U.S. patent application number 11/678424 was filed with the patent office on 2007-07-12 for tool for placing a malleolar implant for partial or total ankle prosthesis.
This patent application is currently assigned to Tornier. Invention is credited to Michel Bonnin, Jean-Alain Colombier, Thierry Judet, Alain Tornier.
Application Number | 20070162025 11/678424 |
Document ID | / |
Family ID | 9549040 |
Filed Date | 2007-07-12 |
United States Patent
Application |
20070162025 |
Kind Code |
A1 |
Tornier; Alain ; et
al. |
July 12, 2007 |
TOOL FOR PLACING A MALLEOLAR IMPLANT FOR PARTIAL OR TOTAL ANKLE
PROSTHESIS
Abstract
A method of implanting in a fibula a malleolar implant including
a head and a shank. The method comprises the steps of creating a
bore in the fibula extending from an inner face to an outer face
and applying a traction force to the malleolar implant so that the
shank is pulled into the bore.
Inventors: |
Tornier; Alain; (Saint
Ismier, FR) ; Bonnin; Michel; (Francheville, FR)
; Colombier; Jean-Alain; (Balma, FR) ; Judet;
Thierry; (Ville D-Avray, FR) |
Correspondence
Address: |
FAEGRE & BENSON LLP;PATENT DOCKETING
2200 WELLS FARGO CENTER
90 SOUTH SEVENTH STREET
MINNEAPOLIS
MN
55402-3901
US
|
Assignee: |
Tornier
Saint Ismier
FR
|
Family ID: |
9549040 |
Appl. No.: |
11/678424 |
Filed: |
February 23, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10254984 |
Sep 26, 2002 |
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11678424 |
Feb 23, 2007 |
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09631938 |
Aug 3, 2000 |
6488712 |
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10254984 |
Sep 26, 2002 |
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Current U.S.
Class: |
606/326 ;
606/328 |
Current CPC
Class: |
A61F 2002/30299
20130101; A61F 2002/30879 20130101; A61F 2002/30785 20130101; A61F
2002/30878 20130101; A61F 2002/3096 20130101; A61F 2002/421
20130101; A61F 2002/30224 20130101; A61B 17/1739 20130101; A61F
2230/0069 20130101; A61F 2230/0093 20130101; A61F 2/4202 20130101;
A61F 2/4606 20130101 |
Class at
Publication: |
606/072 |
International
Class: |
A61B 17/58 20060101
A61B017/58 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 5, 1999 |
FR |
99 10340 |
Claims
1. A method of implanting in a fibula a malleolar implant including
a head and a shank, the method comprising the steps of: creating a
bore in the fibula extending from an inner face to an outer face;
and applying a traction force to the malleolar implant so that the
shank is pulled into the bore.
2. The method of claim 1 comprising applying the traction force to
the shank.
3. The method of claim 1 comprising applying the traction force
from a location external to the outer face of the fibula.
4. The method of claim 1 comprising applying the traction force so
that the head contacts an astragalus or astragalian prosthetic
component when the shank is pulled into the bore.
5. The method of claim 1 comprising applying the traction force in
a direction parallel to a longitudinal axis of the bore.
6. The method of claim 1 comprising inserting a traction member
through at least one orifice in the shank and applying the traction
force to the traction member.
7. The method of claim 1 comprising the steps of: engaging a
traction member with the malleolar implant; and applying the
traction force through the bore.
8. The method of claim 1 comprising selecting one of a plurality of
orifices in the shank and inserting the traction member through the
selected orifice.
9. The method of claim 1 comprising applying the traction force to
a traction member in a direction away from the head.
10. The method of claim 1 comprising applying the traction force in
a direction away from the head and through at least one bore in the
shank.
11. The method of claim 1 comprising extending a flexible traction
member through a bore in the shank and applying the traction force
to the flexible traction member in a direction away from the
head.
12. The method of claim 1 comprising aligning the shank with the
bore.
13. The method of claim 1 comprising applying a traction force to
the implant so that outer radial flanges on the shank frictionally
engage with the bore.
14. The method of claim 1 comprising creating a bore in the fibula
with a diameter substantially the same as a diameter of the
shank.
15. A method of implanting in a fibula a malleolar implant
including a shank coupled to a head, the method comprising the
steps of: creating a bore in the fibula extending from an inner
face to an outer face; aligning the shank and the bore; and
applying a traction force to the shank so that the shank is pulled
into the bore.
16. The method of claim 15 comprising inserting a traction member
through an orifice in the shank and applying the traction force to
the traction member.
17. The method of claim 15 comprising inserting a flexible traction
member through an orifice in the shank and applying the traction
force in a direction away from the head and through the bore.
18. The method of claim 15 applying the traction force in a
direction parallel to a longitudinal axis of the bore.
