DE4412721A1 - Carpometacarpal prosthesis - Google Patents

Carpometacarpal prosthesis

Info

Publication number
DE4412721A1
DE4412721A1 DE4412721A DE4412721A DE4412721A1 DE 4412721 A1 DE4412721 A1 DE 4412721A1 DE 4412721 A DE4412721 A DE 4412721A DE 4412721 A DE4412721 A DE 4412721A DE 4412721 A1 DE4412721 A1 DE 4412721A1
Authority
DE
Germany
Prior art keywords
cup
prosthesis
cavity
bone
insert
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.)
Ceased
Application number
DE4412721A
Other languages
German (de)
Inventor
Jean-Francois Dupuy
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.)
Tornier SAS
Original Assignee
Tornier SAS
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 Tornier SAS filed Critical Tornier SAS
Publication of DE4412721A1 publication Critical patent/DE4412721A1/en
Ceased 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
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30156—Convex polygonal shapes triangular
    • 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
    • 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
    • A61F2002/30332—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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
    • 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
    • A61F2002/4256—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints
    • A61F2002/4258—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints for trapezo-metacarpal joints of thumbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0023—Angular shapes triangular

Abstract

Carpometacarpal prosthesis comprising a combination of the following elements: - a cup-shaped body (2) of small dimensions which is fixed so as to rest against the scaphoid bone (4) and is immobilised with a screw (3); - an insert (5) of a plastic which is inserted in the cup (2) and has a spherical cavity (50) in its interior; - and an anchorage shaft (6) having a triangular profile whose one free end has a spherical head (61) interacting with the cavity (50) in the insert (5). <IMAGE>

Description

Die vorliegende Erfindung betrifft eine Totalprothese des Dau­ mens und insbesondere seines Carpometacarpal-Gelenks, um die Kraft und die Beweglichkeit des anatomischen Gelenks, das durch einen pathologischen Degenerierungs- oder inflammatori­ schen Prozeß in Mitleidenschaft gezogen worden ist, wiederher­ zustellen.The present invention relates to a total prosthesis of the duration mens and in particular his Carpometacarpal joint to the Strength and mobility of the anatomical joint, the through a pathological degeneration or inflammatori process has been affected deliver.

Prothesen dieser Art sind bekannt, die im allgemeinen einen Block aus elastischem Material aufweisen, das zum Beispiel in einem "Silastic" benannten Material besteht. Diese Prothesen unterliegen einer raschen Abnützung, da ihr Grundaufbau den für die Wiederherstellung einer adäquaten und dauerhaften Funktion des Daumens nötigen Anforderungen an Festigkeit und Stabilität nur wenig Rechnung trägt.Prostheses of this type are known, which generally have one Have block of elastic material, for example in a material called "Silastic". These prostheses are subject to rapid wear and tear as their basic structure for the restoration of an adequate and permanent Function of the thumb necessary requirements for strength and Stability takes little account of it.

Darüber hinaus existieren andere Prothesen, die auf dem Prin­ zip eines mechanischen Kugelkopfgelenkes entwickelt worden sind, das auf dem Gebiet der Wiederherstellung von Gelenken zufriedenstellende klinische Ergebnisse erzielt. Es ist jedoch vorgesehen, diese Prothesen in einem im Trapezium-Knochen des Daumens ausgebildeten Hohlraum zu verankern. Dieser Knochen ist von geringer Größe und oft von schlechter Beschaffenheit, was in den meisten Fällen zu einer Loslösung der Prothesenver­ ankerung und einem bedeutenden Verlust an Bewegungsfunktionen führt. In addition, there are other prostheses based on the prin zip of a mechanical ball joint was developed are in the field of joint restoration achieved satisfactory clinical results. However, it is provided these prostheses in a in the trapezium bone of the Anchor the thumb-shaped cavity. That bone is small in size and often of poor quality, which in most cases leads to a detachment of the prosthesis server anchor and a significant loss of movement functions leads.  

Diesen Nachteilen will die vorliegende Erfindung insbesondere abhelfen.The present invention particularly wants these disadvantages help.

