WO2006048520A1 - Lower radial head prosthesis - Google Patents

Lower radial head prosthesis Download PDF

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Publication number
WO2006048520A1
WO2006048520A1 PCT/FR2005/002604 FR2005002604W WO2006048520A1 WO 2006048520 A1 WO2006048520 A1 WO 2006048520A1 FR 2005002604 W FR2005002604 W FR 2005002604W WO 2006048520 A1 WO2006048520 A1 WO 2006048520A1
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WO
WIPO (PCT)
Prior art keywords
cavity
insert
radial head
stud
prosthesis
Prior art date
Application number
PCT/FR2005/002604
Other languages
French (fr)
Inventor
Jean-Luc Roux
Original Assignee
Dedienne Sante
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 Dedienne Sante filed Critical Dedienne Sante
Publication of WO2006048520A1 publication Critical patent/WO2006048520A1/en

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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
    • A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/30934—Special articulating surfaces
    • 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
    • A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
    • A61F2002/4264—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists for radio-carpal 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
    • 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

Definitions

  • the present invention relates to a lower implantable radial head prosthesis for positioning in the wrist joint to replace the lower head of the radius.
  • the wrist is a complex set of naturally unstable joints. It consists of the association of two distinct articulations.
  • the first, of the condylar type is the radiocarpal joint resulting from the interlocking of the distal end of the radius (antebrachial glenoid) whose articular surface looks forward and inward on the carpal condyle (first row of carpal bones: scaphoid, semilunar and pyramidal).
  • the radiocarpal joint is the seat of flexion extension as well as lateral movements called radial inclination (abduction) and ulnar inclination (adduction).
  • the second joint is the inferior radiocubital (or radioulnar) joint. It involves the sigmoid cavity of the radius with the lower cubital head and allows prono-supination movements.
  • the pathologies of the wrist are numerous and quickly become painful and disabling. In the elderly, this joint can undergo significant wear: it is osteoporosis of the wrist. Another serious condition is the fracture of the wrist, of which there are several categories, most of which are located at the distal end of the radius. The most common types of fracture are hyperextension, hyperflexion and axial compression. Complex fractures (patients with osteoporosis, multiple bone fragments, etc.) are common. The treatment of these fractures is difficult and necessarily surgical.
  • osteosynthesis techniques are numerous and widespread. However, they are poorly suited to patients with osteoporosis and multiple fractures. In addition, these techniques present significant risks of complications by perforation of tendons, nerves, arteries or veins located near the treated areas. The failure rate of these techniques is also important.
  • Other techniques of implanting a prosthetic joint exist, and DE-A-102 37 016 or GB-A-2 269 752 describe, for example, lower radial head prostheses.
  • the existing prostheses are all radiocarpal or even radio-metacarpal type. Implantation of these total wrist prostheses induces important bone sacrifices at the radial level but also at the carpal or metacarpal level and is unsuitable in cases of complex fractures of the distal end of the radius.
  • the problem to be solved by the present invention is to develop a prosthesis does not have the disadvantages of the aforementioned techniques, to save the bones of carp and metacarpal in the context of a simple and effective surgical procedure.
  • the prosthesis concerned has, in a manner known per se, at least two concave anatomical cavities, at least one of which, arranged on the distal face of the radial head, is intended to receive the bones of the first row of the carp and to perform a articulation with these, and a second, arranged on the medial side of the radial head, is intended to receive the ulnar head and to achieve a joint therewith.
  • the prosthesis consists of three elements, namely: - an anchoring rod, comprising an elongated body intended to be implanted in the medullary canal of the radius and a distal end flared and flattened able to bear on the distal end of the radius, suitably resected, this distal end of the anchor rod comprising a stud or a cylindrical cavity whose axis is collinear with that of the radius;
