• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    The present invention relates to the Tgp shoulder prosthesis rods capable of being implanted in the medullary canal Cam of an humerus Hu after a fracture of the head of this humerus leaving in place at least one Tub tuberosity consisting of a portion of bone cortico-cancellous bone and ten tendon. The prosthesis stem according to the invention is characterized essentially by the fact that it comprises a tab 10 having a first portion 11 and a second portion 12 integral with the portion 11, this portion 12 being adapted to be implanted in the medullary canal Cam , the portion 11 being shaped to emerge from the Cam channel, one of the two elements of a ball joint Ro consisting of a male element 20 and a female element 21, these two elements being able to cooperate with each other. the other, one of the two elements of Ro ball being integral with the portion 11, a fastening cage 30, fastening means 31 made on the cage 30 to allow attachment means 32 to bind jointly the attachment cage 30 with the Tub tuberosity, and means 33 for fixing the cage 30 on the portion 11 after the attachment means have connected the cage 30 and tub tuberosity.
    公开号:FR3025089A1
    申请号:FR1401929
    申请日:2014-08-29
    公开日:2016-03-04
    发明作者:Jean Marc Chaudruc
    申请人:Jean Marc Chaudruc；
    IPC主号:
    专利说明:

    [0001] The present invention relates to shoulder prosthesis stems. It is quite common that, for various reasons, for example following a degeneration of the glenohumeral joint or following a fracture of the head of the humerus, it is necessary to resort to implantation on the patient, a shoulder prosthesis. Such a prosthesis known to date essentially comprises, as in the embodiment very schematically illustrated in FIG. 1, a humeral prosthetic leg or pivot 10 decomposing essentially into two parts integral with each other, a first part of so-called metaphyseal lug 11 and a second leg portion diaphyseal keel said 12, and one of two elements, respectively male element (humeral prosthetic head) 20 and female element (glenoid prosthesis) 21, a ball joint Ro (l ' articulation proper). In the illustrated embodiment, it is the male element 20 which is secured to the tab 10. It consists of a hemispherical male head secured to the first leg portion 11 and intended to articulate by pivoting in a so-called "glenoid cavity" made on the scapula (prosthetic or original), this cavity forming the female element 21, complementary to the male element 20, the Ro joint, that this cavity is original or artificial. As for the second leg portion 12, it is shaped to be able to be implanted in the medullary canal Cam of the humerus Hu. Bieh heard, a so-called "inverted" shoulder prosthesis is also possible. In this case, the female (ie concave) element 21 is integral with the first leg portion 11 and the male (ie, convex) element 20 is implanted on the scapula. Such a prosthesis is for example described and illustrated in FR-A-2869217. Such a shoulder prosthesis responds perfectly to the restoration of the shoulder joint when this joint is totally, or almost completely, damaged. However, in some cases, it is not necessary to proceed with the implantation of such a total shoulder prosthesis. This is the case, in particular 3025089, of a fracture of the upper end of the humerus when it is possible to recover tuberosities consisting of a cortical hard bone coating to which the tendons attach, of a spongy bone portion under this cortex and a tendon. The bone fragments are those that receive the rotator cuff tendons around the head of the humerus, namely those of the posterior and outer surface of the major tubercle (trochiter) which receives the supra-supinatus tendon (supraspinatus). ) above and infra-supinatus (infraspinatus) tendon behind; those of the anterior surface of the minor tubercle (trochin) which receives the subscapular tendon. Now, we know that the shoulder is the most mobile articulation of the body. Its articular function is therefore very complex and, to obtain such mobility, it is necessary that the articular surfaces are not congruent and that the tendons play both the role of stabilizers and mobilizers.