Die erfindungsgemäße Totalprothese für das Daumen-Carpometa­ carpal-Gelenk hat zum Ziel, den Trapezium-Knochen in seiner Form und in seiner räumlichen Ausdehnung vollständig durch eine metallische Kalotte zu ersetzen.The total prosthesis for the thumb carpometa according to the invention carpal joint aims to trapezium bone in its Form and in its spatial extent completely through to replace a metallic dome.

Die erfindungsgemäße Totalprothese umfaßtThe total prosthesis according to the invention comprises

  • - einen napfartigen Körper von geringen Abmessungen, der mit­ tels einer Klemmschraube gegen den karpalen Scaphoideum-Kno­ chen festgeklemmt wird,- A bowl-like body of small dimensions, the with with a clamping screw against the carpal scapoid is clamped,
  • - einen Einsatz aus einem Kunststoff, der in den Napf einge­ führt ist und in seinem Innenbereich einen kugelförmigen Hohl­ raum aufweist- An insert made of a plastic that is inserted into the bowl leads and a spherical hollow in its interior has space
  • - und einen Verankerungsschaft bzw. -stift, der einen dreiek­ kigen äußeren Umriß aufweist, und dessen eines freies Ende mit einem Kugelkopf ausgestattet ist, der mit dem Hohlraum des Einsatzes zusammenwirkt.- And an anchoring shaft or pin that a triangle kigen outer outline, and one free end with a ball head that is equipped with the cavity of the Interacts.

Die als Beispiel gegebene beiliegende Zeichnung wird ein bes­ seres Verständnis der Erfindung, der Eigenschaften, die sie zeigt und der Vorteile, die durch sie erlangt werden können, ermöglichen:The attached drawing given as an example is a bes seres understanding of the invention, the properties that it shows and the benefits it can bring enable:

Fig. 1 ist eine Ansicht, die eine rechte Hand dar­ stellt, deren Daumengelenk durch eine erfin­ dungsgemäße Carpometacarpal-Daumenprothese er­ setzt ist. Fig. 1 is a view showing a right hand, the thumb joint by a carpometacarpal thumb prosthesis according to the inven tion he is.

Fig. 2 ist eine explodierte Ansicht, die die verschie­ denen, die Carpometacarpal-Totalprothese bilden­ den Elemente zeigt. Fig. 2 is an exploded view showing the various elements forming the Carpometacarpal full denture.

Fig. 3 ist eine vergrößerte Ansicht, die ausschnitt­ weise das Gelenk der Totalprothese zeigt. Fig. 3 is an enlarged view showing a detail of the joint of the full denture.

In Fig. 1 ist das Skelett einer rechten Hand dargestellt, de­ ren Daumengelenk und insbesondere deren Carpometacarpal-Gelenk durch eine erfindungsgemäße Totalprothese 1 ersetzt worden ist.In Fig. 1 the skeleton of a right hand is shown, de ren thumb joint and in particular the Carpometacarpal joint has been replaced by a total prosthesis 1 according to the invention.

Die Carpometacarpal-Totalprothese 1 weist vier verschiedene Elemente 2, 3, 5 und 6 auf, durch deren Kombination das Daumen­ gelenk perfekt reproduziert werden kann. So weist die Prothese 1 einen napfförmigen Körper 2 auf, der mit Hilfe einer Schraube 3 im Scaphoideum-Knochen 4 fixiert ist. Im Inneren dieses Napfes 2 kommt ein Einsatz 5 aus Kunststoff zum Einra­ sten, der die Herstellung der Verbindung mit einem in die Dia­ physe des ersten Metacarpal-Knochens 7 eingeführten Veranke­ rungsschaft 6 erlaubt.The Carpometacarpal total prosthesis 1 has four different elements 2 , 3 , 5 and 6 , by combining which the thumb joint can be reproduced perfectly. The prosthesis 1 thus has a cup-shaped body 2 , which is fixed in the scaphoid bone 4 with the aid of a screw 3 . Inside this bowl 2 , an insert 5 made of plastic comes into engagement, which enables the connection to be made with a shaft 6 inserted into the dia physe of the first metacarpal bone 7 .