  • an insert having, on its proximal face, a cavity or a stud of complementary shape to the stud or the cavity, respectively, of the anchor rod, able to receive this stud or this cavity in a controlled manner but with the possibility of pivoting , the insert also having, on its distal face, a male or female assembly means for assembling the radial head; -
  • the radial head having on its proximal face a form of complementary assembly means of the assembly means present on the distal face of the insert.
  • At least two of the three aforementioned elements of the present invention are thus rotatable between them and allow the maintenance of optimal radio-ulnar congruence during prono-supination movements.
  • the various constituent elements of the present invention are indifferently composed of plastic material of high density polyethylene type, stainless steel, chromium-cobalt alloy or ceramic materials.
  • the insert is made of high molecular weight polyethylene while the other two elements are made of metal.
  • the prosthesis may also consist of materials determining metal-metal, metal-polyethylene, metal-ceramic or ceramic-ceramic friction couples.
  • the prosthesis may exist in cemented version or implantable version without cement.
  • Figures 1 and 2 are exploded perspective views of this prosthesis, according to a first embodiment, from two different angles;
  • Figure 3 is a perspective view of the prosthesis shown in Figures 1 and 2 after assembly;
  • FIG. 4 is a view of this lateral prosthesis, after implantation, and
  • FIG. 5 is an exploded perspective view of the prosthesis, according to an alternative embodiment.
  • FIGS. 1 to 4 show a lower radial head prosthesis 1 consisting of three elements, namely an anchoring rod 2, an insert 3 and a radial head 4.
  • the anchoring rod 2 comprises an elongate body 5 intended to be implanted in the medullary canal of the radius and a flared and flattened distal end 6 adapted to bear on the distal end of the radius, suitably resected.
  • This distal end 6 comprises a cylindrical stud 7 whose axis is collinear with that of the radius.
  • the insert 3 has, on its proximal face, a cavity 8 of complementary shape of the stud 7, able to receive this stud 7 in a controlled manner but with the possibility of pivoting.
  • the insert 7 On its distal face, the insert 7 comprises a stud 9 for the assembly of the radial head 4.
  • the latter has, on its proximal face, a cavity 10 for receiving the stud 9, and on its distal side and its side medial, two concave anatomical cavities 11, 12.
  • the cavity 11 arranged on the distal face of the head 4 is intended, as shown in Figure 4, to receive the bones of the first row of the carp and to achieve a joint with those ci, while the cavity 12 arranged on the medial side of the head 4 is intended to receive the ulnar head and perform a joint therewith.
  • the head 4 has a redan 15 at its proximal face, defining a proximal medial extension 4a.
  • This step 15 is intended to house the insert 3, which is truncated accordingly, and the proximal medial extension 4a allows to develop a cavity 12 of sufficient size to achieve an appropriate articulation with the ulnar head.
  • FIG. 5 shows an alternative embodiment in which the studs 7 and 9 and the cavities 8 and 10 are inverted with respect to the prosthesis 1 shown in FIGS. 1 to 4.
  • the anchoring rod 2 consequently comprises the cylindrical cavity 8 and the proximal face of the insert 3 comprises the stud 7, received pivotally in the cavity 8, while the proximal face of the head 4 has the stud 9 intended to be received in the cavity 10, itself arranged at the level
  • the invention provides a lower radial head prosthesis adapted to patients suffering from osteoporosis and to multiple or complex fractures of the distal end of the radius, presenting low risk of complications, and to save the carp and metacarpal bones in a simple and effective surgical procedure.

Abstract

The inventive prosthesis (1) consists of three elements, that is: an anchoring rod (2) having a distal end (6) that can be supported on the distal end of the radius, is suitably resected, and comprises a segment (7) or a cylindrical cavity (8) having an axis which is colinear to that of the radius; an insert (3) provided with a cavity (8) or a segment (7), on the proximal face thereof, that is respectively complementary to the segment (7) or the cavity (8) of the anchoring rod (2), and can receive said segment (7) or cavity (8) in an adjusted manner but with a pivoting possibility, said insert (3) also comprising, on the distal face thereof, a male or female assembly means (9, 10) for assembling the radial head (4); and a radial head (4) comprising, on the proximal face thereof, an assembly means (10, 9) which is complementary to the assembly means (9, 10) on the distal face of the insert (3).

