Elbow arthrodesis implant with improved anatomical adaptability

Abstract

The present invention relates to an implant (1) for arthrodesis of an elbow, at least comprising a humeral portion (2), an ulnar portion (4) and a transition region (3) connecting the humeral portion to the ulnar portion, wherein the implant has a specific surface relation between the ulnar portion and the humeral portion and a specific orientation of these surfaces relative to one another.

Description

[0001] Elbow arthrodesis implant with improved anatomical adaptability

[0002] The present invention relates to an implant for arthrodesis of an elbow comprising at least a humeral section, an ulnar section and a transition region connecting the humeral and the ulnar section, wherein the implant has a specific surface relationship between the ulnar and humeral sections and a specific orientation of these surfaces to one another.

[0003] Elbow arthrodesis is a rare indication for complications following elbow surgery. During arthrodesis, the elbow joint is temporarily or permanently mechanically stiffened using an implant, thus significantly restricting the mobility of the affected joint. This fusion may be indicated when primary injuries such as trauma or fractures (diacondylar C3 fractures, Monteggia injuries), dislocations, dislocation-fractures ("Monteggia-like fractures"), burns, or surgical procedures (osteosynthesis) preclude other treatment options or make successful completion of these "conservative" treatments unlikely. Furthermore, this therapy can be used in cases of failed prosthetic treatments or as an alternative to prosthetics.For elbow arthrodesis, there is currently a lack of a functional implant that is anatomically adapted and offers high stability while simultaneously protecting soft tissue. In the past, arthrodesis using screws has been attempted alongside the use of intraoperatively modified osteosynthesis plates. Patent and scientific literature also contains a wide variety of solutions for constructing joint endoprostheses and arthrodesis implants for a wide range of applications.

[0004] Kamineni, S. et al in the Journal of Shoulder and Elbow Arthroplasty, 3. 1-7, Elbow Arthrodesis -A Review, 10.1177 / 2471549219870347, provides an overview of possible arthrodesis treatment options for the elbow.

[0005] DE 3 940 728 A1 describes an elbow endoprosthesis comprising a humeral component, an ulnar component, and a radial component, as well as a pivot bearing that guides the ulnar component in the area of ​​the humeral component. The elbow endoprosthesis is characterized by the fact that a bearing that acts on the radial component is arranged in the area of ​​the ulnar component.

[0006] DE 69 818 001 T2 describes an osteosynthesis system for vertebral arthrodesis of the spine. The system comprises at least one rod for vertebral extension or compression, which is suitable for extending over at least part of the spine; at least one orientable vertebral anchoring element having a head with a spherical surface and a vertebral anchoring part; wherein the spherical head of the anchoring element forms the end opposite the anchoring part;a common support for receiving, coupling and locking the vertebral anchoring element and the rod, this common support comprising a first concave seat for receiving the rod and being open upwards towards the anchoring part, and a second concave seat for receiving the ball head, this second seat being arranged so that the ball head can assume any adjustable angular position about its center relative to the support, the first seat being displaced laterally with respect to the second seat;and threaded means for locking the rod and the anchoring element to the support, said locking means comprising at least one nut, characterized in that the nut is screwed onto a threaded part, the threaded part belonging to the support, at least a part of the first seat is located laterally outside the threaded part, this first seat being laterally open, and the concave recess of the two seats is directed axially opposite to the anchoring part of the anchoring element, the unit being constructed in such a way that the nut, when screwed onto the threaded part of the support, axially locks the rod in its seat.;

[0007] Such state-of-the-art solutions offer further potential for improvement. This particularly relates to improved adaptability and improved stabilization of the elbow joint.

[0008] The object of the present invention is therefore to at least partially overcome the disadvantages known from the prior art. In particular, the object of the present invention is to provide an elbow implant that enables both temporary and permanent treatment of pathologies involving significant joint destruction at the elbow, while maintaining both pronation and supination.

[0009] The problem is solved by the features of the independent claim, directed to the implant according to the invention. Preferred embodiments of the invention are specified in the subclaims, in the description, or in the figures. Further features described or shown in the subclaims, in the description, or in the figures may constitute a subject matter of the invention, individually or in any combination, unless the context clearly indicates otherwise.