In Fig. 2 und 3 sind die Totalprothese 1 und insbesondere je­ des der sie bildenden Elemente dargestellt. Der Napf weist eine zylindrische Außenform auf, deren Volumen dem des Trape­ zium-Knochens entspricht, den er gänzlich ersetzt. Der Napf 2 ist aus einem metallischen Material hergestellt, und seine äußere Oberfläche weist eine geneigte Fläche 20 auf, die an die Oberfläche des benachbarten Trapezoid-Knochens 8 angepaßt gestaltet ist, wie in Fig. 3 dargestellt.In FIGS. 2 and 3, the denture 1, and in particular each of the constituent elements are shown. The bowl has a cylindrical outer shape, the volume of which corresponds to that of the trapezium bone, which it replaces entirely. The bowl 2 is made of a metallic material and its outer surface has an inclined surface 20 which is designed to match the surface of the adjacent trapezoid bone 8 , as shown in FIG. 3.

Der Napf 2 ist in seiner Mitte von einer Mündungsbohrung 21 für den Durchgang der Schraube 3 durchbrochen, um den Napf auf dem Scaphoideum-Knochen 4 festzuklemmen. Die Bohrung 21 weist in ihrem unteren Bereich ein dem Kugelprofil des Kopfes 31 der Schraube 3 entsprechendes Profil auf, damit die Schraube unter einem Winkel um die Hauptachse des Napfes 2 schwenkbar ist. Die Bohrung 21 mündet koaxial in einen Hohlraum 22 mit Doppel­ konusprofil.The bowl 2 is pierced in the middle by an orifice bore 21 for the passage of the screw 3 in order to clamp the bowl on the scapoid bone 4 . In its lower region, the bore 21 has a profile corresponding to the spherical profile of the head 31 of the screw 3 , so that the screw can be pivoted at an angle about the main axis of the cup 2 . The bore 21 opens coaxially into a cavity 22 with a double cone profile.

Die untere Außenseite 23 des Napfes 2, d. h. jene, die sich in Anlage gegen den Scaphoideum-Knochen 4 befindet, weist eine derart geriefte Oberfläche auf, daß die Verankerung des Napfes auf diesem Knochen verbessert wird. Die obere ringförmige Seite des Napfes 2, die sich entgegengesetzt der Seite 23 befindet, weist gleichmäßig auf ihrem Umfang verteilte Vor­ sprünge 24 auf.The lower outside 23 of the bowl 2 , that is to say that which is in contact with the scaphoid bone 4 , has a grooved surface such that the anchoring of the bowl on this bone is improved. The upper annular side of the bowl 2 , which is opposite to the side 23 , has cracks 24 evenly distributed over its circumference.

Der Einsatz 5 ist aus einem Material wie Polyethylen oder ähn­ lichem hergestellt, das gute Reibungseigenschaften bietet. Der Einsatz 5 weist in seiner Mitte einen kugelförmigen Hohlraum 50 auf, während sein äußerer Umfang 51 ein exakt in den Hohl­ raum 22 des Napfes 2 übergehendes Kegelstumpfprofil zeigt. Der Einsatz 5 weist auf seinem Umfang und insbesondere auf Höhe des Hohlraumes 50 einen Kragen 52 auf, der mit einer gewissen Anzahl von Kerben 53 versehen ist. Diese Kerben 53 wirken so mit den Vorsprüngen 24 zusammen, daß der Einsatz 5 winkelbe­ ständig im Inneren des Napfes 2 gehalten wird.The insert 5 is made of a material such as polyethylene or similar which offers good friction properties. The insert 5 has in its center a spherical cavity 50 , while its outer circumference 51 shows a truncated cone profile which merges exactly into the cavity 22 of the bowl 2 . The insert 5 has on its circumference and in particular at the level of the cavity 50 a collar 52 which is provided with a certain number of notches 53 . These notches 53 cooperate with the projections 24 in such a way that the insert 5 is constantly held in the interior of the bowl 2 .

