Device for osteosyntheses or arthrodesis of two-bone parts, in particular of the hand and / or foot

Abstract

In one embodiment, the present disclosure is a fixation device including a median zone, a first fixation zone including a base region extending from the median zone and an end region distant from the median zone, and including an expandable region in between the base region and the end region, the expandable region adapted to move between a closed position and an expanded position, wherein the first fixation zone is adapted to be positioned within a bone hole and, with the expandable region in the expanded position, the expandable region is positioned against bone surrounding the bone hole, and a second fixation zone including a base region extending from the median zone at a position different from the base region of the first fixation zone and an end region distant from the median zone.

Claims

1. An intramedullary fixation device, comprising: a monolithic body including a non-expandable median zone having a first width, a first fixation zone and a second fixation zone; the first fixation zone including a base region at a first end of the median zone, the base region having a second width, an end region distant from the median zone, and an expandable region in between the base region and the end region, the expandable region adapted to move between a closed position and an expanded position, wherein the first fixation zone is adapted to be positioned within a bone hole and, with the expandable region in the expanded position, the expandable region is positioned against bone surrounding the bone hole, the first width being greater than the second width; and the second fixation zone including a base region at a second end of the median zone at a position different from the base region of the first fixation zone and an end region distant from the median zone, wherein the second fixation zone is adapted to be positioned within a second bone hole.

2. The device of claim 1, wherein the expandable region, when in the expanded position, includes a first contact region which is positioned against bone surrounding the bone hole.

3. The device of claim 1, wherein the first fixation zone includes first and second tabs which at the base region each extend from the median zone to the end region distant from the median zone.

4. The device of claim 3, wherein each of the first and second tabs of the first fixation zone includes a respective expandable region which, in the closed position are adjacent one another and in the expanded position are distant from one another and are each positioned against bone surrounding the bone hole.

5. The device of claim 1, wherein at least the median zone and one of the first fixation zone or second fixation zone has a flat cross-section.

6. The device of claim 1, wherein the second fixation zone includes first and second tabs which at the base region each extend from the median zone to the end region distant from the median zone.

7. The device of claim 6, wherein each of the first and second tabs of the second fixation zone includes a second contact region for engagement with bone surrounding the second bone hole.

8. An intramedullary fixation device, comprising: a monolithic body having a non-expandable median zone having a first width and a first fixation zone, the first fixation zone including a base region at a first end of the median zone and having a second width, an end region distant from the median zone, and an expandable region in between the base region and the end region, the expandable region having a first contact region and adapted to move between a closed position and an expanded position, wherein the first fixation zone is adapted to be positioned within a bone hole and, with the expandable region in the expanded position, the first contact region is positioned against bone surrounding the bone hole, the first width being greater than the second width.

9. The device of claim 8, further comprising a second fixation zone including a base region at a second end of the median zone at a position different from the base region of the first fixation zone and an end region distant from the median zone.

10. The device of claim 9, wherein the second fixation zone includes first and second tabs which at the base region each extend from the median zone to the end region distant from the median zone.

11. The device of claim 10, wherein the second fixation zone is adapted to be positioned within a second bone hole, and each of the first and second tabs of the second fixation zone includes a second contact region for engagement with bone surrounding the second bone hole.

12. The device of claim 8, wherein the first fixation zone includes first and second tabs which at the base region each extend from the median zone to the end region distant from the median zone.

13. The device of claim 12, wherein each of the first and second tabs of the first fixation zone includes a respective expandable region which, in the closed position are adjacent one another and in the expanded position are distant from one another and are each positioned against bone surrounding the bone hole.

14. The device of claim 8, wherein at least the median zone and one of the first fixation zone or second fixation zone has a flat cross-section.

15. An intramedullary fixation device, comprising: a monolithic body having a non-expandable median zone having a first width and a first fixation zone, the first fixation zone including first and second tabs, each tab extending from a base region having a second width, the base region adjoining an end of the median zone, each tab having an end region distant from the median zone, and each tab having an expandable region in between the base region and the end region, the expandable region of each tab adapted to move between a closed position and an expanded position, wherein the first fixation zone is adapted to be positioned within a bone hole and, with the expandable region in the expanded position, the expandable region is positioned against bone surrounding the bone hole, the first width being greater than the second width.

16. The device of claim 15, further comprising a second fixation zone including a base region extending from the median zone at a position different from the base region of the first fixation zone and an end region distant from the median zone.

17. The device of claim 16, wherein the expandable region of each tab, when in the expanded position, includes a first contact region which is positioned against bone surrounding the bone hole.

18. The device of claim 17, wherein the first contact regions of the first and second tabs are adjacent one another when in the closed positioned and are distant from one another when in the expanded position.