Description

PROTHESE DE TETE RADIALE INFERIEURE LOWER RADIAL HEAD PROSTHESIS
La présente invention concerne une prothèse de tête radiale inférieure, implantable à long terme et destinée à être positionnée dans l'articulation du poignet afin de remplacer la tête inférieure du radius. Le poignet est un ensemble complexe d'articulations naturellement instables. Il est constitué de l'association de deux articulations bien distinctes.The present invention relates to a lower implantable radial head prosthesis for positioning in the wrist joint to replace the lower head of the radius. The wrist is a complex set of naturally unstable joints. It consists of the association of two distinct articulations.
La première, de type condylien, est l'articulation radio-carpienne qui résulte de l'emboîtement de l'extrémité distale du radius (glène antébrachiale) dont la surface articulaire regarde en avant et en dedans, sur le condyle carpien (première rangée des os du carpe : scaphoïde, semi-lunaire et pyramidal). L'articulation radio-carpienne est le siège de la flexion extension ainsi que des mouvements latéraux dits d'inclinaison radiale (abduction) et d'inclinaison cubitale (adduction).The first, of the condylar type, is the radiocarpal joint resulting from the interlocking of the distal end of the radius (antebrachial glenoid) whose articular surface looks forward and inward on the carpal condyle (first row of carpal bones: scaphoid, semilunar and pyramidal). The radiocarpal joint is the seat of flexion extension as well as lateral movements called radial inclination (abduction) and ulnar inclination (adduction).
La seconde articulation est l'articulation radio-cubitale (ou radio-ulnaire) inférieure. Elle met en jeu la cavité sigmoïde du radius avec la tête cubitale inférieure et permet les mouvements de prono-supination.The second joint is the inferior radiocubital (or radioulnar) joint. It involves the sigmoid cavity of the radius with the lower cubital head and allows prono-supination movements.
Les pathologies du poignet sont nombreuses et deviennent rapidement douloureuses et invalidantes. Chez les personnes âgées, cette articulation peut subir une usure importante : c'est I'ostéoporose du poignet. Une autre affection grave est la fracture du poignet dont on distingue plusieurs catégories en majorité situées au niveau de l'extrémité distale du radius. Les types de fracture les plus fréquents sont l'hyperextension, l'hyperflexion et la compression axiale. Les fractures complexes (patient souffrant d'ostéoporose, fragment osseux multiples ...) sont fréquentes. Le traitement de ces fractures est difficile et obligatoirement chirurgical.The pathologies of the wrist are numerous and quickly become painful and disabling. In the elderly, this joint can undergo significant wear: it is osteoporosis of the wrist. Another serious condition is the fracture of the wrist, of which there are several categories, most of which are located at the distal end of the radius. The most common types of fracture are hyperextension, hyperflexion and axial compression. Complex fractures (patients with osteoporosis, multiple bone fragments, etc.) are common. The treatment of these fractures is difficult and necessarily surgical.
Ainsi, les techniques d'ostéosynthèse sont nombreuses et répandues. Elles sont toutefois peu adaptées aux patients souffrant d'ostéoporose et aux fractures multiples. Par ailleurs, ces techniques présentent des risques de complication importants par perforation de tendons, nerfs, artères ou veines situés à proximité des zones traitées. Le taux d'échec de ces techniques est également important. D'autres techniques, consistant à implanter une articulation prothétique existent, et les documents DE-A-102 37 016 ou GB-A-2 269 752 décrivent par exemple des prothèses de tête radiale inférieure.Thus, osteosynthesis techniques are numerous and widespread. However, they are poorly suited to patients with osteoporosis and multiple fractures. In addition, these techniques present significant risks of complications by perforation of tendons, nerves, arteries or veins located near the treated areas. The failure rate of these techniques is also important. Other techniques of implanting a prosthetic joint exist, and DE-A-102 37 016 or GB-A-2 269 752 describe, for example, lower radial head prostheses.