Der Verankerungsschaft 6 weist solch eine langgestreckte und im Schnitt dreieckige Form auf, daß er sich an die innere Form des ersten Metacarpal-Knochens 7 anpaßt. Der Verankerungs­ schaft 6 ist aus solch einem metallischen Material herge­ stellt, daß seine Seiten ein rauhes Erscheinungsbild aufwei­ sen, um seine Plazierung mit oder ohne Zement im Inneren der Diaphyse des ersten Metacarpal-Knochens 7 zu ermöglichen. Ei­ nes der freien Enden des Verankerungsschaftes 6 weist eine ko­ nische Verbindungsfläche 60 auf, die durch einen Kugelkopf 61 verlängert wird. Der Kugelkopf 61 wird in den Hohlraum 50 des Einsatzes 5 so eingeführt und gehalten, daß er frei im Inneren dieses schwenkbar ist. Das Herausziehen des Kugelkopfes 61 aus dem Hohlraum 50 wird mittels einer Zugkraft entlang seiner Hauptachse erreicht, wodurch jegliche Luxation des Gelenkes vermieden wird.The anchoring shaft 6 has such an elongated and triangular shape in section that it adapts to the inner shape of the first metacarpal bone 7 . The anchoring shaft 6 is made of such a metallic material that its sides have a rough appearance to enable its placement with or without cement inside the diaphysis of the first metacarpal bone 7 . Egg nes the free ends of the anchoring shaft 6 has a ko African connecting surface 60 , which is extended by a ball head 61 . The ball head 61 is inserted and held in the cavity 50 of the insert 5 so that it can be pivoted freely inside the latter. The pulling of the ball head 61 out of the cavity 50 is achieved by means of a tensile force along its main axis, whereby any dislocation of the joint is avoided.

Die Schraube 3, die die Fixierung des Napfes 2 auf dem Sca­ phoideum-Knochen 4 ermöglicht, ist ein bekanntes Standardpro­ dukt, dessen Gewinde 30 für eine wirksame Befestigung im Kno­ chenmaterial vorgesehen ist. Die Schraube 3 hat zur Aufgabe, den Napf 2 in festem Kontakt mit dem Scaphoideum-Knochen 4 zu halten, um das Daumengelenk zu bilden und zu ersetzen. Es ist anzumerken, daß die gelenkseitige Oberfläche des ersten Meta­ carpal-Knochens 7a einer Resektion unterworfen wird, um die Plazierung des Verankerungsschaftes 6 in der Diaphyse dieses Knochens zu ermöglichen.The screw 3 , which allows the fixation of the bowl 2 on the Sca phoideum bone 4 , is a known Standardpro product, the thread 30 is provided for an effective fastening in the chen material. The screw 3 has the task of keeping the cup 2 in firm contact with the scapoid bone 4 in order to form and replace the thumb joint. It should be noted that the joint-side surface of the first metacarpal bone 7 a is subjected to a resection in order to allow the placement of the anchoring shaft 6 in the diaphysis of this bone.

Überdies bedarf es für die Einsetzung der Carpometacarpal-To­ talprothese der vollständigen Entfernung des Trapezium-Kno­ chens, so daß er durch den Napf 2 ersetzt wird. Dieser ist so gegen den Scaphoideum-Knochen 4 fixiert, daß seine geneigte Fläche 20 sich in Kontakt mit dem benachbarten Trapezoid-Kno­ chen 8 befindet.In addition, the full removal of the trapezium bone is required for the insertion of the Carpometacarpal to tal prosthesis, so that it is replaced by the bowl 2 . This is fixed against the scapoid bone 4 so that its inclined surface 20 is in contact with the adjacent trapezoid bone 8 .

Eine solche Totalprothese des Daumens ermöglicht es, die drei Freiheitsgrade der Drehung im Raum zu erhalten, die bezüglich des Kugelkopfes 61 und des Verankerungsschaftes 6 zentriert sind. Die Prothese 1 wird axial durch die muskulär-tendinösen und Kapsel-Ligament-Strukturen, die in ihrer Position bleiben, gehalten. Es bleibt darüber hinaus wohlverstanden, daß die voranstehende Beschreibung reinen Beispielcharakter besitzt und daß sie in keiner Weise den Erfindungsbereich einschränkt, der durch das Ersetzen der beschriebenen Ausführungseinzelhei­ ten durch alle anderen gleichwertigen nicht verlassen wird.Such a total prosthesis of the thumb makes it possible to obtain the three degrees of freedom of rotation in space which are centered with respect to the ball head 61 and the anchoring shaft 6 . The prosthesis 1 is held axially by the muscular-tendinous and capsule-ligament structures that remain in place. Furthermore, it is well understood that the foregoing description is merely exemplary in nature and that it in no way limits the scope of the invention, which is not abandoned by the replacement of the described embodiment details by any other equivalent.

