DE102009038517B4 - Modular system for assembling an orthosis for a knee and method for converting an orthosis from this modular system - Google Patents

Abstract

Modular system for assembling an orthosis for a knee, wherein the modular system comprises at least the following elements, a knee bandage (10) having a textile support material (11) extending above and below the knee, wherein at the knee bandage (10 ), and joint rails (20), wherein the joint rails (20) on the one hand directly or indirectly with the knee bandage (10) and on the other hand directly or indirectly with a frame orthosis (25) a) Knee brace (10) b) Knee guide orthosis with lateral hinge rails (20) without extension and / or flexion limitation (23) c) Knee guide orthosis with lateral hinge rails (20) with extensions - and / or flexion limitation (24) d) frame orthosis (25) with upper and lower leg shell (26, 27) and lateral G elbow rails (20) with or without extension and / or flexion limitation.

Description

The invention relates to a modular system for assembling an orthosis for a knee according to claim 1.

In the prior art, there are different types of knee braces that are used depending on the health of the patient to treat the different ailments. It is also known that the individual orthoses are configured individually and flexibly to the leg of the respective patient customizable. From the publication EP 0 393 081 B1 For example, a frame orthosis is known, which is designed individually to the patient customizable. For this purpose, the frame orthosis diverse setting options to customize the diameter of the upper and lower leg shells and the elongated arrangement of the upper and lower leg shells to the respective leg of the patient customizable. However, this orthosis is used only in patients complaining of instability of the cruciate ligament and / or the lateral ligament or in which a meniscus injury with an extension and flexion barrier is required. Thus, the frame orthosis is used exclusively for the treatment of severe knee injuries.

From the further document DE 43 11 500 C1 is a knee joint bandage known, which is composed of an elastic carrier material and is used only in mild postoperative muscle atrophy. This knee joint bandage can also be used to build muscle of the patient. However, this knee joint bandage provides neither a large lateral support nor is an extension or flexion barrier of the knee joint possible.

A generic knee bandage is also from the writings US 4 697 583 A . US 2004/0 054 307 A1 . US 2004/0176 715 A1 . US 2004/0 134 501 A1 . EP 0 393 081 B1 . US 5,626,577 A as well as the writing US 4,064,874A known.

Although there are many different types of knee orthoses that are designed individually customizable, but the individual knee braces are always suitable only for a specific health of the patient.

The object of the present invention is to provide a modular system for assembling a knee brace, which on the one hand is individually adaptable to the patient and on the other hand adapted to the changing health of the patient customizable. This knee brace should be used in particular for education or training in order to optimally support the respective state of health of the patient.

The present invention is achieved by a knee brace with the technical features of claim 1. In the dependent subclaims advantageous embodiments of the knee brace are listed.

The modular system according to the invention for assembling an orthosis for a knee (also referred to as knee orthosis) has the following elements: a knee bandage, which has a textile carrier material which extends above and below the knee, wherein first retaining means for detachable attachment to the knee bandage are provided by lateral hinge rails.

Thus, it is not only possible with the modular system according to the invention to adapt these optimally and flexibly without technical changes to a patient, but it is also possible to adapt the orthosis to the respective state of health or recovery state of the patient. For this purpose, the knee brace from the modular system can be built up or removed in order to achieve a training or Abschulung and thus an adaptation to the respective health of the patient. Thus, it is possible by the modular system according to the invention to determine the right kind of orthosis with the patient directly on site, since these are each from the modular system in a simple manner to produce. The correct type of orthosis can also be individually adapted to the patient on site. So z. B. the patient with the corresponding knee orthosis directly test the effect and give immediate feedback to be treated doctor or therapist. Also directly on site another type of knee brace from the modular system can be assembled to meet the possibly existing change requests of the doctor or the patient. Here, a tool-free modification of the knee brace is done.

• a) Kniebandage (auch Patellabandage)
• b) Knieführungsorthese mit seitlichen Gelenkschienen ohne Extensions- und/oder Flexionsbegrenzung
• c) Knieführungsorthese mit seitlichen Gelenkschienen mit Extensions- und/oder Flexionsbegrenzung (in kurz oder lang)
• d) Rahmenorthese mit Ober- und Unterschenkelschale und seitlichen Gelenkschienen mit oder ohne Extensions-/und/oder Flexionsbegrenzung.

In addition, in the modular system include a top and bottom leg shell, which have second retaining means, wherein the second retaining means also serve to attach the lateral hinge rail to build a Rahmenorthese. Thus, it is conceivable that the following orthoses (types) can be assembled from the modular system:

• a) knee bandage (also patellar bandage)
• b) Knee guide orthosis with lateral joint splints without extension and / or flexion limitation
• c) knee guide orthosis with lateral joint splints with extension and / or flexion limitation (in short or long)
• d) Frame orthosis with upper and lower leg shell and lateral joint splints with or without extension and / or flexion limitation.