Les prothèses existantes sont toutes de type radio-carpienne voire radio- métacarpienne. L'implantation de ces prothèses totales de poignet induit d'importants sacrifices osseux au niveau radial mais également au niveau carpien voire métacarpien et est inadaptée dans les cas de fractures complexes de l'extrémité distale du radius.The existing prostheses are all radiocarpal or even radio-metacarpal type. Implantation of these total wrist prostheses induces important bone sacrifices at the radial level but also at the carpal or metacarpal level and is unsuitable in cases of complex fractures of the distal end of the radius.
Dès lors, le problème que se propose de résoudre la présente invention est de développer une prothèse ne présentant pas les inconvénients des techniques précitées, permettant de sauvegarder les os du carpe et du métacarpe dans le cadre d'un acte chirurgical simple et efficace.Therefore, the problem to be solved by the present invention is to develop a prosthesis does not have the disadvantages of the aforementioned techniques, to save the bones of carp and metacarpal in the context of a simple and effective surgical procedure.
La prothèse concernée présente, de manière connue en soi, au moins deux cavités anatomiques concaves, dont au moins une première, aménagée sur la face distale de la tête radiale, est destinée à recevoir les os de la première rangée du carpe et à réaliser une articulation avec ceux-ci, et dont une deuxième, aménagée sur le côté médial de la tête radiale, est destinée à recevoir la tête cubitale et à réaliser une articulation avec celle-ci.The prosthesis concerned has, in a manner known per se, at least two concave anatomical cavities, at least one of which, arranged on the distal face of the radial head, is intended to receive the bones of the first row of the carp and to perform a articulation with these, and a second, arranged on the medial side of the radial head, is intended to receive the ulnar head and to achieve a joint therewith.
Selon l'invention, la prothèse est constituée de trois éléments, à savoir : - une tige d'ancrage, comprenant un corps allongé destiné à être implanté dans le canal médullaire du radius et une extrémité distale évasée et aplatie apte par prendre appui sur l'extrémité distale du radius, convenablement réséquée, cette extrémité distale de la tige d'ancrage comprenant un plot ou une cavité cylindrique dont l'axe est colinéaire à celui du radius ;According to the invention, the prosthesis consists of three elements, namely: - an anchoring rod, comprising an elongated body intended to be implanted in the medullary canal of the radius and a distal end flared and flattened able to bear on the distal end of the radius, suitably resected, this distal end of the anchor rod comprising a stud or a cylindrical cavity whose axis is collinear with that of the radius;
- un insert, présentant, sur sa face proximale, une cavité ou un plot de forme complémentaire du plot ou de la cavité, respectivement, de la tige d'ancrage, pouvant recevoir ce plot ou cette cavité de manière ajustée mais avec possibilité de pivotement, l'insert présentant également, sur sa face distale, un moyen d'assemblage mâle ou femelle pour l'assemblage de la tête radiale ; - Ia tête radiale, présentant sur sa face proximale un moyen d'assemblage de forme complémentaire du moyen d'assemblage présent sur la face distale de l'insert.an insert having, on its proximal face, a cavity or a stud of complementary shape to the stud or the cavity, respectively, of the anchor rod, able to receive this stud or this cavity in a controlled manner but with the possibility of pivoting , the insert also having, on its distal face, a male or female assembly means for assembling the radial head; - The radial head, having on its proximal face a form of complementary assembly means of the assembly means present on the distal face of the insert.