[0010] According to the invention, an implant for arthrodesis of an elbow comprises at least a humeral section, an ulnar section and a transition region connecting the humeral and the ulnar section, wherein a quotient of a surface of the humeral section relative to a surface of the ulnar section, calculated as the surface of the humeral section divided by the surface of the ulnar section, is greater than or equal to 1.1 and less than or equal to 5 and the amount of an angular difference of a surface vector of the humeral section relative to a surface vector of the ulnar section is greater than or equal to 75° and less than or equal to 180°.

[0011] Surprisingly, it was found that the above-defined implant achieved improved elbow arthrodesis capabilities. Based on the surface area ratios of the humeral and ulnar segments, combined with a specific rotation of both segments relative to each other within the implant, improved implantation of the implant to the dorsal humerus and posteroradial ulna is achieved. Furthermore, the implant allows for the secure insertion and positioning of a penetrating screw through the joint, thus achieving both angular-stable fixation of the joint and the development of compression. This also significantly improves the stabilization of the radius of the joint. Furthermore, the angular alignment of the segments allows for better and more precise integration of additional features, such as elongated holes, which contributes to improved implant positioning.In summary, this results in a safe temporary and definitive treatment of the elbow, whereby the pronation and supination of the joint are largely preserved.

[0012] The implant according to the invention is an implant for elbow arthrodesis. Human elbows can be treated using the implant according to the invention. In contrast to conventional elbow endoprostheses, which incorporate artificial, functional means to increase joint mobility, an arthrodesis implant essentially aims to stabilize and fix the joint. This is intended to prevent further destruction of the elbow and provide the body with time to rebuild an improved joint environment.

[0013] The implant comprises at least one humeral section. The humeral section of the implant is the section that is applied to the humerus by mechanical means and mechanically fastened to it. The humeral section of the implant is preferably elongated and approximately rectangular in its base area, whereby, for example, the end pointing towards the upper arm can be rounded. This humeral section can be curved or uncurved and this section can have a constant or a varying width along its length. Width here is understood to be the spatial extent perpendicular to the axis of symmetry of the bone. The humeral section can preferably have a length of greater than or equal to 5 cm and less than or equal to 20 cm, a width of greater than or equal to 1 cm and less than or equal to 5 cm, and a thickness of greater than or equal to 0.5 cm and less than or equal to 3 cm.This section can be made of titanium, medical-grade steel, high-strength polymers, carbon, or blends of these components. The humeral section does not have any mechanical means that would allow significant mobility or deflection of the section.

[0014] The implant further comprises an ulnar section. The ulnar section of the implant is the section that is applied to the forearm bone, specifically the ulna, and mechanically fastened to it by mechanical means. The ulnar section of the implant is preferably elongated and approximately rectangular in its base area, whereby, for example, the end pointing towards the forearm can have a rectangular shape. This section can have a constant or varying width. Preferably, the ulnar section can have a length of greater than or equal to 5 cm and less than or equal to 20 cm, a width of greater than or equal to 0.5 cm and less than or equal to 3 cm, and a thickness of greater than or equal to 0.2 cm and less than or equal to 2 cm. This section can be made, for example, from titanium, medical steel, high-strength polymers, carbon, or mixtures of these components.The ulnar segment has no mechanical means that would allow significant mobility or deflection of the segment. A transition region connects the humeral and ulnar segments. The transition region connects the upper humeral segment to the lower ulnar segment and has no mechanical means that would allow significant mobility or deflection of the humeral or ulnar segments. The transition region allows for the mechanical coupling between the humeral and ulnar segments and, in the case of implantation, this region encloses the patient's elbow area. Depending on the desired fixation geometry, the region can be straight or angled. This section is preferably angled.This transition area typically has a variable width, thus ensuring the transition between the different dimensions of the humeral and ulnar segments. Preferably, the transition area can have a length of greater than or equal to 2 cm and less than or equal to 9 cm, a width of greater than or equal to 0.5 cm and less than or equal to 5 cm, and a thickness of greater than or equal to 0.5 cm and less than or equal to 4 cm. The transition area can be made, for example, of titanium, medical steel, high-strength polymers, carbon, or mixtures of these components.