    [0002] Multi-fragment displaced shoulder fractures therefore have a major impact on the future of this mobility. In such a case of fracture, the practitioner always tries to repair, when possible, by synthesizing the fracture and trying to preserve the humeral head (vascularization and consolidation problem, articular irregularity). But when the Practitioner is obliged to remove the humeral head, it is necessary to implant at least part of the prosthesis while respecting the anatomical rules (to find the height of the prosthesis head and its anatomical orientation towards the back) . It is necessary to reduce and fix on the prosthesis the fractured bones so that they consolidate around the prosthesis and especially to try to maintain the mobility of the joint by the action of the tendons mentioned above. However, to date, there is no prosthesis that can effectively solve the essential problems described above to restore the function of the shoulder, including a stable attachment of tuberosities the time they consolidate. Also, the object of the present invention is to provide a shoulder prosthesis rod adapted to be implanted in the medullary canal of a humerus, which makes it possible to resolve, to a large extent, the problems mentioned above while facilitating the work of the Practitioner to restore the complex anatomical function of the shoulder joint by positioning the prosthesis at the right height and by attempting to synthesize the tuberosities in a very stable manner, while allowing to envisage a mobilization immediate shoulder operated to avoid the well known adhesions and stiffness that settle during a long immobilization and that are disabling and often tenacious. More specifically, the present invention relates to a shoulder prosthesis rod adapted to be implanted in the medullary canal of a humerus after a fracture of the head of this humerus leaving in place at least one tuberosity consisting of a portion of cortico-cancellous bone and a tendon, said prosthesis stem comprising at least: a lug, said lug having a first leg portion and a second lug portion secured to the first leg portion, said second portion of leg being shaped to be implantable in the medullary canal of the humerus, the first portion being shaped to emerge at least partially from the medullary canal of the humerus, and - one of the two elements of a ball joint consisting of an element male and a female element, these two elements being able to cooperate one in the other, said one of the two elements of the ball joint being integral with the first leg portion, characterized in that it further comprises: - a fastening cage, - - hooking means provided on said fastening cage to allow fastening means to bind said fastening cage integrally to said tuberosity, and - means for securing said attachment cage to said first leg portion after the fastening means has connected said tie cage and said tuberosity.
    [0003] Other features and advantages of the present invention will become apparent from the following description given with reference to the accompanying drawings for illustrative but not limiting purposes, in which: FIG. 1 is a diagrammatic view of a shoulder prosthesis according to 3025089; 4 the prior art which has been described in its essential characteristics in the preamble of the present description, and FIG. 2 is a block diagram of an embodiment of the corresponding shoulder prosthesis stem according to the invention. to a view according to the arrow FI in FIG. 1, in the case where the prosthesis shown in this FIG. 1 would be in accordance with the present invention. It is first of all specified that, in the figures, the same references designate the same elements, whatever the figure on which they appear and whatever the form of representation of these elements.
    [0004] Likewise, if elements are not specifically referenced in one of the figures, their references can be easily found by referring to the other figure. It is also pointed out that the figures represent a single embodiment of the object according to the invention, but that there may be others which meet the definition of this invention. It is furthermore specified that, when, according to the definition of the invention, the object of the invention comprises "at least one" element having a given function, the embodiment described may comprise several of these elements. Conversely, if the embodiment of the object according to the invention as illustrated has several elements of identical function and if, in the description, it is not specified that the object according to this invention must obligatorily comprise a particular number of these elements, the object of the invention may be defined as comprising "at least one" of these elements.
    [0005] 25 Finally, it is pointed out that when, in the present description, an expression defines in itself, without specific particular mention concerning it, a set of structural characteristics, these characteristics can be taken, for the definition of the object of the protection sought. when technically possible, either separately, or in full and / or partial combination. Finally, it is specified that, in the present description, if the adverb "substantially" is associated with a qualifier of a given means, this qualifier must be understood in the strict sense or approached.
    [0006] The present invention relates, with reference to the two appended figures, a shoulder prosthesis rod Tgp adapted to be implanted in the medullary canal Cam of an humus Hu after a fracture of the head of this humerus leaving in place at least one tuberosity Tub consisting of a portion of corticospongous Oss bone and a Ten tendon. The prosthesis stem according to the invention comprises at least one lug 10, this lug having a first lug portion 11 and a second lug portion 12 integral with the first lug portion. This second leg portion is shaped, in a manner known per se, to be implantable in the medullary canal of the humerus, the first portion 11 being shaped to emerge at least partially from the medullary canal of the humerus by making, with the second leg portion 12, an anatomical angle of about 125 to 140 degrees depending on the case. The rod further comprises one of the two elements of a rotatable joint Ro 15, in a manner known per se, of a male element 20 and a female element 21, these two elements being able to cooperate with each other. 1 in the other in a relatively congruent manner, one of the two Ro ball elements being integral with the first leg portion 11. In both figures, the ball member 20 which is integral with the first part leg 11 is the male element. But it is possible that it is the female element and that the male element is then made on the shoulder blade, as described in FR-A-2869217 recalled in the preamble of the present description. According to an important characteristic of the invention, the rod 10 further comprises a fastening cage 30, fastening means 31 made on this fastening cage to allow attachment means 32 to bind it integrally to Tub tuberosity, and means 33 for securing the attachment cage 30 to the first leg portion 11 after the fastening means has connected the tie cage 30 and Tub tuberosity.
    [0007] In a preferred embodiment, the fastening cage 30 has the shape substantially of a dihedron, or wedge, or a shape which can be likened to a dihedron having a top and a base having an area greater than that of the top, as shown in Figure 2, with 3025089 6 faces that can be flat or have a slight curvature. Therefore, the term "dihedron" is used, in the sense of the present description, to designate such a form, without it being obligatorily taken in its strict mathematical sense.