Au moins deux des trois éléments précités de la présente invention sont ainsi mobiles entre eux en rotation et permettent le maintient d'une congruence radio-cubitale optimale lors des mouvements de prono-supination.At least two of the three aforementioned elements of the present invention are thus rotatable between them and allow the maintenance of optimal radio-ulnar congruence during prono-supination movements.
Les différents éléments constitutifs de la présente invention sont indifféremment composés de matériau plastique de type polyéthylène haute densité, d'acier inoxydable, d'alliage de chrome-cobalt ou de matériaux céramiques.The various constituent elements of the present invention are indifferently composed of plastic material of high density polyethylene type, stainless steel, chromium-cobalt alloy or ceramic materials.
Selon une forme de réalisation possible de Ia prothèse selon l'invention, l'insert est en polyéthylène à haut poids moléculaire alors que les deux autres éléments sont en métal.According to one possible embodiment of the prosthesis according to the invention, the insert is made of high molecular weight polyethylene while the other two elements are made of metal.
La prothèse peut également être constituée de matériaux déterminant des couples de frottement métal-métal, métal-polyéthylène, métal-céramique ou céramique-céramique.The prosthesis may also consist of materials determining metal-metal, metal-polyethylene, metal-ceramic or ceramic-ceramic friction couples.
La prothèse peut exister en version cimentée ou en version implantable sans ciment.The prosthesis may exist in cemented version or implantable version without cement.
L'invention sera bien comprise, et d'autres caractéristiques et avantages de celle-ci apparaîtront, en référence au dessin schématique annexé, représentant, à titre d'exemples non limitatifs, une forme de réalisation de la prothèse qu'elle concerne.The invention will be better understood, and other features and advantages thereof will become apparent, with reference to the attached schematic drawing, showing, by way of non-limiting examples, an embodiment of the prosthesis it relates.
Les figures 1 et 2 sont des vues en perspective éclatée de cette prothèse, selon une première forme de réalisation, sous deux angles différents ; la figure 3 est une vue en perspective de Ia prothèse montrée sur les figures 1 et 2, après assemblage ; la figure 4 est une vue de cette prothèse de côté, après implantation, et la figure 5 est une vue en perspective éclatée de la prothèse, selon une variante de réalisation.Figures 1 and 2 are exploded perspective views of this prosthesis, according to a first embodiment, from two different angles; Figure 3 is a perspective view of the prosthesis shown in Figures 1 and 2 after assembly; FIG. 4 is a view of this lateral prosthesis, after implantation, and FIG. 5 is an exploded perspective view of the prosthesis, according to an alternative embodiment.
Les figures 1 à 4 représentent une prothèse de tête radiale inférieure 1 , constituée de trois éléments, à savoir une tige d'ancrage 2, un insert 3 et une tête radiale 4. La tige d'ancrage 2 comprend un corps allongé 5 destiné à être implanté dans le canal médullaire du radius et une extrémité distale évasée et aplatie 6 apte par prendre appui sur l'extrémité distale du radius, convenablement réséquée. Cette extrémité distale 6 comprend un plot cylindrique 7 dont l'axe est colinéaire à celui du radius.FIGS. 1 to 4 show a lower radial head prosthesis 1 consisting of three elements, namely an anchoring rod 2, an insert 3 and a radial head 4. The anchoring rod 2 comprises an elongate body 5 intended to be implanted in the medullary canal of the radius and a flared and flattened distal end 6 adapted to bear on the distal end of the radius, suitably resected. This distal end 6 comprises a cylindrical stud 7 whose axis is collinear with that of the radius.