19. The method of claim 15 comprising applying a traction force so
that the head contacts an astragalus or astragalian prosthetic
component when the shank is pulled into the bore.
20. The method of claim 15 comprising creating a bore with a
diameter substantially equal to the diameter of the shank.
21. The method of claim 15 comprising applying the traction force
from a location external to the outer face of the fibula.
22. A method of implanting in a fibula a malleolar implant
including a shank coupled to a head, the method comprising the
steps of: creating a bore in the fibula extending from an inner
face to an outer face; inserting a traction member through an
orifice in the shank; and applying a traction force to the traction
member in a direction parallel to a longitudinal axis of the bore
so that the shank is pulled into the bore.
23. The method of claim 22 comprising the steps of: extending the
traction member away from the head and through the bore; and
applying the traction force to the traction member through the
bore.
24. The method of claim 22 comprising selecting one of a plurality
of orifices in the shank and inserting the traction member through
the selected orifice.
25. The method of claim 22 comprising applying the traction force
so that the head contacts an astragalus or astragalian prosthetic
component when the shank is pulled into the bore.
26. The method of claim 22 comprising applying the traction force
in a direction generally perpendicular to an orifice in the
shank.
27. The method of claim 22 comprising creating the bore with a
diameter substantially equal to a diameter of the shank.
28. The method of claim 22 comprising engaging a flexible traction
member with the shank and applying the traction force.
29. The method of claim 22 comprising applying the traction force
from a location external to the outer face of the fibula.
30. A method of implanting in a fibula a malleolar implant
including a shank coupled to a head, the method comprising the
steps of: creating a bore in the fibula extending from an inner
face to an outer face; inserting a traction member through an
orifice in the shank; extending the traction member through the
bore from the inner face to the outer face; and applying a traction
force to the traction member from a location external to the outer
face of the fibula so that the shank is pulled into the bore.
31. The method of claim 30 comprising applying the traction force
in a direction generally transverse to an elongated axis of the
shank.
32. The method of claim 30 comprising selecting an orifice in the
shank from a plurality of orifices and inserting the traction
member through the selected orifice.
33. The method of claim 30 comprising applying the traction force
so that the head contacts an astragalus or astragalian prosthetic
component when the shank is pulled into the bore.
34. The method of claim 30 comprising applying the traction force
generally parallel to a longitudinal axis of the bore.
35. A method of implanting a malleolar implant in a fibula, the
method comprising the steps of: creating a bore in the fibula
extending from an inner face to an outer face; providing a
malleolar implant having a shank coupled to a head; and applying a
traction force to the implant from a location external to the outer
face of the fibula so that the shank is pulled into the bore.
36. The method of claim 35 comprising the steps of: inserting a
traction member through an orifice in the shank; extending the
traction member through the bore from the inner face to the outer
face of the fibula; and applying the traction force to the traction
member.
37. The method of claim 35 comprising applying the traction force
in a direction generally parallel to a longitudinal axis of the
bore.
38. The method of claim 35 comprising aligning the shank with the
bore.
39. The method of claim 35 comprising frictionally engaging outer
radial flanges on the shank with the bore.
40. The method of claim 35 comprising creating the bore with a
diameter substantially equal to a diameter of the shank.
41. The method of claim 36 comprising selecting an orifice from a
plurality of orifices and inserting the traction member through the
selected orifice.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application is a continuation of U.S. patent
application Ser. No. 10/254,984, filed Sep. 26, 2002; which is a
divisional of U.S. patent application Ser. No. 09/631,938, filed
Aug. 3, 2000; which claims priority from French Application Serial
No. 99 10340, filed Aug. 5, 1999, all herein incorporated by
reference in their entirety.
BACKGROUND
[0002] 1. Field of the Invention
[0003] The present invention relates to a malleolar implant for a
partial or total prosthesis of the ankle and to an ancillary tool
for placing such an implant.
[0004] 2. Description of the Related Art
[0005] It is known, for example from EP-A-0 864 304, to fit an
ankle prosthesis with a malleolar implant intended to bear against
an articular surface at the level of the astragalus, whether it be
question of a natural surface or of a surface of a prosthetic
component. During an operation on an ankle, access to the internal
articular surfaces is limited by the ligamentary system which does
not necessarily allow a sufficient dislocation of the joint. In
particular, access to the internal surface of the fibular malleolus
may be insufficient, which induces difficulties in positioning the
implant, particularly by impaction.
[0006] With reference to the embodiments of FIGS. 4 and 5, it is
envisaged in EP-A-0 864 304 to introduce an implant from the outer
face of the fibula. However, this necessarily limits the surface of
the head of this implant, which must be less than or equal to the
surface of the orifice provided in the bone, so that it is
necessarily of relatively small dimensions with the result of
substantially fragilizing the malleolus.