19. The device of claim 15, wherein the median zone and the first fixation zone have a flat cross-section.

Description

BRIEF DESCRIPTION OF THE DRAWING

(1) The invention is described below in greater detail in conjunction with the figures of the drawings appended hereto in which:

(2) FIG. 1 is a schematic plan view showing the placement of the intramedullary arthrodesis element of the invention between a proximal phalange and a median phalange to consolidate the proximal interphalangeal joint;

(3) FIG. 2 is a plan view of an embodiment of the arthrodesis element at the time of its introduction;

(4) FIG. 3 is a view corresponding to FIG. 2 showing the arthrodesis element after its implant to produce the compression;

(5) FIG. 4 shows the placement of the element of the invention in a toe.

SPECIFIC DESCRIPTION

(6) The arthrodesis element of the invention consists of an elongated body 1. Each of the ends of the body 1 is conformed to produce a fixation zone 1a linked to a fixation zone 1b.

(7) Between the two fixation zones 1a and 1b, at least one median zone 1c is formed capable of withstanding shear and bending stresses. In general, the shear and bending stresses are applied to the bone site to be consolidated. The shape of this median zone 1c is adapted to the internal shape of the bone. Its length is determined in order to allow a slight offset in the centering.

(8) For information, and in a non-limiting manner, this median zone may have a rectangular cross-section measuring about 2 to 3 mm*1 to 1.5 mm and a length of about 3 to 5 mm for the foot and the hand.

(9) The fixation zones 1a and 1b are conformed to prevent any rotational movement, resist tension, and maintain manual compression applied at the time of the implant by the surgeon in order to reduce the site. To obtain this result, the fixation zones 1a and 1b are made from a shape-memory material to be deformed by thermal action (tepid memory) or mechanical action (superelasticity) (see U.S. Pat. No. 5,958,159). The goal, in the fixation zones, considering their profile on the one hand and the type of material on the other, is to permit an introduction into the bone parts, particularly dorsally without a finger- or toe-tip approach, on the one hand, and to produce a fixation in the bone portion in order to obtain or to maintain the desired compressive force, on the other. The fixation zones 1a and 1b are identical or not, according to the type of bone and its morphology.

(10) Depending on the type of arthrodesis performed, that is, the type of interphalangeal joint to be consolidated for example, the fixation zones 1a and 1b may have different embodiments.

(11) For example, one of the fixation zones 1a has two tabs or wings that are separable under a thermal action for example. Otherwise, these fixation zones 1a may have a single tab or rod which can be curved under the action of a memory of the component material. Otherwise, the fixation zone 1b has, in its thickness, a slot to permit deformation by elasticity, under thermal action for example, and to maintain the position by pressing on the length of the bone.

(12) According to another feature of the invention, to take account of the anatomy of the various phalanges for example, that is the internal shrinkage of the bone (hourglass shape), the median zone 1c is linked to at least one of the fixation zones 1b by a thinner connecting zone 1d.

(13) Reference can be made to the figures of the drawings which show an embodiment of an intramedullar arthrodesis element.

(14) In this embodiment, the body 1 has, at one of its ends, a fixation zone 1a in the form of two tabs or wings 1a1 1a2. This fixation zone 1a is prolonged by a median zone 1c of generally substantially triangular shape in a plan view. The median zone 1c is connected to the other end fixation zone 1b by a connecting zone 1d having a generally rectangular shape in a plan view. The fixation zone 1b has, in its thickness, a slot of generally oblong shape 1b1.

(15) Reference can be made to FIG. 2 which shows the element at the time of its introduction, that is before separation of the tabs 1a1 and 1a2, and the opening of the slot 1b1. For example, this configuration is obtained when the overall element is subject to a temperature much lower than that of the human body for example. Conversely, after implantation (FIG. 3), under the effect of body heat, the tabs 1a1 and 1a2 separate, in the same way as the slot 1b1, concomitantly causing a deformation of the fixation zone 1b.

(16) It should be noted that the profile of the median zone 1c prevents penetration when the site is reclosed.

(17) In an alternative embodiment, the connecting zone 1d can be split to benefit from a swelling effect by shape memory and strengthening of the anchoring in the diaphyseal zone.

(18) It should be recalled that the inventive element is ideal for the treatment of the hammer- or claw-toe syndrome, by performing an arthrodesis in the phalanges P1 and P2 on the radii 2 to 5, while observing that such applications must not be considered as limiting, by means of essentially dimensional adjustments (finger reimplants, arthrodesis of the distal interphalangeal joint and of the proximal interphalangeal joint of the hand, and the arthrodesis of the big toe).

(19) Obviously, the entire arthrodesis element of the invention may have constructive features suitable for improving the fixation and compression in particular.

(20) For example:

(21) notches on the tabs on one of the sides for better fixation in the ethmoid bone;

(22) wavy tabs implanted (straight before implant)

(23) to permit shortening and hence an additional compression of the arthrodesis site compared with a simple fixation;

(24) a tapered central zone to avoid undesirable

(25) penetration of the implant at the time when the site is to be closed.

(26) For information, the memory used is preferably a tepid memory, so that heating is unnecessary because of the lack of access. The opening begins at above 15 to 20° C. and stops at about 30 to 35° C.

(27) The operating technique remains conventional.