    [0008] According to another preferred embodiment, the attachment cage 30 comprises at least one recessed housing 35 able to receive a bone substitute or the like to promote the consolidation of the Tub tuberosity on the humerus Hu. In another very advantageous embodiment, to promote the work of the Practitioner, the means 33 for securing the attachment cage 30 to the first leg portion 11 are arranged to fix an edge 39 of the attachment cage 30 to the portion 11-1 of this first leg portion 11 which is opposed to the portion 11-2 on which is fixed one of the two ball elements Ro. This structure of the attachment cage 30 with the bone substitute 15 makes it possible to obtain better bone reconstruction and good consolidation between the humerus and Tub tuberosity around the prosthesis, and makes it easier to find the correct anatomical angulation between the edge of the tuberosity and the posterior edge of the prosthesis head, without there being a "tendon-head" conflict. It reduces fixation constraints and avoids tendon conflicts. Also to favor, the work of the Practitioner, the edge 39 of the fastening cage 30, fixed on the portion 11-1 of the first leg portion 11 which is opposite to that 11-2 on which is fixed one 20 of the two ball elements Ro (male element in the embodiment illustrated in FIGS. 1 and 2), is the top of the dihedron. In this case, in addition, the portion 11-1 of the first leg portion 11 which is opposed to that 11-2 on which is fixed one of the two elements of Ro ball is constituted by the portion of the first tab 11 emerging of the medullary canal of the humerus which is contiguous with the second leg portion 12. The means 33, defined above, for fixing the attachment cage 30 to the first leg portion 11 may be of any type, but advantageously constituted by one of the following means: fastening by screw, 3025089 7 fixation by male / female interlocking, a combination of these two types of attachment. Advantageously, according to the illustrated embodiment, the attachment means 32 are constituted by flexible links consisting, for example, of suture son made of different materials optionally selected biodegradable or non-absorbable, and even son with reinforcements made of polyethylene. As a result, the attachment means 31 on the attachment cage consist of at least one eyelet 38, several of which are visible in FIG.
    [0009] The shoulder prosthesis rod according to the invention can be used in the case of a surgical procedure such as that very briefly described below. The patient is installed in a serai-sitting position and the approach can be delto-pectoral or acromial external.
    [0010] The minor tuber (trochin) is then disinserted by collapsing the biceps trough and then opening the rotator gap. For this, the Practitioner often practices a bicipital tenotomy which can then be sutured and separates the minor tubercle (trochin) and the major tubercle (trochiter) from the fracture zone.
    [0011] After these operations, the humeral head is removed and its diameter is measured by taking into account the infero-internal portion of the head, the internal cortical still present on the head to be compensated for the correct height of the prosthesis. The cortical elements of the Tub tuberities are then regulated very briefly, and, by suturing with the links 32, the attachment cage (s) 30 are attached to the tuberosities, taking the tendon-bone zones as anatomical landmarks. (up and down for the major tuber, forward for the minor tuber). Since the attachment cages 30 have been attached to the tuberosities, the practitioner can take care of the second leg portion 12 or humeral diaphysis. Raspers of increasing size make it possible to know the diameter of the prosthetic lug 12 which is then put in place with a retroversion 3025089 of ten to twenty degrees of the first lug portion 11. A first estimate of the height is then made. Retroversion and optimal height control can be done by attaching the attachment cage (s) 30 to the first leg portion 11, and thus indirectly to the tuberosities on the rod 10. An absence of overlap or gap between the tuberosity fragments and the diaphysis is a good sign of restitution of the anatomy. If the tests are conclusive, the metaphysis is definitively fixed to the diaphysis in a good position, then the attachment cages 20 are repositioned on the stem. A final suture between the tuberosities, when they are several, can be made to ensure a total fixation and to obtain an optimal resistance of the assembly almost impossible to separate. Finally, it is closed, for example plan by plan, on a suction redon or the like.
    权利要求:
    Claims (10)
    [0001]
    REVENDICATIONS1. Prosthetic shoulder rod (Tgp) capable of being implanted in the medullary canal (Cam) of a humerus (Hu) after a fracture of the head of this humerus leaving in place at least one tuberosity (Tub) consisting of a portion cortico-cancellous bone (Oss) and tendon (Ten); said prosthesis stem comprising at least: - a tab (10), said tab including a first tab portion (11) and a second tab portion (12) integral with the first tab portion, said second tab portion being shaped to be implantable in the medullary canal of the humerus, the first portion being shaped to emerge at least partially from the medullary canal of the humerus, and - one (20) of the two elements of a ball joint (Ro) consisting of a male element (20) and a female element (21), these two elements being capable of cooperating with each other, said one (20) of the two ball elements (Ro) being integral with the first leg portion (11), characterized in that it further comprises: - an attachment cage (30), - hooking means (31) formed on said attachment cage (30) to enable fastening means (32) for integrally bonding said fastening cage (30) with said tuberosity (Tub), and means (33) for securing said attachment cage (30) to said first leg portion (11) after the fastening means has connected said tie cage (30) and said tuberosity (Tub).
