Boots – shoes – and leggings
Patent
1996-08-05
1998-08-25
Elmore, Reba I.
Boots, shoes, and leggings
36446803, 36446825, 36447424, 364512, G06F 1900, G06G 764, G06G 766
Patent
active
057989249
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention relates to a process for producing endoprostheses, in particular individually constructed implants and augments for reconstructive head surgery, in which process the data block of a three-dimensional actual model of the existing bone structure of a patient is acquired by means of computer-tomography, the actual model so determined is subtracted in a computer from the data block of an existing or computer-tomographically acquired three-dimensional should-be model, and a computer-internal model is formed for the endoprosthesis from the difference of the data blocks, which model is adapted on the video screen of the computer to the special anatomical features of the patient by an interactive manipulation of the data, and whose data block is finally used for the computer-controlled manufacture of the endoprosthesis.
2. The Prior Art
Similar methods which, however, do not comprise any corrective adaptation to the special anatomical features of the patient through an interactive manipulation of the data block, are known, for example from EP 0 255 797 B1; EP 0 093 869 A1; EP 0 146 491 A2; or EP 0 097 001 A1. In connection with the methods known according to said state of the art, it is possible with the use of suitable methods generating high-resolution images to adapt such endoprostheses relatively accurately to the existing bone structure of the patient to be supplemented.
However, in the manufacture of endoprostheses for restoring or for filling up bone defects in the region of the facial or brain skull, in particular in the manufacture of augments for supplementing atrophied alveolar processes for making available a suitable base for dental prostheses, an exact adaptation of the surface of abutment of the endoprosthesis on the surface of the still-existing bone structure to be supplemented does not suffice. Even with a highly exact adaptation of the endoprosthesis to the existing surface, painful pressure phenomena occur, for example in the region of the exit points of the bone canals receiving the nerves, or, in the case of progressed atrophy, within the region of the exposed bone canals.
For said reason, the surface of the endoprosthesis has to be shaped within the region of contact with nerval structures in a manner deviating from the directly derived geometric form, by recessing such surface within said region of the surface. In this connection, the recessed surface areas have to change to the adjacent, not recessed surface areas with softly rounded transitions, with the endoprosthesis being supported in said nonrecessed areas on the existing bone structure.
A similar corrective adaptation of the endoprosthesis to special anatomical features of the existing bone structure is required if the surfaces of the existing bone structure and the ones of the endoprosthesis coming into contact with one another have undercuts and/or projections which, when the endoprosthesis it put into place, are in the way. Such undercuts and/or projections interfering with the surgical intervention have to be eliminated prior to surgery as well, by adapting the endoprosthesis.
Finally, recesses in the endoprostheses to be manufactured are required also within the region of other non-osseous anatomical structures of the head, for example within the region of the nasal cavaties and eye sockets, the lateral nasal cavities, the auditory meatus, the middle or inner ear, as well as of the base of the skull, and particularly of the endocranium.
According to the state of the art, the corrective adaptations and recesses on endoprostheses explained above are possible only by highly labor-intensive, manual after-working, for example by carving or milling. Such after-working by hand requires much experience and leads to unusability of the endoprosthesis if the adaptations are flawed.
A process for producing a hip joint prosthesis, which is insertable in the femur, is known from EP 0 093 869 A1, in which process the adaptation of the contours of the endoprosthesis to the spe
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Eufinger Harald
Heuser Lothar
Kruse Dieter
Machtens Egbert
Seifert Hans
Elmore Reba I.
Patel Ramesh
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