Consequently, the aforementioned different types of knee brace can be easily adapted to the health condition of the patient in a simple manner. The mentioned knee bandage itself has an upper portion, a knee portion, and a lower portion, the upper and lower portions serving to fix the knee bandage to an upper and lower leg of the patient. In particular, an adhesive in the form of an anti-slip tape can be provided in the upper and / or lower region, which is intended to prevent the bandage from leaving its original position and slipping off at the upper and lower thighs. By this incorporated adhesive, which is preferably provided on the inside of the textile substrate, an optimal support effect of the bandage can be achieved. The adhesives can be incorporated as silicone threads in the textile support material of the knee bandage.

Furthermore, it is conceivable that the knee bandage has a profile insert and / or a stretching element. The particular segmental profile insert may include a two-piece, laterally fitting, firm knee pad, which serves in addition to the kneecap for support, relief and lateral guidance of the knee joint. Also, a particular one-piece silicone ring can be used as a profile insert. In addition, in the profile insert cranial and / or caudal recesses may be present, the cranial recess over the approach of the quadriceps tendon and the caudal recess over the ligamentum patellae is arranged to avoid unwanted pressure on the possibly painful diseased area of the tendon approaches the usually irritated upper recess is spared. The aforementioned stretching element can consist of a spring-like but flat wound wire element, whereby a lateral movement of the wire element is possible, however, a compression of the stretching element is not possible, whereby a contraction of the knee bandage when wearing is significantly avoided. The corresponding stretching elements are preferably arranged on the left and right sides next to the knee joint within intended receptacles or strips. In order to wash or clean the knee bandage, the stretching elements can be removably arranged from the receptacles or strips provided. It is also conceivable to produce the stretching element from a stainless spiral band or plastic, so that it can be washed with. In this case, the stretching element may be permanently attached to the knee brace.

In order to obtain a kneeling orthosis, lateral joint splints can be fixed (but removable) on the left and right sides (sinisters and dexters) on the knee ligament. The attachment of the lateral hinge rails on the knee brace is realized by first reversibly releasable retaining means. In addition, the joint rails can be fastened to the leg with additional fastening elements in the upper and / or lower region. In particular, these fastening elements can have one or more straps that can be adapted to the circumference of the upper and lower leg by means of hook-and-loop fasteners, snaps or the like. These additional fastening elements, the lateral guidance of the knee joint can be increased, whereby further stabilization takes place. The laterally inserted joint splints support the physiological and collateral joint guidance of the knee joint. The respective joint splint can be fastened directly or indirectly by means of a pocket with the knee bandage. The joint rail itself used in this case has no extension and flexion limitation, so that only a lateral support of the knee joint takes place. This knee guide orthosis with no extension and flexion limit can be used for minor internal or external ligament injuries, instability or strains.

The knee guide orthosis described above can be supplemented by an extension and flexion limitation on the joint splint. In the now present knee guide orthosis, the already described joint rail is also used, which is arranged on the left and right sides of the knee joint. This is just as in the previous knee guide orthosis connected via first retaining means with the knee bandage. However, the joint rail now has an extension and / or a flexion limitation, as a result of which the radius of movement of the joint rail is individually adjustable. Further, the joint of the joint rail is designed as a rotary or pivot joint, preferably as a polygonal joint. The extension and / or flexion limitation in the joint rail can be realized by means of a joint insert, which is of essentially circular design and has corresponding recesses for limiting the angle. An individual adjustment of the joint rail to the desired extension and / or inflection limitation z. B. by an exchange of the hinge insert in the joint rail. In this case, the hinge insert can be fixed in different rotational positions positively with the hinge rail, to which a peripheral toothing is provided on the hinge insert, with a corresponding toothing in the Joint rail cooperates form-fitting manner. The recesses provided in the hinge insert can serve as a guide slot, in which a pivot pin out of the hinge rail is guided on a predetermined pivoting or pivoting track. Due to the corresponding configuration of the guide slots, any movement angle for limiting the extension and / or flexion limitation is thus conceivable. The particular polygonal joint splint with the extension and / or flexion limitation ensures the physiological joint guidance in the range of motion to be defined, whereby the joint apparatus is relieved and protected and the knee joint is guided collaterally. Such a knee guide orthosis with extension and / or inflection limitation is z. B. applicable to mild to moderate cruciate instability with front drawer. Also, this knee guide orthosis can be used after a meniscal suture with combined mild instability or after a patellar dislocation. Also, an internal and / or external ligament injury is treatable in case of instability if present.

