に装着する。偏心装着によって本体に対して、骨頭部分を上下または前後に位置調節することが出来るので、埋め込む肩関節補綴物に一層よく適合させられるようになる。好適実施例において、偏心または同軸装着は多角形の断面形状を有する本体の内腔に形成した固定ソケットと、前記固定ソケットに嵌合させるように作ってある固定部品を提供するために前記骨頭部材に形成した固定フィンガの相互作用により保持される。前記固定ソケットは六角形の断面形状を有するように形成し、前記固定ソケット内に係止する固定フィンガの固定部品を六角形に作成することにより、本体に対して考え得る6つの方向の1つに骨頭部材を位置決めさせることが出来る。
よって、本発明のモジュラー式肩関節補綴物では、個々の部材の異なった寸法、形状、方向を選択することで注文製作の補綴物を組み立て、個々の症例の要件に正確に適合させる能力を提供するものである。キットの供給により病院で保持しなければならない在庫が大幅に減少する。さらにキットの態様をなす補綴物は埋め込み装置の可撓性を大幅に増加させ、他の方法を用いては利用することの出来ないような補綴物の組み立てを行なうことが出来る。
本発明のさらなる目的、特徴、利点は本発明を実現するための最良の形態を例示してある好適実施例についての以下の詳細な説明を記述したとおりに玩味熟読することにより当業者には明らかとなろう。
【図面の簡単な説明】
発明の詳細な説明では特に添付の図面を参照する。図面において、
図1はモジュラー式上腕骨補綴物の展開斜視図であって、2種類の異なる寸法形状の支柱と、2種類の異なる寸法形状で前記支柱に着脱自在の本体と、3種類の異なる寸法で前記本体に着脱自在の骨頭部材と、前記骨頭と前記本体の間に配置することの出来る3種類の異なる寸法のカラーを示す。
図2は前記本体の上面図で、前記骨頭部材の六角形の係止フィンガと嵌合し係止するような構成の内腔を示す。
図3は骨頭部材上の六角形の係止フィンガの非対称装着具を示す。
図4は前記骨頭部材の六角形の係止フィンガの中心位置決めを示す。
図5は図1のキットから選択し上腕骨内で組み立て装着を行なった支柱と、本体と、カラーと、骨頭部材により可能な1つの組み合わせを示す。
図6は別の実施例で、症例の肩峰に対して屈曲するように偏心して装着した骨頭部材を示す。
実施例の詳細な説明
図1に示すように、上腕骨補綴物の組み立て用キット10は複数の異なる寸法の形状の部材を有し、支柱20aおよび20b、本体30aおよび30b、カラー56a、56b、56c、骨頭部材44a、44b、44cを含む。骨頭、骨形部および隣接する上腕骨の一部を置換するための埋め込み装置は支柱20aおよび20bのグループから選択した1本の支柱と、本体30aおよび30bのグループから選択した1個の本体と、骨頭部材44a、44b、44cのグループから選択した1個の骨頭部材を連結することにより組み立てることが出来る。任意で、選択した骨頭部材と選択した本体の間に配置するためのカラーを、カラー56a、56b、56cのグループから選択することが出来る。キット10の提供により所望の寸法形状を有する上腕骨補綴物の組み立てが可能となり、上腕骨の一部を置換するための異なる寸法形状の一体型補綴物を大量に在庫する必要がない。
図1では2種類の異なる寸法形状の支柱20aおよび20bを図示してある。支柱20aは一般に円筒形の形状をなし、下側部分22aと上側部分24aを有するような構造をなしている。上側部分24aは本体30aまたは30bどちらかにねじ込み装着するような構造の外螺子28aで終止する。支柱20aの下側部分22aは上腕骨の窩洞(図示していない)内部へ挿入するように設計してある。
支柱20bも一般に円筒形の形状を有しているが、支柱20aよりも大きな長さと半径を有するように採寸し、寸法の大きな上腕骨への装着に適応するようになしてある。支柱20bは本体30aまたは30bのどちらかにねじ込み装着できる外螺子28bで終止する。支柱20bは骨が内側へ成長するための場所を提供するため下側部分22bに複数のチャネル29bを切ってある。当然のことながら、従来技術で公知の骨セメントを用いて上腕骨への支柱20bの短期および長期両用の固定を促進することが出来る。