Claims (5)

1. Totalprothese des Daumens und insbesondere des Carpometa­ carpalgelenks mit:
  • - einem napfartigen Körper von geringen Abmessungen, der in Anlage gegen den Scaphoideum-Knochen fixiert und mit­ tels einer Schraube immobilisiert ist;
  • - einem Einsatz aus einem Kunststoff, der in den Napf eingeführt ist und in seinem Innenbereich einen kugelför­ migen Hohlraum aufweist;
  • - einem Verankerungsschaft, dessen eines freies Ende einen Kugelkopf aufweist, der mit dem Hohlraum des Ein­ satzes zusammenwirkt, dadurch gekennzeichnet, daß der Napf (2) ein zylindrisches Außenprofil zeigt, das eine geneigte Fläche (20) aufweist, die bei der Befesti­ gung der Prothese (1) gegen den benachbarten Trapezoid- Knochen (8) zur Anlage kommt.
1. Total prosthesis of the thumb and in particular the Carpometa carpal joint with:
  • - A cup-like body of small dimensions, which is fixed against the scaphoid bone and immobilized by means of a screw;
  • - An insert made of a plastic that is inserted into the bowl and has a kugelför shaped cavity in its interior;
  • - An anchoring shaft, one free end of which has a spherical head which interacts with the cavity of the insert, characterized in that the cup ( 2 ) shows a cylindrical outer profile which has an inclined surface ( 20 ) which, when fastening the supply Prosthesis ( 1 ) comes into contact with the adjacent trapezoid bone ( 8 ).
2. Prothese gemäß Anspruch 1, dadurch gekennzeichnet, daß der Napf (2) zur Verbesserung seiner Verankerung im Scaphoideum-Knochen (4) eine geriefte untere Fläche (23) aufweist.2. Prosthesis according to claim 1, characterized in that the cup ( 2 ) has a grooved lower surface ( 23 ) to improve its anchoring in the scaphoideum bone ( 4 ). 3. Prothese gemäß Anspruch 1 oder 2, dadurch gekennzeichnet, daß der Napf (2) auf seiner oberen, sich entgegengesetzt der Seite (23) befindenden Fläche Vorsprünge (24) auf­ weist.3. Prosthesis according to claim 1 or 2, characterized in that the cup ( 2 ) on its upper, opposite the side ( 23 ) surface has projections ( 24 ). 4. Prothese gemäß Anspruch 3, dadurch gekennzeichnet, daß die Vorsprünge (24) gleichmäßig auf dem äußeren Um­ fang des Napfes (2) verteilt sind.4. Prosthesis according to claim 3, characterized in that the projections ( 24 ) are evenly distributed on the outer order of the bowl ( 2 ). 5. Prothese gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß der Einsatz (5) einen Hohlraum (50) aufweist, der von einem in gleichmäßigen Abständen mit Kerben (53) verse­ henen Kragen (52) eingefaßt ist, und daß sein Außenprofil (51) eine der konischen Form des Hohlraums (22) des Napfes (2) entsprechende Form zeigt.5. A prosthesis according to any one of the preceding claims, characterized in that the insert ( 5 ) has a cavity ( 50 ) which is bordered by a collar ( 52 ) provided with notches ( 53 ) at regular intervals and that its outer profile ( 51 ) shows a shape corresponding to the conical shape of the cavity ( 22 ) of the cup ( 2 ).
DE4412721A 1993-04-15 1994-04-13 Carpometacarpal prosthesis Ceased DE4412721A1 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR9304657A FR2703904B1 (en) 1993-04-15 1993-04-15 Trapezo-metacarpal prosthesis.