For medium to severe cruciate ligament instability with a clear front or back drawer, the aforementioned knee guide orthosis with extension and / or flexion limitation can be supported by additional fasteners, for example in the form of inelastic tension elements in the upper and lower part of the knee bandage. Here are preferably four fasteners in the form of four inelastic tension elements used. These fastening elements can be a belt system which can be adapted to the respective thigh diameter of the patient via corresponding closure elements. These closure elements may be Velcro fasteners, snaps or the like. It is also conceivable that the additional fastening elements are connected directly to the pocket for the joint rail or to the joint rail. Thus, one obtains a knee guide orthosis according to the four-point principle, which essentially allows only a two-dimensional guidance of the knee joint. In this case, the individually adjustable in its radius of movement polygon joint in the joint rail allows a variety of Bewegungslimitierungen and a Hyperexungsionsschutz. Thus, the joint rail can also absorb large forces and torques, this can be made of plastic, especially glass fiber reinforced plastic, or light metal.

In principle, it is also conceivable that the joint rails are adjustable in length to the knee bandage and / or Rahmenorthese using the holding means (first and second) can be arranged. Here, the hinge rails can be telescopically extendable, thus allowing better guidance of the knee brace. It is also conceivable that the joint rail can be extended via adapter elements, wherein the adapter elements can only serve to connect the joint rail with the upper and lower shell of the frame orthosis or knee bandage.

In the case of extreme discomfort of the patient in the knee area, the modular system according to the invention for assembling a knee brace can be converted into a frame orthosis. Here, the already known joint rails can be used again, the left and right sides connect the upper and lower leg shell of the frame orthosis to each other movable. Also in this frame orthosis, an extension and / or flexion limitation is provided, in which the already mentioned joint insert for the joint rail is used. In addition, on the knee-facing side of the joint rail, there may be arranged joint pads, which are exchangeably connected to the joint rail. These knee pads are also called condylar pads and ensure a safe and optimal knee guidance within the frame orthosis. As a joint pad both pelotte-like elements are conceivable as well as suction cup or shell-like configurations. Preferably, the two hinge rails are height adjustable or adjustable in length attached to the lower and upper shell. To allow easy adjustment, the hinge rails with locking means, for. B. in the form of rectangular recesses, be present, which cooperate positively with corresponding cam-like projections on the upper and lower leg shells. By an actuating element in the form of a knob, a simple height adjustment can be realized, wherein the actuating element can be designed such spring-loaded that it presses the corresponding locking cam in the locking element of the hinge rail when the actuating element is not operated. It is also conceivable that the upper and lower shell is designed in several parts, thus allowing an individual adaptability of the shells on the upper and lower legs of the patient. So z. B. also the upper shell consist of at least two circular segment-shaped elements, which are designed to be adjustable to each other via an adjustment. As a result, the upper and lower leg shells are designed to be adjustable in circumference, wherein the respective shells at least partially enclose the leg or the upper or lower leg. Also in this adjustment can be made a positive and / or non-positive connection of the two circular segment-like upper shell halves. In addition, cranial and caudal tension elements can be provided in order to likewise effect a stabilization of the knee joint within the frame orthosis secured according to the four-point principle.

As already mentioned, it is possible by the modular system to convert a knee bandage (Patellabandage) via a knee orthosis with and / or extension and / or inflection limitation in a frame orthosis and vice versa. The joint rails also required are on the one hand directly or indirectly configured with the knee brace and on the other hand directly or indirectly fastened with the frame brace. In addition, adapter elements or pockets may be provided for this purpose to secure the wrist rails to the knee brace or the frame brace.

Also, the present invention is directed to a method of modifying an orthosis of a modular system according to any one of claims 1 to 14 for adaptation to a current health of a patient according to claim 15. The method is used for medical education or training of the patient, depending according to the course of the disease or the state of health of the patient.

In this case, all features of the modular system according to the invention apply as co-published to the method and vice versa.

Further measures which improve the invention are specified in the subclaims or are described in more detail below together with the description and the preferred exemplary embodiments of the invention with reference to the figures. Show it:

1 three-dimensional representation of a knee bandage with segmental profile insert,

2 three-dimensional representation of a knee guide orthosis with removable pockets for joint splints,

3 three-dimensional representation of a knee guide orthosis with extension and flexion limitation by joint splint,

4 Three-dimensional view of an extended embodiment of the knee guide orthosis 3 .

5 three-dimensional representation of a frame orthosis with joint splints,

5a three-dimensional representation of a comparable Rahmenorthese 5 .

6a Knee bandage with a detachable bag for the joint splint, which is attached via Velcro fasteners,

6b comparable knee bandage too 6a , wherein the bag is fastened by push buttons,

6c comparable knee bandage too 6a and 6b in which the pocket can be fastened via zips,

6d comparable knee bandage to the 6a to 6c in which the joint rail can be fastened directly via push buttons,

7 Top view of a hinge rail with adjustable adapter element,

8a Top view of a bag for a hinge rail with firmly sewn fasteners,

8b Top view of another bag made as a counterpart to the bag 8a serves, and is equipped with corresponding counter-elements for the fasteners.