[0007] For the foregoing reasons, the positioning of the malleolar
implants in the known prostheses is not entirely satisfactory.
[0008] It is a particular object of the present invention to
overcome these drawbacks by proposing a novel malleolar implant
which may be positioned precisely, even though access to the
internal surface of the fibular malleolus may be limited and
whereas its articular head presents dimensions allowing it to
perform its function efficiently.
SUMMARY
[0009] In one embodiment, the invention is a method of implanting
in a fibula a malleolar implant including a head and a shank. The
method comprises the steps of creating a bore in the fibula
extending from an inner face to an outer face and applying a
traction force to the malleolar implant so that the shank is pulled
into the bore.
[0010] In one embodiment, the invention is a method of implanting
in a fibula a malleolar implant including a shank coupled to a
head. The method comprises the step of creating a bore in the
fibula extending from an inner face to an outer face. The shank and
the bore are aligned. A traction force is applied to the shank so
that the shank is pulled into the bore.
[0011] In another embodiment, the invention is a method of
implanting in a fibula a malleolar implant including a shank
coupled to a head. The method comprises the steps of creating a
bore in the fibula extending from an inner face to an outer face
and inserting a traction member through an orifice in the shank. A
traction force is applied to the traction member in a direction
parallel to a longitudinal axis of the bore so that the shank is
pulled into the bore.
[0012] In another embodiment, the invention is a method of
implanting in a fibula a malleolar implant including a shank
coupled to a head. The method comprises the steps of creating a
bore in the fibula extending from an inner face to an outer face
and inserting a traction member through an orifice in the shank.
The traction member is extended through the bore from the inner
face to the outer face. A traction force is applied to the traction
member from a location external to the outer face of the fibula so
that the shank is pulled into the bore.
[0013] In another embodiment, the invention is a method of
implanting a malleolar implant in a fibula. The method comprises
the steps of creating a bore in the fibula extending from an inner
face to an outer face and providing a malleolar implant having a
shank coupled to a head. A traction force is applied to the implant
from a location external to the outer face of the fibula so that
the shank is pulled into the bore.
[0014] While multiple embodiments are disclosed, still other
embodiments of the present invention will become apparent to those
skilled in the art from the following detailed description, which
shows and describes illustrative embodiments of the invention.
Accordingly, the drawings and detailed description are to be
regarded as illustrative in nature and not restrictive.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] The invention will be more readily understood on reading the
following description of an embodiment of a malleolar implant and
its ancillary tool according to the invention, given solely by way
of example and with reference to the accompanying drawings, in
which:
[0016] FIG. 1 is a view in perspective of an implant according to
the invention.
[0017] FIG. 2 is a view in perspective of the implant of FIG. 1
during positioning in a fibular malleolus, shown with parts torn
away.
[0018] FIG. 3 schematically shows, with parts torn away, an
ancillary tool for placing the implant of FIG. 1, in the course of
use.
[0019] FIG. 4 is a view in perspective of the tool of FIG. 3, from
underneath.
[0020] While the invention is amenable to various modifications and
alternative forms, specific embodiments have been shown by way of
example in the drawings and are described in detail below. The
intention, however, is not to limit the invention to the particular
embodiments described. On the contrary, the invention is intended
to cover all modifications, equivalents, and alternatives falling
within the scope of the invention as defined by the appended
claims.
DETAILED DESCRIPTION
[0021] Referring now to the drawings, the implant 1 shown in FIGS.
1 and 2 is intended to be introduced in a bore 2 made in the
lateral or fibular malleolus 3. The implant 1 comprises a convex
head 4, substantially in the form of a spherical cap and of which
the radius of curvature is substantially equal to that of the outer
cheek of the astragalus of the ankle in question. The shank 5 of
the implant 1 is provided with outer radial flanges 6 of which the
outer diameter d.sub.6 is substantially equal to the inner diameter
d.sub.2 of the bore 2.
[0022] According to the invention, two orifices 7 are provided in
the shank 5 and are capable of receiving a suture thread 8 or other
flexible tie. When such a thread is engaged in one of the orifices
7, it is possible to exert on the thread 8 an effort of traction T
which is transmitted by the thread 8 to the shank 5 as represented
by arrow T' in FIG. 2. In this way, by pulling on the thread 8, the
surgeon introduces the shank 5 in the bore 2 without having to
exert an effort of thrust on the head 4 which may be difficult to
access due to the surrounding ligamentary system.
[0023] In other words, it suffices for the surgeon to place a
thread in one of the orifices 7, to pass the two strands of the
thread 8 in the bore 2 via the inner face of the malleolus, then to
pull the strands via the outer side of the malleolus. The traction
on the thread 8 has the effect of introducing the shank 5 of the
implant 1 in the bore 2 and of applying the head 4 on the bone. The
effort of traction T exerted on the thread 8 may be intense and
directed parallel to the longitudinal axis X.sub.2 of the bore 2,
with the result that the shank is efficiently drawn towards the
inside of the bore 2. In particular, taking into account the
direction and intensity of the effort of traction T, the diameters
d.sub.2 and d.sub.6 can be provided to be substantially equal, with
the result that the shank 5 is firmly maintained in place after
having been positioned.