[0015] The quotient of the surface area of ​​the humeral segment divided by the surface area of ​​the ulnar segment is greater than or equal to 1.1 and less than or equal to 5. The surface area of ​​the two segments is defined as the area that can contact the respective bone. This does not refer to the thickness of the segments, but rather to the surface areas that extend towards or away from the bone. The entire surface area of ​​each segment is used for the calculation, regardless of whether the surface is full-surface or has holes or recesses. This ratio takes into account that the humeral segment is at least 30% larger than the ulnar segment. This can ensure improved fixation of the implant to the bone.Preferably, the ratio can be greater than or equal to 1.25 and less than or equal to 4, further preferably greater than or equal to 1.5 and less than or equal to 3.5. These ratios result in a sufficient surface area for mechanical fastening of the section and improved fixation of the joint.

[0016] The absolute value of an angular difference between a surface vector of the humeral section and a surface vector of the ulnar section is greater than or equal to 75° and less than or equal to 180°. The implant according to the invention has an angled design, with the surfaces of the two attachment sections not pointing in the same direction. The surface vectors of the humeral and ulnar sections, which are perpendicular to the surfaces of the sections, are therefore not aligned parallel to one another, but rather exhibit an angular offset. The offset can be determined by determining the corresponding surface vectors, combining their base points, and determining the angular difference between the two vectors in one plane. In the case of curved or bent surfaces, the surface vector of the center of gravity of the respective region is used for the determination.Overall, the angular arrangement results in the two sections not being fixed to the bone with the same lateral orientation. The implant thus encompasses the joint from at least two sides, resulting in greater mechanical stabilization during the procedure. Preferably, the angulation can result in the humeral section being aligned with the dorsal portion at a defined angle to the posterior surface of the ulna. This arrangement of the sections leads to significantly improved fixation of the joint and a higher healing success rate.

[0017] In a preferred embodiment of the implant, the transition region can have a humeral connection surface to the humeral section, an ulnar connection surface to the ulnar section, and a central connection region connecting these two surfaces, wherein the magnitude of an angular difference of a surface vector of the humeral connection surface relative to a surface vector of the ulnar connection surface is greater than or equal to 75° and less than or equal to 180°. The transition region has a connection surface to the humeral and ulnar sections. These regions arise from the transition region in the direction of the humeral and ulnar sections, wherein the respective connection surfaces are present in the regions in which the cross-section of the respective sections no longer changes and remains constant until the end of the respective section.Excluded from the changes are drill holes and recesses or rounding of the end area of ​​the respective section. Alternatively, the surfaces can be present at the points where a rotation of the area ultimately occurs and the subsequent sections have a constant surface orientation. The changes in the angular orientation mean that the angulation of the implant does not occur through a rotation within the sections, but through a rotation in the transition area. The transition area as such ensures that the sections are attached to the respective bone with different orientations. The surface vector of the humeral connection surface and the ulnar connection surface is therefore on the boundary line between the respective sections and the transition area. If necessary, it may be advisable to manufacture the individual parts separately and join them together at these points.In principle, however, it is also possible for the entire implant to be manufactured additively, for example, using 3D printing. In these cases, the connection surfaces are created as defined above. Preferably, the angulation in the transition area can be greater than or equal to 90° and less than or equal to 160°, and more preferably, greater than or equal to 100° and less than or equal to 140°.

[0018] In a further preferred embodiment of the implant, the transition region can have a non-constant cross-section. For improved mechanical stabilization of the elbow and to create a connection between the two sections that is as inelastic as possible, it has proven particularly suitable for the cross-section of the transition region to vary from the connection to the humeral section to the ulnar section. The width of the transition therefore changes. The change in width of the transition region can preferably occur continuously. Preferably, the cross-section can change by greater than or equal to 50% and less than or equal to 150%, more preferably by greater than or equal to 70% and less than or equal to 125%.

[0019] Within a further preferred aspect of the implant, a quotient of a width of the humeral connection surface relative to a width of the ulnar connection surface, calculated as the width of the humeral connection surface divided by the width of the ulnar connection surface, can be greater than or equal to 2 and less than or equal to 6. The above-specified ratio of the widths has proven particularly suitable for providing improved mechanical holding forces for the two sections. This means that the connection to the humeral part is significantly wider than the ulnar part. Preferably, the ratio can be greater than or equal to 2.2 and less than or equal to 5, and more preferably greater than or equal to 2.5 and less than or equal to 4.5.