In the 1 is a knee bandage 10 represented, which represents an essential element of the modular system. The knee bandage 10 has an upper area 12 , a knee area 13 and a lower area 14 on. The upper and lower area 12 . 14 serves to fix the knee bandage 10 on one upper and one lower leg of the patient. So that the knee bandage 10 not on the leg 50 the patient slips are in the upper and / or lower area 12 . 14 adhesives 15 intended. These adhesives 15 are on the inside of the textile carrier material 11 the knee bandage 10 arranged and interact with the skin of the patient. In this way, a non-slip connection between the knee bandage 10 and the leg 50 produce. The adhesives 15 can themselves be made of silicone threads or a silicone strip, which in the carrier material 11 is incorporated or arranged on the inside.

The knee bandage can be used to provide initial support for the knee 10 , as in this case in 1 shown, a profile insert 16 exhibit. The present profile insert is designed segmental and two-part and has a cranial recess 16.1 and a caudal recess 16.2 on. On the side of the knee are on the knee bandage 10 first holding means 18 arranged, which are designed strip-shaped and from the upper to the lower area 12 . 14 extend longitudinally. The present first holding element 18 is as a reinforcement band 18.4 designed and simultaneously provides a Velcro strip 18.2 On the right side of the knee bandage 10 is also a comparable first holding means 18 arranged, which due to the three-dimensional representation of knee Support 10 is not visible. In the 1 illustrated knee bandage 10 is also due to the existing profile insert 16 as patellabandage 10 designated. This knee bandage 10 is used for slight postoperative muscle atrophy and can also serve to build muscle. Also soft tissue irritation in the form of chronic, post-traumatic or postoperative soft tissue irritation of the knee joint can be treated with it. Patellar patellar disease, chondromalacia patellae and "giving-way" phenomena can also be treated with patellar disease. However, since there is no lateral support of the knee, the in 1 illustrated knee bandage 10 only used for lighter knee complaints.

In the 2 is a comparable knee bandage 10 out 1 shown, with a bag 19 at the first holding means 18 is arranged and thus firmly but reversibly detachable with the knee bandage 10 connected is. The attachment of the bag 19 over the first holding means 18 at the knee bandage 10 can be done with Velcro fasteners, snaps, zippers, locking elements or guides. In the bag 19 is a hinge rail 20 arranged, which causes lateral stabilization of the knee and also represents an essential element of the modular system. Around the hinge rail 20 firmly on the side of the leg 50 Pressing the patient are additional fasteners 33 provided, which are tied as straps around the upper or lower leg. The fasteners 33 are thus adjustable in diameter, what they z. B. are equipped with Velcro. For optimum retention of the joint rails 20 On the leg 50 of the patient are two fasteners 33 in the upper area 12 on the thigh and two fasteners 33 in the area below 14 provided on the lower leg. The fasteners 33 include completely the upper and lower legs and thus push the two joint rails 20 in the pockets 19 sideways to the leg 50 ,

In the 2 used joint rails 20 do not restrict the angle of movement of the knee, as on a joint insert 20.1 in the joint rails 20 has been omitted. Thus, the in 2 illustrated knee guide orthosis 21 . 23 equipped without extension and / or flexion limitation. Such a knee guide orthosis 23 can be used in case of significant postoperative muscle atrophy (up to muscle growth). Even with slight internal or external ligament injuries / instabilities / and / or strains is the use of this knee guide orthosis 23 conceivable without extension / flexion limitation.

In 3 is a comparable knee guide orthosis 22 to the knee guide orthosis 23 out 2 shown. However, here have the joint rails 20 a joint insert 20.1 to also an extension and / or flexion limitation of the knee guide orthosis 22 to reach. Due to the different use of different joint inserts 20.1 can be the movement restriction of the joint rails 20 predefine more or less any. Because the hinge rail 20 not just a pivot 20.2 but two variable pivot points 20.2 has, thus can realize a polygonal joint. In the 7 is the hinge rail 20 with a polygon joint, which through the hinge insert 20.1 and the two pivot points 20.2 is realized, presented in detail.

Furthermore come in the 3 other fasteners 33 used as these fasteners 33 do not consist of a strap that completely covers the leg 50 of the patient, but only in sections around the leg 50 is tied and via counterpart funds 33.1 in the form of eyelets 33.3 with a further sectionally acting fastening element 33 interacts. In the 8a and 8b are the fasteners 33 on the pockets 19 are sewn on, shown in more detail.