支柱20bの下側部分は締め込み部材23bと破壊可能な頚部25bを含む易破壊性トルク制限部材21bで終止する。トルク制限部材21bを用いることによって、本体30aまたは30bの一方へ支柱20bの永久固定を行なう際に支柱20bの外螺子28bを締めるのに必要とされる量のトルクだけを術者が加えることが出来るようになっている。使用方法では、術者が本体30aまたは30bのどちらか一方をクランプまたは万力に仮止めして本体30aまたは30bが回転しないように固定する。仮止めした本体30aまたは30bの内腔32aまたは32bによって形成される内螺子33aまたは33bと外螺子28bが螺子で嵌合するようにそれぞれの本体30aまたは30bに対して支柱20bを位置合わせする。レンチまたはその他のトルクをかける手段(図示していない)を術者が用いて締め込み部材を時計回りの方向に捻り、支柱20bと本体30aまたは30bの一方との螺子嵌合を行なう。締め込み部材23bへ術者が過剰なトルクをかけると、破壊可能な頚部25bの位置で支柱20bの下側部分22bから締め込み部材23bが脱落するようになっているので、トルク制限部材21bが本体30aまたは30bの一方へ支柱20bを締め込みすぎるのを防止している。破壊可能な頚部25bの厚みを適切に選択しておけば、本体30aまたは30bの一方に支柱20bを螺子込み嵌合させるために支柱20bへかけることの出来るトルク量に所定の制限を設けることが出来る。
本体30aおよび30bも表面34aと34bを含み、各々の表面には内腔36aと36bが設けてある。内腔36aと36bは少なくとも内腔36aと36bの一部が非円形の断面形状を有するように設計する。好適な非円形の断面には、楕円と、4面体、6面体、12面体などの軸対称凸面多面体と、6芒星や8芒星を含む軸対称凹面多面体と、菱形または台形などの非対称凹面または凸面多面体を含む。図2で最も良く判るように、内腔36aの係止ソケット37aは等辺対称6面体断面形状を有するように形成する。本体30bは同様の形状の6面体係止ソケット37b(図1で輪郭を図示してある)を有するように形成する。本体30aおよび30bは鍛造、切削加工または鋳造によって製作でき、任意でグリストブラストなどの骨成長または接着強化促進用表面加工または被覆のいずれかを行なうことが出来る。
骨頭部材44a、44b、および44cは上腕骨骨頭を置換するための寸法を有しており、そのため部分球体状の構造を有している。骨頭部材44a、44b、および44cの球形部分47a、47bまたは47cは、埋め込んだ際に関節窩内腔にはまり込むまたは肩の肩峰に対して関節状に連結される。埋め込み自在な上腕骨補綴物を組み立てた場合(たとえば図5に図示してあるように)、骨頭部材44a、44b、および44cそれぞれの球面を切り取った部分48a、48b、および48cが本体30aまたは30bの一方に対向するように位置する。骨頭部材44a、44b、および44cは、わずかにテーパー状(先細)になして本体30a、30bの内腔36aまたは36bの一方との摩擦による締め込みテーパーロック(すなわちモーゼロック)を構成する係止フィンガ45a、45bまたは45cにより本体30aまたは30bの一方との固定的装着において受け入れ自在に保持される。係止フィンガ445a、45bまたは45cは偏心的に(たとえば骨頭部材44aおよび44bのように)または同軸的に(たとえば骨頭部材44cで見られるように)、骨頭部材44a、44b、または44cの切り取り部分48a、48b、または48cに装着してある。骨頭部材44aおよび44bの偏心装着により、非中心位置(切り取り部分44aの中心は図3において点aで図示してある)における係止フィンガ45aと骨頭部材切り取り部分48aまたは48bの永久装着(または一体形成)を行ない、最良の適合に必要な前方、後方、下方、上方への移動のために本体30aまたは30bに対して骨頭部材44aを有利に回転させることが可能となる。骨頭部材47aを永久装着できる本体30aまたは30bに対して考えられる6つの装着位置のうちの3つを図3に図示してある。骨頭部材44cの切り取り部分48cに同軸的に装着してある係止フィンガ45c(図4で最も良く見え、切り取り部分48cの中心点をa’で図示してある)は係止フィンガの中心位置への装着が望ましい場合に任意で用いることが出来る。