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DE4412721A1 true DE4412721A1 (en) 1994-10-20

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FR (1) FR2703904B1 (en)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5645605A (en) * 1995-09-18 1997-07-08 Ascension Orthopedics, Inc. Implant device to replace the carpometacarpal joint of the human thumb
EP1195150A1 (en) * 2000-09-22 2002-04-10 Ceramtec AG Innovative Ceramic Engineering Finger joint implant
EP1627615A2 (en) * 2004-08-18 2006-02-22 Arthrex, Inc. Modular joint replacement implant with hydrogel surface
EP1634548A2 (en) * 2004-09-08 2006-03-15 Arthrex, Inc. Modular system for replacement of radial head
WO2008104889A2 (en) * 2007-02-28 2008-09-04 Small Bone Innovations International Trapezometacarpal joint prosthesis
WO2009136852A1 (en) * 2008-05-06 2009-11-12 Swemac Innovation Ab Joint prosthesis
US7976580B2 (en) * 2005-08-18 2011-07-12 Mayo Foundation For Medical Education And Research Semi-constrained 1st carpometacarpal implant arthroplasty and method

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2770770B1 (en) * 1997-11-07 2002-06-21 Fixano ARRANGEMENT OF ELEMENTS FOR THE CONSTITUTION OF A TRAPEZO-METACARPIAN JOINT PROSTHESIS
EP1781214B1 (en) 2004-08-09 2020-06-03 Ortho - I.D. Sarl Ball-type triple-joint implant system for upper or lower limbs

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4276660A (en) * 1979-05-25 1981-07-07 Laure Prosthetics, Inc. Carpometacarpal thumb joint
US4642122A (en) * 1986-04-02 1987-02-10 Laure Prosthetics, Inc. Toe implant
CH673087A5 (en) * 1987-10-28 1990-02-15 Sulzer Ag
US4955916A (en) * 1989-05-01 1990-09-11 Techmedica, Inc. Thumb joint prosthesis
FR2670109B1 (en) * 1990-10-15 1995-07-07 Lacaffiniere Jean Yves De TOTAL TRAPEZO-METACARPIAN PROSTHESIS WITH INTERMEDIATE PIECE.
FR2679440A1 (en) * 1991-07-24 1993-01-29 Hades JOINT PROSTHESIS, IN PARTICULAR TRAPEZO-METACARPIAN AND DIGITAL.

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5645605A (en) * 1995-09-18 1997-07-08 Ascension Orthopedics, Inc. Implant device to replace the carpometacarpal joint of the human thumb
EP1195150A1 (en) * 2000-09-22 2002-04-10 Ceramtec AG Innovative Ceramic Engineering Finger joint implant
EP1627615A2 (en) * 2004-08-18 2006-02-22 Arthrex, Inc. Modular joint replacement implant with hydrogel surface
EP1627615A3 (en) * 2004-08-18 2006-11-02 Arthrex, Inc. Modular joint replacement implant with hydrogel surface
EP1634548A2 (en) * 2004-09-08 2006-03-15 Arthrex, Inc. Modular system for replacement of radial head
EP1634548A3 (en) * 2004-09-08 2006-10-18 Arthrex, Inc. Modular system for replacement of radial head
US7641695B2 (en) 2004-09-08 2010-01-05 Arthrex, Inc. Modular system for replacement of radial head
US7976580B2 (en) * 2005-08-18 2011-07-12 Mayo Foundation For Medical Education And Research Semi-constrained 1st carpometacarpal implant arthroplasty and method
WO2008104889A2 (en) * 2007-02-28 2008-09-04 Small Bone Innovations International Trapezometacarpal joint prosthesis
WO2008104889A3 (en) * 2007-02-28 2008-11-20 Small Bone Innovations Interna Trapezometacarpal joint prosthesis
WO2009136852A1 (en) * 2008-05-06 2009-11-12 Swemac Innovation Ab Joint prosthesis

Also Published As

Publication number Publication date
FR2703904A1 (en) 1994-10-21
FR2703904B1 (en) 1995-06-09

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