    [0002]
    2. prosthesis rod according to claim 1, characterized in that said fastening cage (30) has the shape substantially of a dihedron.
    [0003]
    3. prosthesis rod according to one of claims 1 and 2, characterized in that said fastening cage (30) comprises at least one recessed housing (35) adapted to receive a bone substitute. 3025089 10
    [0004]
    4. prosthesis stem according to one of the preceding claims, characterized in that the means (33) for fixing said attachment cage (30) on said first leg portion (11) are arranged to fix an edge (39). ) of said fastening cage (30) with the portion (11-1) of the first leg portion (11) which is opposed to that (11-2) to which is attached said one (20) of the two elements of ball (Ro).
    [0005]
    5. prosthesis rod according to claim 4 when it depends on claim 2, characterized in that said one edge (39) of said cage 10 (30) with the portion (11-1) of the first part tab (11) which is opposed to that (11-2) on which is fixed said one (20) of the two ball elements (Ro) is the top of said dihedron.
    [0006]
    6. prosthesis rod according to one of claims 4 and 5, characterized in that said portion (11-1) of the first leg portion (11) which is opposite that (11-2) on which is fixed said one (20) of the two patella elements (Ro) is constituted by the portion of the first leg portion (11) emerging from the medullary canal of the humerus which is contiguous to the second leg portion (12). 20
    [0007]
    7. prosthesis rod according to one of the preceding claims, characterized in that the means (33) for fixing said attachment cage (30) on said first leg portion (11) are constituted by one of the means following: screw fixing, male / female interlocking, a combination of these two types of fasteners.
    [0008]
    8. prosthesis rod according to one of the preceding claims, characterized in that the fastening means (32) are constituted by flexible links. 30
    [0009]
    9. prosthesis rod according to claim 8, characterized in that said flexible links are constituted by son selected from the following son 3025089 11: biodegradable suture son, nonabsorbable suture son, son with reinforcements polyethylene.
    [0010]
    10. prosthesis rod according to one of claims 8 and 9, characterized in that the attachment means (31) are constituted by at least one eyelet (38).
    类似技术:
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    同族专利:
    公开号 | 公开日
    FR3025089B1|2019-05-24|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    WO1999037254A1|1998-01-22|1999-07-29|Sulzer Orthopedics, Ltd.|Humeral head prosthesis|
    EP1088532A2|1999-09-28|2001-04-04|aap Implantate AG|Shoulder endoprosthesis|
    WO2008020161A1|2006-08-14|2008-02-21|Keith Borowsky Llp|Shoulder replacement|
    EP1943985A1|2007-01-11|2008-07-16|DePuy Products, Inc.|Orthopaedic stem with protrusion|
    US20140052192A1|2012-08-20|2014-02-20|Zimmer, Inc.|Trochanter attachment device|EP3520738A1|2018-01-31|2019-08-07|Tornier|Prosthesis for a fractured long bone|
    US10898336B2|2006-03-21|2021-01-26|Tornier, Inc.|Femoral and humeral stem geometry and implantation method for orthopedic joint reconstruction|
    US10973645B2|2012-10-29|2021-04-13|Tornier Orthopedics Ireland, Ltd.|Systems for reverse shoulder implants|
    US10987226B2|2016-04-19|2021-04-27|Imascap Sas|Pre-operatively planned humeral implant and planning method|
    法律状态:
    2015-06-24| PLFP| Fee payment|Year of fee payment: 2 |
    2016-03-04| PLSC| Search report ready|Effective date: 20160304 |
    2016-08-24| PLFP| Fee payment|Year of fee payment: 3 |
    2017-08-01| PLFP| Fee payment|Year of fee payment: 4 |
    2018-08-20| PLFP| Fee payment|Year of fee payment: 5 |
    2019-08-19| PLFP| Fee payment|Year of fee payment: 6 |
    2020-08-24| PLFP| Fee payment|Year of fee payment: 7 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1401929|2014-08-29|
    FR1401929A|FR3025089B1|2014-08-29|2014-08-29|PROSTHESIS ROD FOR SHOULDER|FR1401929A| FR3025089B1|2014-08-29|2014-08-29|PROSTHESIS ROD FOR SHOULDER|
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