本体30aまたは30bに対する骨頭部材44a、44b、および44cの回転移動を防止するための係止装着は本体30aまたは30bに設けた係止ソケット37a、37bと係止フィンガ45a、45bまたは45cの遠心端側に設けてある係止部材49a、49bまたは49cの相互作用によるものである。係止部材49a、49b、および49cは相互に交換自在な同一の6面体断面形状を有しており、係止ソケット37aまたは37bにぴったり嵌合して本体30aまたは30bに対して考えられる6つの装着方向のうちの1つに骨頭部材44a、44b、または44cを係止できるような形状をなしている。当然のことながら、たとえば骨頭部材44cの係止フィンガ45cのように、係止フィンガを同軸的に骨頭部材へ装着してある場合、6つの方向はどれも骨頭部材44cの半径方向の対称性のため相互に識別することが出来ない。理解されるように、係止ソケットへの適切な嵌合のためには、係止部材は係止部材の断面形状と等しい適切な寸法の非円形断面形状を有していなければならない。
一般に、カラー56a、56b、または56cのうちの1つを骨頭部材44a、44b、および44cと本体30aまたは30bの間に装置する。カラー56a、56b、および56cは、これと組み合わせて用いる骨頭部材44a、44b、および44cより小さい半径を有するように採寸した実質的に平坦な円環状の円盤をなしている。カラー56a、56b、56cはそれぞれに開口部57a、57b、または57cを有するように形成してある。開口部57a、57b、または57cは係止フィンガ45a、45bまたは45cがその中を通過できるような寸法に設けてあり、内螺子59a、59b、および59cがそれぞれに設けてある。これらの螺子59a、59b、59cは本体30aと30bにそれぞれ設けてある外螺子39aまたは39bの一方とねじ込み式に嵌合してカラー56a、56b、または56cを本体30a、30bの一方に固定的に保持することができる。カラー56a、56b、または56cは上腕骨に対する本体30aまたは30bの位置を安定させるために有用であり、圧縮力を上腕骨の緻密で強靭な皮質の広い範囲に分散させる一助をなす。
図5は図1に図示したキットから選択したモジュラー式部材で組み立てた上腕骨補綴物100を示す。上腕骨補綴物は上腕骨105に埋伏させた支柱20aを含み、これの上部が本体30bに(外螺子28aによって)螺子嵌合している。カラー56cは本体30bと骨頭部材44aの間の適正な位置に装着してあり、カラー56cと骨頭部材44aの間に間隙bが残されている。カラーは多様な組み立て工具(図示していない)のいずれかを用いて所定量のトルクで本体に取り付け、カラーを確実に取り付けられるようになすことが出来る。係止フィンガ45aの係止部材49aは本体30bに設けてある係止ソケット37bと係合して骨頭部材44aが下方向に向かって配置されるように位置決めされる。
上腕骨補綴物100は骨頭および骨頭頚部(図示していない)を切除した上腕骨105に挿入する。上腕骨105の骨頭および骨頭頚部の切除は一般に平坦な表面104を上腕骨105に残すように行なってある。補綴物100の支柱20aを受け入れるように窩洞106を上腕骨105に形成してある。切除の術式および窩洞106形成術の術式が従来技術において公知であることは理解されよう。
組み立てた補綴物100を上腕骨105に取り付けるには、一般に骨セメント材料を窩洞106内に第1に注入する。次に補綴物100を窩洞内に配置し、本体30bの遠心端が切断した上腕骨105の上部表面104に掛かり、支柱20aが窩洞106内部を下向きに延在するようになす。支柱20a、病例によっては本体30bの一部もセメントが包囲して、上腕骨105内で補綴物100を固定するように作用する。次に骨頭部材44aを肩関節の関節窩窩洞部分107内に納まるように配置する。
図6は偏心的に装着した骨頭部材44aの別の位置決めを示し、係止部材49aと骨頭部材44aを上部位置へ180°回転させてある。この方向だと、関節窩の窩洞が損傷しているような症例で、または骨頭部材44aと適合させるのに他の方法では不適当な場合(たとえば肩関節回旋筋板形成不全症例など)に、肩峰109に対して部分的に球形の骨頭部分47aを関節状に連結させることが出来るようになる。
図面に図示した部材はキット10のほかの部材と交換自在であって、上腕骨補綴物をキット10から選択した図示の部材の組み合わせを用いて組み立てることが出来ることは理解されよう。この、異なる寸法形状の部材を選択して補綴物を組み立てることの出来る能力は施術時に利用可能な可撓性を大幅に増強するものである。つまり、症例の示す解剖学的所見にあわせて、その症例の要件に正確に適合するような多数の組み合わせで施術時に補綴物を組み立てることが可能となる。