In the 4 is a comparable knee guide orthosis 24 out 3 shown, but this is in the upper range 12 and at the bottom 14 longer designed to support the knee even better. Also, this knee guide orthosis 24 an extension and / or inflectional limitation, as the joint splints 20 with a hinge insert 20.1 are provided, which is not shown in detail. The extension of the knee guide orthosis 24 in the upper and lower area 12 . 14 can also be done by additional elements attached to the substrate 11 the knee bandage 10 , z. B. via Velcro or zippers, can be arranged.

The 5 represents a three-dimensional representation of a Rahmenorthese 25 Also for clarification is the leg 50 a patient indicated by dashed lines. The frame orthosis 25 even has a thigh shell 26 and a lower leg shell 27 on, each on the left and right sides via a joint rail 20 connected and fixed together and also forms an element of the modular system. For a good adaptability of the frame orthosis 25 to the leg 50 the patient is the thigh shell 26 designed in two parts, the diameter of the thigh shell 26 through an adjustment 28 is designed changeable. The adjustment element 28 has an adjustment band 28.1 on, which on a first (left) part of the thigh shell 26 is attached and with a knob 28.2 on the second (right) part of the femoral shell 26 interacts positively. The diameter of the thigh shell 26 can be made smaller by the two parts of the thigh shell 26 be compressed, causing the adjustment band 28.1 in a guide 28.3 under the adjustment knob 28.2 enters, s. arrow 28.5 , The adjustment band 28.1 even has z. B. barbed or scale-like locking elements, with the underside of the knob 28.2 interact positively. The adjustment knob 28.2 is itself tiltable configured, which by the arrow 28.6 is indicated. In addition, the adjustment knob 28.2 spring-loaded, so while the adjustment band 28.1 independently in the leadership 28.3 under the adjustment knob 28.2 is retractable, however, the adjustment knob must 28.2 be pressed, whereby the positive connection between the knob 28.2 and the adjustment band 28.1 is lifted to the adjustment band 28.1 back out of the lead 28.3 pulling, reducing the diameter of the thigh shell 26 is enlargeable. The leadership 28.3 is with a cover 28.4 provided so that the adjustment band can not interfere at this point. Such a setting of the thigh shell 26 is also on the lower leg shell 27 conceivable. In 5 but is the lower leg shell 27 by a tension element 31 , designed in the form of a belt, adjustable. So that the frame orthosis 25 Also in their height or length is adjustable, a similar adjustment mechanism, as the adjustment 28 be provided, which by the adjustment 29 is realized. Here are also on the upper leg 20.3 the hinge rail 20 locking elements 20.5 provided, which are designed barb-shaped. These locking elements 20.5 act with a locking agent 32.1 of the second holding means 32 form-fitting together. The locking elements 20.5 the hinge rail 20 at the same time provide the locking elements 32.2 of the second holding means 32 dar. A longitudinal adjustment of the joint leg 20.3 takes place exactly as with the adjustment element 28 has been described. Consequently, the joint leg can be 20.3 without actuation of the locking means 32.1 in the thigh shell 26 Push. However, the locking device must 32.1 be pressed down to the hinge rail 20 again from the thigh shell 26 to be able to pull. By this operation of the locking means 32.1 in the form of the adjustment head 29.1 is the positive connection between the adjustment 29.1 and the locking elements 32.2 respectively. 20.5 canceled. Also the lower leg shell 27 is longitudinally adjustable on the hinge rail 20 arranged, wherein the second retaining means 32 on the lower leg shell 27 identical to the second holding means 32 on the thigh shell 26 is designed. So that the free end of the joint leg 20.3 inside the thigh shell 26 or lower leg shell 27 does not interfere, is a cover 29.3 provided that over the leadership 29.2 is arranged.

It is also conceivable that the hinge rail 20 through an adapter element 20.4 is extendable, wherein the adapter element 20.4 simultaneously locking elements 20.5 having, with the adjusting element 29 or the second holding element 32 interact positively. The adjusting element 29 puts in the 5a and 5b a special second holding means 32 because it is not just the joint splint in a simple way 20 with the upper and lower leg shell 26 . 27 connects, but at the same time gives an adjustment.

In the 5a comes a slightly different adjustment 29 used because the locking elements 20.5 . 32.2 are not barb-shaped or ramp-shaped here, but have rectangular recesses or grooves. Thus, an independent retraction of the joint leg 20.3 in the lead 29.2 of the adjusting element 29 not possible, because always the adjustment knob 29.1 must be pressed to the positive connection of the second holding means 32 repealed. This variant has the advantage that an unintentional adjustment of the frame brace 25 is safely prevented at this point, since always the adjustment 29 , or the adjustment knob 29.1 , must be pressed.

In the 5 and 5a is in each case on the inside of the joint rails 20 , which is directed to the knee, joint pad 20.7 arranged. Through these joint pads 20.7 lie the joint rails 20 on the left and right side of the patient's knee, without causing pain. The joint pads 20.7 are removable on the joint rails 20 by means of z. B. arranged snaps.