[0020] According to a preferred characteristic of the implant, a quotient of the length of the humeral segment relative to the length of the ulnar segment, calculated as the length of the humeral segment divided by the length of the ulnar segment, can be greater than or equal to 1.2 and less than or equal to 3. Particularly effective stabilization of the joint can result in cases where a specific relationship between the lengths of the two segments is maintained. Higher ratios can be disadvantageous, as in this case too great asymmetry develops in the two segments and there is a risk that one of the segments can no longer be evenly attached to the bone, at least partially. Smaller ratios, on the other hand, can be disadvantageous, as in these cases a deterioration in stabilization is accepted.Preferably, the ratio may be greater than or equal to 1.45 and less than or equal to 2.8 and further preferably greater than or equal to 1.5 and less than or equal to 2.5.

[0021] In a further preferred embodiment of the implant, the thickness of the transition region can be greater than or equal to 5 mm and less than or equal to 15 mm. For improved stabilization of the elbow with sufficient mechanical stabilization of the humeral and ulnar sections, it has proven particularly suitable for the thickness of the transition region to be in the above-specified range. The mechanical strength and the necessary adaptability to the existing elbow situation are met. The thickness of the region results from the extent of the transition region from the bone to the surface facing away from the bone. In the case of a transition region with varying thicknesses, the average thickness counts. Preferably, the thickness can be greater than or equal to 7.5 mm and less than or equal to 13 mm, further preferably greater than or equal to 8 mm and less than or equal to 11 mm.

[0022] In a preferred aspect of the implant, the ulnar section can have a width of greater than or equal to 4 mm and less than or equal to 12 mm. The width range specified above has proven particularly suitable for secure attachment of the ulnar section and fixation of the joint. This is particularly the case with an angled implant design. Smaller widths can be disadvantageous because they provide too small a contact surface with the bone. Larger surfaces can be disadvantageous because in these cases the entire section does not lie evenly against the bone. Preferably, the width can be greater than or equal to 5 mm and less than or equal to 10 mm, and more preferably greater than or equal to 6 mm and less than or equal to 9 mm.

[0023] In a further preferred embodiment of the implant, both the humeral section and the ulnar section can each have one or more concentric holes and at least one elongated hole. To ensure secure and movement-free attachment of the implant to the bone, it has proven advantageous to attach both the humeral section and the ulnar section to the bone using holes. The holes can preferably be arranged over the entire length of the respective section. The implant can preferably have several screw holes in the upper, humeral section, which fulfil different functions. Depending on the design, there can be 2 to 6 holes with a diameter of 2-4 mm in this section.The holes in this section can be filled with either angle-stable screws with a threaded head or with non-angle-stable screws, such as lens screws or countersunk screws without a threaded head, of different lengths. The screws serve to firmly connect the implant to the humerus. In the middle area of ​​the upper (humeral) part of the section there can be an oval, 5-30 mm long and 2-5 mm wide hole. Screws without a threaded head can be inserted into this hole to pull the implant onto the bone and, after loosening the screw, to move the implant proximally (upwards) or distally (downwards). The latter can particularly improve the fit of the implant to the bone. Analogous to the humeral section, the ulnar section can have multiple holes, for example 2 to 10 holes, which enable angle-stable screw fixation.Additionally, this section may also contain a slotted hole for the insertion of a lag screw. The slotted hole in the ulnar section can preferably be 5 to 30 mm long and 2 to 5 mm wide.

[0024] In a further embodiment of the implant, the oblong hole of the humeral section can be located axially centrally within the humeral section. For improved adaptation of the implant to the bone, it has proven particularly suitable for the oblong hole to be located centrally within the humeral section. This arrangement is achieved in cases where the center of the oblong hole is greater than or equal to 40% from the outer ends of the humeral section. The reference basis for the percentage specification is the total length of the humeral section.

[0025] Within the scope of a further preferred embodiment of the implant, the humeral section can have a bore, wherein the bore is angled with respect to the surface vector of the humeral section and is designed to guide a screw into the humeroulnar joint. This bore can be arranged in particular in the part of the humeral section adjacent to the transition region. This region can preferably extend from 5% - 20% of the total length of the humeral section from the transition region into the humeral section. In this region, a bore can enable an angle-stable screw connection with an angle of 100° - 160°, which securely fixes the joint and transmits only moderate mechanical forces to the implant.More preferably, this range can extend from 7% to 17% of the total length of the humeral section and further preferably from 8% to 15% of the total length of the humeral section.

[0026] Further advantages and advantageous embodiments of the inventive objects are illustrated by the figures and explained in the following examples. It should be noted that the figures are for descriptive purposes only and are not intended to limit the invention in any way.