本発明はここまで好適実施例および特定の例を参照しつつ詳細に説明されてきたが、添付の請求の範囲に記載しまた定めるとおり本発明の範囲および主旨を逸脱することなく変化および変更が有り得るものである。
Claims (7)
- 上腕骨の骨頭部分と骨頭頚部部分とこれに隣接する部分を置換するためのモジュラー式肩関節補綴物を組み立てるためのキットであって、
それぞれが前記上腕骨内に挿入するための寸法になしてある少なくとも2本の支柱と、
それぞれが前記上腕骨の一部を置換するための寸法になしてあり、前記少なくとも2本の支柱の1本を固定的装着において受け入れるような構造になしてある少なくとも2個の本体と、
それぞれが前記上腕骨の前記骨頭部分を置換するための寸法になしてある少なくとも2個の骨頭部材と、
前記少なくとも2個の骨頭部材のうちの1個を前記少なくとも2個の本体のうちの1個に固定的に装着するための手段とを含み、
前記支柱の少なくとも1本を、前記支柱と前記本体が螺子式嵌合するように前記少なくとも1本の支柱上に設けた外螺子と前記少なくとも1個の本体の内腔内に設けた内螺子によって、前記少なくとも1個の本体へ装着し、
前記支柱の少なくとも1本がさらに前記支柱へのトルク印加を制限するための破壊容易な手段をさらに含み、前記破壊容易な手段は前記支柱と前記本体のねじ込み嵌合を締めるように作用するトルクが所定量印加された際に壊れてそれ以上前記支柱を締め込まないように構成してあることを特徴とする補綴物キット。 - 上腕骨の骨頭部分と骨頭頚部部分とこれに隣接する部分を置換するためのモジュラー式肩関節補綴物を組み立てるためのキットであって、
それぞれが前記上腕骨内に挿入するための寸法になしてある少なくとも2本の支柱と、
それぞれが前記上腕骨の一部を置換するための寸法になしてあり、前記少なくとも2本の支柱の1本を固定的装着において受け入れるような構造になしてある少なくとも2個の本体と、
それぞれが前記上腕骨の前記骨頭部分を置換するための寸法になしてある少なくとも2個の骨頭部材と、
前記少なくとも2個の骨頭部材のうちの1個を前記少なくとも2個の本体のうちの1個に固定的に装着するための手段とを含み、
前記少なくとも2個の骨頭部材の内の1個を前記少なくとも2個の本体のうちの1個に固定的に装着するための手段が前記少なくとも2個の骨頭部材のうちの1個に装着した係止フィンガをさらに含み、前記係止フィンガは非円形の断面形状を有することで前記少なくとも2個の本体のうちの前記1個に対して前記係止フィンガが回転しないようになす係止部材を画成するように形成してあり、
前記少なくとも2個の骨頭部材のうちの1個に装着した前記係止フィンガが偏心的に装着してあることを特徴とする補綴物キット。 - 第1と第2の内腔を内部に形成してある本体と、
上側の部分と下側の部分を有し、前記下側の部分は上腕骨の骨幹内に受け入れられるような寸法になしてあり、前記上側の部分は前記本体の前記第1の内腔に嵌合するように作ってある支柱と、
前記上腕骨の骨頭を置換するための寸法になしてあり前記本体の前記第2の内腔に嵌合するように構成して装着した係止フィンガを有する骨頭部材とを含み、
前記係止フィンガは前記骨頭部材に偏心して取り付けてあり、
前記本体の前記第2の内腔は六角形の断面形状を有する係止ソケットを画成するように形成されており、前記係止フィンガは前記係止ソケットに適合して前記骨頭部材を前記本体に対して6つの考えられる方向のうちの1つに位置決めすることが出来るように設定された六角形の係止部材をさらに含むことを特徴とする上腕骨の一部を置換するための埋め込み装置。 - 第1と第2の内腔を内部に形成してある本体と、
上側の部分と下側の部分を有し、前記下側の部分は上腕骨の骨幹内に受け入れられるような寸法になしてあり、前記上側の部分は前記本体の前記第1の内腔に嵌合するように作ってある支柱と、
前記上腕骨の骨頭を置換するための寸法になしてあり前記本体の前記第2の内腔に嵌合するように構成して装着した係止フィンガを有する骨頭部材と、
を含み、
前記支柱は骨の内側への成長のための表面を提供して前記上腕骨への前記支柱の長期的装着を容易にするように構成してあり、