The already mentioned tension elements 31 are about brackets 30 on the upper and lower leg shell 26 . 27 arranged. The tension elements 31 They are essentially straps that have Velcro straps 31.1 are adjustable and closable and on the inside over upholstery 31.2 have a gentle circumferential pressure on the leg 50 of the patient, but which does not cause pain. Due to the adjustable thigh shell 26 passing through the adjustment element 28 is adjustable, and the three additional existing tension elements 31 can be a four-point attachment of the frame brace 25 On the leg 50 realize the patient. Here is the first tension element 31 below the thigh shell 26 but above the knee of the patient on the articular splints 20 or directly on the thigh shell 26 arranged. Below the knee are two tension elements 31 provided to the frame orthosis 25 to attach to the lower leg. The upper tension element 31 is directly at the lower hinge rail 20.3 or on the lower leg shell 27 attached. The lower tension element 31 is right on the Lower leg shell 27 arranged adjustable. The holder 30 can only be provided on the right or left side, depending on how the tension element 31 is designed. It is also conceivable that in each case a tension element 31 Made up of two straps that hold the leg 50 surrounded only in sections.

In the 6a to 6d are different first holding means 18 represented, with whose help the joint rails 20 directly or undirectly on the knee bandage 10 can be arranged or attached. In the 6a is the first holding means 18 as Velcro 18.2 designed. It is on the knee bandage 10 the Velcro strip 18.2 at the same time as a reinforcement band 18.4 configured, which is from top to bottom alongside, ie right and left side of the knee on the knee bandage 10 extends. Below the Velcro strip 18.2 is additionally a stretching element 17 provided, which consists of a spiral band and is substantially not compressible. By this stretching element 17 It should be avoided that the knee bandage 10 lengthwise while wearing bends. This should also be an optimal fit or hold on the leg 50 be effected by the patient during prolonged wear. The stretching element 17 can through an opening 10.1 under the reinforcement band 18.4 be introduced. At the same time the opening serves 10.1 also as an interruption 18.3 of the first holding means 18 to the mobility in the knee area 13 to improve. With it the bag 19 as a receptacle for a joint splint 20 serves, firmly with the knee bandage 10 can be connected, this also has velcro strips on its inside 18.2 as a counter-agent 18.1 on, with the appropriate velcro strips 18.2 at the knee bandage 10 interact and the first holding means 18 represent. So too the bag 19 in the knee area 13 flexible, also has the first holding means 18 a break 18.3 in the knee area 13 on. Consequently, in the present case, it is off 6a the Velcro strip 18.2 on the bag 19 designed in two parts. Shall now the knee bandage 10 in a knee guide orthosis 21 to 24 be rebuilt, so it is sufficient if the bags 19 over the first holding means 18 be attached. For this, the bags must 19 just on the velcro strip 18.2 at the knee bandage 10 be pressed on. Thus, it becomes clear that no tool is necessary for the conversion of the knee brace from the modular system and a conversion in the simplest way can be realized.

In the 6b are in place of the Velcro strip 18.2 pushbuttons 18.5 arranged. For an optimal hold of the bag 19 at the knee bandage 10 to effect are several push buttons 18.5 intended. Preferably, at least two snaps should 18.5 in the upper area 12 and at the bottom 14 be arranged. In order to achieve optimal mobility in the knee area in this embodiment as well 13 to achieve are the interruptions 18.3 in the first holding means 18 intended.

In the 6c is another example of the design of the first holding means 18 shown. This is the first holding means 18 as a zipper 18.6 designed. Also in this case is a break 18.3 in the first holding means 18 provided, creating a total of two zippers 18.6 are arranged, each with a zipper 18.6 in the upper area 12 and at the bottom 14 is arranged.

In the 6d is the hinge rail 20 not over a bag 19 indirectly with the knee bandage 10 attached. Rather, the joint rail 20 directly on the knee bandage 10 attached by z. B. the first holding means 18 directly on the joint rail 20 is provided. In the present case 6d is the first holding means 18 as push buttons 18.5 designed. Of course, this can also be a Velcro strip 18.2 or the like. At the snaps 18.5 could be used a variant that has a locking means, so that first the locking means must be manually unlocked so that the snaps cancel the positive connection again. It is also conceivable, the joint rail 20 by means of pushbuttons 18.5 with the upper and / or lower leg shell 26 . 27 to connect, creating the second holding means 32 identical to the first holding means 18 is designed.