[0027] The

[0028] Fig. 1 shows schematically the structure of an implant according to the invention in a top view of the humeral section;

[0029] Fig. 2 shows schematically the structure of an implant according to the invention in a top view of the transition region;

[0030] Fig. 3 shows schematically the structure of an implant according to the invention in a top view of the ulnar section;

[0031] Fig. 4 schematically shows the structure of an implant according to the invention in a further plan view of the ulnar section;

[0032] Fig. 5 schematically shows the structure of an implant according to the invention in a further top view of the ulnar section. Fig. 6 schematically shows the definition of the angular relationship between the surface vectors of the humeral and ulnar sections.

[0033] Figure 1 schematically shows the structure of an implant 1 according to the invention in a top view of the humeral section 2. The implant is divided into three parts, with the humeral section 2, which lies against the upper arm, lying against the transition region 3, which is arranged on both the humeral section 2 and the ulnar section 4. The humeral section 2 and the ulnar section 4 have a specific surface ratio to one another, which is responsible for the improved stabilization of the elbow joint by the implant. The figure also shows that the surface of the humeral section 2 has a different orientation than the surface of the ulnar section 4. If one considers the orientation of the surface vectors (not shown) perpendicular to the surfaces of sections 2, 4, they are not aligned parallel to one another, but rather enclose an angle of approximately 90° to one another.This orientation of the surfaces of sections 2, 4 relative to one another can contribute to improved attachment of the implant to the bone and thus to improved stabilization of the joint through arthrodesis. In this embodiment, the humeral section 2 as well as the ulnar section 4 have a more rectangular surface, with the ends of sections 2, 4 pointing away from the transition region 3 being rounded. These ends could optionally also not be rounded. Preferably, the entire implant 1 can have the following dimensions: height 25 cm, width 2.5 cm, average thickness 1 cm, whereby in particular the humeral section can have a height of 10 cm, a width of 2.5 cm, and a thickness of 1 cm, the ulnar section can have a height of 10 cm, a width of 2 cm, and a thickness of 0.8 cm, and the transition region can have a height of 5 cm, a width of 1.5 cm, and a thickness of 0.9 cm.

[0034] Figure 2 schematically shows the structure of an implant 1 according to the invention in a top view of the transition region 3. This figure has the same functional components as listed for Figure 1. It should also be emphasized at this point that both the humeral section 2 and the ulnar section 4 can accommodate additional functional components. Thus, both the humeral section 2 and the ulnar section 4 have several holes 5 and one elongated hole 6 each. The holes 5 serve to permanently attach the implant 1 to the respective bone, while the elongated hole 6 allows the implant 1 to be positioned and moved on the bone. Preferably, the implant 1 is first optimally attached to the bone using a screw that can be moved through the elongated hole 6, and then the entire implant 1 is releasably connected to the bone using additional fastening means, such as screws, through the holes 5.It is also possible that only the humeral section 2 or the ulnar section 2 have elongated holes 6. Additionally, the hole 13 in the humeral section 2 is shown, which is angled and allows the insertion of a screw directly into the elbow joint.

[0035] Figure 3 schematically shows the structure of an implant according to the invention in a top view of the ulnar section 2. Figure 3 also shows the three-part structure of the implant 1, comprising the humeral section 2, the transition region 3, and the ulnar section 4. This figure also shows the humeral connection surface 7 and the ulnar connection surface 8. The two connection surfaces 7, 8 are the surfaces where the respective section 2, 4 transitions into the transition region 3. They each represent the surface of the transition region 3 that has the same cross-section as the adjacent section 2, 4. The further transition region 3 then has a correspondingly different cross-section and forms the connecting region 14.In summary, this means that in the transition area 3 not only the rotation of the sections 2, 4 against each other, but also an adaptation or adjustment of the individual cross-sectional areas of the humeral 2 and the ulnar section 4 takes place.

[0036] Figure 4 schematically shows the structure of an implant 1 according to the invention in a further top view of the ulnar section 2. Figure 4 also shows the three-part structure of the implant 1, comprising the humeral section 2, the transition region 3, and the ulnar section 4. This figure also shows the width 10 of the ulnar connection surface 4 and the length 12 of the humeral section 2. The length 12 results from the longest distance between the humeral connection surface 7 and the end of the humeral section 2.