前記第1の内腔は内螺子を画成するように形成され、前記支柱は前記支柱の前記上側部分にさらに外螺子を画成され、前記外螺子は前記支柱と前記本体のねじ込み式嵌合を行なうために前記内螺子と適合する寸法形状になしてあり、
前記支柱は前記支柱に掛かるトルクを制限するための破壊可能な手段をさらに含み、前記破壊可能な手段は前記支柱と前記本体の前記ねじ込み嵌合を締め込むように作用するトルクが所定量印加されると壊れてさらに前記支柱を締め込まないように設定してあることを特徴とする上腕骨の一部を置換するための埋め込み装置。 - 上腕骨の一部を置換するための埋め込み装置であって、
内部に内腔を画成するように形成された本体と、
前記上腕骨の骨頭部分を置換するための寸法になしてある骨頭部材と、
前記本体に対する前記骨頭部材の調節可能な位置決めを許容するように前記骨頭部材を前記本体へ偏心的に装着するための手段とを含み、
前記偏心装着手段は前記骨頭部材へ偏心して装着された係止フィンガと、前記係止フィンガの遠心端側に設けてある係止部材とをさらに含むことを特徴とする埋め込み装置。 - 上腕骨の一部を置換するための埋め込み装置であって、
内部に内腔を画成するように形成された本体と、
前記上腕骨の骨頭部分を置換するための寸法になしてある骨頭部材と、
前記本体に対する前記骨頭部材の調節可能な位置決めを許容するように前記骨頭部材を前記本体へ偏心的に装着するための手段とを含み、
前記偏心装着手段は前記骨頭部材へ偏心して装着された係止フィンガをさらに含み、
前記本体の前記内腔は非円形の断面形状を有する係止ソケットを設けるように形成してあり、前記係止フィンガは前記係止ソケット内に係止的に嵌合するように構成した係止部材をさらに含むことを特徴とする埋め込み装置。 - 前記係止ソケットは6角形の断面形状を有し、前記係止フィンガの前記係止部材は前記係止ソケット内に嵌合させるための寸法の6角形の係止部材をさらに含むことで前記骨頭部材が6つの考えられる方向のうちの1つで前記本体に対して位置決めできるようになしてあることを特徴とする請求の範囲第6項に記載の埋め込み装置。
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US793,860 | 1991-11-18 | ||
US07/793,860 US5314479A (en) | 1986-08-15 | 1991-11-18 | Modular prosthesis |
PCT/US1992/010240 WO1993009733A1 (en) | 1991-11-18 | 1992-11-18 | Modular prosthesis |
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JPH07501001A JPH07501001A (ja) | 1995-02-02 |
JP3746290B2 true JP3746290B2 (ja) | 2006-02-15 |
Family
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Application Number | Title | Priority Date | Filing Date |
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JP50957993A Expired - Lifetime JP3746290B2 (ja) | 1991-11-18 | 1992-11-18 | モジュラー式補綴物 |
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US (1) | US5314479A (ja) |
EP (2) | EP1080702B1 (ja) |
JP (1) | JP3746290B2 (ja) |
AT (2) | ATE316361T1 (ja) |
AU (1) | AU679434B2 (ja) |
CA (1) | CA2123806C (ja) |
DE (2) | DE69231770T2 (ja) |
DK (1) | DK0613353T3 (ja) |
ES (1) | ES2155441T3 (ja) |
PL (1) | PL171292B1 (ja) |