In the 7 is a hinge rail 20 shown. Here is the upper joint leg 20.3 with an adapter element 20.4 been extended. In this case, the adapter element 20.4 like the adjustment element 28 or the adjusting element 29 be designed. At the upper end of the joint leg 20.3 can be a locking element 32.2 be provided, which with the adjustment 29 on the thigh shell 26 can interact and the second holding means 32 forms. At the lower joint thigh 20.3 is also a second holding means 32 shown, which via rectangular recesses as locking elements 32.2 features. The illustrated hinge rail 20 is only to be understood as an example, since usually the second holding element 32 at the upper and lower joint thighs 20.3 will be configured equal.

Furthermore, in the 7 a joint insert 20.1 indicated, which has recesses on its outer circumference, with which the hinge insert can be fixed in different rotational positions form-fitting manner with the hinge rail. These recesses may also be provided as peripheral teeth on the hinge insert, with corresponding teeth in the hinge rail 20 interact positively. Within the joint insert 20.1 a recess is provided, which serves as a guide for the two pivot points 20.2 serve the polygon gongs. Thus, not only a fixed pivot point for the joint of the joint rail 20 be reached, but also a swivel path, which is similar to the natural movement of the knee. Due to the design of the guide slot within the joint insert 20.1 the movement sequence or each movement angle can be adjusted to limit the extension and / or inflection limitation. It should be mentioned at this point that the illustrated guide slot only serves as a pure example and as already mentioned, can also be configured differently and is.

Around the hinge rail 20 also reinforce laterally, can corresponding reinforcing ribs 20.6 be provided, the z. B. in the longitudinal direction of the joint in the direction of the free ends of the joint legs 20.3 run. These reinforcing ribs 20.6 can also be designed significantly longer to the respective joint leg 20.3 to give more lateral stability. The hinge rail itself may be made of a light metal alloy or a fiber reinforced plastic, so that it has sufficient stability.

In the 8a and 8b is each a bag 19 represented by fasteners 33 with a pocket 19 On the leg 50 of the patient is fastened. These bags 19 Be about first holding means 18 on a knee bandage 10 attached, in the present example, a Velcro strip 18.2 is used, which has been indicated schematically and on the inside of the bag 19 is available. On the visible outside of the bag 19 are the fasteners 33 through seams firmly with the bag 19 connected. The additional fasteners 33 have a total of four straps, bringing the pockets 19 changeable in diameter to the leg 50 of the patient can be safely held. In the upper area 12 Both straps are almost the same length and at their free ends with velcro straps 33.2 Mistake. The topmost fastener 33 is shown folded in with its left end.

In the area below 14 are also two fasteners 33 as in the upper area 12 arranged. However, the upper fastener extends 33 in the area below 14 only on the left side of the bag 19 because this is not completely around the leg 50 the patient is bound. Like in the 8b is recognizable, has the corresponding counter-fastening element 33 even a one-sided counter-agent 33.1 for the fastening strap 33 of the upper fastener 33 in the area below 14 from the 8a on.

In the 8b is the opposite pocket 19 to the bag 19 out 8a shown. These two bags 19 from the 8a and 8b form a pair, which left and right side of the knee bandage 10 is placed next to the knee. Also the illustrated fasteners 33 from the 8a act with the illustrated counter-fastening elements 33 out 8b together. As in 8b can be seen, are the individual fasteners 33 designed only briefly and just protrude just above the left and right edges of the bag 19 with their ends out, at which the counter-holding means 33.1 in the form of eyelets or loops 33.3 for the straps 33 from the 8a are provided.

Now the two bags 19 at the knee bandage 10 left and right side over the corresponding first holding means 18 When the knee guide orthosis is attached, the patient may be attached 21 to 24 the additional fasteners 33 the circumference of the leg 50 Apply accordingly, using the counter-fastening elements 33 out of the counter pocket 19 interact mechanically.

In the 2 on the other hand is shown as a fastener 33 consists of two straps that interact mechanically with each other.

It should finally be mentioned that, of course, there are also numerous variants of the modular system resulting from a combination of the technical features described above. Of course, these combinations are also covered by the present invention.