L'insert 3 présente, sur sa face proximale, une cavité 8 de forme complémentaire du plot 7, pouvant recevoir ce plot 7 de manière ajustée mais avec possibilité de pivotement. Sur sa face distale, l'insert 7 comprend un plot 9 pour l'assemblage de la tête radiale 4. Cette dernière présente, sur sa face proximale, une cavité 10 de réception du plot 9, et, sur sa face distale et son côté médial, deux cavités anatomiques concaves 11 , 12. La cavité 11 aménagée sur la face distale de la tête 4 est destinée, comme le montre la figure 4, à recevoir les os de la première rangée du carpe et à réaliser une articulation avec ceux-ci, tandis que la cavité 12 aménagée sur le côté médial de la tête 4 est destinée à recevoir la tête cubitale et à réaliser une articulation avec celle-ci.The insert 3 has, on its proximal face, a cavity 8 of complementary shape of the stud 7, able to receive this stud 7 in a controlled manner but with the possibility of pivoting. On its distal face, the insert 7 comprises a stud 9 for the assembly of the radial head 4. The latter has, on its proximal face, a cavity 10 for receiving the stud 9, and on its distal side and its side medial, two concave anatomical cavities 11, 12. The cavity 11 arranged on the distal face of the head 4 is intended, as shown in Figure 4, to receive the bones of the first row of the carp and to achieve a joint with those ci, while the cavity 12 arranged on the medial side of the head 4 is intended to receive the ulnar head and perform a joint therewith.
Comme le montrent les figures 1 à 4, la tête 4 présente un redan 15 au niveau de sa face proximale, délimitant une extension médiale proximale 4a. Ce redan 15 est destiné à loger l'insert 3, lequel est tronqué en conséquence, et l'extension médiale proximale 4a permet d'aménager une cavité 12 de dimensions suffisantes pour réaliser une articulation appropriée avec la tête cubitale.As shown in Figures 1 to 4, the head 4 has a redan 15 at its proximal face, defining a proximal medial extension 4a. This step 15 is intended to house the insert 3, which is truncated accordingly, and the proximal medial extension 4a allows to develop a cavity 12 of sufficient size to achieve an appropriate articulation with the ulnar head.
La figure 5 montre une variante de réalisation dans laquelle les plots 7 et 9 et les cavités 8 et 10 sont inversés par rapport à la prothèse 1 montrée sur les figures 1 à 4. La tige d'ancrage 2 comporte par conséquent la cavité cylindrique 8 et la face proximale de l'insert 3 comprend le plot 7, reçu à pivotement dans la cavité 8, tandis que la face proximale de la tête 4 présente le plot 9 destiné à être reçu dans la cavité 10, elle-même aménagée au niveau de la face distale de l'insert 4. Comme cela apparaît de ce qui précède, l'invention fournit une prothèse de tête radiale inférieure adaptée aux patients souffrant d'ostéoporose et aux fractures multiples ou complexes de l'extrémité distale du radius, présentant de faibles risques de complication, et permettant de sauvegarder les os du carpe et du métacarpe dans le cadre d'un acte chirurgical simple et efficace.FIG. 5 shows an alternative embodiment in which the studs 7 and 9 and the cavities 8 and 10 are inverted with respect to the prosthesis 1 shown in FIGS. 1 to 4. The anchoring rod 2 consequently comprises the cylindrical cavity 8 and the proximal face of the insert 3 comprises the stud 7, received pivotally in the cavity 8, while the proximal face of the head 4 has the stud 9 intended to be received in the cavity 10, itself arranged at the level As can be seen from the foregoing, the invention provides a lower radial head prosthesis adapted to patients suffering from osteoporosis and to multiple or complex fractures of the distal end of the radius, presenting low risk of complications, and to save the carp and metacarpal bones in a simple and effective surgical procedure.
L'invention n'est pas limitée aux formes de réalisation décrite ci-dessus à titre d'exemples mais s'étend à toutes les formes de réalisations couvertes par les revendications. The invention is not limited to the embodiments described above as examples but extends to all embodiments covered by the claims.