WO (1) | WO1993009733A1 (ja) |
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-
1991
- 1991-11-18 US US07/793,860 patent/US5314479A/en not_active Expired - Lifetime
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1992
- 1992-11-18 AU AU31493/93A patent/AU679434B2/en not_active Expired
- 1992-11-18 DE DE69231770T patent/DE69231770T2/de not_active Expired - Lifetime
- 1992-11-18 EP EP00126928A patent/EP1080702B1/en not_active Revoked
- 1992-11-18 AT AT00126928T patent/ATE316361T1/de not_active IP Right Cessation
- 1992-11-18 DK DK92925436T patent/DK0613353T3/da active
- 1992-11-18 ES ES92925436T patent/ES2155441T3/es not_active Expired - Lifetime
- 1992-11-18 PL PL92303777A patent/PL171292B1/pl unknown
- 1992-11-18 AT AT92925436T patent/ATE200208T1/de active
- 1992-11-18 WO PCT/US1992/010240 patent/WO1993009733A1/en active IP Right Grant
- 1992-11-18 JP JP50957993A patent/JP3746290B2/ja not_active Expired - Lifetime
- 1992-11-18 DE DE69233597T patent/DE69233597T2/de not_active Revoked
- 1992-11-18 CA CA002123806A patent/CA2123806C/en not_active Expired - Lifetime
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DE69233597D1 (de) | 2006-04-13 |
DE69233597T2 (de) | 2006-08-10 |
CA2123806A1 (en) | 1993-05-27 |
ATE200208T1 (de) | 2001-04-15 |
DK0613353T3 (da) | 2001-06-18 |
CA2123806C (en) | 2000-10-10 |
US5314479A (en) | 1994-05-24 |
PL171292B1 (pl) | 1997-03-28 |
AU3149393A (en) | 1993-06-15 |
EP1080702A2 (en) | 2001-03-07 |
EP0613353A4 (en) | 1995-01-25 |
DE69231770D1 (de) | 2001-05-10 |
EP0613353A1 (en) | 1994-09-07 |
AU679434B2 (en) | 1997-07-03 |
ES2155441T3 (es) | 2001-05-16 |
WO1993009733A1 (en) | 1993-05-27 |
JPH07501001A (ja) | 1995-02-02 |
ATE316361T1 (de) | 2006-02-15 |
EP1080702B1 (en) | 2006-01-25 |
DE69231770T2 (de) | 2001-09-27 |
EP1080702A3 (en) | 2001-04-25 |
EP0613353B1 (en) | 2001-04-04 |
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