LIST OF REFERENCE NUMBERS

10

knee Support

10.1

Opening for 17

11

support material

12

upper area

13

knee area

14

Lower area

15

adhesives

16

Profile insert, segmental or ring-shaped

16.1

cranial recess

16.2

caudal recess

17

Stretch element, spiral band

18

First holding means

18.1

Opposing means

18.2

Velcro strips

18.3

interruption

18.4

reinforcing tape

18.5

pushbuttons

18.6

zipper

19

bag

19.1

seam

19.2

Opening for 20

20

joint rail

20.1

joint insert

20.2

pivot point

20.3

joint leg

20.4

adapter element

20.5

Locking elements, barb-shaped

20.6

reinforcing ribs

20.7

Articulated cushion, sucker-like

20.8

Push buttons too 18.5

21

Knee guide orthosis with pocket

22

Knee guide orthosis (short) with extension / flexion limitation

23

Knee guide orthosis without extension / flexion limitation

24

Knee guide orthosis (long) with extension / flexion limitation

25

Rahmenorthese

26

thigh shell

27

Lower leg shell

28

adjustment

28.1

adjustment band

28.2

adjustment

28.3

Leadership for 21.1

28.4

cover

28.5

Arrow for adjustment direction

28.6

Arrow for actuating direction

29

Adjustment element for 20

29.1

Adjustment

29.2

Leadership for 20.3

29.3

cover

30

bracket

31

Tension element / belt

31.1

velcro fastener

31.2

pad

32

Second holding means

32.1

Locking device, button

32.2

Locking elements, barb-shaped

33

Fastener / counter fasteners

33.1

Opposing means / locking

33.2

Velcro strips

33.3

Eyelet / loop

50

leg

Claims (15)

Modular system for assembling an orthosis for a knee, wherein the modular system comprises at least the following elements, a knee bandage ( 10 ), which is a textile carrier material ( 11 ), which extends above and below the knee, wherein at the knee bandage ( 10 ) first holding means ( 18 ) for the detachable attachment of lateral joint rails ( 20 ) and joint rails ( 20 ), whereby the joint rails ( 20 ) on the one hand directly or indirectly with the knee bandage ( 10 ) and, on the other hand, directly or indirectly with a frame orthosis ( 25 ), wherein the following orthoses can be assembled from the modular system: a) knee bandage ( 10 ) b) knee guide orthosis with lateral joint splints ( 20 ) without extension and / or inflection limitation ( 23 ) c) knee guide orthosis with lateral joint splints ( 20 ) with extension and / or inflection limitation ( 24 ) d) frame orthosis ( 25 ) with upper and lower leg shell ( 26 . 27 ) and lateral joint rails ( 20 ) with or without extension and / or inflection limitation. Modular system according to claim 1, characterized in that in the modular system, an upper and lower leg shell ( 26 . 27 ) are arranged, which via second holding means ( 32 ), the second holding means ( 32 ) also for detachable attachment of the lateral hinge rails ( 20 ) serve to create a frame orthosis ( 25 ). Modular system according to claim 1 or 2, characterized in that the knee bandage ( 10 ) an upper area ( 12 ), a knee area ( 13 ) and a lower area ( 14 ), the upper and lower regions ( 12 . 14 ) for fixation of the knee bandage ( 10 ) on a thigh and lower leg. Modular system according to one of the preceding claims, characterized in that in the knee bandage ( 10 ) a profile insert ( 16 ) and / or a stretching element ( 17 ) is included. Modular system according to one of the preceding claims, characterized in that a joint rail ( 20 ) has a rotary or pivot joint. Modular system according to one of the preceding claims, characterized in that the joint rails ( 20 ) adjustable in length at the knee bandage ( 10 ) and / or the frame orthosis ( 25 ) by means of the retaining means ( 18 . 32 ) can be arranged. Modular system according to one of the preceding claims, characterized in that the joint rails ( 20 ) are telescopically extendable and with the upper and lower leg shell ( 26 . 27 ) are connectable. Modular system according to one of the preceding claims, characterized in that on the joint rails ( 20 ) on the side facing the knee joint pad ( 20.7 ) are arranged, which are designed to be interchangeable. Modular system according to one of the preceding claims, characterized in that the joint rails ( 20 ) with additional fastening elements ( 33 ) in the upper and / or lower area ( 12 . 14 ) are fastened to the leg. Modular system according to one of the preceding claims, characterized in that the joint rails ( 20 ), the upper and / or lower leg shell ( 26 . 27 ) Plastic and / or light metal. Modular system according to one of the preceding claims, characterized in that the holding means ( 18 . 32 ) comprise the following elements individually or in combination: Velcro fasteners, snaps, zippers, pockets, loops, hooks / eyes, locking elements and guides, which cooperate with corresponding counter-holding means on the hinge rails positive and / or non-positive. Modular system according to one of the preceding claims, characterized in that the upper and / or lower leg shell ( 26 . 27 ) a frame orthosis ( 25 ) Adjustment elements ( 28 ) and are thereby designed to be adjustable in circumference, wherein the respective shells at least partially the leg ( 50 ) enclose. Modular system according to one of the preceding claims, characterized in that a knee bandage ( 10 ) of the modular system via a knee guide orthosis ( 21 - 24 ) with and / or without extension / flexion limitation in a frame orthosis ( 25 ) and vice versa. Modular system according to one of the preceding claims, characterized in that the joint rails ( 20 ) on the one hand with the knee bandage ( 10 ) and on the other hand with the frame orthosis ( 25 ) are attached. Method for converting an orthosis from a modular system according to one of the preceding claims for adaptation to a current state of health of a patient, wherein an orthosis from the modular system is converted into another orthosis of the modular system.

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