[0024] The shank 5 is provided with two bores 7 distributed along
its axis X.sub.5, the bore 7 nearest the end 5a of the shank 5
being used. The fact that the shank 5 comprises a plurality of
orifices 7 makes it possible to use an orifice 7 relatively close
to the end 5a of the shank 5 and to avail of such an orifice
including when the shank 5 is cut in order to adapt its length to
the thickness e of the malleolus 3. The number of bores 7 may, of
course, be increased if necessary.
[0025] The bore 2 is made via the outer face 3a of the malleolus 3
with the aid of the ancillary tool shown in FIGS. 3 and 4. This
tool 10 comprises a spacer block 11 provided to be disposed between
the tibia T and the astragalus A of an ankle to be fitted with the
implant 1. The block 11 comprises a substantially planar upper
surface 12 intended to cooperate with a planar surface created by
resection of the distal end of the tibia. The lower surface 13 of
the block 11 is formed by two planar surfaces 13a and 13b inclined
with respect to each other by an angle .alpha., the surfaces 13a
and 13b being provided to bear respectively on corresponding
surfaces created by resection of the upper face of the astragalus
A.
[0026] The surface 12 of the block 11 comprises a C-shaped housing
14 intended to receive a shim 15 of which the upper surface 16 is
in contact with the lower surface of the tibia T. The thickness E
of the shim 15 shown in FIG. 3 is such that its upper surface 16 is
flush with the upper surface 12 of the block 11.
[0027] However, thicker shims may be used when the distance E'
between the lower surface of the tibia and upper surface of the
astragalus is greater than in the configuration shown in FIG.
3.
[0028] The block 11 defines a housing 17 for receiving the end 20
of a substantially C-shaped lug 21. The end 20 is provided with a
bore (not shown) which, in the configuration of FIGS. 3 and 4, is
aligned with a bore 18 made in the block 11 and passing downwardly
through this block, i.e. connecting the surfaces 12 and 13. A screw
19 may be introduced in this bore which is at least partially
tapped, this making it possible to immobilize the end 20 of the lug
21 inside the housing 17. In practice, the clearance made when the
screw 19 is tightened allows a limited pivoting about axis X.sub.18
of the bore 18.
[0029] At its end 22 opposite the end 20, the lug 21 supports a
clamping system 23 adapted to be maneuvered thanks to a knurl 24
and making it possible to apply the malleolus 3 of the fibula P
against a stop 25 formed on an extension 26 of the end 20 of the
lug 21. X.sub.23 denotes the longitudinal axis of these clamping
means. The clamping means 23 are hollow, with the result that a
drill 30 may be introduced up to the level of the outer face 3a of
the malleolus 3 in order to make the bore 2 from the outside
towards the inside of the malleolus 3. In this way, the surgeon may
easily aim at the suitable part of the malleolus 3 thanks to the
clamping means 23 which also constitute a bore guide for the drill
30.
[0030] As the lug 21 is capable of pivoting about axis X.sub.18,
the position of axis X.sub.23 is variable in pivoting about this
axis X.sub.18, which makes it possible optimally to adjust the
orientation of the bore 2 as a function of the exact geometry of
the malleolus 3. .beta. denotes the maximum angle of pivoting of
the axis X.sub.23 about axis X.sub.18. In practice, the angle
.beta. is of the order of 10.degree.
[0031] Thanks to the tool 10, a bore 2 may therefore be formed from
the outside, allowing a rapid and efficient implantation of the
implant 1.
[0032] When shims 15 of thickness greater than those shown in FIG.
2 are used, they can be provided to overlap the bore 18, as the
screw 19 is placed in position before positioning of the shim 15
which is effected during operation as a function of the distance
E'.
[0033] The invention has been shown with a total ankle prosthesis,
which corresponds to the geometry of the surfaces 12 and 13 of the
block 11. However, it is also applicable to a partial ankle
prosthesis, without modification of the implant 1, the ancillary
tool in that case being adapted to the geometry of the anatomical
articulation surfaces between the tibia and the astragalus.
[0034] Various modifications and additions can be made to the
exemplary embodiments discussed without departing from the scope of
the present invention. For example, while the embodiments described
above refer to particular features, the scope of this invention
also includes embodiments having different combinations of features
and embodiments that do not include all of the described features.
Accordingly, the scope of the present invention is intended to
embrace all such alternatives, modifications, and variations as
fall within the scope of the claims, together with all equivalents
thereof.
* * * * *