Claims

REVENDICATIONS
1 - Prothèse de tête radiale inférieure, présentant au moins deux cavités anatomiques concaves (11 , 12), dont au moins une première (11), aménagée sur la face distale de la tête radiale (4), est destinée à recevoir les os de la première rangée du carpe et à réaliser une articulation avec ceux-ci, et dont une deuxième (12), aménagée sur le côté médial de la tête radiale (4), est destinée à recevoir la tête cubitale et à réaliser une articulation avec celle-ci ; prothèse caractérisée en ce qu'elle est constituée de trois éléments, à savoir : - une tige d'ancrage (2), comprenant un corps allongé (5) destiné à être implanté dans le canal médullaire du radius et une extrémité distale évasée et aplatie (6) apte par prendre appui sur l'extrémité distale du radius, convenablement réséquée, cette extrémité distale (6) de la tige d'ancrage comprenant un plot (7) ou une cavité cylindrique (8) dont l'axe est colinéaire à celui du radius ;1 - Lower radial head prosthesis, having at least two concave anatomical cavities (11, 12), of which at least one first (11), arranged on the distal face of the radial head (4), is intended to receive the bones of the first row of the carp and to make a joint with them, and a second (12), arranged on the medial side of the radial head (4), is intended to receive the ulnar head and to achieve a joint with that -this ; prosthesis characterized in that it consists of three elements, namely: - an anchor rod (2), comprising an elongate body (5) intended to be implanted in the medullary canal of the radius and a distal end flared and flattened (6) able to bear on the distal end of the radius, suitably resected, this distal end (6) of the anchor rod comprising a stud (7) or a cylindrical cavity (8) whose axis is collinear to that of the radius;
- un insert (3), présentant, sur sa face proximale, une cavité (8) ou un plot (7) de forme complémentaire du plot (7) ou de la cavité (8), respectivement, de la tige d'ancrage (2), pouvant recevoir ce plot (7) ou cette cavité (8) de manière ajustée mais avec possibilité de pivotement, l'insert (3) présentant également, sur sa face distale, un moyen d'assemblage (9, 10) mâle ou femelle pour l'assemblage de la tête radiale (4) ;an insert (3) having, on its proximal face, a cavity (8) or a stud (7) of complementary shape to the stud (7) or the cavity (8), respectively, of the anchor rod ( 2), being able to receive this stud (7) or this cavity (8) in a controlled manner but with possibility of pivoting, the insert (3) also having, on its distal face, a male assembly means (9, 10) or female for assembling the radial head (4);
- la tête radiale (4), présentant sur sa face proximale un moyen d'assemblage (10, 9) de forme complémentaire du moyen d'assemblage (9, 10) présent sur la face distale de l'insert (3). 2 - Prothèse selon la revendication 1 , caractérisée en ce que ses différents éléments constitutifs sont indifféremment composés de matériau plastique de type polyéthylène haute densité, d'acier inoxydable, d'alliage de chrome-cobalt ou de matériaux céramiques.- The radial head (4), having on its proximal face means of assembly (10, 9) of complementary shape of the connecting means (9, 10) present on the distal face of the insert (3). 2 - prosthesis according to claim 1, characterized in that its various components are indifferently composed of plastic material of high density polyethylene type, stainless steel, cobalt-chromium alloy or ceramic materials.
3 - Prothèse selon la revendication 3, caractérisée en ce que l'insert (3) est en polyéthylène à haut poids moléculaire alors que les deux autres éléments (2, 4) sont en métal. 4 - Prothèse selon la revendication 2, caractérisée en ce qu'elle est constituée de matériaux déterminant des couples de frottement métal-métal, métal-polyéthylène, métal-céramique ou céramique-céramique. 3 - prosthesis according to claim 3, characterized in that the insert (3) is of high molecular weight polyethylene while the other two elements (2, 4) are metal. 4 - prosthesis according to claim 2, characterized in that it consists of materials determining metal-metal, metal-polyethylene, metal-ceramic or ceramic-ceramic friction couples.
PCT/FR2005/002604 2004-10-28 2005-10-20 Lower radial head prosthesis WO2006048520A1 (en)

Applications Claiming Priority (2)

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FR0411503 2004-10-28
FR0411503A FR2877209B1 (en) 2004-10-28 2004-10-28 LOWER RADIAL HEAD PROSTHESIS

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WO2006048520A1 true WO2006048520A1 (en) 2006-05-11

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US8821581B2 (en) 2002-10-24 2014-09-02 Biomet Manufacturing, Llc Method and apparatus for wrist arthroplasty
US8551180B2 (en) 2002-10-24 2013-10-08 Biomet Manufacturing, Llc Method and apparatus for wrist arthroplasty
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US7766970B2 (en) 2002-10-24 2010-08-03 Biomet Manufacturing Corp. Method and apparatus for wrist arthroplasty
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US10085842B2 (en) 2002-10-24 2018-10-02 Biomet Manufacturing, Llc Method and apparatus for wrist arthroplasty
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US7875082B2 (en) * 2008-05-09 2011-01-25 Remi Sciences, Inc. Ulnar head prosthesis system
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