[0037] Figure 5 schematically shows the structure of an implant 1 according to the invention in a further top view of the ulnar section 4. Figure 5 also shows the three-part structure of the implant 1, comprising the humeral section 2, the transition region 3, and the ulnar section 4. This figure also shows the length 12 of the ulnar section 4. The length 12 results from the longest distance between the ulnar connection surface 8 and the end of the ulnar section 4.

[0038] Figure 6 shows a schematic definition of the angular relationship between the surface vectors of the humeral 2 and the ulnar section 4. The surface vectors, which are perpendicular to the surfaces, are shown on the individual surfaces. The base points of the surface vectors are combined to determine the angle, and the rotation of the surfaces is determined from the difference in the orientation of the two vectors in degrees. In this example, the angular difference between the two vectors is approximately 90°. Furthermore, the implant can have a valgus angle, i.e. an angular deviation that describes the lateral deviation of the forearm from the longitudinal axis of the upper arm, of greater than or equal to 0° and less than or equal to 20°, furthermore of greater than or equal to 2.5° and less than or equal to 15°, and more preferably of greater than or equal to 5° and less than or equal to 10°. In addition, the flexion angle caused by the implant, i.e.The angle formed between the humerus and forearm bones after placement of the implant is greater than or equal to 30° and less than or equal to 90°, furthermore greater than or equal to 40° and less than or equal to 80°, and more preferably greater than or equal to 60° and less than or equal to 90°. List of reference symbols.

[0039] Implant humeral section

[0040] Transition area ulnar section

[0041] Hole

[0042] Long hole humeral connection surface ulnar connection surface

[0043] Width of the humeral attachment surface

[0044] Width of the ulnar connection surface

[0045] Length of the humeral section

[0046] Length of the ulnar segment

[0047] drilling

[0048] Connection area

Claims

Patent claims 1. Implant (1) for arthrodesis of an elbow at least comprising a humeral section (2), an ulnar section (4) and a transition region (3) connecting the humeral (2) and the ulnar section (4), characterized in that a quotient of a surface area of the humeral section (2) relative to a surface area of the ulnar section (4), calculated as the surface area of the humeral section (2) divided by the surface area of the ulnar section (4), is greater than or equal to 1.2 and less than or equal to 5 and that the absolute value of an angular difference of a surface vector of the humeral section (2) relative to a surface vector of the ulnar section (4) is greater than or equal to 75° and less than or equal to 180°.

2. Implant according to claim 1, wherein the transition region (3) has a humeral connection surface (7) to the humeral section (2), an ulnar connection surface (8) to the ulnar section (4) and a central connection region (14) connecting these two surfaces, wherein the amount of an angular difference of a surface vector of the humeral connection surface (2) relative to a surface vector of the ulnar connection surface (4) is greater than or equal to 20° and less than or equal to 90°.

3. Implant according to claim 2, wherein the transition region (3) has a non-constant cross-section.

4. Implant according to one of claims 2 or 3, wherein a quotient of a width (9) of the humeral connection surface (2) relative to a width (10) of the ulnar connection surface (4), calculated according to width (9) of the humeral connection surface (2) divided by width (10) of the ulnar connection surface (4), is greater than or equal to 2 and less than or equal to 6.

5. Implant according to one of the preceding claims, wherein a quotient of length (11) of the humeral section (2) relative to a length (12) of the ulnar section (4), calculated as length (11) of the humeral section (2) divided by length (12) of the ulnar section (4), is greater than or equal to 1.2 and less than or equal to 3.

6. Implant according to one of the preceding claims, wherein a thickness of the transition region (3) is greater than or equal to 5 mm and less than or equal to 15 mm.

7. Implant according to one of the preceding claims, wherein the ulnar portion (4) has a width of greater than or equal to 4 mm and less than or equal to 12 mm.

8. Implant according to one of the preceding claims, wherein both the humeral section (2) and the ulnar section (4) each have one or more concentric holes (5) and each have at least one elongated hole (6).

9. Implant according to claim 8, wherein the elongated hole (6) of the humeral section (2) is arranged axially centrally in the humeral section (2).

10. Implant according to one of the preceding claims, wherein the humeral portion (2) has a bore (13), wherein the bore (13) is angled relative to the surface vector of the humeral portion (2) and is designed to guide a screw into the humeroulnar joint.

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